DE20118926U1 - prosthesis - Google Patents

Description

PATENT ATTORNEYS DIPL.-ING. F. W. MOLL · DIPL.-ING. H. CH. BITTERICH

ADMISSIONS BEFORE THE EUROPEAN PATENT OFFICE LANDAU/PALATINATE

19.11.2001 B/Sz

Carstens Medical Supply Store in Marienpark G.m.b.H., 70199 Stuttgart

prosthesis

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Description:

The invention relates to prostheses according to the preamble of claim 1.

The purpose of prostheses is to replace, as far as possible, limbs lost through accident or illness. To temporarily attach prostheses, such as artificial hands or feet, to the stump, special prosthetic shafts are used that must be anatomically adapted to the stump. The hold is achieved by a vacuum between the prosthetic shaft and the stump or between the stump and a silicone liner.

Prosthetic shafts are made of wood or cast resin. They are available with a longitudinal or transverse oval shaft shape, as a full contact shaft, with a valve or with a silicone liner. For amputations below the knee joint, the prosthetic shafts are roughly triangular in shape with holding devices on the bone structure.

Since the prosthetic sockets must be fitted to the stump as precisely as possible in order to be able to create and maintain the vacuum that provides support, they are always custom-made, which must also ensure perfect pressure distribution of the load over the entire stump surface so that the stump can optimally transfer body weight and other forces. Since the stump initially swells and then subsides again within a few days or weeks after an accident or amputation, but from a medical and orthopedic point of view the patient must be fitted with a prosthesis as quickly as possible, several prosthetic sockets must be custom-made during the recovery and acclimation period alone. This is unsatisfactory due to the time and, in particular, cost involved.

Of course, there was no lack of attempts to remedy this situation. For example, inflatable inner bellows were placed between the prosthesis shaft and the stump. However, it quickly became apparent that the hold of the prosthesis on the stump was significantly reduced. Above all, the utility value of the prosthesis was greatly reduced because it was no longer rigidly connected to the stump.

DE U 201 12 884 discloses a prosthetic shaft whose width can be changed so that it can be adapted to swelling and shrinking stumps. For this purpose, the prosthetic shaft is either folded like an accordion or slit lengthwise. Tension bands, tension cords or the like enable the prosthetic shaft to be adjusted to the stump in a continuous manner.

It is known from orthopedic practice that limb stumps not only change in width, but also in length. This is the case, for example, when the tip of the limb stump, which has direct contact with the prosthesis and has to bear the entire weight of a thigh prosthesis, for example, becomes inflamed and therefore has to be surgically removed. The shortened limb stump therefore no longer sits on the conical contact surface provided in every prosthesis socket and can therefore no longer optimally transfer the body weight to the prosthesis, for example. In these cases, too, new prosthesis sockets have to be made. This is unsatisfactory.

The present invention is therefore based on the object of specifying a prosthesis whose length can be changed, either because the length of the stump changes or because it does not fit an already finished prosthesis size, without having to manufacture a new prosthesis shaft.

This object is achieved by a prosthesis having the features of claim 1.

The present invention shifts the conical support surface for the stump and the coupling, which creates the detachable connection to the coupling pin of the silicone liner, from the prosthetic shaft that is anatomically molded to the stump to an adapter that can be moved in the prosthetic shaft. This adapter has the conical support surface for the stump or the silicone liner at the top and one of the commercially available holders at the bottom, to which the actual artificial limb, for example an artificial hand or an artificial foot, is attached either directly or via a connecting tube. If the stump has to be shortened for medical reasons, this can easily be compensated for by adjusting the adapter. The prosthetic shaft that is anatomically adapted to the stump does not have to be reshaped, at least as long as the shortening of the stump does not exceed the adjustment range of the adapter.

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A suitable release mechanism is integrated into the adapter so that the prosthesis wearer can remove the prosthesis again. This consists of a hand lever that the prosthesis wearer can operate by hand and a coupling rod for coupling. Another significant advantage of the present invention is that, unlike many commercially available designs, the coupling pin is not cross-grooved but is designed as a smooth-walled cylinder. Such a smooth coupling pin is not only simpler and less expensive than a profiled coupling pin, but also enables a much simpler coupling design in the form of a perforated clamping plate without compromising operational reliability. In addition, the coupling according to the invention works continuously and can be easily released even under tension.

The adapter advantageously consists of two parts that are held together by screws or the like. According to an advantageous embodiment, one of the fastening screws can simultaneously be used as a pivot axis for the clamping plate of the coupling.

In order to achieve a secure clamping connection between the prosthetic shaft and the adapter, it is recommended to slit the collar with a spring.

According to a preferred embodiment of the invention, the clamping ring itself has a flange for attaching clamping screws.

To put on a prosthesis, the silicone liner is first rolled onto the stump. The stump and silicone liner must then be inserted into the prosthesis shaft of the prosthesis until the tip of the stump or silicone liner rests on the conical support surface, with the coupling pin fully immersed in the coupling. If the prosthesis shaft is very tight, for example because the stump is swollen, it may happen that the optimal position is not achieved. Commercially available prostheses have a built-in gear for this purpose, which the prosthesis wearer can turn from the outside with a coin. This gear meshes with the profiled coupling pin, which can then be pulled into the prosthesis shaft.

In order to be able to force the smooth coupling pin according to the invention into the adapter or its coupling, a second clamping plate is provided according to a further development of the invention, which can be operated by a second hand lever via a coupling rod. The rest position of the second clamping plate is the neutral position in which the retraction or extension of the coupling pin is not hindered. However, if the prosthesis wearer operates the second hand lever, the second clamping plate is pivoted and pulls the coupling pin and with it the silicone liner and the limb stump into the prosthesis shaft until the tip of the limb stump sits on the conical support surface.

As mentioned, the adapter according to the invention enables adaptation to limb stumps that have to be shortened for medical reasons without the actual prosthetic shaft having to be changed. All that needs to be extended is the connecting tube between the artificial limb and the commercially available holder attached to the lower end of the adapter.

According to a preferred embodiment of the invention, the adapter solution according to the invention is combined with a prosthetic shaft whose width is variable, in particular as described in DE-U 201 12 884.

For this purpose, the wall of the prosthesis shaft can advantageously be designed in a fold-like or wave-like manner at least in some regions, wherein the folds or waves extend essentially in the axial direction and a tensioning device is provided for changing the width.

An alternative embodiment provides that the wall of the prosthesis shaft is slotted at least in some areas, wherein the slots again extend essentially in the axial direction and a tensioning device is provided for changing the width.

The tensioning device advantageously consists of at least one tensioning strap with a toggle lever lock. A wire rope tensioning device is also suitable.

In order to make the folds, waves or slits as well as the tensioning devices invisible, the prosthetic shaft can be housed in a container with a smooth outer wall.

The invention will be explained in more detail in the form of an embodiment with reference to the drawing. They show purely schematically

Fig. 1 a piece of a prosthetic shaft with inserted adapter in fully extended position,

Fig. 2 the adapter in its fully retracted position and

Fig. 3 shows an enlarged view of the opened adapter with the silicone liner inserted.

Fig. 1 and 2 show a section of a prosthesis. The lower end of a prosthesis shaft 10 is shown with a silicone liner 1 inserted from above, shown in detail. The prosthesis shaft 10 has a cylindrical collar 12, which is designed to be resilient thanks to a longitudinal slot 13. A clamping ring 40, which is open on at least one side, is placed around the collar 12. This has a flange 41 and can be tightened or loosened using clamping screws 42. In this way, a clamping connection is made to an adapter 20, the details of which will be described with reference to Fig. 3.

The adapter 20 has a conical contact surface 21 (Fig. 3) on the top, on which the tip of the stump or silicone liner sits so that the weight and other forces can be optimally transmitted. In addition, a coupling is housed in the top of the adapter, which creates a detachable connection to a coupling pin 2 (Fig. 3) of the silicone liner 1.

At its lower end, the adapter 20 carries a commercially available holder 11 to which the artificial limb can be attached either directly or via a connecting tube.

As can also be seen from Figures 1 and 2, a first hand lever 23 and a second hand lever 32 are located on the lower outside of the adapter 20. The first hand lever 23 is used to release the coupling that holds the coupling pin 2 of the silicone liner 1. The second hand lever 32 is used to operate a pulling device built into the adapter 20, with the help of which the prosthesis wearer can pull the coupling pin 2 and thus the silicone liner 1 and thus the stump into the prosthesis shaft 10 until the tip of the stump or silicone liner sits on the conical support surface 21. The hand levers 23, 32 are foldable so that they do not cause interference when not in use.

Fig. 1 shows the adapter 20 in the fully extended position, suitable for a long stump. Fig. 2 shows the adapter 20 in its fully retracted position, suitable for the same shorter stump, for example one shortened for medical reasons.

Fig. 3 shows the opened adapter 20. On its top side, one can see the conical support surface 21 for the tip of the stump or the silicone liner 1 enveloping the stump. The silicone liner 1 has a coupling pin 2 at its tip, which is designed as a smooth cylinder. The coupling is formed by a clamping plate 22, which is pivotally mounted about an axis 25, which is also designed as a connecting screw. Two first springs 26 pivot the clamping plate 22 into a clamping position in such a way that the coupling pin 2 can be easily retracted and at the same time is secured against accidental release.

A hand lever 23 is used to release the clamping plate 22, which is connected to the clamping plate 22 via a coupling rod 24 housed inside the adapter 20. If the prosthesis wearer pivots the hand lever 23 downwards, the clamping plate 22 is also pivoted downwards from its rest position shown in the drawing into the neutral position, and the prosthesis wearer can release the coupling pin 2 with the silicone liner 1 and the limb stump from the adapter 20 or prosthesis shaft 10.

A pulling mechanism is also housed inside the adapter 20, which makes it possible to force the coupling pin 2 and with it the silicone liner 1 and the limb stump into the prosthesis shaft 10 until the tip of the limb stump or silicone liner rests on the conical support surface 21. This pulling mechanism consists of a second clamping plate 30, which is supported by a second spring 34.

is held in the neutral position. In this neutral position, the coupling pin 2 can be easily retracted and pulled out. In order to be able to retract the coupling pin 2, the prosthesis wearer operates the second hand lever 32, the movement of which is transmitted to the second clamping plate 30 via a second coupling rod 33. This is pivoted downwards about its pivot axis 31, thereby becoming wedged with the coupling pin 2 and gradually pulling it downwards.

The two clamping plates 22, 30 are simple, hardened steel plates with a

Bore that matches the diameter of the coupling pin 2. This simple construction is extremely durable and reliable.

If the adapter shown in Fig. 1-3 is combined with a prosthetic shaft that can be adjusted in width in accordance with DE-U 201 12 884, the result is a prosthesis whose prosthetic shaft can be adapted to a wide range of different limb stumps. This makes it possible to industrially prefabricate prosthetic shafts in a few different sizes, which the orthopedic technician then only has to adapt to the individual limb stump. The time-consuming and costly individual production of the prosthetic shafts is then only necessary in particularly difficult individual cases.

Claims (15)

1. Prosthesis, essentially comprising: - a silicone liner ( 1 ) with a coupling pin ( 2 ), - a stable prosthetic shaft ( 10 ) suitable for a limb stump, - a conical support surface ( 21 ) for the stump or the tip of the silicone liner, - a coupling ( 22 ) for fastening the coupling pin ( 2 ), - a mechanism for releasing the clutch ( 22 ) - and a holder ( 11 ) for connecting an artificial limb to the prosthetic shaft ( 10 ) characterized by the features: - a cylindrical adapter ( 20 ) is attached to the prosthesis shaft ( 10 ) and is adjustable in height, - the adapter ( 20 ) - carries - above the contact surface ( 21 ) - and below the holder ( 11 ) - and takes in its inner being: - above the clutch ( 22 ) - and below the mechanism for releasing the clutch ( 22 ), - the mechanics include - a hand lever ( 23 ) accessible on the outside of the adapter ( 20 ) - and an internal coupling rod ( 24 ) from the hand lever ( 23 ) to the clutch ( 22 ), - the prosthetic shaft ( 10 ) has a collar ( 12 ) matching the adapter ( 20 ), - a clamping ring ( 40 ) fixes the adapter ( 20 ) in the collar ( 12 ). 2. Prosthesis according to claim 1, characterized by the features: - the coupling pin ( 2 ) is a cylinder with a smooth wall, - the coupling includes: - a clamping plate ( 22 ) with an opening suitable for the coupling pin ( 2 ), - an axis ( 25 ) on which the clamping plate ( 22 ) is pivotally mounted, - and springs ( 26 ) which pivot the clamping plate ( 22 ) into its clamping position. 3. Prosthesis according to claims 1 and 2, characterized by the features: - the adapter ( 20 ) consists of two parts, - the axle ( 25 ) also serves as a connecting element. 4. Prosthesis according to claims 1-3, characterized by the feature: - the collar ( 12 ) of the prosthetic shaft ( 10 ) is spring-loaded. 5. Prosthesis according to claims 1-4, characterized by the feature: - the clamping ring ( 40 ) has a flange ( 41 ) for attaching clamping screws ( 42 ). 6. Prosthesis according to claims 1-5, characterized by the feature: - the adapter ( 20 ) has a device for retracting the coupling pin ( 2 ). 7. Prosthesis according to claims 1-8, characterized by the feature: - the device for retracting the coupling pin ( 2 ) comprises - a second clamping plate ( 30 ) with an opening suitable for the coupling pin ( 2 ), - an axis ( 31 ) on which the second clamping plate ( 30 ) is pivotally mounted, - a second hand lever ( 32 ) accessible on the outside of the adapter ( 20 ), - a second, internal coupling rod ( 33 ) from the second hand lever ( 32 ) to the second clamping plate ( 30 ) - and a spring ( 34 ) which pivots the second clamping plate ( 30 ) into its neutral position. 8. Prosthesis according to claim 6, characterized by the feature: - the second axis ( 31 ) also serves as a connecting element for the parts of the adapter ( 20 ). 9. Prosthesis according to claims 1-8, characterized by the feature: - the hand levers ( 23 , 32 ) can be folded in and out. 10. Prosthesis according to claims 1-9, characterized by the feature: - the width of the prosthetic shaft ( 10 ) is variable. 11. Prosthesis according to claim 10, characterized by the features: - the wall of the prosthesis shaft ( 10 ) is at least partially folded or wave-shaped, - the folds or waves extend essentially in the axial direction, - A tensioning device is provided to change the width. 12. Prosthesis according to claim 10, characterized by the features: - the wall of the prosthesis shaft ( 10 ) is at least partially slotted, - the slots extend essentially in the axial direction, - A tensioning device is provided to change the width. 13. Prosthesis according to claim 11 or 12, characterized by the feature: - the tensioning device consists of at least one tensioning strap with a toggle lever closure. 14. Prosthesis according to claim 11 or 12, characterized by the feature: - the tensioning device uses a wire rope. 15. Prosthesis according to claims 10-14, characterized by the feature: - the prosthetic shaft ( 10 ) with variable width sits in a container with a smooth outer wall.