DE202005012178U1 - X ray or magnetic resonance patient leg positioner has X ray measurement markings on lower support surface - Google Patents

Abstract

An X ray or magnetic resonance patient leg positioner has X ray measurement markings (20) on the lower patient leg support surface (22) or underside of the top cover (23) that holds the foot at the required anatomical angle and is fixed by eccentric fixings (24) with axes (26) perpendicular to the support surface. The measurement markings can be optically transparent and made of metal, methylmethacrylate on a fibre glass rod.

Description

The The invention relates to a device for immobilizing under Train held lower extremities of patients.

From the German utility model DE 297 03 354 U1 In the same applicant, a device is already known for immobilizing and trailing broken lower limbs of patients. This serves as a stabilization device for X-ray diagnostics. In this case, the device has a bearing surface for a part of the fractured lower extremity and contact surfaces, for example, hold the foot of the fractured lower extremity in a certain anatomical angular position.

Known is further that fractures of the lower extremities by means of so-called sandbags in be sedated in a certain way. Before you get the bottom one extremity through a plaster cast or by means of a heel extension in the desired "fracture position" could bring, had to the fractured part of the lower limb raised three to five times become. This is painful for the patient and can cause adverse consequences, such as embolism or vascular injuries, to have. Furthermore, this traditional approach is not suitable for x-rays because the position of e.g. fractured portion of the lower limb is not sufficiently definable to the healthy part of the leg and to so-called "oblique" X-rays leads. Furthermore, this immobilization of the fracture is both unstable and painful.

None The known methods are also suitable for nuclear spin or magnetic resonance tomography, a imaging diagnostic method for the representation of structures in the body. Magnetic resonance imaging uses alternating magnetic fields.

It It is an object of the invention to provide a device for immobilizing under tension, e.g. fractured, lower extremities of Continue to improve patients.

Further It is an object of the invention, a device for immobilizing from under tension, e.g. fractured, lower extremities of patients ready to provide that too for the magnetic resonance tomography is suitable.

To a first aspect a device for immobilizing lower extremities of Patients for X-ray and / or nuclear spin diagnostics a bearing surface for a part of the lower extremity, as well Contact surfaces, the foot of the lower limb holding in a certain anatomical angular position, wherein the position of at least one contact surface with respect to the foot in such a way variable is that of the contact surfaces kept foot in caudal direction is kept under tension, where radiopaque Markings for units in or on the support surface are provided.

at an embodiment the markings are printed on the top of the support surface or incorporated on the underside of a top surface of the support surface.

at a further embodiment is the bearing surface the device according to the invention designed so that they have a separate device, the one Cattle number of radiopaque Markings in the manner of a so-called. "X-ray ruler" has record can, which together with the device according to the invention in an X-ray and / or Magnetic resonance imaging can be used. The separate Device with radiopaque Markings can be made of a flat plastic carrier material, in which a variety of radiopaque Markers inserted at regular intervals are.

at an embodiment be called radiopaque Markings Metal balls or metal discs, possibly different Diameter, to specific units of measurement to mark used.

at an embodiment are at the top or bottom of the bearing surface for part of the lower extremity markings from a radiopaque Material embedded, so that by comparison one on the Read X-rays can, as large as e.g. imaged bones or foreign bodies introduced surgically into the bone. Similarly, one can on x-rays, which are directly e.g. to be taken after an accident, so-called Accident x-rays, when using the device according to the invention recognize any bone substance defects or losses and their Estimate extent. Consequently become the size ratios in a simple way and dimensions of e.g. Bone, bone defects and implanted Materials, such as screws, nails, Plates, etc., on the x-rays for the doctor quickly recognizable and measurable.

In an embodiment The invention is the support surface at the proximal (towards the knee) side flattened to the Allow patients to comfortably apply the lower limb.

Furthermore, in one embodiment of the invention, the cone elements by an elastic band ver around the two cone elements running and taking in the foot, be held together under slight tension.

Further is in one embodiment the invention, the device, except for the X-ray markers for units of measurement, Made of a material that is permeable to X-rays and optical is transparent. As a result, the device according to the invention can fractured lower limb first store and then the X-ray executed in this device mounted foot without passing through the material of the device is affected by the X-ray image. For example, the device may be made of PMMA (polymethyl methacrylate) be prepared.

In a further embodiment each cone element has at least one bore, wherein these Holes parallel to the cone axis are eccentric to the axis of the respective cone element is and these holes each record a pin which protrudes perpendicularly from the support surface. The device also in magnetic resonance imaging or magnetic resonance tomography To make use of, the pins are made of a magnetic resonance Material, such as Fiberglass, made.

Further is on the device according to the invention in use for the magnetic resonance imaging particularly advantageous that the described Immobilization the e.g. fractured portion of lower limb very fast and clearly blocked and at the same time fixed without this a plaster rail would be required.

The inventive device but is also suitable for the immobilization of non-fractured lower extremities, e.g. in a magnetic resonance tomography.

Further the device according to the invention is like this designed to perform MRI and X-ray diagnostics with it, without the magnetic field or X-ray dose for the Patients increased needs to be.

Further Aspects and features of the invention will become apparent from the dependent claims, the following description of exemplary embodiments and the accompanying drawings.

SUMMARY THE DRAWING

embodiments The invention will now be described by way of example and with reference to FIGS appended Drawings in which:

1 a side view of the device according to the invention and a schematic plan view thereof;

2 Markings for units of measurement embedded in the underside of the support surface;

3 a plan view of the device according to the invention;

4 an elevation (frontal of the distal portion of the device);

5 a cone of the device according to the invention;

6 a frontal view of the bearing surface with the pins;

7 a frontal view of the X-ray cassette holder; and

8th a lateral partial view of the X-ray cassette holder.

In the 1 to 6 shows the device according to the invention by the reference numeral 21 a support surface 22 and contact surfaces 23 which, as described below, at the distal end (in the direction of the ankle) of the support surface 22 are mounted. The proximal end 19 (in the direction of the knee) is flattened so that the patient can lay the fractured lower limb comfortably. The flattening radius is preferably 15mm.

The bearing surface 22 It serves as a support for eg a broken lower limb regardless of whether it is the right or left leg, whether it is adult or pediatric, so the fracture is always in a middle position on the support surface 22 located. At the bottom of the support surface 22 are several radiopaque, ie the X-radiation at least partially absorbing markers 20 imprinted or inscribed for units of measurement, eg metal balls or metal discs with a diameter of about 1-2 mm. These units of measurement are spaced 1 mm, 2 mm, 5 mm or 10 mm apart and may have different diameters (see 2 ) and are visible on a radiograph as "ruler" units of measurement because of their characteristics, allowing the markers to detect the size of the bone or bone fragment fragments or missing bone fragments detectable on the radiograph X-ray visible implants such as intramedullary nails, screws and plaques are determined in size, for example, for the surgical leg extension in the broken bone intramedullary nails introduced that he allow to extend the bone. The implanted intramedullary nail has an opposing ratchet mechanism, which is activated by the patient after the operation by small rotational movements. As a result, the nail advances by about one millimeter per day, until a preset maximum value is reached. At the fracture site, callus forms in the following weeks, ossifying for a long time. On the X-ray image, the instantaneous length of the intramedullary nail can be recognized by means of the device according to the invention.

The upper part of the 1 shows a plan view of the embedded in the underside of the support surface markings 20 , The marks 20 are made of a radiopaque material so that they are visible in the radiograph. All other parts of the device are preferably made of a material that is transparent to X-rays and has optical transparency. These parts are not visible on the radiograph. 2 shows a more detailed view of the in the bottom of the support surface at a distance of 5 mm optional markers of different diameters.

The contact surfaces 23 include two cone elements 24 each of which is rotatably mounted eccentrically to the cone axis. With a respectively parallel to the cone element axis projecting hole, the cone elements 24 by means of pins 32 . 33 that is perpendicular to the support surface 22 protrude, so on the support surface 22 stored that the cone elements 24 are rotatable about an axis perpendicular to the support surface 22 is and eccentric to the axis of the cone elements 24 is.

The pencils 32 . 33 are made of a non-magnetic material, so they do not affect, for example, magnetic resonance imaging. A suitable material for this purpose is, for example, fiberglass.

The axes of rotation 26 the cone elements 24 each fall with the axes of the pins 32 and 33 together. If you place the foot of a patient between the contact surfaces 23 coming from the two cone elements 24 are formed, and you turn the two cone elements 24 such that the foot is held under tension (in the caudal direction) with respect to the axis of the fractured lower extremity, for example, as indicated by the arrows 50 . 51 in 4 displayed, the foot is stored stable in a guaranteed anatomical angular position.

As a result of the mutual approximation of the cone elements 24 the foot remains between the cone elements 24 at rest. To both cone elements 24 to hold in a blocking position, ie in the position closest to the foot (be it metatarsal 1 and metatarsals 5 ), become the cone elements 24 by any suitable means, such as a rubber band, in its backward movement, that is, a mutually divergence movement prevented.

The lateral surface of the cone elements faces the bearing surface 22 an angle α in the range between 95 ° and 115 °, wherein the angle is preferably 97 °. The to the axis of the cone elements 24 parallel protruding holes are of the cone element axis 26 in a range between 5 mm and 20 mm away, which may be provided in this area, several holes. The distance from the support surface 22 protruding pins is in a range between 110 mm and 140 mm, wherein it is preferably 120 mm.

The bearing surface 22 is, except for the radiopaque markings 20 for units of measurement, made from a material permeable to X-ray radiation. Furthermore, the other components of the device can be made of a permeable to the X-ray radiation material. For example, the device may be made of PMMA (polymethyl acrylate).

The bearing surface 22 can be an upper one 34 and a lower one 35 Have plate which are spaced on the short sides. For this purpose is at the proximal part of the support surface 22 between the two plates 34 and 35 an intermediate piece 36 inserted, screwed or glued to the plates 34 and 35 issue. At the distal end of the support surface 22 between the plates 34 and 35 is a spacer 38 inserted, the same dimensions as the spacer 36 has, with the respective plates are in turn screwed or glued connected to this spacer.

The described connection of the various parts of the device according to the invention, such as the plates 34 and 35 as well as the spacers 36 and 38 , as well as the screws 37 and 39 and their cone elements 24 allow a very quick assembly and disassembly of the device. Also an exchange of possibly faulty parts is easily possible. In this way, the device is minimized in size and can be stored to save space. The respective individual parts of the device are easy to wash off, their production is simple and they can be bought in part in specialist shops directly.

As possible dimensions, the two pins 32 and 33 on which the cone elements 24 be eccentrically rotated, have a diameter of 10 mm and a total length of 80 mm. These pins will be around 30 mm in the support surface 22 let in, leaving them 50 mm off protrude vertically from this surface. The holes of the cone elements 24 have a diameter of 10 mm and a length of 50 mm, giving them the pins 32 respectively. 33 be able to record. Various eccentric holes 27 For example, 5 mm, 10 mm, 15 mm and 20 mm away from the axis center of the cone can be attached.

According to a further embodiment, the pins are 32 and 33 in the out of the bearing surface 22 protruding section made with a larger diameter than the diameter of that section which is in the bearing surface 22 protrudes (see dash-dotted lines in 6 ). In this way stands the protruding section of the pens 32 and 33 slightly above the border of the corresponding hole in the support surface 22 out, leaving the hole and thus the inside of the bearing surface 22 is sealed by the bolt itself and the material of the support surface. Any ingress of liquid, such as blood, disinfectants, etc., is easily and efficiently prevented without additional sealant.

The 7 and 8th show an X-ray cassette holder, generally with the reference numeral 40 is designated. It has a holder on one side 41 on that with at least one hole 42 and a slot 43 is made for the stabilization of an X-ray cassette. The holder 41 is at right angles with this slot 43 bolted or glued connected. In this way, the inset 43 comfortably between the two plates 34 and 35 be inserted.

The X-ray cassette holder optionally has a base plate with the dimensions 80 mm × 18 mm × 200 mm. The angle between Holder and slot is 90 °. The Mount has dimensions 80 mm × 170 mm and a cross section of 5 mm. The opening, for better handling the bracket is used, has a bore of 30 mm, which is at a height of 50 mm from the base.

Claims (18)

Device for immobilizing lower limbs of patients for x-ray and / or nuclear spin diagnostics, comprising: a contact surface ( 22 ) for a part of the lower extremity, bearing surfaces ( 23 ), which holds the foot of the lower extremity in a certain anatomical angular position, wherein the position of at least one contact surface with respect to the foot is variable in such a way that the of the contact surfaces ( 23 ) is held under tension in the caudal direction, characterized in that radiopaque markings ( 20 ) for units of measure in or on the support surface ( 22 ) are provided. The device according to claim 1, wherein the radiopaque markers for units of measurement on the underside of the support surface ( 22 ) are admitted. Device according to Claim 1, in which the markings on the upper side of the support surface ( 22 ) are printed. Device according to one of the preceding claims, wherein the radiopaque markings ( 20 ) at a distance of 1, 2, 5 and / or 10 mm in or on the bearing surface ( 22 ) are arranged. Device according to one of the preceding claims, wherein the contact surfaces ( 23 ) two fastening elements ( 24 ) whose axes are perpendicular to the support surface ( 22 ) and which are eccentric with respect to their axes ( 26 ) are rotatably mounted. Device according to claim 5, wherein each fastening element is connected via a pin ( 32 . 33 ), which is substantially perpendicular from the support surface ( 22 protrudes, is connected to the support surface. Device according to claim 5, wherein each fastening element ( 24 ) at least one bore ( 27 ), these holes ( 27 ) are parallel to the cone axis ( 26 ), the holes ( 27 ) eccentric to the axis of the respective fastener ( 24 ) and these holes each have a pin ( 32 . 33 ) perpendicular to the support surface ( 22 ) stands out. Apparatus according to claim 6 or 7, wherein the pins ( 32 . 33 ) are made of a non-magnetic material. Device according to claim 8, wherein the pins ( 32 . 33 ) are made of fiberglass. Device according to one of the preceding claims, wherein a proximal side of the bearing surface ( 22 ) is flattened. The device of claim 10, wherein the proximal side is in a radius ( 19 ) is flattened by 15mm. Device according to one of the preceding claims, wherein the device, except for the radiopaque markings ( 20 ) is made of a material which is transparent to X-rays and has optical transparency. Device according to one of the preceding the claims, wherein the device is made of a non-magnetic material. Apparatus according to claim 13, wherein the device, except for the radiopaque markings ( 20 ) for units of measurement, made of polymethylmethacrylate. Device according to a of the preceding claims, in which the radiopaque Markings each from a metal ball or a metal disc are formed of suitable diameter. Device according to one of the preceding claims, in which the support surface ( 22 ) is adapted to receive a separate device containing the radiopaque markers. Maßeinrichtung with a variety of radiopaque Markers incorporated at regular intervals are, for use for A device according to any one of claims 1 to 16. Maßeinrichtung according to claim 17, which consists of a flat plastic carrier material is made in which a variety of radiopaque markers in are inserted at regular intervals.