EP1824437B1 - Dispositif pour guider la jambe pendant une operation de la hanche, notamment lors de l'implantation d'une endoprothese - Google Patents

Dispositif pour guider la jambe pendant une operation de la hanche, notamment lors de l'implantation d'une endoprothese Download PDF

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Publication number
EP1824437B1
EP1824437B1 EP05803333.3A EP05803333A EP1824437B1 EP 1824437 B1 EP1824437 B1 EP 1824437B1 EP 05803333 A EP05803333 A EP 05803333A EP 1824437 B1 EP1824437 B1 EP 1824437B1
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EP
European Patent Office
Prior art keywords
leg
assembly according
bar
leg support
piston
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EP05803333.3A
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German (de)
English (en)
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EP1824437A1 (fr
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Michael Memminger
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Individual
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Individual
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Publication of EP1824437A1 publication Critical patent/EP1824437A1/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/0036—Orthopaedic operating tables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G2203/00—General characteristics of devices
    • A61G2203/30—General characteristics of devices characterised by sensor means
    • A61G2203/42—General characteristics of devices characterised by sensor means for inclination

Definitions

  • the invention relates to an additional device for an operating table for carrying out a hip prosthesis operation, in particular a leg guide.
  • Hip prosthesis operations or hip surgery or prosthetic implantation are performed with increasing frequency to replace worn hip joints with a prosthesis during the life of a patient.
  • This prosthesis is also referred to as an artificial hip joint, hip joint prosthesis or total hip endoprosthesis.
  • the method comprises, firstly, replacing the natural socket of the pelvis and then replacing the femoral head with the prosthetic portion of the femur with the attached artificial head.
  • the most modern methods of hip surgery are minimally invasive, such that an operative incision to reach the joint area is only 6 cm to 10 cm long and can take place without severing muscle or tendon tissue, so in principle the patient already can go the same day again.
  • the leg extension device is a device for exerting a longitudinal pull on the leg and for bringing the leg into certain positions (so that the operation can be carried out more easily).
  • the hip operation proceeds in several steps that are to be distinguished from one another: first, the incision is made and the socket is subsequently replaced.
  • the patient's leg is moved in a well-defined manner to give the surgeon access to the femoral head and / or femoral neck; this well-defined movement comprises, firstly, a lowering of the leg, with the leg remaining in a plane parallel to the sagittal plane of the body, secondly a rotation of the foot by about 90 ° outwards, and thirdly a pulling or an adduction of the leg so that it is in is rotated behind the patient area. Only after these movements of the leg, which is held all the time under a mechanical tension, a further work on the proximal thigh bone is possible. After replacing the condyle, the movements are performed in reverse order and sutured the wound.
  • Another disadvantage is that a lowering of the leg can not be driven away arbitrarily far down, because the foot of the patient otherwise strikes the floor.
  • One Higher-displacement of the patient is not possible because it would leave the area of an optimal operating height.
  • a device of the manufacturer Maquet is known. This is a device that holds both legs of the patient and each provides an adjustable tensile force on the legs of the patient on the adjustable at a distance from the fuselage foot ends.
  • This device (bed) has the following disadvantages: Either the lowering of one leg is possible only gradually in alternation with a continuous readjustment of the tension, or it must be purchased a completely new trauma bed, which is expensive.
  • the tension for the respective leg When operating the axes of rotation, however, the tension for the respective leg must be readjusted stepwise according to the rotation of the arm. This requires a very experienced operator or a time that prolongs the duration of surgery to a noticeable extent and thus represents a disadvantage for the patient.
  • the device is designed with two arms, which makes them more expensive to operate and more expensive.
  • the US Pat. No. 5,658,315 discloses a leg guide for hip surgery having the features of the preamble of claim 1, and an orthopedic table assembly for hip surgery, comprising an operating table with means for horizontal sacral fixation of a patient on one end of the table and the above leg guide, wherein the leg support in the Length is adjustable, so that the distance of a held by the leg holder leg of the rail is adjustable.
  • the invention is intended to enable the precisely defined changes in position of the leg provided during the procedure to be precise and executed in order to give the surgeon optimum access during each phase of the procedure.
  • easy handling should be ensured, and the readjustment should be carried out by untrained personnel or the surgeon with little expenditure of time.
  • the rail can be longitudinally adjustable in the direction of the axis of rotation.
  • the leg guide comprises a chassis, with a holder for a socket for receiving a piston-like element displaceable in the socket, which carries the rail at its free end.
  • the direction of displacement of the piston-like element is substantially parallel to the axis of rotation.
  • the displacement direction of the piston-like element is aligned with the axis of rotation.
  • the leg guide includes a displacement device, which is designed for a defined displacement of the piston-like element and thus also the rail in the direction of the axis of rotation.
  • the piston-like element can be supported on rolling elements against at least one inside of the sleeve
  • the piston-like element is lockable in the socket.
  • the displacement device is actuated by rotating a spindle, which spindle is arranged parallel to the axis of rotation or in alignment with the axis of rotation and is freely rotatably mounted in the side opposite the open side of the sleeve and stored in the piston-like element in that rotation of the spindle causes displacement of the piston-like element parallel to the axis of rotation or along the axis of rotation.
  • the rail bearing, head element is mounted at the free end of the piston-like element.
  • the rail is attached to the head element of the piston-like element.
  • the rail is attached to the head element of the piston-like element by means of holding elements.
  • the head element is lockable with respect to rotation about the axis of rotation.
  • the piston-like element is firmly connected to the rail.
  • the piston-like element is substantially freely slidably and rotatably supported in the female socket.
  • the piston-like element is provided with an external thread.
  • an actuating element is provided with an internal thread which fits onto the external thread of the piston-like element and can be actuated with a handle device.
  • the actuating element is mounted on an end of the piston-like element, which is arranged opposite to the end bearing the rail, wherein the bush carrying the piston-like element is arranged in the middle.
  • rotating the actuator causes displacement of the piston-like member with respect to the female socket.
  • the piston-like element is lockable in the female socket.
  • the female socket has a plurality of bores along a circumference taken perpendicular to the direction of displacement.
  • the piston-like element in the female socket is locked against rotation about the axis by having a longitudinal groove extending over substantially its entire length into which a pin or screw is inserted over one of the holes is screwed in.
  • the rail at a height h, which corresponds substantially to the height of the axis of rotation, a first circular arc portion having a first radius of curvature r and in a height deviating from the height h a second circular portion having a second radius of curvature r ', where: r ⁇ r'.
  • the rail is height adjustable to allow the surgeon an individual operating height
  • the leg guide is provided with lockable rollers, so that it is displaceable on a floor.
  • the leg guide includes a foot fastening device including: a sole plate for laying a sole of a foot, at least one fastening device attached to the sole plate, with which the foot is firmly engaged with the sole plate, and a hollow spar which is attached vertically to the soleplate.
  • the hollow spar / spar is mounted on the opposite side of the heel of the foot.
  • the leg support is longitudinally adjustable and the two ends thereof are pivotable relative to each other in the longitudinal axis.
  • the leg support includes: a slider at a first end of the leg support, a foot attachment device at the other end of the leg support, and an inter-pivoting device interposed therebetween, and adjusting a distance between the slider and the footrest; fastening device.
  • the two ends of the leg support are pivotable relative to each other by at least 90 °.
  • the leg support further comprises: a slider, to which a shaft is attached, which is connected via a hinge with an inner spar, as well as the inner spar slidably and lockably receiving hollow beam, which is attached to the foot-fastening device or at least one spar on which the foot-fastening device is displaceable.
  • the leg support bearing slider is received by the rail and slidable and lockable along the same.
  • the foot attachment device is attached to the end of the leg support opposite the slider.
  • the axes of the joint are locked together.
  • the multi-axis joint comprises a ball joint or a cardan joint or 2 discs rotatable against each other.
  • the axes of the universal joint are formed by two bolts or screws which are arranged perpendicular to one another and can be locked by means of levers.
  • the hinge is formed of a head seated on the shaft which is adapted to rotatably support a disc-shaped end of the inner spar so that the inner spar is rotatable relative to the shaft on the common axis.
  • the joint is lockable by means of a screw.
  • the height h of the rotation axis from the bottom is 85 cm ⁇ h ⁇ 130 cm, and preferably 95 cm ⁇ h ⁇ 120 cm.
  • the second radius of curvature 80 cm ⁇ r ' ⁇ 250 cm
  • the leg support bearing slider is provided with rolling elements.
  • the leg support is displaceably mounted on the rail in a second rail arranged perpendicular thereto.
  • the slider supporting the leg support is designed to carry a further guide rail which is disposed at 90 ° to the first guide rail and which slidably receives the end of the shaft facing the bushing.
  • the shaft has a thread on the shaft surface in a region on the end facing the rail part.
  • a fastening part with a correspondingly matching internal thread which is operatively engaged with the thread of the shaft, is rotatably mounted on the shaft.
  • the attachment part comprises handle devices and projections.
  • the slide accommodated in the rail can be locked by rotating the fastening part on the thread of the shaft in the direction of the rail until the shaft is firmly engaged with the rail.
  • the fastening part has four or six handle devices.
  • an orthopedic table assembly for hip surgery comprising an operating table with means for horizontal sacral fixation of a patient on one end of the table and a leg guide, wherein by means of the leg support, the distance of the leg from the guide rail is adjustable.
  • the operating table is arranged immovably to the leg guide.
  • the leg guide is immovable to the operating table due to its own weight.
  • the leg guide is immovable to the operating table due to a screw connection to the floor.
  • the leg guide is firmly engaged with the operating table by a latching device.
  • the latching device is fixedly connected at one end to the leg guide and at the other end a clamp which firmly engages a column of the operating table by means of a bracket.
  • the operating table has a height h 'from the bottom, for which applies: 80 cm ⁇ h' ⁇ 130 cm, wherein preferably: 90 cm ⁇ h ' ⁇ 120 cm, more preferably that the Height h of the axis of rotation is substantially equal to the height h '' of the hip joint.
  • a hip operation control apparatus comprising an operating table and a leg guide, further comprising at least one sensor for detecting tension on the leg of the patient and suitably mounted and suitably coupled to the sensor actuators for automatically moving the leg into an operative position.
  • the hip operation control device includes: at least two servomotors on the multi-axis joint for pivoting the foot, a servomotor on the slider for sliding the leg support along the rail, and a servomotor on the head element for rotation of the rail; at least one tension sensor at least at the foot mounting device, a program memory, a data memory for storing set values for a time course of a tension and measured values, a device for receiving an external storage medium or a network connection, and a controller based on In the program memory stored instructions measured values of tensile stresses compares with the setpoints and makes a corresponding control of the servomotors.
  • the arcuate Beinfuehrung can be replaced by a straight rail when sensors and actuators maintain a certain set tension
  • FIG. 1 is an embodiment of a leg guide according to the invention, in particular for use in a hip surgery, shown schematically.
  • the leg guide 57 for hip surgery, a rail 31 which is a circular arc-like guide and about a perpendicular to the circular arc-shaped guide axis of rotation 71 is rotatable and a leg holder 75 which is slidably mounted on the rail 31. More preferably, the circular arc-like guide extends along the entire extent of the rail. Due to this arrangement, an axis of rotation of the movement in the body of the patient instead of outside, causing a movement the leg can be guided for the operation in a simple manner; this is in contrast to the prior art, where the fulcrum of movement is outside the patient's body, which requires constant readjustment during movement.
  • the rail is longitudinally adjustable in the direction of the axis of rotation and adjustable in height relative to the ground.
  • the leg guide 57 includes a chassis 55 with a support for a bushing 45 for receiving a displaceable in the sleeve piston-like element 41, which carries at its free end the rail.
  • the direction of displacement of the piston-like element 41 is substantially parallel to the axis of rotation 71.
  • the direction of displacement of the piston-like element 41 is aligned with the axis of rotation 71.
  • the leg guide includes a displacement device 43, 47, 49, which is designed for a defined displacement of the piston-like element 41 and thus also the rail 31 in the direction of the axis of rotation 71.
  • the piston-like element 41 may be mounted on rolling elements 73 against at least one inside of the bushing.
  • rolling elements suitably supported balls are used.
  • rollers running on racks mounted within bushing 45 are used.
  • the piston-like element 41 can be locked in the bushing 45.
  • the displacement device 43, 47, 49 is used for this purpose.
  • the displacement device 43, 47, 49 is actuated by turning a spindle 47, which spindle is parallel to the axis of rotation 71 or in alignment with the axis of rotation is disposed and freely rotatably supported in the open side of the opposite side of the sleeve and is mounted in the piston-like element 41 so that a rotation of the spindle causes a displacement of the piston-like element parallel to the axis of rotation or along the axis of rotation.
  • the spindle is preferably rotated by means of a handwheel or lever.
  • the spindle is freely rotatably supported in a Achsbuchse 47 of the bushing 45 and the end of the spindle in a threaded portion 43 of the piston-like element 41 was added.
  • the spindle drive is mounted in a different height from the height of the axis of rotation.
  • a rotatably mounted about the axis of rotation, the rail bearing, head member 37 is mounted. Further preferably, the head element can be locked by a screw device or plug 39.
  • the rail 31 is attached to the head member 37 of the piston-like member.
  • the rail 31 is attached to the head member 37 of the piston-like member 41 by means of support members 33, 35.
  • support members 33, 35 Preferably, two struts 33, 35 are used as support elements.
  • the rail is mounted on a disc-like spacer directly on the head element.
  • the head member 37 is lockable with respect to rotation about the rotation axis 71.
  • the piston-like member 46 is fixedly connected to the rail 31c, for example, it is formed as a continuous piece having a piston portion and a rail portion.
  • the piston-like member 46 is slidably and rotatably supported substantially freely in the female sleeve 45c in this embodiment, and it is provided with an external thread.
  • An actuator 48 is provided with a matching to the external thread of the piston-like member internal thread and operable with a handle device 50.
  • the actuator is mounted on one end of the piston-like member 46 which is disposed opposite to the end carrying the rail 31c with the sleeve-like member 45c in the center. Rotation of the actuator 48 causes displacement of the piston-like member 46 with respect to the female sleeve 45c.
  • the operation is here as with mutually engaged screw and nut: When turning the screw, their relative position to the nut changes in an axial direction. To make the structure as simple as possible, is dispensed with an abutment point here. An abutment point is not even erfoderlich here, because the required reaction force to prevent the fastener together with piston-like element can move freely back and forth, by the patient's leg, or by the tension guided by the leg applied. The force applied by the leg of the patient is sufficiently large to provide a sufficiently firm hold.
  • the piston-like member 46 is lockable in the female socket 45c.
  • the female socket 45c has a plurality of holes 42 along a circumference taken perpendicular to the direction of displacement.
  • the piston-like member 46 is lockable in the female sleeve 45c against rotation about the axis 71c so as to have a longitudinal groove extending over substantially its entire length into which a pin or screw is inserted or threaded over one of the bores 42 ,
  • This bushing has a smooth, unthreaded inner diameter such that the externally threaded piston-like member 46 is free to rotate and translate within the bushing.
  • the displacement is achieved by the actuator 48, which is provided with a matching to the external thread of the piston-like member internal thread and operable with a handle device 50.
  • the operation is the same as in the threaded nut-screw connection, in which a rotation of the screw causes a movement relative to the threaded nut in the axial direction.
  • Actuation of the fastener by turning it clockwise from the side opposite the patient causes the piston-like member to be moved away from the patient, thereby building up tension in the leg.
  • the rail 31 c is rotatable about the axis 71 c, wherein a lock by the combination of the present in the piston-like element 46 groove with the screw or the pin 44 is achieved with the through holes 42.
  • the through holes 42 are arranged at appropriate intervals, thus enabling the locking of the rail against rotation in a plurality of positions.
  • FIG. 5 shows this engagement in a side view: the fact that the pin or the screw passes through the bushing 45d to a groove depth 40d in the piston-like element 46d, unintentional rotation of the piston-like element 46d and thus unintentional rotation of the rail 31d is prevented.
  • FIG. 6 shows this again in a front view:
  • the piston-like element 46e has a groove with a groove depth 40e; the possible positions of the piston-like element and thus of the rail (not shown here) are defined by the arrangement of the through-holes 42e.
  • the rail 31 includes at a height h, which substantially corresponds to the height of the rotation axis 71, a first circular arc portion having a first radius of curvature r and in a height deviating from the height h a second circular portion having a second radius of curvature r ', wherein the following applies: r ⁇ r '.
  • the areas of different radii of curvature are continuously merged, so that the movement of the slider along the rail is smooth and without abrupt changes. Due to the condition r> r 'it is ensured that the leg of the patient after lowering is under a lower tensile stress than the initial tensile stress. In this way, excessive loading of the tissue is prevented and the operation is facilitated.
  • the slider is designed so that it runs smoothly along the guide rail.
  • it is formed with rolling elements, such as balls.
  • sliding within a rail guide is preferably carried out.
  • the rail is designed in a U-profile, within which slides the slider along the guide rail.
  • the slider can be locked on the rail 31.
  • a kind of gear may be mounted on the slider or rail; the toe of a lever with a wheel shifts the slider up or down on the rail.
  • the leg guide according to the invention may be provided with lockable rollers 53, so that it is displaceable on a floor.
  • the rollers attached to the base plate 51 of the chassis 55 are, in one embodiment, secured by bottom-engaging elements such as screws or the like. Replaceable to a high weight of leg guidance in a special embodiment too holders.
  • the leg guide 57 of the present invention includes a foot mounting device 9, the foot mounting device including: a sole plate for laying a sole of a foot 7, at least one fastening device attached to the sole plate, with which the foot firmly engages the sole plate is brought, as well as a hollow spar 11 (or at least 1 spar), which is mounted perpendicular to the sole plate.
  • the sole plate is provided with straps, so that the foot 7 of the patient P is firmly attached to the sole plate and thus with the leg guide 57 after attachment as in sandals.
  • the foot fastening device 7, 9 is designed like a shoe.
  • the hollow spar 11 (or spar) is mounted on the opposite side of the heel of the foot. In this way it is ensured that the pivoting of the leg holder 75 leads to a pivoting of the leg 5, wherein both pivot axes are aligned with each other.
  • the leg holder 75 is longitudinally adjustable and the two ends thereof are pivotable relative to each other in the longitudinal axis. Furthermore, the leg support 75 includes: a slider 29; 29a; 29b at a first end of the leg support, a foot attachment device 9 at the other end of the leg support, and an inter-pivoting device interposed therebetween, and adjusting a clearance between the slider and the foot attachment device.
  • a sliding element 29a in a rail 31a shows FIG. 2 : The cross section of the rail has a U-shape with inwardly bent ends, so that the slider can not fall out. As only indicated here and described in more detail below, the slider on mounted balls, so that sliding is facilitated.
  • the two ends of the leg bracket 75 are pivotable relative to each other by at least 90 °.
  • the leg support 75 includes: a slider 29; 29a; 29b, to which a shaft 27 is attached, which is connected via a hinge 17 with an inner spar 13, and a the inner spar displaceable and lockable receiving hollow spar 11 which is attached to the foot-fastening device 9.
  • the leg support 75 bearing slider 29 is received by the rail and along the same displaced and locked.
  • the foot mounting device 9 is attached. The axes of the joint 17 can be locked together.
  • a hollow handle and inner spar for setting a well-defined distance between the rail and leg bracket can also be used at least 2 spars, which can be moved parallel to each other via a transition piece or in another variant, the leg bracket can be displaced directly on a (or more senior) spar ,
  • the hinge 17 includes a ball joint or 2 mutually rotatable discs or a universal joint.
  • the axes of the universal joint 17 by two mutually perpendicular, lockable by levers 19f, bolts or screws are formed.
  • FIG. 7 shows a detail of the embodiment formed with a universal joint 17f.
  • the two axes of the universal joint 16f and 18f at the protruding ends so with threaded nuts engaged that with the aid of two levers 19f the universal joint for both pivot directions is firmly locked.
  • the hinge 17g is formed by a head 18 seated on the shaft 27g, formed so as to rotatably support a disc-shaped end of the inner spar 13g, so that the inner spar 13g is rotatable relative to the shaft 27g on the common axis 72, as in FIG FIG. 8 is illustrated.
  • the dimensions of the leg guide result from the anatomical conditions of humans, the fixed dimensions are independent of individual characteristics; for the fixed dimensions rather than a standard patient is assumed - the individual adjustment is achieved in each case by operating the joints and rails described.
  • the height h of the axis of rotation 71 from the bottom the following applies: 85 cm ⁇ h ⁇ 130 cm, wherein the following applies preferably: 95 cm ⁇ h ⁇ 120 cm.
  • the following applies for the first radius of curvature: 90 cm ⁇ r ⁇ 260 cm, wherein the following applies preferably: 100 cm ⁇ r ⁇ 190 cm, whereby more preferably 120 cm ⁇ r ⁇ 160 cm, more preferably r 130 cm.
  • the following applies: 80 cm ⁇ r ' ⁇ 250 cm, with the following preferably being 90 cm ⁇ r' ⁇ 180 cm, more preferably: 110 cm ⁇ r ' ⁇ 150 cm, more preferably: r' 120 cm.
  • the leg support 75 bearing slider 29a is provided with rolling elements.
  • the rolling elements can be designed as balls surrounded by ring springs in grooves of the slider balls to facilitate sliding.
  • An example of this shows FIG. 9
  • the slider 29h accommodated in the rail 31h has balls 141 on the inner friction surfaces with the slide rail, which are respectively in a bushing of elastic material 143 are received, which is fitted in each case in a AufEnglishung 145 of the slider.
  • the leg support is displaceably mounted on the rail in a second rail arranged perpendicular thereto.
  • the leg support 75 bearing slider 29b is carried out in such a way that it carries a further guide rail 77, which is arranged at an angle of 90 ° to the first guide rail and which slidably receives the sleeve 45 facing the end of the shaft 27.
  • FIG. 3 illustrates this arrangement.
  • the rail 31b receives the slider 29b so as to be slidable in the directions 23b and 25b.
  • the slider 29b includes a second guide rail 77 arranged at an angle of 90 ° to the rail 31b.
  • a support piece 79 is slidably received, to which the end of the leg holder 75 facing the bushing 45 is fastened. In this way, in addition to the sliding on the rail 31 predetermined movement by 90 ° rotated movement is possible. This can be advantageous for a fine adjustment of the leg position and position.
  • the shaft 27h has a thread on the shaft surface in a region on the end facing the rail part 31h.
  • a fixing member 91 rotatably mounted with a corresponding mating internal thread, which is operatively engaged with the thread of the shaft.
  • the fastening part 91 has handle devices 93 and projections 95.
  • the slider 29h accommodated in the rail 31h can be locked by rotating the fastening part 91 on the thread of the shaft 27h in the direction of the rail 31h until the shaft is firmly engaged with the rail due to static friction of the projections 95 against the rail Rail 31h is. This is in FIG.
  • the shaft 27h On the end of the leg support closest to the rail 31h, the shaft 27h has a thread on the outer surface in a proper range, so that the fastening part can be turned like a threaded nut on the screw. If the fastener is rotated clockwise, so it approaches more and more of the slide until the projections 95 no longer allow a further rotation due to the static friction. Thus, the movement of sliding of the sliding element is then prevented.
  • the attachment part 91i has four or six handle devices 93i. This is in FIG. 10 illustrated in a side view and a front view, wherein only one embodiment with four handle devices is shown here. The handle devices are for ease of use of the attachment part.
  • the fastening part is locked on the rail by a kind of clamping jaw, which is pressed by springs against the rail.
  • an orthopedic table assembly 57, 59 is provided for hip surgery, comprising an operating table 59 with means 61 for horizontal sacral fixation of a patient P on one end of the table and a leg guide 57, wherein by means of the leg support 75, the distance of the leg 5 of the guide rail 31 is adjustable.
  • the operating table 59 of the orthopedic table arrangement is arranged immovably to the leg guide 57.
  • the leg guide is immovable to the operating table due to its own weight or due to a screw connection to the floor.
  • FIG. 11 shown that Leg guide 57j by a latching firmly fixed to the operating table 59j engaged.
  • the latching device 161 is fixedly connected at one end to the leg guide and has at the other end a bracket 163 which brings a column of the operating table by means of a bracket 165 firmly engaged.
  • the operating table 59 of the orthopedic table assembly has a height h 'from the bottom, for which is: 80 cm ⁇ h' ⁇ 130 cm, wherein preferably: 90 cm ⁇ h ' ⁇ 120 cm, wherein it is further preferred that the height h the axis of rotation is substantially equal to the height h "of the hip joint 1, 3.
  • the embodiments of the invention allow a comparison with the prior art simplified execution of a hip operation.
  • a movement of body parts of the patient is erfoderlich (lowering of the leg, swinging the foot and adduction of the leg) due to the human joints oriented embodiments of the invention only each simple sliding or pivoting movements are required so that a considerable simplification of the handle and thus a quick operation even with less practiced operating personnel is possible.
  • the movement of the three steps is carried out automatically by a controller comprising: servomotors with angle sensors, sensor for detecting a tension in the foot mounting device, program memory for the control of the motors taking into account the recorded measured values, data memory for specifying a time- and angle-dependent desired course for the tensile stress.
  • a control device for hip surgery comprising an operating table 59 and a leg guide 57, further comprising at least one sensor for detecting a tension on the leg of the patient as well as suitably mounted and suitably coupled to the sensor actuators for the automatic movement of the leg in an operating position.
  • the hip operation control apparatus includes: at least two servo motors 111, 113 on the multi-axis hinge 17 for pivoting the foot 7, a servo motor 115 on the slider 29 for sliding the leg bracket 75 along the rail, and a servo motor 117 on the head member 37 for one Rotation of the rail 31, at least one tension sensor 119 at least at the foot mounting device, a program memory 123, a data memory 125 for storing set values for a time course of a tensile stress and measured values, a device for receiving an external storage medium 127 or a network connection 129 and a controller 121 which compares values of tensile stresses measured on the basis of instructions stored in the program memory 123 with the target values and performs a corresponding control of the servomotors 111, 113, 115, 117.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)

Claims (24)

  1. Guide de jambe (57) combiné à un système de table orthopédique (59) pour les opérations de la hanche, comprenant :
    un support de jambe (75) ; et
    un rail arqué (31 ; 31c) équipé d'un guide dans lequel le support de jambe (75) est déplaçable le long de la voie arquée du rail (31 ; 31c) et un châssis,
    caractérisé en ce que le rail arqué (31 ; 31c) s'appuie en rotation sur le châssis de manière à ce que son axe de rotation (71 ; 71c) repose sensiblement parallèlement par rapport au sol sur lequel repose le châssis (55),
    l'axe de rotation (71 ; 71c) du rail (31 ; 31c) se situant sensiblement dans l'extension du support de jambe (75) en position non pivotée du support de jambe (75) et le support de jambe (75), dans sa position non pivotée, s'étendant sensiblement en direction de l'extension longitudinale d'un système de table orthopédique (59) pour les opérations de la hanche.
  2. Combiné selon la revendication 1, dans lequel le châssis (55) est équipé d'un support pour un manchon (45 ; 45c) destiné à recevoir un élément de type piston (41 ; 46) déplaçable le long de l'axe de rotation (71 ; 71c) dans le manchon (45) et qui supporte le rail (31 ; 31c) à son extrémité libre.
  3. Combiné selon la revendication 2, contenant un dispositif de déplacement (43, 47, 49) qui est conçu pour permettre un déplacement défini de l'élément de type piston (41) et donc également du rail (31) en direction de l'axe de rotation (71).
  4. Combiné selon la revendication 3, dans lequel le dispositif de déplacement (43, 47, 49) s'actionne par rotation d'une broche (47), la broche (47) étant disposée parallèlement à l'axe de rotation (71) ou dans l'alignement de l'axe de rotation (71) et s'appuyant en rotation libre dans un côté opposé au côté libre du manchon (45) de même que dans l'élément de type piston (41) de manière à ce qu'une rotation de la broche (47) entraîne un déplacement de l'élément de type piston (41) parallèlement à l'axe de rotation (71) ou le long de l'axe de rotation (71).
  5. Combiné selon une des revendications 2 à 4, dans lequel un élément sommital (37) s'appuyant en rotation autour de l'axe de rotation est installé à l'extrémité libre de l'élément de type piston (41) ; le rail (31 ; 31c) étant installé au niveau de l'élément sommital (37) au moyen d'éléments de fixation (33, 35) et l'élément sommital (37) pouvant être bloqué autour de l'axe de rotation (71) au niveau de sa rotation.
  6. Combiné selon la revendication 2, dans lequel l'élément de type piston (46) est librement déplaçable et s'appuie en rotation dans le manchon (45c) et est raccordé fixement au rail (31c).
  7. Combiné selon la revendication 6, dans lequel l'élément de type piston (46) est pourvu d'un filetage et un élément d'actionnement (48) d'un taraudage interne adapté au filetage de l'élément de type piston (46) et peut être actionné à l'aide d'un dispositif de poignée (50).
  8. Combiné selon les revendications 6 et 7, dans lequel une rotation de l'élément d'actionnement (48) entraîne un déplacement de l'élément de type piston (46) par rapport au manchon récepteur (45c).
  9. Combiné selon une des revendications 1 à 8, dans lequel le rail (31 ; 31c) comporte à une hauteur h, qui équivaut sensiblement à la hauteur de l'axe de rotation (71 ; 71c), une première partie arquée ayant un premier rayon de courbure r et, à une hauteur différente de la hauteur h, une seconde partie arquée ayant un second rayon de courbure r', sachant que r ≥ r'.
  10. Combiné selon une des revendications 1 à 9, pourvue de rouleaux blocables (53), de telle sorte qu'il est déplaçable sur un sol.
  11. Combiné selon une des revendications 1 à 10, comportant un dispositif de fixation de pied (9), le dispositif de fixation de pied (9) comportant les éléments suivants : une plaque de semelle pour y poser une semelle d'un pied (7), au moins un dispositif de fixation installé sur la plaque de semelle et grâce auquel le pied (7) est amené en prise fixe avec la plaque de semelle, de même qu'un longeron creux (11) qui est installé sur la plaque de semelle ou un support déplaçable sur au moins une barre, le longeron creux (11) ou le support déplaçable sur au moins un longeron étant installé sur le côté opposé à la partie talon du pied.
  12. Combiné selon une des revendications 1 à 11, dans lequel le support de jambe (75) est déplaçable en longueur et les deux extrémités de celui-ci sont pivotables l'une vers l'autre dans l'axe longitudinal.
  13. Combiné selon une des revendications 1 à 12, dans lequel le support de jambe (75) comprend les éléments suivants : une pièce de coulissement (29 ; 29a ; 29b) à une première extrémité du support de jambe, un dispositif de fixation de pied (9) à l'autre extrémité du support de jambe (75) et un dispositif installé entre la pièce de coulissement (29 ; 29a ; 29b) et le dispositif de fixation de pied (9) pour permettre le pivotement réciproque effectué, de même que le réglage d'une distance entre la pièce de coulissement (29 ; 29a ; 29b) et le dispositif de fixation de pied (9).
  14. Combiné selon une des revendications 1 à 13, dans lequel les deux extrémités du support de jambe (75) peuvent pivoter l'une vers l'autre d'au moins 90° dans au moins un plan.
  15. Combiné selon une des revendications 13 ou 14, dans lequel le support de jambe (75) comprend en outre : la pièce de coulissement (29 ; 29a ; 29b) sur laquelle est fixé un arbre (27 ; 27g ; 27h) qui est raccordé par une articulation (17) à un longeron interne (13), de même qu'un longeron creux (11) recevant le longeron interne (13) de manière mobile et blocable et qui est installé sur le dispositif de fixation de pied (9).
  16. Combiné selon une des revendications 1 à 5, dans lequel on a, pour la hauteur h de l'axe de rotation (71 ; 71c) depuis le sol : 85 cm ≤ h ≤ 130 cm et préférentiellement : 95 cm ≤ h ≤ 120 cm.
  17. Combiné selon une des revendications 1 à 8, dans lequel le rail (31 ; 31c) comprend à une hauteur h, qui équivaut sensiblement à la hauteur de l'axe de rotation (71 ; 71c), une première partie arquée ayant un premier rayon de courbure r et, à une hauteur différente de la hauteur h, une seconde partie arquée ayant un second rayon de courbure r', sachant qu'on a, pour le premier rayon de courbure : 90 cm ≤ r ≤ 260 cm et préférentiellement 100 cm ≤ r ≤ 190 cm et encore plus préférentiellement : 120 cm ≤ r ≤ 160 cm et encore plus préférentiellement r = 130 cm ; et qu'on a pour le second rayon de courbure : 80 cm ≤ r' ≤ 250 cm et préférentiellement 90 cm ≤ r' ≤ 180 cm et encore plus préférentiellement : 110 cm ≤ r' ≤ 150 cm et encore plus préférentiellement r' = 120 cm.
  18. Combiné selon une des revendications 13 à 17, dans lequel le rail (31 ; 31c) s'étend assez loin pour que la pièce de coulissement (29 ; 29a ; 29b) supportant le support de jambe (75) soit déplaçable le long du rail (31 ; 31c) assez loin pour que le support de jambe (75) puisse prendre par rapport à l'horizontale, qui s'étend sensiblement parallèlement au sol sur lequel le châssis (55) repose, un angle α pouvant aller jusqu'à 60°, sachant qu'on a de préférence α ≤ 50° et plus préférentiellement α = 40°.
  19. Combiné selon une des revendications 13 à 18, dans lequel la pièce de coulissement (29 ; 29a ; 29b) supportant le support de jambe (75) est pourvue d'éléments de roulement.
  20. Combiné selon une des revendications 13 à 19, dans lequel la pièce de coulissement (29 ; 29a ; 29b) est bloquée sur le rail (31 ; 31c) par des mâchoires de serrage ou des tiges.
  21. Combiné selon une des revendications précédentes, comportant une table d'opération (59) avec des moyens (61) de fixation sacrale horizontale d'un patient (P) sur une des extrémités de la table (59), le support de jambe (75) étant réglable en longueur de manière à ce que la distance entre une jambe maintenue par le support de jambe (75) et le rail (31 ; 31c) soit réglable.
  22. Combiné selon la revendication 1, dans lequel le rail (31 ; 31c) est réglable en hauteur.
  23. Dispositif de commande pour opérations de la hanche, comportant une table d'opération (59) ainsi qu'un guide de jambe (57) selon une des revendications précédentes, comportant en outre au moins un capteur pour détecter une tension de traction au niveau de la jambe d'un patient ainsi que des moteurs de positionnement installés de manière adaptée et couplés de manière adaptée au capteur pour permettre un déplacement automatique da la jambe vers une position convenable pour l'opération.
  24. Dispositif de commande pour opérations de la hanche selon la revendication 23, dans lequel l'articulation (17) est réalisée avec plusieurs axes, le dispositif de commande comprenant : au moins deux moteurs de positionnement (111, 113)) au niveau de l'articulation à plusieurs axes (17) pour le pivotement du pied (7), un moteur de positionnement (115) au niveau de la pièce de coulissement (29) pour le déplacement du support de jambe (75) le long du rail (31 ; 31c) et un moteur de positionnement (117) au niveau de l'élément sommital (37) pour la rotation du rail (31 ; 31c), au moins un capteur de tension de traction (119) au moins au niveau du dispositif de fixation de pied (9), une mémoire de programme (123), une mémoire de données (125) pour sauvegarder des valeurs théoriques pour un déroulement chronologique d'une tension de traction et de valeurs mesurées d'un dispositif destiné à recevoir un moyen de mémoire externe (127) ou une liaison de réseau (129), ainsi qu'un contrôleur (121) qui compare des valeurs mesurées sur la base d'instructions enregistrées dans la mémoire de programme (123) de tensions de traction aux valeurs théoriques et procède à une commande correspondante des moteurs de positionnement (111, 113, 115, 117).
EP05803333.3A 2004-11-10 2005-11-09 Dispositif pour guider la jambe pendant une operation de la hanche, notamment lors de l'implantation d'une endoprothese Not-in-force EP1824437B1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PL05803333T PL1824437T3 (pl) 2004-11-10 2005-11-09 Urządzenie do prowadzenia nogi podczas operacji biodra, zwłaszcza przy wszczepianiu endoprotezy

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102004054332A DE102004054332A1 (de) 2004-11-10 2004-11-10 Beinführung, insbesondere für die Verwendung bei einer Hüftoperation
PCT/EP2005/055836 WO2006051077A1 (fr) 2004-11-10 2005-11-09 Dispositif pour guider la jambe pendant une operation de la hanche, notamment lors de l'implantation d'une endoprothese

Publications (2)

Publication Number Publication Date
EP1824437A1 EP1824437A1 (fr) 2007-08-29
EP1824437B1 true EP1824437B1 (fr) 2013-07-03

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EP05803333.3A Not-in-force EP1824437B1 (fr) 2004-11-10 2005-11-09 Dispositif pour guider la jambe pendant une operation de la hanche, notamment lors de l'implantation d'une endoprothese

Country Status (9)

Country Link
US (1) US7762975B2 (fr)
EP (1) EP1824437B1 (fr)
AU (1) AU2005303825B2 (fr)
CA (1) CA2587824C (fr)
DE (1) DE102004054332A1 (fr)
DK (1) DK1824437T3 (fr)
ES (1) ES2429535T3 (fr)
PL (1) PL1824437T3 (fr)
WO (1) WO2006051077A1 (fr)

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JP5267943B2 (ja) * 2009-03-30 2013-08-21 日本電気株式会社 ＰＣＩ−Ｅｘｐｒｅｓｓ通信システム、及びＰＣＩ−Ｅｘｐｒｅｓｓ通信方法
US9801773B2 (en) * 2009-11-12 2017-10-31 Tony Rocklin Hip traction device and methods
US9814648B2 (en) 2009-11-12 2017-11-14 Tony Rocklin Hip traction device, system, and methods
US8986228B2 (en) * 2011-09-19 2015-03-24 Trimanus Medical, Inc. Method and apparatus for monitoring surgical traction
US10206842B2 (en) 2012-01-26 2019-02-19 American Sterilizer Company Medical table with leg support
US9498397B2 (en) * 2012-04-16 2016-11-22 Allen Medical Systems, Inc. Dual column surgical support system
EP4389028A2 (fr) * 2014-01-03 2024-06-26 Innovative Orthopedic Technologies IOT AG Dispositifs de guidage et d'application de traction sur la jambe d'un patient pendant une intervention chirurgicale
WO2016197142A1 (fr) 2015-06-05 2016-12-08 The Regents Of The University Of Colorado, A Body Corporate Table chirurgicale et accessoires pour faciliter une arthroscopie de hanche
CN105478533A (zh) * 2016-01-28 2016-04-13 宁波信泰机械有限公司 一种汽车后门上饰条矫形机构
US11684532B2 (en) 2017-02-06 2023-06-27 Stryker Corp. Method and apparatus for supporting and stabilizing a patient during hip distraction
WO2018145096A1 (fr) 2017-02-06 2018-08-09 Stryker Corp. Système de préhension anatomique pour saisir la jambe et le pied d'un patient lors de la réalisation d'une distraction de la hanche et/ou lors de la réalisation d'un positionnement de jambe
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CN108195573B (zh) * 2017-12-25 2024-04-16 珠海安维特工程检测有限公司 一种拉力试验装置及方法
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US10729577B1 (en) 2019-09-11 2020-08-04 King Saud University Hip spica cast application device
US11564855B2 (en) 2020-09-28 2023-01-31 Stryker Corporation Systems and methods for supporting and stabilizing a patient during hip distraction
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Also Published As

Publication number Publication date
US20080214976A1 (en) 2008-09-04
AU2005303825A1 (en) 2006-05-18
EP1824437A1 (fr) 2007-08-29
DK1824437T3 (da) 2013-10-07
CA2587824A1 (fr) 2006-05-18
PL1824437T3 (pl) 2013-12-31
AU2005303825B2 (en) 2011-10-20
ES2429535T3 (es) 2013-11-15
US7762975B2 (en) 2010-07-27
CA2587824C (fr) 2012-04-17
DE102004054332A1 (de) 2006-05-11
WO2006051077A1 (fr) 2006-05-18

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