EP2633845A2 - Basin support device for holding at least one tension element, underlay, in particular operation table, with such a basin support device and method for distracting at least one bottom extremity - Google Patents

Abstract

The device has a support piece (13) that is formed such that force caused by tensile stress does not act at a location of a path of a nerve over an inner side of ischial protuberances (8) or a lower pubic bone (21) of pelvis of a person, where the tensile stress is initiated at a lower extremity i.e. thigh, and received over the support piece at the ischial protuberances of the pelvis. The support piece is configured such that centering of the pelvis takes place by the tensile stress in a direction transverse to the tensile stress. An independent claim is also included for a method for distracting a lower extremity.

Description

The invention relates to a Beckenabstützvorrichtung for receiving at least one tensile stress, as well as forces and torques acting on the pelvis and caused by the tension, a pad with a Beckenabstützvorrichtung for receiving at least a tensile stress and a method for distracting at least one lower Extremity due to at least one tensile stress.

Distraction of the lower extremities or pulling on lower extremities, such as a leg, is required for some surgical and diagnostic procedures, such as the treatment of fracture of one of the extremities, hip arthroscopy, or imaging. Tension brings parts of the lower limb, such as thighs, knees, lower legs and ankles, into the position required for surgery or examination. Further, by the tension, the joints connecting the parts of the lower extremity can be pulled apart to allow operation or examination of the joints. Instead of distraction, the terms traction and distention are also used.

FIG. 1 shows a pad 1, which can be used for a distraction of lower extremities 2 of a person 3. The person to be examined or treated 3 lies with the back or on the side on the base 1, wherein for the distraction on both lower extremities 2, a tensile or tensile force FZ is applied. The tensile stress FZ can be introduced at the fuselage parts of the legs, for example on the feet, the lower legs or the knees of the person 3. Between the lower extremities 2 of the person 3, a post 4 is generally provided at the fuselage end, which receives a counterpressure to the tensile stresses FZ via the pelvis of the person 3. The post 4 is in general running round and can have different diameters and a padding.

Due to the tensile stress, a counterpressure acts via the post 4 on the pelvis, generally in the region between the ischial tuberosities. This can cause pressure damage to the soft tissues in the region of the support by the post 4. These include, for example, the injury of external genitals, such as the man's penis and scrotum and the woman's labia majora and labia minora. In addition, nerves can be damaged, which manifest themselves by sensory disturbances in the anal region, the perineal region, the scrotum, the penis, or the labia and the clitoris. In addition, dysfunction of the anal sphincter and pelvic floor muscles may occur and important functions, such as continence and sexuality, may be impaired in the longer term, often 4 to 6 weeks, or permanently.

By the tensile stresses FZ also takes place a tilting of the pelvis, which stops only when the pubic symphysis of the pelvis over the lying between pubic symphysis and posts 4 soft parts, such as the above-listed outer genitalia, are so strongly pressed against the post 4, that a sufficiently large counterforce is formed, which prevents further tilting of the pelvis. Tilting of the pelvis may result in a hollow spine of the lower spine, resulting in unclear postoperative lumbar pain, disc injuries, pressure sores on the nerve roots, disc protrusion, or damage to the lumbar spine joint and bone structures. Furthermore, tilting the pelvis may cause additional damage from pressure on the soft tissues around the lower pubic symphysis.

By reducing the tensile stresses FZ, reducing the tensile duration and cushioning the post 4, it is attempted to minimize the complications described above, but this is only partially successful.

The object of the invention is therefore to provide a Beckenabstützvorrichtung, are avoided with the complications of a distraction of at least one lower limb.

The invention achieved this object by a pelvic support device for receiving at least one tensile stress, the tensile stress being introduced via at least one lower limb attached to a pelvis, the tensile stress being absorbed by at least one abutment part on at least one of the ischial tuberosities of the pelvis. By absorbing the tension over at least one of the ischial tuberosities of the pelvis, compressive damage to soft tissues is reduced. The resulting from the tension pressure is not initiated directly by the support member in the at least one ischial tuberosity, but on the skin and the intervening tissue. In contrast to the above-mentioned soft tissues, this tissue is significantly less sensitive to pressure, so that significant pressure damage is avoided. By means of the support part, a counterpressure to the tensile force can be built up through the skin, the tissue and the ischial tuberosities. Since the pelvic support device remains completely out of the person, no wounds and sutures are required, which can lead to complications such as infections. The pelvic support device is non-invasive. The term "pelvic support device" is also understood to mean a pelvic fixation device which is suitable for fixing the pelvis in such a way that the abovementioned surgical and diagnostic procedures can be performed on the pelvis.

In an advantageous embodiment, the tensile stress is absorbed only via the at least one ischial tuberosity. In this way, pressure damage to the soft tissues can be avoided.

In an advantageous embodiment, the support member is formed so that no force caused by the tension acts on an inner side of the ischial tuberosity or a lower pubic bone of the pelvis. In this way, nerves that run on the inner side are not affected.

In an advantageous embodiment, the support member is designed so that at least one centering of the pelvis takes place in at least one transverse direction to the tensile stress by the tensile stress. In this way, the requirements for other support devices with respect to the pelvic fixation can be minimized.

In an advantageous embodiment, the support member is formed so that the support member is not pressed by the tensile stress in a region between the two ischial tuberosities. Soft tissues located in or in front of the area between the ischial tuberosities are thus not affected by the back pressure caused by the tensile stress, so that no pressure damage occurs.

In an advantageous embodiment, the support part has a region which is convex in at least one direction, wherein the convex region extends at least from one ischial tuberosity to the other ischial tuberosity. Due to the convex design, centering of the pelvis in at least one transverse direction to the tensile stress can be achieved.

In an advantageous embodiment, the support part has at least one region which is concave in at least one direction, wherein at least one ischial tuberosity can be accommodated in the concave region. The concave design of the support member may serve to fix the pelvis, for example in at least one transverse direction to the tensile stress.

In an advantageous embodiment, the concave portion has the shape of a ischial tuberosity. Since the concave portion of the support member has the shape of the ischial tuberosity, its position can be more accurately fixed on the support member.

In an advantageous embodiment, the support part is designed so that it provides a fulcrum for the lower limb. In this way, it is possible to exert further forces on joints or bones of the lower limb, or to bring the lower limb in certain positions, which would otherwise be achieved only with a greater expenditure of force.

In an advantageous embodiment, the support part extends at least from at least one ischial tuberosity to the pubic symphysis of the pelvis. Soft parts that are located below the pubic symphysis are protected in this way by the support member in a slippage of the Beckenabstützvorrichtung.

In an advantageous embodiment, the support part in the region of the pubic symphysis on a recess. The recess serves to exempt soft parts, such as outer genitals, from the pressure of the opposing force.

In an advantageous embodiment, the support member is formed in two parts, each part supporting a Sitzbeinhöcker. The two-part embodiment allows better access to areas of the lower pelvis and offers more opportunities to fix the pelvis, as in a one-piece running support.

In an advantageous embodiment, a distance between the two support parts is adjustable, so that the distance between the two support parts can be adjusted to the distance between the ischial tuberosities. In this way, the two support parts can be made smaller, as well as a more individual adaptation to the pelvic geometry can be made.

In an advantageous embodiment, at least one further supporting device is provided, which can receive at least one torque arising from the tensile stress and / or a force resulting from the tensile stress. The further support device serves to prevent tilting of the pelvis and / or slippage of the pelvis on the support part. With a corresponding number of other support devices torques and / or forces acting in different directions on the pelvis can be recorded.

In an advantageous embodiment, the at least one further supporting device absorbs the torque and / or the force at least at one of the hip bone, iliac scoop, iliac crest, upper iliac spine, lower iliac spine, and sites located in areas to the left and right of the pelvis of the pelvis , The acting force and / or torque in this case does not act directly on the said bones, but is forwarded via the skin and the underlying tissue to the bone. The at least one further supporting device thus remains strictly outside the body. These pelvic areas are chosen so that there are no pressure-sensitive soft tissues between the skin and them. Thus, torques and forces can be introduced into the basin without being affected by the at least one further supporting device Pressure damage to soft tissue occurs.

By supporting in the region of the pubic symphysis, the further support device can be made more compact, since the distance to the ischial tuberosities is less than to the other mentioned points.

In an advantageous embodiment, the at least one further supporting device is connected directly to the supporting part. In this way, the forces and / or torques that occur during a distraction can be absorbed within these connected parts. The requirements on the mechanical properties of a substrate can thus be reduced because the forces and / or torques are not forwarded through the substrate. Thus, for example, the pad may be made of lighter non-magnetic material, such as plastic, aluminum, or composites, so that it is suitable for use in imaging techniques, such as magnetic resonance imaging (MRI) or computed tomography (CT). The pelvic support device may also consist of the same materials, so that it is also suitable for magnetic resonance tomography (MRT) or computed tomography (CT) or other imaging methods. At the same time the alignment and attachment of the support member and the at least one further support device on the base is simplified and can be made rotatable, without causing the relation of the support member and the at least one other support device is changed to each other.

In an advantageous embodiment, the tension is absorbed by only one ischial tuberosity.

In an advantageous embodiment, only a tensile stress (FZ) is introduced for distraction over only one lower extremity.

In an advantageous embodiment, at least one force sensor is provided with which at least one tensile stress can be measured. For example, the tension can be controlled via the force sensor; in particular, the acting forces can be monitored and overstretching of the joints can be avoided.

In an advantageous embodiment, at least one pressure measuring matrix is provided on at least one supporting surface of the supporting part and / or at least one further supporting device. The pressure measurement matrix can be used to determine the position of the ischial tuberosities, so that the support part can be optimally placed with respect to the ischial tuberosities. This also allows the acting forces to be monitored.

Furthermore, the invention provides for the use of the pelvic support device according to the invention for distracting at least one lower extremity.

Furthermore, the invention provides a pad with a Beckenabstützvorrichtung invention.

In an advantageous embodiment, the Beckenabstützvorrichtung is rotatably mounted on the substrate. The rotatability of the pelvic support device makes it possible to rotate the pelvis so that the lower extremities can be brought into the most appropriate positions for the treatment or examination.

Furthermore, the invention provides a method for distracting at least one lower limb by at least one tensile stress, in which a Beckenabstützvorrichtung invention is used to absorb the tensile stress.

In an advantageous embodiment, the person whose lower extremity is to be distracted lies on the abdomen or on the side. If the person lies on a support on his stomach or on the side, a part of the torques is introduced into the base, so that optionally one of the further support devices can be dispensed with or these other support devices can be designed for lower forces and torques.

Figur 1

eine bekannte Beckenabstützvorrichtung,

Figur 2

eine Ansicht eines Beckens von vorne,

Figur 3

eine Ansicht eines Beckens von der Seite,

Figur 4

eine Ansicht eines Beckens von unten,

Figuren 5 bis 7

Ausführungsbeispiele eines einteiligen Abstützteils,

Figuren 8 und 9

ein Ausführungsbeispiel eines zweiteiligen Abstützteils,

Figuren 10 bis 12

weitere Ausführungsbeispiele eines zweiteiligen Abstützteils,

Figur 13

ein Ausführungsbeispiel, bei dem die Abstützteile einen Hebelpunkt für die unteren Extremitäten bilden,

Figur 14

ein Ausführungsbeispiel eines zweiteiligen Abstützteils, bei dem die Abstützteile in mindestens einer Richtung kippbar und verstellbar sind,

Figur 15

ein Ausführungsbeispiel einer drehbaren Beckenabstützvorrichtung,

Figuren 16 bis 18

Ausführungsbeispiele für die Form von zweiteiligen Abstützteilen,

Figur 19

Kräfte und Drehmomente, die auf das Becken wirken,

Figuren 20 bis 23

Ausführungsbeispiele von weiteren Abstützvorrichtungen,

Figur 24

eine Unterlage mit Beckenabstützvorrichtung.

In the following the invention will be described by means of embodiments with the aid of the figures. Show it:

FIG. 1

a known Beckenabstützvorrichtung,

FIG. 2

a view of a basin from the front,

FIG. 3

a view of a basin from the side,

FIG. 4

a view of a basin from below,

FIGS. 5 to 7

Embodiments of a one-piece support member,

FIGS. 8 and 9

an embodiment of a two-part support member,

FIGS. 10 to 12

further embodiments of a two-part support member,

FIG. 13

an embodiment in which the support parts form a fulcrum for the lower extremities,

FIG. 14

An embodiment of a two-part support member, wherein the support members are tiltable and adjustable in at least one direction,

FIG. 15

an embodiment of a rotatable Beckenabstützvorrichtung,

FIGS. 16 to 18

Exemplary embodiments of the form of two-part support parts,

FIG. 19

Forces and torques acting on the pelvis,

FIGS. 20 to 23

Exemplary embodiments of further supporting devices,

FIG. 24

a pad with Beckenabstützvorrichtung.

• "vorne" (medizinisch: ventral) bezieht sich auf die Vorderseite des Körpers, an der sich zum Beispiel der Bauch befindet,
• "hinten" (medizinisch: dorsal) bezieht sich auf die Rückseite des Körpers, an die sich zum Beispiel der Rücken befindet,
• "links" und "rechts" bezieht sich auf die linke und rechte Seite des Körpers, aus dem Blickwinkel der beschriebenen Person, an denen zum Beispiel die Arme und die Beine den Rumpf verlassen,
• "oben" (medizinisch: kranial) bezieht sich auf das Ende des Körpers, an der sich zum Beispiel der Kopf befindet,
• "unten" (medizinisch: kaudal) bezieht sich auf das Ende des Körpers, an der sich zum Beispiel die Beine befinden,
• "innere" (medizinisch: proximal) bezieht sich auf Teile, die sich in Richtung zur Mitte des Körpers befinden, wie zum Beispiel das Herz, und
• "äußere" (medizinisch: distal) bezieht sich auf Teile, die sich in Richtung zum Äußeren des Körpers befinden, wie zum Beispiel die Haut.

The following terms are used for orientation on the body 1 of a living being:

• "front" (medically: ventral) refers to the front of the body where, for example, the abdomen is located
• "back" (medical: dorsal) refers to the back of the body to which, for example, the back is located
• "left" and "right" refers to the left and right sides of the body, from the point of view of the person described, for example, where the arms and legs leave the trunk,
• "top" (medical: cranial) refers to the end of the body where, for example, the head is located
• "bottom" (medical: caudal) refers to the end of the body where, for example, the legs are located
• "inner" (medical: proximal) refers to parts that are toward the center of the body, such as the heart, and
• "Outer" (medical: distal) refers to parts that are toward the exterior of the body, such as the skin.

FIG. 2 shows a view of a basin 5 from the front. The pelvis (pelvis) 5 consists of a left and a right hip bone (Os coxae) 6 and the sacrum with coccyx (coccyx) 11. The hip bones 6 are over the sacrum 11 and the upper pubic bone (Os pubis ramus superior) 20 and the lower pubic bone (inferior os pubis ramus) 21 via the pubic symphysis (syphysis pubica) 9. From the sacrum 11, the pubic nerve 10 leads, in part, along the inner side of the lower pubic bone 21, for example, to the external genitals, showing only the left side pubic nerve. Other nerves also not shown, for example, the anal region and the perineal region, also leave the sacrum 11. The lower pubic bone 21 is arcuate. Its lowest point is the ischial tubercle (tuber ischiadicum) 8.

FIG. 3 shows a view of a pelvis 5 from the side, wherein the right hip bone 6 was not shown, so that the course of the pubic nerve 10 can be better represented. The pubic nerve 10 leaves the sacrum 11 and runs on the inner side 18 of the ischial tuberosity 8 to below the pubic symphysis 9. The hip bone 6 has an iliac crest 7, an upper iliac spine 12 and a lower iliac spine Iliac spine (anterior inferior spine) 22.

FIG. 4 shows a view of a pelvis 5 from below, wherein the connection of the hip legs 6 on the pubic symphysis 9 and the sacrum 11 is shown. Also shown on the left side is the course of the pubic nerve 10 from the sacrum 11 to the pubic symphysis 9 along the lower pubic bone 21. The ischial tuberosities 8 are hatched. The positions of the lower iliac spine 22 are also shown.

In the prior art, the post 4 protrudes into the area between the two ischial tuberosities 8 and presses on soft tissues and / or nerves between the ischial tuberosities and pubic bones, the z. B. as the pubic nerve 10 on the inner Side of the lower pubis 21 run. The Beckenabstützvorrichtung invention avoids pressure damage, caused by the tensile force FZ opposing forces and torques at locations of the pelvis 5, where none of the above-mentioned pressure-sensitive soft tissues are and directly, that is, not on the above-mentioned pressure-sensitive soft parts, but on the skin and the underlying pressure-insensitive tissue on the bone of the pelvis 5 can be acted upon. These sites on the pelvis 5 are characterized, for example, by the fact that they are easy to palpate from the outside, since they lie directly under the skin and there are no sensitive soft parts between the skin and bony support points. Examples of such sites are the ischial tuberosity 8, the iliac crest 7, the upper iliac spine 12, the lower iliac spine 22 and the upper edge, as well as the anterior region of the pubic symphysis 9. The pelvic support device is designed in such a way that due to the tensile stresses FZ there is no force on the inner Pages 18 of the ischial tuberosity 8 or the lower pubic bone 21 acts and that caused by the tension torques not about soft tissue, the z. B. between the ischial tuberosities 8 or the lower pubic bone 21, is recorded.

FIG. 5 shows an embodiment of a one-piece support member 13 of the Beckenabstützvorrichtung, wherein from the basin 5 in FIG. 2 only the ischial tuberosities 8 are shown. Also, the tissue between the ischial tuberosities 8 and the support member 13 is not shown. FIG. 5 shows a plan view of the support member along in FIG. 24 shown Y direction while FIG. 19 along the in FIG. 24 shown X-direction shows how the pelvis 5, the support member 13 and the pad 1, for example, can be arranged to each other. To support the pelvis 5, a support member 13 is provided which has a flat support surface 14. The support surface extends at least from one ischial tuberosity 8 to the other ischial tuberosity 8. The support force FS caused by the tensile stresses FZ is directly absorbed via the ischial tuberosities 8. Since the ischial tuberosity 8 and the tissue between the ischial tuberosities 8 and the skin are anatomically suitable for receiving large pressure forces, this does not result in significant pressure damage. Since the support surface 14 is designed to be flat and extends from at least one ischial tuberosity to the other, it is impossible for the support part 13 to protrude into the space between the ischial tuberosities 8, so that damage to the nerves 10 by the Support FS is excluded.

FIG. 6 shows a further embodiment of a one-piece support member 13 of the Beckenabstützvorrichtung, wherein the FIG. 5 executed applies. In contrast to FIG. 5 is the support surface 14 of the support member 13 concave, which also excludes damage to the nerves 10 by the supporting force FS. The support surface 14 can be designed with different curvatures, for example, the curvature of the left and the right side of the support surface 14 from towards the center of the support surface 14 increase, so that a lateral fixation of the pelvis 5 takes place by a wedge effect. The bearing surface 14 may have a curvature in one direction, ie in the form of a groove, or in several directions, ie in the form of a shell. In particular, the support surface 14 may have a three-dimensional shape that corresponds to the contours of the two ischial tuberosity 8, so that in this way the pelvis 5 is fixed in several directions and the risk of slipping is reduced.

FIG. 7 shows a plan view along in FIG FIG. 24 shown Z-direction on the support surface 14 of an embodiment of a one-piece support member 13, as for example in connection with FIG. 5 or 6 have been described. Shown are of the pelvis 5, only the lower pubic bone 21, which are connected by the pubic symphysis 9 and the ischial tuberosity 8. The support surface of the ischial tuberosity 8 on the support surface 14 is shown hatched. The support member 13 is dimensioned in the length L1 and the width L2 so that pelvis 5 can be supported with different distances SA of the ischial tuberosity 8 and that even with a movement of the ischial tuberosity 8 on the support member 13 ensures that this is the support member 13th do not leave. The support member 13 has a recess 16 in the region of the pubic symphysis 9. The recess 16 is provided so that no pressure damage to the outer genitals caused by the support member 13 at a tilt of the pelvis 5 by the tensile stress FZ.

FIGS. 8 and 9 show an embodiment of a two-part support member 13, in which - to the two-part design of the support member 13 - to FIG. 5 said applies. In order to consider different distances SA of the ischial tuberosity 8, the support member 13 is made in two parts, wherein the distance between the two Supporting parts 13 is adjustable and lockable. FIG. 8 shows, for example, the smaller ischial tuberosity SA of a pelvis 5 of a male while FIG. 9 showing the greater ischial tuberosity distance SA of a woman's pelvis 5. Since the distance between the support members 13 is adjustable, the sum of these support surfaces 14 may be smaller than the support surface 14 of a one-piece design of the support member 13, whereby better handling of the support member 13 and a better access to the person 1 is ensured. Are the support members 13 formed in area small and their distance from each other is large enough, so can on a recess 16, as in FIG. 7 is shown to be omitted. The two-part support members 13 in the later described FIGS. 10 to 13 may be in their distances to each other, as related to FIGS. 8 and 9 be described, adjusted and locked.

FIG. 10 shows an embodiment of a two-part support member 13, the bearing surfaces 14 are concave. In contrast to FIG. 8 the two ischial tuberosities 8 are not shown, but in each case a ischial tuberosity 8 should be supported by a support part 13. The same applies to the embodiments in the FIGS. 11, 12 and 13 ,
By a concave shape of the bearing surfaces 14, it is possible to fix the ischial tuberosity 8 better, so that slippage of the pelvis 5 is avoided. The convexity can be present in one direction, ie in the form of a groove or in two directions, that is to say in the form of a shell. A particularly good fixation of the pelvis 5 is obtained when the support surfaces 14 have a shape that corresponds to the three-dimensional shape of the individual ischial tuberosity 8. However, care should be taken to ensure that the support members 13 do not protrude so far into the area between the ischial tuberosities 8 that they press on the nerves in this area, such as the pubic nerve 10.

FIG. 11 shows an embodiment of a two-part support member 13, the bearing surfaces 14 are convex. Due to the convex shape, the supporting force FS can be concentrated on the ischial tuberosities 8, wherein possibly a further supporting device 17 is required in order to prevent the ischial tuberos 8 from slipping off the support surfaces 14.

FIG. 12 shows an embodiment of a two-part support member 13 with enlarged side parts 15. By the side parts 15 is a lateral fixation of the pelvis, for example on the basis of the thighs, which are located on the left and right of the side parts 15, possible. In this way, a lateral slippage of the pelvis 5 on the support members 13 can be avoided. The transition from the bearing surfaces 14 to the side parts 15 is made round, so that injuries to the person 3 are avoided. The side parts 15 can also be used in the one-piece support parts 13.

FIG. 13 shows an embodiment in which the support members 13 are designed so that they form lever points 19 for the lower extremities 2. The support members 13 may have flat bearing surfaces 14, which also as in FIGS. 10 and 11 can be configured shown. Similar to in FIG. 12 For example, the support parts 13 have side parts 15 which are in contact with the lower extremities 2, but which, in contrast, are longer and run towards one another at their ends. Due to this design 15 lever points 19 are created on the side parts, which can be used to support the lower extremities 2, such as a thigh, in the vicinity of the joint in the pelvis 5. If a force is exerted on a point of the lower extremity 2, such as a thigh, which has a greater distance from the fulcrum 19 than the distance between the fulcrum 19 and the joint, a greater force can be exerted on the joint via the lever action can be as if no lever points 19 are present. In addition, the lever points can be used to align bone fragments. Characterized in that the ends of the side parts 15 to run towards each other, a sufficient freedom of movement of the lower extremities 2 is ensured. The transitions from the bearing surfaces 14 to the side parts 15 are as in FIG. 12 rounded to avoid injury. Instead of a two-part support member 13 and one-piece support members 13 can be used.

FIG. 14 shows an embodiment with two support members 13, in which the support members 13 are tiltably mounted. The axis of rotation can be parallel to the Y-direction of FIG. 24 respectively. The lines marked with A of FIG. 14 show the non-tilted state of the support members 13, the B and C marked lines the tilted state. The support members 13 can not only in the manner shown be tiltable, but also in a second or third direction. A three-dimensional tilt can be achieved for example by a ball joint. The tilting of the support members 13 can be locked. Due to the tilting of the support parts 13, the bearing surfaces 14 can be rotated so that they are normal, ie perpendicular, to the contact surface of the ischial tuberosities 8. In this way, only forces occur that are normal to the bearing surfaces 14. Transverse forces which lie in planes of the bearing surfaces 14 are then not present, so that slipping of the ischial tuberosities 8 on the bearing surfaces 14 is minimized. Instead of flat bearing surfaces 14, also in FIGS. 10 and 11 shown bearing surfaces 14 are used. Likewise, this embodiment can be compared with other embodiments, such as those in FIG. 8, 12 and 13 shown, combine.

Another application of the tiltable support members 13 in FIG. 14 is to use them to fix the pelvis 5. For this they are brought into a position indicated by the lines marked C. In position C, in addition to the contact surface of the ischial tuberosity 8 normal, that is vertical force also acts a lateral force on the ischial tuberosity 8. In this way, for example, a rotation or movement of the pelvis 5 to the left or right can be prevented. The support surfaces 14 may have a step or a bend, so that at least part of the support surfaces 14 is more perpendicular to the tensile stress FZ, as the part of the support surfaces 14, which applies the lateral force on the ischial tuberosity 8.

FIG. 15 shows an embodiment of a rotatable Beckenabstützvorrichtung which can be rotated about a pivot point Z. The axis of rotation can be parallel to the Y-direction of FIG. 24 respectively. The marked with A lines of the support members 13 show the non-rotated state, while marked with B lines of the support members 13 indicate the rotated state of the Beckenabstützvorrichtung. The rotation of the Beckenabstützvorrichtung can also take place about a second or third axis of rotation and are limited by stops. The rotation of the pelvic support device makes it possible to bring the person 3 into the optimal position for examination or treatment.

FIGS. 16 to 18 show exemplary embodiments of the shape of the bearing surfaces 14 of two-part support parts 13. The support members 13 are doing, as in FIG. 7 , from above, ie shown in the direction of the ischial tuberosity 8. FIG. 16 shows support members 13 with a support surface 14 which is just large enough to support the ischial tuberosity 8. FIG. 17 shows support parts 13, one opposite FIG. 16 have enlarged bearing surfaces 14. The longer side of the support surfaces 14 is selected so that it extends at least from the ischial tuberosity 8 to the pubic symphysis 9. In this way, the outer genitals are protected by the support members 13, if the ischial tuberosity 8 slip off the support surfaces 14. FIG. 18 corresponds to the in FIG. 17 shown embodiment, wherein an additional recess 16 is provided in the region of the pubic symphysis 8 for the outer genitals.

FIG. 19 shows the forces and torques acting on the pelvis 5 during a distraction. Shown is a person 3, who lies with his back on a pad 1. The pad 1 may for example be an operating table. It may also be suitable for use in a magnetic resonance or other imaging technique such as computed tomography. The tensile stress FZ acting on the lower extremity 2 is absorbed by the supporting part 13 as a supporting force (FS). The support member 13 may be configured as described above and may be connected to the pad 1. Therefore, the tensile stress FZ acts on the hip 5 and the support force FS acts on the ischial tuberosities 8. Since the tensile stress FZ and the supporting force FS do not act along the same line, but instead have the distance a, a torque D which acts on the pelvis 5 arises. In order to avoid a tilting of the pelvis 5, therefore, a counterforce FG must act on the pelvis 5, which applies a torque in the opposite direction to the pelvis 5, which neutralizes the torque D. It can therefore be a further supporting device 17, see FIG. 20 be provided, which provides the counter force FG.

FIG. 20 shows an embodiment of a further supporting device 17, wherein in FIG. 24 the directions X, Y and Z are given, to which reference will now be made. Shown is a pad 1 to which a further support device 17 is attached. The further supporting device 17 is fastened to one side of the base 1, which runs, for example, in the Z direction, for example by means of screws. It can also be plugged into a recess of the pad 1 for attachment. The further support device 17 has a support surface 23, with the help of which the counterforce FG is applied to the basin 5. The support surface 23, as well as the other surfaces that have contact with the body of the person, have a padding to prevent injury to the person. The vertical distance y, the horizontal distance x, as well as the distance in the Z direction of the further support device 17 with respect to the base 1 can be set arbitrarily. In particular, the further support device 17 can be positioned such that the counterforce FG acts on certain areas of the pelvis 5, such as the iliac crest 7, the areas immediately to the left and right of the pubic symphysis 9, the upper iliac spine 12 and the lower iliac spine 22. In FIG. 20 the further support device 17 is shown only on one side. The support surface 23 can be so wide that the counterforce FG acts on the areas listed in the last sentence on both the left and the right side of the pelvis 5. The further supporting device 17 can also be supplemented by an additional further supporting device 17 on the opposite side of the base, wherein each of the further supporting devices 17 introduces a part of the opposing force FG on said areas of the basin 5 on its side.

If the person 3 who is to be examined or operated lies on the base 1 with his abdomen, a counterclockwise torque acts on the pelvis 5. The anterior iliac crest 7 and the upper iliac spine 12 thereby press against the underlay 1, so that a tilting of the pelvis 5 is at least partially prevented. In this case, the further supporting device 17 consists at least of the base 1, which is suitable for example by a corresponding stiffness to absorb the torque. A similar situation arises when the person 3 lies on the side on the base 1.

Although the in FIG. 20 shown further support device 17 can apply only a counter force FG in the Y direction, it can also be designed so that it prevents rotation of the pelvis 5 along a rotation axis in the Y direction and / or the Z direction. In this way, it is possible that the tensile stress FZ can be applied to only one of the lower extremities 2. Compared to FIG. 1 , in which a tensile stress FZ acts on both extremities 2, the supporting force FS acting on the pelvis 5 and the counterforce FG during the distraction can thereby be halved. It is therefore likely that the pressure damage is also strong decline. For the same reason, the mechanical requirements of the pad 1 and the device which generates the tensile stress FZ, reduced. Another advantage of the one-sided distraction is that, unlike FIG. 1 , the healthy, not to be examined or treated lower extremity 2 is not subjected to tensile stress FZ, and whose joints in the foot, knee and pelvis are not distracted and are not exposed to concomitant damage. The additional pelvic fixation by the at least one further supporting device 17 also allows only one of the two ischial tuberosities 8 to be supported.

FIG. 21 shows a further embodiment of another supporting device 17, in which the basin 5 is fixed by means of a belt 17 on the base 1. The belt 17 extends, for example, from the left side of the pad 1 in the X direction over the upper iliac spine 12 to the right side of the pad 1. By the belt 17, a movement of the pelvis 5 in the Y direction and X direction, as well a rotation of the pelvis 5 along an axis of rotation in the X direction are restricted. If the belt 17 is made wide in the Z-direction or a second belt is inserted, which for example runs in the X-direction over the lower iliac spine 22, a rotation of the pelvis 5 along an axis of rotation in the Y-direction can be prevented.

FIG. 22 shows an embodiment of a further supporting device 17, which is connected to the support member 13. The supporting part 13 exerts a supporting force FS on the ischial tuberosities 8 via the skin and the pressure-insensitive tissue, while the further supporting device 17 exerts a counterforce FG on the upper iliac spines 12 via pressure-insensitive tissue. The counterforce FG can act on the iliac crest 7 or on the lower iliac spine 22 instead of on the upper iliac spines 12 via pressure-insensitive tissue. Another support device 17, which acts on pressure-insensitive tissue on any combination of upper iliac spine 12, iliac crest 7 and lower iliac spine 22, is possible. The torque D generated by the tensile stress FZ and the support force FS is thus absorbed directly in the combined Beckenabstützvorrichtung from support member 13 and further support device 17. The torque can be transmitted via the support member 13 to the pad 1, if this is secured to the pad 1, for example by being screwed to it. The torque can also be over other further support device, for. B. a belt FIG. 21 be forwarded to the pad 1, wherein the belt, for example, in the region of the upper iliac spine 12 via the further support device 17 extends. The support member 13 may also be mounted inclined to the pad 1 with respect to the surface of the pad 1 in the direction of the pelvis. In this way, a wedge effect that presses the pelvis 5 to the pad 1 and the pelvis 5 additionally fixed.

FIG. 23 shows an embodiment of another supporting device 17, which as in FIG. 22 , Also connected to the support member 13, so that to FIG. 22 executed also applies to this embodiment. In contrast to FIG. 22 is in FIG. 23 the opposing force FG is not introduced via the further supporting device 17 on the upper iliac spine 12, iliac crest 7 or on the lower iliac spine 22 but via pressure-insensitive tissue on the lower pubic bone 21 in the areas left and right of the pubic symphysis 9.

FIG. 24 shows a perspective arrangement of a base 1 with two-part support members 13 and other support devices 17. Next are in FIG. 24 the directions X, Y and Z are given.

The tensile stress FZ and the opposing forces to the resulting torque can be measured via one or more force sensors in the respective support members 13 and other support devices 17, so that the lower extremities 2 can be protected against excessive tensile stresses FZ. Furthermore, at least one pressure measuring matrix can be provided in the supporting parts 13 and further supporting devices 17, as a result of which it is possible to measure the forces acting thereon. Instead of a pressure measuring matrix, a pressure sensor can also be used. On the basis of the pressure distribution, which can be spatially determined by the pressure measurement matrix, not only conclusions can be drawn on the total force acting, but also, for example, on the location of the acting forces. For example, if the pressure measurement matrix shows a small area with high pressure, the probability is high that the support force FS will be introduced via the intervening pressure-insensitive tissue normally, that is perpendicular to the ischial tuberosities 8. If, on the other hand, a larger area is indicated with a lower pressure, then it is probable that the supporting force FS is still in the seatbone hump 8 surrounding soft tissues is initiated. The orientation of an asymmetric pressure distribution can give hints on the direction of the deviating from the normal acting forces. This makes it possible to set up the positioning of the respective support parts 13 and other support devices 17 so that soft tissue damage can be avoided.

The embodiments described above may be combined at will - as long as they do not contradict each other.

In addition to humans, the pelvic support device can also be used in other vertebrates, such as dogs, cats, cows, horses and elephants.

reference numeral

1 document 2 lower extremity 3 person 4 post 5 pool 6 hip bone 7 Iliac crest 8th Ischial tuberosity 9 pubic symphysis 10 pudendal nerve 11 sacrum 12 Upper iliac spine 13 supporting part 14 bearing surface 15 side panels 16 recess 17 further support device 18 inner side of the ischial tuberosity 19 fulcrum 20 upper pubis bone 21 lower pubis bone 22 lower iliac spine 23 supporting a Distance between the lines of action of tension and support force A, B, C Positions of the support parts D torque FG Drag on pelvis FS Supporting forceps on ischial tuberosity FZ tension L1, L2 Dimensions of the support SA Distance between the ischial tuberosity Z pivot point

Claims (17)

Pelvic support device, in particular a non-invasive pelvic support device, for receiving at least one tensile stress (FZ), the tensile stress (FZ) being introduced via at least one lower limb (2) attached to a pelvis (5),
full
at least one support part (13), the support part having at least one bearing surface (14), wherein the at least one bearing surface (14) for receiving the tensile stress (FZ) is arranged on at least one of the ischial tuberosities (8) of the pelvis (5), the tensile stress (FZ) is absorbed by the at least one ischial tuberosity (8). Pelvic support device according to claim 1,
characterized in that
the at least one support part (13) is planar and extends from one ischial tuberosity (8) to another ischial tuberosity (8). Pelvic support device according to claim 1 or 2,
characterized in that
the at least one support part (13) has a region which is convex in at least one direction, the convex region extending at least from one ischial tuberosity (8) to the other ischial tuberosity (8). Pelvic support device according to one of claims 1 to 3,
characterized in that
the at least one support part (13) has at least one region which is concave in at least one direction, wherein at least one ischial protuberance (8) can be received in the concave region and in particular the concave region has the shape of the ischial protuberance (8). Pelvic support device according to one of claims 1 to 4,
characterized in that
the at least one support part (13) is designed such that it has a fulcrum (19) for the at least one lower extremity (2). Pelvic support device according to one of claims 1 to 5,
characterized in that
the at least one support part (13) extends at least from at least one ischial tuberosity (8) to the pubic symphysis (9) of the pelvis (5). Pelvic support device according to one of claims 1 to 6,
characterized in that
the at least one support part (13) has a recess (16) in the area of the pubic symphysis (9). Pelvic support device according to one of claims 1 or 4 to 7,
comprising two support parts (13), each support part (13) supporting a ischial protuberance (8). Pelvic support device according to 9,
characterized in that
a distance between the two support members (13) is adjustable so that the distance between the two support members (13) can be adjusted to the distance (SA) between the ischial tuberosities (8). Beckenabstützvorrichtung according to any one of the preceding claims,
further comprising
at least one, in particular on the support part (13) fixed, further support device (17) which can receive at least one by the tension (FZ) resulting torque (D) and / or by the tension (FZ) resulting force. Pelvic support device according to claim 10,
characterized in that
the at least one further supporting device (17) comprises at least one support surface (23) attached to one of the hip bone (6), iliac scoop, iliac crest (7), upper iliac spine (12), lower iliac spine (22), and sites located in areas Left and to the right of the pubic symphysis (9) of the pelvis (5). Beckenabstützvorrichtung according to any one of the preceding claims,
further comprising
at least one force sensor which is arranged in the at least one support part (13) and, if present, in the at least one further support device (17). Beckenabstützvorrichtung according to any one of the preceding claims,
further comprising
at least one pressure measuring matrix, which is arranged on at least one support surface (14) of the support part (13) and / or at least one further support device (17). Pad (1), in particular operating table to which a Beckenabstützvorrichtung according to any one of the preceding claims, in particular rotatable, is attached. Underlay according to claim 14,
characterized in that
if present, the further supporting device (17) is fastened to the base (1). Method for distracting at least one lower extremity (2) by at least one tensile stress (FZ),
characterized in that
for receiving the tensile stress (FZ) a Beckenabstützvorrichtung according to one of claims 1 to 13 or a pad (1) according to claim 14 or 15 is used. Method according to claim 16,
characterized in that
the person whose lower extremity (2) is to be distracted lies on his stomach or on his side.

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