EP2873404B1 - Orthopädische Vorrichtung für gegenseitige Bewegungen des Bein- und Hüftbereichs - Google Patents

Orthopädische Vorrichtung für gegenseitige Bewegungen des Bein- und Hüftbereichs Download PDF

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Publication number
EP2873404B1
EP2873404B1 EP14193867.0A EP14193867A EP2873404B1 EP 2873404 B1 EP2873404 B1 EP 2873404B1 EP 14193867 A EP14193867 A EP 14193867A EP 2873404 B1 EP2873404 B1 EP 2873404B1
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EP
European Patent Office
Prior art keywords
support rail
backing plate
gas springs
leg
universal joint
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EP14193867.0A
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English (en)
French (fr)
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EP2873404A1 (de
Inventor
Ari Nurminen
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Merivaara Oy
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Merivaara Oy
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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
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/0036—Orthopaedic operating tables
    • A61G13/0081—Orthopaedic operating tables specially adapted for hip surgeries

Definitions

  • the invention relates to an orthopedic apparatus intended for moving a leg and a hip area relative to each other.
  • the invention relates also to a method for moving a leg and a hip area relative to each other with an orthopedic apparatus.
  • the prior art discloses orthopedic equipment intended for moving a leg and a hip area relative to each other, wherein the hip area is supported with a backing plate under which is coupled a first end of an elongated support rail adapted to carry a leg propping portion, and said support rail having its free end provided with a handle for an adjustment element intended for restricting motions of the support rail, and the leg propping portion being connectable to the support rail in a slidable manner.
  • the support rail linked to the backing plate has its horizontal and vertical trajectories controlled by means of two ball joints with a lockable relative position.
  • Document CA2862302 discloses an orthopaedic apparatus including all the technical features of the preamble of claim 1.
  • the invention relates to an orthopedic apparatus as defined by claim 1.
  • the invention relates also to a method of moving a leg and a hip area relative to each other as defined by claim 8.
  • a further benefit gained by the use of a gas spring in clamping the motions of a support rail connected to the support rail's universal joint is that the support rail's raising motions are lightened by the gas springs.
  • the clamping mechanism's lever arm system comprises a tension rod or the like, which extends inside the support rail, is attached to the handle, and which is adapted to act by way of elongated coupling elements on an end of the piston of each gas spring in such a way that a position of the piston of said gas springs in the respective cylinder is releasable and lockable simultaneously.
  • the coupling elements have a first end thereof connected to the tension rod and have a free end thereof provided with a horizontally pivotable claw.
  • the protrusions are adapted to rotate along with the center shaft.
  • the lever arm system's coupling elements are coupled, in the proximity of a claw present at the free end thereof, in a horizontally pivotable manner, to an upright pin attached respectively onto the center shaft which extends inside the protrusion.
  • Each claw, along with the coupling element acting on an end of the gas spring is located on a gas spring fastener.
  • Restriction of the support rail's horizontal motions is implemented in such a way that the horizontal motions are restricted by a feature limiting the rotation of a rotating shaft extending through an upper joint member of the universal joint, such as a groove present on a surface of the upper joint member, which is matched by a counterpart of the groove located in a joint member opening present in the backing plate or in a joint member opening present in the brackets thereunder.
  • adapted to restrict the support rail's vertical motions is preferably a mutual form-locking engagement of the lower joint member and the upper joint member, which prevents the rotation of these joint members relative to an articulated shaft of the universal joint.
  • the support rail's horizontal motions are adapted to be restricted by a feature limiting the rotation of a rotating shaft P1 extending through an upper joint member of the universal joint, such as a groove present on a surface of the upper joint member, which is matched by a counterpart present on the backing plate or on its brackets, and the support rail's vertical motions are adapted to be restricted by a mutual form-locking engagement of the lower joint member and the upper joint member.
  • the support rail's horizontal or vertical motion is in this context perceived as the support rail's horizontal or vertical pivoting motion around an attachment point, which is located at a junction of the support rail's end coupled to the lower joint member and the lower universal joint.
  • the apparatus 1 best visible from the overall figures 1A and 1B is intended for moving a leg and a hip area relative to each other, and it comprises a backing plate 2 which is intended for supporting the hip area and under which is coupled a first end 3b of an elongated support rail 3 adapted to carry a leg propping portion 8.
  • the support rail 3 has its second, free end 3a provided with a handle 6 for an adjustment mechanism intended for clamping the motions of the support rail, whereby the leg propping portion 8 is connectable onto the support rail 3 in a slidable manner.
  • the aforementioned components of the apparatus can also be found in most of the prior art publications, which is why conventional modifications of the discussed components are regarded as being included in the scope of protection for an apparatus of the invention.
  • the apparatus 1 includes also a first adjustment mechanism, comprising a pair of gas springs 4 which is located between the support rail's first end 3b and brackets 20 attached under the backing plate 2.
  • the first adjustment mechanism is used for counterbalancing motions of the support rail 3 as well as for controlling the clamping of the support rail's trajectories by means of a clamping mechanism 300 partially visible in fig. 1B .
  • the apparatus includes a second adjustment mechanism, which is provided with a universal joint 5 and which defines the extent of horizontal and vertical motion paths for the support rail 3, possibly together with the first adjustment mechanism, and which connects the first end 3b of the support rail 3 under the backing plate 2 or to (gas spring) brackets 20 attached to an underside of the backing plate 2.
  • Fig. 1A also visualizes per se conventional cushions 91, 92 for the backing plate.
  • Figs. 2A and 2B illustrate more precisely a construction of the aforementioned universal joint 5.
  • the universal joint 5 has an upper joint member 51, which is coupled by its top end to the backing plate 2 or to brackets 20 attached to and extending downward from the backing plate 2. By its bottom end, the upper joint member 51 is in turn coupled by way of an articulated shaft 53 to a lower joint member 52, which is L-shaped in its overall configuration and which is in turn coupled by its bottom end fixedly to the support rail's first end 3; 3b.
  • the universal joint has its upper joint member 51 and lower joint member 52 disposed relative to the articulated shaft in a manner to enable rotation of the upper joint member 51 around the universal joint's longitudinal axis P1 in horizontal sense and rotation of the lower joint member 52 in vertical sense around the articulated shaft 53 which functions as a fulcrum.
  • the universal joint 5 by which are enabled vertical and horizontal motions of the support rail 3 fixedly linked with the lower joint member 52; the vertical pivoting motion occurs around a horizontal axis P2 extending through the articulated shaft 53 and the vertical rotating motion occurs around the vertical axis P1 extending through the universal joint 5. Restriction of the horizontal and vertical motions of the support rail 3 occurs respectively by limiting the horizontal pivoting of the upper member 51 of the universal joint 5 around the longitudinal axis P1 and the vertical rotation of the lower member 52 relative to the articulated shaft 53.
  • the horizontal and vertical motions of the support rail 3 refer respectively to the support rail's motions relative to a horizontal direction defined by the plane of the horizontal backing plate 2 and a vertical direction transverse to this horizontal direction.
  • the support rail 3 is generally placed in a horizontal direction or in a direction deviating slightly therefrom.
  • the first adjustment mechanism includes a pair of gas springs 4, which is located between a first end 3b of the support rail and brackets 20 attached under the backing plate 2. More specifically, the discussed pair of gas springs 4 extends by way of gas spring fasteners 38 from the backing plate's brackets 20 to a horizontal rotating shaft 39, or a center shaft 39, extending through a universal joint. Both protrusions 35 and the center shaft 39 (a body of rotation) are provided with concentric openings 35a, 39d at a location by which the gas spring is brought inside the protrusion 35 and to edge grooves present at the ends of the center shaft 39.
  • Clamping of the gas springs is adjusted with a clamping mechanism 300, comprising a handle 6 which is present at a free end 3a of the support rail 3 and which is adapted to employ a lever arm system 30 for acting upon ends 41c, 42c of the gas spring's piston rods 41a, 42a in such a way that a position of the gas spring's piston rod 41a, 42a with respect to a respective cylinder 41b, 42b is capable of being clamped and released.
  • a clamping mechanism 300 comprising a handle 6 which is present at a free end 3a of the support rail 3 and which is adapted to employ a lever arm system 30 for acting upon ends 41c, 42c of the gas spring's piston rods 41a, 42a in such a way that a position of the gas spring's piston rod 41a, 42a with respect to a respective cylinder 41b, 42b is capable of being clamped and released.
  • the pivoting motion of the gas springs 4 connected in a releasable manner to the end grooves 34 of the center shaft 39, and at the same time the pivoting motion of the support rail 3 relative to the gas springs 4, is adapted to be restricted on the one hand by limiting surfaces 34a of the end groove 34 of the center shaft 39 as well as an inner edge 34b of the groove and, on the other hand, by an outer edge 34c of the groove 34.
  • the edges of the opening 35a, 39a may also function for their part as limiters for pivoting motions of the gas springs 4.
  • a pivoting angle of the support rail 3 with respect to the gas springs is adapted to be restricted also by the gas springs' fasteners 38, which connect to the end grooves 34 present at the ends of the center shaft 39.
  • the gas springs 4; 41, 42 have the ends 41c, 42c of their piston rods connected to these gas springs' fasteners 38 in a way to enable a release of the engagement between the gas spring's piston and cylinder. Even though the engagement between cylinders and piston rods is uncoupled, the relative rotating motion between the gas springs 4 and the center shaft 39 in a plane extending through the gas springs is nevertheless prevented by engagements between the ends 41c, 42c of the piston rods 41a, 42a and the gas springs' fasteners 38.
  • the fasteners 38 which connect to the end grooves 34, function also as motion limiters 38 restricting a rotating motion of the shaft 39 around its longitudinal axis.
  • a tension rod 31 which is included in a lever arm system 30 of the clamping mechanism 300 and which extends all the way to a free end 3a of the support rail 3.
  • a trigger 62 intended for the handle 6 and present at the free end of the support rail 3.
  • the trigger 62 acts on the tension rod 31 of the lever arm system 30 in a way that enables the cylinder and the piston of gas springs 4 to be clamped relative to each other.
  • the tension rod 31 of the lever arm system 30 extends to a hollow center shaft 39 connected perpendicularly with a junction of an end 3b of the support rail 3 and a lower member 52 of the universal joint 5 at the end of the support rail 3 proximal to the backing plate 2.
  • a rotation axis i.e. a center shaft 39, which is horizontal in a transverse direction, i.e. co-directional with the backing plate 2.
  • the center shaft 39 has its ends, which protrude from the support rail 3, surrounded by hollow protrusions 35.
  • the center shaft 39 comprises a stub axle through which extends a center opening, such as a center bore.
  • the center bore expands to form an end groove 34, which is limited in a lengthwise direction of the center shaft 39 by a first guide or limiting surface 34a which passes diagonally relative to a transverse direction of the center shaft (stub axle) 39, as well as by an inner edge 34b of the groove 34 proximal to the center bore.
  • a second limit surface lengthwise of the groove 34 of the center shaft 39 is made up by an outer edge 34c of the groove 34.
  • Connection with the tension rod 31 is effected from an engagement point of the support rail and the center shaft by means of an articulated joint 33, such as a stud nut 33.
  • the outer ends of the coupling elements 32, which are free as far as the center shaft 39 is concerned, are designed as claws 32'a and 32"a which extend to the fasteners 38 of the gas springs 4 disposed in the end grooves 34 of the center shaft 39.
  • the lever arm system has its coupling elements 32; 32' and 32; 32" connected to an upright pin 36, such as a cotter pin 36, extending through the stub axle in a horizontally pivotable manner in the proximity of the claw 32'a or 32"a present at the free end thereof.
  • the center shaft has its end grooves 34 provided with the gas springs' fasteners 38, which are set in a horizontally pivotable manner in the end grooves 34 present at both ends of the center shaft 39. Seen from lateral sides 3c, 3d of the support rail 3, the end grooves 34 lie at an approximately right angle in the ends of the center shaft. Inside each of these is disposed the claw 32'a, 32a" of an elongated coupling element 32' or 32"of the lever arm system 30 so as to attach themselves, in a manner pivotable in a transverse direction or towards the gas springs, to attachment pins 38a present at an upper end of the gas springs' fasteners 38.
  • the gas springs fasteners 38 have also engaged thereon the gas springs' piston ends 41c, 42c, such that a functional communication between the lever arm system 30 and the gas springs 4 is openable and closable by means of ball-shaped coupling elements 44 which travel at the gas springs' ends 41c, 42c.
  • the shaft will be connected thereby at the same time functionally to the gas spring 4, whereby the gas springs 4 can be pivoted relative to the shaft 39 in a horizontal direction within a range defined by the motion limiters 34a, 34b as well as 34c present in the end grooves. Since the shaft 39 can be additionally pivoted from the tension rod 3 around its longitudinal axis and laterally in the direction of the backing plate, the gas spring has an effect also on these trajectories of the shaft 39 and the tension rod 3 coupled to the shaft.
  • each claw 32's and 32"a in contact with the piston rod end 41c or 42c of the gas spring 4 by pulling the tension rod 31 by means of the trigger 62 of the handle 6 towards the free end 3a of the support rail 3.
  • the lever arm system 30 is operated from the handle's trigger in such a way that the tension rod 31 travels towards the free end of the support rail 3, the inner ends 32b', 32b" of the coupling elements 32 will also be pulled by the tension rod 31 through the intermediary of the articulated joint 33 towards the support rail's free end 3a.
  • the coupling elements 44 and the claws 32'a and 32"a move away from the fasteners 38, which releases the clamping engagement between the piston and the cylinder 41b, 42b of the gas springs 41, 42 and allows the gas springs 4 to turn along with motions of the shaft 39 and at the same time those of the support rail 3.
  • the gas springs' free ends 41c, 42c are in attachment with the gas springs' fasteners 38 in a pivotable manner.
  • the clamping of the free ends 41c, 42c of the gas springs 41, 42 on the fasteners 38 as the claws 32'a, 32"a become coupled again to the gas springs' fasteners away from the gas springs causes also the clamping of the support rail 3 with respect to the gas springs 4 because the tension rod 31, extending inside the support rail 3, is coupled by way of the claws to the fasteners 38, thereby preventing a relative rotation between the center shaft 39 and the tension rod around a longitudinal axis of the center shaft.
  • the clamping engagement is promoted by the fact that the claws 32'a, 32"a and the gas springs' coupling elements 44 have a substantially equal radius of curvature.
  • the gas springs 41, 42 which are capable of being brought to the gas springs' fasteners 38 for a clamping engagement, have the ends 41c, 42c of their piston rods 41, 42 mounted, in horizontal and vertical directions, i.e. both in a plane extending through the gas springs and in a direction transverse to the plane of the gas springs, pivotably on the gas spring's fastener 38 remaining inside the end protrusion 34 of the center shaft 39.
  • the gas springs' fastener 38 is coupled to the center shaft 39, which is able to rotate relative to the tension rod 3 within a range allowed by the opening 35a, 39a, thus enabling on its part the vertical motions of the tension rod 3 as the gas springs rotate along with the center shaft. Consequently, the pivoting of the support rail 3 relative to the end of the gas springs 41, 42 brings about a change in a distance between the ends 41c, 42c of the gas springs 41, 42 mounted on the center shaft 39 and the part mounted on the backing plate's brackets 20, resulting in a respective change in the length of the gas springs 41, 42.
  • pivoting the support rail 3 in a vertical direction around the articulated shaft 53 brings about a shortening or lengthening of each gas spring 41, 42 simultaneously. It is the lengthening of each gas spring 41, 42 which counterbalances an upward pivoting motion of the support rail 3.
  • pivoting the lower joint member 52, fixedly connected to the end of the support rail 3, in a vertical direction around a horizontal axis P2 of the universal joint 5 located on the articulated shaft 53 brings about pivoting of the support rail 3 relative to the center shaft 39 which is horizontal or co-direction with the backing plate and extends through the universal joint's lower member 52.
  • Fig. 3A depicts a condition in which the claws 32'a and 32"a, present on the gas springs' fasteners 38, have been brought into contact with the ball-shaped coupling elements 44 acting upon the free piston ends 41c, 42c of the gas springs 41, 42. At this point, the ends 41c, 42c of the gas springs' piston rod 41a, 42a continue to be coupled to the gas springs' fasteners 38, 38, but the position between the piston rod 41a, 42a and the lever arm system 30 is no longer clamped.
  • the piston rods 41a, 42a can be pivoted relative to the fasteners 38 in a plane extending by way of the gas springs 4; 41, 42, whereby the angle of a lengthwise direction of the shaft 39 relative to a lengthwise direction of the gas springs 4 will be pivoted at the same time in said plane extending by way of the gas springs 4.
  • the angle between a lengthwise direction of the shaft 39 and a lengthwise direction of the gas springs can be pivoted within a range defined by the limiting surfaces 34a, 32b as well as 34c of the groove 34.
  • the angle between a lengthwise direction of the shaft 39 and a lengthwise direction of the gas springs can be pivoted within a range defined by the limiting surfaces 34a, 32b of the groove 34 as well as by a surface of the protrusion 35 present on top of the groove.
  • the support rail 3 is connected to the universal joint 5 in such a way that the shaft 39 extends through the lower joint member 52 of the universal joint and through the support rail and always in a transverse direction relative to the support rail 3, the angle between a lengthwise direction of the shaft 39 and a lengthwise direction of the gas springs defines also an angle between the support rail 3 and the gas springs 4, i.e. the extent by which the support rail 3 can be pivoted with respect to the lengthwise direction of the gas springs 4 in a plane extending by way of the gas springs 4.
  • the support rail 3 can be additionally pivoted to the extent defined by the universal joint 5 in horizontal and vertical directions when the horizontal direction is perceived as a plane extending by way of the backing level 2.
  • the extent of motions of the support rail 3 in horizontal and vertical directions (as the direction of the backing plate 2 is regarded as a horizontal direction) can be adjusted primarily by means of the universal joint 5 coupled between the end 3b of the support rail 3 and the backing plate 2.
  • the protrusions 35 are adapted to rotate along with the center shaft 39 and the restriction of horizontal motions of the support rail 3 is mainly implemented in such a way that the horizontal motions are restricted by a feature, such as a groove on a surface of the upper joint member 51, which limits rotation of the rotating shaft P1 extending through the upper joint member 51 and which is matched by a counterpart of the groove located in a joint member opening in the backing plate or in a joint member opening in the brackets 20 thereunder.
  • a feature such as a groove on a surface of the upper joint member 51
  • the universal joint 5 has its upper joint member 51 mounted in a horizontally rotatable manner on the backing plate 2 or on the brackets 20 attached thereto so as to enable horizontal pivoting motions of the support rail 3 around a longitudinal axis P1 of the universal joint.
  • the underlying or lower joint member 52 is in turn coupled by way of the articulated shaft 53 to the overlying or upper joint member 51 so as to enable vertical pivoting motions of the support rail 3 around the articulated shaft 53.
  • the patient places first his/her foot on the leg propping portion 8.
  • the patient's hip area, and particularly the hip joint is supported on the backing plate 2 in such a way that a vertical plane extending by way of the hip joint comes across the plane of the backing plate 2 at a location other than the universal joint's longitudinal axis P1.
  • the eccentric shape of the handle Upon pressing down the carriage's handle 88, the eccentric shape of the handle applies pressure by way of a washer 86 to a locking block 84 with four cylindrically shaped protrusions chamfered at their ends to an angle of about 45 degrees. These beveled surfaces apply a wedging pressure on two topmost corners of a tension rod present inside the traction device, thereby pushing a bottom surface of the tension rod against a slide block 82 present inside the traction device.
  • the slide block 82 has a higher friction than other sliding surfaces and the locking works more effectively.
  • the three-point locking eliminates a clearance from the carriage 7 with respect to the tension rod.
  • the handle 88 has an eccentrically bored hole for a stud nut 8 present inside the handle.
  • the locking block 84 rises upward by the force of a spring thereunder, the slide block 82 thereby coming out of its contact with the support rail, thus enabling the carriage 7 to be slid along the support rail 3.
  • the support rail 3 can now be pivoted in horizontal and vertical directions of the backing plate 2 around its vertical and horizontal axes P1, P2 located on the universal joint within a range allowed by both the universal joint 5 and the engagement of the gas springs 4 and the shaft 39.
  • the leg supported by means of the propping portion 8 will change its position with respect to the hip joint supported on the backing plate 2.
  • the gas springs 4 are clamped by operating the lever arm system 30 of the clamping mechanism 300 with the trigger 62 of the handle 6 so as to bring about pivoting of the claws 32'a and 32"a, present at the end of the elongated coupling elements 32; 32', 32' attached to the tension rod 31 extending inside the support rail 3, in a plane defined by the gas springs out of the contact with the coupling element 44 acting on the end 41c, 42c of the piston rod 41a, 42a of each gas spring 41, 42.
  • This is followed by clamping the relative position of the backing plate 2 and the carriage 7 of the leg propping portion 8 and the area of a hip joint lying on the backing plate can be treated for example by imaging.
  • the protrusions 35 are mounted fixedly on the support rail 3 and vertical motions of the support rail 3 are adapted to be restricted not only by the universal joint 5 but also by motion limiters restricting a rotational motion of the center shaft 39, such as by journals extending through the center shaft 39 and the lever arm system's coupling elements 32', 32", which are possible to bring into contact with the protrusions 35 mounted fixed on the support rail 4.
  • motion limiters can be attachment studs 38a of the gas spring's fastener, which are brought into contact with grooves present on internal surfaces of the protrusions 35, which preclude rotation of the center shaft 39.

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  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Invalid Beds And Related Equipment (AREA)
  • Prostheses (AREA)
  • Pivots And Pivotal Connections (AREA)

Claims (14)

  1. Orthopädische Vorrichtung (1), die dazu bestimmt ist, einen Bein- und einen Hüftbereich relativ zueinander zu bewegen, umfassend eine Stützplatte (2), die zum Stützen des Hüftbereichs bestimmt ist und unter der ein erstes Ende (3b) einer langgestreckten Stützschiene (3) gekoppelt ist, die angepasst ist, um einen Beinstützabschnitt (8) zu tragen, und wobei die Stützschiene (3) an ihrem zweiten, freien Ende (3a) mit einem einzelnen Griff (6) für einen Einstellmechanismus, der zum Klemmen und Lösen von Bewegungen der Stützschiene bestimmt ist, und einem montierbaren Beinstützabschnitt (8) versehen ist auf der Stützschiene (3) verschiebbar, und die Vorrichtung (1) einen ersten Einstellmechanismus und einen zweiten Einstellmechanismus umfasst, der mit einem Universalgelenk (5) und dem zweiten Einstellmechanismus (5) versehen ist,
    zusammen mit dem ersten Einstellmechanismus horizontale und vertikale Bewegungsbahnen für die Stützschiene (3) in Bezug auf die Stützplatte (2) definiert, dadurch gekennzeichnet, dass der erste Einstellmechanismus ein Paar Gasfedern (4) umfasst, die zwischen dem ersten Ende (3b) der Stützschiene und Klammern (20), die an der Stützplatte (2) befestigt sind, unter der Stützplatte angeordnet sind, wobei jede Gasfeder (41, 42) ihre Kolbenstangenenden (41c, 42c) aufweist, die sich zu einer Mittelwelle (39) erstrecken, die gleichgerichtet mit einer Ebene der Stützplatte (2) ist, und die sich drehbar durch das untere Gelenkelement (52) des Universalgelenks erstreckt, und die zweiten Enden sich zu Halterungen (20) unter der Stützplatte bis zu einem Abstand von Befestigungspunkten der Kolbenstangenenden (41c, 42c) der Gasfeder (41, 42) an der Mittelwelle (39) erstrecken, und der erste Einstellmechanismus zum Einstellen der Klemmung von Bewegungsbahnen der Stützschiene (3) und der zum Verschwenken der Stützschiene erforderlichen Kraft dient,
    wobei das Paar Gasfedern (4)
    - ihre Kolbenstangenenden (41c, 42c) aufweisen, die lösbar mit dem Befestigungselement (38) der Gasfeder gekoppelt werden können, das auf der Mittelwelle (39) montiert ist, und die zweiten Enden des Paars Gasfedern mit den Klammern (20) gekoppelt sind, die unter der Stützplatte (2) angebracht sind, so dass die Gasfedern (41, 42) im Wesentlichen richtungsgleich mit der Stützplatte (2) sowie zumindest im Ruhezustand der Vorrichtung auch im Wesentlichen richtungsgleich mit der Stützschiene (3) sind,
    - jede seiner Gasfedern (41, 42) aufweisen, die zur Beaufschlagung durch einen Klemmmechanismus (300) des ersten Einstellmechanismus eingerichtet ist, wodurch die die Position der Kolbenstange (41a, 42a) der Gasfeder (41, 42) gegenüber einem Zylinder (41b, 42b) der jeweiligen Gasfeder lösbar und klemmbar ist, und der Klemmmechanismus (300) den einzelnen Handgriff (6) umfasst, der an einem freien Ende (3a) der Stützschiene (3) vorhanden ist und über ein Hebelarmsystem (30) auf das Kolbenstangenende (41c, 42c) der Gasfeder einwirken kann, so dass die Position der Kolbenstange (41a, 42a) der Gasfeder in Bezug auf den jeweiligen Zylinder (41b, 42b) und das Hebelarmsystem (30) lösbar und klemmbar ist, der zweite Einstellmechanismus (5) das erste Ende (3b) der Stützschiene (3) schwenkbar unter der Stützplatte oder mit den unter der Stützplatte angebrachten Halterungen (20) koppelt.
  2. Vorrichtung (1) nach Anspruch 1, dadurch gekennzeichnet, dass das Hebelarmsystem (30) des Klemmmechanismus eine Zugstange (31) umfasst, die sich innerhalb der Stützschiene erstreckt, die Zugstange (31) am Griff befestigt ist, und die geeignet ist, mittels länglicher Kopplungselemente auf ein Ende des Kolbens jeder Gasfeder so einzuwirken, dass eine Position des Kolbens der Gasfedern in dem jeweiligen Zylinder gleichzeitig lösbar und arretierbar ist.
  3. Vorrichtung (1) nach Anspruch 1, dadurch gekennzeichnet, dass das Hebelarmsystem (30) des Klemmmechanismus (300) eine Zugstange (31) oder dergleichen umfasst, die sich innerhalb der Stützschiene (3) erstreckt, an dem Handgriff (6) befestigt ist und die über freie Enden (32'a, 32"a) von länglichen Kopplungselementen (32; 32', 32") angepasst ist, die mit der Mittelwelle (39) gekoppelt sind, die sich drehbar durch das Gelenkunterteil (52) des Universalgelenks (5) erstreckt, um auf das Ende (41c, 42c) der Kolbenstange (41a, 42a) jeder Gasfeder (41, 42) derart einzuwirken, dass die Positionen der Kolbenstange (41a, 42a) der Gasfedern in Bezug auf die jeweiligen Zylinder (41b, 42b) gleichzeitig gelöst und geklemmt werden können.
  4. Vorrichtung (1) nach Anspruch 1, dadurch gekennzeichnet, dass das Universalgelenk (5) des zweiten Einstellmechanismus ein oberes Gelenkelement (51) umfasst, das mit ihrem oberen Ende mit der Stützplatte (2) oder den daran befestigten Bügeln (20) und mit ihrem unteren Ende über eine Gelenkwelle (53) mit einem unteren Gelenkelement (52) gekoppelt ist, das ihrerseits mit ihrem unteren Ende mit dem ersten Ende (3; 3b) der Stützschiene koppelt.
  5. Vorrichtung (1) nach Anspruch 1, dadurch gekennzeichnet, dass das Gelenkoberteil (5; 51) des Universalgelenks an der Stützplatte (2) oder den daran befestigten Konsolen (20) angebracht ist, um zusammen mit dem ersten Einstellmechanismus horizontale Schwenkbewegungen der Stützschiene um die Längsachse (P1) des Universalgelenks in einem bestimmten Winkel zu ermöglichen, z.B. ein Winkel von ±45 Grad, wahrgenommen von einem 0-Niveau der horizontalen Bewegung, und dass das untere Gelenkelement (52) über die Gelenkwelle (53) mit dem oberen Gelenkelement (51) gekoppelt ist, um zusammen mit dem ersten Einstellmechanismus vertikale Schwenkbewegungen der Stützschiene (3) um die Gelenkwelle (53) über einen bestimmten Bereich von Schwenkwinkeln zu ermöglichen, z.B. bei einem Schwenkwinkel von ±75 Grad, wie von einem 0-Niveau der vertikalen Schwenkbewegung wahrgenommen.
  6. Vorrichtung (1) nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, dass der Beinstützabschnitt (8) mit der Stützschiene (3) über einen Schlitten (7) verbunden ist, der entlang der Stützschiene verschiebbar ist.
  7. Vorrichtung (1) nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, dass horizontale Bewegungen der Stützschiene (3) angepasst sind, um durch ein Merkmal wie eine Nut auf einer Oberfläche des oberen Verbindungselements (51) beschränkt zu werden, das die Drehung einer Drehwelle (P1) begrenzt, die sich über das obere Gelenkelement (51) des Universalgelenks (5) erstreckt, und die mit einem Gegenstück auf der Stützplatte (2) oder auf deren Halterungen (20) korrespondiert, und vertikale Schwenkbewegungen der Stützschiene (3) um das untere Gelenkelement (52) des Universalgelenks und einen Befestigungspunkt der Stützschiene (3) angepasst werden, durch einen gegenseitigen formschlüssigen Eingriff des unteren Gelenkteils (52) und des oberen Gelenkteils (51) zu beschränken.
  8. Verfahren zum Bewegen eines Bein- und eines Hüftbereichs relativ zueinander mit einer Vorrichtung (1) nach Anspruch 1, umfassend
    - Aufsetzen eines Fußes auf die Beinstütze (8) so, dass das gleiche Bein mit seinem Hüftbereich auf der Stützplatte (2) aufliegt, so dass das Hüftgelenk des besprochenen Beins in Richtung einer Ebene der Stützplatte (2) an einem anderen Ort als einer Längsachse des Universalgelenks positioniert ist, d.h. eine vertikale Welle (P1), die sich durch das Universalgelenk erstreckt,
    - Lösen des Klemmmechanismus (300), der auf die beiden Gasfedern (41, 42) des Paars Gasfedern (4) des ersten Einstellmechanismus wirkt, durch die Wirkung des Griffs (6), und Lösen auch eines Verriegelungseingriffs des Beinstützabschnitts (8) mit der Stützschiene (3),
    - Bewegen der Stützschiene (3) und des darauf abgestützten Beins unter Zwischenschaltung des Stützabschnitts (8) zur Neupositionierung des Beins in Bezug auf das auf der Stützplatte abgestützte Hüftgelenk, wobei durch den ersten Einstellmechanismus die Bewegungsbahnen der Stützschiene und gleichzeitig die des Beins in vertikaler und horizontaler Richtung bezüglich der Stützplatte (2) definiert werden, einschließlich des Gasfederpaares (4), das sich zwischen dem ersten Ende (3b) der Stützschiene und unter der Stützplatte befestigten Halterungen (20) befindet, zusammen mit einem zweiten Einstellmechanismus, der mit einem Universalgelenk (5) versehen ist,
    - Festklemmen der Position einer Kolbenstange (41a, 42a) jeder Gasfeder (41, 42) in Bezug auf einen Zylinder (41b, 42b) der jeweiligen Gasfeder durch die Wirkung des Griffs (6) und Festklemmen auch eines Verriegelungseingriffs des Beinstützabschnitts (8) mit der Stützschiene, während gleichzeitig auch die Position eines Beins in Bezug auf das jeweilige Hüftgelenk festgeklemmt wird.
  9. Verfahren nach Anspruch 8, dadurch gekennzeichnet, dass, wenn die Stützschiene (3) in horizontaler und vertikaler Richtung in Bezug auf jeweilige vertikale und horizontale Drehachsen (P1, P2) geschwenkt wird, die an dem Universalgelenk (5) angeordnet sind, die auf der Stützplatte (2) montiert ist, gleichzeitig das auf der Stützschiene (3) über den Stützabschnitt (8) abgestützte Bein relativ zu dem auf der Stützplatte (2) befindlichen Hüftgelenk gedreht wird, wobei die vertikale Achse, die sich durch das Hüftgelenk erstreckt, in Bezug auf eine Ebene der Stützplatte an einer anderen Stelle als der vertikalen Achse (P1) des Universalgelenks (5) vorhanden ist.
  10. Verfahren nach Anspruch 8, dadurch gekennzeichnet, dass das Verschwenken der Stützschiene (3) in horizontaler Richtung bezüglich der vertikalen Drehachse (P1), die über das obere Gelenkelement (51) des Universalgelenks (5) verläuft und gegenüber der Stützplatte (2) ein Verschwenken beider Gasfedern (4) jeweils relativ zu Koppelelementen (32', 32") des Hebelarmsystems (30) bewirkt, so dass die gegenseitige Richtung der Längsachsen der Gasfedern (4) und der Stützschiene (3) geändert wird, aber der Winkel zwischen einer über die Gasfedern (4) verlaufenden Ebene und der Stützplatte (2) gleich bleibt, vorzugsweise die Ebene, die sich über die Gasfedern (4) erstreckt, gleichgerichtet mit einer horizontalen Ebene bleibt, die gleichgerichtet mit der Stützplatte (2) ist.
  11. Verfahren nach Anspruch 10, dadurch gekennzeichnet, dass Verschwenken der Stützschiene (3), sowie des fest an der Stützschiene montierten unteren Gelenkelements (52), in vertikaler Richtung in Bezug auf die horizontale Drehachse (P2), die sich über das Universalgelenk (5) erstreckt, und in Bezug auf die Stützplatte (2), ein Verschwenken der Mittelwelle (39), die sich durch das untere Gelenkelement (52) erstreckt, und der daran montierten Gasfedern (4) in Bezug auf die Stützschiene (3) bewirkt, so dass die Gasfedern (4) gleichgerichtet in Bezug auf eine Ebene bleiben, die gleichgerichtet mit der Stützplatte (2) ist.
  12. Verfahren nach einem der Ansprüche 8 bis 11, dadurch gekennzeichnet, dass der Klemmmechanismus (300) des ersten Einstellmechanismus, der auf jede Gasfeder (41, 42) des Paars von Gasfedern (4) wirkt, zum Festklemmen einer Position der Stützplatte (2) in Bezug auf das Universalgelenk (5), sowie einer gegenseitigen Stellung der an der Stützschiene (3) durch den Stützabschnitt (8) gelagerten Beine, sowie des auf der Stützplatte (2) abgestützte Hüftbereichs, gefolgt von der Verwendung des Klemmmechanismus (300) zum Lösen eines Verriegelungseingriffs zwischen der Stützschiene (3) und der Stützplatte (2) sowie dem Universalgelenk (5) dient.
  13. Verfahren nach einem der Ansprüche 8 bis 12, dadurch gekennzeichnet, dass das Verschwenken der Stützschiene (3) in horizontaler Richtung eine Verlängerung der ersten Gasfeder und eine Verkürzung der zweiten Gasfeder bewirkt, während ein Verschwenken der Stützschiene (2) in vertikaler Richtung gleichzeitig eine Verlängerung oder Verkürzung jeder Gasfeder (41, 42) bewirkt.
  14. Verfahren nach einem der Ansprüche 8 bis 13, dadurch gekennzeichnet, dass bei gelöster Reibungsbremse (71) des Schlittens die Stützschiene (3) in vertikaler Richtung geschwenkt werden kann, so dass der Abstand eines auf der Stützschiene gleitenden Schlittens (7) von dem Universalgelenk (5) anhand eines Abstands zwischen der Hüfte und dem Fuß eines Beins bestimmt wird.
EP14193867.0A 2013-11-19 2014-11-19 Orthopädische Vorrichtung für gegenseitige Bewegungen des Bein- und Hüftbereichs Active EP2873404B1 (de)

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CN109223425B (zh) * 2018-07-09 2020-11-06 青岛大学附属医院 一种妇产科检查座椅
CN110478181A (zh) * 2019-09-17 2019-11-22 刘进 一种医用妇科临床治疗手术辅助装置

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FR2596637B1 (fr) * 1986-04-03 1988-07-15 Marzet Aubry Dispositif de traction pour tables d'operations et appareillages de chirurgie orthopedique
RU2057506C1 (ru) * 1991-02-01 1996-04-10 Каушлы Ким Мустафович Тележка для транспортировки инвалидов и больных
US5961085A (en) * 1997-04-04 1999-10-05 Amatech Corporation Locking-cylinder supported surgical boot
CN2910169Y (zh) * 2006-05-24 2007-06-13 上海健医实业有限公司 自动手术台
WO2009062545A1 (en) * 2007-11-13 2009-05-22 Schaerer Mayfield Medical Ag Modular device for positioning and immobilisation of a patient's body for surgical operations and corresponding operating table
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