EP2873404B1 - Dispositif orthopédique pour des déplacements mutuels de zone hanches et jambes - Google Patents

Dispositif orthopédique pour des déplacements mutuels de zone hanches et jambes 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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German (de)
English (en)
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EP2873404A1 (fr
Inventor
Ari Nurminen
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Merivaara Oy
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Merivaara Oy
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Publication of EP2873404A1 publication Critical patent/EP2873404A1/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
    • 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. Dispositif orthopédique (1) destiné à déplacer une zone de jambes et de hanches l'une par rapport à l'autre, comprenant une plaque de support (2) qui est destinée à supporter la zone de hanches et sous laquelle est couplée une première extrémité (3b) d'un rail de support allongé (3) conçu pour porter une partie d'appui de jambe (8), et ledit rail de support (3) ayant sa seconde extrémité libre (3a) munie d'une seule poignée (6) pour un mécanisme de réglage destiné à des déplacements de blocage et de libération du rail de support, et une partie d'appui de jambe (8) qui peut être montée sur le rail de support (3) de manière coulissante, et le dispositif (1) comporte un premier mécanisme de réglage et un second mécanisme de réglage, qui est muni d'un joint universel (5) et le second mécanisme de réglage (5), définissent ensemble avec le premier mécanisme de réglage, des trajectoires de déplacement horizontales et verticales pour le rail de support (3) par rapport à la plaque de support (2), caractérisé en ce que
    le premier mécanisme de réglage comprend une paire de ressorts à gaz (4) situés entre la première extrémité (3b) du rail de support et des équerres (20) fixées à la plaque de support (2), sous la plaque de support, dans lequel chaque ressort à gaz (41, 42) a ses extrémités de tige de piston (41c, 42c) s'étendant vers un arbre central (39), qui est co-directionnel avec un plan de la plaque de support (2) et qui s'étend à travers l'élément d'articulation inférieur (52) du joint universel de manière rotative, et les secondes extrémités s'étendent jusqu'aux équerres (20), sous la plaque de support, à une certaine distance des points de fixation des extrémités de tige de piston (41c, 42c) du ressort à gaz (41, 42) sur l'arbre central (39) et lequel premier mécanisme de réglage est utilisé pour régler le blocage des trajectoires de déplacement du rail de support (3) et la force nécessaire pour faire pivoter le rail de support,
    dans lequel ladite paire de ressorts à gaz (4)
    - a ses extrémités de tige de piston (41c, 42c) capables d'être couplées de manière amovible à l'attache (38) du ressort à gaz montée sur l'arbre central (39) et la paire de ressorts à gaz a ses secondes extrémités couplées aux équerres (20) fixées sous la plaque de support (2), de sorte que les ressorts à gaz (41, 42) sont sensiblement co-directionnels avec la plaque de support (2) ainsi que, au moins avec le dispositif dans un état de repos, également sensiblement co-directionnels avec le rail de support (3),
    - a chacun de ses ressorts à gaz (41, 42) conçu pour être actionné par un mécanisme de blocage (300) du premier mécanisme de réglage, au moyen duquel la position de la tige de piston (41a, 42a) du ressort à gaz (41, 42) est capable d'être libérée et bloquée par rapport à un cylindre (41b, 42b) du ressort à gaz respectif et le mécanisme de blocage (300) comprend ladite poignée unique (6), qui est présente à une extrémité libre (3a) du rail de support (3) et qui est conçue pour agir, par l'intermédiaire d'un système de bras de levier (30), sur l'extrémité de la tige de piston du ressort à gaz (41c, 42c) de telle sorte que la position de la tige de piston du ressort à gaz (41a, 42a) par rapport au cylindre (41b, 42b) respectif et le système de bras de levier (30) est capable d'être libéré et bloqué,
    le second mécanisme de réglage (5) couple la première extrémité (3b) du rail de support (3) pivotant sous la plaque de support ou sur les équerres (20) fixées sous la plaque de support.
  2. Dispositif (1) selon la revendication 1, caractérisé en ce que le système de bras de levier (30) du mécanisme de blocage comprend une tige de tension (31), qui s'étend à l'intérieur du rail de support, laquelle tige de tension (31) est fixée à la poignée, et qui est conçue pour agir au moyen d'éléments d'accouplement allongés sur une extrémité du piston de chaque ressort à gaz de telle sorte qu'une position du piston desdits ressorts à gaz dans le cylindre respectif est simultanément libérable et verrouillable.
  3. Dispositif (1) selon la revendication 1, caractérisé en ce que le système de bras de levier (30) du mécanisme de blocage (300) comprend une tige de tension (31) ou similaire, qui s'étend à l'intérieur du rail de support (3), est fixée à la poignée (6), et qui est conçue, par l'intermédiaire d'extrémités libres (32'a, 32" a) d'éléments d'accouplement allongés (32 ; 32', 32'') couplés à l'arbre central (39) s'étendant de manière rotative à travers l'élément d'articulation inférieur (52) du joint universel (5), pour agir sur l'extrémité (41c, 42c) de la tige de piston (41a, 42a) de chaque ressort à gaz (41, 42) de telle sorte que les positions de la tige de piston desdits ressorts à gaz (41a, 42a) par rapport aux cylindres (41b, 42b) respectifs puissent être libérées et bloquées simultanément.
  4. Dispositif (1) selon la revendication 1, caractérisé en ce que le joint universel (5) du second mécanisme de réglage comprend un élément d'articulation supérieur (51), qui s'accouple par son extrémité supérieure à la plaque de support (2) ou aux équerres (20) fixées à celui-ci et par son extrémité inférieure, par l'intermédiaire d'un arbre articulé (53), à un membre d'articulation inférieur (52), qui s'accouple à son tour par son extrémité inférieure à la première extrémité du rail de support (3 ; 3b).
  5. Dispositif (1) selon la revendication 1, caractérisé en ce que l'élément d'articulation supérieur (5 ; 51) du joint universel est monté sur la plaque de support (2) ou sur les équerres (20) fixées à celle-ci de manière à permettre, conjointement avec le premier mécanisme de réglage, les déplacements de pivotement horizontaux du rail de support autour de l'axe longitudinal (P1) du joint universel à un certain angle, tel qu'un angle de ±45 degrés, tel qu'il est perçu à partir d'un niveau 0 du déplacement horizontal, et que le joint inférieur (52) est couplé, par l'intermédiaire de l'arbre articulé (53), à l'élément d'articulation supérieur (51) de manière à permettre, conjointement avec le premier mécanisme de réglage, des déplacements de pivotement verticaux du rail de support (3) autour de l'arbre articulé (53) sur une certaine plage d'angles de pivotement, comme à un angle de pivotement de ±75 degrés, tel que perçu à partir d'un niveau 0 du déplacement de pivotement vertical.
  6. Dispositif (1) selon l'une quelconque des revendications précédentes, caractérisé en ce que la partie d'appui de jambe (8) se raccorde au rail de support (3) au moyen d'un chariot (7) qui peut coulisser le long du rail de support.
  7. Dispositif (1) selon l'une quelconque des revendications précédentes, caractérisé en ce que les déplacements horizontaux du rail de support (3) sont conçus pour être limités par un élément, tel qu'une rainure sur une surface de l'élément d'articulation supérieur (51), qui limite la rotation d'un arbre pivotant (P1) s'étendant au moyen de l'élément d'articulation supérieur (51) du joint universel (5) et qui est assorti d'une contrepartie présente sur la plaque de support (2) ou sur ses équerres (20), et les déplacements de pivotement verticaux du rail de support (3) autour de l'élément d'articulation inférieur (52) du joint universel et d'un point de fixation du rail de support (3) sont conçus pour être limités par une mise en prise mutuelle de verrouillage de forme de l'élément d'articulation inférieur (52) et de l'élément d'articulation supérieur (51).
  8. Procédé pour déplacer une zone de jambes et de hanches l'une par rapport à l'autre avec un dispositif (1) selon la revendication 1 comprenant
    - la disposition d'un pied sur la partie d'appui de jambe (8) de manière à ce que la même jambe ait sa zone de hanche supportée sur la plaque de support (2) de manière à ce que l'articulation de la hanche de la jambe en question soit positionnée dans la direction d'un plan de la plaque de support (2) à un emplacement autre qu'un axe longitudinal du joint universel, c'est-à-dire un arbre vertical (P1) s'étendant à travers le joint universel,
    - la libération du mécanisme de blocage (300) agissant sur les deux ressorts à gaz (41, 42) de la paire de ressorts à gaz (4) du premier mécanisme de réglage par l'action de ladite poignée (6), et la libération également d'une mise en prise de verrouillage de la partie d'appui de jambe (8) avec le rail de support (3),
    - le déplacement du rail de support (3) et de la jambe supportée sur celui-ci par l'intermédiaire de la partie d'appui (8) pour repositionner la jambe par rapport à l'articulation de la hanche supportée sur la plaque de support, les trajectoires de déplacement du rail de support et en même temps ceux de la jambe dans les directions verticale et horizontale par rapport à la plaque de support (2) sont définis par le premier mécanisme de réglage, y compris la paire de ressorts à gaz (4) qui est située entre la première extrémité (3b) du rail de support et les équerres (20) fixées sous la plaque d'appui, ainsi qu'un second mécanisme de réglage muni d'un joint universel (5),
    - le blocage de la position d'une tige de piston (41a, 42a) de chaque ressort à gaz (41, 42) par rapport à un cylindre (41b, 42b) du ressort à gaz respectif, par l'action de ladite poignée (6) et le blocage également d'une mise en prise de verrouillage de la partie d'appui de jambe (8) avec le rail de support, tout en bloquant en même temps également la position d'une jambe par rapport à l'articulation de hanche respective.
  9. Procédé selon la revendication 8, caractérisé en ce que, lorsque le rail de support (3) est pivoté dans les directions horizontale et verticale par rapport aux axes de rotation verticaux et horizontaux (P1, P2) respectifs situés sur le joint universel (5) monté sur la plaque de support (2), la jambe supportée sur le rail de support (3) par l'intermédiaire de la partie d'appui (8) est en même temps tournée par rapport à l'articulation de la hanche présente sur la plaque de support (2), l'axe vertical s'étendant à travers ladite articulation de hanche étant présente, par rapport à un plan de la plaque de support, à un emplacement autre que l'axe vertical (P1) du joint universel (5).
  10. Procédé selon la revendication 8, caractérisé en ce que le pivotement du rail de support (3) dans une direction horizontale par rapport à l'axe de rotation vertical (P1) s'étendant au moyen de l'élément d'articulation supérieur (51) du joint universel (5) et par rapport à la plaque de support (2) provoque le pivotement des deux ressorts à gaz (4) respectivement par rapport aux éléments d'accouplement (32', 32'') du système de bras de levier (30) de telle sorte que la direction mutuelle des axes longitudinaux des ressorts à gaz (4) et du rail de support (3) est modifiée, mais l'angle entre un plan s'étendant au moyen des ressorts à gaz (4) et la plaque de support (2) reste le même, de préférence le plan s'étendant au moyen des ressorts à gaz (4) restant co-directionnel avec un plan horizontal qui est co-directionnel avec la plaque de support (2).
  11. Procédé selon la revendication 10, caractérisé en ce que le pivotement du rail de support (3), ainsi que l'élément d'articulation inférieur (52) monté fixement sur le rail de support, dans une direction verticale par rapport à l'axe de rotation horizontal (P2) s'étendant au moyen du joint universel (5) et par rapport à la plaque de support (2) provoque le pivotement de l'arbre central (39) s'étendant à travers l'élément d'articulation inférieur (52) et les ressorts à gaz (4) montés sur celui-ci par rapport audit rail de support (3) de telle sorte que les ressorts à gaz (4) restent co-directionnels par rapport à un plan qui est co-directionnel avec la plaque de support (2).
  12. Procédé selon l'une quelconque des revendications 8 à 11, caractérisé en ce que le mécanisme de blocage (300) du premier mécanisme de réglage, agissant sur chaque ressort à gaz (41, 42) de la paire de ressorts à gaz (4), est utilisé pour bloquer une position de la plaque de support (2) par rapport au joint universel (5), ainsi qu'une position mutuelle de la jambe en appui sur le rail de support (3) par l'intermédiaire de la partie d'appui (8) ainsi que la zone de hanche supportée sur la plaque de support (2), suivi de l'utilisation dudit mécanisme de blocage (300) pour libérer une mise en prise de verrouillage entre le rail de support (3) et la plaque de support (2) ainsi que le joint universel (5).
  13. Procédé selon l'une quelconque des revendications 8 à 12, caractérisé en ce que le pivotement du rail de support (3) dans une direction horizontale provoque un allongement du premier ressort à gaz et un raccourcissement du second ressort à gaz, tandis que le pivotement du rail de support (2) dans une direction verticale provoque simultanément un allongement ou un raccourcissement de chaque ressort à gaz (41, 42).
  14. Procédé selon l'une quelconque des revendications 8 à 13, caractérisé en ce que, lorsqu'un frein à friction (71) du chariot est desserré, le rail de support (3) peut être pivoté dans une direction verticale de telle sorte que la distance d'un chariot (7) coulissant sur le rail de support à partir du joint universel (5) est déterminée en fonction d'une distance entre la hanche et le pied d'une jambe.
EP14193867.0A 2013-11-19 2014-11-19 Dispositif orthopédique pour des déplacements mutuels de zone hanches et jambes Active EP2873404B1 (fr)

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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 (fr) * 2007-11-13 2009-05-22 Schaerer Mayfield Medical Ag Dispositif modulaire pour le positionnement et l'immobilisation du corps d'un patient pour des opérations chirurgicales et table d'opération correspondante
US8683631B2 (en) * 2012-01-26 2014-04-01 American Sterilizer Company Sacral pad for a medical table

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EP2873404A1 (fr) 2015-05-20
EA029871B1 (ru) 2018-05-31
FI2873404T3 (fi) 2023-06-02

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