FR2948282A1 - Shoulder immobilization device for patient, has rigid elements arranged in edge-to-edge manner and overlapped completely or partially according to lengths to form spacer element, and fixation units fixing elements on parallel planes - Google Patents

Abstract

The device (1) has a rigid thoracic support (2) pivotably mounted on a rigid brachial support (3). Attachment units (11, 12) integrate the device with a bust and an arm of a patient. Rigid elements (4, 5) i.e. rectangular rigid plates, with determined lengths are pivotably mounted on the supports. The rigid elements are arranged in an edge-to-edge manner and overlapped completely or partially according to the lengths to form a spacer element with variable length. Fixation units fix the rigid elements on parallel planes. The attachment units are metal hinges or flexible, plastic or textile parts and molded in a flexible polymer material. The fixation units are magnets, self-adhering bands, Velcro(RTM: hook-and-loop fastener) type self-gripping bands and push buttons.

Description

DEVICE FOR IMMOBILIZING THE SHOULDER WITH ADJUSTMENT OF THE ABDUCTION ANGLE OF THE ARM

The present invention is in the technical field of immobilization devices of the shoulder with adjustment of the abduction angle of the arm. The so-called abduction position is one in which a limb is separated from the median sagittal plane of the body. The angle of abduction of the arm is thus defined as the angle formed between the trunk and the arm, the summit of which coincides with the hollow under the armpit. The forearm may be in the folded position or not relative to the arm. The devices for immobilizing the shoulder are used in a post-traumatic or post-operative setting and according to an abduction angle determined by the nursing staff, which can vary for example from 15 ° to 90 °. The recommended abduction angle usually evolves during treatment.

There are known shoulder immobilization devices in the form of an airbag comprising inflatable thoracic and brachial supports and an inflatable spacer determining the angle of abduction formed between said thoracic and brachial supports. The spacer can be deflated so that it folds back on itself and changes the angle of abduction.

These devices have the disadvantage that they are bulky, allow adjustment only two non-precise abduction angles corresponding to the positions in which the spacer is either inflated or deflated. Also known are immobilization devices comprising articulated thoracic and brachial supports, without spacer itself, comprising mechanical means for adjusting the formed angle employing mechanical systems tedious to manufacture and adjust, the endless screw type or pistons. Such a device is described in EP 0.359.523. These devices are also bulky for the patient, complex to adjust so that it is necessary to use the competent caregivers. In addition, these devices are generally considered unsightly.

The present invention aims to overcome the problems mentioned in that it relates to a device for immobilizing the shoulder with adjustment of the arm abduction angle comprising a first rigid thoracic support pivotally mounted on a second stiff brachial support, fastening members for securing respectively to the bust and the arm of a patient, and first and second rigid elements of specific lengths pivotally mounted respectively on said first and second supports, adapted to be arranged edge to edge or overlap totally or partially along their lengths to form a spacer member resulting in adjustable length; moreover, said device comprises first fastening means capable of securing said first and second elements arranged in parallel planes. It is believed that said first and second members are arranged in parallel planes when they overlap totally or partially or are disposed edge to edge. The first and second supports and the first and second rigid members preferably have a substantially rectangular shape. The first and second rigid members are pivotally mounted along their transverse edges respectively to the transverse edges of the first and second supports and the free transverse edges of the first and second members may be held edge to edge or in a position of total or partial overlap by the first fixing means. By pivotally mounted, it is understood that the device comprises connecting means between the supports and / or elements for pivoting 25 of said supports and / or elements relative to each other along an axis perpendicular to the longitudinal direction of the supports and / or elements. Such connecting means are preferably selected so as to be compact and to pivot said elements and / or supports at an angle greater than 0 ° and less than 360 °. Such preferred bonding means are a metal or plastic hinge or a textile hinge.

Advantageously, the abduction angle is easily adjustable by cooperating the first and second elements so as to form a resulting spacer element having a length less than or substantially equal to the length corresponding to the cumulative lengths of the first and second elements. The abduction angle chosen is blocked by the first fixing means. The possible positions of overlap of the first and second elements represent so many variations of the angle of abduction. Adjusting the angle of abduction is simple and precise to implement, and does not require the intervention of a health professional.

The immobilization device obtained is light compared to devices of the state of the art which improves the comfort of the patient. Preferably, the first fixing means are arranged on the one hand on the first element and on the other on the second element in one or more predetermined locations, preferably distinct and arranged so as to form, as many visual references for the adjustment. of the abduction angle. The first fixing means may be any means known from the state of the art, for example magnets, self-adhering strips, self-gripping strips of the Velcro type, snaps, ....

The supports and / or elements according to the invention must be sufficiently rigid and mechanically resistant in order to maintain the abduction angle constant despite the weight of the shoulder and the user's arm and the mechanical stresses due to the movements of this latest. In a variant, the device comprises on the one hand at least a third rigid element of fixed length pivotally mounted either on the first support and on the first element or both on the second support and on the second element and secondly securing means adapted to secure said third element respectively with said second or first element in a position in which they are arranged in parallel planes to form a resulting spacer element having a shorter or substantially shorter length. equal to the length corresponding to the cumulative lengths or the first and third elements or the second and third elements. The third rigid element can be removable and adapted to be pivoted directly by the user.

The second fixing means may be identical to the first means. Preferably, the second fixing means are fixed or fixable on the one hand on the third element and on the other hand or on the first element or on the second element in one or more predetermined locations, preferably distinct and arranged in so to form as many visual cues for the adjustment of the angle of abduction. The third element, preferably having a substantially rectangular shape, is pivotally mounted along one of its transverse edges to the transverse edges or the first support and the first element or the second support and the second element, its second transverse edge being preferably free. In a variant, the device comprises at least a third removable rigid element of determined length comprising second fixing means able to cooperate with third attachment means supported by the first and second elements to form a resulting spacer element having a length less than or substantially equal to the length corresponding to the cumulative lengths of the first, second and third elements. The second and third fixing means may be identical to the first means and fixed or fixable in one or more predetermined locations, preferably separate and able to form as many visual cues for the adjustment of the abduction angle. Preferably, the length of the first and second elements is less than that of the first thoracic support or the second brachial support. The length of the third element according to the two previous embodiments, as well as the length of the first or second element, are preferably less than the length of the first thoracic support or the second brachial support so that said elements can be secured by being plated. against the outer and / or inner faces of the first or second support when not used for adjustment of the abduction angle. In a variant, the supports and / or rigid elements pivotally mounted relative to each other, preferably having a substantially rectangular shape, are in the form of flat plates, of small thickness, very resistant to bending, for example in a polymeric material resistant to bending, for example polyamide, optionally reinforced with short and / or long fibers, for example fiberglass. These plates are hinged along their transverse edges joined, through connecting means whose two ends are secured respectively to the support (s) and / or element (s) rigid to mount pivotally relative to each other; it may be metal hinges or flexible parts, especially plastic or a textile material.

The connecting means ensuring pivoting between the supports and / or elements are advantageously light and compact. In a variant, the first, second and possibly third elements comprise, according to their lengths, visual reference marks for adjusting the angle of abduction making it possible to adjust their positioning in parallel planes and the length of the spacer element resulting. In a variant, the device comprises a third forearm support having a substantially rectangular shape, and means for adjusting said third support on the second brachial support in the longitudinal and / or transverse direction of said second brachial support, in particular mounted in one or more sliding connections to the second brachial support so as to be able to slide in the longitudinal direction and / or the transverse direction of said second brachial support. In a variant, the device comprises a fourth support, possibly rigid, configured so as to support the side of the bust, and possibly the hip, and means for adjusting said fourth support on the first thoracic support according to the height, in particular set by means of a slide connection so that the first thoracic support is able to slide on the fourth support at the vertical of the bust. This fourth support makes it possible to arrange the vertex of the angle delimited between the thoracic and brachial supports, perfectly under the armpit of the patient so that this angle corresponds precisely to the angle of abduction, namely the angle corresponding to the distance between the bust and the shoulder regardless of the morphology of the patient. In a variant, the fourth support is configured in the form of an inverted T in order to fit the hip on its posterior and anterior surfaces.

The comfort of the patient is improved since the weight of the device is spread over a larger area of his bust. In a variant, each of the supports and / or rigid elements is in the form of a plate, substantially rectangular, coated on its outer and / or inner faces with a flexible material, such as a textile.

Preferably, said outer and / or inner faces are coated with a textile having loops, for example a brushed textile of the Astrakan type, capable of cooperating with hooks, such as those sold under the trademark Velcro. The hooks are arranged in one or more predetermined locations on said outer and / or inner faces and may be associated with visual cues for the adjustment of the abduction angle. In one variant, the supports and / or rigid elements have longitudinal reinforcing ribs. This arrangement makes it possible to form supports and / or elements having a reduced average thickness, a good mechanical resistance, in particular to bending while optimizing the weight, so as to improve the comfort of the user. In one variant, the supports and / or elements are molded on or at the same time as the connecting means making it possible to pivot said supports and / or elements relative to one another along an axis perpendicular to the longitudinal direction of said supports. and / or elements, said connecting means being in turn molded in a flexible polymer material. The supports and / or elements may be molded in a polymeric material optionally reinforced with long and / or short fibers. The long and / or short fibers may be carbon or glass. The molding techniques employed are well known to those skilled in the art, for example by extrusion of two-component materials, by pultrusion or injection. The device is thus simple to manufacture, optimized in terms of size and weight and therefore more easily considered as aesthetic. The patient will thus accept more easily to wear it over a long period. The first, second and third fixing means may be any means known from the state of the art, for example magnets, self-adhering strips, Velcro type hook-and-loop strips, hooks adapted to cooperate with each other. with the loops of textiles covering all or part of the outer and / or outer faces of the supports and / or elements, snaps, etc. The present invention will be better understood on reading the following two examples of embodiment, Non-limiting, and illustrated in the figures below, appended hereto: - Figure 1 is a simplified representation in perspective of a first exemplary device according to the present invention in the unfolded state; FIGS. 2 to 4 show, in perspective, the first example of a device represented in FIG. 1, adjusted according to three different angles of abduction; FIG. 5 is a representation, in perspective, of the first example of a device represented in FIG. 1 carried on a patient; FIG. 6 is a simplified representation in perspective of a second example of a device according to the present invention, in the unfolded state; FIGS. 7 to 9 represent, in perspective, the second example of a device represented in FIG. 6, adjusted according to three different angles of abduction.

The first example of a device for immobilizing the shoulder and the arm 1 shown in a simplified manner in FIGS. 1 to 4 comprises a first rigid thoracic support 2 pivotally mounted on a second rigid brachial support 3, first 4 and second 5 rigid elements. of respective lengths 11, 12 pivotally mounted according to their transverse edges 4a, 5a respectively to the transverse edges 2a, 3a of the first 2 and second 3 supports. The first 2 and second 3 supports have respective lengths L1, L2. The device 1 also comprises a third rigid element 6 of length 13, mounted capable of pivoting along its transverse edge 6a between the second support 3 and the second element 5. This third element could also be pivotally mounted between the first support 2 and the first element 4. In this specific example, the lengths L1, L2 are respectively about 254 mm and 205 mm and the lengths 11, 12 and 13 are respectively about 125 mm, 230 mm and 50 mm. The transverse edges 4b of the first element 4, 5b of the second element 5 and 6b of the third element 6 remain free. Said first 2 and second 3 supports and first 4, second 5 and third 6 elements are pivotally mounted according to their contiguous transverse edges, and are in the form of substantially rectangular rigid plates, preferably flat and substantially the same widths and thicknesses . Said plates are coated on all their faces, at least their external and internal faces, of a textile not shown in Figures 1 to 5, having on its outer face loops, in particular of the Astrakan type. Pellets or strips comprising hooks, in particular of the Velcro type, not shown for reasons of simplification, are reported according to the external and / or internal faces of the first 2 and second 3 supports as well as on the elements 4, 5, 6 in several parts. defined locations forming as many visual cues for the adjustment of a given abduction angle. Said pellets or strips form the male fastening members and the loops of the textile form the female members of the first and second fixing means in the sense of the present invention. Said textile may also be coated on its inner face, not facing the patient in operation, a foam or a comfort improving material. Said supports 2, 3 and elements 4, 5, 6 are pivotally mounted by means of hinges 7, 8, 9, allowing pivoting of said supports 2, 3 and / or elements 4, 5, 6 relative to each other at an angle greater than 0 ° and less than 360 ° along an axis perpendicular to the longitudinal direction of said supports 2, 3 and / or elements 4, 5, 6. In operation, the first 4 and second 5 elements may overlap partially, as shown in FIG. 2, or totally, as shown in Figure 3, by freely sliding the first element 4 on the second element 5 in the direction F corresponding to the longitudinal direction of the elements 4,5. The first 4 and second 5 elements thus adjusted, are locked in this position of partial or total overlap by said first fixing means so as to form a first al or a second a2 abduction angle, in this specific example of 90 ° respectively or 60 °. The third inactive element 6 can then be kept in operation against the outer face 3a of the second brachial support 3 or against the outer face 5c of the second element 5 via said first and second fixing means.

FIG. 4 illustrates a third example of adjustment of the angle of abduction a3, in this specific example of the order of 30 °. In this case, the second element 5 is maintained thanks to the first fastening means against the inner face 3b of the second brachial support 3. The first 4 and third 6 elements are held together in a position of total overlap and form a spacer element resulting from a length 14 of the order of that of the first element 4. FIG. 5 represents the first example of a complete device 1 comprising fastening members 11 fixed on the external face 3a of the second brachial support 3 for attachment to the patient's arm and attachment members 12 fixed on the outer face 2a of the first thoracic support 2 for its attachment to the bust of the patient. The device 1 comprises a third forearm support 13 mounted according to two slide links, not shown, to the second brachial support 3 and arranged so that said third forearm support 13 is able to slide in the longitudinal direction and the transverse direction of the second brachial support 3. The third forearm support 13 comprises attachment members 14 on its outer face 13a for attachment to the forearm of the patient. The same third forearm support 13 can be used indifferently for the right forearm or the left forearm. To switch from one to the other, it is sufficient to reverse the disposition of this third support 13 with respect to the second brachial support 3.

The device 1 of the example of Figure 5 also comprises a fourth support 15, preferably rigid, configured inverted T-shape and adapted to fit the hip on its posterior and anterior surfaces and support the bust. The first thoracic support 2 is mounted in a sliding connection, not shown, on the fourth support 15 so as to slide vertically of the patient's bust. This fourth support 15 thus makes it possible to adjust the height of the first thoracic support 2 so that the angle of abduction formed can be placed perfectly under the armpit of the patient whatever his morphology. The third 13 and fourth supports are in the form of substantially rectangular rigid plates, preferably flat, whose width, which may be greater than the width of the first 2 and second 3 supports, is imposed by the morphology of the regions of the body that they support. These plates are preferably coated with a textile having on its inner face a foam or other cushioning material improving the comfort and on its outer face of the Astrakan type loops. Preferably, the rigid plates constituting the supports 2, 3, 13, 15 and elements 4, 5, 6 in the first device 1 comprise longitudinal reinforcement ribs, molded or machined. The second example of device 16 shown in FIG. 6 differs from the first example of device 1 in that it comprises a third removable element 17 of length 13 ', in this specific example of the order of 136 mm. The first 18 and second 19 elements differ from the first 4 and second 5 elements of the first example by their lengths li ', 12', preferably of the same order, in this specific example of the order of 130 mm. The first 20 and second 21 supports have respective lengths L1 'and L2', in this specific example of the same order as L1 and L2. The third element 17 is also in the form of a rigid plate of substantially rectangular shape coated at least on its outer and inner faces, preferably on all sides, of a textile having loops adapted to cooperate with hooks reported according to the outer and / or inner faces of the first 20 and / or second 21 supports according to specific locations. Preferably, the third element 17 comprises hooks reported at determined locations along its inner face and / or its outer face so as to cooperate with the textile loops supported by the first 18 and second 19 elements for fixing said third element 17 at the same time to the first 18 and second 19 elements. Said locations are preferably distinct and arranged visually so as to form as many marks for the adjustment of the abduction angle. Figures 7 and 8 illustrate two different angles of abduction a4, a5, in this example respectively 30 ° and 60 °, respectively corresponding to the total and partial overlaps of the first 18 and second 19 elements. If the abduction angle is to be changed during treatment, it is sufficient to increase the length of the resulting spacer 22 by fixing the third element 17 between the first 18 and second 19 elements and partially overlapping both the first 18 and second 19 elements. The abduction angle obtained a6 is in this specific example of the order of 90 °. The elements 4, 5, 6, 17, 18, 19 described in the above two device examples can be formed in rigid plates comprising reinforcing ribs, molded or machined, also acting as guide and sliding grooves. plates with respect to each other thus facilitating their total or partial overlap.

Claims (11)

REVENDICATIONS1. Device (1) for immobilizing the shoulder with adjustment of the angle of abduction of the arm comprising a first rigid thoracic support (2) pivotally mounted on a second rigid brachial support (3), fastening members (12) , 11) for securing respectively to the bust and the arm of a patient characterized in that it comprises first (4) and second (5) rigid elements of determined lengths (11, 12) pivotally mounted respectively on said first (5) 2) and second (3) supports, capable of being arranged edge to edge or overlapping totally or partially along their lengths to form a resultant spacer element (10) of variable length, and in that it comprises first fixing means capable of securing said first (2) and second elements (3) arranged in parallel planes. 2. Device according to claim 1, characterized in that it comprises at least one third rigid element (6) of determined length (13) pivotally mounted or both on the first support (2) and on the first element ( 4) or both on the second support (3) and on the second element (5) and in that it comprises second fastening means adapted to secure said third element (6) with said second (5) respectively. or first (4) element in a position in which they are arranged in parallel planes to form a resulting spacer element (10) having a length (14) less than or substantially equal to the length corresponding to the cumulation of the lengths respectively or second (5) and third (6) elements or first (4) and third (6) elements. 3. Device (16) according to claim 1, characterized in that it comprises at least one third rigid element (17) of predetermined length (3) comprising second fixing means adapted to cooperate with third fixing means supported by the first (18) and second (19) members to form a resultant spacer member (22) having a length less than or substantially equal to the length corresponding to the plurality of lengths of the first (18), second (19) and third (17) elements. 4. Device according to one of claims 1 to 3, characterized in that the supports and / or rigid elements mounted to pivot relative to each other, preferably having a substantially rectangular shape, are articulated according to their transverse edges joined by means of connecting means whose two ends are respectively secured to the support (s) and / or rigid element (s) to be pivotally mounted relative to each other, said connecting means being in particular metal hinges or parts flexible, plastic or textile. 5. Device according to one of claims 1 to 4, characterized in that the first, second, and possibly third, elements comprise according to their lengths of visual reference of adjustment of the angle of abduction to adjust their positioning in parallel planes and the length of the resulting spacer element. 6. Device (1) according to one of claims 1 to 5, characterized in that it comprises a third forearm support (13) having a substantially rectangular shape, and means for adjusting said third support on the second brachial support (3) in the longitudinal and / or transverse direction of said second brachial support, in particular mounted in one or more slide connections to the second brachial support so as to be able to slide in the longitudinal direction and / or the transverse direction said second brachial support. 7. Device (1) according to one of claims 1 to 6, characterized in that it comprises a fourth support (15), possibly rigid, configured to support the side of the bust, and possibly the hip, and means for adjusting the first thoracic support according to the height of said fourth support, in particular implemented by a slide connection so as to be able to slide on said fourth support at the vertical of the bust. 8. Device according to claim 7, characterized in that the fourth support (15) is configured inverted T-shaped to match the hip on its posterior and anterior surfaces. 9. Device according to one of claims 1 to 8, characterized in that the supports and / or rigid elements are in the form of substantially rectangular plates, optionally coated according to their outer and / or inner faces of a flexible material, such as a brushed textile. 10. Device according to one of claims 1 to 9, characterized in that the supports and / or rigid elements have longitudinal reinforcing ribs. 11. Device according to one of claims 1 to 10, characterized in that the supports and / or elements are molded on or at the same time as the connection means for pivoting said supports and / or elements by relative to the others along an axis perpendicular to the longitudinal axis of said supports and / or elements, and in that said connecting means are molded in a flexible polymer material.