JP2002532137A - 体外補装具を装着するための大腿断端用内蔵式補装具 - Google Patents

体外補装具を装着するための大腿断端用内蔵式補装具

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Publication number
JP2002532137A
JP2002532137A JP2000587702A JP2000587702A JP2002532137A JP 2002532137 A JP2002532137 A JP 2002532137A JP 2000587702 A JP2000587702 A JP 2000587702A JP 2000587702 A JP2000587702 A JP 2000587702A JP 2002532137 A JP2002532137 A JP 2002532137A
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Prior art keywords
prosthesis
stump
thigh
built
condyle
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JP2000587702A
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グルンデイ、ハンス
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エスカ・インプランツ・ゲーエムベーハー・ウント・コンパニー
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Publication of JP2002532137A publication Critical patent/JP2002532137A/ja
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2/2814—Bone stump caps
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/78—Means for protecting prostheses or for attaching them to the body, e.g. bandages, harnesses, straps, or stockings for the limb stump
    • A61F2/80—Sockets, e.g. of suction type
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
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Abstract

(57)【要約】 【課題】本発明は、大腿部領域が切断された患者に体外補装具を装着するための大腿断端用内蔵式補装具に関する。 【解決手段】内蔵式補装具は、大腿骨断端（５）に装着可能である近位の幹部分（４）を有し、この幹部分（４）は、少なくとも部分的に、粗いメッシュの、３次元の立体網目構造体（６）で覆われており、末端には、錐形のアダプター（７）を有し、このアダプターによって、膝関節の自然の顆の形状（１１）に倣っている代用の顆（８）は、幹部分（４）に連結可能である。

Description

【発明の詳細な説明】
【０００１】
【発明の属する技術分野】
本発明は、大腿部領域が切断された患者に体外補装具を装着するための大腿断
端用内蔵式補装具に関する。
【０００２】 通常は、体外補装具が装着される患者の、その大腿断端に、例えば、粘弾性プ
ラスチックからなる漏斗又はスリーブが被せられ、この漏斗又はスリーブは、膝
関節・下腿及び足部分のような、補装具の他の部分が取り付けられる。
【０００３】 この場合、大きな問題は、組織を介して大腿骨断端に圧力を如何に加えること
ができるのか、ということである。すなわち、大腿骨断端と大腿断端の外部との
間に、筋肉組織があって、この筋肉組織は、運動の際に、常に高い負荷に晒され
ており、このことによって、患者の感覚的知覚が歩行中の自然な接触へ近づけら
れないのである。
【０００４】
【従来の技術】
刊行物DE-A-43 38 746及びDE-C-31 25 268からは、大腿骨断端用インプラント
が公知である。このインプラントは、前記問題を、骨の溝に長期間取着される幹
部分を大腿骨断端に取着することによって、解決しようとする。インプラントは
、他端に向かってキノコ状に拡大した頭部を有し、これらの頭部は、圧力を、比
較的大きな面に分配することが意図されている。このタイプの装着用部材は、従
来通常の装着可能性と比べて、より良い着用快適性を約束する。但し、インプラ
ントを装着した患者が感じる知覚は、切断前の自然な感覚的知覚と何の共通性も
ない。
【０００５】
【発明が解決しようとする課題】
このような背景を前にして、本発明の課題は、明細書導入部に記載された大腿
断端用内蔵式補装具を、患者の感覚的知覚が著しく改善され、かくて、歩行動作
がより自然と感じられるように、改善することである。
【０００６】 上記課題は請求項１の特徴を有する大腿断端用内蔵式補装具によって解決され
る。他の、好都合な実施の形態は、従属の請求項に記載されている。
【０００７】 これに応じて、内蔵式補装具は、大腿骨断端に装着可能である近位の幹部分を
有し、この幹部分は、少なくとも部分的に、粗いメッシュの、３次元の立体網目
構造体で覆われており、末端には、錐形のアダプターを有し、このアダプターに
よって、膝関節の自然の顆の形状に倣っている代用の顆は、幹部分に連結されて
いることが規定されている。
【０００８】 内部と外部の間を結合する立体網目構造体とも呼ばれる、粗いメッシュの、３
次元の立体網目構造体は、組織に根づいて治癒する期間中に自然の骨材料が内部
に向かって生長し、混ざって生え、後方に生え出及び回りに生え出ることができ
るようにする。それ故に、幹部分は、いずれにせよ基質の流れに関して、比較的
短い時間後に、管状骨に組み込まれ、極めて安定的な２次固定が保証される。粗
いメッシュの、３次元の立体網目構造体への骨材料の生長は、理論内蔵式補装学
から知られている。ここでは、DE-PS 41 06 971を指摘しておく。
【０００９】 末端に設けられた錐形のアダプターは、中実部分の、すなわち、代用の顆の取
付を可能にする。この場合、錐形のアダプターは錐形のコレットと、錐形の締付
ほぞとからなり、前者は例えば幹部分に嵌め込まれており、ほぞは代用の顆の先
に形成されている。
【００１０】 代用の顆によって、圧力は比較的大きな面に分配され、取分け、自然の顆の複
製によって、「骨感知」の名称で知られている、患者の自然の知覚能力が得られ
る。
【００１１】 この骨感知は、大腿断端に被せられる、スリーブの内側ライニングが、自然の膝
関節の大腿骨部分の自然の滑り部材の形に倣っていることによっても、改善され
る。代用の顆の、自然の顆に倣っている形状は、人工の滑り部材用の締付装置と
して用いられ、かくて、歩行中に患者の断端の支えを著しく高める。
【００１２】 好都合な実施の形態によれば、代用の顆は、プラスチックからなりかつ衝撃を
緩和する層で被覆されている金属製の本体からなる。衝撃を緩和する層によって
、衝撃負荷が、残っている大腿骨断端へ緩和されて達する。このことによっても
、骨感知を改善することができる。何故ならば、健康な患者の場合でさえ、足関
節及び膝関節への負荷が大腿骨へ緩和されて加えられるからである。
【００１３】 このために、衝撃を緩和する層が３乃至１０ｍｍの厚さを有することは好まし
い。
【００１４】 特に好ましい実施の形態によれば、衝撃を緩和する層がシリコーンからなるこ
とが、規定されている。このシリコーンは、本発明の枠内での使用に極めて適し
ている一定の粘弾性及び緩衝作用を有する。
【００１５】
【発明の実施の形態】
以下、図面を参照して本発明を詳述する。図１は大腿骨断端５に埋め込まれた
大腿断端用内蔵式補装具を有する大腿断端１を略示している。
【００１６】 髄質内の幹４は大腿骨断端５の骨髄組織へ入れられている近位の幹部分を形成
している。幹部分４の表面は、粗いメッシュの、３次元の立体網目構造体で覆わ
れている。この立体網目構造体を通って海綿質が生長することができるので、幹
部分４は、組織に根づいて治癒する一定の期間後に、基質の流れに関して、いわ
ば、自然の骨の構成要素となった。
【００１７】 幹部分４は、末端で、錐形のアダプター７に接続されている。この錐形のアダ
プター７によって、顆の代用１１は幹部分４に連結されている。
【００１８】 顆の代用８は、膝関節の自然の顆の形状１１に倣うように、形成されている。
【００１９】 顆の代用の部分８は、図示の実施の形態では、シリコーンからなり衝撃を緩和
する層１０で、覆われている。
【００２０】 大腿断端用内蔵式補装具全体は、大腿の内部で位置決めされている。大腿断端
のどの箇所にもギャップが生じない。
【００２１】 大腿断端１は大腿用スリーブ２に包まれており、この大腿用スリーブには、人
工の膝・下腿及び足部分アセンブリ３が取着されている。
【００２２】 自然の顆に倣った形状を有する顆部分８の、その相手方は、膝関節の自然な滑
り部材に倣う、スリーブの内部、そこに形成された対応物である。
【００２３】 大腿用スリーブ２は、この場合、大腿断端の外側及び内側に接触している圧力
パッド１４から形成されている。これらの圧力パッドはクラスプ１２及び旋回可
能なヒンジ１３によって、大腿断端にしっかり取着されている。
【００２４】 膝関節機能自体は、例えばEP-C-0 358 056から公知である人口膝関節１５によ
って果たされる。
【図面の簡単な説明】
【図１】 大腿断端用内蔵式補装具を装着した大腿断端を略示している。

Claims (4)

    【特許請求の範囲】
  1. 【請求項１】 大腿部領域が切断された患者に体外補装具を装着するための
    大腿断端用内蔵式補装具であって、大腿断端（１）はスリーブ（２）に包込み可
    能であり、膝関節・下腿及び足部分からなる補装具（３）は前記スリーブに接続
    されており、前記大腿断端用内蔵式補装具は、大腿骨断端（５）に装着可能であ
    る近位の幹部分（４）を有し、この幹部分（４）は、少なくとも部分的に、粗い
    メッシュの、３次元の立体網目構造体（６）で覆われており、末端には、錐形の
    アダプター（７）を有し、このアダプターによって、膝関節の自然の顆の形状（
    １１）に倣っている代用の顆（８）は、前記幹部分（４）に連結されている、大
    腿断端用内蔵式補装具。
  2. 【請求項２】 前記代用の顆（８）は、プラスチックからなり衝撃を緩和す
    る層（１０）で被覆されている金属製の本体（９）からなる、請求項１に記載の
    大腿断端用内蔵式補装具。
  3. 【請求項３】 前記衝撃を緩和する層（１０）は、３乃至１０ｍｍの厚さを
    有する、請求項２に記載の大腿断端用内蔵式補装具。
  4. 【請求項４】 前記衝撃を緩和する層（１０）は、シリコーンからなる、請
    求項２又は３に記載の大腿断端用内蔵式補装具。
JP2000587702A 1998-12-16 1999-09-10 体外補装具を装着するための大腿断端用内蔵式補装具 Pending JP2002532137A (ja)

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DE19857907A DE19857907C1 (de) 1998-12-16 1998-12-16 Oberschenkelstumpf-Endoprothese für eine exoprothetische Versorgung
DE19857907.1 1998-12-16
PCT/EP1999/006676 WO2000035380A1 (de) 1998-12-16 1999-09-10 Oberschenkelstumpf-endoprothese für eine exoprothetische versorgung

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EP1139923A1 (de) 2001-10-10
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DE59902083D1 (de) 2002-08-22
ES2179675T3 (es) 2003-01-16
HK1040612A1 (en) 2002-06-21
WO2000035380A1 (de) 2000-06-22
ATE220525T1 (de) 2002-08-15

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