JP2014054526A - Front surface strut type long lower limb orthosis - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a highly versatile long lower limb orthosis which can be worn on the spot when needed, is highly compatible like an article fully made to order, and is easily fitted.SOLUTION: The long lower limb orthosis includes an upper part A to be put on the thigh and a lower part B to be put on the cruris. The upper part A is formed of struts 2 and 4 that are branched from a front surface of the thigh to both side faces of the thigh and merge again on the front surface of the cruris, and the struts 2 and 4 at a part equivalent to knee joints on both side faces, that are branched to both side faces, each includes a joint 3 for the knee joint. The lower part B is branched from the front surface of the cruris to both side faces of the cruris, the branched lower end and a part equivalent to an ankle joint of a stirrup 8 are connected through a joint 7 for the ankle joint, and the lower end front surface strut 4 of the upper part A and the upper end front surface strut 6 of the lower part B are connected so as to be freely position adjusted in a vertical direction.

Description

  The present invention relates to a structure of a long leg brace that is worn on a paralyzed leg.

  It is said that patients with acute leg paralysis need to get out of bed at the necessary time. Delayed bed removal can lead to disuse syndrome or spasticity or contracture at the muscle or joint level, with a fatal effect on subsequent recovery. Therefore, it is necessary to get out of bed with long leg braces, standing up training, and walking training at appropriate times.

  The most important purpose of the long lower limb orthosis is to stop knee bending and to enable stable standing training and walking training. In the upright posture, the most important muscle is the psoas muscle, and it is most important to train the psoas muscle for the purpose of the prosthetic long lower limb orthosis. This is because the muscles are most vulnerable with age and lead to stable posture in the sitting position.

As shown in Non-Patent Document 1 (see Fig. 6) below, the conventional long leg orthosis was completely made to order (full made-to-order). There were many cases where it was impossible to prepare a long leg brace. In addition, there are long leg braces that can be worn when needed, but such long leg braces are equipped with struts with a length adjustment mechanism on both sides of the lower leg and a half-moon-shaped fixation band that can adjust the depth. However, due to the complicated adjustment mechanism, it required proficiency and was often incompatible. Furthermore, there is a problem that the long leg brace becomes heavier by the adjustment mechanism, and it was only a long leg brace for temporary training until a formal brace was made (see FIG. 7).
On the other hand, since the thing disclosed by the following patent document 1 is what attached the support | pillar only to the outer side of the lower limb, such a problem has been solved to some extent, but the long leg brace which supports the front of the lower limb. Therefore, the long leg brace is easily displaced from the lower leg, and there is a problem in compatibility.

  On the other hand, there are leg braces disclosed in Patent Documents 2 and 3 below in which the legs of the long leg brace are arranged on the front surface of the leg. The leg braces disclosed in these Patent Documents 2 and 3 are for reducing the load applied to the knee joint of the leg, and an assist function such as a motor is added to the joint portion corresponding to the knee joint of the leg brace. It is.

JP 2010-110365 A JP 2012-090758 A JP 2012-125279 A

Prosthetic Orthotic Checkpoint Medical School Second Edition 177 pages

However, since the leg braces described in Patent Documents 2 and 3 are obtained by adding an assist function to the knee joint (joint) corresponding to the knee joint, they are suitable for patients with acute leg paralysis who must fix the knee joint. There are problems that are not applicable. Further, the knee joint (joint) to which the assist function is added has a problem that it is very heavy and expensive.
In addition, these leg braces are not long leg braces for the treatment of patients with acute leg paralysis, so they cannot be separated into the thigh and lower leg parts, and in the clinic, skin and clothing may be caught between the joint parts. In order to prevent this, the brace can be worn away from the lower limbs, making it difficult to match the lower leg part with the patient's lower leg size. Therefore, there is a problem that a separate adjustment tool has to be provided.
In these leg braces, the intermediate frame extending in the longitudinal direction of the lower leg is attached to an intermediate position that is symmetrical, and the branch point that branches from the lower end of the intermediate frame to the side is also attached to the center position. Therefore, there is a problem that the compatibility with the patient's tibia is poor. Therefore, there is a problem that an adjustment tool must be provided separately. In addition, since the intermediate frame extending in the longitudinal direction of the lower leg portion is disposed on the front surface and has a single frame structure, there is also a problem that the strength is weak with respect to the front and rear.

In this way, patients with acute leg paralysis are required to have long leg braces that can be used for getting out of bed, standing training, and walking training at the necessary times. I have not been able to respond.
The present invention is able to meet such demands, and can be worn on the spot at the required time, like a long leg brace for training. An object is to provide a long leg brace that can be used.

The front strut-type long leg brace according to the present invention is obtained by eliminating the knee joint from the conventional long leg brace. In current clinical practice, by fixing the knee in a fully extended state, stable walking training and standing-up training are possible, and a load can be applied to the lower limbs. In addition, it is said that the psoas major muscle (posture holding muscle) can be effectively trained. Therefore, in the long leg orthosis according to the present invention, in order to satisfy these requirements, a device without a knee joint is used during walking training and standing training.
Specifically, as shown in FIGS. 8 and 9, the upper portion C includes a top portion C to be attached to the thigh and a lower portion D to be attached to the lower thigh portion. The lower part D is located on the front surface of the crus, extending from the top 21 to both sides of the thigh and extending downward and joining again at the front of the crus to become the connecting part 14. The connecting portion 16 extends downward while branching to both side surfaces of the crus, and the branched lower end portions 17 are connected to both side portions corresponding to the ankle joint of the stirrup 18. And the connecting part 16 of the lower part D are connected so that the position can be adjusted in the vertical direction, and the connected connecting parts 14 and 16 are provided at positions offset outward from the tibia of the lower leg. It is characterized by.

The lower leg has a tibia and a rib, and the tibia is located almost at the center of the lower limb when viewed from the front, but the rib is located on the outside. Therefore, the connecting part 14 of the upper part C and the connecting part 16 of the lower part D are biased outwardly from the tibia of the lower leg, so that the connecting part 16 of the lower leg firmly holds the bone part of the tibia and ribs and is compatible with the lower leg. It is improving.
If the brace of the lower limb orthosis is positioned in the center of the lower limb as seen from the front, as in the conventional device, incompatibility occurs because the anatomical features of the body (the ribs are located outward) are not considered. A separate adjustment function is required. In contrast, the present invention does not require such an adjustment mechanism.

When wearing this long leg brace on the lower limb, first, the upper part C and the lower part D are connected, and the lower part D is put on the lower leg part where the knee is bent 90 degrees. Subsequently, the upper part C is attached to the thigh with the knee extended. Thereby, this long leg brace can be easily attached to the patient in the acute phase from the front. And since there is no knee joint, it can be made lightweight and inexpensive. Moreover, according to the treatment state of a patient, it becomes possible to replace with a long leg brace having a knee joint later.

The crown 21 located on the front surface of the thigh is biased outward with respect to the center of the thigh when viewed from the front. This is a physiological valgus because the angle between the femur and tibia (femoral tibia angle) is approximately 174 degrees. Thereby, the upper part C can hold | maintain the bone part of a femur firmly, and the compatibility with respect to a thigh improves.
The struts 13 that branch off from the top of the head 21 are inclined outward from the center of the lower limbs, the head top 21 is biased outward from the center of the thigh, and these are fixed to the thigh. Since the half-moon-shaped fixing band 11 can be freely deformed according to the shape of the thigh, it can be worn while being in close contact with the body without any adjustment function.

  Looking at the alignment of the front of the lower leg and the front of the thigh, the front of the tibial is thinner than the front of the thigh. It's out ahead. Therefore, the crown 21 located on the front of the thigh is projected forward from the tip 22 of the connecting part 16 of the lower leg. While maintaining this positional relationship, the half-moon fixed band 11 connected to the top of the head 21 is fixed with a band A1 wound around the thigh, and a band bridged between both struts 13 positioned on both sides of the thigh. Since the upper part of the kneecap is pressed at A3, and the stretched lower limb is fixed by the three-point support of fixing the meniscus fixing band 15 fixed to the connecting part 16 of the lower part D with the band A4 wound around the lower leg part, The fixed part is minimized and the knee can be firmly stopped.

  Since the long leg brace for treatment of patients with acute leg paralysis may move from the long leg brace to the short leg brace during the course of treatment, the upper part C to be worn on the thigh and the lower part D to be worn on the lower leg It must be separable. The long leg brace can be separated into an upper part C and a lower part D, which are connected to each other by the connecting parts 14 and 16 so that the vertical position can be adjusted, so that only one adjustment function is provided.

  Since the connection part 14 of the upper part C to be attached to the thigh and the connection part 16 of the lower part D to be attached to the lower leg part need a sufficient strength against bending in the front-rear direction, these connection parts 14, 16 The cross-sectional shape of the is strengthened structurally by adopting a "he" shape. As shown in FIG. 11, the front surface of the crus has a thin muscular tissue thickness and a subcutaneous tissue thickness, and the front convex tibia 31 has a triangular shape and has a convex front shape. Therefore, the connecting portions 14 and 16 are formed along the convex shape so that they can be anatomically fitted to the front surface of the lower leg.

When it is necessary to bend and stretch the knee after finishing the acute phase treatment, the upper part C to be attached to the thigh is replaced with the upper part A with the knee joint joint 3 and the lower part C to be attached to the crus is replaced with It replaces with the lower part B with the joint joint 7 for an foot corresponding to the ankle joint of the stirrup 8. The positions of the upper A connecting portion 4 and the lower B connecting portion 6 are also biased outward from the tibia of the lower leg.
When this long leg brace is worn on the lower leg, the lower B is first worn on the lower leg, and then the upper A is worn on the thigh. At that time, after positioning so that the knee joint joint 3 is positioned at the knee joint, the upper part A and the lower part B are connected and fixed by an appropriate fixing method.
As a result, the front strut-type long leg brace can be easily worn from the front of the wearer, and can be easily adapted by adjusting one point. I can do it.

  The brace of the above-mentioned long leg brace is shaped to join again at the front of the lower leg while branching from the parietal portion 21 on the front of the thigh to both sides of the thigh, so that even when the knee is bent, On the other hand, it will not cause pain or incompatibility when worn. Therefore, if the support column has a shape that supports the front surface of the thigh and the front surface of the lower leg, and the position can be adjusted in the vertical direction on the front surface of the lower leg, when the support is branched to both sides of the lower leg The bending angle, shape, etc. are not particularly limited.

  As the joint joint 7 for ankle foot orthosis, an articulated joint (commonly known as a double crenzac) that can limit the range of motion of the ankle joint within a specified range and can be fixed at a specified position is used. For example, a joint joint (common name: dial lock) that can be fixed at a specified position, can move without restriction when unlocked, and can be fixed when locked, can be used in the present invention. Since these joint joints need to be changed, the shape and structure are not particularly limited.

  As the fixing bands a1, a2, a3, a4, a5, a6, and a7 for mounting the long leg brace on the lower limbs, for example, a hook-and-loop fastener or a corset can be used. About a material etc., since an appropriate thing is used according to a wearer's medical condition etc., the shape, a structure, a material, etc. are not restrict | limited in particular.

  ADVANTAGE OF THE INVENTION According to this invention, a suitable long leg brace can be easily mounted | worn from a front surface with respect to a lower-limb paralysis patient of an acute phase at a required time. As a result, getting out of bed, standing posture training and walking training can be performed, and early recovery can be achieved compared with the conventional orthosis.

  In addition, the long lower limb orthosis according to the present invention has a shape that can firmly support the front surface of the lower limb, so that better stability on the front surface of the lower limb can be obtained during getting out of bed, standing posture training, and walking training. . In addition, since it is mounted from the front, there is an effect that it can be easily mounted even on a bed or in a sitting position.

  Explanatory drawing of the state which equipped the long leg brace concerning one embodiment of the present invention.   Exploded perspective view of the lower limb orthosis   Front view of the same embodiment   Outside view of the same embodiment   Inside view of the same embodiment   A perspective view of a conventional long leg brace   A perspective view of a conventional long leg brace for training   (A) is a front view of a state in which a long leg brace according to the second embodiment of the present invention is worn, and (B) is an outer side view thereof.   (A) is a front view showing the shape of a bone wearing the long leg brace according to the second embodiment of the present invention, and (B) is an outer side view thereof.   Long lower limb orthosis connection diagram according to the second embodiment of the present invention   Sectional drawing of the lower leg upper part in the state which isolate | separated the long leg brace which concerns on 2nd Embodiment of this invention   Explanatory drawing of the state which mounted | wore the long leg orthosis which concerns on 2nd Embodiment of this invention.

  Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

  1 to 5, the front strut-type long leg brace includes an upper part A to be attached to the thigh and a lower part B to be attached to the crus. The upper part A to be mounted on the thigh comprises an upper support column 2 that branches from the front surface of the thigh to both sides thereof, and a connecting part 4 at which the branched upper support column 2 joins again at the lower leg part. The upper support column 2 and the connecting portion 4 are connected so as to buckle at the knee joint joint 3. The knee joint joint 3 is provided between the upper support column 2 and the connecting portion 4 at a portion corresponding to the knee joint.

  At the upper end of the upper column 2, an upper half-moon-shaped fixing band 1 to be attached to the thigh is fixed. A hook-and-loop fastener a1 wound around the thigh is connected to the upper half-moon-shaped fixing band 1, and a portion that is on the outer side of the upper half-moon-shaped fixing band 1 is high and a portion that is on the inner side is low. The upper half-moon fixed band 1 and the upper support column 2 are connected to each other on the front surface of the lower limb in order to firmly support the thigh. Therefore, the upper meniscus fixing band 1 can be freely deformed, and can be adjusted in a timely manner according to the shape of the thigh.

  On the other hand, the lower part B to be attached to the lower leg part is composed of a connecting part 6 and stirrups 8 that branch from the front surface of the lower leg part to both sides thereof, and the upper part of the connecting part 6 is a lower part to be attached to the lower leg part. A half-moon fixed band 5 is attached. A hook-and-loop fastener a6 for tightening the lower leg is connected to the lower meniscus fixing band 5. The lower meniscus fixing band 5 and the connecting part 6 support the lower leg part firmly, so that the lower leg part is fixed. Are connected at the front of the. Then, both ends of the lower meniscus fixing band 5 can be freely deformed, and can be adjusted in a timely manner according to the shape of the crus. Further, the connecting portion 6 and the stirrup 8 are connected to a portion corresponding to the ankle joint via an ankle joint joint 7. Further, a foot support plate 9 is connected to the stirrup 8 so that the foot can be firmly supported.

These struts 2, connecting portions 4, 6, upper half-moon fixed band 1, and lower half-moon fixed band 5 are made of aluminum alloy that is easy to work and lightweight and strong.
Further, hooks a2, a3, a4, and a5 wound around the thighs are attached to the support column 2 and the connecting portion 4 at appropriate positions.

  The shapes of the upper half-moon fixed band 1 attached to the thigh and the lower half-moon fixed band 5 attached to the lower leg can be adjusted on the spot according to the shape of the wearer's lower limb. In the conventional long leg braces for training, an adjustment mechanism for adjusting the width and depth of the semilunar fixation band is attached, so that the adjustment mechanism makes the semilunar fixation band a square rather than a semicircle (see FIG. 7). ), The shape of the lower leg and the thigh are incompatible, the overall weight of the long leg brace increases, the adjustment is complicated, and skill is required. Since the adjustment mechanism is not attached to the meniscus fixing band of the long lower limb orthosis, the problem that the conventional long lower limb orthosis has does not occur.

  The strut 2 and the connecting portions 4 and 6 have a shape in which two branched struts merge at one front surface, so that they are light and strong, and can firmly support the front of the lower limbs. Thereby, at the time of getting out of bed, standing training, and walking training, wearing from the front and better leg support at the front are possible. In addition, since the conventional long leg brace has a support surface that supports the rear surface of the lower limb, it is necessary to pass the support surface of the brace on the rear surface of the lower limb when mounted on the bed and in a sitting position. Lifting is required, which puts a heavy burden on the wearer, but according to this lower-limb orthosis, there is a support on the front of the lower limb, so there is no need for it, and there is no burden on the wearer. I can do it.

  As the knee joint 3, a joint that can be fixed at a specified position, moves without limitation when the lock is released, and can be fixed when the lock is applied is used.

  For example, the connecting portions 4 and 6 are connected by, for example, providing a plurality of screw holes in the vertical direction at the upper end of the connecting portion 6 at regular intervals and a plurality of through holes corresponding to these screw holes at the lower end of the other connecting portion 4. A hole is provided, and the through hole of the connecting portion 4 is made to coincide with the screw hole of the connecting portion 6 and then connected by screwing at a plurality of locations.

  As the joint joint 7 for a foot, a joint that can limit the movable range within a specified range and can be fixed at a specified position is used as necessary.

  The stirrup 8 is made of stainless steel, the foot support plate 9 is a plastic resin plate, and the shape is from the heel to the distal joint of the middle footpad.

The hook-and-loop fasteners a1, a2, a3, a4, a5, a6, and a7 for fixing the long leg brace to the lower limb are attached to a plurality of locations of the support column 2 and the connecting portions 4 and 6, but the running direction of these hook-and-loop fasteners is pathological. Since it is necessary to change according to the purpose, the mounting position, material, shape and the like are not particularly limited.
Further, the hook-and-loop fasteners and bands a1, a3, a5, a6, and a7 are fixed by folding the hook-and-loop fastener through an annular plastic resin plate (heel) in order to firmly fix the lower limbs.

  The support column 2 and the upper half-moon fixed band 1, the connecting portion 6 and the lower half-moon fixed band 5, the support column 8 and the foot support plate 9 are connected by caulking with a copper rod. The connecting method of the knee joint joint 3 and the connecting portion 4, the foot joint joint 7 and the support column 8, and the hook-and-loop fasteners a1, a2, a3, a4, a5, a6, and a7 are connected by screws.

Next, a second embodiment of the present invention will be described with reference to the drawings.
8 to 12, the front strut-type long leg apparatus includes an upper part C to be attached to the thigh and a lower part D to be attached to the crus. The upper part C to be mounted on the thigh is composed of an upper column 12 that branches from the crown 21 located on the front surface of the thigh to both sides thereof, and a connecting unit 14 that the branched upper column 12 joins again at the lower leg. Consists of. The upper support column 12 and the connecting portion 14 are connected to each other via a support column 13 located on the side of the thigh.

  An upper half-moon-shaped fixing band 11 to be attached to the thigh is fixed to the top 21 of the upper column 12 on the front of the thigh. A hook-and-loop fastener A1 for fixing the thigh is connected to the upper half-moon-shaped fixing band 11, and a portion that is outside the upper half-moon-shaped fixing band 11 is high and a portion that is inside is low. The upper half-moon fixed band 11 and the upper support column 12 are connected to each other on the outer front surface of the thigh to firmly support the thigh. For this reason, both ends of the upper meniscus fixing band 11 can be freely deformed, and can be adjusted in a timely manner according to the thigh shape.

  On the other hand, the lower part D to be attached to the lower leg part is composed of a connecting part 16 and stirrups 18 that branch from the front surface of the lower leg part to both sides thereof, and the lower part to be attached to the lower leg part is above the connecting part 16. A half-moon fixed band 15 is attached. A hook-and-loop fastener A4 for fastening the crus is connected to the lower half-moon-shaped fixing band 15, and the lower half-moon-shaped fixing band 15 and the connecting part 16 support the crus part firmly. Are connected at the front of the. Therefore, both ends of the lower meniscus fixing band 15 can be freely deformed, and can be adjusted in a timely manner according to the shape of the lower leg. Further, the connecting portion 16 and the stirrup 18 are connected to a portion corresponding to the ankle joint via an ankle joint joint 17. Also, shoes 19 are connected to the stirrup 18 so that the foot can be firmly supported. Further, the top portion 21 of the upper portion C has a shape protruding forward from the tip portion 22 of the connecting portion 16 of the lower leg.

These struts 12 and 13, connecting portions 14 and 16, upper half-moon shaped fixing band 11, and lower half-moon shaped fixing band 15 are made of aluminum alloy, other metals, and plastic resin plates that are easy to work and light and strong.
Further, hooks A1, A2, A3, which are wound around the thighs, are attached to the struts 12, 13 and the connecting portion 14 at appropriate positions.

The shapes of the upper half-moon fixed band 11 attached to the thigh and the lower half-moon fixed band 15 attached to the crus can be adjusted on the spot according to the shape of the wearer's lower limb.
In addition, a cushion material for softening the contact with the trunk is attached to the inner side of the upper half-moon-like fixing band 11 attached to the thigh and the lower half-moon-like fixing band 15 attached to the lower leg.

  In FIG. 10, the connecting portion 14 of the upper part C and the connecting part 16 of the lower part D have a cross-sectional shape of “H”. For the connection of these connecting portions 14 and 16, for example, a plurality of screw holes are provided at regular intervals in the vertical direction of one connecting portion 16, and a plurality of through holes corresponding to these screw holes are also provided in the other connecting portion 14. Provided, the through holes of the connecting portion 14 are made to coincide with the screw holes of the connecting portion 16 and then connected by screwing at a plurality of locations.

  The stirrup 18 was made of stainless steel, and the shoes 19 used foot covers.

The hook-and-loop fasteners A1, A2, A3, and A4 for fixing the long leg brace to the lower limb are attached to the upper half-moon fixed band 11, the lower half-moon fixed band 15, the struts 12 and 13, and the connecting portions 14 and 16 at a plurality of locations. However, since the running direction of these hook-and-loop fasteners needs to be changed according to the medical condition and purpose, the attachment position, material, shape and the like are not particularly limited.
Further, in order to firmly fix the lower limbs, the hook-and-loop fasteners and bands A1, A2, A3, and A4 are passed through an annular plastic resin plate (heel) and the hook-and-loop fastener is folded and fixed.

  The support column 12 and the upper half-moon fixed band 11, the connecting part 16 and the lower half-moon fixed band 15, the support column 18 and the shoes 19, the foot joint joint 17 and the support column 18, the hook-and-loop fasteners A1, A2, A3, and A4 They are caulked or connected with screws.

DESCRIPTION OF SYMBOLS 1 Upper half-moon fixed band 2 Upper support | pillar 3 Knee joint 4 Connection part 5 Lower half-moon fixed band 6 Connection part 7 Joint for foot 8 Stirrup 9 Foot support plate 11 Upper half-moon fixed band 12 Upper support 13 Support DESCRIPTION OF SYMBOLS 14 Connection part 15 Lower half-moon fixed band 16 Connection part 17 Joint for foot 18 Stirrup 19 Shoes 21 Head part 22 Tip part A Upper part B Lower part C Upper part D Lower part

Claims (3)

  It consists of an upper part to be attached to the thigh and a lower part to be attached to the lower thigh, and the upper part extends downward while branching from the top of the head located on the front of the thigh to both sides of the thigh. It consists of a strut that joins at the front of the thigh to become a connecting part, and the lower part extends downward from the connecting part located on the front of the lower thigh while branching to both sides of the lower thigh, and both lower ends of the branches Are connected to both sides corresponding to the foot joint of the stirrup, and the upper connecting portion and the lower connecting portion are connected to each other in a vertically adjustable manner. A front strut-type long leg brace characterized in that the portion is provided at a position deviated outward from the tibia of the lower leg.   The upper part to be attached to the thigh and the lower part to be attached to the lower thigh, and the upper part is joined to the front of the lower leg while branching from the front of the thigh to both sides of the thigh Each of the struts corresponding to the knee joints on both sides branched to the both side surfaces is provided with a knee joint joint, and the lower part is connected to the lower leg from the connecting part on the front of the lower leg The lower end of the branch is connected to a portion corresponding to the stirrup ankle joint via an ankle joint, and the upper connection portion and the lower connection portion are vertically moved. A front strut-type long leg brace characterized by being connected in a freely adjustable manner in the direction, and these connected parts being biased outward from the tibia of the lower leg.   The connection part according to claim 1 or 2, wherein a cross-sectional shape of the connection part is formed in a U-shape, and the top of the upper part protrudes forward from a tip part of the connection part of the lower part. Front brace long leg brace.

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