RU66671U1 - UPPER EXTREMITY ORTHOPEDIC APPARATUS (EXOSCELETON) AFTER INTER-SURGULAR BREAST RESECTION - Google Patents

Abstract

The orthopedic apparatus (exoskeleton) is designed for the rehabilitation of people with disabilities after interscapular-chest resection and consists of a metal frame with tires (1) having hinges (2) at the level of the elbow joint, and cuffs on the shoulder (3) and forearm (4), shoulder pad ( 5) with two mutually perpendicular hinges (6 and 7), a breast receiving sleeve (8), a chest belt (9) and slaps with caps (10). The chest receiving sleeve (8) fits snugly against the rib cage and is individually made using a plaster cast with pelots and is attached to the trunk with the chest strap (9). The shoulder pad (5) has a shape symmetrical to the healthy shoulder girdle and is connected to the breast receiving sleeve (8) by means of a uniaxial hinge (7) located in the projection of the midline of the clavicle and is designed to fasten the shoulder strap (5) to the breast receiving sleeve (8), and provide retention of the upper limb and its abduction in the apparatus in the sagittal plane. The second shoulder axial hinge (6) is perpendicular to the projection of the shoulder joint, provides fastening of the metal frame with tires (1) and cuffs on the shoulder (3) and forearm (4) and the movement of the upper limb in the frontal plane. In addition, the metal frame with tires and cuffs is attached using dowels with caps (10) directly to the chest receiving sleeve (8). The proposed orthopedic apparatus (exoskeleton) allows you to compensate for the anatomical cosmetic defect in patients after MGR and maximize the functionality of the operated upper limb. 1 ill.

Description

The utility model relates to the field of medical technology, namely to the orthosis and technical rehabilitation of persons with disabilities who underwent surgery, interscapular-chest resection (MGR).

Treatment and orthopedic support for cancer patients who underwent amputation and resection of a part of the skeleton is a very difficult task. Of particular difficulty is the orthosis after interscapular-thoracic resection. The operation of the interscapular-thoracic resection (MGR) with the preservation of the distal part of the humerus is a serious surgical intervention exacerbating disability. After such an operation, the shoulder girdle is devoid of the scapula, collarbone and most of the humerus. The distal part of the shoulder, forearm and hand remain skeletonized. After such a resection, the preserved limb is retained by the soft tissues, the skin case and the neurovascular bundle.

Patients are forced to hold the operated limb with their healthy hands, or to fix it with clothing elements, which causes significant inconvenience and discomfort when performing various household and labor operations and limits their vital activity. In an arbitrary position, limb sagging occurs, neurovascular disorders occur, accompanied by pain and impaired motor function (Fig. 1).

To restore the function of the operated limb and rehabilitation of such disabled people, an orthosis is necessary. When performing orthosis, the following requirements must be met:

- from the side of the operated limb there should be no trophic changes;

- the limb must be in the correct anatomical and physiological position;

- fastening of the orthosis (orthopedic apparatus) should not impede excursions of the chest and exert excessive pressure on it;

- functioning of a limb in various spatial positions;

- providing a cosmetic look.

The whole complexity of orthopedic provision is due to the placement and fixation of an artificial shoulder pad with a preserved upper limb to the body and

ensuring the functioning of the entire system in the absence of half of the shoulder girdle, bone bases for the location of the entire structure.

A device is known - an apparatus for the whole arm with a grip of the shoulder joint (AP8-02), consisting of a leather sleeve of the shoulder with a grip of the shoulder joint, leather sleeve of the forearm and a metal frame with hinged joints at the level of the elbow and wrist joints, with a lock in the elbow joint and elastic traction for the implementation of the back flexion of the brush. The device is fastened using lacing and a chest belt (Manual on prosthetics and orthosis / Edited by A.N. Keyer and A.V. Rozhkov. - SPb. 1999. - P.425, Fig. 160).

However, this design cannot be used after MGR, since due to the absence of half of the shoulder girdle, the retention of the operated upper limb is not possible. In addition, the lack of design of the shoulder hinge does not provide the functionality of the operated limb.

There is also an orthopedic unloading and discharge apparatus (AR8-07) - a prototype consisting of a half-corset with tires and an articulated bracket with cuffs on the shoulder and forearm. The bracket consists of metal tires, a brush holder with an emphasis, an axillary biaxial hinge, a vertical axle guide with a bracket mounted on the half-corset tire. The first axillary joint allows the removal of the upper limb in the apparatus to an angle of 180 °, the second axillary joint allows rotation of the arm outward to an angle of 10 °. The half-corset provides unloading of the limb in the apparatus on the body, and also prevents the occurrence of spinal deformity. (Manual on prosthetics and orthosis / Edited by A.N. Keyer and A.V. Rozhkov. - St. Petersburg, 1999. - p. 425, Fig. 161). This design provides only abduction and discharge of the upper limb. However, it also does not allow you to use the functionality of the saved limb and does not provide mobility of the shoulder joint in the frontal plane.

The proposed utility model consists of a metal carcass with tires 1 having hinges 2 at the level of the elbow joint, and cuffs on the shoulder 3 and forearm 4, shoulder 5 with two mutually perpendicular hinges 6 and 7, chest sleeve 8, breast belt 9 and splint with caps 10. The chest receiving sleeve 8 is tightly attached to the chest and is made individually according to the plaster cast with pelots and is attached using the chest strap 9 to the body. The shoulder pad 5 has a shape symmetrical to the healthy shoulder girdle and is connected to the breast receiving sleeve 8 by means of a uniaxial hinge 7 located in the projection

the midline of the clavicle, and is designed to attach the shoulder pad 5 to the chest receiving sleeve 8, and to ensure the retention of the upper limb and lead it in the apparatus in the sagittal plane. The second shoulder axial hinge 6 is perpendicular to the projection of the shoulder joint, provides fastening of the metal frame with tires 1 and cuffs on the shoulder 3 and forearm 4 and the movement of the upper limb in the frontal plane. Additionally, the metal frame with tires and cuffs is attached using dowels with caps 10 directly to the breast receiving sleeve 8 (Fig. 2, 3).

The proposed orthopedic apparatus (exoskeleton) allows you to compensate for the anatomical and cosmetic defect in patients after MGR and maximize the functionality of the operated upper limb.

Claims (1)

Orthopedic apparatus (exoskeleton) to the upper limb after interscapular-thoracic resection, consisting of a metal frame with tires having joints at the level of the elbow joint, cuffs on the shoulder and forearm and splints with drops, shoulder straps, chest sleeve with pelots and chest strap, different the fact that the shoulder strap is provided with mutually perpendicular hinges.