RU95510U1 - MULTIFUNCTIONAL ORTHOPEDIC COMPLEX - Google Patents

Abstract

 A multifunctional orthopedic complex consisting of a rigid corset on the body and orthopedic devices on both lower limbs with hip joints, characterized in that it is equipped with metal tires connecting the corset on the body and orthopedic devices on both lower limbs, hip joints are equipped with locking elements, orthopedic joints additionally equipped with knee joints with locking elements.

Description

The utility model relates to the field of medical technology, namely to orthosis and technical rehabilitation of disabled people with the following neuroorthopedic pathology: hereditary progressive neuromuscular diseases (proximal spinal muscular atrophy, various forms of myopathy, Charcot-Marie polyneuropathy); spinal hernias and / or the consequences of their surgical treatment; consequences of poliomyelitis and poliomyelitis-like diseases.

The rehabilitation of people with disabilities with these diseases is a very difficult task, due to constant or progressive weakness and impaired muscle tone of the trunk and extremities, especially the lower ones, as well as their growing and, as a rule, multiple deformations. Patients with hereditary progressive neuromuscular diseases can usually support with support and rarely move with support until the age of 1-3 years, after which they lose the ability to accept and maintain an upright position and remain sedentary for life. It should be emphasized that the life expectancy of patients with such a pathology in most cases is reduced to 30-40 or less years. Patients with spinal hernias and the consequences of their neurosurgical treatment, in most cases, cannot support and move from birth, while patients after polio are immediately after the disease.

In the practice of neurologists and orthopedists, this category of people with disabilities has so far been a very difficult task in terms of rehabilitation treatment due to the following reasons:

- genetically determined or acquired and often progressive dysfunction of neuromuscular transmission, and accordingly, the function of all skeletal muscles of the body;

- dysfunction of the cardiac and respiratory muscles associated with the same reasons;

- multiple and progressive concomitant orthopedic complications (deformities of the lower extremities and spine).

We believe that patients with the aforementioned diseases need to undergo comprehensive rehabilitation, the main elements of which are the verticalization of patients after conservative and / or surgical preparation and their subsequent movement training, first with support, and then, possibly, on their own. Patients with this pathology need to manufacture a multifunctional orthopedic complex, consisting of a rigid corset on the trunk, rigidly connected to orthopedic devices on both lower limbs with the presence of special hip and knee joints with locking elements.

A device is known - a patent for utility model No. 58911 dated December 10, 2006 - “Modular orthopedic apparatus”, in which one of the modules uses a rigid orthosis on the lumbar spine containing flat landing sites in the area of the hip joints made at an angle to verticals on which hinges are placed, connecting this orthosis with tires rigidly fixed to the side on the thigh sleeves. By using the structure thus obtained, the movement of the lower extremities is ensured while walking in an arc (from the inside to the outside), which ensures optimal movement of the femoral head in the acetabulum. According to the authors, the use of this device allows you to restore or improve the functions of the lower extremities, to get the opportunity to move independently, to correct bone-articular deformities, to prevent secondary deformations, to form the correct stereotypes of movement. This model can be used in neurology, neurosurgery, traumatology, orthopedics, in particular, for the treatment and rehabilitation of patients with cerebral palsy, patients with spinal cord injury, possibly complicated spinal cord injury, scoliosis, patients with consequences of craniocerebral trauma and acute disorders cerebral circulation.

However, this apparatus has disadvantages: the absence of knee joints with locks, which does not allow, depending on the patient's required position, to bend or unbend the patient's lower limbs in the knee joints, and also to fix them in the extension position; the absence of locks in the hip joints, which does not allow the patient to fix the joints in the extension position in an upright position, while the possibility of such locking is an extremely important function in children with severe muscle weakness of the lower extremities and spine, as well as in patients with flexion contractures in the hip joints.

The task of rehabilitation of this contingent of disabled people is to ensure the possibility of stable verticalization of patients for subsequent support and movement in an upright position while maintaining the ability to assume a sitting position with a change in the relative position of the lower limb segments.

Figure 1 shows a general view of a multifunctional orthopedic complex.

Figure 2 shows the appearance of patient K., born in 1999, before treatment: severe flexion contractures in the hip joints are determined.

Figures 3, 4, 5, and 6 show a general view of patient K., born in 1999, in a multifunctional orthopedic complex in the front, right, left, and back, respectively.

The multifunctional orthopedic complex is made according to individual measurements and plaster casts and consists of a rigid corset 1 on the body, connected to orthopedic devices 2 and 3 on both lower extremities with landing on the ischial tubercles and special hip and knee joints 4 and 5 with locking elements 6. Metal tires 7 connect the corset 1 on the body, orthopedic devices 2 and 3 on both lower limbs and are fixed in the hip joints 4.

A multifunctional orthopedic complex is used as follows.

A multifunctional orthopedic complex is placed on a horizontal plane. The attending person puts the patient into corset 1, and then the lower limbs are phased in orthopedic devices 2 and 3. After laying the patient, the multifunctional orthopedic complex, the attending person fixes the patient’s body in corset 1, and the lower limbs of the patient in orthopedic devices 2 and 3. After fixing the patient in a multifunctional orthopedic complex closes the hip and knee joints 4 and 5 in the extension position by the locking elements 6. Then the serving person vert It catalyzes the patient, while the patient uses additional support (walkers, crutches, canes) to maintain a vertical position and can independently move. If necessary, take a sitting position, the attendant or the patient himself will unlock the locking elements 6 of the hip joints 4 and land, bending the lower limbs in the hip joints. The locking elements 6 of the knee hinges 5 in the sitting position can also be unlocked to ensure bending of the lower extremities in the knee joints and, accordingly, greater convenience for the patient.

Here is the clinical observation of patient K., born in 1999, from St. Petersburg. From birth, she was under the supervision of a neurologist in connection with weakness of the muscles of the trunk and lower extremities. Beginning to move from 12 months only with support, and up to 2.5 years old, parents noted a positive trend in the motor development of the child. At the age of 3 years, during the three summer months, she gained excess weight and stopped moving at all, and also stopped independently getting up from the “sitting” and “standing on her knees” positions. I never walked on my own. Up to 4 years, the opportunity remained to place the child at the support; after 4 years, any verticalization became impossible. From 5.5 years old, he was diagnosed with Charcot-Marie disease, type 1. She was constantly observed by a geneticist in the neurology clinic of the St. Petersburg Pediatric Medical Academy, received drug therapy, physiotherapy, massage. From the age of 5-5.5 years, flexion contractures in the hip joints and hyperlordosis in the lumbar spine began to form, which became pronounced by the age of 7. I did not receive regular orthopedic support.

She was initially admitted to the clinic of the Albrecht Center in 2008 at the age of 8 years. Clinical x-ray examination revealed severe hyperlordosis in the lumbar region and extremely severe flexion contractures in the hip joints. The girl constantly led a sedentary lifestyle. In order to prepare for orthosis and verticalization, the clinic conducted a comprehensive conservative treatment and surgical treatment aimed at eliminating myogenic flexion contractures in the hip joints.

In the subsequent child, a multifunctional orthopedic complex was made by individual standards and plaster casts, consisting of a rigid corset on the trunk, connected by metal tires with orthopedic devices on both lower extremities with landing on the ischial tubercles and special hip and knee joints with locking elements.

After issuing a multifunctional orthopedic complex and learning to walk at the physical therapy department, the patient began to move around with a walker a week later, after another 3 months, on her own, with additional support on a cane.

The positive effect of the multifunctional orthopedic complex is the possibility of stable verticalization of patients for subsequent support and movement in an upright position while maintaining the ability to take a sitting position with a change in the relative position of segments of the lower extremities, which significantly increases the ability to self-care and, accordingly, the quality of life for this contingent disabled people.

Claims (1)

A multifunctional orthopedic complex consisting of a rigid corset on the body and orthopedic devices on both lower limbs with hip joints, characterized in that it is equipped with metal tires connecting the corset on the body and orthopedic devices on both lower limbs, hip joints are equipped with locking elements, orthopedic joints additionally equipped with knee joints with locking elements.