TWI412351B - 義足 - Google Patents

義足 Download PDF

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TWI412351B
TWI412351B TW095144874A TW95144874A TWI412351B TW I412351 B TWI412351 B TW I412351B TW 095144874 A TW095144874 A TW 095144874A TW 95144874 A TW95144874 A TW 95144874A TW I412351 B TWI412351 B TW I412351B
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foot
joint
lower coupling
coupling member
joint portion
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TW095144874A
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TW200727880A (en
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Mosler Lueder
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Bock Healthcare Ip Gmbh
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    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/66—Feet; Ankle joints
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2002/5003—Prostheses not implantable in the body having damping means, e.g. shock absorbers
    • A61F2002/5006—Dampers, e.g. hydraulic damper
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2002/5072—Prostheses not implantable in the body having spring elements
    • A61F2002/5073—Helical springs, e.g. having at least one helical spring
    • A61F2002/5075—Multiple spring systems including two or more helical springs
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/66—Feet; Ankle joints
    • A61F2002/6614—Feet
    • A61F2002/6621—Toes
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/66—Feet; Ankle joints
    • A61F2002/6614—Feet
    • A61F2002/6635—Metatarsals
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/66—Feet; Ankle joints
    • A61F2002/6614—Feet
    • A61F2002/6642—Heels
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/66—Feet; Ankle joints
    • A61F2002/6614—Feet
    • A61F2002/6657—Feet having a plate-like or strip-like spring element, e.g. an energy-storing cantilever spring keel
    • A61F2002/6678—L-shaped
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/66—Feet; Ankle joints
    • A61F2002/6614—Feet
    • A61F2002/6657—Feet having a plate-like or strip-like spring element, e.g. an energy-storing cantilever spring keel
    • A61F2002/6685—S-shaped

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  • Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Description

義足
本發明關於一種義足，具有一用於接一小腿部的接頭部及一足前部，該足前部利用一上聯接元件及一下聯接元件與該接頭部樞接，使該接頭部的角度位置控制足前部的角度位置，其中該聯接部之一延伸到一直到義足的踵區域進去。
在未先公開的德專利申請案DE 10 2004 031 562 A1提到一種此類義足，此外一些相關細節可參考其揭示內容。藉著將足前部與該用於接小腿部的接頭部經由二個聯接元件連接，而首此能就角位置方面在接頭部及足前部之間造成強迫式聯接。當接頭部或小腿部的角位置向後改變，會造成足前比成比例地上升。因此該義足可從一個無突部的位置〔熊腳位置(Bärfußstellung)〕放入具有一高突部的鞋中，如此，小腿的位置以及接頭部的位置--相對於人工義足的腳底向角度調角的方向朝後改變。如此，足前部上升一段距離，使它再平行於倚靠面(鞋的前鞋底)。因此，足前部牢牢倚在站立面上，且承受安全站立所需的負荷(它也具有高的突部)。因此，不需將前足部先設計成軟或彈性的設計。
上述義足宜含有一種多關節設置，特別是四關節設置，其中該聯接元件可在足前部與一足中部區域大致互相平行。如此造成接頭部與足前部的角度運動的一種1：1的聯 接，它對於配合突部高度而言係理想者。在上述義足，該上聯接元件一直延伸到踵區域進去，因此設計成一種蹺蹺板(Wippe)的形式，該蹺蹺板大約在中央以樞接方式支承在接頭部上。這種結構有一優點，即：上聯接元件的旋轉關節大約設在自然的骨關節的位置。但其缺點為：該設計成蹺蹺板形式的上聯接元件的負荷運動會將義足在足底區域的是長度改變，因此，舉例而言，在一種蹺蹺板的負荷時，會造成義足之不想要的徘徊。
因此本發明的目的在達成上述種類的義足的優點，而不須忍受由於上聯接元件的運動造成足長度改變的缺點，為達成此目的，在上述種類的義足，依本發明構成之道，係使該下聯接元件一直延伸到腫區域進去。在本發明的人工義足，足前部的運動造成足長度改變，因此由於足長度改變進造成之缺點得以避免。由於對於本發明的義足的趾節運動，下聯接元件的關節係很有關係者，因此本發明的優點導致下聯接元件的關節大約在生理的趾節關節的位置下方，因為基於化粧的理由，並不希望足結構的構造高出很多。在此情形，就旋轉關的位置而言，需根據一種補償的解決之道。
另外本發明的義足可使是前部的角度位置自動配合義足的足底的放置面，這種放置面一方面係用該足前部與該聯接元件(它們構成是中部區域)之間的連接點處的放置點「蹠球(蹠墊)」(Ballen，英：ball of the foot)定義， 另方面用踵區域的後端的「踵」定義。在一個具有一較高的鞋根(Absatz)的鞋中，此放置面與水平面成傾斜。由於小腿部須大致垂重朝向以保持平衡，故在此在下聯接元件與接小腿用的接頭之間造成一向後扭轉的角度。此角度傳送到足前部，且用於使足前部升起，因此足前部平平地平行於地面或鞋的內底區域對準，且在足前部區域中可承受一些力量，這些力量使得站立安全性很高。
一如在DE 10 2004 031 562 A1的上述結構，宜將二聯接元件之一設計成在限度內可改變長度，對於步行，該趾節的角向運動直接傳到足前部的方式並非有利者。較佳者為利用聯接元件的傾斜位置造成的增速(Übersetzung)，這種增速將趾節的角向運動以更高比例轉換成足前部的運動。在此情形，要將鞋跟的高度作補償，需要將其中一聯接元件作長度配合，這種配合可用靜態方式達成，因此只有在換鞋子時，才須作長度配合以配合鞋跟高度。也可用動態方式改變長度，其方法係使二聯接元件之一可呈彈性方式拉長或例如利用一油壓缸作長度調整。如此，舉例而言，可將在該重量預移位時發生之強大的足前部負荷減少。如果可逆著一股遞增的彈性反抗力的作用將長度改變，則如所欲者，可產生一股繼續成長的足前部反抗力。當患者站立時的一些「波動」可利用一股連續成長的彈性抗力安定化，這點造成自然的站立感。
聯接元件的長度改變也可利用一油壓缸造成，且宜用一種只能慢慢改變而調整的油壓缸，它在短時的負荷時阻 塞住。這種油壓缸在DE 10 2004 031 562 A1具體敘述。
對於步行的動力學而言，如果在踵區域與接頭元件之間的相對運動利用一緩衝裝置緩衝，則甚有利。在此，該緩衝裝置要有一種緩衝性彈簧功能，但也宜能設計成使它對靜力負荷反應，其方式係設以一個具一環流開口(Ümströmungsöffnung)的油壓缸，用此方式，可配合不同鞋跟高度，使得各站立位置都不受力且不須對抗一些對抗的力量保持住。
聯接元件的關節式固定方式宜不利用旋轉關節達成，而係利用一種彈簧彈性的結合。在此，該彈簧彈性的結合可只該聯接元件的一端造成，但也可在聯接元件兩端造成。
在本發明一特佳的實施例，該下聯接元件用各一彈簧片元件倚靠在足前部及在接頭部上，其中該二彈簧片元件在踵區域導進，且在該處平坦地互相倚靠。在此，該與接頭元件連接的彈簧片元件形成一C形，而該與足前部連接的彈簧片元件具一輕的波形。
此外，本發明的義足還適用於附加的動態調整，其中一聯接元件的緩衝性質可連續地控制(例如當使用一個具有可用電子方式調整的閥的油壓缸時)。在此，這種控制作用可依義足之測量之負荷狀態及位置狀態達成。
本發明在以下利用圖式中所示的實施例詳細說明。
圖1中所示之一本發明的義足的第一實施例有一接頭 部(1)，其上側設有一承接器突部(2)，呈一種在頭上豎立的截錐部。承接器突部(2)可使一小腿義肢之管形小腿部能用可調整的方式容納。
有一上聯接部(3)利用一旋轉關節(4)與接頭部(1)連接。上聯接元件的另一端經另一旋轉關節(5)與一足前部連接。利用它模仿自然腳的趾區域。在足前部(6)上在旋轉關節(5)下方有另一旋轉關節(7)，有一下聯接元件(8)經此旋轉關節(7)與足前部(6)連接。下聯接元件(8)經一旋轉關節(9)樞接到接頭部(1)之一下端，且有一突部，該突部係由下聯接元件(8)超出旋轉關節(9)出去延續到一自由之踵端而形成者，該突部突伸到義足的踵區域中。因此，自由的踵端略向下彎一角度。圖中可看出，該下聯接元件(8)的後方自由踵端及該二旋轉關節(7)(9)構成一蹺蹺板，舉例而言，當腳放到踵部上，以作踏步時，受到地面在踵端上的阻力使該蹺蹺板受負荷，且因此將一力矩施到足前部(6)，利用該力矩使足前部(6)向上樞轉。該蹺蹺板的旋轉關節(9)相當於趾節關節。
足前部(6)形成一個大約三角形的楔，其下側平行於一放置面(圖未示)以供足在足前部(6)的區域放置。
在圖1中所示的實施例中，該接頭部(1)、聯接元件(3)(8)及足前部(6)呈剛性設計。因此，在踵端(10)的區域的負荷馬上使足前部(6)向上轉，這種動作相當於腳趾上揚。為了減少這種不自然的方應，在圖2之變更實施例中設有一緩衝器(12)，它設在下聯接件(8)的接頭部(1)與踵端(10)之間。當 將踵端(10)施以一地面作用力時，舉例而言，該緩衝器(12)使後踵端(10)向上的樞轉延遲且如有必要還可使之受限制。如此可使足前部的樞轉對應地延遲及受限。
緩衝器(12)宜設計成具一環流開口的油壓缸的形式。該環流開口會受太高的流速封閉。如此，如果例如該義足放入一具高鞋跟的鞋子中時，則可將接頭部(1)及後踵端(10)或下聯接元件(8)之間的角度位置以似靜態方式改變。用此方式可將義肢的接頭部(1)的角位置以及小腿部的角位置相對於下聯接元件(8)作配合，俾當由於高鞋跟使下聯接元件(8)站偏時，能使小腿部保持垂直朝向，這種垂直朝向不須逆著彈性作用力保持。
此外，下聯接元件(8)的角位置係由放置面造成，這些放置面一方面係在後踵端(10)造成，且在該設有旋轉關節(7)的前蹠球端(Ballenende)(13)造成。
此外要說明，該緩衝器(12)同樣地與後踵端(10)及接頭部(1)樞接。由圖2可看到接頭部(1)中一對應的旋轉點(14)。
在圖3中所示之實施例中，該上聯接元件(3’)設計成可利用一油壓缸改變長度。此實施例有助於使義足配合鞋的不同鞋跟高度。此外，該下聯接元件(8)設有一突部(15)(Ansatz)，它係該下聯接元件(8)延續超出旋轉關節(7)出去進到一自由端所形成者，而兩側各有一壓縮彈簧(16)施力，該壓縮彈簧呈彈性緩衝，且被止擋部(17)定出界限，俾避免足部(6)之過度的樞轉作用。
在圖4中所示之本發明的義足的第三實施例，該接頭 部(1)與足前部(6)各設有一倚靠面(18)(19)，各一彈簧片元件(20)(21)的一個對應的部段倚靠在該倚靠面(18)(19)上並對應地固定在該處。該二彈簧片元件(20)(21)一同構成下聯接元件(8)，因此下聯接元件(8)設計成彈性者。與接頭部(1)連接的彈簧片元件(20)設計成大致C形，且同時造成一彈性之踵元件。因此作與圖2的緩衝器(12)相似的功能。與足前部(6)連接的彈簧片元件(21)呈足底的方式呈波狀從足前部(6)延伸到踵端(10)，該二彈簧片元件(20)(21)在該踵端(21)平坦地相倚靠，互相連接，且共同構成一自由端。
由於彈簧片元件(20)(21)的造形，造成旋轉點(22)(23)。旋轉點(22)在接頭部(1)附近，且作趾節關節的功能，而旋轉點位在義足的蹠球(Ballen)區域的彈簧片元件(21)上。
圖中可看出，在圖1~圖4所示之實施例中，係造成前足部(6)的樞轉角度的強迫控制作用，但有效的足長度保持不變。
(1)‧‧‧接頭部
(2)‧‧‧承接器突部
(3)‧‧‧上聯接部
(4)‧‧‧旋轉關節
(5)‧‧‧旋轉關節
(6)‧‧‧足前部
(7)‧‧‧旋轉關節
(8)‧‧‧下聯接元件
(9)‧‧‧旋轉關節
(10)‧‧‧踵端
(12)‧‧‧緩衝器
(13)‧‧‧蹠球端
(15)‧‧‧突部
(16)‧‧‧壓縮彈簧
(17)‧‧‧止擋部
(18)(19)‧‧‧倚靠面
(20)(21)‧‧‧彈簧片元件
(22)(23‧‧‧旋轉點
圖1係一本發明的義足的第一實施例的一側視圖。
圖2係變更之第一實施例的一側視圖，圖3係本發明義足的第二實施例，圖4係本發明的義足的第三實施例。
(1)‧‧‧接頭部
(2)‧‧‧承接器突部
(3)‧‧‧上聯接部
(4)‧‧‧旋轉關節
(5)‧‧‧旋轉關節
(6)‧‧‧足前部
(7)‧‧‧旋轉關節
(8)‧‧‧下聯接元件
(9)‧‧‧旋轉關節
(10)‧‧‧踵端
(12)‧‧‧緩衝器

Claims (11)

  1. 一種義足，具有一用於接一小腿部的接頭部(1)及一足前部(6)，該足前部利用一上聯接元件(3)及一下聯接元件(8)與該接頭部(1)樞接成四關節式裝置，使該接頭部(1)的角度位置控制足前部(6)的角度位置的成比例的變化，其中該接頭部(1)的角度位置的向後變化造成該足前部(6)之成比例的升起，且其中該下聯接部(8)一直延伸到該踵區域進去。
  2. 如申請專利範圍第1項之義足，其中：該二聯接元件(3)(8)之一設計成長度可改變。
  3. 如申請專利範圍第2項之義足，其中：該二長度可改變的聯接元件(3)或(8)設計成可逆著一股增加的彈性逆向力而樞轉。
  4. 如申請專利範圍第2項之義足，其中：該長度可變的上聯接元件(3)有一油壓缸(14)。
  5. 如申請專利範圍第2或第3或第4項之義足，其中：該上聯接元件(3)設計成長度可變。
  6. 如申請專利範圍第1或第2項之義足，其中：該踵區域中延伸的下聯接元件(8)與接頭部(1)之間設有一緩衝裝置(12)。
  7. 如申請專利範圍第1或第2項之義足，其中：該下聯接元件(8)之一的一個樞接部係利用至少一種彈簧彈性的結合而形成。
  8. 如申請專利範圍第7項之義足，其中：該下聯接元件(8)呈彈簧彈性方式倚在足前部(6)及在接頭部(1)上。
  9. 如申請專利範圍第8項之義足，其中：該下聯接元件(8)呈彈簧彈性方式用各一彈簧片元件(20)(21))倚在該足前部(6)及接頭部(1)上，且該彈簧片元件(20)(21)在踵區域中導進且在該處平坦地互相倚靠。
  10. 如申請專利範圍第1或第2項之義足，其中：該足前部(6)相對於下聯接元件(8)的運動受到一接在其間的彈簧彈性的止擋裝置(16)(17)限制。
  11. 如申請專利範圍第1或第2項之義足，其中：該上聯接元件(3)或下聯接元件的緩衝性質設計成可依所測量的負荷狀態及/或位置狀態而定而可調整。
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