WO2000003665A1 - Coiffe prothetique distale, garniture et fourreau - Google Patents

Coiffe prothetique distale, garniture et fourreau Download PDF

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Publication number
WO2000003665A1
WO2000003665A1 PCT/US1999/001460 US9901460W WO0003665A1 WO 2000003665 A1 WO2000003665 A1 WO 2000003665A1 US 9901460 W US9901460 W US 9901460W WO 0003665 A1 WO0003665 A1 WO 0003665A1
Authority
WO
WIPO (PCT)
Prior art keywords
distal end
end cap
cap
liner
socket
Prior art date
Application number
PCT/US1999/001460
Other languages
English (en)
Inventor
Carl A. Caspers
Original Assignee
Caspers Carl A
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Caspers Carl A filed Critical Caspers Carl A
Publication of WO2000003665A1 publication Critical patent/WO2000003665A1/fr

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    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
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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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/005—Rosette-shaped, e.g. star-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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00035—Other metals or alloys
    • A61F2310/00047—Aluminium or Al-based alloys

Definitions

  • the present invention relates to prosthetic devices and more particularly to a distal cap for a prosthetic liner and socket.
  • Residual limbs come in various sizes and shapes with respect to the stump. That is, most new amputations are either slightly bulbous or cylindrical in shape while older amputations that may have had a lot of atrophy are generally more conical in shape. Residual limbs may further be characterized by their various individual problems or configurations including the volume and shape of a stump and possible scar, skin graft, bony prominence, uneven limb volume, neuroma, pain, edema or soft tissue configurations.
  • a below the knee residual limb 10 is shown and described as a leg 12 having been severed below the knee terminating in a stump 14.
  • the residual limb 10 includes soft tissue as well as the femur 16, knee joint 18, and severed tibia 20 and fibula 22.
  • a below the knee residual limb 10 has its stump 14 generally characterized as being a more bony structure while an above the knee residual limb may be characterized as including more soft tissue as well as the vascular routes and nerve bundles.
  • amputees who have lost part of their arm 26, which terminates a stump 28 may also be characterized as having vascular routes, nerve bundles as well as soft and bony tissues.
  • the residual limb 10 includes the humerus bone 30 which extends from below the shoulder to the elbow from which the radius 34 and ulna bones 36 may pivotally extend to the point of severance.
  • the humerus bone 30 are the biceps muscle 38 and the triceps muscle 40 which may still yet be connected to the radius 34 and the ulna 36, respectively.
  • the residual limb amputee that has a severed arm 26 does not have the pressure bearing considerations for an artificial limb but rather is concerned with having an artificial limb that is articulable to offer functions typical of a full arm, such as bending at the elbow and grasping capabilities.
  • An individual who has a paralyzed limb would also have similar considerations wherein he or she would desire the paralyzed limb to have some degree of mobility and thus functionality.
  • All of these various artificial limbs have sockets to put the amputee's stump 14 into.
  • Another category of sockets is a socket that utilizes a liner or insert. Both categories of sockets typically were open ended sockets which had a hollow chamber in the bottom and no portion of the socket touched the distal end of the stump 14. The stump was supported about its circumferential sides as it fit against the inside wall of the sockets.
  • the suction liner produces a kind of Chinese fmger trap action when the weight of the artificial limb pulls on the liner. That is, when the amputee is standing on the artificial limb (phantom lines), weight bearing forces the limb to take the shape of the socket. As the amputee begins to walk and goes into swing phase where the body's weight is off the artificial limb, gravity acts on the artificial limb and the attached suction liner L.
  • the liner L which is typically a somewhat collapsible tube with flexible walls and a closed chamber, has a tendency to draw the soft tissue at the end of the stump 14 toward the artificial limb, as shown by the downward arrow, causing the soft tissue to elongate and the residual limb to narrow. Also, the liner has a tendency to begin to stretch downwardly and as this occurs there is a compression inwardly as shown by arrows C. This also causes a pumping action which causes fluid to be drawn into the elongated and narrowed portion of the residual limb. Then, when the amputee goes back in to weight bearing phase, the soft tissue that was just elongated and narrowed now becomes compressed.
  • the distal end cap must simply be non-collapsing. It does not have to be rigid.
  • the distal end cap may be constructed of any semi-rigid, non-collapsing material, including without limitation plastics, thermoplastics, urethanes, carbon fibers, or aluminum.
  • the distal end cap may cover various portions of the residual limb, depending on the shape, bony structure, and volume of the residual limb. That is, in below the knee amputations, for example, the tissue in the distal end of the residual limb is primarily fluids. Closer to the knee joint, the tissue becomes more in the nature of ligaments, tendons, and white fiber.
  • the distal end cap system of the present invention has advantages over earlier systems that used a double wall socket with a suspension sleeve that holds the inner socket to the residual limb.
  • the suspension sleeve is stretched over the top of the inner socket.
  • the sleeve also has to stretch over the side walls of the socket, which tend to interfere with movement or to create more effort in bending the knee.
  • the knee is an eccentric joint that doesn't have a common center so that as the leg is moved from straight extended to 90° flexion or further, the diameter and shape of the knee changes rather dramatically and the internal socket is quite rigid and doesn't accommodate that motion.
  • the system of the present invention eliminates this displacement and pressure because only the suction liner comes up over the knee and allows for a more normal range of motion without the levering effects of the side walls of the inner socket. Simply put, the liner acts more like skin that flexes when the knee does.
  • a semi-rigid, non-collapsing distal end cap for engaging the socket liner and socket of an artificial limb to prevent the weight of the artificial limb, acting upon the liner, from compressing and stretching the residual limb
  • the distal end cap consisting of a cap portion constructed of a semi-rigid, non-collapsing material adapted to sustain the diameter of the residual limb without collapsing under load and having a height sufficient to enclose the distal end of the residual limb, the cap portion being in contact with the liner and the liner enclosing the residual limb; and a docking portion for connecting to the artificial limb socket.
  • a principal object and advantage of the present invention is that it prevents elongation and narrowing of the distal end of the residual limb due to the weight of the artificial limb pulling on the socket liner.
  • Another principal object and advantage of the present invention is that it prevents the build-up of fluids in the distal end of the residual limb due to the drawing effect of the weight of the artificial limb on the socket liner.
  • Another object and advantage of the present invention is that it prevents a shearing effect on the skin of the distal end of the artificial limb due to the drawing effect of the weight of the artificial limb on the socket liner.
  • Another object and advantage of the present invention is that it can be constructed of any semi-rigid, non-collapsing material.
  • Another object and advantage of the present invention is that the height of the distal end cap can be varied to accommodate the structure of the residual limb. Another object and advantage of the present invention is that it may be permanently attached to the socket liner.
  • Another object and advantage of the present invention is that it may have an attached suspension sleeve for suspending the distal end cap from the residual limb.
  • Another object and advantage of the present invention is that it may be constructed out of a moldable material to mold the shape of the distal end cap to the shape of the distal end of the residual limb.
  • FIG. 1 is a side elevational view of the tissue and skeletal structure of an amputee's residual limb.
  • FIG. 2 is a side elevational view of a residual limb in the form of an amputated arm showing the skeletal and muscular structure of the residual limb.
  • FIG. 3 is a perspective view of a reduced positive model of the socket as described in U.S. Patent No. 5,258,037.
  • FIG. 4 is a perspective view of a liner produced as described in U.S. Patent No. 5,258,037.
  • FIG. 5 shows a prior art liner with shuttle system attached to a residual limb, and showing the elongation forces exerted upon the residual limb as the wearer moves the artificial limb between swing phase and weight-bearing phase (shown in phantom).
  • FIG. 6 is a schematic cross-section of a first embodiment of a distal end cap of the present invention.
  • FIG. 7 illustrates how the distal end cap of FIG. 6 is heated, molded, and attached to the liner which in turn is in place on a reduced positive mold of the residual limb.
  • FIG. 8 illustrates further the process of FIG. 7, with the distal end cap now being conformed to the shape of the residual limb.
  • FIG. 9 shows the completed model ready for manufacture of the socket, with the distal end cap completely conformed to the shape of the residual limb and the valve and docking system removed.
  • FIG. 10 shows the completed artificial limb with the liner and distal end cap shown in phantom and with structure broken away to show the docking system.
  • FIG. 11 is a perspective view of the complete socket system in place on the residual limb, with some structure broken away to show internal components.
  • FIG. 12 is a schematic cross-section of a second embodiment of the distal end cap of the present invention.
  • FIG. 13 shows the embodiment of FIG. 12 in place on the residual limb.
  • FIG. 14 illustrates attachment of the distal end cap to the socket by means of a Velcro strap.
  • FIG. 15 illustrates attachment of the distal end cap to the socket by means of a lanyard and cleat.
  • FIG. 16 is a cross-section along the lines 16 of FIG. 11.
  • the distal end cap of the present invention is generally designated in the Figures as reference numeral 110.
  • a first embodiment of the distal end cap 110 comprises a cap portion 112 constructed of a semi-rigid, non-collapsing material adapted to sustain the WO 00/03665 _g_ PCT US99/01460 diameter of the residual limb without collapsing under load, and a docking portion 114 for connecting to the artificial limb socket.
  • the cap portion 112 may be made of any semi-rigid, non-collapsing material including, without limitation, plastics, thermoplastics, urethanes, carbon fibers, or aluminum.
  • the cap portion 112 is moldable to the shape of the distal end of the residual limb, as will be further discussed below.
  • the height H of the cap portion need only be enough to enclose the distal end of the residual limb.
  • the height H may be higher when the residual limb has a lot of soft tissue, as in above the knee (AK) residual limb, and the height H may be less when the residual limb is more bony, as in a below the knee (BK) residual limb.
  • the first embodiment of the distal end cap 110 is permanently attached to the liner L, preferably by an adhesive, as discussed below.
  • Fig. 6 shows the distal end cap 110 before attachment to the liner.
  • Figs. 7, 8, and 9 show the manufacturing process for an artificial limb socket incorporating the distal end cap 110. It will be understood that Figs. 7 and 8 also show the process of manufacturing the distal end cap embodiment attached to the liner.
  • FIG. 12 A second embodiment of the distal end cap 110 of the present invention is shown in Figs. 12 and 13.
  • the distal end cap 110 is not permanently attached to the liner L. Rather, the distal end cap 110 has a suspension sleeve S (discussed in U.S. Patent No. 5,571,208 and herein incorporated by reference) attached to the cap portion 112.
  • the wearer dons the distal end cap 110 with the suspension sleeve S rolled downwards about the cap portion 112. Then, as shown in Fig.
  • the suspension sleeve S is rolled upward over the liner L and the residual limb 14, so that the suspension sleeve S "tacks up" to the residual limb 14 as previously discussed in U.S. Patent No. 5,571,208.
  • the wearer has the option of replacing the liner L if it becomes soiled or damp with perspiration.
  • the distal end cap 110 may also preferably include a one-way valve 116 traversing the distal end cap 110 and adapted to evacuate air from the liner L as the wearer dons the liner.
  • the valve 116 may traverse the cap portion 112, in which case it is WO 00/03665 _ Q _ PCT/US99/01460 shown as 116a.
  • the valve 116 may traverse the docking portion 114 in which case it is shown as 116b.
  • the docking portion 114 preferably further comprises a mechanical interlocking linkage 114a releasably connecting the distal end cap 110 and the socket 104, as shown in Fig. 11.
  • the Figures show the mechanical interlocking linkage 114a as a cylindrical member with a number of ratchets therealong, for connecting to an appropriate orifice (not shown) in the socket 104.
  • any equivalent mechanical interlocking linkage may be used, as for example the ring 128 and pin disclosed in U.S. 5,258,037 or a smooth cylindrical member (not shown) with a cotter pin inserted therethrough.
  • the function of the docking portion 114 is to hold the distal end cap 110 to the socket 104, and any equivalent structure which accomplishes this task may be used.
  • the distal end cap 110 may include a strap 118 attached to the distal end cap 110 at one end and to the socket 104 at the other end of the strap, as seen in Figs. 14 and 15.
  • the strap 118 has a hook-and-loop fastener 118b attached to one end of the strap 118 and a matching hook-and-loop fastener 118a attached to the socket 104.
  • the strap 118 feeds out of the socket 104 through an opening 122.
  • the strap 118 attaches to the socket 104 by means of wrapping around a cleat 124.
  • the distal end cap 110 may also include an alignment system 130 for aligning the docking system 114 and valve 116 with corresponding structures in the socket 104.
  • the alignment system 130 may preferably comprise a tab, tongue, or protrusion 132 which mates with a groove or slot 134 in the wall of the socket 104.
  • the distal end cap 110 of the present invention is placed upon the liner L which is in turn in placed on the reduced positive model M as shown in Fig. 7.
  • Heat is then suitably applied to conform the distal end cap 110 to the shape of the residual limb, as for example by a heat gun as shown in Fig. 7.
  • the distal end cap 110 conforms to the shape of the residual limb as shown in Fig. 8.
  • adhesive A (Fig.
  • valve V and docking shuttle S may be removed from the distal end cap, as shown in Fig. 9.
  • the construction process then continues as described in U.S. Patent No. 5,258,037. It will be recognized that because the distal end cap 110 is in place on the model M, space will be left in the negative model of the socket to accommodate a distal end cap 110 when it is later donned by the wearer.
  • the end result of the construction process is the artificial limb shown in Fig. 10.
  • the artificial limb includes a socket 104, shin 106, and foot 108.

Landscapes

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

Abstract

L'invention concerne une coiffe d'extrémité distale semi-rigide non comprimable destinée à venir au contact d'une garniture de fourreau et d'un fourreau d'un membre artificiel pour empêcher que le poids de celui-ci, agissant sur la garniture, ne comprime et n'étire le membre résiduel, la coiffe d'extrémité distale étant constituée d'une partie de coiffe composée d'un matériau semi-rigide non comprimable adapté pour supporter le diamètre du membre résiduel sans écrasement sous la charge et ayant une hauteur suffisante pour renfermer l'extrémité distale du membre résiduel, la partie de coiffe étant au contact de la garniture et la garniture enveloppant le membre résiduel; l'invention concerne aussi une partie de retenue destinée à être reliée au fourreau du membre artificiel.
PCT/US1999/001460 1998-07-15 1999-01-25 Coiffe prothetique distale, garniture et fourreau WO2000003665A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US11505398A 1998-07-15 1998-07-15
US09/115,053 1998-07-15
US39970899A 1999-09-21 1999-09-21

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WO2000003665A1 true WO2000003665A1 (fr) 2000-01-27

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PCT/US2000/013613 WO2001021113A2 (fr) 1998-07-15 2000-05-18 Garniture prothetique a renforcement distal

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WO2001021113A3 (fr) * 1998-07-15 2001-11-15 Caspers Schneider Technologies Garniture prothetique a renforcement distal
DE10026399A1 (de) * 2000-05-29 2001-12-06 Medi Bayreuth Gmbh & Co Interimsprothese
US6508842B1 (en) 1999-06-03 2003-01-21 Barbara J. Caspers Socket liner for artificial limb
US6554868B1 (en) 1999-06-03 2003-04-29 Carl A. Caspers Vacuum pump and shock absorber for artificial limb
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US7655049B2 (en) 2001-07-26 2010-02-02 Phillips Van L Socket insert having a bladder system
US8097042B2 (en) * 2006-01-05 2012-01-17 Prosthetic Design, Inc. Double-wall prosthetic limb assembly
US9044348B2 (en) 2012-04-30 2015-06-02 Ossur Hf Prosthetic device, system and method for increasing vacuum attachment
WO2015143249A1 (fr) * 2014-03-20 2015-09-24 Lim Innovations, Inc. Emboîture prothétique modulaire améliorée
US9198780B2 (en) 2012-02-14 2015-12-01 Ossur Hf Vacuum assisted suspension system
US9364348B2 (en) 2013-03-01 2016-06-14 Ossur Hf Vacuum suspension system
US9468542B2 (en) 2013-06-21 2016-10-18 Lim Innovations, Inc. Prosthetic socket and socket liner with moisture management capability
US9468543B2 (en) 2011-11-12 2016-10-18 Lim Innovations, Inc. Modular prosthetic sockets and methods for making same
US9474633B2 (en) 2014-05-05 2016-10-25 Lim Innovations, Inc. Alignable coupling assembly for connecting two prosthetic limb components
US9757256B2 (en) 2014-07-01 2017-09-12 Ossur Hf Pump mechanism for vacuum suspension system
US9943421B2 (en) 2015-05-21 2018-04-17 Ossur Iceland Ehf Membrane pump system for use with a prosthetic system
US9962273B2 (en) 2015-05-13 2018-05-08 Ossur Iceland Ehf Adjustable socket system
US9980779B2 (en) 2013-12-16 2018-05-29 Lim Innovations, Inc. Method and system for assembly of a modular prosthetic socket based on residual limb metrics
US10028845B2 (en) 2015-01-08 2018-07-24 Ossur Iceland Ehf Pump mechanism
US10172728B2 (en) 2015-11-25 2019-01-08 Lim Innovations, Inc. Transtibial prosthetic socket with textile jacket
US10179055B2 (en) 2015-05-29 2019-01-15 Ossur Iceland Ehf Pump system for use with a prosthetic device
US10206795B2 (en) 2015-07-27 2019-02-19 Lim Innovations, Inc. Prosthetic support socket for an osseointegrated femoral abutment
US10245775B2 (en) 2014-06-04 2019-04-02 Lim Innovations, Inc. Method and apparatus for transferring a digital profile of a residual limb to a prosthetic socket strut
US10413429B2 (en) 2015-08-27 2019-09-17 Ossur Iceland Ehf Pump system
US10426640B2 (en) 2010-10-22 2019-10-01 Ossur Hf Adjustable socket system
US10512554B2 (en) 2016-08-26 2019-12-24 Ossur Iceland Ehf Pump system
US10543112B2 (en) 2012-06-28 2020-01-28 Ossur Hf Adjustable prosthetic limb system
US10806607B2 (en) 2017-02-06 2020-10-20 Ossur Iceland Ehf Adjustable socket system
US10940028B2 (en) 2017-02-06 2021-03-09 Ossur Iceland Ehf Adjustable socket system
US11419740B2 (en) 2017-02-06 2022-08-23 Ossur Iceland Ehf Adjustable socket system
US11642233B2 (en) 2020-09-04 2023-05-09 Ossur Iceland Ehf Interchangeable distal end for a prosthetic socket system

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WO2001021113A3 (fr) * 1998-07-15 2001-11-15 Caspers Schneider Technologies Garniture prothetique a renforcement distal
US6508842B1 (en) 1999-06-03 2003-01-21 Barbara J. Caspers Socket liner for artificial limb
US6554868B1 (en) 1999-06-03 2003-04-29 Carl A. Caspers Vacuum pump and shock absorber for artificial limb
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AU5025200A (en) 2001-04-24
WO2001021113A2 (fr) 2001-03-29
WO2001021113A3 (fr) 2001-11-15

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