WO2000024355A1

WO2000024355A1 - Collapsible splint for passive mobilisation of lower limb

Info

Publication number: WO2000024355A1
Application number: PCT/FR1999/002568
Authority: WO
Inventors: Laurent Beny; José ANDRY
Original assignee: Smith & Nephew Kinetec
Priority date: 1998-10-23
Filing date: 1999-10-22
Publication date: 2000-05-04
Also published as: FR2784892B1; ATE274894T1; JP2003517341A; DE69919884T2; AU6345199A; EP1121086B1; FR2784892A1; EP1121086A1; CA2347987A1; DE69919884D1

Abstract

The invention concerns an equipment for functional therapy, more particularly a splint characterised in that: the crural segment is mounted in articulation on a stabilising support (20) telescopically mobile at the base plate, parallel to the direction of the guide way, between two stable positions of maximum retraction and maximum extension; the crural segment (3) is made up of at least one side member (15) telescopically adjustable, comprising a tubular part (16) and a sliding part (17) capable (17) of being substantially entirely retracted inside the tubular part (16) when the support takes the maximum retracted position. The invention is applicable to splints for passive mobilisation of a lower limb.

Description

FOLDABLE PASSIVE MOBILIZATION BRACKET FOR LOWER LIMBS

TECHNICAL AREA :

The present invention relates to the medical field and it relates, more particularly, to the means used to make functional rehabilitation of a lower limb possible.

The object of the invention can find multiple applications, one of which, considered to be the oldest without however being limiting, is the field of post-operative rehabilitation following orthopedic interventions.

Among the most common applications, it is worth mentioning post-operative rehabilitation after intervention on the knee joint.

In the above fields, it has long been known that a definite benefit is to be expected from functional rehabilitation, in particular by mobilization of the joints, intervening in a short time after the intervention.

However, it has been observed that, in order to satisfy this requirement, it was not conceivable to provoke articular mobilization by the active stress produced intentionally by the patient. On the contrary, it has been observed that a definite benefit is obtained when mobilization occurs in the passive mode, that is to say that means outside the patient's will cause mobilization without it being done. call for activation of the muscle chain by the patient.

It is in order to better put such a method into practice that mobilization splints, called passive, have appeared, intended for the lower limb and designed to be used immediately after the intervention by being able to be placed on the mattress of bedding.

PRIOR ART

Passive mobilization splints, which are made for this purpose, generally include a relatively long plinth at the end proximal of which is placed an articulation of transverse orientation at the great length of the base and reserved for the mounting of an articulated structure and, more particularly, of a segment of the latter called "crural cradle".

The articulated structure is composed of another segment, called "cradle leg" which is articulated at the end of the crural segment to extend parallel to the long length of the base on which such a cradle rests by a carriage supported by a track guide presented by the base.

Generally, an electric motor is also provided adapted at the end of the base, so as to be able to actuate, by a transmission, the trolley in rectilinear reciprocating movement over an amplitude adjustable by appropriate control means.

The articulated structure is most often completed by a footrest, so as to provide sufficient support for a lower limb which, via the articulated structure and the carriage, can be passively moved in flexion-extension to promote the mobilization of joints.

Such splints certainly meet the function for which they are designed and give, in this respect, complete satisfaction in their hospital implementation.

For economic reasons, it is increasingly recommended to resort to rehabilitation treatments on an outpatient basis rather than in hospitals, given that this is a daily practice whose essential characteristic is to follow a procedure protocol set by the practitioner and which suffices to adapt by functional adjustment of the mobilization splint.

This new practice can certainly be carried out in a non-hospital setting, using the same mobilization devices.

However, it was found that, for various reasons, the current passive mobilization splints were not suitable for such a practice.

First of all, such splints are relatively heavy and above all bulky because of their very mode of construction implying to produce an apparatus taking into account the need to be able to have the articulated structure in full extension giving it a lengthwise bulk of the order of that of a lower limb. If it can be envisaged to use such devices despite this drawback, it appeared difficult to be able to impose economically on each patient the obligation to purchase a splint to carry out an outpatient rehabilitation process, the duration of which is generally relatively small.

This is the reason why it was recommended to resort, no longer to a purchase, but to a temporary rental of such splints from organizations specialized for this purpose in this type of equipment, as well as in ancillary equipment.

If this form of offer to the public solves the economic aspect, on the other hand, the problem of the size of the current splints is reborn and even becomes almost prohibitive, since for each rental it is necessary to impose a one-way transport and return made by the renting organization or by the tenant beneficiary who are therefore both subject to the obligation to overcome the congestion problems.

It is clear that if a proposal to remove the inconvenience of weight and bulk could be made, it would be likely to strengthen the practice and the use of an outpatient rehabilitation process which, for many reasons, is generally preferred compared to the same rehabilitation process carried out in a hospital environment.

PRESENTATION OF THE INVENTION:

It is precisely the object of the invention to provide a passive mobilization splint of a collapsible nature, that is to say that can be packaged in a relatively small volume to promote transport operations between rental sites and those of commissioning. The invention also aims to propose a mobilization splint which can be folded up, without it being necessary to dismantle one or the other of its elements, that is to say without it being necessary to temporarily separate one of its constituent elements from the assembly in order to pack the splint in a limited volume.

To achieve the above objective, the mobilization splint according to the invention is characterized in that: - the crural segment is mounted articulated on a stabilizing base mobile telescopically to the base, parallel to the direction of the guideway, between two stable positions of maximum retraction and maximum extension,

- The crural segment is constituted by at least one adjustable telescopic beam, comprising a tubular part and a sliding part capable of retracting substantially completely inside the tubular part when the base occupies the position of maximum retraction.

Various other characteristics will emerge from the description given below with reference to the appended drawings which show, by way of nonlimiting example, an embodiment of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS:

Fig. 1 is a perspective view of the splint according to the invention.

Fig. 2 is a partially cutaway partial view showing, on a larger scale, a detail of the constructive embodiment of the splint according to FIG. 1.

Figs. 3 and 4 are partial perspectives highlighting different constructive characteristics.

Fig. 5 is a perspective, similar to FIG. 1, but showing, on a smaller scale, the splint according to the invention in another characteristic position.

Figs. 6 and 7 are partial schematic perspectives referring to other constructive details.

BEST WAY TO IMPLEMENT THE INVENTION

Fig. 1 shows a passive mobilization splint comprising a base 1 carrying an articulated structure 2 composed of a segment or cradle 3, called "crural", and a segment or cradle 4, called "leg". The segments 3 and 4 are linked, in the extension of one another, by articulations 6 which together define an axis x- x 'perpendicular to the general direction of alignment of segments 3 and 4 placed in line with one another.

Although this is not shown, it should be understood, as is known in the art, that each segment 3 and 4 can be equipped with a mattress or a hammock supporting the member to be rehabilitated.

The crural cradle 3 is mounted, by a hinge 7, on the base 1, while the cradle cradle is mounted on a carriage 8 which is supported by a guide track 9 offered by the base 1.

The leg segment 4 is provided, at its end opposite to the crural segment, with a footrest 10 generally constituted by a support 11 carrying a plate 12 orientable in the direction of the double arrow fi and on which is adapted a sole 13 capable to be set in either direction of the arrow f ₂ .

A motorization, not shown in fig. 1, acts directly or indirectly on the carriage 8 to move it in reciprocating rectilinear movement along the track 9 and thus subject, as is known, the structure 2 to a flexion-extension movement favorable to a functional joint rehabilitation of the limb lower to treat, for example the hip joint, the knee joint or even, if necessary, the complex ankle joint.

So that a device of the type of the splint described above can be made to present, outside of its period of use, a relatively small weight and size, with a view to promoting transport for the purpose mentioned above. above, the means according to the invention, as described below, are implemented.

First of all, the crural segment 3 is constituted by two longitudinal members 15 of telescopic nature comprising a tubular part 16 linked to the articulation 6 and a sliding part 17 secured to the homologous part of the second longitudinal member 15 by a cross member, such as 18 , cooperating with joint 7.

The constructive characteristic for the crural segment 3 consists in choosing lengths of tubular parts 16 and of sliding parts 17 such that the latter can be retracted substantially completely inside the tubular parts 16 and be immobilized in an extreme position of maximum extension. , or even in any possible intermediate position, by means of locking members, such as 19, for example each constituted by a tightening button. According to the invention, another constructive means implemented consists in adapting the articulation 7 on an auxiliary stabilizing base 20, for example produced in the form of a cut-out plate or a plate in the shape of a "U", so as to have suitable support stability on any support, even on bedding. The base 20, as it appears in FIGS. 1 and 2 is secured to a slide 21 which is, for example, constituted by one, or even preferably two rods 22 which are supported by bearings 23 which are presented by the base as partially shown in FIG. 2 to permit telescopic sliding from the proximal end _to the the base. The bearings 23 are completed by an elastic return blocking means 24 comprising a lever 25 and a blocking bar 26 which can be engaged for example in notches or notches carried by the rods 22. Such a bar can also act by jamming effect at an angle under the action of one or more return springs. In all cases, it is advantageous to produce the lock 24 so that its neutralization involves a voluntary action of the user.

Additionally, as shown in fig. 2, the auxiliary base 20 has a relatively small thickness, so that it can be entirely retracted in a housing 27 presented by the lower part of the base 1 when this base occupies the position of maximum retraction by means of the slide 21. It should be noted that the base 1 also has, in relation to the proximal part _a and the housing 27, two lateral recesses 28 in which the longitudinal members 15 engage in the retracted state of the base 20ι.

According to yet another arrangement, the articulated structure 2 is linked to the carriage 8 by means of a system 30 which can be qualified as the deformable quadrilateral type, unique or specific to each of the tubular elements 16 of the crural segment 3 and to each of the side members 31 constituting the leg segment 4.

The system 30 includes, in the case of double construction, as illustrated in FIG. 1, for each set 16, 31, the following constituent elements:

- first of all, the element 31, as such, which constitutes one of the sides of the quadrilateral, while the articulation 6 constitutes the first point of articulation, - then the part of the tubular segment 16 between the articulation 6 and a hinge tab 32 which constitutes the second side of the quadrilateral,

- then an axis 33 constituting a second point of articulation,

- additionally, a slide bar 34 extending substantially under the beam 31 in the direction of the carriage 8 and which constitutes the third side of the deformable quadrilateral,

an extension 35 lowering from the side member 31 and forming the fourth side,

- And finally a ring 36 which is threaded on the bar 34 to form a sliding point incorporated in the deformable quadrilateral.

According to a preferred constructive arrangement, the slide bars 34 are joined by a spacer 37 to form a supporting frame which is linked to the carriage 8, as is more particularly illustrated in FIG. 3, by means of a hinge pin 38 which is orthogonal to the direction of the guide track 9.

In such a construction, it may appear useful to link the side members 31 by a spacer 39.

As shown in fig. 1, the construction of each lateral quadrilateral involves an extension 35 whose length is less than the corresponding homologous part of the tubular element 16 comprised between the joint 6 and the tab 32.

According to another constructive characteristic, provision is made to adapt the footrest 10 to the distal ends of the side members 31 of the cradle 4 by means of notched nuts 40, more particularly visible in FIG. 4, which can be released or immobilized by means of buttons 41.

By these means, it becomes possible to orient the footrest 10 in the desired direction, but also to fold it completely over the leg segment 4 in the direction of the axis xx 'in an at least partial erasure position immobilized by tightening the nuts 40.

The above means, as implemented by FIG. 1, make it possible to constitute a passive mobilization splint offering the characteristics of adaptation to the morphology of the lower limb to be rehabilitated, while it is likely to present a reduced bulk in a folded position, such that it appears in fig. 5. Indeed, from the position illustrated in FIG. 1 and when it is desired to reduce the volume of the splint, it suffices to proceed as just said to erase the footrest 10, then to control the buttons 19 to allow the retraction of the parts 17 to inside the tubular elements 16 and acting on the control 24 to allow the auxiliary base 20 to be erased inside the housing 27 of the base 1.

Fig. 5 shows such a position of minimal bulk, in which all of the constituent elements of the splint occupy in plan the bulk of the base 1 while being entirely superimposed on the latter which can then constitute a transport element via a carrying handle 45 which is adapted to it on one of the longitudinal sides for example. In such a state, it is also possible to add to the base 1 a casing or cover, such as 46 coming to adapt as appropriate to perfect the recovery of the constituent elements of the splint. It should be noted that, very advantageously, the folding of the splint according to the invention is carried out without it being necessary to disassemble any of the constituent elements of the splint. By dismantling, it is understood any operation which would consist in separating two elements which are linked when the splint is in conformation of use. Of course, this remark does not apply to the casing or cover 46.

If the elements, as described above, make it possible to save space, it must be remembered that the system or systems 30 in deformable quadrilateral are also provided for introducing a multiplication factor between the movement of the carriage 8 and that imposed to the articulated structure 2. Such a multiplication factor, which occurs due to the constructive relationship of each deformable quadrilateral, and in particular of a length of the extension 35 less than the length of the tubular element 16 between the joints 6 and 33 , makes it possible to reduce the maximum useful stroke of the carriage 8 and, consequently, to reduce in the same proportions the length of the base 1 without reducing the amplitude of movement of the articulated structure which can pass from a bending position to a fully extended position. Such a result is also to be taken into account for the existence of the hinge pin 38 between the sliding armature of the leg segment or cradle 4 and the carriage 8.

To contribute to the reduction in size, it is advantageously provided, according to the invention, to ensure the movement of the carriage 8 by means of a geared motor group 50, of the electrical type, which is associated with a return of angle 50a, so as to be able to be arranged transversely to the direction of the guide track 9. Preferably, the adaptation of the gearmotor group 50 and of its angle gear 50a is ensured by embedding, at least partially, in a housing 51 offered by a transverse distal block 52 constituting the frame of the base 1 in combination with two longitudinal sections 53 connecting it to a transverse block 54 to the right of which are located the bearings 23 as shown in FIG. 2.

The bevel gear 50a, as illustrated in FIGS. 6 and 7, is provided on its output shaft 55 with a pinion 56 capable of attacking a drive pinion 57 integral in rotation with a worm screw 58 engaged with the carriage 8 which is, d on the one hand, guided on a slide 59 and, on the other hand, guided and carried by rolling members 60 cooperating with the longitudinal sections 53 which define with the slide 59 the guide track 9.

By such an assembly, the overall length of the base 1 is reduced, both by the transverse arrangement of the geared motor group 50 and by the parallel arrangement of the worm screw 58 and the slide 59.

Claims

CLAIMS:

1 - Collapsible passive mobilization splint for the lower limb, of the type comprising:

A base or a base (1) carrying an articulated structure (2) composed of a segment or crural cradle (3) articulated at the proximal end of the base,

• a leg segment or cradle (4) linked to the crural segment at the end of the latter by at least one articulated system (30) of the quadrilateral type deformable at a sliding point, an element (34) of which is linked to a carriage (8) by a hinge pin (38) orthogonal to a rectilinear guide track (9) delimited by the base and reserved for guiding the carriage associated with the leg segment,

• a footrest (10) adapted at the end of the cradle,

• and a motorization member (50) acting on the carriage to drive it in reciprocating rectilinear displacement causing the flexion-extension of the articulated structure on the base, characterized in that:

the crural segment is mounted articulated on a stabilizing base (20) movable telescopically to the base, parallel to the direction of the guide track, between two stable positions of maximum retraction and maximum extension,

- the crural segment (3) consists of at least one spar (15) of adjustable telescopic nature, comprising a tubular part (16) and a sliding part (17) capable of retracting substantially completely inside the tubular part (16) when the base occupies the maximum retraction position.

2 - Splint according to claim 1, characterized in that the stabilizing base (20) is linked to the base (1) by a slide (21) capable of occupying at least two stable positions in which it is placed in extension and in maximum retraction from the base.

3 - Splint according to claim 2, characterized in that the stabilizing base (20) can occupy a maximum retraction position in which it is, at least in part, inserted in a housing (24) of the base which delimits by elsewhere two lateral recesses (28) for the partial engagement of longitudinal members (15) of the crural segment.

4 - Splint according to claim 2 or 3, characterized in that the two stable positions of the base relative to the base are assigned by at least one latch (24) with voluntary neutralization carried by the base.

5 - Splint according to claim 1, characterized in that the articulated system is of the deformable quadrilateral type at three points (6, 33, 37) including one sliding.

6 - Splint according to claim 5, characterized in that the articulated system consists of two lateral assemblies (30).

7 - Splint according to claim 1, 5 or 6, characterized in that the articulated system consists of two sets of the deformable quadrilateral type each consisting of a spar (31) constituting the leg segment, a first point of articulation (6) with the corresponding spar (17) of the crural segment, of a part of this spar, of a second articulation point (33) carried by said spar part, of an articulated sliding bar (34) at said second point and linked by the axis (38) to the carriage (8), with a rigid extension (35) lowering downwards from the spar of the leg segment and with a socket (36) carried by the extension to slide on the bar (34) and form the sliding point.

8 - Splint according to claim 7, characterized in that the extension (35) has a length less than that of the part of the spar of the crural segment between the joints (6 and 33).

9 - Splint according to claim 7, characterized in that the two sliding bars (34) are linked together by a transverse bar (37) to form a supporting frame adapted on the carriage (8) by a hinge pin ( 38) orthogonal to the guideway.

10 - Splint according to claim 1, characterized in that the base is formed in the form of a box provided with a carrying handle (45).

11 - Splint according to claim 1 or 10, characterized in that the base comprises a guide track (9) and internally houses a motor means (50) linked by a transmission (58) to the carriage (8) which is also guided in movement by two longitudinal sections (53) forming part of the structure of the base (1). 12 - Splint according to claim 11, characterized in that the motorization means (50) is constituted by an electric gearmotor group mounted on the distal part (52) of the base to extend transversely relative to the direction of the track guidance.

13 - brace of Claim 12, characterized in that the geared motor is provided with a bevel gear mechanism _(50a) attacking transmission (58) which is constituted by an endless screw cooperating with the carriage.

14 - Splint according to claim 1, characterized in that the footrest (10) is mounted on the leg segment (4) by at least one notched nut (40) associated with a tightening button (41) and making it possible to confer said footrest a variable inclination from a folding position on the leg segment.

15 - Splint according to one of claims 1 to 14, characterized in that, in the folded position of the slide (21) of the crural segment (3) and the footrest (10), the various constituent elements of the structure articulated (2) are brought together to occupy a volume that fits into the geometric outline presented in plan by the base (1).

16 - Splint according to claim 15, characterized in that, in the folded position, the articulated structure is entirely contained in a cover (46) adapted on the base.