WO2008113321A1

WO2008113321A1 - Orthosis

Info

Publication number: WO2008113321A1
Application number: PCT/DE2008/000424
Authority: WO
Inventors: Klaus Horstmann; Alexander Schmitt
Original assignee: Otto Bock Healthcare Ip Gmbh & Co. Kg
Priority date: 2007-03-16
Filing date: 2008-03-11
Publication date: 2008-09-25
Also published as: DE102007013387A1

Abstract

The invention relates to an orthosis comprising (a) at least one first fastening part (12), designed so as to be attachable to a first body part of a patient, and (b) a second fastening part (16), designed so as to accommodate a second body part of the patient, (c) wherein the first fastening part (12) and the second fastening part (16) are pivotally connected to one another by a joint (14). According to the invention, the second fastening part (16) comprises a guide (34) opposite the joint (14), said guide guiding the first fastening part (12).

Description

orthosis

The invention relates to an orthosis having at least a first attachment part adapted to be attached to a first body member of a patient and a second attachment part adapted to receive a second body member of the patient, the first attachment part and the first attachment member second fastening part by a, joint against each other are pivotally connected to each other.

Such orthoses are used, for example, to protect the ankle of a patient after a ligament, soft tissue or tendon injury from Umknickkräften. Since such orthoses allow walking, they are also referred to as Walker.

A generic orthosis is known from DE 20 2005 006 409 U1. The orthosis described therein has an adjustment device, with which the first attachment part can be fixed relative to the attachment part, so that an ankle of the patient can be determined, a generic orthosis is also known from US 6 350 246 B1, in which the first attachment part and the second fastening part by means of a stopper in their movement relative to each other can be limited. The stopper is accommodated in an arcuate slot and makes it possible to set the pivoting range from foot to lower leg in any angular steps. A disadvantage of the orthoses described there is their lack of security against kinking.

From DE 10 2005 008 340 A1, an orthosis is known, in which the first fastening part is mounted movably relative to the second fastening part via a ball joint. Again, the lack of security against kinking is disadvantageous. From EP 0 876 130 B1, WO 2005/037139 A2 and DE 697 18 214 T2, one-piece orthoses are known. Although these provide good protection against kinking, but are very uncomfortable to wear, since they hinder a pivoting of the foot while walking. From EP 1 676 549 A2 a joint for an orthosis is known in which balls running in a slot are used to fix the joint at a preselected angle.

A disadvantage of known orthoses is their complex construction, which leads to a complex and therefore cost-intensive production. Known orthoses are also bulky and require a large volume for storage and transport.

The invention has for its object to overcome disadvantages in the prior art.

The invention solves the problem by a generic orthosis, in which the second fastening part has a guide beyond the joint, by means of which the first fastening part is guided.

An advantage of an orthosis according to the invention is that it is very easy to produce. Thus, the joint can be made entirely in the form of a plastic injection molded part. This allows cost-effective production in a mass process. In addition, it is advantageous that, in spite of the simple construction, equally large forces can be transmitted and collected, as in the case of the use of more complex joints made of metal components.

It is also advantageous that the joint is very simple, so that it can be mounted and dismantled by laymen. It is therefore possible to transport the prosthesis in the disassembled state and store and assemble only immediately before use on a patient. This allows space-saving storage and space-saving transport. In a preferred embodiment, the guide is a partial arc-shaped guide whose curvature circle center coincides with a pivot point of the joint. In this way, a particularly easy to produce leadership is obtained.

In a preferred embodiment, the guide is designed so that a pivot angle of the second fastening part relative to the first fastening part can be limited to a predetermined pivoting angle interval. In this way, during the healing process, the range of motion of the damaged joint can be increased gradually to produce on the one hand at the end of the therapy complete mobility of the diseased joint and on the other hand to prevent overloading of the joint by a too early pivoting to a large swing angle.

Preferably, the guide is designed so as to cooperate with the first fastening part, that a Umknickkraft or a Umknickmoment that is perpendicular to a rotational axis of the joint, intercepted. For example, if the orthosis is a foot orthosis, the force of the fold will be that force which, if applied to the foot without the orthosis, may result in an external ligament tear. Such Umknickkraft can, for example, arise when the patient touches down with a foot part of the foot orthosis on uneven ground. To prevent injury to the patient's joint, this Umknickkraft must be safely absorbed by the orthosis.

In order to accommodate the Umknickkraft with a lightweight and inexpensive to be manufactured joint, the guide for receiving at least a portion of the Umknickkraft is formed. Since the guide is spaced from the joint, resulting from the Umknickkraft torque at the location of the guide is smaller than in the joint itself and can therefore be collected with simple structural means. A particularly simple embodiment of the orthosis is obtained if the guide is arranged with respect to a longitudinal extent at one end of the first fastening part, for example a leg part.

A structurally simple possibility for receiving a Umknickkraft by the guide results when the guide has at least one undercut, which cooperates with at least one guide projection which is formed on the first fastening part. For example, the two leading partners form a dovetail guide or a double T-guide.

Preferably, the guide is formed as a guide projection on the second fastening part, which has recesses which are designed to engage by a locking device attached to the first fastening part, for example a screw. In this way, the first and the second fastening part can be fixed by simple means relative to each other permanently, but releasably. A joint surrounded by the orthosis is thereby fixed to a predetermined pivoting angle.

A limitation of the pivoting movement of the first and second fastening part relative to each other is achieved particularly easily by providing a delimiting pin, which is reversibly attachable to the guide projection. In this way, the patient himself can make changes to the swivel angle range.

A particularly simple and cost-effective way of forming the joint is to construct the joint from a condyle head bordered at least in sections by a circular arc and a joint shell bordered at least in sections by a circular arc.

It is advantageous if the condyle is an integral part of the first attachment part. For example, the joint shell can then also be formed by a recess in the second fastening part be. This results in a very easy and inexpensive to produce orthosis, which can be produced for example as an injection molded part.

The orthosis may be, for example, a foot orthosis, a knee orthosis, a hand orthosis or elbow orthosis. When it comes to a foot orthosis, the first attachment part is a leg part for attachment to a lower leg and the second attachment part is a foot part which is designed so that a foot of the patient can be placed in the foot part and thus taken up.

In particular, when the orthosis is a Fußorthese, the second attachment part preferably has a cranially molded insert for receiving, for example, the patient's foot.

Embodiments of the invention will be explained in more detail below with reference to the accompanying drawings. It shows

FIG. 1 shows a perspective view of a foot orthosis according to the invention,

FIG. 2 shows a sectional view of the foot orthosis according to FIG. 1,

FIG. 3 shows a partial exploded view of the foot orthosis according to FIGS. 1 and 2, in which the leg part is detached from the foot part;

FIG. 4 shows a side view of the foot orthosis according to the preceding drawings with a lateral guide for the leg part in a first extreme position,

FIG. 5a shows the foot orthosis according to FIG. 4 in a second extreme position,

FIG. 5b shows an alternative foot orthosis, in which a joint head is formed on the foot part, and

FIG. 6 shows possible components of leg parts of a foot orthosis according to the invention.

FIG. 7 shows a sectional front view of a second embodiment of a foot orthosis according to the invention,

FIG. 8 shows a side view of the embodiment according to FIG. 7,

Figure 9 is a detail view of the view of Figure 8 and

FIG. 10 shows a further embodiment of the invention in the form of a hand orthosis. FIG. 1 shows an orthosis in the form of a foot orthosis 10, which comprises two first fastening parts in the form of a medial leg part 12.1 and a lateral leg part 12.2 for attaching the foot orthosis 10 to a first body limb (not shown) in the form of a lower leg of a patient. The medial leg part 12.1 is over a medial joint

14.1 connected to a second fastening part in the form of a foot part 16. In the same way, the lateral leg part 12.2 is connected to the foot part 16 via a lateral joint 14.2. The leg parts 12.1, 12.2 and the foot part 16 are constructed mirror-symmetrically to a mirror plane E. The foot part 16 is designed to receive a second limb of the patient in the form of his foot.

Components with a suffix ".2" are each mirror-symmetric to the corresponding component with the suffix ".1". In the following, therefore, only one of the components will be described. The suffix without suffix refers to the components in general.

The medial leg part 12.1 comprises a distal leg part element 18.1, which is reversibly latched together with a proximal leg part element 20.1 via a snap-locking device. For this purpose, the proximal leg part element 20.1 has a latching nose 22.1 which can snap into a latching recess 24.1. In Figure 1 that is for the latch

22.2 and the recess 24.2 to recognize.

The distal leg part element 18.1 comprises an integrally formed joint head 26.1, which is bounded by a circular-arc-shaped edge R.1. The condyle 26.1 is received in a joint shell 28.1, which is formed in the foot part 16 in the form of a recess. The joint shell 28.1 and the condyle 26.1 are dimensioned with regard to their thickness D and their diameter d (FIG. 3) such that, during operation of the foot orthosis 10, they typically occur downwards, that is to say on the foot part 16 acting forces can be safely derived without the joint 14.1 is destroyed.

As shown in FIG. 1, in the direction toward the foot, a step-shaped projection 30.1 is arranged on the articulated head 26.1, which extends through a center of the circular condyle 26.1 and projects beyond the condyle 26.1 on both sides with a protruding part. The protruding part engages behind the foot part 16 and thus rotatably fixes the distal leg part element 18. 1 to the foot part 16.

The joint shell 28.1 is provided with a recess 32.1, which has larger dimensions by a small amount than the projection 30.1. The interaction of the projection 30.1 and recess 32.2 will be explained in more detail below in connection with Figure 3.

At its end facing away from the proximal leg part element 20.2, the foot part 16 has a guide projection 34.2 with a width B. In the guide projection 34.2, a locking mechanism in the form of a screw 38.2, which is only partially visible in FIG. 1, can intervene to pivot the pivoting possibility of the leg part 12.2 relative to the foot part 16 to a predetermined pivot angle interval φ (FIGS. 3 and 5), for example. 30 ° to + 30 ° limited.

To use the Fußorthese 10, the patient's foot is placed on a liner 40, and fixed to the foot part 16 with not marked Velcro fasteners. The not shown hook-and-loop fasteners engage through tabs 42.1, 42.2 (FIG. 1) and elongated holes 44.1, 44.2. With likewise not shown Velcro fasteners, the leg parts 12.1, 12.2 by means of oblong holes 46.1, 46.2, 48.1, 48.2 attached to the lower leg of the patient.

Figure 2 shows a cross section through the Fußorthese 10 according to Figure 1. The insert 40 is constructed of foamed plastic and in a Two-component injection molding process has been molded onto a base body 50 of the foot part 16. On the side facing away from the insert 40 an anti-slip sole 52 is molded onto the base body 50, which runs in elongated webs 54 in the base body 50. Between the anti-skid sole 52 and the insert 40 Luftkammem 56 are formed, the cross-sectional area of a toe side 58 to a heel side 60 increases.

Figure 3 shows a partial exploded drawing in which the medial leg portion 12.1 φι a releasing angle is _ös pivoted relative to the foot part sixteenth In this position, the projection 30.1 can pass through the recess 32.1, so that the leg part 12.1 can be released from the foot part 16.

FIG. 3 also shows a circular-arc-shaped guide recess 62.1 in the leg part 12.1 into which the screw 38.1 projects. The screw 38.1 is designed to be screwed in recesses 39a, 39b shown in FIG. The guide recess 62.1 (Figure 3) is bent in a circular arc, wherein the curvature circle center coincides with the center M (Figure 2) of the condyle 26.1 and the radius of curvature corresponds to the distance between the center of the condyle 26.1 and the guide recess 62.1. The center M is in turn arranged at a position which corresponds in operation to the pivot point of the ankle of the patient.

The guide recess 62.1 (Figure 3) has a clear width L, which corresponds to the width B of the guide projection 34.2 (Figure 1). Since the guide projection 34.2, which is not visible in FIG. 3, coincides with the guide recess 62.1 with regard to the curvature circle center and the radius of curvature, the guide recess 62.1 can surround the guide projection 34.2 (FIG. 1). This leads to an additional guidance of the leg part 12 on the foot part 16, which will be explained in more detail below in connection with FIG. FIG. 4 shows how, due to the screw 38.2, the leg part 12.2 can be fixed to a swivel angle φ relative to the foot part 16. The maximum tilt angle is designated as φ _ma χ. FIG. 5a shows the minimum pivot angle φ _max .

FIG. 5 b reveals an alternative embodiment of a foot orthosis according to the invention, in which the joint 14. 2 in turn comprises a conical head 26. 2 which is bounded in the shape of a circular arc and which is now formed on the foot part 16.

For the purpose of transport, the leg portions 12.1, 12.2 (Figure 1) may either be separated from the foot portion 16 or they may be pivoted at an angle of φ «90 ° with respect to the foot portion 16 so as to be separated from the non-slip sole 52 seen from, no longer protrude beyond the foot part 16. In this configuration, the Fußorthese 10 takes only a very small space and can be easily transported and stored.

The prosthetic foot 10 is produced by injection molding the leg part elements 18.1, 18.2, 20.1, 20.2. It is favorable to produce the leg part elements shown in FIG. 6 with a water or gas injection pressure method, since the leg part elements then have a lower weight and cool down more quickly. A lower shrinkage also leads to a higher manufacturing accuracy of the leg part elements. The foot part 16 is produced in a multi-stage two-component injection molding process, in which first the main body 50 (see FIG. 2) is injected. Again, a water or gas pressure injection molding process can be applied. Subsequently, the non-slip sole 52 and the insert 40 are injected. The insert 40 is thereby foamed by blowing a gas. Alternatively, the insert 40 is chemically foamed. The distal leg part elements 18.1, 18.2 are connected to the proximal leg part elements 20.1, 20.2 latched and inserted respectively with their rod ends 26.1, 26.2 in the joint shells 28.1, 28.2.

FIGS. 7 and 8 show a further embodiment of an orthosis 10 according to the invention, in which the first fastening part in the form of the leg parts 12.1, 12.2 and the second fastening part in the form of the foot part 16 are guided against one another by means of the guides 34.1, 34.2 such that bending forces occur F _k ni _ck , which are perpendicular to a rotation axis A, can be recorded. For this purpose, the guide 34.1 has an undercut 64.1, which forms a dovetail or a T-guide with a guide projection 66.1.

FIG. 9 shows, for an alternative variant in the form of a double T-guide, the undercut 64.1 of the guide 34.1 and the guide projection 66.1, which is formed on the distal leg part element 18.1 of the medial leg part 12.1. The piece of the leg part 12.1 between the pivot and guide acts as a lever, the F _k Umknickkraft ni _ck in the lead partner, namely the guide 34.1 and 62.1 the guide recess initiates, and so Gert the attacking the joint 14.1 Umknickdrehmoment verrin-. As a result, the joint 14.1, as described above, can be formed simply in the form of an integrally formed condyle and a joint shell or cup in the form of a recess. It also allows the use of plastic, so that metal is dispensable. Compared to previous foot orthoses there is also a more precise adjustment of the pivoting angle φ.

According to a non-illustrated alternative embodiment, the guide partners are connected to each other by means of an elastic member, so that the leg part 12 is biased relative to the foot part 16 to a predetermined pivot angle φo. Although the leg part 12 can then move relative to the foot part, with increasing deviation from the predetermined pivot angle φ ₀ , a restoring torque increases. As a result, the patient must work against resistance. what strengthens his muscles. The elastic components may be resilient and are arranged, for example, in the guide 34. The elastic components can also be used so that they produce a torque increasing with decreasing distance from a minimum pivot angle φmin or a maximum pivot angle φ _max . This avoids a sudden impact on the extreme swing angles.

FIG. 7 also shows a pivotable lock 68.1, which is articulated on the medial leg part 12.1 and designed to engage in one of a plurality of latching slots 70a, 70b, 70c,... (FIG. 8). The locking slots 70 are formed in the guide projections 34.1, 34.2. By introducing the lock 68.2 in one of the locking slots 70, the leg part is fixed relative to the foot part.

FIG. 8 shows a limiting pin 72.2 which can be brought into engagement with one of the latching slots 70 and can be fixed in this position by means of a screw. By screwing in the limiting pin 72, the pivoting angle φ can be limited in a pivoting direction. It is also possible to limit the pivot angle φ by means of a second, not shown, limiting pin with respect to pivoting in the opposite direction. By suitably arranging the two limiting pins, the pivot angle interval can thus be freely selected to predetermined values.

The provision of a guide, which is arranged with respect to a longitudinal extent L (Figure 8) of the leg portion at a distal end 74, thus has two effects. On the one hand, the pivoting angle interval can be limited as described above or the pivoting can even be completely prevented by screwing the leg part and the foot part. On the other hand, the guide causes the turning force Fknic _k shown in FIG. 7 to be intercepted to a great extent, so that the joints 14. 14.2 can be designed particularly simple and thus cost manufacturable.

The described principle is not only applicable to foot orthoses. FIG. 10 shows a hand orthosis 76 in which the second fastening part 16 is formed by a hand shell 78 and the first fastening part 12 by a forearm shell 80, both of which can be fastened to a forearm or a hand of the patient by means of Velcro fasteners.

The forearm shell 80 has a medial web 82.1 and a lateral web 82.2, both of which are pivotally mounted in a hinge on the hand shell 78. The webs 82.1, 82.2 extend beyond the joints 14, thus forming lever arms and are guided in guides 34.1, 34.2. With regard to the design of the guides, the knee orthosis 76 does not differ from the foot orthosis 10 described above.

LIST OF REFERENCE NUMBERS

10 foot orthosis

12.1 medial leg part 12.2 lateral leg part

14.1 medial joint

14.2 lateral joint

16 foot part 18 distal leg part element

20 proximal leg part element

22 latch

24 recess

26 condyle

28 joint cup

30 advantage

32 recess

34 Leadership lead

38 screw

39 recess

40 Insert 42 Tab 44 Slot

46 slot

48 slot

50 basic body 52 non-slip sole

54 bridges 56 air chamber

58 toe side

60 heel side

62 guide recess

64 undercut

66 Leadership lead

68 locking

70 detent slot

72 limit pegs

74 distal end

76 Hand orthosis

78 hand dish

80 forearm shell

82 footbridge

B width

D thickness d diameter

E mirror plane

L clear width

M pivot

R.1; R.2 edge

φ swivel angle

CPmax maximum angle ψmin minimum angle

Φlös release angle

Claims

claims

1. Orthosis with

(a) at least one first attachment member (12) adapted to be attached to a first body member of a patient, and

(b) a second fastener (16) adapted to receive a second limb of the patient,

(c) wherein the first fastening part (12) and the second fastening part (16) are connected to one another in a pivotable manner relative to each other by a hinge (14),

characterized in that

(D) the second fastening part (16) beyond the joint (14) a

Guide (34), by means of which the first fastening part (12) is guided.

2. Orthosis according to claim 1, characterized in that the guide (34) is a partial arc-shaped guide (34) whose curvature circle center coincides with a pivot point (M) of the joint (14).

3. Orthosis according to one of the preceding claims, characterized in that the guide (34) is formed so that a

Pivoting angle (φ) of the second fastening part (16) relative to the first fastening part (12) to a predetermined pivoting angle interval (<pmin, ψmax) can be limited.

4. Orthosis according to one of the preceding claims, characterized in that the guide (34) with the first fastening part (16) for intercepting a Umknickkraft (Fknick), which runs parallel to a rotational axis (A) of the joint (14) cooperates.

5. Orthosis according to claim 4, characterized in that the guide (34) is arranged at one end of the first fastening part (12).

6. Orthosis according to one of the preceding claims, characterized in that the guide (34) has an undercut (64) which cooperates with a guide projection (66) which is formed on the first fastening part (12).

7. Orthosis according to one of the preceding claims, characterized in that the guide as a guide projection (34) on the second fastening part (16) is formed, the recesses (39.1, 39.2, ...), which is engageable by an on the first fastening part (12) fastened detent (38) are formed.

8. An orthosis according to claim 7, characterized in that the first fastening part (12) has a circular arc-shaped recess (62) whose curvature circle center and radius of curvature of the guide (34) and the inside width (L) of a width (B) the guide projection ( 34), and which is designed to cooperate with the guide projection (34).

9. Orthosis according to one of the preceding claims, characterized by at least one limiting pin (72) which is so relative to the guide projection attachable, that the second fastening part (16) to the predetermined pivot angle interval (φ _m j _n , ψmax) can be limited.

10. An orthosis according to any one of the preceding claims, characterized in that the joint (14) comprises an at least partially arcuately bounded condyle (26) which is mounted in an at least partially circular arc-shaped bound joint shell (28).

11. An orthosis according to claim 10, characterized in that the condyle (26) bounded circular and is mounted in a circular bordered joint shell (28).

12. An orthosis according to one of claims 10 or 11, characterized in that on the condyle (26) a projection (30) is formed, which extends in a radial direction beyond the condyle (26) addition, and the joint shell (28). a recess (32) which is formed so that the projection (30) only in a predetermined angular position of the first fastening part (12) relative to the second fastening part (16) through the recess (32) is movable and in all other angular positions the Rod end (26) in the joint shell (28) holds.

13. An orthosis according to any one of claims 10 to 12, characterized in that the condyle (26) is an integral part of the first fastening part (12).

14. Orthosis according to one of the preceding claims, characterized in that the joint shell (28) is formed by a recess in the second fastening part (16).

15. Orthosis according to one of the preceding claims, characterized in that the first fastening part (12) and / or the second fastening part (16) are injection-molded parts.

16. Orthosis according to one of the preceding claims, characterized in that it is a foot orthosis, knee orthosis, a hand orthosis or an elbow joint orthosis.

17. An orthosis according to claim 16, characterized in that it is a foot orthosis, wherein the first fastening part is a leg part (12) and the second fastening part is a foot part (16).

18. Orthosis according to one of the preceding claims, characterized in that the leg part (12) has a distal leg part element (18) and a proximal leg part element (20), which are reversibly latched together.

19. An orthosis according to claim 18, characterized by a medial leg part (12.1) and a lateral leg part (12.2), which are constructed mirror-symmetrically to one another.

20. Orthosis according to one of claims 17 to 19, characterized in that it is gel-symmetrical with respect to a plane of symmetry (E).

21. An orthosis according to any one of claims 17 to 20, characterized in that the joint (14) is formed so that at least one leg part (12) is foldable forward so that it from a sole (52) of the foot part (16). essentially not about that

Foot part (16) protrudes.

22. An orthosis according to any one of claims 17 to 21, characterized in that the foot part (16) comprises a cranially molded insert (40).

23. An orthosis according to claim 22, characterized in that the insert (40) is foamed, in particular physically foamed.

24. Orthosis according to one of the preceding claims, characterized in that the first fastening part (12) and the guide (34) via at least one elastic member in contact with each other so that the first fastening part (12) relative to the second fastening part ( 16) is biased to a predetermined pivoting angle and a deflection of the first fastening part (12) relative to the second fastening part (16) from the predetermined pivot angle leads to a deflection counteracting force.

25. An orthosis according to claim 24, characterized in that the at least one elastic member between the at least one limiting pin (72) and the first fastening part (12) is arranged.