WO2010139084A1

WO2010139084A1 - Orthosis

Info

Publication number: WO2010139084A1
Application number: PCT/CH2010/000146
Authority: WO
Inventors: Heinz LÄDERACH
Original assignee: Laederach Heinz
Priority date: 2009-06-04
Filing date: 2010-06-03
Publication date: 2010-12-09
Also published as: CH701272A2

Abstract

Orthosis for the shoulder joint, comprising A) a first part (1), which can be fastened to the torso and has a chest section (2), a back section (3), and at least one shoulder section (4); B) a second part (10), which can be fastened to the upper arm; and C) at least two straps (20) for fastening the second part (10) to the first part (1) and for positioning the second part (10) relative to the first part (1), wherein D) at least portions of the surfaces of the first and second parts (1; 10) and of the straps (20) are designed as releasable Velcro or adhesive closures, or E) the first part (1) comprises one or more buckle closures (15), and at least portions of the second part (10) and of the straps (20) are designed as released Velcro or adhesive closures.

Description

orthosis

The invention relates to an orthosis according to the preamble of patent claim 1 and to a kit with orthosis according to the preamble of claim 20.

The purpose of such orthoses is to restrict the freedom of movement of a diseased or traumatized shoulder joint in order to prevent further damage or complications.

The object of the invention is to provide an easy-to-use orthosis for the shoulder joint, which gives the doctor or therapist the greatest possible freedom to limit the range of motion of the shoulder joint according to the therapeutic needs, or to complicate.

The invention solves the stated object with an orthosis, which has the features according to claim 1 and with a kit with orthosis, which has the features according to claim 20.

The advantages achieved by the invention are essentially to be seen in the fact that thanks to the inventive orthosis, the dangers of dislocation or subluxation of the shoulder joint can be reduced without having to limit the mobility of the forearm.

Further advantageous embodiments of the invention can be commented on as follows:

In a specific embodiment, the first part and the second part are realized as two separate parts, which can be connected to one another only by means of the bands. As a result, the advantages are achievable that the orthosis can be easily put on and taken off and that at the junction of the two parts no unwanted wrinkling arises with each movement of the upper arm.

BESTATIGUNGSKOPIE In another embodiment, the first part is designed as a harness, which comprises one or more transversal belts that can be passed around the torso and at least one shoulder belt fastened to the transverse belt (s), the transversal belt (s) forming the chest and back part and the at least one shoulder belt Shoulder part forms. By designing the first part as a harness instead of a closed vest can be prevented that the patient sweats because of excessive heat insulation. The harness preferably comprises two substantially parallel to the sagittal plane of the patient extending shoulder straps and two fixedly connected to the shoulder straps substantially parallel to the transverse plane of the patient can be arranged Transversalgurte, each having a buckle closure on the chest. Preferably, the buckle clasps include snap closure buckles with integrated

Length adjustment means for the transversal belts. The Transversalgurte may be formed as one-piece straps or multipart as attached to the shoulder straps chest and back straps. This achieves the advantages that:

- Due to the formation of the first part as veschliessbare around the thorax unit optimal retention of the first part of the upper body of the patient is made possible, so that slippage of the orthosis is prevented by movements of the patient; and

- A stable fixation of the upper arm by the or the lower bands against movements to the front and back and against further spreading is achievable, especially since the one or more lower bands are attached to the lower part of the hip near the first part.

In another embodiment, the harness comprises two shoulder straps, which are connected to the back part by means of a arranged on the shoulders belt in the transverse direction. By the connection of the two shoulder straps by means of the fastened to the shoulders connecting belt which is attached to one shoulder upper band and thus the attachable to the other end of the upper band second part is held firmly on the shoulder of the patient. Slipping of the shoulder strap by the weight of the arm can be prevented. In yet another embodiment, the chest and back part form a west-like, transversely closable around the thorax unit.

In a further embodiment, the orthosis comprises at least three bands, so that every possible movement of the shoulder joint can be restricted or controlled. Typically, the orthosis comprises four bands which serve to secure the second part to the first part and to position the second part relative to the first part. Two upper bands are preferably attached to the shoulder portion, one of which is directed against the chest and the other against the back. The two upper straps allow the upper arm to be fixed against forward, backward and downward movement. In addition, the upper arm can be held by the patient in a defined splayed position without the expenditure of muscular strength due to the two upper bands. Two lower bands are preferably attachable to the chest, respectively on the back. Due to the two lower bands, the upper arm can be fixed on the one hand against forward and backward movements and, on the other hand, against further distraction. Alternatively, a fastened to the chest and back lower band outside the upper arm are performed and fixed on the upper arm outside on the second part.

In yet another embodiment, at least one of the bands in its longitudinal direction reacts to tensile forces substantially inelastic.

In a further embodiment, at least one of the bands in its longitudinal direction reacts to tensile forces substantially elastically. The elasticity of the band can be produced, for example, by inserting an elastic longitudinal segment into the band.

In another embodiment, one end of one of the bands, preferably two bands, is fixedly connected to the shoulder portion. Additionally or alternatively, the surface of the shoulder portion may be at least partially formed for connection to one or more bands by means of releasable hook-and-loop fasteners.

In another embodiment, at least parts of the first part are designed as releasable Velcro or adhesive closures. The one or more Velcro or adhesive closures can be arranged on the chest and / or back and serve to attach the lower bands or.

In yet another embodiment, at least one band has one or more buckle closures. Thus, the advantage is achieved that the lower band can be easily attached by buckles on the chest and the back of the first part.

In a further embodiment, the orthosis comprises a forearm part which can be fastened to the forearm and which can be connected by means of one or more connecting bands to be movably connected to the second part which can be fastened to the upper arm.

In another embodiment, the second part and the lower arm part are additionally connected to one another by means of one or more plastically deformable connecting parts, preferably by means of one or more wires, so that the second part and the lower arm part are in an angle α which can be adjusted by bending the wire or wires relative to one another being held. This provides the advantage that the forearm can be held in a stooped posture. The angle α can be set by the attending physician in a range up to 30 °.

In another embodiment, the orthosis additionally comprises a wedge pillow which is positionable between the thorax and the upper arm of the patient. By means of the wedge pad and the ligaments between the first and the second part of the upper arm with an abduction of up to 30 ° can be held by the orthosis.

In a further embodiment, parts of the surfaces of the wedge pad are designed to be velcro-resistant or adhesive-friendly. Through the Velcro or adhesive closures between the wedge pillow and the or arranged transversely to the body longitudinal axis lower bands the wedge pillow is held in position between the thorax and the upper arm of the patient. The wedge pillow can also be easily removed due to its attachment to the orthosis by means of Velcro or adhesive closures. Alternatively, the velcro or adhesion-friendly parts on the against the Be arranged upper arm surface, so that the wedge pillow can be fastened by means of Velcro or adhesive closures on the attached to the upper arm second part.

In yet another embodiment, at least one band is connected to the first and second parts only by means of Velcro or adhesive closures and / or buckle closures and thus exchangeable. The orthosis can be supplied with inelastic and elastic straps, which can be connected by means of Velcro or adhesive closures or buckle closures with the first and second part. Thus, elastic or inelastic retaining straps can be used or replaced as needed.

In another embodiment, the breast part and the back part are at least partially formed in two layers, wherein the outer, not intended for the skin contact layer, is made stiffer than the inner layer. Thus, the advantages are achievable that the first west-like part becomes more stable and less easily relative to the body of the patient slip, so that the relation to the second, cuff-like part is maintained and thus also made by the doctor or therapist restriction of mobility of the shoulder joint. The stiff layer can be additionally covered with a third layer to the outside. In this case, either the rigid layer or the third layer have a surface which allows the attachment of the bands by means of flat Velcro or adhesive closures.

In yet another embodiment, the breast part and the back part are at least partially formed four-ply, wherein the outermost layer consists of a material suitable for Velcro material and the inner against it adjacent layer is made of a foam. The intended to the skin contact innermost layer adjacent layer is stiffer than the other layers.

In a further embodiment, the first part can enclose the entire chest circumference. In yet another embodiment, the second part may enclose the entire upper arm circumference.

In another embodiment, no elastic bands are used, i. Only inelastic bands are used.

In another embodiment, only a single elastic band is used.

In another embodiment, inelastic ribbons are employed, the length of the inelastic ribbons being fixed, i. the bands are unverlängerbar.

In practice, different sized first and second parts are stored by the manufacturer or wholesaler. The user (doctor, therapist) orders a suitable kit for each individual patient, which is only used for this patient and later thrown away. The first part will be provided in a legal and a left version. In a right-hand version, the left shoulder remains free.

A preferred use of the orthosis according to one of the embodiments listed above is the therapeutic treatment of the shoulder joint.

The invention will be explained in more detail below with reference to the partially schematic representations of an embodiment.

Show it:

Figure 1 is a view of the chest side of an embodiment of the inventive orthosis.

FIG. 2 shows a view of the back side of the embodiment of the inventive orthosis shown in FIG. 1; FIG.

3 shows a view of the breast side of another embodiment of the inventive orthosis; 4 shows a view of the back side of the embodiment of the inventive orthosis shown in FIG. 3;

5 shows a view of the breast side of a further embodiment of the inventive orthosis;

6 shows a view of the back side of the embodiment of the inventive orthosis shown in FIG. 5; FIG.

7 shows a view of the breast side in turn of a further embodiment of the inventive orthosis; and

Fig. 8 is a view of the back side of the embodiment of the inventive orthosis shown in Fig. 7.

The embodiment shown in FIGS. 1 and 2 is designed as a right-hand design and comprises a west-like, first part 1 which can be fastened to the torso and a separate second part 10 which can be fastened to the upper arm in the form of a closable sleeve. The first part 1 has a two-part breast part 2 open at the front with a continuous opening 6 running in the direction of the patient's sagittal plane, a back part 3 fixed to the breast part 2 on the sides, and a shoulder part 4 on the right side, by means of which the right one Half of the chest part 2 and the back part 3 are firmly connected. In a right-hand version, the left shoulder remains free.

The breast part 2 and the back part 3 of the first part 1 are designed in three layers. The inner lining intended for skin contact is made of a skin-friendly material, for example a terry-like cotton. The middle layer may for example be made of a strong cotton cloth, so that a suitable stability of the first part 1 can be achieved by this rigid layer. The outer layer is optional and may also be made of a suitable material for the Velcro closure, so that unnecessary in this case, the retaining strips 24. On the left half of the breast part 2, three drawstrings 23 are fixed, which are provided on their directed against the chest inside with a first Velcro layer. On the right half of the breast part 2 a parallel to the sagittal plane of the patient extending first closure strip 24 is sewn to a second Velcro layer. On the left side of the back section 3, two further drawstrings 23 are fixed, which are provided on their directed against the chest inside with a first Velcro layer. On the left half of the breast part 2, a second closure strip 24 running transversely to the body longitudinal direction is sewn to the shoulder with a second hook-and-loop fastener layer.

The first hook-and-loop fastener layers on the drawstrings 23 form a hook-and-loop fastener with the second hook-and-loop fastener layer on the retaining strips 24, so that the two halves of the breast section 2 are at the front against each other by means of the three drawstrings 23 fastened to the left half of the breast section 2 and the first fastener strip pulled and fixed around the upper body of the patient. By means of the hook-and-loop fasteners between the two pull straps 23 arranged on the shoulder and the second fastener strip 24 sewn to the shoulder, the left half of the breast part 2 and the left side of the back part 3 are fixed relative to one another.

The attachable to the upper arm, second part 10 is formed as a closable cuff. The second part 10 is formed as a rectangular fabric part with two short sides and two long sides and has a height H parallel to the short sides and a length L parallel to the long sides, so that a tubular cuff with a height H around the upper arm can be formed. On a short side of the second part 10, in turn, three drawstrings 23 are fixed, which are provided on their directed against the arm inside with a first hook and loop fastener layer. On the second part 10, a further closure strip 24 is sewn parallel to the short sides of the second part 10 and on the outside of the second part 10, which is provided with a second hook and loop fastener layer. By the hook-and-loop fastener formed from the first hook-and-loop fastener layers on the three drawstrings 23 and the second hook-and-loop fastener layer on this fastener strip 24, the second part 10 can be fixed to the upper arm. On the second part 10 two fixation strips 25 are further arranged parallel to the short edges, which in turn are each provided with a second Velcro layer. The two fixation strips 25 are spaced apart so that after attachment of the second part 10 on the upper arm a fixation strip 25 comes to rest on the front of the upper arm and the other fixation strips 25 on the back of the upper arm.

Furthermore, the orthosis shown here comprises four bands 20, which serve for fastening the second part 10 on the first part 1 and for positioning the second part 10 relative to the first part 1. Two upper bands 20 are attached to the shoulder portion 4, one of which is directed against the breast part 2 and the other against the back part 3. Each of these two upper straps 20 is provided with a first hook and loop fastener layer on the inner side of the patient's body. One of the two upper straps 20 is fastened to the fixation strip 25 on the front of the upper arm by means of the Velcro fastener, while the other of the two upper straps 20 is fastened to the fixation strip 25 on the back of the upper arm. This fixes the upper arm against forward, backward and downward movements. The upper arm can also be held by the two upper bands 20 in a defined spread position.

Two lower bands 20 are preferably fastened to the breast part 2, respectively on the back part 3. For this purpose, a fixation strip 25 running parallel to the sagittal plane of the patient is sewn on each of the right half of the breast part 2 and the back part 3. By attaching the two lower bands 20 to the fixation strip 25 on the chest and back section 2, 3, the upper arm can be fixed on the one hand against movements to the front and back and on the other hand against further Abspreizen. Alternatively, only a lower band 20, which is releasably secured to the back part 3 by means of a buckle fastener 15 with a snap closure buckle, guided around the upper part attached to the second part 10 and by means of a buckle closure 15 with a snap closure buckle on the chest side. 2 be releasably attached.

In the case of a left execution, the right shoulder remains free and the following elements are arranged side by side:

the drawstrings 23 on the left breast and the left back 2, 3;

the closure strip 24 on the breast part 2 at the shoulder;

the two upper bands 20 which are attached to the shoulder 4; and - The on the chest part 2 and the back part 3 each parallel to the sagittal plane of the patient extending fixation strip 25th

Depending on the application of the orthosis, bands 20 can be used which react inelastically in their longitudinal direction to tensile forces or which react elastically in their longitudinal direction to tensile forces.

The scope of movement of the shoulder joint can be restricted or made more difficult by the physician or therapist by the following measures according to the therapeutic needs:

a) The bands 20 can be fixed at a desired angle to the sagittal plane of the patient at a suitable location of the length L having fixation strips 25. Typically, the lengths L of the fixation strips 25 on the breast part 2 are between 30 cm and 40 cm, and the back part 3 between 15 cm and 25 cm; b) By choosing inelastic bands 20, the arm to be treated can be kept in a desired position, so that only slight movements are possible; c) By the choice of elastic bands 20 and their positioning desired movements can be supported, which are, for example, painful or difficult to carry out feasible. On the other hand, the elastic bands 20 can be positioned so that certain movements can only be carried out against the resistance of the elastic band 20; or d) By using elastic bands in the case of the upper bands 20, the pressure on the shoulder joint can be increased.

The embodiment shown in FIGS. 3 and 4 is designed as a left-hand version and comprises a first part 1, which is designed as a harness 12. The harness 12 comprises two substantially parallel to the sagittal plane of the patient extending shoulder straps 13a, 13b, which form two shoulder parts 4, and two transversely to the transverse plane of the patient can be arranged transversal belts 14a, 14b, which the chest and back section 2, 3 of the orthosis 1 and attached to the shoulder straps 13a, 13b. The transversal belts 14a, 14b are spaced apart from each other so that a vest-like unit closable around the thorax is formed by the first part 1. Furthermore, the Transversalgurte 14a, 14b on the breast part 2 by means of a respective buckle closure 15 can be closed. On the back part 3, the two shoulder straps 13a, 13b are additionally held together by means of a connecting belt 28 in the transverse direction. The buckle fasteners 15 include snap buckles and integral length adjustment means 16 for adjusting the length of the transversal belts 14a, 14b.

The second part 10 is formed analogously to the embodiment shown in FIGS. 1 and 2 and forms an upper arm part 18 of a two-part arm part which can be fastened to the upper arm. This upper arm part 18 is movably connected to a lower arm part 19 which can be fastened to the lower arm by means of two connecting straps 27. The forearm part 19 is formed analogously to the second part 10 as a closable cuff and comprises a plurality of parallel fixation strips 25 and two drawstrings 23 for fixing the forearm part 19 on the forearm. In order for the forearm to be held relative to the upper arm in a physician-adjustable, bent position, the upper arm portion 18 and forearm portion 19 adjacent to the connecting straps 27 are interconnected by one or more bendable metal wires 17. As a result, the upper arm part 18 and the lower arm part 19 are held in an adjustable by bending the wire 17 angle α relative to each other. The second part 10 comprises a plurality of fixation strips 25 which are distributed on the circumference surrounding the arm and which are suitable for adhesive or Velcro fasteners. An upper band 20 which is fixedly connected to the shoulder portion 4 at one end 21 and is adhesive or velcro-friendly at its other end is releasably attached to one of the fixation strips 25 on the upper arm 18. By means of this detachable adhesive or Velcro fastener between the upper arm part 18 and the free end of the upper band 20 fastened to the shoulder strap 13b, the second part 10 can easily be adjusted in a desired position on the upper arm by the attending physician. The orthosis 1 shown in FIGS. 3 and 4 additionally comprises a wedge pad 30, which can be positioned between the thorax and the upper arm of the patient. A lower band 20, which is releasably secured to the back part 3 by means of a buckle closure 15 with a snap closure buckle on the lower transversal 14b, is guided around the upper part attached to the second part 10 and by means of a buckle closure 15 with a snap closure buckle on the Chest side of the lower Transversalgurtes 14b releasably attached. The lower band 20 is formed on its inside adhesive or velcro-friendly, so that the lower band 20 is releasably fixed to the fixation strip 25 on OberarmteiMδ. By the upper band 20, the wedge pad 30 and the lower band 20 of the upper arm is held with an abduction of about 30 ° through the orthosis. Furthermore, the wedge pad 30 is provided at its front and back with other suitable for an adhesive or Velcro fastening fixation strip 25, so that the wedge pad 30 is held by means of attachable to these fixation strip 25 lower band 20 in position. Alternatively, the wedge cushion 30 may also be designed to be adhesive or velcro-friendly on its outer side resting against the upper arm part 18, so that the wedge cushion 30 can be detachably fastened to the fixation strip 25 attached to the upper arm part 18.

In the case of a right-hand version, the following elements are arranged reversed:

- The two buckle fasteners 15, each with a snap closure buckle on the lower transversal 14b, which serve for fastening of the lower band 20; and

- The upper band 20, which is connected at one end 21 fixed to the shoulder portion 4 of the first part 1 and for fixing the second part 10 on the first part 1 is used.

The embodiment shown in FIGS. 5 and 6 is designed as a left-hand version and comprises a first part 1, which is designed as a harness 12. Analogous to the embodiment illustrated in FIGS. 3 and 4, the harness 12 comprises two shoulder straps 13a, 13b which extend substantially parallel to the sagittal plane of the patient and which form two shoulder portions 4, and two transverse straps 14a, 14b which can be arranged substantially parallel to the transversal plane of the patient , which form the chest and back section 2, 3 of the orthosis 1. The Transversalgurte 14a, 14b are spaced apart from each other, that is formed by the first part 1, a west-like, transversely closable around the thorax unit. Furthermore, the Transversalgurte 14a, 14b on the breast part 2 by means of a respective buckle closure 15 can be closed. At the back part 3, the two shoulder straps 13a, 13b are additionally transversal by means of a connecting belt 28 Direction held together. The buckle closures 15 include

Snap closure buckles and integrated length adjustment means 16 for adjusting the length of the Transversalgurte 14a, 14b.

The second part 10 is formed analogously to the embodiment shown in FIGS. 1 and 2. The second part 10 comprises a plurality of fixation strips 25 which are distributed on the circumference surrounding the arm and which are suitable for adhesive or Velcro fasteners. An upper band 20 which is fixedly connected to the shoulder portion 4 at one end 21 and is adhesive or velcro-friendly at its other end is releasably secured to one of the fixation strips 25 on the second part 10. By means of this detachable adhesive or Velcro fastener between the second part 10 and the free end of the upper strap 20 fastened to the shoulder strap 13b, the second part 10 can easily be adjusted in a desired position on the upper arm by the attending physician. A lower band 20, which is releasably secured to the back part 3 by means of a buckle closure 15 with a snap closure buckle on the lower transversal 14b, is guided around the upper part attached to the second part 10 and by means of a buckle closure 15 with a snap closure buckle on the Chest side of the lower Transversalgurtes 14b releasably attached. By the upper band 20 and the lower band 20, the upper arm with an abduction of about 30 ° can be held by the orthosis.

The embodiment shown in FIGS. 7 and 8 is designed as a left-hand version and comprises a first part 1, which is designed as a harness 12. Analogous to the embodiments shown in FIGS. 3 to 6, the harness 12 comprises two substantially parallel to the sagittal plane of the patient Shoulder straps 13a, 13b, which form two shoulders 4. The embodiment illustrated in FIGS. 7 and 8, however, comprises only one transversal belt 14a which can be arranged substantially parallel to the transversal plane of the patient and which forms the thoracic and back part 2, 3 of the orthosis 1. The shoulder straps 13a, 13b and the transverse girdle 14a are arranged such that a vest-like unit which can be closed transversely around the thorax is formed by the first part 1. Furthermore, the transverse belt 14a can be closed on the breast part 2 by means of a buckle closure 15. On the back part 3, the two shoulder straps 13a, 13b are additionally held together by means of a connecting belt 28 in the transverse direction. The buckle closure 15 comprises a snap closure buckle and integrated length adjustment means 16 for adjusting the length of the Transversalgurtes 14a.

The second part 10 is formed analogously to the embodiment shown in FIGS. 1 and 2. The second part 10 comprises a plurality of fixation strips 25 which are distributed on the circumference surrounding the arm and which are suitable for adhesive or Velcro fasteners. Three upper bands 20 which are fixedly connected to the shoulder portion 4 at one end 21 and are adhesive or velcro-friendly at their other end are releasably secured to the fixation strip 25 on the second part 10. By means of this detachable adhesive or Velcro fastener between the second part 10 and the free ends of the upper straps 20 fastened to the shoulder strap 13b, the second part 10 can easily be adjusted in a desired position on the upper arm by the attending physician. By the upper bands 20, the upper arm with an abduction of about 30 ° can be held by the orthosis.

In the case of a legal procedure, the following elements are arranged in a reversed order:

- The three upper bands 20, which with one end 21 fixed to the shoulder

4 of the first part 1 are connected and for fixing the second part 10 on the first part! serve.

Claims

claims

1. Orthosis for the shoulder joint with

A) a fastened to the torso first part (1) with a chest part (2), a back part (3) and at least one shoulder portion (4);

B) a second part (10) attachable to the upper arm; and

C) at least two bands (20) for fastening the second part (10) to the first part (1) and for positioning the second part (10) relative to the first part (1), characterized in that

D) at least parts of the surfaces of the first and second part (1, 10) and the bands (20) are designed as releasable Velcro or adhesive closures, or that

E) the first part (1) comprises one or more buckle closures (15) and that at least parts of the second part (10) and the bands (20) are designed as releasable Velcro or adhesive closures.

2. Orthosis according to claim 1, characterized in that the first part (1) and the second part (2) are realized as two separate parts, which are connectable only by means of the bands (20).

3. Orthosis according to claim 1 or 2, characterized in that the first part (1) as a harness (12) is formed, which one or more around a torso to be passed around Transversalgurte (14a, 14b) and at least one on the or the Transversalgurten ( 14a; 14b), wherein the transversal belt (s) (14a; 14b) form the chest and back part (2; 3) and the at least one shoulder belt (13a; 13b) forms the shoulder part (4) ,

4. Orthosis according to claim 3, characterized in that the harness (12) comprises two shoulder straps (13a, 13b) which are connected to the back part (3) by means of a shoulder portions (4) arranged Verbindungsgurtes (28) in the transverse direction ,

5. Orthosis according to claim 1 or 2, characterized in that the chest and back part (2, 3) form a west-like, transversely closable around the thorax unit.

6. Orthosis according to one of claims 1 to 5, characterized in that it comprises at least three bands (20), so that any possible movement of the shoulder joint can be limited, or controlled.

7. Orthosis according to one of claims 1 to 6, characterized in that at least one of the bands (20) in its longitudinal direction to tensile forces substantially inelastic.

8. Orthosis according to one of claims 1 to 7, characterized in that at least one of the bands (20) reacts in its longitudinal direction to tensile forces substantially elastic.

9. Orthosis according to one of claims 1 to 8, characterized in that one end (21) of one of the bands (20), preferably of two bands (20) is fixedly connected to the shoulder part (4).

10. Orthosis according to one of claims 1 to 9, characterized in that at least parts of the first part (1) are designed as releasable Velcro or adhesive closures.

11. Orthosis according to one of claims 1 to 10, characterized in that at least one band (20) has one or more buckle closures (15).

12. Orthosis according to one of claims 1 to 11, characterized in that the orthosis (1) comprises a forearm fastened to the forearm part (19), which by means of one or more connecting bands (27) movable with the upper arm attachable second part (10) is connectable.

13. An orthosis according to claim 12, characterized in that the second part (10) and the lower arm part (19) additionally by means of one or more plastically deformable connecting parts, preferably by means of one or more wires (17) are interconnected, so that the second part (10) and the lower arm part (19) are held relative to one another in an angle α which can be set by bending the wire or wires (17).

14. Orthosis according to one of claims 1 to 13, characterized in that the orthosis additionally comprises a wedge pillow (30) which is positionable between the thorax and the upper arm of a patient.

15. An orthosis according to claim 14, characterized in that parts of the surfaces of the wedge pad (30) are designed to be velcro or adhesion-friendly.

16. Orthosis according to one of claims 1 to 15, characterized in that at least one band (20) only by means of Velcro or adhesive closures and / or buckles with the first and the second part (1, 10) is connected and thus interchangeable.

17. Orthosis according to one of claims 5 to 16, characterized in that the breast part (2) and the back part (3) are at least partially formed in two layers, wherein the outer, not provided for the skin contact layer is stiffer than the inner layer ,

18. Orthosis according to one of claims 5 to 17, characterized in that the breast part (2) and the back part (3) are at least partially formed four-ply, wherein the outermost layer consists of a suitable material for Velcro fasteners and the inside against it adjacent layer made of a foam.

19. Use of the orthosis according to one of claims 1 to 18 for the therapeutic treatment of the shoulder joint.

20. Kit with orthosis according to one of claims 1 to 18, characterized by a first part (1) with a at the shoulder (4) fixed band (20) and at least one loose band (20).