WO2016152901A1

WO2016152901A1 - Socket for above-elbow prosthesis, and above-elbow prosthesis

Info

Publication number: WO2016152901A1
Application number: PCT/JP2016/059138
Authority: WO
Inventors: 如代清水; 裕高六▲崎▼; 安良和田野; 亮子竹内; 憲一吉川; 大輔片根; 博之鳥島
Original assignee: 茨城県; 有限会社大宮義肢研究所
Priority date: 2015-03-26
Filing date: 2016-03-23
Publication date: 2016-09-29
Also published as: JPWO2016152901A1; JP6714252B2

Abstract

The objective of the present invention is to provide a socket for an above-elbow prosthesis, and an above-elbow prosthesis, which is simple to fit and is not liable to become loose, and with which it is possible to prevent secondary injury. This socket for an above-elbow prosthesis, which is coupled to an upper-arm stump, has a double structure, being provided with an inner socket (1) into which the stump is inserted, and an outer socket (2) covering the inner socket (1). Then, a helical slit (1a) is formed in the inner socket (1), the configuration being such that the inner socket (1) extends and shortens, and/or expands and contracts diametrically, to follow changes in the shape of the stump.

Description

Socket for upper arm prosthesis and upper arm prosthesis

The present invention relates to a socket for an upper arm prosthesis used for an upper arm amputee and an upper arm prosthesis. More specifically, the present invention relates to a contact-type socket that comes into contact with a stump and an upper arm prosthesis including the socket.

Prosthetic limbs are essential in daily life for patients who have had their limbs cut off. In general, a prosthesis is composed of a socket that directly wraps and supports a cut end, a joint corresponding to a joint, a hand tool corresponding to a hand and a foot, and a foot. In the case of an upper arm prosthesis used by an upper arm amputee, a suspension member (harness) for hanging the prosthesis is used for supporting and fixing the stump.

However, the upper arm prosthesis that is supported and fixed using a harness has a problem that neck pain and joint pain occur on the opposite shoulder (see Non-Patent Document 1). In addition, this type of prosthetic hand has a risk that the trunk tilts and shoulder joint pain or low back pain develops because the weight of the upper limb reduced by cutting the upper arm is not supplemented.

In order to improve these secondary obstacles, an upper arm prosthesis is conventionally prescribed in which a stump is supported and fixed by a liner. In the case of a liner-type upper arm prosthesis, a liner formed of silicone resin or the like is directly attached to the stump, and a lock pin is used instead of a harness for the suspension mechanism. By using this liner-type upper arm prosthesis, it is possible to eliminate the uncomfortable feeling of the harness.

In addition, a double-structured prosthetic leg socket portion in which an inner socket made of a tapered substantially cylindrical body having a slit is inserted into an outer socket made of a tapered substantially cylindrical body has been proposed (Patent Document 1). reference). In the socket portion for a prosthetic leg described in Patent Document 1, a slit is provided over the entire length of the tapered substantially cylindrical body constituting the inner socket, whereby the tapered substantially cylindrical body can be expanded and contracted. .

JP 2011-143227 A

The socket is a part that supports and fixes the cut end and transmits the movement of the cut end to the hand tool and the foot, and it is necessary to adapt the socket to the cut end for wearing and using a prosthetic limb. . For this reason, when producing a socket, a prosthetic orthosis wraps a bandage-shaped gypsum called a gypsum cast directly around a patient's stump, and molds the socket using a negative model produced thereby.

However, when the prosthetic hand is attached, the stump is suspended or extended depending on the weight of the prosthetic hand, so that the shape of the stump is different from that at the time of molding. Specifically, when molding, no force is applied to the stump other than the weight of the stump itself, but when actually using a prosthetic hand, the prosthetic hand such as an elbow joint or a hand part is used on the stump. Since the weight of the other member which comprises is applied, a stump part is extended below. For this reason, conventional upper arm prostheses have problems such as loosening of the socket during wearing and easy removal, and secondary problems such as skin damage such as redness and blistering around the socket. There is a problem that arises.

On the other hand, when taking into account the shape change of the stump and making a socket by pulling the stump and hanging or extending it, mounting is difficult when the stump is not suspended or extended become. Such a problem of difficulty in fitting the socket causes skin damage at the stump and neck pain or shoulder joint pain that occurs near the shoulder (proximal portion).

Moreover, in the socket part of patent document 1, although the slit is provided in the inner socket in order to raise fit property, since the actual shape of a stump changes every moment, it describes in patent document 1 In the case of a structure in which ring-shaped members are combined, such as the socket part, there is a possibility that blood flow may be impaired due to local pressure. Furthermore, the socket part described in Patent Document 1 is for an artificial leg, and the structure of the socket part described in Patent Document 1 is applied to the prosthetic hand as it is because the method of applying force and the state at the time of wearing are different from those of the artificial hand. Even so, it is difficult to obtain a stable wearing state.

For these reasons, secondary prostheses such as skin disorders, neck pain, and shoulder pain when using the prosthetic hand as an auxiliary hand when performing two-handed movements necessary for daily life such as writing and changing clothes. Therefore, there is a demand for the development of sockets that are easy to mount, easy to remove, and easy to mount and have good fit and compatibility.

Therefore, an object of the present invention is to provide a socket for an upper arm prosthesis and an upper arm prosthesis which are easy to attach and difficult to remove and which can prevent secondary damage.

A prosthetic hand socket according to the present invention is an upper arm prosthetic hand socket connected to an upper arm stump, and includes an inner socket into which a cut end is inserted, and an outer socket covering the inner socket. The socket has a spiral slit.
The inner socket can be formed of, for example, fiber reinforced plastic.
The inner socket has a diameter and / or length that changes according to the shape of the stump or following the shape change of the stump over time.
Further, the slit of the inner socket can be formed at a spiral angle of 60 to 80 °, for example.
On the other hand, the inner socket and the outer socket may be connected via a resin belt.

The prosthetic hand according to the present invention is an upper arm prosthesis having the socket described above.

According to the present invention, since the inner socket and the outer socket have a double structure, and the spiral slit is formed in the inner socket, it is easy to mount and difficult to remove, and secondary failures can be prevented. An upper arm prosthesis socket and an upper arm prosthesis can be realized.

FIGS. 2A and 2B are perspective views schematically showing the configuration of the prosthetic hand socket according to the first embodiment of the present invention, wherein A shows a state when the inner socket is attached, and B shows a state where the outer socket is attached. FIGS. . It is a figure which shows the state at the time of the expansion | extension of the inner socket. A and B are figures which show the other structural example of an inner socket, A is a front view, B is a side view. It is the figure which compared the extension degree of the inner socket 1 shown to FIG. 1A, and the inner socket 11 shown in FIG. FIGS. 4A to 4D are diagrams showing another configuration example of the outer socket, in which A is a front view, B is a rear view, C is a right side view, and D is a left side view. It is a perspective view which shows typically the structure of the artificial hand of the 2nd Embodiment of this invention.

Hereinafter, embodiments for carrying out the present invention will be described in detail with reference to the accompanying drawings. Note that the present invention is not limited to the embodiments described below.

(First embodiment)
First, the prosthetic socket according to the first embodiment of the present invention will be described. The socket for the prosthetic hand of this embodiment is a socket for the upper arm prosthesis connected to the stump of the upper arm amputee, supports and fixes the upper arm stump, and transmits the movement of the body to the hand tool.

[overall structure]
1A and 1B are perspective views schematically showing a configuration of a socket for a prosthetic hand according to the present embodiment. FIG. 1A shows a state when an inner socket is attached, and FIG. 1B shows a state where an outer socket is attached. As shown in FIG. 1A and FIG. 1B, the prosthetic hand socket of this embodiment has a double structure of an inner socket 1 into which a cut end is inserted and an outer socket 2 that covers the inner socket 1. The inner socket 1 and the outer socket 2 are connected by a resin belt or the like.

[Inner socket 1]
FIG. 2 is a view showing a state when the inner socket 1 is extended. The inner socket 1 is in contact with the cut end portion directly or through a liner or an insert, and is manufactured by casting in a state where the cut end is pulled or suspended or extended. In addition, a slit (cut) 1a is formed in a spiral shape on the side surface of the inner socket 1, so that the diameter and / or length changes according to the shape of the stump or change with time. It has become. Specifically, as shown in FIG. 1A, the slits 1a are in contact with each other at the time of shortening, but at the time of extension shown in FIG. 2, the interval between the slits 1a is widened to follow the shape of the stump or the shape change with time. .

The slit 1a of the inner socket 1 is preferably formed at a spiral angle of 60 to 80 ° from the viewpoint of improving extensibility. Similarly, from the viewpoint of improving extensibility, the pitch of the slits 1a is preferably about 1 to 3 cm and the width is preferably 5 mm or less. The spiral angle, pitch, width, and the like of the slit 1a formed in the inner socket 1 are not limited to the above-described ranges, and can be appropriately selected according to the shape and length of the stump.

3A and 3B are diagrams showing another configuration example of the inner socket, FIG. 3A is a front view, and FIG. 3B is a side view. 4 is a diagram comparing the degree of extension of the inner socket 1 shown in FIG. 1A and the inner socket 11 shown in FIG. The inner socket 11 shown in FIG. 3 has a spiral angle larger than that of the inner socket 1 shown in FIG. 1, and further has a narrow pitch to increase the number of slits 11a. When these

inner sockets

1 and 11 were expanded and compared, as shown in FIG. 4, it was confirmed that the inner socket 11 having a larger helix angle is superior in extensibility.

The material of the inner socket 1 is not particularly limited, and can be formed of a conventionally used material such as a thermoplastic resin, a thermosetting resin, various reinforced plastics to which fibers, reinforcing materials, and the like are added. . Among these materials, from the viewpoint of strength, a fiber reinforced plastic composed of a woven fabric (cloth) formed of carbon fiber, glass fiber, nylon fiber or the like and a matrix resin such as acrylic resin or urethane resin is preferable.

The slit 1a of the inner socket 1 may be formed by first forming a slit-free one, and then forming a slit in a spiral shape. The slit 1a may be formed. In addition, in order to fix a liner or insert to the socket, a connection member such as a lock pin may be attached to the tip of the

inner sockets

1 and 11 on the elbow joint side.

[Outer socket 2]
The outer socket 2 covers the entire inner socket 1, protects the cut end and the inner socket, maintains the shape of the inner socket 1 that expands and contracts following the cut end, and connects the elbow joint and the hand tool. belongs to. The outer socket 2 is manufactured by hanging or extending the stump while the inner socket 1 is mounted, and molding.

The material of the outer socket 2 is not particularly limited, and can be formed of a conventionally used material such as a thermoplastic resin, a thermosetting resin, various reinforced plastics to which fibers, reinforcing materials, and the like are added. . The outer socket 2 may be formed of the same material as the inner socket 1 described above, but can also be formed of a different material.

However, while the stump shape is changing, the outer socket 2 is preferably formed of a thermoplastic resin having a relatively low melting point from the viewpoint of ease of adjustment after molding. On the other hand, after the stump shape is stabilized, the outer socket 2 is composed of a woven fabric (cloth) formed of carbon fiber, glass fiber, nylon fiber or the like and a matrix resin such as acrylic resin or urethane resin in terms of strength. It is preferable to form with fiber reinforced plastic.

The outer socket 2 has a shape that covers the patient's shoulder, which limits the rotation of the socket with respect to the stump. The outer socket 2 is not limited to the shape shown in FIG. 1B, and may have a shape that covers a part of the shoulder. 5A to 5D are diagrams showing other examples of the outer socket, in which FIG. 5A is a front view, FIG. 5B is a rear view, FIG. 5C is a right side view, and FIG. 5D is a left side view. As shown in FIGS. 5A to 5D, the outer socket 21 contacts only the back of the humeral head, the ostium process, and the scapular spine, and the side portion is open.

Patients with combined injury and post-traumatic shoulder and neck trauma need to reduce pain caused by wearing a prosthetic limb as much as possible, but this shape of the outer socket limits the rotation of the socket. Further, it is possible to reduce the occurrence of skin disorders such as friction and rash between the skin at the stump and the socket.

A connecting member for connecting an elbow joint or the like may be attached to the tip of the outer socket 2 on the elbow joint side. The socket and the elbow joint of this embodiment are connected by this connection member.

[Resin belt 3]
The resin belt 3 connects the inner socket 1 and the outer socket 2, and is attached to, for example, the outer surface of the inner socket 1 near the elbow joint (distal portion). The outer socket 2 is provided with a hole through which the resin belt 3 is inserted and a fixing member for fixing the resin belt 3. Then, after the outer socket 2 is mounted on the inner socket 1, the resin belt 3 is passed through the hole and fixed by a fixing member, thereby connecting the inner socket 1 and the outer socket 2.

As described above in detail, the prosthetic hand socket according to the present embodiment has a spiral shape (spiral socket) in which the inner socket is formed with a spiral slit, so that the socket itself extends to follow the shape change of the stump. It is possible. As a result, secondary disorders such as skin disorders, neck pains, and shoulder pains that occur when socket fitting is difficult can be prevented.

The socket for the prosthetic hand according to the present embodiment has a double structure of an inner socket and an outer socket, so that it is easy to be attached and detached and is difficult to be removed when attached. Moreover, since the socket for prosthetic hands of this embodiment is a contact type, a harness can be simplified and the neck pain by the harness and the shoulder pain of the other side can be reduced. In the case of a long cut end, a harness may not be required.

The inner socket of the prosthetic hand socket according to the present embodiment is extended and shortened according to the cut end shape, and the inner diameter is shortened and enlarged, so that it is easy to mount and difficult to remove, and corresponds to various cut end shapes. It is possible. Furthermore, since this inner socket is difficult to apply pressure locally, it also has an effect of preventing secondary damage.

Normally, the stump shape of the upper arm amputee is an inverted conical shape whose circumference increases as it becomes proximal, but in the case of a patient whose upper arm muscle has been excised, the circumference of the proximal portion is larger than the distal portion. Due to the small diameter, the conventional socket creates a gap, and secondary damage such as skin damage is likely to occur due to loosening and friction. In contrast, the prosthetic hand socket according to the present embodiment deforms the inner socket according to the shape of the stump. It does not occur and can be used in good condition.

Furthermore, since the circumference of the stump changes day by day for patients in the period immediately after injury, it is difficult to fit the socket, and conventionally, prosthetic hand training tends not to proceed due to neck pain, shoulder joint pain, and skin disorders. However, by using the socket of this embodiment, it becomes possible to speed up prosthetic limb training. Early prosthetic limb placement training may improve phantom limb pain, an intractable complication of amputees.

(Second Embodiment)
Next, a prosthetic hand according to a second embodiment of the present invention will be described. FIG. 6 is a perspective view schematically showing the configuration of the prosthetic hand of the present embodiment. The prosthetic hand of the present embodiment is an upper arm prosthesis connected to the upper arm cutting part, and as shown in FIG. 6, the forearm support part 30 and the hand tool 40 are connected to the socket 10 via the elbow joint 20. .

The prosthetic hand of this embodiment uses the socket of the first embodiment described above for the socket 10. That is, the socket 10 has a double structure of an inner socket having a spiral slit and an outer socket covering the inner socket. In addition, a well-known member can be used for the elbow joint 20, the forearm support part 30, and the hand tool 40.

The prosthetic hand of this embodiment uses a double-structured socket with an inner socket with a spiral slit and an outer socket covering it, so it is easy to put on and hard to remove, preventing secondary damage It is also possible to do. Further, the prosthetic hand of the present embodiment can be applied not only to a normal upper arm amputee but also to a patient who has excised the muscle of the upper arm.

A patient wearing the prosthetic hand of the present embodiment performs training under the guidance of an occupational therapist or a physical therapist to hold down paper by writing operation as an auxiliary hand for both-hand operation of daily life, or at the time of changing clothes It is possible to hold clothes and take out the wallet when taking out money from the wallet. Thus, by using the prosthetic hand of this embodiment, the use of the prosthetic hand becomes easier than before, and it can contribute to the improvement of daily life operations such as writing and changing clothes and the improvement of QOL (quality of life). .

Also, the prosthetic hand of this embodiment can be used as a myoelectric prosthesis. The “myoelectric prosthesis” is an electrode that attaches an electrode to the remaining part of the arm and detects a potential change (myoelectric potential) that occurs when the muscle is moved to operate the prosthesis. In general, a suction socket is used for a myoelectric prosthetic hand in an upper arm amputated case, and a harness is required in the case of a short stump. Further, in the conventional myoelectric prosthesis, an electrode is attached to the upper arm portion of the patient to detect the myoelectric potential of the biceps or triceps.

On the other hand, since the prosthetic hand of this embodiment uses a socket having a double structure of an inner socket and an outer socket covering the inner socket, the myoelectric potential of the biceps or triceps is detected due to the structure. It is difficult. Therefore, when the prosthetic hand of this embodiment is used as a myoelectric prosthetic hand, an electrode is disposed inside the outer socket, and myoelectric potential around the shoulder such as the deltoid muscle, the great pectoral muscle, and the subspinous muscle is used. The prosthetic hand of the present embodiment can detect the myoelectric potential around the shoulder well, and can obtain an operation performance equal to or higher than that of the conventional myoelectric hand.

Hereinafter, the effects of the present invention will be described in detail by way of examples.

(First embodiment)
The socket of the first embodiment described above was applied to a decorative prosthesis of a right upper arm amputated patient (male in their 40s). In this patient, the wound at the stump was scarred, and neck pain and left shoulder pain associated with cervical spondylosis were also observed. Therefore, when the socket for the prosthetic hand was changed to the socket according to the first embodiment of the present invention, the patient's neck pain and left shoulder pain were reduced, and the skin disorder was also improved. As a result, this patient was able to work.

(Second embodiment)
The socket of the first embodiment described above was applied to a work prosthesis of a patient (male in his twenties) who had a right upper arm cut. This patient had complete right upper limb paralysis due to damage to the right brachial plexus. This patient can detach the socket of the first embodiment of the present invention without any problem, and even after installation, the occurrence of skin disorders such as blister formation and pigmentation due to circulatory disturbance at the stump is recognized. There wasn't.

In this patient, the stump was in the process of maturation, and the circumference of the stump changed by 1 cm or more in 3 weeks. In such a case, the existing socket for the prosthetic hand needs to be remanufactured, but the socket according to the first embodiment of the present invention can be used as it is without being remanufactured.

(Third embodiment)
The socket of the first embodiment described above was applied to a myoelectric prosthesis of a patient with a left upper arm amputation (male in his 30s). The patient had short stumps and neck pain and right shoulder pain. In the case of this patient, when a conventional socket is used, a harness is required, but by using the socket according to the first embodiment of the present invention, the harness is unnecessary, and the load on the right shoulder can be reduced. As a result, this patient improved neck pain and right shoulder pain.

Moreover, when two pairs of electrodes were attached to the inner side of the outer socket, and myoelectric potentials of the deltoid muscle, the great pectoral muscle, the subspinous muscle, etc. were detected, they could be detected well.

(Fourth embodiment)
The socket of the first embodiment described above was applied to a decorative prosthesis of a left upper arm amputee (male in his 70s). Since this patient was cut by a malignant soft tissue tumor of the upper arm, the remaining muscle proximal to the socket (biceps brachii) was usually excised. Since this patient had a small peripheral diameter, the conventional socket for prosthetic hands was loosened and rubbed, which was considered to cause skin damage.

For this reason, the socket of the first embodiment of the present invention was applied to the patient's socket from the beginning for this patient. As a result, this patient was able to use the prosthetic hand in a good condition for a long time without the occurrence of skin trouble. This is presumably because the socket of the first embodiment of the present invention can be deformed following the shape of the stump, so that it is difficult for loosening and friction to occur.

From the above results, it was confirmed that by using the socket of the present invention, it is possible to realize an upper arm prosthesis that is easy to attach and difficult to remove and that can prevent secondary damage.

1,11 inner socket, 1a, 11a slit, 2,21 outer socket, 3 resin belt, 10 socket, 20 elbow joint, 30 forearm support, 40 minions

Claims

A socket for an upper arm prosthesis connected to the upper arm stump,
An inner socket into which the stump is inserted;
An outer socket that covers the inner socket;
A socket for an upper arm prosthesis in which a slit is spirally formed in the inner socket.
The upper arm prosthetic socket according to claim 1, wherein the inner socket is formed of fiber reinforced plastic.
The upper arm prosthetic socket according to claim 1 or 2, wherein the inner socket has a diameter and / or length that changes in accordance with a shape of the stump or according to a change in shape of the stump over time. .
The upper arm prosthetic socket according to any one of claims 1 to 3, wherein the slit of the inner socket is formed at a spiral angle of 60 to 80 °.
The upper arm prosthesis socket according to any one of claims 1 to 4, wherein the inner socket and the outer socket are connected via a resin belt.
An upper arm prosthesis provided with the socket according to any one of claims 1 to 5.