Abstract:
An orthesis for the treatment of injuries to the acromioclavicula joint, especially for the treatment of Tossy I/II/III injuries, has three straps positioned on a shoulder pad. The first strap and the second strap are secured to a forearm holder to be positioned in front of the elbow joint. The first strap can be placed in front of the shoulder and the second strap can be placed behind the shoulder. The third strap is designed to run behind the back to the opposite shoulder and has a loop to be fixed there. Pressure can thus be exerted on the clavicle and at the same time the shoulder can be pulled upwards.

Description:
BACKGROUND  
         [0001]    The invention relates to an orthesis for treating injuries to the acromioclavicula joint (A-C joint) with a shoulder pad and straps connected to the shoulder pad.  
           [0002]    An apparatus is disclosed in German utility model G 92 15 341.0 wherein a shoulder shell is provided to stabilize one shoulder of a patient and is held there with straps. German utility model DE 201 14 446 U1 discloses a shoulder-joint function bandage which is especially designed for the treatment of hemiparesis patients.  
           [0003]    Apparatuses for post-operative application for the restoration of the upper arm and the shoulder are shown in DE 41 34 969 A1 and German utility model DE 90 10 801.9.  
           [0004]    The laceration of and injury to the ligament structures of the acromioclavicula shoulder joint (A-C joint) are frequent clinical occurrences in surgery and orthopaedics. Treatment involves immobilizing the joint with bandages. Bandages of various designs are already known, most involve considerable movement restriction of the injured shoulder and frequently the entire arm.  
           [0005]    Laceration of the ligament structures in the A-C joint involves raising of the clavicle and the collar bone, the so-called piano-key phenomenon. The applied bandage should allow the structures to join together again and heal together. Therefore pressure is applied to the clavicle in order to press it in the direction of the acromium or shoulder. However, this is frequently unsuccessful. After weeks of bandage treatment the patient must, under certain circumstances, undergo an operation to regain the function of the shoulder joint. The healing of the injury is thereby be delayed.  
           [0006]    The object of the invention is to provide an orthesis which achieves sufficient stability of the injured shoulder and fixes the joint securely while maintaining a high freedom of movement for the patients.  
         SUMMARY  
         [0007]    In the present invention, it is important that at least three straps are placed on or connected to the shoulder pad. The first strap and the second strap are secured to a forearm holder positioned just below the elbow joint. The first strap can be placed in front of the shoulder and the second strap can be placed behind the shoulder. A third strap is constructed and/or is provided to run behind the back of the patient to the opposite shoulder and has a loop to fix it there.  
           [0008]    Tossy I/II/III injuries in particular can be treated with this orthesis. However, it is also suitable for Rockwood type III to type VI injuries as well as lateral collar-bone or clavicula fractures. In this use pressure is applied downwards onto the clavicle while pulling the shoulder upwards at the same time. This joint comes into its normal position and the patient retains his natural freedom of movement to a large extent. This orthesis allows natural movements without endangering the aim of the therapy. The patient achieves a positive attitude regarding the injury positively influencing the healing process.  
           [0009]    The shoulder pad has an anti-slip support, preferably silicone, on its side facing the user or the skin of the user. This prevents slippage of the shoulder pad and improves comfort. The shoulder pad is made of a textile material. In order to provide sufficient stability, the textile material is preferably impregnated with a polyurethane or can contain other suitable reinforcements, such as aluminium. The construction of the shoulder pad using plastic is also advantageous.  
           [0010]    The straps are detachably connected to the shoulder pad. In the area of the shoulder pad, rings or eyes are provided through which the straps are guided and placed adjustably in length, fixable with a velcro closure. These rings may have comparatively short attachment straps.  
           [0011]    The straps are secured at three clamping points separated from one another. The three clamping or holding points are arranged on the shoulder pad so that the straps are arranged at an angle of 120° with respect to one another. The straps are more favorably made of textile material or a hygienically safe plastic material.  
           [0012]    The forearm holder is preferably constructed as a clasp completely encircling the forearm or as a forearm cuff. This has a double velcro closure arranged at each end, forming a ring encircling the forearm. Fundamentally the forearm holder could also be constructed as an upwardly open shell. The forearm holder and the shoulder pad are preferably made of the same textile material. In a preferred embodiment of the invention the orthesis is shaped so that the first strap and the second strap run in front of and behind the shoulder, starting from the shoulder pad, and crossing under the upper arm and being secured at the forearm holder. This creates increased stability of the shoulder pad. Preferably the first strap and the second strap are secured to the shoulder pad and to the forearm holder so that they cross below the upper arm. An anti-slip feature may be provided on the inside of the forearm holder. This is formed by a silicone insert, preferably with burls or another rough structure.  
           [0013]    The loop provided at the end of the third strap can be opened with a velcro closure. In another embodiment the loop is closed and the strap arranged thereon is comparatively long so that the loop can be pulled simply over the arm. The length of the strap is variably adjustable by means of a guide at the shoulder pad and is secured by a velcro connection.  
           [0014]    The orthesis has a first holding strap which secured to the wrist and dimensioned so that it is guided around the back in the elongation of the forearm bent in front of the body and is fixable on the upper arm of the injured shoulder. This can be accomplished either with a loop or with a velcro closure. By this means, the forearm is held in position and the wearing comfort is increased. In a further embodiment of the invention the orthesis is assigned a second holding strap secured to the wrist and designed and dimensioned so that it is guided upwards starting from the forearm bent in front of the body and secured on the third strap in the area of the shoulder opposite the injury. This holding strap is also used to fix the forearm in front of the body and increases the wearing comfort of the orthesis. The two holding straps described can be used singly but preferably combined. One of the holding straps preferably has a wrist holder in the form of a wrist cuff and the other holding strap is fixable on this wrist holder. The first holding strap preferably has this wrist holder and a flap through which the second holding strap can pass. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0015]    Other objects and features of the present invention will become apparent from the following detailed description considered in connection with the accompanying drawings which disclose at least one embodiment of the present invention. It should be understood, however, that the drawings are designed for the purpose of illustration only and not as a definition of the limits of the invention.  
         [0016]    In the drawings, wherein similar reference characters denote similar elements throughout the several views:  
         [0017]    [0017]FIG. 1 is a schematic front view of a preferred embodiment of the orthesis according to the invention on a patient;  
         [0018]    [0018]FIG. 2 is an overall schematic view of a preferred embodiment of the orthesis according to the invention;  
         [0019]    [0019]FIG. 3 is a schematic view of the first holding strap assigned to the orthesis according to the invention;  
         [0020]    [0020]FIG. 4 is a schematic view of the second holding strap assigned to the orthesis according to the invention;  
         [0021]    [0021]FIG. 5 is a schematic front view of an embodiment of the orthesis according to the invention on a patient including the holding straps;  
         [0022]    [0022]FIG. 6 is a rear view as in FIG. 5; and  
         [0023]    [0023]FIG. 7 is an enlarged view of the shoulder region with slightly out-stretched arm. 
     
    
     DETAILED DESCRIPTION  
       [0024]    [0024]FIG. 1 shows an orthesis  1  according to the invention for the treatment of injuries to the A-C shoulder joint, especially Tossy I to III injuries. The orthesis has a shoulder pad  2 , a forearm holder  3  and three straps  10 ,  20  and  30 . Shoulder pad  2 , made of one piece, is adapted to the anatomical conditions of the shoulder and has a skin-friendly silicone pad on its underside facing the skin. This guarantees an absolutely slip-proof fit during a lateral abduction of the arm up to approximately 85°, and further with a design having a back strap.  
         [0025]    On the upper side of shoulder pad  2  are three holding points  11 ,  21 ,  31 . Two holding points  11 ,  21  each receive straps  10 ,  20  which pass in front of and behind the shoulder in the direction of the elbow, crossing on the underside of the forearm. They are fixed on clamping points  15  and  25  to forearm holder  3 , located on the forearm and holding on to the bony structures present there, and encircling the arm in a clasp fashion. Third holding point  31  on shoulder pad  2  serves to secure strap  30  which runs transversely over the back to the opposite shoulder and emerges there in a softly padded loop  34 . Strap  30  is also designed as a velcro strip.  
         [0026]    Shoulder pad  2  as well as forearm holder  3  can be made of plastic and textile material. When made of textile material, it is recommended that reinforcing elements be inserted, such as, shaped parts made of easily formable materials, such as aluminium. First strap  10  and second strap  20  preferably have a width of approximately 30 to 40 mm and are made of so-called luggage strap or similar material which best adapts to the anatomical shapes and conditions on account of its flexible quality. Third strap  30  is made of a softly padded material. Straps  10 ,  20 ,  30  and the loop are shown dashed where they run behind the arm or the back and are not visible when viewed in the perspective shown.  
         [0027]    [0027]FIG. 2 shows orthesis  1  according to the invention with shoulder pad  2 , straps  10 ,  20  and  30  and forearm holder  3 . Shoulder pad  2  has a substantially oval basic shape. However, on the side facing the shoulder there is a circular segment or sickle-shaped recess  6 . First strap  10  and second strap  20  are placed on both sides of sickle-shaped recess  6 . Clamping or holding points  11  and  21  have short attachment pieces  16 ,  26  sewn thereto. First strap  10  or second strap  20  are guided adjustably in length through attachment pieces  16 ,  26 . In the same fashion at holding point  31  on the side opposite sickle-shaped recess  6 , an attachment piece  36  is sewn on, having a guide ring  32  to which strap  30  is fixed adjustably in length. Three holding points  11 ,  21  and  31  are arranged at positions on shoulder pad  2  spaced from one another and the straps arranged accordingly thereon each intersect at an angle of approximately 120° in an imaginary elongation.  
         [0028]    Straps  10  and  20  are connected to forearm holder  3  or secured there such that when straps  10  and  20  lie twist-free, they cross in the area of points  14  and  24 . This crossing point lies below the upper arm and permits additional stabilization of shoulder pad  2 . Forearm holder  3 , preferably constructed as a closed clasp or here as a textile-like cuff, has an anti-slip feature  7  on its inside which is formed of a silicone pad. The spacing between shoulder pad  2  and forearm holder  3  can be adjusted with the aid of straps  10  and  20 . Straps  10  and  20  are fed through guide rings  12  and  22  and after the desired length has been set, can be fixed to straps  10  and  20  using velcro areas  13  and  23  located at the ends. Third strap  30  has a loop  34  in its end region which is positioned such that it runs from shoulder pad  2  behind the back to the opposite shoulder. To adjust the length, third strap  30  is fed through guide ring  32  which is fixed to holding point  31  via attachment piece  36  and is secured to this with the aid of velcro area  33  provided at the end of the third strap.  
         [0029]    [0029]FIG. 3 shows a view of a first holding strap  40 . This is fixed to the wrist using a wrist holder  41  which is constructed as a ring-shaped closing wrist cuff and can be closed with a velcro closure. In a central region of wrist holder  41  is a strap  42  which is guided around the back in the elongation of the forearm bent in front of the body and is guided around the upper arm to the injured shoulder and is fixed there with the aid of velcro area  43  in end region of the strap  42 . On wrist holder  41 , i.e., on the outside of wrist holder  41 , is an open flap  44  in continuation or linear extension of strap  42 .  
         [0030]    [0030]FIG. 4 shows a second holding strap  50  which is also provided to fix the forearm bent in front of the body. An end region  51  of a second holding strap  50  is guided around the vertically aligned forearm or the wrist and can be guided through the then vertically open, horizontally aligned flap  44  so that lateral slippage is prevented. A loop can be formed in this region with the aid of a velcro area provided in end region  51 . Another end region  52  of second holding strap  50  also has a velcro area which can be fixed in the region of the shoulder opposite to the shoulder to be treated on third strap  30  of orthesis  1  running therethrough.  
         [0031]    [0031]FIG. 5 shows a front view of a preferred embodiment of orthesis  1  according to the invention with first holding strap  40  and second holding straps  50  assigned to the orthesis  1  on the patient. Shoulder pad  2 , forearm holder  3  and strap  10  placed at holding point  11  are substantially shown. Starting from holding point  11  there is arranged first attachment piece  16  and then guide ring  12  on shoulder pad  2 . Strap  10  is fed through guide ring  12  and fixed with the aid of its velcro area  14  in the end region, adjusted in length. Below the forearm in the vicinity of crossing point  14  first strap  10  crosses second strap  20  which is secured at connection point  25  on forearm holder  3 . Sickle-shaped cutaway region  7  can also be seen on shoulder pad  2  above the outside of the shoulder. On the opposite side there is provided holding point  13  for third strap to which ends in loop  34  laid around the opposite shoulder. In order to fix the forearm in front of the body this is fixed using the holding straps  40  and  50 . Holding strap  40  has a wrist cuff  41  starting from which strap  41  is placed around the back and guided on the left of the drawing around the opposite upper arm and fixed there with the aid of a velcro closure. Second holding strap  50  connects the wrist with the shoulder opposite the injured shoulder and holds the arm high in this fashion.  
         [0032]    [0032]FIG. 6 is a rear view of the orthesis according to the invention positioned as in FIG. 5. Starting from shoulder pad  2 , at holding points  21  and  31  are attachment pieces  26  and  36  arranged thereon with guide rings  22  and  32 . Second strap  20 , starting from guide ring  22 , passes behind the back to the forearm holder not visible from this perspective. Third strap  34  placed around the opposite shoulder, is fed through guide ring  32  and adjusted in length. The end region of third strap  30  can be fixed onto strap  30  with velcro area  33  arranged there according to length or it can be fixed to loop  34  as shown here. End  52  of second holding strap  50  is also fixed on third strap  30  or loop  34  with the aid of its velcro connection in this shoulder region. Also seen here is strap  42  of first holding strap  40  which lies around the back and is fixed to the upper arm on the right of the drawing.  
         [0033]    [0033]FIG. 7 shows an enlarged view in the region of the upper arm which particularly shows the crossing straps. First strap  10  and second strap  20  are secured, especially sewn to forearm holder  3  at connection points  15  and  25  such that when first strap  10  and the second strap  20  are suitably fixed to shoulder pad  2  and first strap  10  and second strap  20  are aligned twist-free, these cross at crossing point  14 . As a result of the slip-free fixing of forearm holder  3 , this application or fixing of straps  10  and  20  at points  15  and  25  on the forearm holder  3  at some distance apart results in a particularly secure fit of the orthesis.  
         [0034]    Accordingly, while at least one embodiment of the present invention has been shown and described, it is to be understood that many changes and modifications may be made thereunto without departing from the spirit and scope of the invention as defined in the appended claims.