Source: https://patents.google.com/patent/CN105377198B/en
Timestamp: 2020-01-17 14:40:06
Document Index: 43853489

Matched Legal Cases: ['art 14', 'art 14', 'art 14', 'art 114', 'art 12', 'art 12', 'art 78', 'art 78', 'art 12', 'art 114', 'art 202', 'art 204', 'art 202', 'art 202', 'art 240', 'art 206', 'art 202', 'art 204', 'art 258', 'art 258', 'art 258', 'art 258', 'art 258', 'art 258', 'art 258', 'art 202', 'art 204', 'art 202', 'art 204', 'art 202', 'art 230', 'art 266', 'art 310', 'art 346', 'art 346', 'art 346', 'art 346', 'art 368', 'art 368', 'art 512', 'art 514', 'art 512', 'art 514', 'art 512', 'art 512', 'art 512', 'art 512', 'art 560', 'art 514', 'art 514', 'art 514', 'art 537', 'art 537', 'art 514', 'art 514', 'art 514', 'art 514', 'art 514', 'art 514', 'art 552', 'art 552', 'art 202', 'art 204', 'art.\n11']

CN105377198B - For treating the orthopedic appliance of hip complication - Google Patents
For treating the orthopedic appliance of hip complication Download PDF
CN105377198B
CN105377198B CN201480017756.5A CN201480017756A CN105377198B CN 105377198 B CN105377198 B CN 105377198B CN 201480017756 A CN201480017756 A CN 201480017756A CN 105377198 B CN105377198 B CN 105377198B
CN201480017756.5A
CN105377198A (en
瓦尔格尔·彼得森
海尔格·瑞·帕尔斯多蒂尔
索雷维尔·斯蒂芬森
2013-01-24 Priority to US201361756220P priority Critical
2013-01-24 Priority to US201361756438P priority
2013-01-24 Priority to US61/756438 priority
2013-01-24 Priority to US61/756220 priority
2013-10-24 Priority to US201361894953P priority
2013-10-24 Priority to US61/894953 priority
2014-01-24 Application filed by 奥索有限责任公司 filed Critical 奥索有限责任公司
2014-01-24 Priority to PCT/US2014/012860 priority patent/WO2014116895A1/en
2016-03-02 Publication of CN105377198A publication Critical patent/CN105377198A/en
2017-12-08 Publication of CN105377198B publication Critical patent/CN105377198B/en
A kind of orthopedic appliance (200) for being used to treat hip complication, it has the mechanism for rotor squish part, pelvic support part, lumbar vertebrae extrusion, the band of a variety of sensings and thigh support part.Rotor squish part and inboard/outboard rotation band (217) slow down pain by extruding and skin sparing, release the load in joint by extruding and sealing, and release load by transferring load.Control pain and it can make it easier to use for the mechanism (220) adjustably by band loading.
For treating the orthopedic appliance of hip complication
Embodiments of the invention are related to a kind of orthopedic appliance, the clothes that are more particularly to used to treating hip complication and/or Hip KAFO, and for the method using the orthopedic appliance.
Traditional hip support and support member mainly for the arthritis related to operation (such as such as arthroplasty operation and Arthroscopic surgery) aftertreatment.Seldom pillar and support member (if any) are designed to treat osteoarthritis (OA) develop or mitigate the symptom related to the arthritis of hip.
Pillar and support member can help powerless muscle, such as be considered as the gluteus medius related to experiencing pain.Also To think, it is favourable for other indications that joint, which is repositioned, and the other indications are, for example, front side ligament (ACL) damage, And improved knee control can be provided.Specific group on the line in patient includes bearing due to jump landing The sportswoman of pain caused by contactless ACL damages.
Jump landing common problem is the fact that, to cause to the talipes valgus of internal rotation it is related transition stretching, extension knee position Put.Think to cause the root of the problem may is that, cause hip transition to be stretched and landing load is delivered to quadriceps muscle of thigh Rather than the powerless gluteus medius of gluteus medius.Therefore, rotate by flexing, abduction and outwards hip, when jump land when, can be with Change knee location and reduce the load on ACL.
Reposition or support hip also to reduce the load in knee inner compartment relative to the optimum position in joint And control the appropriate track of kneecap.Patellofemoral pain is probably as caused by offseting laterally.Most of kneecap supports and branch Support member attempt by kneecap shift onto inner side, still, by outwards rotating femur, can by relative to kneecap come move femur rather than Trial pushes directly on kneecap, so as to obtain more preferable effect.It is well known that for OA patient, inner compartment load and knee The interior receipts torque in portion is related.
Understand according to nearest, inner compartment load is also related to the stretching, extension torque of knee.By outwards rotating femur, Ke Yichuan The gait for being shown as " toe out " is made, to reduce loading on musculus quadriceps and can directly reduce negative in inner compartment Carry.
Hip rectifier can be used for preventing hip from misplacing, and early ambulant is provided after Hip operation, while minimum Change postoperative complication.Specific surgical operation includes hip replacement or all or part of prosthesis, and hip closes Save spectroscopy.These rectifiers can reduce hospitalization and Timing, and total rehabilitation duration.Hip rectifier Continuation hip pain and the hip that can not be performed the operation deformity can also be treated.
Pre- Anti-dislocation or hip joint dislocation is the problem of generation when femoral head is shifted in acetabular bone or acetabular fossa.Generation It is, it is necessary to which hip KAFO is fixed and supported to be helped again by this dislocation after Hip operation table Rehabilitation.
The head of femur contacts pelvis at acetabular bone and forms hip joint.The head (" femoral head ") of femur and acetabular bone Be formed as allowing flexing, stretching, extension, abduction, interior receipts and ball-ball-and-socket joint of circumduction.Hip is arranged to bear body weight, And it there are the connection ligament for supporting hip joint.The rotor of femur is usually located at the position relative with femoral head, and It is included in the outer surface that the insert division of the tendon of gluteus medius is worked.
The existing hip rectifier for being used to prevent hip from misplacing typically has adjustable hinge, and it only allows greatly Calf circumference rotates around hip joint in direction forwardly and rearwardly.These hip rectifiers have can not be in whole range of movement The shortcomings that dynamic abduction power is provided on leg.When standing, abduction power can be provided, but will not apply when sitting down.This is Because the problem of traditional rectifier meeting abduction rigidly keeps leg, and this can cause abnormal gait pattern and compliance.
Similar with other joints, when the articular cartilage destruction between femoral head and acetabular bone, hip joint can make the bone of hip Arthritis development.The damage of cartilage can cause pain, swelling and deformity.Due to osteoarthritis, the patient with osteoarthritis can Difficulty in walking.Although osteoarthritis can not eliminate, non-operative treatment can include rest, antiphlogistic and/or loss of weight.If hip The osteoarthritis in portion has arrived later stage, then can carry out whole coxa substitution operation.
When applying and loading in hip, cartilage wear is especially bothersome.Although have many for treating knee The scheme of osteoarthritis, but almost successfully treat hip Bones and joints without (if any) support and support member is provided Inflammation, particularly it is used to reduce the load on hip.Therefore, demand or needs are arranged to treat the orthopedic dress of hip osteoarthritis Put.
Include pelvic inclination and lordosis for hip complication and another focus related to backbone.Bone Basin, which tilts, refers to its orientation residing and in space of pelvis relative to femur.The pelvic inclination of diversified forms is there are, Leaned forward including pelvis and pelvis hypsokinesis, when hip musculus flexor shortens and hip extensor is elongated, forepelvis tilts and on rear portion Rise the pelvis can be caused to lean forward, pelvis hypsokinesis include when hip musculus flexor is elongated and hip extensor become in short-term forepelvis rising and after Portion tilts.Tilt to describe on the outside of pelvis and tilt in the two directions.
Lordosis is generally associated with pelvic inclination, and is that lumbar vertebrae and cervical vertebra curve inwardly.Lordosis One principal element is that pelvis leans forward, and the pelvis, which leans forward, can cause the pelvis when being sitting on femur to turn forward.A variety of healthy shapes Condition may result in lordosis, and uneven including muscle power and length, for example, in tendon and hip constrictor and Imbalance in extensor.
Another disorder of the vertebral column is spinal canal stenosis, and it includes the stenotic of canalis spinalis.A kind of form of spinal canal stenosis is hair The raw lumbar spinal stenosis at back is relatively lower.In lumbar spinal stenosis, spinal nerve of the root at back is relatively lower is extruded, this The symptom of sciatica can be caused.Sciatica refers to tingle, from back it is relatively lower at it is radial and until buttocks With the powerless or feeling of numbness of shank.
Exist it is a variety of be used to treating excessive pelvic inclination, lordosis and back it is relatively lower at spinal canal stenosis side Case, but almost without the scheme including hip and the orthopedic appliance of above-mentioned illness can be treated.
Described orthopedic appliance is designed to reduce loading and promoting the position in joint to move on hip joint, this quilt Think that pain can be mitigated by the region for guiding hip to be worn or be damaged away from cartilage.By it is ambulant improvement or Person repairs, and user can participate in various activities limiting without the hip by rest pain.The mobility of raising helps In the increased weight that the symptom for avoiding that hip osteoarthritis can be made deteriorates.
According to a preferred embodiment, orthopedic appliance is that clothes for treating hip complication and/or hip are orthopedic Device.Clothes and/or hip KAFO can be provided for rotor squish part, hip support member, lumbar vertebrae extrusion, pointed to everywhere Band, and the mechanism of thigh support part.Rotor squish part and inboard/outboard rotation band are carried by extruding and skin sparing For slowing down pain, the load in joint is released by extruding and sealing, and load is released by transferring load.Band can Adjustably the loading of property being capable of control pain and easy to use.It can allow to mitigate pelvis on the opposite sides by pelvic support part It is sagging.Lumbar vertebrae extrusion improves stability and support.Thigh support part with loading system is to be fixed on orthopedic appliance Simple and lasting use is provided on leg, and is used to receive in hip when needed.
Can be with according to the clothes of the present invention (for example, above waist and a pair of tights at least extending on thigh) To be subjected to dislocation, hip joint reparation, recurrent dislocation, the risk of hip complication that can not be performed the operation patient carry out joint at initial stage The protection of plasty, or be used to prevent in daily life.Some embodiments can also treat the osteoarthritis of hip, pelvis Inclination, lordosis and spinal canal stenosis.
The embodiment of described clothes is fixed femoral head by providing dynamic power on leg and acetabular fossa And control in acetabular bone, misplaced with preventing and for example osteoarthritis is treated.It can be exerted a force on rotor to promote Femoral head enters acetabular bone.
Clothes allow user freely to move, because thigh can in all directions be moved and not only existed Moved on one direction, while required interaction force is sustainably acted on hip.This causes more comfortable and can The muscle around hip joint is more effectively tempered, the muscle can be weakened due to operation.
In the first embodiment, clothes include top waistband part or waistband, and are fixed around knee and/or thigh Bottom wrap, by clothes place and it is fixed on the body of the user.Multiple bands are arranged on clothes and had more Individual orientation is with the power of the offer different directions on user.Band can depart from or be connected to multiple predetermined opening positions.Beam Band can also be semi-elastic to promote certain movement by its elasticity, and gently prevented by its resistance It is mobile.Prevent it is mobile neither rigid nor stop motion, but contrary work and suppress some motions.
Band can be integrated into clothes.The one of the function, wherein fabric of band can be realized using fabric pattern Part, which can have, provides counteractive different elastic property, can either use hook and ring or other tensioning mechanisms individually Regulation is integrated in the band in clothes.Band can extend through the formation of the various sleeves on clothes at least in part to control It is mobile.Sleeve can have non-elastic material to be formed with stabilized beam band and provide additional support, while will not suppress band Elasticity.
Band is preferably fixed on clothes at first end, and free the second end can be according to pulling force and user Anatomical structure and movably adjusted on multiple positions of clothes.
Flexing band can be connected to the forward side of waistband and the forward side of bottom wrap.Band promotes hip Flexing and prevent the stretching, extension of hip.Abduction band can be connected to the Outboard Sections and bottom wrap of top waistband part Outboard Sections.Abduction band can promote hip abduction and prevent to receive in hip.
The rotation band that turns up can cross the rear side of clothes and be connected to lateral side, and curl up the front side for crossing thigh Sidepiece reaches inboard side, and towards the rear section of bottom wrap.The band can promote hip turn up and prevent to Interior rotation.The band can promote the abduction and flexing of hip, while prevent interior receipts and stretching, extension.
Clothes can include waist band or waistband, and it extends around pelvis in outside and circumference at the rotor in femur Tighten up to promote that femoral head is placed or is fixed in acetabular fossa on ground.Bottom wrap or band can prolong near knee in outside Stretch, and form a part for bottom wrap for use as at least for abduction band and the fixing point for the rotation band that turns up.Under Portion's wrap can include the first band and the second band extended respectively above and below knee, or calf band can To be rarely located above or below knee.
According to the hip KAFO of the present invention can to being subjected to dislocation, hip joint reparation, recurrent misplace, can not perform the operation The patient of the risk of knee complication carries out the protection of arthroplasty at initial stage, or is used to prevent in daily life.Some Embodiment can also treat to the osteoarthritis of hip.Hip KAFO can form a part for clothes and/or add In hip clothes.
By multiple embodiments, KAFO on rotor is tensed by using tension system (such as belt wheel type) and come Pain of alleviation can be realized by applying pressure on greater trochanter.The upper part of clothes can be formed with preferably by non-telescoping material Power is transferred to rotor region from tension system.The rotation for producing hip is brought using elastic bunch.The upper part of band is fixed In the dorsal area of clothes.According to required rotation (outwardly or inwardly), by band from being pulled out between leg and reach thigh Front portion, or directly reach thigh front portion, then band is fixed on using fastener in both the above situation Tighten up unit in bottom.The framework for being fixed on clothes has been used, leg can be produced if tension system is tightened and is completely fixed The abduction in portion.
Orthopedic appliance, especially lumbar supports part, and take-up device combination or individually consider be used for improve under back The stationarity in portion, this is improved by resisting flexing, stretching, extension, pelvic inclination, backbone rotation and lateral thrust.Another mechanism It is pelvic stabilization device, wherein lumbar supports part maintains pelvis rightly to be alignd relative to backbone, and reduces in lumbosacral region Pain.Another mechanism is to be used to gently to extrude hydrostatic rising caused by abdominal cavity, and intra-abdominal pressure increase.Another In one mechanism, lumbar supports part guiding vertebral column is antecurvature support member or position lumbar supports part are to provide correct lumbar It is antecurvature to slow down pain, spinal fixation and improve posture.
Orthopedic appliance may include the combination of plate system and tension system, or only take-up device, can be with by layout or structure Lordosis support is provided to apply pressure, thus guides and maintains correct lordosis, for slowing down pain, fixed ridge Post and improvement posture, such as by mitigating lordosis and increasing pelvic inclination.
The embodiment of described hip KAFO on leg and acetabular fossa by providing dynamic power by femoral head Fixed or control is in acetabular bone, to prevent dislocation and treat the symptom of osteoarthritis.The dynamic force mechanisms are provided by maintaining Flexing and stretching, extension limitation imitate the anatomical motion of hip joint.Can on rotor applying power so that femoral head is pushed into hip Mortar.The feature of hip KAFO is attributed to the fact that the KAFO more stable and more general than traditional support.
Due to the versatility of the size of clothes, thus only need several sizes and doctor can by finely tune waistband section and Multiple cables come further sized.Clothes provide pain of alleviation and comfortableness by extruding and skin sparing.This is orthopedic Device makes it possible to extrude rotor by optionally padding, and this allows to release load by extruding and sealing and bear by transmitting Carry to release load so as to slow down pain.
Embodiment can include the band to internal rotation or outwards rotated, and it allows adjustably to load with control pain, And according to whether need inwardly or outwards rotate control and need versatility.The embodiment also allows by relative lateral inhibition The pelvic prolaps of reduction support pelvis.Also allow to extrude lumbar vertebrae, this improves stationarity and support.By rotating disk tension come real Existing thigh support, the rotating disk tenses and provides simple and lasting use, and provides effective hip abduction when needed.
According to the hip KAFO of the present invention can to being subjected to dislocation, hip joint reparation, recurrent misplace, can not perform the operation The patient of the risk of knee complication carries out the protection of arthroplasty at initial stage, or is used to prevent in daily life.Some Embodiment can also treat to the osteoarthritis of hip.
In one embodiment of hip KAFO, it can include elastic parts and be used to operatively prevent by elastic force The interior receipts movement of thigh.The elastic parts operatively applying power and/or torque on thigh, this enables thigh abduction, from The abduction of being looked on front side of people is preferably independent of position of the thigh relative to waist or trunk.
Hip KAFO allows user to move freely, because thigh can move in all directions, not only exists One side moves up, while required interaction force can be with continuous action on hip.This causes more comfortable and can The muscle around hip joint is more effectively tempered, the muscle is weakened due to operation.
In use, elastic parts applying power on hip joint, so as to which hip is pressed into nest under the influence of the power, because This reduce further the risk of dislocation.Elastic parts also applies torque on hip joint.This allows thigh to have relative to body Dry preferable position and/or thigh is rotated to preferable position.The torque, which is oriented to, generally outwards rotates thigh, extremely Rotate to less transverse to the direction of sagittal plane.This can prevent thigh (towards another one leg) hyper-abduction, and reduce hip The risk of dislocation.
The other embodiment of hip KAFO can be hingedly attached to clothes, such as be connected to the part above knee. Hip KAFO can not have elastic parts, but be connected to rotor supports part simultaneously an end including pillar, the pillar And clothes are connected to above knee in another end.
With reference to the description below, appended claim and the accompanying drawing enclosed, embodiment this may be better understood A little and other features, aspect and advantage.
Fig. 1 is the isometric front view according to the embodiment of the clothes of the present invention.
Fig. 2 is the rear perspective view according to Fig. 1 clothes.
Fig. 3 is the side view according to Fig. 1 clothes.
Fig. 4 is the detailed outer side view according to Fig. 1 clothes.
Fig. 5 is the detailed inner side view according to Fig. 1 clothes.
Fig. 6 is showing produces the schematic diagram of the clothes of directive force according to Fig. 1 by tensing multiple bands.
Fig. 7 A-7C are side view, front view and the rearview according to another hip brace embodiment of the present invention.
Fig. 8 be Fig. 7 A-7C with the first waistband section opened to show the schematic diagram of rotor supports part.
Fig. 9 A-9B are the side view and forward sight for the hip KAFO that Fig. 1 extruding waistband with user is combined Figure.
Figure 10 A-10B are showing the side view and front view of another hip brace embodiment according to the present invention.
Figure 11 A are showing the front view of another hip brace embodiment according to the present invention.
Figure 11 B are showing the hip KAFO of Figure 11 A opening and the schematic diagram of installation rotor pad.
Figure 12 is showing the rearview of Figure 11 A hip KAFO.
Figure 13 is showing the details of the rearview without lid of extrusion system.
Figure 14 is the detail view of the belt wheel group in the extrusion system of Figure 11 A hip KAFO.
Figure 15 is the schematic diagram of the Belt with clasp assembly of Figure 11 A hip KAFO.
Figure 16 is the detail view of the lower support in Figure 11 A hip KAFO.
Figure 17 is the schematic diagram of the annex of the lower support and band in Figure 16.
Figure 18 A are the top views of the support component of the lower support in Figure 17.
Figure 18 B are the front views of the band of the lower support in Figure 17.
Figure 19 is the stereogram according to another hip brace embodiment of the present invention.
Figure 20-22 is rearview, front view and the side view of Figure 19 hip brace embodiment.
Figure 23 is the exemplary plot according to another hip KAFO of the present invention.
Figure 24 includes the schematic diagram for showing the hip KAFO for being arranged to the derotation colligation in hip.
Figure 25 includes showing the schematic diagram for being arranged to another hip KAFO of derotation colligation in hip.
Figure 26 includes showing the schematic diagram for being arranged to another hip KAFO of derotation colligation in hip.
Figure 27 and 28 shows the front view and rearview of the strut assemblies for embodiment described herein.
Figure 29 is the schematic diagram of the length adjustment component for take-up device.
Figure 30 is the stereogram according to the embodiment of the hip KAFO of the present invention.
Figure 31 A are the stereograms according to the adjusting part of Figure 30 hip KAFO.
Figure 31 B are another stereograms according to the adjusting part of Figure 30 hip KAFO.
Figure 32 is showing the detail sectional view of the upper part of the hip KAFO according to Figure 30.
Figure 33 is showing the detail view of the rotation governor motion in the hip KAFO adjusted according to Figure 30.
Figure 34 is showing the detail view of the pressure regulating mechanism in the hip KAFO adjusted according to Figure 30.
Figure 35 is showing the cross-sectional rear view of the details of the low portion of the hip KAFO according to Figure 30.
Figure 36 is showing the schematic diagram of another embodiment of orthopedic appliance.
Figure 37 is the stereogram of the frame assembly in Figure 36 orthopedic appliance.
A. the environment and background of embodiment
In order to be further susceptible to understand the clothes of complication and/or the showing for KAFO that are used for treating hip as disclosed The example orthopedic appliance of property form and the exemplary of variant, it is necessary to describe some terms.
Term " rigidity ", " flexibility " " compliance " and " elasticity " can distinguish the spy of the part of the special characteristic of band and clothes Property.Term " rigidity " is intended to illustrate that the element of device generally can will not flexing.In the background of " rigidity " feature, it is intended that explanation When force is applied, it will not lose its global shape, and actually if with enough power flexings, then its is broken.Term " flexibility " is intended to explanation and is capable of the feature of repeated flex so that can be by characteristic flexural into the shape kept, or when force is applied This feature no longer keeps in general shape but continuous modification.
Flexible characteristic can be described as by term " compliance "：When flexible characteristic to be arranged to contact with another object, lead to Any appropriate natural force or the power applied, such as gravity are crossed, or for example, by external agency's application for band mechanism Power conforms generally to this flexible characteristic the shape of another object.Term " elasticity " can be used for flexible characteristic being described as： Initial global shape can substantially be returned to without being permanently deformed.For term " semi-rigid ", the term can be used for explanation to provide Support and for independent support member or housing performance；But this support member or housing can have a certain degree of flexible or bullet Property.Term " elasticity " can be explained draftability, and term " semi-elastic " illustrate it is different degrees of compared with term " non-resilient " Elasticity, wherein " non-resilient " may imply that without any elasticity or not have any elasticity substantially.
Embodiments of the invention are suitable to human body, and can be configured to receive the human body of different type, shape and size The size of size or profile.For the purpose of indicative explaination, the embodiment of described orthopedic appliance refers to body not It is corresponding with part and represented with human dissection common language.
For the purpose of indicative explaination, described each orthopedic frame embodiment or part can be divided into by human body solution Cut open the part of common language expression.These dissection terms are provided come the multiple element for distinguishing stent embodiment, but can not be by It is considered to limit the scope of the present disclosure.
Each in these terms for example for referring to people's leg, people's leg by substantially between femur and shin bone along knee The meniscus in portion and its proximal-distal plane that extends and be divided into similar part.Term " near-end " and " distal end " refer to support Corresponding to leg relative to leg and the position of the position of body tie point.Term " top " and " bottom " can with it is " near-end " and " remote End " is used in combination to imply the position gradient of " near-end " and " distal end ".The support position corresponding with knee joint is used for substantially Define the proximal part and distal portions of support.
By front side-side plane, the embodiment of knee brace is recognized as being divided into front area and posterior region.Before Side-trailing flank is generally corresponding with the coronal-plane or frontal plane that the central longitudinal axis along human body of people's leg extend.Therefore, after Side or rear element are located at behind the front side-side plane, and front side or preceding element are located at before front side-side plane.
Term " inwards " or " inside " may point to front side and with the user's of support commonly used to differentiation support The adjacent sidepiece in leg.Conversely, term " outwards " or " outside " are used for representing the sidepiece relative with the inner side of support.
Term " inner side " and " outside " are to be generally understood as illustrating the position near median plane or center line Relative terms.Therefore, the element near center line is referred to as " inner side " and thinks those elements away from center line It is " outside ".Term " middle part " is used to refer to separating and share inside region and the part of exterior lateral area along joint The region of center line.
Term " interior receipts " is defined as the motion towards trunk.The componental movement that term " abduction " is defined as body is remote The motion of the axis of body.
It has been generally acknowledged that hip regions are located at the outside portion of intergluteal area (i.e. buttocks), the solid lower section of ilium, and cover femur or The greater trochanter of " thigh ".In adult, three pieces of bones in pelvis bone have been fused to the part to form hip regions Hipbone in.
Hip joint, it is the acetabular bone in femur and pelvis scientifically referred to as acetabular bone stock (acetabulofemoral) joint Between joint, and its major function is to support body static (such as standing) and dynamically in (such as walk or run) posture The weight of body.Pelvic obliquity for the most important element of human posture is adjusted at hip.
Pelvis refers to (the sometimes referred to as pelvis area of trunk) of the lower part of trunk between belly and thigh, or Person refers to the skeleton (sometimes referred to as bony pelvis or pelvis skeleton) being embedded in.The pelvis area of trunk includes bone Bony pelvis, pelvic cavity (space surrounded by bony pelvis), the pelvis bottom below pelvic cavity, and square meeting under pelvis It is cloudy.Pelvis skeleton is formed in back region by rumpbone and coccyx, and is formed by a pair of hipbones in anterior and direction Left side and right side.Vertebra is connected by the two hipbones with lower limb.The two hipbones are connected on rumpbone in rear side, in front side each other It is connected, and connects at hip joint with two personal share bone photos.
Waist or lumbar region are a parts for the belly between Rib cage and hip, and generally in proportional human body On be trunk most narrow part.Think thigh or femoral region is region between pelvis and knee.
B. multiple embodiments of orthopedic frame and the part for embodiment
Reference picture 1-5, it is shown that for treating the clothes 10 of hip complication.Wrap up on the top that clothes include waistband form The main part 14 extended with 12, on thigh and the lower bands near knee K or wrap 16.Top wrap 12 and bottom wrap 16 as fixture with the multiple bands on user, being connected to garment-holding on clothes be also such as This.Bottom wrap 16 can be fixed on the below or above of knee, or be fixed on this at two.
Waistband 12 connects around pelvis/waist of user, and its shape meets anatomical structure, and using shackle, Buckled or other retention mechanisms are tightened up.Waistband 12 include the first waistband section for being configured to overlap each other and interfixing and Second waistband section.By circumferentially being extruded on the waist of user, waistband forms the upper stationary part of clothes.
Waistband 12 is preferably made up of scalable and squeezable material, and it is provided in the waist of user and bone Extend on basin.As shown in the mark 46 in Fig. 6, waistband can have the silica gel patch being attached in fabric, and it is created and skin The frictional interface of skin or the underwear of user is to reduce movement.The United States Patent (USP) 8,172,779 authorized with May 8th, 2012 Discussed in lumbar vertebrae band it is similar, waistband can be configured to tension system or pulley system.Embodiment is not limited to belt wheel And post can be included, sliding block or other mechanisms for being used to provide mechanical dominance for cable.Alternatively, tension system can be replaced For multiple bands of belt wheel, cable and similar means.
Lateral cord band 18 can be fixed on the rear side of clothes at first end and the pelvis around user extends.Outside Band 18 has the second end that can be adjustably connected with clothes.Lateral cord band 18 is intended to the offer office on the rotor of user The pressure of portion and enhancing is so that femoral head is maintained in the acetabular fossa of user.
Main part 14 can generally be made up of obdurability fiber elastic-material, such as Lycra or spandex.The quilt of main part 14 The leg of user is configured conform to, and the interface that band extends thereon is provided.
Bottom wrap 16 can form knee/thigh wrap, and it by anatomy is shaped to slide on leg.Parcel Band can be independently around thigh, or is extended downwardly below kneecap.Knee/thigh wrap can have for kneecap Hole, and include band in base section, mid portion or top section, this allows to tighten up to be avoided moving.Band can be with With the silica gel patch for connecing sum, as discussed its is connected with top wrap, to provide frictional resistance.
In Fig. 2-5 embodiment, bottom wrap 16 is configured to adjacent and in user with the knee of user The lateral cord band of extension below knee.Bottom wrap 16 is formed to be fixed to the bottom of clothes, and prevents clothes on shank It is mobile.In the structure shown here, bottom wrap 16 forms the gastrocnemius band corresponding with gastrocnemius, and the calf for passing through user The position that the shape of intestines is secured the stand between knee and the sura of user is to suppress mobile.Alternatively, bottom wrap 16 can be set to extend above and knee in user adjacent with the knee of user.
Bottom wrap 16 can include allowing the lower bundle band 32 for tensing bottom wrap 16 on leg.Wrap up bottom With 16 passages that there is lower bundle band 32 to be extended through that can limit clothes 10 through elasticized part.Also pass through phase For passage regulation elasticity band 32 so as to the tension bottom wrap 16 on the leg of user.Lower bundle band 32 can be with right and wrong It is elasticity or elastic.
In the variant of the bottom wrap 16 shown in Fig. 1, bottom wrap 16, which includes being provided in above knee, to be enclosed Around the top circumference band 40 of lower thigh extension, and it is arranged about the bottom circumference band that shank extends below knee 50.The long and narrow band 44 of the long and narrow band 42 in inner side and outside extended transversely with relative to upper and lower part circumference band 40,50 and It is connected with upper and lower part circumference band 40,50, to keep them to be fixed to one another.
Longitudinal tape or abduction band 20 are longitudinally extended along on the outside of clothes, and are configured to promote hip abduction simultaneously And prevent to receive in hip.Abduction band 20 is fixed at the point 34 of the top of bottom wrap 16, and is adapted to extend to top bag Band 12 is wrapped up in, therefore top wrap 12 is fixed in free end 28.
Main body 14 can limit the sleeve 24 with opening 36, and abduction band 20 passes through the opening 36 from bottom wrap 16 Extend at top wrap 12.There is sleeve 24 width bigger than abduction band 20 to allow relative to sleeve 24 to abduction Band 20 is adjusted.Can being formed at least in part by non-elastic material for sleeve 24 is corresponding to sleeve 24 with stable and support Leg area.
Angled tape or the rotation band 22 that turns up are from the fixed point extension in the rear side of leg wrap 16 and towards leg Interior rear side curls up, and crosses on front side of thigh, and with the rear outside being securable near top wrap or top wrap Free end 26.The rotation band 22 that turns up extends through the passage 30 formed by bottom wrap and reaches position on the front side of clothes Put.Passage 30 is more wider than the rotation band 22 that turns up and is formed on leg stable by non-elastic material at least in part and props up Support, which is turned up, rotates band 22.Passage 30 contributes on pressure dissipation leg.
Clothes 10 can have a flexing band 38, and the flexing band 38 is arranged at bottom wrap 16 and generally edge The top wrap 12 that center line is fixed on along on front side of clothes.Flexing band can promote hip flexing and prevent hip from stretching Exhibition.
In a variant, clothes can have the stretching, extension band being arranged on generally along center line on front side of clothes.Stretching, extension Band can promote to stretch and resist flexing.
Fig. 6 shows multiple power caused by multiple bands.Lateral cord band 18 is provided around pelvis to put on rotor Peripheral force F1.Abduction band 20 provides the upward power F2 from knee to pelvis to prevent to receive in the leg of user.Turn up rotation Turning band 22 provides generally relative to force F1, F2 the inclined power of curling up F3, to promote abduction and therefore the interior receipts of resistance.Lower bundle band 16 provide peripheral force F4 to fix the low portion of clothes.
As shown in Figure 7 A-7C, another embodiment of hip KAFO includes being suitable to be fixed near the pelvis of user Pelvic compression support member 100.The setting can be different from US 8, the lumbar vertebrae extruding support member discussed in 172,779, the lumbar vertebrae Extruding support member provides in section and is intended to the lumbar regions offer extruding of user.Pelvic compression support member 100 With the width 112 significantly bigger than traditional lumbar supports part, and it is different from traditional lumbar supports part, it is configured to position In on the hip of the rotor including being at least partially situated at below the lumbar regions of user back.
Pelvic compression support member 100 includes the first waistband section 102 and the extended from rear portion or rear side extruding support member 106 Two waistband sections 104, this is more fully discussed in US 8,172,779.Take-up device 108,110 is from extrusion system 106 extend and are intended to the offer squeeze adjustments of rear portion extrusion system 106 and are fixed on the first waistband section 102 and the second waistband The top of section 104.Multiple take-up devices can be set on each sidepiece of extrusion system.It can include optionally adjusting per side Save the top take-up device and lower tension carriage of multiple positions of extrusion system.
Fig. 8 is shown positioned at the lower section of the first waistband section 104 and the rotor supports part adjacent with the body of user 114.Because the first waistband section 102 and the second waistband section 104 are fixed to one another, and take-up device 108,110 is used to tense rear portion Extrusion system, therefore extruding support is especially provided at rotor supports part 114, it promotes femoral head to enter acetabular fossa (hip Mortar) with give user provide alleviation.Clothes can have the non-elastic fiber that can receive hook, with including being carried by rotor supports part Rotor pad.
Fig. 9 A and Fig. 9 B show the combination of Fig. 1 hip KAFO and extruding waistband or top wrap 150.It is different from Fig. 7 A-7C extruding waistband, extruding waistband 150 are located towards the waist higher height of user with gap 156, and with narrower Width 158.
In this embodiment, pelvic support part 12 is located at adjacent with user and is being fixed on the second waistband section 154 The lower section of first waistband section 152.At least one of pad 70 of pelvis obtecta support member 12 can be maintained at by pelvic support part 12 At first waistband section 152.
The rotation band 71 that turns up is fixed on strut assemblies 121 at upper stationary part 78 and surrounds leg, and fixed At the lower fixture 80 in lower support 16.The rotation band 71 that turns up, which defines, is suspended to the first of upper stationary part 78 Section 72, the take-up device 76 that first paragraph 72 provides increment type tension by turned-out rotation band 71 are connected with second segment 72.Draw The band tension assembly phase of the orthopedic appliance for the U. S. application 13/739,491 that tight device 76 can be submitted with January 11st, 2013 Should.Alternatively, the rotation band 71A (being represented by dashed line) that turns up can extend and be fixed in the lower section of strut assemblies 121 The rear side of portion's wrap 150.
Strut assemblies 121 include the pillar 123 and pelvic support part 12 being connected with bottom wrap 16.Pillar can be with With rotor supports part 114, and pillar regulating part or rotating mechanism 35 can adjust the position of rotor, such as according to Figure 30 pillar The more fully discussion of component.
Figure 10 A-10B show another embodiment of hip KAFO, and the hip orthopedic appliance has used squeezing for Fig. 9 A-9B Pressure waistband 150 and the rotation band 71 that turns up being commonly connected directly in the rear side for extruding waistband 150 on lateral leg.Draw Tight device 76, which is directly fixed on extruding waistband and allows regulation to turn up, rotates band 71.Take-up device 76 allows tension to be connected to Second band section 74 of lower support 16.Band support member 82 can be combined to divide on thigh with the rotation band 71 that turns up Dissipate pressure.
Reference picture 11A-18 embodiment, orthopedic appliance 200 are combined with clothes and hip KAFO, and including suitable for bag Wrap the first top waistband part 202 and the second top waistband part 204 of the hip of user.Waist band 211 is usually located at orthopedic Device most on part, and suitable for being fixed on the waist of user.Lower bands 231 be usually located at orthopedic appliance most under Part, and the inner surface of lower bands 213 can include frictional interface with skin engagement and preventing clothes on user It is mobile.
Top waistband part 202,204 has is connected to clothes by connector 244 at the outside of KAFO and/or rear side Rear side or outboard end on 216, such as be permanently connected by suture or removedly connected by hook and loop fastener. Top waistband part 202,204 freely extends from connector or suture, and has what is be fixed to one another by Belt with clasp assembly 205 Anterior end.The anterior end of top waistband part has with trimming line come the adjustable area 207 of fringing, and it allows top waistband Part is sized to the specific dimensions of each user.Trimming line can be the area of reduced thickness of top waistband part.
The shape of the front side of waistband part is it is noted that this is due to it generally prolongs more towards the upper part of clothes Stretch, although preferably its best part, somewhat in lower section, as shown in Figure 11 A, and waistband part is forwardly toward clothes at it Become narrow gradually in the range of low portion extension.The highly preferable maximum at connector of waistband part, with scattered by waistband part It is fixed to one another caused power.The height become narrow gradually of waistband part generally along the pelvis area of user anatomical structure, So as to most front side part without interference with daily routines.
Clothes 216 may include there is different retractilities, hardness, or with a variety of tables for being fixed on multiple bands The region of face texture.Outboard Sections 238 can have the property harder than the part 240 outside Outboard Sections 238.Outboard Sections It can be reinforced or provide extra resistance with harder property with the motion for control hip and leg.It is outer with clothes The outer other parts of sidepiece point are compared, and Outboard Sections can also be generally stiff.
Figure 11 B show the rotor pad 267 along the inner surface insertion of top waistband part 206.Rotor pad 267 can pass through hook Loop system is removedly fixed along inner surface, and wherein rotor pad 267 includes being arranged to be fixed on the ring formed along inner surface Material hook material segment.As discussed herein, rotor pad 267 can have the mouth for the frame element for being configured to receive strut assemblies Bag 269.
From the point of view of Figure 11 A and 15, Belt with clasp assembly 205 include be suspended to the first of the first waistband part 202 and the second waistband part 204 Section 206 and second segment 208.The size of first paragraph and second segment, and first paragraph and can be finely tuned according to each user Two sections can be elastic or stiff.First paragraph 206 and second segment 208 can include " the crocodile for forming relative hook surface Fish " type hook presss from both sides, and " crocodile " type hook double-layered quilt is arranged to be clipped on the surface of the reception hook of the first waistband part and the second waistband part.
First paragraph 206 is carried with the pulling-on piece 210 for taking part 258, and this is taken, and part 258 is, for example, pin or other are raised, and Folder 212 suitable for being carried by second segment 208 receives, therefore forms hasp.Folder 212 can limit multiple coupling openings 260, 262 engage to receive to take part 258 and allow to take part 258 with folder 212.
The size of each coupling opening 260,262 is set and is configured to and takes part 258 and quickly connects.In diagram In embodiment, larger opening 261, which allows to take part 258, to be inserted through, and less opening 263 continuously depends on larger open Mouth 261, therefore pulling-on piece 210 can be pulled to be fixedly engaged to less opening 263 so that part 258 will be taken towards the end of folder 212 It is interior.
KAFO 200 includes take-up device 214A-214D, and take-up device 214A-214D is configured to tense extruding system System 229, and be configured to analogously play a role with the extrusion system in Fig. 7 A and 7B embodiment.Take-up device 214A Correspond to the first waistband part 202 with 214B and take-up device 214C and 214D is corresponding with the second waistband part 204.Take-up device Handle 264 be fixed on top waistband part, the top waistband part, which can carry, receives the material of hook, and handle itself can carry hook Material.Be arranged on due to extrusion system 229 on the rear side of hip KAFO 200, thus take-up device from extrusion system 229 from Extended by ground and pull pressing device to tense extrusion system on pelvis from extrusion system 229.
As shown in Figure 13 and Figure 14, extrusion system 229 includes multiple tension groups, for example, including with take-up device 214A- Belt wheel 242A-242D corresponding 214D those tension groups.Belt wheel group with the belt wheel group described in U.S.8,172,779 Similar mode works, and wherein the belt wheel group includes the belt wheel 248 corresponding with each take-up device 214A-214D, and uses In the fixture 250 of each take-up device.Lid 231 can be set to cover extrusion system 229.
In this embodiment, because the first waistband part 202 and the second waistband part 204 can be by connectors 244 in rear side End is sewn on clothes 216, therefore the distance between belt wheel group 242A-242D is adjustable to provide drawing on pelvis Power.Sutured along multiple holes 246, pulling-on piece of the plurality of hole 246 along belt wheel group is formed, so that waistband part is at connector Extend towards the front side of clothes, and tension group extends towards one another in rear side from connector.Waistband part and tension group are preferably It is arranged to act as each other contrary.
Angled tape or the rotation band 217 that turns up are fixed on the fixture 230 from belt wheel group protrusion an end.Top waist Strips 202,204 can limit the rotation band 217 that turns up and may pass through it and fixed opening 236,238, so as to without interference with The operation of waistband part 202,204 and the band 217 that turns up.
The rotation band 217 that turns up can include pulling-on piece 228, and mechanism of the pulling-on piece 228 with for example, lockhole is to be fixed on Fixture 230.If Fig. 9 A are as 9B embodiment, the rotation band 217 that turns up define be suspended to upper stationary part 230 and The first paragraph 218 of second segment 232 is connected to by take-up device 220 and marker sleeve 222, the marker sleeve 222 provides Increment type tenses the rotation band 217 that turns up.
Can according to required rotation (outwardly or inwardly) with different orientations will turn up rotation band be arranged on leg.Or Band is pulled out and moved to before thigh between leg by person, or is directly moved band before thigh to, Huo Zhesui The low portion of clothes is fixed on afterwards.
Reference picture 11A, 12 and 16, bottom tie unit or wrap 226 include being used to receive the rotation band 217 that turns up The joint 227 of second segment 232, and with the rotating disk tie unit 224 for the degree of tension for being used to adjust bottom wrap 226. In embodiment shown in Figure 16, bottom wrap 226 has band 252, and the band 252, which has to be connected to, to be made it possible to quickly connect The locking member or the opposed end of buckle 254,256 connect, bottom wrap is fixed on leg.Locking member 254, 256 can be fixed near the joint 227 of the second segment with the rotation band that turns up.
The embodiment of reference picture 17 and 18A, lower bundle band 226 include the long and narrow pulling-on piece 264 with fixing point 268, and this is narrow Buckle 254 in the long alternate figures 16 of pulling-on piece 264.Fixing point 268 is used to be fixed on the locking entrained by the second end of band 252 Element 256, while pulling-on piece 264 is connected with the first end of band 252.Pulling-on piece 264 includes another fixture 266, and this is solid Determine rear portion of the part 266 along pulling-on piece to extend and suitable for being fixed on the lock to turn up entrained by the second segment 232 of rotation band Determine element 272.
Pulling-on piece 264 has the rotating disk take-up device 224 being connected with cable system 269, and the cable system is fixed on band 252 First end.Rotating disk take-up device 224 allows the tension for fine-tuning band 252.
The rotation band that turns up can be formed by elasticity or non-elastic material.In an illustrated embodiment, turn up rotation band be Elasticity.Preferably, rotation band is turned up in the fine-tuning length in two end correctly to be set on the leg of user Put take-up device.For example, by the mechanism pressed from both sides for " crocodile " type hook and/or by lockhole bindiny mechanism, will can turn up rotation beam Band is removably secured to take-up device 220 and bottom wrap 226.On the medial surface of marker sleeve 222 There can be pad to provide improved comfort level.
Preferably, parcel band 252 in bottom is elastic straps to improve comfort level.Alternatively, bottom parcel band can be with It is stiff or elastic, and is laminated and is formed by hook material/foamed material/ring material.
Figure 18 B show band 252, flexible section 263 of the band 252 and nonelastic range 259, the nonelastic range 259 positioned at carrying at the first end of the locking member 256 with lockhole 257.What band 252 was included in band carries rotating disk The sleeve 265 extended on the second end of take-up device 224.The second end of band carries fixing point 268, the fixing point 268 It is arranged to be connected with the locking member 256 on the second end.The second end is with rotating disk take-up device feature or can be It is non-resilient so that the elasticity of band 252 is limited by stretch section 263, and the stretch section 263 provides comfort level for user.Certainly may be used It is envisaged for other combinations of the stretch section and nonelastic range of band.
The embodiment of any one orthopedic appliance may be provided with plate system, and the plate system is configured at least fixed use The lumbar regions and/or belly of person.It can be found in United States Patent (USP) 8,172,779 various available for orthopedic appliance embodiment A variety of back board systems.It is with the difference of the lumbar vertebrae in United States Patent (USP) 8,172,729-rumpbone KAFO, in the patent KAFO is configured to lumbar vertebrae waistband, but embodiment as described herein is arranged for hip and pelvis.It is if orthopedic Device is configured to be fixed on the lower section in the region, then embodiment here is configurable to have at least higher rear section With accommodates plate system, or with the connector for being used to make plate system, to extend above orthopedic appliance so as to be arranged against Lumbar regions.
For example, backboard is slideably connected with the rear portion of orthopedic appliance.According to the embodiment, backboard be it is flexible or The flexible anatomical structure with receiving wearer back when using closed-system of person.It can be bent around the back of wearer It is particularly advantageous, because backboard can be used for a variety of anatomical contours for supporting a wearer or multiple wearers. But although backboard can be bent around the back of wearer, it can provide the rigidity of abundance to support wearer's Lumbar vertebrae-sacrum area.Alternatively, backboard is formed with can customizing, so that the definite profile with particular wearer is corresponding, its Dorsulum is generally rigid or semirigid.
The backboard of plate system can have specific dissection geometry, and this is specifically dissected geometry and is configured to good The width of a variety of different back anatomical structures is adapted to well.For example, plate can be configured to by with generally from spinal area Curvature outside the outwardly sensing in domain alleviates the pressure of the spine regions at people back.Plate can be configured to by with ridge The profile in sensing extended on muscle by post carrys out the uniformly applied pressure of juxtaspinal muscle to people back.Plate can wrap Profile is included to point to the shoulder portion of wearer, conical top part and generally circular lateral part inwards (it, which is provided, covers The lateral part of the lumbar regions at wearer back is covered, and is contributed in the sensitizing range at wearer back or immunity region More preferable pressure distribution on domain).
Plate can be defined to the generally arcuate in shape profile that wearer provides lordosis support.With reference to passing through closed system System applies pressure onboard, and the profile can introduce and keep correct lumbar antecurvature to pain of alleviation, stable backbone And improve posture, such as reduce lordosis and increase pelvic inclination.Because plate is configured to solution as characterized above Profile is cutd open, therefore more preferable hydrostatics lifting is also created when abdominal cavity is by slight squeeze, and adds intra-abdominal pressure Power.
Such as United States Patent (USP) 8, discussed in 172,729, the dissection shape of plate generates more preferable pelvic stability, this be by It is configured to make pelvis rightly align with backbone in it, thus reduces pain in the lumbar vertebrae sacrum area of wearer's back of the body.Furthermore It is combined with closed-system, plate allows by bending and fixing to improve flexing, stretching, extension, pelvic inclination, backbone rotation and outer lateral bending Fixation to the back of the body of wearer.
Reference picture 19-22, it is shown that the embodiment of hip KAFO 300, wherein the rotation band 302,304 that turns up is arranged on So that hip is maintained at into centre position and limits outwards rotation and to internal rotation in intermediate structure.Turn up rotation band 302, 304 upper end is both secured to the top fixing point 306 on extrusion system, and under being fixed on bottom wrap 314 Portion's fixing point 308.
Figure 19-22 illustrate how to turn up rotation band 302,304 be fixed on the waistband part 310 with tension system with And bottom wrap 314, without necessarily clothes, as shown in multiple embodiments here.Upper and lower part wrap 310,314 It can be connected with may include the long and narrow segmentum laterale 312 of strut assemblies.
Figure 23 shows the embodiment without waistband part, but the embodiment includes clothes 320, on the clothes 320 Turn up rotation band 322,324 be fixed on rear section, or be fixed on embodiment as described herein plate 326 and under Portion's wrap 328.In this embodiment, the rotation band that turns up is used to stablize two hips on two legs.
Figure 24 shows that band provides the embodiment of derotation colligation in hip.In structure in fig. 24, it there are most It is small rotate, minimum abduction, it is and seldom or without flexing resistance or power-assisted.Band 340 includes bottom wrap 342, The bottom wrap 342 has and can extended above and below knee with the part of fixing bundle band 340.Band 344 is rotated under The inner side extension of portion's wrap and along curl up on the inside of leg and cross buttocks reach it is attached in the front portion of hip or forward side Top waistband part 346 closely (generally between outside and inner side).
Figure 25 provides another structure of band 340, and it includes bottom wrap 342 and rotation in Figure 24 embodiment Band 344.Similar with Figure 24 embodiment, rotation band 344 is from the extension of the inner side of bottom wrap 342 and along in leg Sidespin around and cross buttocks.Unlike Figure 24 structure, rotation band 344 is fixed on the outside of top waistband part 346. In the structure, exist to internal rotation and abduction control, and flexing resistance and stretching, extension power-assisted.
The embodiment of reference picture 26, variant and the derotation band 350 of Figure 10 A-10B or Figure 24-Figure 25 hip KAFO It is used in combination.Derotation band 350 is fixed on bottom wrap 342.In the structure shown here, rotation band 344 is configured under The inside portion extension of portion's wrap 342, cross the outside portion or outside back of anterior thigh and fixed pre- top waistband part 346.
Except rotating band 344, derotation band 350 extends from the outside of bottom wrap 342, and in lower end Bottom wrap 342 is fixed at 352, while rotation band is crossed with the inner side for pointing to thigh, it is also about outer side waist Portion and the plurality of positions for being fixed on top waistband part 346 and being fixed on the waistband part of top.As illustrated, derotation band 350 have the upper end 354 for the hips being fixed on above another one leg.According to the structure, hip KAFO provides Inwardly or outwardly rotation control.
Figure 27 and Figure 28 shows the strut assemblies 360 for hip KAFO, and the strut assemblies 360 are used to be connected to this Wrap up in band and bottom wrap in top in literary the disclosed embodiments.Framework 360 includes pillar 362, and the pillar 362 is in upper box Extend between frame 364 and the lower connecting part 368 of bottom wrap 226.Lower connecting part 368 be securable to fixture (such as Fixture 266 disclosed in Figure 17 and Figure 18 embodiment) bottom wrap 226, thus, pin or button 374 be fixed on by In the groove 368 that lower connecting part is limited.
Pillar 362 has the run-on point 366 in upper frame 364, and the upper end of pillar 362 can be slidably It is bonded in the recess being limited in upper frame 364 or region 370 to adapt to the movement of user.Pillar 362 can be It is rigid or be generally rigid to provide extra thigh support.As shown in Figure 9 A, pillar 362 can carry rotor pad To be in close contact rotor.
Framework 360 can be configured to be connected or separate with hip brace embodiment described herein.Clothes can To receive upper frame including pocket, or upper frame can be connected by loop fasteners.Upper frame can be It is flexible to adapt to the shape of the hip of user.Pillar can reduce or prevent interior receipts and be provided for rectifier bigger Rigidity with avoid dislocation risk.
Figure 29 shows the length adjustment component for take-up device or cable 400.Handle 402 is flexible and limited Pocket 408.Embodiment includes retainer 404, and the retainer 404 is arranged for winding exceeding for cable 400 thereon Or unwanted length 406.Retainer 404 can include being arranged for the groove or passage 410 for keeping cable 400.Mouthful The size of bag 408 is set and is configured to the length 406 for accommodating retainer 404 and exceeding.
Figure 30-35 embodiment is intended to be configured to keep the thigh correctly placed relative to trunk in use The embodiment of hip KAFO.
The embodiment of reference picture 30, hip KAFO 510 include pelvic support part 512, rotor supports part 514 and bottom branch Support member 516.Pelvic support part 512 is arranged to be placed at the pelvis of wearer or near pelvis, but rotor supports part 514 is set It is set at or near the rotor relative with femoral head for being placed on femur.Lower support 16 is preferably provided in the knee of wearer Portion is near or over.Pelvis, rotor and lower support 512,514,516 are by including at least upper strut 518 and bottom branch The strut assemblies of post 520 are connected with each other.
Strut assemblies include the leaf spring for example made of metal or plastics.Due to the elasticity of strut assemblies, hip KAFO Can on thigh applying power and/or torque, this enables thigh abduction, and the abduction is preferably independent of as viewed from front side of people Thigh relative to waist or trunk position.Wearer has bigger one-movement-freedom-degree, and this is due to that thigh preferably exists All direction movements.
Upper strut 518 has first end and a fastener 524, and the first end by upper strut 518 by being formed Groove is slidably connected to pelvic support part 512, and the fastener 524 prolongs through pelvic support part 512 and upper strut 518 And fixed with both., can be along the running lengthwise of upper strut 518 by from loosening fasteners 524 on pelvic support part 512 Ground adjusts pelvic support part 512 to adapt to the size of wearer.At least one band 526 is passed through and formed along pelvic support part Groove 527 and fix, and be dimensioned to and be configured about wearer trunk, waist or pelvis extension, by hip Portion's KAFO is fixed at the upper end of the leg of wearer.
Reference picture 31A-32, the second end of upper strut 518 are rotationally connected with lower posts 520 by hinge 528 First end.Hinge 528 has the plate 558 for the outer surface for being fixed on upper strut 518 and allows lower posts 520 to rotate Outer surface away from upper strut 518.Upper strut and the lower posts preferably bar or plate of elasticity, and be flexible Or elasticity, therefore it can return to predetermined shape upon bending.
Pillar regulating part or rotational structure 535 be fixed on upper strut 518 the second end and lower posts 520 One end.Rotating mechanism 535 includes rotating disk 536 and is connected to the pin 538 of rotating disk 536.The first end of pin 538 is installed by pin Part 560 is connected with upper strut 518, and the second end extension by lower posts 520 formed through opening with rotating disk 536 Engage, the rotating disk 536 is located on the outer surface of lower posts 520.It may include that cover plate 66 is located at upper strut 518 to cover At least a portion of pin 538 between lower posts 520.
Figure 33 depicts the rotation of rotating disk 536, and this can promote lower posts 520 to be rotated relative to lower posts 518.This sets The advantages of putting is that wearer can adjust the power that strut assemblies are applied on rotor by rotor supports part 514, by stock Bone is promoted in hip acetabular fossa.Rotating disk 536 can include mark, and the mark can allow wearer's understanding to be applied on hip joint How much power added.
In initial dress, lower posts 520 can be set in wearer so that and it is significantly rotated away from upper strut 518, And then rotate rotating disk so that lower posts 520 are pulled to upper strut 518 to apply bigger pressure on rotor.Rotating disk It can be connected with gear train, the gear train provides mechanical advantage and turned with can more easily adjust and lock with regulation Disk.
Rotor supports part 514 rotationally and is rotationally fixed to upper strut 518 by change 568 and hinge 530 Inner surface.This set allows rotor supports part 514 to adjust the specific anatomical structure to wearer and adapts to wearer's leg The movement in portion.
Pressure regulating mechanism 531 is fixed on upper strut 518 and is preferably located between pin 538 and hinge 528.Pressure Mechanism 531 is suitable to promote rotor support member 514 linearly to move relative to the inner surface of upper strut 518.
Pressure mechanism 531 includes rotating disk 532 and pin 534.Rotating disk 532 is on the outer surface of upper strut 518, and is sold 534 extend between rotating disk 532 and pin installed part 537, and pin installed part 537 is either one of change 568 in change 568 Point.Lower posts 520 can include groove 539, and when rotor supports part 514 is pulled completely towards upper bracket 518, the groove 539 causes Pin 534 is at least partially through wherein.
As shown in figure 34, the rotation of rotating disk 532 causes inner surface line of the rotor supports part 514 relative to upper strut 518 Advance to property.This allows the pressure for fine-tuning rotor supports part 514, without further mutually by upper and lower part pillar 518, 520 are adjusted relative to each other.Rotor supports part 514 can include pad 562 to adjust rotor supports part 514 against wearer When bigger extruding is provided.
Lid 564 has been used to cover both one when pressure mechanism 531 and rotational structure 535 are not used in regulation Part.The part of rotating disk 536 can expose from lid 564 for quick regulation rotor supports part 514, but hide rotating machine Structure 535.
Reference picture 35, lower support 516 is adjustably fixed on by lower posts 520, sleeve 542 by sleeve 542 Engaged with one in the hole 540 formed by lower support 516.Along lower posts 520 length formed hole 540 and Sleeve 542 defines the adjusting means 544 engaged with one in hole 540.Adjusting means 544 includes flexible pulling-on piece 546, and it has Have first the 548 of deviation lower posts flexibly to be engaged with one of hole 540.Adjusting means 544 allows along lower posts 520 The second end slides lower support 516 with the length by the position adjustments of lower support 516 to wearer leg.
Lower support 516 is rotatable and is rotationally adjustably fixed on sleeve 542.Part 552 is rotatablely installed by turning Dynamic pin 556 is fixed on lower support 516, and hinge 554 is connected to lower support 516 by being rotatablely installed part 552.Beam Lower support 516 is fixed on 550 to be circumferentially fixed on the shank of wearer.
Described embodiment can include allowing (such as when using lavatory) when user wants to remove clothes fast Speed removes the mechanism of clothes.Slide fastener can be set can open the opening of clothes to promote to remove or be used as male user The opening used.
There is silica gel to resist the various areas that clothes move on the body of the user on the includable surface of clothes Domain.These regions can be included at the waist section of clothes and the low portion on thigh.Drawn when increasing from take-up device During power, clothes can be tightly held on the body of user by the pulling force of silica gel and clothes.
Clothes can be used in combination with treating the various mechanism of (including cold treatment or thermotherapy), such as at rotor pad, or Include NMES with various forms of diathermies, TENS, PEMF and heat therapy are combined.
Described embodiment provides extruding, skin sparing, sealing, load transfer (extruding/rotation), and reduces bone Basin is sagging and stably.Clothes provide extruding for the user with hip upside or outside osteoarthritis.By to femoral head Apply force to move contact point in hip extruding, or reaction force can be applied on femur to reduce on hip acetabular fossa Load.Extruding to pelvis can also contribute to muscle of hip and loosen and reduce myalgia.
Apply pressure on larger rotor by rotor pad to be advantageous to seal circumferential cartilage, and help to close Save the interior pressure in broad-mouthed receptacle for holding liquid lip seal joint.The major function of acetabular labrum to hip acetabular fossa by providing extra structural support to add Deep hip acetabular fossa, and joint is partly sealed to produce negative intra-articular pressure and then improve the stability in joint, the negative joint Internal pressure can reduce any scattered power or pull-off force.Second function of acetabular labrum is enhancing joint concordance.By in joint Apply pressure on broad-mouthed receptacle for holding liquid lip, femoral head can be drawn into acetabular fossa and move away the region of the infection osteoarthritis in joint.
When hip joint outwards rotates, turning up rotation band can be with pain of alleviation.By outwardly or inwardly rotating femoral head The sealing of circumferential cartilage can be produced.The correcting posture of muscle group can be helped to mitigate pelvic prolaps in more normal position And mitigate myalgia.Pain can be mitigated by stablizing hip, because it is in more correct position.Clothes Multiple embodiments can be formed by smooth elastomeric material such as spandex, and it helps to extrude the body of user and reduces thorn Sharp possibility.The embodiment of reference picture 36, the feature of embodiment as described herein can be coupled in orthopedic appliance 600, should Orthopedic appliance 600 is configured to by separated hip joint to allow arthroscorpe to enter to help hip arthroscopy process.It is orthopedic Device can be used for mitigating the pain as caused by indication such as femur acetabular bone hits disease.
Orthopedic appliance 600 includes the waist belt assembly 602 with take-up device 608, and it can be configured to be similar to orthopedic dress Put 200 the first waistband part 202 and the second waistband part 204 and take-up device 214.Take-up device 608 can be unfolded so that on Portion's take-up device can adjust the pressure in lumbar regions, while lower tension carriage applies pressure in rotor region.Lumbar vertebrae extrudes System can actively release the hip that vertebra loads and preferably keeps patient.
With turn up rotation band 217 and take-up device 220 it is similar, be similarly provided with and being turned up with take-up device 606 Rotate band 604.The rotation band 604 that turns up can be fixed on the lower bundle band 662 similar with lower bundle band 226.Alternatively, outside Turning over rotation band 604 can be by buckled beam in bottom wrap, and this enables a user to open buckle to remove or loosen Turn up rotation band.Described in the United States Patent (USP) 7,198,610 that on April 3rd, 2007 authorizes workable known buckled.
Orthopedic appliance 600 does not have clothes preferably, but including hip KAFO 610.It is suitable that hip KAFO passes through Mechanism such as pocket 630 or other retention mechanisms such as shackle and be fixed on waist belt assembly 602, and be fixed on bottom bag Wrap up in band 622.Hip KAFO can be set to be similar on June 20th, 2012 submit U. S. application 13/528,032 (its On December 20th, 2012 is published as the A1 of U.S. Patent Application Publication 2012/0323154) in hip KAFO.Hip KAFO The U. S. application 12/353,555 submitted on January 14th, 2009 can be used, and (it was published as United States Patent (USP) Shen on May 14th, 2009 Please announce 2009/0124948 A1), United States Patent (USP) on October 6th, 8,172,779,2009 for authorizing on May 8th, 2012 authorizes Feature in the United States Patent (USP) 7,198,610 that authorizes in United States Patent (USP) on April 3rd, 7,597,672,2007.
Reference picture 36 and Figure 37, it is shown that the embodiment of hip KAFO 610, that incorporates by United States Patent (USP) 7,597, Some basic functions of the 672 hip KAFOs partly instructed.According to the embodiment, hip KAFO 602 includes hip plate 612, the hip plate 612 is suitable to be fixed on the hip of user and is maintained at by waist belt assembly 602 in position.KAFO Including lower thigh leg opening 620, the lower thigh leg opening 620 is suitable to be fixed on the thigh of user and wrap up by bottom Band 622 is maintained in position.
Hip plate 612 and lower thigh leg opening 620 are connected to each other by flexible rod 614.Lower elastic rod support member 616 with And top flexible rod support member 622 engages with flexible rod 614.Thigh pad or shell 618 slideably engage with flexible rod 614 And carried by flexible rod 614.Thigh pad or shell 618 can be configured to also be not configured to the thigh relative to user Rotation.Flexible rod 614 is rotationally connected with lower thigh leg opening 620 at rotating connector 628.Lower thigh leg opening 620 can To be configured to regulation height, so that it can slide and be stuck in up and down multiple make a reservation for relative to flexible rod 614 An opening position in position.
For hip plate 612, flexible rod 614 has the end sections being inserted in hip plate 612, and by limitation block piece 626 limitation ground slide into opposite side relative to hip plate 612 from side, and flexing and extension block piece 624 limit hip plate 612 and the motion relative to each other of flexible rod 106.Flexing and extension block piece 624 and limitation block piece 626 are adjustably in On hip plate 102.
It is 0 ° of stretching, extension and 70 ° of flexings to install block piece and range of movement in advance for right hip.Hip is configured if left hip Portion's KAFO and adjust range of movement limitation, then can will limitation block piece and flexing/stretching, extension block piece be placed on correct position.If Two limitation block pieces (a flexing block piece, a stretching, extension block piece) have been put to limit range of movement.Can in the inner side of hip plate and Set guiding piece to be used to refer on Outboard Sections, but caused buckling and stretching angle should be examined to ensure correctly to set Angle is put.
If required angle between 0 ° to 70 °, limitation block piece is placed on (closest in two inside openings Flexible rod).If required angle between 60 ° to 90 °, will limitation block piece be placed in two outside openings (farthest away from Flexible rod).Flexing/stretching, extension block piece is then set according to the mark on the inner side and/or outside of hip plate.
Various bands, wrap and take-up device can be finely adjusted to adapt to the profile of the various sizes of user. Hook material, buckle and other fasteners can be removably secured to these various parts to allow quickly to change size. Band can be oriented in a different direction, such as the rotation band that turns up, to allow modularly to place these bands to allow To stretching, extension and flexing control, and inwardly or outwardly control.Multiple pads can be removably secured to frame element, such as rotor Pad, it can have internal foam to clip and paste to the more preferable fitness of peritrochanteric and comfort level.
1. a kind of orthopedic appliance (200), including：
Clothes (216), it, which has, is arranged about the hip regions that the hip regions of user extend circumferentially over upon；
Characterized in that, also include：First waistband part (202) and the second waistband part (204), the first waistband part (202) and Second waistband part (204) is individually fixed in the first sidepiece and the second sidepiece and respectively from the clothes of the clothes (216) (216) the first sidepiece and the extension of the second sidepiece, are then individually fixed in the forward side of the clothes (216), and described first Waistband part (202) and the second waistband part (204) are configured to be fixed to one another and around the front side sides of the clothes (216) Portion is tensed；
Turn up rotation band (217), and it is at the orthopedic appliance of the foot of the clothes (216) out of described orthopedic appliance Side sidepiece or lateral side extension, and cross femoral region by curling up and obliquely run out to lateral side or inboard side, Cross forward side or rear side sidepiece and be set towards the topmost of the orthopedic appliance, the rotation band (217) that turns up Extend into above the hip regions of user, the rotation band (217) that turns up, which has, to be fixed under the clothes (216) Portion end and be connected to the orthopedic appliance (200) rear side extrusion system (229) upper end,
The rear side extrusion system (229) have the first take-up device (214a, 214b) and the second take-up device (214c, 214d), first take-up device (214a, 214b) and the second take-up device (214c, 214d) are fixed and are arranged to from described The opposite side portion of the posterior region of clothes (216) extends towards the front area of the clothes (216), the rear side extrusion system (229) it is provided on the rear section of the clothes (216) and produces extruding.
2. orthopedic appliance according to claim 1, it is characterised in that the rear side extrusion system (229) have respectively with The first tension group (242a, 242b) that first take-up device (214a, 214b) and the second take-up device (214c, 214d) are engaged With the second tension group (242c, 242d), the first tension group (242a, 242b) and the second tension group (242c, 242d) are respectively It is fixed at the first connector and the second connector in the opposite side portion of the clothes (216), and is directed towards that This, extends towards the rear side sidepiece of the clothes (216).
3. orthopedic appliance according to claim 2, it is characterised in that the first tension group (242a, 242b) and second Tension group (242c, 242d) be provided in tense the first take-up device (214a, 214b) and the second take-up device (214c, Advanced toward each other when 214d), and the pulling force phase applied with the first waistband part (202) and the second waistband part (204) Work inversely.
4. the orthopedic appliance according to Claims 2 or 3, it is characterised in that the first waistband part (202) and the second waistband Part (204) is fixed respectively along first connector and the second connector.
5. orthopedic appliance according to claim 1, it is characterised in that the rear side extrusion system (229) is arranged to make The rear side pelvis overlying regions extension of user.
6. orthopedic appliance according to claim 1, it is characterised in that first take-up device (214a, 214b) and Two take-up devices (214c, 214d), which are provided in above the first waistband part (202) and the second waistband part (204), to be extended simultaneously And it is fixed on the first waistband part (202) and the second waistband part (204).
7. orthopedic appliance according to claim 2, it is characterised in that the first waistband part (202) and the second waistband part (204) there is maximum height, the first waistband part (202) and the second waistband part at the first connector and the second connector (204) clothes (216), and the first waistband part are fixed at first connector and the second connector (202) gradually subtract towards the forward side of the part of the topmost of the clothes (216) with the height of the second waistband part (204) It is small.
8. orthopedic appliance according to claim 1, it is characterised in that the first waistband part (202) and the second waistband part (204) have by trimming line come multiple deburring regions (207) of fringing, to distinguish the first waistband part (202) and second The region of the end sections of waistband part (204).
9. orthopedic appliance according to claim 1, it is characterised in that the clothes (216) include elastic part (240), The elastic part (240) is formed by fabric and is configured in the part of the topmost of the clothes (216) from waist The knee for the user that region is extended at the part of the foot of the clothes (216).
10. orthopedic appliance according to claim 1, it is characterised in that also include：Stiff Outboard Sections (238), institute Elastic part of the Outboard Sections (238) along the clothes (216) is stated in the lateral side of the clothes (216) from the clothes The topmost part of dress (216) extends to foot part.
11. orthopedic appliance according to claim 1, it is characterised in that also include being arranged near the knee of user The bottom wrap (226) that can be tensed of extension, the bottom wrap (226) are fixed on institute at or near lowermost region State clothes (216) and extend above the clothes (216).
12. orthopedic appliance according to claim 11, it is characterised in that be additionally included in the foot of the clothes (216) Elastic webbing (213) at region, the elastic webbing (213) include friction circle being limited on the inner surface of the orthopedic appliance Face, the frictional interface are used for the skin engagement with user to prevent the clothes from being moved on user, the bottom bag Band (226) is wrapped up in above the elastic webbing (213), above the outer surface of the clothes (216) to extend.
13. orthopedic appliance according to claim 1, it is characterised in that it is described turn up rotation band (217) can be by thereon Adjustment length between portion end and lower end.
14. orthopedic appliance according to claim 1, it is characterised in that the upper end of the rotation band (217) that turns up It is fixed on the rear side extrusion system (229).
CN201480017756.5A 2013-01-24 2014-01-24 For treating the orthopedic appliance of hip complication CN105377198B (en)
US201361756220P true 2013-01-24 2013-01-24
US201361756438P true 2013-01-24 2013-01-24
US61/756438 2013-01-24
US61/756220 2013-01-24
US201361894953P true 2013-10-24 2013-10-24
US61/894953 2013-10-24
PCT/US2014/012860 WO2014116895A1 (en) 2013-01-24 2014-01-24 Orthopedic device for treating complications of the hip
CN105377198A CN105377198A (en) 2016-03-02
CN105377198B true CN105377198B (en) 2017-12-08
ID=50071797
CN201480017756.5A CN105377198B (en) 2013-01-24 2014-01-24 For treating the orthopedic appliance of hip complication
US (3) US9314363B2 (en)
EP (1) EP2948107B1 (en)
CN (1) CN105377198B (en)
WO (1) WO2014116895A1 (en)
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