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WO2017199108A1 - Orthèse de cheville-pied articulée à axe de rotation flottant - Google Patents

Orthèse de cheville-pied articulée à axe de rotation flottant Download PDF

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Publication number
WO2017199108A1
WO2017199108A1 PCT/IB2017/051734 IB2017051734W WO2017199108A1 WO 2017199108 A1 WO2017199108 A1 WO 2017199108A1 IB 2017051734 W IB2017051734 W IB 2017051734W WO 2017199108 A1 WO2017199108 A1 WO 2017199108A1
Authority
WO
WIPO (PCT)
Prior art keywords
plate
shell
joint
spacer
orthosis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IB2017/051734
Other languages
English (en)
Inventor
Carlo Ferraresi
Walter Franco
Daniela MAFFIODO
Alberto Leardini
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Istituto Ortopedico Rizzoli
Politecnico di Torino
Original Assignee
Istituto Ortopedico Rizzoli
Politecnico di Torino
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Istituto Ortopedico Rizzoli, Politecnico di Torino filed Critical Istituto Ortopedico Rizzoli
Publication of WO2017199108A1 publication Critical patent/WO2017199108A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F5/0127—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations for the feet
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F2005/0132—Additional features of the articulation
    • A61F2005/0146—Additional features of the articulation combining rotational and sliding movements, e.g. simulating movements of a natural joint
    • A61F2005/0148—Floating pivotal axis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F2005/0132—Additional features of the articulation
    • A61F2005/0151—Additional features of the articulation combining rotational and torsional movements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F2005/0132—Additional features of the articulation
    • A61F2005/0153—Additional features of the articulation combining rotational and stretching movements

Definitions

  • the present invention relates to the biomedical field and specifically to orthotic devices.
  • the present invention relates to ankle-foot orthoses; still more particularly the present invention relates to articulated ankle-foot orthoses usually employed in orthopedic-rehabilitation fields.
  • the articulated orthosis according to the present invention has a preferred and advantageous application for ankle-foot, but it can also be applied to a knee or elbow and, generally, for treating and healing injuries to musculoskeletal or neurological system.
  • An orthosis is an externally applied device used to support, align, prevent or correct functionalities of movable parts of the body; particularly ankle-foot orthoses (AFO) are applied to tibiotarsal joints (between the leg composed of bone segments of tibia and fibula, and the tarsus, namely the hind foot, particularly talus bone) and subtalar joint (between talus bone and calcaneus), acting contemporaneously for supporting and correcting possibly impaired functions and for constraining the motion in order to protect injured anatomical structures in post-traumatic treatments (see references [1], [2] and [3]).
  • AFO ankle-foot orthoses
  • Hinged AFO that is ankle-foot orthoses that provide two rigid shells, for foot and leg of a user, connected by joints that allow them to accomplish a relative motion, particularly flexion-extension motions (dorsiflexion and plantar flexion of the foot), within a given range delimited by suitable stop elements, while they oppose, in a more or less strong manner, the motions in other planes; articulated ankle-foot orthoses can have many applications, as in the case of users suffering from foot drop, clubfoot, hemiplegia and other diseases of the lower limb.
  • HAFO Hybrid AFO
  • Joints connecting the shells in current articulated orthoses are usually of the fixed- axis rotary type or, more generally, are kinematic chains that allow a limited number of relative degrees of freedom to be performed; therefore a common feature of said articulated ankle-foot orthoses known up to now is the fact of having an axis of rotation that disregard physiological conditions of kinematics of the ankle joint (see reference [3]), that on the contrary moves from one to another position (see references [3], [4], [5], [6] and [7]); a scientific publication about the study of the articular kinematics of the ankle, particularly a method for determining, by motion analysis, the behavior of the natural anatomical joint axis (see reference [8]), discloses that the ankle works as a joint with a single degree of freedom, whose axis of rotation rotates and moves when performing the articular motion, based on the coupling between bone segments and on the action of the ligaments; another recent study (see reference [3]) performed by the motion analysis on such
  • the natural movement of the ankle here defined as relative motion between leg and foot considered as rigid segments
  • WO2014/ 060824 Al discloses an articulated ankle-foot orthosis comprising joint, leg shell and foot shell, wherein the joint allows a roto-translation motion with only one degree of freedom between the leg shell and the foot shell; particularly such roto-translation motion depends on the geometry of the joint that, by means of two mobile pins in two corresponding recesses, constrains and defines the trajectory of such motion.
  • US 5,086,760 on the contrary is about a joint allowing the flexion- extension motion to be performed by the rotation about the axis of a pin; the joints, by means of two spherical surfaces, allows also the inversion-eversion motion to be performed, where the two axes of rotation are forced to pass by a fixed point at the center of the spherical surfaces; therefore it is a joint with two degrees of freedom, having the possibility of regulating the limit stop elements for the two rotations.
  • Said technical solution has the drawbacks of allowing only two degrees of freedom of rotation about axes forced to pass by a fixed point; particularly such solution alters the natural articular kinematics of the ankle, that cannot be represented as a motion with two degrees of freedom.
  • the US patent n. US 5,094,232 relates to a joint allowing three degrees of freedom on the sagittal plane, by the provision of two flat plates, each one provided with a groove and arranged at 90° with respect to each other; the two plates, always in contact with each other, are coupled by a sphere, such to allow movements of horizontal translation, vertical translation and rotation in the sagittal plane to be performed.
  • Said technical solution has the drawbacks of allowing only three degrees of freedom in the sagittal plane of the orthosis, possibly obtaining two further degrees of freedom (relative rotations in the frontal plane and transverse plane) by acting on the deformability of the attachments to the leg shell and not by means of the joint itself; particularly such solution alters the natural articular kinematics of the ankle, that requires six relative degrees of freedom between the segments of the leg and foot.
  • none of the known solutions provides an articulated orthosis able not to alter the natural movement of ankle-foot anatomical joint.
  • none of the known solutions provides an articulated orthosis such that the relative motion between the two shells is guided by the structures of the natural anatomical joint and contemporaneously provided with constraining elements able to compensate for possible weaknesses, or necessary functional protections, of natural containment structures.
  • none of the known solutions provide to design and make an articulated orthosis based on the physiological features of the single user by adapting a two shell joint produced according to industrial standards and methods in a customized manner, namely none of the known solutions can fit specific needs of each individual user.
  • the object of the present invention to overcome prior art drawbacks of the field of orthotic devices, specifically articulated orthoses. More precisely the present invention intends to solve the problem of providing an articulated orthosis wherein the joint connecting the two shells allows a relative movement with six degrees of freedom appropriately limited, such to guarantee a physiological behavior of the user anatomical joint, and at the same time to compensate for possible weaknesses of natural containment structures or to provide them with the necessary functional protections.
  • the object of the present invention is to provide an articulated orthosis equipped with an innovative joint for the connection of the two shells that, unlike a conventional fixed-axis rotary joint that limits the relative motion only to one degree of freedom, allows a more free relative movement to be provided, that is more easily guided by the structures of the anatomical joint even if within a confined space (flexion-extension movements are encouraged, while other movements are limited, namely pronosupination, abduction-adduction and the three articular translations).
  • the object of the present invention is to provide an articulated orthosis that adapts the relative movement of the shells to the movement of the mobile instantaneous helical axis (IHA) typical of a natural ankle, by providing a joint with a floating axis of rotation for connecting the two shells of the orthosis and by positioning the mean axis of the floating joint at the "ideal" axis of the ankle of the user (such "ideal" axis being taken as corresponding to the mean helical axis (MHA).
  • IHA instantaneous helical axis
  • the object of the present invention is to provide an articulated orthosis that can fit any user and also different therapeutic-rehabilitation phases of a single user, by being designed and made on the basis of the specific kinematic characteristics of the user ankle, obtained by suitable motion analysis tools and protocols.
  • the articulated orthosis according to the invention provides means for adjusting the position of the joint.
  • the articulated orthosis according to the invention provides first or second elastic deformable elements, transverse or axial ones respectively, to control in a more accurate manner the joint clearances.
  • the technical solution according to the present invention that provides an articulated orthosis with an instantaneous helical axis (IHA) floating about the mean helical axis (MHA) of the user's ankle makes it possible:
  • FIG. 1 is a perspective, partially phantom, view, of the articulated orthosis according to the present invention comprising joint, leg shell (top) and foot shell (bottom);
  • FIG.2 is an exploded perspective view of FIG.l
  • FIG. 3 is a side view (top) and a plan view (bottom) of FIG.l;
  • FIG. 4A is a side view (top) and a plan view (bottom) of the leg shell of FIG.3 with the joint parts integral therewith;
  • FIG. 4B is a side view (top) and a plan view (bottom) of the foot shell of FIG.3 with the joint parts integral therewith;
  • FIG. 5A is a first relative rotation movement in the sagittal plane, in the system of FIG.3;
  • FIG. 5B is a second relative horizontal translation movement in the sagittal plane, in the system of FIG.3;
  • FIG. 5C is a third relative vertical translation movement in the sagittal plane, in the system of FIG.3;
  • FIG. 5D is a fourth relative rotation movement in the frontal plane, in the system of FIG.3;
  • FIG. 5E is a fifth relative rotation movement in the transverse plane, in the system of FIG.3;
  • FIG. 5F is a sixth relative translation movement in mediolateral direction, in the system of FIG.3;
  • FIG. 6 is a cross-section view of the joint of FIG.l
  • FIG.7 is a perspective, partially phantom, view of a first alternative embodiment, with joint positioning plates, of the articulated orthosis according to the present invention
  • FIG. 8 is an exploded perspective view of FIG. 7;
  • FIG. 9A is a cross-section view of a first variant of the joint, provided with viscoelastic elements deformable in the axial direction, of the articulated orthosis according to the present invention.
  • FIG. 9B is a cross-section view of a second variant of the joint, provided with viscoelastic elements deformable in the radial direction, of the articulated orthosis according to the present invention.
  • the articulated orthosis of the present invention in based on the consideration that the natural motion of the ankle can be interpreted as a motion according to a mobile instantaneous helical axis (Instantaneous Helical Axis - IHA), floating about a mean helical axis (Mean Helical Axis - MHA); the bundle of the instantaneous axes IHA and the corresponding mean axis MHA of the user intended to receive the orthosis can be determined by known motion analysis tools and protocols for example by stereophotogrammetry, use of inertial sensors, fluoroscopy.
  • the main characteristic of said articulated orthosis is the fact of providing a floating joint for connecting the two shells to the orthosis, that adapts the relative movement of the shells to the movement of the bundle of the instantaneous helical axes IHA of the user's ankle, and the fact of positioning the mean axis of the joint coinciding with the mean helical axis MHA of the user's ankle.
  • markers For example think of using stereophotogrammetry, such markers have to be applied to the user, whose spatial coordinates are detected for different movements, such as walking, free or forced flexion-extension of the ankle, both active and passive one, etc., and are processed by mathematical algorithms that allow instantaneous helical axes IHA and the mean helical axis MHA to be calculated and graphically represented in a three-dimensional space. It has to be pointed out that in order to apply such method, it is necessary to identify a rigid body model of the foot, operation affected by high numerical noise that generates high scattering values of the results; therefore in order to obtain an efficacious kinematic identification of the ankle it will be necessary to apply also techniques filtering and optimizing the calculated values.
  • the articulated orthosis of the present invention is provided with an innovative joint for connecting the two shells that, unlike conventional fixed-axis rotary joints that limit the relative motion only to one degree of freedom, or unlike other solutions allowing some further degrees of freedom, it allows a completely free relative movement to be performed, that is thus more easily guided by the structures of the natural anatomical joint even if within a confined space (the flexion-extension movement is encouraged, while the other movements are limited, that is pronosupination, abduction-adduction, and the three articular translations); thus when walking the orthosis allows the natural articular movement to be performed defined by the passive articular structures (capsule, cartilaginous surfaces and ligaments) between bone segments, however exerting a constraint action as regards the movements that in not injured anatomical joint usually are limited by the containment physiological structures just mentioned above.
  • the passive articular structures capsule, cartilaginous surfaces and ligaments
  • Figs. 1 and 2 show the articulated orthosis 1 according to the present invention that comprises:
  • a first shell 2 to be associated to a foot 20
  • a second shell 3 to be associated to a leg 30, and
  • first shell 2 and the second shell 3 are made of a thermoplastic material and are padded with polyurethane foam; preferably the first shell 2 to be associated to the foot 20 is equipped with anti-slip sole, for example made of rubber; preferably the second shell 3 to the associated to the leg 30 is equipped with closure means, for example one or more hook and loop fastener straps; preferably the regions of the shells near the joint are reinforced with riveted metal plates.
  • the joint 10 in turn comprises
  • the term "inner plate” means the plate connected to the foot shell, while the term “outer plate” means the plate connected to the leg shell.
  • the hole 50 of the second outer plate 5 has a diameter greater than the diameter of the spacer 6 to obtain a mutual radial clearance.
  • the distance between the outer surface 40 of the first inner plate 4 and the inner surface 70 of the threaded counter-plate 7, determined by the length of the spacer 6, is greater than the thickness of the second outer plate 5 to obtain a mutual axial clearance.
  • the first inner plate 4 is connected with the first shell 2 on the side opposite to the foot 20
  • the second outer plate 5 is connected with the second shell 3 on the side opposite to the leg 30
  • the spacer 6 passes through the hole 5 of the second outer plate 5 and is arranged in contact with the first inner plate 4 and the threaded counter-plate 7 is arranged in contact with the spacer 6.
  • the axis of rotation of the pair of joints 10 is floating around the MHA of a user's anatomical joint so that the articulated orthosis 1 follows the natural kinematics of the user's anatomical joint.
  • a pair of joints 10 allows the first shell 2 and the second shell 3 to accomplish a relative movement with six degrees of freedom consisting in two independent translations in the sagittal plane (as visible in Figs. 5B and 5C respectively), a translation in the mediolateral direction (as visible in Fig. 5F), a rotation in the sagittal plane with respect to a mediolateral axis (as visible in Fig. 5A), a rotation in the frontal plane with respect to an anterior-posterior axis (as visible in Fig. 5D) and a rotation in the transverse plane with respect to a longitudinal axis of the leg (as visible in Fig. 5E).
  • Figs. 3, 4A and 4B show the articulated orthosis 1 to comprise a pair of joints 10; the connection between the two shells 2 and 3 is performed by a pair of joints 10 that allow relative movements with a specific amplitude, particularly as regards the rotation and the two translations in the sagittal plane, the translation in the mediolateral direction, the rotation in the frontal plane with respect to an anterior- posterior axis and the rotation in the transverse plane with respect to a longitudinal axis.
  • the difference between the outer diameter of the spacer 6 and the diameter of the holes 50 of the second outer plate 5 allows three degrees of freedom in the sagittal plane to be accomplished; the difference between the thickness of the second outer plate 5 and the distance between the outer surface 40 of the first inner plate 4 and the inner surface 70 of the threaded counter-plate 7, set by the length of the spacer 6, allows the further translation movements in the mediolateral direction and rotation movement in the frontal plane and in the transverse plane to be accomplished.
  • the amplitudes allowed to the different natural movements, except for the flexion- extension movement, can be determined and modified by simply defining the values of the length and outer diameter of the spacer 6 that will be fitted in each joint 10.
  • the amplitudes allowed to the different natural movements can be determined and modified by simply defining the values of the length and outer diameter of the spacer 6 that will be fitted in each joint 10.
  • the first inner plate 4, the second outer plate 5 and the threaded counter- plate 7 are made of or are covered by a low friction material.
  • FIGs. 7 and 8 show a first alternative embodiment of the articulated orthosis ⁇ according to the present invention.
  • the joint 10' of the articulated orthosis ⁇ further comprises a third plate 9' arranged between the second shell 3' and the second outer plate 5', to adjust the positioning of the hole 50' with respect to the second shell 3', by a horizontal and a vertical translation in the sagittal plane.
  • the third plate 9' has a rectangular shape and is provided with a recess 90', rectangular too, allowing the plate 9' to be fastened in different positions with respect to the shell 3' by means of a pair of screws 91'; it is clear that also other shapes of the third plate 9' and of the recess 90' can be selected that are fit for purpose.
  • the outer plate 5' has a recess 51' allowing the plate 5' to be fastened in different positions with respect to the plate 9' by means of a pair of screws 52'; it is clear that it is possible to select different shapes of the plate 5' and of the recess 51' that are fit for purpose.
  • the joint 10' of the articulated orthosis ⁇ comprises, in turn, a fourth plate 14', such to allow the position of the connecting pin 8' to be adjusted with respect to the first shell 2', by a horizontal and a vertical translation in the sagittal plane.
  • the fourth plate 14' has a rectangular shape and it is also provided with two recesses 141' and 142' wherein the pin 8' and a further pair of adjustment screws 143' can move respectively.
  • FIG. 9A shows a first variant of the joint 10" of the articulated orthosis according to the present invention.
  • the joint 10" further comprises first viscoelastic transverse elements 11" arranged between the first inner plate 4" and the second outer plate 5" and/ or between the second outer plate 5" and the threaded counter -plate 7", to control in a way determined with precision, through stiffness and damping characteristics of the material composing the first viscoelastic elements, the mobility of the joint 10" allowed in the axial direction by the mutual axial clearance between the first inner plate 4" and the second plate 5" and/ or the second plate 5" and the threaded counter-plate 7" .
  • FIG. 9B shows a second variant of the joint 10'" of the articulated orthosis according to the present invention.
  • the joint 10'" further comprises, in addition or as an alternative to the first viscoelastic transverse elements 1 ⁇ , second axial viscoelastic elements 13'", arranged between the spacer 6'" and the second outer plate 5"', to control in a way determined with precision, through stiffness and damping characteristics of the material composing the second viscoelastic elements, the mobility of the joint 10'" allowed in the sagittal plane by the mutual radial clearance between the hole 50 "' of the second outer plate 5'" and the spacer 6'".
  • the first 11" and second 13'" viscoelastic elements are provided in such an amount and quality to adjust as desired the mutual clearance of the elements between which they are placed; for example the first 11" and second 13'" elastic elements can be spring lock washers, Belleville springs, elastomers and the like having specific stiffness values.
  • the articulated orthosis 1, ⁇ in any of its embodiments and variants disclosed above, has the diameter of the spacer 6,6',6",6'" smaller than the diameter of the hole 50,50',50",50'" of the second outer plate 5,5',5",5'”; the difference between the diameter of the spacer 6,6',6",6'”and the diameter of the hole 50,50',50",50'" of the second outer plate 5,5',5",5'” determines the amplitude of the relative translation movements in the sagittal plane.
  • the articulated orthosis 1,1' in any of the embodiments and variants described above, has a length of the spacer 6,6',6",6"' greater than the thickness of the second outer plate 5,5',5",5'", such that the difference determines the amplitude of the relative angular movements in the frontal plane and transverse plane and of the relative translation movement in the mediolateral direction.
  • the articulated orthosis with floating axis of rotation according to the present invention here shown in the preferred and advantageous embodiment for ankle-foot can be also applied to a knee or an elbow; generally the articulated orthosis with floating axis of rotation according to the present invention has many fields of application, that result directly from the innovative characteristics and from the advantages described above, for treating and healing ankle-foot injuries to the musculoskeletal or neurological system such as for example the post-traumatic treatment of ligament injuries, chronic ankle instability, post-operative or conservative joint support, foot drop due to neuromuscular deficit associated with paralysis, muscular dystrophy, myelomeningocele or due to other neurological central or peripheral diseases, central or peripheral paralyses with clubfoot, etc or anyway for any need of adjustable dynamic support.

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  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Rehabilitation Tools (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une orthèse articulée (1, 1') comprenant une première coque (2, 2') destinée à être associée à un pied (20, 20'), une deuxième coque (3, 3') destinée à être associée à une jambe (30, 30'), et une paire d'articulations (10, 10', 10", 10"') ; chaque articulation (10, 10', 10", 10"') comprend à son tour une première plaque intérieure (4, 4', 4", 4"') solidaire de la première coque (2, 2') du côté opposé au pied (20, 20'), une seconde plaque extérieure (5, 5', 5", 5"') solidaire de la deuxième coque (3, 3') sur le côté opposé à la jambe (30, 30') et pourvue d'un trou (50, 50', 50", 50"'), d'une entretoise (6, 6', 6", 6"'), d'une contre-plaque filetée (7, 7', 7", 7'") et d'une broche de liaison (8, 8', 8", 8"') solidaire de la première plaque intérieure (4, 4', 4", 4"') et dont la tête est en butée sur la première coque (2, 2') du côté opposé à la première plaque intérieure (4, 4', 4", 4"'), le trou (50, 50', 50", 50"') de la seconde plaque extérieure (5, 5', 5", 5"') présentant un diamètre supérieur au diamètre de l'entretoise (6, 6', 6", 6"') pour obtenir un jeu radial mutuel, et l'entretoise (6, 6', 6", 6"') passant à travers le trou (50, 50', 50", 50"') de la seconde plaque extérieure (5, 5', 5", 5"') et étant disposée en contact avec la première plaque intérieure (4, 4', 4", 4"') et avec la contre-plaque filetée (7, 7', 7", 7"'), et la distance entre la surface extérieure (40) de la première plaque (4, 4', 4", 4"') et la surface intérieure (70) de la contre-plaque filetée (7, 7', 7", 7"') étant déterminée par la longueur de l'entretoise (6, 6', 6", 6"') et étant supérieure à l'épaisseur de la seconde plaque extérieure (5, 5', 5", 5"') afin d'obtenir un jeu axial mutuel, de sorte que la paire desdites articulations (10, 10', 10", 10"') est telle que les axes des broches de liaison (8, 8', 8", 8"') sont alignés entre eux et permet à la première coque (2, 2') et à la seconde coque (3, 3') d'effectuer un mouvement relatif avec six degrés de liberté consistant en deux translations indépendantes dans le plan sagittal, une translation dans la direction médio-latérale, une rotation dans le plan sagittal par rapport à un axe médio-latéral, une rotation dans le plan frontal par rapport à un axe antéro-postérieur et une rotation dans le plan transversal par rapport à un axe longitudinal, de sorte que l'axe de rotation de la paire d'articulations (10, 10', 10", 10"') est flottant autour du centre anatomique de l'articulation anatomique de l'utilisateur et l'orthèse articulée (1, 1') suit la cinématique naturelle de l'articulation anatomique de l'utilisateur.
PCT/IB2017/051734 2016-05-18 2017-03-27 Orthèse de cheville-pied articulée à axe de rotation flottant Ceased WO2017199108A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITUA2016A003575A ITUA20163575A1 (it) 2016-05-18 2016-05-18 Ortesi piede-caviglia articolata con asse di rotazione flottante
IT102016000051280 2016-05-18

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WO2017199108A1 true WO2017199108A1 (fr) 2017-11-23

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WO (1) WO2017199108A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
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US5176623A (en) * 1991-10-15 1993-01-05 Professional Care Products Incorporated Multiple fixed angle orthopaedic appliance
US20050187505A1 (en) * 2004-02-24 2005-08-25 Tamarack Habilitation Technologies, Inc. Spherical joint orthosis
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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5176623A (en) * 1991-10-15 1993-01-05 Professional Care Products Incorporated Multiple fixed angle orthopaedic appliance
US20050217151A1 (en) * 2002-06-20 2005-10-06 Gerard Valat Boot with floating connection
US20050187505A1 (en) * 2004-02-24 2005-08-25 Tamarack Habilitation Technologies, Inc. Spherical joint orthosis
US20100152865A1 (en) * 2008-12-15 2010-06-17 össur hf. Noise reduction device for articulating joint, and a limb support device having the same

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