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WO2023180528A1 - Dispositif technique orthopédique à axe de rotation pivotant - Google Patents

Dispositif technique orthopédique à axe de rotation pivotant Download PDF

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Publication number
WO2023180528A1
WO2023180528A1 PCT/EP2023/057640 EP2023057640W WO2023180528A1 WO 2023180528 A1 WO2023180528 A1 WO 2023180528A1 EP 2023057640 W EP2023057640 W EP 2023057640W WO 2023180528 A1 WO2023180528 A1 WO 2023180528A1
Authority
WO
WIPO (PCT)
Prior art keywords
joint device
section
joint
medical device
opening
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/EP2023/057640
Other languages
German (de)
English (en)
Inventor
Ulrich Schreiber
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.)
OT Medizintechnik GmbH
Original Assignee
OT Medizintechnik GmbH
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
Priority claimed from DE102022128396.8A external-priority patent/DE102022128396A1/de
Application filed by OT Medizintechnik GmbH filed Critical OT Medizintechnik GmbH
Priority to EP23715468.7A priority Critical patent/EP4498994A1/fr
Publication of WO2023180528A1 publication Critical patent/WO2023180528A1/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
    • A61F5/0123—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 knees
    • 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
    • A61F2005/0134—Additional features of the articulation with two orthogonal pivots

Definitions

  • An orthopedic device is an externally worn aid, such as an orthosis. It is used, for example, in cases of degeneration, after injuries or to prevent injuries/incorrect strain on joints, e.g. B. with torn ligaments or wear and tear on joints. These orthopedic devices are also used after surgical procedures, such as the replacement of a joint or operations on the joint structure or other operations on bony, muscular structures or operations on the joint ligaments.
  • Orthopedic technology devices have the function of relieving, stabilizing or adjusting joints, muscles or bones. They can be made from a wide variety of materials, such as fabrics, plastics, metals, silicones or combinations thereof. Orthopedic technology devices can be used on upper and lower extremities. For example, they can reduce misalignments and movements OT Medizintechnik GmbH restrict or prevent the joint or redistribute or reduce loads.
  • One object of the present invention is to provide a further orthopedic device and a set. The object according to the invention is achieved by an orthopedic technology device with the features of claim 1, a set with the features of claim 21 or 42, a joint device with the features of claim 22 and a method with the features of claim 43.
  • an orthopedic device for applying to the two anatomies adjacent to an anatomical joint, e.g. B. thigh and lower leg, proposed, which has a proximal part for placing on the proximal of the two anatomies adjacent to an anatomical joint, e.g. B. an upper arm or a thigh, and a distal part for application to the distal anatomy, e.g. B. the forearm or the lower leg.
  • the proximal and distal parts are pivotally or rotatably connected to one another via at least one lateral joint device and optionally also a medial joint device.
  • the orthopedic technology device has at least one fastening device with which the orthopedic technology device can be secured to the limb.
  • the lateral joint device and/or the medial joint device has/have a swivel joint with or consisting of a - or exactly one - receiving section and a - or OT Medizintechnik GmbH has exactly one recorded section, the recorded section being rotatably accommodated in the recording section relative to this.
  • the receiving section of the lateral joint device and/or the medial joint device is designed to enable a translational movement of the section rotatably received therein in at least one direction, and/or a movement of the section rotatably received therein in a first, in particular distal-proximal, direction and/or in a second, in particular ventral-dorsal, direction.
  • the receiving section of the lateral joint device and/or the medial joint device can be designed to allow tilting, pivoting, tumbling or inclination of the section rotatably accommodated in it or its longitudinal axis.
  • a rotary movement is preferably structurally possible, the movements made structurally possible by the joint device not being limited to pure rotary movements, but rather allowing the joint device to have at least one further form and/or direction of movement, in particular continuously.
  • the lateral and/or medial joint device is designed to allow the moving, tilting, pivoting, tumbling or inclining of the rotatably received section or its longitudinal axis or the rotation axis when the medical device is in use, e.g. B.
  • a set is further proposed which comprises an orthopedic device according to the invention and/or a joint device according to the invention on the one hand and at least two inserts and/or at least two gears on the other hand, whereby the inserts differ from one another and/or the gears differ from one another.
  • a joint device for a medical device in particular for a medical device according to the invention, is proposed, which has or forms a swivel joint, or a joint with at least one swivel joint function, a receiving section and a received section. The recorded section is rotatably accommodated in the receiving section relative to the latter.
  • the receiving section is designed and/or arranged to allow movement of the section rotatably accommodated in it, or a section thereof, in the distal-proximal direction and/or in the ventral-dorsal direction, and/or to tilt, pivot or To allow tilting of the rotatably received section relative to the receiving section, or an axis of rotation of the joint device, or vice versa, in particular continuously.
  • the joint device is designed to allow the moving, tilting, pivoting, tumbling or tilting of the rotatably received section or its longitudinal axis or the axis of rotation when the joint device is in use, e.g. B. due to or following flexion or extension by the patient.
  • the method according to the invention relates to the preparation of a medical device according to the invention and includes providing a medical device according to the invention, carrying out all the steps required before putting on the medical device, such as. B. Making adjustments to be tailored to the patient, or ensuring that these steps have been taken until the medical device is ready for application in such a way that there is play between components involved in the formation of the joint device in such a way that their relative movement to one another allows both rotation and Moving, tilting, pivoting or tilting is also maintained.
  • Embodiments according to the invention may have some, some or all of the following features in any combination, unless this is technically impossible for those skilled in the art. In all of the following statements, the use of the expression “may be” or “may have” etc.
  • the first direction may be a direction along a longitudinal extent or direction of the proximal or distal part.
  • the second direction may be a direction along a transverse extent or direction of the proximal or distal part.
  • the second direction may be a direction along a transverse extent or direction of the upper part or lower part.
  • an orthopedic device as a device according to the invention
  • the invention is not limited to this. Rather, it can be aimed at a medical device.
  • the replacement of “orthopedic device” as used herein by “medical device” or “medical device” is therefore also covered by the disclosure of the invention.
  • Advantageous further developments of the present invention are the subject of subclaims and embodiments. If an embodiment is mentioned herein, it represents an exemplary embodiment according to the invention, which is not to be understood as limiting.
  • the object according to the invention has one or more features in a specific embodiment, it is also disclosed here that the object according to the invention expressly does not have exactly this or these features in other embodiments also according to the invention, e.g. B. in the sense of a disclaimer.
  • the opposite embodiment OT Medizintechnik GmbH, for example, formulated as a negation, is also disclosed.
  • OT Medizintechnik GmbH for example, formulated as a negation.
  • the permitted movement is or includes pivoting by means of the lateral joint device and/or the medial joint device about several joint axes or about a changing, in particular moving, position during pivoting in relation to the proximal part and/or the distal part. wandering, tilting or pivoting, joint axis or rotation axis.
  • a pivot axis may be a physical axis, similar to the pin or tenon of a hinge joint.
  • An axis of rotation as used herein, may alternatively refer to a non-physical curve or straight line by which the center of rotation of a rotation can be determined.
  • a hinge axis is an imaginary axis in some embodiments. She is in these OT Medizintechnik GmbH embodiments do not have a physical axis; in other embodiments this is different.
  • a hinge axis as used herein is, in some embodiments, a rotation axis. Both terms can therefore be interchangeable.
  • the allowing is effected by the receiving portion serving as a guide or longitudinal guide for the received portion.
  • the receiving section can be designed as a through opening in either the upper part or the lower part, which can be slot-shaped, oval, circular, circular or in another shape.
  • the capture portion is configured to limit the permitted movement of the captured portion in the distal-proximal direction and/or in the ventral-dorsal direction within the capture portion.
  • the lateral joint device and/or the medial joint device comprises an upper part and a lower part, the upper part being connected to the proximal part and the lower part being connected to the distal part, or vice versa.
  • the upper part includes a through opening as the receiving portion and the lower part includes a projection or pin as the received portion. The reverse configuration, in which the OT Medizintechnik GmbH lower part which has the through opening is also included in the present invention.
  • the pin has an external thread, with the orthopedic device having an element which carries an internal thread for screwing to the external thread. So that tilting, pivoting or tilting remains permitted even when the orthopedic device according to the invention or the joint device according to the invention is assembled ready for use or when using it, so that the tilting, pivoting or tilting etc. results in accordance with the movement carried out by the patient, such as flexion or extension, an appropriate facility, e.g. B. a spacer or a spacer, alternatively a provision or a mechanism with the structure and / or function of the device described below.
  • This corresponding device can provide the required play between the components involved in the formation of the joint device, such as. B.
  • Such a device can be a shell, a spacer, a projection of the screw, a sleeve which limits the screwing in of a first component into a second component with respect to the screwing path, e.g. B. a sleeve pushed over the shaft of a screw, a screw with a partial thread, dimensioned in such a way that the possibility of screwing it in is limited, a shoulder, a split pin, a spring or mechanical spring that provides the required distance OT Medizintechnik GmbH and/or the game guarantee and include or consist of the like.
  • the upper part of the lateral or medial joint device optionally has a concave curvature on its side facing the lower part or is optionally non-planar in some other way in the area of the joint device.
  • the lower part advantageously has a convex curvature on its side facing the upper part or is optionally non-planar in some other way in the area of the joint device.
  • the through opening or the edge of the upper part forming it is curved in a longitudinal section (or when viewed from the side) and / or in a cross section (or when viewed from the end face), preferably concavely curved on its upper side.
  • the orthopedic device according to the invention has an insert with a through opening.
  • the insert is designed to be received, preferably releasably, on or in the upper part of the lateral or medial joint device as a receiving section, in particular in the passage opening of the upper part. Alternatively, it is intended to provide the insert on or in the top of the lower part, preferably in a detachable manner. When used in this way, it serves to accommodate the recorded section, at least in sections, in its through opening.
  • the through opening of the upper part of the lateral or medial joint device has a first depth.
  • the insert has a first thickness in a first section and a second thickness in a further section, the first thickness being less than the first depth. In some embodiments, the second thickness corresponds to the first depth.
  • the orthopedic device according to the invention does not have an actuator that would be fixed at fastening points on the upper part and the lower part and could influence a pivoting of the upper part relative to the lower part.
  • the orthopedic technology device further has an angle limiter.
  • the angle limiter, upper part and/or lower part can, for example, have connecting devices which are suitable and intended to connect these three components to one another, in particular releasably, e.g. B. positively and / or non-positively, as through openings, which can be used, for example, to accommodate a screw, a snap connection, an internal thread, e.g. B.
  • the angle limiter is arranged to position the attachment portion OT Medizintechnik GmbH of the upper part relative to the fastening section of the lower part. The positioning is usually the result of a rotation, or a combined movement with a rotation, and the task of the angle limiter can be to limit the rotation to an angular range.
  • the angle limiter includes one, two, or more pins, projections, or pins. You can limit the flexion (bending) and extension (stretching) of the joint treated with the orthopedic device, for example by hitting a stop when rotation occurs between the upper part and the lower part. They may be intended to be adjustable.
  • the angle of the permitted movement(s) can therefore be adjustable.
  • the lower part and/or upper part each have a curvature on the surfaces facing one another, or where they are in contact with one another or rest on one another during use, or on sections of such surfaces.
  • the curvature can be for one of the two components, e.g. B. for the upper part, a concave curvature, and for the lower part then a convex curvature, or vice versa.
  • the curvature can be such that the upper part or lower part having it has a longitudinal curvature in the curved surfaces in some embodiments.
  • the curved surface has a spherical or spherical section-shaped section, alternatively a curvature, convexity or concavity in at least two mutually perpendicular directions.
  • the curvature can result in a dome shape.
  • OTtechnik GmbH it is provided that the angle limiter has or is a combination of components or sections which has a projection or an edge against which another section of the angle limiter, e.g. B. one or more of the optional pins strikes.
  • the lower part has a projection, e.g. B. a circular projection, a pen or the like.
  • the pin can have an internal thread.
  • the angle limiter has other connecting devices that serve to connect to the angle limiter, for example projections of a snap and/or latching connection.
  • the angle limiter is integrated into the upper part of the joint device.
  • the lower part on its upper side or the upper part on its underside has an optional ring gear, which may be part of an optional toothed engagement mechanism.
  • the ring gear or the tooth engagement mechanism can be around the circumference of the aforementioned projection or pin, or around parts of the circumference thereof, e.g. B. only be arranged by 300 ° or less.
  • an optional toothed rail (generally also a toothed section) can be provided on the top of the lower part or on the underside of the upper part, which can also be part of the toothed engagement mechanism.
  • OTtechnik GmbH In the state of use of the lateral joint device and/or medial joint device, the teeth of the toothed ring engage in the teeth of the toothed rail in such embodiments. This can therefore cause a translational (forced) guidance of the lower part relative to the upper part when the lower part rotates relative to the upper part, or vice versa, i.e. a rotation which follows a translation.
  • the lower part optionally has a projection or pin, such as the aforementioned, for example circular projection or pin, as the section to be received or received.
  • the pin or projection may have an internal thread.
  • the lateral hinge device or the medial hinge device includes an insert.
  • the insert can be made of the same material or of a different material than the section of the lateral joint device or the medial joint device that receives it, or can have such a different material.
  • the insert is connected, preferably releasably, to a receiving portion of the upper part or the lower part.
  • the section of the upper part or the lower part that receives it optionally has a receptacle, recess, opening or the like.
  • the insert has a recess which has a stop, e.g. B. in the form of an edge, has or forms, e.g. B. as a limitation of the recess of the insert, which is included, for example, in a continuous receptacle.
  • the recess is a depression, a recess, or the like.
  • the insert is designed as an inlay. It can be provided in different geometries.
  • the set according to the invention can have or include inserts in or with different geometries.
  • a through opening allows, for example, on opposite sides of the insert, for. B. Edges as stops for e.g. B. to design pins.
  • the plurality of edges or the like designed at the through opening or otherwise opposite one another makes it possible to adjust the width of the movement path, for example. B. to limit the pins during rotation on both sides or individually.
  • the insert can have a continuous frame structure, but does not have to. In some embodiments, it is the through opening that serves as a guide for the recorded section.
  • the optional toothed rail is preferably in a recess or recess on the OT Medizintechnik GmbH provided underside of the upper part.
  • the recess can have a smaller depth or material thickness than those sections of the upper part adjacent to or delimiting the recess.
  • the optional toothed rail is provided in a recess or recess on the top of the base.
  • the optional toothed rail is part of the tooth engagement mechanism.
  • the recess or recess can have a circular shape, an elliptical shape, a polygonal shape, a rectangular shape, a combination of shapes, namely partly rectangular, partly part-circular or semicircular, for example as a combination of rectangle and each curved at the end.
  • the optional toothed rail may be part of the boundary of the recess.
  • the insert may be provided with a further toothed rail on its outer edge, by means of which it can engage the teeth of the toothed rail of the recess when it is in use in the recess of the lateral joint device and/or medial joint device Upper part is inserted.
  • the toothed rails can ensure a positive fit of the insert in the upper part.
  • this can be used instead of the additional toothed rail on the outer edge of the insert OT Medizintechnik GmbH have a recess, a recess or another geometric design, which allows the insert to be inserted into the recess without the existing toothed rail of the upper part being in the way.
  • the insert has a further toothed rail on the inside of its through opening, which comes into engagement with the teeth of a gear when the lateral joint device and/or medial joint device is in use.
  • the insert serves to adapt the geometry (or one or more aspects thereof) of the upper part to the extent that this plays a role in the articulation between the upper part and the lower part. These aspects may include the length of the effectively available through-opening, its width, the length of the recess, its width and/or the shape and/or length of the further toothed rail measured against that of the toothed rail of the upper part, etc.
  • the gear has a through opening.
  • the gear wheel has teeth pointing radially inwards facing this through opening. Alternatively or additionally, it has teeth pointing radially outwards on its outer circumference.
  • the gear may engage the teeth of the gear rim of the lower part by means of the radially inwardly facing teeth and/or engage the toothed rail of the insert with the radially outwardly facing teeth or, if the insert were omitted, the toothed rail of the top.
  • an engagement or a rotationally stable storage or recording of the gear on the lower part is also possible through other configurations which do not require a gear ring on the lower part.
  • a rectangular geometry, a triangular geometry, an oval geometry, etc. can be used as an alternative to a gear connection.
  • the set according to the invention can, alternatively or in addition to the insert or the multiple inserts, have several gears, preferably with different diameters.
  • the ring gear or the gear has at least two teeth, which are at different distances from a directly adjacent tooth.
  • a translation of different sizes can take place along the correspondingly designed toothed rail.
  • the number ring or the gear is not provided with teeth on its entire circumference and/or that not all of its teeth have the same distance from a rotation or turning center of the ring gear or the gear, but rather different ones.
  • the upper part and the lower part are connected to one another in such a way, for example by fixing the angle limiter by means of a screw in such a way that the upper part and the lower part are held together, so that the toothed engagement mechanism provides translational (forced) guidance of the lower part relative to the upper part when the lower part rotates relative to the upper part, or vice versa, i.e. a rotation which follows a translation.
  • a suitable receiving section for the screw can be provided.
  • the lower part has, for example, a circular projection or pin as an optional receiving section for the screw.
  • the receiving section has an internal thread.
  • the screw has other connecting devices that serve to connect to the angle limiter, for example projections of a snap and/or latching connection.
  • the screw is cannulated, particularly to pass a K-wire through it and/or to mark the center of rotation of the joint.
  • the receiving section has an optional first marking, for example a projection, against which an optional second marking, for example on the gear, can be aligned. This can prove to be advantageous during assembly. Any other type of marking as an orientation aid is also included in the present invention. Everything that is stated here regarding the design of the upper part can also apply to a design of the lower part in certain embodiments, and vice versa.
  • X-ray markers are positioned or integrated on and/or in the medical device.
  • it is provided to use the medical device to provide active movement support for the joint, for example by coupling it to a motor. This coupling can be done, for example, by means of a gear, cable or the like. Such a coupling can be used advantageously for patients with neurological disorders, or for physiotherapeutic purposes, for example after injuries or operations.
  • the upper part and/or the lower part and/or the joint device consist of steel, stainless steel, fiber-reinforced plastic, high-performance plastic or combinations thereof or have such a material or such a combination of materials.
  • the medical device is integrated into a fabric, for example a knitted fabric, for sole guidance/stabilization. Such integration can be used advantageously during sports or preventatively.
  • the upper part and lower part are only held together by a joint connection, e.g. B. by means of the receiving section and the recorded section or a screw holding the upper part and lower part together, pin connection, material spring or the like. More than just one such screw, pin assembly, material spring and/or the like is not provided in these embodiments.
  • the upper part and the lower part are rotatably connected to one another only by means of the one receiving section and the one received section, or the medical device only has one receiving section and the one received section, not several.
  • the upper part and the lower part lie above one another or on top of one another, at least in sections. They can both have a corresponding curvature, e.g. B. the upper part is concave and the lower part is convex.
  • the upper part and the lower part touch each other in the areas curved in this way during rotation. OT Medizintechnik GmbH
  • the upper part and lower part lie above or on top of one another, at least in sections.
  • no further, third or further component is arranged between the upper part and the lower part, in particular none that have a curvature as described herein or a dome shape.
  • the medical device includes only a top part as disclosed herein and/or only a bottom part as disclosed herein. In certain embodiments, the medical device includes only a top portion which is connected to the bottom portion to achieve the articulation mechanism as disclosed herein. In some embodiments, neither the upper part nor the lower part has a plurality of teeth on the front, end and/or outer circumference with which it would engage with another element of the medical device to achieve the joint function.
  • the upper part and/or the lower part only have one through opening through which a joining element, such as a screw, is passed, which would be used to achieve the joint function.
  • the upper part has one or only one through opening through which a joining element, such as a screw, is passed, which is required to achieve the joint function.
  • the lower part does not have such a through opening and/or OT Medizintechnik GmbH does not have a through opening through which a joining element, such as a screw, is or will be passed.
  • the lower part has a thread for screwing in a screw that extends through the through opening of the upper part. Such a screw can be screwed in.
  • the medical device does not have any element that is separate from the upper part and the lower part or is present therefrom, which is required to achieve the joint function and is intended for screwing with a screw, in particular no clamping shoe, no nut or the like.
  • the medical device does not have a bearing arrangement that is separate from the upper part and the lower part or is separable or manufactured separately, in particular none that is required to achieve the joint function, in particular no clamping shoe, no nut.
  • the joint device or the medical device does not have a bearing arrangement which is inserted into the upper part or into the lower part in a form-fitting and/or force-fitting manner or which can be connected thereto in order to form the swivel joint between the upper part and the lower part.
  • the joint device or medical device does not include a bearing assembly having a curvature as disclosed herein, e.g. B. convex, concave or dome-shaped, for example on exactly one side (e.g. top or bottom) or exactly two sides thereof.
  • the upper part is only connected to the proximal part but not to the distal part, or only part of the proximal part but not the distal part, and/or the lower part is only connected to the distal part but with the proximal part, or only part of the distal part but not the proximal part. In other embodiments this is exactly the opposite.
  • the upper part has at least one fastening device for fastening it to the proximal part or to the distal part.
  • the fastening device can be part of a snap connection, openings for the passage of pins or screws or the like. The same can be the case for the lower part for its attachment to the distal part or to the proximal part.
  • the upper part and/or the lower part are made in one piece, e.g. B. punched from sheet metal.
  • the upper part and the lower part each form an articular surface of the articulation device.
  • the permitted movement is or includes pivoting about several joint axes or about a joint axis or rotation axis that changes during pivoting with respect to the proximal part and / or the distal part, in particular moving, hiking, tilting or pivoting.
  • the permission is effected and supported by the receiving section serving as a longitudinal guide for the received section.
  • the receiving portion and/or another portion of the joint device are configured to limit the permitted movement of the receiving portion in the distal-proximal direction and/or in the ventral-dorsal direction within the receiving portion.
  • the lateral joint device comprises an upper part and a lower part, the upper part being connected to the proximal part of the medical device and the lower part being connected to the distal part of the medical device, in particular releasably and/or movable, displaceable, tiltable or pivotable relative to one another and/or or rotatable, connected, or vice versa.
  • the upper part or the lower part comprises a through opening as the receiving section and the lower part comprises a projection or pin as the received section.
  • the projection or pin carries an external thread and the medical device includes an element which carries an internal thread for screwing to this external thread.
  • the upper part of the joint device has a concave curvature on its side facing the lower part and the lower part has a convex curvature on its side facing the upper part.
  • the joint device according to the invention has an insert with a through opening. The insert is designed to be releasably received in the upper part or in the lower part (as a receiving portion for receiving the received portion).
  • the upper part or the lower part has a recess or a through opening for receiving the insert.
  • the upper part and/or the lower part has a recess or a recess on both its upper side and its underside. In some embodiments of the joint device, the upper part and/or the lower part has at least or exactly two, three or four different thicknesses.
  • the recess or through opening for receiving the insert has a plurality of teeth, e.g. B. in the form of a toothed rail. In some embodiments, the insert of the joint device has a plurality of teeth, e.g. B. in the form of a toothed rail. In some embodiments, the joint device has a ring gear for engaging one or more of the plurality of teeth or toothed rails.
  • the joint device has a gear for engaging in one or more of the plurality of teeth or toothed rails and/or in the gear ring.
  • the gear like the ring gear disclosed herein, does not have to carry teeth over its entire circumference, but in some embodiments only in selected angular areas of the circumference.
  • a gear, as disclosed herein, may have a through hole.
  • the through opening can have a geometry that is suitable for a positive connection, e.g. B. carry teeth, be triangular or polygonal, oval, etc. Such a geometry can be provided, even without the need for a through opening, e.g. B.
  • the joint device according to the invention has a releasably and/or adjustable angle limiter which limits a rotational movement between the upper part and the lower part, preferably in one or more than one direction of rotation.
  • the angle limiter of the joint device has at least one insertion opening OT Medizintechnik GmbH Receiving a pin accommodated or receivable therein, the insertion opening preferably being a through opening.
  • the through opening of the upper part or the lower part has a first depth.
  • the insert has a first thickness in a first section and a second thickness in a further section, the first thickness being less than the first depth.
  • the second thickness corresponds to the first depth.
  • the medical device is a knee orthosis or is designed to be worn on the knee.
  • the medical device is an elbow orthosis or is designed to be worn on the elbow.
  • the medical device is not a hip orthosis or is not designed to be worn on the hip.
  • the joint device has a connecting means, which can be, for example, mushroom-shaped, cup-shaped, goblet-shaped, half-shell-shaped and / or convex on its underside, e.g. B. in side view.
  • the connecting element can rest with its underside on the edge of the through opening of the upper part, whereby the OT Medizintechnik GmbH passage opening can be circular, oval, rectangular, polygonal, square, etc.
  • a screw connection, a plug connection, a snap connection, etc. can connect the connecting means to the lower part (alternatively: to the upper part).
  • a head of the connecting means which has a diameter which is larger than the diameter of the through opening of the upper part, can lie on one side of the upper part.
  • the connecting means may comprise a stem connected to the base extending through the through opening.
  • the trunk may be longer than the opening is deep or the top is strong.
  • the width or diameter of the trunk can be thinner than the diameter of the through hole.
  • the upper part and/or lower part can be flat.
  • the joint device has or consists of no more than three, four, five or six components.
  • An advantage of the present invention can be that the joint unit or joint units of the orthopedic device, in contrast to a simple hinge joint during flexion/extension, does not only limit the flexion/extension movement to a rotation by exactly one relative to the space or to a coordinate system of fixed or spatially unchanged axis of rotation is reduced or limited as a single axis of movement for the flexion/extension movement.
  • the at least one axis of rotation can oscillate, wobble or pivot about a point or area and/or the at least one axis of rotation can move, whereby the axis of rotation, or a section thereof, moves in space or during flexion/extension can move in the coordinate system, in particular in the first, in particular distal-proximal, direction mentioned herein and / or in the second, in particular ventral-dorsal, direction.
  • a further advantage of the present invention may be that the orthopedic device allows the flexion of a joint to which it is applied to be carried out with a pivoting axis of rotation, since this allows a flexion/extension to be permitted which approximates the physiological or anatomical movement .
  • a further advantage of the present invention may be the possibility of immobilizing joints in defined positions. This can contribute to faster healing, especially immediately after surgery.
  • OT Medizintechnik GmbH Another advantage of the present invention can be that a patient only needs one orthopedic device for the entire period of care for the joint, i.e. from immediately after an operation until the joint regains its full load-bearing capacity, as these are based on different Positions can be defined and/or their range of motion can be adjusted to the corresponding load situation. This can help save time for adjustments and, above all, costs.
  • the present invention can also advantageously represent a possible supply for support during sports. This can help prevent injuries.
  • Fig. 1 shows the orthopedic technology device according to the invention in a first embodiment in perspective; OT Medizintechnik GmbH Fig.
  • FIG. 2A shows the upper part of a lateral joint device or medial joint device of an orthopedic technology device
  • 2B shows the lower part of a lateral joint device or medial joint device of an orthopedic device
  • Fig. 2C shows a further, optional element of the orthopedic technology device
  • Figure 3A shows an insert for insertion into the top of the lateral hinge device or the medial hinge device
  • Figure 3B shows the top of a lateral hinge device or a medial hinge device with an insert inserted
  • 4A and 4B show a lateral joint device or a medial joint device of the orthopedic device according to the invention in an exemplary embodiment, each in a side view
  • Fig. 5A shows the lateral joint device or the medial joint device of Fig. 4A in plan view
  • FIG. 5B shows the lateral joint device or the medial joint device of FIG. 5A in a further angular position
  • 6A shows the lateral joint device or the medial joint device in a further embodiment in a top view
  • Fig. 6B shows the lateral joint device or the medial joint device of Fig. 6A in side view
  • Fig. 6C shows the lateral joint device or the medial joint device of Fig. 6A in a different angular position than in Fig. 6A in a top view
  • Fig. 6D shows the lateral joint device or the medial joint device of Fig. 6C in side view
  • Fig. 6E shows the lateral joint device or the medial joint device of Fig. 6A in an exploded view
  • FIG. 6F shows the top of the lateral joint device or the medial joint device of Fig. 6E looking at the bottom;
  • Fig. 7A shows the lateral joint device or the medial joint device in another OT Medizintechnik GmbH embodiment in a perspective from diagonally above;
  • 7B illustrates pivoting the axis of rotation of the lateral hinge device or the medial hinge device;
  • Fig. 7C shows the lower part of the lateral joint device or the medial joint device of Fig. 7A in a perspective obliquely from above;
  • 8 shows the lateral joint device or the medial joint device in a further embodiment with an insert in a top view;
  • 9A shows the upper part of a lateral joint device or the medial joint device with a view of the underside thereof in a further embodiment;
  • FIG. 9B shows the lower part of a lateral joint device or the medial joint device in the further embodiment of Fig. 9A with a view of the top;
  • 10A shows a gear engagement mechanism between the upper part and the lower part of a lateral joint device or a medial joint device, in an embodiment without a gear;
  • Fig. 10B shows the tooth engagement mechanism between the upper part and the lower part of a lateral joint device or a medial joint device in another embodiment with a small diameter gear;
  • 10C shows the meshing mechanism of the upper part of a lateral hinge device or a medial hinge device in another embodiment with a large diameter gear without an insert;
  • Fig. 11A shows the placement of an angle limiter on a joint device with a toothed engagement mechanism;
  • FIG. 11B shows the orientation of the angle limiter when assembling the joint device in detail
  • Fig. 11C shows the assembly of the joint device with placement of the angle limiter and a connecting device
  • 12A shows a joint device according to the invention in a further embodiment
  • Fig. 12B shows the joint device of Fig. 12A in an exploded view
  • Fig. 12C shows the joint device of Fig. 12A from the side
  • Fig. 12D shows the joint device of Fig. 12C in the wobble position
  • Fig. 13 shows the joint device in a further embodiment.
  • Fig. 1 shows the orthopedic technology device 1 according to the invention in a first embodiment, its left edge is “lateral” and its right edge is “medial”.
  • the orthopedic device 1 has a proximal part 10 for placing on an upper arm or a thigh and a distal part 20 for placing on the forearm or the lower leg.
  • the proximal part 10 and the distal part 20 are pivotally connected to one another via a lateral joint device 30 and a medial joint device 40, wherein in some embodiments only the lateral or only the medial joint device 30, 40 is provided, and wherein the medial joint device, which is little discussed here 40 how the lateral joint device 30 primarily discussed herein may be configured, optionally in each embodiment of the lateral joint device disclosed herein.
  • the orthopedic technology device 1 has, for example, a fastening device 11 on its proximal part 10 and 20 on its distal part OT Medizintechnik GmbH has two fastening devices 21 as an example.
  • the orthopedic technology device 1 can be secured to the limb by means of the fastening devices 11, 21.
  • the lateral joint device 30 and/or the medial joint device 40 of the orthopedic technical device 1 according to the invention comprise an upper part 50 and a lower part 60, the upper part 50 being connected to the proximal part 10 and the lower part 60 being connected to the distal part 20 of the orthopedic technical device 1, or the other way around.
  • Upper part 50 and lower part 60 are shown in FIGS. 2A to 2C and will be described in more detail.
  • the longitudinal extent of the proximal and distal parts extends in an up-down direction of the figure in FIG. In FIG. 1, the transverse extension extends in a direction out of or into the plane of the drawing.
  • 2A shows an upper part 50 of a lateral joint device 30, as it could also be part of the medial joint device 40, and vice versa.
  • the upper part 50 optionally has a concave curvature on its side facing the lower part 60.
  • the lateral joint device 30 and/or the medial joint device 40 are designed to allow a section 33 received in it when the orthopedic device 1 is in use (see FIG. 2B) to be moved in the distal-proximal direction and/or ventral-dorsal direction.
  • a permitted movement is or includes this OT Medizintechnik GmbH Moving the recorded section 33 within a recording section 31 and thus, e.g. B. radial, shifting and / or tilting of the joint axis or rotation axis D when pivoting.
  • the joint axis or axis of rotation D which changes during pivoting in relation to the proximal part 10 and/or the distal part 20 can thus result.
  • the upper part 50 has the above-mentioned receiving section 31 with a through opening 51.
  • the receiving section 31 is configured by the, here exemplarily elongated, design of the through opening 51 to allow, but also to limit, the permitted movement of the recorded section 33 (see FIG. 2B) in the distal-proximal direction and/or in the ventral-dorsal direction. Or in other words: Allowing the movement is effected by the receiving section 31, here formed by the through opening 51 as an example, serving as a guide or longitudinal guide for the received section 33. In the embodiment shown, the receiving section 31 would limit the movement of the section 33 received therein less in the distal-proximal direction than in the ventral-dorsal direction. This will be explained further with reference to FIGS. 3A, 3B, 4A and 4B. Fig.
  • FIG. 2B shows the lower part 60 of a lateral joint device 30 or medial joint device 40.
  • the lower part 60 has a convex curvature on its side facing the upper part 50, which fits into the OT Medizintechnik GmbH can nestle into the concave curvature of the upper part 50.
  • This configuration of the lateral joint device 30 and/or the medial joint device 40 can advantageously ensure a good fit of the orthopedic device 1 on the joint during use.
  • the lower part 60 has a projection or pin 61 as a section 33 to be received or received. In the example of Fig. 2B, the pin 61 has an external thread G.
  • Fig. 2C shows a further element 70 of the orthopedic device 1, which can be optionally provided.
  • the element 70 can have an internal thread on its underside (not visible in FIG. 2C), which can be provided and/or suitable for screwing to the external thread G (see FIG.
  • the element 70 is designed in the example of FIG. 2C with an initially round shape with recessed grips 71.
  • the recessed grips 71 can increase the grip of the element 70 and thus significantly facilitate the described screwing of the element 70 to the external thread G of the lower part 60.
  • the element 70 can carry a sleeve with an internal thread on its underside, which is screwed onto the external thread G of the pin 61 from FIG. 2B.
  • Sleeve and pin 61 can together form a device for ensuring or maintaining a clearance between the upper part 50 and the lower part 60 by dimensioning the sleeve sufficiently long such that when it abuts the surface of the lower part 60, a further approach of the upper part 50 and lower part 60 is no longer possible. If the pin 61 is sufficiently long, the desired play is ensured.
  • a further approach of element 70 and lower part 60 is limited. 2A to 2C show by way of example, the joint device can consist of no more than three elements, namely the upper part and the lower part as well as a screw or, as here, an element 70 with an external or, as here, internal thread.
  • FIG. 3A shows an insert 80 with a receptacle, here a through opening 83 as a receiving section 31, for insertion into a recess or through opening 51 of the upper part 50 of a lateral joint device 30 and/or medial joint device 40.
  • the insert 80 is designed to be detachable, in particular without tools, to be accommodated in the through opening 51 of the upper part 50 (see FIG. 3B) and to form or encompass the receiving section 31 of the upper part 50 (see also FIG. 2A), it thus serves to receive the recorded section 33.
  • the insert 80 has a first thickness D1 in a first section and a second thickness D2 in a further section. Unlike the example in FIG.
  • the insert 80 can be detachably accommodated and therefore replaceable. So it may be advantageous to have a general OT Medizintechnik GmbH to have a suitable upper part 50 injection molded and then to make an adjustment using a selected insert 80. Likewise, e.g. B. in the course of a longer period of wear of the orthopedic device 1, the latter can be adjusted again and again by replacing the insert 80 alone.
  • 3B shows the upper part 50 of a lateral joint device 30 or medial joint device 40 with an inserted insert 81.
  • the through opening 51 of the upper part 50 has a first depth T1.
  • the first thickness D1 of the insert 81 (see here analogously the insert 80 of Fig. 3A) is less than the first depth T1 of the upper part 50 and the second thickness D2 of the insert 81 corresponds to the first depth T1 of the through opening 51 of the top.
  • a set according to the invention can comprise an orthopedic device 1 according to the invention, as well as at least two inserts 80, 81, which differ from one another. By means of the inserts, the limits of the freedom of movement of the sections 33 accommodated in them can be set differently both in the distal-proximal direction and in the ventral-dorsal direction.
  • FIGS. 4A and 4B show a lateral joint device 40 or a medial joint device 50 of the orthopedic technology device 1 according to the invention in an exemplary embodiment in a side view.
  • the upper part 50, the lower part 60 and the element 70 can be clearly seen in FIGS. 4A and 4B.
  • the lower part 60 lies snugly in the concave section of the upper part 50 and can be fixed, preferably releasably, by means of the element 70.
  • the receiving section 31 of the upper part 50 see, for example, FIG.
  • the lower part 60 can move downwards (in the distal-proximal direction) when the upper part 50 is pivoted relative to the lower part 60, which results in pivoting of the joint axis or axis of rotation D up to an angle ⁇ , i.e. between their positions D(A) and D(A').
  • the upper part 50 and the lower part 60 are optionally each curved once in the drawing plane to the left and once to the right, i.e. in their longitudinal extent when viewed from the side, they are each curved in two opposite directions.
  • 5A shows the lateral joint device 30 or the medial joint device 40 of FIG. 4A in a top view.
  • fastening devices 55 of the upper part 50 and fastening devices 65 of the lower part 60 can be seen, here designed for example as through openings, which can serve to connect the upper part 50 with the proximal part 10 and the lower part 60 with the distal part 20 of the OT Medizintechnik GmbH orthopedic technology facility 1 (see Fig. 1).
  • the longitudinal extent of the upper part 50 extends in FIG. 5A, like the longitudinal extent of the lower part 60, in a top-bottom direction of the figure, as is also the case in FIG. 1.
  • the transverse extension of the upper part 50 extends in FIG. 5A like the transverse extension of the lower part 60 in a left-right direction of the figure.
  • 5B shows the lateral joint device 30 or the medial joint device 40 of FIG.
  • FIGS. 5A and 5B show the lateral joint device 30 or the medial joint device 40 in a further embodiment in a top view. In Fig.
  • FIG. 6A fastening devices 55 of the upper part 50 and fastening devices 65 of the lower part 60 can be seen, here designed for example as through openings, which can serve to connect the upper part 50 to the proximal part 10 and the lower part 60 to the distal one OT Medizintechnik GmbH part 20 of the orthopedic technology facility 1 (see Fig. 1). Reference is made to the comments on the previous figures in order to avoid repetition.
  • the embodiment of FIG. 6A further has an optional angle limiter 95; it can optionally take on the function of the element 70. Its design in FIG. 6A is purely optional. Angle limiter 95, upper part 50 and lower part 60 can thus, for example, have connecting devices which are suitable and intended to connect these three components to one another, in particular releasably, e.g. B.
  • the angle limiter 95 can have an internal thread on its underside, which can be provided and/or suitable for screwing to an external thread on the upper side of the lower part 60 (analogous to FIG. 2B).
  • the angle limiter 95 is at the proximal end (left in FIG. 6A). OT Medizintechnik GmbH through opening 51 of the upper part 50 pushed.
  • flexion and extension (stretching) of the joint supplied with the orthopedic device 1 can be adjusted and thus limited on the angle limiter by means of at least one or, as here, two or more pins, projections or pins 97.
  • the pins 97 protrude beyond the underside of the angle limiter 95 and hit on one side against a stop, such as a projection or an edge 99, e.g. B. the upper part 50, in particular on the top of the upper part 50.
  • a stop such as a projection or an edge 99, e.g. B. the upper part 50, in particular on the top of the upper part 50.
  • this striking prevents further flexion or extension of the joint.
  • the angle limiter 95 fixes the joint in an extended position (0° flexion, 0° extension) by means of the positioning of the two pins 97.
  • the flexion can be limited between 0° and 120° and/or the extension can be limited between 0° and 90°.
  • a postoperative determination can be made at a certain angle, e.g. B in 90° position, may be possible.
  • the pins 97 in the embodiment shown here can be moved, repositioned or otherwise on the angle limiter 95 or relative to it OT Medizintechnik GmbH is intended to be movable.
  • a pin-opening pairing as shown in the figures is just one option for the design of the angle limiter 95.
  • the angle limiter 95 can carry markings that make it easier for the practitioner to set a desired angle range or limit angles. For this purpose, degrees of flexion or extension can be displayed, for example printed.
  • 6B shows the lateral joint device 30 or the medial joint device 40 of FIG. 6A in a side view. It can be seen from Fig. 6B that due to the position of the angle limiter 95 at the proximal end (left in Fig. 6B, with proximal and distal also being disclosed interchangeably herein) in the extended position of the lateral joint device 30 and/or the medial Joint device 40, the sections with the respective fastening devices 55, 65 (see Fig.
  • the possibility of adjusting this angle can, for example, help to take into account the natural “carrying angle” of an elbow joint supplied with the orthopedic device 1, i.e. the natural radial deviation of the forearm from the upper arm.
  • the “carrying angle” of the elbow joint can also apply to its Q angle in alternative embodiments and for the care of a knee joint.
  • the normal carrying angle of the elbow (with arms extended and palms facing forward) is between 5° and 15° and is greater in women than in men.
  • the normal Q OT Medizintechnik GmbH Angle when the leg is outstretched is 14° for men and 17° for women.
  • 6C shows the lateral joint device 30 or the medial joint device 40 of FIG. 6A in a different angular position than in FIG. 6A in a top view. Reference is made to the description of FIG. 5B in order to avoid repetition. Pins 97 are not shown for clarity.
  • the angle limiter 95 is pushed to the distal (right in FIG. 6C) end of the through opening 51 of the upper part 50. This arrangement of the angle limiter 95 relative to the upper part 50 is described in more detail with reference to FIG. 6D.
  • 6D shows the lateral joint device 30 or the medial joint device 40 of FIG. 6C in a side view. The distal (right in FIG.
  • the left position of the angle limiter 95 causes the angular position between the fastening sections 55 of the upper part 50 and the fastening sections 65 of the lower part to be 60180 ° (see FIG. 6D).
  • 6B and 6D it can be seen that the longitudinal displacement of the lower part 60 relative to the upper part 50, or vice versa, is due to the curvature of the upper part 50 and/or the lower part 60 (the curvature is apparent from the side view, see e.g B. Figs. 6B and 6D), the height of the free end z. B. the lower part 60 above a horizontal when the free end of the upper part 50 rests on the horizontal can change.
  • the angle limiter 95 can, in particular continuously, assume any position between the right and left edge of the through opening 51 of the upper part 50. This means that when an elbow joint is supplied with the orthopedic device 1, the carrying angle of the joint can be adjusted to any patient-specific level between 0° (or below or less than 0°, i.e. a negative angle) and ⁇ .
  • 6E shows the lateral joint device 30 or the medial joint device 40 of FIG. 6A in an exploded view. Reference is made to the descriptions of the previous figures. 6E shows clearly the projection or edge 99 against which the pins 97 strike and thus come to a halt in their rotation and can thus limit the flexion or extension of the joint being supplied.
  • the lower part 60 has a circular projection or pin 61 as the section 33 to be received or recorded.
  • the pin 61 may have an internal thread.
  • it has other connecting devices that serve to connect to the angle limiter 95, for example projections of a snap and/or latching connection.
  • Fig. 6F shows the upper part 50 of the lateral joint device 30 or the medial joint device 40 of Fig.
  • an optional toothed rail 93 can be seen, which can also be part of the toothed engagement mechanism 90.
  • the teeth of the toothed ring 91 of the lower part 50 engage in the teeth of the toothed rail 93 and thus bring about a translational (forced) guidance of the lower part 60 relative to the upper part 50 when the lower part 60 rotates relative to the upper part 50, or vice versa, i.e. a rotation which follows a translation.
  • the optional toothed rail 93 is preferably provided in a recess or recess on the underside of the upper part 50.
  • the recess can have a smaller depth or material thickness than those sections of the upper part 50 adjacent to or delimiting the recess.
  • the recess can, as shown by way of example in FIG. 6F, have a circular shape, an elliptical shape, a polygonal shape, a rectangular shape, a combination of shapes such as. B. shown in Fig. 6F, namely partly rectangular, partly part-circular or semi-circular, as in Fig. 6F as a combination of rectangle and each curved at the end.
  • the optional toothed rail 93 can be part of the limitation of the recess. As can be seen in the combination of FIGS.
  • the upper part 50 optionally the lower part 60, optionally has a recess or recess on both its upper side and its underside.
  • the upper part 50 and/or the lower part 60 can, as can be seen from the synopsis of FIGS. 6E and 6F, have three or exactly three (alternatively exactly or at least two, four or more) different thicknesses from one another.
  • the different thicknesses allow different components such as insert 80, pins 97, etc. to be functionally integrated.
  • 7A shows the lateral joint device 30 or the medial joint device 40 in a further embodiment in a perspective obliquely from above.
  • the other side of the orthopedic device 1 can have a joint device, as can be seen in FIG. 7A.
  • the setting options of the embodiment of FIG. 7A are freer, among other things. since a tooth engagement mechanism such as the tooth engagement mechanism 90 of FIG. 6F is not provided in this embodiment, or also because an angle limiter 95 is not provided. OT Medizintechnik GmbH The patient-specific carrying angle can be adjusted by itself. To illustrate this, two positions D(A), D(A') of the axis of rotation D of the joint device 30, 40 are inserted into the through opening of the element 70' in order to illustrate the inclination of the element when moving along the through opening 51 of the upper part 50.
  • the through opening 51 of the upper part 50 can also serve in these embodiments to accommodate connecting devices, in particular a screw.
  • the carrying angle and the axes of rotation depend in some embodiments on the radius of curvature of the upper part 50 and/or the lower part 60, e.g. B. where they come together, because the pivot point depends on these radii and shifts if the curvature is greater or less.
  • the carrying angle also depends on the length of the through opening 51, or on the distance along which the through opening 51 allows the upper part 50 and the lower part 60 to be moved or displaced relative to one another.
  • Fig. 7B shows a cone K and serves to illustrate the process of the possible pivoting of the axis of rotation D of the lateral joint device 30 or the medial joint device 40.
  • pivoting the axis of rotation D of the joint device 30, 40 may be possible, but its extent can still be limited. This can enable or support natural movement of the joint to be treated.
  • OT Medizintechnik GmbH The base area of the cone K describes the possible orientations of the axis of rotation D of the joint device 30, 40 in some embodiments, which this axis of rotation D can assume if pivoting is possible and is not further restricted.
  • Its tip is defined by the pivot point PP, which is determined by the design of the joint device and its components, e.g. B. is defined by the radii of the curvatures of the upper part 50 and the lower part 60.
  • the intersection of the positions D(A) and D(A'') (see FIG. 7A) of the axis of rotation D of the joint device 30, 40 is also at this point.
  • pivoting in the example of FIG. 7B is limited to a pivoting surface PF due to the interaction of the upper part 50 and the lower part 60.
  • the axis of rotation D must run through it in all its positions D(A), D(A'), D(A'').
  • the limitation of the through opening 51 does not allow the axis of rotation D to be pivoted out of this area.
  • FIG. 7C shows the lower part 60 of the lateral joint device 30 or the medial joint device 40 of FIG. 7A in a perspective obliquely from above.
  • the lower part 60 optionally has a projection or pin, such as the circular projection or pin or projection 61 of FIG. 6E, as a section 33 to be received or received.
  • the pin or projection 61 may have an internal thread in some embodiments.
  • it has other connecting devices which serve to connect to the element 70' (see FIG. 7A), for example projections of a snap and/or latching connection, or is in operative connection with such.
  • the insert 80 is connected, preferably releasably, to the upper part 50 or the lower part 60. It serves to limit a relative movement between the upper part 50 and lower part 60, e.g. B. the rotation between them. For this purpose, it can serve as a stop for another element, described below in an exemplary embodiment thereof.
  • OTtechnik GmbH In the example of FIG. 8, it is the upper part 50 which has the insert 80.
  • the upper part 50 optionally has a receptacle 87, recess, opening or the like, which is suitable and/or intended to accommodate the insert 80 in a positive and non-positive manner.
  • the insert 80 in turn has a recess 89, which has a stop 85, e.g. B. in the form of an edge similar to the edge 99, has or forms, e.g. B. as a limitation of the recess 89 of the insert 80, which is only included here as an example in a continuous receptacle 87, in other embodiments it is a recess, recess, etc.
  • the insert 80 can therefore z. B. be designed as an inlay. It can be provided in different geometries and can also be part of the set according to the invention in different geometries.
  • the recording 87 can thus accommodate various inserts 80, which are z. B.
  • stops 85 and / or a through opening 83 differ from each other. It is obvious that, for example, differently designed stops 85 can allow different freedoms with regard to flexion and/or extension with an otherwise unchanged design of the orthopedic technology device 1.
  • the selection of a stop 85 suitable for the specific patient is therefore possible by selecting a suitable insert 80 from the set. OT Medizintechnik GmbH
  • the insert 80 which does not necessarily have to be designed in order to be used, but, for. B. can also be put on, etc., is optionally designed to be releasably recorded, in particular without tools, in the receptacle 87 and to form or encompass the receiving section 31 of the upper part 50, it thus serves to receive the recorded section 33.
  • the through opening 83 serves to accommodate the recorded section 33, which has to take over the function of the pins 97 from the previous figures.
  • the insert 80 and the upper part 50 or the lower part 60 can be detachably connected to one another, it may advantageously be possible to have a generally fitting upper part 50 injection molded or otherwise manufactured, and then to adapt the orthopedic device 1 by means of a specifically selected insert 80 to be carried out.
  • a specifically selected insert 80 e.g. B. in the course of a treatment or a wearing period of the orthopedic technology device 1, OT Medizintechnik GmbH The latter can be adjusted again and again by replacing the insert 80 alone.
  • the limits of the freedom of movement of the sections 33 accommodated therein can optionally be set differently both in the distal-proximal direction and in the ventral-dorsal direction.
  • the flexion can be limited between 0° and 120° and/or the extension can be limited between 0° and 90°.
  • a determination can also be defined postoperatively for the joint being treated, for example a 90° position.
  • 9A shows, looking from below, the upper part 50 of a lateral joint device 30 or the medial joint device 40 in a further embodiment. Reference is made to the descriptions of the previous figures.
  • an optional toothed rail 93 can be seen, which can be part of the toothed engagement mechanism 90.
  • An insert 80 may be provided with a further toothed rail 93A on its outer edge and, when the insert 80 is in use, in the recess of the lateral joint device 30 and/or medial joint device 40 OT Medizintechnik GmbH comes into engagement with the teeth of the toothed rail 93 of the recess when it is inserted into the upper part 50. This insertion and its direction are indicated by a black block arrow in Figure 9A.
  • the toothed rails 93, 93A can ensure a positive fit of the insert 80 in the upper part 50.
  • the insert 80 in the example of FIG. 9A has a further toothed rail 93B on the inside of its through opening 83, which, in the state of use of the lateral joint device 30 and/or medial joint device 40, has the teeth of a complete or only part of 360° circumscribing, Gear 92 (see Fig. 9B) comes into engagement.
  • the insert 80 serves to adapt the geometry (or one or more aspects thereof) of the upper part 50, insofar as this plays a role in the articulation between the upper part 50 and the lower part 60.
  • These aspects can include the length of the effectively available through-opening 51, its width, the length of the recess, its width and/or the shape and/or length of the further toothed rail 93B measured against that of the toothed rail 93 of the upper part 50, etc.
  • OT Medizintechnik GmbH it may be possible to provide inserts 80 with different geometries, which can each be inserted into the upper part 50 to create gears 92 with different diameters D T to be able to accommodate and engage with them (see Fig. 9B).
  • the toothed rail 93 or 93B may extend only over a portion of the length of the insert 80 or the through opening 51. In this way, there can be areas in which positive guidance is canceled and other areas in which positive guidance caused by engagement with the number rail 93, 93B re-enters.
  • FIG. 9B shows the lower part 60 of a lateral joint device 30 or the medial joint device 40 in the embodiment of FIG. 9A with a view of the top of the lower part 60.
  • OTtechnik GmbH Reference is made to the descriptions of the previous figures.
  • the upper part 50 of FIG. 9A and the lower part 60 of FIG. 9B can both be part of or form part of a common medical device 1 or together part of a common joint device.
  • there is a single gear 92 which can optionally be considered or be part of the lower part 60.
  • the gear 92 has a through hole 92A.
  • the gear 92 can engage with the teeth of the ring gear 91 of the lower part 50 and with the teeth pointing outwards it can engage with the toothed rail 93B of the insert 80 or, if the insert 80 were omitted, which would also be the case of the present invention, on the toothed rail 93 of the upper part 50. It should be noted that an engagement or a rotationally stable storage or recording of the gear 92 on the lower part 60 is also possible through other configurations which do not have a toothed ring 91 on the side of the lower part 60 require.
  • a rectangular geometry, a triangular geometry, an oval geometry or other key-lock geometry, etc. may be used as an alternative to a gear connection as in the example of FIG. 9B, which is also encompassed by the present invention.
  • the set according to the invention can have several inserts 80, 81 and/or several gears 92 OTtechnik GmbH different diameters D T or tip circle diameters (determined from tip surface to tip surface through the center point). If the upper part 50 and the lower part 60 are connected to one another, for example by screwing the angle limiter into a receiving section 31A for the screw - or alternatively fixing it in another way - by means of a connecting device, for example a screw (see FIG.
  • the toothed engagement mechanism 90 causes a translational (forced) guidance of the lower part 60 relative to the upper part 50, if a rotation of the lower part 60 is to take place relative to the upper part 50, or vice versa, i.e. a rotation, which follows a translation, or vice versa.
  • the lower part 60 optionally has a receiving section 31A for the screw, a circular projection or pin.
  • the receiving section 31A may have an internal thread.
  • it has other connecting devices that serve to connect to the angle limiter 95, for example projections of a snap and/or latching connection. In the example of FIG.
  • the receiving section 31A optionally has a projection as a first marking 35, against which an optional second marking 37 of the gear 92 can be aligned.
  • This can prove to be advantageous during assembly.
  • the position and design of the first and second markings 35, 37 are purely exemplary and are not to be understood as limiting. Any other kind of one OTtechnik GmbH marking as an orientation aid is also included in the present invention.
  • the configuration of the upper part 50 as shown and discussed in the figures, can also be a configuration of the lower part 60, and vice versa.
  • the lower part 60 can have the recess on its upper side, unlike shown here in the figures.
  • FIG. 10A shows the tooth engagement mechanism 90 between the upper part 50 and the lower part 60 of a joint device according to the invention, for example the lateral or medial joint device mentioned herein, in an embodiment without a gear 92.
  • the insert 80 optionally has a toothed rail 93A on its outer circumference, which comes into positive and non-positive engagement with the toothed rail 93 of the upper part 60 according to the principle shown in FIG. 9A.
  • the insert 80 engages positively in the teeth of the toothed ring 91, which in the present example is integrated into the lower part 60 as an example.
  • the toothed engagement mechanism 90 thus establishes a guided connection between the upper part 50 and the lower part 60.
  • 10B shows the toothed engagement mechanism 90 between the upper part 50 and the lower part 60 of a joint device according to the invention, for example that mentioned herein OT Medizintechnik GmbH lateral or medial joint device, in a further embodiment with a gear 92 with a small diameter DT.
  • the insert 80 has a toothed rail 93A on its outer edge, which comes into positive and non-positive engagement with the toothed rail 93 of the upper part 60.
  • the insert 80 engages positively in the radially outwardly arranged teeth of the gear 92, which in the present example has a small diameter DT and in turn positively and non-positively engages in the teeth with its radially inwardly arranged teeth of the ring gear 91, which is integrated into the lower part 60 analogously to the example in FIG. 10A.
  • the toothed engagement mechanism 90 thus establishes a guided connection between the upper part 50 and the lower part 60.
  • FIG. 10C shows the tooth engagement mechanism 90, the upper part 50 and the lower part 60 of a joint device according to the invention, for example the lateral or medial joint device mentioned herein, in a further embodiment with a gear 92 with a large diameter DT without an insert 80.
  • OTtechnik GmbH Reference is made to the description of the preceding figures.
  • no insert 80 is used.
  • the radially outwardly arranged teeth of the gear 92 which in the present example has a larger diameter DT compared to the example in FIG.
  • FIG. 10B engage directly in a positive manner in the toothed rail 93 of the lower part 60, while the radially inwardly arranged teeth in the Teeth of the ring gear 91 engage, which is integrated into the lower part 60 analogously to the aforementioned examples of FIGS. 10A and 10B.
  • the toothed engagement mechanism 90 thus establishes a guided connection between the upper part 50 and the lower part 60.
  • Fig. 11A shows the placement of an angle limiter 95 on a joint device 30, 40 shown by a block arrow.
  • the ring gear 91 and the gear 92 of the tooth engagement mechanism 90 can be seen through the through opening of the upper part 50 (before the angle limiter 95 is placed). Reference is made to the description of the previous figures, in particular to the comments on the angle limiter 95.
  • the initial position for assembly corresponds to full extension (0°), i.e. H. the longitudinal axes of the upper part 50 and lower part 60 run in the same direction (at least parallel).
  • OTtechnik GmbH Fig. 11B shows the orientation of the angle limiter 95 when assembling the joint device 30, 40 in detail. The through openings for pins 97 can be seen.
  • the angle limiter is preferably aligned in such a way that both the 0° position of the extension and the 0° position during flexion are aligned with the stop 99 (see also FIG. 6E) of the upper part 50. These positions are highlighted with white circles. It can also be seen from Fig.
  • FIG. 11B shows the assembly of the joint device with placement of the angle limiter 95 and by means of a connecting device V, here a screw.
  • a connecting device V here a screw.
  • the angle limiter 95 is fixed (here: screwed) in a receiving section 31A provided for this purpose for the connecting device (see FIG.
  • the tooth engagement mechanism 90 causes a translational OT Kunststofftechnik GmbH (forced) guidance of the lower part 60 relative to the upper part 50, if a rotation of the lower part 60 is to take place relative to the upper part 50, or vice versa, i.e. a rotation which follows a translation, or vice versa.
  • the receiving section 31A of the lower part 60 (see FIG. 9B), designed for example as a circular projection or pin, preferably has an internal thread suitable or intended for the screw in the example of FIG. 11C.
  • the joint device according to the invention has other connecting devices which serve to connect to the angle limiter 95, for example projections of a snap and/or latching connection or the like.
  • Fig. 12A shows a joint device 30, 40 according to the invention in a further embodiment viewed from the side. Reference is made to the descriptions of the previous figures.
  • an optional angle limiter 95 is optionally integrated into the upper part 50 of the joint device 30, 40.
  • the pins 97 which serve to limit the extension or flexion of the joint to be treated, can be seen.
  • a connecting device V here a screw, an element is arranged centrally on the connection between the lower part 60 and the upper part 50, which has or comprises the shape of a half-shell 100 (see FIG.
  • the element 100 can have a lower, curved end in one, here as an example OT Medizintechnik GmbH immerse circular opening or through opening of the upper part 50.
  • the connecting device V can clamp the upper part 50, the half-shell 100 and the lower part 60 together.
  • a spacer such as the cylindrical shoulder that closes off the half-shell 100 at the bottom, can provide the necessary clearance between the upper part 50 and the lower part 60.
  • Fig. 12B shows the joint device of Fig. 12A in an exploded view. Reference is made to the description of FIG. 12A.
  • Fig. 12C shows the joint device of Fig. 12A from the side.
  • the half-shell 100 Due to its design, the half-shell 100 is movably arranged in the through opening of the upper part 50, similar to a ball joint head in its socket. This allows the joint device to “stagger” – here by approx. 5° – and can thus support natural movement of the joint to be treated.
  • Fig. 12D shows the joint device of Fig. 12C in the wobble position. It can be clearly seen that the distance S2 has significantly reduced compared to the distance S1 in FIG. 12C (S2 ⁇ S1).
  • the half-shell 100 and with it the lower part 60 are in a significantly inclined position compared to the position in FIG. 12C, also referred to herein as the wobble position.
  • a joint device according to the invention can be provided on one side of the medical device, approximately medially, and a joint device according to the invention on the other, approximately laterally.
  • Fig. 13 shows the joint device according to the invention in a further embodiment.
  • a connecting means V that appears mushroom-shaped, purely as an example.
  • the connecting element V has a convex shape on its underside, with which it rests on the edge of the through opening 51, which is circular, oval, rectangular, polygonal, square, etc . can be.
  • the connecting means V can connect the connecting means V to the lower part 60 (alternatively: to the upper part 50) in such a way that a head VK of the connecting means V, which has a diameter which is larger than the diameter of the through opening 51 is, comes to rest on one side of the upper part 50, a trunk VS of the connecting means V, which is connected to the lower part 60, extends through the through opening 51, so that since the trunk VS is longer than the through opening 51 deep, lower part 60 and upper part 50 can move relative to each other, so there is play for this, but at the same time cannot separate from each other. Since the width or diameter of the trunk VS is thinner than the diameter of the through opening 51, the in OT Medizintechnik GmbH Fig.

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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)

Abstract

L'invention concerne un dispositif (1) technique orthopédique (1) comprenant une partie proximale (10) destinée à être appliquée sur un bras ou une cuisse et une partie distale (20) destinée à être appliquée sur l'avant-bras ou la jambe, qui sont reliées l'une à l'autre de manière pivotante par l'intermédiaire d'au moins un dispositif d'articulation latéral (30) et qui présentent au moins un dispositif de fixation (11, 21) au moyen duquel le dispositif technique orthopédique (1) peut être fixé aux membres, le dispositif d'articulation latéral (30) et/ou le dispositif d'articulation médial (40) présentant une articulation tournante comportant une partie de réception (31) et une partie reçue (33), la partie reçue (33) étant reçue dans la partie de réception (31) et pouvant tourner par rapport à celle-ci. La partie de réception (31) du dispositif d'articulation latéral (30) et/ou du dispositif d'articulation médial (40) est configurée pour permettre un déplacement de la partie (33) qu'elle reçoit de manière rotative dans le sens distal-proximal et/ou dans le sens ventral-dorsal.
PCT/EP2023/057640 2022-03-25 2023-03-24 Dispositif technique orthopédique à axe de rotation pivotant Ceased WO2023180528A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP23715468.7A EP4498994A1 (fr) 2022-03-25 2023-03-24 Dispositif technique orthopédique à axe de rotation pivotant

Applications Claiming Priority (4)

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DE102022107096 2022-03-25
DE102022107096.4 2022-03-25
DE102022128396.8A DE102022128396A1 (de) 2022-10-26 2022-10-26 Orthopädietechnische Einrichtung mit pivotierender Drehachse
DE102022128396.8 2022-10-26

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WO2023180528A1 true WO2023180528A1 (fr) 2023-09-28

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Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6090057A (en) * 1998-01-20 2000-07-18 Wonderful Widget Works, Ltd. Multi-axial external orthotic joint
US20110112452A1 (en) * 2009-11-10 2011-05-12 Schiff Robert A Adjustable Knee Orthosis
KR101418833B1 (ko) * 2012-08-01 2014-07-17 (주)트리플씨메디칼 내외측 힌지 상호작용식 무릎보조기
US20190201226A1 (en) * 2016-09-06 2019-07-04 Bauerfeind Ag Tiltable articulated joint brace
KR20200024571A (ko) * 2018-08-28 2020-03-09 트라이캠테크놀로지주식회사 힌지 어셈블리
WO2020170111A1 (fr) * 2019-02-22 2020-08-27 F.G.P. S.R.L. Articulation polycentrique biaxiale pour les orthèses ou appareils orthopédiques
US20200345529A1 (en) * 2017-12-22 2020-11-05 Bauerfeind Ag Hard frame with pivotable bridge
US20210085501A1 (en) * 2017-07-11 2021-03-25 Ottobock Se & Co. Kgaa Connection device and joint device for an orthopedic device

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5086760A (en) * 1989-04-14 1992-02-11 Neumann Holm W Articulated orthotic brace for an anatomical joint

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6090057A (en) * 1998-01-20 2000-07-18 Wonderful Widget Works, Ltd. Multi-axial external orthotic joint
US20110112452A1 (en) * 2009-11-10 2011-05-12 Schiff Robert A Adjustable Knee Orthosis
KR101418833B1 (ko) * 2012-08-01 2014-07-17 (주)트리플씨메디칼 내외측 힌지 상호작용식 무릎보조기
US20190201226A1 (en) * 2016-09-06 2019-07-04 Bauerfeind Ag Tiltable articulated joint brace
US20210085501A1 (en) * 2017-07-11 2021-03-25 Ottobock Se & Co. Kgaa Connection device and joint device for an orthopedic device
US20200345529A1 (en) * 2017-12-22 2020-11-05 Bauerfeind Ag Hard frame with pivotable bridge
KR20200024571A (ko) * 2018-08-28 2020-03-09 트라이캠테크놀로지주식회사 힌지 어셈블리
WO2020170111A1 (fr) * 2019-02-22 2020-08-27 F.G.P. S.R.L. Articulation polycentrique biaxiale pour les orthèses ou appareils orthopédiques

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