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CN102076284B - 具有关节的矫形外科装置以及用于控制该矫形外科装置的方法 - Google Patents

具有关节的矫形外科装置以及用于控制该矫形外科装置的方法 Download PDF

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CN102076284B
CN102076284B CN200980124147.9A CN200980124147A CN102076284B CN 102076284 B CN102076284 B CN 102076284B CN 200980124147 A CN200980124147 A CN 200980124147A CN 102076284 B CN102076284 B CN 102076284B
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orthopedic device
locking system
locking
lower member
joint
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CN102076284A (zh
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P·肯帕斯
R·帕弗利克
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Otto Bock Healthcare Products GmbH
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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  • Life Sciences & Earth Sciences (AREA)
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  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

本发明涉及一种矫形外科装置和一种用于控制矫形外科装置的方法,具有关节和锁止装置(3),该矫形外科装置具有上部件(1)和可摆动地支承在该上部件上的下部件(2),其中,在所述上部件(1)上设置有用于固定在肢体上的上连接机构,所述锁止装置防止所述上部件(1)相对于所述下部件(2)进行屈曲运动,其中,所述锁止装置(3)被构造成能够通过该矫形外科装置的使用者主动操作,其中,给所述锁止装置(3)配置控制装置(9),该控制装置与安置在所述装置上的至少一个传感器(6,7,8)连接并且根据传感器信号使所述锁止装置(3)自动地解锁或锁止。

Description

具有关节的矫形外科装置以及用于控制该矫形外科装置的方法
技术领域
本发明涉及一种具有关节的矫形外科装置,该矫形外科装置具有上部件和可摆动地支承在该上部件上的下部件以及锁止装置,其中,在所述上部件上设置有用于固定在肢体上的上连接机构,所述锁止装置防止所述上部件相对于所述下部件进行屈曲运动,其中,所述锁止装置被构造成能够通过该矫形外科装置的使用者主动操作。本发明还涉及一种用于控制矫形外科装置的方法。这种矫形外科装置特别是用作矫正器或假肢,优选用作膝关节矫正器或膝关节假肢。
背景技术
具有两个可彼此相对运动的部件和一个设置在所述两个部件之间的用于将所述两个部件锁止在预确定的相对位置中以及用于使所述部件解锁以释放所述部件彼此间的运动的矫形外科装置被用于大量应用,以便补偿人体上短时或持久存在的缺陷或者允许否则不可实施的功能。在照料具有低移动度的患者、即大多处于室内并且有时其肌肉和机能的功能能力受限的患者时,即在所谓的老年患者的情况下常常设置具有闭锁关节的矫形外科装置,其中,这种设备特别是用来支持腿脚功能。因此例如将膝关节矫正器或者膝关节假肢用作闭锁关节,它们在完全伸展时由于闭锁机构而自动锁止并且为了屈曲必须手动解锁。膝关节是被闭锁的膝关节,其可以是假肢或矫正器,其对于站立和行走是可靠的构型。特别是在照料老年患者时,防跌倒是一个重要的目标,其中,解锁主要通过牵拉牵引绳进行,该牵引绳从所述膝关节向上铺设至大腿,使得在站立时也能良好地够到该牵引绳。即站立和行走通过僵硬的膝关节进行,而坐下在屈曲的可自由运动的膝关节的情况下进行,只要所述膝关节在坐下时没有完全伸展。
DE 103 11 187 A1描述了一种矫形外科技术方面的辅助装置,其具有用于使两个可彼此运动地支承的部件锁止和解锁的锁止装置,其中,该锁止装置可由机电式控制模块操纵,操纵信号被从操纵单元无线地传递给所述控制模块。所述操纵单元可以集成在行走辅助装置中,使得所述锁止装置可借助于远程操作解锁。
DE 103 51 916 A1描述了一种用于老年患者的膝关节假肢,其设有液压式阻尼单元,该阻尼单元可作为锁止装置运行。在固定的角度范围之内,所述关节装置的屈曲被阻止,其中,在所述固定的角度范围之外,下部件在屈曲方向上可自由摆动。所述下部件的伸展应在任何时间都可以。这种膝关节假肢用作站起-和坐下辅助。
EP 1 237 513 B1涉及一种代替肢体的支持装置的存在或功能,所述支持装置包括传感器,其中,该传感器检测一个与关节连接的元件相对于固定线的位置,其中,该传感器与控制装置耦合,该控制装置用于基于所述传感器的位置数据来控制所述关节。用于控制膝关节的装置在最简单的形式中是锁止或制动装置。
发明内容
本发明的任务在于,提供一种矫形外科装置和一种用于控制矫形外科装置的方法,用其可以在足够可靠性的情况下在行走和站立期间实现更高程度的舒适性。
根据本发明,该任务通过一种具有主权利要求特征的矫形外科装置以及一种具有权利要求10特征的用于控制这种矫形外科装置的方法来解决。本发明的有利构型和进一步方案在从属权利要求中描述。
根据本发明提出了一种具有关节的矫形外科装置,该矫形外科装置具有上部件和可摆动地支承在该上部件上的下部件以及锁止装置,其中,在所述上部件上设置有用于固定在肢体上的上连接机构,所述锁止装置防止所述上部件相对于所述下部件进行屈曲运动,其中,所述锁止装置被构造成能够通过该矫形外科装置的使用者主动操作,本发明提出,给所述锁止装置配置控制装置,该控制装置与安置在所述装置上的至少一个传感器连接并且根据传感器信号使所述锁止装置自动地解锁或锁止。在传统的矫形外科装置中、特别是在膝关节假肢或膝关节矫正器中为了使所述关节屈曲必须主动地解除锁止,而本发明的矫形外科装置提出,除了关节装置的随心所欲的锁止和解锁之外,该关节装置也可以根据安置在所述矫形外科装置上的传感器的传感器信息不由自主地解锁或锁止。除了随心所欲地激活锁止和解锁之外,也可以根据上部件的或下部件的位置或者其他参数自动解除锁止或者降低所述关节的阻力,使得恰恰在机能受限的使用者的情况下简化使用操作。因此在膝关节假肢方面可以的是,使用者能够以锁止的关节坐下,而无需将锁止装置主动解锁,其中,在达到所述上部件和/或下部件的预给定方位时所述关节自动解锁,使得在坐姿中可自由运动。此外,在坐姿中当腿完全伸开时防止所述关节锁止,这在假肢佩戴者的坐姿中是不方便的。对于关节矫正器的相应应用也是可以的,其中,在此在所述下部件上设置用于固定在肢体上、例如小腿或小臂上的固定装置。在所述矫形外科装置构造为关节假肢的构型中在所述下部件上安置另外的矫形外科部件或假肢部件。
本发明的一个进一步方案提出,所述传感器构造为用于检测所述上部件和/或所述下部件在空间中的方位的位置传感器、构造为用于检测所述上部件与所述下部件之间的角度的角度传感器、构造为用于检测在所述矫形外科装置中起作用的力的力传感器和/或构造为用于检测在所述矫形外科装置中起作用的力矩的力矩传感器并且与所述控制装置耦合。例如在已知上部件与下部件之间的角度变化的情况下,根据旋转方向结合上部件和下部件的绝对位置可推断出,患者是否想要站起,从而在站起时在关节完全伸展之前所述关节就可以自动地锁止。所述锁止也可以仅仅在一个方向上进行,使得始终允许伸展,但是屈曲已经在所述站起的第一阶段中被禁止以避免患者在站起时意外地向后倒。由此例如可以的是,当所述伸展仅仅被近似达到时、例如在达到伸展止挡前的15°,当小腿近似竖直定向时,膝关节在站起期间被锁止。除了考虑上部件与下部件之间的角度之外也可以设置用于检测所述上部件和/或所述下部件在空间中的方位的传感器,以便能够单独地或结合所述角度传感器数据引起所述锁止装置的自动解锁或锁止。因此在膝关节假肢的构型中当上部件水平地取向时,在所述上部件基本上水平地取向时当上部件与下部件之间的角度同时接近直角的情况下可推断出使用者处于坐姿中,从而自动地进行解锁。同样可以的是,构造用于求得在所述矫形外科装置中起作用的力或者在所述矫形外科装置中起作用的力矩的力-或力矩传感器,其中,所述力-和/或力矩传感器也可以附加于所述角度传感器或所述位置传感器使用。在所述下部件中优选设置一个用于检测在所述下部件中起作用的力、特别是轴向力的力传感器,其与所述控制装置连接。通过这种方式可以识别,所述下部件是否承受载荷,例如,患者是否站立并且所述矫形外科装置、特别是假肢是否承受载荷。因此在坐姿中当不存在轴向载荷或者轴向载荷很小时在所述下部件竖直定向的情况下保持锁止,而当轴向负载时、例如在站立或站起期间可开始屈曲方向的锁止以防止患者向后倒。由此也防止当腿或假肢完全伸展时所述关节在坐下期间锁止并且同时识别出在下部件中没有轴向力起作用。可设置用于检测关节中上部件与下部件之间的有效力矩的关节力矩传感器,其中,该关节力矩传感器也与所述控制装置连接。通过关节力矩传感器可以求得关于所述矫形外科装置内部的有效力的另外信息,使得可更精确地进行控制。
所述矫形外科装置优选构造为膝关节矫正器或膝关节假肢,但是原则上也可以用作例如肘矫正器或小臂假肢。
优选所述锁止装置是液压阻尼器,其具有至少一个能够通过执行机构转换的阀或能够通过执行机构转换的节流部位,其中,所述执行机构与所述控制装置连接。由此可以提高或降低液压阻尼,以便当相应的阀完全闭合时锁止关节或当阀或节流部位以确定的程度打开或闭合时提供期望的阻尼阻力。
本发明的一个进一步方案提出,给所述控制装置配置定时开关机构,该定时开关机构在相应的传感器信号后使所述锁止装置的解锁或锁止或者说闭锁延迟。通过所述定时开关机构允许大量控制变型方案,例如自动解锁后的时间控制的保持打开或控制信号解锁之后的时间控制的再次锁止。同样也可以的是,在随心所欲的解锁后在一定时间内不能重新锁止,从而使用者有足够的时间在解锁后例如实施附加的保持并且坐下。同样,在随心所欲的解锁后可以在一定时间之后自动进行重新锁止,只要这个传感器信号或这些传感器信号没有识别出锁止、即解锁后的使用的话,使得可以假定,使用者忘了解锁。因此为了安全性而进行自动锁止。
可以给所述矫形外科装置配置阻尼元件,该阻尼元件这样地作用于所述执行机构,使得解锁连续地进行,即在解锁时所述阀或节流部位只能缓慢打开,而不是冲击式地打开,从而解锁不是立即进行,这对于大多使用者来说将是不安全的。
所述锁止装置作为液压阻尼器的构造可以这样进行,使得该液压阻尼器从伸展止挡到固定的屈曲角度允许受阻尼的屈曲,而从达到所述固定的屈曲角度起阻止进一步的屈曲。这可以通过机械控制装置进行,所述机械控制装置允许锁止装置内的间隙,例如其方式是从所述伸展止挡起在5°至10°的范围上保持一旁路打开,该旁路在达到所述屈曲角度后通过控制盘或类似物闭合。对此替代地,所述阻止可通过控制装置进行。
为了提高舒适性提出,所述控制装置也被构造成能够远程操作,以便除了所述关节的自动控制之外还可以进行个性化的控制。由此将保证矫形外科装置的使用者在任何时间都能主动影响所述关节的锁止状态。
可以在该装置上设置信号发出器,该信号发出器显示或预示所述锁止装置的打开,使得矫形外科装置的使用者在所述关节打开、即解锁时或前不久得到通知:可靠的锁止已被取消或将被取消。
本发明还提出了一种用于控制根据上述矫形外科装置的方法,所述锁止装置根据所述上部件和/或所述下部件在空间中的、求得的方位被解锁或闭锁。特别是当下部件基本上水平定向时所述锁止装置解锁,因为由此假定:当所述矫形外科装置构造为膝矫形器或膝关节假肢时患者是坐下的并且所述下部件或小腿应可自由活动。
同样可以求得上部件与下部件之间的角度,并且所述锁止装置根据求得的所述角度被解锁或闭锁,其中,可求得在所述下部件中起作用的力,并且所述锁止装置可根据求得的所述力被解锁或闭锁。特别是对于膝关节假肢来说有利的是,从伸展止挡起在固定的屈曲范围上在所述锁止装置中提供阻尼阻力,该阻尼阻力允许受阻尼的屈曲,并且在超过所述固定的屈曲角度时所述锁止装置被闭锁。由此能够以轻微屈曲的膝关节假肢站立,这更好地相应于自然形象。同样可提出,在所述锁止装置解锁之前发出报警信号,从而可声响地、视觉地或触觉地进行所述关节的反馈,以便可以通知患者将进行或已进行实际的解锁。所述解锁可以连续进行、特别是在所述锁止装置构造为液压阻尼器的情况下,其方式是,相应的阀或节流部位缓慢打开。通过定时开关可以防止所述关节在解锁后又马上闭锁,从而使得患者有时间准备坐下或所述关节的屈曲。在预给定时间之后,所述锁止装置自动锁止,以便使得所述关节的松脱状态不会保持较长的时间,因为会出现下述情况:虽然进行了所述关节的主动触发和解锁,但是患者又把这事忘了。由此保证在预先确定的持续时间之后当所述关节不屈曲时又自动地自行锁止,由此所述关节又处于保险状态中。
此外提出,所述控制方法在所述关节的伸展运动期间在超过所述固定的关节角度时锁止屈曲运动,而进一步的伸展运动仍然被允许,这特别是对于下肢假肢或矫正器是有利的,但是原则上也可以的是,在屈曲姿态被视为保险姿态的情况下颠倒运动方向。
附图说明
下面借助于附图对本发明的实施例进行详细说明。唯一的附图示出呈膝关节假肢构型的矫形外科装置的示意图。
具体实施方式
附图示出呈膝关节假肢构型的矫形外科装置的示意图,该膝关节假肢具有关节上部件1和关节下部件2,所述关节上部件具有用于假肢筒的连接机构,所述关节下部件可摆动地固定在所述关节上部件1上。呈液压阻尼器构型的锁止装置3固定在所述关节下部件2上并且通过活塞杆31与所述上部件耦合。所述液压阻尼器31设有执行机构4,该执行机构使配置给所述液压阻尼器3的阀5打开或闭合以便使所述锁止机构3闭锁或解锁。所述闭锁或解锁通过所述阀5的打开或闭合进行,其中,除了所述阀5的突变式打开或闭合之外还可以在状态“打开”与“闭合”之间实现持续时间相应较长的过渡。
在所述下部件2中设置多个传感器6、7、8,它们与控制装置9耦合,所述控制装置基于传感器信号来控制呈马达或开关元件构型的执行机构4。在所述下部件2中设置一位置传感器6,以便检测该下部件2在空间中的方位。在此,优选获得相对于重力的定向,使得可容易地确定所述下部件2的位置。除了所述位置传感器6之外,在所述下部件2的远中区域中设置一个力和力矩传感器7,以便能够检测该下部件2内部的有效力和力矩,例如以便能够检测在下部件2中起作用的轴向力或者检测在行走或站立时出现的弯曲力矩。在所述上部件1的区域中设置膝角传感器8,该膝角传感器获得所述上部件1和位于其上的连接至人体肢体的连接元件与所述下部件2的相对位置。然后在所述控制装置9中由所述传感器6、7、8的数据计算所述锁止装置3是否被解锁、被锁止或者被转换到阻尼模式中,该阻尼模式与检测到的状况最好地适配。因此在期望的站起时允许所述上部件1相对于所述下部件2伸展,但是防止向后倒下,其方式是在颠倒的膝角和/或下部件内相应的力时闭锁相应的控制回路。
除了所述假肢之外,示出了一个远程操作装置10,其具有用于输入一个或多个控制指令的按键,使得除了所述锁止装置3的自动解锁或闭锁之外该锁止装置也可以由使用者随意闭锁或解锁。将操作装置10构造为远程操作装置的优点是,其可以放置在任意的地方,使得所述锁止装置3能够与当前的位置并且与使用者的能力无关地闭锁或解锁。
除了声响式信号发出器11之外(其同样设置在所述下部件2中以便显示解锁或者即将来临的解锁),在所述假肢上还可以设置一个振动信号发出器12,由此即使在嘈杂的环境中或者在该假肢使用者的听觉能力受限时发出信息:触发已被实施或者即将实施。
利用所示假肢,即使在载荷下也能执行解锁,同样也可以在载荷下实现锁止,使得在任何时间都能闭锁屈曲运动,以便对于使用者最大限度地保证安全。除了远程操作装置10之外,也可以在该矫形外科装置本身上设置相应的操作装置。除了作为膝关节假肢的构型之外,该矫形外科装置也可以设置为膝关节矫正器或用于上肢的假肢或矫正器。

Claims (14)

1.一种具有关节的矫形外科装置,该矫形外科装置具有上部件(1)和可摆动地支承在该上部件上的下部件(2)以及锁止装置(3),其中,在所述上部件(1)上设置有用于固定在肢体上的上连接机构,所述锁止装置防止所述上部件(1)相对于所述下部件(2)的屈曲运动,其中,所述锁止装置(3)被构造成能够通过该矫形外科装置的使用者主动操作,给所述锁止装置(3)配置控制装置(9),该控制装置与安置在所述矫形外科装置上的至少一个传感器(6,7,8)连接并且根据传感器信号使所述锁止装置(3)自动地解锁或闭锁,所述传感器构造为用于检测所述上部件(1)和/或所述下部件(2)在空间中的方位的位置传感器,其特征在于,所述锁止装置(3)构造为液压阻尼器,其从伸展止挡到固定的屈曲角度允许受阻尼的屈曲并且从达到所述固定的屈曲角度起阻止进一步的屈曲。
2.根据权利要求1的矫形外科装置,其特征在于,所述传感器还构造为用于检测所述上部件(1)与所述下部件(2)之间的角度的角度传感器(8)、构造为用于检测在所述矫形外科装置中起作用的力的力传感器(7)和/或构造为用于检测在所述矫形外科装置中起作用的力矩的力矩传感器(7)并且与所述控制装置(9)耦合。
3.根据权利要求1或2的矫形外科装置,其特征在于,所述矫形外科装置构造为膝关节矫正器或膝关节假肢。
4.根据权利要求1或2的矫形外科装置,其特征在于,所述锁止装置(3)是液压阻尼器,其具有至少一个能够通过执行机构(4)转换的阀(5)或节流部位,其中,所述执行机构(4)与所述控制装置(9)连接。
5.根据权利要求1或2的矫形外科装置,其特征在于,给所述控制装置(9)配置定时开关机构,该定时开关机构在相应的信号后使解锁或锁止延迟。
6.根据权利要求4的矫形外科装置,其特征在于,给所述执行机构(4)配置阻尼元件,该阻尼元件使解锁连续地进行。
7.根据权利要求1或2的矫形外科装置,其特征在于,所述控制装置(9)被构造成能够远程操作。
8.根据权利要求1或2的矫形外科装置,其特征在于,在该矫形外科装置上设置信号发出器(11,12),该信号发出器显示或预示所述锁止装置(3)的打开。
9.一种用于控制根据权利要求1-8任一项的矫形外科装置的方法,其中,所述锁止装置(3)根据所述上部件(1)和/或所述下部件(2)在空间中的求得的方位被解锁或闭锁,其特征在于,在所述关节的伸展运动期间在超过所述固定的屈曲角度时锁止屈曲运动,而进一步的伸展运动仍然被允许。
10.根据权利要求9的方法,其特征在于,在所述下部件(2)基本上水平地定向时,所述锁止装置(3)被解锁。
11.根据权利要求9或10的方法,其特征在于,求得上部件(1)与下部件(2)之间的角度,并且所述锁止装置(3)根据求得的所述角度被解锁或闭锁。
12.根据权利要求9或10的方法,其特征在于,求得在所述下部件(2)中起作用的力,并且所述锁止装置(3)根据求得的所述力被解锁或闭锁。
13.根据权利要求9或10的方法,其特征在于,从伸展止挡起在固定的屈曲范围上在所述锁止装置(3)中调节出阻尼阻力,该阻尼阻力允许受阻尼的屈曲,并且在超过所述固定的屈曲角度时所述锁止装置(3)被闭锁。
14.根据权利要求9或10的方法,其特征在于,在所述锁止装置(3)解锁之前输出报警信号。
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CN102076284A (zh) 2011-05-25
US20110130846A1 (en) 2011-06-02
US9913739B2 (en) 2018-03-13
EP2278942B1 (de) 2016-01-06
DE102008024747A1 (de) 2009-12-03
US9161847B2 (en) 2015-10-20
WO2009141115A1 (de) 2009-11-26
EP2278942A1 (de) 2011-02-02
US20160038312A1 (en) 2016-02-11

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