CN103747763B - 矫形装置、矫形装置的使用及其制造方法 - Google Patents
矫形装置、矫形装置的使用及其制造方法 Download PDFInfo
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Abstract
本发明涉及一种矫形装置,包括狭长的刚性或半刚性的支柱组件(106、108),枢转式与支柱组件相连的弧形套(104),以及固定于套并且形成能调节的周向结构的束带(114)。张力装置(606)可安装在套(104)上并且与束带(114)相连以在多个预选择的水平之间递增式调节张力装置(606)使得束带(114)的第一端部固定于张力装置(606),并且束带(114)的第二端部固定于套(104)。柔性的组件(112)与支柱组件(106、108)相连并且具有嵌入在多个层内的柔性支撑垫(240)。柔性的组件(112)适合于形成能调节的周向环,支撑垫(240)仅处于环周长的片段内。
Description
技术领域
本公开的实施方案涉及矫形装置,尤其是治疗髋部的髋部矫正器及其使用,以及涉及用于制造矫形装置的方法。
背景技术
髋部矫正器可用于阻止髋部脱位,并且在髋部手术后提供早期运动,同时最小化手术后的并发症。特定的手术操作包括髋关节更换或完全或部分修复手术,以及髋部镜。这些矫正器可用于降低住院治疗和恢复的长度,以及康复的总周期。髋部矫正器也可用于处理髋部的持续性痛和不可手术的髋部残疾。
预防或髋部脱位是当股骨头在髋臼或髋窝中移位时会发生的问题。典型地,在髋部手术后,需要髋部矫正器用于固定和支撑,以通过阻止这种脱位的再次发生而有助于恢复。
股骨的头部与作为髋臼的骨盆接触,并且形成髋关节。股骨的头部(“股骨头”)和髋臼形成允许弯曲、伸展、外展、内收和环形运动的球-窝关节。髋部设置为承受重量,并且存在用于支撑髋关节的连接韧带。
用于阻止髋部脱位的已知的髋部矫正器典型地可具有能调节的铰链,其仅允许大腿关于髋关节在向前和向后方向中转动。这些髋部矫正器具有以下缺点:在整个运动范围中不能在腿上提供动态的外展力。换句话说,可在站立时提供外展力,而在坐下时不提供外展力。由于传统的矫正器刚性地将腿保持为外展,因此这可能会导致异常步态和顺应性问题。
发明内容
根据本公开的髋部矫正器涉及一种髋部矫正器形式的矫形装置,其可用于保护主关节成型手术的病人防止脱位、髋部修复、反复脱位、不能手术的髋部残疾的风险,或在日常生活中供预防性使用。也可将特定的实施方案用于治疗髋关节炎。
这里所描述的髋部矫正器的实施方案可通过在腿和髋窝上提供动态的力来保证和控制股骨头处于髋臼中,以阻止脱位并治疗关节炎。这种动态力机构通过保持规定的弯曲和伸展限制而顺从髋关节的解剖学运动。此外,髋部矫正器的特征有助于比传统的支撑更稳定和更多用途的矫正。
髋部矫正器由于无铰链设计而允许动态外展。髋部矫正器包括弹性的钢杆,其设置为在使用者的整个运动范围内给腿施加动态的外展力,甚至在坐下时也是如此。包括有滑动式连接,其会顺从髋关节的解剖学运动,同时保持弯曲和伸展限制。
髋部矫正器具有下部异形结构,其提供了改善的舒适性、美观性和病人顺应性。髋部矫正器优选为模块化的,这是由于其会提供最佳的使用者适应性,并且降低库存量。
在本公开的一个实施方案中,矫形装置、例如髋部矫正器可包括狭长的刚性或半刚性的支柱组件、枢转式固定于支柱组件的弧形套,以及固定于套并且由此形成可调节的周向结构的束带。
该装置可包括用于锁定套的相对于支柱组件的位置的转动机构。套或转动机构中的一个可包括多个间隔开的凸起,其设置为将套定位在相对于支柱组件的多个预选择的角度处。该装置可具有安装夹,其连接于同支柱组件相连的套,并且允许套相对于支柱组件转动。
该套可为柔性的,并且优选地能够相对于支柱组件转向右腿结构或左腿结构。
该装置可具有安装在套上并且与束带相连的张力装置。张力装置优选地设置为可递增地调节由束带和套形成的周向结构的周长。束带的第一端部固定于张力装置,并且束带的第二端部与套相连。束带可包括能固定于由套形成的开口的安装托架。
根据本公开,提供了使用张力装置以调节矫形装置中的周向结构的方法。作为替代地是,可将张力装置和套以及束带装置用在多个不同的矫形装置中,并且不专用于髋部矫正器。
该装置可额外地包括与支柱组件相连的柔软、舒适的组件。该柔软、舒适的组件可具有嵌在多个层内的柔性支撑垫。该柔软、舒适的组件适合于形成可调节的周向环,支撑垫仅位于环周长的片段中。该柔软、舒适的组件可限定袋子,并且板与袋子相邻或间隔开地设置。板可属于支柱组件。板可安装在支柱组件的第一端部,并且套安装在支柱组件的第二端部。
根据本公开,提供了用于形成柔软、舒适的组件的方法,所述柔软、舒适的组件包括柔性支撑垫和围绕在支撑垫周围的多个织物层。
通过下面的描述和所附的附图,这里多个实施方案的多个优点、特征和功能将变得显而易见并且更容易理解。下面的说明书不意在限制髋部矫正器的范围,而是仅提供示例性的实施方案以便于理解。
附图说明
根据以下描述、所附的权利要求和附图,本发明的这些和其他特征、方面和优点将会变得更容易理解,其中:
图1A是显示了髋部矫正器框架的一个实施方案的透视图。
图1B是显示了图1A的髋部矫正器框架和用于髋部矫正器框架的柔软、舒适的组件的透视图。
图1C是显示了对图1A的髋部矫正器进行调节的示意图。
图2是属于图1B的髋部矫正器的柔软、舒适的组件的骨盆接合件的细节透视图。
图3A-3D是显示了用于装配准备用在图2的骨盆结合件中的织物片的步骤的示意图。
图4A-4C是用于图1A的髋部矫正器的大腿套组件的示例性实施方案的透视图。
图5A-5C是显示了根据图4A-4C的髋部矫正器的大腿套组件的一个变体的透视图。
图6A-6D是显示了根据图4A-4C的髋部矫正器的大腿套组件的一个变体的透视图。
在各个附图中,同样的元件具有同样的附图标记。应当理解的是,附图没有按照比率或比例来绘制,而是作为替代地绘制用于更好地理解其部件,附图并不意在限制范围,而是提供示例性的说明。
具体实施方式
图1A-1C显示了髋部矫正器的一个实施方案,所述髋部矫正器包括在美国专利7597672中部分地教导的髋部矫正器的一些基本功能。根据本实施方案,髋部矫正器100包括适合于固定在使用者的髋部上并且通过骨盆束带组件112保持在位置中的髋部板102。矫正器包括适合于固定在使用者的大腿上并且通过大腿束带114保持在位置中的小腿套104。
弹性杆106将髋部板102和小腿套104彼此相连。下部弹性杆支撑件108和上部弹性杆支撑件120与弹性杆106接合。大腿垫或大腿壳110与弹性杆106滑动式接合。
弹性杆106与小腿套104枢转式相连。对于髋部板102,弹性杆106具有插入在髋部板102中的端部部分,并且通过由限位挡块118所限制的运动而相对于髋部板102从一边到另一边地滑动,而弯曲和伸展挡块116限制了髋部板102和弹性杆106相对于彼此的运动。弯曲和伸展挡块116以及限位挡块118可调节地处于髋部板102上。
这些挡块预装配用于右侧髋部以及从0°伸展到70°弯曲的运动范围。如果将髋部矫正器适用于左侧髋部并调节运动限制的范围,则可将限位挡块和弯曲/伸展挡块设置在正确的位置。两个限位挡块、一个弯曲挡块和一个伸展挡块设置为可限制运动范围。可在髋部板的内侧部分和外侧部分上提供引导以作用基准,但是应当检验所得到的弯曲角度和伸展角度,以保证设置了正确的角度。
如果所要求的角度在0°到70°之间,则将限位挡块设置在两个内部开口(与弹性杆最近)中。如果所要求的角度在60°到90°之间,则将限位挡块设置在两个外部开口(与弹性杆最远)中。根据髋部板内侧和/或外侧上的标记来设置弯曲/伸展挡块。
如图1C所示,通过松开上部弹性杆支撑螺钉128并且将上部弹性杆支撑架120和下部弹性杆支撑架108保持在一起来将大腿垫110沿着弹性杆106滑动而将大腿垫110向上调节和向下调节。下部弹性杆支撑件108可在枢轴点126处被枢转式拉离弹性杆106。可将保持大腿套110的锁定螺钉124松开以允许其运动。
髋部板102设置在骨盆束带组件112的开口中。骨盆束带组件112具有由能伸缩的材料形成的侧边,所述侧边应向外朝向,使得其可顺应弯曲和伸展挡块116以及限位挡块118。当将髋部矫正器设置在使用者身体上时,骨盆束带组件112可包括设置为直接与使用者股骨的较大转子上部对齐的标记。然后可将标记与束带的顶部、髂骨尖端对齐。
骨盆束带组件112包括处于其一个端部处的指状袋子,使用者可将手指或手放置到所述指状袋子中。束带围绕骨盆而缠绕。骨盆束带装置112包括具有第一端部和第二端部的内部束带,第一端部部分固定于骨盆缠绕的相反的第二端部部分。通常与内部束带叠置的外部束带固定于在第一端部部分和第二端部部分的至少一个的上方的表面处。
在图2中说明了骨盆束带组件112的一个实施方案。根据该实施方案,骨盆束带组件112包括通常提供在骨盆束带组件112中部的外部束带220,以方便收紧在使用者骨盆周围的矫正器。优选地,能够将外部束带220沿着适合于接收髋部板的板状部分210或沿着板状延伸部分230而折叠。可使用现有技术中熟知的固定件,即钩-环固定件、束带、扣子、别针以及带扣来将外部束带220固定于板状部分210或板状延伸部分230。骨盆束带组件112限定了适合于接收髋部板的袋子250。
通过首先拾取第一端部部分235和第二端部部分236,接着将这些端部部分彼此固定(通过适当的固定件,例如钩-环固定件),可将骨盆束带组件112围绕在使用者躯干的周围,以便定位骨盆束带组件112。可在任一个端部部分处提供适当的袋子260,以允许使用者将手指或手放到其中而不是要求抓住端部部分235、236。可将外部束带220用于收紧板状延伸部分,以保证骨盆束带组件112固定在使用者的腰上。
在一个变体中,骨盆束带组件112的板状延伸部分230是成型的层叠式织物。在髋部矫正器100的一个变体中,板状延伸部分230通过包括选择性地设置在定制的成型片状织物内的支撑垫240而能阻止骨盆束带组件112的转动和折叠。髋部板102可设置为与支撑垫240相邻或间隔开,并且髋部板102从属于支柱组件。
支撑垫240可由乙烯-醋酸乙烯共聚物(EVA)或类似的柔性和弹性材料以及用作支撑层的聚酯纤维而制成。支撑垫240为骨盆束带组件112的柔软、舒适的材料提供了支撑,同时具有足够的变形能力以当穿着髋部矫正器100时收紧支撑件。
图3A-3D公开了使用热压方法制造板状延伸部分230的示例性方法。根据这种方法,首先将顶部板固定到热压件的顶部侧,所述顶部板具有织物材料形状的凸出形状。接着将底部板312固定到热压件的底部侧,并且底部板312具有形状与织物材料匹配的凹陷314。接着将不同的层以预确定的顺序层叠到底部板的凹陷中。
如图3A所示,通过首先将第一、底部织物层310放置到底部板的凹陷中进行层叠。接着,如图3B所示,将聚合物支撑垫340放置在第一织物层310上的预确定和预选择的区域中。
通过待实现的特定功能来确定支撑垫340的选择。根据一个变体,可沿着板状延伸部分230的端部而设置支撑垫240,以阻止板状延伸部分230的转动和折叠。
如图3C所示,在将支撑垫340设置到预选择的位置中后,将粘结层316放置到支撑垫和底部织物层的上方。最后,如图3D所示,将第二、顶部织物层318放置到组合结构的上方。
接着对热压件加热,并且通过夹紧、挤压或类似的施加压力的方式压在一起。热压会有效地熔化粘结剂,以将各层与所设置的支撑垫340组合在一起,从而形成板状延伸部分230。
支撑垫为聚合物材料的成型件,并且设置在织物层例如莱卡和泡沫层之间。在层叠期间,可使用粘结剂例如培纶(PELLON)将层粘结在一起。层叠通过在将层热压在一起之前将织物层的聚合物材料层叠而实现。该方法不限于使用聚合物材料,而是可使用金属和复合材料支撑垫。
在传统的织物产品、例如层叠中,典型地具有相等面积的织物、片材和织物。这导致端部材料在整个面积上具有相似的性能。通过这种方法,优选地使用由聚合物材料制造的定制的形状,但是也可设想使用材料例如金属和复合材料用于支撑垫。这种方法是有利的,这是由于能够将支撑垫放置在层叠织物的局部区域中,因此降低对使用者的整体影响。这使得能够较大程度地控制插入部件的影响。
如果将支撑垫设置为与脊柱重叠,则材料选择应使支撑垫足够软以避免任何大的妨害。例如,支撑垫可为1.5mm,并且选择为比具有1mm厚度的聚乙烯片材的标准材料性能更柔软的材料。已经发现,与较薄但是较硬的材料以及厚度相比,1.5mm的较厚支撑垫能改善层叠过程。
用于制造板状延伸部分的方法也可用于髋部矫正器的任何其他部件中,以便为髋部矫正器的多个部分的柔软、舒适部件提供加强。此外,定制的成型织物提供了支撑垫在织物产品中的无缝插入,以降低外部边缘或镶边刺激皮肤的风险。这种插入支撑垫的方法通过将支撑垫集成并固定设置在织物层之间而降低了支撑垫运动的风险。此外,也可任选地通过缝合来束缚板状延伸部分,以加强层叠的织物材料。
应理解地是,这种方法不限于髋部矫正器,而是可延伸到多种制品的应用中,所述制品包括鞋子、服装、袋子、包,或具有可刺激皮肤的边缘或镶边的类似制品。
图4A-4C显示了大腿套组件410的实施方案。可通过使用能够缠绕在使用者的大腿周围的束带,或由氨纶、尼龙或其他类似的材料或其结合制成的小腿绷带来将大腿套组件410与使用者的腿相连。
在图4A所示的实施方案中,大腿套组件410能够通过转动机构而关于一轴枢转,以允许将弹性杆在右侧/髋部组件和左侧/髋部组件之间重新定位。这通过首先将沿大腿套组件410外表面上的轨道430而设置的按钮锁420脱扣而实现。
如图4C所示,一旦将按钮锁420松开,大腿套组件410会额外地具有与锁定机构450接合的能下压的法兰440。当将法兰440下压时,锁460会从其在锁定机构450中的锁定位置移开,其中在锁定位置中,锁460会保持转动机构470固定以阻止转动。
一旦锁460从锁定位置移出,转动机构470会松开并且允许自由转动360度。当大腿套组件410转动约180度,即大腿套从右侧/髋部组件重新定位到左侧/髋部组件时,由柔性材料制成的能下压的法兰440会返回到其非加载状态。换句话说,当正确定位时,能下压的法兰440可自动使锁460返回到在锁定机构450中的锁定位置中。
图5A-5C显示了大腿套组件500的一个变体。根据这种变体,大腿套组件500包括适合于固定在使用者的大腿上的壳体502。安装夹504能转动地固定于壳体502上,以允许大腿套组件适合于右腿或左腿,如标记520、522所示。夹子504包括托架506,用于枢转式固定于弹性杆。
夹子504可围绕通常形成在其中间的孔508和形成在壳体502上的相应的孔510转动,同时通过适当的固定件将夹子504固定于壳体502。夹子504限定了多个以弧形形式设置的凹陷512,并且所述凹陷处于夹子的朝向壳体502的表面的相反侧上。夹子504也限定了相应于夹子504的右侧结构或左侧结构的上部和下部狭长的、弧形凹陷516。壳体502限定了多个凸起518,所述凸起以弧形、上部和下部方式设置,并且当夹子构造为右侧或左侧结构时,所述凸起通常对应于狭长凹陷516的位置。
凸起518用作半转动障碍以阻止夹子自由转动,但是通过凹陷512、516和凸起或半转动性障碍518的结合允许一些自由转动。夹子504可在转动方向A或B中转动,以便相对于壳体502进行调节而使髋部矫正器与右腿结构或左腿结构相适应。
当将髋部矫正器穿在使用者上时,小腿套组件使较长的部分设定为朝向使用者的腿的前部。套的取向取决于支撑件是与右侧髋部还是与左侧髋部相适合。适合支撑件的使用者或医生可根据指示以保证小腿套的正确的取向和装配。
图6A-6D显示了与根据图1A-1C的髋部矫正器一起使用的大腿套组件600的另一实施方案。在许多矫正器中,已经发现一些套组件是难以触及到的,特别是对于虚弱的使用者而言,并且是难以绑束的,以及缺乏改变尺寸的能力。至少在髋部矫正器中,大腿套组件可在弹性件中具有外展力,这使得难以将其穿上并且难以达到所要求的收紧水平。
根据图6A-6D的实施方案,大腿套组件600包括固定于腿支柱或弹性组件604上的能裁剪的套602,如上文根据髋部矫正器的讨论,还包括在弹性组件的第一侧625上的张力装置606,所述张力装置适合于调节张力和由此在使用者腿上的大腿套组件600的收紧。张力装置606可为与线缆组件608相连的转盘式张力装置,所述线缆组件与束带612相连,并且允许束带612相对于套602递增式调节。可提供适当的盖子610以至少覆盖线缆组件和大腿套的至少一部分,并且所述盖子具有提供用于接触张力装置606的开口620。
束带612的第一端部固定于线缆引导件628,所述线缆引导件包括用于接收线缆组件的通道630。由于束带612的第一端部固定于线缆组件608,则束带612的第二端部包括托架614和连接元件616,所述连接元件适合固定于由套602在弹性组件604的第二侧626上形成的开口632。可将托架614从开口632中移除,以因此将束带的第二端部与套快速分开。
通过将托架614固定于套602,大腿套组件形成了周向的套组件,用以稳固地固定于使用者的腿上。张力装置允许使用者容易地抓住并调节束带,并且因此可调节束带张力而不考虑弹性组件的外展力。一旦将束带托架固定于套,则仅需要一只手。此外,套是能调节的,并且优选地由能裁剪的聚合物材料形成以允许定制套。
张力装置可以本领域的技术人员所熟知的任何方法构成。在2009年5月15日提交的美国专利申请12/466597中可找到多个张力装置的实施例。在2005年12月21日授权的美国专利7198610中可找到托架和束带的实施例。
支柱或弹性组件604可通过枢轴连接与套602枢转式相连,所述枢轴连接由形成在支柱或弹性组件上的凸起622和由套形成的托架624而形成。当然,支柱或弹性组件可以这里所讨论的其他实施方案中描述的其他任何方式而固定。
根据用于调节束带和套的周向结构的方法,使用者或医生可在多个预选择的水平之间递增式调节张力装置,使得束带的第一端部固定于张力装置并且束带的第二端部与套相连。套和束带的结合形成了连续的周向结构。
尽管已经描述和显示了前文的实施方案,应理解地是这些实施方案的替代或改进例如由其他所建议的可落入本发明的范围内。此外,这里所描述的任何规则可延伸到任何其他的矫形装置或其他类型的要求这里所描述的这些结构的元件的类似功能的制品。
Claims (12)
1.一种矫形装置,包括:
狭长的刚性或半刚性的支柱组件(106,108);
弧形套(104);
束带(114);
其特征在于,所述束带(114)固定于所述套(104)上并且形成能调节的周向结构,所述套枢转式固定于所述支柱组件(106,108),
所述矫形装置还包括用于相对于所述支柱组件而锁定所述套的位置的转动机构(504,506),所述套(104)包括形成有孔(510)的壳体(502),所述转动机构(504)在其中间形成有与所述壳体(502)的所述孔(510)相应的孔,并且所述转动机构(504)通过固定件与所述壳体(502)固定到一起,所述套(104)或转动机构(504,506)中的至少一个包括多个间隔开的凸起(518),所述凸起设置为将所述套(104)定位在相对于所述支柱组件(106,108)的多个预选择的角度处,所述套(104)能够相对于支柱组件(106,108)转动成右腿结构或左腿结构。
2.根据权利要求1所述的矫形装置,其特征在于,所述套(104)能够相对于所述支柱组件转动至少180度。
3.根据权利要求1所述的矫形装置,其特征在于,还包括与所述套(104)相连的安装夹(420,430,440),所述安装夹(420,430,440)与所述支柱组件(106,108)相连,并且允许所述套(104)相对于所述支柱组件(106,108)转动。
4.根据权利要求1所述的矫形装置,其特征在于,还包括安装在所述套(104)上并且与所述束带(114)相连的张力装置(606),所述张力装置(606)设置为递增式调节所述周向结构的周长。
5.根据权利要求4所述的矫形装置,其特征在于,还包括盖子(625),所述张力装置(606)具有将所述张力装置(606)与所述束带(114)相连的线缆(608),所述盖子(625)在所述线缆(608)和套(604)的整体的上方延伸。
6.根据权利要求4所述的矫形装置,其特征在于,所述束带(114)的第一端部固定于所述张力装置(606),并且所述束带(114)的第二端部与所述套(104)相连。
7.根据权利要求6所述的矫形装置,其特征在于,所述束带(114)包括能固定于由套(104)形成的开口(632)的安装托架(614)。
8.根据权利要求1所述的矫形装置,其特征在于,还包括与所述支柱组件(106,108)相连的柔性组件(112),所述柔性组件(112)具有嵌入在多个织物层内的柔性支撑垫(240)。
9.根据权利要求8所述的矫形装置,其特征在于,所述柔性组件(112)适合于形成能调节的周向环,所述支撑垫(240)仅处于所述环周长的片段内。
10.根据权利要求9所述的矫形装置,其特征在于,所述柔性组件(112)限定了袋子(250),并且板(102)设置为相邻或远离支撑垫(240)并且属于所述支柱组件。
11.根据权利要求9所述的矫形装置,其特征在于,还包括安装在所述支柱组件(106,108)的第一端部处的板(102),所述板(102)插入到由所述柔性组件形成的袋子(250)中,并且所述支撑垫(240)设置为相邻或远离所述袋子。
12.根据权利要求1所述的矫形装置,其特征在于,还包括安装在所述支柱组件(106,108)的第一端部处的板(102),并且所述套(104)安装在所述支柱组件(106,108)的第二端部处。
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- 2012-06-20 EP EP12740242.8A patent/EP2720653B1/en active Active
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Also Published As
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---|---|
WO2012177700A3 (en) | 2013-02-21 |
US20120323154A1 (en) | 2012-12-20 |
WO2012177700A2 (en) | 2012-12-27 |
EP2720653B1 (en) | 2018-11-28 |
US9439800B2 (en) | 2016-09-13 |
US20160346112A1 (en) | 2016-12-01 |
EP2720653A2 (en) | 2014-04-23 |
CN103747763A (zh) | 2014-04-23 |
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