RU2213544C2 - Orthopedic device - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has thoracic and pelvic belts designed as cases cut in the middle on one side. Recesses responding to vertebral column curvature are manufactured in them. Active correction members are attached to the recesses. Distraction rods have three coaxial cylindrical members two of which have screw drives and the third one spring drive for drawing them apart. The active correction members have supporting plate which working surface is curved corresponding to topographic properties of body area receiving linear titanium nickelide member action. The member is mounted outside and is rigidly attached to one of the cases with at least one end whereas the second end being freely movably attached to the opposite case. To apply distraction-constriction action, the linear member is designed as spiral having its pieces shaped as meander and having loops for fastening to both ends to the cases. To apply detorsion- reclination action, the linear member is L-shaped with its upper part ending in loop for fixing to case and making an angle of 90 deg with the lower part. The lower part has arc-shaped protrusion in its upper 1/3 part. Its plane is inclined at least at 45 deg to upper part plane. To apply reclination action, the linear member is shaped as flat arc having case fixation loop at one end. EFFECT: enhanced effectiveness of treatment. 6 dwg

Description

 The invention relates to medical equipment and can be used to treat spinal curvature of various etiologies.

 Closest to the proposed is an orthopedic device - a corset (1), consisting of a chest and pelvic girdles for fixing on the patient’s body, interconnected by an exhaust mechanism, including telescopic screw rods with axillary stops, attached by means of guide bushings and hinges to the chest and pelvic girdles .

 However, the use of this device is also ineffective, because with its help it is possible to carry out only a limited range of effects, mainly distraction.

 A new technical result is an increase in the effectiveness of the corrective effect on pathological curvature of the spine by reducing the degree of residual curvature, increasing patient comfort during the wearing of the device and reducing treatment time.

This technical result is achieved by the use of a new orthopedic device consisting of a chest and pelvic girdles for fixation on the patient’s body, interconnected by an exhaust mechanism, including telescopic distraction screw rods mounted on ball bearings located on the belts, and the chest and pelvic girdles are sleeves with cuts on one side in the center and recesses made on them in accordance with the topography of the curvature of the spine, to which the active corregir are attached and distraction rods consist of three coaxially arranged cylindrical elements, two of which are equipped with screw and the third with spring-loaded sliding actuators, and also active corrective elements consist of a thrust plate with a working surface bent in accordance with the topography of the body part to which the action is directed a linear element made of an elastic material mounted on the outside, rigidly connected to one of the sleeves with at least one end, and the second with the opposite sleeve with the possibility of free longitudinal movement, also for constriction-distraction action, the linear element is made in the form of a spiral having the configuration of elements in the form of a meander, provided with fixation loops to the sleeves at both ends, and for the detorsion-reclamation action the linear element is made in the L-shape whose upper part ends with a loop for fixing the sleeve and oriented at an angle of 90 ^o to the bottom, provided in the upper third arcuate projection plane koto nd is at an angle of at least 45 ^o to the upper part of the plane element, also for reklinatsionnogo exposure, the line element is in the form of a shallow arc, one end provided with a loop for fixing to the sleeve.

 In FIG. 1 shows an orthopedic device for the treatment of scoliosis, containing thoracic 1 and pelvic 2 sleeves with recesses made on them, for example, 3, 4 (Fig. 3) in accordance with the topography of the curvature of the spine. Corrective active elements 5 are movably attached to the recesses on the sleeves, containing a thrust plate 6 congruent to the patient’s deformations, fixed from the outside by a linear element 7 (a, b, c) of a shape corresponding to the type of exposure rigidly connected to the chest 1 or pelvic 2 sleeves with at least one end with a fixing loop (13), and the second with the opposite sleeve with the possibility of longitudinal movement (14) (for example, through brackets placed longitudinally to the surface of the corresponding sleeve).

Figure 2 is a side view;
Figure 3 - installation on the patient's body.

 Sleeves 1 and 2 are interconnected by distraction rods 9, each of which consists of three coaxially arranged cylindrical elements that can be moved apart by spring and screw drives (two of which are connected by screw and the third by spring drives).

 In FIG. 4 shows the distraction rod a) with its two elements; b) a rod with a screw rod; and c) a spring placed in the third cylindrical element d).

Figure 5 shows three types of linear elements 7a), 7b), 7c) used to correct various types of deformations:
a) in the form of a spiral having a configuration of elements in the form of a meander for the implementation of constriction-distraction effects (with loops for fastening on the chest and pelvic sleeves);
b) the L-shaped form used to carry out the detorsion-reclining action;
c) in the form of a gentle arc, equipped at one end with an element of rigid fastening on the corresponding sleeve for the implementation of the reclining action.

 The device is used as follows.

 Pelvic and thoracic sleeves, anatomically mocked up and made of polyvic, equipped with a flange at the edges, are put on the patient's body and tightened with lacing 12 until they fit tightly. The screw drive of the expansion of the distraction rods 9 burst sleeve 1, 2 to the full compression of the spring drive. Thrust plates of corrective active elements are installed in a working position congruent with the patient’s deformations. In this case, the linear elements 7 (b, c) are rigidly fixed at one end to the corresponding sleeve using a loop (13) for fixation, so that the bend in the linear element 7b) (Fig. 5) is displaced in the plane relative to the fixation point, and the opposite end is fixed in the sleeve with the possibility of longitudinal movement, (14) the linear element 7a) (Fig. 5) is not necessarily rigidly attached at both ends by means of fixing loops to the chest and lumbar sleeves.

 The attainability of the technical result is confirmed by examples of specific implementation in the treatment of sick children in the children's surgical hospital 4 of Tomsk.

Example 1
Patient Ivleva A. - 13 years old. Diagnosis: stage 2 scoliosis (18 ^o ) was diagnosed since 1999. Since April 2000, the patient has installed a device for the treatment of curvature of the spine according to the claims.

 Pelvic 2 and thoracic 2 sleeves (Fig. 3) are anatomically mocked up and made of polyvic. The liners are connected by four distraction rods mounted symmetrically with respect to the sagittal plane, in pairs - front and rear. Excavations (3, 4) are made in the thoracic and pelvic sleeves, which provide angular mobility of the active corrective elements. A recess made on the left on the pelvic sleeve provides mobility of the lower left portion of the active corrective element relative to its main array. Linear elements selected forms 7b) and 7c) (figure 5).

 Monitoring the effectiveness of the impact was carried out using x-ray studies. Figure 6 shows two x-rays taken a) before treatment and b) during treatment, which clearly shows positive dynamics during the correction.

The action of the device is performed gently, slowly and steadily. As the scoliotic curvature is corrected, the pelvic sleeve moves away from the chest and the spring drive ceases to act. Occasionally, as this situation occurs, the screw drive of the destruction rods eliminates the formed looseness of the unloading force of the cartridges, bringing it to its original value. The degree of curvature of the spine and the dynamics of recovery are controlled by the standard method of projection of the spinous processes on the surface of the patient's body. For 6 months of wearing the device, the patient attended school, the degree of curvature decreased to the first (8 ^o ).

 The use of active moving corrective elements in this device allows the most accurate and effective effect on areas of pathological deformation, as well as the use of various types of linear elements, with the help of which the type and magnitude of the effect necessary for each individual section are “formed”. Also, the use of a material - titanium nickelide, which has a unique feature of shape restoration, allows you to choose the effect that is necessary in magnitude and constant in time.

 The specified technical result is achieved by the fact that in the proposed device for the treatment of curvature of the spine, all types of effects on existing deformations are combined: unloading or distraction and wedging in the frontal (sagittal) plane and detorsion. At the same time, a certain mobility of the spine is maintained, which contributes to maintaining the tone of the back muscles and improving the quality of life in the process of wearing the device. Correction of pathological bends of the spine is carried out by the synchronous action of distraction rods directed along the axis of the spine and causing it to stretch between the pelvic and thoracic sleeves, and by the action of linear elements working by twisting through the moving sections of the thrust plates, performing the frontal and detorsion effects on the spine, the coordinated action of unloading and correction leads to a noticeable increase in the effectiveness of treatment compared to the prototype. Sleeves 1 and 2, tightly fitting the patient’s body, in combination with distraction rods, form a rigid structure that allows a significant effort to stretch the spine with corrective action. Due to the tight girth around the body part of the patient with sleeves, the corrective effect is distributed. Efforts are transmitted through the costal heads to the vertebrae. The anatomical axis of the spine is restored. Skeletal muscle relaxation occurs, pain and sprain are relieved, elastically restoring the displaced vertebrae to a normal position.

 The use of distraction rods of this design also allows you to maintain the necessary distraction force in the dynamics for a long time, periodically eliminating the loosening of the unloading force of the sleeves that was formed during the correction of scoliotic curvature, bringing it to its original value using a screw drive. The presence of a spring drive in combination with a screw drive contributes to the treatment more gently, gradually.

 Thus, the use of the proposed orthopedic device allows to obtain better results in the treatment of the spine of various etiologies with equal success. The device is more versatile and convenient to use due to the possibility of choosing the optimal configuration and location of the thrust plates and linear elements that provide a corrective effect in appearance and magnitude of the existing deformation, while maintaining bending mobility. The device is compact, barely noticeable when wearing loose clothing, is easily removed at night for unloading and resting the spine.

Sources of information
1. A.S. US 1671288, A 61 F 5/02, BI 31, 08/13/91 (prototype).

Claims (1)

An orthopedic device consisting of thoracic and pelvic sleeves with cuts interconnected by distraction rods, characterized in that the chest and pelvic sleeves are equipped with cuts on one side in the center of each of them, each of four distraction rods consisting of three coaxially arranged cylindrical elements , two of which are equipped with screw and the third with spring-loaded sliding drives mounted on a ball bearing located on sleeves, on which, in accordance with the topography of the curvature of the spine, the recesses to which the active corrective elements are fastened, consisting of a thrust plate with a working surface curved in accordance with the topography of the body section to which the linear element is directed, made of titanium nickelide and installed on its outside, rigidly connected to one of the sleeves at least one end, and the second with the opposite sleeve with the possibility of free longitudinal movement, moreover, for the implementation of constriction-distraction effects, the linear element it is made in the form of a spiral having the configuration of elements in the form of a meander, provided with fixation loops to the sleeves at both ends, the linear element is also made L-shaped for detorsion-reclamation action, the upper part of which ends with a fixation loop to the liner and is oriented at an angle of 90 ^o to the bottom, equipped in the upper third with an arched protrusion, the plane of which is located at an angle of at least 45 ^o to the plane of the upper part of the element, also linear the element is made in the form of a gentle arc equipped with a loop at one end for fixing to the sleeve.

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