Hand gel brace

Abstract

Wrist orthosis with a forearm part (1) and a hand part (2), which are pivotally connected to one another about a pivot axis (S), wherein an adjusting device is arranged between the forearm part (1) and the hand part (2), by means of which adjusting device the distance between the forearm part (1) and the hand part (2) can be reversibly increased in a distraction direction (F) running transversely to the pivot axis and the adjusting device can be elastically compressed counter to the distraction direction (F), characterized in that, to form the adjusting device, the forearm part (1) has at least one open receiving bore (15) pointing in the distraction direction (F) and the hand part (2) has corresponding immersion tubes (25) which can be inserted into the receiving bore (15) at a variable depth, and a spring element (17) acting on the inserted immersion tube (25) in the distraction direction (F) is arranged in the receiving bore (15).

Description

The invention relates to a wrist orthosis having a forearm part and a handpiece part which are connected together in an articulated manner about a pivot axis.Wrist orthosiss of the type mentioned at the beginning are known and serve to support, stabilize or relieve a temporarily or permanently damaged wrist. Embodiments with a forearm part and a handpiece, which are connected to each other in an articulated manner about a pivot axis, permit a guided movement of the wrist despite being fixed to the forearm and the hand.The wrist may be affected, for example, by trauma, rheuma or arthrotic diseases. As a result, affected persons have pain in the proximal metacarpootic joint between ulna, spoke and the 3 proximal metacarpobones (cahnone, mondone and triangle). By stretching or distraction the wrist and a consequent relief of the injured tissue, the discomfort can be alleviated and treated. However, until now, no wrist orthosiss that can be easily handled and flexibly adjusted and act as a distraction brace in the aforementioned sense have been available.A wrist orthosis of the aforementioned type is known from GB 2 184 659 A, but the adjustment possibilities and the open-access adjustment devices appear to be in need of improvement. The known wrist orthosis can also only compensate to a slight extent for shocks and vibrations.It is therefore an object of the invention to propose a wrist orthosis of the type mentioned at the beginning, which can be easily put on and off by the patient and by means of which the wrist can be stretched and relieved in a distraction direction with an adjustable distraction force.To achieve the object set, the embodiment of a wrist orthosis with the features of claim 1 is proposed according to the invention.Advantageous embodiments and developments of the invention are the subject matter of the dependent claims.The invention is based on the fact that an adjusting device is provided between the forearm part and the handpiece, by means of which the distance between the forearm part and the handpiece can be reversibly increased in a distraction direction.According to the invention, it is thus possible, after application of the wrist orthosis, which fixes itself in a manner known per se with the forearm part on the forearm of the patient and with the handpiece on the wrist of the patient, to actuate the adjusting device in order to bring about an increase in the distance between the forearm part and the handpiece in the distraction direction, whereby a force acting in the distraction direction is exerted on the wrist to be supplied, which force lifts and releases the friction surfaces of the wrist from one another in the desired manner. For this desired relief, a displacement in the range of tenths of a millimeter is already sufficient, which can be realized with a reasonable exertion of force. Due to the connection between forearm part and handpiece, which is still pivotable about the pivot axis, it is nevertheless possible for the patient to move the hand in the usual manner.Since it is provided according to the invention to bring about a reversible increase in distance between the forearm part and the handpiece in the distraction direction by means of the adjustment device, the wrist orthosis according to the invention can be adapted to the patient in an initial position with a non-increased distance and can be placed in this configuration in order subsequently to set the desired increase in distance or distraction, which can be tolerated by the feeling of pain. This can be changed individually as the treatment time progresses. Before the wrist orthosis according to the invention is put down, the set distance increase can moreover be reversed reversibly in order to enable the wrist orthosis according to the invention to be put down easily and painlessly.In the sense of a load-relief of the wrist that can be effected as effectively as possible, it is considered advantageous if the distraction direction of the wrist orthosis according to the invention runs transversely to the pivot axis, preferably approximately at right angles thereto.In addition, the adjusting device is elastically compressible counter to the distraction direction, whereby shocks and vibrations can be compensated and, moreover, the force acting to adjust the distance increase in the distraction direction can be adjusted particularly simply and effectively.Thus, it is provided according to the invention that, for forming the adjusting device, the forearm part has at least one open receiving bore pointing in the distraction direction and the handpiece part has corresponding immersion tubes which can be inserted into the receiving bore in a depth-variable manner, wherein a spring element acting on the inserted immersion tube in the distraction direction is arranged in the receiving bore. This spring element not only enables the desired elastic compressibility counter to the distraction direction, but also applies the desired force in the distraction direction due to the inherent spring force for adjusting the increase in distance between the handpiece and the forearm part.It is already considered sufficient if the forearm part has only one such receiving bore and correspondingly the handpiece has a corresponding immersion tube, but the wrist orthosis according to the invention preferably has two such receiving bores in the interest of a symmetrical and tilt-free application of force and the handpiece has correspondingly two associated immersion tubes which run on both sides of the course of the forearm section of the patient facing the forearm part.The spring element is not subject to any general restriction and can be selected by the person skilled in the art depending on the circumstances. Examples include helical or helical springs, an elastomeric member, a gas or air pressure spring, and the like.According to a further proposal of the invention, the prestress of the spring element is designed to be adjustable in order to be able to adapt the force applied by the spring element in order to increase the distance, which force simultaneously acts on the wrist as a distraction force.According to a proposal of the invention, for this purpose the spring element is designed as a helical spring which extends between the end of the immersion tube inserted into the receiving bore and an abutment arranged in the receiving bore. For setting the prestress, the position of the abutment in the receiving bore can be changed by means of a prestressing device in such a way that, by activating or increasing the action of the prestressing device, the position of the abutment relative to the inserted end of the immersion tube is reduced, as a result of which the helical spring located therebetween experiences greater compression and therefore an increase in the inherent prestressing force with which it then presses on the inserted end of the immersion tube in the distraction direction.According to a proposal of the invention, the pretensioning device can be formed by a pretensioning ratchet connected to the abutment via a pretensioning cable, which ratchet, upon actuation, rolls up and shortens the pretensioning cable guiding the abutment in a ratcheted manner, whereby the abutment is carried along in the direction of the inserted end of the immersion tube. When the prestressing ratchet is released in the opposite direction, the helical spring under prestress presses the abutment back again into a greater distance with respect to the inserted end of the immersion pipe. Such pretensioner pedals are known, for example, as tensioning means in sports shoes such as ski boots and in-line skates and are commercially available. They make it possible to apply large clamping forces with particularly simple handling.In order to be able to carry out the change in distance between the forearm part and the handpiece in a defined manner, which change can be effected with the adjusting device, and also to limit the adjusting path which can be traveled over in this case, it is proposed that the receiving bore be formed in regions with a guide groove which extends in the distraction direction and in which a corresponding projection of the immersion tube can be guided and serves as an end stop for the adjusting path in each case when an end region of the guide groove is reached. In this way, an undesired separation of the forearm part and the hand part of the wrist orthosis according to the invention is moreover prevented.According to a further proposal of the invention, the forearm part is designed like a sleeve with a lower half shell and an upper half shell, which are configured together to enclose a covered forearm section of the patient, and a clamping device is provided, by means of which the lower half shell and the upper half shell can be mutually clamped while receiving the forearm section. Such a tensioning device can in turn be formed by a tensioning ratchet and a tension cable that can be wound up, wherein the tension cable can preferably be wound up more or less strongly on the tensioning ratchet with its two ends or only one end, while the other is fixed in a fixed position. The tension cable is guided in such a way that it can be suspended over its course on at least one hook of the upper and / or lower half shell in order to bring about the desired tensioning of the upper and lower half shell.The hooks can be integrally formed on the lower and / or upper half shell and also be provided with a guide catheter which automatically pulls the tension cable, which is preferably made of metal, automatically into the desired hooking position on the hook in order to facilitate the handling of the wrist orthosis according to the invention.The upper and lower half shell of the forearm part, like the handpiece, can be formed from a plastic component molded and manufactured individually for the patient, preferably obtained in a 3-D printing process, which can be provided with a plurality of perforations for achieving a good breathability and a low weight. The handpiece can be equipped in a manner known per se with eyes and a fixing band passed through it, for example with hook and loop fastener elements, in order to connect the handpiece to the hand and is furthermore designed as a clip in order to retain the hand in accordance with the orthopedic 3-point principle.To create the articulated connection between forearm part and handpiece, according to a further proposal of the invention, the immersion tubes can be formed with a joint head at their end facing away from the receiving bore and the handpiece with dropouts assigned to the joint head, wherein a connection is produced in a manner pivotable about the pivot axis via a pin defining the pivot axis between joint head and dropouts.Further embodiments and details of the invention are explained below with reference to the drawing illustrating an exemplary embodiment. The following are shown: FIG. 1 is a plan view of a wrist orthosis according to the invention in use on a patient; FIG. 2 is a bottom view of the wrist orthosis according to FIG. 1 ; FIG. 3 is a left side view of the wrist orthosis according to FIG. 1 ; FIG. 4 is a right side view of the wrist orthosis according to FIG. 1 ; FIG. 5 shows an enlarged, partially transparent illustration of the forearm part according to FIG. 3 ; FIG. 6 shows the forearm part according to FIG. 5 from the opposite viewing position; FIG. 7 shows the handpiece according to FIG. 4 in an individual part illustration.Referring now to FIGS. 1-4, a wrist orthosis for treating, for example, rheumatic pain in a patient's wrist from various viewing angles is shown.The wrist orthosis comprises a forearm part 1 assigned to the forearm of the patient and a handpiece 2 facing the hand of the patient.The forearm part 1 and the handpiece 2 are manufactured, for example, from thermoplastic materials by the 3-D printing method, preferably individual to the patient after impression and provided on their surface facing the skin with a suitable cushioning material.The forearm part 1 is embodied in two parts in the manner of a sleeve and comprises a lower half shell 10 opened toward the top and an upper half shell 11 opened toward the bottom corresponding thereto, between which the forearm section is clamped. For this purpose, a tension cable 12 is provided, which is guided in regions by a plurality of channels 110 formed integrally in the lower half shell 10 and upper half shell 11. The two ends of the tension cable 12 are brought together in a rotatable tension ratchet 14 fastened laterally to the lower half shell, on which ratchet these can be wound more or less strongly by rotating the tension ratchet 14 while shortening the overall length of the tension cable 12. On the other hand, as can be seen in particular from FIG. 4, the tension cable 12 is suspended on the side of the lower half shell 10 opposite the tension ratchet 14 in two integrally formed hooks or projections 13 a, 13 band runs from there via the upper half shell 11 back to the tension ratchet 14 of the lower half shell 10.On the other hand, the hand part 2 of the wrist orthosis, which is shaped like a clip, is adapted in particular to the contour of the palm of the hand and is passed between thumb and index finger with partial gripping around the back of the hand and is firmly clamped on the back of the hand by a fixing band 22 fixed at fixed points and guided over an eyelet 21 and having hook-and-loop fastener elements on the hand according to the orthopedic 3-point principle.At the rear end of the hand part 2 facing the forearm part 1, the latter is formed on both sides of the accommodated wrist region with protruding dropouts 23, in which a bore 230 is formed for accommodating a pivot pin 231, which forms the subsequent pivot axis S, see in particular FIGS. 2 and 7.Pivotably attached to this pin 231 is a joint head 24 which merges into a substantially cylindrical immersion tube 25 which projects from the handpiece 2 in the direction of the forearm part 1. In a corresponding manner, the forearm part 1 is provided on its end side facing the handpiece 2 in the region of the lower half shell 10 with receiving bores 15 on both sides, which extend substantially parallel to the received forearm section and into which the immersion tubes 25 are inserted or introduced.As can be seen in particular from the illustration according to FIG. 5, a helical spring 17 is arranged in each case in the interior of the receiving bore 15, which coil spring extends from the inserted end of the immersion tube 25 as far as an abutment 16 likewise inserted into the receiving bore 25, with the result that the helical spring is supported at the end of the immersion tube 25 and the abutment 16 in each case by one end.Furthermore, the immersion tubes 25 have a transversely projecting projection 26, preferably designed as a spring pin, which is guided in a slot-shaped guide groove 101 extending parallel to the receiving bore 15, so that the connection between forearm part 1 and handpiece 2 effected by inserting the immersion tubes 25 into the receiving bores 15 cannot be lost.In addition to the already explained clamping ratchet 14 for fixing the forearm section, the lower half shell 10 carries a further clamping ratchet which serves as a pre-tensioning ratchet 19 of a pre-tensioning device for the helical spring 17. As can be seen in particular from FIG. 5, starting from the prestressing ratchet 19, a prestressing cable 18 is guided partially through a shaped channel 120 in the interior of the lower half shell 10 into the receiving bore 15, from where the prestressing cable 18 passes over into the central tube interior of the inserted immersion tube 25. From there, the prestressing cable 18 runs through the immersion tube 25 and the spiral spring 17 abutting it as far as the abutment 16, to which the end of the prestressing cable 18 is fixed. By appropriate actuation of the prestressing ratchet 19, the length of the prestressing cable 18 is shortened and, as a result, the abutment 16 fastened to the end of the prestressing cable 18 is carried along in the direction of the inserted end of the immersion pipe 25. As a result, the receiving space available for the helical spring 17 within the receiving bore 15 is correspondingly reduced and the helical spring 17 experiences a corresponding compression, which leads to an increase in the prestressing force originating from it and bearing against the immersion tube 25.If the wrist orthosis described above is thus fixed to the forearm and the hand of a patient as shown in FIGS. 1-4, the immersion tube 25 is pushed out of the receiving bore 15 by a certain amount when the prestressing ratchet 19 is actuated, increasing the prestressing force of the helical spring 17. Since the handpiece 2 articulated to the immersion tube 25 is in turn rigidly connected to the hand, this results not only in an increase of the distance between the forearm part 1 and the handpiece 2 in the region of the orthosis, but also in a corresponding extension of the wrist in a distraction direction indicated by arrow F. This stretching of the wrist releases the injured tissue of the wrist, whereby the desired therapy effect occurs.Nevertheless, even when the desired application of force in the distraction direction F is desired, the wrist can be pivoted about the pivot axis S and the strength of the distraction that has taken place can be varied individually by adjusting the prestressing ratchet 19. The projection 26 guided within the slot-shaped guide groove 101 which likewise extends in the distraction direction F additionally brings about a limitation of the possible extension, since the ends of the slot-shaped guide groove 101 serve as end stops.Since the force applied in the distraction direction F for increasing the distance is exerted by the helical spring 17, it is elastically compressible in order to absorb, for example, shocks. Moreover, the exertion of force is completely reversible, i.e. by releasing the biasing ratchet 19, the forearm part 1 and the handpiece 2 resume their original position without an increased distance in the distraction direction F.The wrist orthosis explained above thus serves as a distraction brace and can be individually adjusted within wide limits.

Claims

Wrist orthosis having a forearm part (1) and a handpiece (2) which are connected to one another in an articulated manner such that they can be swivelled about a swivel axis (S), wherein an adjusting device is arranged between the forearm part (1) and the handpiece (2), by means of which adjusting device the distance between the forearm part (1) and the handpiece (2) can be increased reversibly in a distraction direction (F) running transversely to the swivel axis and the adjusting device can be elastically compressed counter to the distraction direction (F), characterized in that, that, for forming the adjusting device, the forearm part (1) has at least one open receiving bore (15) pointing in the distraction direction (F) and the handpiece part (2) has dip tubes (25) corresponding to the depth-variably insertable into the receiving bore (15), and a spring element (17) acting on the inserted dip tube (25) in the distraction direction (F) is arranged in the receiving bore (15).Wrist orthosis according to Claim 1, characterized in that the prestress of the spring element (17) is adjustable.Wrist orthosis according to one of Claims 1 or 2, characterized in that the spring element (17) is designed as a helical spring which extends between the end of the immersion tube (25) inserted into the receiving bore (15) and an abutment (16) arranged in the receiving bore (15), and the position of the abutment (16) in the receiving bore (15) can be changed by means of a prestressing device.Wrist orthosis according to Claim 3, characterized in that the prestressing device comprises a prestressing ratchet (19) connected to the abutment (16) via a prestressing cable (18).Wrist orthosis according to one of Claims 1 to 4, characterized in that the receiving bore (15) is formed in regions with a guide groove (101) which extends in the distraction direction (F) and in which a corresponding projection (26) of the immersion tube (25) can be guided.Wrist orthosis according to one of Claims 1 to 5, characterized in that the forearm part (1) comprises a lower half shell (10) and an upper half shell (11), which are configured jointly to enclose a forearm section and have a clamping device for mutually clamping the lower half shell (10) and the upper half shell (11).Wrist orthosis according to Claim 6, characterized in that the tensioning device comprises a tensioning cable (12) which can be wound with its ends on a tensioning ratchet (14), and at least one hook (13a, 13b) which is formed on the upper and / or lower half shell (10, 11) and is intended for the suspension of the tensioning cable (12).Wrist orthosis according to one of Claims 1 to 7, characterized in that the immersion tubes (25), at their end facing away from the receiving bore (15), are formed with an articulated head (24) and the handpiece (2) with dropouts (23) assigned to the articulated head (24) and are pivotably connected to one another via a pin (231) defining the pivot axis.

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