Hip orthosis for mobilizing a hip joint

Abstract

Hip orthosis, including: a central orthosis belt section which is adapted to extend at least partially along a lateral hip region of the patient, a hip belt assembly provided at a proximal region of the central orthotic belt portion and configured to engage a pelvic region of the patient; at least one first elongate stabilizing band having at least one proximal and one distal band portion and adapted to be wrapped around a thigh of the patient in a first orientation; at least one second elongate stabilizing band having at least one proximal and one distal band portion and adapted to be guided around the thigh in a second orientation; and a hip joint splint for stabilizing the hip joint of a patient, wherein the hip joint splint comprises a joint arrangement and is arranged at least in sections on the central orthosis belt section; wherein the hip belt assembly, the proximal band portion of the first stabilizing band, and the proximal band portion of the second stabilizing band are provided on the central orthosis belt portion at different positions with respect to a longitudinal direction of the central orthosis belt portion, and wherein the first orientation is different from the second orientation in a state applied to the patient.

Description

The present invention relates to a hip orthosis for mobilizing a hip joint of a patient.Hip orthosiss are used for medical and therapeutic application and are nowadays used in numerous indications in which functional safety and / or mobilization of a hip joint is necessary. They are used, for example, after hip joint luxation, during loosening of hip prostheses, for the therapy of coxarthrosis and / or in muscular dysbalances in the lumbar-pelvic-hip region. Hip orthosiss are already known from the prior art. Document EP 3 202 376 B1, for example, discloses a hip orthosis which substantially comprises a side portion at the opposite ends of which a lumbar strap and a thigh strap are arranged, respectively. In the fitted state, the lumbar strap encloses a lumbar region of a patient, the thigh strap encloses a portion of a thigh of a patient, and the side portion encloses a lateral hip region. Both the lumbar strap and the thigh strap are substantially each formed as a flexible band which, when put on, is wound around the corresponding body region and fastened by means of a hook and loop fastener. In addition to a hinge rod, two tension straps can also be attached to the outside of the orthosis, of which the first end section is fastened to the lumbar strap and the second end section to the thigh strap are fastened to counter-fastening devices provided for this purpose. The two counter-fastening devices for the two first end sections of the two tension straps and the counter-fastening devices for the two second end sections are arranged respectively at the same height of the lumbar strap and of the leg strap. Furthermore, the tension straps are fastened in such a way that they each extend diagonally between the lumbar strap and the leg strap and cross over in the laid state. However, due to the belt arrangement and the unidirectional belt guidance of the leg belt, pressure acting on the hip joint is not uniformly reduced, but rather is non-uniformly reduced. This not only reduces wearing comfort, but also significantly influences the progress of therapy.Since the use of hip orthosiss reduces the need for complicated invasive treatments and plays an important role in the postoperative treatment and rehabilitation of a patient, there is always an interest in exploring hip orthosiss with improved properties with regard to user-friendliness and their therapeutic effect.It is an object of the present invention to provide a hip orthosis with optimized orthopedic properties, so that in particular the stabilizing and supporting effect on the hip joint of a patient is improved. It is a further object of the invention to provide a hip orthosis having improved properties for applying the same.At least one of the above objects is achieved according to the invention by the features of independent claim 1. Further developments of the invention can be found in the dependent claims.A hip orthosis according to the invention comprises a central orthosis strap section which is configured to extend at least in sections along a lateral hip region of the patient. Furthermore, the hip orthosis comprises a hip strap arrangement which is provided at a proximal region of the central orthosis strap section and is designed to engage around a pelvic region of the patient. In addition, the hip orthosis comprises at least one first elongate stabilizing strap which has at least one proximal and one distal strap section and which is provided to be guided around a thigh of the patient in a first orientation, and at least one second elongate stabilizing strap which has at least one proximal and one distal strap section and which is provided to be guided around the thigh of the patient in a second orientation. For stabilizing the hip joint of a patient, the hip orthosis according to the invention also comprises a hip joint rail with a joint arrangement. This hip joint rail is arranged at least in sections on the central orthosis chord section. The hip strap assembly, the proximal strap portion of the first stabilizing strap, and the proximal strap portion of the second stabilizing strap are provided at the central orthosis strap portion at different positions with respect to a longitudinal direction of the central orthosis strap portion. According to the invention, the first orientation is different from the second orientation in a condition of the hip orthosis applied to the patient.The features according to the invention make it possible to provide a hip orthosis with optimized therapeutic properties, which has in particular an improved supporting and stabilizing effect. The inventors have recognized that the use of two stabilizing straps, the proximal strap sections of which are provided on a central orthosis strap section at different positions with respect to a longitudinal direction, i.e. in the main extension direction, of the central orthosis strap section and the windings of which around a thigh of a patient differ with respect to their orientation in a state applied to the patient, brings advantages over conventional hip orthosiss which have only one leg strap. In particular, a hip orthosis configured in this way with at least two stabilizing straps, which are oriented differently, has the advantage of a bi- or multidirectional force distribution, so that a load in the loaded state of a hip joint of a patient is distributed uniformly over the hip joint of the patient and the pressure is reduced. Furthermore, this facilitates the correct placement of the hip orthosis, because the different orientation specifically counteracts undesired twisting of the orthosis during placement. By the embodiment of the hip orthosis according to the invention, it is thus possible not only to increase wearing comfort, but also to speed up the progress of therapy.A "hip orthosis" is to be understood in particular as a functional medical device which is configured to support, stabilize and improve the function of a hip or at least one hip joint. The hip orthosis may be configured to alleviate pain from a patient, improve the mobility thereof, and promote healing and / or correct alignment of the hip joint. The term "hip joint" in the context of this invention, unless explicitly indicated, includes not only bone structures, but also joint capsules, joint straps, as well as muscles and chords adjacent to the hip joint. "Configured" is to be understood to mean, in particular, provided, designed, formed and / or equipped. The fact that an object is set up for a specific function is to be understood furthermore to mean that the object fulfills this specific function in at least one application state.The "central orthosis belt section" is, in the context of this invention, in particular a subsection of the hip orthosis which, in a state in which it is applied to a patient, extends on an inner side along a lateral section of a thigh and / or hip region of the patient. The central orthosis harness section further has a proximal region. The proximal region is to be understood in particular as the region which, when the orthosis is attached to a patient, is arranged closest to the body center point thereof. "Central" in this context means that this orthosis belt section is positioned in a central region of the hip orthosis.By "hip strap attachment" is meant, in particular, a configuration of one or more straps or straps adapted to be applied around a hip. It can be provided for securing the hip orthosis to the patient at least in the region of the hip. The hip strap arrangement plays a decisive role in stabilizing the hip and supporting an affected area. An "affected area" refers to a specific part of a patient's body, which is located in particular in the hip region of the patient affected by a medical disease, injury or orthopedic problem. This region may include, for example, joints, muscles, bone structures, and / or other anatomical structures that have adverse effects, pain, or functional problems. The hip strap arrangement can furthermore have adjusting devices, preferably in the form of buckles and / or hook-and-loop fasteners, by means of which the hip orthosis and in particular the length of the straps can be adapted individually to the patient in order to ensure a secure and proper hold of the orthosis. Furthermore, the fit of the orthosis can thus be adapted to the patient in order to achieve the required pressure and / or support effect. In addition, the hip strap arrangement can comprise a pelvic brace which is configured to engage around and stabilize or support the pelvis or a pelvic region of the patient. The pelvic brace contributes in particular to the correct orientation of the pelvis during a treatment and can likewise be set or positioned individually for the patient.According to the invention, a stabilizing strap is understood to mean a strap or strap construction which is configured to secure the hip orthosis to a thigh section and to provide the desired stability and support for the hip joint. According to the invention, such a stabilizing strip is configured to be elongate, which means that the length dimension is greater than the width dimension of the strip. The length dimension can be at least 100%, preferably at least 300%, preferably at least 500% and particularly preferably at least 600% of a width dimension of the stabilizing tape. Further, the width of a stabilizing tape may vary along the stabilizing tape. In particular, a stabilizing strip can have a tapered shape at least in sections. According to some embodiments, the stabilizing tapes may be configured differently. Such a configuration of the stabilizing straps makes it possible to improve, in particular, the fit, the stabilizing effect and the wearing comfort of the orthosis. It goes without saying that a high degree of variation is possible in the design or dimensioning of the stabilizing tapes. The addition "at least" is to be understood such that, for example, at least one first and at least one second stabilizing band etc. can be provided.The proximal strap section is understood to be the section of a stabilizing strap which, in the non-applied state of the orthosis, is arranged close to a reference point on the central orthosis strap section. The distal strap section of a stabilizing strap is to be understood as the section which, in the non-applied state of the orthosis, is located at a distance from the reference point on the central orthosis strap section.The fact that the stabilizing bands are intended to be wound around a thigh of the patient in an "orientation" can mean within the scope of this invention that the stabilizing bands can be wound around a thigh of a patient in a defined rotational direction, or in other words to express it, according to a specific rotational sense or a winding direction and / or in a predefined winding angle. The winding direction and / or the winding angle in which / the stabilizing bands are guided around a thigh of a patient or around or relative to a winding axis which runs along a thigh or through the longitudinal extension of a thigh of the patient can be adapted patient-individually.Within the scope of this invention, a hip joint rail can be understood to mean a medical device which is configured, for example, to stabilize the hip joint of a patient and / or to restrict movements of the hip joint, such as, for example, in the form of an abduction / adduction and / or flexion / extension. The hip joint rail may comprise two joint legs movably coupled to each other by means of a joint mechanism. The articulation mechanism is configured to control and / or support a movement of an articulation of a patient. The mechanism may further include various components, such as hinges, hinges, springs, and / or actuators, that allow for adjustment of desired movement restriction or support for the patient. The articulation mechanism can vary according to the individual requirements of the patient and / or according to a progress of therapy.According to a development of the hip orthosis, the hip strap arrangement, the first stabilizing strap and / or the second stabilizing strap can / can be configured as a separate component / s with respect to the central orthosis strap section. In this case, it can also be provided that the hip strap arrangement, the first stabilizing strap and / or the second stabilizing strap can be exchanged with respect to the central orthosis strap section. This has the advantage that individual components can be replaced independently of one another if necessary. In addition, this can facilitate the production of the hip orthosis. The waistband assembly, the first stabilizing strap, the second stabilizing strap, and / or the central waistband portion can be made of different materials. Different materials can have different compressing and / or elastic properties in particular. Individual components can also have a combination of a plurality of materials, such that the components have at least in sections and / or different compressing and / or elastic properties. Preferably, materials are used which are insensitive to perspiration and which bring about breathable properties. Depending on the indication and / or progress of therapy or in the case of deficiencies, individual components can be exchanged, i.e. replaced by components with other application-specific properties.For the assembly or fastening of the individual components, fastening mechanisms with fastening devices and / or complementary counter fastening devices, for example in the form of buckles, magnets and / or Velcro fasteners, can be provided on the individual components. Preferably, the fastening and / or counter fastening devices are arranged on the individual orthosis components in such a way that they can be attached reversibly and captive to the central orthosis belt section of the hip orthosis. In particular, individual or all fastening mechanisms can be configured such that in the locked state, degrees of freedom, i.e. movement possibilities of the respective component, are permitted, which can positively influence both the wearing comfort and the therapeutic effect.According to a further embodiment, the hip strap arrangement, the first stabilizing strap and / or the second stabilizing strap can / can be formed integrally with the central orthosis strap section. In other words, in this embodiment, at least individual components are irreversibly connected to the central orthosis belt section, that is to say for example sewn, welded, bonded and / or manufactured at least for the most part seamless from a textile fabric. At this point, it should be pointed out that, depending on the field of application in the production of the hip orthosis, a wide variety of materials and material combinations can also be used in this embodiment. However, it can also be provided that one part of hip strap arrangement, first stabilizing strap and / or second stabilizing strap is reversibly configured with respect to the central orthosis strap section and the other part is irreversibly configured with respect to the central orthosis strap section.In a development, the hip strap arrangement, the first stabilizing strap, the second stabilizing strap and / or the central orthosis strap section can be configured with different lengths and / or different widths. Furthermore, the length and / or width of individual orthosis components can be equipped by means of adjustment devices such as buckles and / or velcro fasteners and can be adapted patient-individually. Adjustment devices of this type have the advantage, among other things, that a hip orthosis only has to be produced in a few different sizes, since it can be adapted to a large number of different patient dimensions. Moreover, in some embodiments, the width of the hip strap assembly, the first stabilizing strap, the second stabilizing strap, and / or the central orthosis strap portion may vary along a respective longitudinal extent or extension direction. By means of this feature, it is possible to attach the orthosis to the patient with an exact fit. Furthermore, such a configuration not only increases the wearing comfort, but also generates a precise and local supporting effect. Preferably, the hip strap arrangement has a greater length than the first and / or second stabilizing strap.According to a further embodiment, the first and / or the second elongate stabilizing strap can be arranged on the central orthosis strap section in such a way that an extension direction of the first and / or of the second stabilizing strap is oriented at a respective angle relative to the longitudinal direction of the central orthosis strap section, which angle is different to 90 degrees, at least in the region of the proximal strap section of the stabilizing strap. In other words, the proximal strap section of the first and / or of the second stabilizing strap can run obliquely to a reference axis, namely the longitudinal direction, which extends in the main extension direction of the central orthosis strap section. In other embodiments, the proximal strap portion of the first and / or second stabilizing strap may extend perpendicular to the reference axis extending in the main extension direction of the central orthosis strap portion. The orientation of the proximal strap section of the first and / or second stabilizing strap influences in particular the winding angle at which the first and / or the second stabilizing strap is guided around the thigh when applying the orthosis to the thigh of a patient. Depending on the angle, the first and / or second stabilizing band can be guided, for example, at least in sections, annularly, helically or spirally around the thigh of a patient.A development provides that the second orientation and the first orientation are opposite or contrary to one another. In other words, the first and the second stabilizing strap can extend in opposite directions starting from the central orthosis strap section at least with regard to the winding direction around the thigh or can be provided to be wound in opposite or different directions around the thigh of a patient. "Opposite" can mean in this context that the extension direction of the proximal strap section of the first stabilizing strap differs from the extension direction of the proximal strap section of the second stabilizing strap by at least 90°, preferably at least 100°, particularly preferably 180° and at most 270°.In a development, the distal band section of the first elongate stabilizing band and / or the distal band section of the second elongate stabilizing band for applying the hip orthosis to a patient can be configured to be attached to the central orthosis belt section. In other words, the hip orthosis can be designed such that the stabilizing straps can be wound around the thigh of the patient under tension when applied and the distal strap sections can be attached to the central orthosis strap section for fixing the winding. In order to enable a particularly flexible locking, an outer side, i.e. a side facing away from the patient in the fitted state, of the hip strap arrangement, of the central orthosis strap section, of the first stabilizing strap and / or of the second stabilizing strap can serve and be configured at least in sections as a locking surface or counter-fastening device. The distal end sections can be equipped on their inner sides with a fastening device which can be designed to be complementary to the counter fastening device. Thus, the distal end sections can be attached flexibly and individually to the patient and / or according to a progress of therapy not only to the central orthosis belt section, but also to a stabilizing strap and / or the hip belt arrangement if necessary.A fastening mechanism described above may include, for example, a magnetic mechanism or a hook and loop fastener mechanism. Alternatively or additionally, the distal end portions may be reversibly attached and fixed by means of, for example, buckles and / or hook devices.According to a further development, the hip joint rail provided on the hip orthosis can be reversibly attachable to the central orthosis strap section. Furthermore, at least the central orthosis strap section can have a fastening section which is designed to attach the hip joint rail at different positions on the central orthosis section. In some embodiments, the fastening portion can be configured, for example, as a type of fluff, velour or magnetic material. The hip joint rail can be equipped with a fastening device, in particular in a region of a joint limb. This can be designed in particular complementary to the fastening mechanism of the fastening section of the central orthosis strap section. In particular, the fastening device can comprise a textile band with barbs, such that the hip joint rail can be attached to the fastening section of the central orthosis belt section via a hook and loop fastener mechanism. In this way, the articulated rail can be installed or uninstalled and aligned individually for the patient and at different positions on the central orthosis belt section. According to some embodiments, the central orthosis strap portion may comprise a pocket-like device. In particular, this pocket-like device can be integrated into the central orthosis belt section and designed in such a way that a joint limb of the joint rail can be positioned and fixed therein at least in sections. Alternatively or additionally, this pocket device can be designed as a component which is separate and / or separable from the central orthosis belt section and in which a joint rail and in particular a joint limb can be positioned and fixed.The joint legs of the hip joint rail and / or the hip joint rail can comprise an aluminum material. The aluminum material enables a low weight with at the same time simple deformability, which facilitates the adaptability of the hip joint rail to the patient.The hip joint arrangement of the joint rail can permit a pivoting within an angular range by means of a limiting device and prevent a pivoting outside the angular range. In this way, the freedom of movement with respect to a flexion and extension movement and the stability of the hip joint can be controlled and limited, which serves in particular to relieve the hip joint and thus to prevent overloading. In some embodiments, the joint rail or hip joint arrangement and in particular the angular range can be adapted or varied individually for the patient and according to a progress of therapy, in order to be able to set different degrees of restriction. Preferably, the angle range of the joint rail, i.e. the degree of pivoting of the joint limbs relative to one another, can be limited to in particular 0°, 15°, 30°, 45°, 60°, 75° and 90° by means of an adjustment mechanism.The central orthosis belt portion, the hip belt assembly, the first and / or the second stabilizing strap may comprise a breathable material. Furthermore, it can be provided that the central orthosis belt section, the hip belt arrangement, the first and / or the second stabilizing band comprise a material with a high, in particular predominant, cotton content. This contributes to a pleasant wearing comfort.Furthermore, the hip orthosis can have at least one pressure pad which can preferably be reversibly fastened to the central orthosis belt section. A pressure pad is understood within the scope of this invention to mean a padded, shaped insert which is configured to relieve, distribute or control certain body regions of a patient from pressure and load. It can additionally or alternatively be provided that the pressure pad provides a massage function, in particular an intermittent massage. The massage function can contribute to pain relief. "Certain body regions" can be, in particular, regions close to the hip in the vicinity of or in the region of the hip joint or trochanter. These include, inter alia, surrounding muscle tissue, such as piriformis muscle. The at least one pressure pad can be attached to the inner side, i.e. the side facing the patient in the fitted state, of the hip orthosis via a fastening mechanism. The attachment can be effected, for example, via a hook and loop fastener mechanism, so that the at least one pressure pad can be positioned individual to the patient.In some embodiments, the at least one pressure pad can be configured to exert pressure on the patient in the region of the trochanter major in the state of the hip orthosis applied to the patient and / or to cushion this region. Furthermore, it can be provided that the pressure pad provides a massage function. Such a massage function can contribute to pain relief and / or be designed intermittently. Alternatively or additionally, the hip orthosis can have a pressure pad which is configured to exert pressure on the patient in the region of the piriformis muscle and / or to cushion this region in the state of the hip orthosis applied to the patient. The pressure pad of the piriformis muscle can have a harder material property compared to the pressure pad of the trochanter major. In particular, the harder material property can provide a trigger point massage function of the piriformis muscle.According to a further development, the hip orthosis can additionally comprise a hose- or cuff-shaped thigh bandage which is configured to additionally improve the wearing comfort of the hip orthosis. Such a thigh bandage can prevent skin folds, for example, from being pinched when the stabilizing straps are wound around the thigh or when the patient moves. In this embodiment, the thigh bandage is tightened before the stabilizing straps are guided around the thigh section.The hip orthosis according to the invention should not be limited to the application and embodiment described above. In particular, in order to fulfil a mode of operation described herein, these can have a number which differs from a number of individual elements, components and units mentioned herein. In addition, in the value ranges specified in this disclosure, values lying within the stated limits should also be considered as disclosed and usable as desired.The present invention is described below by way of example with reference to the attached figures. The drawings, specification and claims contain numerous features in combination. The person skilled in the art will also expediently consider the features individually and use them in combination within the scope of the claims.If more than one instance is present from a particular object, only one of them may be provided with a reference sign in the figures and in the description. The description of this instance can be transferred to the other instances from the object accordingly. If objects are designated in particular by means of numerical words, such as first, second, third objects, etc., these are used for designating and / or assigning objects. Accordingly, for example, a first object and a third object, but no second object, can be included. However, a number and / or an order of objects could also be derived additionally on the basis of numerical words.The following are shown: FIG. 1 shows a hip orthosis according to the invention in a front view; FIG. 2 is a perspective view of the joint arrangement of the hip orthosis according to FIG. 1 ; FIG. 3 shows a front view of the pelvic brace of the hip orthosis with a joint arrangement according to FIG. 1 ; FIG. 4 shows a detailed view of the pelvic brace with hip joint rail according to FIG. 3 ; FIG. 5 shows a rear view of the hip orthosis according to FIG. 1 ; FIG. 6 is an explanatory view illustrating the attachment of a trochanter pad to the hip orthosis of FIG. 1 ; FIG. 7 is an explanatory view showing the attachment of a piriformis pad to the hip orthosis of FIG. 1; FIGS. 8 and 9 are further explanatory views each showing steps for applying the hip strap assembly of FIG. 1 to the hip region; FIGS. 10-15 are further explanatory views showing further steps for applying the hip orthosis of FIG. 1 to the femoral region; FIG. 16 is a side view of the hip orthosis according to FIG. 1 in a state in which it is applied to the patient; FIG. 17 is a front view of the patient with the hip orthosis applied; FIG. 18 is a rear view of the patient with the hip orthosis applied; and FIG. 19 is a perspective side view of the patient with the hip orthosis applied.In FIG. 1, a hip orthosis according to the invention is shown in an open state and generally designated by 10 in a front view, more precisely the outer side 60 of the hip orthosis. The hip orthosis 10 has a central orthosis strap section 12, on the proximal or upper region 14 of which a hip strap arrangement 16 is arranged. A lap brace 18 is arranged on the hip strap arrangement 16. The pelvic brace 18 can comprise, for example, padding and / or foam inserts and structural or stiffening elements, for example made of metal and / or other slightly elastic or stiff materials, and serves primarily for stabilizing the hip and pelvic region of a patient when wearing the hip orthosis. Further, straps 20, 22 are formed on the hip strap assembly 16. The first strap 20 is wider than the second strap 22 in the height direction shown in the embodiment shown. The pelvis brace 18 is arranged on the first strap 20 or between the first strap 20 and the second strap 22. According to the embodiment shown in FIG. 1, the first belt 20 has elastic or partially elastic properties at least in sections. The second strap 22, on the other hand, is at least largely non-elastic. Also visible are deflection loops 24 which are configured to adapt the belt length of the belt 22 for individual patients. The deflection loops 24 are arranged directly on the belt 22 in the embodiment shown. In addition to the deflection loops 24, the hip orthosis 10 shown here also has through loops 26 b, which are configured to secure the pelvic brace 18 or the belt 22 to the belt 20 and / or to ensure a proper position or course. The through loops 26 bare arranged in this embodiment on the outer side 60 of the hip orthosis 10 or, more precisely, on the outer side of the belt 20. The through loops 26 bare in particular arranged in such a way that they extend transversely to the pelvic brace 18 in a central region 82 and in outer regions 84 which are spaced apart to the left and right from the central region 82 of the pelvic brace 18. For a better understanding, reference is made at this point to FIG. 3, which shows the released pelvic clip 18 and the positions of the through loops 26 b.Furthermore, the belt arrangement 16 according to this embodiment has at least one further through-loop 26 a, which is configured in particular to position the belt 22 according to the application. According to some embodiments, the strap 22 may only pass through the at least one further through-loop 26 aand be positioned or fixed. Alternatively or additionally, the strap 22 can also extend through the through loops 26 b, which are substantially configured to fix the pelvic brace 18. The at least one further through-loop 26 acan be arranged, viewed spatially, above the pelvic brace 18 and above the through-loop 26 bwhich fixes the central region 82 of the pelvic brace. It is understood that the position and / or the number of through loops 26 a, bmay vary in further embodiments not shown here. The through loops 26 a, bmay furthermore be reversibly closable, as a result of which simple installation and removal of the pelvic brace 18 and / or of the belt 22 may be made possible.Furthermore, the outermost end sections 20 a, b, 22 a, bof the belts 20, 22 have fastening devices 21, by means of which the belts can be reversibly closed or locked. In order to make the placement of such a hip orthosis 10 as user-friendly as possible, the outermost end sections 20 a, b, 22 a, bhave additionally guide tabs 40. The guide tabs 40 can preferably be gripping or ergonomic gripping devices that are easy for a patient, for example in the form of projections or gripping holes, which facilitate and ensure the proper application of the straps or the manual guide.The hip strap assembly 16 is connected to the central orthosis strap portion 12 via a hinge assembly 28 in the embodiment shown. The joint arrangement 28 comprises a hip joint rail 30 having two hip joint limbs 30 a, bwhich are configured to stabilize the hip joint of a patient and / or restrict movements of the hip joint in the form of an abduction / adduction and / or flexion / extension. Furthermore, the joint arrangement 28 has a limiting device 32, by means of which the movement of the two hip joint limbs 30 a, brelative to one another can be limited to a defined range, that is to say an angle amount β. The upper or proximal hip joint limb 30a is fastened vertically to the pelvic brace 18. The lower or distal hip joint limb 30 bextends along a substantial part of the central orthosis belt section 12 and is arranged in a pocket device 70 which is fastened to the central orthosis belt section 12 via a hook and loop fastener mechanism on a fastening surface 42 or hook and loop surface provided for this purpose. This fastening surface 42 can be formed from a different material, in particular velours, and from a different textile than the remaining orthosis components. The fastening surface 42 can be adhesively bonded or sewn, for example, to the outer side 60, i.e. the surface of the orthosis facing away from the patient in the fitted state.Proceeding from a central region 34 of the central strap section 12, a first elongate stabilizing strap 36 extends, the outer end section of which, the distal strap section 36 a, has a fastening device 21. This end section 36 aof the stabilizing strip 36 also has a guide tab 40.Starting from a lower or distal region 44 of the central strap section 12, a second elongate stabilizing strap 38 extends. It can furthermore be seen that the second stabilizing strap 38 extends in a direction different from the direction of extension E of the first stabilizing strap 36 and is thus provided to encompass the thigh of a patient in a different orientation. The outer end section, namely the so-called distal strap section 38 aof the second stabilizing strap 38, likewise comprises a guide tab 40 and a fastening device 21. The average width B 2 of the second stabilizing band 38 is wider than the width B 1 of the first stabilizing band 36 according to the embodiment exemplarily shown here.FIG. 2 shows a perspective view of the joint arrangement 28 of the hip orthosis 10 according to FIG. 1. the joint arrangement 28 comprises a proximal and a distal hip joint limb 30 a,b. The two hip joint limbs 30 a,bare also referred to below as joint limbs. The proximal hip joint limb 30 ais configured to be fastened to the pelvic brace 18, whereas the distal hip joint limb 30 bis configured to be fastened to the central orthosis chord section 12 or in a pocket device 70 which is arranged or can be arranged on the central orthosis chord section 12. The two joint limbs 30 a, bmay differ both in terms of their shape and in terms of their physical, in particular their mechanical, properties. In the present embodiment, the distal joint leg 30 bis longer and narrower than the proximal joint leg 30 a. Furthermore, the distal joint limb 30 bhas material recesses 46, which increase the flexibility of the joint arrangement 28 and in particular reduce the weight of the orthosis. Furthermore, the material recess serves to facilitate adaptation of the distal joint limb 30 bto the contour of a patient. For the sake of clarity, only one material cutout 46 is provided with a reference sign. The two joint limbs 30 a, bare coupled to one another via a limiting device 32, by means of which the movement of the two joint limbs 30 a, brelative to one another can be limited to a defined range as required. At the same time, the limiting device 32 has the function of holding the two joint limbs 30 a, btogether in a captive manner.FIG. 3 shows a front view of the pelvic brace 18 of the hip orthosis 10 according to FIG. 1 with the joint arrangement 28, which shows the through loops 26 b,by means of which the strap 22 is fastened to the hip strap arrangement 16 or the pelvic brace is fastened to the strap 20. The basin brace 18 comprises the middle region 82, as well as the outer regions 84 extending from the middle region 82 to the left and right. The outer regions 84 are configured to be narrower along the transverse direction of the basin brace 18 than the middle region 82, which contributes to better handling. Furthermore, the fastening of the joint arrangement 28 to the pelvic brace 18 is shown schematically, wherein the joint limb 30 ain this embodiment is fastened to the rear side of the pelvic brace 18 and therefore its contour is indicated as a dotted line. As can be seen from the detailed view in FIG. 4, the proximal joint limb 30 ais connected to the pelvic brace 18 via two rivets 48. This detail view shows the region of the pelvic brace 18 circled in FIG. 3, but from behind, i.e. with regard to the side of the pelvic brace 18 facing the patient-in the state in which it is placed on the patient. FIG. 5 shows a rear view of the hip orthosis 10 according to FIG. 1. Thus, the hip orthosis 10 is viewed from behind, that is to say from the side which faces the patient in the state in which it is attached to the patient. The central orthosis strap section 12 can be seen, on the proximal region 14 of which a hip strap arrangement 16 is arranged, on the distal region 44 of which a second stabilizing strap 38 is arranged. Between the hip strap arrangement 16 and the second stabilizing strap 38, the first stabilizing strap 36 extends in an extension direction E 1 opposite to the extension direction E 2 of the second stabilizing strap 38. The direction of extension can relate in particular to the state of the hip orthosis 10 in the open state or not applied to the patient.It can also be seen that the first and the second elongate stabilizing bands 36, 38 are arranged on the central orthosis belt section 12 in such a way that the respective direction of extent E 1, E 2 of the first and the second stabilizing bands 36, 38 is oriented at an angle α 1, α 2 relative to the longitudinal direction LR of the central orthosis belt section 12 that is different from 90 degrees, at least in the region of the proximal belt section 36 b, 38 b.Furthermore, an optional pressure pad 50 is arranged in the central region 34 of the central orthosis belt section 12. The pressure pad 50 shown herein has an oval to drop shape with a central recess 66. A durckpelott 50 shaped in this way is configured in particular to cushion a hip region, in particular around the trochanter muscle, of a patient and / or to exert pressure on this region. According to this embodiment, the pressure pad 50 is positioned and fastened on a fastening surface 52 provided for this purpose, for example in the form of a hook-and-loop surface, on the hip orthosis 10. The fastening surface 52 can be formed from a different material, in particular velours, and from a different textile than the remaining orthosis components. The fastening surface 52 can be adhesively bonded or sewn, for example, to the inner side 62, i.e. the surface of the orthosis facing the patient in the fitted state. The detailed attachment mechanism of pad 50 is shown in Fig. 6.FIG. 6 shows the attachment of the trochanter pad 50 to the hip orthosis 10. Preferably, the hook-and-loop surface corresponds to the contour or the basic shape of the pad to be attached. As shown in the following FIG. 7, the hook and loop surface is by no means limited to the attachment of a trochanter pad 50. Thus, depending on the anatomy of the patient and / or the application or indication, different pads, not shown here, or combinations thereof can be used. For example, Fig. 7 shows the attachment of a piriformis pad 54 to the hip orthosis 10. The piriformis pad may be configured to cushion or support a region of the patient's piriformis muscle. According to the embodiment shown, the piriformis pad 54 is elongate and is configured flat on its underside, wherein the piriformis pad 54 is configured on its upper side in its central region an elevation 64.In some embodiments, the pressure pads may already be firmly integrated into the hip orthosis or its inner surface 62. Further embodiments not shown here may be configured entirely without pressure pads.The application of the hip orthosis 10 according to the invention to a patient is described step by step with reference to FIGS. 8 to 15 below:For the proper attachment of the hip orthosis 10 to a patient, the opened orthosis 10 or the hip strap arrangement 16 according to FIGS. 1 and 2 is first placed with the inner side 62 around the hip and placed centrally on the pelvis of a patient. Preferably, the joint arrangement 28 or the coupling region of the two joint limbs 30 a, bis placed laterally on the thigh 70 of the patient at the height of the hip joint and somewhat above the trochanter major of the patient. Subsequently, the first strap 20 is guided around the hip region of the patient from both sides and closed or stitched. For simple and precise attachment of the belt 10, the guide lugs 40 provided for this purpose can be used during application.In the next step, as shown in FIG. 9, the non-elastic narrow second strap 22 is guided forward toward the abdomen of the patient and fastened or clipped under tension to the first strap 20. A side view of the hip orthosis after the hip strap assembly 16 has been applied to the patient is shown in Figure 10. The embodiment of the hip orthosis 10 shown in FIG. 10 is configured for a right hip joint of a patient. It goes without saying that this embodiment is not limited to use on a right hip joint of a patient, but rather the joint arrangement 28 and the central orthosis belt section 12 with the stabilizing straps 36, 38 can be arranged in an analogous manner on the opposite side of the pelvic brace 18, such that the hip orthosis 10 is designed for use on the left hip joint of a patient. If appropriate, the hip orthosis 10 has a structure that is substantially mirrored about the longitudinal direction LR for this purpose. Furthermore, in an alternative embodiment not shown here, the hip orthosis 10 can be configured symmetrically, such that both the left and the right hip joint can be stabilized simultaneously.Subsequently, according to FIG. 11, the joint arrangement 28 or the distal hip joint limb 30 bcan be fastened and aligned on the central orthosis harness section 12. By means of a Velcro mechanism, the orientation and position of the joint arrangement 28 can be individually adapted to the anatomy or the position of the hip joint of the patient.Subsequently, as shown by way of example in FIG. 12, the second stabilizing band 38 is, in the direction of extension thereof or in the present case in the right direction, guided around the thigh 70 of the patient under tension by one hand of the hip side concerned into the guide tab 40 provided for this purpose at the distal region of the central orthosis belt section 12 and is then fastened or corded to the central orthosis belt section 12 by the other hand according to FIG. 13. The belt guidance of the second stabilizing belt 38 can take place, as indicated by the arrow in FIG. 14, slightly obliquely to the winding axis WA.In the next step, as shown in FIG. 15, the first stabilizing band 36 is also guided under tension around the relevant thigh 70 of the patient and then fastened or secured below the hip joint. According to the present embodiment, the winding is in the leftward direction, i.e., in the direction opposite to the winding direction of the second stabilizing tape 38. In this case, the first stabilizing strap 36 can cover portions of the second stabilizing strap 38, in particular in a region around its distal strap portion 38 a. As indicated by the arrow in FIG. 15, the distal tape portion 38 aof the second stabilizing tape 38 is obliquely pulled upward after the winding, so that a batch-wise helical or spiral winding is achieved. Due to this special type of winding, the two stabilizing straps act uniformly and multidirectionally and in particular in a direction which relieves the hip joint. In addition, the different winding direction around the thigh of the patient prevents the hip orthosis from twisting during application.For purposes of illustration, Figures 16 through 19 illustrate different perspectives of the hip orthosis 10 in a properly applied condition to the patient.FIG. 16 shows a side view of the hip orthosis 10 according to FIG. 1 in a state in which it is applied to the patient. The orientation W 1, W 2 of the two stabilizing bands 36, 38 which is contrary and offset along the thigh portion of the patient can be seen in particular. Further, it can be seen from Figs. 17 to 19, which show a front view, a rear view and a perspective side view of the hip orthosis in a condition in which it is applied to the patient, that the hip strap arrangement 16 extends around the hip pelvic region of the patient in the condition in which it is applied to the patient. The two stabilizing straps 36, 38 each extend over a lateral, medial, ventral and dorsal region of the patient's thigh. In this case, the distal strap sections 36 a, 38 aare fixed to the hip orthosis 10 at a lateral region of the thigh of the patient. In alternative embodiments or alternative winding forms of the stabilizing straps 36, 38, the distal strap sections 36 a, 38 acan also be fixed to the orthosis 10 at a medial, ventral and / or dorsal femoral region of the patient.References included in the specificationThis list of documents cited by the applicant has been produced in an automated manner and is only included for the better information of the reader. The list is not part of the German patent application or utility model application. The DPMA does not take any adhesion for any faults or omissions.Patent Literature citedEP 3 202 376 B1

[0002]

Claims

Hip orthosis (10) for mobilizing a hip joint of a patient, comprising: a central orthosis belt section (12) which is configured to extend at least in sections along a lateral hip region of the patient, a hip belt arrangement (16) which is provided at a proximal region (14) of the central orthosis belt section (12) and is configured to engage around a pelvic region of the patient; at least one first elongate stabilizing strap (36) which has at least one proximal and one distal strap section (36b, 36a) and which is configured to be guided around a thigh of the patient in a first orientation (W1); at least one second elongated stabilizing strap (38), which has at least one proximal and one distal strap section (38b, 38a) and which is provided to be guided around the thigh of the patient in a second orientation (W2); and a hip joint rail (27) for stabilizing the hip joint of a patient, wherein the hip joint rail (27) comprises a joint arrangement (28) and is arranged at least in sections on the central orthosis strap section (12); wherein the hip strap arrangement (16), the proximal strap portion (36b) of the first stabilizing strap (36) and the proximal strap portion (38b) of the second stabilizing strap (38) are provided on the central orthosis strap portion (12) at different positions with respect to a longitudinal direction (LR) of the central orthosis strap portion (12), and wherein the first orientation (W1) is different from the second orientation (W2) in a patient-applied state of the hip orthosis.Hip orthosis (10) according to claim 1, wherein the hip strap arrangement (16), the first stabilizing strap (36) and / or the second stabilizing strap (38) are / are configured as separate component / s with respect to the central orthosis strap section (12).Hip orthosis (10) according to claim 1, wherein the hip strap arrangement (16), the first stabilizing strap (36) and / or the second stabilizing strap (38) are / is formed integrally with the central orthosis strap section (12).Hip orthosis (10) according to Claim 1, wherein the hip strap arrangement (16), the first stabilizing strap (36), the second stabilizing strap (38) and / or the central orthosis strap section (12) are / are designed to be of different lengths and / or widths.Hip orthosis (10) according to one of the preceding claims, wherein the width of the hip strap arrangement (16), of the first stabilizing strap (36), of the second stabilizing strap (38) and / or of the central orthosis strap section (12) varies / varies along a respective direction of extension (E) of the hip strap arrangement (16), of the first stabilizing strap (36), of the second stabilizing strap (38) and / or of the central orthosis strap section (12).Hip orthosis (10) according to one of the preceding claims, wherein the first and / or the second elongate stabilizing strap (36, 38) are arranged on the central orthosis strap section (12) in such a way that the direction of extension (E) of the first and / or the second stabilizing strap (36, 38) is oriented at an angle (α 1, α 2) relative to the longitudinal direction (LR) of the central orthosis strap section (12), which angle is different from 90 degrees, at least in the region of the proximal strap section (36b, 38b) of the stabilizing strap (36, 38).The hip orthosis (10) according to any one of the preceding claims, wherein the second orientation (W2) and the first orientation (W1) are opposite each other.The hip orthosis (10) according to any one of the preceding claims, wherein the distal strap portion (36a) of the first elongate stabilizing strap (36) and / or the distal strap portion (38a) of the second elongate stabilizing strap (38) is provided to be attached to the central orthosis strap portion (12) for applying the hip orthosis (10) to the patient.The hip orthosis (10) according to any one of the preceding claims, wherein the hip joint rail (27) is reversibly attachable to the central orthosis strap portion (12).The hip orthosis (10) according to claim 9, wherein at least the central orthosis strap portion (12) comprises a fastening portion (32) configured to attach the hip joint rail (27) to the central orthosis strap portion (12) at different positions.Hip orthosis (10) according to one of the preceding claims, wherein the joint arrangement (28) permits pivoting within an angular range (β) and blocks pivoting outside the angular range (β).Hip orthosis (10) according to Claim 11, wherein the angular range (β) is variable.Hip orthosis (10) according to one of the preceding claims, wherein the hip orthosis (10) has at least one pressure pad (50, 54), which can preferably be reversibly fastened to the central orthosis belt section (12).Hip orthosis (10) according to claim 13, wherein the at least one pressure pad (50, 54) is configured to exert pressure on the patient in the region of the trochanter major area and / or to cushion this region in the state of the hip orthosis (10) applied to the patient.Hip orthosis (10) according to claim 13, wherein at least one pressure pad (50, 54) is configured to exert pressure on the patient in the region of the piriformis muscle and / or to cushion this region in the state of the hip orthosis (10) applied to the patient.

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