Adjustable orthotic joint for controlled movement and / or fixation of a hand, and orthosis with such an orthotic joint.

Description

[0001] The present invention relates to an adjustable orthotic joint for the controlled movement and / or fixation of a patient's hand, at least comprising a first pivoting lever for executing an extension and / or flexion movement of the hand and a second pivoting lever pivotably arranged on the first pivoting lever for executing an ulnar and / or radial deviation of the hand, as well as an orthosis for the controlled movement and / or fixation of a hand or a hand and a forearm of a patient with such an orthotic joint.

[0002] As part of the rehabilitation process following a hand injury, the patient's affected hand or forearm often requires immobilization for a certain period of time. Immobilization is usually achieved with hand / forearm orthoses, which fix the hand and forearm in a specific position and, once immobilized, no longer allow any movement of the limbs. An orthosis designed for immobilizing the hand or forearm is disclosed, for example, in US 2021 / 014 56 20 A1. The splint described therein consists of at least two adjustable holding devices that can exert pressure on the palmar or dorsal upper surface of the forearm. By controlled alignment of said holding devices to each other and subsequent fixation in a desired position, the bone fragments of a forearm fracture can be stabilized during fracture treatment.However, this inevitably immobilizes joints in the hand and / or forearm that are not actually affected by the injury. Depending on how long such an orthosis is worn, this can adversely lead to so-called secondary stiffening of the joints not affected by the injury. Their additional mobilization after the end of the healing process results in unnecessary costs due to a prolonged rehabilitation period and thus longer periods of work absence for the patient. In complex injuries of the hand or forearm, it may also be desirable to move individual joints that are more advanced in their healing process in a controlled manner while simultaneously continuing to immobilize more severely damaged joints. In this context, a "controlled movement" is understood to mean, in particular, a guided movement with a limited angle of movement.In physiotherapy and orthopedics, orthoses are often used for this purpose. These support limbs and allow movement of a specific joint within a specified angular range, allowing the patient to perform the movement independently and safely. The angular range can then be gradually expanded depending on the patient's training and health status, ultimately restoring the original range of motion.

[0003] Such range-of-motion (ROM) devices are known from the prior art, particularly for knee orthoses or for the flexion and extension movements of the knee. EP 0 546 331 A1 and EP 0 832 624 A2, for example, disclose orthotic joints with an adjustable range of motion relative to a movement in one plane, which can preferably be used in a knee orthosis. US Pat. No. 7,081,102 B1 also discloses a carpal tunnel support with a joint that allows limited radial and / or ulnar deviation of the user's hand. A similar device for controlled deviation of the hand is described in CN 2 10 843 695 U.

[0004] However, the human wrist is characterized by a more complex, "multidimensional" range of motion, which can be described by a combination of an extension / flexion movement (bending and stretching movement in a plane perpendicular to the palm) and an ulnar or radial deviation (swiping movement in the plane of the palm). The orthotic joints and ROM devices known from the prior art, which are adjustable in their range of motion, do not allow the control of such multidimensional movement, as is the case, for example, with the device described in US 2004 / 001 93 06 A1, or require several separate joints. Examples of this include DE 10 2019 130 404 A1, WO 2021 / 093 919 A2, and US 2011 / 028 22 53 A1.

[0005] Based on this, the present invention is based on the object of providing an orthotic joint, in particular for a hand orthosis, which is improved compared to the prior art and which enables the control of both an extension / flexion movement and an ulnar and / or radial deviation of the hand of a patient and is constructed as compactly as possible yet is robustly designed.

[0006] This object is achieved by an adjustable orthotic joint having the features of independent patent claim 1 or by an orthosis having the features of the independent patent claim 10.

[0007] The orthotic joint according to the invention is distinguished from prior art orthotic joints in that the orthotic joint comprises a fastening element for pivotably fastening the first pivot lever; a first, upper angle adjustment element which, when in use with respect to a back of the hand, is arranged on the fastening element above the fastening element and rotatable about a rotation axis; and a second, lower angle adjustment element which, when in use with respect to the back of the hand, is arranged on the fastening element below the fastening element and rotatable about the rotation axis; wherein the first angle adjustment element and the second angle adjustment element each comprise at least one pivot limiter which limits the range of motion of the extension and / or flexion movement of the first pivot lever.

[0008] The adjustable orthotic joint according to the invention advantageously enables the angles of extension and flexion, as well as the ulnar and radial deviation of the hand, to be controlled depending on the patient's state of health and therapeutic needs. The angle of extension or flexion can advantageously be fixed either at 180° (γ 1 = γ 2 = 0°; outstretched hand) or released in a controlled manner in various angle ranges from 180° to 180° + γ 1 (dorsiflexion), from 180° to 180° - γ 2 (palmar flexion), and across the entire range of motion from 180° + γ 1 to 180° - γ 2 with γ 1 , γ 2 > 0°. The angles γ 1 , γ 2 can advantageously be adjusted to the desired angle by rotating the upper and / or lower angle adjustment element around the rotation axis.

[0009] As a result, an orthosis according to the invention with such an adjustable orthotic joint can advantageously accompany the healing process in such a way that the patient's freedom of movement can be increased in a controlled manner. Permitted movements from a therapeutic perspective can be guided in a controlled manner, while simultaneously critical movements from a therapeutic perspective can be completely or partially restricted. In this way, unnecessary stiffening of healthy joints of the hand can be advantageously counteracted. The orthotic joint according to the invention has a particularly compact and robust design, so that an orthosis according to the invention equipped with it can also advantageously be designed to be compact and minimize the patient's daily life.

[0010] Further advantageous embodiments and developments, which can be used individually or in combination with one another, are the subject of the dependent claims.

[0011] In one embodiment of the invention, it has proven advantageous if the at least one upper pivot limiter is arranged on an underside of the first, upper angle adjustment element, wherein the first, upper angle adjustment element can preferably be disc-shaped. An upper pivot limiter arranged in this way can advantageously be used to adjust the angle range from 180° to 180° + γ 1 , i.e., to adjust the extent of dorsal extension.

[0012] In a further preferred embodiment, the first, upper, preferably disc-shaped, angle adjustment element can comprise at least two, preferably four, upper pivot limits arranged on the underside, wherein the pivot limits are spaced from one another by an angle which is formed by the respective positions of the pivot limits on the underside and the intersection point of the axis of rotation with the underside, and wherein the pivot limits are designed differently from one another in such a way that the extension movement of the first pivot lever is limited differently in its range of movement by interaction with the various pivot limits.Two or more upper pivot limits arranged on the underside, which are designed differently from one another and arranged at an angle to one another, advantageously enable the setting of different angle ranges from 180° to 180° + γ 1 for the dorsal extension depending on the specific limit angle γ 1 that the pivot limit selected in each case by rotation about the axis of rotation allows.

[0013] Furthermore, a configuration of the invention has proven successful in which the at least one lower pivot limiter is arranged on an upper side of the second, lower angle adjustment element, wherein the second, lower angle adjustment element can preferably be disc-shaped. A lower pivot limiter arranged in this way can advantageously be used to adjust the angle range from 180° to 180° - γ 2 , i.e., to adjust the extent of palmar flexion.

[0014] In a further embodiment, the second, lower, preferably disc-shaped, angle adjustment element can also advantageously comprise at least two, preferably four, lower pivot limits arranged on the upper side thereof, wherein the pivot limits are spaced from one another by an angle formed by the respective positions of the pivot limits on the upper side and the intersection point of the rotation axis with the upper side; and wherein the pivot limits are designed to differ from one another in such a way that the flexion movement of the first pivot lever is limited differently in its range of movement by interaction with the various pivot limits.Two or more lower swivel limits arranged on the upper side, which are designed differently from one another and arranged at an angle to one another, advantageously enable the setting of different angle ranges from 180° to 180° - γ 2 for the palmar flexion depending on the specific limiting angle γ 2 that the swivel limit selected in each case by rotation about the axis of rotation allows.

[0015] Particularly preferably, the pivoting limits can be designed as recesses in the first and / or second angle adjustment element, so that in the case of the first angle adjustment element, a thickness of the angle adjustment element is reduced from its underside towards its upper side in such a way that the first pivot lever is blocked after a swept angle γ 1 ≥ 0° during a pivoting movement towards the first, upper angle adjustment element; and in the case of the second angle adjustment element, a thickness of the angle adjustment element is reduced from its upper side towards its underside in such a way that the first pivot lever is blocked after a swept angle γ 2 ≥ 0° during a pivoting movement towards the second, lower angle adjustment element.Swivel limits designed as recesses in the respective angle adjustment elements represent a particularly compact and robust solution for limiting the angle of the swivel movement of the first swivel lever, whereby additional components on the respective angle adjustment elements can advantageously be saved.

[0016] In a further preferred embodiment of the invention, at least one upper locking means can be arranged on the underside of the first, upper angle adjustment element, which is designed to reversibly connect the upper angle adjustment element to the fastening element via at least one locking hole arranged on an upper side of the fastening element and formed corresponding to the upper locking means, so that an unintentional rotation of the first angle adjustment element about the axis of rotation is prevented.

[0017] Alternatively or cumulatively, in one embodiment of the invention, at least one lower latching means can be arranged on the upper side of the second, lower angle adjustment element, which is configured to reversibly connect the lower angle adjustment element to the fastening element via at least one latching hole arranged on an underside of the fastening element and formed corresponding to the lower latching means, so that an unintentional rotation of the second angle adjustment element about the axis of rotation is prevented.

[0018] Such lower and / or upper locking means with correspondingly designed locking holes on the fastening element advantageously enable reversible fixation of the respective angle adjustment element, preferably independently of one another, on the fastening element in a position in which the respectively selected upper and / or lower pivot limit can come into clean operative connection with the first pivot lever when a pivoting movement is performed. This advantageously prevents unintentional rotation of the respective angle adjustment element about the rotation axis, which could disadvantageously lead to an improper operative connection during a pivoting movement.However, if a different swivel limit is to be selected, particularly in the case of two or more swivel limits arranged on the respective angle adjustment elements, the locking of the respective locking means can be overcome by a relatively small but deliberate application of force and a different swivel limit can be brought into an effective position.

[0019] Furthermore, a configuration of the present invention has proven successful in which at least one first stop and at least one second stop are arranged on the first pivot lever, which are configured to limit an angle of the pivoting movement of the second pivot lever. The stops are preferably designed to be reversibly connectable to the first pivot lever. Such stops arranged on the first pivot lever advantageously also enable the limitation of the pivoting movement of the second pivot lever about its pivot joint for implementing ulnar and radial deviation of the hand.

[0020] Finally, a configuration of the invention has proven successful in which the second pivot lever comprises at least one slide configured to movably connect the second pivot lever to a connecting element to a hand, wherein the connecting element preferably comprises a rail configured to correspond to said slide. Such a second pivot lever, movably connected to a connecting element to a hand, advantageously makes it possible to accommodate changing geometric conditions (for example, changes in the optimal length ratios with respect to the distance between the pivot joint of the second pivot lever and a connection point between the second pivot lever and the connecting element), particularly during a combined movement of the hand, for example during palmar flexion with simultaneous ulnar or radial deviation.

[0021] The present invention further relates to an orthosis for the controlled movement and / or fixation of a hand or a hand and a forearm of a patient, with an adjustable orthotic joint as described above.

[0022] These as well as additional details and further advantages of the invention are described below with reference to preferred embodiments, to which the present invention is not limited, and in conjunction with the accompanying drawings.

[0023] It shows schematically: Fig. 1 shows an embodiment of an orthotic joint according to the invention in a perspective exploded side view; Fig. 2 shows the embodiment of Fig. 1 in a perspective exploded top view; Fig. 3 in the partial figures a to d, side views of sections of a further embodiment of an orthotic joint according to the invention, which exemplify various movement angle ranges predetermined by the respectively selected pivot limitations on the respective angle adjustment element; Fig. 4 in the partial drawings a to c, a design of a first, upper angle adjustment element with a view of its underside ( Fig. 4a ); a design of a fastening element with a view of its upper side ( Fig. 4b ) and a second, lower angle adjustment element with a view of its upper side ( Fig. 4c ); Fig. 5 shows a plan view of a further embodiment of an orthotic joint according to the invention with a second leg lever movably connected to a hand via a slide with a connecting element; and Fig. 6 shows a plan view of an embodiment of an orthosis according to the invention during use.

[0024] In the following description of preferred embodiments of the present invention, like reference numerals designate like or comparable components.

[0025] In Fig. 1 an embodiment of an orthotic joint 10 according to the invention is shown in a perspective exploded side view.

[0026] An adjustable orthotic joint 10 according to the invention for the controlled movement and / or fixation of a patient's hand comprises at least a first pivot lever 15 for executing an extension and / or flexion movement of the hand and a second pivot lever 16, pivotably arranged on the first pivot lever 15, for executing an ulnar and radial deviation of the hand. For this purpose, the orthotic joint 10 comprises a preferably disc-shaped fastening element 12 to which the first pivot lever 15 is attached, preferably via a pivot joint 121, and is designed to be pivotable about a rotation axis D3. The second pivot lever 16 can be operatively connected to the first pivot lever 15, in particular via a pivot joint 153, and can thus be pivoted about a rotation axis D2, which is preferably oriented perpendicular to the first pivot lever 15.

[0027] Fig. 2 shows the design from Fig. 1 in a perspective exploded view.

[0028] As can be seen here, the second pivot lever 16 can preferably cover a pivot angle δ, wherein the pivot angle δ, depending on the deflection of the first pivot lever 15, lies on different planes of a plane bundle, the carrier line of which is precisely the rotational axis D3 of the first pivot lever 15. In Fig. 2 It is also shown that at least one first stop 151 and at least one second stop 152 can be arranged on the first pivot lever 15, which are designed to limit the angle δ of the pivoting movement of the second pivot lever 16, wherein the stops 151 and 152 are preferably designed to be reversibly connectable to the first pivot lever 15. The stops 151 and 152 can be reversibly connectable to the first pivot lever 15, in particular via fixing elements 154. In the Fig. 1 and Fig. 2 For this purpose, fixing elements 154 are indicated, which are designed as simple holes and can be easily inserted and screwed through the stops 151 and 152. Said fixing elements 154 designed as holes can be extended, as in Fig. 1 and Fig. 2 indicated, but there can also be several holes placed close together, as in Fig. 4b shown. However, as fixing elements 154, magnetic holding positions can also be arranged on the first pivot lever 15, on which the stops 151 and 152 can be reversibly placed.

[0029] The orthotic joint 10 according to the invention further comprises a first, upper, preferably disc-shaped, angle adjustment element 11, which, when used with respect to the back of the hand, is arranged above the fastening element 12 and rotatable about a rotation axis D1, on the fastening element 12, and a second, lower, preferably disc-shaped, angle adjustment element 13, which, when used with respect to the back of the hand, is arranged below the fastening element 12 and rotatable about the rotation axis D1, on the fastening element 12. The first angle adjustment element 11 and the second angle adjustment element 13 each comprise at least one pivot limiter 111 and 131, respectively, which limit the range of motion of the extension and / or flexion movement of the first pivot lever 15.The at least one upper pivot limiter 111 can be arranged in particular on an underside 114 of the first, upper, preferably disc-shaped, angle adjustment element 11, and the at least one lower pivot limiter 131 can be arranged in particular on an upper side 133 of the second, lower, preferably disc-shaped, angle adjustment element 13. In the present example, both the first, upper angle adjustment element 11, the second, lower angle adjustment element 13, and the fastening element 12 are shown as approximately round discs, which have a similar diameter to one another and are arranged one above the other in a sandwich-like manner; in other words, the individual planes are arranged parallel to one another.In the context of the present invention, the term "disk-shaped" is also to be understood as meaning components with outlines deviating from a circle; in particular, the first, upper angle adjustment element 11, the second, lower angle adjustment element 13 and / or the fastening element can each have a polygonal outline, as already shown in . Fig. 2 indicated. Furthermore, the first, upper angle adjustment element 11 can also be designed as a disc-shaped component with an approximately semicircular outline, which is arranged perpendicular to the plane of the fastening means 12 (not shown here). In this case, the at least one upper pivot limiter 111 can preferably be designed as a stop, which protrudes from the plane of the vertically arranged first, upper angle adjustment element 11 and can thereby limit the range of motion of the dorsal extension movement of the first pivot lever 15.

[0030] However, an embodiment of an orthotic joint 10 according to the invention with at least two, particularly preferably - as shown in the Fig. 1 and 2shown - with four upper pivot limits 111 arranged on the underside 114 of the first, upper, preferably disc-shaped, angle adjustment element 11, or with at least two, particularly preferably with four, lower pivot limits 131 arranged on the upper side 133 of the second, lower, preferably disc-shaped, angle adjustment element 13. The number of pivot limits 111 or 131 arranged on an angle adjustment element 11 or 13 is not, however, limited to the numbers two or four, but can vary and can also be an odd number. In principle, the maximum number depends only on the ratio of the selected width of the first pivot lever 15 to the radius of the respective angle adjustment element 11 or 13. The narrower the first pivot lever 15, the more pivot limits 111 or 131 designed to correspond thereto can be provided, given the same radius of the respective angle adjustment elements 11 or 13.13 on said angle adjustment elements 11 or 13.

[0031] If more than one upper pivot limit 111 and one lower pivot limit 131 are arranged on the angle adjustment elements 11 and 13, respectively, the upper pivot limits 111 can be spaced apart from each other by an angle α, which is formed by the respective positions of the pivot limits 111 on the underside 114 and the intersection point of the rotation axis D1 with the underside 114. Accordingly, the lower pivot limits 131 can be spaced apart from each other by an angle β, which is formed by the respective positions of the pivot limits 131 on the upper side 133 and the intersection point of the rotation axis D1 with the upper side 133 (see also Fig. 4 ). In the example shown here, with four swivel stops 111 and 131 per angle adjustment element 11 and 13, the angles α and β are each 90°. With a suitably narrow first pivot lever 15, the number of swivel stops 111 and 131 on the first, upper angle adjustment element 11 and the second, lower angle adjustment element 13 can also differ from one another, and the angles α and β can be correspondingly unequal.

[0032] Fig. 3 shows in the sub-figures a until d Side views of sections of a further embodiment of an orthotic joint 10 according to the invention, which exemplify various movement angle ranges predetermined by the respectively selected pivot limits 111 and 131 on the respective angle adjustment element 11 and 13.

[0033] As in Figuren 3a bis d As shown, the upper pivot limits 111 and the lower pivot limits 131 can preferably be designed differently from one another in such a way that the extension or flexion movement of the first pivot lever 15 is limited differently in its range of motion by interaction with the various upper 111 and lower 131 pivot limits. The pivot limits 111 and131 can for this purpose particularly preferably be designed as recesses in the first 11 and / or second 13 angle adjustment element, so that in the first angle adjustment element 11 a thickness 115 of the angle adjustment element 11 is reduced from its underside 114 towards its upper side 113 such that the first pivot lever 15 is blocked during a pivoting movement towards the first, upper angle adjustment element 11 after a swept angle γ 1 ≥ 0°; and in the second angle adjustment element 13 a thickness 135 of the angle adjustment element 13 is reduced from its upper side 133 towards its underside 134 such that the first pivot lever 15 is blocked during a pivoting movement towards the second, lower angle adjustment element 13 after a swept angle γ 2 ≥ 0°.

[0034] Fig. 3a shows, for example, an adjustment of the orthotic joint 10 according to the invention, in which the upper 111 and the lower 131 pivot limiters are of identical design and do not reduce the thickness 115 of the first, upper angle adjustment element 11 or the thickness 135 of the second, lower angle adjustment element 13. The angles γ 1 and γ 2 covered by the first pivot lever 15 are equal to 0° in this case - the extension or flexion movement of a hand supported by an orthosis with the orthotic joint 10 according to the invention would be fixed. The hand would be extended and could only perform an ulnar and radial deviation guided by the second pivot lever 16. In the embodiments described below Fig. 3b until d For the sake of clarity, the second pivot lever 16 is not shown, but the functioning of the second arm lever 16 remains as previously described. Fig. 3b now shows an adjustment of the orthotic joint 10 according to the invention, in which the upper pivot limit 111 is designed as a recess, wherein the thickness 115 of the angle adjustment element 11 is reduced from its underside 114 towards its upper side 113 in such a way that the first pivot lever 15 is blocked during a pivoting movement towards the first, upper angle adjustment element 11, after a swept angle γ 1 > 0°. The lower pivot limit 131 does not reduce the thickness 135 of the second, lower angle adjustment element 13, so that the angle γ 2 that can be swept by the first pivot lever 15, as in Fig. 3a , is equal to 0°, since the lower pivot limit 131 blocks any pivoting movement of the first pivot lever 15. Such an adjustment of the orthotic joint 10 according to the invention, which can be achieved by simply rotating the upper angle adjustment element 11 about the axis of rotation D1 up to a position of the first, upper angle adjustment element 11 at which the pivot limit 111 suitably designed for the desired angle γ 1 can come into operative connection with the first pivot lever 15, enables, for example, exclusively a dorsal extension of the respective hand, wherein in combination with this, an ulnar and radial deviation can again be carried out. Fig. 3c shows an example of an adjustment of an orthotic joint 10 according to the invention, in which the first, upper angle adjustment element 11, as in Fig. 3a , any pivoting movement of the first pivot lever 15 is blocked, while the second, lower angle adjustment element 13 is in turn brought into a position by rotation about the rotation axis D1, in which the lower pivot limit 131, which interacts with the first pivot lever 15 during a movement, is designed as recesses in the second angle adjustment element 13 and the thickness 135 of the angle adjustment element 13 is reduced from its upper side 133 towards its lower side 134 in such a way that the first pivot lever 15 is blocked during a pivoting movement towards the second, lower angle adjustment element 13, after a swept angle γ 2 ≥ 0°. In the present example, the amount of the swept angle γ 2 is shown smaller than that of the angle γ 1 in Fig. 3b . However, these amounts can also be the same, depending on which swivel limits 111 or 131 are selected by the user. Fig. 1 and Fig. 2 For this purpose, the corresponding maximum angles of movement are indicated in degrees on the upper side 113 of the first angle adjustment element 11, for example, above each of the four upper pivot limits 111 shown here – here 0°, 30°, 50°, and 70° – although other angle specifications are of course also possible. A corresponding marking can also preferably be applied to the second, lower angle adjustment element 13 (not shown here).

[0035] Fig. 3d Finally, it shows an adjustment of the orthotic joint 10 in which both pivoting limits 111 and 131 allow pivoting angles γ 1 and γ 2 greater than 0°. The possible total movement angle γ of the first pivoting lever 15 results in this case from the sum of the two angles γ 1 and γ 2 . In the example shown, the said angles γ 1 and γ 2 are unequal, resulting in an asymmetrical, maximum possible total movement; however, the two angles γ 1 and γ 2 can also be equal (not shown), which would lead to a symmetrical, maximum possible total movement.

[0036] In Fig. 4 is in the partial drawing a until c a configuration of a first, upper angle adjustment element 11 with a view of its underside 114 ( Fig. 4a ); an embodiment of a fastening element 12 with a view of its upper side 123 ( Fig. 4b ) and a second, lower angle adjustment element 13 with a view of its upper side 133 ( Fig. 4c ) is shown.

[0037] At least one upper locking means 112 can preferably be arranged on the underside 114 of the first, upper angle adjustment element 11, which is configured to reversibly connect the upper angle adjustment element 11 to the fastening element 12 via at least one locking hole 122 arranged on an upper side 123 of the fastening element 12 and formed corresponding to the upper locking means 112, so that an unintentional rotation of the first angle adjustment element 11 about the axis of rotation D1 is prevented.Accordingly, as shown, at least one lower locking means 132 can be arranged on the upper side 133 of the second, lower angle adjustment element 13, which is configured to reversibly connect the lower angle adjustment element 13 to the fastening element 12 via at least one locking hole 122 (not shown here) arranged on an underside 124 of the fastening element 12 and formed corresponding to the lower locking means 132, so that an unintentional rotation of the second angle adjustment element 13 about the axis of rotation D1 is prevented.

[0038] The locking means 112 and 132 - in the Fig. 4a und 4c Four are shown as examples on the upper 11 and lower 13 angle adjustment elements - they can be designed in particular as small, hollow grub screws, wherein a spring can be located in the respective cavity of each grub screw, which spring presses a ball outwards at the open end of the grub screw. The respective spherical surface then snaps into the provided snap-in hole 122 on the fastening element 12, preferably designed as a groove. Snap-in holes 122, in particular snap-in holes 122 designed as a groove, can, as already mentioned, be arranged both on the upper side 123 and on the underside 124 of the fastening element 12. Alternatively or additionally, the upper 112 and / or the lower 132 snap-in means and the corresponding snap-in holes 122 can also be designed as simple milled recesses (groove plus recess, toothing, etc.).The advantage of using grub screws, as described above, is that the nature of the click or snap-in action can be precisely defined and, at the same time, it is an elegant and cost-effective solution.

[0039] Fig. 5 shows in a plan view a further embodiment of an orthotic joint 10 according to the invention with a second arm lever 16 which is movably connected to a hand via a slide 161 with a connecting element 163.

[0040] For attachment to an orthosis 1 for controlled movement and / or fixation of a hand or a hand and a forearm of a patient, the orthosis joint 10 according to the invention can be closed off downwards, i.e. towards the back of the hand or the forearm, by a cover plate 14, as shown in the Fig. 1 , 2 , 5 and 6shown. Said cover plate 14 can preferably be formed from any plastic material; the first, upper 11 and second, lower 13 angle adjustment elements as well as the fastening element 12 can in particular be formed from aluminum, stainless steel, or a medical plastic.

[0041] Fig. 5 also shows that the cover plate 14 can have an elongated shape, which can extend at least in one direction beyond the extent of the first, upper 11 and / or the second, lower 13 angle adjustment element, or beyond the fastening element 12. Such an elongated shape advantageously enables an indirect or direct connection of the orthotic joint 10 via such a cover plate 14 to the forearm of a patient.

[0042] The second pivot lever 16 may also comprise at least one carriage 161, which is configured to connect the second pivot lever 16 to a connecting element 163 so as to be movable by one hand, wherein the connecting element 163 may preferably comprise a rail 162, which is designed to correspond to said carriage 161. In Fig. 5 The connecting element 163 is shown as a plastic component. However, it can also be made of aluminum or stainless steel. In this embodiment, the second toggle lever 16 is advantageously movably connected to the connecting element 163 via the slide 161, wherein the slide 161, as shown here, can preferably run in a correspondingly designed rail 162 - here, for example, formed as a recess in the connecting element 163. When performing a combined movement of the hand, for example, palmar flexion with simultaneous deviation or dorsal extension with simultaneous deviation, the connecting means 163 can advantageously be displaced relative to the second toggle lever 16 and adapt to the changing geometric conditions during a movement.

[0043] Fig. 6 finally shows in a plan view an embodiment of an orthosis 1 according to the invention during use.

[0044] The present invention relates to an adjustable orthotic joint 10 for the controlled movement and / or fixation of a patient's hand, as well as to an orthosis 1 comprising such an orthotic joint 10, which is characterized in that it comprises at least one fastening element 12 for pivotably fastening a first pivot lever 15; at least one first, upper angle adjustment element 11, and at least one second, lower angle adjustment element 13; wherein the first angle adjustment element 11 and the second angle adjustment element 13 each comprise at least one pivot limiter 111 and 131, respectively, which limit the range of motion of the extension and / or flexion movement of a first pivot lever 15.The adjustable orthotic joint 10 according to the invention advantageously allows the angles of extension and flexion as well as the ulnar and radial deviation of the hand to be controlled depending on the patient's state of health and therapy needs and is advantageously compact and robust. Bezugszeichenliste

[0045] 1Orthosis 10Orthosis joint 11First, upper angle adjustment element 111 Upper pivot limit 112 Upper locking means 113 Top of the first angle adjustment element (11) 114 Bottom of the first angle adjustment element (11) 115 Thickness of the first, upper angle adjustment element (11) 12Fastening element 121 Pivot joint for first pivot lever (15) 122 Locking hole 123 Top of the fastening element (12) 124 Bottom of the fastening element (12) 13Second, lower angle adjustment element 131 Lower pivot limit 132 Lower locking means 133 Top of the second angle adjustment element (13) 134 Bottom of the second angle adjustment element (13) 135 Thickness of the second, lower angle adjustment element (13) 14Cover plate 15First pivot lever for Extension / Flexion (E / F) 151 First stop 152 Second stop 153 Swivel joint for the second pivot lever (16) 154 Fixing element for stops (151;152) 16Second pivot lever for ulnar / radial deviation (urD) of the hand 161 Slide 162 Rail 163 Connecting element to the hand αAngle between the upper pivot limits (111) βAngle between the lower pivot limits (131) γTotal angle of movement of the first pivot lever (15); γ = γ 1 + γ 2 γ 1 angle of the pivoting movement of the first pivot lever (15) towards the first, upper angle adjustment element (11) γ 2 angle of the pivoting movement of the first pivot lever (15) towards the second, lower angle adjustment element (13) δ angle of the pivoting movement of the second pivot lever (16) D1 axis of rotation of the angle adjustment elements (11; 13) D2 axis of rotation of the pivot joint (153) for the second pivot lever (16) D3 axis of rotation of the pivot joint (121) for the first pivot lever (15);

Claims

1. Adjustable orthosis joint (10) for the controlled movement and / or fixation of a hand of a patient, comprising at least - a first pivot lever (15) for performing an extension and / or flexion movement of the hand; - a second pivot lever (16), arranged pivotably on the first pivot lever (15), for performing an ulnar and / or radial deviation of the hand; - wherein the orthosis joint (10) comprises a fastening element (12) for pivotable fastening of the first pivot lever (15); characterized in that the orthosis joint (10) comprises - a first, upper angle adjustment element (11), which during use is arranged in relation to the back of a hand above the fastening element (12), rotatably about a rotation axis (D1), on the fastening element (12); and - a second, lower angle adjustment element (13), which during use is arranged in relation to the back of a hand below the fastening element (12), rotatably about the rotation axis (D1), on the fastening element (12); - the first angle adjustment element (11) and the second angle adjustment element (13) each comprising at least one pivot limitation (111; 131), which limit the extension and / or flexion movement of the first pivot lever (15) in its range of movement.

2. The orthosis joint (10) as claimed in claim 1, characterized in that the at least one upper pivot limitation (111) is arranged on a lower side (114) of the first, upper angle adjustment element (11), the first, upper angle adjustment element (11) preferably being configured in the form of a disk.

3. The orthosis joint (10) as claimed in claim 1 or 2, characterized in that - the first, upper, preferably disk-shaped angle adjustment element (11) comprises at least two, preferentially four upper pivot limitations (111) arranged on the lower side (114), - the pivot limitations (111) being spaced apart from one another by an angle (α) that is formed by the respective positions of the pivot limitations (111) on the lower side (114) and the point of intersection of the rotation axis (D1) with the lower side (114); and - the pivot limitations (111) being configured differently to one another in such a way that the extension movement of the first pivot lever (15) is limited differently in its range of movement by cooperation with the various pivot limitations (111).

4. The orthosis joint (10) as claimed in one of claims 1 to 3, characterized in that the at least one lower pivot limitation (131) is arranged on an upper side (133) of the second, lower angle adjustment element (13), the second, lower angle adjustment element (13) preferably being configured in the form of a disk.

5. The orthosis joint (10) as claimed in one or more of the preceding claims, characterized in that - the second, lower, preferably disk-shaped angle adjustment element (13) comprises at least two, preferentially four lower pivot limitations (131) arranged on the upper side (133), - the pivot limitations (131) being spaced apart from one another by an angle (β) that is formed by the respective positions of the pivot limitations (131) on the upper side (133) and the point of intersection of the rotation axis (D1) with the upper side (133); and - the pivot limitations (131) being configured differently to one another in such a way that the flexion movement of the first pivot lever (15) is limited differently in its range of movement by cooperation with the various pivot limitations (131).

6. The orthosis joint (10) as claimed in one or more of the preceding claims, characterized in that the pivot limitations (111; 131) are configured as recesses in the first (11) and / or second (13) angle adjustment element, so that - in the case of the first angle adjustment element (11), a thickness (115) of the angle adjustment element (11) is reduced from its lower side (114) in the direction of its upper side (113) in such a way that the first pivot lever (15) is blocked after a swept angle γ1 ≥ 0° during a pivot movement toward the first, upper angle adjustment element (11); and - in the case of the second angle adjustment element (13), a thickness (135) of the angle adjustment element (13) is reduced from its upper side (133) in the direction of its lower side (134) in such a way that the first pivot lever (15) is blocked after a swept angle γ2 ≥ 0° during a pivot movement toward the second, lower angle adjustment element (13).

7. The orthosis joint (10) as claimed in one or more of the preceding claims, characterized in that - at least one upper latching means (112) is arranged on the lower side (114) of the first, upper angle adjustment element (11), which is adapted to reversibly connect the upper angle adjustment element (11) to the fastening element (12) via at least one latching hole (122) that is arranged on an upper side (123) of the fastening element (12) and is configured so as to correspond with the upper latching means (112), so that accidental rotation of the first angle adjustment element (11) about the rotation axis (D1) is prevented; and / or - in that at least one lower latching means (132) is arranged on the upper side (133) of the second, lower angle adjustment element (13), which is adapted to reversibly connect the lower angle adjustment element (13) to the fastening element (12) via at least one latching hole (122) that is arranged on a lower side (124) of the fastening element (12) and is configured so as to correspond with the lower latching means (132), so that accidental rotation of the second angle adjustment element (13) about the rotation axis (D1) is prevented.

8. The orthosis joint (10) as claimed in one or more of the preceding claims, characterized in that at least one first stop (151) and at least one second stop (152), which are adapted to limit an angle (δ) of the pivot movement of the second pivot lever (16), are arranged on the first pivot lever (15), - the stops (151; 152) preferably being configured to be reversibly connectable to the first pivot lever (15).

9. The orthosis joint (10) as claimed in one or more of the preceding claims, characterized in that the second pivot lever (16) comprises at least one slider (161) which is adapted to movably connect the second pivot lever (16) to a hand connecting element (163), the connecting element (163) for this purpose preferably comprising a rail (162) which is configured so as to correspond with said slider (161).

10. An orthosis (1) for the controlled movement and / or fixation of a hand, or of a hand and a forearm, of a patient, characterized by an adjustable orthosis joint (10) as claimed in one or more of the preceding claims 1 to 9.