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 controlled movement and / or fixation of a patient's hand, comprising at least a movement module for controlling an extension and / or flexion movement as well as for controlling and executing an ulnar and / or radial deviation of the hand; and a pivot lever operatively connected with the movement module for executing the extension and / or flexion movement of the hand; as well as an orthosis for controlled movement and / or fixation of a hand or a hand and forearm of a patient with such an orthotic joint.

[0002] As part of the rehabilitation process following a hand injury, the affected hand or forearm often needs to be immobilized for a certain period. This immobilization is usually achieved with hand / forearm orthoses, which fix the hand and forearm in a specific position and, once fixed, prevent any movement of these limbs. However, this inevitably immobilizes joints of the hand and / or forearm that are not actually affected by the injury. Depending on the duration of wear, this can adversely lead to so-called secondary stiffness of the uninjured joints. Mobilizing these joints after the healing process is complete incurs unnecessary costs due to a prolonged rehabilitation period and thus longer periods of absence from work for the patient. In cases of complex hand injuries,In the case of forearm injuries, it may also be desirable to allow controlled movement of individual joints that are further along in their healing process, while simultaneously keeping more severely damaged joints immobilized. In this context, "controlled movement" refers specifically to movement that is limited in its range of motion. In physiotherapy and orthopedics, orthoses are often used for this purpose. These devices support the limb and allow movement of a specific joint within a predetermined range of angles, enabling the patient to perform the movement independently and safely. Depending on the patient's fitness level and overall health, the range of motion can then be gradually increased to eventually restore the original range of motion.

[0003] Such range-of-motion (ROM) devices are known from the prior art, particularly for knee orthoses or for 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 in a single plane, which can preferably be used in a knee orthosis. US 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.

[0004] The human wrist, however, is characterized by a more complex, "multidimensional" range of motion, which can be described by a combination of extension / flexion (bending and straightening movement in a plane perpendicular to the palm) and ulnar or radial deviation (swiping movement in the plane of the palm). Orthotic joints and ROM devices known from the prior art, which are adjustable in their range of motion, do not allow for the control of such multidimensional movement or require several separate joints. Examples include WO 2021 / 093 919 A2, US 2021 / 014 56 20 A1, US 5 520 625 A, and CN 210 843 695 U.In this context, reference should also be made to the applicant's DE 10 2019 130 404 A1, which describes an orthosis for the controlled movement and / or fixation of a forearm and / or hand, which takes into account the described multidimensional movement, but is disadvantageously designed to be comparatively bulky and practically prevents everyday use of the orthosis by users.

[0005] State-of-the-art orthotic joints, such as those known from WO 03 / 070129 A1, do allow the control of a single degree of freedom in a more compact design, but are unable to replicate the described multidimensional movement of the wrist.

[0006] To solve this problem, the applicant's patent DE 10 2021 121 819.5 already provides an adjustable orthotic joint which technically accounts for the complex combination of extension / flexion movement and ulnar or radial deviation. The orthotic joint described therein is designed to be particularly robust and advantageously allows for use during comparatively strenuous occupational and daily activities. However, this robustness also necessitates a certain design which, on the one hand, can only be adjusted to the individual needs of patients with the aid of tools, and on the other hand, may be perceived as too large and therefore bothersome by certain groups of people who only have to perform comparatively light and moderately strenuous activities during prolonged use.

[0007] Based on this, the present invention aims to provide an alternative orthotic joint, particularly for a hand orthosis, which improves upon the existing state of the art in that it enables the control of both extension / flexion movements and ulnar and / or radial deviation of a patient's hand, while simultaneously being designed to be so user-friendly that it can be adjusted by the patient himself to the changing individual needs during progressive rehabilitation without the use of special tools, and at the same time being so compact that its use is perceived by the patient as pleasant or non-disruptive in everyday life.

[0008] This problem is solved by an adjustable orthotic joint with the features of independent claim 1 or by an orthosis with the features of dependent claim 14.

[0009] The orthotic joint according to the invention is distinguished from orthotic joints of the prior art in that the movement module comprises at least one basic element and at least one control element with a top surface and a bottom surface facing the basic element and opposite the top surface. wherein a rotary cylinder is arranged on the underside, by means of which the control element is rotatably mounted relative to the base element with respect to a deviation axis, wherein a first recess for deviation control is arranged on the underside; wherein the control element comprises at least one first control slide, which is displaceable with respect to the pivot lever operatively connected to the motion module by means of at least one first actuating means; and wherein the control element is configured to restrict the movement of the pivot lever in its range of motion by means of the first control slide; and wherein the orthosis joint comprises at least one second control slide, cooperating with the control element, for controlling the ulnar / radial deviation movement of the hand;wherein the control element is arranged to be limited in its rotational movement about the deviation axis by an interaction of the first recess for deviation control and the at least one second control slider.

[0010] With the help of the first control slider, the working connection between the movement module and the pivot lever can be changed safely and easily to control the extension and flexion movement of the hand, and thus adjusted to the individual needs of the patient.

[0011] The adjustable orthotic joint according to the invention advantageously allows the angles of extension and flexion, as well as ulnar and radial deviation of the hand, to be controlled according to the patient's health condition and therapeutic needs. The angle of extension or flexion can advantageously be fixed at 180° (|WE / F| = 0°; outstretched hand) or released in a controlled manner within a range of motion of 180° ± |WE / F| with |WE / F| > 0°. The angle range from 180° to 180° - |WE / F| corresponds to dorsiflexion, and the angle range from 180° to 180° + |WE / F| corresponds to palmar flexion. The angles of ulnar and radial deviation, also referred to as "ulnar abduction" and "radial abduction," can advantageously be fixed at |WD1 = |WD2 = 0° (hand points straight forward) or within a range of motion of |WD1, |WD2 | > 0° will be released in a controlled manner.The magnitudes of the angles |W D1 | and |W D2 | can be equal or different, thus defining an asymmetrical range of motion. The axes of movement for extension and flexion, or for ulnar and radial deviation, which are technically realized by the movement module of the orthotic joint according to the invention, advantageously lie in the region of the physiological joint axes and thus particularly well reflect the "natural" range of motion of the wrist or hand.

[0012] An orthosis according to the invention with such an adjustable orthotic joint can advantageously support the healing process by allowing for a controlled increase in the patient's range of motion. From a therapeutic perspective, permissible movements are guided, while at the same time, therapeutically critical movements can be completely or partially restricted. In this way, unnecessary stiffening of healthy hand joints can be advantageously prevented. The orthotic joint according to the invention has a particularly compact design, so that an orthosis equipped with it can also be advantageously compact and cause minimal disruption to the patient's daily life.

[0013] Further advantageous designs and advanced developments, which can be used individually or in combination, are the subject of dependent claims.

[0014] In one embodiment of the invention, it has proven advantageous if the first control slide is essentially cuboid in shape and has a forked end facing the pivot lever. A slidable, cuboid first control slide with a forked end can advantageously be pushed towards the pivot lever in such a way that, in particular, the end of the pivot lever, which is pivotally mounted by means of a pivot axis, is enclosed by the "fork tines," i.e., the end of the pivot lever is located inside the forked end of the first control slide. The "fork tines," i.e., the upper and lower parts of the forked end, can advantageously each act as a stop and limit the extent of the pivoting movement of the pivot lever.

[0015] In a further preferred embodiment of the invention, it has proven advantageous if the first actuating means comprises at least one head and one actuating cylinder, which are connected to each other, preferably via a collar, so that a component with a longitudinal axis is formed, wherein the actuating cylinder has a circular cross-section and is connected to the head of the first actuating means off-center with respect to the longitudinal axis. The first control slide can then advantageously include at least one recess which is configured to receive the actuating cylinder and to interact with it.A first actuating device with an actuating cylinder having a circular cross-section and connected off-center to the head can, when the first actuating device is received by the recess of the first control slide, move the first control slide. This is achieved by the actuating cylinder engaging with a side limit of the recess when the first actuating device is rotated, exerting force on said side limit and thereby pushing the first control slide away from the axis of rotation of the first actuating device. Due to the off-center arrangement of the actuating cylinder, acting like an eccentric screw, when the first actuating device is rotated in the opposite direction, the effective contact with said side limit decreases and increases with an opposite side limit of the recess, so that the first control slide is pushed in the other direction accordingly.

[0016] Alternatively, an embodiment of an orthotic joint has proven effective in which the first adjusting element comprises at least one head and one adjusting cylinder, which are connected to each other, preferably via a collar, so that a component with a longitudinal axis is formed, wherein the adjusting cylinder has a channel, preferably substantially C-shaped, on its side facing away from the head. The first control slide can then accordingly comprise a connecting pin which engages in the channel of the adjusting cylinder when the orthotic joint is in use, wherein the connecting pin is preferably arranged within a recess of the first control slide which is designed to receive the adjusting cylinder.When a first actuating device designed in this way is rotated, force can advantageously be exerted on the first control slide via the connecting pin, which engages in the essentially C-shaped channel of the actuating cylinder, through interaction with the walls of the channel. Depending on the direction of rotation, the first control slide can thereby be advantageously moved in the direction of the pivot lever or in the opposite direction.

[0017] Furthermore, a design has proven effective in which the first actuating element and / or the first control slide includes at least one locking mechanism configured to reversibly fix the first control slide in its displacement movement relative to the pivot lever operatively connected to the motion module at at least one predetermined position. A locking mechanism advantageously allows predetermined maximum possible extension / flexion angles to be set reliably and quickly.

[0018] In a further preferred embodiment of the invention, the first recess for deviation control can extend from an edge of the control element towards the rotary cylinder, such that the height of the control element in the region of the first recess is less than the height of the control element in the region outside the first recess. This allows at least four side edges to be formed, which delimit the region inside the first recess from the region outside the first recess. Two of these side edges are substantially opposite each other at a distance dn with n = 1, 2, ... and form a side edge pair SP n with n = 1, 2, ... The distance dn between two opposite side edges of a side edge pair SP n located closer to the rotary cylinder is always less than the distance d n+1 between two opposite side edges of a side edge pair SP n+1 located closer to the edge of the control element.A control element designed in this way advantageously enables the setting and control of at least two different maximum rotation angles about the axis of deviation, i.e., control of the angles of ulnar and radial deviation. A particularly preferred embodiment of the invention is one in which a plurality of side edges, preferably eight, are formed, two of which are essentially opposite each other and form a side edge pair SP n with n = 1, 2, ... The more side edge pairs SP n are provided, the more precisely the angular ranges of ulnar and radial deviation can be divided by the patient and / or therapist.Providing four pairs of lateral edges SP n (corresponding to eight lateral edges) for setting maximum ulnar / radial deviation movements of |W D1 | and |W D2 | = 0°, 10°, 20°, 30° has proven particularly suitable for generating the fastest possible rehabilitation progress, but any other angles can also be provided.

[0019] Furthermore, a design has proven effective in which the second control slide is essentially cuboid in shape and has a length, a width, and a height. The width can preferably correspond to the distance d 1 between the opposing side edges of the first pair of side edges SP 1, which is located closest to the rotary cylinder; and the second control slide can be designed to be inserted into and removed from the first recess of the control element and to interact with the side edges.A second control slide with a width corresponding to the distance d 1 of the opposing side edges of the first pair of side edges SP 1, which is located closest to the rotary cylinder, advantageously enables the hand to be completely fixed in a straight position with respect to a deviation movement, i.e. in a position with |W D1 | and |W D2 | = 0°, especially when the second control slide has been pushed completely towards the rotary cylinder.

[0020] Alternatively, a further embodiment of the orthotic joint according to the invention has proven effective, in which two second control sliders, cooperating with the control element, are provided for controlling the ulnar / radial deviation movement of the hand, wherein the second control sliders are each essentially cuboid in shape and have a length, a width, and a height; wherein the sum of the widths corresponds to the distance d 1 between the opposing side edges of the first pair of side edges SP1, which is located closest to the rotating cylinder. Each second control slider can preferably be designed to be inserted into and removed from the first recess of the control element and to interact with the side edges.Two second control sliders, whose widths, when added together, correspond to the distance d1 between the opposing side edges of the first pair of side edges SP1, located closest to the rotating cylinder, advantageously allow the total range of motion of the hand's deviation movement to be divided into an angular range of ulnar abduction (corresponding to |WD2| > 0°) and an angular range of radial abduction (corresponding to |WD1| > 0°) and controlled independently. Advantageously, movements within an angular range of 0° ≤ |WD2| ≤ 30° for fixation or controlled ulnar abduction, movements within an angular range of 0° ≤ |WD1| ≤ 30° for fixation or controlled radial abduction, as well as combinations of different angles |WD1|, |WD2| can be set by the patient or therapist.

[0021] Furthermore, in another preferred embodiment, it has proven advantageous if every second control slider is arranged to be reversibly fixed at predetermined positions during insertion into and removal from the first recess, preferably by means of a snap-in mechanism. For this purpose, every second control slider can, in particular, have a sawtooth profile on its side facing the orthosis, which can reversibly engage with a correspondingly designed side of the orthosis and / or a housing for the second control slider(s) facing the second control slider, thus forming a snap-in mechanism.Alternatively or cumulatively, the locking mechanism can also be formed by one or more, preferably spring-loaded, pins or studs, which can be arranged on the side of the orthosis and / or the housing for the second control slider facing the second control slider and interact with correspondingly shaped recesses, in particular holes, in the side of the second control slider(s) facing the orthosis. One or two control sliders configured in this way advantageously allow predetermined deviation angles for maximum possible ulnar and / or radial abduction to be set safely, quickly, and without the use of tools.

[0022] In a further alternative embodiment of the orthotic joint according to the invention, two second control slides, cooperating with the control element, can also be provided for controlling the ulnar / radial deviation movement of the hand, and at least one fourth recess arranged on the control element for deviation fixation. In this particularly preferred embodiment, one of the second control slides can be designed as a deviation control slide and comprise at least a head region, which is configured to be guided into and out of the first recess of the control element and to interact with the side edges of the first recess of the control element, and a body region, which has a guide track for a control pin of a second adjusting means encompassed by the orthotic joint.The other of the two second control slides, on the other hand, can be designed as a fixing slide and comprise at least a head region configured to interact with the fourth recess of the control element, and a body region having a guide track for the control pin of the second adjusting device. In this embodiment, the deviation control slide and the fixing slide are also preferably slidably mounted and designed so that they can be moved relative to each other by means of the control pin of the second adjusting device.

[0023] Two such second control slides, one designed as a deviation slide and the other as a fixing slide, which are movable relative to each other by means of a second adjusting mechanism, advantageously allow both the control of the ulnar and radial deviation of the hand and the fixing of the deviation movement at a specific angle by means of a single additional component, namely the second adjusting mechanism. In this embodiment, the adjustment and fixing of the ulnar and radial deviation can advantageously be achieved by rotating the second adjusting mechanism, just as easily as the adjustment and fixing of the extension and flexion movements of the hand by rotating the first adjusting mechanism, without the use of any additional, special tools.

[0024] Furthermore, it has proven advantageous if the head region of the deviation control slide is formed by two opposing lever elements, which are resiliently movable relative to each other and whose outer edges, in a relaxed state, have a distance from each other corresponding to the distance d 1 between the opposing side edges of the first pair of side edges SP 1 of the first recess, which is located closest to the rotary cylinder. The head region of the fixing slide can also preferably include a head element for interaction with the fourth recess, which is rigidly connected to the body region of the fixing slide.The head of such a deviation control slider can advantageously dampen the interaction of the outer edges of the deviation control slider with the side edges of the first recess, thus providing the user with the sensation of a softer stop at the respective end position of the deviation movement. The head of such a locking slider can advantageously interact with the control element, in particular with one or more fourth recesses arranged on the control element, preferably within the first recess of the control element, thus enabling the hand's deviation movement to be fixed at a desired angular position.

[0025] The present invention also relates to an orthosis for controlled movement and / or fixation of a hand or of a hand and forearm of a patient, with an adjustable orthotic joint as previously described.

[0026] 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 drawing.

[0027] This schematically illustrates: Fig. 1 shows an embodiment of an orthosis joint according to the invention in a perspective view (control element shown as an outline drawing); Fig. 2 shows a section along a longitudinal axis of an orthosis comprising an embodiment of an orthosis joint according to the invention; Fig. 3 shows, in partial figures a to c, an embodiment of a first adjusting means according to the invention in a top view ( Fig. 3a ), with regard to a subside of the first actuating device ( Fig. 3b ) and in a side view ( Fig. 3c ); Fig. 4 in partial drawing shows a further embodiment of a first adjusting means according to the invention in a perspective view of a bottom side of the first adjusting means ( Fig. 4a ) or in a view looking at a subside of the first actuating device ( Fig. 4b ), a correspondingly designed first control slide in a side view ( Fig. 4c ) as well as a perspective view of a control element with a first actuating device designed in this way ( Fig. 4d ); Fig. 5a in a top view of an embodiment of a control element with an embodiment of a first control slider and a pivot lever connected thereto; Fig. 5b - in sub-figures 5b to 5d, three possible positions of the first control slider in relation to the pivot lever in a side view to illustrate the mode of action of the first control slider in controlling the extension and flexion of the hand; Fig. 6a an embodiment of a control element and a cover element in a perspective view of the underside of the control element; Fig. 6b the control element made of Fig. 6a with a view of the underside; Fig. 7 in sub-figures a to d the interaction of an embodiment of a second control slide with the control element from the Fig. 6 a and b to illustrate the control of the deviation movement of the hand; Fig. 8 in subfigures a to d the interaction of two second control sliders with the control element from the Fig. 6 a and b to illustrate the control of the deviation movement of the hand; Fig. 9 an embodiment of an orthosis with an embodiment of an orthotic joint according to the invention in a perspective view; Fig. 10 a further embodiment of an orthotic joint according to the invention with two second control sliders, wherein one of the control sliders is designed as a deviation control slider and the other as a fixing slider; Fig. 11 an embodiment of a deviation control slider as in Fig. 10 Shown individually; Fig. 12 shows an embodiment of a fixing slide as in Fig. 10 also shown individually; Fig. 13 in sub-figures a to c the interplay of the in Fig. 10 The illustrated embodiment of an orthotic joint with a deviation control slider and a fixing slider to illustrate the control and fixation of the deviation movement of the hand; and Fig. 14 a view of an embodiment of a basic element of an orthotic joint as shown in Fig. 10 shown, as well as a deviation control slider inserted therein.

[0028] In the following description of preferred embodiments of the present invention, the same reference numerals denote identical or comparable components.

[0029] In Fig. 1 Figure 1 shows an embodiment of an orthotic joint 2 according to the invention in a perspective view. A control element 212 is shown as an outline drawing in order to also make underlying components visible.

[0030] An adjustable orthotic joint 2 according to the invention for the controlled movement and / or fixation of a patient's hand comprises at least one movement module 21 for controlling an extension and / or flexion movement E / F as well as for controlling and executing an ulnar and / or radial deviation urD of the hand. A pivot lever 22 is operatively connected to the movement module 21 for executing the extension and / or flexion movement E / F of the hand. The pivot lever 22 can preferably be operatively connected to the control element 212 via a pivot axis 221 or pivotably mounted thereon. The movement module 21 further comprises at least one base element 213 and at least one control element 212 with a top surface 2126 and a bottom surface 2127 facing the base element 213 and opposite the top surface 2126.A rotary cylinder 2121 is arranged on the underside 2127, by means of which the control element 212 is rotatably mounted relative to the base element 213 with respect to a deviation axis DA. The base element 213 preferably has a receptacle 2131 for the rotary cylinder 2121. The control element 212 together with the rotary cylinder 2121 can in particular be made of a metallic material, preferably aluminum. For the rotatable mounting of the control element 212 relative to the base element 213, a guide 2132 for the rotary cylinder 2121 can also be provided between the base element 213 and the rotary cylinder 2121. Such a guide 2132, which is preferably made of steel in the form of a sleeve, can advantageously reduce friction between the metallic rotary cylinder 2121 and the base element 213, in particular against a base element 213 made of a plastic (see in particular [reference]). Fig. 2 ).

[0031] According to the invention, the control element 212 is configured to have its rotational movement about the deviation axis DA controlled and to also control the movement of the pivot lever 22 within its range of motion. The pivot axis 221, via which the pivot lever 22 is preferably operatively connected to the control element 212, can be arranged within a recess 2124, which in turn can be located at the edge 2129 of the control element 212. This second recess 2124 can, in particular, extend over the entire height H of the control element 212, thus allowing the pivot lever 22 freedom of movement for its pivoting motion perpendicular to the plane of the control element 212, and is preferably located at the opposite edge 2129 to a first recess 2122 for deviation control located on the underside 2127 of the control element 212.Accordingly, a recess 2111 for the pivot lever 22 can also be provided in a cover element 211 to cover the control element 212.

[0032] As in Fig. 1 As can be seen, the control element 212 also comprises at least one first control slide 214, which is displaceable relative to the pivot lever 22 operatively connected to the motion module 21 by means of at least one first actuating means 216. For this purpose, the control element 212 can have a third recess 2125 for the first control slide 214, which is preferably arranged on the upper surface 2126 of the control element 212 and in particular extends along a connecting line from the center of the first recess 2122 for deviation control to the center of the second recess 2124 for the pivot lever 22.

[0033] Fig. 2 Figure 1 shows a section along a longitudinal axis LA of an orthosis 1 comprising an embodiment of an orthosis joint 2 according to the invention. Fig. 2 The first control slide 214 is highlighted with diagonal hatching and it can be seen how it is guided within the third recess 2125.

[0034] The first control slide 214 can, as in the Fig. 1 und 2 The first control slide 214 is shown to be essentially cuboid in shape and fork-shaped at its end facing the pivot lever 22. The fork-shaped end 2142 of the first control slide 214 can preferably be designed such that the end of the pivot lever 22 connected to the pivot axis 221 can be pushed between the "fork tines," the extent of the pivoting movement of the pivot lever 22 being restricted the further the end of the pivot lever 22 connected to the pivot axis 221 is received into the space between the tines of the fork-shaped end 2142. Fig. 5b bis 5d This mechanism is illustrated by way of example. The first actuating means 216, provided for moving the first control slide 214 within the third recess 2125, preferably comprises at least one head 2161 and one actuating cylinder 2164, which are connected to each other, preferably via a collar 2163, so that a component with a longitudinal axis 2165 is formed. The collar 2163 can, in particular, serve to rotatably fix the first actuating means 216 within the movement module 21, for which purpose the movement module 21 can comprise a cover element 211, which at least partially covers the control element 212 together with all components arranged thereon upwards, i.e., on the side of the movement module 21 opposite the base element 213. Fig. 2 For example, it can be seen that the cover element 211 covers the control element 212 and all components arranged on it, except for the head 2161 of the first actuating device 216. The collar 2163 is located below the cover element 211 and prevents the first actuating device 216 from falling out of the Fig.1 clearly visible opening in the middle of the cover element 211.

[0035] Fig. 3 shows in the partial figures a until c an embodiment of a first actuating means 216 according to the invention in a top view ( Fig. 3a ), with regard to a subside of the first actuating device 216 ( Fig. 3b ) and in a side view ( Fig. 3c ).

[0036] The actuating cylinder 2164 of the first actuating device 216 can – as shown here – have a circular cross-section and be connected to the head 2161 of the first actuating device 216 off-center with respect to the longitudinal axis 2165. The radius of such an actuating cylinder 2164 can, in particular, be smaller than the radius of the head 2161. The actuating cylinder 2164 can also interact with at least one recess 2141 of the first control slide 214, which is provided for receiving the actuating cylinder 2164. For this purpose, the first actuating means 216 can be rotated by the patient himself via a groove 2162, which is preferably arranged on the top of the head 2161, whereby the actuating cylinder 2164 comes into operative contact with a side limit of the recess 2141, exerts force on said side limit and thereby pushes the first control slide 214 away from the axis of rotation of the first actuating means 216.Due to the off-center arrangement of the actuating cylinder 2164 in the sense of an eccentric screw, when the first actuating means 216 is turned in the opposite direction, the effective connection with said side limit decreases and increases with an opposite side limit of the recess 2141, so that the first control slide 214 is pushed accordingly in the other direction.

[0037] In Fig. 4 The partial drawing shows a further embodiment of a first actuating means 216 according to the invention in a perspective view of a bottom side of the first actuating means 216 ( Fig. 4a ) or in a view looking at a subside of the first actuating device 216 ( Fig. 4b ) shown, as well as a correspondingly designed first control slide 214 in a side view ( Fig. 4c ) and a perspective view of a control element 212 with a first actuating device 216 designed in this way ( Fig. 4d ). In Fig. 4d The first actuating device 216 is not shown completely; rather, it is only a section through the actuating cylinder 2164 of a first actuating device 216 as in the Fig. 4a und 4b shown to illustrate the engagement and guidance of the connecting pin 2143 within the channel 2166.

[0038] As an alternative to the embodiment described above, the first actuating means 216 can also comprise at least one head 2161 and one actuating cylinder 2164, which are connected to each other, preferably via a collar 2163, so that a component with a longitudinal axis 2165 is formed, wherein the actuating cylinder 216 has a channel 2166, preferably substantially C-shaped, on its side facing away from the head 2161. In this embodiment, the first control slide 214 can in particular comprise a connecting pin 2143, which engages in the channel 2166 of the actuating cylinder 2164 when the orthosis joint 2 is used. The connecting pin 2143 can preferably be arranged within a recess 2141 of the first control slide 214, which is configured to receive the actuating cylinder 2164 (see Figure 2164). Fig. 4c The head 2161 of the first actuating means 216 can, as before, be provided with a groove 2162, via which the first actuating means 216 can be rotated with respect to its longitudinal axis 2165. When a first actuating means 216 designed in this way is rotated, force can advantageously be exerted on the first control slide 214 via the connecting pin 2143, which engages in the substantially C-shaped channel 2166 of the actuating cylinder 216, by interaction with the walls of the channel 2166 ( Fig. 4d Depending on the direction of rotation, the first control slide 214 can thereby be moved in the direction of the pivot lever 22 or in the opposite direction within the third recess 2125 of the control element 212.

[0039] To illustrate the mode of action of the first control slider 214 in controlling the extension and flexion of the hand, the following is shown in Fig. 5a In a top view, an embodiment of a control element 212 with an embodiment of a first control slide 214 and a pivot lever 22 connected therewith is shown and in the partial figures 5b until 5d Each side view shows three possible positions of the first control slide 214 in relation to the pivot lever 22 during use.

[0040] As already described, the first control slide 214, guided by the third recess 2125 provided on the control element 212, can be displaced relative to the pivot lever 22 or its pivot axis 221 by means of the first actuating means 216. An example of this is a circular, eccentrically positioned actuating cylinder 2164 (dashed line). Fig. 5a indicated, a positioning cylinder 2164 with channel 2166, as previously described (see above). Fig. 4a und 4b ), however, it has a corresponding effect. Fig. 5b Figure 1 shows a position of the first control slide 214 in which it is fully pushed towards the pivot axis 221 of the pivot lever 22, and the forked end 2142 of the first control slide 214 completely encloses said pivot axis 221 and the adjoining part of the pivot lever 22. The fork tines of the forked end 2142 act as a stop and prevent pivoting of the pivot lever 22 about its pivot axis 221. The angle between the pivot lever 22 and the first control slide 214 is 180° in this position. Fig. 5b (indicated by an angled arc and a dashed line), which corresponds to a patient's hand extended with respect to the forearm and represents, so to speak, a zero position. In this position of the first control slider 214, the hand is thus fixed with respect to extension and flexion movements E / F. Fig. 5c Figure 1 shows the position of the first control slide 214 in which it has been pushed away from the pivot axis 221 of the pivot lever 22 by means of the first actuating device 216. This movement is indicated by a Fig. 5c The arrow pointing to the right indicates this. In this position, the forked end 2142 of the first control slide 214 still grasps the part of the pivot lever 22 located near the pivot axis 221 to a certain degree, but no longer completely prevents the pivoting movement of the pivot lever 22. The fork tines, in turn, serve as a stop and limit the extension and flexion movement E / F of the hand guided by the pivot lever 22 at a predetermined angle ± WE / F. Twice this angle |WE / F| then determines the maximum possible range of motion for the extension and flexion movement E / F of the patient's hand. Fig. 5d The first control slider 214 is shown in a position completely displaced from the end of the third recess 2125 opposite the pivot axis 221. The forked end 2142 no longer engages the pivot lever 22 and its pivot axis 221. The pivoting movement of the pivot lever 22, and thus also the extension and flexion movement E / F of the hand, occurs completely unhindered within the anatomically possible range of motion. However, the operative connection between the pivot lever 22 and the control element 212 via the pivot axis 221 still allows for advantageous guidance of the extension and flexion movement E / F of the hand, thereby stabilizing the patient's wrist.

[0041] The first adjusting means 216 and / or the first control slide 214 may, in particular to ensure a safe and patient-adjustable setting of the respective possible range of motion of the extension and flexion movement E / F of the hand, preferably comprise at least one locking mechanism 217 which is configured to reversibly fix the first control slide 214 in its displacement movement with respect to the pivot lever 22 operatively connected to the movement module 21 at at least one predetermined position. Fig. 4a until dFigure 217 illustrates an embodiment of such a locking mechanism 217 using the example of a first adjusting element 216 with a channel 2166. The channel 2166, located on the side of the adjusting cylinder 2164 facing away from the head 2161, can include recesses 2172 arranged at predetermined positions within the channel 2166. The connecting pin 2143, located on the first control slide 214, can then engage in these recesses 2172 when the first adjusting element 216 is rotated about its longitudinal axis 2165. With the application of a small additional force, it can also be moved out of the respective recess 2172 and guided to the next recess 2172. The patient can feel the "engaging" in the individual recesses 2172 when rotating the first adjusting element 216. This advantageously signals to the patient that the orthotic joint 2 is correctly adjusted.In a preferred embodiment of such a locking mechanism 217, the connecting pin 2143 can also be spring-mounted on the first control slide 214. Fig. 4c An example of this is a spring 2171. This spring 2171 can advantageously facilitate both the engagement and disengagement of the connecting pin 2143 from a recess 2172 within the channel 2166. In an embodiment of the first actuating means 216 with an eccentrically arranged actuating cylinder 2164 as shown in Fig. 3 As shown, the locking mechanism 217 can in particular be designed as a structured, preferably corrugated ring, which is arranged on the side of the collar 2163 facing the actuating cylinder 2164 and interacts with a correspondingly structured area of ​​the control means 212 and / or the first control slide 214.

[0042] The Fig. 6a und 6b show an embodiment of a control element 212 and a cover element 211 in a perspective view of the underside 2127 of the control element 212 ( Fig. 6a ); or a look at said subpage 2127 ( Fig. 6b ).

[0043] As previously mentioned, the control element 212 comprises a first recess 2122 for deviation control, which is arranged on the underside 2127 of the control element 212 and preferably extends from an edge 2129 of the control element 212 in the direction of the rotary cylinder 2121. The height h of the control element 212 in the region of the first recess 2122 can thus be less than the height H of the control element 212 in the region outside the first recess 2122, thereby forming at least four side edges 2123 that delimit the region inside the first recess 2122 from the region outside the first recess 2122. Any two of the side edges 2123 can be substantially opposite each other at a distance dn with n = 1, 2, ... and form a side edge pair SP n with n = 1, 2, ...A distance dn between two opposing side edges 2123 of a side edge pair SP n arranged closer to the rotary cylinder 2121 is preferably always smaller than a distance d n+1 between two opposing side edges 2123 of a side edge pair SP n+1 arranged closer to the edge 2129 of the control element 212. As in the . Fig. 6a and b As can be seen, the first recess 2122 can also be formed by a plurality of side edges 2123, preferably eight side edges 2123, of which two are substantially opposite each other and form a side edge pair SP n with n = 1, 2, ... The first recess 2122 can be closed off towards the rotary cylinder 2121, in particular by an end edge 2128. The opposing side edges 2123 of the first side edge pair SP 1, arranged adjacent to the rotary cylinder 2121, can be, as shown in Fig. 6b The side edges 2123 of the side edge pairs SP 2, SP 3, SP 4, ... are shown to run approximately parallel to a connecting line that links the center of the second recess 2124 for the pivot lever 22 and the intersection of the deviation axis DA running through the rotary cylinder 2121 with the plane of the control element 212. The side edges 2123 of the side edge pairs SP 2, SP 3, SP 4, ... preferably each form an angle with this connecting line. Fig. 6b The individual side edges 2123 are extended by dash-dot lines to clarify the angle that is created in each case.

[0044] To control the ulnar and radial deviation movement urD of the hand, a second control slide 215 interacts with the control element 212. The second control slide 215 can be essentially cuboid in shape and have a length 2152, a width 2153, and a height 2154. The width 2153 of the second control slide 215 preferably corresponds to the distance d1 between the opposing side edges 2123 of the first pair of side edges SP1, which is located closest to the rotary cylinder 2121. Furthermore, the second control slide 215 can be designed to be inserted into and removed from the first recess 2122 of the control element 212 and preferably interact with the side edges 2123.

[0045] Fig. 7 Figures a to d show the interaction of a second control slide 215 with the control element 212 from the Fig. 6 a and bto illustrate the control of the deviation movement of the hand.

[0046] Fig. 7a Figure 1 schematically shows the underside 2127 of the control element 212 with rotary cylinder 2121, first recess 2122, and second recess 2124 in a top view. The second control slide 215 is inserted into the first recess 2122 up to the end edge 2128 of the first recess 2122. In this configuration, the width 2153 of the control slide 215 corresponds to the distance d1 between the opposing side edges 2123 of the first pair of side edges SP1. In this position, the edges of the second control slide 215 interact with the side edges 2123 of the first pair of side edges SP1, thus preventing rotation of the control element 212 about the deviation axis DA passing through the rotary cylinder 2121. A pivot lever 22 operatively connected to the control element 212 (not shown here, but e.g. in the Fig. 1, 2 , 5 and9 (as seen) therefore cannot move within the framework of a rotational movement with respect to the deviation axis DA, so that no deviation movement of the hand is allowed - the hand is fixed with respect to an ulnar and radial deviation urD.

[0047] In Fig. 7b The second control slide 215 is shown in a position where it is slightly extended out of the first recess 2122 and away from the end edge 2128 of the first recess 2122. In this position, there is no longer any contact with the side edges 2123 of the first side edge pair SP 1, and a rotational movement of the control element 212 by means of the rotary cylinder 2121 about the deviation axis DA is possible (curved arrows in the Fig. 7c and 7d ). In the Fig. 7c and 7d are the endpoints of said rotational movements shown, whereby Fig. 7c the endpoint of a radial deviation movement (radial abduction) and Fig. 7d The endpoint of an ulnar deviation movement (ulnar abduction) is shown. The rotational movement about the deviation axis DA in one direction is terminated by the renewed interaction between the corresponding edge of the second control slider 215 and the respective side edge 2123, here exemplified by the second side edge pair SP 2. The magnitudes of the swept angles |W D1 | (radial abduction) and |W D2 | (ulnar abduction) are equal in this configuration. The range of motion for the entire deviation movement urD permitted in this position of the second control slider 215 is the sum of |W D1 | and |W D2 |, here 2 x |W D1 |. By further extending the second control slider 215 out of the first recess 2122, the possible range of motion permitted by the control element 212 can be increased. From the Fig. 7c and 7dIt is evident that if the second control slide 215 is positioned somewhat further away from the rotary cylinder 2121 or the end edge 2128, then, when the control element 212 is rotated about the deviation axis DA, the side edges 2123 of the second side edge pair SP 2 would no longer interact with the respective edges of the second control slide 215, but rather the side edges 2123 of the side edge pairs SP 3 or SP 4, which are located further towards the edge 2129 of the control element 212, would interact. The magnitude of the total angle swept |W D1 | + |W D2 | would be correspondingly larger.

[0048] For the sake of clarity, the designations of the individual pairs of side edges SP n have been placed in the Fig 7a - d and 8 a - d omitted, however they can Fig. 6b can be taken.

[0049] Alternatively to the one in the Fig. 7a - 7d In the illustrated embodiment of the orthotic joint 2 according to the invention, instead of one, two second control slides 215, cooperating with the control element 212, can be provided for controlling the ulnar or radial deviation movement urD of the hand, wherein the second control slides 215 are each essentially cuboid in shape and can have a length 2152, a width 2153, and a height 2154. In this embodiment, the sum of the widths 2153 preferably corresponds to the distance d 1 between the opposing side edges 2123 of the first pair of side edges SP 1, which is located closest to the rotary cylinder 2121. Each second control slide 215 can also be designed to be inserted into and removed from the first recess 2122 of the control element 212 and preferably interact with the side edges 2123.

[0050] Fig. 8 shows in the partial figures a until din turn the interaction of two second control slides 215 with the control element 212 from the Fig. 6 a and b to illustrate the control of the deviation movement of the hand.

[0051] Fig. 8a corresponds to the in Fig. 7a In the depicted situation, both second control slides 215 are guided into the first recess 2122 up to the end edge 2128 of the first recess 2122. Since the sum of the widths 2153 of the second control slides 215 corresponds to the distance d1 between the opposing side edges 2123 of the first pair of side edges SP1, which is located closest to the rotary cylinder 2121, both control slides 215 interact with the respective side edge 2123 of the first pair of side edges SP1 nearest to them, and rotation of the control element 212 about the deviation axis DA running through the rotary cylinder 2121 is prevented. The embodiment shown here with two second control slides 215 now enables, on the one hand, the same control mechanism for controlling the ulnar and radial deviation movement urD of the hand as described in the Fig. 7a - d The illustrated configuration. A prerequisite for this is that the two second control slides 215 always occupy the same positions within the first recess 2122, i.e., are always inserted into and removed from the first recess 2122 to the same extent. For this control mechanism, refer to the description of the Fig. 7a - 7d referred.

[0052] On the other hand, the configuration shown here with two second control sliders 215 also allows for asymmetrical control of the deviation movement urD of the hand. In the Fig. 8b and 8cAn exemplary situation is shown in which one of the second control sliders 215 is moved slightly out of the first recess 2122 towards the edge 2129 of the control element 212, while the other second control slider 215 remains in its original position in contact with the end edge 2128 of the first recess 2122. With such a positioning of the two second control sliders 215, the control element 212 can only perform a rotation about the deviation axis DA within the scope of a radial deviation (corresponding to a radial abduction) by means of the rotary cylinder 2121; a rotational movement beyond the initial position ( Fig. 8b ) outwards in the direction of an ulnar deviation (corresponding to an ulnar abduction) is prevented by the interaction between an edge of the second control slider 215, which remains in its original position, and the adjacent side edge 2123 of the first side edge pair SP 1. The magnitude of the maximum possible angle swept out within the radial deviation movement |W D1 | is, as in Fig. 7c The configuration with a second control slider 215 is shown and described, determined by the interaction of an edge of the previously displaced second control slider 215 with the side edge 2123 of the second side edge pair SP 2. If the magnitude of the sweepable angle |W D1 | is to be larger, the second control slider 215 can be moved further away from the end edge 2128 of the first recess 2122 and then interact accordingly with the side edge 2123 of the third SP 3 or fourth SP 4 side edge pair. The same applies, of course, to the Fig. 8a - 8d upper second control slide 215 in its starting position (cf. Fig. 8a ) remain and the one in the Fig. 8a - 8d The lower second control slide 215 is led out of the first recess 2122 in order to block radial deviation, but to allow ulnar deviation (corresponding to ulnar abduction). Fig. 8d Finally, a situation is shown in which both second control slides 215 are moved from their starting position into Fig. 8a in the direction of the edge 2129 of the control element 212 out of the first recess 2122, the displacement within the first recess 2122 of the two second control slides 215 being of different distances. The in Fig. 8d The upper second control slide 215 is located in a position within the first recess 2122, which allows interaction with the side edges 2123 of the second side edge pair SP 2, whereas the one in Fig. 8d The lower second control sliders 215 were shifted slightly further towards the edge 2129, thus enabling interaction with the side edges 2123 of the third side edge pair SP 3. In this positioning of the two second control sliders 215, rotation of the control element 212 by means of the rotary cylinder 2121 about the deviation axis DA covers a different angular range for the radial deviation (angle magnitude |W D1 |) and for the ulnar deviation (angle magnitude |W D2 |). Fig. 8d These two angles of different sizes are indicated by dashed lines and curved double arrows. The total possible range of motion of the ulnar and radial deviation urD, with the positioning of the two second control sliders 215 shown here, is again the sum of the values ​​|W D1 | and |W D2 |, where in this example the permissible range of motion of the ulnar deviation (corresponding to |W D2 |) is greater than the permissible range of motion of the radial deviation (corresponding to |W D1 |). By positioning the two second control sliders 215 differently within the first recess 2122, a variety of different ranges of motion of the ulnar and radial deviation urD can thus be advantageously controlled, allowing for individual adaptation to the respective health or rehabilitation condition of the patient.

[0053] In Fig. 9 Figure 1 shows an embodiment of an orthosis 1 according to the invention with an embodiment of an orthosis joint 2 according to the invention in a perspective view.

[0054] In this embodiment of the orthosis 1, the orthotic joint 2 is connected to a forearm attachment 11 of the orthosis 1, in particular via the base element 213 of the motion module 21. Alternatively, part of the forearm attachment 11 can also form the base element 213 of a motion module 21 and, in particular, have a receptacle 2131 for the rotary cylinder 2121 of the control element 212 (not shown). The orthosis 1, or its forearm attachment 11, can also be reversibly attached to the patient's forearm by means of fasteners 12. Suitable fasteners 12 include, in particular, hook-and-loop fasteners or straps with perforations and a buckle in the broadest sense. However, the fasteners 12 can also be manufactured by an additive manufacturing process ("3D printing"), for example, as a band-like extension of the forearm attachment 11 and equipped with a locking mechanism (e.g., a buckle).by arranging studs on one side of the band-like extension and correspondingly formed holes on another band-like extension of the forearm attachment 11), as shown in . Fig. 9 The forearm attachment 11 and the fastening means 12 can preferably be made of a plastic.

[0055] To ensure safe, rapid, and tool-free adjustment of predetermined deviation angles for maximum possible ulnar and / or radial abduction (or ulnar / radial deviation movement urD) by the patient, every second control slider 215 can be further configured to be reversibly fixed at predetermined positions during insertion into and removal from the first recess 2122. A locking mechanism 2151 can preferably be provided for this purpose. In particular, every second control slider 215 can have a sawtooth profile (not shown) on its side facing the orthosis 1, which can reversibly engage with a correspondingly designed side of the orthosis 1 facing the second control slider 215 and / or a housing 13 for the second control slider(s) 215, thus forming a locking mechanism 2151.An embodiment of a housing 13 for the second control slide 215 is shown in the . Fig. 1, 2 and 9 The second control slider 215 can also have a control element 2155 for easy operation by the patient, by means of which it can be moved, in particular within the housing 13, to the movement module 21 and thus to the first recess 2122 of the control element 212, or away from the movement module 21 and thus from the first recess 2122.

[0056] Alternatively or cumulatively, the locking mechanism 2151 can also be formed by one or more, preferably spring-loaded, pins or studs, which can be arranged on the side of the orthosis 1 and / or the housing 13 for the second control slide 215 facing the second control slide 215 and interact with correspondingly shaped recesses, in particular holes, in the side of the second control slide(s) 215 facing the orthosis 1. Fig. 1 und 2 Such a locking mechanism is shown as an example in Figure 2151.

[0057] For use of an orthosis 1 according to the invention by a patient, the pivot lever 22, which is operatively connected to the control element 212 of the movement module 21, can be used as shown in Fig. 9 The connecting element 3 is shown, and preferably connected to a hand attachment 4 via a connecting element 3. The connecting element 3 can be permanently connected to the hand attachment 4 or, for example, designed to be reversibly connected via a click or snap-in mechanism. The connecting element 3 can preferably be slidably mounted relative to the pivot lever 22, which advantageously accommodates changes in the distance between the movement module 21 and a contact point between the hand attachment 4 and the top of the hand during the execution of an extension and flexion movement E / F.

[0058] For the reversible connection of a patient's hand to the hand attachment 4, a fastening element 41 can be arranged on the hand attachment 4, wherein the fastening element 41 can in particular be made of a textile material which is preferably designed to be connectable to the underside of the hand attachment 4 via a hook-and-loop fastener. The fastening element 41 can advantageously enclose the patient's thumb, for example by means of a hole within the textile material of the fastening element 41 through which the patient's thumb can be inserted and thereby enclosed. vgl. Fig. 9 ) or by a fastening device 41, which is formed from several textile bands that can be placed around the patient's thumb (not shown). A fastening device 41 designed in this way advantageously prevents the orthosis 1 from slipping when the patient moves.

[0059] In Fig. 10 A further, alternative embodiment of an orthosis joint 2 according to the invention is shown with two second control sliders 215, wherein one of the control sliders 215 is designed as a deviation control slider 218 and the other as a fixing slider 219.

[0060] In this embodiment, two second control sliders 215 – one designed as a deviation control slider 218 and one designed as a fixing slider 219 – preferably work together to control the ulnar / radial deviation movement urD of the hand with the control element 212.

[0061] In the Fig. 11 and 12 The embodiments of a deviation control slide 218 and a fixing slide 219 are each shown individually.

[0062] The second control slide 215, designed as a deviation control slide 218, can, as shown, preferably comprise a head region 2181 and a body region 2182, wherein the head region 2181 is configured to be guided into and out of the first recess 2122 of the control element 212 and to interact with the side edges 2123 of the first recess 2122 of the control element 212. The body region 2182 of the deviation control slide 218 preferably comprises a guide track 2184 for a control pin 2169 of a second adjusting means 2167 encompassed by the orthosis joint 2. The second adjusting means 2167 can, for example, be designed as a type of screw which can be rotated clockwise and counterclockwise via a groove 2168.The guide track 2184 can preferably be approximately L-shaped, wherein the transition from the longer part of the "L" to the shorter part of the "L" is preferably round and wherein the shorter part of the "L" can be oriented in particular towards the head region 2181 of the deviation control slide 218.

[0063] The head region 2181 of the deviation control slide 218 can particularly preferably be formed by two opposing lever elements 2183, which are resiliently movable relative to each other. The spring action of the lever elements 2183 can be generated, in particular, on the one hand, by the elastic properties of the material from which the deviation lever 218 is made, which are present to a certain degree. For this purpose, for example, a metallic material, especially aluminum, can be used. On the other hand, the lever elements 2183 can also be designed – alternatively and cumulatively – to generate a certain degree of elasticity. Fig. 11 It is shown by way of example that the lever elements 2183 can be designed, in particular, as the tines of a fork, which point away from the body area 2182 of the deviation control slide 218. The respective narrow design of the lever elements 2183, especially at the transition to the body area 2182, advantageously generates a certain spring effect of the respective lever elements 2183 when acted upon from the outside. In a relaxed state, i.e., without external action on the lever elements 2183, the outer edges 2185 of said lever elements 2183 can also preferably have a distance A from each other, which corresponds to the distance d 1 of the opposing side edges 2123 of the first pair of side edges SP 1 of the first recess 2122, which is located closest to the rotary cylinder 2121.

[0064] The second control slide 215, designed as a fixing slide 219, preferably also comprises at least one head region 2191 and one body region 2192, wherein the head region 2191 of the fixing slide 219 is specifically configured to interact with a fourth recess 2120 of the control element 212. In this embodiment, the orthotic joint 2 according to the invention preferably comprises at least one fourth recess 2120 arranged on the control element 212 for deviation fixation. However, a plurality of fourth recesses 2120 are preferably provided, as shown by way of example in the Fig. 13 b und 13 c as indicated by four such fourth recesses 2120.

[0065] The head area 2191 of the fixing slide 219 can interact with said fourth recess 2120, as shown in Fig. 12 The head element 2193 is shown to be a head element 2193, which is firmly connected to the body area 2192 of the fixing slide 219. Apart from the head element 2193, the head area 2191 of the fixing slide 219 can also be concave, so that when the head element 2193 interacts with the fourth recess 2120, the remaining head area 2191 of the fixing slide 219 can also come into contact with the control element 212 (see Figure 2). Fig. 13 c) . Such contact advantageously enables a further, more evenly distributed force transmission from the control element 212 to the fixing slide 219 and thus advantageously reinforces the fixing of the deviation movement urD when the head element 2193 engages in the fourth recess 2120.

[0066] The body area 2192 of the fixing slide 219 can in turn have a guide track 2194 for the control pin 2169 of the second adjusting device 2167. This guide track 2194 can, as shown in Fig. 12 to be seen, preferably in a U-shape, wherein the opening of the "U" is preferably directed towards a longitudinal side of the fixing slide 219 and wherein the arm of the "U" closer to the head region 2191 may preferably be shorter than the arm of the "U" further away from the head region 2191.

[0067] Fig. 13 Figures a to c now show the interplay of the elements in Fig. 10 The illustrated design of an orthotic joint 2 with a deviation control slider 218 and a fixing slider 219 illustrates the control and fixing of the deviation movement of the hand.

[0068] Fig. 13 aFigure 1 shows, by way of example, the underside 2127 of the control element 212 with a deviation control slide 218 inserted up to the end edge 2128 of the first recess 2122. If the control element 212 remains at rest with respect to the deviation slide 218, as shown here, the distance A between the two lever elements 2183 preferably corresponds to the distance d 1 between the two side edges 2123 that are closest to the rotary cylinder 2121, i.e., the side edge pair SP 1 (see Figure 2123). Fig. 13 b) In this position of the deviation control slider 218, the deviation movement urD permitted by the orthosis joint 2 in both directions would be blocked, except for a very small angular range resulting from the aforementioned spring action, by interactions between the outer edges 2185 of the deviation control slider 218 and the side edges 2123, thus fixing the hand. Complete fixation can be ensured by a modification, in particular of the base element 213 of the orthosis joint 2, which is described further below in connection with Fig. 14 will be described in more detail.

[0069] In Fig. 13a Furthermore, it can be seen that the deviation control slide 218 and the fixing slide 219 are slidably mounted and can be designed to be slidably positioned relative to each other by means of the control pin 2169 of the second adjusting element 2167. The second adjusting element 2167, which can, for example, be designed as a screw having the control pin 2169 on one side and a groove 2168 on the opposite side, can interact with both the deviation slide 218 and the fixing slide 219 by means of the control pin 2169. For this purpose, the control pin 2169 of the second adjusting element 2167 can preferably be positioned such that it extends into both the guide track 2184 of the deviation control slide 218 and the guide track 2194 of the fixing slide 219 and can move in both guide tracks 2184 and 2194.

[0070] In the Figuren 13a bis c The second adjusting device 2167 (or its visible parts) and its control pin 2169 are each shown hatched. In the Fig. 13 In a and 13 c, the two sliders 218 and 219 are also "shown solidly", so that the deviation control slider 218 covers the fixing slider 219 to a different extent. Fig. 13 b In contrast, the deviation slide 218 is shown as an outline drawing, so that the fixing slide 219 shines through the deviation control slide 218 and the course of the two guide tracks 2184 and 2194 of this embodiment of the invention is visible.

[0071] Due to the differently shaped and oriented guideways 2184 and 2194, when the second actuating means 2167 is rotated, the deviation control slide 218 can first be pushed away from the end edge 2128 of the first recess 2122 in the direction of the fixing slide 219, whereby the fixing slide 219 can preferably initially remain in its position.

[0072] This can, for example, lead to an adjustment of the orthosis joint 2, as described in Fig. 13 b shown.

[0073] In this setting of the orthotic joint 2, the head region 2181 of the deviation control slider 218 projects to a certain degree into the first recess 2122, whereby there is no longer any contact between the outer edges 2185 of the deviation control slider 218 and the side edges 2123 of the first recess 2122. In this setting, the control element 212 can rotate about the rotary cylinder 2121 or about its axis of rotation DA passing through said rotary cylinder 2121, and the user can perform a deviation movement urD of the hand. Fig. 13b Such a deviation movement urD is exemplified by a small curved arrow indicating a clockwise rotation of the control element 212. However, in this setting, the deviation movement urD is only possible until the head area 2181, in particular its lever element 2183, comes into contact again with a side edge 2123 of the first recess 2122 (indicated by a straight dashed arrow in Fig. 13 b) The mechanism works here as in the other configurations described above (see below). Fig. 7a bis 7d and Fig. 8a bis 8d ).

[0074] At the moment of contact between lever element 2183 and side edge 2123, said lever element 2183, due to its spring properties, advantageously dampens the stop, so that the user can perceive the stopping at the respective endpoints of the deviation movement urD as being softer than in the two other embodiments of the present invention shown. Fig. 13 b This possible damping movement on the upper of the two lever elements 2183 is indicated by a small curved arrow.

[0075] Fig. 13 c Figure 2 shows a setting of the orthosis joint 2 in which the second adjusting element 2167 was rotated further until its control pin 2169 had moved almost to the end of the guide track 2184. During this rotation, the control pin 2169 pulls the deviation slider 218 further out of the first recess 2122, while at the same time, from approximately halfway through its travel, it advantageously pushes the fixing slider 219 towards the first recess 2122, so that finally an end position as shown in Figure 2184 is reached. Fig. 13 c It can be shown how it can be achieved.

[0076] In this end position, the head element 2193 of the fixing slider 219 can advantageously engage in one of the fourth recesses 2120 arranged on the control element 212, particularly within its first recess 2122, and thus fix the orthosis joint 2. If a plurality of fourth recesses 2120 are provided, such as four distributed over an angular range as shown here, the fixing can be achieved not only in a relatively straight hand position, as illustrated here, but also advantageously with the hand angled with respect to a deviation movement urD, depending on how the control element 212 was previously rotated with respect to its axis of rotation DA.

[0077] Fig. 14 Finally, a view of a design of a basic element 213 of an orthotic joint 2 as in Fig. 10 shown, as well as a deviation control slide 218 inserted therein.

[0078] As mentioned above, due to the design of the head region 2181 of the deviation control slider 218 in this embodiment of the invention, a complete fixation of the deviation movement urD cannot be achieved by simply pushing the deviation control slider 218 towards the end edge 2128 of the first recess 2122, since the lever elements 2183 can always perform a certain spring movement on their own. In order to enable complete fixation in an extended hand position even in this embodiment of the orthotic joint 2 according to the invention, as described in Fig. 14 As shown, a stop pin 2133 is preferably arranged on the base element 213 of the orthosis joint 2. This stop pin 2133 is preferably positioned on the base element 213 and firmly connected to it such that said stop pin 2133 is not displaced when the deviation control slider 218 is fully pushed towards the end edge 2128 (i.e., the one shown in the figure). Fig. 13 (as shown in the situation shown) is located precisely between the lever elements 2183. The stop pin 2133 then advantageously prevents a spring movement of the lever arms 2183 inwards, i.e. towards each other, when a force is applied to the outer edges 2185 of the deviation slide 218 via the respective side edges 2123 of the first pair of side edges SP 1, thus advantageously enabling complete fixation of the hand even in this embodiment.

[0079] The present invention relates to an adjustable orthotic joint 2 for the controlled movement and / or fixation of a hand, and to an orthosis 1 with such an orthotic joint 2. The orthotic joint 2 according to the invention is characterized by a movement module 21, which comprises at least one base element 213 and at least one control element 212 with a top surface 2126 and a bottom surface 2127 facing the base element 213 and opposite the top surface 2126, wherein a rotary cylinder 2121 is arranged on the bottom surface 2127, by means of which the control element 212 is rotatably mounted relative to the base element 213 with respect to a deviation axis DA, wherein the control element 212 is configured to be controlled and limited in its rotational movement, and wherein the control element 212 is configured to control and limit the range of motion of a pivot lever 22 operatively connected to the movement module 21.It can be adjusted by the patient without tools and is so compact that its use in everyday life is not perceived as disruptive. Bezugszeichenliste

[0080] 1 Orthosis 11 Forearm attachment 12 Fastening device 13 Housing for second control slider (215) 2 Orthotic joint 21 Motion module 211 Cover element 2111 Recess for pivot lever (22) 212 Control element 2121 Rotary cylinder 2122 First recess for deviation control 2123 Side edge of recess (2122) 2124 Second recess for pivot lever (22) 2125 Third recess for first control slider (214) 2126 Top side 2127 Bottom side 2128 End edge of recess (2122) 2129 Edge 2120 Fourth recess for deviation fixation 213 Base element 2131 Receptacle for rotary cylinder (2121) 2132 Guide for rotary cylinder (2121) 2133 Stop pin 214 First control slider for extension / flexion (E / F) 2141 Recess for first adjusting device (216) 2142 Forked end 2143 Connecting pin 215 Second control slide for ulnar / radial deviation (urD) of the hand 2151 Locking mechanism 2152 Length 2153 Width 2154 Height 2155 Operating element 216 First adjusting element 2161 Head 2162 Groove 2163 Collar 2164 Actuating cylinder 2165 Longitudinal axis 2166 Channel 2167 Second adjusting element 2168 Groove 2169Control pin 217 Locking mechanism 2171 Spring 2172 Recess 218 Deviation control slider 2181 Head area 2182 Body area 2183 Lever element of the deviation control slider (218) 2184 Guide track of the deviation control slider (218) 2185 Outer edge of the lever element (2183) 219 Locking slider 2191 Head area of ​​the locking slider (219) 2192 Body area of ​​the locking slider (219) 2193 Head element of the locking slider (219) 2194 Guide track of the locking slider (219) 22 Swivel lever for extension / flexion (E / F) 221 Swivel axis 3 Connecting agents 4 Hand fastening 41 Fastening devices Distance between the outer edges (2185) of the lever elements (2183) LA Longitudinal axis of the orthosis (1) DA Deviation axis of the orthosis joint (2) E / F Extension and flexion of the hand ur Dulnar and radial deviation of the hand dn Distance between the cutout edges (2123) h Height of the control element (212) in the area of ​​the first cutout (2122) H Height of the control element (212) outside the area of ​​the cutout (2122) SP n Side edge pair |W D1 |, |W D2 | Magnitude of the deviation angle |WE / F | Magnitude of the extension / flexion angle

Claims

1. An adjustable orthosis joint (2) for the controlled movement and / or fixation of a patient's hand, at least comprising - a movement module (21) for controlling an extension and / or flexion movement (E / F) and for controlling and executing an ulnar and / or radial deviation (urD) of the hand; and - a pivot lever (22), which is operatively connected to the movement module (21), for carrying out the extension and / or flexion movement (E / F) of the hand; characterized in that - the movement module (21) comprises - at least one base element (213) and - at least one control element (212) with a top side (2126) and a bottom side (2127) facing the base element (213) and lying opposite the top side (2126), - wherein a rotary cylinder (2121), by way of which the control element (212) is mounted rotatably relative to the base element (213) with respect to a deviation axis (DA), is arranged on the bottom side (2127), - wherein a first cutout (2122) is arranged on the bottom side (2127) for deviation control; - wherein the control element (212) comprises at least one first control slide (214), which can be moved by means of at least one first actuating means (216) with respect to the pivot lever (22) which is operatively connected to the movement module (21); - and wherein the control element (212) is designed to restrict the range of movement of the pivot lever (22) by the first control slide (214) in a controlled manner; - and wherein the orthosis joint (2) comprises at least a second control slide (215) which interacts with the control element (212) to control the ulnar and radial deviation movement (urD) of the hand; - wherein the control element (212) is designed such that its rotational movement around the deviation axis (DA) can be restricted in a controlled manner by an interaction of the first cutout (2122) of the deviation control and the at least second control slide (215).

2. The orthosis joint (2) as claimed in claim 1, characterized in that the first control slide (214) is of substantially cuboid-shaped configuration and, at its end facing the pivot lever (22), is of fork-shaped configuration.

3. The orthosis joint (2) as claimed in claim 2, characterized in that the first actuating means (216) comprises at least one head (2161) and one actuating cylinder (2164) which are connected to each other, preferably via a collar (2163), with the result that a component with a longitudinal axis (2165) is formed, - wherein the actuating cylinder (2164) has a circular cross section and is connected to the head (2161) of the first actuating means (216) eccentrically with respect to the longitudinal axis (2165).

4. The orthosis joint (2) as claimed in claim 3, characterized in that the first control slide (214) comprises at least one cutout (2141) which is configured to receive the actuating cylinder (2164) and to interact with it.

5. The orthosis joint (2) as claimed in claim 2, characterized in that the first actuating means (216) comprises at least one head (2161) and one actuating cylinder (2164) which are connected to each other, preferably via a collar (2163), with the result that a component with a longitudinal axis (2165) is formed, - wherein the actuating cylinder (2164), on its side facing away from the head (2161), has a, preferably substantially C-shaped, channel (2166).

6. The orthosis joint (2) as claimed in claim 5, characterized in that the first control slide (214) comprises a connecting pin (2143) which engages in the channel (2166) of the actuating cylinder (2164) during use of the orthosis joint (2), - wherein the connecting pin (2143) is preferably arranged within a cutout (2141) of the first control slide (214), which is configured to receive the actuating cylinder (2164).

7. The orthosis joint (2) as claimed in one or more of claims 2 to 6, characterized in that the first actuating means (216) and / or the first control slide (214) comprises at least one snap-in mechanism (217) which is configured to reversibly fix the first control slide (214) in its displacement movement with respect to the pivot lever (22) which is operatively connected to the movement module (21) at at least one predetermined position.

8. The orthosis joint (2) as claimed in one or more of the preceding claims, characterized in that the first cutout (2122) for deviation control, - extends from an edge (2129) of the control element (212) in the direction of the rotary cylinder (2121), with the result that a height (h) of the control element (212) in the region of the first cutout (2122) is smaller than a height (H) of the control element (212) in the region outside the first cutout (2122), - as a result of which at least four side edges (2123) are formed which delimit the region within the first cutout (2122) from the area outside the first cutout (2122), - of which two lie substantially opposite each other at a spacing dn where n = 1, 2, ... and form a side edge pair SPn where n = 1, 2, ...; - wherein a spacing dn between two side edges (2123), which are arranged closer to the rotary cylinder (2121) and lie opposite one another, of a side edge pair SPn is always smaller than a spacing dn+1 between two side edges (2123), which are arranged closer to the edge (2129) of the control element (212) and lie opposite one another, of a side edge pair SPn+1.

9. The orthosis joint (2) as claimed in claim 8, characterized in that a multiplicity of side edges (2123), preferably eight side edges (2123), are formed, of which two each lie substantially opposite each other and form a side edge pair SPn where n = 1, 2, ....

10. The orthosis joint (2) as claimed in claim 8 or 9, characterized in that the second control slide (215) is of substantially cuboid-shaped configuration and has a length (2152), a width (2153) and a height (2154); - wherein the width (2153) corresponds to the spacing d1 of the opposite side edges (2123) of the first side edge pair SP1 arranged closest to the rotary cylinder (2121); - and wherein the second control slide (215) is configured such that it can be inserted into the first cutout (2122) of the control element (212) and can be removed from it and can interact with the side edges (2123).

11. The orthosis joint (2) as claimed in claim 8 or 9, characterized by two second control slides (215) which interact with the control element (212) for the control of the ulnar / radial deviation movement (urD) of the hand, - wherein the second control slides (215) are each of substantially cuboid-shaped configuration and have a length (2152), a width (2153) and a height (2154); - wherein the sum of the widths (2153) corresponds to the spacing d1 of the opposite side edges (2123) of the first pair of side edges SP1 arranged closest to the rotary cylinder (2121); - and wherein each second control slide (215) is configured such that it can be inserted into the first cutout (2122) of the control element (212) and can be removed from it and can interact with the side edges (2123).

12. The orthosis joint (2) as claimed in claim 10 or 11, characterized in that each second control slide (215) is configured to be reversibly fixed at predetermined positions during insertion into and removal from the first cutout (2122), preferably by means of a snap-in mechanism (2151).

13. The orthosis joint (2) as claimed in claim 8 or 9, characterized by two second control slides (215) which interact with the control element (212) for the control of the ulnar / radial deviation movement (urD) of the hand and at least one fourth cutout (2120) for the deviation fixation which is arranged on the control element (212); - wherein one of the second control slides (215) is designed as a deviation control slide (218), at least comprising: - a head region (2181) which is configured to be inserted into the first cutout (2122) of the control element (212) and to be removed from it, and to interact with the side edges (2123) of the first cutout (2122) of the control element (212), - and a body region (2182) which has a guide track (2184) for a control pin (2169) of a second actuating means (2167) which is covered by the orthosis joint (2); - wherein the other of the two second control slides (215) is designed as a fixing slide (219), at least comprising: - a head region (2191) which is configured to interact with the fourth cutout (2120) of the control element (212), - and a body region (2192) which has a guide track (2194) for the control pin (2169) of the second actuating means (2167); - and wherein the deviation control slide (218) and the fixing slide (219) are displaceably mounted and configured by means of the control pin (2169) of the second actuating means (2167) in a displaceable manner with respect to each other.

14. The orthosis joint (2) as claimed in claim 13, characterized - in that the head region (2181) of the deviation control slide (218) is formed by two opposite lever elements (2183) which are resiliently movable with respect to each other and the outer edges (2185) of which are at a spacing (A) from each other in a relaxed state, which spacing corresponds to the spacing d1 of the opposite side edges (2123) of the first side edge pair SP1, arranged closest to the rotary cylinder (2121), of the first cutout (2122); - and in that the head region (2191) of the fixing slide (219) comprises a head element (2193) for interaction with the fourth cutout (2120), which is firmly connected to the body region (2192) of the fixing slide (219).

15. An orthosis (1) for the controlled movement and / or fixation of a hand or a hand and a forearm of a patient, characterized by an adjustable orthosis joint (2) as claimed in one or more of the preceding claims 1 to 14.