Active wrist brace for guidance and musculotendinous relief at the elbow (epicondylar and epitrochlear) and wrist.

Abstract

Active wrist brace for guiding and relieving musculotendinous pain at the elbow (epicondylar and epitrochlear) and wrist. The invention relates to a new type of wrist brace that relieves pressure on the forearm muscles and their tendon insertions at the elbow and wrist. Due to repetitive movements, the tendons of the elbow and wrist become inflamed, resulting in tendinitis. The wrist is responsible for this elbow condition. This brace will preferably consist of a flexible sleeve (1) covering the wrist and perforated for the thumb (2). One or more dorsal tunnels (3) (3') will be arranged on this flexible sleeve (1). One or more tunnels (3) (3') will be located on the palmar side of the sleeve (1). One or more flexible elastic strips (5) will be placed in these palmar and dorsal tunnels (3) or tunnels (3').

Description

Title of the invention: Active wrist brace for guidance and musculo-tendinous relief at the elbow (epicondylar and epitrochlear) and wrist.

[0001] The present invention relates to a new type of wrist splint characterized in that a flexible sleeve is obtained including the wrist and thumb having as its distal limit the base of the metacarpophalangeal joints and proximal limit approximately five to ten centimeters beyond the wrist (towards the elbow).

[0002] On this flexible sleeve, a guiding and active element is fitted which is elastic due to its return after stretching like a flexible and undeformable blade.

[0003] It is known that most existing systems are not splints that guide and assist movement.

[0004] Most of them are more like holding and support and blocking systems.

[0005] Generally, what is done is to block the flexion with a rigid palmar blade or blocking of extension with a rigid dorsal blade or complete blocking of flexion and extension thanks to a rigid palmar blade and a rigid dorsal blade of the wrist.

[0006] In fact today we do not treat elbow problems (epicondylitis or epitrochleitis) with a wrist support system, but it is therefore natural that what we find on the market does not correspond to our product.

[0007] The invention therefore aims in particular to provide a very effective and comfortable splint to combat several musculoskeletal disorders: epicondylitis (or tennis elbow) and epitrochleitis and various tendinitis of the wrist.

[0008] This new type of wrist brace will address elbow and wrist disorders and its action will tend to resolve pathological problems such as extensor tendinitis (epicondylitis) or flexor tendinitis (epitrochleitis) or tendinitis, fracture or sprain of the wrist.

[0009] Regardless of the positioning of this splint (4 possible), the primary goal is to guide and limit certain movements that can trigger musculoskeletal disorders due to repeated movements.

[0010] Regardless of the muscle involved, the goal is to avoid working it in maximum contraction (internal muscle travel), which is its shortest range of motion. Therefore, to avoid the internal travel of the extensor (epicondylar) muscles, the wrist will be locked in a position of slight extension (12 degrees maximum) without being able to extend further. This will prevent overloading at the insertion point on the elbow (outer end), while allowing relatively free movement in the opposite direction (the wrist flexion) and tilt.

[0011] The most common pathology affecting the elbow is epicondylitis, that is, tendinitis of the extensor muscles (outer dorsal part of the hand and forearm). This pain and tendinitis at this level of the elbow is caused by the movement of the wrist against resistance, with the palm facing downwards and often repetitive, in extension.

[0012] Thus we treat and relieve the wrist and we will heal the elbow.

[0013] So, if I want to treat or take preventative measures concerning the extenders that The brace inserts onto the epicondyle (to combat epicondylitis). My goal is to position the brace to prevent the wrist from being too extended, thus preventing it from moving internally, but allowing other possible wrist movements (flexion, however, should be limited in the upper degrees to avoid excessive strain on the tendons). The wrist has free flexion. Therefore, within the total range of motion of the wrist, we will intentionally limit, using the brace, both internal (full extension) and external (full flexion) movement. The wrist will work in a mid-position, and the extensor muscles will be in a mid-range of motion to work.

[0014] The same principle will apply to the extensor tendons of the wrist.

[0015] The length of a muscle is thus broken down according to the joint range of motion, so in external stroke we will have the longest muscle then medium stroke (the medium-length muscle) and internal stroke (the shortest muscle).

[0016] The primary goal is therefore to avoid extremes in amplitude and to work the muscle to be protected in its average length, knowing that it suffers more in short contraction (the shortest) in the internal stroke of the joint and in full stretch (the longest) in the external stroke of the joint.

[0017] The second, and no less important, objective is to facilitate the work of the muscles, to relieve them through passive joint recoil. One or more elastic strips are positioned on the same side as the muscles to be protected (dorsal surface of the wrist for the epicondylar muscles of the elbow and palmar surface of the wrist for the epitrochlear muscles of the elbow).

[0018] Other advantages of this rather technical and complete system will be highlighted below.

[0019] Knowing, however, that the almost permanent origin of tendon problems of the elbow and wrist is initiated by wrist movements, it is still surprising to never treat or adapt the work of the wrist to obtain an action at the level of the elbow (as a preventative measure or as a cure).

[0020] According to particular embodiments of the invention, we will give a detailed description concerning a splint adaptation for epicondylitis or external musculotendinous protection of the elbow (therefore dorsal antebrachial). For cases of protection of the musculotendinous elements of the epitrochlear flexors, it will suffice to simply place the same system on the palmar side of the wrist and anteriorly. arm.

[0021] The splint can also be studied for this purpose, i.e., from 1 to 4 possible placements depending on the manufacturer's choice. Above or below: for the right or left wrist depending on the thumb opening, provide or not an ambidextrous splint with two epicondylar openings (2): dorsal placement of the flexible elastic blade(s) 5 and 5'.

[0022] Right side and left side.

[0023] Epitrochlear: palmar placement of the blade(s) for flexible elastic 5 and 5'.

[0024] Right side and left side.

[0025] With two holes for the thumbs it will be possible to turn the splint over without moving the blades, otherwise everything can be done analytically (a right wrist epicondyle splint, a left wrist epicondyle splint and the same for the right and left epitrochlear muscles.

[0026] This splint will preferably consist of a flexible sleeve (1) covering the (right) wrist and perforated with an opening (2) for the thumb; in the case of an ambidextrous splint, we will also have an opposite opening 2' for the other (left) hand.

[0027] A longitudinal dorsal tunnel (3) will be placed on this flexible sleeve (1), bridging over the wrist joint and extending well beyond the first commissure of the thumb (4) distally. This dorsal tunnel will allow a flexible elastic blade to be inserted into it via a superior (6) or lateral access point. Preferably made of stretch fabric.

[0028] We slide an elastic splint or blade (5) inside this dorsal tunnel, which, after being folded, will return to its initial state. This passive return effect will allow the affected muscle to rest and be supported.

[0029] For the versatility and scalability of the system, it will also be important to position one or more tunnels on the opposite side, which will allow for the treatment of a wider range of pathologies (such as wrist blockage after a fracture). Our splint, thus constituted, is therefore capable of responding, on the one hand: to the widest range of positioning options (4) thanks to the two thumb holes which will allow our flexible sleeve (1) to be placed on the left and right (wrists) and to have the possibility of reversing them (above and below) with tunnels for flexible blades (5) (5') for the dorsal or palmar aspect of the wrist; and on the other hand, to the widest range of treatments which will thus allow, thanks to the presence of tunnels on the palmar and dorsal aspects of the wrist, for the wrist to be almost completely blocked by adding a rigid (or not) blade on the side opposite our elastic spring blades (5) (5').As explained previously, the blade (5) or blades (5') will, by compression, block extension if positioned dorsally, and a rigid or flexible splint will block flexion on the palmar side. For the system's adaptability, this configuration will be used, for example, for fractures, post-operative conditions, or severe wrist sprains, and then, after a certain time, we can remove the rigid splint for a [missing word - likely "adjustment"]. start of rehabilitation. For cases of wrist tendinitis we will return to our initial configuration with flexible spring blade (5) and (5') affected side and the same will apply to elbow tendinitis (flexible blade on the painful side).

[0030] The idea of ​​making a flexible sleeve (1) that slips on is for me the best solution but it will be possible that this sleeve will be open laterally to fix it and the closure of the latter will be done by lateral overlap.

[0031] Thus, as many healthcare professionals request, there is no longer any need to have a plethora of splint choices, but with one splint we can resolve many pathologies in many positions.

[0032] In our example of right epicondylitis (dorsal musculotendinous involvement of the forearm and external location of the elbow), the laminae will bridge the back of the wrist and will cause:

[0033] • a flexion against slight resistance of the blade (antagonistic muscular work). • a return to equilibrium position (12° of extensions) aided by the elasticity of the blade (5). • Passive return of the extensor muscles. • A locking by compression of the blade at these 12° of extension (approximately) and therefore the movement will be guided. • Return to functional position.

[0034] From a pathophysiological point of view, the consequences on the extensor muscles of the wrist (epicondylar) will be very important and will aim to reduce stress on them and not put them in extreme positions of stretch (very long) or contraction (very short). The extensor muscles will be assisted towards extension by the blade (5) which will itself naturally limit the range of motion of the wrist (no complete flexion or complete extension), just an average range.

[0035] Regarding the elastic blade (5), it must allow passive wrist retraction to supplement the extensors and therefore must have a certain average rigidity and, above all, effective elasticity with a return identical to that at rest. In profile, it may be straight (5) or slightly concave at the top (5a) to maintain the 12° of extension.

[0036] From the front, a rectangular shape (5b) or one widened on its dorsal part (5c) can be adapted, corresponding to the dorsal face of the hand, to have better efficiency and optimized comfort.

[0037] For the sake of efficiency, several dorsal tunnels (3”) can be made, housing several elastic blades (5) (or spring blades), narrower at the wrist and then flared towards the back of the hand but with several blades (5d). Regardless of the number of blades, the aim is not to restrict the wrist but rather to allow flexion against resistance and assisted passive upward movement. The act of making Working the antagonist of the extensors tends to relax them, and passive recoil also helps to relax the extensor. The more surface area covered by the elastic bands (5'), the more their rigidity must be reduced. These spring bands (5) and (5') will always be positioned anterior to the first web space (4) distally and anterior to the wrist proximally.

[0038] These elastic spring blades (5) and (5') may be made of metal, steel, aluminum, tempered or untempered copper, plastics, wood, fiberglass or composite having excellent initial return without breaking.

[0039] Thus, according to this configuration, the epicondylar extensor muscles will be assisted by the spring system and therefore less stressed.

[0040] The second advantage is to make the antagonists (flexors) work in resistance of the spring blade (5) to have a better release of the Agonist (extensor).

[0041] If we want to transpose the system to the protection of the epitrochlear muscles, it is sufficient to transpose this whole system of elastic spring blades (5) at the level of the palm of the hand towards the wrist.

[0042] The third advantage of such a system is to guide the movement of the joint which, due to the compression of the elastic blades (3), will limit extreme movements: maximum contraction (internal movement) and maximum extension (external movement).

[0043] To maintain the system in place and ensure its effectiveness, the elastic spring blade(s) (5) (5') must be held firmly against the wrist joint by one or more straps, preferably the most distal (7) passing over the first web space in front of the thumb, the medial (8) just behind the thumb in the middle of the spring blade (5), and the most proximal (9) on the outside of the blade (5) [Fig. 4]. The blade (5) is held against the front of the wrist by three straps, preferably. The blade (5), positioned in the tunnel (3), may be removable.

[0044] Or the elastic spring blades (5') placed in the tunnels (3') can be removable. It is important to secure this or these spring blades (5) (5') firmly, for example, using our three straps: distal (7), middle (8), and proximal (9).

[0045] Thanks to this system, we have therefore achieved our objectives, namely to provide maximum rest to the inflamed tendons, while also allowing all other movements to be possible (flexion and flexion of the wrist for an epicondylitis splint and extension and flexion for epitrochleitis). This allows work to continue with the help of the splint.

[0046] According to a variant A which has the advantage of dissociating the guidance of the wrist (its movement) and the elastic of the assisted muscular return.

[0047] Indeed, it is sufficient to replace the elastic strip(s) (5) (5') with a blade hinge (10) which will guide the movement without force or resistance and it will be enough to position locking lugs (11) in order not to exceed the movement.

[0048] This hinged hinged blade (10) can, for example, prevent the internal movement of the extensor muscles by means of a locking lug (11) positioned on the hinge axis, which will block extension beyond our 12° of extension, thus preventing maximum muscle contraction. This hinged blade will be installed in the tunnel (3) in place of our elastic blade (5), and the two sides of the hinged blade (10) will be held against the back of the hand by two straps.

[0049] According to this same variant, various elements or the locking lug (11) can be arranged on the hinge axis to block certain movements (hyperextensors and hyperflexion). Therefore, wrist functionality is still maintained and work is possible, but the desired movements are guided.

[0050] If in addition we want to create a spring or passive return effect we can stretch an elastic (14) from the two ends of this hinge to allow the two points (12) and (13) to come together again.

[0051] The axis of the hinge blade (15) shall correspond to the transverse axis of the wrist.

[0052] This system is quite interesting if one does not want to create passive wrist return to relieve forearm muscles.

[0053] This system makes it possible to block traumatic movements purely and simply.

[0054] As with epicondylitis: full extension should be avoided so as not to contract the muscle too much which would cause significant traction on its tendons, particularly at the elbow (outside).

[0055] Thus, the blocking lug (11) will force the extension to stop at the desired degree (for example 12 degrees of extension which is the best degree of muscle relaxation.

[0056] The hinge blade (10) therefore has three parts:

[0057] • an anterior brachial part (10A) integral with the antebrachial part. • A central part: the axis (15) on which the blockers (11) will be positioned. In figure 5 we see the blocker (11) which generates the hinge to close vertically (no wrist extension). • A dorsal part of the hand (10A)

[0058] The anti-brachial part (10A) prevents the dorsal part (10B) of the hand from rising thanks to the locking lug (11).

[0059] We could also have reversed the two parts of the blade.

[0060] Movements other than full extension are possible (flexion and extension). Most applications have been developed primarily for the treatment of epicondylitis (affecting the extensors of the outer wrist of the elbow), i.e., preventing full extension while passively assisting the return to extension.

[0061] For our hinged blade (10), for example, if we want to position it for a rare but possible case of medial epicondylitis (affecting the wrist flexors, inner elbow), this is possible and is the reverse of the previous method, namely: hinged blade on the palmar or anterior part of the wrist, and consequently the wrist will no longer be able to flex, the locking lug (11) will be positioned lower and block flexion. And, if an elastic band (14) is placed, it will assist the flexion movement because it is the medial epicondylar flexors that are affected.

[0062] Whether with elastic spring blade (5) or hinge blade (10).

[0063] One can have a splint for each problem (epicondylitis and epitrochleitis) and one splint per side (right and left).

[0064] Either a total of four different splints or only two right and left, having provided tunnels (3 or 3') on both faces of the splint in which the blade(s) (5, 5') or the hinge blade (4) will be positioned.

[0065] Ideally, however, a single splint can be positioned in four different ways thanks to thumb holes on the left and right (ambidextrous), and the splint can be turned over so that the tunnels (3) which were underneath are now underneath, and the presence of a symmetrical tunnel (3X) for versatility of the system.

[0066] So a splint for four possible uses thanks to the orifices (2) of the thumb provided to be ambidextrous and possible reversibility of the splint which goes from a struggle of the epicondyles (extensors of the wrist on the outside of the elbow) to a struggle of the epitrochleans (palmar face of the forearm and value of the elbow) and palmar or dorsal tendons of the wrist.

[0067] Thus, we have described in the first instance (still for the epicondylars, elbow, (external tendons), knowing that for the epitrochlear, internal tendons of the elbow it is enough just to pass the elements described such as the elastic spring blade (5) or hinge (10) from the dorsal side to the palmar side of the wrist.

[0068] The presentation, in order to relieve the tendons affected as epicondylitis, is to place on the dorsal side of the wrist one or more elastic spring blades (5 to (5').

[0069] This system configuration perfectly meets our expectations, namely a limitation of amplitude by compression of the spring blade(s) (5) (5'), an action against resistance of the antagonistic muscles to those that we want to protect and finally a passive return of the joint in extension which relieves our epicondylar agonist muscles and tendons.

[0070] Then, according to variant 1, we have, in a way, articulated the blade into a hinged blade (10), that is to say, two surfaces (X and Y), preferably rectangular, or even flared at the dorsal level of the hand, and connected by an axis located at the level of the wrist. In this case, one or more locking lugs (11) will guide and limit the movement (Like the The elastic spring blade, due to its compression, limits extension to approximately 12°. Depending on the desired or undesired movements, locking tabs (11) can be placed, adjustable in position according to different pathologies and individual theories. For example, some specialists may require a 20-degree extension block, or other restrictions. To achieve the passive joint return effect, as with the elastic spring blade (5), a taut elastic band or spring can be placed between the two ends (12) and (13) of the hinged blade (10), and the system held in a tunnel (3) on the splint.

[0071] Here again we achieve our objectives of guiding the movement and limiting the extension by blocked egos passive return by elastic (14) and work against resistance of the antagonists.

[0072] Indeed, one can imagine [fig.6] a central hinge blade (10) in its flexible tunnel (3) without the return elastics (14) therefore a single guiding action with limitation in particular of the extension to the position of 0 degrees (straightness of the wrist) to 20° of extension thanks to a locking lug (11) on the axis of the hinge (19) one can also imagine a locking lug (11') to limit the total flexion and therefore the maximum stretch.

[0073] It is quite possible that in use a configuration which combines hinge blade (10) and spring blades (5') is the most suitable and even the most scalable.

[0074] The axis (15) of the hinge blade (10) will be on the axis of the wrist (XP) and the dorsal part of the hinge blade may be flared for more comfort.At this stage, we have good guidance with limitation of joint movement (no internal movement of the muscle that puts stress on the tendon). However, we have lost the passive joint return in extension due to the absence of an extensor system. Therefore, the idea is to combine this hinge blade system (10) with the spring blade system (5'). Indeed, we can add laterally to this central hinge blade (18) one or more elastic spring blades (5) (5'). These will complement the blade's guidance while also providing a blocking effect in extension and compression, which will serve a dual purpose. However, these elastic blades will also allow, in a complementary way, a passive joint return towards extension to assist the extensor muscles. We will also thus have work against the resistance of the antagonists towards flexion.

[0075] We can therefore find 3 tunnels (preferably 3') on the back of the splint, with our hinge blade (10) in the middle, for example, and our elastic blades (5') on the sides. Our objectives are thus achieved (range of motion limitation, passive return, work against antagonistic resistance), with the added benefit of progressive functional improvement of the splint. At the most severe stage of tendinitis, we can use the entire system (hinge blade (10) and elastic spring blades (5')), then a few days later we can remove the spring blades (5') and keep just the joint guidance, weaning the splint little by little in a way.

[0076] The hinge blades (10) and elastic spring blades are removable during operation (3). Depending on the practitioners and their preferences, the splint can be used by removing the relevant elements in the desired order.

[0077] It's a good evolutionary choice.

[0078] Whatever the blades, they can therefore be removed from the tunnels (3) by their widest part (the most distal).

[0079] It is interesting to have the choice, particularly for certain prescribing practitioners, of not subjecting any passive flexion or extension constraints thanks to the unique positioning of the hinge blade (10) which limits extension but allows other movements (flexion-inclination).

[0080] As explained previously, the positioning of a systemic tunnel (3X) is interesting to complement the functionality of the splint, particularly in its reduction of movement.

[0081] As an example, a usage protocol is detailed below:

[0082] • Actions on the wrist: • Fracture and severe sprain, right or left. • Firm immobilization with a soft blade on the back of the hand and a rigid or soft blade on the palm side of the hand. • Keep for three weeks day and night then in the fourth and fifth week remove the rigid palmar blade for a start of rehabilitation using the soft spring blade (5) dorsal. • Tendinitis, mild sprain, carpal tunnel syndrome, right or left pain. • If the wrist tendon is painful on the back, place the flexible spring blade (5) on the back (always on the side to be treated) or if the tendon pain is on the palm side, place the flexible elastic spring blade (5) on the palm side. • For carpal tunnel syndrome or localized pain, place the flexible spring blade (5) on the back. Wear for six hours a day. • Actions on the elbow: • Epicondylitis: • Splint with a flexible blade on the back of the wrist: • blocks maximum extension • blocks maximum flexion • promotes work at a medium pace • wrist flexion exercise against resistance • passive return to extension with relief • allows for automatic return to functional position • educational tool. • Epitrochleitis • Splint with flexible blade on the palm side • blocks wrist flexion • blocks maximum wrist extension • promotes work at a medium pace • work against resistance from antagonists that relieve the agonists (flexors) • Passive return to wrist flexion, which relieves the flexors • allows a return to a functional position • rehabilitation tool.

[0083] [Fig. 1] shows a schematic top view of the splint with its tunnel (3) into which the elastic spring blade (5) is inserted, with thumb holes (2) for ambidextrous splint use. A tunnel (3X) will be symmetrically opposite on the palm side.

[0084] [fig.2] is a variation of [fig.1] but with smaller spring blades 30 elastic (5').

[0085] [fig.3] shows schematic front and profile views of a flared elastic spring blade or no, and flat or not, that is to say slightly concave and at the top.

[0086] [fig.4] shows a schematic view of the splint showing the blade contact lock (5) thanks to straps 7, 8 and 9.

[0087] [fig.5] shows a top view of the hinge blade (10) with its two parts X and Y is connected by an axis (15) on which one or more locking elements (11) form a kind of hard wart (hard button or hard protrusion). Panels X and Y can be encouraged to close by means of elastic bands (14) until they lock due to the locking lug, and it is considered that they cannot go beyond 20° (preferably around 12° as it is the resting position) of extension.

[0088] [fig. 1] shows in schematic top view a combination of elements with, for example, in the middle the hinge blade (10) which locks in extension and allows flexion and inclination without resistance, and surrounded by two elastic blades (5') so as to give the user the choice of assisted return in passive mode and resistance of the opposing forces. These two elastic blades (5') also block the extension of the movement by their pressure.

[0089] Thus, the technical embodiment of the invention is favorably designed with a flexible material for the sleeve and a rigid material for the hinge blade (10) and an elastic spring made of steel, aluminum, various fibers, or plastics for the elastic blades. spring (5) (5') and the various modes of use of the invention find application in the care of the elbow and wrist and its tendinitis by means of movement guidance and passive joint work and resistance center but is by no means limited to its preferred embodiments and on the contrary embraces all variants.

[0090] Where the elastic spring blades (5) or (5') must have the power capacity to perform a passive joint return on the side of their position, i.e., passive extension when the blade is on the back of the wrist, preferably up to the functional position of 12 degrees of extension, but at a minimum to the straight position of the wrist, and likewise conversely when it comes to the flexors...

[0091] This wrist brace is characterized in that the elastic spring blade (5) extends distally beyond the first web space of the thumb (4). This wrist brace must have one or more blades (5) with sufficient elastic spring force to allow passive joint retraction to the minimum straight position of the wrist joint. The wrist brace is designed in that an elastic band (14) assists in closing the hinge. The elastic spring blades (5) and (5') conform to the anatomical shape of the wrist by means of at least three straps with three points of support on the spring blade(s) (5) and (5'): at both ends and in the middle of the blade(s). The elastic spring blade (5) extends distally beyond the first web space of the thumb (4).

Claims

Demands

1. wrist splint characterized in that it comprises a flexible sleeve (1) on which are positioned a dorsal tunnel (3) (back of the wrist) and a ventral tunnel (3X) (palmar face of the wrist) bridging over the wrist in which an elastic spring blade (5) is positioned.

2. Wrist splint according to claim 1 characterized in that it is a single elastic blade per face of the forearm (one dorsal and one ventral).

3. Wrist splint according to claim 2 characterized in that the profiles of the spring blades (5') or the profile of the elastic spring blade (5) is concave for a return to functional position at 12 degrees of extension.

4. Wrist splint according to any one of claims 1 to 3 characterized in that the elastic spring blade (5) extends in length beyond the first commissure of the thumb (4) distally.

5. Wrist splint according to claims 1 to 4 characterized in that the blade (5) or elastic spring blades (5') are flared distally for better comfort and efficiency.

6. Wrist splint according to any one of claims 1 to 5 characterized in that the elastic power spring of the elastic blade (5) allows the return to lock the wrist in a position of slight extension.

7. Wrist splint according to any one of claims 1 to 6 characterized in that it comprises a system for securing the ventral and dorsal blades to the forearm by means of at least three straps or tightening system with two at the ends and one in the middle.

8. Wrist splint according to claim 6 characterized in that the distal element of the clamping system as a strap passes between the thumb and index finger to extend beyond the first commissure.

9. Wrist splint according to any one of the preceding claims characterized in that the elastic spring blades are removable in their respective tunnel.

10. Wrist splint according to any one of the preceding claims characterized in that there is a certain symmetry between the palmar face and the dorsal face of the splint in order to have indifferent use on the left hand or the right hand thanks to a reversal thereof.

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