RU2332965C2 - Corset-vertikalisator - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: improve aftertreatment of sick children with serious disturbances of a locomotorium using vertical adjustment of lower limbs segments, a trunk and a head in fixed and corrected position with simultaneous maintenance of lower limbs unloading, vertical basic elements with bottom-breast and pelvis semicorsets are executed in the form of a corset consisting of a trunk sleeve and a coxofemoral sleeve from a thermoplastic material bridged between themselves by means of carbonplastic splints. The coxofemoral sleeve is bridged, by means of carbonplastic splints, with foot sleeves, the carbonplastic splints being installed to adjust the distance between the sleeves, the trunk sleeve being supplied with a demountable adjustable headholder made to hold parietal, occipital and lateral areas of a head. The trunk sleeve, coxofemoral sleeve, foot sleeves and headholder contain a softening layer inside, the trunk sleeve being supplied with softened auxiliary platens, the basis being executed in the form of a platform.

EFFECT: increased efficiency of device use.

6 cl, 2 dwg

Description

The invention relates to medical equipment, in particular to orthopedic products-orthoses, in particular to vertical corsets, and is shown as one of the components of complex rehabilitation for severe forms of cerebral palsy, spinal injuries, with progressive muscular dystrophy, spinal amyotrophy of Werdnig-Hoffmann, Louis-Bar syndrome, various ataxia and other diseases of the central nervous system, accompanied by a delay in standing skills and deformations of the musculoskeletal system.

A device is known that contains vertical supporting elements with stops for the lower extremities and the pelvic region of the patient’s trunk, the vertical supporting elements being provided in the hip region with a fastener, and the lower part is mounted on a base having two foot sleeves (1). This device makes it possible to upright the patient.

The disadvantages of the known device include the fact that it does not fix the patient in an upright position and cannot be used if the patient has contractures in the hip, knee joints, in severe forms of spinal pathology, muscle lesions of the musculoskeletal system.

A known method of treating patients with severe lesions of the musculoskeletal system using the vertical corset (2).

The closest prototype of the invention is a vertical support corset containing support elements equipped with lower thoracic, pelvic semi-corsets, fastening elements in the area of the knee joint, and on the basis of which two foot sleeves are installed (3).

The disadvantages of the known corset-upright include the fact that it does not fix the lower limbs and the patient’s trunk in an upright position, does not create the necessary orthopedic correction of the position of the body segments, does not unload the lower extremities, and cannot be used for lesions of the thoracic, upper thoracic, cervical spine, and also, if necessary, fixing the head. In addition, the existing fastening elements of the knee joints in the known verticalizer corset only fix the joints, but do not eliminate contractures, pathological installations in the joints of the legs, leading to the development of secondary deformations that impede the verticalization of the patient in a corrected position, and the patient with a severe form of musculoskeletal pathology apparatus in the absence of unloading of the lower extremities cannot be in the corset-upright for a long time. This prevents verticalization, and bedriddenness of a sick child due to the development of orthopedic complications is the cause of joint deformation, flattening of the nape, skull deformation and development of torticollis, and spinal curvature. In addition, cardiovascular disorders develop. The absence of the formation of a vertical posture of the body is the cause of the disorder of a number of important functions - speech, free hand movements, adaptation to the environment, etc.

The aim of the invention is to improve the rehabilitation of sick children with severe disorders of the musculoskeletal system by verticalizing segments of the lower extremities, trunk and head in a fixed and corrupted position while ensuring unloading of the lower extremities.

This goal is achieved by the fact that in the vertical support corset containing vertical supporting elements with lower thoracic and pelvic half-corsets, fastening elements, foot sleeves and base, vertical supporting elements with lower thoracic and pelvic half-corsets are made in the form of a corset consisting of a trunk sleeve and a hip sleeve thermoplastic material interconnected using carbon fiber thermoformed tires, and the hip sleeve below is connected using carbon fiber tires to the sleeve of the foot, with this tire is installed with the ability to adjust the distance between the sleeves of the foot and the hip sleeve, the hip sleeve and the sleeve of the torso; in addition, the trunk sleeve is equipped with a head holder made to capture the parietal, occipital and lateral areas of the head, the head holder mounted on the trunk sleeve using an adjustable tire, and the trunk sleeve, hip sleeve, foot sleeve and head holder contain softening layers of thermoplastic foam material; in addition, the trunk sleeve is provided with softened rollers in the axillary regions.

The base of the corset-stand is made in the form of a rectangular platform, and between the hip sleeve and the base there is a sliding adjustable bar with a push button latch, at the ends of which there are connecting "P" -shaped planks with an axis and a central bolt installed in the base and in the hip sleeve. The hip sleeve has a saddle shape and a softened emphasis for the perineum. Sleeves of the foot are installed on the base using movable hinges. The knee joint fastening elements have three independently adjustable tape traction and are equipped with a softened platform.

Figure 1 shows the corset-upright, front view. Figure 2 is a vertical corset, side view.

The corset-upright consists of a corset 1, consisting of a left foot sleeve 2 with a softening layer 3, a right foot sleeve 4 with a softening layer 5, a hip sleeve 6 with a softening layer 7 and a trunk sleeve 8 equipped with a head holder 10 with a softening layer 11, while right foot sleeve 4 and left foot sleeve 2 are connected to the hip sleeve 6 by means of carbon fiber tires 12 having holes 13 with screws 14 installed therein, forming with embedded nuts 15 installed in carbon fiber tires 12, a fastening pair 14, 15, and in g On the left foot foot 2 and on the right foot sleeve 4, a corrective braid 16 is installed, two elements of the knee joint fasteners 13 are installed on the hip sleeve 6, each of which contains a softened 18 and tape rods 19, made in the form of a pile clasp 20 mounted on the hip sleeve 6, moreover, with the help of rivets 21 and the frame 22 on the saddle-shaped part of the hip sleeve 6, a softening pad 23 is located, and the upper part of the hip sleeve 6 and the lower part of the trunk sleeve 8 are interconnected by carbon fiber tires 24 having and holes 25 with screws 26 installed therein, forming with a nuts 27 located in the carbon fiber tires 24, a fastening pair, axillary softening rollers 28 are made from the sides along the upper torso sleeve of the upper 8, and in the middle of the torso sleeve 8 are provided sternal fastenings 29, made in the form of a tape 28.30, mounted on the sleeve of the trunk 8 with rivets 31 and a softening layer 32, in the lower part of the sleeve of the trunk 8 there are grooves 33 through which the waist mount 34 with the locking lock 35 is passed. the head of the body sleeve 8 through the tire 36 is attached a head holder 10 with a softening layer 11, in the upper part of the body sleeve 8 and the head holder 10 there are holes 37 with screws 38 installed therein, forming a screw pair with embedded parts 39, moreover, the head holder has a mount 40 installed with rivets 41, while the hip sleeve 6 is connected via a screw 42 to the strap 43 having an axis 44 with an adjustable rod 45 having a push button latch 46, while the lower part of the adjustable rod 45 is connected it is not connected by means of axis 47 with a “P” -shaped plate 48, which in turn is screwed together with a base 50, with the left sleeve 2 and the right sleeve 4 connected to the base via loops 51.

Clinical example. Patient Alexey B., 18 years old, was admitted September 1, 2004 with the diagnosis: “Cerebral palsy with severe cerebro-motor disorders, accompanied by a delay in the formation of standing skills, instability and in a defective pose with the risk of falling, with complications from the spine, joints of the lower extremities (flexion contractures).

On the orthopedic table, plaster negative is made, and on it is a plaster positive. After correcting the positive shape, a vertical corset was made on it, sleeves were molded, fastenings were adjusted. Compliance with the orthopedic regime: stay in the corset-verticalizer for one hour, followed by a break for one hour. Performing breathing exercises, meals, corrective exercises, individual lessons with parents in a vertical corset, holding leisure activities. At the same time, the traditionally used treatment was prescribed by the orthopedic surgeon: exercise therapy, massage and medications.

Results:

Primary. The child’s vertical position is stable, the possibilities of arm movement are practically unlimited, the orthograde posture has allowed the child to adapt to the environment, the pose corrected by the vertical corset protects the superficial muscles of the trunk from excessive fatigue, the knee and hip joints flexion contractures are corrected, and the body is also fixed in cleared position. Thus, the primary treatment results were effective.

Long-term results after 4 months: the disappearance of rapid muscle fatigue with corrected presence in the vertical corset is noted. The patient is able to maintain a vertical position for a long time due to a decrease in muscle tone in muscle groups caused by pathological cervical-tonic reflexes. The severity of hyperkinesis is minimal. Hand movements are free, significant integration of the child into the team is noticeable, an increase in interest in the environment. Negative dynamics were not detected. The treatment is continued.

Dosed use of a vertical corset provides a reduction in pathological manifestations, increases the effectiveness of rehabilitation.

The advantages of the invention over the base object are as follows:

1. Provides reliable fixation in the corrected position of the segments of the legs and torso of the patient, and due to the use of the head holder - keeping the head in a physiologically correct position.

2. Pathological settings of limb segments are eliminated, their contractures are reduced.

3. Secondary deformations of the musculoskeletal system are prevented.

4. Provides unloading of the lower extremities in the corrected position of the musculoskeletal system.

5. Provides adjustment of the impact on the musculoskeletal system of the patient due to the possibility of changing the parameters of the vertical corset, the shape of its sleeves during treatment in accordance with the change in medical indications.

6. The severity of hyperkinesis is minimized.

7. Improved comfort, hygiene.

8. There is an increase in the effectiveness of treatment and rehabilitation.

The corset-upright operates as follows: the fastening elements are unlocked, placed inside the corset-upright of the patient and again fixed. With the help of an adjustable bar with a push button latch provide the required angle of inclination of the corset-upright in the sagittal plane. Knee fastening elements using adjustable tape rods provide the necessary medical correction of contractures of the knee joints. If necessary, the distances between the foot sleeves, the hip sleeve, the trunk sleeve and the head holder are adjusted, as well as the individual shaping of the sleeve and head holder in order to provide orthopedic correction as the medical condition changes, the child's physiological growth. If it is necessary to increase or decrease the degree of unloading, the distance between the sleeve of the foot and the hip sleeve is changed.

INFORMATION SOURCES

1. The device for vertical position for vertical position UOPV-02. Prospectus of the company "Medtekhnika", Russia. 1996 year

2. Patent No. 2203610, publ. 05/10/2003. Bull. fig. No. 13.

3. Standing Orthoses. Prospectus from Becker Orthopedic Appliance Co.635 EXECUTIVE DRIVE, TPOY, MICH 48083 USA 2003

Claims (6)

1. The vertical support corset containing vertical supporting elements with lower thoracic and pelvic semi-corsets, fastening elements, foot sleeves and a base, characterized in that the vertical supporting elements with lower thoracic and pelvic semi-corsets are made in the form of a corset consisting of a trunk sleeve and a hip sleeve made of thermoplastic material interconnected by carbon fiber tires, the hip sleeve being connected by carbon fiber tires to the sleeve of the foot, while carbon fiber tires are installed with the possibility of adjusting the distance between the sleeves, and the sleeve of the body is equipped with a removable adjustable head holder made with the capture of the parietal, occipital and lateral areas of the head. 2. The corset-upright according to claim 1, characterized in that the trunk sleeve, hip, sleeve of the foot and head holder contain inside a softening layer, while the sleeve of the trunk is equipped with softened axillary rollers. 3. The corset-stand according to claim 1, characterized in that the base is made in the form of a platform, and between the hip sleeve and the base there is a sliding adjustable bar with a push button latch. 4. The corset-stand according to claim 1, characterized in that the hip sleeve is made saddle-shaped and has a softened emphasis for the crotch. 5. The corset-stand according to claim 1, characterized in that the sleeves of the foot are installed on the base using movable loops. 6. The corset-upright according to claim 1, characterized in that the fastening elements of the knee joint have three independently adjustable tape traction and are equipped with a softened platform.

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