Surgery: splint – brace – or bandage – Orthopedic bandage – Splint or brace
Reexamination Certificate
1999-08-30
2001-07-03
Pothier, Denise (Department: 3764)
Surgery: splint, brace, or bandage
Orthopedic bandage
Splint or brace
C602S023000, C602S024000
Reexamination Certificate
active
06254559
ABSTRACT:
BACKGROUND OF THE INVENTION
This invention relates to orthopedic devices for limbs and more particularly to a joint assembly for a hip brace that is adjustable to various body shapes while ensuring that the thigh will move from a straight or neutral position wherein extended to an abducted position when flexed to prevent dislocation of the hip joint.
When a hip joint is unstable and subject to subluxation or dislocation, a brace may be employed to stabilize the joint. Such a brace will permit limited movement through the extension/flexion plane while restricting lateral movement i.e. abduction/adduction, or away/toward the midline. Such a brace may be employed for a congenital or injured hip. The most common application of such orthotic devices is after a hip joint has been replaced with an artificial ball and socket joint, especially when the posterior surgical approach is employed. Many of the structures normally holding the ball in place have been cut through. The ball is especially prone to escape from its socket when the leg is flexed and adducted, such as in sitting. To prevent this dislocation, braces applied after hip joint replacement surgery are generally provided with a joint that permits enough flexion extension motion through a limited angle for ambulation and that also provides for a fixed or adjustable degree of abduction. Davis et al. In U.S. Pat. No. 5,421,810 issued Jun. 6, 1995 teach a hinge having a continuously adjustable stop at one end of the extension-flexion rotation. They provide discontinuous means for adjustment of the fixed abduction angle that requires releasing the joint connection, moving the limb to the desired angle, and then tightening the connection. Williamson et al. In U.S. Pat. No 5,368,552 issued Nov. 29, 1994 provide an excellent review of the art and disclose a ball and socket connection in the joint to allow another degree of rotation . Borig et al. In U.S. Pat. No 4,881,532 issued Nov. 21, 1989 disclose ajoint in which there is free abduction through a limited angle.
When fitting a brace, especially a hip brace after surgery, the physician will often prescribe a fixed abduction angle to reduce stress on the joint, especially when sitting. When fabricating the brace, it is difficult to predict what the actual abduction angle will be until it is mounted on the body. If it is not as prescribed, it must be removed, adjusted and mounted again. When the angle is to be changed for some clinical reason, the process must be repeated. When fitting the brace, it is often tempting to disregard small deviations from the required abduction angle. The same holds true for adjustments of the flexion/extension angular extremes.
Diefenbacher and the Applicant, in U.S. patent application Ser. No. 09/148,233 filed Sep. 4, 1998 disclose ajoint with free flexion extension movement between adjustable stops and continuous adjustment of a fixed abduction angle in which the adjustment of abduction angle can be made while the brace is in place on the body.
The joint assemblies of the prior art effectively protect the joint from dislocation when sitting. However, they cause the wearer to stand and walk with the leg abducted. This is uncomfortable and places undue stress on leg structures, and the back. It would be useful to have a brace that would ensure abduction when sitting while providing a leg position when standing and walking that places the foot beneath the hip in a more normal stance.
SUMMARY OF THE INVENTION
It is accordingly an object of the invention to provide an orthotic hip joint brace and hip joint assembly in which the extremes of flexion and extension are adjustable. It is another object that the joint provide a preset angle of abduction when flexed and a substantially neutral or zero degree of abduction when extended. It is yet another object that the invention provide means for adjusting the assembly to fit various body shapes while maintaining these preset flexion/extension and abduction/adduction adjustments.
The hip joint assembly of the invention comprises a first attachment for connection to the pelvis and a second attachment for connection to the thigh of a user. A first elongate connector connects to the first attachment and second elongate connector connects to the second attachment. A pivot support member pivotally supports the second connector for rotary movement through a non vertical plane at a fixed angle of between about ten to thirty degrees, preferably about 20 degrees, from the vertical. Connecting means for connecting the first connector to the pivot support member is adjustable so as to enable the first connector to be aligned with the second connector at maximum extension while the first attachment engages the user's pelvis, the second attachment engages the user's thigh, and the leg is vertical. This structure causes the leg to abduct and rotate externally as it flexes to the sitting position. The leg is substantially vertical during ambulation and abducts substantially when sitting. The first and second attachments are linearly adjustable on their respective connectors so that the rotation point can be adjustably positioned to be precisely lateral to the patient's hip joint . This prevents the attachments from being forced fand down on the body parts during flexion, termed “pistoning” in the art.
These and other objects, features and advantages of the invention will become more apparent when the detailed description is studied in conjunction with the drawings, in which like reference characters indicate like elements in the various drawing figures.
REFERENCES:
patent: 3414908 (1968-12-01), Waggott
patent: 3671978 (1972-06-01), May
patent: 4481941 (1984-11-01), Rolfes
patent: 4881532 (1989-11-01), Borig
patent: 5344391 (1994-09-01), Modglin
patent: 5421810 (1995-06-01), Davis et al.
patent: 5460599 (1995-10-01), Davis
patent: 5507818 (1996-04-01), McLaughlin
patent: 5669873 (1997-09-01), Towsley
patent: 5766140 (1998-06-01), Tillinghast, III
patent: 6027466 (2000-02-01), Diefenbacher et al.
patent: 6090057 (2000-07-01), Collins et al.
patent: 2188240 (1987-10-01), None
Blum Alvin S.
Pothier Denise
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