DE20217525U1 - Method for fitting orthopaedic cover for stump has a double layer sleeve with pull loops at the bottom for easy removal when the cover is fitted - Google Patents

Abstract

A method for fitting an orthopaedic cover/stocking onto a stump without abrading the skin has a double layer sleeve made in one piece and folded inside itself. The two parts of the sleeve taper to bottom holes fitted with pull loops. The double layer sleeve is fitted to ease fitting of the cover/stocking and is easily removed by pulling the loops. The two sleeves are made of the same textile material covered with a low friction coating.

Description

Tools
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Area of application and state of the art

The invention relates to a means for putting on orthopedic or therapeutic aids, as stated in the preamble of claim 1. Such orthopedic aids are, for example, the shafts of external limb prostheses into which a stump is inserted for the purpose of wearing a prosthesis. Therapeutic aids are, for example, support stockings.

Such means serve to make it easier to insert the thigh stump into the prosthesis socket or to put on a support stocking. EP 497 858 B1 discloses such a means. It consists of two sheaths that are put inside one another. When put inside one another, this means has an upper open end and a lower closed end. It is pulled over a foot so that it surrounds it like a kind of loose and two-layered stocking. A support stocking is then pulled over it. A lower open end

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of the support stocking, the agent is pulled out using a tab at the lower end of the outer cover. The agent or the outer cover moves out between the inner cover and the support stocking. Using a material with low surface friction for the covers makes it easier to pull out the agent. This is achieved primarily because the cover material does not have to be pulled directly along the skin, which would be painful for the prosthesis wearer and would also require high friction and therefore high pulling force.

The disadvantage of this solution is that it is difficult to adjust the fit of the device on the limbs when putting it on. There is often the problem that the inner cover on the limbs forms many annoying folds or warps. This is painful on the one hand and leads to an imprecise fit of the limbs in the device on the other.

Task and solution

The invention is based on the object of creating a means for putting on orthopedic or therapeutic aids as mentioned above, by means of which the problems of the prior art can be solved, in particular a precise insertion and adjustment of the limbs with respect to the aids is possible.

This object is achieved by a means having the features of claim 1. Advantageous and preferred embodiments of the invention are the subject of the further claims and are explained in more detail below. The wording of the claims is made part of the content of the description by express reference.

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According to the invention, an innermost cover and an outermost cover are connected at a first end and form an opening into the means or into the innermost cover. The innermost cover is put into the outermost cover to attract the aids, so that they form a two-layer or two-layer arrangement.

At a second end, the innermost sleeve has innermost gripping means or gripping options. These are designed to grip or pull on the innermost sleeve. The outermost sleeve has an outermost passage. The innermost gripping means can be reached through this outermost passage. This makes it possible to pull on the innermost sleeve even when the means or sleeves have already been pulled over a thigh stump, for example. Above all, however, it is possible in this way to pull on the innermost sleeve even when the thigh stump and means or sleeves have been inserted into a prosthetic socket of a prosthesis. By pulling on the innermost sleeve, the thigh stump can be pulled deeper into the prosthetic socket, regardless of any effect on the outermost sleeve lying on the inside of the prosthetic socket. Folds of skin or flesh can also be smoothed out. This is no longer possible as soon as the means has been pulled out of the prosthetic socket. The skin of the thigh stump then lies against the inside of the prosthetic socket. The friction is so great that changing the seat is no longer possible.

Gripping means here are understood to mean possibilities by which a casing can be grasped in order to exert force, for example pulling.

After aligning the seat of the femoral stump in the prosthetic socket by pulling on the innermost sleeve using the innermost gripping device, the device or sleeves are removed in the usual way. The outermost sleeve is therefore pulled out through the bottom open end of the device, for example the prosthetic socket. This results in

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The advantage known from the state of the art of low friction between the material of the covers and the inside of the device is again evident.

In a further embodiment of the invention, the means are advantageously designed to be tubular, i.e. elongated. For many applications, they can taper towards the second end. This makes it possible, for example, to adapt them to the shape of a stump, which also tapers downwards.

The outermost passage of the outermost casing can be designed in such a way that this outermost casing has an opening or is open. It is advantageous if it is completely open at this end, i.e. without any narrowing in diameter from the longitudinal direction inwards.

The innermost gripping means can be designed in such a way that they can be reached when gripping the outermost passage. They are advantageously elongated and reach out through the outermost passage. This makes them particularly easy to grasp for pulling.

In addition to the innermost cover, the outermost cover can also have outermost gripping means. This makes it easier to pull the device out of the device. The gripping means can be designed in a similar way for the covers. For example, they can be designed as elongated tabs or loops. Two spaced-apart areas at the end of the respective cover are advantageously selected for fastening. This makes gripping easy. Furthermore, they can be connected to the covers in such a way that they are not only connected at certain points, for example sewn. A particularly good and durable as well as force-transmitting connection between the gripping means and the cover is achieved if they are connected to the cover along a greater length. They advantageously extend in the direction of the longitudinal extension.

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ck of the medium, in this direction the tensile force also acts. They can be attached to seams of a cover, which is particularly advantageous if the cover has seams and these run in the lengthwise direction of the medium. On the one hand, the process is simplified by sewing through twice. On the other hand, the material of the cover is reinforced at this point anyway by the doubling. In addition to sewing, particularly with textile materials, gluing is also possible as a connection. Gluing is particularly suitable for film-like covers.

In addition to the outermost shell, the innermost shell can also be open at the second end. It can be designed in a similar way to the outermost shell.

Furthermore, if several gripping devices are provided on the covers, they can be given different colors. This makes it easy for the user to see which gripping device needs to be pulled to correct the position of, for example, a thigh stump in a prosthetic socket. Likewise, it is then impossible to confuse which gripping device needs to be pulled to remove the device from the device.

The connection between the innermost cover and the outermost cover at the first end, which forms the opening into the device, is advantageously linear and circumferential. On the one hand, it is possible to connect two separate covers by sewing or gluing, especially if more than two covers are to be connected to one another. On the other hand, it is possible to cut the device from a single sheet of material and connect or process it into a cover, with the connection then advantageously being located approximately in the middle. By putting the innermost cover into the outermost cover, the two-layer structure is created and the opening is created into which the limbs can be inserted.

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In general, it is advantageous to make the innermost cover and the outermost cover from similar or the same material. This is preferably a textile material. Furthermore, at least the outermost cover should be made of a material with low friction, little or no stretchability, and high suppleness. Polyamide fabrics, for example, are suitable for this, and should be relatively thin. These have high tear resistance and low surface friction despite their low material thickness.

In addition, the material can be coated to reduce surface friction in certain areas or in complete areas of the casing. This can reduce surface friction even further. PTFE coatings are suitable for this purpose. Furthermore, for possible materials or material combinations or coatings, reference is made to EP 497 858 B1, the content of which is made part of this description by express reference.

In addition to the innermost and outermost shells, a third shell can be provided which, when turned inside out, acts as a middle shell between the other two and has approximately the same shape. It is connected to the other two shells at the first end and thus forms the opening into the middle. Here, for example, it is possible to provide a single connection, particularly in the form of a seam, for all three shells. At the second end, this middle shell then has a middle passage. The innermost gripping means extend through this or are at least accessible from the outside. This is particularly important because it is important to be able to correct the fit of the innermost shell. The middle passage of the middle shell can, for example, be designed as described above.

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Furthermore, it is possible to provide the middle cover with gripping means that can correspond to those described above. They can be reached through the outermost passage or protrude from it. If the middle cover is pulled in the tightened and adjusted state using the middle gripping means, the middle cover is moved out of the aid. Due to the connection at the first end, both the outermost cover and the innermost cover are pulled along. The outermost cover turns inwards. The innermost cover turns outwards in such a way that the innermost and outermost covers are pulled between themselves in the direction of the second open end of the middle cover. In this way, it can be ensured that friction of the material occurs exclusively between the cover materials.

These and other features of preferred developments of the invention emerge not only from the claims but also from the description and the drawings, wherein the individual features can be implemented individually or in combination in the form of sub-combinations in an embodiment of the invention and in other fields and can represent advantageous and protectable embodiments for which protection is claimed here.

Short description of the drawings

Two embodiments of the invention are shown schematically in the drawings and are explained in more detail below. In the drawings:

Fig. 1 a donning aid consisting of a tube with inner and outer cover in the pulled apart state,

Fig. 2 the dressing aid from Fig. 1, with the inner cover put into the outer cover,

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Fig. 3 is a cross-sectional view of how the donning aid from Fig. 2 is pulled over a thigh stump and the latter is inserted into a prosthetic shaft of a knee prosthesis,

Fig. 4 shows another version of a tube-shaped dressing aid, in which a middle cover is provided in addition to that of Fig. 1, in the extended state and

Fig. 5 is an enlargement of a cross-section through a representation similar to Fig. 3, with the middle shell pulled downwards.

Detailed description of the implementation examples

Fig. 1 shows a donning aid 11 which is tube-like and elongated. The tube 12 of the donning aid 11 consists of an inner cover 13, which is shown at the top in Fig. 1. It merges into an outer cover 14 via the connecting area 16. In order to form the covers 13 and 14, the material of the tube 12 is essentially made up of two layers and connected to one another accordingly, depending on the material. As can be seen from Fig. 1, the connecting area 16 is continuous. This means that the inner cover 13 and outer cover 14 are seamlessly formed from one piece of material without any material separation. In other possible embodiments of the invention, it is also possible to select different materials here, depending on requirements, and to connect them to one another accordingly.

25 30

The inner cover 13 has an inner opening 23 at the inner end 19, which is at the top in Fig. 1. In the area of the edge of the inner opening 23, an inner flap 27 is attached, for example sewn on. In a similar way, the outer opening 24 is provided at the outer end 20 with the outer flap 28. The openings 23 and 24 are created by the tubular design of the covers 13 and 14 and are simply left open, so to speak. Alternatively, it is also possible to

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lent to make them narrower compared to the course of the shell in the area of the ends 19 and 20. Likewise, small openings could be provided for a part of the tabs 27 or 28.

In Fig. 2 it can be seen how the inner cover 13 is put into the outer cover 14. This creates a kind of two-layer funnel with an upper access opening 30. The donning aid 11 is open at the bottom through the openings 23 and 24. From Fig. 2 it can already be seen that the outer opening 24 is important in order to be able to grasp the inner tab 27 and pull it out downwards. The inner opening 23, on the other hand, is not absolutely necessary.

Fig. 3 shows schematically how the donning aid 11 is pulled over a thigh stump 40 by means of the entry opening 30. It extends so far that the lower end of the stump 41 is still covered by the donning aid 11 or extends to just before the openings 23 and 24.

The amputation stump 40 is inserted into a prosthetic shaft 35 using the donning aid 11. The prosthetic shaft 35 can, for example, belong to a thigh prosthesis. It can be seen how the donning aid 11 with the covers 13 and 14 completely covers the space between the stump 40 and the prosthetic shaft 35. In the upper area, the donning aid 11 with the connecting area 16 extends a little beyond the upper opening 36. Furthermore, at least the outer cover 14 extends a little beyond the lower opening 37 of the prosthetic shaft 35. The tabs 27 and 28 protrude downwards from the lower opening 37 and are easy to grip.

The representation of the prosthesis shaft 35 is schematic here. As a rule, at least the lower opening 37 is not central and large-scale downwards, but rather small and slightly slanted to the side.

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However, this is not relevant for illustrating the functional principle of the invention.

Deviating from an actual normal state, there is a relatively large distance between the stump 40 and the inside of the prosthetic shaft 35 in Fig. 3. In practice, the stump 40 should lie as completely as possible against the inside of the prosthetic shaft 35 and in doing so press the sleeves 13 and 14 together. However, for the sake of better clarity, the representation according to Fig. 3 has been chosen.

Because the inner cover 13 can be reached according to the invention by means of the inner tab 27, the stump 40 can now be pulled further in or readjusted in individual areas even if it has already been inserted into the prosthesis shaft 35 with a certain amount of force. Due to the contact pressure between the skin on the stump 40 and the inside of the inner cover 13, the stump 40 is pulled further downwards by pulling on the inner tab 27 and thus the inner cover downwards. It is thus as if the stump 40 or its lower end 41 itself were being pulled downwards. The inner tab 27 is very easy to reach thanks to the particularly large lower opening 24. After the stump 40 has been sufficiently pulled into the prosthesis shaft 35 or a corresponding, comfortable fit has been adjusted, the donning aid 11 is removed.

In accordance with the method known from the prior art, in the illustration according to Fig. 3, the outer tab 28 is now pulled in order to remove the donning aid 11 from the prosthesis shaft 35. In doing so, the donning aid turns outwards and only friction occurs between the outside of the inner shell 13 and the inside of the prosthesis shaft 35 with the outer shell 14 moving along in between.

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Fig. 4 shows a further possible embodiment of the invention. The donning aid 111 is again essentially tubular in shape with an inner cover 113 and an outer cover 114. In this embodiment, these are again seamlessly connected to one another via the connecting area 116, as they are made from the same material web. The design of the inner end 119 with the inner opening 123 and the inner tab 127 and the outer end 120 with the outer opening 124 and the outer tab 128 also corresponds to that of Fig. 1.

In addition, however, the donning aid 111 is provided with a middle cover 115. In principle, this is similar in shape to the inner cover 113 or the outer cover 114, i.e. funnel-shaped. It is connected in the connection area 116, preferably along the dot-dash line, to the donning aid 111 or the other covers 113 and 114. The middle cover 115, as can be seen, lies within the outer cover 114.

The middle shell 115 has a middle end 121. This is provided, corresponding to the other two ends, with a middle opening 125 and a middle tab 129.

Before the donning aid 111 can be put on, the inner cover 113 is put into the middle cover 115. This produces a state that is approximately the same as that shown in Fig. 2. However, the funnel is then made up of three layers. The openings 123, 124 and 125 are then at approximately the same height. The tabs 126, 127 and 128 can be reached from the outside.

In Fig. 5 it is shown, roughly corresponding to Fig. 3, how the three-layered donning aid 111 is placed between the stump 140 and the prosthesis shaft 135. Donning is again made easier by the fact that the middle

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Opening 125 and the outer opening 124, the inner tab 127 is easily accessible for pulling in and adjusting the stump 140. In this respect, with such a three-layer design, it must again be ensured that the inner tab 127 is accessible from the outside.
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To remove the donning aid 111, the middle tab 129 is pulled. This causes the middle cover 115 to be pulled downwards. Via the attachment point on the connecting area 116 to the inner cover 113 and the outer cover 114, these two are pulled downwards following the path of the middle cover. The inner cover 113 and the outer cover 114 are then folded inwards, as can be seen in Fig. 5. This means that there is no longer any friction from a cover on the inside of the prosthesis shaft 135. There is only friction between the covers themselves, so to speak.

If these are made of a material with as little surface friction as possible, the overall friction is very low.

It should be noted that in this design, in contrast to the one in Fig. 3, four layers of covers may be placed on top of each other and can be applied accordingly thickly. This greater thickness of the application makes it more difficult to pull out on the one hand due to the higher pressure. On the other hand, as mentioned, the friction is extremely low. This also means that the inside of the prosthesis shaft 135 can be specially designed to accommodate the stump 40. The surface properties with regard to pulling out the donning aid 111 no longer need to be taken into account. This increases the design freedom and the wearing comfort.

Instead of a full-surface middle cover 115, the middle tab 129 could also be guided upwards to the connecting area 116. However, this would have the disadvantage that the ring-shaped closed connecting area 116 would not be able to extend downwards between the inner

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Sheath 113 and the outer sheath 114, but the connecting area 116 forms an open edge, so to speak. This in turn makes it more difficult to pull out.

Furthermore, it is possible, unlike in Fig. 4, to arrange the additional cover not inside the cover 114, but outside. In this case, the covers 114 and 115 would be swapped. This would mean that a funnel-shaped cover would be attached to a hose 12 similar to Fig. 1 over the lower area, all the way around the outside, to the connecting area 16. This additional cover would then be the outer cover and the surrounding cover the middle cover. This may have manufacturing advantages, since a connection with a seam, adhesive or the like would then take place on the outside and would be easily accessible and thus made.

A four-layer design is also possible. This can be obtained by mirroring the shape from Fig. 1 downwards. By folding them together twice in the lengthwise direction, you then get the four-layer funnel. This would have the advantage that the wandering edge as shown in Fig. 5 could be avoided. Above all, the two covers that lie in the middle when pulled apart would then be the middle covers. They can be connected at the narrow end as they can be pulled out simultaneously. This makes it possible to manufacture the entire dressing aid from one sheet of material without doubling the layers as shown in Fig. 5.

Materials that can be used for a dressing aid 11 or 111 have been described at the beginning. Manufacturing as seamlessly as possible as shown in Fig. 1 or manufacturing with as few seams as shown in Fig. 4 has the advantage that, on the one hand, manufacturing is simpler. On the other hand, the material of the dressing aid is then thinner and the seams do not interfere when pulling out the dressing aid.

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If surface coatings are applied, they should be applied primarily to areas where surface friction occurs.

Of course, it is obvious to the person skilled in the art based on the above description that the donning aid for actual use should be designed differently than shown in Fig. 2. Very long versions are possible here, for example for an arm stump or the like. It would also be conceivable to provide a bend for an ankle or the like, for example for putting on support stockings.

Claims (15)

1. Means ( 11 , 111 ) for putting on orthopaedic or therapeutic aids, for example prosthetic shafts ( 35 , 135 ) or support stockings, wherein - the device is elongated with two ends and can be pulled over a limb in question, - the means comprises at least two adjacent shells ( 13 , 14 ; 113 , 114 , 115 ), namely an innermost shell ( 13 , 113 ) and an outermost shell ( 14 , 114 ), - the innermost cover is put into the outermost cover to put on the aids, - the innermost shell and the outermost shell are connected to each other at a first end ( 16 ), characterized in that at a second end ( 19 , 20 ; 119 , 120 , 121 ) the innermost shell has innermost gripping means ( 27 ; 127 ) and the outermost shell has an outermost passage ( 24 ; 124 ), the innermost gripping means being accessible from the outside through the outermost passage. 2. Means according to claim 1, characterized in that it is tubular and preferably tapers towards the second end ( 19 , 20 ; 119 , 120 , 121 ). 3. Means according to claim 1 or 2, characterized in that the outermost passage ( 24 ; 124 ) of the outermost sheath ( 14 , 114 ) is an open end. 4. Means according to one of the preceding claims, characterized in that the innermost gripping means ( 27 ; 127 ) extend outwards through the outermost passage ( 24 ; 124 ), in particular is elongated. 5. Means according to one of the preceding claims, characterized in that the outermost sheath ( 14 ; 114 ) also has outermost gripping means ( 28 ; 128 ). 6. Means according to one of the preceding claims, characterized in that the innermost shell ( 13 ; 113 ) is open at the second end ( 19 ; 119 ). 7. Means according to one of the preceding claims, characterized in that the connection ( 16 ; 116 ) of the innermost shell ( 13 ; 113 ) and the outermost shell ( 14 ; 114 ) is formed linearly circumferentially at the first end, preferably surrounding the opening ( 30 ; 130 ) in the innermost shell. 8. Means according to one of the preceding claims, characterized in that the innermost cover ( 13 ; 113 ) and the outermost cover ( 14 ; 114 ) consist of the same material, preferably a textile material, wherein they consist in particular of the same material web with a corresponding cut. 9. Means according to one of the preceding claims, characterized in that at least the outermost cover ( 14 ; 114 ), in particular the entire means ( 11 ; 111 ), consists of a supple low-friction material, in particular a polyamide fabric, wherein a coating is preferably provided. 10. Means according to one of the preceding claims, characterized by a middle sheath ( 15 ; 115 ) which is arranged between the innermost sheath ( 13 ; 113 ) and the outermost sheath ( 14 ; 114 ), wherein at the first end all three sheaths are connected to one another, in particular with the same connection ( 16 ; 116 ), and at the second end the middle sheath has a middle passage ( 25 ; 125 ) for the innermost gripping means ( 27 ; 127 ). 11. Means according to claim 10, characterized in that the middle shell ( 15 ; 115 ) is open at the second end, wherein in particular the middle passage ( 25 ; 125 ) is the open end. 12. Means according to claim 10 or 11, characterized in that the middle sleeve ( 15 ; 115 ) has middle gripping means ( 29 ; 129 ) which can be reached through the passage ( 24 ; 124 ) of the outermost sleeve ( 24 ; 114 ) for pulling out the middle sleeve, wherein during pulling out the middle sleeve pulls the outermost sleeve and the innermost sleeve ( 13 ; 113 ) along due to the connection ( 16 ; 116 ) at the first end, wherein the outermost sleeve turns inside out and the innermost sleeve turns outside. 13. Means according to one of the preceding claims, characterized in that the gripping means ( 27-29 ; 127-129 ) for the covers ( 13-15 ; 113-115 ) are designed in a similar manner, preferably having different colors. 14. Means according to one of the preceding claims, characterized in that the gripping means are designed as tabs ( 27-29 ; 127-129 ) and are preferably attached to two spaced points at the end of the respective sheath ( 13-15 ; 113-115 ). 15. Means according to one of the preceding claims, characterized in that the gripping means ( 27-29 ; 127-129 ) are connected, in particular sewn or glued, to the respective casing ( 13-15 ; 113-115 ) along a greater length in the direction of the longitudinal extension of the means ( 11 ; 111 ), wherein they preferably run along a connection of, for example, seams on individual casings.