RU34074U1 - SWIVEL AND DISTRACTION DEVICE WITH SETUP CONTROL SYSTEM - Google Patents

Description

The proposed utility model relates to the field of medicine, in particular to passive-action mechanotherapeutic devices for restoring the shape and function of joints.

It is known that for faster restoration of the shape and function of the joint, it is necessary to begin movement immediately after the operation. In this case, it is necessary to exclude the mutual pressure between the fragments of the operated joint, so as not to disrupt the healing of tissues. For these purposes, articulated-distraction apparatuses are used, for example, a device for restoring joint function adopted as a prototype — utility model No. 24923. This device contains a fixed and movable platform for fixing limb segments articulated, while the movable platform is connected to an electric drive, the engine of which is connected to the control system, the movable platform is connected to the electric drive through additional traction by means of a motion resistance sensor, and the system and further comprises a control angle sensor, the angular velocity of the optimizer, the first and second Schmitt Triggers, setpoint limit the range of motion of the corner points limiting setpoint resistance,

a clock pulse generator, as well as a logic block including a switch, a data trigger and an “exclusive” logic element, or while the output of the motion resistance sensor is connected to the functional input of the first Schmitt trigger, the control input of which is connected to the output of the limit torque generator, the output of the angle sensor connected to the hinge is connected to the functional input of the second Schmitt trigger, the control input of which is connected to the limiter of the maximum range of motion along the corner, the outputs of both triggers Ш Mitts are connected to the inputs of the logic unit, the output connected to the input of the Converter connected to the output of the angular velocity optimizer, the input connected to the angle sensor.

The common essential features of the prototype, which coincide with the essential features of the proposed technical solution, are the presence of a supporting and movable platforms for fixing segments of the limbs, an electric drive with a speed and reverse control system, and a sensor that responds to movement resistance.

The quality of the articulated distraction apparatus is determined by the accuracy of positioning of the fragments of the joint relative to the axis of rotation. In the prototype device about the accuracy of the reposition, indirect information is carried by the motion resistance sensor. If the fragments are not precisely tuned, then during the trial rotation of the moving platform relative to the supporting one, extreme mutual

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pressure between fragments, which causes excessive muscle tension, which affect the drive shaft, increasing the moment of resistance, which captures the sensor. The control system contains elements that provide reverse engine on condition that the moment of resistance from the muscles beyond the threshold value. In addition, the drive optimizes rotational speed based on the achievement of the maximum range of motion. Due to this, in the “man-apparatus” system, self-determination of the area of motion and speed of movement is achieved. The area of motion and the volume of motion are indirect integral visual information for setting fragments. The setting is based on the maximum range of movements. For this, it is necessary to compare the volumes of movements before and after tuning and apply the so-called techniques of successive approximations.

The main disadvantage of the above device is the low accuracy and particularly low speed settings of the parameters. This is explained by the fact that the tuning process is multi-parameter, and the tuning is done according to the integrated visual information. Changing the range of motion and range of motion in the described device can be achieved by turning the fragments and their linear movements. The number of tuning components can reach 8 (two linear and two angular coordinates of one fragment and the other), and the output visual information is mediated only through the area of motion and the range of motion (two parameters). The proposed utility model solves the technical problem.

increasing the accuracy and speed of adjusting the position of fragments of the joint, and, accordingly, the time and quality of joint restoration.

To achieve the named technical result, an articulated-distraction apparatus with a control and adjustment system comprising a fixed base made with the possibility of fixing and unfastening a support platform on it, as well as a movable platform, each of which includes beams and spoke trusses connected through two-stage distractors for fastening fragments of the joint made of two brackets rigidly interconnected by a pair of threaded rods, an electric drive equipped with a speed control system in ascheniya and ratchet, and multicomponent tenzovesy connected to a multichannel analog-to-digital converter, provided with the information processing system; moreover, the tensile weights are rigidly connected at one end to the electric drive shaft, and at the other end to the beam of the movable platform with the possibility of disconnection; the axis of rotation of the electric platform of the movable platform is within the limits of adjustment of the central spokes of the truss of the supporting platform; each of the two-stage distractors is made of two orthogonally located adjusting elements containing a threaded rod with at least three longitudinal grooves with balls inserted into them, inserted into the separator, a sleeve put on the balls on the outside of the separator, a nut in contact with

4 with the sleeve directly, and the nut in contact with the sleeve through

a spring installed between it and the sleeve, while the bushings of the adjusting elements of each two-stage distractor are rigidly interconnected directly or via a spacer, and the threaded studs of the trusses of the supporting and movable platforms are simultaneously threaded studs of the adjusting elements of the two-stage distractors, while one end of the threaded rods located orthogonally to them the adjusting elements are rigidly fixed on the beams, and the second are made with the possibility of mutual articulation nenia.

Distinctive features of the proposed device is that it contains a fixed base for mounting a support platform on it, with the possibility of its removal, as well as that the supporting and movable platforms include beams connected through two-stage distractors and spoke trusses for attaching joint fragments made of two brackets rigidly connected to each other by a pair of threaded rods, which are multicomponent tensile weights connected to a multichannel analog-digital pre an educator associated with an information processing system. Moreover, one end (base) of the strain gauges is rigidly connected to the shaft of the electric drive, and the second end is connected to the beam of the movable platform with the possibility of disconnection, while the axis of rotation of the electric drive of the movable platform is within the adjustment of the central spoke of the truss

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supporting platform. Moreover, each of the two-stage distractors is made of two orthogonally located adjusting elements containing a threaded rod with at least three longitudinal grooves with balls inserted into them, inserted into the separator, a sleeve put on landing on the balls outside the separator, a nut that contacts the sleeve directly, and a nut that contacts the sleeve through a spring installed between it and the sleeve, while the bushings of the adjusting elements of each two-stage distractor are rigidly interconnected directly either directly or through a spacer, and the threaded rods of the trusses of the supporting and movable platforms are simultaneously the threaded rods of the adjusting elements of two-stage distractors, while one ends of the threaded rods of the adjusting elements located orthogonal to them are rigidly fixed to the beams, and the second are made with the possibility of mutual articulation. It is especially important here that mutual adjustment is made not of trusses, but of platforms containing trusses and beams, the presence of multicomponent tensile weights, which allow to decompose the loads into components in coordinates, the processing and visualization systems of this information, as well as distractors, which allow for the corresponding multi-stage adjustments.

Multicomponent scales are made in the form of a rod with elastic elements on which load cells are glued. The basic principles for the separation of loads on components are described in the book by A. I. Chudnov, “Methods and techniques for flight testing of aircraft for strength. Moscow.

"Engineering. 1972, pp. 96 ... 106, and the schemes of sensitive elastic elements used in rod tensile weights are given in the book of R. A. Makarov “Strain measurement in mechanical engineering. Moscow "Mechanical Engineering 1975, p. 128 ... 130.

To separate the loads component-wise (into three orthogonal forces and three moments), the output signals from strain gauges are amplified fed to the inputs of analog-to-digital converters. Digital data from the transducers can be processed on a computer and presented on the display in the form of force diagrams and moment diagrams, valid; they are relative to the axes of the selected orthogonal coordinate system, which coincides with the coordinate system formed by the orthogonal adjustment elements of the apparatus.

In particular, the MZ element highlighted in this way - the moment of ingrowth of the turntable, can be a feedback signal for the engine reverse control system, providing it with the limitation of intraarticular loads. The MX and My components are moments relative to the axes lying down; they can be reduced in the plane of the orthogonal support platform by adjusting the support truss by turning it in the platform plane and in the plane indicated above. And the forces FX and Fy by adjusting the rotary truss - by changing the longitudinal and transverse diastasis (i.e. linear mixing; changes along the indicated axes). Here, the direction X coincides with the longitudinal axis of the fragment fixed on

7 supporting truss, and Y - with the axis of the fragment, heeled on the rotary truss

at an angle between them of 90 °, the Z axis is orthogonal to X and Y.

In order for the weights to measure the intra-articular forces, it is necessary to separate the supporting and rotary platforms. Only in this case the rotary fragment “hangs on the tensile weights. The base of the tensile weights will be fixed rigidly to the bulk of the engine. For this purpose, a detachable connection is established between the support and the turntable. When the device is passively worn, this connection is closed; when working, it is open. Also, the connection of the support platform with the base of the drive is detachable.

The stiffness of the springs of the adjusting elements in this case, as a rule, is chosen from the condition that the force of full compression will be less than the strength of the bone tissue.

Due to the presence of these distinguishing features in combination with the known ones mentioned above, the following technical result is achieved - the accuracy of setting fragments relative to the axis of growth increases with increasing speed (due to the use of component-wise settings instead of an integral assessment). In addition, due to the possibility of connection-detachment of the movable platform relative to the tensile weights and the engine, as well as the movable platform relative to the support, the platforms are located on the articular fragments in the device adjusted after the operation

position, which allows you to develop a joint without re-tuning to

simpler devices, for example, a prototype device.

As a result of a search by sources of patent and scientific and technical information, the totality of features characterizing the proposed device was not detected. Thus, the proposal meets the eligibility criterion of “new.

The proposed device can be used in the treatment of severe joint diseases requiring arthroplasty, as well as for postoperative restoration of the function of any joints - elbow, knee, ankle and shoulder, as well as for accurate reposition of any bone fragments. Thus, the present invention meets the eligibility criteria industrially applicable.

The technical solution is illustrated by the drawings of FIG. 1-3.

In FIG. Figure 1 shows a functional diagram of a hinged-distraction apparatus with a control and adjustment system.

In FIG. 2 shows a photograph of a support and movable platform in a connected form.

In FIG. 3 is a drawing of a distraction element. Depicted in FIG. 1-3, the articulated-distraction apparatus with a control and adjustment system comprises a fixed base 1 made with the possibility of fixing-unfastening on it a support platform 2, as well as a movable platform 3, each platform includes beams 5 and spokes connected through two-stage distractors 4

9 truss 6 for mounting fragments of the joint, made of two brackets 7,

rigidly interconnected by a pair of threaded rods 8, as well as an electric drive 9, equipped with a speed control system and a reverse 10, and multi-component tensi 11 connected to a multi-channel analog-to-digital converter (ADC) 12, equipped with an information processing system 13; moreover, the tensile weights 11 are rigidly connected at one end to the shaft of the electric drive 9, and at the second end to the beam 5 of the movable platform 3 with the possibility of disconnection; the rotation axis of the electric drive 9 of the movable platform 3 is within the adjustment of the Central spokes 14 of the truss 6 of the supporting platform 2; each of the two-stage distractors 4 is made of two orthogonally located adjusting elements 15, containing a threaded rod 16c with at least three longitudinal grooves 17c with balls 18 inserted into them, inserted into the separator 19, a sleeve 20, put on landing on the balls 18 outside the separator 19, nut 21 contacting the sleeve 20 directly (in this case, the washer rigidly connected to the sleeve - is not indicated in the drawing) and a nut 22 contacting the sleeve 20 through the spring 23 installed between it and the sleeve (in this case a hinge nut is installed between the spring 23 and the sleeve 20 - it is not indicated in the drawing) while the bushings 20 of the adjusting elements 15 of each two-stage distractor 4 are rigidly interconnected, and the threaded rods of the trusses 6 of the supporting 2 and the movable 3 platforms are simultaneously threaded rods 16 of the adjusting

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elements 15 of the diesel engine engine of power distractors 4, while one ends of the threaded rods 16 orthogonal to them 16 adjusting elements 15 are rigidly fixed to the beams 5, and the second are made with the possibility of mutual connection-disconnection through the hinge 24.

The device works as follows;

In the operating room, the support 2 and the movable platform 3 with spoke trusses 6, as well as the detachable hinge 24, are received in a separate form. After the knitting needles (including the central 14), the supporting platform 2 is hung and surgical access and joint arthroplasty are performed. Then, the movable platform 3 is mounted and the detachable hinge 24 closes. The hinge-distraction apparatus of FIG. 2. In this case, the first adjusting nut (nuts) 21 acts as a positioner of the adjustable elements, and the second adjusting nut (nuts) 22, pressing 1; the spring to the sleeve, plays the role of a compression force adjuster.

This initial setup is as follows. If, after the support 2 and the movable 3 platforms are closed, the fragments of the joint come into contact (and this depends on the actual position of the spokes in the fragments), then the trusses 6 will begin to move in the distractors 4 relative to the platforms 2 and 3, compressing the springs 23. Also, the bushings 20 will move away from the nuts 21 in contact with them. The gap between the nut 21 and the sleeve 20 indicates that there is no gap between the fragments. To get the necessary clearance

11 (diastasis) between fragments, we must turn nuts 21 until

contact with the sleeve 20 and further on the number of revolutions, calculated by the formula n 3 / h, where s is the required clearance, h is the thread pitch. Since all the adjusting elements 15 in the distractors 4 are made orthogonal to each other, it can be practically assumed in a first approximation that there are no cross-links along the axes. To avoid excessive efforts on soft tissues during initial adjustment, the nuts 22 are set to positions in which the springs 23 are minimally compressed.

If, after the closure of platforms 2 and 3, the fragments of the joints do not touch, then the trusses 6 remain in place, resting against the nuts 21. In this case, we must rotate the nuts 21 in the opposite direction until they come out of contact with the bushings 20. This moment will indicate moment of touching fragments. Then it is necessary to start the nuts 21 to rotate in the opposite direction, as described above, to set the diastasis.

Visual information is available until surgical access is closed. After closure of the surgical approach, as a rule, a secondary adjustment is required, since the intraarticular soft tissues deform upon closure, which affects the mutual pressure between the fragments. In addition, the real center of mutual rotation of the fragments is, as a rule, outside the axis of the central spokes 14.

On the second day after the operation, secondary adjustment of the mutual arrangement of the fragments, as well as the position of their axis of rotation relative to each other, is performed. For this, the supporting platform 2 is installed on

12 fixed base 1 and is fixed on it. Turntable 3

through the beam 5 it is connected to the tensile weights 11 connected to the shaft of the electric drive 9 and to a multi-channel analog-to-digital converter (ADC) 12 equipped with an information processing system 13. The detachable hinge 30 opens. The drive 9 is turned on. The information processing system (strain signals) 13 sends the torque value MZ to the control system 10 connected to the drive 9, which operates according to the algorithm described in the prototype. At the same time, in the biotechnological complex, the volume of movement, the speed of movement and the area of movement are self-installing. After the initial adjustment, the range of motion is small and can be 5 ... 10 °. They stop the electric drive 9 and in the static position they measure the strain signals for all six components, for example, alternately using the multi-channel ADC 12, the output signals of the ten weights 11 are input into the processing system 13. On the display of the indicated system, the forces and moments can be presented in the form of diagrams. It is also possible to represent the strain information in the form of deformational mutual displacements between fragments, since there is a certain relationship between forces and deformations. This relationship can be established as follows.

By adjusting the compression force between the fragments by rotating the nut 21, making contact with the sleeve 20 and noting the movement of this nut 21, as well as measuring this force by the tensor 11, we can determine the stiffness of the joint tissue in the direction of the compression axis. Stiffness value and

N}

13 establishes a relationship between force and strain. Processing System 13

strain signals can present a picture of shifts between fragments in dynamic form. Today, Skada-type processing programs are known that allow you to depict the movements of bodies controlled by external signals. Deformation patterns can completely replace X-ray photographs. Moreover, this visual information is available in real time. For this, a strain signal processing system similar to the so-called RTM (real-time monitor) should be used.

By adjusting the position of the trusses 6, and at the same time observing the mutual deformations of the fragments in real time, it is definitely faster and more accurate to adjust the articulated-distraction apparatus to the patient's limbs. The positions of the trusses 6 are regulated by turning the nuts 21. In this process, the nuts 22 are in a position in which the springs 23 are unclenched and do not create significant force on the distractors. This condition is necessary for the free mixing of farms 6 relative to platforms 2 and 3. Thus, fragments of the joint do not create significant pressure on soft tissues during the adjustment process. At the end of the setup, when the force and moment diagrams are minimized, the nuts 22 compress the springs to the limit, thereby fixing the rigid position of the trusses 6 and, accordingly, the position of the fragments. Now you can turn on the drive control system 10. In this case, the movement in the joint will take place strictly in the same plane with minimal pressure in the soft periarticular tissues.

14 After a session of adjustment and development of the joint movable

the hinge 24 closes again, fixing the rigid and adjusted relative position of the trusses 6 and fragments. In this case, the hinge-distraction apparatus remains on the patient. For further joint development, reconfiguration, as a rule, is not required and restoration (development) by movement can be drained; carried out on a simpler device, for example, built on the basis of a prototype device.

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Claims (1)

A hinged-distraction apparatus with a control and adjustment system, characterized in that it contains a fixed base, made with the possibility of fixing and unfastening the supporting platform on it, as well as a movable platform, each of which includes beams and spoke trusses connected through two-stage distractors for fastening fragments of the joint made of two brackets rigidly interconnected by a pair of threaded rods, an electric drive equipped with a speed control system and reverse, and a multicomponent nt tenzweights connected to a multichannel analog-to-digital converter equipped with an information processing system, moreover, the ten weights are rigidly connected to the electric drive shaft at one end and disconnected with the movable platform beam at the second end, the axis of rotation of the movable platform’s electric drive is within the range of adjustment of the central spoke of the supporting truss platforms, each of the two-stage distractors is made of two orthogonally located adjusting elements containing a threaded rod with at least three longitudinal grooves with balls inserted into them, inserted into the separator, a sleeve put on the balls on the outside of the separator, a nut in direct contact with the sleeve, and a nut in contact with the sleeve through a spring installed between it and the sleeve, while the adjustment sleeves the elements of each two-stage distractor are rigidly interconnected, and the threaded studs of the trusses of the supporting and movable platforms are simultaneously the threaded studs of the adjusting elements of the two-stage distractor s, wherein the one ends of them arranged orthogonally threaded studs adjusting elements are rigidly fixed on the beams, and the latter are capable of mutual articulation-detachably.