U.S. patent number 3,799,159 [Application Number 05/193,327] was granted by the patent office on 1974-03-26 for hydraulic flexion control device.
This patent grant is currently assigned to The United States of America as represented by the Secretary of Health. Invention is credited to Charles M. Scott.
United States Patent |
3,799,159 |
Scott |
March 26, 1974 |
HYDRAULIC FLEXION CONTROL DEVICE
Abstract
A hydraulic knee flexion control device which when unlocked is
completely flexible and free to align with the knee joint axis. It
is comprised of a rectangular cross-section spring wound tight with
a flexible cable positioned in the center of the spring. A
hydraulic system holds the cable immovable when the joint is to
remain rigid and lets the cable extend thus permitting the spring
to bend when flexion is desired.
Inventors: |
Scott; Charles M. (Los Angeles,
CA) |
Assignee: |
The United States of America as
represented by the Secretary of Health, (Washington,
DC)
|
Family
ID: |
22713182 |
Appl.
No.: |
05/193,327 |
Filed: |
October 28, 1971 |
Current U.S.
Class: |
602/16; 602/26;
623/39; 623/26 |
Current CPC
Class: |
A61F
2/64 (20130101); A61F 2/68 (20130101); A61F
2/72 (20130101); A61F 2002/748 (20130101); A61F
2002/745 (20130101) |
Current International
Class: |
A61F
2/60 (20060101); A61F 2/68 (20060101); A61F
2/50 (20060101); A61F 2/64 (20060101); A61F
2/74 (20060101); A61F 2/72 (20060101); A61f
003/00 () |
Field of
Search: |
;128/8C,8R,8Q,8F
;3/1.2,22,29,34 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
1,179,328 |
|
Oct 1964 |
|
DT |
|
1,491,236 |
|
May 1969 |
|
DT |
|
Other References
Orthopaedic Appliances Atlas, Vol. 2, pages 247-250 1960..
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Yasko; J.
Claims
What is claimed is:
1. A flexion control device, for use on human limb joints,
connecting an upper brace with a lower brace, comprising:
a flexion spring;
a flexible cable passing through the center of said flexion
spring;
first connection means connected to one end of said flexion spring
and one end of said cable for connecting the device to one of the
braces;
mechanical control means connected to the other end of said flexion
spring and the other end of said flexible cable for allowing said
flexible cable to be completely flexible when in one mode and
causing said cable to be rigid when in another mode; and
second connection means connected to said control means for
connecting the device to the other one of the braces.
2. A flexion control device in accordance with claim 9 wherein said
control means comprises:
a main cylinder closed at one end thereof and connected at the open
end thereof to said flexion spring;
a piston within said cylinder connected to said flexible cable;
a closure means within said cylinder near the open end thereof,
said piston and said closure means forming a chamber within said
cylinder;
spring means connected to said piston for urging said piston away
from said closure means;
hydraulic fluid within said chamber;
accumulator means for storing said fluid;
fluid passage means connecting said chamber and said accumulator
means for allowing fluid to pass therebetween; and
a control valve in said fluid passage means for controlling the
flow of said fluid.
3. A flexion control device in accordance with claim 1, further
including:
rigid spacers having an outside diameter approximately equal to the
inside diameter of said flexion spring and having an inside
diameter approximately equal to the outside diameter of said cable
whereby said cable is held centered within said flexion spring.
4. A flexion control device in accordance with claim 1,
wherein:
said flexion spring is of a rectangular cross-section.
5. A hydraulic flexion control device in accordance with claim 1,
further including:
a one way check valve in said fluid passage means and bypassing
said control valve whereby said fluid can pass through said check
valve from said accumulator means to said chamber but cannot
return.
6. A hydraulic flexion control device in accordance with claim 1,
wherein said accumulator means includes:
a cylinder,
a sealed piston within said cylinder;
an accumulator spring connected to said sealed piston for urging
said sealed piston in the direction which forces said fluid out of
said accumulator means.
7. A hydraulic flexion control device in accordance with claim 1,
further including:
needle valve means in said fluid passage means for restricting the
flow of said fluid and thereby dampening the flexion of the
device.
8. A hydraulic flexion control device in accordance with claim 1,
further including;
automatic control means connected to said control valve for closing
said control valve when weight is applied to the device and opening
said control valve when weight is released.
9. A hydraulic flexion control device in accordance with claim 8;
wherein said automatic control means includes:
a body connected to said main cylinder, and having an opening
adapted to receive one of said connection means;
a control spring connected to said body urging said connection
means away from said body;
control means connected to said connecting means for opening and
closing said control valve in response to the relative motion
between said connecting means and said body.
Description
The present invention relates to novel means for controlling the
flexion of a brace joint of particular value for use at the knee
joint of a leg brace.
In the field of orthotics, the problem of fitting a fixed axis
mechanical device to the human knee is a serious one. The human
knee is a polycentric joint, that is, there is a different axis of
rotation for every increment of flexion. Therefore, when an attempt
is made to utilize a single axis joint, i.e., one with only one
center of rotation, adjacent to the knee in an orthotic device,
undesirable motion will exist between the brace and the limb. This
is particularly true if inflatable structures are used as the thigh
and skin braces.
A recent development in the field orthotic bracing has been the use
of pneumatic structures. These structures are lightweight, strong,
comfortable and inexpensive braces that can be readily adjustable
by increasing or decreasing the amount of air pressure contained in
the inflatable structure. Furthermore, the structure can be easily
tailored to the contours of the individual patient and can be
readily changed to meet the needs of the body segments for bracing
as they change as a result of treatment, growth or both.
It has been found that an airmat type of structure formed into a
double-walled cylinder with a simple closure to permit application
to the patient has adequate mechanical strength to provide the
necessary support to the limb in all applications including those
of weight bearing. The only problem involved is how to handle the
flexion of the knee.
The brace structures known in the prior art are of the single-axis
joint type. However, due to the fact that the human knee has a
polycentric axis, when a single axis brace is used there will be
some linear displacement of the brace segments along the body.
Since there is greater contact with the body when using an
inflatable brace, this problem is somewhat more critical and could
produce considerable discomfort to the patient. Actual motion of
the skin with respect to the skeletal structure would be required
in order to provide this movement.
The device of the present invention has no fixed axis of its own.
It is flexible under one condition and sufficiently rigid under
another condition to withstand the forces required across the knee.
It can adapt to any knee axis without deforming the brace structure
in any way. It has a relatively small diameter and due to the fact
that it extends only between the thigh and calf section of the
brace it is relatively good from the cosmetic standpoint. The
combination of the present device with inflatable structures
provide a feasible application of the inflatable structure system
to long leg bracing. The device may also be used to advantage in
combination with conventional leg braces.
In its preferred embodiment, the present invention consists of a
rectangular cross-section spring, wound solid. A flexible cable
passes through the spring and is centered therewithin by means of
nylon or polyethylene spacers. The cable is attached to one brace
bar at one end and at the other end is attached to a hydraulic
assembly consisting of a piston and cylinder, a check valve, a
control valve, and a small accumulator with pressurization springs.
The theory of operation is that in order for the spring to bend
with the cable suspended at its center, the length of the cable
must be made longer. If the cable were retained mechanically so
that it could not become longer it would be impossible to bend the
spring. The retention of the length of the cable is the function of
the small closed circuit hydraulic system.
Accordingly, it is an object of the present invention to provide a
polycentric knee joint for use with leg braces.
It is another object to overcome the defects of the prior art, as
indicated above.
It is another object of the present invention to provide a flexion
control device which is flexible under one condition and rigid
under another.
It is another object to provide for improved support of joints.
It is a further object to provide a joint device for use with
pneumatic braces.
It is still another object of the present invention to provide an
automatic control for the flexion control device so that when
weight is applied the device will remain rigid and when weight is
removed the device will become flexible.
These and other objects will become evident from the following
detailed description, taken in conjunction with the accompanying
drawings, in which:
FIG. 1 is an elevational side view of a leg having a pneumatic
brace and the flexion control unit of the present invention.
FIG. 2 is a front view of the leg of FIG. 1.
FIG. 3 is a cross-sectional view of the flexion control device of
the present invention.
FIG. 4 is an elevational view of an automatic control device which
may be used with the device of FIG. 3.
Referring to FIGS. 1 and 2 it is seen that one or a pair of flexion
control units 11 connect the upper leg brace 12 with the lower
brace 13. The leg of the patient is shown at 15. In these drawings,
the braces 12 and 13 are shown to be of the inflatable pneumatic
type. The flexion device 11 is joined to the braces 12 and 13 by a
metal gusset 14 or the like.
A view of the unit 11 in more detail is seen in FIG. 3. A coil
spring 28 is wound closed using a rectangular cross-section spring
wire. A flexible, but inelastic, cable 30 passes through the center
of spring 28 and is held centered by a series of spacers 29. These
spacers 29 may be of any suitable material, such as Teflon, nylon
or polyethylene heads. As there is little or no relative motion
between spacers 29 and cable 30, no internal wear of the heads is
anticipated; only a very small amount of wear will occur on the
outside between spacers 29 and spring 28.
The cable 30 terminates at one end in an adjustable end fitting 34.
This fitting 34 is in turn connected to the lower brace bar 35
which is attached to a lower leg brace, such as the brace 13 via
the gusset 14.
The other end of cable 30 is connected to a main piston 25 which
may be provided with suitable gaskets. A closure 27 cooperates with
the piston 25 to define the main hydraulic cylinder 37. A return
spring 26 within the cylinder 37 maintains a light tension on the
flexible cable 28 by urging the piston 25 away from the closure
27.
The main cylinder 37 is connected via a fluid passage 31 to an
accumulator assembly 21. This assembly 21 includes a piston 23,
seal 24 and spring 22. The accumulator 21 is connected to the upper
brace bar 36 which in turn is attached to the upper leg brace. The
accumulator assembly 21 provides storage under pressure of the
hydraulic fluid in the system. Spring 22, which constantly urges
the piston 23 in the direction of the seal 24, allows the volume of
fluid stored to vary during actuation of main piston 25. A one way
check valve 32 permits fluid to pass from the accumulator 21 to the
main cylinder 37 but not return. A control valve 33 in the fluid
passage 31 determines whether the unit is flexible or rigid by
controlling return of fluid from the main cylinder 37 to the
accumulator 21.
The theory of operation is based on the fact that in order for the
spring to bend as assembled, the relative length of the cable
through its center must become longer. Thus, as the device is bent,
the coil spring 28 separates and the cable 30 extends so that the
main piston 25 is pulled into its cylinder 37. Thus, with the
control valve 33 open, fluid is free to pass through the fluid
passage 31 into storage in the accumulator 21, in effect permitting
cable 30 to lengthen and allowing spring 28 to bend; the unit
becomes flexible when the control valve 33 is open. With the
control valve 33 closed, fluid cannot pass from the cylinder 37 to
the accumulator 21 either through the check valve 32 or the control
valve 33. Therefore, the main piston 25 is locked with respect to
movement in the direction required for the unit to bend and the
unit is rigid.
If the control valve 33 is closed with the unit bent, it cannot be
bent any further but can straighten since fluid can bypass the
control valve 33 through the check valve 32 in this direction. The
force of the two springs 22 and 26 tend to cause the unit to
straighten. Once the unit is fully straightened it cannot bend in
any direction as long as the control valve 33 is closed.
When the patient is walking it is most desirable for the knee to be
free to bend during the swing portion of his gait and for the joint
to be rigid when he needs it for weight bearing. With the control
unit shown in FIG. 4, this can be accomplished automatically. As an
alternative, suitable electrical controls may be provided.
A suitable automatic control unit may be located between the
accumulator assembly 21 and the upper brace bar 36, if desired. A
body 39 if the automatic control unit houses the lower end of the
upper brace bar 36. Springs 38 urge the upper brace bar 36 away
from the floor of the body 39. A suitable connection device 40
connects the upper brace bar 36 with the control valve 33. A slot
41 in the body 39 and a knob 43 on the brace bar 36 cooperate to
limit the possible travel of the brace bar 36 with respect to the
control unit body 39. In operation, downward pressure on the upper
brace bar 36 will cause it to deflect against springs 38.
Deflection of the bar 36 with respect to the body 39 of the control
unit will cause connector 40 to actuate control valve 33. In this
way when weight is applied to the brace, control valve 33 will be
closed resulting in locking of the device. When weight is removed
from the brace, the upper brace bar 36 will be returned by springs
38 and the control valve 33 will be open causing the device again
to be flexible.
With automatic operation, the patient is able to flex his knee in a
normal manner during the swing through phase of walking but have
the knee locked as soon as weight is born on the braced limb. A
manual override is necessary to allow the patient to sit down. On
rising from the seated position, the patient would return the lock
to the automatic position. The units would then extend freely but
would not bend further until fully extended. This action assists
the patient in rising.
The units are preferably used in pairs, as seen in FIG. 2, one on
each side of the limb to be braced at knee or ankle, depending on
where support is needed. It is also possible to adapt this unit for
use at the hip joint for totally involved patients.
It is often desirable to provide a resistance to flexion of the
knee in an orthotic device when the knee is free to flex during the
swing phase of gait. An adjustable needle valve 42 (FIG. 3) in the
fluid passage 31 will restrict the flow of hydraulic fluid and
consequently dampen or act as a brake to flexion of the knee. The
adjustable needle valve 42 will permit the brace to provide the
exact amount of resistance to flexion required.
A simple automatic control device has been described but it should
be understood that other mechanisms could also be used with the
present device. Devices sensing the application of the patient's
weight in the shoe, strain gauges in the vertical support members
of the brace, or myoelectrically sensing the muscle activity in
remaining leg muscles are other means to activate the control.
The knee flexion control unit described may be manufactured with a
relatively small diameter and due to the fact that it extends only
between the thigh brace section and the calf brace section it is
cosmetically acceptable. When in a flexible position its ability to
conform easily to any relative motion between the thigh and skin
makes it extremely comfortable to the patient. Although it may be
adapted for use with any conventional leg bracing device, its
combination with inflatable structures provides a feasible
application of the inflatable structure system to long leg bracing
for the first time.
Various changes may be made in the specific embodiments of this
invention without departing from the spirit thereof or from the
scope of the appended claims. Other modifications and adaptations
-- such as use of the device in artificial limbs -- may be made
without departing from the scope of the invention.
* * * * *