Apparatus and device for respectively slipping on and removing from a limb a tubular compression orthosis

The invention relates to an apparatus intended to facilitate the slipping on, over a limb, of a tubular compressive orthosis, of support stockings type, made in elastic material, or similar and a device for removing said orthosis.

In treatments of venous ulcer, varicose veins, lymphoedema, and more generally in the field of treatments for surface or deep venous insufficiencies, tailor-made orthoses in an elastic material, traditionally a knitted stitch, are well known. In the following text, compressive orthoses called “support stockings or socks” are meant to be stockings covering the thighs and calves, tights covering both lower limbs and the abdomen up to the waist, in a single piece, or even socks only covering the calves.

Tubular compressive orthoses are usually prescribed for the treatment of circulatory pathologies which often affect awkwardly mobile, sometimes mobility handicapped, elderly patients, inflicted with ostearthritic phenomena deforming their hands and feet, etc, i.e. whose mobility is normally limited. Yet, slipping them on proves to be particularly difficult for these people, notably about the foot and ankle where there is greatest compression, with the risk of misfitting, notably around the top of the foot and heel which are zones where slipping on is always very delicate and all the more so as the pressure of the orthosis increases.

As compressive orthoses are prescribed for the treatment of circulatory pathologies which affect, more particularly elderly patients with a most often limited mobility and with at least a reduced muscular force, their putting-on and their removal require assistance from a third party. In addition to the fact that assistance from a third party is badly received by the patients, the inability of the latter to put on and remove these compressive orthoses leads physicians to prescribe compressive orthoses with a low compression coefficient, or even to no longer prescribe these orthoses, although the wearing of orthoses having a sufficient compression coefficient provides very satisfactory results in many pathologies.

The invention allows to resolve this difficulty of slipping on and removing by proposing an apparatus and a device of particularly simple design, that can be easily maneuvered and requiring little effort from the person to be fitted with the orthosis or from a third party applying the orthosis to the patient or from the person removing the orthosis.

In this regard, this apparatus intended to facilitate the slipping on over a limb, of a tubular compressive orthosis, of support stockings type, made in elastic material, or similar, is remarkable in that it comprises a support arm, an extensor vice comprising a tubular casing mounted to slide longitudinally, being inhibited in rotation, on the support arm and two jaws facing the stage plates, substantially parallel, on which, when the vice is closed and the two jaws are touching, a tubular orthosis in a retracted rest state can be slipped on, a first jaw being made integral with the tubular casing and extending longitudinally from this casing whereas the second jaw extends transversally from a slide mounted longitudinally mobile, being inhibited in rotation, on the tubular casing and a mechanism for controlling the opening of the extensor vice mounted on the support arm, to act on the slide, made integral to the second jaw, a thrust to progressively distance the second jaw from the first jaw until reaching an end position of the slide corresponding to the maximum stretch of the orthosis, stretching which is retained via an auto-jamming of the slide and of the second jaw on the tubular casing.

Another purpose of the invention relates to a device for removing socks, stockings, tights or the like, such as compressive orthoses called “support stockings or socks”, made in a knitted elastic fabric material, which are prescribed to patients for treating circulatory pathologies, is remarkable in that it consists of a sleeve comprising a rod provided at its first end with a handle and at its second end with a curved spatula in the shape of a lunar crescent, with a decreasing transverse section from its tip to its heel, said rod being made integral with the spatula on its upper face near its heel, and in that the spatula has an upper face, convex from its tip to the rod and overall planar from the rod to the heel, and a lower concave face in order to generate excessive thickness between the lower and upper surfaces of the spatula in front of the rod thereby forming an embossment on the upper face of the spatula so that, the tip of the spatula being introduced between the sock and the calf of a patient, said sock is removed from the foot by a downward vertical movement combined with a pronation or supination movement of the spatula.

Other advantages and features will become more apparent from the description which follows of several alternative embodiments, given as non-limiting examples, of the device for slipping on an orthosis and a device for removing said orthosis according to the invention with reference to the appended drawings wherein:

FIG. 1 is a perspective view of an embodiment of an apparatus according to the invention;

FIG. 2 is a perspective view of the extensor vice being a part of the apparatus represented in FIG. 1;

FIGS. 3, 4 and 5 are partial diagrammatic elevation views illustrating diverse positions of the mechanism for controlling the opening of the extensor vice, until reaching a position of maximal extension of an orthosis placed on the jaws of the vice;

FIG. 6 is a top view, to a larger scale, of the extensor vice, in the initial closed position;

FIG. 7 is a vertical and transversal cross section view along line VII-VII in FIG. 6;

FIG. 8 is a top view of the extensor vice partly opened;

FIG. 9 is a top view of the extensor vice in the open position and in maximum extension;

FIG. 10 is a vertical and transversal section view along line X-X in FIG. 9;

FIG. 11 is a top view of the extensor vice in the maximum open position represented separate from the support arm of the apparatus;

FIG. 12 is a top view of the base of the apparatus;

FIG. 13 is a perspective view of an embodiment of a merchandiser of the extensor vice in an adjustable position;

FIG. 14 is a diagrammatic elevation view of the merchandiser represented in FIG. 13;

FIG. 15 is a diagrammatic elevation view of a base plate fixed to a wall and supporting the mechanism for controlling the opening of the extensor vice;

FIG. 16 is a perspective view of the device for removing a compressive orthosis according to the invention;

FIG. 17 is a horizontal sectional view along line B/B′ of FIG. 16;

FIG. 18 is a partial sagittally sectional view of the device according to the invention illustrated in FIG. 16.

The apparatus, according to the invention which is globally represented in FIG. 1, consists of four individually detachable parts, i.e. an extensor vice 1 and a mechanism 2 for controlling the opening of the extensor vice 1, both located on the upper part of the apparatus, a base 3 resting on the ground or on another appropriate support, and a vertical extension 4 linking the upper control mechanism 2 to the base 3.

The mechanism 2 comprises a strut 5 constituted by a piece of profile of square or rectangular section, to be connected to the upper end part of the extension 4, via interlocking. The upper end of the strut 5 is fixed to an end of a horizontal support arm 6 constituted by a piece of profile of square transversal section. The extensor vice 1 is mounted to slide longitudinally along the support arm 6, being inhibited in rotation on the latter. In this regard, the vice 1 comprises a tubular casing 7 constituted by a piece of profile of square transversal section, axially interlocked with slight give on the support arm 6. The vice 1 comprises two jaws 8 and 9 of which one, that being the jaw 8 nearest the strut 5, is fixed to the tubular casing 7 of the vice whereas the other jaw 9 can slide longitudinally along the casing 7. The fixed jaw 8 is constituted by an arm 11 extending horizontally and transversally from the casing 7 and fixed to the internal side of the latter, and by a vertical stage plate 12, made integral to the arm 11, perpendicular to the latter and extending upwards. The other jaw, i.e. the mobile jaw 9, comprises a hollow slide 13, of internal transversal section substantially corresponding to the external square transversal section of the casing 7, interlocked with this casing 7. The slide 13 is made integral to a horizontal and transversal arm 14, coplanar with the lower partition of the slide 13 and with the arm 11 of the fixed jaw 8 and extending on a parallel plane and horizontally on the same side as the latter. The arm 14 is made integral to a vertical stage plate 15 perpendicular to the arm 14, extending upwards, parallel and identical to the stage plate 12 of the fixed jaw 8. As can be more clearly seen in FIG. 2, the slide 13 has, on its two lateral and vertical sides, two inhibitors 16 transversally facing each other which intervene in the controlling of the movement of the slide 13 on the casing 7, as will be detailed later on.

As can be seen in FIGS. 1 and 2, the stage plates 12 and 15 have the same profile shape converging towards their ends resting against the arms 11 and 14 supporting them and have several stages of variable width, so as to slip on, in an appropriate manner, support stockings of different diameters over the two plates 12 and 15. For example, the stage plate 15 comprises an upper holding stage 15a of narrow width a, an intermediary stage 15b, of width b greater than width a, and a lower holding stage 15c of width c greater than width b. The different stages 15a, 15b and 15c are defined by opposite convex rounded edges separated by concave rounded edges which act as brakes to grasp and hold on to the opening edge of support stockings of different diameters.

The mechanism 2 for controlling the opening of the extensor vice 1 comprises a lever 17 located above the support arm 6, articulated, at its lower end, on the end of the support arm 6, around a horizontal and transversal axle 18, and comprising, at its upper end, an operating handle 19 and possibly another ring-shape handle 21 facilitating the prehension in some positions.

The mechanism 2 also comprises a double branch axle rod 22 in order to create a mechanical link between the lever 17 and the slide 13 of the extensor vice 1. This U-shaped double branch axle rod 22 comprises a body 22a which is articulated, around a horizontal and transversal axle, on the lever 17, at a distance from the axle of articulation 18 of the latter which is adjustable. The axle rod 22 also comprises two parallel branches 22b and 22c which extend from the two ends of the body 22a, whose lengths are adjustable and whose pointed ends rest against cavities created in the rear faces of the corresponding lateral inhibitors 16 of the slide 13 of the extensor vice 1.

As an accessory, the device can advantageously comprise a plate, not represented in the figures, made integral to the lever 17 and warped at its free ends in order to create a protective casing for the pointed parts of the branches 22b and 22c of the axle rod 22 so as to prevent any risk of injury whilst the device is being maneuvered.

During the opening phase of the extensor vice 1, the casing 7 of the vice is immobilized, on the support arm 6, its front face resting against a retractable inhibitor 23. This inhibitor is constituted, for example, of a radial lug made integral with a rod 24, of circular transversal section, placed in a coaxial manner on the inside of a tube 25 also of circular transversal section. This tube 25 has a diameter substantially equal to the width of the square internal transversal section of the support arm 6 and it is welded to this arm. The radial lug 23 passes through a transversal hole 26 created in the wall of the tube 25. The extension of this hole is such that it allows the internal rod 24 to turn by 45° between an active position in which the lug 23 extends vertically upwards and is in contact with the front face of the casing 7, as it is represented in FIGS. 1 and 7, and an inactive position in which the lug 23 is turned by 45°, as it is represented in FIGS. 9 and 10. In this inactive position the lug extends along a diagonal of the square transversal section of the casing 7 and it has a sufficiently small height to be entirely located inside this internal transversal section, which allows this casing 7 to freely slide outwards so as to separate the extensor vice 1 from the support arm 6, as it is represented in FIG. 11. The internal rod 24 is advantageously fitted, at its end, with a handle 27 facilitating its rotation on the inside of the tube 25.

According to an alternative embodiment not represented in the figures, the tubular casing 7 can advantageously comprise one or several holes in which the lug 23 can be positioned, the location of the holes corresponding to the preset distances between the jaws 8 and 9, i.e. with set support strengths. Moreover, the tubular casing 7 can comprise a fixed inhibitor positioned at its free end without departing from the scope of the invention.

The operating of the apparatus according to the invention will now be described, in referring in particular to FIGS. 3 to 11. In FIG. 3 the extensor vice 1 is represented in the closed position in which the two jaws 8 and 9 are touching and a support stocking A is slipped on to the retracted rest state, the two stage plates 12 and 15 are thus adjacent. The lever 17 of the mechanism 2 is in the vertical position and its lower part creates a right angled triangle with the horizontal support arm 6 and the sloping axle rod 22. The casing 7 of the extensor vice 1 is attached to the support arm 6 with its front face resting against the lug creating the inhibitor 23. The pointed ends of the two branches 22b and 22c, creating tappets, of the fork 22 are, themselves, inserted in the cavities set into the rear face of the inhibitors 16 of the slide 13.

To provoke the opening of the extensor vice 1 and consequently the progressive transversal stretching of the support stocking A, the user of the apparatus pulls on the level 17 in order to make it progressively pivot downwards, towards the support arm 6, as illustrated in FIG. 4. Through the pivotal movement of the lever 17, the branches creating tappets 22b and 22c of the fork 22 push forwards, i.e. to the right in FIG. 4, the slide 13 which moves along the casing 7 immobilized by the lug creating the inhibitor 23. The mobile jaw 9 is therefore progressively displaced to the right, which provokes the progressive stretching of the support stocking A. FIG. 8 represents the extensor vice 1 partially open and the support stocking A partially stretched.

FIG. 5 represents the extensor vice 1 in its position of maximum extension which is reached after pivoting the lever 17 by 90°. This lever now extends horizontally above the support arm 6. In the position of maximum extension, the slide 13 is pushed by the branches 22b and 22c of the fork 22 to as far right as possible. Once this position of maximum extension has been reached, the lever 17 can be returned to its initial vertical position, drawing with it the fork 22, and the extensor vice 1 is then free. It remains in the position of maximum extension, despite the return force exercised by the fully stretched support stocking A, through the auto-jamming of the jaw 9 on the casing 7. This auto-jamming engenders a slight tilting of the mobile jaw 9 due to the traction exercised by the support stocking A, as in the case of a clamp. The extensor vice 1, bearing the fully stretched support stocking A is as represented in FIG. 9.

The user can thus release the extensor vice 1 bearing the fully stretched support stocking A by turning the rod 24 by 45° so as to return the lug, creating the inhibitor 23, into the diagonal position as represented in FIG. 10. Once in this position, the user only has to pull on the extensor vice 1 to slide the casing 7 towards the exterior on the support arm 6 and totally free the extensor vice 1 from the rest of the apparatus, as illustrated in FIG. 11. The stretched support stocking A is ready to be easily slipped on a limb of the user of the apparatus.

FIG. 12 represents a non-restrictive embodiment of the base 3 of the apparatus. This base 3 comprises two cambered bars 28 and 28′, in the shape of a cross, symmetric in relation to a vertical plane P, in which lies the support arm 6 and the lever 17. The ends of the two bars 28 and 28′ are fitted with pads 31 made in rubber or a similar material providing four ground supports. The two bars 28 and 28′ are linear along the greatest part of their length, they converge towards each other creating an isosceles- trapezoid. They are integral, in their parts closest to each other, i.e. defining the small base of the trapezoid, of a vertical lug 32, a square or rectangular horizontal transversal section, on which the lower part of the vertical extension 4, also constituted by a tubular profile of square or rectangular transversal section, can be interlocked. Furthermore the far ends of the bars 28 and 28′ which link to the large base of the trapezoid, are connected by a band 29, in flexible or rigid material, constituting a foot support for the user whilst maneuvering the apparatus.

As represented in FIGS. 1 and 12, the extension 4 can be made integral to its lower part, of two facing feet 33 and 33′, constituted by cambered rods and fitted at their ends with support pads made in rubber. The feet 33 and 33′ extend in a vertical plane, perpendicular to a plane P containing the small base of the trapezoid, and they contribute to increasing the stability of the entire apparatus. This stability can possibly be reinforced with ground support plates welded to the lower part of the extension 4, and extending in a vertical plane P.

The apparatus according to the invention can also be used without the extension 4, the support arm thus being directly fitted to the base 3 via interlocking its strut 5 into the vertical lug 32 of the base 3.

FIGS. 13 and 14 represent a device 34 which can be mounted, instead of the mechanism 2 for controlling the opening of the extensor vice 1, on the upper part of the extension 4.

All the same, it is obvious that this device 34 can be fitted to the middle part of the extension 4 under the mechanism 2 for controlling the opening of the extensor vice 1, without however departing from the scope of the invention.

This device 34 is intended to facilitate the slipping on of a stretched support stocking A which is on the fully opened extensor vice 1, by placing this extensor vice 1 in a position, adjustable in height and angle around a horizontal axis, suitable for the user of the support stocking A. The device 34 comprises a slide 35, constituted by a piece of profile of square or rectangular transversal section, mounted vertically mobile on the extension 4 and capable of being jammed at an appropriate height, by means of a handle screw 36. The slide 35 is made integral to a pivot 37 of horizontal axis around which can pivot a radial arm 38 that can be immobilized in one or several preset angular positions, by means of a hand lever. For example, the pivot 37 can comprise a far end part of transversal section in the shape of a regular polygon to be inserted into a hole of the same shape made in the arm 38. At the free end of the support arm 38 is mounted in rotation, around a horizontal axis perpendicular to the arm 38, a disc 41 made integral to a coaxial central stud 42. This stud 42 has a square transversal section interlocking into the casing 7, also of square transversal section, of the extensor vice 1. To facilitate the rotating of the disc 41 and of the extensor vice 1 which it bears, the disc 41 is made integral to a hand wheel of large diameter 43 extending along a sector of circle of about 140′. Furthermore, the disc 41 is fitted with, on one of its front faces, a peripheral crown of cavities co-operating with a spring ball fitted pawl device, not represented, in order to be able to immobilize, in rotation, the disc 41 and the extensor vice 1 which it bears in any one of several angular positions around the axis of the disc 41.

The device 34 can also be fitted with a plate 44 fixed to the slide 35 or to the pivot 37 in order to retain a device to facilitate the slipping on or removing of the support stocking A which will be described in detail later on.

FIG. 15 represents a wall support of the mechanism 2 for controlling the opening of the extensor vice 1. This support is constituted by a pad 45, with a vertical section of triangular shape, which is fixed to a wall through a vertical face. The pad 45 also comprises an upper face which is tilted downwards and outwards at an angle a of about 14°. A perpendicular stud 46 is fixed on this face, of square or rectangular transversal section, on which the strut 5 can interlock being made integral to the support arm 6. Thus, the stud 46 and the lever 17 extend along an angle a compared to the horizontal when the lever 17 is in the rest or inactive position. This slightly upwardly-tilting position of the lever 17, compared to the horizontal, allows the user of the apparatus to best use his/her muscular force to provoke the opening of the extensor vice 1.

Even though the preceding description bears on an apparatus comprising a manually controlled mechanism 2 to provoke the opening of the extensor vice 1, it is obvious that in an alternative embodiment, this mechanism can be powered by using for example an electric jack to push the slide 13 on the casing 7 of the vice 1. Furthermore, the inhibiting device comprising the lug 23 and the bar 24 can be replaced by a simple pin being transversally inserted into two holes facing each other created in two walls facing each other of the support arm 6.

Moreover, it is obvious that the apparatus according to the invention is also adapted to facilitate the slipping on of socks, stockings, tights or similar and that the examples that have just been given are only specific illustrations and by no way restrictive in terms of the fields of application of the invention.

The device for removing socks, illustrated in FIG. 16 and capable of leaning against the plate 44 represented in FIG. 13, consists of a sleeve 101 comprising a rod 102, overall extending vertically, provided at its first so-called upper end with a handle 103, the ergonomics of which is advantageously suitable for its prehension by a right-handed person or a left-handed person, and at its second so-called lower end with a curved spatula 104 in the shape of a lunar crescent similar to a traditional shoe-horn. With reference to FIG. 17, the spatula 104 has a decreasing transverse section from its tip 105 to its heel 106, the rod 102 of the sleeve 101 being made integral with the spatula 104 on its upper face 107 near its heel 106, the tip 105 and the heel 106 thereby corresponding to the distal end and to the proximal end of the spatula 104, respectively. With reference to FIG. 18, the upper face 107 is convex from its tip 105 to the rod 102 and overall planar from the rod 102 to the heel 106. Moreover, the spatula 104 has a concave lower face 108 with a radius of curvature substantially equal to the radius of curvature of the upper convex face 107, but with different centers, so as to generate an excessive thickness e between the upper 108 and lower 107 faces of the spatula 104 in front of the rod 102 thereby forming an embossment 109 on its upper face 107.

It is obvious that the spatula 104 may have an upper face 107 convex from its tip 105 to the rod 102 and overall planar from the rod 102 to the heel 106 and a lower concave face 108 with a radius of curvature larger than the radius of curvature of the upper convex face 107 so as to generate the excessive thickness e between the lower 108 and upper 107 surfaces of the spatula 104, without however departing from the scope of the invention.

The upper face 107 advantageously comprises a groove 110 extending from the tip 105 to the embossment 109, with reference to FIGS. 17 and 18, and into which slides the heel of the foot of the patient upon removal of the orthosis as it will be seen later. The groove 110 has a profile in the shape of a circular arc, the generatrix of which decreases from the tip 105 to the embossment 109 of the spatula 104 (FIG. 17).

Moreover, with reference to FIG. 17, the spatula 104 is made integral with the rod 102 by crimping its lower end into a blind hole 111 provided on its upper face 107 near its heel 106 so that the axis A of the rod 102 forms an angle θ between 90° and 180°, and preferably an angle of 157°, with a line d passing through the tip 105 and through the fixation point of the rod 102 with the spatula 104. In this particular exemplary embodiment, the rod 102 is advantageously bent along a suitable angle in its lower portion, i.e. near its end made integral with the spatula 104 so that the latter forms an angle of 157° with rod 102.

It is obvious that the blind hole 111 may be provided on the upper face 107 of the spatula 104 so that its axis coincides with the A axis of rod 102, without however departing from the scope of the invention.

According to a particularly advantageous alternative embodiment of the device according to the invention, not shown in the figures, rod 102 consists of a first hollow portion, one of the ends of which is made integral with spatula 104 and into which slides a second portion provided with the handle 103, the first hollow portion comprising means for blocking the second portion, such as a wing screw for example, in order to adjust the dimension of rod 102 according to the patient's morphology.

Nevertheless, it has been reported that a device according to the invention, the rod 102 of which has a length of 51 cm from the handle 103 to the spatula 104 and the spatula 104 of which has a length of 225 mm and a maximum width of 45 mm, may advantageously be used by patients with any morphology, whether disabled or not.

The operation of the device according to the invention for removing a sock type orthosis covering the calf will now be explained with reference to FIG. 17.

The patient seizes the device with the handle 103 and positions the tip 105 of the spatula 104 between the orthosis and his/her calf. The patient then performs a downward vertical movement as indicated by the arrow b illustrated in FIG. 16, combined, considering the symmetry of the calf, with a pronation or supination movement of the spatula 104, illustrated on the double arrow c of FIG. 16, until the tip of the latter reaches the heel of the foot of the patient. By pronation and supination movement, is meant a movement of the spatula 104 from the outside to the inside and respectively from the inside to the outside, i.e., a movement of the spatula 4 from the calf to the sagittal plan of the patient and respectively a movement of the spatula 104 from the calf outwards.

The patient then continues with his/her downward vertical movement until the tip 105 of the spatula 104 is positioned under the heel of the foot of the patient, said spatula 104 being always positioned between the orthosis and the calf of the patient, so that the heel of the patient rests in the groove 110. The heel of the patient then slides along the groove 110 up to the embossment 109 where the excessive thickness e frees the orthosis from the heel of the patient so that the open end of the orthosis is between the instep and the plantar arch of the patient who, by a forward movement of the device, i.e., a movement towards the tip of his/her foot, definitively frees the orthosis from his/her foot.

Of course, it is understood that when the open end of the orthosis is between the instep and the plantar arch of the patient, the latter may definitively free the orthosis from his/her foot by laying the heel 106 of the spatula 104 on the ground, thereby relieving him/her from the weight of his/her leg, and then by performing a movement from the front to the rear of his/her foot. Further, it is obvious that the device according to the invention may advantageously be used for putting on an orthosis on the foot of a patient in order to facilitate the passage of the latter orthosis between the instep and the heel of said patient.

Finally, it is obvious that the spatula 104 of the device for removing a sock or similar type orthosis according to the invention, may be obtained in any type of material such as plastic, metal, ox horn or the like, and that the examples which have been given, are only particular illustrations, and by no means restrictive on the fields of application of the invention.

Apparatus and device for respectively slipping on and removing from a limb a tubular compression orthosis

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