Finger orthosis

• US 8,038,637 B2
• Filed: 07/29/2008
• Issued: 10/18/2011
• Est. Priority Date: 09/18/2000
• Status: Expired due to Term

• Current Assignee: Bonutti Research Incorporated (Bonutti IP LLC)
• Original Assignee: Bonutti Research Incorporated (Bonutti IP LLC)
• Inventors: Bonutti, Peter M.
• Primary Examiner(s): Brown; Michael A.
• Application Number:
  US12/181,520
• Publication Number:
  US 20090036814A1
• Time in Patent Office: 1,176 Days
• Field of Search: 602 20- 23, 128877-880
• US Class Current: 602/20
• CPC Class Codes: A61F 2005/0137 with two parallel pivots
• CPC Class Codes: A61F 2005/0153 combining rotational and stretching movements
• CPC Class Codes: A61F 5/013 for the arms, hands or fingers A61F5/0118 takes precedence
• CPC Class Codes: A61F 5/05875 for fingers
• CPC Class Codes: A61H 1/0288 Fingers

Abstract

The same orthosis can be used to sequentially move joints of different fingers of a hand. A hand cuff of the orthosis is mounted on the hand. Mechanisms operable to move the joints are connected to the hand cuff at locations aligned with the fingers. The mechanisms are connected with the fingers. The joints of the fingers are moved by operating the mechanisms. The joints and first and second portions of the fingers define on one side of the joints outer sectors which decrease in angle as the joints are extended. Force is applied to the first and second portions of the fingers to move the joints by providing relative rotation between internally and externally threaded members disposed in the outer sectors. Actuator members connected with the internally or externally threaded members are moved along paths that extend through the joints.

Claims

1. A method of moving a joint between first and second portions of a finger with a first cuff and a second cuff of an orthosis, said method comprising:

contacting the first cuff to the first portion of the finger and the second cuff to the second portion of the finger;

applying force to an actuator member, the actuator member rotationally coupled to the first and second cuffs; and

rotating the first and second cuffs with respect to the actuator member to move the first and second portions of the finger, wherein rotating the first and second cuffs comprises effecting relative rotation between the first and second cuffs about an axis extending through the joint.

2. A method as set forth in claim 1 wherein applying force to an actuator member comprises moving the actuator member along an axis which extends through the joint.

3. A method as set forth in claim 1 wherein applying force to an actuator member comprises manually moving the actuator member connected with at least one of the first and second cuffs.

4. A method as set forth in claim 1 wherein applying force to an actuator member comprises applying a force by the person having the finger.

5. A method as set forth in claim 1 further comprising connecting the first cuff of the orthosis with the first portion of the finger and connecting the second cuff of the orthosis with the second portion of the finger.

6. A method as set forth in claim 5, wherein connecting the first cuff of the orthosis with the first portion of the finger and connecting the second cuff of the orthosis with the second portion of the finger comprises connecting the first cuff and the second cuff such that the orthosis does not extend adjacent to lateral sides of the joint between the first cuff and the second cuff.

7. A method as set forth in claim 1 further comprising:

connecting the first cuff and a first cuff arm of the orthosis with the first portion of the finger and connecting the second cuff and a second cuff arm of the orthosis with a second portion of the finger; and

moving one of the first and second cuffs along one of the first and second cuff arms.

8. A method as set forth in claim 7 wherein moving one of the first and second cuffs along one of the first and second cuff arms comprises transmitting force from the actuator member to at least one of the first and second cuffs to move the at least one of the first and second cuffs along at least one of the first and second cuff arms under the influence of force transmitted from the actuator member to the at least one of the first and second cuffs while moving the joint.

9. A method as set forth in claim 7 wherein moving one of the first and second cuffs along one of the first and second cuff arms comprises moving the first cuff along the first cuff arm and simultaneously moving the second cuff along the second cuff arm while moving the joint.

10. A method as set forth in claim 9 wherein moving the first cuff along the first cuff arm and simultaneously moving the second cuff along the second cuff arm while moving the joint comprises simultaneously moving the first and second cuffs toward the joint under the influence of force transmitted to the first and second cuffs from the actuator member.

11. A method as set forth in claim 1 further comprising:

connecting the first cuff and a first cuff arm of an orthosis with the first portion of the finger and connecting the second cuff and a second cuff arm of the orthosis with the second portion of the finger; and

transmitting force from the actuator member to the first cuff arm to pivot the first cuff arm about an axis which is offset distally from the joint, the actuator member supported by a frame connected to the first and second arm cuffs.

12. A method as set forth in claim 1 wherein rotating the first and second cuffs comprises moving the joint in a direction away from an initial condition of the joint, interrupting relative rotation between the first and second cuffs for a period of time, and, thereafter, resuming rotating the first and second cuffs to move the joint in the direction away from the initial condition.

13. A method as set forth in claim 1 further comprising mounting a first plate of a hand cuff on a palm of a hand having the finger and mounting a second plate of the hand cuff on a back of the hand opposite from the palm.

14. A method as set forth in claim 13 further comprising connecting a mechanism operable to apply force to the first and second portions of the finger to the second plate mounted on the back of the hand at a location aligned with the finger.

15. A method as set forth in claim 14 wherein connecting the mechanism to the second plate comprises connecting the mechanism to the second plate at one of a plurality of locations on the second plate.

16. A method as set forth in claim 15 wherein connecting the mechanism to the second plate comprises clamping a connecting portion of the mechanism to the second plate.

17. A method as set forth in claim 16 wherein connecting the mechanism to the second plate comprises extending the connecting portion of the mechanism into one of a plurality of cylindrical members connected to the second plate, and clamping the connecting portion of the mechanism to the second plate comprises threadably engaging a set screw with the one of the plurality of cylindrical members to clamp the connecting portion of the mechanism with the one of the plurality of cylindrical members.

18. A method as set forth in claim 1, wherein applying force to an actuating member comprises applying a first force to cause flexion of the joint followed by applying a second force to cause extension of the joint, the first force being generally opposite the second force.

19. A method of moving a joint between first and second portions of a finger, wherein the joint and first and second portions of the finger define on a first side of the joint an outer sector which decreases in angle as the joint is extended, said method comprising:

operatively coupling a first cuff arm of an orthosis with the first portion of the finger and operatively coupling a second cuff arm of the orthosis with the second portion of the finger; and

providing relative rotation of the first and second cuff arms by an actuator member in the outer sector to transmit force to the first cuff arm to pivot the first cuff arm about a first axis which is offset distally from the joint and to transmit force to the second cuff arm to pivot the second cuff arm about a second axis which is offset proximally from the joint.

20. A method as set forth in claim 19 wherein providing relative rotation of the first and second cuff arms comprises transmitting force from a frame of the actuator member to a first cuff and a second cuff to simultaneously move the first and second cuffs along the first and second cuff arms.

21. A method of moving a joint between first and second portions of a finger, said method comprising:

coupling an orthosis including a first cuff and a second cuff to the finger including the joint; and

providing relative rotation between the first and second portions of the finger connected to the orthosis along a path which extends through the joint

by transmitting a force to the first and second cuffs.

22. A method as set forth in claim 21 wherein the joint and first and second portions of the finger define on a first side of the joint an inner sector which decreases in angle as the joint is flexed and define on an opposite second side of the joint an outer sector which decreases in angle as the joint is extended, said method further comprising positioning an input member in the outer sector.

23. A method as set forth in claim 21 wherein providing relative rotation between the first and second portions of the finger comprises effecting relative rotation between the internally and externally threaded members along an axis extending through the joint.

24. A method as set forth in claim 21 wherein providing relative rotation between the first and second portions of the finger comprises manually moving an input member connected with one of the internally and externally threaded members.

25. A method as set forth in claim 21 wherein providing relative rotation between first and second portions of the finger comprises providing relative rotation between the first and second portions of the finger by the person having the finger.

26. A method of moving a joint between first and second portions of a finger, wherein the joint and first and second portions of the finger define on a first side of the joint an outer sector which decreases in angle as the joint is extended, said method comprising:

connecting a first cuff to a first cuff arm of an orthosis with the first portion of the finger connected to the first cuff and connecting a second cuff to a second cuff arm of the orthosis with a second portion of the finger connected to the second cuff;

providing relative rotation between the first and second portions of the finger;

transmitting force from an actuator member to the first and second portions of the finger, wherein actuating the actuator member in a first direction causes flexion of the joint and actuating the actuator member in a second direction causes extension of the joint; and

moving one of the first and second cuffs along one of the first and second cuff arms.

27. A method as set forth in claim 26, wherein transmitting force comprises moving the actuator member along a path which extends through the joint.

28. A method as set forth in claim 26, wherein providing relative rotation between the first and second portions of the finger comprises effecting relative rotation between the first and second portions of the finger about an axis extending through the joint.

29. A method as set forth in claim 26, wherein providing relative rotation between the first and second portions of the finger comprises manually moving the actuator member.

30. A method as set forth in claim 26, wherein providing relative rotation between the first and second portions of the finger is performed by the person having the finger.

31. A method as set forth in claim 26, further comprising connecting a first cuff of an orthosis with the first portion of the finger and connecting a second cuff of the orthosis with the second portion of the finger.

32. A method as set forth in claim 26, further comprising transmitting force to at least one of the first and second cuffs to move at least one of the first and second cuffs along the first and second cuff arms under the influence of force transmitted from the actuator member.

33. A method as set forth in claim 26, wherein moving at least one of the first and second cuffs along one of the first and second cuff arms comprises moving the first cuff along the first cuff arm and simultaneously moving the second cuff along the second cuff arm while moving the joint.

34. A method as set forth in claim 33, wherein moving the first cuff along the first cuff arm and simultaneously moving the second cuff along the second cuff arm while moving the joint comprises simultaneously moving the first and second cuffs toward the joint under the influence of force transmitted to the first and second cuffs from the actuating member.

35. A method as set forth in claim 26, further comprising:

transmitting force from the actuator member to the first cuff arm to pivot the first cuff arm about an axis which is offset distally from the joint.

36. A method as set forth in claim 26, wherein providing relative rotation between the first and second portions of the finger comprises rotating the a first cuff and a second cuff relative to each other to move the joint in a direction away from an initial condition of the joint, interrupting relative rotation between the first and second cuffs for a period of time, and, thereafter, resuming relative rotation between the first and second cuffs to further move the joint in the direction away from the initial condition.

37. A method of moving a joint of a finger, said method comprising:

connecting an orthosis including a first cuff and a second cuff to the finger including the joint; and

moving the joint using the first and second cuffs while allowing the joint to rotate about an instantaneous axis of rotation, wherein at least one of an orientation and a position of the instantaneous axis of rotation changes during the moving operation.

38. A method as set forth in claim 37, wherein allowing the joint to rotate about the instantaneous axis of rotation comprises allowing self-centering of the orthosis on the joint.

39. A method as set forth in claim 38, wherein allowing the joint to rotate about the instantaneous axis of rotation comprises allowing the orthosis to remain substantially aligned with a joint plane that varies as the joint is rotated.

40. A method as set forth in claim 37, wherein the finger includes a first portion and a second portion interposed by the joint;

wherein the first portion and the second portion define on a first side of the joint an inner sector which decreases in angle as the joint is flexed and define on an opposite second side of the joint an outer sector which decreases in angle as the joint is extended; and

wherein moving the joint using the orthosis comprises operating an actuator mechanism to apply force to the first portion and the second portion.

41. A method as set forth in claim 40, wherein operating the actuator mechanism comprises providing relative rotation between a screw and an internally threaded frame thereby translating the screw relative to the frame;

and

wherein translating the screw relative to the frame translates an actuator coupled to the screw, the actuator pivotably coupled to a first cuff associated with the first portion and a second cuff associated with the second portion.

42. A method as set forth in claim 37, wherein moving the joint comprises flexing the joint followed by extending the joint.

43. A method as set forth in claim 37, wherein moving the joint comprises extending the joint followed by flexing the joint.

44. A method of moving a joint, said method comprising:

connecting an orthosis including a first cuff and a second cuff to a finger including the joint; and

moving the joint using the first and second cuffs of the orthosis, wherein the orthosis does not include one or more hinges positioned generally along an axis of rotation associated with the joint.

45. A method as set forth in claim 44, wherein connecting an orthosis including a first cuff and a second cuff the a finger further comprises attaching the orthosis proximally and distally relative to the joint.

46. A method as set forth in claim 44, wherein connecting an orthosis including a first cuff and a second cuff the a finger further comprises attaching the first cuff of the orthosis to a first finger portion

and attaching the second cuff of the orthosis to a second finger portion,

wherein the first finger portion and the second finger portion are interposed by the joint.

47. A method as set forth in claim 44, wherein moving the joint comprises allowing the joint to move about an instantaneous axis of rotation;

and

wherein at least one of an orientation and a position of the instantaneous axis of rotation changes during the moving operation.

48. A method as set forth in claim 47, wherein allowing the joint to move about the instantaneous axis of rotation comprises allowing self-centering of the orthosis on the joint such that the orthosis remains substantially aligned with a joint plane that varies as the joint is moved.

49. A method of moving a joint, said method comprising:

affixing a first cuff of an orthosis to a first portion of a finger and a second cuff of the orthosis to a second portion of the finger, wherein the first portion and the second portion are interposed by the finger joint; and

moving the first cuff with respect to the second cuff using the orthosis to provide one of flexion and extension of the finger joint while allowing the finger joint to move about an instantaneous axis of rotation that varies with a relative angular position of the first portion with respect to the second portion.

50. A method as set forth in claim 49, wherein allowing the finger joint to move about the instantaneous axis of rotation comprises allowing the orthosis to self-center on the finger joint as the finger joint moves.

51. A method as set forth in claim 49, wherein allowing the finger joint to move about the instantaneous axis of rotation comprises allowing the orthosis to remain substantially aligned with a finger joint plane associated with the finger joint;

and

wherein an orientation of the finger joint plane varies as the finger joint is moved.

52. A method as set forth in claim 49, wherein affixing an orthosis comprises attaching a first cuff to the first portion and attaching a second cuff to the second portion.

53. A method as set forth in claim 52, wherein moving the first portion with respect to the second portion using the orthosis comprises pivoting the first cuff about a first axis which is distally offset from the finger joint and pivoting the second cuff about a second axis which is proximally offset from the finger joint.

54. A method as set forth in claim 53, wherein moving the first portion with respect to the second portion using the orthosis comprises operating an actuator mechanism by providing relative rotation between a screw and an internally threaded frame thereby translating the screw relative to the frame;

and

wherein translating the screw relative to the frame translates the actuator mechanism coupled to the screw, the actuator pivotably coupled to the first cuff and the second cuff.

55. A method as set forth in claim 49, further comprising moving the first portion with respect to the second portion using the orthosis to provide the other of flexion and extension of the finger joint while allowing the finger joint to move about the instantaneous axis of rotation that varies with the relative angular position of the first portion with respect to the second portion.

56. A method of stretching tissue about a joint of a finger, said method comprising:

connecting a first cuff of an orthosis to a first portion of a finger and a second cuff of the orthosis to a second portion of the finger, the first portion of the finger and the second portion of the finger interposed by a joint; and

moving the first portion of the finger relative to the second portion of the finger about an instantaneous axis of rotation of the joint by applying a force in a single plane to the first cuff and the second cuff using a frame, the frame connecting the first cuff and the second cuff,

wherein the instantaneous axis of rotation of the joint changes relative to an axis of rotation of the orthosis across a range of motion associated with the joint.

57. A method as set forth in claim 56, wherein at least one of the first cuff and the second cuff is pivotably attached to the frame;

and

wherein moving the first portion of the finger relative to the second portion of the finger comprises pivoting the at least one of the first cuff and the second cuff with respect to the frame.

58. A method as set forth in claim 56, wherein at least one of an orientation and a position of the instantaneous axis of rotation changes relative to the axis of rotation of the orthosis during the moving operation.

59. A method of moving a joint, said method comprising:

coupling an orthosis to a finger by engaging a first cuff of the orthosis with a first portion of the finger and a second cuff of the orthosis with a second portion of the finger, a joint of the finger interposing the first portion and the second portion; and

moving the joint using the orthosis by pivoting the first cuff and the second cuff about a first axis spaced apart from an instantaneous axis of rotation of the joint.

60. A method as set forth in claim 59, wherein moving the joint comprises pivoting the first cuff about the first axis which is distally offset from the finger joint and pivoting the second cuff about a second axis which is proximally offset from the finger joint.