阅读说明：本技术 具有可枢转的桥架的硬框架 (Hard frame with pivotable bridge ) 是由 弗洛里安·戈尔纳特 桑德罗·黑本施特赖特 汉斯·B·鲍尔法因德 于 2018-12-21 设计创作，主要内容包括：本发明涉及一种用于桥接关节的肢体关节矫形器的硬框架(100),其包含两个相对置的纵向延伸的关节夹板(110,120),其近端侧关节臂(113,123)通过横向的近端侧桥式拱形件(310)彼此连接并形成近端侧肢体支架(300),并且其远端侧关节臂(112,122)通过横向的远端侧桥式拱形件(210)彼此连接并形成远端侧肢体支架(200)。在此,关节夹板(110,120)的相应配属的关节臂(112,122)的关节臂端部(114,124)上的至少一个桥式拱形件(210)沿至少一个枢转轴线(222)可枢转地支承在关节(220)中,所述关节夹板连接所述桥式拱形件(210)。(The invention relates to a hard frame (100) for a limb joint orthosis for bridging a joint, comprising two opposite, longitudinally extending joint plates (110, 120), the proximal joint arms (113, 123) of which are connected to one another by a transverse proximal bridge arch (310) and form a proximal limb support (300), and the distal joint arms (112, 122) of which are connected to one another by a transverse distal bridge arch (210) and form a distal limb support (200). At least one bridge arch (210) on the joint arm ends (114, 124) of the respectively associated joint arms (112, 122) of the joint splints (110, 120) is mounted in the joint (220) so as to be pivotable along at least one pivot axis (222), said bridge arch (210) being connected to said joint splints.)

1. Hard frame (100) for a limb joint orthosis for bridging a joint, comprising two opposite, longitudinally extending joint splints (110, 120) which are connected to one another by means of a transverse, proximal-side bridge arch (310) on their proximal-side joint arms (113, 123) and form a proximal-side limb support (300) there, and which are also connected to one another by means of a transverse, distal-side bridge arch (210) on their distal-side joint arms (112, 122) and form a distal-side limb support (200) there, characterized in that,

at least one bridge arch (210) is rigid and is mounted in a joint (220) so as to be pivotable along at least one pivot axis (222) at the joint arm ends (114, 124) of the connected joint arms (112, 122), wherein the pivot axis (222) extends in the connecting direction of the two joint arms (112, 122) connected by the bridge arch (210).

2. A hard frame (100) according to claim 1 wherein the joint (220) has a pivot limit (223) for pivoting along at least one pivot axis (222).

3. A hard frame (100) according to claim 1 or 2 wherein for pivoting along at least one pivot axis (222) the articulation (220) is formed between a rigid bridge arch (210) and an articulated arm end (114, 124) overlapping it, respectively, wherein the end portion (212) and the articulated arm end (114, 124) are rotatably coupled to each other by a pin (224), respectively.

4. Hard frame (100) according to claim 2 or 3, wherein the pivoting limit (223) of the articulation (220) is formed respectively by a long hole (216) in the end portion (212) of the rigid bridge arch (210) and a sliding pin (226) fixed on the respective articulation arm end (114, 124), which slides in the respective long hole (216).

5. A hard frame (100) according to any of the previous claims wherein the articulation (220) has a mechanical resistance that applies a resistance to pivoting.

6. A hard frame (100) according to claim 5 wherein the obstruction is achieved by a locking lug provided between an end portion (212) of the rigid bridge arch (210) and the articulated arm end (114, 124) to which it is respectively lap joined.

7. A hard frame (100) according to claim 6 wherein the obstruction is achieved by mechanical friction between the end portion (212) of the rigid bridge arch (210) and the articulated arm ends (114, 124) with which it is in respective overlapping connection.

8. A hard frame (100) according to claim 7 wherein the mechanical friction is changed by friction linings (218) provided on the end portions (212) and/or on the articulated arm ends (114, 124).

9. A hard frame (100) according to any of the preceding claims wherein the end portions (212) of the rigid bridge arches (210) and the articulated arm ends (114, 124) in respective overlapping connection therewith are elastically coupled to each other by elastomer blocks acting as torsional joints.

10. A hard frame (100) according to any of the preceding claims wherein at least one articulated arm end (114, 124) is configured as a leaf spring.

11. The hard frame (100) according to claim 10 wherein the at least one articulated arm end (114, 124) configured as a spring leaf allows the articulated arm end (114, 124) to spring resiliently tilt outwards from a main pivot plane of the articulating splint (110, 120).

12. A hard frame (100) according to any of the previous claims wherein in one or both joint splints (110, 120) additionally at least one fixable tilting joint (115) is configured for tilting at least one joint arm (112, 113, 122, 123) outwards from the main pivot plane of the respective joint splint (110, 120).

13. A joint orthosis comprising a hard frame (100) according to any one of the preceding claims and further comprising straps (350, 250) for securing a limb to be supported on the respective proximal and distal side brackets (300, 200) of the hard frame (100).

14. The knee joint orthosis of claim 13.

Technical Field

The invention relates to a medical joint orthosis, in particular a knee joint orthosis, for guiding or supporting joint functions on a limb joint. The invention also provides an improved rigid support frame (hard frame) for constructing such a joint orthosis, wherein the hard frame has in particular a support with a tiltable or pivotable frame bridge.

Background

Joint orthoses with rigid hard frames according to the invention are known. A joint orthosis hard frame for bridging and thus supporting and guiding a limb joint, for example a knee joint, is usually formed by two opposite joint splints which, in the worn state of the orthosis, bridge the limb joint to be supported or guided. These joint splints each have a joint which is constructed monoaxially or polyaxially in order to be able to simulate and follow the anatomical joint movement of the limb joint to a large extent. On both sides of the joint, the arms of the joint splint are connected to a support that is either close to the body (proximal) or far from the body (distal). These braces securely enclose the respective limb portion near or far from the body to effect a mechanical coupling with the limb, arm or leg, hand or foot to convey the required support function of the joint splint to the bridged joint of the limb. The limb support and the joint splint essentially constitute the unit of this universal hard frame. Such rigid frames are generally connected directly to the limb by means of suitable straps, in particular in the region of the limb support, or alternatively or additionally to joint bandages placed against the limb, that is to say mechanically coupled to the joint bandages.

A problem of the known hard frame is that in the region of the support of the respective limb part, that is to say in the knee joint orthosis, in particular on the lower leg, mechanical overloading of the underlying tissue part, in particular due to pressure or shear stress, can occur during use. In favourable circumstances this can lead to uncomfortable pressure or pain for the wearer of the orthosis, and in unfavourable circumstances this can lead to severe tissue damage, which can result in the orthosis not being able to be worn anymore.

On the other hand it has been demonstrated that: in many cases, in order to form a well-supported orthosis, the two lateral, articulated splints in the hard frame must be connected to one another by rigid bridges, these frame bridges at the same time being part of the limb support. Such a mechanically necessary frame bridge may be pressed right into the adjacent tissue parts of the limb when the orthosis is worn. The technical solution of compensation includes arranging a pad on the frame bridge, which disperses and reduces the pressure on the underlying tissue. This solution is disadvantageous because it also prevents the rigid frame from being fixed in position and securely fixed to the limb, causes an undesired migration of the orthosis, reduces the necessary mechanical force introduction or force coupling of the rigid frame and the limb and thus reduces the supporting effect of the orthosis or renders it completely ineffective. Similar functional relationships and related problems are also present in knee, wrist and ankle and elbow orthotics.

Disclosure of Invention

Therefore, the technical problems to be solved are as follows: a known hard frame is developed as a component of a joint orthosis, so that the joint orthosis can be worn without problems and the full function of the orthosis can be retained without undesirable or harmful pressure loads or shear stresses on the adjacent tissues of the limb, while at the same time an undesirable migration of the orthosis can be effectively suppressed.

This technical problem is solved by a hard frame for a limb joint orthosis according to claim 1. The hard frame has in particular two opposing joint plates extending in the longitudinal direction, each of which, starting from a central, in particular polyaxial joint, has two joint arms extending in the proximal direction and in the distal direction in the worn state. The joint arms of the joint splints are connected to each other by bridges to form a hard frame for the orthosis. The bridge is configured to be arcuate so as to closely surround the respective proximal or distal limb portion. They constitute a major component of limb braces. In order to achieve a completely force-fit on the support with the respective limb part, a tension band is preferably provided; alternatively or additionally, the rigid frame is preferably mounted on a tightly fitting elastic joint bandage for fixing to the limb. In addition to arthritis or joint dislocation, indications for such hard-frame orthoses include, inter alia, post-operative functional support for the treatment of torn ligaments or cartilage defects.

According to the invention, at least one bridge arch connecting the joint plates is now mounted pivotably on the arm of the respective joint plate to which it is connected. Here, according to the invention, the support allows the frame bridge to pivot at least along the following pivot axes: the pivot axis is substantially parallel to a connection line between two articulated arms connected by the bridge, which means that the pivot axis extends in the connection direction of the respective two articulated arms connected by the bridge arch. Such a bearing of at least one of the two bridges connecting the arms of the articular splint according to the invention allows the arched bridge to be advantageously inclined along the pivoting direction of the articular splint, that is to say the bending or stretching direction of the joint in the worn condition. The inclination of the bridge in this case allows in particular: the inevitable changes in the relative position of the support with respect to the limb that occur during flexion or extension, due on the one hand to the elasticity of the tissues during flexion or extension and on the other hand to the inelasticity of the supporting rigid frame, can be compensated and balanced. Frictional movement of the rigid frame bridge on the limb support due to the shear stresses that occur and pressure loads across the edges of the bridge arches due to unfavorable articulation angles of the bridge arches relative to the limb surface can be reduced or completely avoided. This is particularly important and effective in the case of the use of bridge arches that are entirely rigid, i.e. inelastic and torsionally rigid.

The subject of the invention is a hard frame for a limb joint orthosis for bridging a joint, comprising two opposite, longitudinally extending joint plates which are connected to one another by their proximal joint arms via a transverse proximal bridge arch and form there a proximal limb support; and are further connected to one another by their distal-end articulated arms via a laterally distal-end bridge arch, and form there a distal-end limb support, characterized in that at least one bridge arch is particularly rigid and is accordingly mounted pivotably in the joint according to the invention on the articulated arm end of the connected articulated arm along at least one pivot axis, wherein the pivot axis extends in the connecting direction of the two articulated arms connected by the bridge arch.

In particular, it is provided that the joint between the respective end of the bridge arch supported in an articulated manner and the end of the joint arm connected thereto is realized in the simplest case by a joint pin, which thus forms a simple axial joint. For this purpose, in the simplest case, the flat material (Flachmaterial) of the end of the articulated arm is riveted or screwed or similarly connected to the flat material of the end of the bridge arch at a point to form the axial articulation. In this case, it is preferably provided that the articulated arm end and the end of the bridge arch connected thereto overlap in a planar manner and slide against one another there upon a defined pivoting of the bridge arch relative to the articulated arm end. In particular, the direction of the pivot axis is thus also determined, more precisely perpendicular to the surface of the flat articulated arm end on which the end of the bridge arch slides.

Accordingly, the subject matter of the invention is also preferably a rigid frame according to the invention, wherein a joint for pivoting along at least one pivot axis is respectively formed between an end portion of the rigid bridge arch and an articulated arm end overlapping it, wherein the end portion and the articulated arm end are respectively rotatably coupled to one another by means of a pivot pin.

In a first variation, nearThe end-side bridge arch extends in the worn state on the front side (expansion side) of the limb; that is, in the case of implementation as or in a knee joint orthosis, extends in the region of the tibia. In an alternative variant, the proximal bridge arch extends in the worn state on the rear side (flexion side) of the limb; in the case of a knee joint orthosis or in the case of a knee joint orthosis, the muscle mass extends in the muscle region on the inner and outer sides of the lower leg and is laid flat in a particularly firm manner as a soft tissue cushion when coupled under force

The above.

In one variant, the distal bridge arch extends in the worn state on the front side (the expansion side) of the limb; in the case of a knee joint orthosis or in the case of a knee joint orthosis, this extends in the region of the straight thigh muscles and the lateral and medial thigh muscles and lies in particular firmly on the muscle mass which serves as a soft tissue cushion during the coupling of forces. In an alternative variant, the bridge arch on the distal end extends in the worn state on the rear side (curved side) of the limb; in the case of a knee joint orthosis or in the case of a knee joint orthosis, this means that it extends in the region of the neck tendon muscles, the double-ended thigh muscles and the large tightening muscles and lies in particular firmly on the muscle mass which serves as a soft tissue cushion when the force is coupled. In particular, it is preferred that the distal bridge arches of the rigid frame extend on the front side of the limb, while the proximal bridge arches extend on the rear side of the limb, i.e. in the region of the calf muscles when embodied as or in a knee brace.

The pivoting preferably takes place in the direction of rotation: the upper edge of the bridge arch can be tilted outwards from the bridged joint, in particular in order to compensate for the shortening of the effective length of the hard frame on the rear side (flexion side) of the limb and/or the lengthening of the effective length of the hard frame on the front side (extension side) of the limb that occurs when the limb is flexed. According to the invention, pressure loads which would occur as a result, caused in particular by the edges of the rigid bridge arches, can thereby be avoided. In the case of the design of the hard frame as a knee joint orthosis or in the case of a knee joint orthosis, in particular the proximal bridge, which in the worn state, in particular in the region of the rear side, i.e. on the calf, surrounds the lower leg, is pivotable. This pivotability allows the bridge to be shifted proximally from the normal position in order to prevent or reduce shear and pressure loads on the calf when the knee is bent.

Preferably, only the bridge on the distal side is pivotable, and preferably the bridge on the proximal side is here rigidly connected with the two proximal joint arms of the joint splint, and more preferably is formed as an integral unit with the joint splint. Alternatively, or in addition thereto, the proximal bridge can be pivotable, while the distal bridge can be rigidly connected to the two distal joint arms of the joint splint and more preferably formed as an integral unit therewith. In another embodiment, the proximal bridge and the distal bridge are pivotally supported on respective joint arms of the joint splint.

In a particularly preferred embodiment, however, at least a particularly rigid distal bridge is always pivotable, which distal bridge rests in the worn state on the calf muscle, particularly in connection with a knee orthosis. In an alternative embodiment of the hand joint orthosis or in the case of the hand joint orthosis, it is provided in particular that at least one, in particular rigid, proximal bridge is pivotable, which in the worn state rests on the forearm muscle. In a further alternative embodiment of the hand joint orthosis or in the case of the hand joint orthosis, it is provided in particular that at least the, in particular rigid, distal bridge is pivotable, which rests against the palm in the worn state.

In a particularly preferred embodiment, the extent of pivoting of the bridge arches on the respectively connected articulated arm ends along at least one pivot axis is limited. Such a pivoting restriction only allows a certain movement of the bridge arches on the limb support, so that during flexion or extension, in particular while compensating for the above-mentioned relative movement of the limb on the support with respect to the orthosis, a sufficiently firm mechanical coupling between the limb and the hard frame can still be ensured. In a first variant, the pivoting restriction means is realized by a hard stop. In a particularly preferred manner, a slot is provided at the respective end of the bridge arch, in which slot a sliding pin, which is connected in a positionally fixed manner to the end of the respective articulated arm, can slide. Alternatively or additionally, the elongated hole is formed on the end of the articulated arm, and the sliding pin is formed on the end of the bridge arch. Alternatively or additionally, a mechanical stop is provided on the end of the side arm and/or on the bridge arch, wherein the outer edge of one articulation element engages with the projection of the other articulation element to form a pivoting limitation.

Preferably, the limitation of the pivoting of the bridge is set at about 20 ° or about 15 ° starting from the zero position. However, it is particularly preferred that the angle of the pivoting limitation is designed differently depending on the use and application of the hard frame, that is to say in particular depending on the movement curve of the wearer and/or depending on the therapeutic objective. That is, the pivoting limitation can be particularly low-limiting, in particular limited to 12 ° to 20 °, if a greater mobility is to be maintained when the orthosis is worn or the therapy goal to be pursued is not particularly strict. On the other hand, if it is desired to increase the supporting effect by the orthosis or to limit the mobility of the wearer anyway, the pivoting limitation can be restrictive and limited to a small angle, in particular 5 ° to 12 °. In a known manner, a variable pivot limit can be implemented, which can be achieved in such a way that the joint is optionally completely locked. Preferably, in an embodiment with a pin sliding in the slot, one or more sliding pins have different insertion points with a constant arc length of the slot, or alternatively or additionally form slots of different lengths, which can optionally be selected by inserting a sliding pin.

In a preferred embodiment, provision is alternatively or additionally made for: the articulation on the joint formed between the end of the articulated arm and the bridge arch is mechanically impeded so as to exert a mechanical resistance to the pivoting of the bridge arch. Thereby, it is advantageously achieved: on the one hand, the pressure load of the tissue on the limb support is sufficiently reduced and on the other hand it is ensured that the bridge on the support still retains sufficient mechanical resistance to achieve a functionally correct mechanical coupling of the hard frame to the limb. Such a pivot resistance is preferably achieved by mechanical friction between the end portions of the bridge arches and the ends of the articulated arms to which they are respectively connected by means of articulations. For this purpose, at least one of the two joint elements preferably has a friction lining, as a result of which the mechanical friction on the joint can be varied, preferably increased. Alternatively or additionally, provision may be made for the joint clamp and the end section of the bridge to be bridged to be knurled or provided with teeth around the pivot pin in order to increase the friction caused by such a surface structure. In particular, it is provided here that the locking means are formed by teeth, so that the locking means can be pivoted further only from a certain force input, and so that the normally rigid guiding function of the bridge can be kept constant only in the region of slight force inputs which have not yet overcome the locking resistance.

In an alternative or additional preferred embodiment, the joint between the end of the articulated arm and the bridge arch is formed exclusively or additionally by an elastomer block constructed between these two elements. This serves on the one hand advantageously to mechanically hinder the pivoting movement and on the other hand also to slightly acting pivoting limits, which depend on the pivoting angle. The elastomer block is here a torsion joint with a spring action and a damping action. Preferred elastomeric materials are silicone elastomers and polyurethane elastomers. In a particular variant, a heat-sensitive polymer is provided which becomes more flexible with increasing mechanical stress. This enables an automatic adjustment of the degree of pivoting and the blocking of pivoting as a function of the respective movement state. In an alternative embodiment similar thereto, a simple axial joint with a coupled helical spring can be provided.

In a preferred embodiment, at least one articulated arm end is provided on the hard frame, in particular in the case of the connection according to the invention to the pivotable bridge arch, which is embodied as a leaf spring, i.e. as an elastic leaf spring. This advantageously allows the joint arm ends to tilt elastically outwards from the plane of the longitudinal extension of the joint splint, i.e. in particular outwards from the main pivot plane of the joints of the joint splint. This allows, in particular, a compensation of a misalignment on the limb joint transverse to the main flexion and extension direction of the joint in connection with a further fixable, tilting joint in the joint splint or an active guidance of the limb joint to such a tilting, wherein at least one joint arm of the joint splint can be tilted out of the main pivot plane of the joint splint by means of the fixable, tilting joint. Such a fixable, tilting joint can be formed as an additional axial joint in one or more joint arms, wherein the axis of the tilting joint lies in the plane of the joint splint and is oriented transversely to the longitudinal extension of the joint splint. Alternatively or additionally, the fixable, tilting joint may be constructed beside, in or as part of the main pivot joint of the joint splint.

In this case, it is provided in particular that the fixable tilting joint forces the joint arm to be fixed adjustably tilted outward from the pivot plane of the joint splint, which forced tilting is preferably compensated by a spring leaf additionally arranged on the joint arm end of the respectively tilted joint arm, so that the bridge arch can be oriented exactly transversely to the longitudinal extent of the limb even in the case of such a lateral tilting. This allows the limb support formed by the bridge arch to extend transversely to the longitudinal extent of the limb at all times and thus with the smallest possible circumference at that location. This counteracts undesired movements of the hard frame and of the joint orthosis caused by slipping of the brace.

The rigid frame structure described here with a tiltable bridge between the joint plates can be particularly well suited for knee joint orthoses, wherein preferably at least the limb support for the distal side, i.e. the support for the lower leg, is designed to be rigid and the bridge arch is pivotably and hingedly arranged in the manner according to the invention on the distal joint arm ends of the two joint plates connected by the bridge arch. The compressive and shear stresses occurring in particular on the lower leg during flexion or extension of the knee are largely or completely compensated by the pivotable bridge arches, so that a reliable lower leg support is achieved which at the same time is mechanically less burdensome for the wearer. A particular subject of the invention is therefore a knee joint orthosis comprising a hard frame according to the invention.

In an alternative embodiment, the joint orthosis comprising the hard frame according to the invention is a wrist joint orthosis. In another alternative embodiment, the joint orthosis comprising the hard frame according to the invention is an elbow joint orthosis. In another alternative embodiment, the joint orthosis comprising the hard frame according to the invention is an ankle joint orthosis or a foot orthosis (Fu β hebeorthese).

The invention will be elucidated in detail below with reference to an embodiment illustrated in the drawing. The drawings herein show preferred embodiments which illustrate, in addition to inventive features, further optional features in accordance with the present invention. The latter should not be construed as limiting the invention but merely as illustrating practical and preferred embodiment variants.

DETAILED DESCRIPTION OF EMBODIMENT (S) OF INVENTION

FIG. 1 shows a schematic view of aThere is shown a perspective view of one embodiment of a hard frame 100 as or for a knee brace in accordance with the present invention. The hard frame 100 is basically comprised of two opposing, articulating joint splints 110, 120. The outer joint splint 120 has substantially the same principle structure as the inner joint splint 110. The joint splints 110, 120 each have a central joint 111, 121, which is designed in particular as a polyaxial joint in order to anatomically simulate the joint movement of the knee joint to be supported. In the joint splint 110, the proximal-side joint arm 113 and the distal-side joint arm 112 start at the center joint 111. They are coupled by a joint 111 and can be pivoted relative to one another in the main pivot plane of the joint splint 110 there in order to follow the joint movement. Similarly, in the joint splint 120, the proximal sideThe articulated arm 123 and the distal articulated arm 122 start from a central joint 121, which are coupled by the joint 121 and can be pivoted relative to one another in the main pivot plane of the joint splint 120 there in order to follow the joint movement. The articular splints 110, 120 are connected to each other at the ends of the proximal articular arms 113, 123, respectively, by the proximal bridge 310 and at the ends of the distal articular arms 112, 122 by the distal bridge 210, in order to finally form the hard frame 100.

In the exemplary embodiment shown, a fixable, tilting joint 115 is additionally provided on each of the distal joint arms 112 and 122. The fixable tilt joint 115 enables the respective articulated arm 112, 122 to tilt outwardly from the main pivot plane of its articular splint 110, 120.

In accordance with the present invention, in the illustrated embodiment, the distal bridge 210 is pivotally supported on the articulating arm ends 114 and 124, respectively, of the distal articulating arm 112. According to the invention, the articulated arm end 114 is connected to the overlapped end part 212 of the bridge 210 by means of a fixed-position rivet (which serves as an axle pin 224) and is rotatably supported there in a bushing formed in the end part 212, and thus forms an axial joint 220, by means of which the bridge 210 is pivotably supported on the articulated arm end 114. Likewise, the articulated arm end 124 is connected to the lapped end section 212 of the bridge 210 by means of a fixed-position rivet (which serves as an axle pin 224), and thus likewise forms an axial joint 220 there, by means of which the bridge 210 is also pivotably supported on the articulated arm end 124.

In order to achieve an advantageous pivoting restriction at the joint 220, a further rivet 226 is connected in a positionally fixed manner to the respective joint arm end 114, 124 and slides as a sliding pin 226 in a corresponding elongated hole 216, which is formed in the respective overlapping end section 212 of the supported bridge 210. The elongated hole 216 acts as a stop for the slide pin 226 and thus limits the degree of pivoting of the bridge 210.

Furthermore, in the illustrated embodiment, the respective articulated arm ends 114 and 124 are configured as spring plates, which are mechanically coupled in a positionally fixed manner to the articulated arms 112 and 122, respectively, by means of rivets 116. Correspondingly, a pivot pin 224 and a slide pin 226 are also formed in the spring plate.

FIG. 2There is shown a perspective view of one embodiment of a knee brace according to fig. 1 placed over a schematically-shown knee. Reference numerals apply accordingly. The proximal bridge 310 together with the tension band 350 form a proximal limb support 300 which in the worn state surrounds the thigh. The distal bridge 210 together with the tension band 250 form a distal limb support 200 that surrounds the lower leg in the worn state. Thus, in this illustrated embodiment, the hard frame 100 is mechanically and securely connected to the limb by the straps 250, 350 and the bridge 210, 310 in order to achieve sufficient force introduction for the support function of the orthosis.

FIG. 3A detailed view of the embodiment according to fig. 1 and 2 is shown. In accordance with the present invention, the distal bridge arch 210 may correspondingly rotate about the pivot axis 222 in the joint 220 when in use. The respective pivot axis 222 of the joint 220 is schematically shown. The pivot axis 222 extends substantially perpendicular to the plane of the flat articulated arm ends 114, 124. In particular, the upper edge 214 of the rigid bridge arch 210 may be temporarily angled distally (dashed line shape) in use to specifically compensate for shear and pressure loads on the lower leg of a worn knee orthosis that occur during motion, primarily when the knee is flexed.

FIG. 4An embodiment is shown as an ankle brace. The reference numerals in fig. 1 to 3 apply to the corresponding structures. In the hard frame according to fig. 4, the bridge arch 310 on the proximal side is pivotably supported on the joint 220, which is formed by the rivet 224 on the joint arm end 118 on the proximal side.

FIG. 5An embodiment is shown as a wrist brace. The reference numerals in fig. 1 to 4 apply to the corresponding structures. In the hard frame according to fig. 5, the proximal bridge arch 310 is pivotably supported via the joint 220 at the proximal articulated arm end 118 and the distal bridge arch 210 is pivotably supported via the joint 220 at the distal articulated arm end 118On the end side articulated arm end 114.