Ottobock 17H100 Gebrauchsanweisung Seite 37

The Reciprocating Hip Joint System (RGO) was developed
specifically for patients using the hip joint system 17H100
Please fax this order form to your Ottobock service facility.
Company:
Tel:
General instructions:
The RGO Hip Joint System is suitable for patients up to 65 kg. The system is available in three
different versions. 17H100=2 for ages 4-8, up to a body weight of 34 kg. 17H100=1/ 0 for ages
9 and up, up to a body weight of 65 kg. Pelvic tubes are available in 1 cm increments for clear
pelvic widths of 200 mm to 380 mm.
The pelvic width must be measured between the two trochanters in both the sitting and prone
position.
When selecting the pelvic tube, also take into account the wall thickness of the pelvic module
to be fabricated including the padding!
Please checkmark the desired combination!
17H100=2
Combination
up to 34 kg
17Y140=210
17Y140=220
17Y140=230
17Y140=240
17Y140=250
17Y140=260
17Y130=270
17Y130=280
17Y130=290
17Y130=300
17Y130=310
17Y130=320
17Y130=330
17Y130=340
17Y130=350
17Y130=360
17Y130=370
17Y130=380
Stamp and signature
Order Form
Fax:
17H100=1 17H100=0
up to 65 kg up to 65 kg
Technician:
Date:
Pelvic width
in mm
Pelvic depth in
mm
Patient name:
Body weight:
Body height:
Age:
Diagnosis:
Hip joint
pivot point
Hip joint
pivot point
kg
cm