DE102020118480A1 - Orthopedic shoe insole for the therapy of hallux valgus - Google Patents

Abstract

Orthopedic shoe insert (10) with a rear foot section (20), a metatarsal section (30) and a forefoot section (40), characterized by a wedge (50) which is arranged in the transition area from the metatarsal to the forefoot section (30, 40) and extends from the medial edge (60) of the orthopedic shoe insert (10) tapering towards the lateral edge (70), in the direction of the anterior edge (80) and in the direction of the posterior edge (90) of the orthopedic shoe insert (10).

Description

The invention relates to an orthopedic shoe insole for treating the deformity of the foot called hallux valgus.

Hallux valgus is the oblique position of the big toe due to impaired biomechanics of the foot. Due to the heavy load on the forefoot, the first beam of the metatarsus tends towards the center of the body (medial). As a result of this rotation of the metatarsophalangeal joint of the big toe, the course of the flexor hallucis muscle slips out of its anchoring in the area of the sesamoid bones and pulls the big toe outwards (laterally). This deformity ensures that the bursa sitting on the first ray is injured and irritated. The result is an irritated and painful first ray.

The course of the disease at the joint of the big toe is steadily deteriorating and can irritate the entire musculature of the foot. In addition, the hallux valgus symptom can result in secondary diseases such as flat / flat / splayfoot, claw toe / hammer toe and heel spur.

In order to counteract this misalignment and to alleviate the pain it causes, in addition to surgical procedures, shoe insoles have also been developed for patients with hallux valgus. For example, from the DE 10 2007 008 703 B4 a hallux valgus insert known, which forms a bearing shell for the big toe affected by hallux valgus and forces it into a predetermined posture.

The disadvantage of this configuration is, on the one hand, the effort required to adapt and manufacture such a shoe insert. On the other hand, although such a bearing shell alleviates the pain caused by the hallux valgus, it is at the same time not very comfortable to wear.

The object of the present invention is therefore to create a shoe insert that is easy to manufacture and comfortable to wear, which counteracts the misalignment of the foot known as hallux valgus and / or alleviates its consequences.

This object is achieved according to the invention by the shoe insert with the features of claim 1. The subclaims reproduce advantageous embodiments of the invention.

The basic idea of the invention is not to force the big toe affected by hallux valgus into a predetermined posture, but rather, by means of the orthopedic shoe insole according to the invention with a correspondingly designed wedge with regard to hallux valgus, a pressure redistribution in the entire foot by raising the first beam of the metatarsus to reach. The pressure redistribution starts as soon as it occurs. Due to the configuration according to the invention, the longitudinal arch is prevented from tilting in the medial direction when it is subjected to loading. The insert prevents the increased stress on the 1st beam. The raising of the entire 1st beam according to the invention then acts in the same direction. The big toe is relieved and automatically assumes a relaxed position without being forced.

The natural gait has the property that in the middle as well as in the terminal stance phase the load is directed towards the first beam and is rolled over the big toe. The first jet in particular has a strong pressure load. According to the invention, the pressure load is intercepted and redistributed by the hallux valgus wedge, as a result of which the first beam is relieved and an almost natural posture can be assumed despite the hallux valgus symptom.

Due to the lower pressure when wearing the insole in the decisive, described areas of the hallux valgus, a worsening of the deformity can be prevented and secondary diseases avoided.

The hallux valgus insert proposed here is an orthopedic insert that works against hallux valgus and the subsequent diseases. The specially hand-made insert consists of supporting, bedding and corrective elements, which are arranged between a base cover and a top layer. The base of the insert is preferably an EVA material as a carrier and a thermoplastic stiffening material that is molded to the anatomy of the foot. The longitudinal arch support in the rear foot area of the insert serves as a supporting element, which maintains its shape thanks to the thermoplastic stiffening material and provides permanent support for the foot. The inlay preferably has a stepped pad in the forefoot area and padding in the entire foot, especially 15 Shore - this padding is considered to be bedding elements.

An essential element of the invention is the wedge. This corrective element is preferably designed as a (semi) moon-shaped wedge. The wedge has its maximum height on the inside of the foot, in the middle of the wedge and slopes down on all sides to its tip. The wedge is particularly preferably made of a plastic that is at least 45 Shore hard.

The height of the wedge is preferably individually adapted to the hallux valgus. A distinction is made between the extent to which the hallux valgus development process has progressed (easy, medium, difficult). The progression is made with a Angular system established. For this purpose, a protractor is placed on the metatarsophalangeal joint of the big toe and the hallux valgus or intermetatarsal angle is determined. This hallux valgus or intermetatarsal angle is the bending of the toe bone from the axis of the first metatarsal bone.

A slight hallux valgus is defined with an intermetatarsal angle of 11 to 15 degrees and is treated with a 2 mm high wedge. An angle of 16 to 20 degrees (medium hallux valgus) is provided with a 4 mm high wedge and in the case of severe hallux valgus with an intermetatarsal angle of 20 degrees or more, a 6 mm high wedge is worked into the insert.

Positioning on the insert is particularly important with the wedge. The highest point of the wedge is preferably on the furthest protruding point of the hallux valgus towards the middle of the body, namely in the area of the gap of the metatarsophalangeal joint of the big toe. This coordination of the material-technical component and the body's own position is of great importance for an optimal therapeutic effect of the insert according to the invention.

According to the invention, an orthopedic shoe insert is proposed with a rear foot section, a metatarsal section and a forefoot section, with a wedge arranged in the transition area of the metatarsal to the forefoot section, which tapers from the medial edge of the orthopedic shoe insert in the direction of the lateral edge, in the direction of the anterior edge and extends toward the posterior edge of the orthopedic shoe insert.

Starting from the medial edge of the orthopedic shoe insert, the wedge of the orthopedic shoe insert is preferably designed to taper evenly in all directions. In particular, this creates an essentially crescent-shaped shape of the wedge.

Furthermore, it is preferably provided that the wedge extends from the medial edge of the orthopedic shoe insert in the direction of the lateral edge of the orthopedic shoe insert up to the middle thereof. In particular, the wedge is particularly preferably designed in such a way that the wedge extends exclusively in the region of the orthopedic shoe insert set up to receive the first beam of a foot supported by the orthopedic shoe insert.

Specifically, it is provided that the wedge has its highest point on the medial edge of the orthopedic shoe insert in the area of the orthopedic shoe insert set up to receive the metatarsophalangeal joints of a foot supported by the orthopedic shoe insert.

The section of the wedge facing the medial edge of the orthopedic shoe insert is preferably designed with a sickle-shaped edge.

The wedge is specially designed so that it has a thickness d of 1 mm d 3 mm and particularly preferably a thickness d of d at its highest point when an orthopedic shoe insert is set up to accommodate a foot with an intermetatarsal angle of 10 ° to 15 ° = 2 mm. If the orthopedic shoe insert is set up to accommodate a foot with an intermetatarsal angle of> 15 ° to 20 °, the wedge preferably has a thickness d of 3 mm <d 5 mm and particularly preferably a thickness d of d = 4 at its highest point mm on. Finally, it is provided that the wedge has a thickness d of 5 mm <d 7 mm and particularly preferably a thickness d of d = 6 mm at its highest point in the case of an orthopedic shoe insert designed to accommodate a foot with an intermetatarsal angle greater than 20 ° .

Furthermore, a method for producing an orthopedic shoe insert for a foot of a patient suffering from hallux valgus is provided, with the following steps: determining the hallux valgus or intermetatarsal angle of that foot for which the shoe insert is to be produced, and producing the orthopedic shoe insert with a Wedge ( 50 ), the height of which is determined by the positive correlation of the amount of the previously determined hallux valgus or intermetatarsal angle.

For this purpose, the wedge has a thickness of 1 mm d 3 mm and particularly preferably a thickness d of d = 2 mm at an intermetatarsal angle of 10 ° to 15 ° at its highest point, with an intermetatarsal angle of greater than 15 ° to 20 ° at its highest point a thickness d of 3 mm <d ≤ 5 mm and particularly preferably a thickness d of d = 4 mm, and at an intermetatarsal angle of greater than 20 ° at its highest point a thickness d of 5 mm <d ≤ 7 mm and particularly preferably a thickness d of d = 6 mm.

In a study with 100 patients with hallus valgus, their feet were measured and the pain sensation in the metatarsophalangeal joint as well as in the entire foot was recorded on a scale from 1 (no pain) to 10 (severe pain). In addition, a static impression was made and the severity of the hallux valgus determined.

After three or six months, in which the patients with an inventive equipped hallux valgus inlay, a static impression was made again, asked about the pain sensation and the severity of the hallux valgus was determined once more.

The study showed that the pain at the metatarsophalangeal joint of the big toe decreased from an average of 8.9 to 2.1 in the 100 people after wearing the hallux valgus inlay equipped according to the invention. Furthermore, the pain in the entire foot decreased from 7.4 to 1.8 at the beginning.

The evaluation of the static footprint showed that the hallux valgus deformities had changed from an average of 19 ° to 14 °. It was thus possible to demonstrate that the insert according to the invention has a positive effect on the entire foot, but above all on the hallux valgus, and that the tested people can walk more painlessly with the insert according to the invention.

• 1 eine schematische Draufsicht auf eine besonders bevorzugt ausgestaltete orthopädische Schuheinlage nach der Erfindung;
• 2 eine Seitenansicht einer orthopädischen Schuheinlage nach dem Stand der Technik, mit einem darauf ruhenden, eine Hallux-valgus-Deformität aufweisenden Fußskelett;
• 3 eine Seitenansicht einer besonders bevorzugt ausgestalteten orthopädischen Schuheinlage nach der Erfindung, mit einem darauf ruhenden, eine Hallux-valgus-Deformität aufweisenden Fußskelett;
• 4 eine Draufsicht auf die orthopädische Schuheinlage aus 2; und
• 5 eine Draufsicht auf die orthopädische Schuheinlage aus 3.

The invention is explained in more detail below with the aid of a particularly preferred embodiment shown in the accompanying drawings. Show it:

• 1 a schematic plan view of a particularly preferably configured orthopedic shoe insert according to the invention;
• 2 a side view of an orthopedic shoe insert according to the prior art, with a foot skeleton resting thereon and having a hallux valgus deformity;
• 3 a side view of a particularly preferably configured orthopedic shoe insert according to the invention, with a foot skeleton resting on it and exhibiting a hallux valgus deformity;
• 4th a top view of the orthopedic shoe insert 2 ; and
• 5 a top view of the orthopedic shoe insert 3 .

1 shows a schematic plan view of a particularly preferably configured orthopedic shoe insert according to the invention. The orthopedic insole 10 is built up in a manner known per se in multiple layers with a base cover, a core and a cover layer and has a rear foot section from posterior to anterior 20th , a metatarsal section 30th and a forefoot portion 40 on.

In the transition area from the metatarsal to the forefoot section 30th , 40 is a crescent-shaped wedge 50 arranged with a crescent-shaped edge extending from the medial edge 60 the orthopedic insole 10 tapering towards the lateral margin 70 , towards the anterior margin 80 and towards the posterior margin 90 the orthopedic insole 10 extends to about the middle.

The effect of the wedge becomes clear when the foot position on a shoe insert according to the prior art is compared with the foot position on a shoe insert designed according to the invention. As part of a comparison shows 2 a side view of an orthopedic shoe insert according to the prior art with a foot skeleton resting thereon and having a hallux valgus deformity; 3 a side view of a particularly preferably configured orthopedic shoe insert according to the invention with a foot skeleton resting on it and exhibiting a hallux valgus deformity.

2 shows that the foot skeleton exhibiting a hallux valgus deformity, when using a conventional foot insert according to the prior art, assumes a position on the shoe insert in which the tarsus T and metatarsus M form an angle to one another that leads to an introduction of force in the area of the metatarsal joint Metatarsus M and Antetarsus A leads. The stress in the metatarsophalangeal joint of the big toe causes great pain and promotes further secondary diseases.

In contrast to this, by providing one in the transition area from the metatarsal to the forefoot section 30th , 40 or in the area of the metatarsophalangeal joint between metatarsus M and antetarsus A between the base layer and the top layer of the insert 10 arranged wedge 50 causes a load redistribution, which leads to a relief of the first ray and thus an elongated conformation of metatarsus M and antetarsus A. The introduction of force directly into the phalanges protects the metatarsophalangeal joint of the big toe and prevents pain.

4th and 5 show the differences between the orthopedic shoe insert known from the prior art 2 and the orthopedic shoe insert designed according to a preferred embodiment of the invention 3 again in a plan view.

Out 4th it becomes clear that the hallux valgus deformation is retained in full when a conventional shoe insole is used. In contrast, leads - how 5 shows the use of a shoe insert according to the invention for improved posture with reduced pain.

QUOTES INCLUDED IN THE DESCRIPTION

This list of the documents listed by the applicant was generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Patent literature cited

• DE 102007008703 B4 [0004]

Claims (12)

Orthopedic shoe insert (10) with a rear foot section (20), a metatarsal section (30) and a forefoot section (40), characterized by a wedge (50) which is arranged in the transition area from the metatarsal to the forefoot section (30, 40) and extends from the medial edge (60) of the orthopedic shoe insert (10) tapering towards the lateral edge (70), in the direction of the anterior edge (80) and in the direction of the posterior edge (90) of the orthopedic shoe insert (10). Orthopedic shoe insert (10) according to Claim 1 , characterized in that the wedge (50) from the medial edge (60) of the orthopedic shoe insert (10) is designed to taper evenly in all directions. Orthopedic shoe insert (10) according to one of the preceding claims, characterized in that the wedge extends from the medial edge (60) of the orthopedic shoe insert (10) in the direction of the lateral edge (70) of the orthopedic shoe insert (10) up to the middle thereof . Orthopedic shoe insert (10) according to one of the preceding claims, characterized in that the wedge (50) extends exclusively in the area of the orthopedic shoe insert (10) set up to receive the first beam of a foot supported by the orthopedic shoe insert (10). Orthopedic shoe insert (10) according to one of the preceding claims, characterized in that the wedge (50) has its highest point on the medial edge (60) of the orthopedic shoe insert (10) in the one of the orthopedic shoe insert (10) mounted for receiving the metatarsophalangeal joints Has the established area of the orthopedic shoe insert (10). Orthopedic shoe insert (10) according to one of the preceding claims, characterized in that the section of the wedge (50) facing the medial edge (60) of the orthopedic shoe insert (10) has a sickle-shaped edge. Orthopedic shoe insert (10) according to one of the preceding claims, characterized in that the wedge (50) has a thickness d of 1 at its highest point in the case of an orthopedic shoe insert (10) set up to accommodate a foot with an intermetatarsal angle of 10 ° to 15 ° mm ≤ d ≤ 3 mm. Orthopedic shoe insert (10) according to one of the Claims 1 to 6th , characterized in that the wedge (50) has a thickness d of 3 mm <d ≤ 5 mm at its highest point for an orthopedic shoe insert (10) set up to accommodate a foot with an intermetatarsal angle of> 15 ° to 20 °. Orthopedic shoe insert (10) according to one of the Claims 1 to 6th characterized in that the wedge (50) has a thickness d of 5 mm <d ≤ 7 mm at its highest point in the case of an orthopedic shoe insert (10) set up to accommodate a foot with an intermetatarsal angle greater than 20 °. Orthopedic shoe insert (10) according to one of the preceding claims, characterized in that the wedge (50) is formed from a plastic with a Shore hardness of ≥45. Method for producing an orthopedic shoe insert for a foot of a patient suffering from hallux valgus according to one of the preceding claims, characterized by the following steps: - determining the hallux valgus or intermetatarsal angle of that foot for which the shoe insert is to be produced, and - making the orthopedic one Shoe insert with a wedge (50), the height of which is determined by the positive correlation of the amount of the previously determined hallux valgus or intermetatarsal angle. Procedure according to Claim 11 , characterized in that the wedge (50) - with an intermetatarsal angle of 10 ° to 15 ° at its highest point a thickness of 1 mm ≤ d ≤ 3 mm, - with an intermetatarsal angle of greater than 15 ° to 20 ° at its highest point a thickness d of 3 mm <d 5 mm, and - with an intermetatarsal angle greater than 20 ° at its highest point, a thickness d of 5 mm <d 7 mm.

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