DE9211750U1 - Ankle brace - Google Patents

Description

Dr. Christoph Schönle, Tönsheide 6, 2356 Aukrug

New ankle joint bandage to prevent the foot from bending outwards. (Prophylactic ankle joints kspr the se)

1. Anatomical basics of the upper ankle joint

The upper ankle joint of humans has the shape of a two-pronged fork: the tips of the fork are formed by the inner and outer malleolus (Fig. 1 and 2). The almost cylindrical talus lies in this fork like a roller (Fig. 2). This enables the foot to move up and down.

This joint role is guided by strong ligaments on both the outer and inner ankle (Fig. 1 and 2).

The ankle joint is narrower at the back than at the front, which means that there is more joint play when the foot is extended (toe lowered) than when the foot is bent (= toe raised). The ankle joint is therefore less stable when the foot is extended and is only held in place by the ligaments and a few muscle tendons.

Three bands (Fig. 2) are attached in a fan shape to the tip of the outer ankle. They run diagonally forwards, straight downwards, and almost diagonally backwards. This ensures that when the foot is extended or flexed, at least one band prevents the foot from twisting outwards (supination).

2. Risk of injury to the upper ankle joint

Both in leisure activities (walking, dancing, gardening) and in sports (hobby or competitive sports), sprains of the upper ankle joint are one of the most common causes of accidents. This is shown by the medical literature and clinical practice. Usually one or two of the lateral ankle ligaments are torn or at least severely strained. Occasionally, all three lateral ankle ligaments are torn.

Treatment options include surgical ligament repair or immobilization in a cast or plastic splint. If the ligaments heal well - which is not always the case - then the ankle is as stable as before.

3. Problem

However, sometimes the ligaments scar so badly after a tear that the ankle joint becomes unstable. These unstable ankle joints must now be protected from further outward bending (supination) during sport and physical work, as this can cause new tears.

However, the remaining functions of the foot, in particular extension and flexion (plantar flexion and dorsal extension), but also inward bending (pronation) should not be hindered, as otherwise, especially in sports, a reduction in jumping power, starting speed or speed of movement to the side (e.g. tennis) would occur.

4. Current status of ankle brace technology

The existing stable bandages (ortheses) protect the ankle joint from outward bending (supination) in different ways:

4.1. Fixed ankle splints (e.g. MHH ankle splint):

They stabilize the ankle joint completely in the upper ankle joint, thus also hindering the flexion and extension of the foot. They are only useful in the treatment of acute, recent injuries. They cannot be used as preventative measures because the ankle joint is too severely hindered in its normal rolling motion and a limping gait occurs.

4.2. Non-specific bandages, so-called "elastic ankle bandages": There is no stabilizing effect here.

4.3. Lace-up bandages (e.g.: Micors V-Bandage):

There is a certain protective effect against outward bending, which is stated in the literature as moderately to highly effective. However, the extension and flexion of the foot is somewhat restricted by the bandage. The lace-up bandages must be re-tightened occasionally.

4.4. Shell-shaped ankle supports (e.g.: ankle brace, aircast): These ankle supports only work in conjunction with the shoe, which should have a high shaft if possible. The friction between the shoe shaft and the inner or outer shell prevents twisting. Without a shoe, the ankle supports are ineffective. The foot’s rise and fall are only slightly affected. The side shells bulge the inside and outside edges of the shoe and can lead to premature wear of the footwear or the shell tips.

According to the literature, these bandages are also moderately effective. Unfortunately, they also prevent the foot from bending inwards (pronation), which is naturally necessary for quick starts.

4.5. Ankle cuff with strap ("Safety" , Rehband) Here, a padded ankle cuff is fixed over the ankle, from where a U-shaped strap leads from the inside to the outside. The protective effect against the foot bending outwards is stated to be moderate to good, but the protection is no longer effective when the foot is stretched out because the direction of the strap no longer corresponds to the normal anatomical course of the strap.

When you twist your ankle and pull on the straps, the ankle cuff can also slide down a little and thus

reduce stability.

4.6. Tape dressing:

The tape bandage provides good stabilization of the upper ankle joint when applied correctly. However, an experienced physiotherapist or doctor is always required to apply a tape bandage. In addition, the stability of a tape bandage decreases significantly after just half an hour due to the tape fabric stretching and slipping on the skin. The tape bandage can also cause skin damage

5. Your own prophylactic ankle orthosis

The invention is based on the object of creating an ankle support that prevents the foot from bending outwards (supination) without restricting the raising and lowering of the foot and the inward rotation (pronation).

In contrast to conventional ankle supports, stability is ensured, especially when the foot is stretched, because the diagonal arrangement of the tension straps protects the ankle from buckling outwards in all positions.

This is ensured by the tension straps running diagonally from the heel to the front and the other way from the middle outer edge of the foot to the back and the ankle cuff, with the crossing point being above the tip of the outer ankle. The shoe forms a firm connection with an ankle cuff via the tension straps.

The tight connection of the ankle cuff can also be made to a specially made inner shoe or insole. The principle remains the same. This arrangement of the tension straps imitates the direction of tension of the three important anatomical ankle ligaments, especially the front and middle ones.

When tensioned - i.e. when the ankle begins to bend outwards - the tension straps press the ankle cuff together and thus act as a restraint, so that the ankle cuff does not slip downwards, as can happen with other cuffs. In addition, another stabilising ankle ligament (anterior syndesmosis) is supported in its stability effect.

6. Description

An ankle cuff (1) made of flexible plastic is padded with soft pads (7 and 8). The padding is designed so that the contour of the outer and inner ankle is well covered. The Achilles tendon is not covered by the cuff. The cuff itself can be opened and put on via an opening.

Two fixed straps (4 and 5) can be incorporated into the shoe (or an inner shoe) running from the sole to the outer shaft of the shoe, each with a buckle attached. From these buckles, a fixed strap runs diagonally forwards and diagonally backwards in the same direction as the shoelace. It is connected to the buckle either by a flat hook or by sewing. The straps (2 and 3) cross over the tip of the outer ankle and then run in a spiral around the cuff (1). The straps (2) and (3) are fixed to the upper edge of the cuff with a Velcro fastener.

7. How it works

The two straps (2 and 3) prevent the foot from bending outwards, even when the foot is raised or lowered to an extreme degree. All other movements are not hindered. If the straps (2 and 3) are tightened because the foot is in danger of twisting, a constricting effect occurs on the ankle cuff (1), which presses the cuff firmly against the lower leg and ankle and thus reduces slipping downwards.

8. Legends for the figures

Fig. 1

Foot skeleton from the outside, showing some ligaments. The three lateral malleolus ligaments that are important for stability and run from the tip of the lateral malleolus forwards, downwards and backwards, the anterior talofibular ligament (11), the fibulocalcaneal ligament (12) and the posterior talofibular ligament (13) are shown in white. The heel bone is marked with (22).

Fig. 2

Foot skeleton seen from behind. Ankle ligaments run along the inner (23) and outer (24) ankles. Two of the three ligaments, the ligamentum fibulocalcaneare (12) and ligamentum talofibulare posteriorius (13), can be seen on the outer ankle. Another stabilizing ligament (14) lies between the tibia and fibula (the so-called "syndesmosis"). The heel bone (22) and talus (21) are shown from behind.

Fig. 3

Ankle cuff with laced straps that cross over the outer ankle tip and are firmly connected to the shoe via buckles (6). The cuff is shown transparent here so that the inner padding (7 and S) can also be seen.

Fig. 4

Foot skeleton from behind, with laced ankle cuff (1). The talus is marked with (21), the heel bone with (22), the middle and rear ankle ligaments with (12) and (13). The strap straps (2 and 3) are connected to the shoe via a buckle. Reinforcing straps (4) can run inside the shoe, or an inner shoe (or insole) can be attached. The shoe is shown as a cross-section (oblique lines).

Claims (2)

Dr. Christoph Schortle Tönsheide 6 2356 Aukrug Protection claims 1. Padded ankle cuff (1) made of flexible material with a movable connection to parts of a shoe, characterized in that two (or more) band structures (2 and 3) running spirally or crossed on the cuff meet above the outer ankle tip to form a common pivot point for the connection to the shoe part. Due to their spiral (or crossed) course, the bands press the ankle cuff firmly against the lower leg when there is increased tension. 2. Ankle cuff according to claim 1, characterized in that movable - but tensile-resistant structures (e.g.: straps) - run from the cuff at the level of the outer ankle tip both diagonally forwards and diagonally backwards towards the outer edge of the foot and there form a tensile-resistant connection with the shoe, with an inner shoe or an insole. This imitates two of the important ligaments of the outer ankle and prevents the foot from bending outwards.