ES2438015T3 - Plantar orthotic of particular relief - Google Patents

Abstract

Plantar orthosis comprising, in a substantially flat area (17), a retrocapital bar area (13), areas called subcapitals in relief, namely a subcapital area (11) for the first metatarsal and a subcapital area (12) for the fourth and fifth metatarsals, the aforementioned subcapital areas being separated from each other and arranged in front of the retrocapital bar area (13), the retrocapital bar area (13) being located just behind the metatarsal heads and presenting a median protuberance just behind the second and third metatarsal heads and longitudinally a maximum arrow height just behind the metatarsal heads that is regularly transformed into an inclined plane.

Description

Plantar orthotic of particular relief

The present invention relates to a new plantar orthosis or orthopedic sole.

This sole can be made in removable form or plantar orthosis or insoles, or not be removable and constitute a glued insole, or even the upper part of the footwear insole.

In orthopedic practice, it is common to create plantar orthoses according to the needs, at least as determined by the orthopedic, for the person destined to wear the orthosis. This results in a practically handmade manufacture of a unit, which implies a high cost.

In the state of the art, orthotics are already known that allow to satisfy a certain number of orders of orthopedic soles for a certain number of pathologies found.

In this regard, it may refer to documents EP-A-1 358 812, DE-U-1887 407, GB 761 148 and US-A-4 841 648. But these orthotics do not allow treating a large number of pathologies.

The present invention aims to remedy these inconveniences.

Thanks to the invention, it has been discovered that in reality, it is possible to perform a unique orthotic sole or orthotic profile that allows treating the vast majority of individual cases, and this regardless of their individual anatomical or pathological particularities. Thus, thanks to the invention, it is possible, surprisingly, to manufacture industrially identical soles (in their right and left forms and obviously taking into account the different foot sizes) that allow to satisfy the requirements of orthopedic soles in more than one 80%, even more than 90% and up to 95%, of the pathologies found. Only the small remaining amount of pathologies will then require different soles that must be individually adapted to these infrequent pathologies.

The subject of the invention is a plantar orthosis comprising, from front to back, in a substantially flat area (17), areas called subcapitals, namely a zone (11) for the first metatarsal and a zone (12) for the fourth and Fifth metatarsals, behind these zones, separated from each other, a retrocapital bar or retrocapital support zone (13), the aforementioned areas having the contours represented in Figure 1, and the reliefs substantially such as they appear in Figure 2 .

Preferably, the plantar orthosis may optionally further comprise, at the rear, an internal semi-dome zone (14) and an external semi-dome zone (15), the plantar orthosis ending at a heel ring (16), having those mentioned zones the contours represented in figure 1, and the reliefs of these zones substantially such as they appear in the cuts of figure 2.

In a plantar orthosis according to the invention, the combination of all these zones leads to the universal character of the plantar orthosis, the aforementioned zones having respectively the following characteristics, from a horizontal geometric reference plane:

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the subcapital zones (11) and (12) have a height between 0.5 mm and 10 mm and are flat or slightly inclined towards the front;

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The retrocapital bar area (13) has a medium protrusion behind the different metatarsal heads (with a flat or profiled shape in cross section and inclined towards the rear in longitudinal section), the maximum height of said zone being comprised between 2 mm to 10 mm, preferably 4 mm to 5 mm;

- or the retrocapital bar zone is replaced by a retrocapital support zone located behind the second, third and fourth metatarsal heads, the maximum height of said zone being comprised between 2 mm to 10 mm;

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 the inner half-dome zone (14) is generally convex in a longitudinal plane and adapts to the internal plantar vault of the foot, and in a transverse plane it is convex or concave or S-shaped; this area is generally concave in the sense of its length and its cross section is regularly concave, convex or S-shaped, the greatest height being located between 2 mm and 25 mm, the aforementioned area extending longitudinally from approximately 1/3 posterior of the calcaneus towards the neck of the first metatarsal and transversely to approximately 2/3 of the width of the foot;

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the outer semicupula area is convex in the longitudinal plane extending approximately from the posterior third of the calcaneus to the back of the head of the fifth metatarsal, supporting the external plantar vault, and extending transversely to approximately half the width of the foot, being the concave cross section, inclined flat or convex;

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 the heel ring area (16) has a concave semiannular shape, the longitudinal sections of the two branches being of constant height or slightly inclined towards the front, the sections being cut slightly convex, inclined flat or concave.

Other advantages and features of the invention will become apparent in reading the following description, made by way of non-limiting example and referring to the accompanying drawings, in which:

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Figure 1 represents a top view of a plantar orthosis or according to the invention shows all areas of the orthosis;

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Figure 2 represents a top view of this orthosis in a specific embodiment, in which the orthosis is formed by an assembly of a plurality of pieces of which some are superimposed to enhance the areas of the orthosis according to Figure 1 , this figure 2 also representing a plurality of sections according to lines 1-1 to 7-7, said sections being vertical with respect to the sole placed in a horizontal plane;

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Figure 3 represents longitudinal sections of the subcapital parts;

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Figure 4 represents a top view of the heel ring and of the longitudinal and transverse sections, at different levels;

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Figure 5 represents a longitudinal sectional view and three cross sections according to three variants of the inner half-dome;

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Figure 6 represents longitudinal and cross sections of the middle retrocapital support zone;

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Figure 7 represents longitudinal and transverse sections according to different variants of the piece that allows the retrocapital bar to be formed;

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Figure 8 represents longitudinal sections and cross-sectional variants of the outer half-dome.

The plantar orthosis shown in Figure 1 has, at its lower level, a base plate 10 cut out, for example, on a thick sheet of a flat material and forming a flat template. In this base plate, a certain number of zones are arranged, in relief, namely a subcapital zone 11 of the first metatarsal, a zone 12 for the subcapitals of the fourth and fifth metatarsals, a retrocapital bar or retrocapital support 13, an internal semi-dome 14, an external half-dome 15 and a heel ring 16.

The arrangement represented in figure 1 defines, according to the invention, the contour lines of the different zones, it being understood that these zones may vary, in their width or in their length. Preferably, the length and / or width of the zones may vary within the limits of! 10%, and preferably! 7%, with respect to the dimensions as they appear in the figure, the dimensions being proportional to the sizes of the orthoses.

The presence of zones 11 to 16 shows a supplementary zone that remains flat, namely an anterior zone 17 for the phalanges, and eventually an internal flat zone 18 internal to the heel ring and equally delimited by the semi-domes, but which could Be also slightly concave.

The different zones 11 to 16 are joined to the flat zones 17 and 18, as well as to each other for the adjacent zones, by smooth splice lines, avoiding any abrupt transition that facilitates a sensitive foot flange.

Different zones can be performed in different ways. Thus, a first embodiment allows the orthosis according to Figure 1 to be manufactured from a flat sheet, conveniently cut and deformed and stiffened so that it presents the different zones 11 to 18 forming a single piece.

Another embodiment consists of performing the orthotic by molding.

Another embodiment may consist of providing zones 11 to 16 cut along the lines shown in Figure 1, these areas being juxtaposed and then fixed, for example by gluing or sewing, to the sheet or template that will allow the flat areas to appear (17 ) and (18).

Another embodiment, of which an example is represented in Figure 2, consists in making parts that will be partially overlapped and assembled, preferably by gluing.

Thus, in Figure 2, it is seen that the orthosis comprises a first piece A, whose anterior extremities respectively form zones 11 and 12. A piece B forms, in its central part, the retrocapital bar. This can be completed, on its surface, by a piece C that thickens in its center.

Another piece D forms the outer half-dome 15, and extends towards the front and towards the inner side. This protrudes on the outer side of the orthosis (10).

A piece E forms the heel ring 16 and has a U-shape that extends it under the outer and inner half-domes.

A piece F forms the inner half-dome that partially overlaps the inner metatarsal part of the part A, the central part of the part D, and one of the branches of the part E. This half-dome 14 protrudes from the contour of the sole 10 on the inner side, as usual.

The contours of these pieces are as follows.

Part A:

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previous limits (21, 22): these correspond in a plantar footprint to the subdigital vacuum a few millimeters ahead of the previous limit of the instep footprint, so that it anticipates the advance of the plantar captain and the metatarsals during the digitigrado phase of the passage . From the strictly anatomical point of view, this limit is located above the proximal diaphyses of the fingers. From the geometric point of view, the previous limit is placed on the cut-off line of the soles ¾ (1/16; 3/10). Each element will occupy 1/6 of this width;

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posterior limit: if the subcapital elements are executed alone, the posterior limit 23 is located at the level of the Lisfranc joint; if the subcapital elements are associated in monobloc with the retrocapital element, the limit corresponds to the limit of the metatarsal necks;

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lateral limits 24, 25, 26, 27: these correspond to the transverse divisions of the front part of the foot in 1/6 of its width.

The reliefs 11 and 12 have a height preferably between 0.5 mm and 10 mm. These areas can be flat or slightly inclined towards the front.

Referring to Figure 3, three possible longitudinal section variants are seen for the sub and anterocapital elements of the first, fourth and fifth metatarsals defined by piece A, the maximum thickness being located substantially at the level of the metatarsal neck, being discovered the inclined or flat surfaces between the neck and the 1/6 boundary to form zones 11 or 12 while the rear parts located between the Lisfranc articulation neck will be covered by part B.

Piece B

This piece is intended to form the retrocapital bar (BRC) zone or, in a variant, the retrocapital support zone (ARC).

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BRC: is an element located just behind the metatarsal heads that constitute the metatarsal palette for the whole. This usually presents a medium protuberance (just behind the second and third metatarsal heads) being its lower limit indifferent;

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longitudinally, it is an element that has a maximum arrow height just behind the metatarsal heads and that is regularly transformed into an inclined plane going towards its lower limit;

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ARC idem to the preceding element, except that the element is located behind the second, third and fourth metatarsal heads.

The limits are, for the BRC:

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previous limit 31: corresponds to the line of metatarsal necks;

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posterior limit 32: corresponds to the joint interline of the Lisfranc joint;

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internal lateral limit 33: corresponds to the projection of adaptation with the convex footwear inside, varying the

protrusion from 2 mm to 4 mm; - External lateral limit 34, convex outside, varying the projection from 2 mm to 4 mm. The limits are, for the ARC: - previous limit: follow the limit of the necks of the second, third and fourth metatarsals; - posterior limit: point located at the intersection of the Lisfranc interline or at the intersection of the axis

geometric foot, or also at the intersection of the instep axis;

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lateral limits: slightly convex, the width is equal to 3/6 corresponding to the second, third and fourth metatarsals. Internal, at 2/6 transverse, external at 2/6 longitudinal, 5/6 transverse, 2/5 longitudinal.

The thicknesses are preferably between 1 mm and 10 mm.

Referring to Figure 7, a longitudinal sectional view is shown in the central part of the retrocapital bar, inclined towards the rear. In cross-section, it can be flat, or profiled with a gutter, as shown in section 4-4, see Figure 2, or also flat with a medium protrusion without lateral gutter, or profiled with a gutter and lateral ailerons.

The height in the thickest part is at least 2 mm to 5 mm up to 8 mm or 9 mm.

When it is performed in the form of retrocapital support, it is seen, in Figure 6, that it has a longitudinal central section similar to that of the retrocapital bar, but extends only below the central metatarsals, namely the second, third and fourth metatarsals, and then presents convex cross sections with maximum heights below the second, third or fourth metatarsal. The height can vary from at least 2 mm to 5 mm up to 8 or 9 mm.

Internal half-dome (F):

This is an element that adapts to the internal plantar vault of the foot or internal arch. In a longitudinal plane, this is generally convex. In a transverse plane it is totally convex or totally concave, or in an S-shape, that is, concave in its upper part, convex in its lower part. It can extend behind the posterior 1/3 of the calcaneus to the front of the neck of the first metatarsal. Transversally, it can extend up to 2/3 of the width of the foot.

The limits are:

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anterior limit 41: neck of the first metatarsal;

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posterior limit 42: ½ of the length of the calcaneus or 1/3 of the length of the calcaneus;

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internal lateral limit 43: adaptation projection: straight or slightly convex limit inside;

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outer lateral limit 44: convex line outward, maximum width above the scaphoid. ½ of the

template width.

Referring to Figure 5, one sees, on the one hand, the longitudinal section and, on the other, three variants of cross-section for the relief of this internal half-dome. For relief for the longitudinal section, the maximum height may be at the inner edge above the scaphoid or above the scapho-cunean joint, or also above the internal Lisfranc (cuneo-metatarsal) joint.

In the transverse direction, the section, taken at its maximum height, can be regularly convex, or S-shaped, or also regularly concave.

The height varies from 2 mm to 25 mm.

External half-dome (D):

It is an element that adapts to the external plantar vault or external arch of the foot (see the constitution of the external arch of the foot according to Kapandjl). In a longitudinal plane, this is generally convex, but it can be flat, even concave.

In a transverse plane, this is totally convex, or totally concave, or S-shaped, that is concave in its upper part, and convex in its lower part. It can extend behind the back third of the calcaneus to the front of the back of the head of the fifth metatarsal; transversely, it can extend to 2/3 foot width.

The limits are: - anterior limit 51: neck of the fifth metatarsal; - posterior limit 52: 1/3 of the length of the calcaneus or ½ of the width of the calcaneus; - internal lateral limit: ½ of the width of the template above the styloid apophosis of the fifth metatarsal; - External lateral limit: slightly convex outward adaptation projection.

Referring to Figure 8, a longitudinal section and three variants of cross sections of this external half dome. The maximum height is significantly above the cuboid or the styloid apophosis. The transverse relief can be concave or inclined flat, or convex. The height is between 2 mm and 25 mm.

Heel ring (E):

It is an element that adapts and accentuates the heel footprint (calcaneus). This follows the anatomical contours of the posterior support of the calcaneus on the floor. It has a relief and a thickness that prefigure the heel support on the floor. The relief given by this element is essentially concave.

The limits are

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antero-internal limit 61: it is located in front of the scafocunean joint;

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antero-external limit 62: external edge of the template in front of the external Lisfranc joint;

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internal limit 63: in its internal part, the limit is more or less convex. In its previous part, the width of

This portion is equal to 1/3 internal of the width of the template, then concave on the back. The width of the concave portion is equal to 1/5 internal of the width of the template in its outer portion. In the front part, it is convex inside, its width is equal to the outer quarter of the template, then concave in its posterior portion and the width corresponds to the outer 1/5;

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lateral limits 64, 65: these are limits that correspond to the projection of adaptation with the footwear. These limits are convex, the maximum projection being 3 mm to 5 m approximately ½ of the length of the element.

Referring to Figure 4, the reliefs are seen in the longitudinal direction, of substantially constant height, or slightly inclined towards the front, in the scheme on the left. The reliefs in cross-section 1-1, 2-2 or 3-3 can be especially slightly convex or inclined flat in the anterior part corresponding to section 1-1, or inclined flat or slightly concave for sections 2-2 and 3-3. The height can vary from 2 mm to 25 mm.

The braces according to the invention can be performed in different ways.

In general, it is preferred that the plantar orthosis falls above an empty volume or that it contains a light or porous material, ensuring the orthosis in turn the resistance to deformation due to foot and stress.

For example, an orthosis according to Figure 1 can be manufactured in one piece by injection molding or, preferably, by deformation, in a press provided with matrices complementing convenient areas, to facilitate a rigid orthosis although provided with a certain elasticity and that rests on the base or sole of a shoe, essentially by its periphery, for example, the volume being empty under the reliefs of the orthosis.

As already mentioned, in another embodiment, the orthosis can be made by separate production of its different constituents, which are then assembled and fixed to the flat base plate 10, for example by gluing.

In a variant, as seen in Figure 2, the different constituents can be obtained by partial stacking of constituents that extend one below the other.

Finally, the orthoses can be manufactured with the whole of a sole of footwear and not constitute a template that is later integrated into it. This can be obtained, for example, by molding in a suitable material. The materials used in general will have a shore hardness between 0 and 200.

In summary, the orthosis according to the invention can constitute a template or form its upper part, or be part of a mounting template, or be part of an external sole, according to the different types of footwear, and the footwear can be added orthosis according to the invention, or on the contrary forming a single piece with the insole, or the mounting template or the outsole, the orthosis being removable or not with respect to a shoe.

Claims (11)

one.

 Plantar orthosis comprising, in a substantially flat area (17), a retrocapital bar zone (13), so-called subcapital areas in relief, namely a subcapital zone (11) for the first metatarsal and a subcapital zone (12) for the fourth and fifth metatarsals, said subcapital zones being separated from each other and arranged in front of the retrocapital bar zone (13), the retrocapital bar zone (13) being located just behind the metatarsal heads and presenting a middle bulge just behind of the second and third metatarsal heads and longitudinally a maximum arrow height just behind the metatarsal heads that is regularly transformed into an inclined plane.

2.

 Plantar orthosis according to claim 1, comprising at the rear of the retrocapital bar zone (13), an internal semi-dome zone (14) and an external semi-dome zone (15), terminating the orthosis in a ring of heel (16).

3.

 Plantar orthosis according to one of claims 1 and 2, characterized in that:

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the subcapital zones (11) and (12) have a height between 0.5 mm and 10 mm and are flat or slightly inclined towards the front; why

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 the inner half-dome zone (14) is generally convex in a longitudinal plane and adapts to the inner plantar vault of the foot, and is convex or concave or S-shaped in a transverse plane, this area being internal half-dome (14) generally concave in the sense of its length and its cross section being regularly concave, convex or S-shaped, the greatest height being located between 2 mm and 25 mm, the said area extending longitudinally from the posterior 1/3 of the calcaneus towards the back of the neck of the first metatarsal and transversely to 2/3 of the width of the foot; why

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the outer half-dome zone (15) is convex in the longitudinal plane extending from approximately the posterior third of the calcaneus to the back of the head of the fifth metatarsal, holding the external plantar vault and extending transversely to approximately half the width of the foot , the cross section being concave, inclined flat or convex; and because

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 the heel ring area (16) has a concave semiannular shape, the longitudinal sections of the two branches being of constant height or slightly inclined towards the front, the sections being cut slightly convex, inclined flat or concave.

Four.

Plantar orthosis according to claim 3, characterized in that the maximum arrow height of said retrocapital bar area (13) is between 2 mm to 10 mm.

5.

 Plantar orthosis according to any one of claims 1 to 4, comprising, on its inner face, an empty space or full of porous material.

6.

 Plantar orthosis according to one of claims 1 to 4, comprising, on its inner face, a solid material.

7.

 Plantar orthosis according to any one of claims 1 to 6, characterized in that it is removable with respect to a shoe.

8.

 Plantar orthosis according to claims 1 to 6, characterized in that it is not removable with respect to a shoe.

9.

 Plantar orthosis according to one of claims 1 to 4, characterized in that it forms the upper part of a complete sole of footwear.

10.

 Plantar orthosis according to one of claims 1 to 8, characterized in that it is part of a shoe mounting template.

eleven.

 Plantar orthosis according to one of claims 1 to 6 or 8, characterized in that it is part of an external sole of a shoe.