FR3046926A1 - ORTHESE OF ANKLE - Google Patents

Abstract

The invention relates to an ankle brace 1 comprising at least one lateral support means 7A, of elongated shape, and intended to be positioned opposite and along at least one leg segment 4, said orthosis 1 comprising: 31A flexible secured to said lateral holding means 7A, said lug 31A protruding substantially transversely thereof, ○ a retaining strap 32, designed to at least partially cover said lug 31A to press against a lateral side 2 or a medial side 3 of the foot, by winding said holding strap 32 around the foot, when said lateral holding means 7B is positioned facing and along said leg segment 4, and to prohibit, or at least limit, any movement inversion and / or eversion of the foot. orthotics

Description

ORTHESE OF ANKLE

The present invention relates to the field of ankle orthoses intended to allow stabilization of the ankle and foot, for therapeutic or sports applications, in particular for the treatment or prevention of sprains.

The present invention relates more particularly to an ankle brace intended to be worn at an ankle connecting, on the one hand, a foot having opposite lateral and medial sides and, on the other hand, a tibial segment, said orthosis comprising at least one elongate lateral support means extending between a lower end and an opposite upper end, and intended to be positioned opposite and along at least said leg segment.

Such an orthosis is commonly referred to as an "ankle brace" and is generally indicated, either as a preventive measure to avoid, in particular, movements of the foot likely to cause a sprain, that is to say a traumatic ligament lesion, or a sprain. ankle, either as part of a functional, post-operative, or re-education treatment, in the case of a proven sprained ankle, and in particular a recent external sprain, particularly severe or of moderate severity . It may also be indicated to stabilize an ankle suffering from instability or chronic laxity, possibly excluding ankle instabilities of nerve origin and non-traumatic instability.

Thus, ankle splints are already known comprising two rigid lateral holding elements, for example hull-type, intended to be arranged facing each other and the long tibial segment on each side of the ankle. Such shells are equipped with one or more tightening belts to hold them firmly in position against the ankle and thus provide a guardian effect. The lower parts of the hulls are usually connected by means of a flexible band (commonly called "heel") against and on which is intended to rest the heel. While this type of rigid ankle stiffening orthosis known generally satisfactory, offering a suitable guardian effect of the ankle, it does not have less different disadvantages. In particular, it turns out that this type of known orthosis does not provide optimal immobilization of the ankle if the latter is not worn in a closed lace shoe, particularly with respect to the inversion movement and the eversion movement. It is generally accepted that the great majority, or almost all, of the ankle sprains correspond to sprains of the lateral lateral ligament, that is to say to a distension, or even to a rupture, of this lateral ligament. external caused by a sudden inversion movement of the foot, amplitude greater than the normal amplitude of said ligament.

It has therefore been proposed another type of orthosis, which comprises, in addition to rigid lateral support elements, an outer frame to support the sole of the foot. This orthosis is found to be of use, and in particular of implementation, relatively uncomfortable for an unsuspecting user. It is also particularly bulky, generally prohibiting the joint port of a shoe, and significant weight, which makes it impractical and uncomfortable to wear. Last but not least, its effectiveness in limiting inversion and eversion movements is not optimal. The invention therefore aims to remedy the various disadvantages mentioned above, and to propose a new ankle brace which, by a combination of at least one lateral support means conferring a guarding effect and a holding strap, provides improved stabilization of the tibiotarsal joint and effective limitation of inversion and / or eversion movements of the foot, thereby ensuring better prevention and more effective treatment of medium to severe tibiotarsal sprains.

Another object of the invention is to propose a new ankle orthosis offering an excellent proprioceptive reminder.

Another object of the invention is to propose a new evolutionary ankle orthosis whose configuration and conformation allows early release of the tibio-tarsal articulation in the sagittal plane.

Another object of the invention is to propose a new ankle orthosis that is both compact and comfortable.

Another object of the invention is to provide a new ankle orthosis suitable for both a right and a left ankle.

Another object of the invention is to propose a new ankle orthosis that is particularly easy and intuitive to put in place, with or without a shoe.

Another object of the invention is to propose a new ankle orthosis for limiting the anterior slipping of the astragalus.

The objects assigned to the invention are achieved by means of an ankle orthosis intended to be worn at the level of an ankle connecting, on the one hand, a foot having opposite lateral and medial sides and, on the other hand, a leg segment, said orthosis comprising at least one elongate lateral holding means extending between a lower end and an opposite upper end, and intended to be positioned opposite and along at least said segment leg, said orthosis being characterized in that it comprises: - a flexible lug secured, removably or permanently, to said lateral holding means in the vicinity of the lower end thereof, said lug protruding substantially transversely of said lateral holding means, - a holding strap, designed to at least partially cover said lug in order to press against the lateral side or the lug. e medial side of the foot, by winding said strap around the foot, when said lateral holding means is positioned opposite and along said leg segment, and to prohibit, or at least limit, any inversion movement and / or eversion of the foot. Other objects and advantages of the invention will appear in more detail on reading the description which follows, and with the aid of the accompanying drawings provided for purely explanatory and non-limiting purposes, in which: FIG. a side view of the orthosis of the invention, which is shown for example to a left foot and comprises at least one left lateral support means positioned opposite and along the left leg segment and the tibiotarsal joint, which is secured a left lug protruding transversely of said lateral holding means; FIG. 2 illustrates, in front view, the left lateral holding means of the orthosis of FIG. 1, at the lower end of which a lug is secured, and comprising a clamping means comprising two clamping straps and a support strap; - Figure 3 illustrates, in front view, a second lateral holding means, in this case for example a right lateral holding means, that comprises according to a preferred embodiment of the orthosis of Figures 1 and 2; - Figure 4 illustrates, in top view, a heel for connecting the two right and left lateral holding means that preferably comprises the orthosis of Figure 1; - Figures 5 and 6 illustrate, respectively in front view and in rear view, an embodiment of a lug provided with a single extension, which is intended to allow the attachment of said lug to the lateral holding means; - Figure 7 illustrates, in profile view, a preferred embodiment of a lug provided with two extensions intended to allow the attachment of said lug to the lateral holding means; FIG. 8 illustrates, in a front view (at the top) and a rear view (at the bottom), a preferential embodiment of the external and internal faces respectively of the retaining strap that comprises the orthosis of the invention; FIGS. 9 to 13 illustrate, for their part, in front view, the different stages of the implementation of an orthosis preferably comprising two lateral holding means and two lugs, taking the example of an installation at a leg segment and a left foot, so as to highlight the manner in which the holding strap of Figure 8 at least partially cover a right lug in order to press against the medial side of the left foot (Figures 9 and 10), and then comes to wrap around the foot (Figures 11 to 13) also covering at least partially a left lug to prohibit, or at least limit, any inversion and eversion movement of the foot.

As illustrated in particular in Figure 1, the invention relates to an ankle orthosis 1, that is to say an apparatus especially designed to assist the articular and muscular structure of an ankle of a human being or an animal and stabilize this ankle, for therapeutic or sports applications, in particular for the prevention of sprains or during a treatment, rehabilitation or rest phase following a sprain of said ankle. In known manner, said orthosis 1 is intended to be worn at an ankle connecting, on the one hand, a foot having an opposite lateral side 2 and medial side 3 and, on the other hand, a tibial segment 4.

The term "medial side" 3 is the side of the foot that is closest to the medio-sagittal axis (or median axis) of the body of the user of the orthosis 1, in other words, the side facing the inside of the foot. By contrast, reference is made hereinafter to the term "lateral side" 2 to designate the side of the foot opposite to the medial side 3 and therefore furthest from the medio-sagittal axis.

The tibial segment 4 in question thus corresponds, in humans, to the lower end of a right or left leg, that is to say the end of the leg at which the respective distal ends of the tibia and the fibula (or fibula) cooperate with the talus (or talar) of the foot so as to form the tibio-tarsal joint. By analogy with the description of the foot above, the tibial segment 4 has a medial face 5, the closest to the medio-sagittal axis of the body of the user of the orthosis 1, and a side face 6, opposite and therefore furthest from the medio-sagittal axis. By reference to this medio-sagittal axis and the associated medio-sagittal plane, which is well known for designing, in anatomy, the only plane that separates the left half from the right half of the body, the following will be referred to as "plane sagittal "any plane parallel to the medio-sagittal plane. The orthosis 1, by design and sizing, is advantageously provided can be worn both on the skin than over a garment or underwear sock type, low or sticky.

According to the invention, said orthosis 1 comprises at least one lateral support means 7A, of elongate shape, which extends, preferably longitudinally along a first axis A-A ', between a lower end 8A and an opposite upper end 9A .

To ensure its maintenance function, the lateral holding means 7A is substantially rigid and is advantageously in the form of a rod, a plate or a shell 10A. It can be made of any material sufficiently rigid and resistant to torsion and shocks, for example metal (aluminum, titanium, etc.), plastic or composite material. A plastic material, such as a thermoplastic polymer, for example polyamide 6.6 (PA 6.6), can advantageously be retained for the good compromise between weight, geometric space and mechanical strength that can present a part made of such a material.

As is illustrated in particular in FIG. 1, the lateral holding means 7A is intended to be positioned facing and along at least said leg segment 4, advantageously bearing against at least said leg segment4. In other words, once the orthosis 1 is put in place, said lateral holding means 7A extends vertically, its mean longitudinal extension axis A-A 'being substantially parallel to the tibia and the fibula in a plane sagittal, that is to say in a plane parallel to the mid-sagittal plane, its lower end 8A being directed towards the calcaneus (or heel), and so as to come into direct or indirect contact with at least the tibial segment 4. Advantageously, the lateral holding means 7A is intended to be positioned so as to extend along the tibiotarsal joint to the immediate vicinity of the calcaneal tuberosity, at which the foot comes into contact. with the ground, and can therefore also advantageously bear against said tibio-tarsal joint. Advantageously extending in an average plane of extension Pi, this lateral holding means 7A preferably has an inner surface (not shown), which is intended to face and along at least the medial face 5 or the side face 6 of said tibial segment 4, and an outer surface 11 A, opposite said inner surface. Said at least one lateral holding means 7A is further defined longitudinally by two opposite edges 12A, 13A which connect the upper ends 9A and lower 8A. Among these edges 12A, 13A, a rear edge 12A is preferably distinguished, which is intended to be the closest to the heel and the rear face of the tibial segment 4 when the said lateral holding means 7A is positioned facing and along at least said tibial segment 4, and an anterior edge 13A which, in contrast, is intended to be the closest to the forefoot and the front face of the tibial segment4. These rear edges 12A and 13A can be parallel or symmetrical, or have substantially different profiles and configurations as shown in the figures.

According to the preferred embodiment illustrated in the figures, and as introduced above, said lateral holding means 7A is advantageously in the form of a shell 10A, which has an inner surface (not shown) of generally concave shape, advantageously complementary to the contour of the tibial segment 4, and an outer surface 14A of generally convex shape.

According to a particularly advantageous variant of the orthosis 1, the lateral holding means 7A can have a configuration, in the form for example of a recess of the shell 10A, to avoid the bone projection that represents the malleolus, which protrudes could naturally tend to increase the pressure of this zone against the lateral holding means 7A. In addition, a sprained ankle is very often accompanied by peri-malleolar edema, ie an increase in volume and tissue pressure in the area around the malleolus. In addition, during a bending movement or extension of the ankle, the engagement of the talus between the malleoli causes their separation. These phenomena could therefore also cause a painful potential increase in the pressure of this zone against the lateral holding means 7A. Such a configuration, and in particular such a malleolar recess of the shell 10A, thus allows the rigid lateral support means 7A to adapt perfectly to the anatomy and physiopathology of the tibial segment 4 in its sagittal plane. other words, the lateral holding means 7A can thus be positioned vertically closer to the tibia or fibula, depending on the right or left leg segment 4 concerned, avoiding the curve of the malleolus, Efficiency and wearing comfort of the orthosis 1 are thus improved.

In order to further improve wearing comfort, the orthosis 1 preferably comprises a lining 15A, of envelope or panel type, assembled with the lateral holding means 7A. This lining 15A, preferably made of a material or assembly of compressible materials, for example in a foam-type material covered with an elastane sheath, can completely cover the lateral holding means 7A in the manner of an envelope or of a sheath, the lateral holding means 7A thus forming a rigid insert. However, according to the preferred embodiment illustrated in particular in Figures 1 and 3, this liner 15A preferably forms a flat panel, an inner wall 16A is fixed to the inner surface (not shown) of the lateral holding means 7A while its wall external (not shown), opposite to the inner wall 16A, is intended to bear against at least the tibial segment 4 and preferably also against the tibio-tarsal joint.

In this preferred embodiment, the liner 15A is advantageously removably attached to the lateral holding means 7A, for example by means of complementary hook-and-loop means respectively disposed on the inside wall 16A of the lining 15A and on the inner surface of the lateral holding means 7A. While the attachment of the liner 15A to the lateral holding means 7A advantageously prevents their relative sliding during the establishment and then the port and the use in situation of the orthosis 1, the removable nature of this fixation allows easy separation of the liner 15A, for example to wash or replace it when it is dirty or worn, or to replace it with another type of lining. In addition, said lining 15A preferably resumes substantially the geometrical configuration of the lateral holding means 7A and even advantageously extends slightly beyond the edges 12A.13A and the upper end 9A of the latter, so that no part and, in particular, no edge 12A, 13A or upper end 9A of the lateral holding means 7A can come into contact with the leg segment or any part of the tibiotarsal joint, which would be a source of discomfort and discomfort when worn.

According to a particularly advantageous variant of the orthosis 1 of the invention, and as it appears in the figures, the latter comprises two lateral holding means 7A, 7B of elongate shape, preferably in the form of shells 10A, 10B, which holding means 7A, 7B side are therefore intended to be respectively positioned facing and along at least one side face 6 and a medial side 5 of said leg segment 4, so as to be substantially parallel in a sagittal plane.

These two lateral holding means 7A, 7B are furthermore advantageously shaped, so that they can be adapted morphologically preferably indifferently, for one, to the medial side 5 of a right leg segment4 or to the lateral face 6 a left leg segment thus constituting a left lateral support means 7A and, for the other, to the medial side 5 of a left leg segment 4 or to the lateral face 6 of a right leg segment 4 thus constituting to him a means of lateral support 7B right. The orthosis 1 could, according to this preferred embodiment, thus be described as "ambidextrous" in the sense that it can also be worn at the leg segment 4 right or left.

Preferably, each of the two lateral holding means 7A, 7B is fixed a lining 15A, 15B as described above.

In the case taken as an example and illustrated in FIGS. Of side-holding means 7A, 7B in the form of shells 10A, 10B, it is thus possible to provide, preferably at the level of the zone of the posterior edge 12A, 12B which is closest to the end. upper 9A, 9B respectively of the lateral holding means 7A, 7B, a portion 17A, 17B projecting extending towards the rear face of the tibial segment 4 so as to further improve the quality of the lateral support and the ergonomics of said means lateral support 7A, 7B. Thus arranged parallel to the tibia and the fibula in a sagittal plane, on either side of the tibial segment 4 and tibio-tarsal joint concerned, the shells 10A, 10B confer, thanks to their adapted geometric configuration a. maintaining the tibio-tarsal joint without impeding the frontal plane, which advantageously allows not to hinder the dorsal and plantar flexion movements of the ankle.

Still according to this preferred embodiment of an orthosis 1 with two lateral holding means 7A, 7B, and as can be seen in the figures, said lateral holding means 7A, 7B are advantageously interconnected at their lower ends 8A , 8B respective, by a heel 18 (Figure 4), that is to say a substantially flat element against and on which the heel is intended to come to rest. To this end, each of the lateral holding means 7A, 7B preferably comprises, at its lower end 8A, 8B, two parallel rectangular openings 19A, 19B, 20A, 20B of substantially rectangular shape, positioned one above the other. other. These openings 19A, 19B, 20A, 20B are dimensioned so as to be able to insert flexible tabs 21 extending on either side of a platform 22 designed to be positioned under the heel, said platforms 22 and 21 flexible tabs forming said heel piece 18.

Each of said tabs 21 is preferably inserted by passing under a lateral holding means 7A, 7B, then introducing its free end 23 into the first lower opening 20A, 20B from the outside towards the inside of the lateral holding means 7A, 7B , then by introducing said free end 23 into the second upper opening 19A, 19B from the inside to the outside of said lateral holding means 7A, 7B before securing its free end 23 to the outer surface 11A, 11B of said means of lateral support 7A, 7B, above the openings 19A, 19B, 20A, 20B.

Preferably, the free end 23 of at least one of said tabs 21, and even more preferably of each of said tabs 21, is preferably releasably secured to the outer surface 11A, 11B of a lateral holding means 7A, 7B. For this purpose, the free end 23 of at least one of said tabs 21 preferably comprises on its inner face 24, that is to say the face intended to come opposite the outer surface 11 A, 11B of a said lateral holding means 7A, 7B, loops (not shown) adapted to cooperate with hooks covering a specific fastening zone 24A, 24B positioned on the outer surface 11A, 11B of said lateral holding means 7A, 7B, above openings 19A, 19B, 20A, 20B. It is thus possible to precisely adjust the spacing of the lateral holding means 7A, 7B and ensure a perfectly fitted positioning and clamping of the latter facing and along at least the tibial segment 4 concerned.

In order to maintain the precise adjustment thus obtained from the spacing of the lateral holding means 7A, 7B, said platforms 22 and flexible tabs 21 of the heel piece 18 are preferably formed of a material or a material assembly substantially free of material. 'elasticity. The adjustment of the spacing is thus done by modifying, if necessary iteratively, the positioning of the fixing point of the free end of at least one of said tabs 21 on the outer surface 11A, 11B of said lateral holding means 7A. , 7B.

According to the preferred embodiment illustrated in FIG. 7, the platform 22 and its flexible tabs 21 preferably form a single piece in one piece, advantageously in the form of a soft and thin heel strap whose lateral edges flare towards the central portion of said strap so as to materialize the platform 22. Preferably, each face of this strap is entirely covered with thin loops, which are therefore intended to cooperate with the hooks of at least one fixing area 24A, 24B. The heel 18 is thus easily adjustable, reversible, and is more comfortable even if worn on the skin.

In order to detachably fix and maintain the at least one lateral holding means 7A in position relative to said tibio-tarsal joint and tibial segment 4, the orthosis 1 also preferably comprises a clamping means. The latter advantageously comprises a plurality of clamping straps 25, 26, which are two in number in the example particularly illustrated in FIGS. 1 and 3 and thus constitute respectively an upper clamping strap 25 and a lower clamping strap 26. Preferably, as shown in FIG. 2, these clamping straps 25, 26 are attached to said lateral holding means 7A by one of their respective ends, preferably in an irremovable manner, for example by means of a rivet 27, staggered and back-to-back so that they can extend in substantially parallel directions and in opposite directions. During the establishment of the orthosis, the tightening straps 25, 26 can thus advantageously be wrapped around the tibial segment 4 in opposite directions, so as to allow perfect positioning of the lateral holding means 7A next to and along said tibial segment 4.

In the preferred case where the orthosis 1 comprises two lateral holding means 7A, 7B, the tightening straps 25, 26 are preferably attached to one and the same lateral holding means 7A, 7B, for example by lateral holding means 7A alternatively, according to the embodiment illustrated in Figure 3. Alternatively, it is of course quite possible to provide that these clamping straps 25, 26 are instead attached to the only lateral holding means 7B right, or still each of them is attached to a lateral holding means 7A, 7B different.

In order to allow effective immobilization of the ankle, said clamping straps 25, 26 are advantageously devoid of elasticity. Preferably of self-gripping type, these clamping straps 25, 26 are for example provided at their respective free ends 28, 29 of hooks, adapted to cooperate with loops which advantageously cover each of the faces of said clamping straps 25, 26, so as to to be able to fix the latter respectively on themselves.

Particularly advantageously, said at least one lateral holding means 7A, or both, or in any case that of the two lateral holding means 7A, 7B to which is attached one and / or the other of said straps clamping device 25, 26 is provided, as illustrated in particular in FIG. 2, with strap loops 30. When fitting the orthosis 1, the user consequently wraps each tightening strap 25, 26 around the tibial segment 4, then insert the respective free end of said straps 25, 26 into the corresponding strap pass 30, before continuing the winding of each straps 25, 26, this time in the opposite direction, until the desired level of clamping and coming fix each strap 25, 26 on itself as described above. The presence of these straps 30 allows on the one hand to limit the phenomenon of rotation of the orthosis 1 around the tibial segment 4 during tightening and, secondly, to ensure a perfect implementation of said tightening straps 25, 26 around said leg segment 4, avoiding that they can slide along the latter once fixed.

The combination of the juxtaposition of said lateral holding means 7A, and even more so of the two lateral holding means 7A, 7B of the preferred embodiment, opposite and along at least the medial face 5 and / or and the face lateral segment6 of the tibial segment 4, parallel to the tibia and the fibula, and the tightening of said lateral holding means 7A, 7B by means of said clamping means, makes it possible to guarantee an excellent "guarding effect" at the level of the tibio-peroneal mortise and lower tibio-peroneal joint, that is to say, excellent maintenance of the alignment of the tibial segment 4 and the ankle. The tibio-tarsal joint is effectively immobilized, without the frontal plane being impeded, which allows to maintain dorsal and plantar flexion movements of the ankle. It is furthermore understood that this guarding effect can be further improved by the presence of the heel piece 18, which moreover is advantageously inelastic, when the latter connects the two lateral holding means 7A, 7B, since it actually prevents it relative spacing at their lower ends 8A, 8B respectively.

In addition to providing effective stabilization by immobilization of the tibiotarsal joint, orthosis 1 of the invention is specifically designed to prohibit, or at least limit, any inversion and / or eversion movement of the tibiotarsal joint. foot, that is to say that the orthosis 1 is intended to oppose, when it is worn, to such movements, voluntary or involuntary, the foot. It comprises for this purpose: a flexible pin 31A secured in a removable or permanent manner to said lateral holding means 7A in the vicinity of the lower end 8A of the latter, said pin 7A protruding substantially transversely of said lateral holding means 7A and a holding strap 32 designed to at least partially cover said pin 31A in order to press it against the lateral side 2 or the medial side 3 of the foot, by winding said holding strap 32 around the foot, when said 7A lateral holding means is positioned facing and along at least said leg segment4, and prohibit, or at least limit, any movement of inversion and / or eversion of the foot. Since the beginning of the inversion movement takes place at the level of the forefoot, an effective locking system of the inversion movement must therefore specifically act on this zone and, more precisely, on the level of the pair formed by the bones. scaphoid and cuboid. It has been observed that the physiological displacement of the cuboid is both downward and inwardly of the foot. However, if the ideal location for positioning a reminder system of the first component of the movement, that is to say, downwards, is accessible since it is located under the cuboid bone, an effective system for recalling the second component, that is to say towards the inside, is on the other hand more complex to implement since its ideal localization would be located internally of the foot.

Therefore, it has been recognized that an effective and technically feasible reversing movement blocking system, on the other hand, can advantageously be positioned externally of the foot at the point which first undergoes rotation of the cuboid. that is to say against the edge of the lateral side 2 of the foot, facing and along the cuboid, and more precisely still, facing and along the cuboid and the head of the fifth metatarsus (or M5). A similar reasoning can be held with regard to the eversion movement, an effective blocking system of this second movement thus being preferentially positioned externally at the point which first undergoes rotation of the scaphoid, that is to say say against the edge of the medial side 3 of the foot, facing and along the scaphoid. That is why the orthosis 1 is advantageously configured so that, when said at least one lateral holding means 7 A is positioned opposite and along at least said leg segment 4, said pin 31A comes into contact with the edge of the lateral side 2 or the medial side 3 of the foot respectively opposite and along the cuboid or scaphoid (not shown). Even more advantageously, for the reasons set out above, the orthosis 1 is preferably configured so that, when said lateral holding means 7A is positioned opposite and along at least said leg segment 4, said pin 31A comes into contact against the edge of the lateral side 2 opposite and along the cuboid and the head of the fifth metatarsal (or M5). Such a preferred configuration can for example result in a judicious choice of the geometric characteristics of the lug 31A, in particular its general shape, its length and its width, coupled with a precise positioning of the latter relative to the holding means. lateral 7A. On the other hand, the orthosis 1 is further advantageously designed and configured so that, when said at least lateral holding means 7A is positioned facing and along at least said leg segment 4, the holding strap 32 can come and go. under the foot to support the cuboid, preferably so that the holding strap 32 can extend under the foot secant to the axis of extension of the fourth metatarsus (or M4), that is, that is to say in particular by connecting the lateral side 2 to the medial side 3 of the foot.

These important features of the orthosis 1 of the invention being exposed, hereinafter will now be described in more detail in detail said pin 31A and retaining strap 32 that said orthosis 1 comprises.

As illustrated in Figures 1 to 3, said lug 31A protrudes substantially transversely from said lateral holding means 7A. In other words, the lug 31A or, preferably at least a portion of the lug 31A, projects beyond one of the edges 12A, 13A, advantageously in the present case of the front edge 13A, of said lateral holding means. 7A, and this mainly in a direction B-B 'substantially perpendicular to the first axis of longitudinal extension A-A' of said lateral holding means 7A.

According to the preferred embodiment illustrated in particular in FIGS. 5 to 7, this pin 31A is preferably in the form of an elongate and substantially flat main body 33, extending in a second mean extension plane P2, longitudinally along a second axis of longitudinal longitudinal extension C-C 'and transversely along a third axis D-D'. Its third dimension, orthogonal to the plane P2 and the second axis of longitudinal longitudinal extension CC defines its thickness E. Said pin 31A therefore advantageously has the shape of a plate or a panel of average thickness E, of average length L along the second axis of longitudinal longitudinal extension C-C 'and of width I along the third axis D-D'. According to the preferred embodiment illustrated in particular in Figures 5 and 6, the main body 33 of the pin 31A preferably has the general shape of a quadrilateral, and extends longitudinally between a first side 34 and a second side 35 and laterally between a lower edge 36 and an upper edge 37. More preferably, the upper edge 37 converges slightly towards the lower edge 36 towards said second second end side 35.

In addition, and in order to be advantageously positioned against the edge of the lateral side 2 or medial 3 of the foot, facing and along the cuboid or scaphoid and, where appropriate, advantageously facing and along the cuboid and the head of the fifth metatarsal, the main body 33 preferably has a length L between 6 and 8 cm and an average width of between 2 and 6 cm. The thickness E can for example be typically between 2 and 8 mm.

Preferably, as illustrated in particular in Figure 2, the lug 31A is secured to the lateral holding means 7A so that their respective mean extension planes P1, P2 are substantially coincidental and that said direction B -B 'extension of the lug 31A relative to the lateral holding means 7B and said second axis of longitudinal longitudinal extension C-C' coincide.

It is important to note that the lug 31A of the orthosis 1 of the invention is flexible, that is to say that it can, under the effect of its own weight or external force, undergo a deformation in at least one direction of space. This deformation is preferably elastic so that said lug 31A can resume its initial configuration once the effect of its own weight canceled or the external force ceased, advantageously without having undergone perceptible alteration of its mechanical properties. As such, the lug 31A is preferentially flexible in a plane P3 perpendicular to its extension plane P2, that is to say that it can deform so as to move away on either side of said plane P2 so to approach or to deviate from the side 2 or media! 3 of the foot when orthosis 1 is worn. It is however, in a particularly preferred manner, substantially devoid of flexibility in said P2 plane and in a plane P4 perpendicular to said P2 and P3 planes. This characteristic makes it possible, in particular, thus to keep substantially the same angle as the said lug 31A forms with the lateral holding means 7A in the plane P2.

Although flexible in at least one direction of space, the lug 31A preferably has a clean mechanical strength. I! is therefore advantageously substantially devoid of flaccidity and is instead sufficiently rigid not to deform under the effect of its own weight, and whatever the direction of the space considered. Such pin 31A may for example be made of a material or a flexible and compressible material assembly, for example an elastomer core or polymer foam covered with a textile envelope. If necessary, depending on the nature of the material or materials chosen, it is possible to provide that said lug 31A further comprises a reinforcement element, external or in the form of an insert, in order to contribute to conferring on it the combination of properties of flexibility and clean mechanical strength described above.

This combination of flexibility and mechanical strength thus provides a good compromise between mechanical strength and rigidity on the one hand and flexibility and comfort on the other. The lug 31A can therefore be pressed against a lateral side 2 or medial 3 of the foot by slightly marrying the profile, without causing discomfort or discomfort and without risk of hurting the foot, especially when the orthosis 1 is worn with a shoe. In any event, it should be noted that the lug 31A has, in general, a lower rigidity than that of said lateral holding means 7A to which it is secured or intended to be secured. This feature is particularly advantageous in that it allows a fitting of the orthosis 1 not only comfortable but also compatible with the wearing of a shoe. Indeed, if the lug 31A had too much rigidity, and even more if it formed with the lateral holding means 7A a piece of a single piece rigid, it would be particularly complex and uncomfortable, if n It is even impossible to insert into a shoe a foot equipped with such an orthosis 1.

Preferably, the orthosis 1 comprises a means for securing said pin 31A to said at least one lateral holding means 7A, in order to secure the latter to one another, and is designed in such a way that the pin 31A can evolve between: an active position, advantageously corresponding to the position described above, wherein said pin 31A is secured to said lateral holding means 7A by means of said securing means and extends longitudinally, when said means 7A is positioned opposite and along at least said leg segment 4, in a direction B-B 'substantially transverse to said lateral holding means 7A so as to come into contact with the edge of the lateral side 2 or the side medial 3 of the foot, and - at least one inactive position in which said lug 31A is, instead, positioned so as not to come into contact against the edge of a side lat ral 2 or 3 medial foot.

It will therefore be understood that, in this inactive position, the orthosis 1 substantially corresponds to a relatively conventional orthosis of the stent type with a stent effect, comprising at least one, and preferably two, lateral holding means 7A, 7B held at least by biasing means, and preferably a heel 18, so as to immobilize the tibio-tarsal joint maintaining the alignment of the tibial segment 4 and the ankle.

Preferably, said means for securing the lug 31A to the lateral holding means 7A that comprises the orthosis 1 is a removable securing means, which advantageously allows said lug 31A to be completely separated from said lateral holding means 7A. Thus, said inactive position of the lug 31A may advantageously correspond to a position in which said lug 31A is disengaged, and preferably kept away, from said lateral holding means 7A. If it is perfectly conceivable that the lug 31A is directly secured to the lateral holding means 7A, for example to its outer surface 11A, said lug 31A is, according to a preferred embodiment of the orthosis 1, advantageously secured to indirectly to said lateral holding means 7A through the liner 15A. To do this, said lug 31A and said lining 15A respectively comprise a first attachment means 38 and a second fastening means (not shown) complementary, for example of the type loops / hooks, for removably fixing said lug 31A to said pad 15A.

As illustrated in FIGS. 5 and 6, said lug 31A preferably comprises at least one extension 39, advantageously in the form of a flat and flexible tab 39, advantageously designed to ensure the fastening of the lug 31A by means of lateral support 7A. This extension 39 preferably extends from the first side 34 of the main body 33 of the lug 31A. It thus preferably comprises on its inner face 40, that is to say the face intended to come opposite an inner wall 16A or outer of said lining 15A, said first attachment means 38 complementary to said second additional fastening means which is positioned on said inner wall 16A or outer of said lining 15A.

Even more preferably, and as illustrated in FIG. 7, said pin 31A comprises two extensions 39 as described above and configured so that their respective internal faces 35 are positioned substantially opposite each other, otherwise said one face to face with the other. These extensions 39 thus make it possible to removably fix said lug 31A on one and the other of the inner and outer walls 16A of said lining 15A. The lug 31A in its variant with two extensions 35 thus has a Y-shaped profile. In this way the lining 15A "sandwiched" between its two extensions 39, the lug 31A is secured to said lining 15A in a particularly efficient way, even when the fixing means is reversible. This furthermore makes it possible to provide extensions 39 which are particularly thin, of very limited bulk, and which therefore do not give rise to any discomfort or discomfort in the foot and the tibiotarsal articulation when the lug 31A is secured by means of lateral support 7A and orthosis 1 span.

Preferably, such a lug 31A is therefore intended to be secured to the lateral holding means 7A so that the first side 34 of said lug 31A comes opposite the front edge 13 of said lateral holding means 7A.

In addition, as is particularly visible in FIGS. 5 and 6, the one or more extensions 39 preferably extend in a secant direction to the second axis of longitudinal extension C-C 'of the lug 31A at a first angle d elevation obtuse, for example between 110 and 170 °. Such an inclination of the extension extension direction 39 is able to further strengthen the attachment of the lug 31A to the lateral holding means 7A, particularly in the case of a plantar or dorsal flexion of the foot.

Alternatively, and without departing from the scope of the invention, said lug 31A could be pivotally and permanently fixed, directly or indirectly through, for example, the lining 15A, to the lateral holding means 7A. According to this variant, said inactive position could then correspond to a retracted position in which said pin 31A would preferably extend in a direction parallel to the first longitudinal extension A-A 'of said lateral holding means 7B, towards the upper end 9A of the last.

The above description made of the lug 31A, its extension or extensions 39, and its relation to the lateral holding means 7A obviously applies to the preferred variant of an orthosis 1 comprising two lateral holding means 7A. , 7B. Thus, according to this variant the orthosis 1 preferably comprises two lugs 31A, 31B, namely a lug 31B right secured to the lateral holding means 7B right (Figure 3) and intended to come into contact, for example, with the side medial 3 of a left foot, and a lug 31A left reciprocally secured to the lateral holding means 7A left (Figure 2) and therefore intended, according to this example, to come into contact with the lateral side 2 of a left foot. Even if the desired effect is particularly well achieved using an orthosis 1 comprising two lateral holding means 7A, 7B and two lugs 31A, 31B respectively secured to one and the other of said lateral holding means 7A , 7B, it remains conceivable however that said orthosis 1, while including two lateral holding means 7A, 7B, comprises only one lug 31A, for example a lug 31A left secured to the lateral holding means 7A left, as one can see it in Figure 1.

As generally introduced above and illustrated in the figures, the orthosis 1 of the invention comprises, in addition to said at least one lateral holding means 7A and said lug 31A secured to the latter, a holding strap 32, which that is to say a bandage intended to allow the maintenance, advantageously firm, of the body part to which it is applied. This retaining strap 32 may be described as a strap of "contention", or strap "strapping" in the sense that it advantageously allows immobilization of the area of the body to which it is intended to be implemented, without prejudging however, at this stage of a possible elastic nature or not of said retaining strap 32. Extending longitudinally between a proximal end 41 and a distal end 42, the retaining strap 32 is preferably attached to the lateral holding means 7A, by its proximal end 41 by means of a fastening means 43A which is advantageously provided with said lateral holding means 7A, said distal end 42 remaining free.

This attachment means 43A is conveniently designed and positioned to facilitate as much as possible the implementation of said retaining strap 32 while ensuring excellent resistance of the foot and the ankle when said retaining strap 32 is wrapped around these last, as will be seen later. In particular, as shown in the figures, the attachment means 43A is preferably positioned on the outer surface 11A of the lateral holding means 7A at a zone intended to face or in the immediate vicinity of one of the malleoli , medial or lateral, of the ankle when the orthosis 1 is worn. Even more preferably, said proximal end 41 of the holding strap 32 is pivotally attached to said lateral holding means 7A through said attachment means 43A, which advantageously makes it possible to vary the starting orientation of the said holding strap 32 according to the morphology of the foot and the ankle and avoid any crease of the retaining strap 32 may create discomfort or degrade the holding performance.

Particularly preferably, and complementary or alternative to what has just been stated about the attachment means 43A, said proximal end 41 of the holding strap 32 is advantageously removably attached to said lateral holding means 7A. By way of example, a snap fastener may advantageously constitute a fastening means 43A making it possible to fix the proximal end 41 of the holding strap 32 to said lateral holding means 7A both pivotally and removably.

By preferentially combining such a removable character of the holding strap 32 with a design of the orthosis 1 allowing or pins 31A, 31B to move between an active position and an inactive position, it is possible to obtain an orthosis 1 evolutive whose configuration and conformation can be advantageously modified to follow the evolution of a sprain during treatment or to better support a sprain prevention program. The configuration and the conformation of the orthosis 1 are therefore, in other words, advantageously variable. Indeed, it is possible for a user, for example, in a first phase of treatment of a sprain, to wear an orthosis 1 whose lug (s) 31A, 31B occupy their active position and that the retaining strap 32 comes to plaster. , by winding around the foot, against the lateral side 2 and / or the medial side 3, so as to obtain both a stabilization of the tibio-tarsal joint and a blockage, or at least a limitation, of the movements of inversion and / or eversion. In a second phase of consolidation, that is to say, preferably after tissue healing is sufficiently advanced, the user can release the tibio-tarsal joint in the sagittal plane, while retaining a protective effect. guardian of the tibial segment4 and ankle. It suffices for it to remove on the one hand the retaining strap 32 and to change, on the other hand, the lug or pins 31A, 31B in their inactive position, for example by disengaging the lug or pins 31A , 31B of the or the gaskets 15A, 15B. Orthesel, in this particularly advantageous variant, therefore allows the user to no longer need to use two different orthoses, as conventionally known, namely a first orthosis for immobilizing the forefoot and ankle , heavy and bulky, and a second orthosis classic simple guardian effect, depending on the progress of treatment of his sprain. I! It should be noted that, in the case of the preferred variant of the orthosis 1 in which the latter comprises two lateral holding means 7A, 7B, it is possible to provide that only one of said lateral holding means 7A, 7B is provided. a fastening means 43A of the proximal end 41 of the holding strap 32. However, in the case where this holding strap 32 is removably fixed, it is particularly advantageous that each of said lateral holding means 7A , 7B is provided with such attachment means 43A, 43B, so that it is possible for the user to choose on which side of the ankle will be attached the proximal end 41 of the retaining strap 32.

As is particularly clearly seen in FIGS. 2 and 8, said retaining strap 32 is preferably predominantly formed of a flexible strip 44 which comprises a third and a fourth fixing means 45, 46 which preferably extend substantially over the entire surface, respectively, of the outer 47 and inner 48 faces of said flexible band 44. These third and fourth fixing means 45, 46 may, for example, respectively form a web of loops covering respectively the outer 47 and inner 48 faces of the flexible band 44. Said retaining strap 32 further advantageously comprises, at its distal end 42, a fifth fastening means 49, for example of the hook type, complementary to said third fastening means 45. The holding strap 32 can thus advantageously be fixed on itself after being wound by the user of the orthosis 1 around the foot and ankle.

In order to ensure an efficient and uniform maintenance, said flexible band 44 is preferably substantially free from elasticity. However, the retaining strap 32 advantageously comprises, in the vicinity of its distal end 42, an elastic portion 50 which, without calling into question the advantage of a flexible non-elastic band 44, nevertheless makes it possible to ensure an optimal adjustment of the tension of tightening the retaining strap 32.

To further facilitate the implementation of the orthosis 1 and in particular the retaining strap 32, while ensuring good control of the tension of the retaining strap 32 and effective cooperation of the latter with the lug or pins 31A, 31B, a number of additional removable fastening means may be provided. Said strip 44 of the retaining strap 32 may thus preferably be provided on its outer face 47, in the vicinity of the proximal end 41 of the retaining strap 47, a sixth attachment means 51, for example of the hook type, complementary to said fourth fastening means 46 of the inner face 48 of said strip 44. With this sixth fastening means 51, the user can, once the holding strap 32 passed under the foot, come cross and fix said strap 32 on itself on the top of the foot, 'advantageously facing the talus (or astragalus). This makes it possible to maintain constant the tension in the loop which then forms said holding strap 32 around the foot and to limit the anterior slipping of the astragalus.

It can also be advantageously provided that said one or more lugs 31A, 31B, as is also visible in FIG. 5, are provided on their respective external faces 52A, 52B, that is to say on the face opposed to the respective inner face 53A, 53B of said lugs 31A, 31B intended to come into contact with the edge of a lateral side 2 or medial side 3 of the foot, of a seventh fixing means 54, for example of the hook type , complementary to said fourth fixing means 46 of the inner face 48 of said strip 44. This seventh fixing means 54 is particularly useful in the case of the preferred embodiment of an orthosis comprising two lateral holding means 7A, 7B and two lugs 31A, 31B. Indeed, and with reference now to the example illustrated in FIGS. 9 to 13 in which the orthosis 1 is worn on a right foot, at the level of a tibial segment 4 and an ankle rights, the cooperation of these seventh e and fourth fastening means 54, 46 makes it possible, on the one hand, to prevent any slipping of the right and left pins 31A and 31B along the foot when they are at least partially covered by the holding strap 32 and that this last is put in tension. It also makes it possible to maintain, advantageously, constant tension in the holding strap portions 32 extending respectively between the point of attachment of the proximal end 41 of the holding strap 32 to the lateral holding means. 7B left and the seventh fastening means 54A of the right lug 31A, and between the seventh fixing means 54A of the right lug 31A and the seventh fixing means 54B of the lug 31B right.

Finally, the retaining strap 32 also comprises, optionally and advantageously, at its proximal end 41, an eighth fastening means 55, for example of the hook type, also complementary to said fourth fastening means 46 of the inner face 48. of said strip 44. This eighth fastening means 55 thus allows, again according to the example taken above, to keep constant the tension that prevails in the holding web portion 32 extending between the left lug 31B and its seventh fixing means 54B and the point at which the holding strap 32 comes to cover its attachment point after being crossed opposite the astragalus and then passed behind the ankle. Thus, the cooperation of this holding strap 32 with the, or preferably the pins 31A, 31B, makes it very advantageous to form very easily around the foot a kind of stirrup which makes it possible to block effectively, or less to significantly limit any movement of inversion and / or eversion of the foot.

In order to further facilitate the use of the orthosis 1 by an unsuspecting user, it is possible to provide a visual cue 56 with the faces of the elements of the orthosis 1 intended to be oriented towards the outside of the body, namely in particular the respective outer faces of the tightening straps 25, 26, the outer face 47 of the holding strap 32, as well as the outer face 52A, 52B of the lugs 31 A, 31 B. Even more advantageously, this visual cue 56 can also also constitute a tactile mark, for example being configured in relief or recessed on or in the surface concerned, which can be particularly useful during an implementation of the orthosis 1 by a person have a visual impairment or a decrease in visual ability (such as an elderly person).

Finally, the orthosis 1 of the invention may optionally comprise a complementary element (not shown), for example neoprene, removable or attached to the retaining strap 32, intended to be interposed between the skin and the retaining strap 32, to promote, in the early phase of the treatment of a sprain, compression (analgesia) and resorption of edema, often found in the area surrounding the talus. For purely informative and illustrative purposes, hereinafter will be described the methodology or method of setting up an orthosis 1 according to the description given above, with reference to FIGS. 9 to 13. In the illustrated example In these figures, the orthosis 1 is in its preferred embodiment in which the latter comprises two lateral holding means 7A, 7B, which are positioned opposite and along a leg segment 4 and a left ankle. Alternatively, they could be positioned opposite and along a leg segment 4 and a right ankle. The orthosis 1 could obviously, as envisaged above, have only one lateral holding means 7A, in which case it would preferably be positioned opposite and along the lateral face 6 of the tibial segment 4, so as to first and foremost to limit or even prohibit any inversion movement.

As illustrated in Figure 9, the user comes first rest his left heel on the platform 22 of the heel 18, which connects the left lateral holding means 7A and 7B right at their lower ends 8A, 8B respectively. It then comes to position the lateral holding means 7A, 7B opposite and along said left leg segment 4, and preferably opposite and along the left tibio-tarsal joint, then comes to fix said lateral holding means 7A, 7B firmly in position against said leg segment by means of the clamping straps 25,26 of the orthesel clamping means The lateral holding means 7A, 7B are thus positioned facing one another, from the and other of the tibial segment 4 and substantially parallel in a sagittal plane. The left lugs 31A and 31B extend transversely to said lateral support means 7A, 7B towards the forefoot and are positioned so as to respectively come into contact with the edge of the lateral side 2 and the medial side 3 of the foot, and advantageously respectively along and against the cuboid and the scaphoid. Once the retaining strap 32 is attached to the outer surface 11A of the left lateral holding means 7A by means of the fastening means 43A, if it is not already so, the user just stretches and passes the strap of maintaining 32 on the top of the foot until it covers, at least in part the lug 31B right and advantageously until come to cooperate the seventh fixing means 54B of this lug 31B right with the fourth fixing means 46 of the inner face 48 of the flexible band 44 of the retaining strap 32. The lug 31B right is thus pressed against the medial side 3 of the foot (Figure 10). Then, as illustrated in FIG. 11, the user then comes to pass the holding strap 32 under the foot, always exerting on the latter a tension sufficient to properly press the retaining strap 32 against the arch. The user then comes to press the retaining strap 32 on the left lug 31A so as to cover it at least partially and, advantageously, until the seventh fixing means 54A of this left lug 31A comes into contact with the fourth means of locking. fixing 46 of the inner face 48 of the flexible band 44 of the retaining strap 32. The lug 31A left is thus pressed against the lateral side 2 of the foot. Then, as can be seen in FIG. 12, the user comes across the retaining strap 32 on the top of the foot, advantageously facing the astragalus, and preferentially secures the retaining strap 32 on itself, on the top of the foot, using the sixth and fourth complementary fixing means 51,46. In a particularly advantageous manner, the user crosses said holding strap 32 on the top of the foot so that the angle β defined by the superposition of the holding strap 32 on itself is as large as possible. Such a wide opening, corresponding to a high angle β, is indeed particularly favorable in case of presence of edema.

As illustrated in FIG. 13, the user then successively presses the holding strap 32 against the outer surface 11B of the right lateral holding means 7B, winding it behind the peg, and then pressing it against the outer surface 11A of the holding means. lateral support 7A left, so preferably to cover the attachment means 43A, and even more preferably, to fix the retaining strap 32 on itself by cooperation of the eighth and fourth attachment means 55, 46 complementary.

It is thus well understood that the tensioning of the retaining strap 32 makes it possible to apply an anti-inversion preload with stabilizing and proprioceptive virtues.

Finally, the user comes back the support strap 32 to the forefoot and fix said retaining strap 32 on itself on the top of the foot, by cooperation of the fifth and third attachment means 49, 45 complementary.

Claims (18)

1 - ankle orthosis (1) intended to be worn at an ankle connecting, on the one hand, a foot having opposing lateral (2) and medial (3) sides and, on the other hand, a tibial segment (4), said orthosis (1) comprising at least one lateral support means (7A), of elongate shape, extending between a lower end (8A) and an opposite upper end (9A), and intended to be positioned in look and along at least said leg segment (4), said orthosis (1) being characterized in that it comprises: a lug (31 A) secured, removably or permanently, to said lateral holding means (7A) in the vicinity of the lower end (8A) of the latter, said lug (31A) protruding substantially transversely from said lateral holding means (7A), a holding strap (32) designed to cover at least partially said lug (31A) in order to press against the lapped side ral (2) or the medial side (3) of the foot, by winding said holding strap (32) around the foot, when said lateral holding means (7A) is positioned facing and along at least said leg segment ( 4), and to prohibit, or at least limit, any movement of inversion and / or eversion of the foot. 2- orthosis (1) according to the preceding claim, characterized in that it is configured so that, when said lateral holding means (7A) is positioned opposite and along at least said leg segment (4), said pin ( 31 A) comes into contact with the edge of the lateral side (2) or the medial side (3) of the foot, respectively along and facing the cuboid or scaphoid. 3 - orthosis (1) according to any one of the preceding claims, characterized in that said lug (7A) has a clean mechanical strength. 4 - orthosis (1) according to any one of the preceding claims, characterized in that it comprises a means for securing said lug (31 A) to said lateral holding means (7A) and that it is designed so that that the lug (31 A) can evolve between: an active position in which said lug (31 A) is secured to said lateral holding means (7A) by means of said securing means and extends longitudinally, when said means of lateral support (7A) is positioned facing and along at least said leg segment (4), in a direction substantially transverse to said lateral holding means (7A) so as to come into contact with the edge of the lateral side ( 2) or the medial side (3) of the foot, and at least one inactive position in which said lug (31A) is positioned so that it can not come into contact with the edge of a lateral side (2) or medial (3) of the foot. 5- orthosis (1) according to the preceding claim, characterized in that it comprises a means for releasably securing said lug (31A) to said lateral holding means (7A), said inactive position corresponding to a position in which said lug (31) A) is disengaged from said lateral holding means (7A). 6. Orthosis (1) according to the preceding claim, characterized in that ,orthorthosis (1) further comprising a lining (15A), envelope or panel type, assembled to said lateral holding means (7A), said lug (31A) and said lining (15A) respectively comprises a first fixing means (38) and a second complementary fixing means, for example of the loops / hooks type, for removably securing said lug (31A) to said lining (15A). 7 - orthosis (1) according to the preceding claim, characterized in that said lug (31 A) comprises at least one extension (39), which comprises on its inner face (40), that is to say the face intended for facing an inner wall (16A) or an outer wall of said lining (15A), said first fixing means (38) complementary to said second fixing means, which is positioned on said inner wall (16A) or outer of said lining (15A). 8 - orthosis (1) according to the preceding claim, characterized in that said lug (31 A) comprises two extensions (39), configured so that their respective inner faces (35) are positioned substantially vis-à-vis, which extensions (39) and allow to removably fix said lug (31A) on one and the other of the inner wall (16A) and outer of said liner (15A). 9- orthosis (1) according to any one of the preceding claims, characterized in that it comprises a clamping means designed to allow the holding in position of said lateral holding means (7A) facing and long at least said leg segment (4), which clamping means comprises at least two clamping straps (25, 26) substantially free from elasticity and attached to the lateral holding means (7A) in a stepped and back-to-back manner, that is to say in parallel directions and opposite directions of extension, so as to be able to surround the leg segment (4) in opposite directions. 10- orthosis (1) according to any one of the preceding claims, characterized in that, said holding strap (32) extending longitudinally between a proximal end (41) and a distal end (42), said holding means lateral (7A) is provided with means (43A) for attaching said proximal end (41) of the holding strap (32) to said lateral holding means (7A). 11 - orthosis (1) according to the preceding claim, characterized in that said proximal end (41) of the holding strap (32) is pivotally attached to said lateral holding means (7A). 12 - orthosis (1) according to claim 10 or 11, characterized in that said proximal end (41) of the retaining strap (32) is removably attached to said lateral holding means (7A). 13- Orthotic (1) according to any one of the preceding claims, characterized in that said holding strap (32) is predominantly formed of a flexible band (44) which comprises a third and a fourth fixing means (45, 46) which preferably extend substantially over the entire surface, respectively, of the outer (47) and inner (48) faces of said flexible band (44), said holding strap (32) further comprising, at the level of its distal end (42), a fifth fixing means (49), for example of the hook type, complementary to said third fixing means (45). 14 - orthosis (1) according to the preceding claim, characterized in that said strip (44) flexible is substantially devoid of elasticity. 15 - orthosis (1) according to claim 13 or 14, characterized in that said retaining strap (32) comprises in the vicinity of its distal end (42) a portion (50) elastic. 16 - orthosis (1) according to any one of claims 13 to 15, characterized in that said strip (44) of the holding strap (32) is provided on its outer face (47), in the vicinity of the end proximal (41) of the retaining strap (32), a sixth fastening means (51), for example of hook type, complementary to said fourth fastening means (46) of the inner face (48) of said strap (44) . 17 - orthosis (1) according to any one of claims 13 to 16, characterized in that said lug (31A) has on its outer face (52A), that is to say on the face opposite to the inner face (53A) intended to come into contact with the edge of a lateral side (2) or medial (3) of the foot, a seventh fastening means (54), for example of the hook type, complementary to said fourth means of fixing (46) the inner face (48) of said strip (44). 18- orthosis (1) according to any one of the preceding claims, characterized in that it comprises two lateral holding means (7A, 7B) of elongate shape, which are intended to be positioned opposite and along, respectively, at least one lateral face (6) and one medial face (5) of said leg segment (4), so as to be substantially parallel in a sagittal plane.