JPH0753608Y2 - Short leg brace - Google Patents

Description

[Detailed description of the device]

[0001]

[Industrial application] The present invention is intended to improve foot drop due to peripheral nerve palsy and correct ankle clubfoot foot due to central nervous system palsy such as cerebrovascular disorder and cerebral palsy, and ataxic gait due to central nervous system disorder. The present invention relates to an orthosis for short legs, which is applied to the treatment of ankle joint sprain and fracture due to forced varus and valgus of the ankle.

[0002]

2. Description of the Related Art Peripheral nerve palsy takes the form of flaccid paralysis,
Central nerve palsy takes the form of spastic paralysis. Peroneal nerve palsy, which is a peripheral nerve palsy, causes the ankle joint to drop foot (relaxing and flexing) during the swing phase (when the plantar is away from the floor), resulting in voluntary dorsiflexion of the ankle. Becomes impossible.

Cerebral vascular disorders and cerebral palsy, which are central nervous system paralysis, cause the ankle joint to be in the varus anterior position (the state where the ankle joint is planted, adduction, and supination) due to ankle joint during the swing phase. His voluntary dorsiflexion, pronation and abduction are disabled. Further, the deep sensation and the sense of position (a function of recognizing the position of one's limbs) of the natural sense are also deteriorated. As a result, the toes get caught on the floor during the swing phase, making walking difficult.

[0004] In the case of ataxia in which functional deficits in deep sensation and position sense are strongly manifested due to disorders of the central nervous system, it becomes extremely difficult to control the lower limbs based on the senses. There is no state.

Various types of short leg orthoses have been used for these symptoms. Of the currently known short leg orthoses,
Main examples include a hard plastic short leg orthosis (shoon brace) a shown in FIG. 10 and a shoe-shaped orthosis b with a metal strut shown in FIG.

In the shoe horn brace a, the plantar flexion and varus of the toes d are prevented by the sole e of the orthosis, that is, the physical strength of the material itself.

In the shoe-shaped orthosis b with metal struts, the elasticity of springs incorporated in a uniaxial cleansack foot joint (slight bottom, only dorsiflexion allowed) used in the ankle joint portion prevents plantar flexion.

[0008]

As described above, the conventional ankle foot orthosis has achieved some results in improving drop foot and clubfoot in the swing phase. However, due to the small floor of the ankle joint and the rigid structure that allows only dorsiflexion, the movement of the ankle joint within the normal range necessary for walking during the stance phase (when the sole is in contact with the floor) (plantar flexion, It also inhibits dorsiflexion, varus, and valgus), and also inhibits other ankle joint dynamic dorsiflexion movements such as "squatting".

Of the movements of the ankle joint during the stance phase, varus is particularly important for balancing to maintain the posture, but the conventional orthosis has not been given the function of allowing voluntary varus. As a result, it becomes difficult to perform a balancing action during lateral movement necessary for walking, which causes a sense of instability and deterioration of gait.

Furthermore, excessive fixation, hardness of the material, and disagreement between the mechanical joint axis of the brace and the physiological joint axis of the ankle joint not only hinder smooth walking but also cause imperfections during wearing. Pleasure is also occurring. In ataxic gait, it has been surprisingly impossible to hold the affected limb in the limb position necessary for walking, and it is not useful for fundamental improvement.

The present invention has been made in view of the above-mentioned problems of the prior art. The function lost due to an obstacle (voluntary dorsiflexion of the foot, It is an object of the present invention to provide an ankle foot orthosis capable of assisting smooth walking by improving drop foot, clubfoot, ataxic gait by supplementing pronation, abduction, and deep sensation.

[0012]

In order to achieve the above-mentioned object, the short leg brace of the present invention is made of a material having appropriate elasticity, flexibility and stretchability, and is formed from the triceps surae tendon transition portion to the foot. An opening of an appropriate width is opened in the range from the front of the lower leg of the main body formed so as to cover and wrap around the apex to the back of the foot and the apex of the body, and is fixed to the affected limb with a belt etc. In addition, a deformable and reversible compression part is provided to apply required pressure from the left and right sides around the medial malleolus at the lower end of the tibia, the outer malleolus at the lower end of the fibula, and the heel, and the foot of the main body is provided. The anterior surface of the joint is provided with a bent portion whose opening edge is openable and outwardly forward and outward when the ankle joint is dorsiflexed, on a line connecting the inner and outer ankle joints. .

[0013]

[Function] The ankle foot orthosis is worn on the affected limb after it is attached to the affected limb, and the back of the foot, the front of the ankle joint, the front of the lower leg and the upper part thereof are fixed to the affected limb with a belt, and the ankle joint is wrapped tightly. To do. At this time, the belt in front of the ankle joint may be omitted.
When worn as described above, the opening allows
It prevents pressure on the tibial bone and extensor pollicis longus.

When the ankle joint of the affected limb tries to assume the varus valgus position during the swing phase in the above-mentioned worn state, the orthosis exerts an external force (the ankle joint axis on the ankle joint) to deform in accordance with the movement of the affected limb. At the boundary, an extension force is applied to the front part and the little finger side, and a compression force and a bending force are applied to the rear part and the thumb side. The ankle joint is tightly wrapped by the brace, and the necessary pressure is applied to the area around the ankle joint and the heel by the compression parts from the left and right sides. , The patient's foot itself plays the role of internal structure (as a beam) as reinforcement of the brace.

The function of the foot itself as an internal structure is to prevent inward bending deformation of the orthosis due to compressive force and bending force on the thumb side and the rear side of the ankle joint axis, and resist extension force on the front side of the little finger. Force is generated to suppress clubfoot deformity of the affected limb. In addition to this, elasticity generated by the dorsiflexion, pronation, and abduction angle of the brace initially set based on the elasticity, flexibility and elasticity of the material,
During the swing phase, plantar flexion and varus tendencies of the affected limb are balanced, and the ankle joint is flexibly maintained in a normal limb position.

When the affected limb strengthens the degree of clubfoot, the tension on the surface of the orthosis increases in proportion to it, and the orthosis gradually increases the varus valgus flexion restraining force and also becomes an involuntary obstacle to walking. It flexibly and flexibly suppresses foot drop inversion and improves gait.

Usually, involuntary plantar flexion or varus has a weaker force than that of voluntary voluntary flexion, and the orthoses are only involuntary plantar flexion or varus at the initial stage of starting deformation by external force. Since the rigidity is set in advance in the range of suppressing the movement, it has almost no effect on voluntary movement.

Further, although the orthosis has a flexible structure, since the movement of the ankle joint outside the range of motion of the ankle joint is almost completely restricted, a severe ankle joint varus is generated. When used in the recovery period against a sprain, the ankle joint is protected adequately and it is possible to return to a social life early.

When the orthosis is worn and the ankle joint is moved, a gap occurs between the orthosis and the skin, which is more clarified by applying pressure to the skin around the joint that plays a role of an internal structure. Somatic sensation and position sense are supplemented, and ataxic gait is improved.

[0020]

Embodiments of the present invention will be described below with reference to the drawings. As shown in FIG. 1, the main body 1 is elastically deformable and recoverable, and has appropriate elasticity, flexibility and stretchability.
It is integrally molded from materials such as rubber and plastic. The main body 1 is formed in a shape that entirely covers and wraps the triceps surae tendon transition portion 2 to the apex portion 3, and the tibia crest 4 and extensor pollicis brevis longus muscle (not shown). In order to prevent the pressure from being applied, the range from the front surface of the lower leg 5 to the apex 3 through the back of the foot 6 is opened in the opening 7 having a predetermined width A. The width A of the opening 7 is, for example, 1 to 4
It is set to cm.

Further, the main body 1 has belts 10, 11, 12 and fasteners 10a, 11 thereof so as to correspond to the back of the foot 6, the front surface of the ankle joint 8a, the front surface of the lower leg 5 and the upper portion 9 thereof.
a and 12a are fixed to each other so that they are fixed to the affected limb. The illustrated example shows the front 8 of the ankle joint.
This is the case where the belt of a is omitted, and thus the belt of the front surface 8a of the ankle joint may be omitted.

Further, the orthosis is not a shoe for rehabilitation, but when it is used in combination with a commercially available general shoe (not shown), the foot point is large and it is difficult to wear the shoe. In addition, the tip may be cut off from a line (metatartophagus joint) connecting the vicinity of the first metatarsal head 13 and the vicinity of the fifth metatarsal head 14.

1 and FIG. 1 are compression parts 18 and 19 for applying a required pressure from the left and right sides (both inner and outer sides) to the medial malleolus of the lower end of the tibia 15, the outer malleolus of the lower end of the fibula 16 and the heel part 17. As shown in FIGS. 2 to 4, it is formed so as to be deformable and restoreable corresponding to the above-mentioned respective parts.

That is, the compression portions 18 and 19 are provided to generate tension on the surface of the brace, and reduce the volume in the main body 1 with respect to the foot of the patient within the range of 1 to 35%. Is molded as. Such compression parts 18, 19
This makes it possible to create a structure that complements somatic sensation and sense of position.

The most important thing here is the body 1
The upper and lower cylindrical portions 1a and 1b centering on the ankle joint 8 of
Although it is possible to adjust the tension acting on the surface of the device by tightening and tightening the attached belts 10 to 12, it is impossible to take this direction around the ankle joint 8 and the heel part 17. Therefore, in order to apply pressure from the left and right of the ankle joint 8 and the heel portion 17, a molding die (not shown) is formed in a shape in which the width at the frontal plane is reduced in the range of 1 to 40%. That is, by using this mold, the compression parts 18 and 19 are
In particular, in order to apply pressure to the skin in the ankle 8 and around the outer malleolus, it is possible to adopt a structure in which it is depressed by about 0.5 to 2 cm.

When the ankle joint 8 is dorsiflexed, as shown in FIG. 2, the opening edges 7a, 7a of the opening 7 in the front part of the front surface of the main body 1 can be opened and closed flexibly to the outside. In order to give the above, in the front of the ankle joint 8 of the main body 1, a height of about 10 mm is set as a ridge line on the line B connecting the vertices of the inner joint 8b and the outer joint 8c of the ankle joint 8 at the shortest. Bent portions 20, 20 are formed so as to rise in a substantially elliptical hill shape or a mountain range shape. Accordingly, when the ankle joint 8 is dorsiflexed, the bent portions 20 and 20 are prevented from being excavated outward and outward in a bellows shape and injuring the affected foot. Although the single bent portion 20, 20 is provided in the illustrated example, it is also possible to provide a plurality of rows in the vertical direction at regular intervals.

When the ankle joint 8 undergoes plantar flexion and inversion, stress is applied to the surface of the main body 1 in the direction indicated by the arrow in FIGS. 5 and 6, and the orthosis is distorted. For normal stress, the restoring force and elasticity of the material work to keep the orthosis in a normal shape, but if a force greater than that is applied, it will be applied to the surface of the main body 1 in the direction of compression stress. It bends at a right angle and wrinkles, which causes plantar flexion and varus restraining force to drop sharply, which may further damage the skin.

Therefore, when it is used in a patient with a high degree of spasticity, the body 1 shown in FIGS.
In the shaded areas C, D and E, the same material as the main body 1,
Alternatively, a material having higher hardness is attached to reinforce the portions C, D and E.

When the main body 1 is molded by the injection method, the portions C, D and E are reinforced by making them thicker than the other portions. The main body 1 is
In order to reduce the change in volume due to the movement of the ankle joint 8,
Since its thickness is set to, for example, about 1 to 4 mm,
Each of the above parts C, D and E is thicker than this.

Further, since the main body 1 has a structure that encloses the entire ankle joint 8, stuffiness is likely to occur at the time of wearing, but a large number of ventilation holes (not shown) of about 1 to 5 mm are also provided in a portion where stress is not applied. It is provided to deal with the above-mentioned stuffiness.

[0031]

[Effect of the Invention] Since the short leg orthosis according to the present invention is configured as described above, by wearing it on the affected limb so as to wrap the ankle joint tightly, tension acts on the surface of the orthosis, and Since the feet themselves will play the role of internal structure as reinforcement of the brace, the function lost due to obstacles, voluntary dorsiflexion of the foot, pronation, external I am able to compensate for the tumbling and deep feeling,
It can improve foot drop, clubfoot, ataxic gait and help smooth walking.

Further, the opening formed in the range from the front side of the lower leg of the main body to the back of the foot and the apex prevents the compression of the tibial crest and the extensor pollicis longus muscle and is provided on the front side of the ankle joint. When the bent portion bends back of the ankle joint, the bent portion is opened and drained to the front and outside, so that the skin of the affected foot can be prevented from being damaged.

[Brief description of drawings]

FIG. 1 is a perspective view showing an embodiment of an ankle brace according to the present invention.

FIG. 2 is a front view showing a state in which a belt and a stopper are removed in the embodiment shown in FIG.

FIG. 3 is a side view showing a state in which a belt and a stopper are removed in the embodiment shown in FIG.

4 is a rear view showing a state in which a belt and a stopper are removed in the embodiment shown in FIG.

FIG. 5 is a medial side view showing a stress distribution acting on the surface of the brace when the ankle joint is plantar flexed and varus.

FIG. 6 is an outer side view showing a stress distribution acting on the surface of the brace when the ankle joint is plantarly flexed and varus inversion.

FIG. 7 is a rear view showing a reinforcing portion of the left foot orthosis.

FIG. 8 is an inner side view showing a reinforced portion of the left foot orthosis.

FIG. 9 is an outer side view showing the reinforced portion of the right foot orthosis.

FIG. 10 is a side view showing a conventional ankle brace.

FIG. 11 is a side view showing another example of the conventional ankle foot orthosis.

[Explanation of symbols]

 1 main body 2 triceps surae tendon transition part 3 foot point 5 front leg part 6 leg back 7 opening 8 ankle joint 8a ankle front face 8b ankle inner joint 8c ankle outer joint 10, 11, 12 belt 15 Lower end of tibia 16 Lower end of fibula 17 Heels 18, 19 Compression part 20 Bending part

Claims (1)

[Scope of utility model registration request] 1. From the front of the lower leg of the main body, which is formed of a material having appropriate elasticity, flexibility, and stretchability so as to entirely cover and cover from the triceps surae tendon transition part to the foot point. An opening with an appropriate width is opened in the range up to the back of the foot and the apex of the foot so that it can be fixed to the affected limb with a belt etc. A deformable and restorative compression part that applies required pressure from both left and right sides to the heel part is provided, and the front edge of the ankle joint of the main body has an opening edge of the opening part when the ankle joint is dorsiflexed. An ankle foot orthosis, characterized in that a flexion that can be opened and closed outward is provided on the line connecting the inner and outer ankle joints.