RU208981U1 - DEVICE FOR THE TREATMENT OF CONGENITAL FOOT DEFORMATION IN INFANT CHILDREN - Google Patents

Abstract

The device relates to medicine, and specifically to the designs of orthopedic shoes (brace) prescribed for the treatment of clubfoot, adduction of the forefoot and vertical ram in children, mainly in the younger age group. A device for the treatment of congenital deformities of the feet in young children, including elements for fixing the feet, a corrective splint made of two parts, at one end of each of which a mechanism for fixing and angular adjustment of the boot is installed, and the other ends of the splint are fastened together by a connecting element that provides the ability to changes in the total length of the tire, characterized in that the foot fixation elements are made in the form of transparent orthopedic boots, the boot consists of four main parts: the sole, which passes into the heel stiffening element, the upper part of the boot, straps on movable fasteners, pressure saddle. The sole with a heel stiffener is made of a solid polymer material and is a single cast element. The sole is anti-varus, that is, the medial and lateral sides of the boot are equal, and they can be worn on any foot. The upper of the boot is made from a flexible, transparent polymer and is co-polymerized to the sole, creating a single molded piece. The joint polymerization method eliminates the peeling of the upper part of the boot from the sole, which provides an absolute healing effect. Simplification of adjustment and increase in the accuracy of the installation of angular abduction and dorsal flexion is achieved through the use of the mechanism of fixation and angular adjustment proposed in the utility model. This function is very important, for example, in case of unilateral deformity, when flexion of a healthy limb in the ankle joint is not necessary, or in the case of a vertical ram, congenital adduction of the forefoot. Setting the dorsal flexion at 10-15-20 degrees of a boot for a clubfoot allows many times to reduce the percentage of tendon transplantation of the anterior tibial muscle, because. the proposed design performs early activation of the antagonist muscles immediately after the removal of the last cast. The inventive device is highly manufacturable, easy to use, allows you to quickly correct the deformity of the foot and get a good functional result without complications and technical difficulties, while the manufacture of the device does not require significant material costs. 3 w.p. f-ly, 23 figs.

Description

Technical field

The utility model relates to medicine, and specifically to the designs of orthopedic shoes (brace) prescribed for the treatment of clubfoot, forefoot adduction and vertical ram in children, mainly of the younger age group.

Among the most common deformities of the lower extremities, as a rule, congenital deformities are distinguished, such as clubfoot (accounting for 13 cases per 1000 newborns), vertical or oblique ram (occur in 1 case per 10,000 newborns), adduction of the forefoot (1 case per 1000 newborns ).

All of these ailments of the lower extremities (clubfoot, vertical or oblique ram, adduction of the forefoot) have a similar main stage of treatment - deformity correction with plaster bandages. And the final stage of treatment is to maintain the achieved correction result with the help of specialized orthopedic shoes - braces.

However, there is a significant drawback associated with the design of the used orthopedic splints. This disadvantage when using existing splints is that if it is necessary to fix the feet in one plane, movements in other planes are impossible, which has an extremely negative effect on the development of the muscles of the lower extremities, and which provokes the patient's great discomfort and an increase in the frequency of relapses. The main reason for relapse, according to most of the world's most respected orthopedic doctors (Dr. Christof Radler as part of the OMI Satellite Symposium on November 25, 2011), is the failure of parents to wear their child's braces. The main reasons for non-compliance with the regime, most parents call: the discomfort of the child due to the limited range of motion of the lower extremities. It should be noted that children with congenital clubfoot disease require special care and treatment. Special individual orthopedic shoes, as well as brace (Denis Brown's splint) are expensive.

The scientific and technical task in the treatment of children with congenital clubfoot is to create special devices for orthopedic shoes that would provide maximum comfort for the child and the highest possible degree of mobility of the lower extremities while maintaining the correction.

Prior Art

To assess the novelty of the claimed solution, consider a number of well-known technical means of a similar purpose, characterized by a set of features similar to the claimed device.

A device for the treatment of congenital clubfoot in young children (RU 107476 U1, IPC A61F 5/00, priority 07/21/2010, publication 08/20/2011) is known, containing insoles with foot fixation elements, which are made in the form of a pair of leather orthopedic shoes with a tongue and with an open toe, equipped with three fixing straps attached from the medial side of the shoes, and buckles from the lateral side, both foot pads are made in the form of metal plates commensurate with the sole of the shoes, each attached from the heel side to its own metal bar with the possibility of establishing angles between the foot pad and the bar from 30° to 70° for a possible change in position in the horizontal plane to ensure the abduction of the foot by 30-70°.

The disadvantages of the known device are the complexity of the design of the device, expressed in bulkiness, which makes it difficult to care for a sick child. Deformation elimination can only be achieved in certain planes. During fixation, some movements of both lower limbs are excluded, which can lead to hypotrophy, muscle atrophy. This device is quite complicated and time-consuming in setting up the horizontal abduction of the foot and the device does not provide for setting the dorsal flexion, which is important in the treatment of clubfoot, for the prevention of recurrence of the equinus. The disadvantage is also the difficulty of separating the boot from the midsole.

A set of children's orthopedic shoes for maintaining treated congenital clubfoot is known (patent RU 176962 U1, IPC A61F 5/00, priority 08/29/2017, publication 02/02/2018), including a pair of orthopedic shoes, a mechanism for their fastening, a mechanism for changing and fixing the angle of abduction of the feet, as well as a bar connecting orthopedic shoes, made of two parts, at one end of which there are platforms for orthopedic shoes, and its other ends are fastened together by a clamping sleeve with the possibility of changing their total length, characterized in that the mechanism for attaching orthopedic shoes is made in the form of a nest on its sole, which, when putting on shoes, includes a spring-loaded latch located on the upper side of the mechanism for changing and fixing the angle of abduction of the feet, which is made in the form of a protrusion on the underside of this mechanism, which enters one of the through radial slots made in the horizontal part platform, the vertical part of which is hinged connected to one of the parts of the vertically oriented bar with the possibility of rotating the horizontal part of the platform around the horizontal axis, while in the horizontal part of the platform and in the mechanism for changing and fixing the angle of abduction of the feet, coaxial holes are made in which the bolt connecting them is placed.

This technical solution ensures the achievement of a technical result, which lies in the fact that, unlike many existing analogues, the claimed kit provides the ability to move in a plane different from the plane of fixation of his feet, in this case in a vertical plane, which is more physiological, does not cause discomfort patient and has a positive effect on the development of the muscles of the lower extremities, reducing the degree of their atrophy. The latter will reduce the percentage of tibialis anterior tendon transplantation, as The proposed design will allow early activation of the antagonist muscles immediately after the removal of the last cast.

The disadvantages of this device is the absence of a limiter on the hinges of the rotation mechanism, which allows the patient to move the lower limbs in the frontal plane by 180 degrees, which can lead to undesirable results, namely, "twisting" of the feet, turning off the antagonist muscles, increasing the mobility of the knee joint ligaments and, as a result, the appearance of instability (knee joint), a decrease in the therapeutic effect of the structure. All of the above reduces the effectiveness of treatment and comfortable conditions for the patient during its operation.

The closest analogue (prototype) is a device for the treatment of congenital clubfoot, (RU 143629 U1, IPC A61F 5/01, priority 11/07/2013, publication 07/27/2014 - prototype), containing foot pads in the form of plates, commensurate with the size of the shoe sole, associated with foot fixation elements, made in the form of a pair of leather orthopedic shoes with a tongue and an open toe, equipped with three fixing straps attached from the medial side of the shoes, and buckles from the lateral side, and with a removable shoe fastening device to provide the possibility of unfastening and fastening it to the footrest , as well as with metal slats through a structure that allows for dorsiflexion of the foot and adjustment of the position of the forefoot relative to the heel, while the long side of the metal slats is rigidly connected to each other to form a common spacer with the possibility of expanding it, it is made so that each footrest is connected to fixation element feet through the landing bar, rigidly fixed on the sole by means of two screws, screwed into the nuts connected by a metal bridge, pressed into the soles of the shoes in advance, while the footplate and the landing bar are made to form a detachable dovetail joint with a fixing latch, and the design, providing dorsiflexion of the foot (dorsiflexion) and adjustment of the position of the forefoot relative to the heel, is a rotary device with a toothed lock that allows you to change the angle between the footrest and the bar in the horizontal plane from 0 to 90 degrees in 10-degree increments and change the inclination of the foot ( back flexion) from 0 to 20 degrees, connected to the metal bar with one screw, which provides the possibility of adjustment when loosening, and fixing the selected and installed settings when tightened.

The product design described in patent RU 143629 U1 and its adjustment during operation has significant advantages over many other devices. Simplification of the design is achieved by simplifying the fastening of the foot fixation element on the footrest by using a dovetail-type detachable connection with a fixing latch. The adjustment was simplified by developing a design containing a toothed lock for adjusting the position of the forefoot relative to the heel, a hinge mechanism for adjusting the dorsiflexion of the foot, and one fixing screw, which provides the possibility of adjustment when loosening, and fixing the selected and installed settings when tightened. The effectiveness of treatment was increased due to the possibility of prompt adjustment of the foot inclination (dorsal flexion) in the range from 0 to 20 degrees and expansion of the range of horizontal abduction to 90 degrees in 10-degree increments.

However, over time, shortcomings were found in this design. These include the design of an orthopedic boot made of leather and not providing a clear fixation of the patient's foot and visual control of its position, the complexity of the mechanism for fixing the boot on the tire, the use of metal elements in the design, which creates inconvenience in use, makes the device heavier. The manufacturing process of the device is quite laborious and costly.

The objective of the utility model is to develop a device for the treatment of congenital deformities of the feet using orthoses for abduction of the foot and ankle in order to prevent recurrence of the deformity after correction of the clubfoot, which meets the requirements of the treatment process as much as possible. Development of orthopedic footwear that prevents relapses and ulcers, has high technological, ergonomic and organoleptic properties, which is easily attached to the tire, and creates comfortable conditions for the child, the attending physician and parents.

Utility Model Disclosure

The essence of the claimed technical solution is expressed in the following set of essential features sufficient to solve the problem and achieve a new technical result.

According to the utility model, a device is proposed for the treatment of congenital deformities of the feet in young children, including foot fixation elements made in the form of orthopedic boots with a hard sole and with an open toe, equipped with three fixing straps and buckles, a splint made of two parts at one end each of which has a mechanism for fixing and angular adjustment of the boot, which includes a device for removable fastening of the boot and a device for adjusting the angle of abduction in the horizontal plane from 0 to 90 degrees and back flexion from 0 to 20 degrees, which is a rotary device with a ball joint and a toothed lock connected to the removable boot fastening device and connected to the tire with a screw passing through the axis of the rotary device and the hinge, providing the possibility of adjustment when loosened, and fixing the selected and installed settings when tightened, and the other ends of the tire are fastened together by a connecting element, providing giving the possibility of changing the overall length of the tire, in which new distinctive features are introduced.

The foot fixation elements are made in the form of transparent orthopedic shoes, each of which consists of four main parts: the sole, which passes into the heel stiffening element of the boot, the upper part of the boot, belts, pressure saddle, while the sole is anti-varus and, together with the heel stiffening element, is made of hard polymeric material, such as PVC, you can also use another material suitable for the sole, has transverse diagonal ribs, perforations, and is a single molded element,

the upper part of the boot is made up to the border between the middle and lower third of the child's shin, made of an elastic transparent polymer, for example, PVC, but not limited to, and is attached to the sole by co-polymerization, creating one molded part, a ventilation system is provided throughout the upper part of the boot : Moisture wicking and perforations that mimic those of the outsole

each shoe is made with an anatomical fit of the heel area, repeating the shape of the foot, due to the expanded part of the shoe in the heel area and the narrowing of the shoe above the heel tubercle,

straps for fixing the foot in the boot are made of a polymeric material such as thermoplastic polyurethane, but can be made of leather or any elastic but durable material,

on the back of the ankle joint there is a short or long pressure saddle with eyelets for fixing the belt, made of a soft polymer material, for example, PVC, but not limited to, and perforation and moisture wicking are made on the inside of the saddles.

Both parts of the tire and the connecting element are made of a durable polymer material, for example, polyamide, while the parts of the tire are identical in design, have an I-beam shape in cross section and end at one end with a round platform with a hole and technological recesses for the mechanism of fixation and angular adjustment of the boot, moreover, the recess on the upper plane of the platform, having the shape of a bowl with annular thread, is designed to mate with the movable part of the ball joint, the recess on the lower plane of the platform is provided with a radial gear thread and is designed to match with the rotary device.

The movable part of the ball joint is made in the form of a hemisphere, ending at the top with a horizontal platform, and having a radial slot in the vertical plane, above which teeth are made on both sides, which, when the device is mounted, engage with the annular thread, providing adjustment and fixation of the rear flexion after 5 degrees in the range of 0-20 degrees,

the rotary device is made in the form of a disk with a protrusion along the central axis in the form of a cylinder with cut parallel side segments, with a central hole and with a toothed radial thread on one side and with an angular adjustment scale on the other side and is connected to a ball joint through a hole in the platform with a screw, which, when tightened, fixes both parts on the platform.

The connecting element consists of two half-couplings with longitudinal grooves, which, when folded, form a section that matches the section of the busbar in shape and size, tightened after adjusting the total length of the busbar with screws.

Removable shoe fastening device is made in the form of a rectangular platform with two spring clamps, installed on a horizontal platform of a ball joint, equipped with buttons for closing/opening the clamps, and inserted into a cavity molded in the hard sole of the boot along the line of its axial symmetry with two recesses, which include latch protrusions.

Additional distinguishing features:

the short pressure saddle has two lugs, made symmetrically about the longitudinal axis of the saddle for fixing the middle belt.

the long pressure saddle has one lug on the longitudinal axis of the saddle for fixing the middle belt;

long pressure saddle has two lugs on the longitudinal axis of the saddle for fixing the upper and middle belt;

long pressure saddle has three lugs on the longitudinal axis of the saddle for fixing the upper, lower and middle belt;

straps for fixing the foot in the boot are attached to the sole using movable fasteners, such as metal axles;

belt buckles are equipped with a curved tongue;

on the heel area of the boot on both sides there are two viewing holes.

The claimed device is novel in comparison with the prototype, differing from it in the declared essential features, which together ensure the achievement of a new technical result.

The claimed device is a development of the prototype design, the patentee of which is the applicant of the proposed utility model, is widely used in medicine, namely in traumatology and orthopedics, and therefore meets the criterion of "industrial applicability".

Brief description of the drawings

The utility model is illustrated by images, which are shown on:

Fig. 1. Side view of the boot

Fig. 2. View of the boot from the other side

Fig. 3. Side view of the upper transparent part of the boot

Fig. 4. Front view of the upper transparent part of the boot

Fig. 5. Perspective view of the upper transparent part of the boot from the sole

Fig. 6. Front view of a boot with a short pressure saddle

Fig. 7. Front view of a boot with a long pressure saddle

Fig. 8. Front view of short pressure seat

Fig. 9. Rear perspective view of the short pressure seat

Fig. 10. Front perspective view of the long pressure seat

Fig. 11. Rear perspective view of the long pressure seat

Fig. 12. Front view of the boot with the spatial separation of the movable strap fasteners

Fig. 13. Shoe sole in perspective

Fig. 14. View of the mechanism of fixation and angular adjustment of the boot to the tire in perspective from above

Rice. 15. Side view of the boot locking mechanism and angle adjustment

Fig. 16. View of the locking mechanism and angle adjustment in perspective from below

Fig. 17. Top view of the tire in perspective

Fig. 18. View of the connecting element of the tire in perspective from below

Fig. 19. Sectional view of the tire connector

Fig. 20. View of one part of the tire with a spatial separation in perspective from above

Fig. 21. View of one part of the tire with a spatial separation in perspective from below

Fig. 22. View of the tire with the spatial separation of the locking mechanism and angular adjustment in perspective

Fig. 23. Exploded perspective view of the complete brace set

Description of the claimed device

1. In FIG. 1 shows the boot 100 from the side. The shoe consists of four main parts: the sole 101, passing into the heel stiffener 102; the upper part of the boot 103; belts 104 on movable mounts 105; pressure saddles 106. The sole 101 with the heel stiffener 102 is made of a hard PVC polymer material and is a single molded element. The sole is anti-varus, that is, the medial and lateral sides of the boot are equal, and they can be worn on any foot. The upper 103 of the boot is made of flexible, transparent PVC polymer and is co-polymerized to the sole, creating a single molded piece. Polymerization, unlike gluing, ensures the reliability and versatility of the method. The shoe straps 104 are made of thermoplastic polyurethane and are attached to the sole by movable attachments 105 such as metal axles, allowing replacement of damaged elements. The pressure seat 106 is made of PVC polymer material and is placed on the middle belt. Since the entire shoe is made of polymer material, it is easy to use and maintain. The boot can be washed in the dishwasher or washing machine.

2. In FIG. 2 shows boot 100 from the other side.

3. In FIG. 3 shows the upper transparent part 103 of the boot 100. In contrast to the opaque material, the proposed polymer provides absolute visual control of the foot in the boot. In addition, two viewing holes 107 are provided on the back of both sides to check the correct fit of the heel. A ventilation system is provided throughout the upper 103: moisture wicks 108 and perforations 109. This ensures minimal perspiration and therefore prevents foot wrestling, maceration and irritation. Through perforation is also provided on the solid sole 101 (Fig. 1). Minimization of maceration provides softness and elasticity of the material.

4. In FIG. 4 shows the upper transparent part 103 of the shoe 100, seen from above.

5. In FIG. 5 shows the upper transparent part 103 of the shoe 100 in perspective, seen from the sole. The perforation 109 repeats the perforation of the sole 101.

6. In FIG. 6 shows the boot 100 in perspective with the pressure saddle 106. This saddle reduces the pressure of the middle strap on the shin, as the braces require a strong fixation, which often leads to maceration and calluses.

7. In FIG. 7 shows the boot 100 in perspective with a long pressure saddle 110. For newborns with hypersensitive skin, a long saddle is provided to distribute the pressure of three straps at once.

8. In FIG. 8 shows a short pressure seat 106 in front perspective. It is a single molded piece of soft polymer with two lugs 111 for the middle strap.

9. In FIG. 9 shows the short pressure seat 106 in rear perspective. A moisture wicking system 112 is made over the entire surface of the saddle.

10. In FIG. 10 shows a long pressure saddle 110 in front perspective with one lug 113 for the middle belt.

11. In FIG. 11 shows the long pressure seat 110 in rear perspective. A ventilation system is made over the entire surface of the saddle: perforation 114 and moisture vents 115.

12. In FIG. 12 shows a boot 100 with a spatial separation of the straps 104 and movable bindings 105.

13. In FIG. 13 shows the sole 101 of the shoe 100. The sole is a single molded piece of hard polymer and all of its elements are an integral part. Cross-diagonal ribs 116 provide extra rigidity and lightness to the outsole. The attachment cavity 117 and the recesses of the latch 118 provide a comfortable and strong fixation of the boot to the tire. The perforation 119 on the sole 101 repeats the perforation 109 on the transparent part 102.

14. In FIG. 14 shows the tire element 120 - the mechanism for fixing and angular adjustment of the boot. The pad 121 is inserted into the boot attachment cavity 117 (FIG. 12) until the latches 122 snap into the recesses 118 (FIG. 12) in the locked position. The disengagement of the boot and the tire occurs through the button 123, which actuates the spring mechanism and closes the latches 122 to remove the boot. The mechanism 120 allows adjustment of the angle of abduction from 0° to 90° and the angle of dorsal flexion from 0° to 20°. Zero dorsiflexion is important in the treatment of congenital vertical talus, as well as in unilateral foot lesions, so as not to cause discomfort to the child. The angular adjustment mechanism is equipped with a ratchet 124, which allows you to easily and accurately set the required angle, each division is 5 °.

15. In FIG. 15 shows the mechanism for fixing the boot and angulation on the side.

16. In FIG. 16 shows the boot locking mechanism and angle adjustment in perspective from below.

17. In FIG. 17 shows tire 125. The tire is made of a durable plastic material, polyamide. It consists of a central connecting element 126, a right and left part 127 and is equipped with a boot locking mechanism and an angular adjustment 120.

18. In FIG. 18 shows the connecting element 126 of the tire 125, a perspective view from below. The element connects the right and left parts 127 through six screws 128. The connecting element allows you to change the center distance of the tire as the child grows until the end of treatment.

19. In FIG. 19 shows the connecting element 126 of the tire 125 in section. To change the center distance, it is required to loosen the screws 128 that press the right and left parts 127 by tightening the connecting element.

20. In FIG. 20 shows the spatial separation of one part of the tire 127 with the boot locking mechanism and the angle adjustment 120, in perspective view from above. The boot locking and angulation mechanism 120 is located in the cup 129 of one part of the tire and is attached with a single screw 130. To adjust the angle of abduction and dorsal flexion, you need to loosen the screw, set the desired angle and tighten the screw. The boot locking and angle adjustment mechanism is equipped with a ratchet and a 131 degree scale.

21. In FIG. 21 shows the spatial separation of one part of the tire 127 with the boot locking mechanism and the angular adjustment 120, a perspective view from below.

22. In FIG. 22 shows the spatial separation of the tire, boot locking mechanism and angular adjustment.

23. In FIG. 23 shows the device in a complete set with a spatial separation of elements.

When using the proposed device, a medical worker or a parent fixes the shoes on the turntables by sliding the platform into the grooves of the boot until the latches snap into place in the recesses of the groove. Next, adjust the distance between the shoes. To do this, loosen 6 screws on the tire connecting element, which fixes the straps, and set the required distance between the shoes by expanding or moving the straps, then tighten the screws. Then, the required values of the angles of horizontal abduction of the boot and back flexion are set. To do this, loosen the axial screws on the mechanism of fixation and angular adjustment, and by turning the movable part of the mechanism, set the angle of horizontal retraction and rear flexion. After setting the desired settings for abduction and dorsal flexion, the axial screw is tightened. After the adjustment is completed, the shoes are removed from the structure. To remove it, you need to press two buttons on the fastening and angular adjustment mechanism to close the latches on the turntable, after which the shoes are easily shifted and removed from the device. Next, the shoes are put on the child's feet and fixed with straps. In order to ensure the most complete contact of the child's foot with the inner side of the sole of the boot, it is recommended to fix the straps in a certain sequence. Tighten the middle strap first, then the bottom strap, and finally the top strap. Next, the shoes are again fixed on the structure.

Achievable technical result

The device proposed in the utility model has a number of advantages.

Lightness, compactness, ease of use of the proposed brace while meeting the requirements of the treatment process. The co-polymerization method allows the boot to be converted into a single molded part. This eliminates the peeling of the upper part of the boot from the sole (as opposed to gluing) and provides an absolute healing effect. The ventilation system minimizes perspiration, ensuring the comfort of the brace and reducing the degree of maceration of the foot. A long pressure saddle distributes the pressure of the straps, minimizing microtrauma (abrasions, bruises, calluses) of the foot when wearing brace. The shape of the shoes is designed taking into account the anatomical features of the foot, which ensures maximum girth and fixation of the leg. Suitable for the treatment of typical and atypical clubfoot. The shape of the heel and the provided longitudinal-transverse elastic ribs allow the child's foot to take the correct position. The transparent material of the brace provides maximum control of the correct position of the heel and is safe to use, non-toxic and does not cause allergic reactions. The perforation and moisture wicking system prevent intense sweating, preventing the baby's feet from rubbing and chafing.

Simplification of adjustment and increase in the accuracy of the installation of angular abduction and dorsal flexion is achieved through the use of the mechanism of fixation and angular adjustment proposed in the utility model. The mechanism for setting the angle of abduction of the foot is equipped with a ratchet, with the help of which the desired angle is accurately set from 0 to 90 degrees. This function is very important, for example, in case of unilateral deformity, when flexion of a healthy limb in the ankle joint is not necessary, or in the case of a vertical ram, congenital adduction of the forefoot. In such cases, a zero position is established (without dorsal flexion), which is more physiological, does not cause discomfort to the patient and has a positive effect on the development of the muscles of the lower extremities, reducing the degree of their atrophy. Setting the dorsal flexion at 10-15-20 degrees of a boot for a clubfoot allows many times to reduce the percentage of tendon transplantation of the anterior tibial muscle, because. the proposed design performs early activation of the antagonist muscles immediately after the removal of the last cast.

Claims (4)

1. A device for the treatment of congenital foot deformities in young children, including foot fixation elements made in the form of orthopedic boots with a hard sole and with an open toe, equipped with three fixing straps and buckles, a splint made of two parts, at one end of each of of which a mechanism for fixing and angular adjustment of the boot is installed, including a device for removable fastening of the boot and a device for adjusting the angle of abduction in the horizontal plane from 0 to 90 degrees and rear flexion from 0 to 20 degrees, which is a rotary device with a ball joint and a toothed lock, connected with a removable boot fastening device and connected to the tire with a screw passing through the axis of the rotary device and the hinge, which, when loosened, makes it possible to adjust, and when tightened, fixes the selected and installed settings, and the other ends of the tire are fastened together by a connecting element, which makes it possible to change the overall tire length, characterized in that the foot fixation elements are made in the form of transparent orthopedic shoes, each of which consists of four main parts: a sole with a heel stiffening element, the upper part of the boot, belts, a pressure saddle, while the sole is anti-varus and together with a stiffening element the heel is made of a solid polymer material, has transverse diagonal ribs, perforations and is a single cast element, the upper part of the boot is made up to the border between the middle and lower thirds of the child's shin from an elastic transparent polymer and is attached to the sole by copolymerization, creating one cast detail, ventilation means are provided along the entire upper part of the boot: moisture wicking and perforation, repeating the perforation of the sole, each boot is made with an anatomical fit of the heel area, repeating the shape of the foot, due to the expanded part of the boot in the heel area and the narrowing of the boot over the heel tubercle, on the back side ankle a pressure saddle with eyelets for fixing the belt, made of soft polymer material, is installed on the entire surface of the saddles, and perforation and moisture wicking are made on the inside of the saddles, both parts of the tire and the connecting element are made of plastic material, while the parts of the tire are identical in design, have in cross section, the shape of an I-beam and at one end end with a round platform with a hole and technological recesses for the mechanism of fixation and angular adjustment of the boot, and the recess on the upper plane of the platform, which has the shape of a bowl with annular thread, is designed to mate with the movable part of the ball joint, the recess on the lower plane of the platform is equipped with radial gear cutting and is designed to match with the rotary device, the movable part of the ball joint is made in the form of a hemisphere, ending at the top with a horizontal platform and having a radial slot in the vertical plane, above which on both sides there is a teeth are full, which, when mounting the device, engage with the annular thread, providing adjustment and fixation of the back flexion after 5 degrees in the range of 0-20 degrees, the rotary device is made in the form of a disk with a protrusion along the central axis in the form of a cylinder with cut parallel side segments, with a central hole and with a toothed radial thread on one side and with an angle adjustment scale on the other side and is connected to the ball joint through a hole in the platform with a screw that, when tightened, fixes both parts on the platform, the connecting element consists of two coupling halves with longitudinal grooves, which when folded, they form a section that is consistent in shape and size with the section of the tire, tightened after adjusting the total length of the tire with screws, the removable boot fastening device is made in the form of a rectangular platform with two spring clips, installed on a horizontal platform of a ball joint, equipped with buttons for closing / opening the latch into and inserted into a cavity molded in the hard sole of the boot along the line of its axial symmetry with two recesses, into which the protrusions of the clamps enter. 2. The device according to claim 1, characterized in that the straps for fixing the foot in the boot are attached to the sole using movable fasteners, such as metal axles. 3. The device according to claim. 1, characterized in that the belt buckles are equipped with a curved tongue. 4. The device according to claim. 1, characterized in that on the heel area of the boot on both sides there are two viewing holes.

Images