US1930188A - Orthopedic brace - Google Patents

Description

Oct. 10, 1933. e. v. ARTHUR ORTHOPEDIC BRACE Filed March 25, 1931 4 Sheets-Sheet l Frinna:

0ct.l0, 1933. G. v. ARTHUR 1,930,188

ORTHOPEDI C BRACE Filed March 23, 1931 4 Sheets-Sheet 2 1951 4 Sheets-Sheet 3 Filed March 23 (Ittorneg Oct. 10, 1933. 5. v. ARTHUR 1,930,188

ORTHOPEDIC BRACE Filed March 23, 1931 4 Sheets-Sheet 4 3nncntor Gttorncg Patented Oct. 10, 1933 UNITED STATES PATENT OFFICE 4 Claims.

This invention relates to orthopedic appliances and particularly such as are in the nature of a detachable remedial brace, having for its object to provide a construction more efficient in operation and less costly to manufacture than those heretofore proposed.

With these and other objects in View the invention resides in the novel details of construction and combinations of parts as will appear more fully hereinafter and be particularly pointed out in the claims.

Referring to the accompanying drawings forming a part of this specification and in which like parts are designated by like numerals,-

Fig. 1 is a perspective view of the main brace structure as it would appear when applied to a foot;

Fig. 2 is a perspective View somewhat similar to Fig. l and illustrating a reinforcing member which may be used in combination with the main structure shown in Fig. 1 or may be used independently thereof;

Fig. 3 is a side elevation of a foot showing in vertical cross section the combined main and reinforcing members in their applied position on the foot;

Fig. 4 is a development in plan view of the main brace member;

Fig. 5 is a View similar to Fig. 4 of the reinforcing member;

Figs. 6, '7 and 8 are viewsof modifications of the invention presently to be disclosed, indicating the application of such modifications to a foot;

Fig. 9 is a side elevation of a foot to which has been applied a main brace member similar to that shown in Fig. l but 'having incorporated therewith a reinforcement slightly different from that shown in Fig. 2; and

Fig. 10 is a bottom plan view of the parts shown in Fig. 9 in partly applied position on the foot.

This invention is particularly directed to a structure for use in connection with the treatment of fallen arch conditions of a foot, and therefore to a structure which has remedial effect upon not only the main arch of the foot but the transverse arch as well. This invention is not especially intended to cover a brace structure which is to be worn continuously on the foot although it may be so used, but this device is intended for application to a foot either after the muscles thereof have been subjected to considerable strain, or to be applied to a foot prior to a contemplated and known subjection of the foot muscles to increased and severe strains. The device is so planned and constructedthat, after formation to a foot, it is readily attachable and detachable or may be applied to a shoe structure and, as illustrated in Fig. 8, the invention contemplates the provision of a brace which may be retained either in remedial position or which can be loosened while still being worn, all in accord- T ance with the conditions to which the foot muscles have or may be subjected and according to the comforts of the patient.

Referring particularly to Figs. 1 and 4 the main brace structure comprises a cone generally indicated by the numeral 1 which is adapted to fit over and closely confine the forward instep of the foot. This cone has extensions constituting a pair of heel straps 2 and 3, the forward ends of which adjacently merge with the under portion of the cone substantially centrally of the foot; but the straps diverge rearwardly so that they pass to the side of and across the back of the heel as clearly indicated in the drawings,

the rear portion of each heel strap preferably being preformed with three diverging tabs clear- 13 indicated in Fig. 4. That is to say, the strap 2 has the tabs 4, 5 and 6, and the strap 3 has the tabs 7, 8 and 9. The purpose of this construction is to provide a blank which may be readily fashioned on and adapted to various shapes and conditions of feet, whereby it always results that each heel strap will have at least two tabs for securing the brace on the foot, one of these tabs encircling the ankle to meet the corresponding tab of the other heel strap, and the other tab passing completely around the rear of the heel and joined to said other heel strap.

Fig. I particularly shows the ultimate utilization of these tabs from which figure it will be seen that the tabs 6 and 9 have been removed as by cutting along the dashed lines 10 and 11 respectively whereby there remain the tabs'4 and 5 on the heel strap 2 and the tabs '7 and 8 on the heel strap 3. bent around the heel of the patient in order to-get the correct size, the extreme ends of said tabs subsequently being secured to the main portion of the adjacent heel strap as by stitching indicated at '12. their extreme ends fashioned suitably to secure said tabs in tight application around the ankle of the foot, there being illustrated a buckle 13 for this purpose. If the foot, to which this brace The tabs 5 and 8 have been .100 The other tabs 4 and 7 have was to be applied, had been of different size and/or shape, the tabs 4 and 7 would have been cut oil as along the dotted lines 14 and 15 respectively in which event the fastener such as the buckle 13 would have been applied to the ends of the tabs 5 and 8, and the tabs 6 and 9 would have been secured to the adjacent heel straps 3 and 2 respectively.

In order to maintain proper distribution of applied pressures in the brace, as well as to prevent too divergent spreading of the heel straps 2 and 3, one of said straps has integrally associated therewith (as through the stitching 16) one end of a cross strap 17 the other end of which is subsequently secured as by the stitchfin ing 18 to the adjacent heel strap 3 after the brace structure has been applied to the foot, and the correct length of the cross strap 1'7 ascertained, it being understood that the cross strap is positioned at substantially the center of the main arch of the foot. To further assist in the fitting of this brace to a foot there is attached to the heel strap 2 a relatively narrow strap or lacing 19 adapted to be of a length to tie with a similar lacing secured to the other heel strap 3, the pair of lacings extending laterally away from their heel straps up and around the instep of the foot as clearly indicated in the drawings.

The cone 1 is preferably formed integrally with the heel straps 2 and 3 whereby all of the parts of the main brace with the exception of the cross strap 17 and the lacings 19 and 20 may be stamped as a unitary piece from a sheet of heavy fabric, leather, or other suitable material. To this end the cone 1, in the precut blank, will have a shape as shown in Fig. 4. That is to say, there will be a portion at the forward end of the heel straps 2 and 3, which portion extends laterally of the brace as a whole in a direction at right angles to the generally longitudinal axis of the brace when applied to the foot. This portion 25 will fit the underside of the foot in the transverse plane thereof containing the forward or transverse arch. One side of this portion 25 is extended, to form the portion 26, in a direction substantially rectangular to the heel strap 2, said portion adapted to be folded upwardly and over to ultimately lie on the top of the foot above the portion 25. The other side of the main portion 25 is extended in a forwardly and decidedly curved direction to form the portion 27 which, when brought up and over the foot will lie in a superposed position with respect to the main portion 25, the extreme end of the portion 26 being laid exteriorly on the portion 27 and secured thereto as by the stitching 28 after the portions 26 and 27 have been drawn around the patients foot to obtain a close fitting thereover. In other words, the blank is formed as shown in Fig. 4 so that when the portions 26 and 27 are brought upwardly and across the top of the patients foot, said portions will naturally fall into overlapping position and create what' is termed the cone 1.

In the treatment of some foot conditions, it has been found highly advantageous to incorporate, with the main brace structure just described, a supplemental member or reinforcing brace which is applied exteriorly of the main brace, or applied after the main brace has been put in position on the foot. Such a reinforcing member is shown particularly in Figs. 2 and 5, and may be precut from a sheet of material substantially similar to the material of which the main brace is formed, and when so cut it will have the general shape of the blank shown in Fig. 5. In other words, there will be provided an oval shaped portion 30 joined to another oval shaped portion 31 by a relatively narrow band 32, the portions 30. and 31 having their major axes at substantially right angles to each other in the blank, and the band 32 so formed that when the blank is folded and applied as indicated in Fig. 2, the ovals 30 and 31 will be substantially coincident.

The oval 30 has an extension constituting a heel strap 33 the extreme end of which is provided with three tabs such as 34, 35 and 36 corresponding similarly to, the tabs 7, 8 and 9 of the heel strap 3 of the main brace. In like manner the oval 31 has an extension constituting a heel strap 37 the extreme end of which is provided with three tabs 38, 39 and 40 corresponding similarly to the tabs 4, 5 and 6 of the heel strap 3 of the main brace. Also lacings 41 and 42 are attached to the heel straps 33 and 37 respectively, and a cross strap 43 is carried by one of the heel straps, the parts 41, 42 and 43 being similarly formed, similarly placed, and for similar purposes, as the corresponding parts 20, 19 and 17 of the main brace.

When the reinforcement is applied to the foot the middle of the strap 32 is placed on the bottom of the foot and the two ends of the reinforcement brought upwardly and over to cross on the top of the foot as indicated at 44 in Fig. 2 where the crossing portions of the strap may be secured as by the stitching shown. The ends of the reinforcements are then passed downwardly and under the foot where the ovals 30 and 31 will ultimately lie, the heel straps 33 and 37 extending divergently rearward in substantially the same positions relative to the foot as the heel straps of the main brace above described. Likewise, according to the size and shape of the foot of the patient, one of the tabs at the end of each heel strap will be cut ofi leaving'two which will pass around the heel and be secured in place in a manner similar to that described for the main brace. v

When the reinforcing brace is used in its entirety as shown in Figs. 2, 3 and 5, and in conjunction with the main brace, the strap 32 is applied next to the foot on the underside thereof at substantially the mid point; then the toe portion of the foot is slipped into the cone 1 of the main brace and the remainder of the main brace applied tightly to the foot, utilizing sufficient pressure to hold the muscles of the foot in the desired positions intended. Then the remainder of the reinforcing strap is crossed above the forward part of the foot and over the upper portion of the cone 1, and th n brought down over the outside of the'cone and underneath the same to maize the ovals 30 and 31 lie immediately beneath the main portion 25 of the cone; then the heel straps of the reinforcing member are tightly drawn rearwardly, passed about the rear of the heel, and secured in place by whatever fastening (such as the buclde 45) is provided.

The modifications shown in Figs. 6, '7 and 8 embody the principles of the main brace structure shown in Fig. 1 in that there is provided the forward cone 1 which is fitted to the foot so that it accurately conforms with the contour thereof and will prevent the entire foot pushing forward through the cone to a point where the cone becomes ineflicient and inadequate to hold the muscles of the transverse arch. Joined to the cone at its under central part is a pair of heel straps the extreme ends of which, however, are not split or bifurcated, each heel strap being a unitary member. According to the construction shown in Fig. 6 these heel straps provide only a single securement across the back of the heel;

in Fig. '7 these heel straps are made longer so that they cross each other back of the heel and thence pass forwardly to encircle the ankle, the

correct tension of the brace as a whole being obtained in both of these modifications by use of a suitable fastener such as the buckle illustrated.

In Fig. 8 the construction of the brace is substantially identical with that shown in Fig. 6 except an adjustable securernent of the forward cone is provided by the use of a buckle instead of the stitching. Also Fig. 8 contemplates a brace which can be used in combination with an ordinary shoe, which has been provided with slits indicated at 50 on each side of the forward part, to receive therethrough the ends of the forward cone forming straps as will be readily understood whereby, after the shoe has been put on the foot, the forward cone straps may be drawn tightly and secured to create the proper tension on the forward arch of the foot. In a similar manner slots such as 51 are provided on the sides of the shoe at a point substantially in line with the forward edge of the leather heel thereof in order that the two heel straps may be passed therethrough to lie exteriorly of the shoe. The heel straps can then be adjustedfor tension as found suitable through the securing means such as the buckle shown.

The advantage of the modified construction shown in Fig. 8 lies particularly in the fact that some people have an arch condition which is not so aggravated that a brace would have to be used for a considerable length of time, although such a brace should be used at more or less frequent intervals to give relief and support to the muscles of the foot through use. Such people therefore might desire to go about their daily business, which naturally would necessitate or make desirable the wearing of their shoes. It would be an inconvenience for them to have to remove their shoes in order to adjust the braces, which adjustments including the release of pressure could very easily be done with the arrangements shown in Fig. 8.

The construction illustrated in Figs. 9 and 10 is another modification also involving the same principles heretofore described, in that there is provided the cone 1 at the forward part of the foot carrying the heel straps and 61 which are fashioned similarly to the heel straps 2 and 3, although they may if desired be lacking in the ankle encircling portions. In other words, the two end tabs of eachheel strap may be drawn tightly, cut off to measure. and then secured as by the stitching 62 to provide an unadjustable heel stirrup into which the heel of the foot is squeezed, the entire brace having additional pressure supplied thereto through the utilization of lacings 63 similar to those hereinbefore described. The main point of difference between the construction of this modification and those above pointed out lies in the integral incorporation of a reinforcing member with the main brace. This reinforcing member comprises a strap 64 the mid portion of which is positioned to lie in contact with the central under portion or arch of the foot as indicated at 65, the ends of said strap being brought up and crossing themselves over the top of the cone 1 as indicated at 66 and then extending down around the sides and the under portion of said cone. This strap is preformed of a length to lit the cone as well as the foot of the patient and therefore it is possible to have it of a length so that the extreme ends of said strap can be brought together in abutting relation as clearly indicated at 67in Fig. 10. Preferably the ends of this strap are flared or otherwise enlarged in area to provide a pad effect on the bottom of the cone 1 which will not be disagreeable or uncomfortable during walking. Stitching indicated at 68 secures the ends of this strap to the bottom of the cone 1.

The particular advantages in providing the reinforcing member in any of the constructions shown lie in the fact that an additional stress a may be placed upon the muscles of the foot by its use. In other words, as the cone 1 is drawn back upon the foot by pressures exerted through the heel straps, the foot will tend to cause the cone to expand, and this in turn will cause a foreshortening of the strap distance between the point shown in Fig. 10 and the crossing of the strap shown at 66 in Fig. 9, as a result of which an upward pull is exerted on the muscles and flesh in the under central portion of the foot. This naturally results in a tendency to raise the longitudinal or main arch of the foot thereby relieving the muscles associated therewith of undue strains and holding them up in place particularly when the weight of the body is not supported by the'foot.

In certain foot conditions, it may be found advisable to use an additional reinforcement in connection with the main brace, but it might not be necessary to use the entire reinforcing member as shown in Figs. 2 and 5. In the modification last described and illustrated in Figs. 9 and 10 it was shown how the reinforcing member could be utilized in combination with the main brace but devoid of any heel straps. Instead of having the ends of the reinforcing strap 64 terminating in abutting edges, as shown at 67, the blank reinforcing member illustrated in Fig. 5 could be utilized by cutting off the heel straps along the dot and dash lines 70 and 71 and letting the two ovals 30 and 31 overlap under and be stitched to the cone of the main brace.

Also for some curative or remedial effects it might be found advantageous to place an additional bracing efiect only on one side of the foot. In such a case, for example, the blank shown in Fig. 5 could be out along the dot and dash line 72 using only the oval 31 with its attached heel strap 37. Again, the blank shown in Fig. 5 might be used by cutting along the dot and dash line 70 and utilizing the parts 30, 31, 32 and 37 in a manner similar to that above described for obtaining not only an additional pressure on one side of the foot but the additional pressure created through the central part of the strap 32 passing beneath the center of the foot. Obviously by cutting along the dot and dash lines 73 or 71 portions of the entire reinforcing member could be obtained for application of additional pressures tothe opposite side of the foot and similar to those just described.

The particular feature desired stressed isthe fact that braces made in accordance with the above disclosures will be highly eflicient in curative or remedial effects due especially to (1) the provision of the cone forming portion of the brace encircling the forward arch of the foot, and (2) the divergent dispositon of the heel straps. That is to say, the cone formed either as a cone in Fig. 1 or as formed by the cross strap 32 shown in Fig. 2, will create a binding of the flesh and muscles associated with the transverse arch of the foot when the brace as a whole is applied tightly to the foot, thus giving nature a chance to remedy the laxity of the muscles and the fallen or broken down condition of the'muscles and the honey structure forming said transverse arch.

The other particular feature just recited, namely, the particular divergent disposition of the heel straps, is important because such divergence causes the strains inherent in the brace to be distributed as nearly accurately as is artificially possible to create the remedial effects on the transverse arch. In other words, and as perhaps can possibly be shown in Fig. 10, there is illustrated the bottom of the left foot to which is being the heel straps applied a remedial brace and it is quite clearly shown that the heel straps 60 and 61 are divergent, but they are connected by the cross strap 17 so that the degree of divergence is limited. When the brace is applied to this foot pressures are exerted rearwardly through the heel straps which in turn cause the cone 1 to be drawn into very tight contact with the flesh of the foot at the forward or transverse arch. Not only this, but the pressure exerted through the heel strap 60 will be transmitted in substantial coaxial prolongation of said strap to a point in the cone 1 on the side thereof adjacent the big toe; and-similarly the pressure exerted through the other heel strap 61 will be transmitted in substantial coaxial prolongation of said strap to a point in the cone 1 on the side thereof adjacent the little toe; in heretofore known types of orthopedic braces, the entire rearward pressure has been exerted only in a line which includes the longitudinal central axis of the foot, and therefore there has been a tendency of such heretofore braces creating a buckling in any portion thereof which was applied transversely about the forward. arch. As contradistinguished from this, the present invention contemplates the transmission of pressures through in a direction transversely crossing the foot, thus bringing the pressures to bear as much as possible inwardiy from the extreme sides of the foot, resulting-in a greater degree of compactness of the flesh and muscles adjacent the transverse arch, which results in at raising of said arch.

Summarizing the foregoing, it therefore results that this invention contemplates not only an orthopedic brace but one which can be made from a single sheet of material to the end that it can be fitted to a patients foot,then cut and stitched, much in the same manner as a garment is treated by a tailer. Thus while the blanks shown in Figs. 4 and 5 can be furnished to orthopedists, yet they will require but little change in order to fit all shapes and conditions of feet. The limitation of the divergence of the heel straps is accomplished not only by the positioning and securement of the cross straps such as 17, but also by oneof the tabs of each of the heel straps. In other words, the diverging heel straps will have a tendency to pass from under the foot to assume a positionon the rear and lateral side of the foot as shown in Figs. 6, 7 and 8, but this increased divergence is prevented by the cross strap and also by such straps as 5 and 8 illustrated in Fig. l which will assume low positions around the sides of the heel, and thus made to prevent the heel straps from climbing higher than would be desirable. It may be desirable in some instances to provide a single continuous heel strap instead of the pair of straps illustrated in which case the single strap will be made integral at one end with the cone-forming portion of the brace, the other free end secured as by stitching to said portion after fitting the brace to the foot, whereby the combined cone and heel strap may still be formed unitarily from sheet material. The material from which these braces are fiashicned contains no rubber as has been heretofore used, and therefore the forward arch encircling portion of each brace after being fitted to the foot will have a dimension incapable of yielding. In other words, by this invention there is provided an efficient check of the spread of the arch which occurs when the weight of the body or a material portion thereof is sustained by the foot atthe end of the normal spread of the arch, thereby preventing the normal spread extending into a state of collapse. These braces exert no tension when the foot is free of sustained weight and permit free blood circulation. I

It isobvious that those skilled in the art may vary the details of constructions as well as arrangements of parts without departing from the spirit of the invention and therefore it is not desired to be limited to the foregoing except as may be required by the claims.

Whatis claimed is:-

1. An orthopedic brace the same comprising a cone fitting the forward arch portion of the foot;

9, pair of rearwardly diverging straps joined to said cone; and tabs formed on the rear end of each strap to secure the brace in position, one of the tabs of each strap encircling the ankle and another of the tabs of each strap encircling the heel, the ankle engaging tabs secured to each other and the heel engaging tab of each strap secured to the other strap.

2. An orthopedic appliance the same comprising a main brace and a reinforcement therefor; the main brace having a forward arch encircling portion of unyielding dimension held in place by rearwardly diverging straps disposed under the foot and terminating in securing tabs encircling the ankle and the heel; the reinforcement comprising a strap disposed under the foot back of the forward arch, the ends of the strap brought upwardly over the sides of the foot, crossed on top of the arch encircling portion, brought downwardly over the sides of and crossed beneath the arch encircling portion, and extended rearwardly under the foot, terminating in securing means.

3. A blank for forming anorthopedic brace from sheet material, said blank comprising a portion generally of J shape which when secured around the forward arch section of the foot will form a forwardly tapering cone; a pair of divergent straps joined to one edge of the cone forming portion in close juxtaposition said straps adapted to pass under the foot and back of the heel to force the cone into binding relation with respect to the forward arch section of the foot; and a plurality of tabs formed in substantial prolongation of each strap, said tabs divergently disposed and adapted to encircle the heel and the ankle to secure the brace on the foot.

4. A blank for forming an orthopedic brace from sheet material, said blank generally of M shape and comprising a strap portion constituting the V of the M, said strap portion terminating in enlarged ovals, the. ovals having their major axes disposed substantially at right angles to each other whereby when the strap portion is wrapped around the forward arch section of the foot the strap will form a cage with the ovals in registry and forming, a pad under the ball section of the foot; a pair of heel straps joined respectively to the ovals and constituting the outer legs of the M, each heel strap disposed at an angle to the major axis of its adjoined oval, said heel straps adapted to pass under the foot and back of the heel to force the cage into bindingv relation with respect to the forward arch section of the foot; and a plurality of tabs formed in substantial prolongation of each heel strap, said tabs divergently disposed and adapted to encircle the heel and the ankle to secure the brace on the foot.

GILBERT V. ARTHUR.

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