US3413977A - Corrective shoe - Google Patents

Description

Dec. 3, 1968 A; SOBLE ET A. 3,413,977

CORRECT IVE SHOE Filed Oct. 22, 1965 2 Sheets-Sheet l ABRAHHM SOBL-E 5y HHRoLD CpHToR Dec. 3, 196s A, SOBLE ET AL' 3,413,977

CORRECTI VE SHOE Filed ocr. 22, 1965 2 Sheets-Sheet 2 ABRAHAM SoBLE HnRoL-v cnNTOR United States Patent O 3,413,977 CORRECTIVE SHOE Abraham Soble, Cedarbrook Hill Apts., Wyncote, Pa.

19095, and Harold Cantor, 940 E. Slocum St., Philadelphia, Pa. 19150 Filed Oct. 22, 1965, Ser. No, 501,570 7 Claims. (Cl. 12S-583) ABSTRACT OF THE DISCLOSURE A corrective shoe for the treatment and correction of club foot deformity (talipes equino-varus) having a strap adapted to be drawn tautly across the instep of the wearers foot in a direction to pull the hindefoot portion of the foot into a position of valgus, the pull being from a fixed point on the lateral or distal side of the heel pocket of the shoe which overlies the tarsal bones to a point of quick-releasable securement on the opposite medial side f the heel pocket, the strap being operative to hold and maintain the hind-foot in that firm condition of valgus which was initially obtained by casting. The outer exposed surface of the strap on the medial side of the shoe is smooth and free of protuberances which might injure the flesh or skin upon scraping contact therewith of the tautly secured strap.

This invention relates generally to corrective shoes and more particularly to improvements in the design and construction of shoes adapted to maintain the correction achieved by previous therapy, such as conventional casting procedures, for correction of that species of club foot deformity, known as talipes equino-varus, in which the foot is drawn upwardly and bent inward out of its normal position.

The present methods employed for correction of talipes equino-varus, whether by casting along or by surgery combined with casting, require that when the shoe is worn following such treatment its last should be such as to hold the hind foot in a condition of valgus with the fore foot portion turned distally outward beyond and away from the medial axis of the normal foot position, while at the same time maintaining adequate pressure under the cuboid region of the foot. This forcing of the fore part of the foot outwardly is known as abduction and is sought to be achieved by fixing the hind part of the foot in a neutral or somewhat valgus position simultaneously as the fore part of the foot is held in more or less pronounced abduction by providing the shoe with an outward flare which originates in the taloscaphoid and calcaneo-cuboid joint areas of the foot and extends toward the toe of the shoe at an angle of about 30 degrees with respect to the medial front to rear axis of the normal foot.

Most feet corrected for talipes equino-varus by casting or other therapy retain some tendency toward undesired rotation of the hind portion into varus when the forefoot portion has been brought into abduction. While corrective shoes have been designed and are in use for maintaining the forefoot portion in abduction, their upper boot portions have been invariably provided with fastening straps having buckles or other securing means disposed on the distal or outside of the Shoe and so arranged that when the strap is drawn taut, the heel and ankle portion of the foot is pulled in distal (varus) direction, i.e., toward the outside of the foot tending to shift the hind foot portion out of its desired valgus condition. This, of course, defeats the primary objective which is to maintain the hind foot in valgus while holding the forefoot in its abducted correction.

While various attempts have been made heretofore to ICC hold the heel and ankle portion of the foot in proper posi- -tion to correct for talipes equino-varus, as by building into the last of the shoe special formed calcaneo-cuboid lifts and by specially shaping the heel itself, these expedients have been relatively costly and moreover have not entirely and satisfactorily cured the tendency of the heel and ankle portion of the foot to rotate into a position contra to that required for holding the hind foot in a condition of valgus.

Having in mind the foregoing, it is among the objects of the present invention to provide in a corrective shoe quick-releasable strap means on the upper or boot portion of the shoe for exerting and maintaining pull of the hind foot into the desired condition of valgus.

A further and important object of the present invention is to provide the boot portion of the shoe with buckle-free strap means interengageable upon the inside or medial face of the shoe to exert pressure upon and maintain the hind foot in valgus and which thereby allows attachment of a short leg brace the use of which is prevented by the presence of a buckle fastener upon the inner or medial face of the upper portion of the shoe.

Still another and important object of the present invention is to provide a corrective shoe of the character above described in which buckle-type straps are eliminated and in which the interengageable straps for holding the hind foot in valgus are smooth and free of intertangling elements such as characterize strap buckles and so render them ideally suitable for interengagement upon the inner or medial sides of the shoes.

Other objects and advantages of the invention, such as the provision of strap means of the character aforesaid which are adjustable to fit about ankles varying in girth and the provision of such strap means which permit equal pull from opposite sides of the shoe to securely seat the heel portion of the foot in neutral position within the shoe or unidirectional pull from either side of the shoe as may be required for correction of a particular foot deformity, will appear more fully hereinafter.

It will be understood that the present invention consists substantially in the combination, construction, location and relative arrangement of parts, all as described in detail in the following specifications, as shown in the accompanying drawings and as finally pointed out in the appended claims.

In the accompanying drawings:

FIGURE l is a perspective view of an existing type of shoe currently in use for the correction` of talipes equinovarus, which shoe designed for use upon the right foot, is illustrated for purposes of obtaining a better understanding of the principles of the presen-t invention;

FIGURE 2 is a perspective view of a shoe, also for the right foot, constructed in accordance with and embodying the principles of the present invention;

FIGURE 3 is another perspective view of the same shoe shown in FIGURE 2;

FIGURE 4 is a top plan View of a pair of shoes constructed pursuant to the present invention;

FIGURE 5 is a horizontal sectional view of the right foot shoe as taken along the line 5 5 ,of FIGURE 2;

FIGURE 6 is an enlarged horizontal cross-sectional view of a fragmental part of the left foot shoe shown in FIGURE 4, this sectional view being generally similar to the sectionalized portion of FIGURE 5 except for the fact that it pertains to aleft foot shoe;

FIGURE 7 is a horizontal sectional view of a modig fied construction of a right foot shoe, Ias taken along a gaging strap elements as employed in the corrective shoe ofthe present invention.

Referring now to the drawings and more particularly to FIGURE 1 thereof, which illustrates a corrective shoe 10 of conventional construction for post-therapy treatment of talipes equino-varus deformity of the foot, it will be noted that the forepart 11 of this shoe which is designed to be worn upon the right foot is outwardly flared for the purpose of accommodating and holding the frontal portion of the foot in abduction, into which condition the foot was rotated by the casting or other operative procedure employed for correction of the deformity. This outfiare of the forepart of the shoe is designed to enforce abduction of the fore and middle parts of the foot.

For attempting to maintain the heel and ankle part of the foot in its desired valgus position, the conventional shoe as shown in FIGURE 1 is provided with a strap or band 12 one end of which is xedly anchored, as at 13, to the inner or medial side of the shoe while its opposite free end is provided with a series of spaced buckle holes 14 for adjustably securing it to a buckle 15 ixedly anchored to the distal side of the shoe. The strap 12 extends freely through a pair of slits 16-16 respectively provided in the opposite side walls 17--17 of the boot portion of the shoe and is disposed in such overlying relation to the tongue 18 of the shoe as to draw its boot portion more or less tautly about the instep and ankle portion of the foot with the objective of fixing the heel in valgus position within the shoe.

However, the direction of pull of the strap 12, being `from the inside or medial side of the shoe outwardly toward its distal side, subjects the hind part of the foot to a force which is in a direction, as indicated by the arrow in FIGURE 1, not favorable to holding the hind foot in valgus, since instead of holding the heel of the foot in valgus position as desired, the strap 12 in the conventional shoe tends to rotate and/or incline the tarsus of the foot into a varus position. Particularly in the case of a club foot deformity wherein the heel was in varus, the application of a strap as in the illustrated conventional shoe will tend to interfere with, if not actually oppose, proper correction of heel varus, this for the reason that the pull of the strap is in a direction favoring the maintenance of any pre-existing heel varus.

To reverse the pull of the strap 12 about the instep portion of the foot would necessarily require its securing buckle to be anchored upon the inner or medial side of the shoe. However, the location of buckles or the like upon the inner sides of a pair of shoes is most undesirable since the buckled portions of the straps would interfere with free movement of the shoe-fitted feet relatively to one another and could cause serious injury, particularly in the case of infants wearing the same, by the rubbing of the buckle of one shoe against the skin or flesh of the opposite leg. Also, as above mentioned, the presence of any strap buckles or other portuberances upon the medial faces of the shoe uppers would interfere with the use of short leg braces having inside bars extending vertically upward from the shoe to a cuff fastened to the leg just below the knee.

We have found not only that the direction of the pull of the strap 12 of the conventional corrective shoe should be reversed lfrom that shown in FIGURE 1 but also that this may be accomplished effectively by employing strap means which are free of interfering buckles and yet may have the separable portions interengaged under conditions adequate to impose the requisite degree of tension and direction of pull about the instep of the foot for holding the hind foot in valgus.

The shoe 20 as constructed in accordance with the principles of the present invention is provided with a forepart which is outwardly ared, as in the case of the conventional shoe illustrated in FIGURE 1, and is characterized, as shown in FIGURES 2 and 3, by the provision of a flexible strap member 21 having one end thereof anchored to the outer or distal side of the shoe, preferably to the inner lining thereof by stitching 22, with its opposite end extending freely through one or another of a pair of slits 23-24 formed in the inner or medial side of the shoe, the strap 21 being thus adapted to be drawn across the instep portion of the foot fitted in the shoe, preferably in overlying relation to the conventional shoe tongue 25.

It will Vbe noted that the point of securement of the strap 21 to the distal side wall of the shoe is located approximately at the calcaneo-cuboid joint area of the shoe so that the freely extending portion of the strap 21 is brought into positive contact with and exerts maximum pressure against the instep of the foot along the full extent of its transverse arch.

By so arranging the strap 21 for pull across the instep of the foot from the distal to the medial side thereof, as illustrated in FIGURE 2, even one with least experience in fitting corrective shoes upon the feet could not fail to obtain the desired maintenance of the hind foot in valgus, since the pull of the strap arranged pursuant to the principles of the present invention is such that the hind foot is automatically pulled in correct direction for placing and holding it in valgus.

The strap 21 is preferably formed of a flexible, inextensible narrow woven fabric having a velvet-like pile face of closely spaced miniature loops and serves as one element of a quick-releasable type of closing means or fastener for garments and other articles having separable parts adapted to be releasably secured together, which type of fastener, now being marketed under the name of Ve1cro, is described in United States Letters Patent No. 2,717,437, owned by Velcro S.A. of Fribourg, Switzerland.

The strap 21 is disposed with its pile-face presenting inwardly and is adapted to have its freely extending end portion 26 quick-releasably secured to a retaining strip or pad 27 which serves as the second element of the Velcro type fastener and is ixedly secured, as by stitching 28, to the outer surface of the inner or medial side of the shoe with its pile-face exposed for nterengagement with that of the strap 21. As in the case of the strap 21, the fixed anchoring pad 27 is also in the form of a narrow woven fabric, the pile face of which is provided, however, with closely spaced loops of heat-set sythetic yarn cut to provide miniature hooks which are adapted to engage the pile loops of the strap 21 when the latter is presed at against the pad 27. Thus, when the pile facing of the strap 21 is pressed into atwise engagement -with the pile facing of the fixedly secured retaining strip 27, the said strap and its retaining strip or pad are securely interlocked so as to hold the strap 21 secured in taut condition about instep portion of the foot. It will be apparent that this arrangement permits the strap 21 to be pulled in proper direction, i.e., from the outer or distal side of the shoe toward the inner or medial side thereof, as indicated by the direction-of-pull arrow in FIGURE 3, under such tension as is required to hold the hind foot in valgus.

Preferably, the retaining pad 27 extends along the medial side of the shoe in inclined relation to the shoe last, while the strap 21 is also disposed for pull along an inclined line paralleling that of the pad so that when the strap and pad are interengaged as shown in FIGURE 3, the strap, when pulled taut across the instep, forces the heel of the foot downwardly and rearwardly into the heel pocket of the shoe.

FIGURE 4 illustrates the application of the fastener elements 21 and 27 to a pair of shoes wherein the same are respectively provided with the strap members 21 arranged so that their directions of pull are respectively in the directions indicated by the arrows to thereby insure that each shoe holds the hind portion of the foot in the desired condition of the valgus. It will be noted also that the free end portion of the strap 21 when interengaged with its complemental anchoring member 27 presents an uninterrupted smooth surface upon the inner side of each shoe which is completely free of any laterally projecting elements which might abrade or otherwise cause injury to a limb upon relative movement of the feet or interfere with the attachment of a short leg brace as above mentioned.

FIGURE 6 illustrates the application of the present invention to a shoe for the left foot as distnguished from the right foot shoe illustrated in FIGURES 2, 3, 4 and 8, it being noted that the equivalent parts of the left shoe and the right shoe as shown in the drawings are respectively designated by the same reference numerals. The use of the Velcro type quick-releasable strap fastener as shown permits the application of a finely adjusted tension across the instep of the foot under treatment, the degree of which tension may be expeditiously relaxed or increased as may be required for any particular individual case. Depending upon the girth of the hind portion of the foot under treatment, the strap 21 may be threaded alternatively through one or the other of the slits 23-24 to insure the most comfortable and effective fit of the shoe upon the foot.

FIGURE 7 illustrates a modified construction of the shoe wherein a pair of the Velcro type strap retaining members 27a- 27a are respectively stitched or otherwise secured to opposite sides of the shoe 20a, i.e., one such member upon each of the distal and medial sides of the shoe. The strap 21a which extends about the instep portion of the foot is provide with freely extending end portions 26a-26a which are respectively threaded through one or the other of two pairs of slits 23a-23a and 24a- 24a suitably formed in opposite sides of the shoe. It will be apparent that in this modified arrangement, either end of the strap 21a may be initially anchored to the shoe by engagement with one of the retaining members 27a, thereby rendering the opposite end of the strap free to be pulled tautly about the instep of the shoe and then anchored to the other one of the retaining members exactly as in the above described construction wherein one end of the strap is permanently secured to the shoe. Thus, in the modified construction of FIGURE 7, the strap may be employed to exert a pull toward either the distal or medial side of the shoe as may be required for correction of a particular case of malformation of the foot. In some instances it may be desired simply to seat the heel of the foot firmly in the heel pocket of the shoe without imposing any medially or distally directed force upon the hind part of the foot and where such a neutral pull is indicated for use of the shoe following the initial therapy, both of the opposite end portions of the strap 21a would be drawn rearwardly with uniform pull and then respectively anchored to their anchoring pads 27a-27a.

In all constructions of the shoe in accordance with the principles of the present invention, the shoe is preferably of the conventional blucher type having an open toe portion and quarters which are laced together as shown in overlying relation to the tongue 25 which is preferably of the swing-away type.

It will be understood that the present invention is sus- I ceptible of various changes and modifications which may be made from time to time without departing from the general principles or real spirit of the invention. Accordingly, it is intended to claim the invention broadly, as well as specifically, as indicated by the appended claims.

What is claimed as new and useful is:

1. In a corrective shoe of the character described hav- -ing its forepart distally flared to enforce and maintain abduction of the fore-foot for post-therapy treatment of talipes equine-varus malformation of the foot, an inextensible, flexible strap member having one of its end portions lixedly anchored to the distal side of the heel of the shoe in the region thereof which covers the tarsal bones and its opposite end portion free to be drawn into position overlying the opposite medial side of the shoe, and means on said medial side of the shoe `for quick-releasably engaging said freely extended end portion of the strap to hold latter in tension across the tarsal part of the foot fitted in the shoe, said strap being extended about the instep of the foot in the form of an open-ended loop and so positionally oriented relatively to the hind-foot fitted in the shoe as to press the heel of the foot downwardly and rearwardly into the heel pocket of the shoe and at the same time rotate the heel on its longitudinal axis into a position of valgus.

2. In a corrective shoe as defined in claim 1 wherein the freely extending portion of said strap member extends completely through the medial side wall part of the shoe from the inside to the outside thereof to overlie the said side wall in the heel portion thereof, said strap being formed in at least its freely extending portion of a pilefaced fabric arranged with its pile-facing presenting inwardly toward the medial surface of said heel portion of the shoe and wherein said strap-engaging means on the medial side of the shoe is in the form of a pad member permanently secured to the shoe for underlying registry with said freely extending portion of the strap, said pad member having a facing of pile threads adapted 'for interengagement with the pile-facing of the strap when the latter is pressed flatwise against the pad member, the pilefacing of at least one of said strap :and pad members being in the form of miniature hooks operative to engage in and be caught up by the pile-facing of the other of said members.

3. In a corrective shoe as defined in claim 1 wherein said strap is `disposed with its longitudinal center line substantially coincident with a plane extending transversely of and inclined at an acute angle to the longitudinal axis of the hind-foot fitted in the shoe whereby its force component, when drawn taut against the instep of the foot, is in a direction for rotating the hind-foot about its said longitudinal axis to hold and maintain it in valgus.

4. In a corrective shoe as defined in claim 2 wherein said first-mentioned end portion of the strap member is permanently anchored to the distal side of the shoe and said co-acting strap engaging means on the medial side of the shoe is in the form of a pad against which the free portion of the strap is adapted 'to be pressed for securement together of the strap and pad in flatwise engagement, the meeting faces of the strap and pad being respectively provided with means for releasably securing the same together and the outer exposed surface of the starp being smooth and free of projections which might abrade or otherwise injure the skin or flesh of the wearers leg opposite that upon the shoe is fitted 5. In a corrective shoe as defined in claim 1 wherein at least the medial side wall of the shoe is provided with a pair of slits through either one of which the freely extending portion of the strap may be projected from the inside to the outside of the shoe for overlying registry and releasable engagement with said strap-holding means.

6. In a corrective shoe of the character described having its forepart distally flared to enforce and maintain abducion of the fore-foot for post-therapy treatment of talipes equino-varus malformation of the foot, an inextensible, flexible, Anarrow strap member extending across the instep portion of the shoe with its opposite end portions each threaded through a side wall. of the shoe from the inside to the outside thereof, said end portions of the strap being respectively adapted to overlie the medial and distal surfaces of the shoe in the region of its heel pocket, and strap anchoring pads permanently secured to said medial and distal surfaces of the shoe in underlying relation to said opposite end portions of the strap for flatwise engagement therewith and securement of the strap 4in taut condition across the instep portion of the .foot fitted in the shoe, said strap being adapted to be drawn tautly from one side of the heel pocket of the shoe toward the opposite side thereof to rotate the wearers hind-foot into a position of valgus or to be drawn against the instep of the wearer with equal pull upon both ends of the strap to seat the hind-foot rmly in the heel pocket free of any rotational force moment about the longitudinal axis of the heel.

7. In a corrective shoe as dened in claim 6 wherein the engaging surfaces of said strap and its said anchoring pads are respectively provided with raised heat-set synthetic pile threads certain of which are in the form of looped elements and others in the form of hook-shaped elements which are interengageable for releasable securement of each opposite end portion of the strap and its associated pad when `the same are pressed together, the outer of said strap being smooth and devoid of skinabrading protuberances.

References Cited UNITED STATES PATENTS 1,012,017 12/1911 Salt 128--80 5 1,351,248 8/1920 Hill 12S-166 3,028,861 4/1962 Shapiro 128-166 3,308,829 3/1967 Edwards 128-80 OTHER REFERENCES Advertisement for Sabels Equino-Varus Shoes, p. 55, 10 The Journal of Bone and Joint Surgery, vol. 45-A #7,

October 1963.

L. W. TRAPP, Primary Examiner.

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