WO2004066890A1 - Dispositif orthopedique - Google Patents

Dispositif orthopedique Download PDF

Info

Publication number
WO2004066890A1
WO2004066890A1 PCT/GB2004/000335 GB2004000335W WO2004066890A1 WO 2004066890 A1 WO2004066890 A1 WO 2004066890A1 GB 2004000335 W GB2004000335 W GB 2004000335W WO 2004066890 A1 WO2004066890 A1 WO 2004066890A1
Authority
WO
WIPO (PCT)
Prior art keywords
shoe
gaiter
foot
leg
gas strut
Prior art date
Application number
PCT/GB2004/000335
Other languages
English (en)
Inventor
Faye Pitt
Nigel Jones
Shane Willard Nickson
Original Assignee
Trulife Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Trulife Limited filed Critical Trulife Limited
Publication of WO2004066890A1 publication Critical patent/WO2004066890A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F5/0104—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation
    • A61F5/0111—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation for the feet or ankles
    • A61F5/0113—Drop-foot appliances

Definitions

  • This invention relates to an orthopaedic device for treating contractures of muscle and tendon in the lower leg.
  • Certain medical conditions are characterized by a shortening of the Achilles tendon or of the posterior tibial muscles.
  • the shortened tendon or muscle holds the foot at an obtuse angle, and the patient is unable to pivot the foot about the ankle joint so as to permit standing or walking.
  • treatment is by physiotherapy in which the tendon or muscle is stretched by the application of a pivoting force to the foot.
  • the application of such a force requires physical effort, and only be sustained by a physiotherapist for a few minutes.
  • the ankle joint is capable of some lateral movement, the physiotherapist must take care to apply the restoring force precisely at right angles to the pivot axis of the ankle, and this degree of control is somewhat difficult to achieve.
  • an orthopaedic device for treating a contracture of the lower leg which holds the foot in an open condition
  • the device comprising lower member for attachment to a close fitting shoe within which the heel is substantially immobilized, and an upper member for attachment to a close fitting gaiter within which the leg is substantially immobilized, the lower and upper member being connected by a hinge having an axis substantially coincident with the pivot axis of the ankle, and the device further comprising a gas strut operably connected at one end to the upper member and at the other end to the lower member whereby, in use, the foot is urged towards a closed condition.
  • the open condition of the foot describes the most obtuse angle between leg and foot, and the closed condition describes the most acute angle.
  • 'shoe' is meant an enclosure of the foot which may or may not be suitable for walking.
  • a gas strut has the known advantage of being capable of applying a substantially constant force over a significant travel, thus ensuring that the contracture is stretched at a precisely predetermined level of force.
  • the invention also has the substantial advantage that, once applied to the patient, no inadvertent relaxation of the stretching force is possible. Accordingly the treatment can be applied in accordance with predetermined parameters, and the risk of misuse, overuse or underuse can be avoided. In particular the patient can be treated and monitored by suitably trained but lesser skilled medical personnel.
  • the device can be easily fitted and removed and thus treatment for several hours is easily achieved.
  • the disadvantages of repeated short applications of force or long term immobilization are thereby avoided.
  • Repeated treatments can be effected using settings which are accurately reproducible.
  • the gas strut is to the side of the leg.
  • the lower member is formed as part of the shoe, and the upper member is formed as part of the gaiter so that the device is entirely self-contained.
  • the lower and upper members are preferably integrated in the respective shoe and gaiter, to provide a lightweight and slim assembly. Nevertheless, for reasons of practicality it is envisaged that means for attachment of the device to a separate shoe or gaiter or both may be necessary or desirable in some circumstances.
  • immobilization of the ankle is achieved by the use of a close fitting sock moulded by conventional techniques from a cast of the patient's foot.
  • the sock is preferably of polypropylene and thus relatively rigid. In use the sock forms part of the shoe of the device. Alternatively the shoe may be directly moulded from a cast of the patient's foot.
  • the gaiter can be of any suitable material, for example polypropylene, which can provide the necessary degree of rigidity and support for the hinge joint.
  • the gaiter may for example be strapped around the patient's leg, and may if desired extend above the knee so as to substantially immobilize the knee joint.
  • the gas strut acts on a rearwardly directed cantilever portion.
  • the cantilever portion is preferably located in a rear facing pocket of the lower member or of the shoe, and in the preferred embodiment is at the side thereof.
  • Such an arrangement permits fore and aft adjustment of the cantilever portion and thus the lever ratio of the strut about the hinge axis.
  • the cantilever portion also permits forces to be transmitted over a significant area of the shoe rather than via a single pivot mounting.
  • the force of the strut is in use applied to the sole of the foot via the shoe.
  • This force is a compressive force and is distributed over a significant area; in contrast the application of force directly to the heel requires application of a tensile force to the foot, and a rather close fitting heel cup of the shoe.
  • the gas strut of the invention urges the device to the closed condition.
  • the strut In order to fit the device to a patient, the strut must be tensioned in order to move the shoe towards the open condition, and the device preferably includes tensioning apparatus.
  • the tensioning apparatus comprises an inextensible strap extending from the lower member to the upper member and adapted to be shortened.
  • the strap can extend directly from the shoe to the gaiter.
  • the strap includes a latch to hold the device in a desired open condition.
  • the strap may comprise a belt having one end fixed on the upper member or gaiter, and the other end running through a loop defined by the lower member or shoe, and preferably on the heel of the shoe.
  • the strap may include a hook and loop fastener as the latch, whereby a region of the free end can be secured to the fixed end.
  • a pair of matched gas struts are mounted on either side of the leg so as to apply the restoring force to the posterior of the ankle joint. This arrangement provides additional stability to the device, and helps to avoid the risk of lateral movement of the ankle joint.
  • a pair of cantilever members may be provided in side pockets of the lower member or shoe, one each being associated with a respective gas strut.
  • these cantilever members extend in use generally parallel to the sole of the shoe and are immediately adjacent the sole.
  • the pockets are preferably located to the anterior of the ankle joint.
  • the cantilever members preferably terminate at one end close to the posterior surface of the foot, so as not to cause discomfort when the patient is lying down.
  • the ram of the gas strut is at the bottom whereas the body is at the top. This arrangement gives greater clearance in the region of the hinge, and thus greater design freedom.
  • Fig. 1 illustrates a human leg and foot.
  • Fig. 2 illustrates a preferred embodiment of a device according to the invention.
  • Fig. 3 illustrates a half-section on line 3-3 of Fig. 2.
  • Fig. 4 illustrates a half-section on line 4-4 of Fig. 2.
  • Fig. 5 illustrates a tensioning strap of the device
  • Fig. 6 illustrates a preferred embodiment from the front.
  • FIG. 1 shows a human leg 10 with a foot tending towards an open condition due to a contraction force in the Achilles tendon or posterior tibial muscles, represented by arrows 11.
  • the foot tends to pivot anticlockwise about ankle joint 12, as represented by arrow 13.
  • This medical condition is uncomfortable and makes walking difficult if not impossible. It often applies to both legs, and is treated by stretching the contractile tissues in a controlled and predetermined manner.
  • Figs. 2-4 illustrate a device 14 for treating this condition.
  • a gaiter 15 is open at the front and sized to closely engage a patient's leg. Typically the gaiter is moulded of polypropylene and is conformable to the leg contours.
  • the mouth 16 (Fig. 3) may have flexible lips 17 to permit easy entry of the leg, and securing means (such as hook and loop fasteners) may be used to strap the gaiter securely in place.
  • a shoe 18 is attached to the gaiter by means of hinges 19 intended to be substantially coincident with the pivot axis of the patient's ankle.
  • a hinge is provided symmetrically on either side of the device, and the ends thereof may be housed in pockets 20 of the gaiter and shoe, as illustrated.
  • the shoe 18 substantially encircles the patient's foot and is a very close fit over the posterior part and in the region of the heel.
  • the shoe may be moulded directly from a plaster cast of the patient's foot, but preferably the patient is provided with a moulded sock (not shown) which is itself a very close fit in the shoe. This latter technique simplifies moulding somewhat, and the shoe may in fact be moulded directly over the sock.
  • Both shoe and sock are typically of polypropylene, and having a respective wall thickness of 4.5 mm and 2.5 mm.
  • a pocket 21 is provided on either side of the shoe for respective rear facing arms 22 which are generally parallel to the sole of the foot/shoe and to each other.
  • the arms are rigidly secured in a respective pocket 21 by any suitable means, such as one or more rivets or screws 23 (Fig. 4).
  • the arms are of any suitably stiff material, such as aluminium.
  • the free ends of the arms 22 terminate approximately level with the posterior of the heel cup 24.
  • a gas strut 25 extends on either side of the device from the free end of a respective arm 22 to a respective side of the gaiter 15, as illustrated, and is arranged to urge the shoe in the direction of arrow 26 to the closed condition.
  • Fig. 6 illustrates the general appearance of the device from the front, and showing the mouth 16 of the gaiter 15, and mouth 27 of the shoe 18. (Other parts of the device are omitted for reasons of clarity).
  • the foot and leg are slipped into the device from the front side, assisted by partial opening of the mouths 16,27 if necessary.
  • the gaiter and shoe may be further secured for example by the use of external circumferential straps of any suitable kind, or by elastic clips over the respective mouth of gaiter and shoe.
  • the shoe In order to fit the device comfortably the shoe is moved to the open condition by means of a strap 31 illustrated in Fig. 5.
  • the strap 31 is riveted at one end to the back of the gaiter 15, and passes through a loop 32 of the shoe to a free end 33.
  • a hook and loop fastener 34,35 is provided on facing sides of the strap in order to secure the free end in a predetermined position.
  • the strap In use the strap is tensioned by pulling in the direction of arrow 38 until the shoe is at the desired orientation, and then locked by use of the fastener 34,35. Once the leg and foot are in position the latch is released to permit the struts 25 to tension the muscles/tendons.
  • the tensioning force can be relieved, if necessary, by relatching the strap 31.
  • the struts 25 are mounted to respective stiffeners 36 of e.g. aluminium which are housed in pockets of the gaiter, and extend longitudinally of the leg as illustrated (Fig. 3). By this means the operational force is adequately supported, and several spaced mounting points can be provided if desired. Furthermore the lower end of the struts can also have spaced mountings on the arms 22, via which the lever ratio of the struts can be varied.
  • the arrangement permits use of standard struts of a variety of lengths, and a relatively easy change of restoring torque from a standard strut exerting a substantially fixed effort. It will be appreciated that the lever ratio may also be varied by adjusting the depth of the arms in the respective pockets 21.
  • the struts In use the struts typically exert a combined torque in the range 8-12 Nm, and contain a relatively thick oil to ensure that movement of the ram is heavily damped.
  • stiff ener 36 and arm 22 could be adapted for external attachment to a respective gaiter and shoe, by suitable external clamps or screws. Such an arrangement would tend to be more bulky, but may be appropriate in certain clinical circumstances or for example where an immediate temporary treatment is required in the absence of suitably tailored gaiter and/or shoe.

Landscapes

  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

Dispositif orthopédique destiné à traiter une contracture de la jambe, qui retient le pied dans une position ouverte et qui comporte une guêtre (15) moulante, une chaussure (18) moulante et une ou plusieurs tiges à gaz comprimé (25) s'étendant entre la guêtre et la chaussure de manière à contraindre le pied vers la position fermée. Ledit dispositif comporte de préférence un élément inférieur (22) logé dans une poche latérale (21) de la chaussure et à extension vers l'arrière par rapport à ladite poche, en direction de la tige à gaz comprimé (25).
PCT/GB2004/000335 2003-01-28 2004-01-28 Dispositif orthopedique WO2004066890A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0301954.4 2003-01-28
GB0301954A GB0301954D0 (en) 2003-01-28 2003-01-28 Orthopaedic device

Publications (1)

Publication Number Publication Date
WO2004066890A1 true WO2004066890A1 (fr) 2004-08-12

Family

ID=9951961

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2004/000335 WO2004066890A1 (fr) 2003-01-28 2004-01-28 Dispositif orthopedique

Country Status (2)

Country Link
GB (1) GB0301954D0 (fr)
WO (1) WO2004066890A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3357460A1 (fr) * 2017-02-06 2018-08-08 Hervé Teyssedre Orthèse dynamique
US11278439B2 (en) 2016-03-07 2022-03-22 Orthotic Care Services, LLP Ankle-foot orthosis
US11484426B2 (en) 2017-05-12 2022-11-01 Ast Design, Llc Foot ankle orthoses
US11857448B2 (en) 2018-02-02 2024-01-02 Otto Bock Healthcare Lp Methods and apparatus for treating osteoarthritis of the knee
US11872151B2 (en) 2017-05-12 2024-01-16 Ast Design, Llc Method of manufacturing an ankle foot orthosis

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996040017A1 (fr) * 1995-06-07 1996-12-19 Empi, Inc. Orthese pour l'augmentation de l'amplitude articulaire de la cheville
US5826304A (en) * 1993-08-06 1998-10-27 Carlson; J. Martin Composite flexure unit
US6148824A (en) * 1997-06-20 2000-11-21 Sultan; Hashem Method for moving a portion of a paralyzed limb
EP1382317A1 (fr) * 2002-07-19 2004-01-21 SNC Aeropneumatiss Orthèse dynamique

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5826304A (en) * 1993-08-06 1998-10-27 Carlson; J. Martin Composite flexure unit
WO1996040017A1 (fr) * 1995-06-07 1996-12-19 Empi, Inc. Orthese pour l'augmentation de l'amplitude articulaire de la cheville
US6148824A (en) * 1997-06-20 2000-11-21 Sultan; Hashem Method for moving a portion of a paralyzed limb
EP1382317A1 (fr) * 2002-07-19 2004-01-21 SNC Aeropneumatiss Orthèse dynamique

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11278439B2 (en) 2016-03-07 2022-03-22 Orthotic Care Services, LLP Ankle-foot orthosis
EP3357460A1 (fr) * 2017-02-06 2018-08-08 Hervé Teyssedre Orthèse dynamique
FR3062565A1 (fr) * 2017-02-06 2018-08-10 Herve Teyssedre Orthese dynamique
US11484426B2 (en) 2017-05-12 2022-11-01 Ast Design, Llc Foot ankle orthoses
US11872151B2 (en) 2017-05-12 2024-01-16 Ast Design, Llc Method of manufacturing an ankle foot orthosis
US11857448B2 (en) 2018-02-02 2024-01-02 Otto Bock Healthcare Lp Methods and apparatus for treating osteoarthritis of the knee

Also Published As

Publication number Publication date
GB0301954D0 (en) 2003-02-26

Similar Documents

Publication Publication Date Title
US6110138A (en) Stance-correcting knee brace
US5700237A (en) Device for correcting ankle contractures
US4771768A (en) Controlled motion ankle fracture walker
US5496263A (en) Ankle stabilization system
US5582579A (en) Orthopedic therapy and rehabilitation device
US8672865B2 (en) Weight-bearing lower extremity brace
US5599288A (en) External ligament system
US6126625A (en) Orthotic device for a joint of the human body
US5776090A (en) Means and method for treating Plantar Fasciitis
US5941263A (en) Leg support crutch
CA2025596C (fr) Orthese de marche
US4693239A (en) Orthosis
US8403872B2 (en) Weight-bearing lower extremity brace
US4981132A (en) Orthosis for the treatment of tibial torsion in children
US9820870B2 (en) Weight-bearing lower extremity brace
EP2381902B1 (fr) Attelle pour articulation portante d'extrémité inférieure
US8540655B2 (en) Weight-bearing lower extremity brace
US20040015112A1 (en) Controlled motion ankle walker brace
US10357390B2 (en) Ankle foot tensioned orthosis
US7850632B2 (en) Knee brace having an adaptable thigh pad
US5954678A (en) Orthosis for an anatomical joint
US5571206A (en) Leg amputee orthosis
JPH0622993A (ja) 踵関節矯正器
CA2841816C (fr) Dispositif de support pour pieds
US4664099A (en) Traction device

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NA NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): BW GH GM KE LS MW MZ SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LU MC NL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
122 Ep: pct application non-entry in european phase