CA1308617C - Orthosis for metatarsus adducts - Google Patents

Orthosis for metatarsus adducts

Info

Publication number
CA1308617C
CA1308617C CA000495733A CA495733A CA1308617C CA 1308617 C CA1308617 C CA 1308617C CA 000495733 A CA000495733 A CA 000495733A CA 495733 A CA495733 A CA 495733A CA 1308617 C CA1308617 C CA 1308617C
Authority
CA
Canada
Prior art keywords
foot
component
heel
brace
leg
Prior art date
Legal status (The legal status 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 status listed.)
Expired - Lifetime
Application number
CA000495733A
Other languages
French (fr)
Inventor
Andrew K.C. Chong
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=24718432&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=CA1308617(C) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by Individual filed Critical Individual
Application granted granted Critical
Publication of CA1308617C publication Critical patent/CA1308617C/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/01Orthopaedic devices, e.g. splints, casts or braces
    • A61F5/0102Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F5/0104Orthopaedic 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
    • A61F5/0111Orthopaedic 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/01Orthopaedic devices, e.g. splints, casts or braces
    • A61F5/14Special medical insertions for shoes for flat-feet, club-feet or the like

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

ABSTRACT
A brace made of rigid thermoplastic material that retains the corrective features of a corrective cast without the disadvantages of a cast. The brace securely encloses the heel and the medial portion of the foot up to or slightly beyond the tip of the big toe on the medial side only.
A strap, adjustably secured to the brace, directs a corrective force on the apex of the deformity on the lateral aspect of the foot, thus effecting correction. The brace has a leg-embracing component which includes a strap for preventing the heel from pulling away from the brace.

Description

1 3~6 1 7 Back~he Invention There are numerous causes of intoeing in children, including meta-tarsus adductus, clubfeet, and internal tibial torsion. The device of the present invention is designed specifically for the treatment of metatarsus 5 adductus only.
Metatarsus adductus is a congenital condition in whieh the forefoot is adducted or turned in relative to the hindfoot or heel. rhe primary treatment is corrective casting, which giYeS excellent results. However, it has serious disadvantages, including repeated expensive castings, skin 10 pressure problems, and potentially disastrous vascular problems.
Alternatives to casting have been sought over the years, and they basically fall into two groups: shoes (or boots) and braces (or splints). In spite of several introductions over the years~ these alterna~ives have not been utilized to any significant degree, and casting remains even today the 15 treatment of choice. The reason is that these alternatives lack the features that enable them to correct the deformity.
Shoes and boots have been ineffective in obtaining correction because, being all enclosing, they do not provide enough pressure at specific points to effect correction. At the present time shoes are used 20 mainly as a holding device aeter correction has been obtained with casts.
The braces ~nd splints that have been introduced so far do not hold ths heel and the medial portion of the foot securely enough to allow for successful correction of the deformity; for example U.S. patents 3,924,615 to McKim; 3,812,850 and 3,910,267 to Reiman; and the brace designed by 25 Lusskin as reported in The Journal of Bone and Joint Surgery, Jan. 1951. p.

1 30~6 1 7 269. All these devices use straps to hold the medial portion of the foot, which is insufficient for correetion.
U.S. patent no. 3,973,559 to Reiman attempts to address the problem by adding a wall along the medial side of the footplate. This patent is 5 believed to be the closest prior art. However, it still does not hold the medial portion Oe the foot securely enough to effect correction, and lacks several important features that determine success or tailure:
1) The medial wall extends only to the base of the big toe, and depends on the child wearing both footplates attached together in an 10 angular relationship, and the child lying prone (on his stomach), and the mattress on which the child lies, to effect correction of the big toe varus, which is an important component of the deformity. Hence, the splint has cumbersome constraints of wearing both footplates even if only one foot is affected, and of posture since the child has to be lying prone.
2) The medial wall does not have an upper ledge to prevent dorsal migration of the big toe and medial portion of the forefoot, thus escaping from the corrective influence of the medial wall. This is very important if one real;zes how wiggly the infant foot can be.
3) The medial wall is straight. This is much less effective than a 2n slightly convex border (abducted position) which allows the foot to be placed in a slightly over-corrected position.
4) The splint does not have rigid support for the lateral aspect of the heel to prevent valgus (turning out) of the heel, a complication to he avoided in the treatment of metatarsus adductus.
'~5 Brief Summary of The Invention The presen~ invention is a brace preeerably made of rigid thermo-plastic material which securely encloses the heel and medial portion of the foot up to or slightly beyond the tip of the big toe. The invention embodies the three~oint fixation principle. By holding the heel and the medial 30 portion of the forefoot and great toe securely, the brace fixates the adducted foot at two points - the lleel, which becomes the first point of fixation, and the base of the big toe, which forms the second point of fixation. When these two points of Eixation are secure, the third point ot fixation can then be applied between the first two points by means of a 1 30 :36 1 7 st.rap which directs a corrective force on the apex of the con-vexity of the deformity on the lateral aspect of the foot, thus effecting correction.
The invention may be summarized, according to a first broad aspect, as a unitary rigid foot brace for the correction of metatarsus adductus in children, comprising a foot component for enclosing and providing a static force at the medial portion of the foot from the heel to, or slightly beyond, the tip of the big toe, said foot component having a medial wall C-shaped in cross-sectional configuration, which extends laterally to confine the medial portion of the foot, including the big to~, but not the lateral portion of the foot, adjustable strap means for apply-ing a dynamic force at the convexity on the lateral border of the deformed foot to urge the foot into contact with said medial wall and anchor the foot to said component, a heel component extending backwards from said foot component for embracing the bottom and both sides of the heel, a leg component extending upwardly from said heel component for embracing the lower portion of the leg, and adjustable strap means on said leg component to embrace the leg and prevent the heel from pulling away from said heel com-ponent.
According to another aspec-t, the invention provides a unitary rigid foot brace fo.r the correction of me-tatarsus adduc~
tus in children, comprising a foot component shaped to embrace the sole and the top of the foot on the medial side only, said component extending from the heel to the tip of the big toe to 1 3('~6 1 7 -3a- 1368-771 provide a static force at the heel and the biy -toe, and an adjustable strap on said foot component for applying a dynamic force to the convexi-ty on the lateral border of the foot to urge the foot against the resisting static force provided by said foot component at said heel and said tip of the big toe.
Descri~tion Of The Dr~wings __ _ _ For illustrative purposes, the brace for the left foot only is shown.
Figure 1 is a perspective anterior view of the brace of the invention without straps;
Figure 2 is a cross-sectional view -taken on line 2-2 of figure l;
Figure 3 is a cross-sectional view taken on line 3-3 of figure l;
Figure 4 is a cross-sectional view taken on line 4-4 of figure l;
Figure 5 is a medial elevational view of the brace;
Figure 6 is a lateral elevational view;
Figure 7 is a posterior elevational view;
Figure 8 is a bottom view;
Figure 9 is a perspective view of the brace with straps shown alongside the foot to be corrected; and Figure 10 is a bottom view of the brace with the foot in corrected position.
Descrip_ion Of The Invention The brace is designed for application to the foot with metatarsus adductus (forefoot adduction) to effect correction.

1 30u6 1 7 -3b- 1368-771 Referring to figure 1, the brace is made of a molded thermoplastic material, and consists of a foot component 5, a heel component 6, and a leg component 7 that hold the foot in the cor-rected position. The foot component 5 extends from the heel to the tip of the big toe or slightly beyond. This is important because hallux varus (turning in of the big toe) is a component of the metatarsus adductus deformity, and correction must include the big toe as well as the foot. The foot component 5 is C-shaped in cross-section (refer to figure ~), and embraces the sole and the top of the foot on the medial side only. On the dorsal ~upper) aspect, an upper ledge 8 extends laterally to co~er the medial portion of the foot as well as the first two toes. On the plantar (lower) aspect, a lower ledge 9 extends la-terally to cover the medial part of the sole of the foot and the medial two toes. Horizontal edges 8,9 are important because they hold the forefoot securely between them, and prevent -the big toe and fore-foot from migrating upwards or downwards during correction~ and thus escaping from the corrective influence of foot component 5.
Horizontal edges 8,9 must -~- 1 30'~6 1 7 not reach to the lateral border of the foot. If they do9 the corrective force (described below) cannot be utilized.
It should also be noted that foot component 5 is not perfectly straight, but slightly convex medially (abducted) to allvw for over-correction if necessary.
The heel component 6 continues backwards from the foot component 5 as an integral unit and encloses the heel securely during correction. The cross-sectional shape is shown in figure 3. It is shaped like a C tilted backwards on itself. The heel is seated securely in this component during correction, the medial aspect Oe the heel being held by medial portion 10 and the lateral aspect of the heel by lateral portion 11. The heel is fixated by portion 10 for correction, while portion 11 prevents the heel from going into valgus during correction, a posture to be vigorously prevented.
The leg component 7 extends upwards from the heel component 6 as an integral unit. It has a cross-section like an inverted U, and the posterior aspect of the leg or calf rests against it. The angle that the leg component 7 forms with the foot component 5 is not a right angle, but a slightly obtuse angle (plantarflexion or equinus position). Anatomically, dorsi-flexion of the ankle and valgus of ~he heel occur together, while plantar~
flexion of the ankle occurs with varus of the heel. Holding the ankle in slight plantarflexion therefore helps to prevent valgus of the heel during correction.
The length of the leg component 7 is variable, as long as it is sufficient to keep the heel se&urely seated in the heel compoment 6, and to keep the ankle in slight plantarflexion.
To hold the foot in the brace, strap means 15,16,17 (figure 9) are provided which ~asten onto the margins of the brace by a velcro touch and grip fastener, al~h~ugh any other adjustable means of fastening would do just as welL
Strap 15 holds the leg to the component 7.
Strap 16 holds the heel seated securely in the heel component 6.
Strap 17 holds the foot to the foot component 5, but more impor-tantly, it performs the vital task of applying a corrective force on the appex of the convexity 18 (figure 9) of the deformity on the lateral border ~5~ l 3r)~ 1 7 of the foot. With the foot securely held in components 5,6, two points o fixation have been established at the two ends of the deformity--at the heel and at the base of the big toe, as shown in figure 10. The principle OI
three~oint fixation can now be utili~ed by applying the third point of 5 fixation at the apex of the deeormity at 18. This is effected by tightening the adjustable strap against convexity 18. The amount of correction can be controlled by the tautness of the s~rap against convexity 18 and this can be carefully graduated over a period of weeks until complete correction is obtained. The usual period for completing correction varies from six weeks 10 to three months.

Claims (6)

1. A unitary rigid foot brace for the correction of metatarsus adductus in children, comprising a foot component for enclosing and providing a static force at the medial portion of the foot from the heel to, or slightly beyond, the tip of the big toe, said foot component having a medial wall C-shaped in cross-sectional configuration, which extends laterally to confine the medial portion of the foot, including the big toe, but not the lateral portion of the foot, adjustable strap means for applying a dynamic force at the convexity on the lateral border of the de-formed foot to urge the foot into contact with said medial wall and anchor the foot to said component, a heel component extending backwards from said foot component for embracing the bottom and both sides of the heel, a leg component extending upwardly from said heel component for embracing the lower portion of the leg, and adjustable strap means on said leg component to embrace the leg and prevent the heel from pulling away from said heel com-ponent.
2. The brace of claim 1 in which said medial wall is curved convexly from heel to toe.
3. The brace of claim 1 which is molded from thermoplastic material and in which said straps are secured by velcro connections.
4. The brace of claim 1 which includes an adjustable strap on said heel component to reinforce the seating of the foot.
5. The brace of claim 1 in which said leg component forms an obtuse angle with said foot component.
6. A unitary rigid foot brace for the correction of metatarsus adductus in children, comprising a foot component shaped to embrace the sole and the top of the foot on the medial side only, said component extending from the heel to the tip of the big toe to provide a static force at the heel and the big toe, and an adjustable strap on said foot component for applying a dynamic force to the convexity on the lateral border of the foot to urge the foot against the resisting static force provided by said foot component at said heel and said tip of the big toe.
CA000495733A 1984-12-03 1985-11-20 Orthosis for metatarsus adducts Expired - Lifetime CA1308617C (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US06/677,372 US4922895A (en) 1984-12-03 1984-12-03 Orthosis for metatarsus adductus
US677,372 1984-12-03

Publications (1)

Publication Number Publication Date
CA1308617C true CA1308617C (en) 1992-10-13

Family

ID=24718432

Family Applications (1)

Application Number Title Priority Date Filing Date
CA000495733A Expired - Lifetime CA1308617C (en) 1984-12-03 1985-11-20 Orthosis for metatarsus adducts

Country Status (3)

Country Link
US (1) US4922895A (en)
CA (1) CA1308617C (en)
GB (1) GB2167964B (en)

Families Citing this family (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE8700201U1 (en) * 1987-01-05 1987-02-19 Rau, Roland, Dr.Med., 7614 Gengenbach, De
US4998537A (en) * 1988-07-27 1991-03-12 Deutsche Sporflex Gmbh Support for the ankle joint area
US4981132A (en) * 1990-04-30 1991-01-01 Andrew Chong Orthosis for the treatment of tibial torsion in children
US6155997A (en) * 1997-12-16 2000-12-05 Castro; Ernesto G. Custom ankle brace system
JP2006505344A (en) * 2002-11-07 2006-02-16 オスール・エイチエフ Short leg orthosis
CN100369591C (en) * 2005-07-12 2008-02-20 杨寿峨 Article for treating equinovarus
IL184812A (en) * 2007-07-24 2016-05-31 Izak Daizaede Clubfoot orthotics
AU2009227900B2 (en) * 2008-10-23 2014-02-13 Izak Daizade Clubfoot orthotics
US8882690B2 (en) * 2010-11-16 2014-11-11 Fred W. Toenges Orthotic device and method of manufacture
USD797299S1 (en) 2015-01-21 2017-09-12 Dominique Ruel Neonatal hand splint
RU193319U1 (en) * 2019-02-04 2019-10-23 Общество С Ограниченной Ответственностью "Айэмти" ORTHESIS FOR IMMOBILIZATION OF THE Ankle

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US1012017A (en) * 1911-05-20 1911-12-19 Edward William Salt Device or appliance for treating or curing deformations of the foot.
US1691235A (en) * 1927-06-01 1928-11-13 Ottillie L Fischer Brace for club feet
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US2474634A (en) * 1948-03-30 1949-06-28 Carl T Mason Surgical splint for small animals
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DE3228753C2 (en) * 1982-07-31 1994-01-13 Helmut John Foot support rail with a shell with slots in the area of the instep
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Also Published As

Publication number Publication date
US4922895A (en) 1990-05-08
GB2167964B (en) 1989-01-11
GB8529069D0 (en) 1986-01-02
GB2167964A (en) 1986-06-11

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