Abstract:
An orthotic for a joint of the human body, at which a body part pivots, includes first and second hinge members able to extend along respective posterior portions of body parts near the joint. The second member is able to be fitted with alternate orthotic support portions. A hinge connection joins the first member and the second member, permitting angular motion about an axis, and mutual disconnection and reconnection of the members at the hinge connection as the second member pivots relative to the first member.

Description:
PRIORITY INFORMATION 
     The present application claims priority as a continuation-in-part of application having Ser. No. 12/215,733, now issued as U.S. Pat. No. 8,062,243, which was filed in the United States on Jun. 30, 2008, the disclosure, subject matter and contents of which are incorporated herein by reference in its entirety. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     This invention relates generally to an orthotic device, and particularly to an orthotic that provides adjustable control of a range of angular motion and interchangeability of supports at a joint of the human body where pivoting normally occurs. 
     2. Description of the Prior Art 
     An orthotic is a device, such as a brace or splint, for supporting, immobilizing, or treating muscles, joints, or skeletal parts, which are weak, ineffective, deformed, or injured. To assist in restoring a joint of the human body to normal, effective function, the joint may be restricted for a period by an orthotic, which imposes a fixed pivoting position. Or, an orthotic may permit adjustable angular displacement of the joint, which is retained for a period by the orthotic and gradually increased at intervals to improve the pivotal range of use. 
     A need exists for an orthotic that can be adjusted without removing it from the body to provide proper support while walking, and having interchangeability of suitable replacement supports, via connecting and disconnecting members, for mobile and immobile patients. 
     SUMMARY OF THE INVENTION 
     An orthotic having a hinge device for a joint of the human body, at which a body part pivots, includes first and second hinge members able to extend along respective posterior portions of body parts near the joint. The second hinge member is able to be fitted with alternate orthotic support portions. A hinge connection joins the first member and the second member, permitting angular motion about an axis, and mutual disconnection and reconnection of the members at the hinge connection as the second member pivots relative to the first member. 
     The orthotic is manufactured from lightweight materials, e.g., aluminum and plastic, which are formed by conventional techniques and at low cost. The aluminum may be roll formed or forged, and the plastic may be molded. 
     Notably, the orthotic device can also include an upper support member attached to an upper support. In turn, the upper support member is adjustably attached to one end of the first hinge member, which is then attached to the second hinge member at an opposite end of the first member, to provide multiple ranges of pivotal movement about respective spaced axes. 
     A lower support especially suited for use while walking and secured to the second member can be disconnected from the first member by pivoting the second member about a hinge axis to a retracted position and sliding the second member laterally away from the first member. Further, a second lower support, especially suited for use with a shoe or while the user is in bed, and secured to a functionally identical, replacement-second member, can be connected to the first member by sliding the replacement-second member into position at the hinge axis and pivoting said replacement-second member and its second lower support to an extended position. In the extended position, the replacement-second member and its support are mechanically engaged with the first member, preventing their removal until the replacement-second member is again pivoted to the retracted position. 
     The scope of applicability of the preferred embodiment will become apparent from the following detailed description, claims and drawings. It should be understood, that the description and specific examples, although indicating preferred embodiments of the invention, are given by way of illustration only. Various changes and modifications to the described embodiments and examples will become apparent to those skilled in the art. 
    
    
     
       DESCRIPTION OF THE DRAWINGS 
       Having generally described the nature of the invention, reference will now be made to the accompanying drawings used to illustrate and describe the preferred embodiments thereof. Further, these and other advantages will become apparent to those skilled in the art from the following detailed description of the embodiments when considered in light of these drawings in which: 
         FIG. 1  is a rear view of a hinge device for a joint of an orthotic; 
         FIG. 2  is a side view of  FIG. 1 ; 
         FIG. 3  is a side view of the first hinge member of the device of  FIG. 1 ; 
         FIG. 4  is a front view of the first member of  FIG. 3 ; 
         FIG. 5  is a side view of the second hinge member of the device of  FIG. 1 ; 
         FIG. 6  is a front view of the second member of  FIG. 5 ; 
         FIG. 7  is a bottom view of  FIG. 5 ; 
         FIG. 8A  is a perspective view showing the first and second members assembled and in the extended position without the lockout plate; 
         FIG. 8B  is a perspective view showing the first and second hinge members of the device assembled in the extended position with a lockout plate installed; 
         FIG. 9  is a perspective view showing the first and second members assembled and in the retracted position; 
         FIG. 10  is a plan view of a rectangular lockout plate; 
         FIG. 11  is a rear view of an upper leg support, into which the orthotic device of  FIGS. 1 and 2  can be inserted and retained; 
         FIG. 12  is a perspective view of the leg support of  FIG. 11  aligned for assembly; 
         FIG. 13  is a perspective view of an alternative embodiment of the joint device showing alternative first and second hinge members assembled and in the extended position; 
         FIG. 14  is a side view showing the alternative first and second members of  FIG. 12  assembled and in the retracted position; 
         FIG. 15  is a partial side view of the embodiment of  FIGS. 13 and 14  showing the members assembled and in the extended position; 
         FIG. 16  is a side elevational view of an assembled orthotic positioned on a patient, wherein the orthotic includes the hinge device of the invention for a joint with the second member attached to a bone cast as a lower support; 
         FIG. 17  is a side elevational view of the assembled orthotic positioned on the patient, wherein the second member is attached to an open, foot portion with a walking base used for limited mobility as the lower support; and 
         FIG. 18  is a side elevational view of the assembled orthotic positioned on the patient, wherein the second member of the hinge device is attached to a sole insert to wear with a shoe for more advanced mobility than the configurations depicted in  FIGS. 16 and 17 . 
     
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Referring now to  FIGS. 1 through 3 , an orthotic hinge device  10  for a joint preferably includes an upper member  12 , intermediate first hinge member  14 , and lower second hinge member  16 , each member preferably being of aluminum or another structural material having density, strength and endurance comparable to those of aluminum. Notably, the first hinge member  14  is adjustably attached to an end of the upper member  12 , and the second hinge member  16  is hinged at an opposite end of the first member  14 . 
     More specifically, the lower end of the upper member  12  is formed with a circular arc  18  having a center  20 . The upper end of the first hinge member  14  is formed with a circular arc  22 , which is centered at  20  and whose outer surface nests within the inner surface of arc  18 . Members  12  and  14  are connected mutually at an adjustable connection  23 . An outer block  24  is formed with a flat outer surface  26 , engaged by the head of threaded attachment  28 , e.g., a screw or bolt  28 , and a circular cylindrical inner surface  30  centered at  20 . An inner block  32  is formed with a circular cylindrical outer surface  34  centered at  20 , and a flat inner surface  36  contacted by self-locking nuts  38 , each nut engaging a respective attachment bolt  28 . The upper member  12  is formed with two parallel slotted holes  40 . The first hinge member  14  is formed with two holes  42 , each hole  42  being aligned with a respective slotted hole  40 . Each attachment  28  extends through a hole in the outer block  24 , a pair of holes  40 ,  42  in members  12  and  14 , respectively, and a hole in the inner block  32 . The lower portion of first member  14  and the upper portion of second member  16  together form an arc that is continuous across a lower hinge connection  44 . 
     Referring to  FIGS. 3 and 4 , the inner surface of the first hinge member  14  includes a planar surface  46 , which terminates at a cylinder  48  extending laterally about one-half of the width of member  14 . The cylinder  48  is formed with an outer stop surface  50  and an inner stop surface  52 , which extend along the cylinder&#39;s length, which is about 0.750 inch. A blind hole  54  formed in cylinder  48  receives a hardened, anodized stainless steel hinge pin  56  retained in hole  54  with a press fit. A portion of the length of pin  56  extends laterally from the hole. A locking projection  58  is an extended uniform projection, spaced about 0.10 inch from the nearest edge of member  14  and directed radially from the center of hole  54 , and extends laterally about 0.187 inch along the length of cylinder  48 . 
       FIGS. 5-7  illustrate details of the lower, second hinge member  16 . The inner surface of the second member  16  includes a planar surface  60 , which is substantially coplanar with the surface  62  at the base of the stop surface  52  when the lower connection  44  is extended or open, as shown in  FIG. 2 . Planar surface  60  terminates at a stop surface  61 . A cylinder  64  is aligned with cylinder  48  and extends laterally about one-half of the width of member  16 . Cylinder  64  is formed with an outer stop surface  66 , which extends along the length of cylinder  64  and is located and sized to contact surface  50  when the lower connection is in the extended position of  FIG. 2 . A blind hole  68  formed in cylinder  64  is sized to receive the portion of hinge pin  56  that extends laterally from cylinder  48 . A tapped hole  70  is formed through the thickness of the second member  16  between its outer arcuate surface and its planar surface  60 . 
     The second hinge member  16  is formed also with a concave cylindrical surface  72 , complementary to the outer convex surface of cylinder  48 . Concave cylindrical surface  72  is located and sized to receive cylinder  48  therein. A rectangular groove  74  is formed through the rear surface of concave cylindrical surface  72  and is sized and located to receive therein the locking projection  58  that extends from cylinder  48  of the first hinge member  14 , thereby forming a preferred locking mechanism between the first and second members  14 ,  16 , respectively. 
     In the alternative, of course, the hinge pin  56  may be secured to either member  14  or  16 . And, projection  58  may be formed on member  16  and groove  74  may be formed on member  14 . 
     In operation (with reference to the preferred embodiment), when the lower connection  44  is closed, or retracted from the extended position shown in  FIG. 8A , by rotating the second member  16  counterclockwise relative to the first hinge member  14  as shown in  FIG. 9 , hinge pin  56  can be inserted into the blind hinge pin hole  68  in cylinder  64  of the second hinge member  16 , thereby allowing cylinder  48  of the first hinge member  14  to enter the concave surface  72 , and locking projection  58  to become laterally aligned with rectangular groove  74 . 
     Thereafter, when the lower connection  44  is extended to the position shown in  FIG. 8A  by rotating the second member  16  clockwise about axis  76  relative to the first hinge member  14 , locking projection  58  enters, engages and becomes retained in groove  74 , thereby securing the second member  16  to the first member  14 . More specifically, while projection  58  is engaged with groove  74 , the second member  16  is prevented from becoming disconnected from the first member  14 . The second member  16  can be disconnected from the first member by rotating the second member counterclockwise to the retracted position shown in  FIG. 9 , thereby disengaging the locking projection  58  from rectangular groove  74 , and slipping the hinge pin  56  out of cylinder  64  by moving the second member laterally relative to the first member  14 . 
       FIG. 10  shows a flat, rectangular hinge lockout plate  78  formed with a countersunk hole  80  and lateral edges  82 ,  84  at opposite sides of the plate. When the lower connection  44  is extended to the position shown in  FIG. 8A , rotation of the second member  16  relative to first member  14  about axis  76  is prevented by inserting lockout plate  78  into the recessed section formed by aligned planar surfaces  60 ,  62  such that opposite edges  82 ,  84  of plate  78  contact the stop surface  52  on the first hinge member  14  and the stop surface  61  on the second hinge member  16 . In this position, the hinge plate is secured to the lower connection  44  of the orthotic hinge device  10  by inserting a threaded fastener  86  into the hole  80  and engaging the fastener with the tapped hole  70 , as shown in  FIGS. 2 and 8B . 
       FIGS. 11 and 12  show an upper calf support  150 , which includes a front or inner surface that conforms to the contour of the calf of the human leg, and an outer surface  152 , which is substantially parallel to its inner surface. The outer surface  152  is formed with a hollow pocket  154  enclosed by a wall  156  and having an opening  158 , into which the upper end  160  of the upper member  12  is inserted. The outer surface  162  of the pocket  154  has a series of holes  164 , which extend through the pocket  154  and the inner and outer surfaces of the upper support  150 . Threaded attachments  166 ,  168 , inserted through at least some of the holes  164  and through a slotted hole  170  in the upper member  12 , secure the upper support  150  and upper member  12  in a desired position. 
     When the orthotic hinge device  10  is not being locked in the extended position, the rectangular hinge lockout plate  78  and its threaded fastener  86  can be removed from their secured position in the lower connection  44  and retained on the upper support  150  by inserting plate  78  in a recess  90  formed in the rear surface of the upper support and engaging threaded fastener  86  with the plate, via hole  80  and the corresponding tapped hole  164  in the recess  90  in the support. 
     A rotating bar  172 , in the form of a thin elongated plate, is secured at one end by an attachment  174  to a boss  176  formed on the outer surface  162  of pocket  154 . When the rotating bar  172  is not in use, the opposite end  180  of the rotating bar  172  bears against the outer surface  152  and is held in place as shown in  FIG. 11 . The rotating bar  172  can be rotated in either direction about attachment  174  from the position shown in  FIG. 11 , such that the area of the rotating bar near its end  180  contacts a surface, e.g., the surface of a bed in which the user is lying, to prop the foot against rotation from the desired position. 
     As an alternative to lower hinge connection  44 ,  FIGS. 13 ,  14  and  15  illustrate a second embodiment, i.e. lower hinge connection  200 . In this alternative design, a first member  202  terminates at its lower end with a planar contact surface  204 , which abuts a planar contact surface  204  at an upper end of a lower second member  206  (best seen in  FIG. 15 ) when the hinge connection  200  is in the extended position shown in  FIG. 13 . The angular pivotal displacement of the second member  206  in the extended position, i.e. relative the first member  202 , is, therefore, limited by contact between surfaces  204 . 
     Further, regarding lower hinge connection  200 , a first hinge plate  208  is formed with a cylinder  210 , which extends laterally about one-half of the width of the lower connection  200 . Cylinder  210  is formed with a central, hinge pin hole aligned with axis  76  and sized to receive therein a length portion of a hinge pin  212  that extends laterally from another cylinder  220 . Hinge plate  208  is secured by rivets  214  to the first member  202 . 
     A second hinge plate  216  is secured to the second member  206  (as described below) and is formed with a second cylinder  220 , which extends laterally about one-half of the width of the lower connection  200 . Cylinder  220  surrounds and retains a hardened, anodized stainless steel hinge pin  212 , which is aligned with the hinge axis  76 . A portion of the length of hinge pin  212  extends laterally from an inner end of cylinder  220 . 
     Finally, in the locking mechanism of this alternative embodiment, a locking member  222  is secured by rivets  218  above the second hinge plate  216 , with rivets  218  passing though and securing it to the second hinge plate  216  and second member  206  as seen in  FIG. 15 . Specifically, the locking member  222  overlaps the face of second hinge plate  216  and includes a locking arm or projection  224 , and the locking projection in this case overlaps lateral side edges of the first and second members  202 ,  206 , respectively (i.e. adjacent the contact surfaces  204  of lower connection  200  when in the extended position as shown in  FIGS. 13 and 15 ). The locking arm  224  has a hooked end  226  with an arcuate profile, whose radial inner surface is substantially coaxial with axis  76  and is sized to surround the outer surface of cylinder  210 . 
     In operation (i.e. to disconnect and reconnect first and second members  202 ,  206 , respectively), with the lower connection  200  closed, or retracted from the extended position shown in  FIG. 13  (by rotating second member  206  counterclockwise relative to first member  202  as shown in  FIG. 14 ), cylinder  210  can pass through the arcuate profile and hook  226  as the second member  206  is moved laterally along hinge axis  76 . Notably, when reconnecting, hinge pin  212  becomes inserted into the hinge pin hole in cylinder  210  of the first member  202  until the inner end of cylinder  210  of the first member  202  abuts the inner end of cylinder  220  of the second member  206 , to form the hinge joint of lower connection  200 . 
     Thereafter, when the second member  206  is rotated relative to first member  202  clockwise about axis  76  to the extended position shown in  FIG. 13 , the hook  226  rotates to a position where it overlaps the outer lateral surfaces of the first member  202  and the first hinge plate  208 , thereby securing the lower second member  206  to the first member  202 . While hook  226  overlaps the outer lateral surfaces of the first member  202  and the first hinge plate  208 , lateral movement of the first member  202  tending to disconnect the lower connection  200  causes the inner surface of the hook  226  to contact the first member  202  and the first hinge plate  208 , preventing the disconnection. 
     To disconnect the second member  206  from the first member  202 , the second member  206  is rotated counterclockwise to the retracted position shown in  FIG. 14 , thereby rotating hook  226  away from overlapping the outer lateral surfaces of the first member  202  and the first hinge plate  208 . Then, the first member  202  slides laterally away from the second member, disconnecting hinge pin  212  from cylinder  210 . 
     It is important to note that, alternatively, the hinge pin  212  may be secured to the first cylinder  210  and extends toward the second cylinder  220 , and the locking arm  224  and hook  226  may be located at the opposite lateral side of the second member  206  from the location shown in  FIGS. 13-15 . In another option, the locking member  222 , locking projection  224  with hook  226  may be secured to the first member  202 , such that these components  222 ,  224 ,  226  can be located on either lateral side of member  202 . 
     The adjustable connection  23  and hinge connections  44 ,  200  can be used in various therapeutic treatment situations with interchangeable upper and lower supports, such as with a typical leg cast for the treatment of broken bones, as seen in  FIG. 16 . The custom cast  240  for the immobilization of a patient&#39;s leg, allowing the healing of broken bones, can be formed by use of either hinge connections  44 ,  200 , although hinge connection  44  is preferred. In the example chosen for illustration, the custom cast  240  is formed about and on the patient&#39;s leg after the bone has been set. The bone cast  240  is typically formed by building up multiple layers of fabric material saturated with a hardening medium, such as plaster of Paris. As the bone cast  240  is formed, the orthotic hinge device  10  with adjustable connection  23  is incorporated to provide an adjustable relationship between an upper leg bone cast support  242  and a lower foot bone cast support  244 . Second member  16 , which extends from the preferred hinge connection  44 , is secured to the foot cast support  244 . 
       FIG. 17  illustrates another application of an orthotic hinge device  10  that includes adjustable connection  23  and hinge connection  44 ,  200  for use by a patient while in bed or with limited mobility. The orthotic shown in  FIG. 17  includes a lower foot support  250  attached to the second member  16 ,  206 ; an upper calf support  150  attached to the upper member  12 ; and a heel portion which includes first member  14 ,  202  intermediate to and interconnecting members  12  and  16  (or  206  with reference to first member  202 ). The upper calf support  150  and lower foot support  250  are made of synthetic plastic resin, so that they can be molded or pre-formed to the desired contours with various shapes required for engagement with a patent&#39;s leg  252 . Upper calf support  150 ′ shown in  FIG. 18 , for example, restricts mobility of the patient&#39;s calf more than upper support  150  shown in  FIG. 17 , in order to secure the patient&#39;s leg and foot while walking. 
     The foot support  250  includes a foot pad  254  connected to a generally rectangular attachment base  256 , which has a resilient walking pad  258  secured to its lower surface. The foot pad  254  is also of a generally rectangular configuration. A mounting pocket  260  extends inwardly from the bottom of the foot pad  254  for engagement of the second member  16 ,  206  between the foot pad  254  and the abutting attachment base  256 . A toe extension member  262  can be adjustably secured to the foot pad  254  opposite mounting pocket  260 . The toe extension member  262  has a flat base area  264  with an upturned angular offset end portion  266 , whose length is sufficient to support a bed sheet and blanket above the patient&#39;s toes while wearing the orthotic in bed. The toe extension member  262  is attached between the foot pad  254  and the attachment base  256  by a mounting slot and adjustable fasteners, which extend from the foot pad  254  through the attachment base  256  allowing for lengthening of the overall foot portion  250 . 
       FIG. 18  illustrates yet another orthotic that includes the orthotic hinge device  10 , with adjustable connection  23  and hinge connection  44 ,  200  for use by a patient while walking. In this case, second member  16 ,  206  extends from hinge connection  44 ,  200  into a modified shoe  270 , shown in broken lines of  FIG. 18 . The second member  16 ,  206  in this case is preferably connected to a sole insert  272  as the lower support formed to conform to the shape of the patient&#39;s foot. The orthotic of  FIG. 18  provides structural continuity and support between the patient&#39;s calf and foot. Notably, it is not necessary to include the rotating bar  172  with this configuration since this arrangement is primarily intended to control lateral movement of the leg relative to the foot while walking. In other words, it, unlike the orthotics of  FIGS. 16 and 17 , is not intended to be worn in bed where control of leg and foot rotation is desired. 
     Of course, many other upper and lower supports can be used with this invention. Notably, this invention allows for interchangeability or replacement, via the quick and easy disconnecting and reconnecting of the hinge connection  44 ,  200 , so that any of the various upper supports (e.g., calf supports  150 ,  150 ′,  242 ) can be fitted with any one of the many lower supports (e.g., foot supports  244 ,  250 ,  272 ), to best treat the patient&#39;s immediate and/or long-term condition and rehabilitation protocol. 
     It should be noted that the present invention can be practiced to treat any of the several joints of the human body and is not limited to the foot and ankle as specifically illustrated and described herein. Further, the present invention may be embodied in other specific forms without departing from its spirit or scope. It is intended that all such modifications and alterations be included insofar as they are consistent with the objectives and spirit of the invention. All changes that come within the meaning and range of equivalency of the claims are to be embraced within their scope.