Abstract:
A collapsible posterior splint capable of sustained biplanar (frontal and sagittal) dorsiflexion of the foot. The splint is comprised of a compression support sleeve, inserted into a flexible frame, and utilizing adjustable tension straps. This splint is a method of treatment for foot pain, including plantar fasciitis.

Description:
FIELD OF THE INVENTION 
     The present invention relates to a collapsible posterior splint capable of sustained biplanar (frontal and sagittal) dorsiflexion of the foot. More particularly, the present invention relates to a splint comprised of a compression support sleeve, inserted into a flexible frame, and utilizing adjustable tension straps. 
     BACKGROUND OF THE INVENTION 
     Plantar fasciitis is one of the most common causes of heel pain, which accounts for approximately 15% of all foot-related complaints. This condition occurs in a wide variety of individuals. Commonly, age at onset is in the mid-40&#39;s, but plantar fasciitis can develop at any age. Many studies have shown a female-male predominance of 3:1. 65% of patients exhibiting plantar fasciitis are overweight. Approximately 22% of all patients with plantar fasciitis have moderate pronation; about 15% have high-arched, ridge foot; and the remainder have an anatomically normal or non-affected foot. Only 45% of the patients who undergo radiography for suspected plantar fasciitis are found to have a subcalcaneal or “bone” spur. 
     Evidence of the need for effective therapy is apparent when it is considered that over 95% of all heel pain is diagnosed as plantar fasciitis. Plantar fasciitis is best described as an inflammation of the ligament that runs from the heel to the ball of the foot, which helps support the arch. Patients with plantar fasciitis will experience pain, upon standing, on the bottom or inside of their heel. Typically, the pain is worse in the morning when getting out of bed and after resting when standing up. 
     Typically the primary anatomic cause of plantar fasciitis is some degree of microtrauma and tearing at the site of the Plantar Fascia insertion. These abnormalities, which may also be present at the origin of the Plantar Fascia, result from repetitive trauma and collagen degeneration and angiofibroblastic hyperplasia. Upon physical examination the range of motion of the affected ankle is less than that of the contralateral ankle. By pressing the thumb against the middle of the affected heel, the physician can delineate the area of the Plantar Fascial pain. Pressure similarly applied underneath the calcaneus reveals the area of subcalcaneal pain. The correlation between plantar fasciitis and subcalcaneal spurs is not significant, therefore radiographic findings are not specific. Conservative treatment, including night splints, results in relief of plantar fasciitis in 85% of patients. In 15% of patients in whom this approach fails, surgery is indicated. 
     One medical method known in the art in reducing Plantar Fascial pain is to stretch the Plantar Fascia for a period of time. By keeping the Plantar Fascia on stretch, it is believed that an ultimate reduction of the internal tension of the Plantar Fascia can be achieved. Through this treatment, it is believed that the pain associated with this medical condition can be reduced, and possibly eliminated. 
     A typical treatment program would have the patient wear the splint while sleeping, and remove the splint immediately upon awakening in the morning. The patient will continue wearing the night splint for a 3-month period. After that time the patient will be weaned off of the splint in 2-week increments, using the device every other night, then every third night, then every fourth night, and from then on as needed. 
     A number of plantar fasciitis night splints are known in the art. However, none have the suspension architecture or offer the comfort, ease of use, compactability, or degrees of rotation and angulation of the present device. 
     By way of illustration of the state of the art, U.S. Pat. No. 4,649,939, issued to R. Curtis on Mar. 17, 1987 utilized over a shoe. U.S. Pat. No. 5,038,762, issued to H. Hess, et. al., on Aug. 13, 1991, teaches of a U-Shaped yoke which can be wrapped about the heel and ankle. U.S. Pat. No. 5,090,404, issued to C. Kallassy on Feb. 25, 1992, teach of another way to place a strap about the heel and foot. U.S. Pat. No. 5,257,969 issued to C. Mance on Nov. 2, 1993 teaches of a foot support which consists of a toe pouch and straps the wrap about the ankle. U.S. Pat. No. 5,425,701 issued to C. Oster et al. on Jun. 20, 1995, teaches of a boot with upright struts which attach to a foot pad designable for each patient&#39;s foot shape. U.S. Pat. No. 5,472,411 issued to H. Montag, et. al., on Dec. 5, 1995 teaches of a U-shaped flexible joint collar which wraps about the foot, heel and ankle. U.S. Pat. No. 5,620,413, issued to D. Olson on Jul. 14, 1995 teaches of an ankle brace and wrap comprised of a support sleeve to fit over the foot. U.S. Design Pat. No. Des. 388,174 issued to W. Stano on Dec. 23, 1997 teaches of a ankle brace which wraps about the lower leg, ankle, and foot. U.S. Pat. No. 5,645,525, issued to R. Krivosha on Jul. 8, 1997 teaches of a heel stabilizing device which fits over the foot and heel. While these devices teach of flexible means of foot support, they do not teach a means to keep the foot on stretch which would properly facilitate the treatment indicated for a diagnosis of plantar fasciitis. 
     U.S. Pat. No. 4,320,748, issued to W. Racette, et al., on Nov. 20, 1980 teaches of a semi-rigid shell which wraps about the leg from the knee below and consists further of a heal plate pivotally connected to said shell. U.S. Pat. No. 4,693,239 issued to W. Clover on Sep. 15, 1987, teaches of a semi-rigid shell similar to the Racette et al. patent, but allows for use in the presence of soft tissue damage. U.S. Pat. No. 5,209,722 issued to J. Mikalus, et al., on May 11, 1993 teaches of an ankle brace consisting of a semi-rigid plates about the leg and a pivotally connected semi rigid foot plate. While these patents teach us of durable means of providing support to the leg, ankle and foot, they do not teach suspension architecture to keep the foot on stretch which would properly facilitate the treatment indicated for a diagnosis of plantar fasciitis. 
     U.S. Pat. No. 5,603,692, issued to R. Maxwell on Feb. 18, 1997, teaches of a rigid leg support which would keep the foot on stretch at a 90° angle. U.S. Pat. No 5,605,535, issue to J. Lepage on Feb. 25, 1997 teaches of a load bearing foot brace with a pair of splint arms which, in conjunction, will keep the ankle on stretch at a 90° angle. These patents teach of a means to keep the ankle on stretch, however they are limited in the angulation at 90°, lack tension adjustment features, and prove to be uncomfortable to the patient wearing such devices. 
     U.S. Pat. No. 5,718,673 issued to C. Shipstead on Feb. 17, 1998 teaches of an ankle wrap that is connected to a foot wrap by means which allow for keeping the ankle on stretch at a 90° angle. This teaches a less uncomfortable means to keep the ankle on stretch, but does not provide the degrees of angulation, nor means for applying an ice/cold pack this current invention teaches. 
     In summary, while night splints have been used in the past for plantar fasciitis, all are deficient in either comfort, suspension architecture, adjustability, or ease of patient use. 
     OBJECTIVES OF THE INVENTION 
     A primary objective of this invention is to provide a collapsible posterior splint which overcomes the disadvantages of the prior art devices to allow comfort, ease of patient use, suspension architecture and adjustability. 
     It is a further objective of this invention to provide a posterior splint capable of sustained biplanar dorsiflexion of the foot in both frontal and saggital directions. 
     It is still a further objective of this invention to provide a splint that can be used in preventing contracture of soft tissue structures responsible for heel, Achilles tendon fascia and triceps surae pain. 
     It is a yet further objective of this invention to provide a collapsible posterior splint capable of containing a removable ice/cold pack to further reduce heel and plantar fascia pain, and to provide comfort to further encourage patient compliance. 
     The method and manner of accomplishing these and other objectives is described below. 
     SUMMARY OF THE INVENTION 
     The collapsible posterior splint basically comprises a bottom stabilizing plate to which is attached at its posterior end leg braces, and on the opposite end are attached two straps which can be attached to the leg braces. The leg brace may have an additional attached strap which will provide support about the leg. A soft sleeve for receipt of a patient&#39;s foot and designed to surround the foot, ankle and lower leg is inserted and attached within said bottom stabilizing plate and leg brace. Adjustable straps to secure said sleeve around the foot, ankle and leg are placed on said sleeve. An ice/cold pack is designed to be inserted within the interior of said sleeve beneath the foot and beneath and behind the heel. The coaction of these parts in use provides comfort, adjustable suspension architecture and cold pack use all at once. 
    
    
     DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is an elevated perspective view of an ankle splint constructed in accordance with this invention, and in use. 
     FIG. 2 is an elevated side view of the ankle splint shown in FIG. 1 displaying one possible flexion adjustment of the device. 
     FIG. 3 is a front view of the device of FIG.  1 . 
     FIG. 4 is also a front view, but displaying the ability of the device to provide biplanar positioning. 
     FIG. 5 displays an ice/cold pack constructed in accordance with this invention. 
     FIG. 6 is a cross sectional view taken along line  6 — 6  of FIG.  5 . 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     FIG. 1 shows an improved biplanar foot dorsiflexion collapsible posterior splint in accordance with the present invention. It includes a lightweight, semi-rigid bottom stabilizing plate  10  which has two posterior wings  21  on the medial and lateral sides and two anterior wings  23   21  also on the medial and lateral sides. The posterior wings are pivotally attached at locations  20  to the leg brace  12  in both medial and lateral aspects, providing rotation about pivots  20 . At the top of the leg brace  12  is attached a semi-rigid back leg collar  14 . Affixed to the back leg support or collar  14  is a front leg strap  16 . These means of attachment preferably include thistle cloth or hook and pile fasteners sold under the trademark “Velcro”. Adjustable flexion straps  18  are attached anteriorly to the back leg support  14  at pivot connections  24 . Adjustable flexion straps  18  are attached to the medial and lateral anterior wings  23  of the stabilizing plate  10  through anterior pivot connections  22 . These straps are adjustably through use of thistle cloth or hook and pile fasteners sold under the trademark “Velcro”. 
     A foam sock  26  is made of a soft, durable natural fiber or foamed polymeric material designed to encompass a portion of the foot, the ankle and lower leg. Preferably, the sock is made so that the anterior of the portion which covers the leg and the top of the portion which covers the foot can be opened, adjusted and then closed and secured. Preferably, these means of securing the sock include thistle cloth or hook and pile fasteners sold under the trademark “Velcro”. Preferably, additional sock straps  28  are placed to circumnavigate the foot, interior to the heel to provide additional means to secure the sock about the foot (FIG.  3 ). 
     An ice/cold pack  30  (FIGS. 5 and 6) can be inserted on the interior portion of the sock to provide contact with the lower foot portion of the heel and also the back of the heel. If desired, ice pack  30  can be a foam pack of identical configuration, except foam replaces the ice. The ice pack  30  comprised of an outer shell  38 , preferably made of a durable nylon cloth encasing ice/cold cells  34  and a thin temperature transfer plate  36 , preferably made of inert plastic. Transfer plate  36  is placed between the ice/cold cells and the patient&#39;s foot to facilitate even transfer of the temperature from the ice/cold cells  34 . Adhesion fastener points  32  are affixed on the exterior of the outer shell  38  and are subsequently attached to the inside of the sock  26 . Preferably these attachments  32  are also thistle cloth or hook and pile fasteners sold under the trademark “Velcro”. 
     The sock  26  is then inserted into the shell, formed mainly of the bottom stabilizing plate  10 , the leg brace  12  and the back leg collar  14 . The sock is then attached to said shell by adhesion fasteners  32 . 
     In actual operation, the orthopedic splint works as follows. The patient&#39;s foot is inserted into sock  26  and then into the shell formed by foot stabilizing plate  10 , leg brace  12  and back leg collar  14 . Front leg straps  18  can be adjusted to provide an adjustable suspension position of the foot as illustrated in FIGS. 1 and 2. Pronation adjustments of the strap can also be made, see FIGS. 3 and 4. As well, the cold pack  30  can be inserted in sock  26 , if desired. Cold pack  30  and sock  26  are optionally used, but are preferred.