Abstract:
An ankle and foot orthosis brace for use in supporting, immobilizing and correction of physical anomalies associated with a patient&#39;s ankle or foot. The brace is of a multi-part construction having a generally L-shaped configuration with a contoured upper leg support and a foot support portion interconnected by a multi-planar adjustment hinge and bi-lateral bearing assemblies there between. A foot pad with apertured tabs extending there from being part of the foot portion with adjustable fabric fasteners extending from the foot portion and the leg portion securing the brace to the patient&#39;s leg and foot.

Description:
BACKGROUND OF THE INVENTION 
   1. Technical Field 
   This invention relates to therapeutic leg and foot braces, more particularly to a securing apparatus therefore having a foot pad, a fabric foot engagement enclosure for releaseably securing the brace to the foot and ankle of the patient to provide and maintain a constant pressure against the foot, sole and ankle of the patient for therapeutic purposes including adducted and abducted conditions of the foot. 
   2. Description of Prior Art 
   An orthotic foot and ankle brace typically has an L-shaped construction with a contoured leg support portion, a foot portion, and an interconnecting heel portion connected there between. An integral fabric foot engagement enclosure is provided to secure the brace to the patient&#39;s foot and ankle. 
   Prior art devices of this type provide for a variety of leg, ankle and foot stabilization utilizing two-part brace assemblies interconnected by free hinges of elastomeric material as seen in U.S. Pat. No. 5,496,263 that permit the tolocural articulation to move about a single axis. 
   Other prior art patents such as U.S. Pat. No. 5,431,624 discloses leg and foot braces having adjustable angles between the two sections with an extended ground engagement sole and a cam action locking assembly. 
   U.S. Pat. No. 5,486,157 discloses a hinge at the apex of a contoured heel portion to provide free dorsiflextion and plantar-flexion with a pivot point below the hinges for inversion, eversion and pronation and supination of the foot. 
   Applicant&#39;s own U.S. Pat. Nos. 5,088,479, 5,545,127, 5,593,383, 5,908,398, 5,944,679 and 6,302,858 B1 define the present state of the art in ankle and foot orthosis beginning with resilient L-shaped construction in U.S. Pat. No. 5,088,479, the introduction of lateral adjustable ankle and foot orthosis in U.S. Pat. No. 5,545,127, adjustable ankle and foot orthosis brace having adjustable hinge assembly between the leg configuration and heel configuration, in U.S. Pat. No. 5,908,398 a compound adjustable ankle and foot orthosis brace, in U.S. Pat. No. 6,302,858 B1 having a unique intermedial transition portion with adjustable multi-angular bearing surfaces to impart selective angular inclination both laterally and dorsi/plantar flexion by respective multiple overlapping intermedial end portions of respective resilient interconnecting portions. 
   Additional prior art devices can be seen in U.S. Pat. Nos. 5,961,477 and 6,056,712. 
   In 5,961,477 an ankle and foot orthosis can be seen having a one piece L-shaped support member interconnected to a foot portion having a walking sole thereon. 
   In U.S. Pat. No. 6,056,712 a multi-functional orthosis for the foot, heel, ankle and lower leg is disclosed in which an upper leg engagement portion has adjustable locking hinge assembly on either side of the dorsi and plantar flexion positioning. 
   SUMMARY OF THE INVENTION 
   An ankle and foot orthosis device for supporting and selectively immobilizing a patient&#39;s ankle and foot having a tri-planer adjustment in frontal, sagittal and transverse planes. The orthotic brace comprises a leg portion, a foot portion with an interconnecting heel portion having multi-angular adjustment bearing surfaces for dorsi-plantar flexion, bi-lateral adjustment and trans-axial rotation of the leg and heel portion with respect to the foot portion. Multiple overlapping intermedial end portions at the distal end of the respective resilient interconnecting heel portions allow for tri-planer adjustment. 
   OBJECTS AND ADVANTAGES 
   It is the object of the present invention to provide an incremental adjustable limit of bi-lateral angular inclination and imputable limited degrees of plantar flexion and dorsi-flexion in the sagittal plane as well as axial rotation adjustment in the transverse plane to address the specific problems of adducted condition in which the foot turns inwardly towards the mid-line of the body and abducted foot condition in which the foot turns outwardly from the mid-line of the body that can be addressed and corrected by adjustment of the transverse axial plane of the foot portion in relation to the leg portion. 

   
     DESCRIPTION OF THE DRAWINGS 
       FIG. 1  is a side elevational view of the present invention; 
       FIG. 2  is an enlarged partial side elevational view thereof; 
       FIG. 3  is a partial rear elevational view thereof with portions broken away; 
       FIG. 4  is a partial top plan view thereof with portions broken away; 
       FIG. 5  is an enlarged cross-section on lines  5 — 5  of  FIG. 4 ; 
       FIG. 6  is an enlarged top plan view of a portion of the foot engagement element portion shown in  FIG. 2 ; 
       FIG. 7  is an enlarged side elevational view thereof; 
       FIG. 8  is an enlarged top plan view of a second intermedial portion shown in  FIG. 2 ; 
       FIG. 9  is an enlarged side elevational view thereof; 
       FIG. 10  is a graphic top plan representation of normal foot position of a patient; 
       FIG. 11  is a graphic top plan representation of an adducted foot condition of a patient; and 
       FIG. 12  is a graphic top plan representation of an abducted foot condition of a patient. 
   

   DESCRIPTION OF THE PREFERRED EMBODIMENT 
   Referring now to  FIGS. 1 and 2  of the drawings, a tri-planer ankle and foot orthosis brace  10  of the invention can be seen having a leg portion  11 , a foot portion  12  and an interconnecting multi-part heel portion  13  extending there between. The leg portion  11  has an elongated transversely contoured leg support  14  having a recessed channel  15  formed inwardly from one end thereof. The foot portion  12  has a foot pad  16  connected to a generally rectangular attachment brace  17 . The attachment brace  17  has a resilient walking pad  18  secured thereto. The foot pad  16  is of a generally rectangular configuration with an area of reduced transverse dimension at  19  which defines pairs of longitudinally spaced oppositely disposed aperture tabs  20  thereon. 
   A mounting bracket  21  extends downwardly from the bottom of the foot pad  16  adjacent one end thereof for registering engagement with the heel portion  13  between the foot pad  16  and abutting attachment base  17 . 
   In practice, the leg and foot portions are made of synthetic plastic resin material so they can be molded or pre-formed to the desired contour required for engagement with a patient&#39;s leg L shown in broken lines in  FIG. 1  of the drawings. 
   A toe extension member  22 , best seen in  FIG. 1  of the drawings, is adjustably secured to the foot pad  16  opposite the mounting bracket  21  hereinbefore described. The toe extension member  22  has a flat base area  23  with an upturned angularly offset end portion  24 . The toe extension member  22  is registerably attached between the foot pad  16  and the attachment brace  17  by fasteners F (not shown) extending from the foot pad  16  so as to allow for longitudinal adjustment thereto. The interconnecting heel portion  13  comprises an upper leg element  25 , a first intermediate bearing engagement element  26 , a second intermediate bearing engagement element  27  and a lower foot engagement element  28 , all of which are comprised of a metal alloy or other suitable material. 
   The upper leg element  25  is secured within the recess channel  15  of the leg support  14  by fasteners F and has an articulated curved free end at  29 , best seen in  FIG. 2  of the drawings. 
   The foot engagement element  28  extends from and is secured within the hereinbefore described mounting bracket  21  of the foot pad  16  by a pair of fasteners F, shown in dotted lines, that inter-engage there through in registration with selective fixed apertures in the mounting bracket  21 . The foot engagement element  28  has an apertured free end at  30  with a pair of transversely spaced articulated slots S 1  within and a pivot opening at PO- 1  there between, best seen in  FIG. 4  of the drawings. 
   The second intermediate bearing engagement element  27  is adjustably secured to the apertured free end  30  of the foot engagement element  28  by a central pivot pin  32  and a pair of threaded stop limit fasteners TF extending through the slots S 1  and threadably disposed into said first intermediate bearing engagement element  27 , best illustrated in  FIGS. 2 ,  3  and  4  of the drawings defining a trans-axial pivot fitting assembly  33 . 
   The bearing engagement element  27  is curved at  36  with an upper articulated arcuate end  31  having a pair of transversely spaced arcuate slots S 2  therein and a pivot opening PO 2  there between as best illustrated in  FIG. 3  of the drawings. 
   Accordingly, an overlapping apertured curved free end  37  of the intermediate bearing engagement element  26  and the apertured pivot engagement end  31  of the intermediate bearing engagement element  27  define a trans-lateral pivot fitting assembly  42 . A pivot pin  43  interconnects said respective overlapping ends  37  and  31  extending through the pivot opening PO 2  and aligned apertures at  44  in the first intermediate bearing element  26  respectively and aligned apertures therein. 
   A pair of oppositely disposed stop limit threaded fasteners  45  and  46  are threadably secured into registering threaded apertures in the pivot engagement end  37  of the intermediate bearing engagement element  26  through the respective aligned slots S 2  in the overlapping free end portion  31  of the intermediate bearing element  27  as hereinbefore described. 
   A hinge assembly  47  is formed by the overlapping articulated free end  29  and a curved slotted free end portion  48  of the first intermediate bearing element  26  having a hinge block  49  registerable therein and correspondingly a compression cap fitting  50  with a curved inter-engagement surface  51  positioned over the aligned slots S in the articulated curved free end  29  of the leg element  25  and oppositely disposed aligned relation to the hinge block  49 . The hinge block  49  and compression cap fitting  50  are registerably secured together by a pair of threaded fasteners  51  extending through aligned apertures therein and the corresponding aligned slots S of the respective upper leg element  25  and first intermediate bearing engagement element  26  and threadably engaged by lock nuts  52 , best illustrated in  FIG. 2  of the drawings. 
   In use, three distinct planar angular adjustments can be made independently or in a variety of combinations to achieve the desired therapeutic effect as thus illustrated. 
   The second pivot fitting assembly  42  allows for the intermediate bearing engagement element  26  and associated leg portion  11  to be disposed laterally in relation to the intermediate bearing engagement element  27  and the foot portion  12  when the pivot fitting assembly  33  is in centrally aligned locked position as will be discussed in greater detail hereinafter. 
   The lateral adjustment of the second pivot fitting assembly  42  is indicated in broken lines in  FIG. 3  of the drawings with incremental adjustability achieved by alignment of indicator groove  53  on the pivot end  34  of the intermediate bearing engagement element  27  as illustrated with multiple incrementally radially spaced indicator grooves  54  formed inwardly of the free end  37  of the intermediate bearing element  26 . Once the desired degree of lateral alignment is achieved, the stop limit fasteners  45  and  46  are secured locking to so aligned overlapping pivot engagement ends  34  and  37  respectively together. 
   Referring now to  FIGS. 1 ,  4  and  5  of the drawings, the trans-axial pivot fitting assembly  33  of the invention will provide for trans-axial lateral adjustment indicated in broken lines in  FIG. 4  of the drawings between the foot engagement element  28  and the second intermediate bearing engagement element  27 . Incremental adjustment is achieved by loosening of the set bolt fasteners TF and aligning a trans-axial indicator groove  55  in the foot engagement element  28  with multiple radially spaced indicator grooves  56  in the surface of the intermediate bearing engagement element  27  adjacent its respective free ends shown in broken lines in  FIG. 4  of the drawings. This trans-axial lateral adjustment allows for the unique axial rotation of the leg portion  11  and heel portion  13  with respect to the foot portion  12  to address the clinical treatment of abduction and adduction of the patient&#39;s foot by applying incrementally adjustable pressure thereon to correct in stages the hereinbefore described clinical conditions. 
   Referring now to  FIGS. 10 ,  11  and  12  of the drawings, graphic illustrations of human feet  57  and  58  are shown depicting normal foot orientation at  59  in  FIG. 10  of the drawings and adducted condition at  60  in  FIG. 11  of the drawings in which the feet  57  and  58  are turned inwardly towards one another. In  FIG. 12  of the drawings, an abducted condition  61  is illustrated in which feet  57  and  58  are turned outwardly from one another. 
   It will be seen by applying an incremental angular rotational displacement of the respective feet  57  and  58  by the main adjustable pivot fitting assembly  33  of the tri-planar orthotic brace  10  of the invention can correct these conditions. 
   In use, the brace  10  can be readily adjusted in multiple planes to accommodate the patient&#39;s foot and associated conditions. Then, as noted, by incremental adjustment of the main pivot fitting assembly  33  will provide positive resistance to the foot curvature alignment over a prolonged period of time, the pressure on the foot and its tissue diminish thus altering the effects of the abduction of adduction as set forth hereinbefore. 
   Referring back to  FIG. 1  of the drawings, the foot portion  12  is illustrated comprising a fabric foot engagement enclosure  62  that is removably secured to the foot pad  16  by a plurality of attachment strips  63  that extend from the foot engagement enclosure  62  through the aperture tabs  20  and back against themselves onto interlocking hook and loop fastening material inserts  65  thereon as will be well understood by those skilled in the art. 
   Secondary enclosure straps and buckle assemblies  66 ,  67  and  68  provide for overlapping closure of the foot engagement enclosure  62 . 
   A leg attachment strap assembly  70  is secured to and extend from the leg portion  11  adjacent is respective upper and lower free ends. 
   A leg attachment strap  71  secures the patient&#39;s upper leg L shown in broken lines to a fabric pad  72  secured independently to the leg portion  11  by the use of hook and loop fastener materials as hereinbefore described. 
   It will be apparent from the above description that the present invention provides for stable accommodations of a patient&#39;s particular range of dorsiflexion and plantarflexion motion with the incremental adjustment degree of lateral angular inclination as well as the axial trans-lateral rotational adjustment by use of the hereinbefore described composite hinge, bi-lateral pivot assembly and trans-lateral axial rotation pivot tri-planar assembly. 
   It will thus be seen and apparent to those skilled in the art that various changes and modifications may be made therein to the invention.