Abstract:
The instant invention is a dynamic exoskeletal orthosis apparatus that operates as an adjustable protective brace for the protection and rehabilitation of joints. The instant invention provides protection to a joint with provisions to allow for the graduated increase in range of motion in one, two or more planes while limiting or allowing free motion in the remainder of the planes. The device allows the protection, mobilization, and stabilization of an injured joint or limb without the necessity of changing the device or utilizing multiple orthotic devices. The device is especially suitable for use in sports by providing a device that allows for a full range of movement, yet protects against impact as well as prohibits movement into positions that may lead to injury.

Description:
FIELD OF THE INVENTION 
     The instant invention relates to orthotic devices and, in particular, a dynamic exoskeletal orthotic device having provisions to secure a joint or limb and provide defined mobility along any or all planes. 
     BACKGROUND OF THE INVENTION 
     It is a common belief that an injury, trauma or congenital deformation to a joint or limb must be immobilized to be corrected. For this reason the joint or limb is wrapped in a cast for months at a time to effectuate healing. For example, a brace or splint is secured to the body used to maintain alignment during a fracture healing of a bone. Immobilization of a joint or limb results in atrophy secondary due to lack of use. For example, in order to protect the elbow status-post surgical correction for ulnar entrapment immobilizers may be used. However, immobilizers lack range of motion allowing for adhesion to disuse atrophy. Improvements in this area have been mainly directed towards the use of lighter materials that improve the construction, comfort and hygiene of those individuals in need of fixation to various extremities. 
     Orthotics is a broad term that is used for devices that may be applied to the body to restrict or enhance motion or to simply support a body segment. The body has several types of movable joints. Ball and socket joints, which allow free movement in all directions, are found in the hip and shoulder. Hinge joints, allowing movement in one plane only, are found in the elbows, knees, and fingers. Pivot joints, permitting rotation are found between the first two vertebra. Gliding joints, in which the surface of the bones move a short distance over each other, are found between various bones of the wrist and ankle. Orthotics being a branch of biotechnology deals with the application of force through a mechanical device. Orthotic treatment may also be useful in the management of patients having various injuries to the joints including fractures of a long bone, rupture of muscles, cartilage and tendons. Some of the earlier evidence of orthotics dates back to Hippocrates who describes in detail methods of influencing the position of joints and stabilizing fractures. 
     Off-the-shelf orthoses can be professionally fit in a doctor&#39;s office and are typically selected by measurement of the anatomical segment. In other instances the orthoses is custom-made. In either event the function of the device is to influence body segments by the application of force to provide support, correction, or stabilization. This may provide mobility to a weakened muscle. However, it is not uncommon for the orthosis device to fail the expectations placed on it due to either spastic muscle groups, excessive reaction forces, or simply the weakening of the surrounding muscle. 
     Still other orthotic devices are used to protect and area. For instance, in order to protect the elbow status-post surgical correction for ulnar entrapment immobilizers may be used. Such devices afford protection but lack range of motion allowing for adhesions to disuse atrophy. 
     A further problem in the art is the lack of protection available to prevent injury in sporting activities. While devices exist to cushion impact, no known devices exist designed to allow a full range of motion yet prevent movement into positions that may lead to injury. For example, a race car driver requires a full range of motion but should an accident occur, the prevention of overextension may prevent breakage of the arm. This applies to basketball, football, or any other type of sport. 
     Further, no protection is known for otherwise non-contact sports such equestrian or polo. For instance, equestrian riding may place a person&#39;s back in a precarious position during jumping. Commonly such riders use no protection and should they fall they could break their neck or otherwise damage there spine. Use of a pad cushion does nothing to prevent such injury. 
     Attempts to provide dynamic braces have been made such as U.S. Pat. No. 5,117,814 sets forth a dynamic splint that couples to the upper and lower arm but fails to provide rotation support. 
     U.S. Pat. No. 5,178,137 discloses a segmented dynamic splint which accommodates normal joint component motion including triplanar motion but fails to provide a stability or protection. 
     Thus, orthotic devices typically serve to provide either stability, mobility, or protectablity. What is lacking in the art is a device capable of performing all three functions. 
     SUMMARY OF THE INVENTION 
     The instant invention is a device that operates as an exoskeletal supporting structure for the stability, mobility and predictability of joints and limbs. The device provides dynamic exoskeletal orthosis mobility along the desired planes and locks out undesired planes. Further, the device provides stability and protection. 
     In one embodiment the instant invention is used to support an arm or other body joint while allowing the flexing and extending of the arm through normal joint motion including triplanar motion. The arm embodiment includes a first rigid section preferably constructed of plastic that is secured around the upper portion, humerus, of an arm and a second rigid section preferably constructed of plastic, that is secured around the lower portion, radius, of the arm. The upper portion and lower portion are coupled together by a multi-piece shell elbow joint having a common pivot point allowing pivotal movement of the shell. The shell includes various coupling points so as to secure each section in a fixed position allowing for a limited range of motion. In addition, the lower portion can be secured to the elbow section and thereby fixated in a position relative to the upper portion by use of adjustable securement screws. 
     In this manner, an injury may be rehabilitated by allowing movement of the arm in a predetermined noninjurious direction allowing the injured portion of the arm to heal yet providing freedom of movement so as to maintain muscle tone in circulation through the arm thereby allowing hastened recovery. A wrist section can be further attached to the lower arm portion for use in maintaining the wrist in a fixed position or allowing the wrist to be used as a support element should another part of the arm such as the radius be injured. In this manner, the wrist section operates to position or limit movement of the wrist in a particular direction. 
     Dr. Marc Rosenblatt, the inventor, working in close cooperation with Dr. Joseph John Rizzuto, II, an orthotics specialist, further perfected the invention through a close cooperation between medicine and engineering by focusing on the biomechanical deficits of the prior art with an initial prototype manufactured by John Bergen and Jamalm Shafiullah. In particular the invention allows for the graduated increase in range of motion in one, two or more planes while limiting or allowing free motion in the remainder of the planes while maximizing protection. As an injury heals the rehabilitation may allow for the range of motion to change wherein the device allows for altered graduation of range of motion without the necessity of changing the brace or utilizing other orthotic devices. 
     Unique to this invention is its ability to operate as a protective as well as corrective brace in order to prevent injuries from occurring. For instance, a symptom known as carpal tunnel syndrome has developed due to repetitive tasks particularly aggravated by improper arm positioning. In this instance, the instant invention can be used by a person and once correctly positioned will prevent the individual from improperly positioning their hands leading to the carpal tunnel injury. Thus the invention may operate as a training device prohibiting the individual from placing their wrist in an improper position thereby providing a positive reinforcement as to the correct positioning for the particular task. A result is that after a period of time the individual will be trained in the proper placement of the wrist for the task. For example, typists and prolific computer keyboard operators are notorious for improper positioning of their arms when performing such a repetitive task as that demanded by a keyboard where an individual maintains their fingers in an exact location. In this instance, the device would be used to train the individual in proper placement of their arms and wrists as the device will absolutely prohibit movement into the improper position. 
     Injury prevention can further be directed into sports. For instance, numerous sports utilize elbow pads to protect the funny bone which is the medial epicondyle of the humerus. The funny bone gaining its terminology because pressure applied over this area stimulates the ulnar nerve and produces a distinct sensation. While an elbow pad provides cushioning to this area, it does not protect the area nor prevent improper movement of the elbows. Hockey is such a sport that propels an individual at a high speed and should the individual fall or be clipped it is probable that their arm may be twisted in such a position so as to cause temporary if not permanent injury. 
     Temporary injury may be as simplistic as bruising the funny bone or as serious as breaking a long bone. Permanent injury may be a result of over extending a muscle causing a torn ligament. The instant invention allows for attachment to a healthy arm. In other embodiments a finger, knee, ankle, spine, foot and so forth may use the teachings of the instant invention so as to protect the joint from injuries yet provide a device that prevents improper joint movement which can lead to permanent injury. 
     Thus, an objective of the instant invention is to teach a dynamic exoskeletal orthosis device which can be easily attached to a limb or joint providing protection, mobility and stability. The device having a full range of motion is allowed at any and all planes with full protection being maintained. The device may be anchored distally via the radius or more proximally if necessary. 
     Yet another objective of the instant invention is to disclose a brace having dynamic capabilities allowing pre-described movements of areas surrounding an injured area providing enhanced rehabilitation to the particular area by providing continuing movement of joints surrounding the affected area to maintain muscle tone hastening rehabilitation. 
     Still another objective of the instant invention is to provide a brace that operates as a training device for use in situations where improper joint movement can lead to injury. As an example, prevention of carpal tunnel syndrome. 
     Yet still another objective of the instant invention is to set forth a device for protection of an arm to prevent improper extension of a healthy arm which may lead to injury. 
     Still another objective of the instant invention is provide a protective device that mimics a joint in movement. 
     Yet still another objective of the instant invention is to disclose a shell mechanism with adjustment screws that can be used on any limb or joint of the human body as well as disclose a device adaptable to animals such as horses and dogs. 
     Other objectives and advantages of this invention will become apparent from the following description taken in conjunction with the accompanying drawings wherein are set forth by way of illustration and example, certain embodiments of this invention. The drawings constitute a part of the specification and include exemplary embodiments of the present invention and illustrate various objects and features thereof. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is an exploded perspective view of the instant invention; 
     FIG. 2 is a plane side view of the instant invention; and 
     FIG. 3 is a plane bottom view of the instant invention. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Although the invention has been described in terms of a specific embodiment, it will be readily apparent to those skilled in this art that various modifications, rearrangements and substitutions can be made without departing from the spirit of the invention. The scope of the invention is defined by the claims appended hereto. In light of the various types of joints that may be based upon the instant invention, it is believed that it would be most appropriate to set forth a specific embodiment directed to the protection of the arm as the elbow sets forth a hinge joint and a wrist uses a gliding joint. 
     Now referring in general to FIGS. 1-3, set forth is an embodiment of the dynamic exoskeletal orthosis device according to the teachings of the instant invention directed to the bracing of a human arm. In this embodiment the device 10 provides a controlled movement through a programmable range of motion. 
     The device 10 consists of a first member 12 which is secured to the upper arm of an individual relying upon the support of the humerus. As will be described later in this invention, if the humerus is damaged, the device will supply support thereto. The upper member 12 consists of an upper section defined by a rigid shell 14 having length with a substantially U-shaped curvature allowing for placement against the backside or triceps muscle of an arm. A lower section 16 of the first member 12 is enlarged defining a curvature encompassing a portion of said rigid shell and formed integral thereto. The lower section 16 is shaped to accommodate and protect the individual&#39;s elbow, namely, the lateral and medial epicondyle. A cushioning pad 18 is positioned along an inner surface 20 of the rigid shell 14 providing a cushion to the arm and a moisture barrier layer. 
     Flexible strap 22 is secured to a side surface of the shell 14 for use in wrapping around the front of the arm with free end 24 available for securement to an opposite end 26 of the strap secured to an outer surface of the shell 14, ends 24 and 26 having a receptacle hook and loop VELCRO type attachment. It is noted the rigid shell 14 is enlarged along each side edge forming the U-shaped section to accommodate the triceps of a person which is typically larger than the brachialis muscle. For this reason, a lower portion 30 of the shell 14 is slightly narrowed with a frontal edge 32 forming a curvature backward to the leading edge of the upper elbow shell edge 34. The elbow shell edge 34 forming a hinge joint 36 having apertures 38 and 39 to be used in coupling multiple articulating shells as will be described later in this specification. Aperture 39 is positioned across from the first aperture 38 creating an axis of movement between the two apertures. The lower portion 16 of the shell 14 has an inner surface 33 which is formed toward the rear of the shell including sufficient room sideward area to encompass the lateral and medial epicondynale of humerus. The lower portion 16 of the shell includes an adjustment slot 40. 
     In the upper arm there is but one bone, the humerus. The upper part of the bone is at first cylindrical and as it approaches the elbow it flattens out and expands sideways. There are two joint surfaces, side-by-side, at the expanded end of the humerus. The inner one resembles a spool, pulley or hour glass laid on its side and is known as the trochlea. The part of the ulna that bends around the trochlea of the humerus is commonly referred to as the &#34;funny bone&#34;. The nerve running to the ulna passes close by it and when we strike the bone this nerve tingles. The lower portion 16 the aforementioned second and third members provide an ancillary benefit of protecting the funny bone. 
     The second member 42 is operatively associated with the upper member 12 by use of coupling ends 44 and 46 having mounting aperture 50 and 48 respectively, allowing for alignment and the pivotal rotation along said axis of movement with apertures 38 and 39 of the first member. The second member 42 is defined by a curved shell which is slidably insertable along an outer curvature of the lower portion 16 of the first member 12. A plurality of through hole mounting holes 49 are centrally disposed and positionable over adjustment slot 40 and available for the threadable insertion of an adjustable locking screw for maintaining the upper member 12 in a fixed position relative to the second member 42 and further for allowing for an angular rotation along the axis of movement formed by mounting apertures 48 and 50 which may be further locked in position by use of the locking screws 122 having an enlarged head 124 for ease of rotation by human fingers. The inner surface 72 is formed backward toward the rear of the shell including sufficient sideward room pursuant to the upper member 12 to encompass the lateral and medial epicondynale. Locking screws may simply have an enlarged head 124 allowing for ease of rotation of an embedded screw or another type of locking means may be utilized such as a push and release type screw mechanism wherein the upper member has provisions for being locked in position in relation to the second member by depression of a locking screw fixating the components together. The screws described through this specification may be color coded providing ease of instruction and operation of which locking mechanism that needs to be moved in order to position a component in proper relation to a second member or in relation to the entire brace. It is further noted that the invention is not limited by locking by use of said screws as it is well known that various locking mechanisms may be used such as friction pins, spring loaded tabs, wedges, and so forth, all of which are embodied by this invention as a means for limiting the movement of the members. 
     Third member 60 is operatively associated with the second member 42 using coupling apertures 62 and 64 for engaging apertures 48 and 50 of the second member 42, and 38 and 39 of the upper member 12. The third member 60 employs an elongated slot 66 which allows for the securable positioning of the second member 42, or a range of motion, by placement of a threaded screw attachment 126 or the like which fits through the slot 66 and is securable to one of the mounting apertures 49 of the second member 42. The inner surface 68 of the member allows placement of the elbow with the outer surface 70 sized to allow for the slidable insertion along inner surface 72 of the second member 42. An insertion sleeve portion 90 is formed along one end of the member having three sections of adjustment hole 74, 76 and 78 positioned about the insertion sleeve. 
     The inner bone of the forearm, the ulna, hooks onto the trochlea form behind. Because the ulna is primarily concerned with bending and straightening the elbow, it is thick and massive at the elbow and tappers at the wrist. The radius carries the hand at the wrist and so is thick and heavy there and narrows at the elbow to the same type or kind of disc like head that the unit displays at the wrist. The radius of the arm is protected by lower member 80 which is also formed from a rigid elongated shell having a first end 82 and a second end 84 with a padded surface liner 86 along an inner side surface of the shell. First end 82 is enlarged using a step ridge 88 extending outwardly from the liner 86 for attachment to the insertion sleeve 90 of the third member 60. The sleeve 90 with adjustment slot 92 is placed through the shell for attachment to mounting aperture holes 76, 78 and 74. As with the upper member, the lower member includes a flexible strap 94 having a hook and loop attachment 96 on one end of the strap available for wrapping around the arm of an individual placed within the shell with the strap releasably securing to receptive end 98 thereby relying upon the radius bone in a fixed position or if necessary providing limited movement to the radius and ulna as allowed by adjustment to the device. Adjustment screw 132 is placed through the slot located on the lower member. Similarly each side of the shell is secured by side attachment screws 130 and 138 each allowing for adjustment of the lower member in respect to the radius. Along second end 84 is a first wrist mounting aperture 102, second mounting aperture 104 and adjustment slot 106. 
     Wrist member 107 is formed from a one piece rigid shell having adjustment slot 108 operatively associated with mounting aperture 102, upper adjustment slot 110 is operatively associated with second mounting aperture 104. Adjustment slot 106 of the lower member 80 is positionable between locking aperture holes 112 located along a bottom of the wrist member 107 allowing adjustment of wrist movement thereof. As with the upper member 12 and lower member 80, strap 114 is provided for placement between the thumb and first finger so as to maintain the carpal bones and metacarpal bones in a fixed position if necessary. The strap 114 includes a hook and loop attachment 116 available for placement to a receiving hook and loop attachment 118 thereby fixating the wrist in a pre-determined position. When the palm of the hand is directed forward and then the thumb is pointing away from the body, the radius and ulna lie side-by-side. As the palm is turned, wherein the thumb is directed toward the body the radius turns and the lower end rolls across the ulna. A frontal section of the elbow member is substantially U-shaped with centrally disposed mounting apertures 74 and securement holes 76 and 78 located along an upper end of the centrally mounted holes. 
     It is to be understood that while I have illustrated and described certain forms of my invention, it is not to be limited to the specific forms or arrangement of parts herein described and shown. It will be apparent to those skilled in the art that various changes may be made without departing from the scope of the invention and the invention is not to be considered limited to what is shown in the drawings and described in the specification. The teachings of the invention may easily be directed to stability and mobility of the femur and fibula providing protection to the patella.