Abstract:
An improved foot abduction apparatus allowing movement in a horizontal and vertical plane. The embodiments allow a user to more easily manipulate the apparatus in one or both planes through the use of strategically placed pivot points. The device utilizes at least one rigid member attached to coupling devices which contain at least one pivot point. The specialized coupling devices may be selectively attached to shoe receiving member or plates which are well known in the art. Additionally the shoe receiving members are able to receive an improved shoe containing a sole member contained with a silicone boot.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application claims priority to provisional patent application 61/034,450 which was filed on Jul. 29, 2008, and is hereby expressly incorporated by reference. 
     BACKGROUND 
     Dr. Ignacio Ponseti is an internationally famous physician and surgeon specializing in the treatment and management of a childhood deformity commonly know as a club foot. Dr. Ponseti has for many decades promoted the use of a foot and ankle abduction device, or orthosis, that is used to correct and prevent relapses of the club foot deformity. These abduction devices typically consist of a rigid bar connected between shoes worn by the child which bar separates the feet of the child and holds the feet in an outward rotation or abduction. Typically, if the condition is diagnosed early enough, this device is worn full-time for a period of months, but during the period of treatment, the angle of outward rotation is periodically adjusted. 
     The Ponseti technique, as it has become known throughout the world, has been highly successful in treating club feet without the necessity of corrective surgery. Many devices have been designed and used for many, many years in applying the Ponseti technique. Currently used devices that apply the Ponseti technique are shown in U.S. Pat. No. 7,267,657. In this patent, there are disclosed improvements in such devices which provide for quick release of the shoes from the abduction bar and which also provide a method for varying the abduction angle and locking it in place at a selected angle. Devices of this type have been extremely successful and are widely used by those who treat patients using the Ponseti technique. However, the devices allow the user limited movement in the horizontal and vertical planes. Typically the user must pivot on his or her feet to move forward or backward. Additionally, the rigid current foot abduction apparatuses make any movement difficult for the user. There is; therefore, a need for an improved orthosis that allows greater mobility in the horizontal and vertical planes for use in treating club feet and other gait issues using the Ponseti technique. 
     SUMMARY OF THE INVENTION 
     The improved abduction apparatus system for correcting gait issues allows the user, typically a patient with a club foot, greater mobility while wearing the brace. The at least two pivot points allow a greater range of movement in at least one of the horizontal and vertical planes. Several embodiments of the invention are possible to obtain the preferred result. 
     A first embodiment consists of a metal or plastic bar with connection means on the far sides of the bar. One coupling device is attached to each side of the metal bar and the coupling devices are pivotable in a vertical plane. Each coupling device is then attached to either a left footplate or a right footplate. The footplates are attached to the coupling device such that the angle of outward rotation may be periodically adjusted. The selected angle of outward rotation may be maintained once the footplate is firmly secured to the coupling device. The user of the foot abduction apparatus can lift up each foot in the vertical plane via the pivot point while maintaining the corrective angle of outward rotation. The user may achieve horizontal movement by manipulating the device in a “waddling” motion. The same embodiment also allows a user to more easily crawl if the user is unable to walk. 
     A second embodiment of the invention allows a user to manipulate the device in a horizontal plane. This embodiment consists of two rigid bars connected to coupling devices on both ends of the bars. The coupling device maintains the rigid members in parallel. Also attached to the coupling device are footplates which can receive a shoe. The rigid bars are attached to the coupling devices such that they are selectively pivotable at the point of connection. A user of the second embodiment attaches the shoes to the footplates. The user then manipulates the device by pushing one foot forward. The force causes the rigid bars to pivot allowing horizontal movement of the user&#39;s feet. 
     A third embodiment of the invention is similar to the first two and contains at least a second pivot point and an additional metal or plastic bar. The two bars are substantially in parallel and contain a means for attachment at each end. A connecting device is attached to each side of the bars. The bars may pivot about the coupling device in a horizontal direction while maintaining the bars in parallel. Each coupling device contains a third pivot point which may be attached to either a left footplate or a right footplate. The third pivot point allows movement in the vertical plane. Again the footplate contains a means to adjust and maintain the angle of outward rotation. A left shoe may then be attached to the left footplate and a right shoe attached to the right footplate. The user of this embodiment of the invention may simultaneously manipulate the device in a vertical and horizontal direction without the “waddling” motion associated with the first embodiment. 
     The coupling devices of the embodiments are preferably a one-piece plastic made from rotomolding or injection molding techniques. The attachments means may be of any of several know techniques for attachment but preferably the means is a standard screw. Additionally, the preferred embodiment contains a metal or rigid plastic base with means for attachment to the left or right footplate. The base is contained within a soft substance on all sides. The soft substance is preferably silicone rubber which allows greater comfort and reduces the potential of an allergic reaction to the wearer of the invention as it cushions the foot. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a perspective view generally from the top-rear of the invention showing the single bar embodiment; 
         FIG. 2  is a perspective view of possible connecting devices for the invention; 
         FIG. 3  is a top view of the double bar design without vertical movement; 
         FIG. 4  is a side view of the double bar design without vertical movement; 
         FIG. 5  is a top view of the double bar design with vertical movement; 
         FIG. 6  is a rear view of the double bar design with vertical movement; 
         FIG. 7  is a right side view of the shoe; 
         FIG. 8  is a cross-sectional view of the shoe taken at line  8 ; 
         FIG. 9  is a bottom perspective of the boot in which the rigid sole is inserted on the top of the silicone rubber; 
         FIG. 10  is a right side view of the shoe; 
         FIG. 11  is a cross-sectional view of the shoe taken at line  11 ; and 
         FIG. 12  is a bottom perspective of the boot in which the rigid sole is placed within the silicone. 
     
    
    
     DETAILED DESCRIPTION 
     Now referring to the drawings,  FIG. 1  shows a single bar foot abduction system  2  comprising a rigid member  4 , a first coupling device  6 , a left shoe receiving member  8 , a left plate  12 , a second coupling device  14 , a right shoe receiving member  16  and a right plate  18 . The system  2  allows the user of the device to lift and lower each foot independently through a first pivot point  20  and a second pivot point  22 . 
     The rigid member  4  may be comprised of a left rigid member  24  and a right rigid member  26 . The left rigid member  24  and the right rigid member  26  substantially overlap one another and are housed in the bar adjuster device (not shown). The bar adjuster device allows the length of the overlap of the left rigid member  24  and the right rigid member  26  to be varied; thus, controlling the overall length of the rigid member  4 . The greater the overlap of the left rigid member  24  and the right rigid member  26 , the shorter the overall length of the rigid member  4 . 
     The rigid member  4  further comprises a first end  28  and a second end  30 . The first end  28  may be selectively attachable to the first coupling device  6  by several known methods; however, the preferred mode of attachment is by a nut and bolt (not shown in order to demonstrate shape of coupling device  6 ). The first coupling device  6  may then be selectively attachable to the left plate  12  by the preferred means of a nut  9  and bolt  11 . The left plate  12  may then be attached to the left receiving shoe member  8 . The angle of the left shoe receiving member  8  in relation to the rigid member  4  may be adjusted by loosening the attachment mechanism securing the first coupling device  6  to the left plate  12 , manipulating the left plate  12  to the desired angle, and then retightening the attachment mechanism. 
     The second end  30  may be selectively attachable to the second coupling device  14  in the same manner as the first end  28  is attached to the first coupling device  6 . Similarly to the left plate  12  and its attachment to the first coupling device  6  and its attachment to the left shoe receiving member  8 , the right plate  18  is selectively attachable to the second coupling device  14  and the angle between the right shoe receiving member  16  in relation to the rigid member  4  may be adjusted. Referring additionally to  FIG. 2 , the first coupling device  6  and the second coupling device  14  may be of a variety of configurations that allow movement in a vertical plane. 
     After the angle between the left shoe receiving member  8  and the rigid member  4 , and the angle between the right shoe receiving member  16  and the rigid member  4  are set; the user inserts his left shoe and right shoe (neither shown) into the appropriate shoe receiving member  8  or  16 . Once inserted, the shoes are held in place by any of several known attachment means including a snap-on means. As the user elevates or lowers his right foot, the rigid member  4  pivots about a first pivot point  20  located at the point where the rigid member  4  and the first coupling device  6  selectively attach. As the user elevates or lowers his left foot, the rigid member  4  pivots about a second pivot point  22  located at the point where the rigid member  4  and the second coupling device  14  selectively attach. The user may move in a horizontal direction by pivoting on the bottom of the left plate  12  or the right plate  18  in a shuffling type motion. 
     Now referring to  FIG. 3  and  FIG. 4 , a second embodiment of a foot abduction system  202  is detailed. The system  202  comprises a first rigid member  204 , a second rigid member  206 , a first coupling device  208 , a second coupling device  210 , a left plate  212 , a right plate  214 , a left shoe receiving member  216 , and a right shoe receiving member  218 . The first rigid member  204  and the second rigid member  206  lie within the same horizontal plane and are spaced such that they are substantially parallel with one another. Each rigid member  204 ,  206  are preferably made of metal or a rigid plastic and further comprise a first end  220 ,  222  respectively and a second end  224 ,  226  respectively. The first ends  220 ,  222  are selectively attachable to the first coupling device  208 , while the second ends  224  and  226  are selectively attachable to the second coupling device  210 . 
     The first coupling device  208  and the second coupling device  210  are preferably made of plastic and each further comprise three segments  230 ,  231 ,  232 . The coupling devices are preferably made by rotomolding or injection molding techniques. The segment  232  is preferably substantially perpendicular to segments  230 ,  231 . The segment  230  of the first coupling device  208  is selectively attachable to the first end  220  of the first rigid member  204 ; and the segment  230  of the second coupling device  210  is selectively attachable to the second end  224  of the first rigid member  204 . The segment  231  of the first coupling device  208  is selectively attachable to the first end  222  of the second rigid member  206 ; and the segment  231  of the second coupling device  210  is selectively attachable to the second end  226  of the second rigid member  206 . 
     Again referring to  FIG. 3  and  FIG. 4 , the segment  232  of the first coupling device  208  is selectively attachable to the left plate  212 . The means for attachment is preferably two standard screws. The segment  232  of the second coupling device  210  is selectively attachable to the right plate  214 , again with a two screw attachment. Once each of the segments  230 ,  231 ,  232  of each coupling device  208 ,  210  are selectively attached, the preferred embodiment has the rigid members  204 ,  206 , the left plate  212  and the right plate  214  in a position such that they remain in a fixed angle position. The first coupling device  208  and the second coupling device  210  may be located on an underside  250  of the rigid members  204 ,  206  or on an upper surface  252  of the rigid members  204 ,  206 , although the preferred embodiment is on the underside  250  of the rigid member. 
     The left shoe receiving member  216  may be attached to the left plate  212  by a variety of known techniques including a screw. Similarly, the right shoe receiving member  218  is attached to the right plate  214 . The left shoe receiving member  216  and the left plate  212  define an angle which may be adjusted and selectively fixed. The right shoe receiving member  218  and the right plate  214  define an angle which may be adjusted and selectively fixed. A shoe (not shown) may be of any of those well known in the art which have the capability of attaching to the left shoe receiving member  216  or right shoe receiving member  218 . Additionally, the left plate  212  is preferably angled downward such that the bottom of the left shoe receiving member  218  is the same elevation as the bottom of the first coupling device  208  when the left plate  212  is attached to the left shoe receiving member  216  and the first coupling device  208 . Similarly, the right plate  214  is preferably angled such that the bottom of the right shoe receiving member  218  is the same elevation as the bottom of the second coupling device  210  when the right plate  214  is attached to the right shoe receiving member  218  and the second coupling device  210 . 
     The points at which the rigid members  204 ,  206  attach to the first coupling device  208  and second coupling device  210  define pivot points  260 . The rigid members  204 ,  206  are pivotable upon the first coupling device  208  and the second coupling device  210 . A user can then manipulate the device  202  in a first plane which would typically be the horizontal plane. As the user moves the right shoe receiving member  218  or the left shoe receiving member  216  in the horizontal plane, the rigid members  204 ,  206  pivot allowing horizontal movement. As the rigid members  204 ,  206  are substantially in parallel and there are at least four pivot points  260 , the rigid members  204 ,  206  remain substantially in parallel with one another during operation. The horizontal movement is depicted by the first position of the device  202  evidenced by the dashed lines and the second position indicated by solid lines. Additionally, the fixed positions of the left plate  212  and the right plate  214  ensure the angle defined by the left plate  212  and the left shoe receiving member  216  remain constant as well as the angle defined by the right plate  214  and the right shoe receiving member  218  remain constant during operation of the system  202 . 
     Now referring to  FIG. 5  and  FIG. 6 , a third embodiment of a foot abduction system  302  is detailed. The system  302  comprises a first rigid member  304 , a second rigid member  306 , a first coupling device  308 , a second coupling device  310 , a left plate  312 , a right plate  314 , a left shoe receiving member  316 , and a right shoe receiving member  318 . The first rigid member  304  and the second rigid member  306  lie within the same horizontal plane and are spaced such that they are substantially parallel with one another. Each rigid member  304 ,  306  are preferably made of metal or a rigid plastic and further comprise a first end  320 ,  322  respectively and a second end  324 ,  326  respectively. The first ends  320 ,  322  are selectively attachable to the first coupling device  308 , while the second ends  324  and  326  are selectively attachable to the second coupling device  310 . 
     The first coupling device  308  and the second coupling device  310  are preferably made of plastic or metal alloy and each further comprise three segments  330 ,  331 ,  332 . The coupling devices are preferably made by machining or injection molding techniques. The segment  332  is preferably substantially perpendicular to segments  330 ,  331 . The segment  330  of the first coupling device  308  is selectively attachable to the first end  320  of the first rigid member  304 ; and the segment  330  of the second coupling device  310  is selectively attachable to the second end  324  of the first rigid member  304 . The segment  331  of the first coupling device  308  is selectively attachable to the first end  322  of the second rigid member  306 ; and the segment  331  of the second coupling device  310  is selectively attachable to the second end  326  of the second rigid member  306 . 
     Again referring to  FIG. 5  and  FIG. 6 , the segment  332  of the first coupling device  308  is selectively attachable to the left plate  312 . The segment  332  further comprises an elongated slot  340 . The elongated slot  340  is of a size and shape which allows left plate  312  to slide within the confines of the elongated slot  340 . The segment  332  of the second coupling device  310  is selectively attachable to the right plate  314 . The segment  332  further comprises a slot  342  which is a size and shape which allow right plate  314  to slide within the confines of the slot  342 . The attachment means for connecting left plate  312  to the first coupling device  308  or the right plate  314  to the second coupling device  310  is preferably a bolt  350  and a nut  352  or a screw pin (not shown). Once each of the segments  330 ,  331 ,  332  of each coupling device  308 ,  310  are selectively attached the preferred embodiment has the rigid members  304 ,  306 , the left plate  312  and the right plate  314  in a position such that they remain in a fixed position to one another. The first coupling device  308  and the second coupling device  310  may be located on an underside  370  of the rigid members  304 ,  306  or on an upper surface  372  of the rigid members  304 ,  306 , although the preferred embodiment has the coupling devices on the upper surface  372  of the rigid members  304 ,  306 . 
     The left shoe receiving member  316  may be attached to the left plate  312  by a variety of known techniques including a screw. Similarly, the right shoe receiving member  318  is attached to the right plate  314 . The left shoe receiving member  316  and the left plate  312  define an angle which may be adjusted and selectively fixed. The right shoe receiving member  318  and the right plate  314  define an angle which may be adjusted and selectively fixed. A shoe (not shown) may be of any of those well known in the art which have the capability of attaching to the left shoe receiving member  316  or right shoe receiving member  318 . Additionally, the left plate  312  and the right plate  314  are preferably angled downward such that the bottom of the left shoe receiving member  316  and the right shoe receiving member  318  are the lowest elevation points of the device  302 . 
     The points at which the rigid members  304 ,  306  attach to the first coupling device and second coupling device define pivot points  380 . The rigid members  304 ,  306  are pivotable upon the first coupling device  308  and  310 . A user can then manipulate the device  302  in a first plane which would typically be the horizontal plane. As the user moves the right shoe receiving member  318  or the left shoe receiving member  316  in the horizontal plane, the rigid members  304 ,  306  pivot allowing horizontal movement. As the rigid members  304 ,  306  are substantially in parallel and there are at least four pivot points  360 , the rigid members  304 ,  306  remain substantially in parallel with one another during operation. Additionally, the fixed positions of the left plate  312  and the right plate  314  ensure the angle defined by the left plate  312  and the left shoe receiving member  316  remain constant as well as the angle defined by the right plate  314  and the right shoe receiving member  318  remain constant. The dashed lines of  FIG. 5  indicate a first horizontal position while the solid lines indicate a second position. 
     In addition to movement in a horizontal plane, unique pivot points  362 ,  364  allow vertical movement as well. As a user lifts the left shoe receiving member  316 , the right plate  314  pivots about pivot point  362  allowing vertical movement. Similarly, when the user lifts the right shoe receiving member  318 , the left plate  312  pivots about pivot point  364  which allows vertical movement. The vertical movement is depicted in  FIG. 6  in which a first position is shown by solid lines and a second position is shown by dashed lines. A user may manipulate the device in both the horizontal and vertical planes simultaneously. The pivot points  362  and  364  are always above the rigid members  304  and  306  during the normal operation of the system hereby limiting the range of motion of the left plate  312  and the right plate  314  such that the left plate  312  and the right plate  314  are prevented from becoming substantially inverted during operation of the system. 
     Now referring to  FIG. 7 ,  FIG. 8  and  FIG. 9 , a boot  400  which may be attached to the foot abduction apparatuses  2 ,  202 ,  302  detailed above is shown. The boot  400  comprises a flexible portion  402  and a rigid sole  404 . Specifically referring to  FIG. 8 , a cross-sectional portion of the boot  400  is shown. A cavity  406  is formed within the flexible portion  402 . The shape of the cavity  406  corresponds to the shape of the rigid sole  404 . The rigid sole  404  is inserted into the cavity  406 . Once in place, the flexible portion  402  surrounds a bottom surface  408  of the rigid sole  404 . The flexible portion  402  is preferably made of silicone which possesses a cushioning characteristic. The cushioning characteristic allows the user of the boot  400  more comfort and greater shock absorption. 
     Again referring to  FIG. 7 , the rigid sole  404  is substantially planar. Once the rigid sole  404  is inserted into the cavity  406 , attachment means  410  may be used to connect the boot  400  to the shoe receiving members described in the embodiments described above. Preferably, the attachment means  410  are standard screws that may be counter sunk in the rigid sole  404 . Any number of attachment means  410  may be utilized, but the preferred embodiment has three attachment means  410 . 
     The flexible portion  402  comprises a heel extension  412  which is at a substantial perpendicular in relation to the rigid sole  404 . The heel extension  412  is shaped such that it conforms to a user&#39;s bank ankle, heel and lower back calf. The heel extension  412  also allows straps (not shown) to be connected to stabilize and support a user&#39;s foot and ankle. A heel hole  414  in the flexible portion  404  allows a doctor or parent to observe the placement of a user&#39;s ankle and heel to verify the correct positioning of the user&#39;s foot. Additionally, the flexible portion  402  comprises two flaps  415  which substantially cover the user&#39;s foot. The flaps  415  also allow straps to span the width of the shoe while protecting the user from the friction created by such straps. 
     Now referring to  FIG. 10 ,  FIG. 11  and  FIG. 12  another embodiment of a shoe  500  for a foot abduction apparatus is detailed. The boot  500  comprises a flexible portion  502  and a rigid sole  504 . Specifically referring to  FIG. 8 , a cross-sectional portion of the boot  500  is shown. A cavity  506  is formed within the flexible portion  502 . The shape of the cavity  506  corresponds to the shape of the rigid sole  504 . The rigid sole  504  is inserted into the cavity  506 . The flexible portion  502  further comprises an edge  522  which is flexible. The cavity  506  and the edge  522  may be manipulated in such a way that the rigid sole  504  can be placed in the cavity  506 . The edge  522  maintains the rigid sole  504  in the flexible portion  502 . The flexible portion  502  is preferably made of silicone which possesses a cushioning characteristic. The cushioning characteristic allows the user of the boot  500  more comfort and greater shock absorption. 
     Again referring to  FIG. 10 , the rigid sole  504  is substantially planar. Once the rigid sole  504  is inserted into the cavity  506 , attachment means  510  may be used to connect the boot  500  to the shoe receiving members described in the embodiments described above. Preferably, the attachment means  510  are standard screws that may be counter sunk in the rigid sole  504 . Any number of attachment means  510  may be utilized, but the preferred embodiment has three attachment means  510 . 
     The flexible portion  504  comprises a heel extension  512  which is at a substantial perpendicular in relation to the rigid sole  504 . The heel extension  512  is shaped such that it conforms to a user&#39;s bank ankle, heel and lower back calf. The heel extension  512  also allows straps (not shown) to be connected to stabilize and support a user&#39;s foot and ankle. A heel hole  514  in the flexible portion  504  allows a doctor or parent to observe the placement of a user&#39;s ankle and heel to verify the correct positioning of the user&#39;s foot. Additionally, the flexible portion  502  comprises two flaps  515  which substantially cover the user&#39;s foot. The flaps  515  also allow straps to span the width of the shoe while protecting the user from the friction created by such straps. 
     Having thus described the invention in connection with the preferred embodiments thereof, it will be evident to those skilled in the art that various revisions can be made to the preferred embodiments described herein with out departing from the spirit and scope, of the invention. It is my intention, however, that all such revisions and modifications that are evident to those skilled in the art will be included with in the scope of the following claims.