Abstract:
An improved orthopedic walking brace for providing therapeutic pressure to an ankle and lower leg is provided. An exterior stirrup frame and detachable front tongue and rear panel members apply compressive forces through an inner liner member to the foot, ankle and leg. Inflatable bladders are positionable adjacent the ankle for providing adjustable pressure. The air inlet tubes for the bladders are adjustable to an infinite number of positions relative to the stirrup member.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application acclaims priority to U.S. Provisional Patent Application Ser. No. 61/068,959 filed on Mar. 10, 2008, the entire contents of which are herein incorporated by reference. 
     
    
     FIELD OF THE INVENTION 
       [0002]    This invention relates generally to orthopedic devices, and more particularly to orthopedic walker support boots which are configured to immobilize and/or protect injured limbs or parts of the anatomy for use by persons recovering from injuries such as broken bones, sprains or other trauma of the lower leg, ankle or foot. 
       BACKGROUND OF THE INVENTION 
       [0003]    Orthotic or orthopedic devices to which this invention relates function to brace and support injured limbs, muscles, joints and bones. Such injuries can arise in numerous ways, such as through strenuous physical activity or from weakened conditions that may be experienced by frail or elderly people. In the management of certain such injuries to the lower extremities, such as fractures to the tibia and fibula, malleolar fractures, or severe ankle sprains, it is common to first completely immobilize the lower extremity by use of well-known molded plastic or resin casts. However, once the injured extremity has become stable, it has been found that recovery can be advanced more rapidly by gradually and progressively permitting the extremity to bear weight and undergo other permitted exercises. It has been found that non-cast devices typically known as walking boots or braces are particularly effective for filling this need. Besides aiding in the healing process, they provide the wearer with significantly increased mobility, greater comfort and the ability to bathe and readily examine the injured extremity. 
         [0004]    Many configurations of such walking braces are known in the art. One such early device disclosed, for example, in U.S. Pat. No. 3,955,565 to Johnson, comprises a pair of complimentary shaped half shell members that are configured to be secured to one another in enclosing relation about a damaged limb, to form an enclosed boot-like structure. Another example of a walker boot of such cooperating front/back two part construction, is shown in U.S. Pat. No. 5,827,210 to Antar et al. 
         [0005]    Other such devices such as, for example, that of U.S. Pat. Nos. 5,078,128 or 5,464,385 to Grim, employ a lighter weight frame construction generally including a load bearing sole structure for supporting the foot, connected to a pair of lateral support members extending upwardly from the sole along the inner and outer sides of the ankle or leg to form a stirrup-like structure. The wearer&#39;s foot and injured limb are supported in a padded liner member that is retained within the outer stirrup frame structure by means of a plurality of strap fasteners. The referenced walker devices are generally open at the front and back of the stirrup frame, except for the support liner and the fastening straps. One or more inflatable bladders have been used with the liner or frame structure to selectively apply pressure to the retained limb(s) of the wearer. 
         [0006]    U.S. Pat. No. 5,577,998 to Johnson et al. illustrates a walking brace structure having a rear shell portion that appears to be of the open back stirrup configuration, an interior resilient foam liner, a front shell portion and a plurality of straps for securing the assembly about the wearer&#39;s leg. Johnson further discloses an air cell structure that can be inflated without the use of an external pump. 
         [0007]    The present invention provides a walking brace that offers advantages over those of the prior art. The walker of this invention provides the support benefits of known walker devices with a lightweight yet strong and fully protective support structure that offers adjustable air bladder comfort features to the wearer heretofore not found in prior walkers. 
       SUMMARY OF THE INVENTION 
       [0008]    The invention provides an improved therapeutic walking brace in the form of a walking boot with a rocker sole that effectively immobilized the foot and ankle of a patient/wearer while allowing the wearer to walk without pain. An internal padded line member wraps around the wearer&#39;s foot and ankle. Immobilizing pressure is applied to the foot, ankle and leg of the wearer through the liner by an external framework of a sole and stirrup configuration and front tongue and back panel members. The external force applying members are adjustably secured together by a plurality of adjustable straps. A pair of fluid bladders are positioned within pocket members of the liner at positions alongside the inner and outer ankle portions of the wearer. The bladders are readily removable from their support pockets and include inflation tubes that extend upwardly to the top of the liner for easy inflation of the bladders. The inflation tubes are configured to be positioned at an infinite number of positions relative to the ankle and external stirrup framework to provide for maximum comfort to the wearer. 
         [0009]    According to one aspect of the invention there is provided, a walking brace for providing therapeutic pressure to the ankle and lower leg of a person, comprising:
       a. an exterior stirrup frame construction, comprising:
           i. a full length sole portion; and   ii. a pair of rigid or semirigid generally parallel elongate strut members extending substantially vertically upward from said sole portion on either side thereof so as to extend along an ankle and leg of a person wearing said brace;   
           b. an interior resilient liner pad configured to cushion the ankle and leg of a person and to cooperatively position the leg within said stirrup frame;   c. at least one detachable variable pressure fluid bladder;   d. at least one bladder support pocket attached to said liner pad configured to support said at least one fluid bladder, said support pocket having an access suitable for enabling ingress and egress of said bladder therethrough;   e. a fluid inlet tube operatively connected to and extendable from said fluid bladder to a position remote therefrom and accessible externally of said liner and said stirrup frame; and   f. a fastener operatively connectable to said inlet tube to selectively secure said inlet tube at a plurality of locations relative to said liner and said stirrup frame.       
 
         [0018]    According to another aspect of the invention there is provided, an inflatable fluid bladder support member for selectively applying pressure to an ankle and leg of a patient and of a type suitable for placement between an outer shell of an orthopedic brace member and the ankle or leg of a patient, comprising:
       a. a fluid inflatable bladder; having an internal cavity;   b. an inlet tube having a first end operatively connected to said bladder in fluid communication with said bladder internal cavity, and extending to an opposite second end suitable for selective attachment to a pump; and   c. a fastener member secured to said tube between said first and second ends thereof and having an outer surface suitable for detachable connection to a second attachment surface; said outer surface being attachable at an infinite number of positions along said second attachment surface.       
 
         [0022]    These and other aspects of the invention will become more apparent upon a description of a preferred embodiment of the invention. It will be appreciated that the preferred embodiment is not to be construed as limiting the invention to any particular configuration, designs, or applications that are specifically presented herein. The preferred embodiment is presented to illustrate a specific application and implantation of the broader principles of the invention and is not to be construed in a limiting manner. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0023]    Referring to the Figures of the Drawing, wherein like numerals represent like parts throughout the several views: 
           [0024]      FIG. 1  is a top, front, perspective view of a preferred embodiment of a right foot walking brace of the present invention, illustrated as it would appear assembled and positioned around the foot and leg of a wearer; 
           [0025]      FIG. 2  is a top, front, perspective view of the outer stirrup portion of the brace of  FIG. 1 ; 
           [0026]      FIG. 3  is a perspective view illustrating the front tongue and pad, and back panel member portion of the brace of  FIG. 1 ; 
           [0027]      FIG. 4  is a left side view of the inner liner portion of the brace of  FIG. 1 , shown removed from the outer stirrup member, and illustrating an outer pocket and an air bladder assembly operatively positioned therein. 
           [0028]      FIG. 5  is a diagrammatic perspective view of the inner liner of  FIG. 4 , illustrating the liner as it would appear in an unfolded, open position relative to the outer stirrup prior to insertion of a foot/leg therein; 
           [0029]      FIG. 6  is an enlarged exploded view of the inside portion of the right upright stirrup support member of  FIGS. 1 and 2 , illustrating the interconnection of the upper and lower portions thereof; 
           [0030]      FIG. 7  is a diagrammatic view of a typical placement of the air bladder of  FIG. 4  relative to a foot and ankle of a wearer of the brace of  FIG. 1 ; and 
           [0031]      FIG. 8  is an enlarged fragmented view of the air bladder assembly of  FIGS. 4 and 7 , illustrating its connection with a pump. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0032]    Referring to the drawings, wherein like numerals represent like parts throughout the several views,  FIGS. 1-8  illustrate a first embodiment of a walker brace  10  constructed according to the principles of this invention. The walker brace is shown assembled in  FIG. 1  as it would appear when secured to the foot and leg of a patient (not illustrated). The outer shell portions of the walker brace are preferably constructed of a light weight plastic material suitable for use with injection molding equipment. The outer shell portions of the walker brace include a stirrup-like frame portion  12 , front tongue member  35  and a rear panel member  40 . 
         [0033]    The stirrup-like frame portion  12  includes a lower foot support full length sole portion  13  for supporting the bottom of the wearer&#39;s foot. The back portion of the lower foot support  13  defines a slightly raised heel portion  14 , continuously connected with opposed inner and outer side portions  15  and  16  respectively which rise to form a pair of inner and outer strut base members  15   a  and  16   a  respectively configured to lie along the lower ankle portions of a wearer. The walker brace illustrated in the figures is a “right” foot brace. A left foot brace would comprise a mirror image of the walker brace illustrated in the figures. Accordingly, the previously described inner side  15  of the lower foot support portion would correspond to the left side of the right foot walker brace member when positioned on a user&#39;s foot; and the outer side  16  would correspond to the right side of the illustrated right foot walker brace when positioned on a user&#39;s foot. The inner/left side and the outer/right side terminology will be used interchangeably throughout the description, it being understood that such reference is to a right foot walker brace member of the preferred embodiment illustrated. It will also be understood that the same principles as described with respect to the right foot walker brace, apply to a walker brace design for a wearer&#39;s left foot. The lower foot support sole portion defines a fairly wide footbed to provide comfortable fit to the wearer. A footbed foam cushion  17  provides improved energy absorption and reduces shock input to the heel and foot of the wearer. The raised heel portion  14  is configured to engage the back of the heel of the wearer and to define the rearward extent of a foot position when secured within the walker brace. The outer bottom  13  of the foot support sole portion is continuously curved to provide a “rocker” bottom to facilitate a more natural walking gait pattern for the wearer. The lower surface of the sole portion has a patterned rubberized tread (not illustrated) as is known in the art to provide an anti-slip walking surface for the brace. Other materials such as gel or foam, or air bladder structures may be used for forming the footbed cushion  17  of the walker brace, as will be appreciated by those skilled in the art. 
         [0034]    A left side elongate strut extension  15   b  is secured to the lower upright strut brace member  15   a . Similarly, a right side elongate strut extension  16   b  is secured to the lower upright strut brace member  16   a . The strut brace member  15   a  and its elongate strut extension  15   b  form a left side upright support member for the walker brace. Similarly, the upright strut brace member  16   a  and its associated elongate extension  16   b  form a right side upright support member of the walking brace. The left and right upright support members, in combination with the lower foot support sole portion  13 , the heel portion  14 , and the left and right outer side portions  15  and  16  collectively form a stirrup-like outer support structure for the walker brace  10 . 
         [0035]    The left side strut extension  15   b  overlaps with the upright strut brace member  15   a  and is secured thereto by a rivet  21   a , an inner mounting band  21   b  inwardly projecting from the left side upright strut brace member  15   a  and an outer collar sleeve member  21   c  that slides over the upper edge of the lower strut brace member  15   a  (see  FIGS. 2 and 6 ). Similarly, the right side elongate strut extension  16   b  is secured to the upright strut brace member  16   a  by means of a rivet  22   a , an inner mounting band  22   b  (not shown) inwardly projecting from the right upright strut brace member  16   a  and an outer collar sleeve member  22   c  that slides over the upper edge of the lower strut brace member  16   a . Each of the upper strut extension tongue portion  15   c  and  16  respectively the cooperatively slides through and is retained by the inner mounting bands  21   b  and  22   c  of the lower strut brace member  15   a  and  16   a  respectively. The pair of elongate upright members  15   a/b  and  16   a/b  form semirigid support for the inner and outer sides of the wearer&#39;s ankle/leg members for the brace. The semirigid support members are longitudinally anatomically contoured to accommodate the general shape of a wearer&#39;s ankle and leg that they will support. 
         [0036]    The left side elongate upright support member  15   a,b  of the stirrup includes three pairs of longitudinally spaced slots  23   a ,  23   b  and  23   c  through which are retainably threaded fastener straps, as described in more detail hereinafter. The right side elongate upright support member  16   a,b  of the stirrup includes three pairs of longitudinally spaced slots  24   a ,  24   b  and  24   c  through which are retainably threaded fastener straps, as described in more detail hereinafter. 
         [0037]    Referring to  FIG. 2 , first and second D fastening rings  25   a  and  25   b  are pivotally mounted by rivet fasteners to the left or inner side portion  15  of the lower foot support portion  13  of the brace. A pair of fastening straps  30   a  and  30   b  are pivotally secured by means of rivets to the outer side  16  of the lower foot support sole portion  13  at positions therealong which cooperatively laterally align with the D-rings  25   a  and  25   b  respectively such that the strap members  30   a  and  30   b  can be threaded through the D-ring fasteners  25   a  and  25   b  respectively and folded back upon themselves to form securing fastener strap members in a manner well-known in the art. The outer surfaces of the strap members  30   a  and  30   b  include appropriately positioned hook and loop fastener material to enable fastening of the strap members  30   a  and  30   b  when folded back upon themselves. The inside surfaces of the outer shell portions include hook-type Velcro fastener tabs positioned for securing to a removable inner liner, as hereinafter described in more detail. Referring to  FIG. 3 , a front tongue member  35  is in the preferred embodiment constructed of an upper portion  35   a  and a lower portion  35   b , pivotally connected by means of a rivet  36 . The lower portion  35   b  includes a pair of laterally spaced slots  37  which could be sized to threadingly accommodate the first fastening strap  30   a  therethrough. The back side of the tongue  35  includes a plurality of hook-type fastener members  38 . The lowermost fastener member  38   a  on the lower tongue portion  35   b  is configured to hold the lower tongue portion  35   b  in position relative to the toe portion of the inner liner member. The upper fastener members  38   b  secure a pad member  39  to the inner surface of the upper tongue portion  35   a.    
         [0038]    The rear panel member  40  ( FIG. 3 ) includes two pairs of laterally spaced slots  41   a  and  41   b . The slots  41   a  are longitudinally spaced from the slots  41   b  along the rear panel member  40  and positioned therealong to cooperatively accept fastener straps therethrough. When operatively connected by the fastener straps, the slots  41   a  generally vertically align with the slots  23   b  and  24   b  of the upright stirrup support members, and the slots  41   b  generally vertically align with the slots  23   c  and  24   c  of the upright supports of the stirrup assembly. 
         [0039]    Upper fastener straps  42 ,  43 , and  44  secure the left and right upright stirrup members, the front tongue  35  and the rear panel member  40  to one another and apply pressure through the outer brace framework to the inner liner of the brace. A first end of each of the straps  42 ,  43 , and  44  has a D-ring  45  fastener secured thereto, to enable the opposite free end of the strap to be threaded through the D-ring such that each strap can be secured back upon itself. The upper fastener strap  42  is threaded through the upper slots  23   a  and  24   a  in the support struts  15   b  and  16   b  respectively. The middle fastener strap  43  is threaded through the slots  24   b  and  23   b  of the upper support struts  16   b  and  15   b  respectively and also through the upper slots  41   a  of the rear panel member  40 . The lower fastener strap  44  is threaded through the slots  23   c  and  24   c  of the upright strut members  15   a  and  16   a  respectively, as well as through the lower slots  41   b  of the rear panel member  40 . The straps  43  and  44  may also be optionally threaded through appropriately placed aligned slots within the upper portion  35   a  of the tongue  35 , to fix placement of the upper portion of the tongue  35   a  relative to the upright support arms of the stirrup portion. As with the lower fastener straps  30   a  and  30   b , the upper fastener straps  42 ,  43 , and  44  include hook and loop fastening materials along their outer surfaces to enable self fastening of the straps back upon themselves in a manner well-known in the art. As shown in the Figures, the straps  42  and  44  are wound around the brace (when viewed from above) in a counter clockwise direction; whereas the middle strap  43  in a clockwise direction. 
         [0040]    A removable inner liner wrap member  50  is sized to cooperatively fit within the outer stirrup  12  and is configured to cooperatively encircle the ankle, foot and lower leg portions of the wearer. In the preferred embodiment, the liner  50  is constructed of an ultra plush foam material which offers superior patient comfort. The liner includes thicker padding adjacent the heel area for additional comfort to the heel and protection of the lower portion of the Achilles tendon. The liner member includes a pair of upper flaps  51   a  and  51   b  that can be folded forward in overlapping manner around the upper ankle and leg portion of the wearer, and a pair of lower flaps  52   a  and  52   b  that can be folded in overlapping manner around the lower foot portion of the wearer. A detachable toe pad  53  is adjustably attachable to the liner member  50  at the forward foot portion of the liner to optionally cover the toes of the wearer. The toe pad  53  is secured to the outer surface of the liner  50  by means of hook-type fastener portions. The liner includes a pair of pockets  56   a ,  56   b  positioned along the lower outer sides of the liner  50  for supportively housing a pair of air bladders  58   a ,  58   b  respectively. The pockets  56  are configured to position the air bladders  58  adjacent the ankle portions of the wearer for selectively providing therapeutic pressure and/or additional comfort to the ankle portion and to cushion the ankle from the upright support arms of the brace stirrup. 
         [0041]    The outer surfaces of the inner liner wrap member  50  comprise a Velcro hook receivable material such as brushed nylon so as to cooperatively receive and fasten to the Velcro hook fasteners of the outer shell portions and tongue and rear panel members so as to cooperatively positionally secure the inner liner member thereto. The inner surface edge of the upper flap portion  51   b  and the inner edge portion  52   b  of the lower foot engaging flap each include a small strip of Velcro hook fastener material  51   c  and  52   c  enable the upper and lower flaps  51  and  52  respectively to fasten to one another when folded in overlapping manner about the leg and foot portions of the wearer. The pockets  56  for retaining the air bladders are in the preferred embodiment, constructed of four-way expandable elastic material to accommodate expansion of the air bladders  58  inserted therein. Small double-sided adhesive strips (not shown) may be are optionally secured to the outer surfaces of the inner liner  50  near the front and back portions thereof to hold the tongue member  35  and the rear panel member  40  in place against the liner as the brace is being secured to the wearer. 
         [0042]    The air bladders  58  may be constructed of any appropriate material suitable for retainably holding a charge of gas or fluid. In the preferred embodiment, the fluid retained by the bladders  58  is air; however, other fluids could be used. Such bladder constructions are well-known in the art and will not be detailed herein. In the preferred embodiment, the retaining pocket  56   b  on the right outer portion of the liner  50  holds bladder  58   b , and the retaining pocket  56   a  on the left outer portion of the liner  50  holds bladder  58   a . Air is supplied to each of the bladders  58   a  and  58   b  by means of a plastic air inlet tube  59   a  and  59   b  respectively. The outer terminus of the air inlet tubes defines an air inlet port  59   a  and  59   b  includes a valve structure of a type well-known in the art, generally indicated at  60   a  and  60   b  respectively. The length of the air inlet tubes  59  is sized to extend generally up toward the upper edge of the liner member  50  and configured so as to be accessible by the user when the brace is secured to the wearer&#39;s foot and leg, for adjustably pressurizing the air bladder  58 . In prior art brace configurations, the position of the air inlet port is generally at a fixed location relative to the walker shell construction.  FIG. 4  illustrates the air bladder  58  as being fully inserted within its pocket  56  as it would operatively be positioned when the walker brace is operatively mounted on a patient or wearer.  FIG. 8  illustrates the air bladder  58  and it associated air inlet tube  59  as it would appear fully removed from the retaining pocket  56 . Removability of the air bladder  58  from their retaining pockets enables ready replacement of the air bladders in the event of failure thereof or other need for replacement of the air bladders, without requiring replacement of the entire liner assembly.  FIG. 8  illustrates an air bladder  58  in more detail.  FIG. 8  also illustrates a hollow resilient pump bulb  62  of a type well-known in the art, which can be used to inflate the bladder  58  through its air inlet tube  59  and associated valve outlet  60  by a simple squeezing motion, as is well known in the art. The pump bulb  62  is illustrated as it would be operatively connected to the air inlet tube and valve outlet thereof during a pumping operation. 
         [0043]    A significant feature of the invention is the ability to adjust the longitudinal and lateral position of the air inlet tubes  59  and their respective valve outlets  60  relative to the side portions of the inner liner  50 , and thus relative to the position of the elongate upright support members of the stirrup assembly. The ability to adjust the position of the air inlet tubes  59  enables the wearer to position the valve outlet portions of the inlet tubes at positions that are readily assessable and reachable by the wearer for ease of adjusting the pressure within the bladders  58 . Further, the air inlet tubes and respective valve outlets can be positioned so as not to underlie various portions of the upright frame portions of the stirrup shell, for maximizing comfort to the ankle and leg of the wearer. The air inlet tube adjustment feature is in the preferred embodiment provided by means of a pair of Velcro tubular fastener sleeve members  65  in which the air inlet tubes  59  are positioned as illustrated in  FIGS. 7 and 8 . In the preferred embodiment, that surface of the fastener sleeve  65  which addresses the outer surface of the inner liner  50  is formed of a hook-type Velcro fastener, for cooperatively engaging the outer surface of the liner. The Velcro fastener sleeves  65  enable a wearer to rapidly detach and move the sleeve and attached air inlet tube from the outer surface of the liner  50 , to rapidly reposition the fastener sleeve and its attached air inlet tube  59  to the desired position. They also enable the bladder assembly to be rapidly removed and replaced in the liner.  FIG. 4  illustrates the air inlet tube adjustability feature provided by the fastener sleeve  65 . In  FIG. 4 , the air inlet tube  59   a  is illustrated as positioned generally along a center portion of the side of the liner at position “A”. The air inlet tube  59   a  and its associated valve outlet  60   a  are shown secured more toward the back portion of the liner  50  at position “B”. The air inlet tube  59   a  is illustrated as being secured by the fastener sleeve  65   a  more toward the front portion of the liner assembly  50  at position “C”. It will be appreciated that with an elongated fastener member such as  65 , the retained air inlet tube can be continuously positioned in fastened manner relative to the underlying outer surface of the liner  50  in a multitude of arcuate or serpentine configurations. It will be understood that fastener members other than the tubular sleeve configuration depicted at  65  could be used for securing and changing the relative position of the air inlet tubes  59  relative to the liner  50  and thus relative to the stirrup configuration of the walker brace. It will also be appreciated that the length of the air inlet tube is sufficient to allow filling of the bladder with an air pump from external of the brace, when the brace is operatively positioned on a wearer. 
         [0044]    It will be appreciated that additional padding materials may be included to add comfort to the wearer. For example, pad  39  ( FIG. 3 ) could be added to the front tongue member  35 . 
         [0045]    The walker brace may be assembled by first attaching the rear panel member  40  to the upright strut brace members  16   a  and  16   b  on the right side of the brace and  15   a  and  15   b  on the left side of the brace by means of the fastener straps  43  and  44 . Strap  44  is threaded through the slots  23   c  of the strut  15   a , the slots  41   b  of the rear panel member  40  and slots  24   c  of the right side strut  16   a  such that the D ring  45  strap  44  lies adjacent the forward edge of the left strut member  15   a . Strap  43  is threaded in the opposite direction, starting with the slots  24   b  of the right side strut extension  16   b , the slots  41   a  of the rear panel member  40  and the slots  23   b  of the left side strut extension  15   b , such that the D ring  45  thereof lies adjacent the forward edge of the right side strut extension  16   b . Straps  43  and  44  thus align and hold the rear panel member  40  in position between the rear edges of the upright stirrup members. The upper strap  42  is threaded through the upper slots  23   a  of the left strut extension  15   b , is positioned over the rearward facing surface of the rear panel member  40 , and is threaded through the upper slots  24   a  of the right side strut extension  16   b , such that the D ring  45  thereof lies adjacent the forward edge of the left strut extension  15   b.    
         [0046]    The inner liner  50  is operatively positioned and aligned within the foot support and stirrup-like frame portion  12  in open manner (such as shown in  FIG. 5 ) so as to receive a foot and leg therein. The liner is held in place within the outer framework by a Velcro fastener  65  ( FIG. 2 ) in the inside portion of the heel  14 , and by other hook-type fasteners disposed within the inner surfaces of the stirrup assembly as generally shown at  67  in  FIG. 2 . The toe panel  53  is folded forwardly down to expose and open the front portion of the inner liner  50 , and the upper and lower flap panels  51  and  52  of the liner are detached from one another and opened so as to enable access through the top and front of the liner into the inner liner cavity. The wearer&#39;s foot is then positioned within the inner liner and moved backward therein such that the wearer&#39;s heel lies adjacent the heel portion  14  of the lower foot support  13 . If necessary, or desired, additional auxiliary pads (not shown) are positioned as desired relative to the wearer&#39;s leg and are secured in the desired position(s), to the inner or outer surfaces of the liner  50 . 
         [0047]    The upper flaps  51  and the lower flaps  52  are then folded in overlapping manner and respectively secured to one another by their Velcro strips to encircle the wearer&#39;s leg and foot portions. The toe portion  53  of the liner is then folded up over the toes of the wearer and fastened to the outer surface of the main liner insert  50 . At this point, the Velcro sleeve fasteners  65  can be appropriately adjusted to position the air inlet tubes  59  and their respective valve outlets  60  at the desired positions along the outside surfaces of the liner  50  to provide maximum inflation accessibility and/or comfort to the wearer. The lower strap  30   a  is positioned over the tongue portion  35   b  or threaded through the spaced slots  37  of the lower portion  35   b  of the tongue  35  and through the D ring  25   a , to position the lower tongue portion  35   b  over the foot portion of the wearer. The strap  30   b  is pulled across the forward surface of the tongue  35  and threaded through the D ring  25   b . As the strap  30   b  is pulled through the D ring  25   b  pressure is applied through the tongue  35  and the forward portion of the liner  40 , to urge and secure the wearer&#39;s foot and ankle toward the back heel portion of the brace. The strap  30   b  is folded back upon itself to secure its Velcro fasteners, and thus the strap  30   b , in the desired fastened position. The three upper straps  42 ,  43 , and  44  are extended to overlie the forward surface of the upper portion  35   a  of the tongue  35  and are threaded through their respective D rings  45  to apply rearward and compressive pressure to the wearer&#39;s ankle and leg through the tongue  35  and the elongate upright stirrup supports. The straps  42 ,  43  and  44  are tightened to the desired pressure and fastened in the same manner as strap  30   b  by folding the straps respectively over onto themselves to secure their hook and loop fastening structures. The strap  30   a  is tightened in similar manner by folding upon itself to apply the desired pressure to the forward foot portion of the wearer. The individual straps can be selectively loosened and tightened to provide the desired pressures to the wearer&#39;s foot, ankle and leg portions being retained by the brace. Finally, the air bladders  58  and be pressurized to the desired pressure by pumping air into them with a pump such as the bulb pump  62 , through the valve assemblies  60 , as previously described. 
         [0048]    It will be understood that the forgoing description and accompanying drawings relate to a preferred embodiment of the invention. Various modifications may be employed without departing from the spirit and scope of the invention. Further, while various preferred materials have been described with respect to construction of the walker brace, it will be understood that other comparable materials that perform the desired functions of the brace can be used within the scope of the invention. Further, while various fastening mechanisms have been illustrated to secure the various parts of the walker brace to one another, it will be understood that other such fastening mechanisms which perform the desired functions could be used. It will also be appreciated that the unique two part construction of the side upright portions  15  and  16  of the stirrup  12  enables the length of the stirrup sides to be shortened if desired, by detaching the upper portions  15   a  and  15   b  respectively from their associated lower portions  16   a  and  16   b . If such a low-top configuration were to be employed, appropriate “shorter” tongue and back panel members could be provided to accommodate the shorter height of the brace. 
         [0049]    The above specification and examples provide a complete description of the manufacture and use of the composition of the invention. Since many embodiments of the invention can be made without departing from the spirit and scope of the invention, the invention resides in the claims hereinafter appended.