Patent Publication Number: US-2021177636-A1

Title: Adjustable-Footplate, Equinus Brace With Toe Wedge

Description:
CROSS REFERENCE 
     This application claims the benefit of U.S. Provisional Application No. 62/947,621 filed on Dec. 13, 2019, the entire content of which is hereby incorporated by reference herein. 
    
    
     FIELD 
     The present disclosure relates to devices and processes used to treat foot and ankle conditions. More specifically, the present disclosure relates to braces or device and their methods of use to treat ankle conditions by stretching the Gastrocnemius muscle, Plantaris muscle and/or the Soleus muscle. 
     BACKGROUND 
     Dorsiflexion is the movement of the foot toward the body by bending the ankle by drawing the toes backward toward the shins. Plantar flexion is the movement of the foot away from the body by bending the ankle such as when standing on tiptoes or when pushing down on the gas pedal while driving. Both dorsiflexion and plantarflexion depend on the muscles of the ankle and calf to work properly. 
     Equinus is typically described as a condition in which the upward bending motion of the ankle is limited. Equinus is defined as the inability or lack of ankle joint dorsiflexion less than a right angle relative to the leg. 
     Equinus may result in a lack of flexibility past the right angle relative to the leg. Referring to  FIGS. 1-3 , someone suffering with equinus may lack the flexibility to bring the foot  18  past a right angle (90°) relative to the leg. A typical maximum ankle range of motion for dorsiflexion is indicated as twenty-five degrees (25°) less than a right angle relative to the leg. Equinus may also be characterized as a limited ankle range of motion for dorsiflexion which is no more than five (5°), ten (10°) or even fifteen degrees (15°) less than a right angle relative to the leg. 
     An injury to any one of the muscles supporting the act of plantarflexion will limit the range of motion of the foot. Ankle injuries are one of the most common ways to severely limit plantarflexion. 
     There are several possible causes for limited range of ankle motion. Limited range of ankle motion is often due to tightness in the calf muscles (the soleus muscle, the plantaris muscle and/or the gastrocnemius muscle). Shortening of the gastrocnemius muscle (also known as gastroc equinus) is a very common condition which may affect most people because the gastrocnemius muscle crosses two joints. Gastrocnemius muscle  24  originates above knee  12  joint, while soleus  26  originates below knee  12  joint. Both muscles join to form the Achilles tendon, which attaches to the heel. Therefore, the gastrocnemius muscle crosses two joints: knee  12  and ankle  16 , while soleus muscle  26  only crosses ankle  16  joint. 
     Regardless of the cause of limited ankle motion, someone suffering with equinus can develop a wide range of foot problems. There are several ways to treat limited ankle range of motion, such as gastroc equinus, including stretching exercises, orthotics with heel lifts, padding, molded shoes, serial casting, as well as night splints, braces, and boots. 
     Many current night splints and braces are awkward and uncomfortable for sleeping. Since night splints and many current braces are supposed to be worn throughout the night, an awkward or cumbersome night splint or brace may cause user  22  to either not get a good night&#39;s sleep or cause user  22  to remove the device. If user  22  does not get a good night&#39;s sleep, user  22  may not choose to use the device in the future. This lack of compliance leads to the current devices not performing their intended function. 
     Both U.S. Pat. No. 8,777,884 (DeHeer, et al.) and U.S. Pat. No. 8,814,815 B2 (DeHeer, et al.), describe a hinged equinus brace device constructed with a footplate and a plurality of adjustable elongated rods (lateral and medial) to run along lateral and medial portions of the leg which extend above the knee of the user to the foot of the user for placement into the device. 
     U.S. Pat. No. 9,375,342 B2 (DeHeer et al.) describes a brace to treat ankle equinus. The brace locks the knee in full extension while dorsiflexing the ankle joint. 
     U.S. Pat. No. 7,922,677 (Daiju) describes a brace for rectification of clubfoot. The foot bottom plate can rotate 20 degrees in dorsiflexion and 45 degrees in plantarflexion. The brace includes a dorsal midfoot strap, and it does not include an ankle strap or toe wedge. There is no means to reduce painful friction to the heel, and the brace is not molded to gently approach the heel and Achilles tendon. 
     US Patent Application Pub No. 20040030275A1 (Morinaka) describes a body orthosis especially effective as a body corrective orthosis for talipes equinovarus. The foot sole plate can rotate 20 degrees in dorsiflexion and 45 degrees in plantarflexion. The brace includes a dorsal midfoot strap. However, there is no means to reduce painful friction to the heel, and the brace is not molded to gently approach the heel and Achilles tendon. 
     US Patent Application Pub No. 20130226059A1 (Philip George Littleavon Morris) describes an ankle foot orthopaedic device for the treatment of various conditions of the ankle and foot. The device can be arranged to permit up to 90 degrees of plantarflexion and up to 30 degrees of dorsiflexion. The device does not contain a dorsal midfoot strap. However, there is no means to reduce painful friction to the heel, and the brace is not molded to gently approach the heel and Achilles tendon. 
     U.S. Pat. No. 9,707,118 B1 (Meyer at al.) describes a orthosis designed for increasing the range of motion and correcting the alignment of a patient&#39;s foot and ankle. The orthosis includes a dorsal midfoot strap but does not include an ankle strap. There are no means for plantarflexion. Dorsiflexion is limited to the range of approximately 18 to 22 degrees. There is no means to reduce painful friction to the heel, and the brace is not molded to gently approach the heel and Achilles tendon. 
     Therefore, a need remains for a device with ankle hinge positions which allow for either dorsiflexing or plantarflexing the ankle joint while extending the knee , where the device is molded to gently approach the heel and Achilles tendon. 
     A need also remains for a device that locks the knee in full extension while either dorsiflexing or plantarflexing the ankle joint. 
     SUMMARY 
     The device of the present disclosure has more degrees in dorsiflexion than other devices while also holding the knee at full extension. The device can also hold the knee at full extension while also flexing the ankle. 
     The present disclosure includes a device for treating ankle equinus by stretching the Gastrocnemius muscle, the Plantaris muscle and soleus muscle. The present disclosure also includes a device for treating numerous foot and ankle deformities such as Achilles tendonitis/tendonosis, plantar fasciitis, flatfoot, arch pain, forefoot pain, metatarsalagia, morton&#39;s neuromas, diabetic forefoot ulcers, and others, such as conditions resulting from Myelomeningocele (Spina Bifida), Flexor Hallucis Longus Tendinosis, Anterior Ankle Impingement, and Plantar fasciitis. 
     In one embodiment of the invention, the brace further comprises a boot pad for the top of a user&#39;s foot while placed in the brace. 
     In another embodiment of the invention, the device may further comprise a wedge. The wedge may be located beneath the hallux of the user and may be configured to engage the user&#39;s Windlass Mechanism. 
     The present disclosure also includes a method of treating equinus by stretching the Gastrocnemius, soleus and plantaris muscles, the method comprising the steps of extending the knee of the user and dorsiflexing the foot by using a brace. 
     The present disclosure also include a method of treating and plantar fasciitis by stretching the gastrocnemius, soleus muscles and plantaris muscles, the method comprising the steps of extending the knee of the user and plantarflexing the foot by using a brace. 
     In one embodiment of the method, the method further comprises the step of measuring the angle of the ankle of the user using the brace. 
     From the present disclosure, the equinus is associated with any condition selected from the group consisting of Heel Spur Syndrome, Plantar fasciitis (also known as plantar heel pain), neuromuscular disorders including disorders selected from the group consisting of Cerebral Palsy and Friedreich&#39;s Ataxia, Congenital disorders including disorders selected from the group consisting of Congenital equinus, Clubfoot, Vertical Talus and Calcaneal Valgus, Pediatric Flexible Flatfoot deformity, Adult Flexible Flatfoot deformity, Tibialis Posterior Tendon Dysfunction or adult flat foot deformity, muscle strains, stress fractures, shin splints/Medial tibial stress syndrome, Iliotibial band syndrome, patellofemoral syndrome, ankle sprains or fractures, metatarsal or forefoot pain, metatarsophalangeal joint (MPJ) synovitis, hallux abducto valgus, hammer toes or claw toes, Lis franc&#39;s or Midfoot arthrosis, hallux limitus or hallux rigidus, forefoot calluses, Morton&#39;s neuroma, Chronic ankle instability, poor balance or increased fall rate in elderly, Sever&#39;s disease, lateral foot pain, Genu recurvatum, lower back pain, arch pain, ankle arthrosis, subtalar arthrosis, sesamoiditis, anterior compartment syndrome, forefoot nerve entrapment, Achilles tendonitis and tendonosis, Achilles tendon injuries, Haglund&#39;s Deformity, Retrocalcaneal heel spurs and tendonosis, Tarsal Coalitions, Bunion deformities, Metatarsalgia, Forefoot pain, Charcot deformity, Diabetic forefoot ulcers and toe ulcers, Equinovarus deformities from post-injury or post-stroke patients, Post Transmetatarsal or Chopart&#39;s amputation patients, Midfoot degenerative joint disease at Lis Franc&#39;s joint or Chopart&#39;s joint, Hypermobile first ray disorders and Cross-over toe deformities. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a back view of calf muscles with a knee at extension and an ankle at neutral position. 
         FIG. 2  is a side view of the calf muscles of  FIG. 1 . 
         FIG. 3  is a perspective view of calf muscles with a knee in flexion and the ankle in dorsiflexion. 
         FIG. 4  is an illustration of the brace with a grid support structure and toe support. 
         FIG. 5  is an exploded view of the brace with a foot plate. [ 0031 ] Figure 6  is a side view of the boot in one embodiment of the brace, including boot pad and a fully contracted brace. 
         FIG. 7  is a front angled view of one embodiment of the fully extended brace, including boot pad and leg pad. 
         FIG. 8  is a front angled view of one embodiment of the fully extended brace, including boot pad (not shown), leg pad, leg straps, ankle strap, toe wedge, and boot lining. In this embodiment the ankle strap is secured to the boot. 
         FIG. 9  is a side view of one embodiment of the fully extended brace of  FIG. 8 . 
         FIG. 10  is a rear view of one embodiment of the fully extended brace of  FIG. 8 . 
         FIG. 11  is a side view of the heel and ankle contact points of the brace. 
         FIG. 12  is cross-sectioned perspective view of another embodiment of the brace wherein the ankle strap is secured to the receiver. 
         FIG. 13  is a stylized perspective view of an embodiment of the brace wherein the ankle strap is secured to the receiver. 
         FIG. 14  is a top view of the curvature in the mold of ankle strap of the brace. 
         FIG. 15  is perspective view of a foot and the placement of the molded ankle strap. 
         FIG. 16  is a normal view of the brace, before placing the foot inside, showing the order numerically to feed and fasten the strap. 
         FIG. 17  is a normal view of the brace, before placing the foot inside, showing the fastened strap. 
         FIG. 18  is a side view of a foot and ankle in dorsiflexion in the brace. 
         FIG. 19  is a side view of a foot and ankle in plantar flexion in the brace. 
         FIG. 20  is a side view of a user in the brace sitting in a chair, with a non-extended knee and plantar flexing the ankle. 
         FIG. 21  is a side view of user in the brace standing with a fully extended knee and the ankle in dorsiflexion. 
         FIG. 22  is a side view of the brace including the ankle strap secured to the brace, toe wedge, and boot lining. 
         FIG. 23  is a side view of the brace wherein the foot plate is extended. Th ankle strap is secured to the brace as well as the boot lining and toe wedge. 
         FIG. 24  is a bottom view of the front part of the foot plate where the lining is secured to the brace. 
         FIG. 25  is a side view of the brace fully contracted. The boot and lining are removed, and the grid of the foot plate is exposed 
         FIG. 26  is a side view of the brace fully extended. The boot and lining are removed, and the grid of the foot plate is exposed. 
         FIG. 27  is a front view of the foot plate with the foot adjustment screw and the leg extender fastened to the footplate by two screws. 
         FIG. 28  is a top view of the brace wherein the boot and the ankle strap are installed in the brace. 
         FIG. 29  is a top view of the brace wherein the footplate is extended, and the ankle strap and boot are installed. 
     
    
    
     DETAILED DESCRIPTION 
     For the purpose of promoting an understanding of the principles of the invention, reference will now be made to certain embodiments illustrated in the disclosure, and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended, such alterations and further modifications in the illustrated device, and such further applications of the principles of the invention as illustrated therein being contemplated as would normally occur to one skilled in the art to which the invention relates. 
     As shown in  FIGS. 1 and 2 , thigh  10 , knee  12 , calf  14 , ankle  16 , foot  18 , and calf muscles  20  of user  22  are illustrated. Calf muscles  20  are shown as gastrocnemius muscle  24  and soleus muscle  26 . Each of these muscles  24 ,  26  shares a common insertion (attachment) via Achilles tendon  28  into the posterior calcaneus. Soleus muscle  26  originates at the proximal to posterior portions of tibia  30  and fibula  32 . Soleus muscle  26  and gastrocnemius muscle  24  unite via their respective apponeurosis to form Achilles tendon  28 . Unlike soleus muscle  26 , gastrocnemius muscle  24  originates at posterior femur  34  just above knee  12  and also inserts into heel  36 . Gastrocnemius muscle  24  crosses two joints: knee  12  and ankle  16 . 
     As illustrated with knee  12  in extension and ankle  16  in normal position, soleus muscle  26  and gastrocnemius muscle  24  are not stretched to capacity in a person with normal ankle range of motion including maximum ankle dorsiflexion of twenty-five degrees (25°). In a person with limited ankle range of motion, such as equinus, soleus muscle  26  or gastrocnemius muscle  24  may be stretched to capacity with knee  12  in extension for gastroc equinus or gastrosoleal equinus and ankle  16  in normal position or in a dorsiflexed position. 
     As illustrated in  FIG. 3 , a person with limited ankle range of motion due to gastroc equinus, moving knee  12  from extension to flexion releases gastrocnemius muscle  24  from full stretch capacity. A person suffering from gastroc equinus may be able to place ankle  16  in dorsiflexion with knee  12  in flexion even though gastrocnemius muscle  24  is shortened. 
     As illustrated in one embodiment in  FIG. 4 , brace  100  may include a grid support structure  111  and toe support  112 . Brace  100  is shown in a fully contracted form, slider  116  is in front of receiver  119 . Support  138  bridges the two interior faces of receiver  119 . 
     An exploded view of the connection between boot  114  and receiver  119  in contracted brace  100  is illustrated in  FIG. 5 . Boot  114  may include foot plate  113  either with or without the grid support structure and toe support. Slider  116  includes openings  134  to secure leg straps  109  (see also  FIG. 8 ). Support  138  is an integrated part of receiver  119  in this embodiment. Both sides of boot  114  are secured to receiver  119  by insertion of screw  136  into opening  127  and opening  141  on either side of both boot  114  and receiver  119  respectively. 
     The flexion angle of contracted brace  100  is controlled by insertion of screw  124  into one of the openings  125  and into opening  140  of receiver  119 . 
       FIG. 6  is an illustration of a close up of the boot  114  of a fully contracted brace  100 . Achilles opening  117  is between receiver  119  and boot  114 . When the brace  100  is fully contracted, a bottom portion of slider  116  is visible beneath the top of the Achilles opening  117 . Each side of boot  114  includes panel  127  to cover bolt  136  (as shown in  FIG. 5 ). 
     Additional means for securing boot  114  to receiver  119  are also envisioned, such as a ball and socket multiplanar hinge. 
     Sole  132  is attached to the bottom of boot  114 . 
     Boot  114  may include a boot pad  115 . 
     Boot  114  includes a flexion angle region  139  which defines a plurality of flexion angle apertures  125 . Screw  124  is configured to be located in any one of flexion angle apertures  125  and affixed to receiver  119 . Placement of screw  124  in each flexion angle aperture  125  changes the flexion angle of foot  18  of user  22 . Five flexion angle settings  125  are shown in this embodiment. Other divisions of flexion angle settings are envisioned down to an angle change of 5 or 10 degrees such as −20°, −10°, 0°, +10°, and +20°. Flexion angle settings  125  permit a flexion angle range of 40 degrees. Additional embodiments include a flexion angle range of up to 20 degrees. 
     Alternatively, flexion angle aperture  125  may comprise one or more slots in flexion angle region. For example, one continuous slot along each of the plurality of flexion angle apertures would facilitate placement of user&#39;s foot in any degree of plantarflexion or dorsiflexion orientation. 
     Additional alternative embodiments include a gear mechanism. 
     Additional means for affixing the flexion angle are also envisioned such as a snap lock mechanism of the peg-in-hole and the screw secure the ankle angle. 
     Boot  114  includes heel openings  128  to secure ankle strap  101 . 
     Boot  114  includes tarsal openings  129 . Tarsal openings  129  may be used to secure a boot lining  120 . 
     A fully extended brace  100  is illustrated in  FIG. 7 , including boot pad  115  and leg pad  118 . The bottom of slider  116  is visible near the top of receiver  119 . Achilles opening  117  is beneath receiver  119 . Receiver  119  secures to boot  114  via bolts  126  and bolts  124 . The outside of boot  114  includes panels  127  that cover bolts  126 . The back of panel  130  is visible in openings in the bottom of receiver  119 . The back of clip  131  is visible in openings that pass through both receiver  119  and slider  116 . 
     Leg pad  118  and slider  116  both have openings  134  on both vertical sides for securing leg straps  109 . 
       FIG. 8  illustrates a front angled view of the fully extended brace  100 , including leg pad  118 , leg straps  109 , ankle strap  101 , toe wedge  104 , and boot lining  120 . 
     Boot lining  120  may include openings for ankle strap  101 . 
       FIG. 9  illustrates a side view of the fully extended brace  100 , including leg pad  118 , leg straps  109 , ankle strap  101 , toe wedge  104 , and boot lining  120 . Ankle strap  101  is secured to boot  114  via heel openings  128 . 
       FIG. 10  illustrates a rear view of a fully extended brace  100 , including leg straps  109 , and ankle strap  101 . Ankle strap  101  is secured to brace  100  via heel openings  128 . Slide  121  runs along the vertical center of the rear of slider  116 . Slider  116  includes openings  122  to secure leg straps  109 . 
     The top of receiver  119  includes opening  123 . 
     Clip  131  pass through openings in both receiver  119  and slider  116 . Clip  131  is engaged to keep slider  116  in a locked position. Clip  131  is loosened before slider  116  can change position, then slider  116  translates vertically. When brace  100  is fully extended, clip  131  passes through the bottom of slide  121  on slider  116 . When brace  100  is fully contracted, clip  131  passes through the top of slide  121  on slider  116 . 
       FIG. 11  illustrates the heel and ankle contact points in a side view of brace  100 . Heel area  106  is circled, ankle strap  101  is molded to gently approach heel  36  and Achilles tendon  28 . Molded foot plate  103  does not require any additional tarsal straps. 
       FIG. 12  illustrates a cross-section perspective view of the inside of another embodiment of brace  100  wherein receiver  119  and strap  101  are molded around Achilles tendon  28 . Strap  101  attaches to the inside of receiver  119  via openings  135 . Openings  135  are at a 45 degree angle relative to a horizontal plane. 
     The flexion angle of brace  100  is affixed via bolts  136 . Additional means  136  for affixing the flexion angle are also envisioned. 
     Both bolts  136  and bolts  137  secure receiver  119  to boot  114 . Additional means  137  for securing receiver  119  to the boot  114  are also envisioned. 
     Another embodiment of a fully extended brace  100  is illustrated in  FIG. 13 . Brace  100  includes an ankle strap  101  secured via openings  102  in receiver  119 . Brace  100  may also include toe wedge  104 . Molded foot plate  103  does not require any additional midfoot straps. 
     Receiver  119  is secured to molded foot plate  103  via bolts  136 . The flexion angle of molded foot plate  103  is varied by changing openings  125 . 
     Leg straps  109  and ankle strap  101  may terminate with fasteners and hook and loop  107 . 
       FIG. 14  illustrates the curvature in strap  101  to reduce pain and friction to the heel. Strap  101  is molded around Achilles tendon  28  and heel  36 . 
       FIG. 15  illustrates the configuration of the mold of ankle strap  101  around Achilles tendon  28  and heel  36 . 
       FIG. 16  illustrates the strap configuration. The steps to secure ankle strap  101  are as follows: First feed the strap  101  through the farthest back openings and fasten with a D-loop to anchor. Then feed the strap  101  back through the farthest opening to the outside. Finally feed the strap  101  back inside the brace through the openings and fasten to the top. Padding  109  may be included on strap  101 . 
       FIG. 17  illustrates the normal view of ankle strap  101  before placing a foot inside the boot. Padding  109  may be included on strap  101 . 
       FIG. 18  is a side view of a foot  18  in brace  100 , while ankle  16  is dorsiflexing. Bolt  124  is in the left most opening  125  of boot  114 . Ankle strap  101  with pad  108  is secured to boot  114  via heel openings  128 . 
       FIG. 19  is a side view of foot  18  in fully extended brace  100 , while ankle  16  is plantar flexing and the knee is fully extended. Bolt  124  is in the right most opening  125  of boot  114 . Ankle strap  101  with pad  108  is secured to boot  114  via heel openings  128 . 
       FIG. 19  illustrates a method of treating foot and ankle conditions by stretching the Gastrcnemius, Soleus, and Plantaris muscles, the method comprising the steps of: simultaneously extending the knee of the user and plantarflexing the ankle by using brace  100 . 
       FIG. 20  is a side view of user  22  in a non-extended brace  100  sitting in chair  99 . Ankle  16  is in plantar flexion. Ankle strap  101  with pad  108  is secured to boot  114  via heel openings  128 . Leg straps  109  are secured around the lower leg and calf  14 . 
       FIG. 21  is a side view of user  22  standing in a fully extended brace  100 . Ankle  16  is in dorsiflexion. Ankle strap  101  with pad  108  is secured to boot  114  via heel openings  128 . Leg straps  109  are secured around thigh  10 . 
       FIG. 21  illustrates a method of treating foot and ankle conditions by stretching the Gastrocnemius , Soleus, and Plantaris muscles , the method comprising the steps of: extending the knee of the user and the ankle of the user in dorsiflexion by using brace  100 . The method of treating foot and ankle conditions is associated with any condition selected from the group consisting of: Heel Spur Syndrome, Plantar fasciitis, equinus related to neuromuscular disorders including disorders selected from the group consisting of Cerebral Palsy and Friedreich&#39;s Ataxia, Congenital disorders including disorders selected from the group consisting of Congenital equinus, Clubfoot, Vertical Talus and Calcaneal Valgus, Pediatric Flexible Flatfoot deformity, Adult Flexible Flatfoot deformity, muscle strains, stress fractures, shin splints or Medial tibial stress syndrome, Iliotibial band syndrome, patellofemoral syndrome, ankle sprains or fractures, metatarsal or forefoot pain, metatarsophalangeal joint (MPJ) synovitis, hallux abducto valgus, hammer toes or claw toes, Lis franc&#39;s or Midfoot arthrosis, hallux limitus or hallux rigidus, forefoot calluses, Morton&#39;s neuroma, Chronic ankle instability, Sever&#39;s disease, lateral foot pain, Genu recurvatum, lower back pain, arch pain, ankle arthrosis, subtalar arthrosis, sesamoiditis, anterior compartment syndrome, forefoot nerve entrapment, Tibialis Posterior Tendon Dysfunction, Achilles tendonitis and tendonosis, Achilles tendon injuries, Haglund&#39;s Deformity, Retrocalcaneal heel spurs and tendonosis, equinus related to tarsal coalitions, Bunion deformities, Metatarsalgia, Forefoot pain, Charcot deformity, Diabetic forefoot ulcers and toe ulcers, Equinovarus deformities from post-injury or post-stroke patients, Post Transmetatarsal or Chopart&#39;s amputation patients, Midfoot degenerative joint disease at Lis Franc&#39;s joint or Chopart&#39;s joint, Hypermobile first ray disorders and Cross-over toe deformities, equinus related to myelomeningocele, Flexor Hallucis Longus Tendinosis, Anterior Ankle Impingement. 
     The side view of the fully contracted foot plate  103  in  FIG. 22  reveals the The boot lining  120  and ankle strap  101  installed and secured. The toe wedge  104  is used to angle the lining  120  of the boot to aid in dorsiflexion and plantar flexion motions. An adjustable slider  142  is installed to allow different foot sizes to be inserted in the brace. 
     The side view of the fully extended molded foot plate  103  in  FIG. 23  shows the slider  142  extended to make the invention amendable for different foot  18  sizes. The extension of the foot plate  103  is executed by the motion of sliding. The boot lining  120 , toe wedge  104 , and ankle strap  101  are secured into place to allow for proper alignment of the foot  18 , ankle  16 , and leg  19  within the brace  100 . 
     The bottom view depicted in  FIG. 24  demonstrates the fully extended foot plate  103  with the boot lining  120  in place. The foot plate  103  is attached to the rest of the brace  100  via different means as described above, including via bolts, or via a ball and socket multiplanar hinge. In one embodiment, receiver  119  is secured to molded foot plate  103  via bolts  136 . The flexion angle of molded foot plate  103  is varied by changing openings  125 . Boot lining  120  includes openings for ankle strap  101 . The ankle strap  101  is secured to foot plate  103  via heel openings  128 . The ankle strap  101  is secured via openings  102  in receiver  119 . 
     The side view of the fully contracted foot plate  103  in  FIG. 25  shows the full contraction of the foot plate  103  via a sliding mechanism. The bottom of the slider  142  to the top of the foot  18  extension of the foot plate  103  is approximately 5 inches. Conversely, the fully extended foot plate  103  depicted in  FIG. 26  shows an extension of approximately 5 inches. The adjustable slider  142  is configured to be attached at the end of the foot plate  103 , the adjustable slider  142  defining a center slot extending along a substantial length of the slider  142 , wherein the adjustable slider  142  extends horizontally to change the overall length of the foot plate  103  to accommodate different foot  18  sizes of different users  22 . This variable foot plate  103  length is implemented to allow for the adjustment for different foot  18  sizes. 
     The front view of the fully extended foot plate  103  in  FIG. 27  shows the adjustment mechanism of the slider  142 . A screw  143  is inserted through an opening  144  on the bottom of the foot plate 103  and through an opening  145  on the bottom of the slider  142 . Screw  143  secures slider  142  to the foot plate  103  and allow for different foot sizes to be inserted in the brace. The adjustment mechanism operates by the motion of sliding the slider  142  after loosening the screw  143 . The lining of the boot  120  can be installed via Velcro  146 . 
     The top view of the foot plate  103  is shown in  FIG. 28 . The foot plate  103  is contracted, and the boot lining  120  and ankle strap  101  are secured into place to allow secure placement of the foot  18  and ankle  16  into the brace. 
     The top view of the foot plate  103  in its fully extended conformation is shown in  FIG. 29 . The extension is shown to allow for different foot sizes to be secured into the brace with the boot and ankle strap secured into place. 
     While the inventions have been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that the preferred embodiment has been shown and described and that changes and modifications that come within the spirit of the invention are desired to be protected.