Patent Publication Number: US-2023157857-A1

Title: Walking boots and methods of making the same

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of, and priority to, U.S. Provisional Application No. 62/696,580, filed on Jul. 11, 2018, which is hereby incorporated by reference herein in its entirety. 
    
    
     TECHNICAL FIELD 
     The present disclosure relates generally to walking boots. More specifically, the present disclosure relates to walking boots with one or more removable elements or openings and methods of making the same. 
     BACKGROUND 
     Ankle surgery often requires a physician to make one or more incisions on a patient&#39;s ankle. After surgery (e.g., one to two weeks after surgery), physicians often provide the patient with a walking boot (e.g., a controlled ankle motion or “CAM” walking boot) which immobilizes the ankle while permitting the patient to put weight on the injured ankle. The walking boot also aids in protecting the incision area from further injury. While these walking boots are often made from a rigid polymer material in order to provide sufficient mechanical support, this rigid polymer material can contact (e.g., directly or indirectly) the incision area on the ankle, which can cause the wearer of the walking boot pain/discomfort and/or adversely influence skin and/or incision healing due to, for example, the rigid polymer material rubbing on the incision and/or adjacent area of the incision. Moreover, such rubbing can cause the incision to break open (e.g., dehiscence), which can lead to infections and other negative complications. The present disclosure is directed to solving these and other problems. 
     SUMMARY 
     According to some implementations of the present disclosure, a boot includes a rigid outer shell including a main body having a base portion adjacent to a portion of a foot of a subject, a leg portion adjacent to a portion of a leg of the subject, and an ankle support portion integral with and coupling the base portion of the main body with the leg portion of the main body, the ankle portion of the main body being adjacent to two opposing sides of an ankle of the subject, the ankle support portion of the main body having one or more removable elements. A first one of the one or more removable elements, adjacent to a first one of the two opposing sides of the ankle, is configured to be removed from the rigid outer shell to aid in preventing contact between an incision area on the first side of the ankle of the subject and the rigid outer shell. 
     According to some implementations of the present disclosure, a boot includes a rigid outer shell including a main body having a base portion adjacent to a portion of a foot of a subject, a leg portion adjacent to a portion of a leg of the subject, and an ankle support portion integral with and coupling the base portion of the main body with the leg portion of the main body, the ankle portion of the main body being adjacent to two opposing sides of an ankle of the subject, the ankle support portion of the main body having an opening and one or more reinforcing members, wherein the opening in the ankle support portion aids in preventing contact between an incision area on the first side of the ankle of the subject and the rigid outer shell. 
     According to some implementations of the present disclosure, a method for making a walking boot includes identifying an area of an ankle support portion of a main body of a rigid outer shell of the boot that is directly adjacent to an incision area on an ankle of a subject when the boot is worn by the subject, selecting one or more removable elements of the ankle support portion being at least partially positioned within the identified area of the ankle support portion, and removing the one or more selected removable elements from the ankle support portion of the rigid outer shell, thereby aiding in preventing contact between the incision area on the ankle of the subject and the rigid outer shell when the boot is worn by the subject. 
     According to some implementations of the present disclosure, a boot includes a rigid outer shell including a main body having a base portion adjacent to a portion of a foot of a subject, a leg portion adjacent to a portion of a leg of the subject, and an ankle support portion integral with and coupling the base portion of the main body with the leg portion of the main body, the ankle portion of the main body being adjacent to two opposing sides of an ankle of the subject, the ankle support portion of the main body having an opening and a reinforcing portion adjacent to a portion of the opening, wherein the opening in the ankle support portion aids in preventing contact between an incision area on the first side of the ankle of the subject and the rigid outer shell. 
     According to some implementations of the present disclosure, a boot includes a rigid outer shell including a main body having a base portion configured to support a portion of a foot of a subject, a leg portion configured to support a portion of a leg of the subject, an ankle support portion integral with and coupling the base portion of the main body with the leg portion of the main body, the ankle portion of the main body being configured to support two opposing sides of an ankle of the subject, the ankle support portion including (i) an opening, (ii) a removable element disposed within the opening, and (iii) a bulged portion configured to receive an attachment portion of the removable element therein such that the removable element is removably coupled to the bulged portion, wherein responsive to decoupling of the removable element from the bulged portion, the opening in the ankle support portion aids in preventing contact between an incision area on the first side of the ankle of the subject and the rigid outer shell. 
     The above summary is not intended to represent each embodiment or every aspect of the present invention. Additional features and benefits of the present invention are apparent from the detailed description and figures set forth below. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1 A  is a perspective view of a walking boot according to some implementations of the present disclosure; 
         FIG.  1 B  is a perspective view of an inner fabric lining of the walking boot of  FIG.  1 A  according to some implementations of the present disclosure; 
         FIG.  1 C  is a side view of a main body of a rigid outer shell of the walking boot of  FIG.  1 A  according to some implementations of the present disclosure; 
         FIG.  2 A  is a side view of a force director of a removable element of the main body of  FIG.  1 C  according to some implementations of the present disclosure; 
         FIG.  2 B  is a side view of the force director of  FIG.  2 A  and a tip of a removal tool according to some implementations of the present disclosure; 
         FIG.  3    is a partial side view of a main body of a rigid outer shell of a walking boot according to some implementations of the present disclosure; 
         FIG.  4 A  is a side view of the main body of a rigid outer shell of a walking boot according to some implementations of the present disclosure; 
         FIG.  4 B  is a perspective view of an upper track and a lower track of the main body of the rigid outer shell of  FIG.  4 A  according to some implementations of the present disclosure; 
         FIG.  4 C  is a perspective view of one of a plurality of removable elements of the main body of  FIG.  4 A  according to some implementations of the present disclosure; 
         FIG.  5 A  is a flow diagram of a method for making a walking boot according to some implementations of the present disclosure; 
         FIG.  5 B  is a partial side view of a target area and a plurality of removable elements of an ankle support portion of the walking boot of  FIG.  3    according to some implementations of the present disclosure; 
         FIG.  5 C  is a partial side view of the ankle support portion of the walking boot of  FIG.  3    with a plurality of removable elements removed according to some implementations of the present disclosure; 
         FIG.  6    is a side view of a main body of a rigid outer shell of a walking boot according to some implementations of the present disclosure; 
         FIG.  7 A  is a perspective view of a walking boot according to some implementations of the present disclosure; and 
         FIG.  7 B  is a partial side view of an ankle support portion of the walking boot of  FIG.  7 A  according to some implementations of the present disclosure. 
     
    
    
     While the disclosure is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that it is not intended to limit the invention to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims. 
     DETAILED DESCRIPTION 
     Referring generally to  FIGS.  1 A and  1 B , a walking boot  100  comprises an inner fabric lining  110  and a rigid outer shell  120 . Generally, the walking boot  100  can be worn by a subject to immobilize an injury (e.g., an ankle injury, a foot injury, a leg injury, etc.) while permitting the subject to put weight on the injury (e.g., walk without the use of crutches). The walking boot  100  also aids in protecting the injury (e.g., an incision area from a surgical procedure) from further injury and/or aid in promoting healing of the injury while permitting the subject to put weight on the injury during the healing process. 
     As best shown in  FIG.  1 B , the inner fabric lining  110  of the walking boot  100  includes a plurality of fasteners  112  (e.g., hook and loop fasteners) to secure the inner fabric lining  110  to a portion of a foot, a portion of ankle, and a portion of a leg of a subject. The inner fabric lining  110  is generally used to support for and cushion the portion of a foot, the portion of ankle, and the portion of a leg of a subject. The inner fabric lining can also include an inflatable air bladder (not shown) that can be inflated with an external air pump (not shown) to improve the fit of the inner fabric lining  110  on a subject (e.g., such that the inner fabric lining  110  conforms to the portion of a foot, the portion of ankle, and the portion of a leg of a subject) and/or to compress or cushion an injury. 
     As shown in  FIG.  1 A , the rigid outer shell  120  includes a main body  130 , a foot cover  170 , and a shin cover  180 . The rigid outer shell  120  is made from a rigid polymer material that resists bending/flexing when the walking boot  100  is worn by a subject. The rigid outer shell  120  can also include inner padding (not shown), such as a foam material, that provides additional support/stability for the wearer of the walking boot  100  and provides additional comfort/protection for the wearer of the walking boot  100 . As described in further detail below, the rigid outer shell  120  receives a majority of the inner fabric lining  110  therein when the walking boot  100  is worn by a subject. 
     Referring to  FIGS.  1 A and  1 C , the main body  130  includes a plurality of fasteners  131  ( FIG.  1 A ), a base portion  140 , a leg portion  150 , and an ankle support portion  160  ( FIG.  1 C ). As described in further detail below, the main body  130  receives a portion of the inner fabric lining  110  ( FIG.  1 A ) therein when the walking boot  100  is worn by a subject. The main body  130  includes a plurality of fasteners  131  (e.g., hook and loop fasteners) that couple the foot cover  170  and the shin cover  180  to the main body  130  to assemble the walking boot  100  ( FIG.  1 A ). 
     As shown, the base portion  140 , the leg portion  150 , and the ankle support portion  160  are unitary and/or monolithic. The base portion  140 , the leg portion  150 , and the ankle support portion  160  of the main body  130  are coupled to one another such that the main body  130  has a general “L” shape (e.g., the base portion  140  is generally perpendicular to the leg portion  150 ). This “L” shape of the main body  130  of the rigid outer shell  120  aids in inhibiting pivoting/bending of an ankle of a wearer of the walking boot  100 . 
     The base portion  140  receives a portion of the inner fabric lining  110  therein and supports a foot of a wearer of the walking boot  100 . As best shown in  FIG.  2   , the base portion  140  includes an outer sole  142  that contacts the ground when a wearer of the walking boot  100  is walking. As shown, the outer sole  142  has a generally convex shape such that when the wearer of the walking boot  100  steps on the heel, the convex shape of the outer sole  142  of the base portion  140  urges the wearer to roll forward onto their toes. The outer sole  142  can include a plurality of treads (not shown) to aid in providing traction. 
     The leg portion  150  receives a portion of the inner fabric lining  110  therein and supports two opposing sides of a leg of a wearer of the walking boot  100 . The leg portion  150  has a generally U-shaped profile such that the leg portion  150  at least partially surrounds two opposing sides of the leg of the wearer of the walking boot  100 . The leg portion  150  can optionally include an air pump (not shown) that can be connected (e.g., using a tube) to the inflatable air bladder of the inner fabric lining  110  discussed above. 
     The ankle support portion  160  receives a portion of the inner fabric lining  110  therein and supports an ankle of the wearer of the walking boot  100  by at least partially surrounding two opposing sides of the ankle of the wearer. As best shown in  FIG.  1 C , the ankle support portion  160  includes a plurality of removable elements  162 . As described in further detail below, removing at least one of the plurality of removable elements  162  from the ankle support portion  160  of the main body  130  of the rigid outer shell  120  aids in inhibiting contact between an incision area on a first side of the ankle of the wearer of the walking boot  100  and the rigid outer shell  120 . 
     The plurality of removable elements  162  of the ankle support portion  160  includes a first removable element  162   a,  a second removable element  162   b,  a third removable element  162   c , and a fourth removable element  162   d,  although other numbers of removable elements are possible (e.g., one removable element, three removable elements, six removable elements, ten removable elements, twenty removable elements, etc.). Each the plurality of removable elements  162  are defined by a plurality of fracturable score lines  164 . As described in further detail below, the plurality of fracturable score lines  164  are lines of weakness that can be fractured (e.g., using a tool) to remove one or more of the plurality of removable elements  162  from the ankle support portion  160 . 
     Each of the plurality of removable elements  162  optionally includes a plurality of force directors  166 . As shown in  FIG.  1 C , each of the plurality of removable elements  162  includes one or more force directors  166  which are positioned adjacent to the corners of each of the plurality of removable elements  162 . While each of the plurality of removable elements is shown as including four force directors  166 , other numbers of force directors  166  per removable element  162  are possible (e.g., one force director, two force directors, six force directors, twelve force directors, etc.) Further, while the force directors  166  are positioned adjacent to corners of each of the plurality of removable elements  162 , the plurality of force directors  166  can more generally be positioned anywhere on each of the plurality of removable elements  162  (e.g., adjacent to the corners of a removable element, in the center of a removable element, along the edges of the removable element adjacent to the fracturable score lines, or any combination thereof). 
     Referring to  FIGS.  2 A and  2 B , each of the plurality of force directors  166  is formed on an outer surface of the plurality of removable elements  162  and protrudes outwardly therefrom. Each of the plurality of force directors  166  has a generally concave profile for receiving a tip  202  of a removal tool  200  therein. As described in further detail below, placing the tip  202  of the removal tool  200  in one or more of the plurality of force directors  166  and moving (e.g., striking, hammering, etc.) the removal tool  200  in the direction of arrow A causes fracturing one or more of the plurality of score lines  164  defining one or more of the plurality of removable elements  162 . The plurality of force directors  166  directs the force caused by movement (e.g., hammering) of the removal tool  200  to a concentrated area (e.g., an area that is smaller than if the tip  202  of the removal tool  200  were placed on the outer surface of one of the plurality of removable elements  162 ). Directing the force to this concentrated area aids in fracturing a desired one of the plurality of fracturable score lines  164  without breaking the ankle support portion  160  or fracturing other ones of the plurality of fracturable score lines  164 . 
     In some implementations, the ankle support portion  160  includes a reinforcing portion  168  that surrounds the outermost ones the plurality of fracturable score lines  164 . The reinforcing portion  160  can be made from the same material as the ankle support portion  160  or a different material (e.g., a metal material). The reinforcing portion  168  protrudes outwardly from an outer surface of the ankle support portion  160  to inhibit contact (e.g., direct or indirect contact) between the reinforcing portion and the wearer of the walking boot  100 . 
     Referring to  FIG.  3   , a walking boot  300  that is the same as, or similar to, the walking boot  100  ( FIG.  1   ) described above includes a main body  330  that is similar to the main body  130 . The main body  330  includes a base portion  340 , a leg support portion  350 , and an ankle support portion  360 . The ankle support portion  360  includes a plurality of removable elements  362  that are similar to the plurality of removable elements  162  ( FIG.  1 C ) in that removing at least one of the plurality of removable elements  362  from the ankle support portion  360  of the main body  330  aids in inhibiting contact between an incision area on a first side of the ankle of the wearer of the walking boot  300  and the main body  330 . 
     The plurality of removable elements  362  includes a first removable element  362   a,  a second removable element  362   b,  a third removable element  362   c,  and a fourth removable element  362   d.  As shown, the plurality of removable elements  362  differ from the plurality of removable elements  162  ( FIG.  1 C ) described above in that each of the plurality of removable elements  362  has a generally oval shape and are concentrically arranged such that each of the plurality of removable elements  362  has an outer perimeter (periphery) that is different than the others of the plurality of removable elements  362 . More specifically, the fourth removable element  362   d  has an outer perimeter that is greater than the outer perimeter of the third removable element  362   c,  the third removable element  362   c  has an outer perimeter that is greater than the outer perimeter of the second removable element  362   b,  and the second removable element  362   b  has an outer perimeter that is greater than the outer perimeter of the first removable element  362   a.    
     The ankle support portion  360  includes a plurality of fracturable score lines  364  that are similar to the fracturable score lines  164  ( FIG.  1 C ) described above which define the plurality of removable elements  362 . Further, each of the plurality of removable elements  362  includes a plurality of force directors  366  that are the same as, or similar to, the force directors  166  ( FIGS.  2 A and  2 B ) described above. The plurality of fracturable score lines  364  ( FIG.  3   ) differ from the plurality of fracturable score lines  164  ( FIG.  1 C ) in that a single fracturable score line defines each of the plurality removable elements  362 . As shown, the plurality of fracturable score lines  364  includes a first fracturable score line  364   a  defining the first removable element  362   a,  a second fracturable score line  364   b  defining the second removable element  362   b,  a third fracturable score line  364   c  defining the third removable element  362   c,  and a fourth fracturable score line  364   d  defining the fourth removable element  362   d.  Thus, fracturing the one of the plurality of score lines  364  defining the outer perimeter (periphery) of a given removable element of the plurality of removable elements  362  causes the given removable element to be removed along with any of the plurality of removable elements  362  that have an outer perimeter (periphery) than the given removable element. For example, removal of the third removable element  362   c  by fracturing (e.g., using a tool) the third fracturable score line  364   c  causes the third removable element  362   c  to be removed along with the second removable element  362   b  and the first removable element  362   a.  In this manner, multiple removable elements of the plurality of removable elements  362  can be removed from the ankle support portion  360  by fracturing a single one of the plurality of fracturable score lines  364 . 
     While each of the plurality of removable elements  362  are shown as being generally oval, other shapes are possible (e.g., generally rectangular, generally circular, etc.) Further, while the plurality of removable elements  362  is shown as including four removable elements, other numbers of removable elements are possible (e.g., one removable element, three removable elements, eighth removable elements, fifteen removable elements, etc.) 
     Referring generally to  FIGS.  4 A- 4 C , a walking boot  400  that is similar to the walking boot  100  ( FIG.  1 A ) and the walking boot  300  ( FIG.  3   ) described above includes a main body  430 . The main body  430  is similar to the main body  130  ( FIG.  1 C ) and the main body  330  ( FIG.  3   ) in that the main body  430  includes a base portion  440 , a leg support portion  450 , and an ankle support portion  460 . Like the ankle support portion  160  ( FIG.  1 C ) and the ankle support portion  360  ( FIG.  3   ), the ankle support portion  460  includes a plurality of removable elements  462  that can be selectively removed to aid in inhibiting contact (e.g., direct or indirect contact) between an incision area on an ankle of a wearer of the walking boot  400  and the main body  430  of the rigid outer shell. 
     The ankle support portion  460  differs from the ankle support portion  160  ( FIG.  1 C ) and the ankle support portion  360  ( FIG.  3   ) in that the ankle support portion  460  includes an upper track  490  and a lower track  494 . As best shown in  FIG.  4 B , the upper track  490  includes a groove  492 . As described in further detail below, the groove  492  is sized and shaped to receive (e.g., slidably engage) a tongue of one or more of the plurality of removable elements  462 . The lower track  494  includes a tongue  496 . As described in further detail below, the tongue  496  is sized and shaped to be received within (e.g., slidably engage) a groove of one or more of the plurality of removable elements  462 . The upper track  490  is spaced from the lower track  494  to define an opening  498  in the ankle support portion  460  of the walking boot  400 . 
     As best shown in  FIG.  4 C , each of the plurality of removable elements  462  includes a tongue and a groove. For example, a first removable element  462   a  of the plurality of removable elements  462  includes a groove  464  protruding from an upper surface and a tongue  466  formed on an opposing lower surface of the first removable element  462   a.  The tongue  466  is sized and shaped to be received within (e.g., slidably engage) the groove  492  of the upper track  490  and/or a groove of a different one(s) of the plurality of removable elements  462 . Similarly, the groove  464  is sized and shaped to receive (e.g., slidably engage) the tongue  496  of the lower track  494  and/or a groove of a different one(s) of the plurality of removable elements  462 . In this manner, each of the plurality of removable elements  462  can removed from the ankle support portion  460  by sliding the removable element along the upper track  490 , the lower track  494 , or both. Advantageously, each of the plurality of removable elements  462  can reengage the upper track  490 , lower track  494 , or both after being removed. In contrast, each of the plurality of removable elements  162  ( FIG.  1 C ) and the plurality of removable elements  362  ( FIG.  3   ) cannot be put back into place after removal. Thus, the walking boot  400  can be reused for a different subject and/or a different injury. Further, in some implementations, certain ones of the plurality of removable elements  462  can be removed initially, and then added to fill a portion of the opening  498  as an incision area begins to heal (e.g., shrinks in size) to provide further structural support/stability as the wearer increases activities (e.g., walking) as the incision area heals. 
     While the plurality of removable elements  462  is shown as including five removable elements ( FIG.  4 A ), other numbers of removable elements are possible (e.g., one removable element, four removable elements, eight removable elements, twenty removable elements, etc.) Further, while the upper track  490 , lower track  494 , and the plurality of removable elements  462  are shown as being formed on a first side of the main body  430  (i.e., such that the plurality of removable elements  462  are adjacent to one of two opposing sides of an ankle of a wearer of the walking boot  400 ), the upper track  490 , lower track  494 , and the plurality of removable elements  462  can be reversed and formed on a second side of the main body  430 . Alternatively, a second upper track, a second lower track, and a second plurality of removable elements (not shown) can be formed on the second side of the main body  430  (i.e., such that the plurality of removable elements  462  is adjacent to a first side of an ankle of a wearer and the second plurality of removable elements is adjacent to a second, opposing side of the ankle of the wearer). 
     Referring to  FIG.  5 A , a method  500  for making a walking boot (e.g., the walking boot  100 , the walking boot  300 , or the walking boot  400 ) includes a first step  510 , a second step  520 , a third step  530 , and a fourth step  540 . 
     The first step  510  includes identifying an area of the ankle support portion of the main body of the rigid outer shell of the walking boot that is directly adjacent to an incision area on a first side of an ankle of a subject. For example, referring to  FIG.  5 B , the first step  510  can include identifying a target area  512  of the ankle support portion  160  of the main body  130  of the rigid outer shell  120  of the walking boot  100  ( FIGS.  1 A and  1 C ). As described above, the ankle support portion  160  at least partially surrounds and supports two opposing sides of the ankle of the subject when wearing the walking boot  100 . Contact (e.g., pressure, rubbing, etc.) between the rigid outer shell  120  and the incision area on the ankle of the subject while wearing the walking boot  100  is undesirable as such contact can cause the subject pain/discomfort (e.g., while walking) and/or slow the healing of the incision area. The undesirable contact may be direct contact between the incision area and the rigid outer shell  120  or indirect contact between the incision area and the rigid outer shell  120  (e.g., contact through one or more layers, such as the inner fabric lining  110  ( FIG.  1 A )). 
     To identify the target area  512  during the first step  510 , a user (e.g., a physician, a physician&#39;s assistant, a nurse, or the like) can place the main body  130  of the rigid outer shell  120  on the foot, ankle, and/or leg of the subject and identify the target area  512  by directly inspecting which area of the ankle support portion  160  is directly adjacent to the incision area on the ankle. The subject may provide feedback to the user to aid in identifying the target area  512 . Alternatively, the user can measure the location of the incision area on the ankle of the subject and use this measurement to identify the target area  512  on the ankle support portion  160  without having to place the main body  130  of the rigid outer shell  120  on the subject, which may cause pain/discomfort and requires the presence of the subject. 
     In some implementations, the identified target area  512  is larger than the incision area on the ankle of the subject (e.g., 110% of the incision area, 125% of the incision area, 150% of the incision area, 200% of the incision area etc.) to aid in inhibiting contact (e.g., direct contact or indirect contact) and allowing for variations in the position of the incision area on the ankle relative to the ankle support portion  160 , for example, while the subject is walking. 
     After identifying the target area  512  during the first step  510 , the user then selects one or more of the removable elements of the ankle support portion that are at least partially positioned within the target area  512 . For example, as shown in  FIG.  5 B , a portion of the second removable element  162   b  and a portion the third removable element  462   c  are positioned within the target area  512  identified during the first step  510 . During the second step  520 , the user selects the second removable element  162   b,  and the third removable element  162   c  for removal during the third step  530  described below. 
     The third step  530  includes removing the one or more selected removable elements from the second step  520 . As shown in  FIG.  5 C , the second removable element  162   b  and the third removable element  162   c,  which were selected during the second step  520 , are removed from the ankle support portion  160 , thereby defining an opening  532  in the ankle support portion  160 . The one or more selected removable elements (second step  520 ) can be removed by, for example, by placing the removal tool  200  ( FIGS.  2 A and  2 B ) described above in a group of the plurality of force directors  166  and applying a force (e.g., by striking the removal tool  200  with a hammer) to cause the removal tool  200  to fracture a group of the plurality of fracturable score lines  164  defining the periphery of the second removable element  162   b  and the third removable element  162   c.  Alternatively, the one or more selected removable elements (second step  520 ) can be removed in the third step  530  by cutting (e.g., using a knife, a saw, or the like) one or more of the fracturable score lines  164 . In other implementations, one or more of the fracturable score lines  164  can be fractured using a stamp (not shown) that acts like a cookie-cutter to remove the one or more selected removable elements. 
     During the optional fourth step  540 , the user or the subject then places the walking boot  100  ( FIG.  1 A ) on the subject. To do so, the user or the subject places the inner fabric lining  110  ( FIG.  1 B ) on at least a portion of the foot, the ankle, and the leg of the subject and secures the inner fabric lining  110  to the subject using the plurality of fasteners  112 . The user or the subject then places the inner fabric lining  110  in the main body  130  of the rigid outer shell  120  ( FIG.  1 C ) such that the base portion  140  supports the foot of the subject, the leg portion  150  supports the leg of the subject, and the ankle support portion  160  supports the ankle of the subject. The user or the subject then completes the assembly of the walking boot  100  ( FIG.  1 A ) by placing the shin cover  180  and the foot cover  170  on a front surface of the inner fabric lining  110  and securing the shin cover  180  and the foot cover  170  to the main body  130  using the plurality of fasteners  131  ( FIG.  1 A ). 
     If the subject reports any undesirable contact (e.g., direct or indirect) between the rigid outer shell  120  and the incision area (e.g., while walking in the walking boot  100 ) to the user after the fourth step  540 , the method  500  can further include disassembling the walking boot  100  and repeating the first step  510 , the second step  520 , the third step  530 , and the fourth step  540  one or more times until the subject reports that there is no contact (e.g., direct or indirect) between the rigid outer shell  120  and the incision area on the ankle. 
     Advantageously, the method  500  permits a user to customize the walking boot  100  as needed for a given subject to inhibit or prevent contact (e.g., direct or indirect) between the rigid outer shell  120  and the incision area on the ankle of the subject. Physicians often have a limited supply of walking boots and thus it is advantageous that the walking boot  100  can be adapted to any subject rather than requiring a custom-made walking boot for each subject. In many cases a subject may require a walking boot but does not have an incision area that requires the removal of one or more removable elements to inhibit contact with the rigid outer shell  120 . A physician can provide the walking boot  100  to a variety of subjects, such as, for example, a subject that has an injury but no incision area, a subject with a large incision area, a subject with a small incision area, a subject with multiple incision area, etc. 
     By requiring a tool (e.g., the removal tool  200 , a cutting tool, a stamp, etc.) during the fourth step  540 , the method  500  limits the ability of the subject to remove (unintentionally or intentionally) other ones of the plurality of removable elements  162  other than those selected during the second step  520 . This is advantageous because removing all of the removable elements of the plurality of removable elements  162  from the ankle support portion  160  could cause the walking boot  100  to fail during use by the wearer (e.g., if the wearer is overweight). Thus, a physician can selectively remove only the ones of the plurality of removable elements  162  that are necessary to inhibit contact with an incision area while ensuring that the other ones of the plurality of removable elements  162  remain in place to provide the required support/stability. 
     While the method  500  has been described and shown in  FIGS.  5 B and  5 C  being used to make the walking boot  100 , the method  500  can more generally be used to make the walking boot  300 , the walking boot  400 , or other similar walking boots. In such implementations, the removal of the selected removable elements during third step  530  may differ depending on the configuration of the walking boot (e.g., sliding the selected removable elements along the upper track  490  and the lower track  494  in the case of walking boot  400 ). 
     Referring to  FIGS.  6 A and  6 B , a walking boot  600  that is similar to the walking boots  100 ,  300 , and  400  described above includes a main body  630  of a rigid outer shell. The main body  630  ( FIG.  6   ) is similar to the main body  130  ( FIG.  1 C ) in that the main body  630  includes a base portion  640 , a leg support portion  650 , and an ankle support portion  660 . The main body  630  ( FIG.  6   ) differs from the main body  130  ( FIG.  1 C ) in that the main body  630  includes a reinforcing member  632 . Further, the ankle support portion  660  differs from the ankle support portion  160  ( FIG.  1 C ) in that the ankle support portion  660  includes an opening  662 . 
     As best shown in  FIG.  6 A , the opening  662  has a general “C” or semi-circular shape. Like the opening  532  ( FIG.  5 C ), which is formed when one or more removable elements are removed from the ankle support portion  160  as described above, the opening  662  aids in inhibiting contact (e.g., direct contact or indirect contact) between incision area(s) on one (or both) of two opposing sides of an ankle of a subject and the main body  630  of the rigid outer shell. In other words, the opening  662  of the ankle support portion  660  is positioned such that incision area(s) on the ankle of the subject are positioned within the opening  662  when the walking boot is worn by a subject. 
     As described above, the walking boots described herein after used to immobilize an injury and permit a subject to put weight on the injury. Including the opening  662  in the ankle support portion  660  of the walking boot  600  reduces the maximum stress that the main body  630  can accommodate without failing (e.g., compared to the walking boot  100 ). The reinforcing member  632  is coupled to the main body  630  to provide structural support and stability such that the main body  630  can accommodate the same maximum stress as a main body without the opening  662  (e.g., the walking boot  100 ). The reinforcing member  632  can be made from a polymer material (e.g., the same material as the main body  630 ) and can be unitary and/or monolithic with the main body  630 . Alternatively, in some implementations, the reinforcing member  632  is made from a metal material and is coupled to the main body  630  (e.g., using an adhesive, one or more clips that are integrally formed with the main body  630 , or the like, or any combination thereof). 
     The reinforcing member  632  includes a first segment  642  coupled to the base portion  640  of the main body  630  and a second segment  652  coupled to the leg portion  650  of the main body. The first reinforcing member  632  also includes a third segment  666  coupled to the ankle support portion  660 . As shown, the third segment  666  couples the first segment  642  and the second segment  652  together and has a general “C” or semi-circular shape such that the third segment  666  partially surrounds the opening  662 . 
     Advantageously, the reinforcing member  632  allows the walking boot  600  to accommodate the same or similar stresses as a main body without an opening (e.g., the main body  130 ) without requiring the steps of identifying a target area, selecting removable elements, and removing the selected removable elements (e.g., as described in reference to the method  500 ). Thus, the walking boot  600  can be worn by a subject (e.g., a subject with multiple incision areas on one side of the ankle, a subject with an incision area(s) on both sides of the ankle, a subject without any incision areas, etc.) without any further modifications or steps. 
     While the opening  662  and the reinforcing member  632  are shown on one side of the walking boot  600  (e.g., such that the opening  662  is adjacent to one of two opposing sides of an ankle of a wearer of the walking boot  600 ), the walking boot  600  can include a second opening (not shown) that is the same as the opening  662  and a second reinforcing member (not shown) that is the same as the reinforcing member  632  such that the first opening  662  is adjacent to a first side of an ankle of a wearer of the walking boot  600  and the second opening is adjacent to an opposing second side of an ankle of a wearer of the walking boot  600 . 
     Referring to  FIGS.  7 A and  7 B , a walking  700  that is similar to the walking boots  100 ,  300 ,  400 ,  600  described herein includes an inner fabric lining  710  and a rigid outer shell  720 . The rigid outer shell  720  includes a main body  730 , a foot cover  770 , and a shin cover  780 . The main body  730  also includes a plurality of fasteners  731  (e.g., hook and loop fasteners) that couple the foot cover  770  and the shin cover  780  to the main body  730  to assemble the walking boot  700 . 
     The main body  720  includes a base portion  740 , a leg portion  750 , and an ankle support portion  760 . As best shown in  FIG.  7 B , the ankle support portion  760  differs from the other ankle support portions described herein in that the ankle support portion  760  includes an opening  761 , a bulged portion  762 , and a removable element  790  removably disposed within the opening  761 . 
     As shown in  FIG.  7 B , the removable element  790  includes an upper tongue  792   a,  a lower opposing tongue  792   b,  a plurality of posts  794 , and a clasp  796 . The removable element  790  is sized and shaped such that the removable element  790  generally fills the opening  761  of the ankle support portion  760  when the removable element is coupled to the ankle support portion  760 . The upper tongue  792   a  and the lower tongue  792   b  define the opening  761  and each have a general u-shape, although other shapes are contemplated (e.g., rectangular, triangular, polygonal, etc.) As described in further detail herein, the upper tongue  792   a  and the lower tongue  792   b  aid in removable coupling the removable element  790  to the bulged portion  762  of the ankle support portion  760 . 
     Each of the plurality of posts  794  of the removable portion extends from an outer surface of the removable element  790  and have a generally cylindrical shape, although other shapes and sizes are contemplated (e.g., rectangular, triangular, polygonal, etc.) While the plurality of posts  794  is shown as including two posts, more generally, the plurality of posts  794  can include any suitable number of posts (e.g., one post, three posts, five posts, etc.) As described in further detail herein, the plurality of posts  794  of the removable element  790  aid in removably coupling the removable element  790  to the bulged portion  762  of the ankle support portion  720 . 
     The clasp  796  is positioned between two of the plurality of posts  794  and extends from an outer surface of the removable element  790 . The clasp  796  includes a deflectable tongue  798  that is unitary and/or monolithic with the clasp  796 . The deflectable tongue  798  is configured to at least partially defect responsive to application of a force and is generally biased towards the position shown in  FIG.  7 B . As described in further detail herein, the clasp  796  and the deflectable tongue  798  thereof aid in removable coupling the removable element  790  to the bulged portion  762  of the ankle support portion  760 . While the removable element  790  is shown as including both the plurality of posts  794  and the clasp  796 , in some implementations, the removable element  790  includes just the plurality of posts  794  or just the clasp  796 . 
     The bulged portion  762  is unitary and/or monolithic with the ankle support portion  760  and extends outwardly in a direction away from the ankle of the subject when the walking boot  700  is worn. The bulged portion  762  includes an upper track  764   a,  an opposing lower track  764   b , a plurality of sockets  766 , a hollow clasp housing  768   a,  and a clasp tongue aperture  768   b.  The upper track  764   a  and the lower track  764   b  are sized and shaped (e.g., with a generally u-shape) to correspond to the shape of the upper tongue  792   a  and the lower opposing tongue  792   b  of the removable element  790  such that the upper track  764   a  and the lower track  764   b  can receive the upper tongue  792   a  and the lower opposing tongue  792   b,  respectively, to aid in removable coupling the removable element  790  to the ankle support portion  760 . 
     While the bulged portion  762  is shown as including both the upper track  764   a  and the lower track  764   b  (e.g., female connectors) to receive portions of the upper tongue  792   a  and the lower tongue  792   a  (e.g., male connectors) of the removable element  790  therein, in other implementations, the bulged portion  762  and the removable element  790  can include any combination of male and/or female connectors (e.g., the bulged portion  764  includes one track for receiving a tongue of the removable element  790  and the bulged portion  764  includes one tongue that is received by a track of the removable element  790 . 
     The plurality of sockets  766  of the bulged portion  762  are sized, shaped, and positioned to receive the plurality of posts  794  of the removable element  790  therein. Disposing the plurality of posts  794  into the plurality of sockets  766  creates an interference or press fit that aids in removably coupling the removable element  790  to the bulged portion  762  of the ankle support portion  760 . 
     Similarly, the hollow clasp housing  768   a  is sized, shaped, and positioned to receive the clasp  796  of the removable element  790  therein. Disposing the clasp  796  of the removable element  790  within the hollow clasp housing  768   a  aids in removably coupling the removable element  790  to the bulged portion  762 . More specifically, as the clasp  796  is initially disposed within the hollow clasp housing  768   a,  the deflectable clasp tongue  798  deflects to permit the clasp  796  to move within the hollow clasp housing  768   a.  As the clasp  796  continues to be inserted into the hollow clasp housing  768   a,  the deflectable clasp tongue  798  engages the clasp tongue aperture  768   b  that is sized and shaped to receive the deflectable clasp tongue  798  therein such that a portion of the delectable clasp tongue  798  protrudes from the clasp tongue aperture  768   b.  This engagement of the deflectable clasp tongue  798  and the clasp tongue aperture  768   b  further aids in removably coupling the removable element  790  to the bulged portion  762 . To remove the clasp  798  from the hollow clasp housing  768   a,  a force is applied to the deflectable clasp tongue  798  (e.g., a user presses the portion of the deflectable clasp tongue  798  protruding from the bulged portion  762 ) to deflect the deflectable clasp tongue  798  and permit the clasp  796  to be removed. 
     While the walking boot  700  is shown and described herein as included one removable element  790  on a first side of the ankle support portion  760 , in some implementations, the walking boot  700  includes a second removable portion (not shown) that is the same as, or similar to, the removable portion  790  that that is positioned on a second opposing side of the walking boot  700 . In such implementations, the second removable portion is coupled to the walking boot  700  in the same or similar manner as the removable portion  790  described herein. 
     It is to be understood that many modifications and variations may be devised given the above description of the general principles of the present disclosure. It is intended that all such modifications and variations be considered as within the spirit and scope of the present disclosure, as defined in the following claims.