Abstract:
An ankle and foot orthosis brace for use in supporting an immobilization of a patient&#39;s ankle and foot. The brace is of a multi-part L-shaped configuration with a contoured leg support portion and a foot portion interconnected by an incrementally hinge and lateral bearing assembly therebetween. A foot pad with an apertured tab extends therefrom and is part of the foot portion with adjustable fabric fasteners extending from both the foot portion, apertured tabs and the leg support portion secured to the brace to the patient&#39;s leg and foot.

Description:
BACKGROUND OF THE INVENTION 
     1. Technical Field 
     The present invention relates to therapeutic leg and foot braces more particular to a securing apparatus having a footpad, a fabric foot engagement enclosure for releasably securing the brace to the foot and ankle of the patient and to maintain a consistent pressure against the foot, sole and ankle of the patient for therapeutic purposes. 
     2. Description of Prior Art 
     An orthotic foot and ankle brace typically has an L-shaped construction with a contoured leg support portion, a foot portion, and an interconnecting heel portion connected therebetween. An integral fabric foot engagement enclosure is provided to secure the brace to the patient&#39;s foot and ankle. 
     Prior art devices of this type provide for a variety of leg, ankle and foot stabilization utilizing two-part brace assemblies interconnected by free hinges of elastomeric material as seen in U.S. Pat. No. 5,496,263 that permit the tolocural articulation to move about a single axis. 
     Other prior art patents, such as U.S. Pat. No. 5,431,624 disclose leg and foot braces having adjustable angles between the two sections with an extended ground engagement sole and a cam action locking assembly. 
     U.S. Pat. No. 5,486,157 discloses a hinge at the apex of a contoured heel portion to provide free dorsiflexion and plantar flexion with a pivot point below the hinges for inversion, eversion, pronation and supination of the foot. 
     Other therapeutic foot devices can be seen in U.S. Pat. No. 5,431,624 in which an ankle controlling section slidably attaches to a foot supporting section so that the angle between the two sections can be changed and flexed to a wearer&#39;s foot in the desired manner. 
     Applicant&#39;s own U.S. Pat. Nos. 5,088,479, 5,545,127, 5,593,383, 5,908,398 and 5,944,679 define the present state of the art in ankle and foot orthosis beginning with the resilient L-shaped construction in U.S. Pat. No. 5,088,479, the introduction of a laterally adjustable ankle and foot orthosis in U.S. Pat. No. 5,545,127 and adjustable ankle and foot orthosis brace having an adjustable hinge assembly between the leg configuration and the heel configuration in U.S. Pat. No. 5,908,398 and various foot enclosure mechanisms set forth in relation to foot pads and leg engagement sections. 
     SUMMARY OF THE INVENTION 
     An ankle and foot orthosis device for supporting and selectively immobilizing a patient&#39;s ankle and foot having both adjustable lateral angular inclination with dorsiflexion and plantar flexion motion or static position. The orthotic brace generally comprises a leg portion, a foot portion and an interconnecting heel portion with a unique intermedial transition portion with adjustable multi-angular bearing surfaces to input selective angular inclination both bi-laterally and dorsi/plantar flexion by respective multiple overlapping intermedial end portions of respective resilient interconnecting portions. 
     OBJECTS AND ADVANTAGES 
     Accordingly, it is the object of the present invention to provide an incremental adjustable limit of bi-lateral angular inclination and imputable limited degrees of plantar flexion and dorsiflexion in the sagitial plane. An intermedial transition element provides a mechanical interface between adjacent input portions while maintaining resilient interplay between the leg and foot portions of the orthosis device. 
    
    
     DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a side elevational view of the present invention; 
     FIG. 2 is a rear elevational view thereof; 
     FIG. 3 is a top plan view of the foot portion of the invention with portions broken away; 
     FIG. 4 is a side elevational view of the hinge and bi-later adjustment element with hinge range of motion illustrated in broken lines of the foot engagement portion; 
     FIG. 5 is an enlarged partial rear elevational view of the hinge and lateral adjustment elements illustrating the bi-lateral range of motion imparted to the leg engagement portion in broken lines; 
     FIG. 6 is a rear elevational view of intermedial transition element defining both its support bearing surface and a bearing element for respective adjustment portions; 
     FIG. 7 is an enlarged side elevational view of the intermedial transition element shown in FIG. 6; 
     FIG. 8 is an enlarged side elevational view of the hinge engagement distal end of the leg support portion; 
     FIG. 9 is an enlarged rear elevational view of the hinge engagement portion shown in FIG. 8; 
     FIG. 10 is an enlarged cross-sectional view of the hinge engagement portion on lines  10 — 10  of FIG. 5; and 
     FIG. 11 is a cross-sectional view of lateral adjustment portion on lines  11 — 11  of FIG.  5 . 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Referring to FIGS. 1 and 2 of the drawings, an ankle and foot orthosis brace of the invention can be seen comprising, a leg portion  10 , a foot portion  11  and an interconnecting heel portion  12  extending therebetween. The leg portion  10  has an enlarged transversely contoured leg support  13  having a recessed channel  14  formed inwardly from one end thereof. The foot portion has a footpad  14  connected to a generally rectangular attachment brace  15 . The attachment brace  15  has a resilient walking pad  16  secured thereto. The foot pad  14  is also of a generally rectangular configuration with an area of reduced transverse dimension at  17  defining pairs of longitudinally spaced apertured tabs  18 , as best seen in FIG. 3 of the drawings. A mounting bracket  19  extends inwardly from the bottom of the footpad  14  for engagement of the interconnecting heel portion  12  between the footpads  14  and abutting attachment base  15 . In practice, the leg and foot portions are made of synthetic plastic resin material so that they can be molded or preformed to the desired contours required for engagement with a patient&#39;s leg  20  shown in broken lines, as best seen in FIG. 1 of the drawings. 
     A toe extension member  21  can be seen in FIGS. 1-3 of the drawings and is adjustably secured to the footpad  15  opposite the mounting bracket  19 . The toe extension member  21  has a flat base area  22  with an upturned angular offset end portion  23 . The toe extension  21  is registerably attached between the footpad  17  and the attachment base  15  by a mounting slot  24  aligned for registration with adjustable fasteners  25  extending from said footpad  15  through the attachment base  15  allowing for the lengthening of the overall foot portion  11 . 
     The interconnecting heel portion  12  comprises an upper leg element  26 , an intermediate bearing engagement element  27  and a lower foot engagement element  28 , all of which are comprised of a resilient metal alloy or suitable material. The upper leg element  26  is secured within the recessed channel  14  of the leg support  13  by multiple fasteners F and has an articulated curved free end at  29 . The foot element  28  extends from and is secured within the mounting bracket  19  of the foot pad  15  by a pair of fasteners F that interengage therethrough in registration with selective fixed apertures in the mounting bracket  19 , as best seen in FIG. 3 of the drawings. The foot engagement  28  has an apertured free end at  30 . The intermediate bearing engagement element  27  has an articulated upper curved end at  31  with transversely spaced longitudinal slots S within and an oppositely disposed apertured pivot engagement end  32  as best seen in FIGS. 6,  7  and  10  of the drawings. 
     A hinge assembly  33  is formed by the respective overlapping articulated free ends  29  and  31  with a hinge block  34  registerable within the arcuate upper contoured free end  31  of the intermedial bearing engagement element  27  and correspondingly a compression cap fitting  35  with a curved interengagement surface  36  is positioned over the aligned slots S in the articulated curved free end  29  of the leg element  26  in oppositely disposed aligned relation to the hinge block  34 . The hinge block  34  and compression cap fitting  35  are registerably secured together by a pair of threaded fasteners F extending through aligned apertures therein and the corresponding aligned slots S of the respective upper leg element  26  and intermedial bearing engagement element  27  and threadably engaged by lock nuts  36 A. 
     Referring now to FIGS. 4 and 5 of the drawings, the respective overlapping apertured curved free end  30  of the foot engagement element  28  and the apertured pivot engagement end  32  of the intermedial bearing engagement element  27  define a main pivot fitting  37 . Accordingly, a pivot pin  38  interconnects said respective overlapping pivot ends  30  and  32  extending through centrally positioned respective and aligned apertures therein as best seen in FIG. 11 of the drawings. A pair of oppositely disposed limit stop fasteners  39  and  40  are threadably secured into registering threaded apertures in the pivot engagement end  32  of the intermediate bearing engagement element  27  through respective aligned arcuate slots  41  and  42  in the overlapping free end portion  30  of the foot engagement element  28 , best seen in FIGS. 10 and 11 of the drawings. 
     In use, the intermedial bearing engagement element  27  can be disposed laterally in relation to the foot engagement element  28  as illustrated in solid and broken lines in FIG. 5 of the drawings. The degree of lateral movement therebetween can be incrementally adjustably achieved by alignment of an indicator groove  42  on the pivot engagement end  32  of the intermedial bearing engagement element  27  in initial vertical alignment with the central pivot pin and multiple incrementally spaced indicator grooves  43  formed on the free end  30  of the foot engagement portion  28  so as to be selectively aligned therewith. 
     Once the desired degree of lateral alignment is achieved, the stop limit fasteners  39  and  40  are secured locking the so aligned overlapping pivot engagement end  32  of the intermedial bearing engagement element  27  and the free end  30  of the foot engagement portion  28  together. 
     Referring now to FIG. 4 of the drawings, the hereinbefore described hinge assembly  33  can be seen allowing an effective range of motion of the foot portion  11 , not shown, in relation to the leg element  13  delineated by broken lines at  28 A and  28 B of the foot engagement element  28  and is limited thereto. 
     It will also be seen that the adjustable range of movement of the foot element  28  so illustrated is limited to the interengagement of the hereinbefore described arcuate free ends at  29  and  31 . 
     Referring back now to FIG. 1 of the drawings, it will be seen that the foot portion  11  is illustrated comprising a fabric foot engagement enclosure  44  that is removably secured to the foot pad  14  by a plurality of attachment strips  45  that extend from the foot engagement enclosure  44  extending through the respective apertured tabs  18  and back against themselves at  46  by interlocking hook and loop material inserts  47  thereon. 
     Secondary enclosure straps and buckle assemblies  48 ,  49  and  50  provide for overlapping closure of the foot engagement enclosure  44 . Leg attachment straps assemblies  51  and  52  are secured to and extend from the leg portion  13  adjacent its respective upper and lower free ends. A leg attachment strap areas  51  and  52  secure the patient&#39;s upper leg L shown in broken lines to a fabric pad  53  secured independently to the leg portion  13  by the use of hook and loop fasteners as hereinbefore described. 
     It will be apparent from the above description that the present invention provides for the static accommodation of a patient&#39;s particular range of dorsiflexion and plantar flexion motion and the incremental adjustment degree of lateral angular inclination by use of the hereinbefore described composite hinge and bi-lateral pivot assembly. 
     It will be apparent to those skilled in the art that various changes and modifications may be made therein without departing from the spirit of the invention.