U.S. patent application number 17/099579 was filed with the patent office on 2021-05-13 for tools and methods for fitting orthoses.
This patent application is currently assigned to Horsepower Technologies Inc.. The applicant listed for this patent is Horsepower Technologies Inc.. Invention is credited to Carl Kirker-Head, Richard Miller, Mouli Ramani, Geralyn Schad, Kristin Size, Keith Sproat, Victoria Thompson, Evan Williams.
Application Number | 20210137073 17/099579 |
Document ID | / |
Family ID | 1000005348462 |
Filed Date | 2021-05-13 |
United States Patent
Application |
20210137073 |
Kind Code |
A1 |
Ramani; Mouli ; et
al. |
May 13, 2021 |
TOOLS AND METHODS FOR FITTING ORTHOSES
Abstract
An orthosis is fitted to a body joint, in a preferred embodiment
the equine fetlock, by locating the center of rotation (COR) of the
joint; measuring the bones comprising the joint at points located
with respect to the COR; selecting the appropriate orthosis from a
selection of models thereof; and custom-fitting the orthosis to the
individual by heating it to soften a layer of thermoformable foam
on the interior of the orthosis and clamping the orthosis in place
over the body joint. A kit of tools for performing the measurements
is disclosed, as are a method for location of the COR of the body
joint by palpation and a preferred heater.
Inventors: |
Ramani; Mouli; (Lowell,
MA) ; Thompson; Victoria; (South Hamilton, MA)
; Sproat; Keith; (Truckee, CA) ; Size;
Kristin; (Waltham, MA) ; Miller; Richard;
(Needham, MA) ; Kirker-Head; Carl; (Sturbridge,
MA) ; Schad; Geralyn; (Northborough, MA) ;
Williams; Evan; (Boston, MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Horsepower Technologies Inc. |
Lowell |
MA |
US |
|
|
Assignee: |
Horsepower Technologies
Inc.
Lowell
MA
|
Family ID: |
1000005348462 |
Appl. No.: |
17/099579 |
Filed: |
November 16, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
15932101 |
Feb 5, 2018 |
10834898 |
|
|
17099579 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61F 2005/0172 20130101;
A61F 2005/0165 20130101; A61B 5/1072 20130101; A61F 5/0127
20130101; A61D 9/00 20130101; A01K 13/007 20130101; A61F 5/0102
20130101 |
International
Class: |
A01K 13/00 20060101
A01K013/00; A61F 5/01 20060101 A61F005/01; A61D 9/00 20060101
A61D009/00; A61B 5/107 20060101 A61B005/107 |
Claims
1-18. (canceled)
19. A method for fitting an orthosis to a body joint, said method
comprising: locating a center of rotation of a body joint;
measuring first and second bones of the body joint at predetermined
points located with respect to the center of rotation of the body
joint; selecting an orthosis comprising proximal and distal cuffs
joined to one another by a pivot structure from a plurality of
models thereof, said cuffs each comprising an outer shell and a
layer of thermoformable foam; heating the orthosis; and positioning
the orthosis over the body joint so that the thermoformable foam of
the orthosis conforms to the first and second bones.
20. The method of claim 19, wherein said body joint is an equine
fetlock, made up of cannon and pastern bones, and wherein said
measurement step comprises (1) measuring the width of the cannon
bone and the depth at which its maximum width is disposed from a
forward surface of the cannon bone, (2) measuring the circumference
of the pastern bone, and (3) measuring the width of the
fetlock.
21. The method of claim 20, wherein said step (1) is performed
using a cannon tool for simultaneously measuring the maximum width
of the cannon bone and the depth at which its maximum width is
disposed from a forward surface of the cannon bone.
22. The method of claim 21, wherein said cannon tool comprises an
elongated beam, a first anvil fixed to one end of said beam, and a
second anvil sliding along said beam, whereby said first and second
anvils are brought into contact with opposed side surfaces of said
cannon bone to determine its width.
23. The method of claim 22, wherein said sliding anvil is provided
with markings for convenient identification of the depth at which
the maximum width of the cannon bone is disposed from a forward
surface thereof.
24. The method of claim 23, wherein the sliding anvil is provided
with a plurality of spring-biased pins extending out of the surface
of the anvil in contact with an outer side surface of the cannon
bone, such that one of the pins protrudes out an opposite surface
of the anvil at a position corresponding to the maximum width of
the cannon bone.
25. The method of claim 20, wherein said step of measuring the
width of the cannon bone and the depth at which its maximum width
is disposed from a forward surface of the cannon bone is performed
at a plurality of locations along the axial extent of the cannon
bone, measured from the center of rotation of the fetlock.
26. The method of claim 25, wherein said plurality of locations
along the axial extent of the cannon bone are located by disposing
an alignment tape on the surface of the cannon bone, with a
reference point on the alignment tape located at the center of
rotation of the fetlock and plural measurement locations indicated
on the alignment tape.
27. The method of claim 20, wherein said step (2) of measuring the
circumference of the pastern bone is performed by disposing a
pastern tool comprising a head member, disposed over the center of
rotation of the fetlock, a tongue member defining a predetermined
distance from the center of rotation of the fetlock, and a
measurement ribbon, said ribbon being passed around the pastern to
measure its circumference at said predetermined distance from the
center of rotation of the fetlock.
28. The method of claim 27, wherein said ribbon is provided with
colored sections employed for measuring the circumference of the
pastern.
29. The method of claim 22, wherein said elongated beam is provided
with colored sections disposed along its length, and said sliding
anvil comprises a reference mark for comparison to said colored
sections for determining the spacing of the sliding anvil from the
first fixed anvil in order to measure the width of the cannon and
of the fetlock.
30. The method of claim 19 wherein the center of rotation of the
joint is located by palpation.
31. The method of claim 30, wherein the joint is an equine fetlock,
and the location of its center of rotation is performed by:
locating a depression between a palmar process of the first phalanx
and a base of a proximal sesamoid bone; identifying a joint margin,
and marking this point as point A; identifying a prominence of an
intercondylar ridge on a cranial aspect of a cannon bone near the
fetlock, and marking a point B where the intercondylar ridge merges
with a flat cranial surface of the distal cannon bone; marking a
point C at the same level as point B with respect to the
horizontal, but on the forward-most part of a lateral surface of
the cannon bone; and marking a point D midway between points A and
C, which is the center of rotation of the fetlock.
32. A tool for measuring dimensions of a fetlock, said tool
comprising: an elongated beam; a first anvil fixed to one end of
said beam; and a second anvil sliding along said beam, whereby said
first and second anvils are brought into contact with opposed side
surfaces of a cannon bone of the fetlock to determine its width;
and wherein one of said anvils is provided with markings for
convenient identification of the depth at which the maximum width
of the cannon bone is disposed from a forward surface thereof.
33. The tool of claim 32, wherein the second anvil is provided with
a plurality of spring-biased pins extending out of the surface of
the anvil in contact with an outer side surface of the cannon bone,
such that one of the pins protrudes out an opposite surface of the
anvil at a position corresponding to the maximum width of the
cannon bone.
34. The tool of claim 32, further comprising a level for ensuring
that the tool is correctly aligned with respect to the cannon
bone.
35. The tool of claim 32, wherein said beam is provided with
dimensional information, and said second anvil is provided with an
indicating line for comparison with said dimensional
information.
36. The tool of claim 35, wherein said dimensional information
comprises a series of colored markings on said beam.
37. A heating device for heating an orthosis, the heating device
comprising: a fan; a plenum defining one or more outlet ducts, the
plenum configured to receive the orthosis; and a first platen and a
second platen positioned on opposite sides of the plenum such that
a proximal cuff of the orthosis can be confined between the plenum
and the first platen and a distal cuff of the orthosis can be
confined between the plenum and the second platen to define
substantially closed cavities; a fan coupled to the plenum via
ducting; and a heating assembly configured to generate hot air and
positioned relative to a fan such that the fan provides a stream of
hot air to the plenum via the ducting to cause the hot air to heat
a layer of thermoformable foam of the proximal and distal
cuffs.
38. The heating device of claim 37, further comprising a plurality
of ribs positioned on the first platen and the second platen to
provide a controlled exit for the hot air flowing from the plenum.
Description
FIELD OF THE INVENTION
[0001] This invention relates to tools and methods for properly
fitting orthoses to body joints.
BACKGROUND OF THE INVENTION
[0002] It is well-known to employ orthoses fitting around body
joints to assist in injury prevention, and for joint support for
recovery after injury or surgery. The art shows many
well-characterized classes of orthoses. It is self-evidently
important that a given orthosis must properly fit the joint being
treated so that the full therapeutic effect will be realized. Where
the orthosis comprises, for example, cuffs secured to opposed
members of a body joint meeting at a pivot point, and where the
orthosis is designed to permit a degree of joint pivoting during
rehabilitation or training, it is important both that the cuffs fit
the opposed members, so that the orthosis does not slide out of
position in use, and that the pivot point of the orthosis be
aligned correctly with that of the joint, so that no improper
forces are exerted on the body joint as it is extended and
flexed.
[0003] One known class of orthosis is for limiting the range of
motion of the equine fetlock joint. The fetlock joint connects the
distal cannon bone (metacarpal bone III) to the proximal aspect of
the long pastern bone (first phalanx) of the horse's leg (both fore
and hind legs are considered to have fetlocks, although their
detailed anatomy obviously varies somewhat). Both fore and hind
fetlocks are subject to accident or injury, in particular due to
hyperextension. An orthosis which limits the range of motion (ROM)
of the fetlock can be very useful in preventing hyperextension and
thus assisting in recovery from injury or surgery. An orthosis for
this purpose for the fore equine fetlock is described in
commonly-assigned application Ser. No. 14/545,799, filed Jun. 22,
2015. A comparable orthosis to aid in prevention of injury, e.g.,
during training could also be provided.
OBJECT OF THE INVENTION
[0004] This application describes the invention in connection with
fitting the orthosis of Ser. No. 14/545,799 to equine fetlocks, but
is not limited thereto, nor to equine joints. In fact, the tools
and methods of the invention may have applicability to the fitting
of orthoses to a wide variety of body joints, including human.
Furthermore, the invention is not limited to the fitting of
orthoses for limiting the range of motion of the joint, but may be
useful in fitting of orthoses for various clinical purposes. The
invention may also find use in fitting of prostheses.
SUMMARY OF THE INVENTION
[0005] The present invention relates to fitting of orthoses
involving a several-step procedure. First, the center of rotation
of the joint is located, preferably using a palpation technique to
identify various anatomical features of the joint. Specialized
tools are used to measure the joint at key points. Next, these
measurements are used to select the correctly-sized orthosis from a
predetermined selection. Finally, the orthosis is custom-fit to the
individual. The specialized tools could also be used for making the
measurements needed to make a custom designed orthosis, not just
for selecting a stock model from a set of predetermined sizes.
BRIEF DESCRIPTION OF THE DRAWINGS
[0006] The invention will be better understood if reference is made
to the accompanying drawings, in which:
[0007] FIG. 1 shows a perspective view of the range of motion
limiting orthosis disclosed in Ser. No. 14/545,799, as installed
over a horse's left fore fetlock;
[0008] FIG. 2 is a cross-section through the orthosis at a point
where it fits around the cannon bone, illustrating the different
components thereof;
[0009] FIGS. 3-8 are perspective views of a horse's right fore
fetlock, illustrating the steps performed in locating the center of
rotation (COR) of the fetlock;
[0010] FIG. 9, comprising FIGS. 9 (a)-(e), shows views of the tools
employed in the method of the invention, each being discussed
separately below, these comprising a cannon tool, a pastern tool,
an alignment tape, COR markers, and a measurement card,
respectively;
[0011] FIG. 10 shows the use of the alignment tape;
[0012] FIG. 11 shows a perspective view of the cannon tool in use
to measure the width of the left cannon bone at one of three
defined distances from the COR, and includes in FIG. 11 (a) an
enlarged plan view of a measurement screen;
[0013] FIG. 12 is a view comparable to FIG. 11, showing the cannon
tool in use to measure the width of the left fore fetlock, and
includes in FIG. 12 (a) an enlarged plan view of the measurement
screen;
[0014] FIG. 13 is a perspective view of the pastern tool in use to
measure the circumference of the left fore pastern; and
[0015] FIG. 14 is a perspective, partially-cutaway view of a heater
used to heat the orthosis prior to final fitting to an individual,
with the orthosis in position for being heated.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0016] As summarized above, the method of the invention involves
four separate steps, performed in order: location of the center of
rotation (COR) of the fetlock; measurement of key dimensions of the
cannon, fetlock, and pastern, at points located with respect to the
COR; selection of the appropriate orthosis from a selection of
models thereof; and final fitting of the selected orthosis to the
individual.
[0017] More particularly, the orthosis 10 used to limit the range
of motion (ROM) of the fetlock disclosed in Ser. No. 14/545,799 is
shown in FIG. 1 affixed to the left fore fetlock region (more
specifically, to the cannon and pastern) of a horse. The orthosis
10 comprises an upper or proximal cuff 12 and a lower or distal
cuff 14. As currently implemented, the proximal cuff 12 comprises a
hard forward shell 17 and a rear outer sheath 18 of fabric or
leather. The inner padding structure comprises an outer layer 20
(see FIG. 2) of molded polyurethane (PU) foam, and an inner layer
22 of thermoformable sheet foam, such as ethylene vinyl acetate
(EVA). The proximal cuff 12 is secured to the cannon bone
(including in "bone" the overlying fleshy structures, skin, and
coat) by straps 16. The structure of the distal cuff 14 and its
affixation to the pastern bone by strap 15 are similar.
[0018] The proximal cuff 12 is pivotally secured to the distal cuff
14 by lateral members 12a and 14a fixed to the respective cuffs.
The lateral members 12a and 14a meet at a pivot structure 24, which
may be as fully described in Ser. No. 14/545,799. Briefly, as the
pastern rotates clockwise in FIG. 1, extending the fetlock joint, a
stop 14b affixed to the distal cuff abuts a stop 12b affixed to the
proximal cuff 12, limiting the ROM of the fetlock. The relative
position of one or the other of the stops can be varied to limit
the ROM to a desired degree. Again, see Ser. No. 14/545,799 for a
preferred structure permitting this adjustment to be readily
accomplished. Not seen in FIG. 1 are medial members corresponding
to lateral members 12a and 14a which meet at a similar pivot
structure, but lack the ROM stop mechanism, which is provided only
on the lateral side of the orthosis 10.
[0019] The right-side orthosis is a mirror-image of that shown in
FIG. 1. As noted, the pivot structures 24 allowing adjustment of
the ROM of the fetlock are placed on the laterally-outer sides of
the fetlocks, to avoid interference that would likely occur if this
protruding structure were disposed on the medial inner side of the
fetlock, especially noting that the orthoses are typically employed
in pairs.
[0020] It will be apparent that in order to provide the maximal
therapeutic function the cuffs must fit their respective bones
closely and securely, so as to avoid slippage, and that the COR of
the pivot structure of the orthosis must be substantially aligned
with the COR of the fetlock, so as to achieve friction-free
rotation and avoidance of unnatural pivoting of the fetlock.
[0021] The present invention is directed to achieving the good fit
and accurate alignment mentioned above while providing the orthosis
in a readily manufacturable form at reasonable cost. That is,
although it would theoretically be possible to custom-fit a unique
orthosis to each horse to be treated, this would be very
time-consuming and inefficient. Moreover, the time taken to
manufacture such a custom orthosis for a given horse might
interfere with healing; that is, it would be preferred to have a
number of premanufactured orthoses on hand for custom-fitting in a
rapid fashion, so as to obtain the therapeutic effects thereof as
rapidly as possible. An important aspect of the invention is
therefore to provide a method for expeditiously determining which
of a plurality of premanufactured orthoses is the best fit for a
particular horse, and then to provide a method for rapidly
custom-fitting the orthosis to the horse. However, as indicated
above, the tools employed for selecting the correct orthosis from a
selection thereof could also be employed for making measurement
useful in making custom-made orthoses.
[0022] As noted above, referring to FIG. 2, the proximal cuff 12
fitting over the cannon bone, shown approximately as a hatched
section 23, comprises a forward shell 17 formed of plastic or
metal, to which the straps 16 are attached, and to which the medial
and lateral members 12a and 14a are riveted, and comprising
bump-outs 17a on either side for alignment of the medial and
lateral members, a thinner rear sheath 18 of fabric or leather, a
first layer 20 of foam, e.g., polyurethane (PU) that is molded to
define the basic inner contour of the cuff in contact with the
cannon bone, and a second layer 22 of thermoformable sheet foam, of
uniform thickness, and made of ethylene vinyl acetate (EVA) or the
like. The foam layers may be made in several portions, as
illustrated, and assembled with adhesive. The combination of the
forward shell 17, rear sheath 18, and the molded PU layer 20
together define the "model" of the cuff, which is selected in
response to the detailed measurement techniques described below.
The cuff 12 is then custom fit to the horse by heating it,
preferably in a specialized appliance described below, until the
EVA layer 22 is warmed sufficiently to be formable. The cannon cuff
12 is then placed quickly over the cannon bone and the straps 16
tightened. The pastern cuff 14 is fit similarly and simultaneously.
As the EVA cools it hardens, so that its surface conforms to the
outer surface of the respective bones. The heat content of the EVA
is low, so that the horse is not burned painfully in the process.
It should also be understood that a generally comparable technique
employing a thermoformable foam is used for fitting ski boots to
skiers' feet.
[0023] More specifically, the padding consists of two layers, an
outer polyurethane (PU) foam layer 20 and an inner thermoformable
foam layer 22. The PU foam layer 20 is injection-molded to define
the shape of the inner contour of the cuff in a flat configuration
with webs between the three sections in which it is molded, as
indicated at 20a. The webs are either made sufficiently flexible
that the PU layer 20 can be folded into its final shape, or the
webs are removed and the parts are separated for later re-assembly.
The thermoformable foam layer 22 is cut to shape and then heated
and compression molded so as to follow the contours of the PU foam
layer 20. The PU foam layer 20 and the thermoformable foam layer 22
are then laminated together using adhesive.
[0024] In order to prevent the top and bottom edges of the
thermoformable foam layer 22 from flattening out during the heating
and fitting process for the horse, its edges are stitched to small
injection-molded pieces of elastomeric thermoplastic polyurethane
(TPU) termed welts (not shown). Therefore, the complete process of
assembling the thermoformable foam layer 22 is to (a) cut out the
thermoformable parts, (b) stitch them to the welts and (c) laminate
the welts and the thermoformable foam to the PU foam using
adhesive. When the orthosis is fitted to the horse, the
thermoformable foam maintains its outer contour due to the
lamination but the inner contour changes to replicate the anatomy
of the horse.
[0025] The provision of tooling to form the forward shell 17 is the
most costly part of arranging for manufacture of the orthosis.
Research has shown that the vast majority of horses can be
accommodated with left and right shells 17 in a single size. The
molded PU foam then defines the basic fit of the cuff over the
cannon bone. Again, research has shown that the vast majority of
horses can be accommodated if the molded PU is provided in four
widths, dimension X in FIG. 2, where X is the maximum interior
transverse dimension of an approximately oval forward section of
the cuff, and two lengths, dimension Y in FIG. 2, the fore and aft
dimension between the forwardmost surface of the oval forward
section of the cuff and its narrowest point. Accordingly, 16
possible proximal cuffs are provided: 4 widths.times.2
lengths.times.2 (for left and right).
[0026] It has further been determined that there is some variation
from horse to horse in the way in which the width of the cannon
bone varies along its axial length. Therefore, as will be explained
further below, its width is measured at three locations spaced from
the COR, and the widest selected for the width X.
[0027] The distal pastern cuff 14 is structured and fit similarly,
and is provided in 4 sizes, selected responsive to measurement of
the circumference of the pastern at a given distance from the
COR.
[0028] The medial and lateral members 12a and 14a are also provided
in differing widths, corresponding to the width of the distal
pastern cuff 14.
[0029] Thus a total of 128 models of the orthosis (16 proximal
cuffs.times.4 distal cuffs.times.2 for left and right) is
sufficient to fit the vast majority of horses.
[0030] Turning now to the method of fitting the orthosis to the
horse, the first step is to locate the center of rotation (COR) of
the fetlock, so as to ensure that the COR of the orthosis is
correctly aligned with that of the fetlock. The COR is also used as
the reference point from which the locations for most of the
measurements needed are taken. The steps described in the following
are but one way to locate the COR, and other methods of doing so
are within the scope of the invention.
[0031] The first step is shown in FIG. 3, which illustrates the
horse's right foreleg, with the bone contours shown by lighter
weight lines. With the horse standing still on a flat firm surface,
the user palpates the fetlock with the index finger and locates the
depression between the palmar process of the first phalanx and the
base of the ipsilateral (same side) proximal sesamoid bone. This
can be identified as feeling like a "divot" on the surface of the
fetlock.
[0032] Next, as shown in FIG. 4, the user employs a thumbnail to
identify the palmar-most (toward the rear of the horse) joint
margin. As shown in FIG. 5, an adhesive marker, identified as
marker A, is then applied to the joint at this point.
[0033] Next, as illustrated by FIG. 6, the user identifies the
proximal-most prominence of the intercondylar ridge on the cranial
aspect of the cannon near the fetlock. A marker B is placed where
the intercondylar ridge merges with the flat cranial surface of the
distal cannon bone. This point is identified by deeply palpating
the front of the lower cannon bone with both thumbs, as
illustrated. After marker B is placed at this point (see FIG. 7), a
second marker C is placed at the same level with respect to the
horizontal, but on the forward-most part of the lateral surface of
the cannon bone. Again, see FIG. 7. Marker B can then be
removed.
[0034] Finally, a fourth marker D is placed is placed midway
between markers A and C, as illustrated by FIG. 8. This is the
center of rotation (COR) of the fetlock. Markers A and C can then
be removed.
[0035] The COR of the fetlock having thus been located,
measurements can be taken using the COR as a "base point" from
which the other measurement are located, ensuring that the orthosis
thus fitted will have its COR substantially aligned with the COR of
the fetlock.
[0036] FIG. 9, including FIGS. 9 (a)-(e), shows a kit of tools
provided by the proprietor of the orthosis to ensure proper fitting
of the orthosis to the fetlock. It will be appreciated by those of
skill in the art that comparable measurements could be made using
different tools; those shown are but one convenient possibility.
Further, several different embodiments of the tools shown could be
employed; these will be discussed as appropriate.
[0037] The cannon tool 24 shown in FIG. 9 (a) is used to measure
the width X of the cannon bone and to locate the distance Y between
the front of the cannon bone and its point of maximal width, which
are important in selecting the proper model of the proximal cuff,
as described above with reference to FIG. 2. The cannon tool 24
resembles a caliper, comprising a beam 26, a first anvil 28 fixed
to one end of the beam 26, and a second anvil 30 sliding along beam
26. As illustrated by FIG. 11, and more fully discussed below, in
order to measure the width of the cannon bone, the fixed anvil 28
is juxtaposed to one side of the cannon bone, with the beam held
horizontal (as may be confirmed using a bubble level 32 mounted to
the sliding anvil 30), in contact with the cannon bone, and square
to the horse's centerline. The sliding anvil 30 is then brought
into contact with the opposite side of the cannon bone. The
distance between anvils 28 and 30 is then equal to the width X of
the cannon bone. At the same time, a plurality of numbered pins 34
sliding in bores in sliding anvil 30, and spring-biased toward the
inner surface of sliding anvil 30, that is, in the leftward
direction in FIG. 9 (a), are brought into contact with the outer
surface of the cannon bone. These pins are numbered, as indicated.
One of the pins, located over the widest portion of the cannon
bone, will protrude more than the others; its number is noted and
used to specify the depth Y of the widest point of the cannon bone
from its forward surface.
[0038] The distance X between the anvils during the measurement
process may be determined in a variety of ways; for example, the
beam 26 could be inscribed with inch or metric indicia, as in a
conventional caliper. However, for reasons of convenience to the
user, color-coded marks indicated by "colors 1-6" are printed on
beam 26 of the cannon tool 24. A window 36 is formed in the sliding
anvil 30, with a reference line 36a provided thereon. When a
measurement is made, the color of the mark under the reference line
36a is noted, and a measurement card 37 shown in FIG. 9 (e) marked
accordingly. The number of the pin that protrudes outwardly more
than the others is also noted. The color-coding scheme employed in
the preferred embodiment is described in connection with FIG. 11,
below, as are details of the measurement process.
[0039] The cannon tool 24 is also used to measure the overall width
of the fetlock, as described in connection with FIG. 12 below; this
measurement is used to determine whether the orthosis is wide or
narrow, that is, whether wide or narrow medial and lateral members
12a and 14a are needed.
[0040] The cannon tool 24 is provided with a second window on its
opposite side, and the beam provided with a second set of colored
marks, so that the tool 24 can be flipped over and used to make
similar measurements of the opposite leg.
[0041] As discussed briefly above, the circumference of the pastern
is measured in order to determine the proper combination of molded
PU and thermoformable sheet foam to be provided in the distal cuff.
A pastern tool 38, shown in FIG. 9(b), is provided for the purpose.
This comprises a circular head portion 40 having an aperture 42 at
its center. The pastern tool 38 is disposed on the pastern so that
aperture 42 is located directly over the COR of the fetlock, that
is, tool 38 is located so that marker D (FIG. 8) is disposed within
aperture 42. A tongue 44 depends from head member 40, and a
measuring ribbon 46 is secured thereto at a distance Z from the
center of aperture 42. In use the ribbon 46 is passed around the
pastern and the length of the ribbon 46 needed to circumscribe the
pastern is noted. Again, this measurement could be made using
conventional inch or metric indicia, but is preferably implemented
using a color-coded system, as further detailed in FIG. 13
below.
[0042] FIG. 9 (c) shows an alignment tape 48 that is employed to
locate three distances from the COR along the axial extent of the
cannon bone at which measurements of the width and length of the
cannon bone are made, as detailed below in connection with FIGS. 10
and 11. Tape 48 has an aperture 48a that in use is located over the
COR of the fetlock. Tape 48 has an adhesive backing for allowing it
to be conveniently secured to the cannon bone. A ring of hook and
loop fastening material, nonwoven fabric or the like is preferably
provided around the aperture 48a for attachment of the pastern tool
38, which is provided with a mating ring of mating material.
[0043] FIG. 9 (d) shows one of the adhesive markers 50 that are
used in determination of the COR, as described above.
[0044] Finally, FIG. 9 (e) shows a measurement card 37 which
provides printed spots which can be darkened with a pen or marker
to record the width measurements in a convenient, easy-to-use
manner, numbers that may be circled to identify the pin noted in
the depth measurement, a space for provision of horse
identification data, and the like. After the measurements are
recorded, card 37 may be sent to the proprietor of the orthosis for
selection of the correct model, or may be used as part of a
paper-based, online or electronic selection method.
[0045] The measurement process begins as illustrated by FIG. 10,
showing that the alignment tape 48 is secured to the cannon bone
such that marker D, locating the COR as discussed above, appears
within an aperture 48a in the alignment tape 48. The alignment tape
48 is also preprinted with markings 48b-d indicating predetermined
distances from the COR at which the measurements of the cannon
bone's width and depth are made; these are referred to as positions
1-3.
[0046] FIG. 11, including an enlarged version of the window 36 as
FIG. 11(a), illustrates the process of simultaneously measuring the
width and depth of the cannon bone. As discussed above, the cannon
tool 24 is brought into contact with the cannon bone such that beam
26 contacts the forward surface of the cannon bone at a
predetermined distance above the COR, as indicated by the alignment
tape 48; in the drawing, the cannon tool 24 is being used to take
measurements at position 1 on the alignment tape 48, as indicated
by marking 48b. The cannon tool 24 is held level, employing level
32 to confirm this, and square to the central axis of the horse.
The anvils 28 and 30 are brought into contact with medial and
lateral surfaces of the cannon bone, such that the distance between
the anvils is equal to the width X of the cannon bone at position
1. As noted above, this distance could be measured directly using
inch or metric markings, but is preferably simply recorded as a
color value.
[0047] More particularly, as illustrated in FIG. 9(a), the beam is
provided with three sets each of four colored areas, corresponding
to positions 1-3 on the alignment tape. These are indicated as
"colors #1-#4", as colors cannot be used in patent drawings; in the
preferred embodiment, these are four different colors. When a
measurement is made, the color under the line 36a in window 36
corresponding to the position at which the measurement is made is
noted, and the corresponding spot on the measurement card 37
darkened. In the example shown in FIG. 11(a), color #1 is under the
line 36a opposite the marking corresponding to position 1, and the
corresponding spot on the measurement card 37 in FIG. 9(e) has been
darkened.
[0048] At the same time, the spring-biased pins 34 are in contact
with the lateral outer surface of the cannon bone, and one of these
will protrude more than the others, corresponding to the depth of
the cannon, that is, its widest point. In FIG. 11, this is pin 3.
The corresponding pin number has been circled on the measurement
card 37. It will be appreciated that the pins 34 could be omitted,
and the sliding anvil 30 be provided with numbered markings
corresponding to the numbers of the pins shown, so that the depth
of the maximum width of the cannon bone could be identified by
noting the marking corresponding thereto, e.g., by eye or touch.
However, the pins 34 make this identification more positive.
[0049] It will be appreciated that the cannon tool 24 is thus
capable of making measurements in two dimensions simultaneously,
that is, the width X of the cannon bone and the depth Y at which
its maximum width is located.
[0050] The same procedure is then repeated at positions 2 and 3 as
defined by markings 48c and 48d on the alignment tape 48, and the
results recorded similarly on the measurement card 37.
[0051] As illustrated, the positions of the colors on the beam are
offset with respect to one another at positions 1, 2 and 3. This is
done corresponding to the variation in width of the cannon bone
with distance from the COR; the cannon bone narrows near its
midpoint as compared to its ends.
[0052] The cannon tool 24 is then used to measure the width of the
fetlock by placing the opposed anvils against the fetlock at the
height of the COR, as illustrated in FIG. 12, including an enlarged
view of the window 36 in FIG. 12 (a). In this case, the width is
measured by noting the position of line 36a to one of two colors,
#5 and #6, provided along the edges of the beam 26, as shown in
FIG. 9 (a). In the example of FIG. 12, the line 36a is disposed
over color #5, and the corresponding spot on the measurement card
of FIG. 9(e) has been darkened. This measurement is used to
determine whether the orthosis is to be wide or narrow.
[0053] The final step in taking the measurements is measurement of
the pastern circumference. This is done as illustrated in FIG. 13.
The pastern tool 38 described above is affixed to the alignment
strip 48 so that the aperture 42 in the pastern tool is disposed
over the COR; mating hook and loop fasteners or the like may be
provided thereon for convenience. The tongue 44 extends downwardly,
over the fetlock, defining the distance Z between the COR and the
point on the pastern at which the circumference is measured. The
ribbon 46 is pulled around the pastern snugly. Ribbon 46 is
provided with four colored sections, A-D, as indicated. That which
is located opposite a marker 50 (FIG. 9(b)) is taken as the
measurement, and is recorded on the measurement card 37. In the
example of FIG. 13, color B is thus chosen, and the corresponding
spot on measurement card 37 has been darkened.
[0054] The same process is then performed on the other leg, as the
orthoses are generally used in pairs. As noted, the cannon tool is
provided with measurement windows and colored patches on both
sides, so that the tool can simply be flipped over and used on the
opposite leg. As shown by FIG. 9 (e), the measurement card 37 is
provided with duplicate spots for entry of the same measurements
for both legs.
[0055] The measurement card 37 is then, for example, forwarded to
the provider of the orthoses, who chooses the appropriate orthoses
from the stock of models and provides these to the user, typically
a veterinarian. Other options include ordering the orthoses
employing a manual look up table, a phone app, or an online
selection webpage. As discussed above, where the width of the
cannon bone varies along its length, the maximal width is used to
select the correct orthosis.
[0056] The final step is fitting the orthosis to the individual. As
noted above, the measurement steps above are used to select the
closest-fitting orthoses from a considerable number of models. The
final fitting is performed by heating an inner layer 22 (FIG. 2) of
a thermoformable foam material, for example ethylene vinyl acetate
(EVA), of the proximal and distal cuffs, to the point that it can
be compressed around the cannon and pastern bones, and clamping the
orthosis on the fetlock in place using the straps 15 and 16. As the
EVA cools it takes the shape of the cannon and pastern bones,
ensuring a very good fit of the orthosis to the fetlock.
[0057] FIG. 14 shows a heating device 52 particularly adapted for
heating the orthosis as described above. Heating device 52
comprises a heating assembly 54 of a heating element and a fan,
providing a stream of hot air via ducting 56 to a perforated plenum
58 defining a number of outlet ducts 58', which provide a number of
air streams indicated by arrows in FIG. 14. In use, the orthosis 10
is placed over the plenum 58, so that the cannon cuff 12 is
confined between plenum 58 and a first platen 60, and the pastern
cuff 14 between plenum 58 and a second platen 62, defining
substantially closed cavities. The width of the plenum is selected
in correspondence with the space between the cannon and pastern
cuffs defined by the pivot structure. All of the various sizes of
the orthosis have the same longitudinal dimensions, so that the
same heater can be used to fit any size of orthosis. However, it
would be within the skill of the art to make the platens relatively
movable with respect to the plenum if it were desired to
accommodate orthoses of differing dimension or to change the degree
of sealing between the corresponding surfaces. Plenum 58, platens
60 and 62, and ducting 56 may all be molded of glass-fiber
reinforced nylon of the specification referred to in the art as
nylon 6, 6.
[0058] The hot air heats the EVA foam 22 to a desired temperature,
typically 250.degree. F., at which point the orthosis 10 can be
removed from the heating device 52 and promptly clamped around the
fetlock, as described above, so that the EVA layers 22 in the
proximal and distal cuffs conform to the shapes of the cannon and
pastern, respectively. The temperature of the surface of the EVA
layers 22, and/or the air temperature within the inner cavities may
be measured and used to control the operation of the heating
assembly, or a timer may be employed to ensure adequate
heating.
[0059] Geometric features, such as ribs 64, are shown on the inner
surface 62' of platen 62, juxtaposed to the pastern cuff 14. These
features, which if implemented as ribs 64, may be on the order of
1/8-1/4'' in height, space the end of the pastern cuff 14 from the
platen 62, providing a controlled exit for air flowing from plenum
58, that is, between the end of the generally cylindrical pastern
cuff 14 and platen 62. Similar geometric features (not shown) may
be provided for the same purpose on the surface (not shown) of
platen 60 juxtaposed to the cannon cuff 10, and on the surface (not
shown) of plenum 58 juxtaposed to the pastern cuff of the orthosis
10. However, in a preferred embodiment, no such features are
provided on the surface 58'' of the plenum 58 juxtaposed to the
cannon cuff 12. Thus, in this embodiment the surface 58'' of the
plenum 58 is relatively sealed to the cannon cuff 12, while the
surface of the cannon cuff juxtaposed to the platen 60 is spaced
therefrom by ribs 64, and the surfaces of plenum 58 and platen 62
are both spaced from the pastern cuff 14, providing controlled
leakage of hot air flowing from plenum 58. In general, all of the
surfaces that are juxtaposed to the orthosis during the heating
step may or may not have geometric features as needed to govern the
flow of air in order to produce relatively uniform heating. The
contoured shapes of the plenum and platen surfaces relative to the
mating contours at the ends of the padding also control the amount
of air leakage. In order to limit the escape of hot air from the
openings at the rear of the cuffs that are necessary to allow the
orthosis to slip over the fetlock, these openings may be closed
during heating using the straps and overwrapped with Velcro
closures. However, the hot air flows at sufficiently high velocity
from ducts 58' that most of the flow is in the vicinity of the
inner surface of the cuffs, providing efficient heating.
[0060] Noting that the interior volume of the cannon cuff 12 is
substantially greater than that of the pastern cuff 14, due to
their differing axial lengths, the differing degrees of sealing
thus provided, together with the detailed design of ducts 58' in
plenum 58, are cooperatively selected so as to control the flow of
air from plenum 58 via ducts 58' so that the flow of air from
heating assembly 54 substantially uniformly heats the interior
surfaces of thermoformable foam layers 22 of the cannon and pastern
cuffs, so that when the orthosis is subsequently clamped over the
fetlock the thermoformable members 22 thereof are substantially
uniformly formable over the respective leg geometry.
[0061] It will be appreciated that by fitting closely over the
heating device 52, with the cannon and pastern cuffs in
substantially sealed relation with plenum 58 and platens 60 and 62,
the orthosis 10 essentially provides two substantially closed
volumes over the plenum 58, one each within the volume defined by
the cannon and pastern cuffs. In this way, the hot air heats only
the interior EVA surface of the cannon and pastern cuffs. By
comparison, if the orthosis were to be heated, for example, in an
oven, it would be heated throughout, including its exterior
surface, which would be inconvenient for handling, and would
require a great deal of additional energy. Similarly, heating the
orthosis by supplying hot air to one end would not promote uniform
heating of the inner surface.
[0062] While a preferred embodiment of the invention has been
described in detail, further improvements and modifications will
occur to those of skill in the art, and these are within the scope
of the invention where not excluded by the following claims.
* * * * *