U.S. patent number 3,814,088 [Application Number 05/217,217] was granted by the patent office on 1974-06-04 for orthopedic boot.
Invention is credited to Edward A. Raymond.
United States Patent |
3,814,088 |
Raymond |
June 4, 1974 |
ORTHOPEDIC BOOT
Abstract
A snugly fitting orthopedic boot having a rigid sole wherein the
sole plate is part of a unitary frame along with side splints for
the leg extending upwardly from the sole plate. The junction of
each side splint with the sole plate is sufficiently long to render
the side splints substantially inflexible in the longitudinal
direction of the sole plate, and the entire frame is encased in a
generally conventional leather boot structure which is preferably
provided with an open toe construction and lacing means extending
from toe to top of the boot to provide a very snug fit. When the
boot is properly laced, the internal frame is rigid enough to
immobilize the foot and permit walking and bearing weight on an
injured foot or ankle without any significant articulating motion
of any joint of the foot or ankle.
Inventors: |
Raymond; Edward A. (Hartsdale,
NY) |
Family
ID: |
22810138 |
Appl.
No.: |
05/217,217 |
Filed: |
January 12, 1972 |
Current U.S.
Class: |
602/27 |
Current CPC
Class: |
A61F
5/0111 (20130101); A43B 7/00 (20130101) |
Current International
Class: |
A43B
7/00 (20060101); A61F 5/01 (20060101); A61f
005/04 () |
Field of
Search: |
;128/89,87,80,84
;36/2.5F,2.5N,2.5G,2.5R,33,68 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Yasko; J.
Claims
I claim:
1. An orthopedic boot of the ambulatory type to permit walking
without any substantial articulating motion of any joints of the
foot comprising a rigid sole structure, a boot upper section
assembly of substantially knee length secured to said sole
structure, means associated with said upper section assembly for
adjusting the boot to the leg of a wearer, and a unitary frame
member positioned to said sole structure and said upper section,
said frame member including a rigid sole plate secured to and
extending for substantially the entire length of said sole
structure, and a rigid side splint secured to and extending
upwardly from each side edge of said sole plate, the jointure line
of each of said side splints to said sole plate extending for a
longitudinal length of at least about 75 percent of the length of
said sole structure, each of said side splints being encased in
said upper section assembly and extending upwardly to substantially
the top of the upper section assembly, and at least a substantial
portion of the upper section of said side splints being curved to
generally fit the contours of the leg of the wearer.
2. A boot according to claim 1 in which said means for adjusting
said boot comprises lacing means extending from substantially the
toe of said boot to the top thereof.
3. A boot according to claim 1 in which an arch support is located
on the inner sole of the wearer to adjust the boot to the foot of
the wearer.
4. A boot according to claim 1 in which said unitary frame member
includes an undivided counter surrounding the heel of the boot and
is affixed to said plate, and to the rear edges of said side
splints of said frame member extending upwardly from said counter.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention is concerned with an orthopedic device for
immobilizing the skeletal joints of the human foot and thereby
permit a patient convalescing from a foot or ankle injury to walk
without any danger of further injury to the foot or of hindering
its healing.
2. Prior Art
A number of devices have been proposed for enabling a person with
an injured foot or leg to walk during the period of convalescence
by securing one or more joints of the injured member against any
motion of the bones relative to one another. Walking leg casts are
being used to a considerable extent for the purpose. These are
typically plaster casts completely surrounding the lower leg, and
often practically the entire leg; and they usually have a rubber
heel or sometimes a metal stirrup extending from the lower
extremity of the plaster for contact with the ground and
supporting, in conjunction with the entire cast, the weight of the
patient while walking. Although these casts provide excellent
protection for the wearer, they are not only very conspicuous but
also cumbersome by reason of their size and weight; moreover they
are often rather uncomfortable.
Some of the proposals for improving the comfort or ease of walking
of a patient in a leg cast did not eliminate the plaster cast with
its bulk and weight but merely added attachments to the cast as
exemplified by U.S. Pat. Nos. 2,278,626 and 3,085,569. Other
devices provided adjustable leg splints in the form of rods or bars
which were adjustable to hip length as illustrated by U.S. Pat.
Nos. 874,446 and 1,226,013. These devices seem to have been
intended chiefly or wholly for use in cases of leg or knee injuries
rather than an injured foot, because there do not appear to have
been any specific provisions for immobilizing the joints of the
foot, particularly the ankle joint, of an ambulatory patient.
Moreover, the long narrow rods, tubes and slotted bars employed as
side splints may be expected to provide rather low resistance to
flexure in the longitudinal direction of the foot, and consequently
relatively little protection of the ankle, etc. joints, for the
amount of weight involved in such apparatus. There was no
disclosure of any convenient means for attaching the splints along
the leg of the wearer, for Pat. No. 1,226,013 describes a
cumbersome, and doubtless rather uncomfortable, array of many
overlapping bands and straps for such purposes as exerting traction
on the injured limb and of keeping weight off of the injured member
while walking.
SUMMARY OF THE INVENTION
The present invention relates to an orthopedic boot which
effectually immobilizes all skeletal joints of an injured foot or
ankle and permits the patient to walk and bear weight on the leg,
ankle and foot which carry the patient's weight without pain and
without further injury. The novel combination of features involves
a rigid sole which includes a sole plate that constitutes part of a
unitary frame that is provided with a stiff splint extending
upwardly from each side of the sole plate, a boot upper section
affixed to both the sole and splints, said side splints being
substantially inflexible in the longitudinal direction of the foot
or sole and means for fitting and fastening the boot to the
wearer's leg.
Still other aspects of the invention relate to one or more of such
features as the side splints shaped to at least approximately fit
the leg of the wearer and also to increase the rigidity of said
frame; an internal frame wherein the side splints are integral with
the sole plate; a frame wherein the length of the junction between
each side splint and the sole plate is more than about 20 percent
(and preferably over 50 percent) of the length of the sole; lacing
means extending from the toe of the boot to its top for insuring a
snug fit that will prevent motion of the joints; boots of the
below-the-knee-type; the inclusion of arch supports for adjusting
or improving the fit; side splints which preferably extend upward
substantially the entire height of the boot, and another element
for enhancing the rigidity of the internal frame in the form of a
U-shaped counter surrounding the heel and affixed both to the sole
plate and the side splints.
DESCRIPTION OF THE DRAWINGS
In the accompanying drawings:
FIG. 1 is a front elevation of one embodiment of an orthopedic boot
according to the present invention shown on the leg of the
wearer;
FIG. 2 is a corresponding side elevation;
FIG. 3 is a vertical sectional view of another embodiment of the
boot taken on a plane corresponding to the line 3--3 of FIG. 2;
FIG. 4 is a fragmentary horizontal section of the side of the boot
taken on the line 4--4 of FIG. 3; and
FIG. 5 is a fragmentary vertical section of the lower part of the
boot taken on the plane of the line 5--5 of FIG. 3.
DESCRIPTION OF SPECIFIC EMBODIMENTS
Turning now to FIG. 1, a boot of the open toe variety is shown with
a composite sole 10 which is described hereinafter, an upper or leg
covering section 11 and a lace 12 which is threaded through a
series of eyelets 13 which extend from the open toe to the top of
the boot. Other means may be employed for fitting or adjusting the
boot to the leg of the wearer as may be exemplified by substituting
conventional hooks for some or all the eyelets 13 in order that one
may either lace up or remove the boot quicker, or using straps and
buckles, snap hooks or zippers; but lacing is generally preferable
in providing a snugger fit. Moreover, pads of cotton fiber, foam
rubber, various synthetic resin foams of the flexible type, felt or
cotton batting may be used to adjust the boot to the leg and foot
of the wearer. In the case of a universal or "one size" boot,
padding in that manner can greatly assist fitting the boot on
various patients having different foot and leg sizes. Such padding
may also ease the discomfort of a sore or tender foot or leg.
The toe of the boot may be of the closed type, particularly where
the boot is likely to be worn out of doors during inclement
weather. However, in many cases, the open toe boot with the full
length lacing of FIG. 1 is preferred in order to provide a better
fit than is obtainable with a closed toe boot, especially in the
case of a universal boot. It is often important to obtain the
closest possible fit of the boot to the contours of the leg and
foot of the patient in order to prevent any articulating motion
within the various joints of the wearer.
The fit of the boot may also be improved in some instances by
installing an arch insert 14 within the boot in the approximate
location shown in dotted lines in FIG. 2. Such an arch insert may
vary in size and location according to the patient's requirements,
and it may be secured in the proper location on the inner sole of
the boot by means of a temporary adhesive of the pressure sensitive
type which retains its tackiness in order to facilitate removal of
the arch support in fitting the boot to another patient.
Another method of fitting a universal size boot to feet or legs of
different proportions involves the use of a double-walled sock or
sleeve of rubber or other suitable elastomer which may be inflated
by a suitable fluid under pressure, such as compressed air, to fill
the space between the leg and foot of the wearer and interior of
the boot. Such a sock may be divided into a plurality of separate
compartments which are inflated separately. When an inflated sock
is employed it is generally advisable for the patient to wear a
sock of absorbent material to avoid discomfort from
perspiration.
The foot and ankle joints are immobilized while walking in this
boot by means of a unitary frame which is composed of three parts
or sections in the form of a sole plate 15 and two upwardly
extending side splints 16 which are affixed to both plate 15 and
the leg section 11 of the boot as described hereinafter. Although
this frame may be made of relatively thin material, for instance,
1/32 inch or even somewhat thinner sheet metal in some cases, it
produces surprising rigidity in a well laced boot by reason of its
disposition and configuration within the boot structure. It will be
observed in FIGS. 2 and 5 that the sole plate 15 extends for
substantially the full length of the sole structure 10, that
splints 16 desirably extend to the top of the boot, and that the
junctions 17 of the lower ends of side splints 16 with plate 15
extend over a substantial proportion of the length of the sole,
desirably from the heel to about the ball of the foot as in FIG. 2.
This structural combination of long junctions 17 between long
splints and a long sole plate provides for a very high degree of
resistance against flexing of the boot and the enclosed joints in a
vertical plane oriented with the length of the foot, that is, in
the longitudinal direction of the sole plate. That also is the
important direction for immobilizing the skeletal joints involved
because most of the normal articulating motion in the ankle and
other joints of the foot takes place in a vertical plane disposed
along the length of the foot.
In resisting such longitudinal flexural stresses, suitable lengths
for the junctions 17 may be based upon the length of the sole of
the boot, for greater rigidity is required in an orthopedic boot
having a 15-inch long sole and worn by a man weighing 200 pounds
than in a 7-inch boot on a small child. Usually, the length of each
junction or crease 17 exceeds about 20 percent of the length of the
boot sole, but a length of at least about 50 percent on that basis
and a minimum of about 2 inches is preferable for most of such
protective boots, and junction lengths above about 75 percent of
the sole length are better still; long junctions are particularly
preferred. The rigidity of the boot structure is also improved by
relatively long side splints 16, and these desirably extend for at
least 40 percent of the distance above the ankle joint toward the
knee joint, and preferably to the top of the boot. Moreover, the
structural rigidity imparted by the internal frame member may be
increased by the additional rigidity imparted by forming the side
splints 16 into curves which approximate the contours (see FIG. 4)
of the wearer's leg.
Boots of this invention are somewhat less rigid in the transverse
direction, that is in a plane perpendicular to the longitudinal
direction of the sole, than they are in the longitudinal direction;
but walking does not impose stresses in the transverse direction as
large as those encountered in the longitudinal direction. Also, a
small or moderate amount of flexibility in the transverse direction
prior to lacing the boot is helpful in enabling the side splints to
fit closely to the contours of the wearer's leg as the boot is
being laced. In addition, the embodiment of the boot with a rigid
heel counter as illustrated in FIG. 3 and described hereinafter
affords greater protection against transverse flexure.
Upon referring to FIG. 3, it will be observed that the side splints
16 are desirably encased in the sides of the boot uppers between
the exterior layer 18 of leather or other flexible boot material
and the lining 19 of the boot, since it is generally preferable to
keep the material of the stiff side splints out of contact with the
leg of the wearer. The boot exterior 18 is desirably made of a
relatively stiff leather or leather substitute, such as various
synthetic resin materials, including poromeric materials, and
optionally reinforced with textile or glass fibers; such material
should be sufficiently flexible or contoured to provide a good fit
when properly laced. Also, one may use a relatively limp leg
covering material, such as the rubber or rubberized cloth uppers of
galoshes, particularly when relatively stiff side splints are
used.
The inner lining 19 is generally a relatively flexible and limp
material, and it may be fabricated from leather of one of the
aforesaid substitutes in a conventional manner. The lining 19 may
also be fabricated from a flexible plastic foam or foam rubber when
the limb of the wearer is still sore or tender as the result of
injury.
The side splints 16 are affixed to the upper or leg covering
portions of the boot in order to provide the rigidity in the
internal unitary frame that immobilizes the ankle foot joints, and
this involved firmly securing those splints, and particularly their
upper ends, to the side walls of the leg of the boot. This may be
accomplished by cementing the side splints to either of the outer
leather layer 18 or the liner 19 or both using a conventional
synthetic resin adhesive; also the side splints may be attached to
the boot wall by a series of rivets commencing near the top of the
splints and continuing downwards, preferably at relative closely
spaced intervals of about 1 inch or less, or both rivets and
adhesive may be employed as an extra precaution.
In the embodiment of FIGS. 1, and 2, the internal supporting frame
consists of a flat sole plate 15 and two sides splints 16 which
extend upwardly from each side of the sole plate, and these side
splints are not joined in the back of the heel. Although it is
possible to employ flat side splints with appropriate padding
inside the boot, it is preferable to use splints that are curved in
both horizontal cross section as shown in FIG. 4 and in vertical
cross section in order to provide better fitting of the boot as
well as the improved rigidity mentioned earlier.
Another embodiment of the invention is illustrated in FIG. 3,
wherein a stiff and solid counter 20, which is U-shaped in
horizontal cross section, extends completely around the heel of the
boot instead of being split at the rear in the usual fashion. This
heel counter extends above the inner sole 21 for a short distance,
as for instance about 1.5 to 4 or more inches; above that point the
rear edges of the two splints 16 project separately upward on each
side of the boot from the counter 20. This counter is unitary, and
preferably formed integrally, with the other frame members, namely
splints 16 and sole plate 15. The fabrication of an internal
supporting frame of this type is somewhat more complicated, but it
has the desired effect of providing an even more rigid boot
structure for protecting the foot against any flexing in the
longitudinal and transverse directions relative to the sole; and
the improvement is particularly marked in respect to the latter,
for instance, in protecting against both inversion and eversion of
the ankle joint.
The internal frame structure may be constructed of a variety of
materials and it may be fabricated by a number of different
methods. The finished frame with its upstanding side splints should
be as rigid as possible, for only a minor degree of transverse
flexure is necessary in the said splints in fitting the boot, as by
lacing. On the other hand, thinness and lightness of the frame are
desirable in promoting the comfort and convenience of the wearer. A
good balance between these somewhat contradictory qualities can be
obtained by a suitable choice of materials and construction of the
frame. The configuration of the frame member also plays a very
important part in obtaining desired rigidity.
The material of the frame members 15, 16, and 20 should be as stiff
as possible; but it is often desirable, as in the case of sheet
metals, to use material which may be bent into curves to fit the
leg or creased at right angles as in the junction of the sole plate
and said splints. In other cases, it is possible to use materials
which cannot be creased or even bent but which may be shaped by
casting or various types of molding. Among the many materials which
may be employed are sheet metals, as exemplified by ordinary and
stainless steels and especially the light metals, such as
magnesium, titanium and aluminum or their alloys, preferably metals
of relatively stiff characteristics. Sheet metal may be cut and
shaped with the conventional tools, and other metals may be formed
into the final shape of the entire frame or any of its several
parts by forging by hand or machine, or by casting in the case of
the light metals.
Other suitable materials include, flat and molded plywood, and a
great variety of plastic materials containing the usual fillers and
reinforcing agents and especially the laminates of paper, synthetic
and natural fabrics including cotton, nylon and hemp, etc. and
glass fibers in woven or mat form impregnated with any of a variety
of resins that produce a stiff product, including, inter alia,
unsaturated polyester, melamine-formaldehyde, urea-formaldehyde,
phenol-formaldehyde, epoxy, polystyrene and other rigid
thermoplastic resins. According to known properties of the resin,
the selected resin in either the filled or unfilled state, with or
without fiber reinforcement, may be formed at an appropriate room
or elevated temperature by known methods, including casting, hand
lay-up, vacuum forming or matched die molding techniques.
To provide the necessary structural rigidity, the internal frame
member is a unitary structure comprising sole plate 15 and side
splints 16 (and optionally counter 20), and it is preferably, but
not necessarily, an integral structure with the splints and sole
plate being constructed from a single piece of material. There are
advantages, particularly in obtaining maximum rigidity for any
given weight, in providing an integral frame; and that may be
accomplished by either forming the frame from sheet metal by die
cutting and stamping operations, bending side pieces (splints)
upwards at right angles from a central section (sole plate), or one
may mold the entire frame by hand lay-up laminating of glass cloth
or mat with an epoxy or a styrenated polyester resin at room
temperature on a very simple, or even crude, mold or form. However,
it is only necessary that the frame members be securely affixed to
one another in order to procure the necessary rigidity. Thus, one
can form metal side splints into the desired contours and then weld
or rivet those splints to a sole plate of the same or a different
metal which may have upturned flanges at the side to facilitate
joining the three pieces. Similarly, one may join laminated plastic
splints to a flat wooden sole plate by means of wood screws,
desirably in conjunction with a suitable synthetic resin
adhesive.
The sole plate 15 may constitute the entire sole of the boot, but
it is generally preferable for maximum comfort to employ a
composite sole structure 10 wherein this plate is securely attached
to one or more layers of other materials which may include an inner
sole of leather or the like and an outer sole of rubber or leather
or equivalent material. Also, the sole plate may be attached to
another layer of stiffening material (e.g., cemented to a layer of
plywood or a plastic laminate) in the sole of a boot that has a
relatively thin sheet metal sole plate. In any event, the sole
plate member 15 of the unitary frame is all or part of the sole
structure, and it contributes stiffness to that structure.
A composite sole 10 of the wedge type inclined downwardly towards
the front is depicted in FIG. 5 with a sole plate 15 molded or
laminated in the interior thereof. This multilayer sole structure
is made up of an outer sole 22 of leather, a sole plate 15 which is
part of the protective frame of this invention, a cushioning layer
of fairly firm sponge rubber or foamed plastic 23 and a leather or
cloth inner sole 21.
Although the boots of this invention may also be made in full thigh
length with the side splints and laced leg of the boot extending
almost to the hip for the purpose of immobilizing the knee joint as
well as the lower joints, it is believed that the major utility of
the present invention is concerned with below-the-knee boots that
are designed to immobilize foot and ankle joints.
From the foregoing description, it is apparent that the boots of
this invention may be relatively inconspicuous, especially when
most of the boot is covered by a leg of a pair of trousers or
slacks; more importantly these boots are of moderate size and
relatively light weight while still providing a surprising degree
of structural rigidity that immobilizes all the joints of the foot
and ankle against articulating motion within the joint while the
patient is walking.
While the present articles have been described in considerable
detail in respect of a few embodiments of this invention for the
purpose of providing a complete and detailed disclosure, it will be
apparent to those skilled in the art that these articles may be
modified in many ways within the purview of this invention.
Accordingly this invention should not be construed as limited in
any particulars except as may be set forth in the appended claims
or required by the prior art.
* * * * *