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.

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.

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.