.. 1 , Th~ pr~sent lnv~ntlon rel~tos to ~rthotlcs and ln p~rtlcul~r, to S orthotlcs ~h1ch accommod~ta ~nd/or support n~t only ~he re~r ~nd mldtoot but ~lso the Porefe~t ln t~lr ~unctlon~l planes durlng ~1t.
BAC~IJI~D_~ ;
Orthot1cs ~r~ usod t~ ~1o-mach~nlca11y control the lnt1vldu~1's teet durlng ~a1t.
Orthotlcs adJust the osssous allgnm~nt and allo~ tht ~t to ~dapt;to An~ ~unct10n on the ground ~1th 1ncre~s~d ~trlc1~ncy. ~ :
The foot fun~t~n~ mo~ e~flcl0ntly ~f 1t c~n ~uplnott An4 pronat~
~round lts Sub ralar Jolnt'~ n~tral posltlon. ~Sub Tal~r Jolnt's nautr~
ls where tho Jo~nt 1s ne1ther ~upln~t~d nor pronat~d).
16 Thr ~normal" ~cot 1~ sllghtlY suplnated ~po1ntlng ~nwardly) ~s 1t swlngs throush the alr durlng ~lt and on he~l ~trlkc moves through the S7 neutral pos1t10n to ~ pronat~ pos~tton tpo~ntln~ out~rdly) wlthln a s~e~nd. ; , ~:
The ~oot returns to 1ts STJ nautral pDsltlon Just be-or- hn~ t;.
the forefoo~ 1~c~sases lts welght bearlng and b~lns to l~tk a~lnst the re~rfoot to form ~ rlgld lev~r. : .
onc~ th~ h~1 llfts, th~ ~scl~s lnvcr thc ~ody over thls loc~d , :
levcr~ge ~c~h~nlc~ ~propulslon) to repe~t the process on th~ othvr ~oot. ~:
Varlat10n~ ln oss-ous rQlatl~nshlp~ m~ pl~ee any p~rt ~1.-. :
2S c~lcaneus, ~et-t~rs~l hends? Or the ~oot vhlch ccntacts the welght bearln~
~ur~ce, ln a pl~nc ~th~r than the we1~ht bear1n~ surrac~, durlng the STJ' -~
neutral posltlon. :
Th~e ~ nctl~n~l pldnrs~ ~ay be mcasured by pl~c1n~ th~ fo~t 1n lt~
STJ n~utr~l poslt~on and c~mp~r1ng tho orefoot to thc r~ar~oot pocltl~n, :~ 30 or th~ ~hole foot to the le~
A ~ore~oot whlch 1s cverted to thc ~e~ght-bo~r~ng sur~ac~ ~hll~ th~:
ST~ ls neutr~l wlll l~ck ~g~lnst the re~rtoot earl~cr ln thc g~t cycle;
~hile the 1nverte~ f~rtfoot ~t STJ neutral wlll rnt~rd the lock1n~
~rcchan~s~ 1m~ng orl S~nc~l lt~ ~or~At~on cc~ t~ly.
Varl~tlon eO thl~ th~c m~ oceur lf on- or ~nore ~tAtArsel head~
unct10n ln d1ttcr~ "Funct1~n~1 plan~s" to c~ch other.
Inc~rlclency ln tl-~ lock1n~ ~ech~nlsm durln~ propulslon rtsult~ ln ~ nor~al ~otlon, su~lux~on or d~ catloll ot tha tcot'~ ~olnt ~Orp~-Nn~, ; ~
.
Z0038~3i Z
~t~te ~f tlle Art othot~s ar~ malnl~ o t~D ba~lc deslgn~: ¦
l. A h~rd shell ~ ch termln~te~ p~st~rlorly to th~ ~tat~rsal h~ads ~nd, therefore do~s not support th~ 1n thelr ~uncttonAl pl~n~"
a~t~r ~hecl llft".
2. h s~ft ~l~xlblr ~rth~t1c ~h1ch ag~ln do~t not ~UPport thr mct~tar~l he~ds in th~lr ~func~1~nal pl~nc' a~t~r "hee~ llft~ .
Th~ proposed orthotlc w~ll r,ot only c~ntrol th~ rQar, ~Id ana forefoht betore ~he~l llft~ but al~o ~rt~r ~hoe1 lltt~ b~ acco~datlng or suppor~ln~ the~ ln thelr "Functlonal" p~an~s. I
For~Atlon o~ thc locklng r~chanls~ can thus b~ controll-d to proYlOo ~ppr~prl~te functlonal effltl~ncy o~ th~ foot durln6 ~alt.
q~JE~T QF THE IN
~t ~ an ob~ect ot ths prc~snt lnventlon to pro~ld~ an orthot1c ~h~Ch :~
eontretls the re~r, ~ld ~nd tor~foot before heel lt~t b~t ~lso att~r hu~
llft by acco~odatlng and supportln~ them ln thelr funct10n~ Plnno~.
It 15 ~ an ob~ct ~ th~ pre~nt 1n~/ent10n to pro~d~ a ~thod o ' :
m~nufacturln~ ~n orthotlc ~hlch has the abovem~ntloneJ advantag~
2~ QS~RE OF THE INYE~TION
~ccordlng to ona ~spcct or ths pr-s~nt 1n~8ntlon th~re 15 d1sclosod a ~ethod of manuf~tture o an orthotlc, co~pr~ln9 the step~ ~ na~1n~ n po~ltlv~ plast~r C~st of a rOot ~hll~ th~ ~ub-tal~r Jolnt ts ln neut~Al and ~th the forefoot fully pronated about both thn ~J tars~l 301nt Z5 longltudtn~l and obllque ~s, ~odlfyln~ 5~1d pla~ter c~st ccordln~ to ~
roqulred sh~P-, lns~rt1ng s~ld plAster CAst ln A nould~ng ~uns ~h~reby thQ
~lane o- lts pl~nAr surf~c~ corresponds to tht varus or v~lgus d~for~lty Of the toot, ~h~reln ~ pl~stlcs ~1~turr ls poureO ~nto salC ~wuld and ~lowed to cure ~ccordlng to the propert1~s ~t the pl~stlcs ~1xture.
` 30 A~cordlng to anDther ~spect of th- presont ~nventlon th-r- 1S
dlsclo~od an orthotlc ~nufactur~d uslng thQ abovrn~nt10ned ~4thot.
~.E.QEs~ .
F~g. 1 ~s a sche~at1c sup~r~or ~ Of ~ ~oot lllustr~tSn~ the , 5k~l~tdl arrAngement,, , :~
~19, 2ISs a re~lil v1e~ o~ the skelet~l arran~ament of ~19. 1~
Flg. 3 ls ~ rrar vSe~ o~ ~ pa1r ot t~et 111ustr~tln9 the supln~ted And pronat~d posltlons ot the t~t dur1n~ ~lt. .
~' : .,";,.'', ::
,. :.~
,-~''''~
~ '~ '" ' '' ~01)38~31.
- !
~1g. ~I ls a re~r vlo~ on~ ~ront vlow Or dl~ftr~nt unctlon~ a~ple$
of fe~t whllst thc s~Jb-t~ r Jo1nt 1~ ln the nautral p~s1t10n.
f1~. 5 ts ~ sch~atlc d1a~ra~ ~f a oretwt ~n a po~t to be c~nsld~red In th~ wor~1ngs ol~ th~ present 1nv~nt10n, F~g. 6 ls ~ schemAt1c ~1de v~ Or an orthotlc us1ng pr~or art technology, Flg, 7 1~ A schemAtlc s1de V1Qw of an orthotle us1no dl~r~nt pr10r , - -0 ort tochnol~gy, rl~ 8 ~s ~ schem~tlc slde v1~w of ~n orthotlc of one ~bodlm~nt o~
th~ pre~ent lnv~nt10n, Fl~. 9 15 ~ schemat1c sldQ v1~ of ~n ~rtl-otlc o~` ~noth~r mb~ nt, f1g. I~ ls ~ ro~r v1e~ or ~n orthotlc of anothtr R~bcdlmunt, ~1g. 11 ls ~ rear vlew o~ an orth~t1c Or ~ turthrr e~bod1~ent.
Flg. 12 ls A ~ch~mat1c ~lde v1s~ ot an orthotlc o~ a turthvr e~bod~m~nt, Fl~. 13 ts ~ schom~t~c slde vlaw of a ~oot model ~nd a c~t~ng llnlng us~d to ~n~f~cturt ~n orthot~c o~ She pref~nr~d ~mbcdlncnt, t1g. l~ St ~ porspectlve vlew or ~ castlng mould ~1th east~d foot nodel, ~lfl~ t n~d~1 ~nd c~t-d orthotlc, Flg. 15 1s an 1nvers~ pl~n v~w o~ on orthot1c cast u~llng ~thods o-th- ~ref~rret e~botlntents~ and ls a l~tar~l v~c~ the orth~tlc ~t Flg. 15 sl~ln~ v~ru~
~5 fore~CoDt 5UpPort.
Tho dr~lngs, ~lgs. l to 7 h~lp 111ustrat~ th~ pr10r ut. tlgs.-l and 2 111ustrat~ the compon~nts of a fDot ~h11e Flg. 3 111ustrates ~ root ~ ln ~ s~ln~ted and pronated c~nd1tlon. ~h~ toot 1 ls baslc~lly ~-p~rate~
: 30 lnto thre- p~rt~, n~mel~ th~ re~; toot 1~, th~ ~ld-oot 17 and tor~foo~ 18.
~: Th~ r~r foot 16 1nc1udQs th~ ~lc~neus 7 ~nd t~lus ~ ~hleh U t ~o1ne~ ~y th~ sub-talar.~olnt 10 rhe ~d~oot 1~ lnc1ud~ thr mld-t~rs~l ~o1nt 11 and the ~otetoot 18 1ncludes thn ræt~tarsal shaft 9, the m~t~tars~t hcads 3 ~nd thejh~llux 12. As tu~n ln rl9. l, the rOOt h~s a medlal column 5 and a 3S later~t colu~n ~.
F1g. 4 ~lustr~t~ exAmpl~s o~ thu tJnct1onal plAnes ~hllst th~
sUb-tarl~r ~olnt 10 1s ln th~ ncutr~l pos1tlon Flg. 4~ lllu~tr~t~s ~n lnv~rt~d ~v~rus~ (uncllon~l pl~n~ on th~ ~or~t'oot l~ wl~ t Plg. 4~b) ~ho~s - . :
. ~ . .
- ' , ' .
.
-; . , , .: .
~ .
~ 200381~1.
an ~nverted (v~rUs) fu~ctlonsl pl~n~ o~ th~ rc~rtoot 1~, ~lo. 4tc) sho~s an ln~erted fun~tl~n~l plano ~ th~ medlal tolu~n ~hllst ~l~. q~o) sho~ an everted ~vAl~us) ~unctl~n~l plane ot ~ha re~rtoot 16.
Illustr~ted ln F1g5. 5 And 6 1s ~ sthematlc dt~gr~ ot a toot u-1ng ~n orthottc. Tn Fly. 5, 5 m~t~tArso ph~lan~al ~olnts 3 restlng on ~ post 4 ls lllustrat~d. The post 4 ls ~ny bulk m~ter1~1 that "ln thls ca~
sllow th~ ~ore~oot to functlon ln ~ pl~ne determlned by ltY vdrus defor~lty. Tho vlew ls ~ front vte~ sh~ln~ th~ m~dlal sld~ 5 ~nd a l~terlal slde 6.
Th~ orthotlc 15 ~hlch ls lllustrated ln flg. 6 ls shown wlth ~ oot rest1nq th~r~on. The varlous p~rts o~ th~ root re ~llu~trAted sho~1ng th- irear ~oot 16, the mld foot 17 and part o~ th~ orofoot lB bo1n~ support~d by th~ orthotlc 15 ln m1d~t~nce.
Thls orthot1c lS ls dQslgned to post a Y~rus de~r~ty ot th~
f~retoot la.
It ls seen that the calcan~s ~, ths ~ld ~oot 17 ~nd the ~etltarsal sh~ft 9 are supported by th~ orthot1c 1; ~h11e 'che flrst ~etat~r~al ph~l~ng~ olnt 3 and th~ ~reat toe. or tallux 12, are susp~ndQd~
~hen on hocl ltft, th~ c~lc~ne~s 7 lea~e~ th- gr~und, the bod~ ~c1g~t ls transf~r~d ~orward along thc o~tat~r~al ~h~ft 9, ~nd ~orccs th~
~tatars~l phalangeal heads 3 to descent h conta~t A st~ble surface ~t.g.
the surtace ol' th~ lnnrr sole~.
2S Flg~ 6 ~ tr~tes ~ kno~n ortl~t1t 15 whereby ~ har~ shotl t-rmlnates pos h rlor11y to met~t~r~al heDds 3 and, th~r~-~t~ does not : support thtr 1n thelr "functlon~l plane~ a t-r. ~hrel llft". Illustrat~d ln Flg. 7 lt a soft rl~xlble orthotle l~ or th~ prlor ~rt ~h1ch ~ln de~- not support the met~tarsal h~ads 3 ln th~lr "functlon~l pl~n~ tt~r "hcel l~t". ' ~
The orthot~c 13 the pr~s~nt ~nv~ntlon lllustr~t~d 1n F1g. 8 not onty controls th- r~ar foot 16, th~ ~ldfoot 17 and the ~ore~oot 1~ be~ors "hn 1 ~-: llPt", but ~lso ~ter ~heel l~ft~ by ~ccolmod~t1n~ or ~upport1n~ thrm ln t~ir functlonAl plan~s. The ~ormatlon o~ the lock1n~ ~e~hanls~ o~ th~
35 g~lt cdn thus be controll-d to prov1d~ ~ppropriat~ ~unctlon~t e-t1elenc~ of ¦
the ~oot dur~n~ ~alt. I .
Tho orth~tlcs 13 ~re manufa~tu~d of any ~aterl~t ~ble to provld~
approprl~h support ard ~llo~ th~ ~oot ~o ~ov~ as re~ulred. For c~a~lc, ~ .. j . ...
20038~1.
therm~sets or thermoplastlcs wlth or ~Ithout ~lcro-ball~ors or ~ny other synthet~c ~nd~r n~t~r~1 flll~rs.
s lllustrat~d ln Fl~. 9 1~ anoth~r ~mbodlm~nt o~ th~ orthotlc 21 o~ the prese~t lnv~ntlon lllustrated wlth ~ synth~tlc lllcr ~Z wlth t~o ~ctlon~
of corks/rubber co~pound 23 wlth ~ le~tll~r shel1 24 surround1ng th~
ortho~c.
In ~nother ~mbod~ment 111us~rited ln ~l~s. 12 an orthotlc 25 hes lo l~rs and~or sectlons 26 of raterl~ls ~ndtor tlbr~s of propertles appr~p~1ate to th~ treated ~r~s Bre ~ttached or hlng~d to ~ch other ~ndlor ~ttathed or contalnYd by an outer cover 2~. The v~rl~s p~rt~ Z9 or ~n orthotlc 28 111u~tr~ted 1n flgs. 10 ~nd ll c~n have thelr dens1ty redu~ed by usl~ olth~r a so~ter ~ator~al ln p~rts of th~ orthot1c Z8 ~r rQmov'ng th~ support as lllustr~ted ln Flg. ~1.
Ont ~ttho~ of constructlng ~n orthot~c of th~ pref~rr~d Iwbodlm~nt 1ncl~d~5 the s~ps of pl~lng ~ specl~l sllpp~r ovor each ~oot o the p~tl~nt nol~t~n~d pl~.stor b~1n~ loc~t~d l~lthln the $11pp~r. The t~et aro th~n posltloned eorret~ly an~ th!s pc~lt1On 1~ tho~ktd vl~u~lly and by t~eltng wlth the tlng~rs. Thc pl~ster sllpper ls ~llow~d t~ h~rden ~nd removed from th~ ~oot. It c~n be tut so th~t ~t ean b~ rt~oved l~
n~c~e~ry. A ccs~ foot mo~sl 30 ~Flg. 13) ls t~cn preparQd uslng the plcster ~oulOs. Th~ c~st fo~t model S0 t~ th~n L~np~r~d w1th thr propsrly ~ ned f~t of the p~tlent and modl~leC 1f n~ess~r~ and pot~lble. The ~oot model 12 h~s A tube ~3 pastlll~ through tt.
A palr of sho~s lnto ~hlch the orthot~c 1~ to b- pl~c~t ~r~ lns~rt~d ~ and pnotecte~ ln a pl~stle shot b~g ln ~ ~orkst~tlon d-vlc-. Th~ p~1r o~
: ~ho~s ~nt~ln ~ castln~ llnlng 31 havlng An lnlet tube 32 trtg. 13~. Theshselsces of th~ shw ~ ~ro bo~nd ln nor~l vQa~1ng pos1tlons. Plaster 1s :~ 30 mvlstenQd and poured Around the outs1d~ of th~ p1~st1e sho~ b~g ln th~
: workst~tlon devlce And th~ pl~st~r ls lct to h~rden. The ln1nt tub- 32 or tht p-1~ of c~stln~ lln~n~ 31 are ~ttach-d to th~ tubo outlet 34 Or the foot ~odcl~ ~nd lnserted lnto the cho~6. Ths ~ot ~od-l~ 30 ~re ~onn-ct~
tojtn~ workst~tl~on ~nd ~11gned to fh- rl~ht po$1t10n. Th~ naxt st~p ls to c~t ant f~nlsh th~ orthotle by m1x1ng the co~ponentS and cast~ng ~nd ln~cctlng th~m through the tube ~nto the c~stlnp lln~ng. ~ha tub- 33 1c sed untl1 the com~oncnts arc w~lc1~ntly cur~d. Th~ shots ~nd ~nould~n~ ~re det~ch~d and tho ~rthotlc ~1th1n th~ c~-tlng lln~n~ 1s ~ :
'' ~, ' ~ .
20038~3~
'6 -I re~oYed. ~e ~nlet tub~ 3~ ls then r~ovod fro~ the orthot~ c ~nd the l orthotlc 15 r~ady to ~e lns~rted 1nto ~ shos ror thc p~tlcn~. In thls ~y ¦ S th~ orthotl~ 1~ so ~ast~d ln the ~hot of the pt~tlQnt so th~ lt l~ ~1rcady I tha correc~ ~1zl~ and al~gnm~nt. ¦
¦ In anotheir method o~ construct1ng an orthot1c, ~uslng lco~ponent- as ¦ 1:1ustrat~d 1n,Flg. ~ t~r mould~ ot' the ~et and c~st ~oot modol~ 30 ¦ ~re pr~par~d ~s! pr~YSously dcscrlbed. the foot ~odQls 3~ ~ru ther lnsertc l~o thk castlnlg mould3 36. The foot m~dtls 30 are ~odlf1s~ to ~tt tht dl~nslons of ~Ihe clos~d c~stlng ~oulds 36 whon tho cast1ng ~ lds 36 ~rc clos~d, the caslt~ng m~t2r1als ar~ ca~t w1th mod3~od foot mold~l~ 37 ¦ thereln. OnCQ ,the e~stlng materlals ~re cured, th~ casts l~jr~3v~d ~ndI the ~rthot~c 38 1~ th~n f~n1shtd by cuttSng th~ ed~es An~ ch~c~1ng. The¦ lS ortho~1c 33 ~anl bo co~ered w~th a ~u~t~ mat~r1al ~ r~qu~ed. 7ho l orthot1c ls ~ to be c~st ln~ect~d through a tube or ~pert rc slmllar to th~ above descr;l~2~ ~ethod.
In anothcr ~othod of constructlng ~he orthot1c c~ ~ pr ~rred Pmbodlment ~nc1,ud~s c~st1nt foot ~o~els 30 as descr1bed prev ously. The foot ~otelt ~0 ar~ m~dlf1~d by s~o~thln~ thc solc~. Th~e ~cd1~1-d ~ot modQl~ ~7 are al~gnfid In the ~orkstat10n and pr~soa~ed leath r ~s placed underneath the ~t1re soles ot the ~odlfled ~oot no~tl 37. ther ~ter1als ar~ a~le to be . .
lnserted b~tweeh the l~yers. ~hc ~oot ~cdel- ~ro prossed on o the o~de~
leathtr and the le~ther ls allow~d to try, ~h~n th~ ther 1s dry, the prossure 1s rel~e~ed ~nt tho ~ouldot le~th~r blan~s ~ro re ~ ed. ~hes-lvather ~l~nks ar~ cut to slze and th~l~ Qdges are bond~d lf neCoss~r~.
These orthot~cs'are then tho shaps ~hlch ls re~ulr~d.
th~ ortho~1c 3t ll~ustr~tcd 1n Fl~. 15 and 16 ls ~h~ ~ to h~ve a f1ange ~shad~d) Th~ orthotlc 38 ln flg. 16 sho~s rarus for ~oot supPort ! ~had~d). Yarl$t10ns of suPPort ~111 occur dependlng on Yar s or Y~lgusdefor~ltles o~ th~ r~ar~oot, ontlre foref~ot, n~d1al or lat~ al cotu~ns.
It 1~ notld that dlfferent s1ze noulds are uset to C~s t1--urent ~ ' slz~ Qrthotlcs.; ':., -3s ~ ~h~ ~or;eg~ng to~cr1be~ on,ly -om- ambcd~rents of the p esent 1nventlon, ~nd ~sdl~lcatl~ns o~Ylous to thosr skllled ln th~ art tan be n~ ehersto ~hr,ut ~er~rtIng trc~ ths scoP- ot the pr~;~ntl~nv~ae~on. ¦
~'' ' ,,.
. ~ .