CA2003881A1 - Full foot posted orthotic - Google Patents

Abstract

ABSTRACT
A full posted orthotic (13,21,25,38) which accommodates and/or supports not only the rear and midfoot but also the forefoot in their functional planes during gait. The orthotic (13,21,25,38) are manufactured using a variety of materials to provide the appropriate support. The materials include thermosetting plastics, thermoplastics with or without microballoons or other synthetic or natural fibres.

Description

.. 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~, ; ~

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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. .
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~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 - . :
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~ 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 ~ :
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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. ¦

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Claims (8)

1. A methods of manufacture of an orthotic, said method comprising the steps of making a positive plaster cast of a foot while the sub-talar joint is in neutral and with the forefoot fully pronated about both the mid tarsal joint longitudinal and oblique axes, modifying said plaster cast according to a required shape. Inserting said plaster cast in a moulding means whereby the plane of its planar surface corresponds to the varus or valgus deformity of the foot, wherein a plastic mixture is poured into said mould and allowed to cure according to the properties of the plastics mixture.

2. Method according to claim 1, wherein said modified plaster cast of foot are modified in order that the orthotic is cast in the desired shape to fit in a shoe.

3. Method according to claim 1 wherein said orthotic is cast by injection through a tube or aperture.

4. A method of manufacture of an orthotic, said method comprising the steps of making a positive cast of a foot while the sub-talar joint is in neutral and with the foot fully pronated about both the mid tarsal joint longitudinal and oblique axes, placing the positive plaster cast of the foot in a cast model of a shoe having a inflatable casting lining located therein, casting an orthotic in said casting lining via injection means, allowing said cast orthotic to cure, removing the plaster casts and finishing with an orthotic of correct size and alignment.

5. Method according to claim 4 wherein said injection means includes an inlet tube in said casting lining.

6. A method of manufacture of an orthotic, said method comprising the steps of making a positive plaster cast of a foot while the sub-talar joint is in neutral and with the forefoot fully pronated about both the mid tarsal joint longitudinal and oblique axes, modifying the positive plaster cast and placing in a casting mould, inserting moist leather or like substance in said casting mould and allowing to dry while said modified positive plaster cast is pressed against said leather, removing said casting mould and cutting said orthotic to size.

7. Method of manufacture according to claim 6 wherein other filling materials are used within the shell of the leather or like substance.

8. An orthotic manufactured according to any one of the claims 1-7 wherein said orthotic is full posted.