HK40089961A - Orthopedic bracing system and method of use - Google Patents

Description

Orthopedic support system and usage instructions

Technical Field

The teachings disclosed herein generally relate to orthopedic support systems and methods for supporting a patient’s leg throughout the recovery period from injury or surgery.

Background Technology

Certain types of injuries and surgeries require immobilization and support of the patient's ankle, foot, and lower leg at different stages to facilitate recovery. During the recovery period after injury or surgery, it is also often necessary to reduce or eliminate weight-bearing on the ankle or foot. Furthermore, better environmental protection for the foot or ankle may be required during recovery.

Currently available orthotic devices typically achieve only one of these three goals. For example, ankle-foot orthoses (“AFOs”) stabilize and support the foot and ankle in an optimal position, but offer only limited environmental protection and do not reduce the weight-bearing burden on the user's foot and ankle. To protect the limb and reduce its burden, a combination of casts or walking boots with crutches, walkers, scooters, and other devices must be used. Therefore, patients may need to purchase and use multiple devices during their recovery process.

Furthermore, many orthopedic stents must be custom-made for each user. This often involves a lengthy process, including sending the patient to an external laboratory to fabricate the stent. This process is expensive, time-consuming, and often delays treatment by weeks or more.

Another problem with existing support systems is compliance. Because the components of a complete support system are not designed to work together in a way that is both economical and convenient for the patient, and do not take into account the patient's needs at different stages of recovery or even at different times of the day, many patients do not adhere to the treatment instructions. Non-compliance with support systems or premature removal can cause harm to the foot, ankle, and leg, such as fracture displacement, delayed wound healing, or prolonged recovery and rehabilitation. For example, walking boots are often used to protect the foot and ankle after injury or surgery without the cost of custom-made AFOs. However, these boots often become dirty with daily use. They are bulky and heavy, often causing the lower extremities to become hot and sweaty. For these and other reasons, patients often remove their boots during the day to relieve discomfort, and then cannot bring the unhygienic boots to bed at night. As a result, the foot and ankle are unprotected and intermittently not held in the proper angle for most of the day and night. This can lead to contractures or other injuries, potentially requiring more healing time, additional surgery, and a longer recovery period compared to consistently supporting the ankle in the correct position. Patients sometimes forget to put their walking boots back on before getting off the sofa or getting out of bed, leading to further injury. Failure to adhere to the rule of wearing walking boots properly, such as removing them day and night, is a common problem.

Furthermore, a patient's needs change during recovery, but currently available devices are not designed for easy adaptation. For example, initially, a patient's injured foot may not be able to bear any weight, so crutches may be needed to reduce the burden on the foot. As recovery progresses, the patient may only need to reduce the burden by 50%, but it is difficult to know how to bear 50% of their weight with crutches, so patients often simply carry crutches with them, putting 100% of their weight and the weight of the crutches on the injured foot.

What is needed is an orthotic support system that can accommodate a wide range of patients without the delays and costs of custom fittings, and that can meet most or all of a patient's needs throughout their recovery and daily life. A device that can reduce the burden on the limbs and protect them both day and night, even after removing bulky outer shells or walking boots is also required.

Summary of the Invention

This disclosure provides a modular orthotic support system comprising an ankle-foot orthosis (“AFO”), a walking boot, and a patellar tendon support bracket (“PTB”). In some embodiments, the PTB is replaced by a support attached to the upper region of the patient’s thigh and calf.

An AFO (Ambient Air Force) can be configured to hold the patient's foot, ankle, and lower leg at a prescribed angle to allow healing and prevent conditions such as contractures. The AFO's shell is made of a rigid or semi-rigid material (e.g., plastic). The AFO has a base that attaches to and supports the patient's foot and a pillar portion that forms an angle with the base. The angle between the base and the pillar portion can be approximately perpendicular. The pillar portion is attached to the patient's leg via, for example, a strap. The AFO can be detachably attached to a walking boot to provide additional support and hold the foot, ankle, and lower leg at the prescribed angle. Because the AFO can be removed from the walking boot, it can also be worn independently when only support is needed (e.g., when the patient is sleeping or resting during the day), or, in the later stages of recovery, can be worn inside a regular shoe.

PTB can be detachably attached to or permanently attached to a walking boot. PTB can reduce some or all of a patient's weight and is superior to crutches, walkers, or other assistive devices because it does not require the upper body to bear the weight, making PTB generally easier to use. PTB can suspend part or all of a patient's foot, ankle, and lower leg inside a walking boot.

The innovative modular design of the system disclosed in this paper allows patients to remove their walking boots during periods when they may be inconvenient or unnecessary for them. For example, the walking boots can be removed while sleeping or resting because they can be detached from the AFO, allowing the AFO to remain on the foot without the walking boots. The AFO can provide sufficient support and protection for activities such as sleeping or resting without the inconvenience and discomfort caused by the increased volume and weight of the walking boots.

Advantageously, the modular design and adjustable nature of the system disclosed herein allow patients to achieve their full recovery using a single system. For example, as a patient becomes able to bear more weight on their foot, the relative proportion of the patient's weight borne by the PTB and the plantar pad can be appropriately adjusted to achieve this in a controlled and systematic manner, in contrast to other methods like crutches that cannot systematically control the weight borne by the foot.

Furthermore, it is advantageous that the modules of the orthopedic support system can be connected. For example, attaching the AFO to a walking boot prevents the AFO from slipping inside the boot, increasing stability and reducing friction on the wound.

This article also discloses a novel design for a walking boot configured to work in conjunction with the overall orthopedic support system and address long-standing problems in the field. The most widely used medical or orthopedic walking boots comprise a rubber sole, a foam-padded metal outsole, and two vertically oriented metal struts with straps attached to their inner and outer surfaces. A soft fabric lining rests on the padded metal outsole. This lining is attached to the inner surfaces of the two metal struts. The fabric lining is open at the front to accommodate the patient's leg. After the leg has rested in the boot, the lining closes, and three to four circumferential straps are attached to the outer surfaces of the two metal struts and then tightened to securely hold the leg in place. This design has several practical problems. The circumferential straps stick together, become stuck to each other, are detachable and frequently lost, often become tangled, flipped, knotted, and are often roughly cut off and discarded in frustration.

The lining has a similar problem. It can stick to anything it's attached to. It's difficult to remove from the boot's metal struts, often requiring the removal of all the straps at once. Therefore, removing the lining for cleaning and putting it back in the boot is often a frustrating experience. However, if the lining isn't cleaned regularly, it can develop an odor. Properly changing the lining requires product knowledge and patience. Few patients are able to change their linings and maintain a good fit. Many patients return to the healthcare provider's office feeling uneasy because they can't control their boots with the straps and lining.

The novel fabric lining disclosed herein solves these problems. It can be completely removed from the side support. In one non-limiting embodiment, the lining may be provided with two wide side pockets that slide over and capture the side support. The openings of the pockets are along the underside or bottom side. The side pockets are reinforced to prevent tearing. The side pockets may also be in a trapezoidal configuration, for example, wider at the top and narrower at the bottom. This would allow for greater adjustment for different calf sizes. The narrower bottom helps maintain proper lining and foot position relative to the footpad. Generally, the wide side pockets allow the lining to move backward to accommodate thicker legs and forward to accommodate thinner legs.

Since there are no linings on the two side pillars, the lining can be easily placed in place and removed. Removing the lining for cleaning, maintenance, and reassembly is also very simple. The lining can only be installed on the boot in one way to prevent confusion.

Two finitely wide stripes at the ends can be permanently attached to the lining to prevent strip loss, misalignment, and minimize tangling. The strips can be oriented relative to each other for easy tightening and securing of the boot. They can also be used at the bottom of the lining or otherwise secured to the padded metal sole.

Alternatively, the lining can be closed using two wide straps with loops at both ends attached to knobs or hooks on the side supports. In this example, the side pocket may have a cutout to allow access to the knobs or hooks on the side supports. In another embodiment, the lining can be closed using a series of straps attached to one end of a connector and the other end of the connector attached to the side support. The side pocket may have a cutout to allow access to the connector on the side support. Alternatively, a drawstring closure, side-release buckles, or a loop system can be used to close the lining.

The lining may optionally include a mesh portion to allow for increased airflow. This mesh portion may be located on the back of the lining, the side of the lining, or the foot of the lining.

The lining may optionally include a pneumatic device for compression. The pneumatic device can be inflated using, for example, an air tank, a manual pump, or an open-cell foam combined with an air valve.

Similar to other walking boots that can be used with the disclosed orthotic support system, the AFO can be attached to a fabric-lined walking boot. For example, the AFO can be attached to the walking boot via a knob and crossbar connector, or via a strap that passes through the lining and bottom of the walking boot and wraps around the user's ankle. Alternatively, in another example, the strap can connect the AFO to the lining, and the lining can be attached to the bottom and support of the walking boot using any of the methods described herein. The AFO can also be attached to the walking boot using a continuous strap.

PTB or support pieces attached to the patient's thigh can also be used in conjunction with fabric-lined walking boots.

A trapezoidal extension pad can be added to the lining to accommodate very thick legs. Currently, walking boots are designed to fit the size of a patient's foot, but increasingly, patients have calves and calves that are too thick to fit snugly in the lining. Often, the boot lining is open at the front, or the boot size is too large for the foot to fit around the calf, creating a tripping hazard. Extension pads can be made from the same material as the lining and can be easily added to the lining to provide adequate coverage for thicker legs.

In a first embodiment, this disclosure provides a walking boot configured to cover a portion of a user's foot, ankle, and lower leg. The PTB is detachably or permanently attached to the walking boot and configured to partially or completely suspend a portion of the user's weight. The AFO is also detachably attached to the walking boot.

In one aspect of the first embodiment, the AFO can be configured to be inserted into a shoe. For example, a walking boot may not be necessary later in the recovery process, but some form of support may still be needed to maintain stability and keep the foot at the correct angle. During such a recovery phase, the AFO can be removed from the boot and used with regular shoes.

In a second aspect of the first embodiment, the AFO has a base configured to cover the user's sole and arch, and a column portion configured to cover the user's heel and the back of the user's ankle. However, those skilled in the art will understand that the AFO can be configured to extend upwards to the user's lower leg or even cover the entire lower leg.

On the other hand, AFOs can be a universal or standard pattern suitable for most foot types. Alternatively, AFOs can be easily molded to produce a stronger fit and improved support. For example, AFOs can be molded in the clinics of healthcare professionals.

In another aspect of this embodiment, the PTB consists of a rear shell and a front shell, with a strip connecting the rear and front shells. The strip can pass through a loop attached to an arched fence in either the rear or front shell. This provides the ability to adjust the PTB to accommodate users of different sizes and heights.

On the other hand, the connection between the PTB and the walking boot is adjustable. Adjusting the height of the PTB further enhances the orthotic support system's ability to adapt to patients of different heights and also improves the control of weight-bearing on the user's foot and ankle.

On the other hand, the PTB is configured to provide a first upward force to the user, while the footpad of the walking boot is configured to provide a second upward force to the user, and the relative amounts of the first and second upward forces are adjustable.

On the other hand, a wedge is placed under the sole of the walking boot, so that the sole of the walking boot forms a certain angle with the ground. The angle formed by the wedge can vary between 1° and 60°.

In another embodiment, this disclosure provides a walking boot configured to cover a portion of a user's foot, ankle, and lower leg. The AFO can be detachably attached to the walking boot.

On the one hand, the walking boot has a foot pad and the distance between the AFO and the foot pad is adjustable.

In another aspect, the AFO is attached to the walking boot via rails, crossbars, ridges, extensions, protrusions, flush mount brackets, hook-and-loop fasteners, hook-and-loop fasteners (e.g., magnets), or strips. For example, the walking boot may have rails, crossbars, ridges, extensions, protrusions, or flush mount brackets on its inner surface, while the AFO may have grooves, slits, recesses, notches, pits, slots, or flush mount brackets on its outer surface, configured to mate with attachment mechanisms on the inner surface of the walking boot. The grooves, slits, recesses, notches, pits, or slots on the exterior of the AFO capture the rails, crossbars, ridges, extensions, or protrusions of the walking boot to releasably attach the AFO to the walking boot. The flush mount brackets, buttons, knobs, or levers on the exterior of the AFO may be configured to mate with the flush mount brackets or rails in the walking boot to detachably attach the AFO to the boot. Alternatively, the AFO may have a flush mounting bracket or rail on its outer surface, while the walking boot may have a flush mounting bracket, button, knob, or lever on its inner surface. The flush mounting bracket, button, knob, or lever inside the walking boot may be configured to mate with the flush mounting bracket or rail on the AFO to detachably attach the AFO to the walking boot. This disclosure also contemplates other suitable structures for attaching the AFO to the boot.

In another embodiment, a method for supporting an injured lower limb is provided. For example, a first support member may be attached to the area around the patellar tendon of the injured patient. A second support member may be provided for the area at or below the foot. A first upward force may be provided in the patellar region of the user by the first support member, and a second upward force may be provided in the foot of the user by the second support member. The amounts of the first and second upward forces can be adjusted to a desired balance.

In one respect, the magnitudes of the first force and the second force can be adjusted by changing the positions of the first support member and the second support member.

On the other hand, the first supporting component is PTB.

On the other hand, after adjusting the magnitude of the first upward force and the second upward force, a predetermined angle can be maintained between the foot and the leg.

On the other hand, AFO can be used to maintain a prescribed angle between the foot and leg.

In another embodiment, a support assembly is provided. The support assembly includes: a walking boot configured to cover at least a portion of the sole of a user's foot; and an alternative support member connectable to the walking boot, the support member having a first support portion configured to attach to the user's thigh. In some embodiments described herein, the alternative support member may replace the PTB (Personal Foot Bath). The support member includes a lockable connector. When the connector is unlocked, the angular position of the first support portion relative to the walking boot is adjustable, and when the connector is locked, the angular position of the first support portion relative to the walking boot is fixed.

In another embodiment, a support assembly is provided. The support assembly includes: a walking boot configured to cover at least a portion of the sole of a user's foot; and an alternative support member connectable to the walking boot, the support member having a first support portion configured to attach to the user's thigh. In some embodiments described herein, the alternative support member may replace the PTB (Platelet-Tooth Bearing). Furthermore, the walking boot has a sole axis and a calf axis, the angle β between which is adjustable. The position of the user's calf relative to the sole of the walking boot is adjustable.

In another embodiment, a support assembly is provided. The support assembly includes: a walking boot configured to cover at least a portion of the sole of a user's foot; and an alternative support member connectable to the walking boot, the support member having a first support portion configured to attach to the user's thigh. In some embodiments described herein, the alternative support member may replace the PTB (Personal Foot Bath). Furthermore, the walking boot has a height-adjustable sole.

In another embodiment, a support assembly is provided. The support assembly includes: a walking boot configured to cover at least a portion of the plantar surface of a user's foot; and an alternative support member connectable to the walking boot, the support member having a first support portion configured to attach to the user's thigh. In some embodiments described herein, the alternative support member may replace the PTB (Platelet-Tooth Brace). Furthermore, the support assembly includes an ankle-foot orthosis (“AFO”) detachably connected to the walking boot.

In one aspect of the above embodiments, the alternative support further includes a second support portion configured to attach to the user's leg below the kneecap.

In one aspect of the above embodiments, when the connector of the alternative support is unlocked, the position of the second support relative to the walking boot is fixed, and it is adjustable relative to the first support.

In one aspect of the above embodiments, the first support portion may have a shape configured to surround the user's thigh.

In one aspect of the above embodiments, the walking boot may have a bottom axis and a calf axis, the angle β between which is adjustable. Therefore, the position of the user's calf relative to the bottom of the walking boot is adjustable.

In one aspect of the above embodiments, the walking boot has a height-adjustable sole. This height can be adjusted using a wedge or pad. The wedge or pad can be attached to the sole pad of the walking boot. Alternatively, the wedge or pad can be attached to the sole of the walking boot.

In one aspect of the above embodiments, the support assembly includes an AFO detachably attached to the walking boot. The AFO can be attached to the walking boot via a crossbar, guide rail, crossbar and protrusion, flush mounting bracket, hook-and-loop fastener, hook and loop fastener, magnet, strip, and continuous strip.

In one aspect of the above embodiments, the support assembly may optionally include a pneumatic feature configured to provide pressure to the user's foot, ankle, and/or calf. The pneumatic feature may include an inflatable bag, a pump, and/or a self-inflating airbag.

As described above, one advantage of certain embodiments of this disclosure is that patients can use a single system as disclosed herein throughout their recovery process. In particular, the detachable and adjustable features of the AFO and PTB modules in the disclosed embodiments allow for adjustment of the user's weight during patient recovery, such that additional weight can be transferred from the PTB to the foot/ankle.

Another advantage of some of the embodiments disclosed herein is modularity, which allows a single system to be used throughout the patient's recovery process and reduces some perceived adherence barriers. For example, as described above, when the patient is sleeping, the boots can be removed and set aside while the AFO remains on the limb, thus increasing patient comfort as the patient does not have to wear bulky boots. Similarly, the AFO can be adjusted later in recovery so that the patient can slide their foot while the AFO is already attached to the shoe.

Another advantage of some of the embodiments disclosed herein is the adjustability of the modules within the system, which allows patients of different body types to use the same support. For example, the same PTB or alternative support can be adjusted to accommodate patients of different body types without requiring a custom PTB or support for each patient. The boot and AFO can be designed to accommodate different sizes of feet, ankles, and calves.

Attached Figure Description

The above aspects of the exemplary embodiments will become more apparent and will be better understood from the following description of the embodiments in conjunction with the accompanying drawings, in which:

Figure 1A is a perspective view of an orthopedic brace assembly according to the present disclosure, wherein a portion of the patient's leg is shown in dashed lines.

Figure 1B is a side view of the orthopedic brace assembly shown in Figure 1A.

Figure 1C is a rear perspective view of the orthopedic brace assembly shown in Figure 1A.

Figure 2A is a perspective view of the PTB, a portion of which is also depicted in Figure 1A.

Figure 2B is a side perspective view of the PTB depicted in Figure 2A.

Figure 2C is a view of the PTB in the open position as depicted in Figure 2A, showing the interior of the front shell (left) and the rear shell (right).

Figure 3A is a front perspective view of the walking boot shown in the components depicted in Figure 1A.

Figure 3B is a front perspective view of the walking boot shown in the component depicted in Figure 3A, with the optional overlay shown.

Figure 3C is a front perspective view of the walking boot shown in the component depicted in Figure 3A with the optional lining shown.

Figure 4A is a front perspective view of the AFO, a portion of which is also depicted in Figure 1A.

Figure 4B is a side view of the AFO shown in Figure 4A.

Figure 4C is a rear view of the AFO shown in Figure 4A.

Figure 5 is a partially disassembled view of the orthopedic brace assembly shown in Figure 1A.

Figure 6 is another perspective view of the orthopedic brace assembly shown in Figure 1A, with a portion of the patient's leg, foot, and ankle shown in dashed lines.

Figure 7A depicts a system according to this disclosure with a simple force diagram.

Figure 7B depicts a portion of the system shown in Figure 7A, with further explanation of the forces involved.

Figure 7C shows a partial cross-sectional view of a portion of the system shown in Figure 7A.

Figure 7D depicts a side view of an orthopedic brace assembly according to the present disclosure.

Figure 8A depicts a front perspective view of an orthopedic brace assembly according to the present disclosure.

Figure 8B depicts a simplified force diagram of the orthopedic brace assembly shown in Figure 8A.

Figure 8C depicts a simplified force diagram of the orthopedic brace assembly shown in Figure 8A.

Figure 8D is a partially disassembled view of the orthopedic brace assembly according to Figure 8A.

Figure 9A is a perspective view of the frame of a walking boot for an orthotic brace assembly according to the present disclosure.

Figure 9B is a front perspective view of the frame of the walking boot shown in Figure 9A.

Figure 9C is a perspective view showing the frame of the walking boot shown in Figure 9A, with the lining partially attached.

Figure 9D is a perspective view of the frame of the walking boot shown in Figure 9A, showing the partially attached lining.

Figure 9E shows an AFO that can be used with walking boots according to this disclosure.

Figure 9F is a front perspective view of the walking boot shown in Figure 9A, showing the attached lining.

Figure 9G is a front perspective view of the walking boot shown in Figure 9A, illustrating the attached lining and AFO.

Figures 10A, 10B, 10C, 10D, 10E, 10F, 10G, 10H and 10I are illustrations of walking boots with various attachment configurations for lining.

Figures 11A, 11B, 11C, 11D, 11E, 11F, 11G, 11H, 11I, 11J, 11K, 11L, 11M and 11N show various options for attaching an AFO to a walking boot.

Figures 12A, 12B, 12C, 12D, 12E, 12F, 12G, 12H and 12I illustrate different configurations for providing aerodynamic features for compression in the walking boot of this disclosure.

Figures 13A, 13B, and 13C illustrate alternative embodiments of an orthotic support assembly including a walking boot with supports attached to the upper regions of the user's thigh and calf.

Detailed Implementation

The embodiments described below are not intended to be exhaustive or to limit the invention to the precise forms disclosed in the following detailed description. Rather, the embodiments were chosen and described so that others skilled in the art can understand and appreciate the principles and practice of this disclosure.

In this disclosure, terms such as “horizontal” and “vertical” are generally used to establish the position of the various components relative to each other, rather than absolute angular positions in space. Furthermore, regardless of the frame of reference, terms such as “vertical,” “parallel,” “horizontal,” “right-angled,” and “rectangular” are not used in this disclosure to indicate precise mathematical orientation or geometric shape unless explicitly stated otherwise, but are used as approximate terms. According to this understanding, for example, the term “vertical” certainly includes structures exactly 90 degrees to the horizontal direction, but should generally be understood to mean roughly vertically positioned, rather than horizontally positioned. Other terms used herein to indicate orientation, position, or shape should be interpreted similarly. Furthermore, it should be understood that the various structural terms used throughout this disclosure and the claims should not be subject to a single interpretation unless explicitly stated herein.

Furthermore, it should be understood that all terms used throughout this disclosure and claims, whether or not they are prefixed with the phrases “one or more,” “at least one,” etc., should not be subject to a single interpretation unless expressly stated herein. That is, all terms used in this disclosure and claims should generally be interpreted as meaning “one or more” or “at least one.”

Throughout this disclosure, the terms "support" and "alternative support" are used interchangeably. At least, these terms refer to a bracket or support comprising first and second support portions. The first support portion may be configured to surround the user's thigh, while the second support portion may be configured to surround the patient's leg at or below the patella.

Figures 1A-1C illustrate one embodiment of the orthotic support assembly 2. The illustrated configuration includes a patellar tendon support bracket (“PTB”) 4 attached to a walking boot 36. The patient’s foot is situated within an ankle-foot orthosis (“AFO”) 60, which is detachably attached to the walking boot 36. In this configuration, the AFO 60 can be completely suspended within the walking boot 36, such that the AFO 60 does not contact the bottom of the walking boot 36. Alternatively, in this configuration, the AFO 60 may also contact the bottom of the walking boot 36. It is understood that different configurations are also possible, for example, the PTB 4 attached to the walking boot 36 without the AFO 60. In another possible configuration, the AFO 60 may be attached to the walking boot 36 without the PTB 4 and the AFO 60 may be in full contact with the bottom of the walking boot.

PTB

The first module of the orthopedic support system 2 is PTB 4. Figures 2A-2C depict an example of PTB 4.

The PTB 4 can be formed in two parts: a rear shell 6 and a front shell 8. The rear shell 6 and the front shell 8 can be connected by straps 10. In the illustrated embodiment, the straps 10 are formed of a hook-and-loop material (e.g.). However, those skilled in the art will understand that the straps 10 can be formed of a variety of materials, including leather, metal, elastic materials, plastics, or some combination of various materials. One end of the strap 10 is anchored to a retaining groove 12 on one side of the rear shell 6. The free end of each strap 10 is then extended around the front shell 8 to a pair of strap guides 18. The free end of the strap 10 passes through the pair of strap guides 18 and extends around the remainder of the front shell 8. The free end of the strap 10 passes through an adjustable ring 20 or buckle 22 (shown as a rectangular ring in FIG. 2C) which is attached to the rear shell 6. Finally, the free end of the strap 10 is secured to itself using hook-and-loop fasteners. It is understandable that the free end of the strip 10 can be fixed in different ways, such as by snaps, buttons, pin mechanisms, locking mechanisms, buckles, ratchet systems, small cables, etc.

Other configurations of the PTB 4 are also applicable to this disclosure. For example, instead of the strap 10, the rear shell 6 and the front shell 8 can be connected using various structures, such as hinges, straps, locking mechanisms, interlocking rails, locking mechanisms, buckles, ratchet systems, small cables, etc. The connection between the rear shell 6 and the front shell 8 can also include snap rings or ratchet buckles to form a tighter fit. In another option, the rear shell 6 and the front shell 8 can be integrally molded, and there can be a slit in the PTB 4 to allow the leg to pass through before the edges of the slit are pulled together with shoelaces or a zipper.

As shown in Figure 2B, the adjustable ring 20 is mounted on the arcuate guide rail 24 within the rear housing 6. The adjustable ring 20 can slide up or down along the arcuate guide rail 24 to obtain different heights and angles suitable for its position. This allows adjustment of the PTB 4 to accommodate patients of different heights, weights, and leg/calf diameters. The buckle 22 can be attached to the rear housing 6 by, for example, rivets 26 as shown, or by welding, sewing, adhesive, or any method known in the art.

The PTB 4 is held in place on the leg by tightening the strap 10, which presses the patellar tendon 30 (also known as the "patellar tendon knot") in the anterior shell 8 against the patient's patellar tendon, the lower surface of the patella, and tightens it towards the lower leg. The patellar tendon 30 is a protrusion in the anterior shell 8 of the PTB 4. It is conceivable that the PTB 4 can be held in place by other or additional structures, such as a compressible foam liner or an air bladder.

The exterior of the PTB 4 can be formed of rigid or semi-rigid materials, such as plastics, plasticized organic fabrics, etc. To improve user comfort, the inner surface 14 of the PTB 4 can be formed of an anti-slip material to prevent friction and skin irritation, or it can be formed of a softer material, such as foam, fabric, or a combination of various softer materials. Ventilation holes 34 can be provided in the back shell 6. Furthermore, the top edge of the back shell 6 can be a curved piece 28 recessed below the back of the knee to prevent pinching the back of the legs when the user sits down.

Walking boots

The second module of the orthopedic support system 4 is the walking boot 36, as shown in Figures 3A-3C.

The walking boot 36 includes a sole 50 and a top 52. The sole 50 and top 52 can be integrally formed from plastic or other suitable rigid, lightweight material. For example, the walking boot 36 can be formed from any rigid, hard, and durable material, including plastic, metal, steel, aluminum, glass fiber, carbon fiber, composite materials, or any combination thereof. In another non-limiting example, the walking boot 36 can also be formed from, for example, polypropylene or polyethylene.

Alternatively, the upper portion 52 of the walking boot 36 can be formed by connecting rigid posts to the bottom 50. The posts can be spaced apart from each other. For example, one post may be located near the user's heel, and another post may be located on the outside of the user's leg. The posts can be formed of any rigid material, such as plastic or metal (e.g., steel). For example, the posts can be formed of any rigid, strong, and durable material, including plastic, metal, steel, aluminum, fiberglass, carbon fiber, composite materials, or any combination thereof. The posts can also be formed of, for example, polypropylene or polyethylene. Fabric can be stretched around the posts to form a protective structure for the user's legs.

The bottom 50 of the walking boot 36 has a sole 44 made of an elastomer or rubber material for better traction during walking. The top surface of the bottom 50 is a broad, flat sole pad 42 that can accommodate various foot sizes. The sole pad 42 may be surrounded or partially surrounded by sidewalls 54 that extend vertically from the sole pad 42 to protect the sides of the foot. Optionally, the bottom 50 of the walking boot 36 may include a strip 38 attached to the sidewalls 54 by means of, for example, rivets 48 as shown in FIG. 3A, or by some other suitable attachment mechanism (e.g., adhesive, glue, welding, screws, bolts, threads, etc.). The strip 38 may also be detachably attached to the sidewalls 54 by means of, for example, snaps, buttons, or pin mechanisms. The strip 38 can be used to secure the bottom 50 of the walking boot 36 to the patient's foot at certain stages of recovery. Alternatively, as shown in FIG. 3B, the strip 38 can be used to secure the forefoot or overlay 39 of the walking boot 36, which covers the forefoot, ankle, leg, and instep.

The upper portion 52 of the walking boot 36 extends upward from the bottom 50 approximately to the proximal end of the patient's lower leg. It wraps around the back and outside of the patient's lower leg and is open at the front. The upper portion 52 of the walking boot 36 can be secured to the patient's leg using, for example, a hook-and-loop strap 38. However, other attachment mechanisms are also conceivable, such as snaps, buttons, hooks, locking mechanisms, buckles, ratchet mechanisms, small cables, etc. The straps 38 can be attached to the walking boot 36 using the same mechanisms discussed regarding the straps 38 for the bottom 50, or they can be attached to the walking boot 36 using the strap guide 46 shown in Figure 3A.

The walking boot 36 may include optional features to enhance patient comfort, such as ventilation holes 40. It may also include a cover 39 as shown in Figure 3B, or a lining 41 as shown in Figure 3C.

AFO

The AFO 60 is the third module of the support system depicted in Figures 4A-C. The AFO 60 holds the foot and ankle at a prescribed angle. For example, when the foot and ankle are suspended by the PTB (Plate Bearing), the AFO prevents or minimizes the natural plantar flexion that occurs when the foot is unloaded or freely suspended. When the user walks on their foot, the AFO also prevents or minimizes dorsiflexion.

The outer shell 62 of the AFO 60 is made of a material such as rigid or semi-rigid plastic, for example, polypropylene, copolymer, polyethylene, or any suitable plastic, which provides a structure for stabilizing the foot and ankle. The interior of the AFO 60 can be made of a softer material for comfort, such as fabric or foam, for example, products sold under the trademark of Zotefoams.

The base 66 of the AFO 60 is designed to accommodate various sizes. It may slope slightly upwards at the toe portion 68. The arch portion 70 is shown as flat, allowing the AFO 60 to be worn on either the right or left foot. It is also envisioned that the base 66 may include a curved arch portion 70 to provide additional support. The sidewalls 72 extend upwards from the arch portion 70 to the heel portion 74 to protect the dorsum of the foot. The heel portion 74 of the base is hemispherical to accommodate the patient's heel.

The upright portion 76 of the AFO 60 extends upward from the heel portion 74. The upright portion 76 curves to fit around the rear of the lower leg. In the illustrated embodiment, the front of the leg is exposed.

The AFO 60 can be secured to the patient's legs and feet using the strap 78. As a non-limiting example, the strap 78 can be secured using hooks and loops, snaps, buttons, elastic materials, or any suitable material known in the art. The AFO 60 can also be secured to the feet and/or legs using some other means, such as bandages, wraps, socks, or some combination of these methods.

The AFO 60 may be a universal or general-purpose model, fitting most foot sizes and shapes. It can also be easily molded, for example, in a healthcare professional's clinic, to provide a more secure fit without the need for a visual orthodontist or measurements. The AFO 60 can also be customized for the user. The AFO 60 can be reversibly attached to the walking boot 36, resting on the insole 42 of the walking boot 36, or suspended within the walking boot 36 with or without the PTB 4.

Orthopedic support system

The modules of Orthopedic Support System 2 are designed to work in combination to provide the required level of stability, protection and reduction of the burden on the patient's weight.

Specifically, as shown in Figure 5, the rear shell 6 of the PTB 4 can be detachably and adjustably attached to the upper part 52 of the walking boot 36 in the attachment area 80 (shown in Figure 3). The attachment mechanism 82 can be a thin/flush mounting locking mechanism, bolts, screws, interlocking rails, or any fastener suitable for forming a releasable attachment.

As shown in Figure 6, when the PTB 4 is attached to the walking boot 36, it suspends the user's foot above the sole pad 42 of the walking boot 36, creating a gap 92. In this arrangement, the user's foot and ankle do not bear any weight. The AFO60 can be used to support the foot and prevent plantar flexion.

It is also envisioned that the attachment mechanism 82 for attaching the PTB 4 to the walking boot 36 can be adjustable to allow the percentage of patient weight borne by the user's foot and ankle to range from approximately 0% (as shown in Figure 6) to approximately 100%. For example, the walking boot 36 may have multiple sets of bolt holes 32 at higher and lower points of the attachment area 80, which can be used to attach the PTB 4 to the walking boot 36 to control the degree of contact between the patient's foot and the footpad 42 of the walking boot 36. Alternatively, the PTB 4 may be attached to a guide rail that allows the PTB 4 to slide up and down on the walking boot 36. This guide rail may also include a locking mechanism to hold the PTB 4 at the desired height. In another alternative, the walking boot 36 may have strip guides at different heights, and the PTB 4 can be attached to the strip at the desired height. In yet another example, the walking boot 36 may have a movable platform that can be adjusted by a lever or knob, and the PTB 4 can be attached to the platform.

The footpad 42 can also be adjustable. For example, it can be raised or lowered using a knob, and it can also include an inflatable or deflated air bladder. In another example, it can be configured to accommodate attachments, such as inserts, which would effectively raise the height of the footpad 42.

Similarly, the degree of hydrostatic compression generated by PTB 4 is also adjustable. For example, the strip 10 of PTB 4 can be configured to apply greater or less force to the user's legs. Alternatively, PTB 4 can have an internal air bladder that can be inflated or deflated to adjust the compressive force exerted by PTB 4 on the user's legs. In another alternative, a ratchet can be used to adjust the force.

When no longer needed, the PTB 4 can be removed from the walking boot 36. Users can then continue to use other modules of the orthotics support system. For example, the AFO 60 can be used in conjunction with the walking boot 36, or it can be used with regular shoes.

As shown in the non-limiting embodiment of Figure 5, AFO 60 can be configured to be releasably attached to the upper portion 52 of walking boot 36 at attachment region 84. Attachment region 84 may be larger or smaller than the length depicted in Figure 5 or Figure 8D. In one non-limiting embodiment, attachment mechanism 86 may be a flush mounting bracket with clips 88 on the back of AFO 60, as shown in Figure 4C, configured to connect with clips 90 in attachment region 84 of walking boot 36 as shown in Figure 5. Attachment mechanism 86 may also be any suitable structure known in the art, including, for example, hook-and-loop fasteners, straps, knobs configured to connect with guide rails, hook-and-loop materials (e.g.), etc. Alternatively, as shown in Figure 8D, AFO 60 may have cut-out guide rails 86, 88 on the exterior of the post portion 76, which mate with knobs or posts 86, 90 in walking boot 36 to form a detachable connection. Other embodiments are also contemplated. For example, the AFO 60 can be attached to the foot pad 42 of the walking boot 36 by various means (such as hook and loop material, pin, magnet, snap fastener or any other suitable means).

The attachment between the AFO 60 and the walking boot 36 effectively prevents the AFO 60 from shifting. This improves stability and reduces the risk of friction injuries.

When the walking boot 36 is used in conjunction with the PTB 4, as shown in Figure 6, the AFO 60 can hold the patient's ankle and foot in a prescribed position to avoid contractures, etc. This is especially important when a large portion of the patient's weight is transferred to the PTB 4, allowing the patient's foot to hang completely above the footpad 42 of the walking boot 36.

Alternatively, in a configuration of the orthotic support system 2 excluding PTB 4, as shown in Figure 8A, the AFO 60 can be placed directly on the footpad 42 of the walking boot 36. In this configuration, the connection between the AFO and the walking boot can be made on the footpad 42, rather than on the upper part 52. The AFO 60 can also be attached to the walking boot 36 above the footpad 42, so that the AFO is suspended in the walking boot 42 as shown in Figure 8C. For example, the AFO 60 can be slidably mounted to a rail or crossbar in the walking boot 36, which can serve as a guide while preventing weight-bearing.

Because the connection between the AFO 60 and the walking boot 36 is releasable, patients can remove the walking boot, for example, when they are sleeping, sitting, or resting. The AFO 60 will continue to provide stability and proper positioning for the foot, only with less protection against external forces, but this is suitable for activities such as sleeping or relaxation.

When a patient's recovery progresses to the point where the walking boot 36 is no longer needed, the AFO 60 can be removed from the walking boot 36 and used with regular shoes. The AFO 60 continues to provide stability and positioning for the foot and ankle, but without the additional structure of a full walking boot.

How to use the orthopedic support system

The specific structure and features of the stent assembly disclosed above can be better understood by referring to the following description of how the assembly fits onto the patient's foot/ankle and how the weight ratio can be adjusted as needed.

The orthotic brace assembly 2 is worn by first attaching the AFO to the injured foot or ankle. If needed, the PTB 4 can be attached to the walking boot 36 and adjusted to a distance from the plantar pad 42 that accommodates the user's height and achieves the desired weight-bearing ratio between the patellar region and the foot. The plantar pad 42 can also be adjusted to create the desired distance between the PTB 4 and the plantar pad 42. For example, the plantar pad 42 can be raised by attaching an insert to the top of it. The plantar pad 42 can also be raised using an inflatable air bladder. In another alternative example, the plantar pad 42 can be a platform that can be raised and lowered by turning a knob. The user's leg can be placed in the walking boot 36, and the AFO can then be attached to the walking boot 36. The front shell 8 of the PTB 4 can be adjusted so that the patellar bar 30 contacts the user's patellar tendon and the straps of the PTB 4 can be tightened. Finally, the walking boot 36 can be secured to the leg.

A method for supporting an injured lower limb can be provided using the disclosed orthotic support system. In one embodiment of this method, a first support member is attached to a region surrounding the patient's patellar tendon and lower leg, and a second support member is provided for a region at or below the sole of the injured leg. The first support member may be, for example, a PTB 4. A first upward force is provided by the first support member in the patellar region and lower leg. A second upward force is provided by the second support member in the foot. The second support member may be, for example, the sole pad 42 of a walking boot 36. The amounts of the first and second upward forces can then be adjusted to a desired balance.

The force can be adjusted by changing the positions of the first and second support members. In particular, it can be adjusted by changing the attachment position of the support members to the orthotic walking boot.

In another aspect of this method, after adjusting the amounts of the first and second upward forces, a predetermined angle can be maintained between the foot and leg. Using the AFO 60, a predetermined angle can be maintained between the foot and leg. For example, when the first upward force constitutes all or almost all of the upward force, the AFO 60 can hold the foot at a predetermined angle instead of letting it dangle from the ankle.

Figure 7A shows a simplified force diagram. In Figure 7A, the entire orthopedic support system 2 provides an upward force F on the user's legs, which is equal to the force from the user's body weight, as shown by vector W.

In an exemplary method for supporting an injured lower limb, a first support member is attached to the area around the injured patient's patellar tendon and calf, and a second support member is provided for the area at or below the foot of the injured leg. In the example shown in Figure 7A, the first support member is PTB 4, and the second support member is the footpad 42 of the walking boot 36.

The upward force F is divided into two parts. The first upward force F1 is applied to the area of the lower leg, proximal tibial plateau, and patellar tendon through the first support member, while the second upward force F2 is applied to the foot through the second support member. When the user walks or stands, the sum of the first upward force F1 and the second upward force F2 will be equal to the downward force W from the user's weight. Of course, the force W will change during the user's movement (e.g., walking) and may sometimes exceed the user's weight.

In the example shown in Figure 7A, PTB 4 and AFO 60 are attached to the walking boot 36 at their highest position, and PTB 4 is adjusted to its tightest position. In this configuration, almost all of the user's weight is borne by PTB 4, and almost none of the user's weight is borne by the user's foot or ankle. Therefore, F≈F1 and F2≈0.

The proportions of F1 and F2 to the total force F can be adjusted to achieve the desired balance. For example, F1 can be approximately 0% to approximately 100% of F, and F2 can also be approximately 0% to approximately 100% of F. Within these ranges, F1 can be 100% of F, 95% to 100% of F, 90-95% of F, 80-90% of F, 70-80% of F, 60-70% of F, 50-60% of F, 40-50% of F, 30-40% of F, 20-30% of F, 10-20% of F, or 0-10% of F. F2 can be 0% of F, 0-5% of F, 5-10% of F, 10-20% of F, 20-30% of F, 30-40% of F, 40-50% of F, 50-60% of F, 60-70% of F, 70-80% of F, 80-90% of F, 90-100% of F, or 100% of F.

The ratio of F1 to F2 can be adjusted by changing the positions of the first and second supports. For example, as described above, PTB 4 can be attached to the lower part of the walking boot 36 so that AFO 60 contacts the footpad 42 of the walking boot 36. Alternatively, also as discussed above, the footpad 42 of the walking boot 36 can be raised to contact AFO 60. The upward force F2 is primarily a function of the firmness of the contact between the foot and AFO 60 in contact with the footpad 42.

Unlike the plantar pad 42, which provides a generally horizontal surface that easily provides an upward force F2, the PTB relies on several features to provide force F1. For example, as shown in Figure 7B, the PTB 4 has a conical or "truncated cone" shape because the apex of the PTB 4 has a diameter slightly larger than the base. Thus, by utilizing the tightening strip 10 to apply a radially inward force to the patella and lower leg region, the PTB provides a surface that is slightly inclined relative to the vertical direction, which in turn provides a vertical force vector, as shown in Figure 7B, as F1 _y2 . Similarly, the patellar bar 30 provides another slightly horizontal surface on which the tendon can rest, providing an upward force F1 _y1 . Of course, when the strip 10 is tightened, the static friction between the patient's leg and the inner surface of the PTB 4 provides another component of the vertical upward force F1 _y3 . Those skilled in the art will understand that there may be other structural features that provide a vertical upward force from PTB 4, which contributes to the total upward force F1 exerted by PTB 4.

Another example of a structural feature that could contribute to the upward force F1 exerted by the PTB 4 is shown in Figure 7C, which shows a partial cross-sectional view of the PTB 4 having a portion of an inflatable bladder portion 94 that, when inflated, forms a slightly inclined horizontal surface 96. When the bladder is inflated in a predetermined manner, the patient's lower leg 98 is compressed such that the soft tissue conforms closely to the shape of the bladder, thereby providing a complementary inclined horizontal surface 100 that abuts the surface 96. In this way, the corresponding horizontal surface of the lower leg and the patient's anatomical features can be enhanced to better provide the necessary vertical component of force. In another embodiment discussed below, the PTB 4 can be replaced by an alternative brace extending to the user's thigh and can be adjusted to allow force to be transmitted to the posterior thigh and knee. From these teachings, those skilled in the art will readily recognize other variations of the PTB 4 to generate and enhance the vertical force required to support the patient's weight W.

Another example of a structural feature that can contribute to the upward force F1 applied by PTB 4 is shown in Figure 7D. A wedge 45 can be inserted under the sole 44 of the walking boot 36, causing the heel 47 of the walking boot 36 to rise. When the heel 47 of the walking boot 36 rises above the toe 49, the upper portion 52 of the walking boot 36 and PTB 4 are positioned at an angle of less than 90° to the ground. This provides additional horizontal surface area that can be used to increase F1. The wedge 45 can be used to position the sole 44 at various adjustable angles to the ground during patient recovery. In some embodiments, the wedge 45 can form an angle between the sole 44 and the ground ranging from 0° to 85°, including end values.

If the AFO 60 is used in certain embodiments, such as as shown in FIG7D, the attachment mechanism 86 between the AFO 60 and the walking boot 36 may preferably include a sliding mechanism, such as an interlocking rail or a knob and rail system. Then the bottom 66 of the AFO 60 can move relative to the upper part 52 of the walking boot 36. For example, the bottom 66 of the AFO 60 can move 0-2 inches, 0-1 inch, 0-0.5 inches, or 0-0.25 inches relative to the upper part 52 of the walking boot 36.

Several possible alternatives for adjusting F1 and F2 have been disclosed above. The ability to adjust F1 and F2 during patient recovery provides the advantageous capability to control the percentage of patient weight borne by the injured foot and ankle.

Figures 8B and 8C show alternative force diagrams of the orthotic support system 2 configuration without PTB 4, as shown in Figure 8A. In Figures 8B and 8C, the downward force from the user's weight is shown as vector W. In Figures 8B and 8C, the bottom 66 of AFO 60 supports the force from the user's weight. The ground reaction force, shown as vector GR, is the upward force that occurs on AFO 60 when the bottom of walking boot 36 contacts the ground. As shown in Figure 8B, when AFO 60 rests on the footpad 42 of walking boot 36, the ground reaction force is also distributed on the bottom 66. However, when AFO 60 is suspended above the footpad 42, as shown in Figure 8C, the ground reaction force is transmitted through the attachment point between AFO 60 and walking boot 36.

Figure 8D illustrates an alternative attachment mechanism 86 that can be used to attach the AFO 60 to the walking boot 36. One or more rails 88 can be inserted into the upright portion 76 of the AFO 60. The rails 88 can be configured to attach the back of the AFO 60 to a knob 90 inside the upper part 52 of the walking boot 36. Other attachment mechanisms 86 are also envisioned. The AFO 60 can be attached to the walking boot 36 via rails, crossbars, ridges, extensions, protrusions, flush mounting brackets, snap-fit connections, hook-and-loop connectors (e.g.), magnets, or straps. For example, the walking boot 36 may have an attachment mechanism 86, such as a rail, crossbar, ridge, extension, protrusion, or flush mount, on the inner surface of the upper portion 52, and the AFO 60 may have grooves, slits, recesses, notches, pits, slots, or flush mounts on the outer surface of the post portion 76, configured to mate with the attachment mechanism 86 on the inner surface of the walking boot 36. The grooves, slits, recesses, notches, pits, or slots on the exterior of the AFO 60 may be configured to capture the rails, crossbars, ridges, extensions, or protrusions of the walking boot 36 to releasably attach the AFO 60 to the walking boot 36. Alternatively, a flush mount, button, knob, or lever on the exterior of the AFO 60 may be configured to mate with a flush mount or rail in the walking boot 36 to detachably connect the AFO 60 to the walking boot 36. Alternatively, the AFO 60 may have a flush mounting bracket or rail on its outer surface, while the walking boot 36 may have a flush mounting bracket, button, knob, or lever on its inner surface. The flush mounting bracket, button, knob, or lever on the inside of the walking boot 36 may be configured to mate with the flush mounting bracket or rail on the AFO 60 to detachably connect the AFO 60 to the walking boot 36.

Further details and features of the embodiments previously described with reference to the walking boot 36 are shown in more detail in Figures 9A-9G. As explained above and shown in Figures 9A and 9B, the upper portion 52 of the walking boot 36 may be formed by rigid posts 102, 103 connected to the bottom 50. The posts 102, 103 may be spaced apart from each other. For example, one post 103 may be located near the user's heel, and the other post 102 may be located on the outside of the user's leg. The posts 102, 103 may be formed of any rigid material, such as plastic or metal (e.g., steel). For example, the posts 102, 103 may be formed of any rigid and durable material (including plastic, metal, steel, aluminum, glass fiber, carbon fiber, composite materials, or any combination thereof). The posts 102, 103 may also be formed of, for example, polypropylene or polyethylene. Other materials are also feasible, as will be understood by those skilled in the art.

The sole 50 may be formed of a rigid and durable material, such as metal or plastic. The metal or plastic may be covered with padding, such as foam padding, fabric or a combination of foam, fabric or other elastic materials. The boot sole 51 may be made of an elastic material, such as rubber. The strap 38 may be attached to the sole 50 and used to attach the bottom of the walking boot 36 to the patient.

As shown in Figures 9C and 9D, the lining 41 slides on the post 102. The lining 41 may have a side pocket 104 opening along the bottom edge, allowing the side pocket 104 to slide on the post 102. The side pocket 104 may be narrower at the bottom to maintain proper lining and foot positioning relative to the bottom of the boot. The side pocket 104 may be wider at the top to accommodate larger or smaller legs by adjusting the position of the lining 41 relative to the rear of the walking boot 36.

The liner 41 may also have a slit 106 through which the rear post 102 can slide. When the rear post 103 passes through the slit 106 leading into the interior of the liner, as shown in FIG9F, the attachment mechanism 86 is exposed, allowing the AFO 60 to be attached to it.

The bottom of the lining 41 can also be secured to the bottom 50 of the walking boot 36 using, for example, snaps, hooks or other suitable attachment mechanisms known in the art.

As shown in Figure 9D, the front flap 110 can be wrapped around the front of the patient's lower leg, and then the lining 41 can be secured using a wide strap 108. The strap 108 can be made of, for example, fabric, foam, or a combination of materials and is attached at one end to the lining 41 to prevent tangling, twisting, or loss. The strap 108 can be wrapped around the lower leg and a portion of the lining 41, and then the loose end of the strap 108 can be secured with, for example, snaps, hooks, buttons, or other suitable attachment mechanisms. Furthermore, the strap 108 can be oriented such that it wraps around the leg in different directions, i.e., from left to right or from right to left, to facilitate tightening and a secure fit of the strap 108.

Various methods can be used to secure the lining around the patient's leg. For example, Figure 10A shows a lining 41 attached to a walking boot 36 via a side pocket 104 that slides on the post 102. The lining is then secured to the user's leg using a strap 208. As in the example in Figure 9D, one end of the strap 208 in Figures 10A and 10B is attached to the lining. As shown in Figure 10A, the free end of the strap 208 can be a loop 209, which can be made of any suitable material, such as plastic, fabric, metal, etc. The strap 108 can be wrapped around the calf and a portion of the lining 41. The loop 209 can be attached to a knob 213 (see Figure 10B), which is attached to the post 102. The side pocket 104 of the lining 41 can have an opening 105, allowing the knob 213 to be accessed after the lining 41 has been secured to the walking boot 36. In addition, there may be a strip 211 for securing the lining to the rear post 103.

Additional optional features of the liner 41 are also shown in Figures 10A and 10B. For example, toe flaps 111 may wrap around the top of the patient's foot. The liner 41 may also have mesh portions 43 to allow for better airflow and ventilation.

In the examples of Figures 10C and 10D, the lining 41 is attached to the walking boot 36 via a side pocket 104 that slides on the post 102. The lining is then secured to the user's leg using a strap 308. The strap 308 may be adjustable. As shown in Figure 10C, the free end of the strap 308 may be connected to a first end of a side release buckle 309. As shown in Figure 10D, the strap 308 may wrap around the calf and a portion of the lining 41. The first end of the side release buckle 309 may then be attached to a second end of a side release buckle 313, which is attached to the post 102. The side pocket 104 may have an opening 105 that allows access to the second end of the side release buckle 313 after the lining 41 has been secured to the walking boot 36.

In the example of Figure 10E, the lining 41 is attached to the walking boot 36 via a side pocket 104 that slides on the post 102. The lining is then secured to the user's leg using shoelaces 409. The shoelaces 409 can be tied, or, as shown in Figure 10E, any known quick-lacing system can be used to secure the shoelaces 409.

In the examples of Figures 10F and 10G, the lining 41 is attached to the walking boot 36 via a side pocket 104 that slides on the post 102. The lining is then secured to the user's leg using a strap 508. The strap 508 can be multiple small straps or cords 507. As shown in Figure 10F, one end of the multiple small straps or cords 507 can be connected to a first end of a buckle 509 to form the strap 508. As shown in Figure 10G, the strap 508 can be wrapped around the calf and a portion of the lining 41. The first end of the buckle 509 can then be attached to a second end (not shown), which is attached to the post 102 or optionally to the lining 41.

In the examples of Figures 10H and 10I, the lining 41 is attached to the walking boot 36 via a side pocket 104 that slides on the post 102. The lining is then secured to the user's leg using buckle rings 609 and 613. As shown in Figure 10I, one half of the buckle ring 613 can be attached to the post 102. The other half of the buckle ring 609 can be attached to the lining 41, as shown in Figure 10I. The lining 41 can be wrapped around a portion of the calf, and the buckle rings can be fastened to secure the lining to the user's leg. The side pocket 104 may have an opening 105 that allows access to the second end of the buckle ring 613 after the lining 41 is secured to the walking boot 36. Alternatively, the lining 41 may include a pocket 610 that slides on the post 103 and is secured by a strap 611.

The AFO 60 shown in Figure 9E can be attached to the walking boot 36. The wider strap 112 shown in Figure 9E secures the AFO 60 to the patient's foot and leg. The attachment mechanism 86 on the back of the AFO 60 matches the attachment mechanism 86 on the walking boot 36, as shown in Figure 9F. The walking boot 36 with the AFO 60 attached is shown in Figure 9G.

Those skilled in the art will understand that various methods are feasible for attaching the AFO 60 to the walking boot 36. For example, as shown in Figure 11A, an attachment 122, such as a hook or loop, may be present on the back of the AFO 60. The liner 41 may have a flap 141 configured to open, thereby providing access to the back of the AFO 60 and the attachment 122. A strap 121 may be present, passing through the attachment 122. After passing through the attachment 122, the strap 121 may be secured by one or more buckles 123. The buckles 123 may be directly attached to the walking boot 36. Alternatively, the buckles 123 may be attached to the liner 41, which is attached to the walking boot 36, thereby indirectly attaching the AFO 60 to the walking boot 36.

In the examples of Figures 11B and 11C, the AFO 60 can be attached to the walking boot 36 using a knob and rail system. As shown in Figure 11B, the protrusion or knob 223 can be attached to the rear post 103, while the rail 222 is attached to the back of the AFO 60. The AFO 60 can then be attached to the walking boot 36 by sliding the rail 222 onto the knob 223, as shown in Figure 11C.

In the examples of Figures 11D to 11G, a strap can be used to attach the AFO 60 to the walking boot 36. The strap 322 can pass through a slit 323 in the heel of the bottom 50, as shown in Figure 11D. The strap 322 can then pass through an opening 325 in the lining 41. Those skilled in the art will understand that the strap 322 can be more than a single strap; it can alternatively pass through the post 102 (not shown in Figures 11D-11G). The opening 325 can be positioned in the lining to accommodate the placement of the strap 322. The ends of the strap 322 can also optionally pass through guides (not shown) on the inside of the lining 41 to minimize tangling and facilitate the placement of the strap relative to the AFO 60. The AFO 60 can then be placed in the lining 41, and the strap 322 can be wrapped around the AFO 60 and the user's foot or calf, and secured using, for example, a hook-and-loop closure 324, as shown in Figures 11E and 11G. Those skilled in the art will understand that any suitable closure 324 can be used, including but not limited to snaps, buttons, buckles, pins, etc.

Alternatively, as shown in Figures 11H and 11I, the AFO 60 can be attached to the walking boot 36 using a strip sewn directly into the lining 41. The strip 422 can be attached to the lining 41 by any suitable means (e.g., stitching, gluing, adhesive, hooks, and loops, etc.). The AFO 60 can then be placed inside the lining 41, and the strip 422 can be wrapped around the AFO 60 and the user's foot or calf, and secured using, for example, a hook-and-loop closure 324. Those skilled in the art will understand that any suitable closure 324 can be used, including but not limited to snaps, buttons, buckles, pins, etc.

Alternatively, the AFO 60 can be attached to the walking boot 36 using a magnet 523. One possible placement of the magnet 523 in the heel of the bottom 50 is shown in Figure 11J. However, the magnet 523 can be placed anywhere on the bottom 50 or on the posts 102, 103. The magnet 523 secures the AFO 60 in place while the liner 41 is secured around the AFO 60 and the user's foot and leg.

In the alternative shown in Figures 11K and 11L, the AFO 60 can be attached to the walking boot 36 using a continuous strip 908. The continuous strip 908 can be secured to the post 102 via a sleeve 911. The continuous strip 908 passes through the sleeve 911, leaving a handle end 910 of the continuous strip 908 above the sleeve 911, accessible from the outside of the walking boot 36. The other end of the strip 908 is an attachment end 909. To attach the AFO 60 to the walking boot 36, the AFO 60 is attached to the patient's leg and placed inside the walking boot 36. The attachment end 909 can then be loosely placed over the patient's ankle and secured to the bottom 50 by, for example, a buckle, snap, magnet, or any other suitable fastener 912. The continuous strip 908 can then be tightened by pulling the handle end 910 to secure the AFO 60 in place (see Figure 11M).

Other configurations of the continuous strip 908 are possible. For example, as shown in Figure 11N, there can be two continuous strips 908, one attached to each post 102. The attachment ends 909 of the two continuous strips 908 can be secured to each other by fasteners 912. The continuous strips 908 can then be tightened by pulling one or both of the handle ends 910.

Optional pneumatic devices can be added to the liner 41 to provide compression during the user's leg healing process. Various configurations of the pneumatic devices are feasible. For example, self-inflating airbags as shown in Figures 12A, 12B, and 12C can be used. The liner 41 may have an inner liner airbag 542. As shown in Figure 12B, an open-cell foam 544 can be placed inside the inner liner airbag 542. A vent 540 can be connected to the liner airbag 542. When the valve 530 is turned to the open position 532, air can freely flow through the vent 540 into or out of the inner liner airbag 542. When the valve 530 is in the closed position 531, no air flows through the vent 540 and a relatively constant volume of air is maintained in the liner airbag 542, except for the usual level of leakage in such systems. As shown in Figure 12C, when the lining airbag 542 is empty and the valve 530 is turned to the open position 532, air flows through the vent 540 into the lining airbag 542, inflating the perforated foam 544. If the valve 530 remains in the open position 532, some air will flow out of the lining airbag 542 through the vent 540 because the lining 41 is wrapped around the user's calf 98, as shown in Figure 12D. When the valve 530 is turned to the closed position 531, the air retained in the airbag 542 and the perforated foam 544 will provide compression to the user's calf and ankle.

Those skilled in the art will understand that different configurations of valve 530 are possible. For example, Figure 12E shows a spiral valve 530' that can be used to inflate the liner airbag 542. Additionally, the spiral valve 530' actuates cavities within the airbag 542, and the displacement of air within the airbag 542 creates further compression.

Other configurations of the pneumatic device will apply to this disclosure. For example, the pneumatic device may be a pump built into the walking boot 36. Non-limiting examples of such a pump are shown in Figures 12F and 12G. The pump mechanism shown in Figure 12F includes a lever 630 and an air inlet 631. As shown in Figure 12G, by moving the lever 630 toward the bottom 50, air can be forced from the air inlet 631 into the lining airbag 633.

Another non-limiting example of a pneumatic device that will work with this disclosure is a manually inflatable device, such as the one shown in FIG12H. An air bag 730 may be connected to a channel 731. Channel 731 may be connected to a port 735, which in turn connects to a liner air bladder 733. When the air bag 730 is compressed, air flows through channel 731, port 735, and into the liner air bladder 733. Port 735 may be a one-way valve to prevent air from flowing out of the air bladder when the pressure on the air bag 730 is released.

Those skilled in the art will understand that, depending on the patient's compression requirements, the liner airbag can be configured in various ways, as shown in Figures 12A to 12H. In Figure 12I, the liner airbag 833 is shown as a separate flap. Advantageously, the liner airbag 833 can be positioned to achieve more direct compression of the foot and ankle. For example, as shown in Figure 12I, the liner airbag 833 can be configured to cover the front of the foot and ankle without being covered by the AFO 60. Furthermore, more than one liner airbag can be used in a single liner 41.

The alternative support will also work in conjunction with embodiments of the previously disclosed orthopedic support system 2. For example, as shown in Figures 13A, 13B, and 13C, the PTB 4 can be replaced by a support member 1304. The support member 1304 serves the same purpose, namely, to reduce or eliminate the weight borne by the patient's foot and ankle during recovery, and it can be attached to or removed from the walking boot 36 at different stages of treatment and recovery. The support member 1304 includes a first support portion 1303 surrounding the patient's thigh and a second support portion 1305 surrounding the upper part of the patient's calf and part of the knee. As shown in Figures 13A and 13B, the first support portion 1303 may have a rod 1306 extending along the medial and lateral sides of the patient's thigh and a strip 1320 securing the first support portion 1303 to the patient's thigh. The second support portion 1305 may have a rod 1308 extending along the medial and lateral sides of the patient's calf and a strip 1320 securing the second support portion 1305 to the patient's calf. Rods 1306 and 1308, as well as the first support 1303 and the second support 1305, can be pivotally connected via a lockable joint 1310. Furthermore, rod 1308 can be attached to walking boot 36. For example, guide rail 1309 can be secured to the bottom 50 of walking boot 36 via, for example, bolts 1312. Rod 1308 can be inserted into guide rail 1309 and secured using fasteners 1311. Additional structural support for guide rail 1309 can be provided by, for example, a post 1318.

Alternatively, as shown in Figure 13C, the support 1304 includes a first support portion 1303 surrounding the patient's thigh and a second support portion 1305 surrounding the upper part of the patient's calf and part of the knee. The first support portion 1303 may have a rod 1306 positioned along the posterior aspect of the patient's thigh and a strap 1320 securing the first support portion 1303 to the patient's thigh. The second support portion 1305 may have a rod 1308 positioned along the posterior aspect of the patient's calf and a strap 1320 securing the second support portion 1305 to the patient's calf. The rods 1306 and 1308, as well as the first and second support portions 1303, can be pivotally connected via a lockable joint 1310. Furthermore, the rod 1308 may be connected to the walking boot 36. For example, a guide rail 1309 may extend from the toe region or optionally the arched region through the interior of the bottom 50 and bend to extend upward from the heel 74 of the bottom 50. The rod 1308 can be inserted into the guide rail 1309 and secured using fasteners (not shown). Alternatively, the rod 1308 and the guide rail 1309 can be pivotally connected to facilitate additional adjustments to the positioning of the patient's lower leg and knee.

Rods 1306 and 1308 can be made of lightweight materials such as carbon fiber, aluminum, or hollow tubes made of metal alloys. Those skilled in the art will understand that alternative materials can be chosen for heavier patients.

In such an embodiment, the patient's knee can also be held in a fixed position. For example, as shown in Figures 13A and 13B, connector 1310 may include lock 1313, such that rods 1306 and 1308 can be held at a fixed angle θ. Preferably, the patient's knee can be held in a bent position, such that the patient's weight can be borne by a combination of the posterior thigh, knee, and top of the calf.

The support 1304 can be adjusted to redistribute the force from the patient's body weight among the thigh, knee, and foot. For example, in Figure 13B, axis _A1 extends parallel to rod 1306, while axis _A2 extends parallel to rod 1308. Angle θ is the angle between axis _A1 and axis _A2 . Angle θ can be adjusted by unlocking joint 1310 and moving the patient's thigh and lower leg so that the relative positions of rods 1306 and 1308 form the desired angle θ. Joint 1310 can then be locked to maintain angle θ. Adjustment of angle θ will allow more or less of the patient's body weight to be borne by the back of the patient's thigh.

Furthermore, the angle of the support 1304 relative to the bottom 50 of the walking boot 36 can be adjusted to allow the patient's knee to bear more or less weight. As shown in Figure 13B, axis _A3 is approximately parallel to the bottom 50, while axis _A2 is approximately parallel to the rod 1308. Angle β is the angle between axis _A2 and axis _A3 . Adjustment of angle β can be achieved by moving the bolt 1312 along the bottom 50 of the walking boot 36 to different attachment points 1314, as shown in Figures 13A and 13B. Alternatively, the rod 1308 can be pivotally connected to the bottom 50 via a locking joint (not shown).

In most embodiments envisioned herein, the AFO 60 is also detachably connected to the walking boot 36 (the AFO is not shown in Figures 13A and 13B). Therefore, as discussed above with reference to Figure 7D, the AFO 60 will move relative to the walking boot 36 when the angle β is adjusted. In this way, the angle between the patient's foot and lower leg is preserved when β is adjusted.

The support member 1304 can also be size-adjustable. The strap 1320 can be tightened or loosened to accommodate different thigh sizes. Furthermore, the first support portion 1303 of the support member 1304 can also be adjusted in length to accommodate longer or shorter legs. For example, the first support portion 1304 can extend as shown by the dashed line 1322 in Figure 13B. The second support portion 1305 can be similarly adjusted in size and length to accommodate different calf sizes.

The position of the support 1304 relative to the bottom 50 of the walking boot 36 can also be adjusted. In the examples shown in Figures 13A and 13B, the rod 1308 slides into the guide rail 1309 and is secured to the guide rail 1309 by fastener 1311. To accommodate longer or shorter legs, the rod 1308 can be inserted into the guide rail 1309 by a greater or smaller distance.

Furthermore, the sole 51 of the walking boot 36 is adjustable to different heights and angles. For example, a wedge 1316 can be releasably attached to the sole 51, resulting in a height _H1 at the heel of the bottom 50, and, depending on the shape of the wedge 1316, a height _H2 or _H3 at the toe of the bottom 50. The wedge 1316 can be attached to the sole 51 and/or bottom 50 using sheet metal and screws, adhesives, interlocking rails, or any other attachment method known in the art. Alternatively, the height of the footpad 42 can be adjusted by releasably attaching a wedge 1316' to the footpad 42. The density of the material used to manufacture the wedges 1316, 1316' can also be variable, thus also providing an adjustable degree of compression.

The adjustability of angles θ and β, as well as the various heights and lengths achievable through the adjustable components of support 1304, allows the orthopedic support system 2 to fit any patient, ensuring that the patient's hips remain at approximately the same height during walking. In existing non-weight-bearing support systems, the patient's hips are pushed up during walking, leading to back and hip pain.

Support 1304 can replace PTB 4 in the foregoing embodiments to reduce or eliminate the weight that is typically borne by the patient's foot. Support 1304 can also be added to embodiments of this disclosure where PTB 4 is not shown. Just as PTB 4 can be removed from orthotic support system 2, support 1304 can be removed when the patient is able to bear his or her full weight on his or her foot.

Although exemplary embodiments have been disclosed above, the present invention is not limited to the disclosed embodiments. Rather, this application is intended to cover any variations, uses, or modifications of the general principles of this disclosure. Furthermore, this application is intended to cover deviations from this disclosure that fall within the scope of known or customary practices in the art to which the invention pertains and fall within the scope of the appended claims.

Claims (61)

1. A support assembly, comprising: Walking boots are configured to cover the user's ankle, the sole of the user's foot, and part of the user's calf; A patellar tendon support bracket (“PTB”), detachably attachable to the walking boot and configured to suspend a portion of the user’s weight at the user’s patellar tendon; and Ankle-foot orthosis (“AFO”) that can be detachably attached to the walking boot. 2. The support assembly of claim 1, wherein the AFO is configured for insertion into a shoe. 3. The support assembly of claim 1, wherein the AFO comprises: a base configured to cover the user's sole and arch; and a column portion configured to cover the user's heel and the posterior part of the user's ankle. 4. The support assembly of claim 1, wherein the AFO comprises a moldable AFO. 5. The support assembly of claim 1, wherein the PTB comprises: Back cover; Front shell; and Strips, in which the strips connect the rear shell to the front shell. 6. The bracket assembly of claim 4, wherein the strip passes through a ring connected to an arcuate guide on the rear or front housing. 7. The support assembly of claim 4, wherein the PTB extends onto the user's thigh. 8. The support assembly of claim 1, wherein the connection position between the PTB and the walking boot is adjustable. 9. The support assembly of claim 1, wherein the PTB is configured to provide a first upward force to the user, and wherein the footpad of the walking boot is configured to provide a second upward force to the user, wherein the relative amounts of the first upward force and the second upward force are adjustable. 10. The support assembly of claim 1, wherein the wedge is positioned below the sole of the walking boot. 11. A support assembly, comprising: Walking boots configured to cover the user's ankle, the sole of the user's foot, and the user's calf, wherein the front of the walking boot is open; and Ankle-foot orthosis (“AFO”) that can be detachably attached to the walking boot. 12. The support assembly of claim 11, wherein the walking boot includes a foot pad and the distance between the AFO and the foot pad is adjustable. 13. The support assembly of claim 11, wherein the AFO is attached to the walking boot via one of a crossbar, a guide rail, a crossbar and a protrusion, a flush mounting bracket, a snap-fit connector, a hook and loop connector, a magnet, a strip, and a continuous strip. 14. A method for supporting an injured lower limb, the method comprising: The first support member is attached to the area surrounding the user's patellar tendon; Provide a second support structure for the area around or below the user's feet; The first support member provides a first upward force on the patellar region; A second upward force is provided at the foot by a second support member; and Adjust the magnitudes of the first upward force and the second upward force to achieve the desired balance. 15. The method of claim 14, wherein adjustment is made by changing the positions of the first support member and the second support member. 16. The method of claim 14, wherein the first support member is a PTB. 17. The method of claim 14, further comprising maintaining a predetermined angle between the user's foot and leg after adjusting the amounts of the first upward force and the second upward force. 18. The method of claim 17, further comprising using an AFO to maintain the prescribed angle between the foot and the leg. 19. A support assembly, comprising: Walking boots, configured to cover at least a portion of the sole of the user's foot; and A support member, connected to the walking boot, having a first support portion configured to attach to the user's thigh. The support includes a lockable connector, wherein when the connector is unlocked, the angular position of the first support relative to the walking boot is adjustable, and wherein when the connector is locked, the angular position of the first support relative to the walking boot is fixed. 20. The support assembly of claim 19, wherein the support further comprises a second support portion configured to be at least partially attached to the user's leg below the patella. 21. The support assembly of claim 20, wherein when the connector is unlocked, the position of the second support relative to the walking boot is fixed and adjustable relative to the first support. 22. The bracket according to any one of claims 19-21, wherein the first support portion has a shape configured to surround the user's thigh. 23. The support according to any one of claims 19-22, wherein the walking boot has a bottom axis and a lower leg axis and an adjustable angle β therebet between them, wherein the position of the user's lower leg relative to the bottom of the walking boot is adjustable. 24. The support assembly according to any one of claims 19-23, wherein the walking boot has a height-adjustable bottom. 25. The support assembly according to any one of claims 19-24, further comprising an ankle-foot orthosis (“AFO”) detachably connectable to the walking boot. 26. The support assembly of claim 25, wherein the AFO is attached to the walking boot via one of a crossbar, a guide rail, a crossbar and a protrusion, a flush mounting bracket, a snap-fit connector, a hook-and-loop connector, a magnet, a strip, and a continuous strip. 27. The support assembly according to any one of claims 19-26 further includes a pneumatic feature configured to provide pressure to the user's foot, ankle, and/or calf. 28. The support assembly of claim 27, wherein the pneumatic feature includes an inflatable bag, a pump, and/or a self-inflating airbag. 29. A support assembly, comprising: Walking boots, configured to cover at least a portion of the sole of the user's foot; and A support member, connected to the walking boot, having a first support portion configured to attach to the user's thigh. The walking boot has a bottom axis and a calf axis and an adjustable angle β between them, wherein the position of the user's calf relative to the bottom of the walking boot is adjustable. 30. The support assembly of claim 29, wherein the support includes a lockable connector, wherein when the connector is unlocked, the angular position of the first support relative to the walking boot is adjustable, and wherein when the connector is locked, the angular position of the first support relative to the walking boot is fixed. 31. The support assembly of claim 29, wherein the support further comprises a second support portion configured to be at least partially attached to the user's leg below the patella. 32. The support assembly of claim 31, wherein when the connector is unlocked, the position of the second support is fixed relative to the walking boot, but adjustable relative to the first support. 33. The bracket according to any one of claims 29-32, wherein the first support portion has a shape configured to surround the user's thigh. 34. The support assembly according to any one of claims 29-33, wherein the walking boot has a height-adjustable bottom. 35. The support assembly according to any one of claims 29-34, further comprising an ankle-foot orthosis (“AFO”) detachably connectable to the walking boot. 36. The support assembly of claim 35, wherein the AFO is attached to the walking boot via one of a crossbar, a guide rail, a crossbar and a protrusion, a flush mounting bracket, a snap-fit connector, a hook and loop connector, a magnet, a strip, and a continuous strip. 37. The support assembly according to any one of claims 29-36 further includes a pneumatic feature configured to provide pressure to the user's foot, ankle, and/or calf. 38. The support assembly of claim 37, wherein the pneumatic feature includes an inflatable bag, a pump, and/or a self-inflating airbag. 39. A support assembly, comprising: Walking boots, configured to cover at least a portion of the sole of the user's foot; and A support member, connected to the walking boot, having a first support portion configured to attach to the user's thigh. The walking boots described therein have a height-adjustable sole. 40. The support assembly of claim 39, wherein the support includes a lockable connector, wherein when the connector is unlocked, the angular position of the first support relative to the walking boot is adjustable, and wherein when the connector is locked, the angular position of the first support relative to the walking boot is fixed. 41. The support assembly of claim 39, wherein the support further comprises a second support portion configured to be at least partially attached to the user's leg below the patella. 42. The support assembly of claim 41, wherein when the connector is unlocked, the position of the second support is fixed relative to the walking boot, but adjustable relative to the first support. 43. The bracket according to any one of claims 39-42, wherein the first support portion has a shape configured to surround the user's thigh. 44. The support assembly according to any one of claims 39-43, wherein the walking boot has a bottom axis and a lower leg axis and an adjustable angle β therebet between them, wherein the position of the user's lower leg relative to the bottom of the walking boot is adjustable. 45. The support assembly according to any one of claims 39-44, further comprising an ankle-foot orthosis (“AFO”) detachably connectable to the walking boot. 46. The support assembly of claim 45, wherein the AFO is attached to the walking boot via one of a crossbar, a guide rail, a crossbar and a protrusion, a flush mounting bracket, a snap-fit connector, a hook and loop connector, a magnet, a strip, and a continuous strip. 47. The support assembly according to any one of claims 39-46 further includes a pneumatic feature configured to provide pressure to the user's foot, ankle, and/or calf. 48. The support assembly of claim 47, wherein the pneumatic feature includes an inflatable bag, a pump, and/or a self-inflating airbag. 49. The support assembly according to any one of claims 39-48, wherein the height of the bottom is adjusted by a wedge. 50. The support assembly of claim 49, wherein the bottom includes a foot pad and the wedge is attached to the foot pad. 51. The support assembly of claim 49, wherein the bottom includes a boot sole, and the wedge is attached to the boot sole. 52. A support assembly, comprising: Walking boots, which are configured to cover at least a portion of the sole of the user's foot; A support member, attached to the walking boot, the support member having a first support portion configured to attach to the user's thigh; and Ankle-foot orthosis (“AFO”) that can be detachably attached to the walking boot. 53. The support assembly of claim 52, wherein the support member includes a lockable connector, wherein when the connector is unlocked, the angular position of the first support relative to the walking boot is adjustable, and wherein when the connector is locked, the angular position of the first support relative to the walking boot is fixed. 54. The support assembly of claim 52, wherein the support further comprises a second support portion configured to be at least partially attached to the user's leg below the patella. 55. The support assembly of claim 54, wherein when the connector is unlocked, the position of the second support is fixed relative to the walking boot, but adjustable relative to the first support. 56. The bracket according to any one of claims 52-55, wherein the first support portion has a shape configured to surround the user's thigh. 57. The support assembly according to any one of claims 52-56, wherein the walking boot has a height-adjustable bottom. 58. The support assembly of claim 52, wherein the AFO is attached to the walking boot via one of a crossbar, a guide rail, a crossbar and a protrusion, a flush mounting bracket, a snap-fit connector, a hook and loop connector, a magnet, a strip, and a continuous strip. 59. The support assembly according to any one of claims 52-58 further includes a pneumatic feature configured to provide pressure to the user's foot, ankle, and/or calf. 60. The support assembly of claim 59, wherein the pneumatic feature includes an inflatable bag, a pump, and/or a self-inflating airbag. 61. The support assembly of claim 52, wherein the walking boot includes a foot pad and the distance between the AFO and the foot pad is adjustable.