US2099401A - Orthopedic correcting appliance - Google Patents

Description

Nov. 16, 1937. JUNGMANN ORTHOPEDIC CORRECTING APPLIANCE Filed June 19, 1955 2 Sheets-Sheet l W 1U n e m I Mmzkz 57 PML dvQuz I Nov. 16, 1937. M. JUNGMANN 2,099,401

ORTHQPEDIC CORRECTING APPLIANCE Filed June 19, 1935 2 Sheets-Sheet 2 Patented Nov. 16, 1937 v STATES PATENT arr-ICE.

2,099,40 7 7 E H IQ Q QHNG. A PLM QE Martin Jungmann, Vienna, Austria Application June 19, 1935, Serial Ne. 27,2{50

5 Claims.

This invention relates to orthopedic correcting appliances, more particul'arly for the relief and treatment of flatfieet, sunk insteps, and like afie9ti9 he. oo

The 'h a foot eonstitutes' anon-rigid arch parts of fiigd shape (the bones) which are held "ligaments and controlled as to posit 'pr ffl,

v be. strained beyond the limits of it's en-- with the result'that the bones assume abnormal pons under the influence of the weight of the the The t ansitiona nsifi e stages of Such deferrnatie'n, may even go to the point of complete destruction of the normal construction oithefoot, are'to be form-din the various known i s-f r subsidsi a Sufik i ep fl er p I a ees, and the like). n. er e ha "hitherto usually been had to the use ofrigid n str in or be egi g' part of e foot,'which ho wever implies lossof "within the foot structure.

f rms t H 4 ead foot, and their consequences (crooked V A i N counteract or to correct abnormal cement ofthe bones of the foot reeourse placed beneath the instep or of cir- V of the front freedom tr movement With a'viewto reli 'ng'the" strain onth'ear'ch of't'he foot; it has also" been "proposed to place a stfapor bandage around thefront 'part of the foot, and then either to attach' two'tensioning straps. to this encircling element: which are crossed over beneath the sole and made fast to the ankle or to the heel, or toattach'a pulling strap on the under side which is' likewise made fast to the heel.

Appliances of this nature are not satisfactory, since the tension of the longitudinal straps, in view of its direction, tends to pull the encircling gaiter member back towards the heel, with the result that this member ceases to be capable of gripping the pier common to" both the transverse arch and the longitudinal arch of the foot, namely the first of the metatarsal bones to which the big "toe is artioulatedfat'the point best suited for a fast hold thereof; that is to say adjacent its forward end; moreover, the transversebinding action of the gaiter is then no longer in the direction of the transverse arch but obliquely thereto, which is likewise unsatisfactory.

In the appliance according to the present invention the point of application of the longitudinal tension strap to the gaiter member encircling the forepart of the foot is fixed by being anchored, preferably to the big toe, the result I n Austria June 21, 1 934 be n the eby ac e ed that the encircling transverse binder is kept inthe right position for sustaining the transverse arch and at the same time amine were: er

of the arch as nearly as possib e. at its forward end, so that both th-e'tran's v rse; ch and" a oss nd, su tain in a the avoidance of the tie the longitudinal the longitudinalarch are tied avo a e ma w th drawback peculiar to known whi'chrnerely serve to arch "and consist for this purpose of a tension member looped around the a a mad? t to back consists in This dr f the' big toe 'at the forward the heeliatthe rear end. the fact that in the apforce to the phalangial the phalanx of this toe of the toe in a man} nereounter to all natural stresses, while at the same time the noose the Pas in ra portion of the appliance big' toe and the "adjacent toeexerts an undesirable spreading action upon the 'rnetatarsal bones 'to which these toes are articulated. "l'his' unnatural pressure and'fsp'retding action become so 'insuiferable to the user as the appliance impossible.

to" render the necessary prolonged wearing of mostirnportanttypes of foot deformation s b 'n diag'rammau drawings; in whieh:

due to ligamntal and muscular msufliciency are cally in the accompanying dotted lines, the manner inwhi'ch" this arch can give way and subside.

"Fig"; 2 is a plan View Figs. 3

flattened, and in of the no while showing the same of thetransverse' arch and 4 are cross-sections condition, respectively.

Fig. 5 shows the normal position, and, in dotted liriesltwo abnormal positions of the big toe relatively'to the metatarsal bones.

Fig. 6 shows the'skeleton of the foot from below, with the correcting appliance according to the present invention, 'action exerted upon represented by the (as to illustrate the torsional the heel, the latter being calcis.

Figl'i shows, in full lines, the normal position,

and, 'in broken lines,

tion of the os calcis. Figs. 8 and 9 show the abnormally tilted posithe correcting appliance according'to the invention in the operative position on a foot, as seen from the dorsal side and from the sole, respectively.

Fig. 10 shows the tiveview.

' It is'the purpose 0 appliance alone, in perspecf the appliance according to the normal the invention to tie the longitudinal arch shown in Fig. 1, and also the transverse arch shown in Figs. 2 and 4, by straining force applied at the piers of these arches, and thus to relieve the load on the muscles which strive to counteract the natural deformation of the arches normally brought about in walking or other movement involving strain thereon, and to efiect or facilitate the restoring of these muscles into their initial positions. For this purpose, as shown in Figs. 8, 9, and 10 and indicated in the remaining figures of the drawings, the appliance according to the invention consists of a transverse binder a encircling the foot at the forward end of the metatarsal bones, the portion cu in contact with the dorsal portion of the foot being made of nonelastic material such as leather, fabric, or the like, while the portion (12 in contact with the sole and attached to the above-mentioned portion at both sides for instance by adhesion or stitching consists of two parts made of elastic material such as rubber and adapted to be tightened up by any suitable means. According to the adjustment of the tensioning of these parts, the binder a will tend with more or less force to restore the transverse arch of the foot to its normal condition after each subsidence due to overload, and to assist or restore into the normal or resting position the muscles which normally fulfill this function as soon as the load is taken off the foot. After passing through slots 17 in a flat plate 0, which can be attached to a thin or even soft pressure-distributing backing d, the parts (12 of the binder are preferably united to a tension strap e which is attached, say by means of a buckle g or the like, with adjustable tension, to a ring 1, for instance of leather, which is adapted to grasp the heel, and which is slightly obliquely set. As can be seen from Fig. 10, the relatively broad tension strap e of rubber is divided at one end by a longitudinal slot into two narrower straps which constitute the parts (12 of the binder a; The adjustment of the tension of these parts (12 and of the tension strap is effected by drawing the latter to a greater or less extent through the clamping buckle g in the direction of the'heel ring f. On the spreading of the foot in walking, the tension strap is elastically distended and then restores the arch of the foot and the muscles and ligaments pertaining thereto into the initial or resting position, or initiates and facilitates this restoring, as soon as the load is taken off. The position of the point of application of the tensile force exerted by the strap is fixed by the means now to be described, which means also serve to correct the position of the toe.

Whereas given normal foot development, the phalanx of the big toe is in alignment with the adjoining metatarsal bone, permanent deformation through collapse generally involves upward inclination, and sometimes downward inclination, of the phalanges relatively to the metatarsals, according to whether, in consequence of relaxing or cramping of the flexing or stretching muscles of the big toe, the one or the other of these sets of muscles becomes predominant. Whereas the latter condition, the permanently downwardly bent toe, is corrected in a manner independent of the subject matter of the present invention, the first mentioned abnormality (turned up toe) is corrected in accordance with the invention'by the application to the toe at a ball joint, of a torsional force directed essentially downwards and towards foot, with the avoidance as far as possible of any thrust on the joint at the root of the big toe. This torsional force is brought to bear by the tension of a non-elastic noose h which is passed around the base joint of the big toe, and attached, with adjustable tension, by means of elastic straps hi and ha, to the above-mentioned plate 0. The strap hz may for example be fixedly attached to the plate 0, while the strap hl is passed through a slot in this plate and held fast therein by clamping action. The adjustment of the tension is effected in a manner similar to that adopted in connection with the tension strap e, namely by pulling the free end of the strap hi to a greater or less extent through the slot provided for it in the plate 0.

In order to fix the noose h in position and to prevent the same from cutting into the fork between the toes, there is resiliently attached to the dorsal portion d1 of outrigger 2' which the adjacent toe,

passes between the big toe and keeping at a certain distance from the base of the gap therebetween, to a point on the front portion of the sole between these two toes where it holds the noose h in a fixed position, for instance by means of a small swivel member is, so that this noose h, when drawn downwards and towards the inner edge of the foot, can not cut into the fork between the toes. This arrangement also ensures the maintenance of the proper direction of the force exerted by the noose h upon the big toe. By means of its straps hi and ha, this noose also holds the plate 0 in its required position adjacent the forward end of the pier of the arch, and tends to turn the toe back into its normal position without pressing it to any appreciable extent against the metatarsal to which it is articulated. The eifective force thus exerted is taken up by the outrigger It is desirable to provide an articulate or moving joint between the latter and the binder a, so that it may be capable of adapting itself to the gait of the wearer, and. not set up any additional drag or strain giving rise to discomfort. In the form of construction shown, this articulate connection is obtained by providing the outrigger i with an eyelet i1 by which it can travel along a steel wire i2 secured by its ends to the binder a. This form of the articulate joint is shown in Fig. 10.

The bad posture of the foot engendered by the development of flat-foot results in the tilting of the os calcis inwards, which is tantamount to rotation of this bone towards the outside. Whereas given sufliciently strong muscles the os calcis bears with a portion of its under surface which is in alignment with or slightly outside the load axis, this bone becomes turned and displaced outwards, under the influence of the load, when the muscles give way. The result is the inward tilting of the foot.

This deformation is initiated and only rendered possible by the giving way of the highly important big toe fiexor muscle is (Fig. 5) which runs from the under side of the big toe to the calf of the leg, and which has a tendon which passes beneath the prominence l on the 0s calcis 112. On contraction, this muscle draws the prominence l on the os calcis upwards and inwards, so that the whole of this bone is turned inwards counter to the action of the load, and held in this position.

In order to prevent this displacement of the os calcis outwards it is necessary as far as possible to provide a force component which counteracts this rotation. This result is achieved in accordance the binder a a rigid i with the invention by two features, namely: nal arch of the foot, an adjustable noose adapted (1) By the feature that the point of application to be looped around the big toe of the said foot of the force exerted by the tension strap 6, and and fastened near both its ends to the said bindwith it the direction of this force, is soadjusted er strap next the point of attachment of the that a horizontal component of force directed tolongitudinal tension strap to the binder strap, wards the centre line of the body is set up, as means for determining the position of another shown diagrammatically in Figs. 6 and 7. The point of the said noose relatively to the binder tension strap e is not disposed in the longitudinal strap, so as to be held remote from this strap axis of the foot but at an angle thereto, with the and for causing a tension created in the noose result that an inwardly directed component of to exert a downwardly directed torsional pull force it is set up. In order to give the heel ring I upon the said toe.

a better hold, and to prevent displacement of the 2. An appliance as claimed inclaim 1, in which tension strap e into alignment with the axis of said means consist of a distancing outrigger. arthe foot, the heel ring is preferably provided with ticulately attached by oneend to the portion of grooving f1 or other roughening elements which the said binder strap intended to contact with press into the skin and ensure a firm hold withthe dorsum of the foot and secured by the other out inflicting any injury. It will be clear without end to the said noose. further explanation that the pull of the strap 6 3. An appliance as claimed in claim 1 in which efiects, through the intermediary of the ring I, a the said means consist of a distancing outrigger rotation of the 0s calcis in a direction counter to articulately attached by one end to the portion that in which it tends to become rocked in conof the said binder strap intended to contact with sequence of muscular deficiency. the dorsum of the foot and secured by the other (2) By the feature that the action of the elastic end to the said noose at a point which, when the pull exerted upon the big toe in a downward diappliance is in use, is adapted to be'near the rection so assists and strengthens the long flexor front of the sole of the foot substantially between muscle that it is restored to its full efliciency and thebases of the big .toe and of the second toe thus enabled to exert its above-mentioned toradjacent the said big toe.

sional and pronating action upon the os calcis by 4. An appliance as claimed in claim 1 in which co-action with the prominence l (the sustentacuthe said tension strap is longitudinally slit over lum tali) on this bone. part of its length, the branches of the strap pro- I claim: duced thereby forming portions of the said bind- 1. An orthopedic appliance for correcting defer strap.

ormations of the foot, comprising in combination 5. Anappliance as claimed in claim 1 in which an adjustable tensional binder strap adapted to the portion of the said binder strap which is in- X encircle the foot in the region of the metatarsal tended to contact with the dorsum of the foot is f bones and to cross-tie the transverse arch of the made of non-elastic material while the portion foot, a longitudinal tension strap adapted to lie thereof intended to contact with the sole of the against the sole of the foot and attached at one foot as also the said longitudinal tension strap are end thereof tothe said binder strap and adapted made of elastic material.

to be fastened at its other end tothe heel of the foot for the purpose of cross-tying the longitudi- MARTIN JUNGMANN.

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