HK1024854B - Immobilization brace with overlapping ventilation ports and foam material liner - Google Patents

Description

Positioning fixture and foam liner with overlapping vents

Technical Field

The present invention relates to a semi-flexible molded polyurethane outer boot that encloses an open ventable microporous foam inner liner for forming a low profile or conventional walker and is provided with adjustable lever-type stop clips and rack closure means for full and focused compression of the binding, and more particularly to a ventilation system consisting of overlapping ventilation holes or windows in the back and upper portion of the outer boot that overlap with the ventilation holes or windows in the liner that are directed toward the skin of the lower leg and foot of the patient wearing the binding.

Background

The object of the present invention is to improve a low profile or conventional walker in the form of a positioning fixture with adjustable uniform compression, the fixture being the subject of U.S. patent 5,370,133 issued on 12/6 of 1994 and assigned to the common assignee. The binding comprises a semi-flexible molded polyurethane outer boot which is closed at the rear and sides and open at the front, preferably surrounding an inner lining of open, breathable, microporous foam material covering the lower leg, ankle and foot of a patient. The front part of the outer boot is fixed to the walking bottom having the smallest vibration effect and the smallest thickness. The foot portion of the outer boot has a rounded heel contour and a foot base contoured to a shock absorbing foam insole within the outer boot portion to form a plantar surface of the boot bottom. The back of the outer boot and its upper portion are provided with spaced apart ventilation apertures or windows to ventilate the user's lower leg, ankle and foot through the open porous foam liner. Spaced, adjustable lever type closure means are provided on the back and upper portions of the outer boot to provide adjustable overall and focused pressure to ensure proper fit of the binding and reduce swelling throughout the lower leg, ankle and foot due to edema. The upper portion of the outer boot and the foot portion of the outer boot may be formed separately as two parts hinged together, but are preferably fixed to prevent longitudinal rotation of the upper portion of the outer boot relative to the foot portion fixed to the sole. In this position fastener device, the patient is protected by a hard shell and perimeter as a plaster or cast, while on the other hand unlike a cast, the position fastener of us 5,370,133 does not lose its effectiveness as the edema subsides and the muscles begin to sag. In addition, like the tie-down on a ski boot, the lever fastener is mounted directly to the molded plastic shell to control pressure and hold during the entire treatment without becoming disorganized and failing like a hook and loop fastener. The shell portion can move its position one button at a time to accommodate changes in the shape of the lower leg as it changes during treatment.

In any case, the patient, while wearing the positioning fixture of the prior patent, presents a major drawback during use in that the positioning device is perceived as particularly hot, despite the presence of air holes and windows in the back and upper part of the moulded plastic outer boot.

Disclosure of Invention

It is therefore a primary object of the present invention to provide such a positioning fixture with suitably arranged ventilation apertures or windows extending through the inner liner, preferably in an elongated shape to intersect and overlap with a series of mutually spaced ventilation apertures and windows in a molded plastic outer boot, thereby facilitating direct access of external air to the skin of the user while allowing the dissipation of body temperature without the outer boot and liner arrangement having a detrimental effect on the comfortable fit of the user's lower leg, ankle and foot.

It is another object of the present invention to provide a liner component for a device that employs a woven loose coarse mesh material sewn over the ventilation holes of the liner to prevent the shape of the elongated pores in the liner from expanding while also avoiding pushing the soft tissue of the user out of the pores of the liner, particularly in the case of edema.

To achieve the above objects, according to one aspect of the present invention, there is provided a lower calf, ankle and foot positioning brace for preventing torsion of the lower calf, ankle and foot of a user's limb while avoiding backward bending and plantar bending of the ankle, the brace comprising:

a substantially rigid base;

a flexible, open-front outer boot fixedly attached to the upper edge of the base;

at least one elongated ventilation aperture is provided in the outer boot;

a foam liner located within said outer boot and surrounding the lower calf, ankle and instep of the user;

a closure device spanning the open-front outer boot for applying full and concentrated pressure to the lower calf, ankle and instep of the user's limb wrapped in the foam liner to minimize swelling due to edema throughout the outer boot;

wherein said foam liner includes at least one elongated ventilation aperture in said foam liner positioned to overlap said at least one elongated ventilation aperture in said outer boot such that cool air flows directly from the exterior of the outer boot to the skin of the user's limb, which skin is surrounded by the foam liner and exposed through said at least one elongated ventilation aperture in said foam liner,

wherein said outer boot has a foot portion overlying said sole portion directly, and an upper portion of the outer boot secured to said foot portion adjacent the ankle of the user and extending over the foot portion, and wherein said at least one elongated ventilation aperture of said outer boot includes substantially horizontal ventilation apertures spaced vertically across said upper portion of the outer boot, and said at least one elongated ventilation aperture in said liner includes at least one elongated substantially vertical ventilation aperture in said liner, surrounded by said upper portion of the outer boot and extending in a straight line so as to intersect a line through at least one of said plurality of elongated ventilation apertures in said upper portion of the outer boot.

According to another aspect of the present invention there is provided a ventilated foam liner for use in a lower calf, ankle and foot positioning brace for preventing twisting of the lower calf, ankle and foot of a user's limb while avoiding backward and plantar flexion of the ankle, said brace comprising:

a substantially rigid base;

a flexible, open-front outer boot fixedly attached to the upper edge of the base;

at least one elongated ventilation aperture is provided in the outer boot;

said outer boot surrounding the lower calf, ankle, foot and instep of the user's limb, said breathable foam liner being placed in said outer boot, said outer boot including closure means across the open-front outer boot for applying full and concentrated pressure to said foam liner of the user's limb wrapped over the lower calf, ankle and instep, thereby minimizing swelling due to edema throughout the outer boot;

the improvement comprising at least one elongated ventilation aperture located substantially in overlapping relation with said at least one elongated ventilation aperture in said outer boot so that cool air flows directly from the exterior of the outer boot to the skin of the user's limb, the skin being surrounded by the foam liner and being open to said at least one elongated ventilation aperture in said foam liner, wherein said at least one elongated ventilation aperture in said outer boot includes a plurality of spaced apart ventilation apertures and the liner is formed from molded foam sheet material cut and sealed together to form a sleeve L-shaped in side view for receiving the lower calf, ankle and foot of the user, wherein said at least one elongated ventilation aperture in said liner includes a vertical elongated ventilation aperture in the vertical portion of the L-shaped sleeve, in a position overlapping a plurality of vertically spaced, substantially horizontal, elongate ventilation apertures in said outer boot.

Further advantages of the invention will be apparent from the description of preferred embodiments and the accompanying drawings.

The present invention is directed to improvements in the positioning of the lower leg, ankle and foot anchors and to improvements in the ventilation system to the lining in the form of a leg walker, which is essentially composed of an outer boot made of injection molded plastic, for providing controlled, uniform pressure to the foot, ankle and lower leg surrounded by the anchor, while anchoring the aforementioned parts of the lower limb that are subject to surgery or trauma. The manually adjustable full compression closure of the retainer is readily accomplished by forming a compression retaining retainer from an adjustable lever stop clip and a rack closure or the like. The back and upper part of the outer boot are provided with vent holes for ventilating the lower leg, ankle and foot of the user. Vents are provided in a vented foam inner liner, preferably at an angle to overlap with vents in the upper and/or back of the molded plastic outer boot. The ventilation holes in the liner act as a passage for the cool air so that the cool air entering from outside the outer boot through the ventilation holes in the outer boot comes into direct contact with the skin of the user along the surface of the lower leg and/or foot. In addition to the cooling effect, body temperature can escape from the lower legs and feet through the vent holes. The ventilation apertures of the upper portion and the back portion of the outer boot may extend in a generally horizontal direction, forming a spaced longitudinal series across the rear of the upper portion of the outer boot, or forming longitudinally spaced pairs of rows on opposite sides of the upper portion of the outer boot. The ventilation apertures in the back portion may be elongate or square in shape, the ventilation apertures being spaced apart and extending generally horizontally along the length of the back portion towards the front of the upper portion of the outer boot. Preferably, the ventilation holes are covered with a coarse mesh porous cloth inside the liner. The edges of the ventilation apertures in the liner may be stitched and a welt strip may be underlain to prevent the apertures from being enlarged in use without affecting the flow of air through the ventilation apertures covered by the mesh in the liner.

Drawings

FIG. 1 is a side view of a low-profile leg walker which constitutes a preferred embodiment of the present invention;

FIG. 2 is a rear view of the low-leg walker of FIG. 1;

fig. 3 is a rear, left side view of the liner of fig. 1 and 2 forming a key component of the short-tube walker, with the opposite side being a mirror image thereof.

Detailed Description

Referring to the drawings, a low-profile leg walker or stabilizer device for the lower leg, ankle and foot is generally indicated at 10 and is a preferred embodiment of the present invention. This device is similar to us 5,370,133 and comprises two main components, a semi-flexible outer boot generally indicated at 12, preferably made of an injection moulded material such as polyurethane, which surrounds and supports the second main component, an inner lining of breathable foam material generally indicated at 14. The contents of U.S. patent 5,370,133 are incorporated herein by reference.

Referring to the above-mentioned patents, the anchor 10 provides controlled, uniform pressure to the foot, ankle and lower leg while immobilizing those parts of the body of the wearer or user. The outer boot 12 of the binding 10 has a walking base indicated at 16, all in accordance with the referenced patent. The base structure 16 may be identical to the base of the referenced patent. In addition, the walker has an open toe area forward of the foot portion 18 of the outer boot, and the outer boot 12 has an upper portion, generally indicated at 32, at the rear of the foot portion 18, which is hinged to the foot portion 18 of the outer boot on the opposite side of the outer boot by means of larger size rivets 22. The sole projection 20 of the outer boot extends around the rear of the binding 10. A series of ventilation apertures or windows 24 are formed in the foot portion 18 of the outer boot 12, in this case three on each side of the boot, which extend generally horizontally and are elongated and spaced from each other in the horizontal direction. The upper portion 32 is generally C-shaped in horizontal cross-section, is elongated in the vertical direction, and has a front opening, indicated at 26. Preferably, the upper portion 32 of the outer boot 12 should be constructed of a material that is somewhat less rigid than the foot 18 to provide sufficient rigidity in the upper long axis while being semi-flexible to allow the outer boot to be entirely flexibleThe upper part can be adapted to the lower leg of the user. Unlike the retainer fasteners of the referenced patent, the ventilation holes or windows 24 in the upper portion 32 of the outer boot are in the form of two rows one on each of the opposite sides of the upper portion, the ventilation holes or windows being generally parallel to each other and vertically spaced and extending at a slight angle to the horizontal, as shown in figure 1, with a single ventilation hole or aperture 28 in the right side of the outer boot 12. The vent hole 28 is elongated, i.e. its length exceeds its height. This can be easily changed as desired. As shown in fig. 1, the top of the liner 14 extends above the top of the molded plastic outer boot 12. In the same manner as in U.S. patent 5,370,133, the upper boot portion 32 and the foot portion 18 are provided with a stop catch and rack and lever closure device or fastener, generally designated 30, which joins the opposite sides of the upper boot portion 32 together. In the same manner, the stop catch and rack lever closure means or fastener 30 of the positioning fixture 10 for adjustably coupling together the opposite sides of the foot portion 18 of the outer boot 12 is the same as that provided for the upper portion 32 of the outer boot. They consist essentially of a flexible molded plastic strap, generally indicated at 64, and a pivotable fastening, generally indicated at 66. The details of which are known from us patent 5,370,133. In fig. 1 and 2, the outer surface of the liner 14 is visible through the open vents or windows 24, 28. Turning to fig. 3, which is a perspective view of the liner 14, it can be seen that the liner 14 is similar to that of fig. 2 of U.S. patent 5,370,133, except for the modification of the air holes or windows in the device 10. The liner 14 in fig. 3 is preferably cut from a sheet of open cell foam material that is vented, molded to have a thickness of 1 inch (about 2.54 cm), and is bounded by sealed or sewn together air holes to form an L-shaped sleeve in side view, with the back and sides of the base closed, but open at the front, to facilitate and free placement of the user's lower leg, ankle and foot. Thus, the lateral sides 34 of the liner, which are correspondingly placed in the upper portion 32 of the outer boot, one piece will be draped over the opposite piece to wrap the lower leg over the ankle. Similar to U.S. patent 5,370,133, on both surfaces of the open cell foam sheet forming the liner 14, as an outer layerA layer and an inner layer, covered with a woven sheet material, and a VELCRO^Strips of hook material 49 are attached to the inner surface of the backing material along one of the side edges 34 so as to frictionally and mechanically engage the surface of the cloth outside the opposite backing side edge 34 to hold the foam backing releasably secured against and cooperating with the user's calf, or may be attached in spaced relation to a loop VELCRO secured to the surface of the cloth^A strip or patch 50.

Similarly, for the user's instep, the back panel 36 of the lining 14 wraps around the outside of the user's foot, while the overlapping panel 36 may use a second VELCRO^Strips or tapes 49, 50 of hook-and-loop type fastener material are arranged in the same manner as the overlapping edges of the releasably securable liner side edges 34. All as in us patent 5,370,133. Thus, a releasable VELCRO^The hook and loop fastening system is implemented in the instep and shin areas of the user, wrapping the lower leg, ankle and foot in a safe, breathable, soft, pressurizable foam shell.

The above description of the liner 14 is exemplary of the description of U.S. patent 5,370,133.

One principal aspect of the invention involves forming suitable vents or windows 40 in both sides 34 of the liner 14, as shown in fig. 3, and vents or windows 42 in both panels 36 of the component. The vent holes 40 are generally vertical or nearly vertical, having an elongated length and a given width, to dissipate body temperature and allow air to freely pass through the vent holes or windows 40 that are open on both sides of the device 10 directly to the skin of the lower leg below the knee above the ankle of the user. Instead, the ventilation apertures or windows 42 in the two panels 36 are approximately horizontal, although elongated in shape but short in length, so as to be overlappingly open to each of the ventilation apertures 24 in the outer boot 12. The edges of the vents or windows 40, 42 are preferably provided with straps or bands 44 and sewn to the liner 14 with stitching 46 to prevent the outer and inner layer fibers overlying the porous foam liner 14 from unraveling at the vent edges. In addition, a highly porous, woven porous material 48 is preferably applied over the lower surface of the vents or windows, adjacent the skin, as a covering for the vents or windows 40, 42. This woven loose or coarse mesh material, which is spread over the open ventilation holes or windows of the liner 14, prevents the soft tissue of the user's limb from being pushed out of the ventilation holes, especially in the case of edema. This woven porous material 48 is so porous as not to interfere with the dissipation of heat from the foot and lower leg through the ventilation apertures or windows 40, 42, while also allowing air to circulate through the ventilation zone of the overlapping ventilation apertures in the molded plastic outer boot 12.

As shown in fig. 1 and 2, the near vertical air holes 40 and the near horizontal air holes 42 in the liner 14 are configured such that the lengths of the air holes partially or completely overlap each other and extend out of the row of vertical air holes 28 in the upper portion 32 of the outer boot when the liner 14 is inserted into the outer boot 12 to form the device 10. The corresponding ventilation apertures of the outer boot component of the binding are then located across or intersecting a row of ventilation apertures or windows 24 in the foot portion 18 of the outer boot 12. As can be seen in fig. 2, the approximately vertical ventilation holes or windows 40 in the two lateral edges 34 of the liner do not extend along the entire length of the outer boot 12, although this is readily possible, but instead intersect the ventilation holes 28 in the lowermost edge of the outer boot 12.

The combination of these two main components of the boot, namely the liner 14 modified from US 5,370,133, and the molded plastic outer boot 12, provides an excellent skin ventilation system along both sides of the user's foot, ankle and lower leg, allowing ambient air to come into direct and unimpeded contact with the user's skin surface without compromising the compression protection of the positioning device 10 and protecting the lower leg, ankle and foot from sprains, while preventing dorsiflexion and plantar flexion and inversion and eversion of the foot and ankle.

While certain changes and modifications have been made to the described embodiments to a certain extent, it is apparent that other changes may be made to the positioning fixture without departing from the scope of the invention, as disclosed in U.S. patent 5,370,133, with modifications to the application of the fixture. In this regard, although the description of the upper boot portion 32 and foot portion 18 includes a row of ventilation apertures on either side of the boot 12, the size, number and shape of the ventilation apertures can be readily varied. For example, a plurality of rows of ventilation holes may be provided in each part of the moulded plastic outer boot. Although the side and backsheet portions of the liner 14 have been described as having a single vertical, near vertical and near horizontal vent hole, as shown in figure 3, the number, orientation, and length and width of the vent holes or windows can be readily varied to effectuate and generate the flow of displaced air through the vent hole system formed by the overlapping vent holes or windows in the respective components 14, 12.

Additional features are incorporated into the walker, particularly the liner 14 of such a walker, which overcome the problems associated with using a walker such as that of U.S. patent 5,370,133. It was found that after some time of wearing the liner, the hook-shaped VELCRO was on the front of the closure surface of the liner^The material, and the material on the top of the foot bottom sheet, is no longer sufficiently secure. As can be seen in FIG. 3, the spaced annular VELCRO^The sheet 50 may be adhesively secured to the outer surface of the right side sheet 36 and the right side of the vertical portion of the foam liner 14 to form a more secure closure of the open front L-shaped sleeve.

In addition, loose foam padding placed on the walker near the ankle or ankle joint, or other pressure points, has a tendency to slip off even with an L-shaped sock-like liner secured in place on the user's calf and foot. In FIG. 3, hook-shaped VELCRO is used^To the rectangular ankle padding 52, shown in phantom, are attached fastening strips (not shown) which are frictionally and mechanically attached directly to the inner surface of the cloth pad layer of the lining 14, on respective sides thereof, at locations facing the user's ankles. To avoid the liner slipping off in the walker as shown in figures 1 and 2, the outer surface of the liner at the rear of the L-shaped shell, as shown in figure 3, and the inner surface of the outer boot 12, as shown in figure 1, are correspondingly provided with hook shapes at the same height position, respectivelyAnd annular VELCRO^The tabs 54 thereby forming a frictional and mechanical engagement face-to-face.

Although open cell foam is used in walkers, the primary opinion of the patient or user wearing the walker is that the walker is very hot. The heat causes excessive heat build-up and sweating, which is uncomfortable for the user. The major problem of overheating is mitigated by the use of a mesh covering the window. The liner 14 in fig. 3 differs from that shown in fig. 2 of us patent 5,370,133. In the one piece L-shaped shell of the' 5,370,133 patent, it can be seen that the foot does not conform well to the bottom of the liner, and there is a particular need for an insole to be placed on the foot portion of the liner because the liner does not have the shape of such an insole. This problem can be solved by using a separate foot portion 58 sewn to the liner to better fit the foot and to place an insole or other device such as a PLASTAZOTE^TMTo accommodate the foot bottom afflictions. Accordingly, the invention is not to be restricted except in light of the attached claims.

Claims (11)

1. A positioning fixture for the lower part of the lower leg, ankle and foot to prevent twisting of the lower part of the lower leg, ankle and foot of a user's limb while avoiding backward bending and plantar bending of the ankle, the fixture comprising:

a substantially rigid base;

a flexible, open-front outer boot fixedly attached to the upper edge of the base;

at least one elongated ventilation aperture is provided in the outer boot;

a foam liner located within said outer boot and surrounding the lower calf, ankle and instep of the user;

a closure device spanning the open-front outer boot for applying full and concentrated pressure to the lower calf, ankle and instep of the user's limb wrapped in the foam liner to minimize swelling due to edema throughout the outer boot;

wherein said foam liner includes at least one elongated ventilation aperture in said foam liner positioned to overlap said at least one elongated ventilation aperture in said outer boot such that cool air flows directly from the exterior of the outer boot to the skin of the user's limb, which skin is surrounded by the foam liner and exposed through said at least one elongated ventilation aperture in said foam liner,

wherein said outer boot has a foot portion overlying said sole portion directly, and an upper portion of the outer boot secured to and extending over the foot portion of said outer boot adjacent the ankle of the user, and wherein said at least one elongated ventilation aperture of said outer boot includes substantially horizontal ventilation apertures spaced vertically across said upper portion of the outer boot, and said at least one elongated ventilation aperture in said liner includes at least one elongated substantially vertical ventilation aperture in said liner, surrounded by said upper portion of the outer boot and extending in a straight line so as to intersect a line passing through at least one of said plurality of elongated ventilation apertures in said upper portion of the outer boot.

2. The positioning fixture of claim 1, wherein said plurality of elongated ventilation apertures in said outer boot include a plurality of spaced, substantially horizontal ventilation apertures in the foot portion of said outer boot, and wherein said liner includes at least one substantially horizontal, elongated ventilation aperture in a portion of the liner covering the instep of the user's limb extending along a line intersecting at least one of said foot ventilation apertures of said outer boot.

3. The positioning fixture of claim 1 wherein said foam liner is formed from an open porous foam sheet.

4. The positioning fixture as claimed in claim 3, wherein said open foam sheet is covered on both sides with a porous cloth.

5. The positioning fixture of claim 1, wherein said at least one elongated vent hole in said liner further comprises a sewn attachment trim strip extending around the edge of said vent hole.

6. The positioning fixture of claim 1 wherein said at least one elongated ventilation aperture in said liner is covered by a loosely woven material and is secured about the periphery of said liner and in contact with the skin of the user's limb around said at least one elongated ventilation aperture in the surface of the foam liner to maintain the soft tissue of the limb from being pushed out of said at least one elongated ventilation aperture of said liner in the event of edema without significant effect on the dissipation of heat from the exposed foot and/or lower leg while allowing ambient air to flow through the ventilation zone defined by the overlapping elongated ventilation apertures of said outer boot and said liner.

7. A ventilated foam liner for use in a lower calf, ankle and foot positioning brace for preventing twisting of the lower calf, ankle and foot of a user's limb while avoiding posterior and plantar flexion of the ankle, said brace comprising:

a substantially rigid base;

a flexible, open-front outer boot fixedly attached to the upper edge of the base;

at least one elongated ventilation aperture is provided in the outer boot;

said outer boot surrounding the lower calf, ankle, foot and instep of the user's limb, said breathable foam liner being placed in said outer boot, said outer boot including closure means across the open-front outer boot for applying full and concentrated pressure to said foam liner of the user's limb wrapped over the lower calf, ankle and instep, thereby minimizing swelling due to edema throughout the outer boot;

the improvement comprising at least one elongated ventilation aperture located substantially in overlapping relation with said at least one elongated ventilation aperture in said outer boot so that cool air flows directly from the exterior of the outer boot to the skin of the user's limb, which skin is surrounded by the foam liner and is open to said at least one elongated ventilation aperture in said foam liner, wherein said at least one elongated ventilation aperture in said outer boot comprises a plurality of vertically spaced, substantially horizontal, elongated ventilation apertures, and the liner is formed from molded foam sheet material cut and sealed together at boundaries to form an L-shaped sleeve in side view to receive the lower calf, ankle and foot of the user, wherein said at least one elongated ventilation aperture in said liner, includes a vertical elongated ventilation hole in the vertical portion of the L-shaped sleeve at a position overlapping the plurality of elongated ventilation holes in said outer boot.

8. The breathable foam material liner of claim 7, further comprising at least one substantially horizontal elongated ventilation aperture in a horizontally extending portion of the L-shaped sleeve positioned to overlap at least one of the plurality of elongated ventilation apertures in the outer boot.

9. A vented foam liner according to claim 7, wherein said liner is formed of an open cell foam sheet material with a cloth cushioning layer on both sides of the wall of the L-shaped sleeve, and wherein the exposed edge of said at least one elongated vent hole in said foam liner has a tape sewn along said edge to prevent the cloth cushioning layer on both sides of the open cell foam sheet material forming the L-shaped sleeve from unraveling.

10. A venting foam liner as defined in claim 9, wherein said L-shaped sleeve includes two L-shaped foam liner sheet portions each including a vertical elongated vent hole in a vertical portion thereof and a horizontal elongated vent hole in a horizontally extending portion thereof.

11. A ventilating foam liner according to claim 7, wherein said at least one elongate ventilation aperture in said liner is covered by a loosely woven material, and the covering is secured around said at least one elongate ventilation aperture in the surface of said foam liner at the periphery of said liner and in contact with the skin of the user's limb to maintain the soft tissue of the limb from being pushed out of the at least one elongate ventilation aperture of the liner in the event of oedema without significantly affecting the dissipation of heat from the exposed foot and/or lower leg, while allowing ambient air to flow through the ventilation zone defined by the overlapping elongate ventilation apertures of said outer boot and liner.