WO2004047693A1 - Device for the correction of talipes equinovarus - Google Patents

Abstract

The invention relates to an orthotic device for the correction of talipes equinovarus. The inventive device comprises solid, metal contralateral elements which are articulated at a toothed section which is located at one end of the arm, i.e. the head or round area. One of the faces of said head comprises a toothed section which is connected to the toothed section of the head of another arm. The device comprises eight longitudinal metal arms, two of which are provided solely for connection and length-adjustment purposes, i.e. said two arms do not comprise a toothed articulation head. According to the invention, the aforementioned co-operating arms form a support system for the thigh, the knee joint, tibia support (leg support system) and the ankle joint. The invention also constitutes a foot support system comprising a hindfoot component and mid/forefoot component. The hindfoot component takes the form of a metal frame which houses the ankle, heel and Achilles tendon and the outer part of said component comprises two lateral toothed sections which are connected to the distal tibia arms, thereby enabling the device to perform limited rotational movements in the vertical plane. The mid/forefoot component is a flat platform in the form of a step, whereby the upper step houses the sole of the foot and the lower step is the toothed section which is articulated with the hindfoot component, thereby enabling the device to perform rotational movements in the horizontal plane. The device also comprises a series of clasps which are positioned securely to the lateral surfaces of the arms, as well as components which are used to secure the thigh, leg and foot comfortably using adjustable straps.

Description

 DEVICE FOR CORRECTION OF FOOT EQUINO VARÓ

FIELD OF THE INVENTION

The present invention relates generally to an orthosis device, and more particularly a multi-functional orthosis device for foot, ankle, heel, leg and thigh, in e | treatment of the extremities of young children suffering from the condition of varus equine foot, particularly newborns and up to one year of age.

BACKGROUND OF THE INVENTION Numerous devices are known in the state of the art whose purpose is the immobilization of the leg and the foot of the human patient. Examples are casts and some others that do not provide immobilization protection, nor angular orientation in the vertical and horizontal planes of the patient's foot. Consequently, there is a need for multi-functional orthotic devices for the foot, heel, ankle, leg, knee, which provides three-dimensional immobilization with possibilities of orientation in the vertical and horizontal planes, which has a range of positions and different orientations of the foot. United States of America Patent No. 6,4,06,450 issued to

Kowalczyk et al., Published on June 18, 2002, describes and protects a boot-type orthopedic arm for the treatment and stabilization of the ankle with respect to inward and outward deflection without limiting the normal flexion of the sole of the foot and ankle, at the same time it provides a focal compression on the anterior talofibular ligament. This device is generally manufactured from a flexible material, and has the advantageous feature that it does not completely immobilizes the diseased lower limb and progressively allows movement to perform some rehabilitation exercises.

Japanese patent No. JP2001353172, granted to urineka Shigeru and published on December 25, 2001, provides a device for use from the calf to the foot, it is a device that allows a patient to walk with a horse equine foot naturally, doing An angular change of the ankle.

Japanese patent No. JP2001095828, granted to Kasahara Iwaq and published on April 10, 2001, is a support that corrects at the same time two conditions or malformations of the foot, it is a cylindrical part, it is made of elastic band that tightly tightens from the big toe to the small finger and joins them towards the center, thus correcting diseases of the pyre.

Japanese patent No. JP2000325376, issued to Hata Shigδ and published on November 28, 2000, refers to a tape that is entangled between the toes to correct conditions of the varus foot, in athletes mainly, removable soft tape with properties of air permeability and moisture absorption, it is changed from finger to finger after using it more than four times in one of them, when the cycle is closed it starts again, so on.

Japanese patent No. JP2000308654, granted to Kasahara I ao, published on November 7, 2000, is a film that corrects two conditions of! foot at the same time, that is, hallux valgo and hallux varo, in addition to a distortion of a pedis plant, corrects the rotation of the foot and the balancing of the pedis plant and causes it to be able to walk correctly. It is a soft device that is entangled in the foot, with three padded areas that make contact with the bulging portions of the foot, one of them is placed between the big toe and the second finger. United States Patent No. 6,056,712, issued to

Tracy E. Grim, published on May 2, 2000, refers to a multi-functional orthosis for foot, heel, ankle and lower leg, this device immobilizes the lower leg along with the heel, ankle and foot, provides adjustable therapeutic pressure to the plant, of the foot, also allows displacement. It consists of two main parts, the upper and lower parts that are joined so that they rotate by means of the lateral hinges placed at the ankle. The upper part supports the calf and the lower part receives in a tight manner to the sole of the foot and prevents its turning outwards or inwards.

United States Patent No. 5,624,389, issued to Armin Zepf, published on April 29, 1997, describes a joint orthosis device for the thigh, knee and leg, fits tightly to the patient's thigh by means of Straps, in the same way fits the part of the lower leg. It has two lateral joining bars, opposite one another and parallel with respect to the extension of the leg, these bars connect the two upper and lower frames. Said tie rods extend from a minimum position (bent leg) to a maximum position corresponding to the extended leg, they can also rotate at the point of attachment, allowing turns from 30 °, 40 ° and up to 90 ° in the position of seated. The. bars correspond to a system of two articulated bars then one after the other, the upper one is hollow with a spring inside that allows extension or compression, the lower one is rigid and only allows articulation.

United States of America Patent No. 5,345,701, issued to Leland Smith R., published on September 13, 1994, describes and protects an adjustable orthosis device for the correction of valgus diseases. and varus, it contains a plurality of posts that match the variation of degrees for the fasteners of the rear and anterior parts of the foot. In some modalities the device is part of the patient's shoe. The device is an assembly comprising at least a bed portion for the sole of the foot that is selected according to the size of the left or right foot, this bed is of substantially non-deformable material; It also contains a plurality of wedges that define different angles, this plurality of wedges enable for the alignment of the foot and thereby correct the abnormalities of the pyre and valgus when walking or standing. The United States Patent of America No. 5,306,230, issued to

Robert Bodine, published on April 26, 1994, describes a carcass-type device that serves to keep the knee joint of the comatose, of weakened patients, in an extended position. The device generally includes one or more elongated struts adjacent to the knee and having a hinge that bends to allow the knee joint. Said device consists of an upper housing that adjusts to the thigh by means of tapes that are secured by means of buckles, the part of the knee that articulates; The housing that is secured on the leg with calf support; the buckles are placed on the side bars that then with the joint form the support structure of the extension position device; the calf support forms a single piece with the support of the sole of the foot, which in the instep area has a tape of adjustment to the foot. This prevents the movement of the foot up or down.

US Patent No. 5,088,480, issued to Wang Tzu, published on February 18, 1992, describes an orthosis device with two rigid parts that are articulated in the heel part; includes a attached to the upper that is secured by means of tape to the calf and front part of the leg, the lower part is adjusted to the foot of the patient by means of ribbons. This device accommodates patients with different leg and calf configurations. United States Patent No. 4,981, 132, issued to

Andrew Chong, published on January 1, 1991, describes a molded plastic shell orthosis to treat tibial torsion in children, femoral hip torsion, which adjusts or accommodates according to the growth of the leg and thigh of the child. It comprises a first lower portion which surrounds the foot and the tibia, a second portion that surrounds the upper part of the tibia and the femur along with the knee in a flexed position. The tibia portion of the second orthosis overlaps with the tibial portion of the first orthosis and these overlapping portions are secured with fasteners such as Velero® tape so that two arms are secured with rotation . United States Patent No. 5,056,535, issued to

Leonard Bonnell, published on October 15, 1991, describes a device for adjusting the position of a leg of a patient with valgus and varus in a medical procedure as a means of fixation on an operating table, on the basis that it joins with a jaw joint.

BRIEF DESCRIPTION OF THE INVENTION.

The present invention provides a device to aid in the treatment of the equine foot varus adduct. The device is adapted for use in newborn children and up to one year of age who suffer from the condition of the equine foot varus adduct. The device is adapted to avoid the need to use casts and provide as much comfort as possible during the period of treatment of the disease from the first months of birth.

The apparatus is also adapted to allow changes in the vertical and horizontal orientation of the patient's foot.

The device comprises two sets of contralateral articulated bars in the knee and ankle, which are adjusted by means of Velero® tapes to the calf thigh and foot of the patient.

The present invention has advantages over the state of the art relating to prostheses because they are parallel articulated bars that fit from the thigh to the instep of the foot, for each of the lower limbs of the patient.

It is another object of the present invention to provide a device for the treatment of varus equine foot, an adduct consisting of articulated metal lateral portions, adapted to allow correction in ailments of the feet at an early age such as a newborn and up to year old

It is yet another object of the present invention to provide a device for the treatment of varus equine foot that can be used for conservative management or as a surgical assistant.

It is also another object of the invention to provide a device for the treatment of the equine-varus foot which provides greater comfort in use compared to the plaster splint, since it is of less weight because it is made of aluminum or light metal alloy, with the additional advantage that it is more resistant to deformities. It is still another object of the present invention to provide a device for the treatment of varus equine foot of easy placement to the patient, since in this case, the parents of the child can place it once the doctor has taught them to do it, it is more cheap compared to plaster, since the plasters would have to be changed every fifteen days for four months or more.

It is also another object of the present invention to provide a device for the treatment of the equine foot varus in which the orthopedic doctor places the device with the necessary degrees in knee, ankle and foot as required by conservative management and they are modified (increasing) progressively according to the clinical radiological correlation, which allows correcting the deformities

presented.

It is another object of the present invention to provide a device for the treatment of varus equine foot in which if the patient undergoes surgery, surgical wounds can be assessed, postoperative cast replacement is not necessary or a new anesthetic procedure is required to modify the position of the foot, since with this device the necessary degrees of correction that the orthopedic doctor needs for alignment are given externally.

BRIEF DESCRIPTION OF THE DRAWINGS.

Figure 1 represents a top view of one of the fastening arms for femur of the device, with two holes to fix the carrier buckle where the tapes are secured by means of screws, in addition to the articulation head that serves as a connecting element with the lower clamping arm of the proximal tibia. Figure 2 represents a front view of the proximal tibia clamp arm, with the middle hole for buckle and distal clamp for intermediate arm clamping, also shows the spline of the articulation head with the central hole that houses the Alien screw clamping Figure 3, represents the tibial intermediate arm that serves as a link between the proximal tibial arm and the distal tibial arm, shows two slots in which the trunk that allows the arm to slide to adjust the length of the device in the region of the lower leg as required.

Figure 4 represents a rear view of the distal tibia holding arm, its two holes, the upper joint with the intermediate arm and the lower buckle holder for the adjustment strap with the calf.

Figure 5 shows the retropié system, subsection (a) is a side view where the groove for the articulation with the distal tibia arm, the upper groove for the fastening tape is detailed; at the base the striatum for the articulation stands out with the forefoot or base for the sole of the foot.

Figure 5b, shows a front view of the rearfoot system where the heel of the foot rests, the lateral striations for the joints with the other elements (tibial arms), half-forefoot component and the grooves for the tapes they hold are detailed The instep. Figure 5 c represents the rear view of the rearfoot system. of figure 5 b highlighting the curvature of the upper edge that houses the Achilles heel.

Figure 6 depicts the piece of the device in the form of a step, which functions as a support for the midfoot.

Figure 6 a is a side view of the support of the forefoot means, in which the groove for the fastening tape, the spline for coupling with the back piece is shown. Figure 6 b, is a top view of the support of the forefoot half of Figure 5 a, shows the detail of the striatum and its central hole for articulation with the back piece.

Figure 7 represents the shape of the belt-buckle holder for femur and tibia that is anchored by means of screws to the arm for femur and tibia.

DETAILED DESCRIPTION.

Physiotherapy is the set of scientific physical procedures used in the treatment of patients with a disability, disease or injury, in order to achieve and maintain functional rehabilitation and avoid dysfunction or deformity. The treatments are designed to minimize residual physical disability, to accelerate convalescence, and to contribute to patient comfort and well-being. Physiotherapy is prescribed in patients with orthopedic, neurological, vascular and respiratory disorders, which may be congenital, disabilities acquired due to diseases or trauma, or inherited dysfunctions.

In the treatment of a patient, physiotherapists sometimes use devices that help the patient wander, for example, canes, crutches, walkers, braces and artificial limbs. They also teach patients and their families the techniques of exercises and the use of prostheses, such as artificial limbs and orthotics.

After the great conflagration of World War II, physiotherapy was widely used in patient care. Among the reasons for the great increase in the demand for physiotherapy services are the excellent results obtained in the treatment of war wounded during World War II,

Vietnam, Korea, accidents at work, the increase in chronic disabilities due to the increasing number of elderly people in the population, the rapid development of hospital and medical assistance programs. Some conditions have their origin in congenital anomalies or congenital diseases, structural or functional diseases at the time of birth. Embryonic and fetal development can be altered by various external factors such as radiation, heat, chemicals, infections and maternal diseases. These external agents are called "teratogens" (from the Greek teratós, "monster", and genes, "birth"). Congenital anomalies can also be caused by a genetic alteration of the fetus, or by the joint action of a teratogenic agent and a genetic alteration. Around 10% of congenital anomalies are caused by external factors. As demonstrated in the malformation of the children of the Japanese who were exposed to the radiation produced by the explosion of the atomic bombs dropped in the cities of Hiroshima and Nagasaki in 1 45.

Many structural congenital malformations can be corrected by surgery. These include the cleft palate and cleft lip, digestive tract development defects, cardiac malformations, clubfoot and congenital scoliosis.

Prosthetics are devices that are used to reproduce the shape and / or function of an absent member (or part of it). There are two major types: stents and exoprostheses. The former are implanted by surgery, anchored to the host and serve to replace a joint damaged by osteoarthritis, arthritis, trauma or other diseases. The exoprosthesis serves to replace or correct a member of the organism. Before World War I, wood was the best material to make artificial limbs. Leather devices with metal bands deformed and produced unsatisfactory results. The appearance of duralumin, an aluminum alloy, and later synthetic fibers, made it possible to manufacture lightweight and resistant artificial limbs. Current synthetic polymers provide prostheses with a coverage similar to natural skin.

The fabrication of prostheses has become a science in recent years as a result of the huge number of amputations resulting from wars. Prostheses for the lower limbs may have knee joints, and | ankle to simulate a natural step that even allows you to run and play sports. The upper limbs present difficulties since they must contemplate movements in two "rotations" planes. Stents with good clinical results are those of the hip, knee, shoulder and elbow, since they are very similar to the natural one. The materials used seek to obtain a very low coefficient of friction joint; highly polished metals (stainless steel, chrome-cobalt-molybdenum alloy or titanium alloy) and a very high density plastic polymer (polyethylene) are used. Special exoprosthetic units are currently being created for the correction of deformations.

The human body have various types of mobile joints. The hip and shoulder are sphere-cavity type joints, which allow free movements in all directions. The elbows, knees and fingers have hinged joints, so that only one plane mobility is possible. The pivot joints, which allow only rotation, are characteristic of the first two vertebrae; it is also the joint that makes possible turning the head from side to side. The sliding joints, where the bone surfaces move separated by very short distances, are observed between different bones of the wrist and ankle.

Orthopedic surgery is the medical specialty dedicated to the diagnosis and treatment of diseases, injuries, deformities and malformations of the musculoskeletal system (bones, joints, muscles and tendons). Orthopedic surgeons treat, among many other pathologies, traumatic bone lesions

(fractures) and joints (dislocations, ligament sprains, articular cartilage lesions), inflammations of muscles and connective tissues (bursitis, myositis, tendinitis), diseases of the spine (lumbalgia, herniated discs, scoliosis), deformations of the feet (flat foot, cavo foot, clubfoot). In this specialty many mechanical devices are used, both internal and external. Among those of external application are casts and splints, bandages, functional bandages, orthotics, external fixators to external prostheses (for amputated limbs). The internal devices serve to stabilize fractures until consolidation (needles, wires, screws, plates, nails) or to replace joints permanently (hip stents, knee knee or elbow).

The foot is the lower structure of the leg, it is formed by short and thick tarsal bones, parallel metatarsals, the fingers are made up of 14 phalanges. All bones are connected through bands of tissue called ligament; The plantar ligament is from the instep bone to the metatarsals and keeps all the bones in place. Foot movements are controlled by leg muscles. The tarsal and metatarsal bones form the two arches of the foot: the plantar arch goes from the instep to the metatarsal eminence and, usually, it only contacts the ground at its ends, and the metatarsal arch that crosses the metatarsal eminence. With the thick layer of fatty tissue under the sole of the foot, the flexible arches dampen the pressure and the blows produced when walking or jumping. The foot can suffer numerous deformities and functional alterations, as in the case of flat feet, caused by weakness of the muscles and ligaments of the arch. The clubfoot is a more serious disorder, which usually has a congenital origin, and occurs as a result of the shortening of the muscles and tendons. The foot is also a place of frequent localization of arthritis, and even gout.

Astragalus, it is also talus or taba, tarsal bone located between the tibia and fibula and the rest of the tarsus.

The human being is formed by a bulky body, a neck and a head. The upper face of the body articulates with the tibia and the fibula forming the ankle. The lower face of the body constitutes the subastragaline joint with the calcaneus (heel bone). The head forms the Chopart joint with the tarsal scaphoid and with the cuboid. The talus is the vertex or key of the arch of the foot, which receives and distributes the weight of the body between the calcaneus and the antee. Its irrigation enters only through the neck. Astragalus is the anatomical center of some of the largest congenital deformities of the foot (clubfoot, congenital vertical talus).

The heel is the posterior area of the human foot.

The talus divides the weight of the body between the midfoot (head of the metatarsals) and the hindfoot. The lower and posterior bone of the hindfoot, heel bone or heel, is the calcaneus. It is a parallelepiped in two parts, anterior or body and posterior or posterior tuberosity. The body of the calcaneus present in its upper face three sub-faces that form, with the talus, the subastragaline joint. The anterior face of the body articulates with the cuboid to form the outer edge of the hindfoot. The posterior and inferior zone of the posterior tuberosity forms the support of the hindfoot or heel itself. The heel skin can be up to one centimeter thick to fulfill its purpose of protection and cushioning.

Plantar fasciitis, talalgia or calcaneal spur is inflammation due to overload (overweight) of the insertion in the calcaneus of the plantar soft tissue. In the valgus hindfoot the calcaneus is diverted outward and in the hindfoot inward, and is not placed vertically under the talus and ankle. The equine foot is characterized by an anatomical deformity in which there is an exaggerated plantar flexion.

The joint between the leg and the foot is called the ankle. The lower end of the tibia forms a widened platform, tibial pylon, which supports and transmits the load to the dome of the agagegal body; On its inner side, an eminence stands out in the form of a flattened puem, tibial or internal malleolus, which prevents the internal movement of the talus. The useless bone fibula in its upper two thirds, joins the tibia in its lower third by strong ligaments, and its lower part forms the peroneal or external malleolus, shaped like a snakehead, which prevents the external movement of the talus.

The leg is the region of the lower limb located between the knee and ankle joints. The skeleton of the leg is formed by the tibia (internal side, palpable on its entire anterointema face) and the fibula (external, palpable at its upper and lower ends). Both are joined by their upper and lower ends in the proximal and distal tibioperoneal syndesmosis, lacking movement. The interosseous fibrous membrane extends between its diaphysis. The congenital varus equine foot, or club foot is a deformity of the foot that is characterized by four distinct components: planar (equine) ankle flexion, taion adduction (varus), high arch (cavus) instep, and adduction of the anterior region of the foot. Although there are many theories about varus equine foot, discussions about the etiology that develops them continue. Most cases are idiopathic and occur in normal children. The neuromuscular varus equine foot is also a congenital deformity associated with disorders such as myelomeningocele, arthrogryposis, congenital constriction band syndrome.

The corrective device presented is based on the deformities of the components of the foot, in the same way at the normal angles that the foot must have (astragalus-calcaneus angle in the range of 20 ° -40 °) in the dorsoplanar position. This device can be used in conservative and surgical management.

The device consists of a femoral contralateral arm with a head that articulates with the striatum of the proximal tibial arm head; an intermediate arm for coupling the proximal tibial arm with the distal tibial arm consisting of a lower joint head, all these arms have their contralateral part; the foot restraint system or rearfoot component has the shape of the heel to accommodate it, the external part of said piece contains on both sides, at the ankle, the gear toothed area with the head of the distal tibial arm, in The lower part of the piece also has a gear toothed area, where the half foot or floor clamping device is attached. The knee joint, formed by the femoral arm and the proximal tibial, allows the orientation angle to be modified and kept in a fixed position; the intermediate arm provides the longitudinal adjustment device as per. require due to patient growth. This arm is of union between the proximal and distal tibial arms.

The distal tibial arm engages and engages the external toothed areas of the backward housing at the ankle that serves to position the foot at its normal angles; Also forming part of the foot restraint system, we have the component of the forefoot that engages in the lower teeth of the base of the rear foot component and allows the adjustment of the angle in a horizontal rotation and thereby correct the orientation of the adduction of the heel.

The femoral component (fig. 1) or holding arm for femur (1) is a substantially rectangular bar of varying length as required, preferably of metal and preferably of aluminum or its alloys. Said bar contains a round articulation head (8) of approximately 2 cm in diameter, in which a central hole is housed that houses an Alien-type clamping screw (7) of 4 mm in diameter, the internal part of said head contains a round toothed area to provide an articulated coupling with the proximal tibial arm, the longitudinal body contains two threaded holes that house two flat head shaft logs (5) for fastening the belt-buckle that adjusts to the patient's thigh, said straps they also hold the contralateral arm identical to that already described. The femoral component arm comprises a width (2) of 1.5 cm, a thickness (3) of 0.5 cm, the inner part that is in contact with the patient's skin contains a 3 mm thick foam rubber padding layer Compression module such as pelite, gel, ppt, which last approximately one year. The diameter of the head of Toothed joint (6) is approximately 2 cm, the height of the teeth found on the inside of the head is approximately 2 mm. The thigh adjustment straps are preferably Velero® tape, they can also be made of leather. The arm has a graduated articulation head on the distal part that allows the desired knee flexion.

Figure 2 shows a view of the frontal part of the proximal tibial arm

(21) which is identical to the arm of fig. 1, in terms of manufacturing material and dimensions. The articulated coupling head explicitly shows the radial teeth (22) and the central hole where the Alien clamping screw (26), the holes (23 and 24) that house the flat head logs that respectively hold The width (25) is the same as the femoral arm of fig. 1 defined above.

The proximal femoral and tibial arms are coupled so that the dentitions of their respective heads coincide in such a way that their teeth face each other and thereby prevent the rotation of the component longitudinal arms. The coupling occurs after having secured the femoral arm by means of the fastening tapes on the buckles arranged on the contralateral arms in the area of the holes for the securing logs.

The intermediate arm for the tibia of fig. 3, is made of the same material as that of the two arms described above, the intermediate arm bar (31) has a length of 10 cm, width of 1.5 cm and thickness of 0.5 cm, the distance of the proximal and distal ends to the grooves (32 and 33) is 1.5 cm, the length of the central grooves (34 and 35) is 2 cm and a width of 4 mm, the grooves (34 and 35) are placed a distance from the side edges ( 36) 0.5 cm; This intermediate arm because it is not in contact with the patient's skin does not need a cushioned coating. The grooves (34 and 35) house the clamping rings that serve to join the proximal tibial arm with the distal tibial arm, as well as to give length adjustment to the correction device and thereby adjust it to the patient as it develops in its growth. This arm slides in a sliding way with the tibial distal and proximal arms, sliding that is adjusted by means of the screws that pass through the grooves (34 and 35).

Tibial distal arm of Figure 4, is made of the same dimensions and material as the proximal femoral and tibial arms. The arm (41) highlights the hole (42) that houses the Alien clamping screw with the backrest component, the holes (43 and 44) for holding clamping screws with the intermediate arm of fig. 3 and the buckle carries adjustment tape to the lower part of the leg, it also highlights the coating layer (45) that is in contact with the patient's skin.

The corrective device of the equine foot varus has so far the following parts arranged next to each other and with its proper contralateral part: femoral arm coupled in articulation with the proximal tibial arm, intermediate arm that generates in addition to giving longitudinal adjustment in a sliding way to the proximal tibial arms and the distal tibial arm; The distal tibial arm has a toothed lower head that engages in articulation in the lateral toothed areas of the foot restraint system that consists of two parts, that is, the rearfoot support component and the midfoot support component. The rearfoot system of Figure 5 shows a side view (a), rear view (c) and front view (b) of the rearfoot component (50) where the heel of the patient, has a maximum height of 3 cm, a maximum length of 3 cm, the serrated circular space (51) of diameter equal to 1.5 cm, in whose center a hole for screw Alien type of 4 mm is made, in said The circular area is coupled to the joint of the contralateral distal tibial arm head (40), the circumference that defines the border of the dentate radial zone is 0.75 cm from the outer face of the rear side wall of the backrest clamping system. The surrounding back wall that together puts the outer face of the base of the component forms a right angle, limits the heel housing area. The lower wall or base of the component has a toothed area (53) centered and limited by the lateral face of the base of the foot plant, the toothed area of the lower coupling (53) and together with the toothed coupling area of the component of Half foot has a diameter of 1.5 cm. In the center a hole of 4 mm diameter (51 A) is made that houses an Alien clamping screw. Referring to the side face shown in the figure and next to the ascending profile of the upper front contome is the groove (54) that allows to secure the backrest fastening tape, the groove is 3 mm wide and 1 cm long. The tape is attached to the foot by the instep and prevents its movement forward and keeps it in a tight position against the inner wall and base of the sole of the component. Figure 5b, shows a front view of the back housing component in which the base (57) and the inner wall (56) covered with foam rubber are uncovered, said inner wall has a recess (55) type of chair which houses the Achilles tendon and the grooves (54) that serve to secure the foot by means of ribbons stand out; It is of importance the arrangement of the lateral toothed areas (51) in the external wall of the component, as well as the centered lower toothed zone (53) that is located below the bearing surface of the plant of the foot (57), note the curvature that defines the union of the base with a curved internal wall (56) that defines the heel housing and as described above, is covered with 5 mm thick foam rubber.

Figure 5 c, describes a rear view of the rearfoot component with the foot (60) housed therein, stands out the position of the Achilles tendon (55 A), the calcaneus bone (56 C) and the foot in planar position adjusted by the internal coating of 5 mm thick foam rubber (56 H).

This rearward component is articulated with the contralateral distal tibial arms by means of the toothed area (51) that is held by the Alien screw housed in the central hole (51 A).

Figure 6 is a side view of the midfoot component (61) that is articulatedly coupled by means of the toothed areas (53) and (53 I), joined by means of the central Alien screw housed in the recess (53 OR). This component of the forefoot can be rotated at will according to the patient's requirement or need because the teeth are made uniformly spaced with a predetermined angular separation, thereby correcting the adduction of the heel.

Figure 6 a, is a side view of the midfoot component (step shape) presenting a lower flat base (62) that functions as a floor has a length of 5 cm, a vertical front wall (63) high 7.5 mm, a flat cantilever base that together with the upper plane (66) form the front wall

(64) height 1 cm and width 3 cm, in the same direction of travel we have the base of the floor of the foot (66) with a length of 3 cm, next to which there are a couple of slots (65) for tape or strap 1 cm long and 4 mm wide, a cushion (66 H) with a thickness of 5 mm is adhered to the base (66), then a vertical wall (53 F) that defines the base of the foot and the recess of coupling with the retropié component, has a height of 1.25 cm and makes a right angle with a horizontal surface (53 L) that serves as housing and support of the toothed area (53 I) in whose center is the hole of 4 mm (53 O) for the placement of the Alien screw. In this way the rearfoot and half-forefoot components are articulated.

Figure 7, represents the plastic buckle for fastening tapes for femur and tibia, presents a rectangular flat body (71) with a central long groove (73) 4 mm wide, which defines two straight central protrusions, said groove serves to fix it with the thyme which in turn is fixed to the femur arm, the central groove is flanked by two short lateral grooves (72) of 3 mm wide where the Velero® belt or strap is fastened to hold the arms contralateral against the femur or tibia, the lateral grooves are made at a distance (74) of 2 mm from the longitudinal external edges of the buckle, the central groove protrudes from the transverse short ends in a regular straight protrusion (75) of 5 mm wide that defines the central area of the buckle, the thickness (76) of the plastic buckle is 2 mm, the length of the longitudinal faces (77) is 2 cm. Which together with the length of the two protuberances (78) make a total length for the buckle of 3 cm. The fastening straps enter through the lower part of a groove, then enter through the upper part of the other and finally exit through the lower part of the latter, thus ensuring the femoral arm, tibial or retropy system and half forefoot They keep in position.

This is how you have the complete varus equine foot correction device, that is, the femoral contralateral arms, articulated with the proximal tibial contralateral arms, coupled with the intermediate contralateral arms, slidably coupled with the arms distal tibial contralaterals, articulated with the dentate areas of the hindfoot component which in turn is articulated with the midfoot support component.

The femoral bar or arm has a graduated distal head to give the desired flexion to the knee, which is articulated with the head of the proximal tibial arm (secured by means of a 4mm Alien head trunk), this circular gear 2 cm in diameter, is formed by teeth regularly distributed angularly in the gear circle, that way the degrees of knee flexion are determined, the height of the teeth is 2 mm. It also has fastening loops for the thigh support buckle by means of straps.

The fastening buckle used in the femoral and tibial component serves to fix the straps and arms on the patient's limb, a double fastening system is offered to ensure a lower risk of loosening the system. The strap or strap can be made of leather or Velero® tape, the Velero® belt has a double way of holding due to the closing device that characterizes this type of ribbons that secure the plastic hooks in ties of the same material,

Leg support system, the proximal tibial component depends on the length and age of the patient, its width is 1.5 cm, its thickness 0.5 cm; in its next part! It also presents a head! Graduated with a diameter of 2 cm and a height of 2 mm, it is articulated with the head of the femoral arm and both are fixed with a central Alien head screw, in the middle part it has another hole to place the screw that fixes the fastening buckle , at its lower end another hole to fix the intermediate arm. It has a gel coating on the inner surface in contact with the patient's skin. pelite, or ppt. Of the same mode the other distal tibial arm that joins the intermediate arm and the backward component in the coupling area at the ankle.

Foot restraint system, has two components, one rearfoot and half forefoot. The first component is placed on the heel, it has the form of this one to fit comfortably, it can be lined with ppt, silicone or pelite, it has a height of 3 cm, length of 3 cm, on the top front it has a groove 1 cm long and 3 mm wide to accommodate the fastening tape, it has two 1.5 cm diameter gear heads that can be used to attach to the articulation head of the distal part of the tibia; at the bottom it also has a 1 cm diameter gear zone that is properly oriented to give the desired correction to the forefoot.

The midfoot component is placed from the middle of the foot towards the fingers, has a total length of 5 cm, the height is 1.75 cm, the inner part is covered with ppt, silicone or pelite. The upper length is 3 cm, the lower one is 4 cm, the anterior base has a gear zone to couple with the rearward component and thus give the desired orientation in degrees for proper correction of the pfe, on the lateral faces they find two slots to place the tape or strap of support of the foot.

The above description does not have a limiting character, the limitations of the present invention are only determined by the following aggregate claims.

Claims

1.- Orthotic device for the correction of varus equine foot comprising articulated contralateral solid metal elements comprising: a pair of longitudinal arms (1) with articulation head (.6) at one of its ends and two buckle-holder elements (5) arranged in the bar in which the fastening and adjustment tapes are inserted; a second pair of longitudinal arms (21) with articulation head that are arranged in such a way that the distal head and the proximal head of the other arm form the articulation of the patient's knee, also have a buckle carrying element and a clamping element of the pair of intermediate arms arranged in the bar that form the arm, which slidably connect with another pair of contralateral arms and its articulation head is arranged such that they form the ankle joint (51) in cooperation with the element retropíé clamping; the retropie element has an internal space in the shape of the heel to accommodate it properly, in addition to three circular areas serrated on its outer side to couple the joint with the tibial arm and the midfoot component; a half-forefoot element (61) which is a step-shaped platform arranged next to the rearward element so that in cooperation they give the desired correction to the forefoot; said arms and elements have a cushion of pelite, gel or ppt in its internal part and connect in an articulated way the thigh, the knee, the leg, the ankle, the heel and the sole of the foot, allow the rotation of said joints and operationally each of the elements is connected to join the patient's foot, leg and thigh in a preferred orientation. 2. Orthotic device for the correction of varus equine foot comprising solid articulated metal elements according to claim 1, further characterized in that the femur or thigh support arm is identical to the distal tibia support arm and together there are four; a long bar with two holes for fastening screws of the buckles in which the fastening straps are secured, is covered in its internal part by a longitudinal cushion, at its lower end it has a circular articulation head whose internal part contains a serrated Regularly distributed angularly with teeth 2 mm high, in the central part the head has a hole that houses the Alien type clamping screw. 3. Orthotic device for the correction of varus equine foot comprising solid articulated metal elements according to claim 1, further characterized in that the proximal tibia clamping arm is identical to that of claim 2, only having the longitudinal cushion on the side opposite the toothed surface of the head which is the one in contact with the patient's skin, together there are two pieces of this type, which contains the device. 4. Orthotic device for the correction of varus equine foot comprising solid articulated metal elements according to claim 1, further characterized in that the pair of intermediate connecting arms between the articulated elements are rectangular bars with two central grooves that allow the sliding of logs between them and the tibial articulation arms, thus adjusting the length of the entire device, these bars are not padded because they are not in contact with the patient's skin, together they are two pieces of the same type. 27 step towards the fingers, it is covered with a cushion, it contains two lateral grooves that house the strap or fastening strap of the forefoot, the low step has a serrated round area with a central hole to accommodate a type fastening screw Alien, this zone is coupled in cooperation with the base of the rear foot component and allows to adjust the orientation of the foot in a horizontal plane.