US2821032A - Orthopedic appliance for flat-footedness - Google Patents

Description

Jan. 28, 1958 A. J. HELFET ,03

ORTHOPEDIC APPLIANCE FOR FLAT-FOOTEDNESS Filed Nov. 29,1955 2 Sheets-Sheet 1 .m/vs/vroe ARTHUR JACOB HELFET Jan. 28, 1958 A; J. HE LFET ORTHOPEDIC APPLIANCE FOR FLAT-FOOTEDNESS Filed Nov. 29, 1955 2 2 Sheets-Sheet 2 \rowo bwono L J F m R OF ma H 8 M0 C m. R U H T R United States ORTHOPEDIC APPLIANCE FOR FLAT-FOOTEDNESS Application November 29, 1955, Serial No. 549,778

Claims priority, application Great Britain December 24, 1954 5 Claims. (Cl. 36-71) This invention relates to an orthopedic appliance for the correction of fiat-footedness or other deformities of the human foot caused by an everted heel and is a continuation-in-part of my invention disclosed in my copending application, Serial No. 307,245, filed August 30, 1952, now abandoned.

Flat-footedness in humans is of two kindsi. e.. congenital or acquiredand commences in childhood in an otherwise normal mobile foot. Flat-footedness is caused by the weakness of the tibial group of tendons and muscles on the inner side of the foot and the consequent stronger pull of the peroneal tendons and muscles of the outside, resulting in the everted tilting of the os calcis transversely of the foot in an oblique direction with its lower portion directed outwardly and its upper portion directed inwardly of the foot. Since the normal human foot bears a persons weight chiefiy in tripod fashion at three points-that is, at the heel (os calcis) and at the heads of the first and fifth metatarsalssuch everted tilting of the os calcis causes the talus and the adjacent bones of the foot arch to lower, thus breaking down the arch of the foot so as to place the weight of the person along the inner or medial border of the foot, which is not suitable for weight-bearing and thus produces discomfort and awkward gaitsi. e., pigeon-toed walking or an outwardly splayed gait. This eversion of the heel, and consequent lowering of the arch, causes the stiffening material of the counter of the shoe worn on such foot to break down after little use and spread laterally outward of the shoe, as is well known.

It was first sought to remedy this condition by the use of arch support (which are still used to some extent), but such arch supports only raise the arch of the foot and do not develop strength in the muscles thereof to sustain the arch in its normal raised position. Thus, when the arch support is removed, the arch of the foot collapses.

Lately, and now quite prevalently, the, so-called, Thomas heel has been employed to correct eversion i. e., by elongating the heel on the bottom of the shoe for about one inch along the inner or medial edge of the shoe to extend under the arch of the foot and by thickening (by about As-inch) the heel on its medial or inner side to tilt the ankle of the foot outwardly within the shoe upper. With this construction, and if the stiffened heel counter of the shoe fits snugly around the heel of the foot, this tilting of the ankle does temporarily tend to correct the eversion of the os calcis; but, since the forwardly extending elongated portion of the shoe heel inverts the forefoot slightly, no matter how long the child wears these altered shoes, his foot and heel relapse in some degree after the treatment is discontinued.

Among the other disadvantages of the Thomas heel, the main one is that it is difficult to preserve the snug fit of the counter of the shoe around the childs heel as the foot tends to slip down the sloping inner sole to the outer side of the shoe, deforming the outer wall of the stiffened counter and wearing the shoe heel down along its outer border. Once the grip on the heel of the foot is lost, the

* atent shoe must be repaired or renewed, or otherwise it is ineffective. Another disadvantage is that the Thomas heel is not wholly effective for forming or re-forming the arch of the foot, as continuity of wear must be maintained and the child cannot wear other types of shoes such as slippers, sandals, boots, tennis shoes, or football shoes, without breaking the continuity of treatment.

The object of the present invention is to effectively correct the everted heel with an appliance which is fitted to the heel of the foot in the area only of the os calcis and which is so formed and shaped that, when the foot supports the weight of the wearer in the normal way-that is, with the heel of the foot and the fore part of the foot resting upon a supporting surface-the os calcis is shifted by the appliance from its everted position to its normal vertical position and lifts the bones in the arch of the foot to their normal relationship, thus restoring the three-point weight bearing position of the foot, whether or not the foot is enclosed by a shoe or boot or other foot covering, and without the aid of arch supporting means or other devices, whereby, in the case of growing children, permanent correction is eventually attained due to the surrounding muscles and tendons developing and strenghtening in their normal way to hold the os calcis and the other bones of the foot in corrected position, thus permitting the discontinuance of the use of the device or any other further aid.

Another object of the invention is the provision of such an appliance, as just mentioned, that may be inserted into and removed at will from any shoe or foot covering its user may desire to wear, whereby the user needs only one such appliance (for each foot that may require correction) during the period that such appliance proper fits his foot; or, in other words, until he has outgrown it and needs a larger size. While the appliance is equally effective if no foot covering is employed (should it be laced onto the foot) and since most people wear shoes of some type, it is practical to use the appliance in connection with a boot, shoe, tennis shoe or the like.

The objects of the present invention are attained by providing a relatively thin rigid heel-seat having a generally scoop-shaped formation with its inner surfaces shaped to conform snugly to the contour of the foot of an individual by whom it will be worn, embracing only the os calcis portion of the foot and extending no farther forward of the foot than to underlie approximately the navicular or scaphoid bones of the foot, the upper and under faces of the bottom wall of the scoop-like device or heel-seat being fiat under the os calcis bearing portion thereof to provide a non-rolling or non-rocking anchor for the appliance under the weight of the wearer and having its side walls generally vertical; but, since the sustentaculum tali broadens transversely of the foot as it approaches the under surface of the head of the talus, substantially the forward and upper horizontal half of the side walls follow this broadening and diverge slightly upwardly and outwardly; and the inner or medial side wall has a slight inwardly projecting bulge which corresponds to and complements an opposing depression in the 0s calcis underlying the sustentaculum tali. Thus, the inner surface of the generally vertical side walls of the rigid scoop-like heel-seat follows and fits the configuration of the flesh or tissue enveloping the os calcis and boxes the os calcis firmly between its bottom, side and rear walls. The outer surface of the heel-seat generally conforms with the configuration of the inner surface. It should be noted that the heel-seat of this invention gives no direct support whatever to the arch of the foot.

The invention will be understood more readily from the following detailed description of one embodiment thereof when read in conjunction with the accompanying applied totth'e foot;

Figure 1-3 is a a longitudinal secti'o'nalfi viewtakenion' line 3-3 of Figure: 1;.

Figur'e '4' is a2bnttomtplan viewrof theiheehseat shown in Iligure l;.

W'Figure S isa transverse'zsectionalwiew takenmn line fir- -fixofiFigurezl';

. Eig'ut'ei 6'='iS &?tr8IISV61TSe?SBCfiUIIHl View taken zonxiline Figure: 7. .is:'a' plan view-ofsthe'sheelseatiwith ithe'front -portionrnfi its: medial zorftinsidex'sidei wall. in section and Iakenzonline 7-s7t-:-:of Figure-into :illustratefheinwardly extending bulge thereof inr a horli-zontaLplane;

JFigureLSiS zat-backornean view-of kanitevertedaheelrof. va left fact i .il lustratingizthe;:positions of iithe .osl \calcis'. :and ltalus relative to the @tibialeg :bone 'andiits essociatedsfibula, theaflesh -layer beingsshownrin phantom lines;

Figure 9;is a baCkliQl'iIBHB viewrofsan everted:heel, similar touEigure r8, hut :witlr ithes-heeleseat appliancezof this invention :applied ztoesaidnheel; and; theyfoot. hearing ;the weighto'fthe weareravhichlhasscaused the os calcis; and talusz to shift; to. proper 310111181 .zposition, :thevfieshr-tlayer and a shoe being shown in phantom lines;

Figure 10 isan-elevational view;csimilar'tozFigure 2, .showingthe. :me'dial or zinner.sidewfnhesheeleseat and-tits relationship with the 'tbDIlBS wof like 1.foot :when. :applied .to the foot; l

.Figure =11 .is-a :bottomrplanaofJthefleftifoot showniin Figure 8- and illustrating :the weightebearing.,characteristics of a fiatfoothaving anreverted-heel:.and.:fallen;arch;

and

Figure 12:is,a view similarjtorFigure llzand :illustrat- .ing the normal three-point Vweightabeari-ng areas soft a normal foot.

The heel-seat S shown-in thedrawings; Figshlslto 7,-

inclusive (which'is intended fol 711561011 thelleft heel of "the wearer) is inthe generalshape ofa; scoop, comprising a bottom-wall orplatform portion- 1 from which-upwardly extend an outer sidewall 2 an inner side-Wall and a curved rear wall 4,,all of said walls connecting, and

To effect the corrective inverted tiltinglo'f'the' os calcis' vwith sthis -.heel=seat,"theaforwardsportionw of. thehmnerh or medial wall 3 is formed with an inwardly extending convexed bulge 3c positioned to be opposite and conform with the contour of the depression x in the os calcls lyrng under its portion y, known as the sustentaculum tali, the a upon the" foot "resting" upon .a supporting "snrfacesaid weight anchors thei flat-12bot'tom". facelb of fthei=heel-seat to said supportingisurffa'ce; awithztheiforwirrd portion of the foot bearing itsv share oftthe weightlon the supporting mergingnand being ofa one-piece rigidconstruction lof relatively thin material, substantially, uniform in thickg :ness, that may be molded from suitable plastic-materials seat of this invention in different. sizes according to the development of the child or adult.

The bottom wall or platform 1 has fiat opposite parallel bottom and top surfaces for its major area 1b that underlies and affords the main bearing support for-the 0s calcis O. 'The forward or front marginal portion 1a of the platform'maylbe declined'very slightly on a gentle curve, as shown in. Figures 2 and'l'Q, and does not extend beyond the forward part of the wearers heel area-that is, no farther than-the proxi'rn'aredge of the navicular or the scaphoidbone; and,"further, the major portions of the sidewalls 2 2111413 are substantially vertical and di verge forwardlywith their forward upper marginalvpor- 'tions sloping gradually upwardly and outwardly, thereby surface. Under the ationofSuchweight, the bulge 30 on the :inner Wall 3 then presses against the face ,o'f'the "depressionvx .ofzrthe -os calcis, under the sustentaculum tall y, and shifts the :os :calcis: at the subastragaloid joint from its everted lpositionto-a vertical'positionand presses in the forward end of the os calcis'O-causing the talus'T and its. associated bone's-and-hence the archiof the footto :rise, =relievingthe weight fromhthe inner or medial iborder of the forefoot (Figs 11) and establishingthe normal ithreezpoint weight-bearing forthe foot as shown in-Figure lZ.

,By-holdin'g the os-calcis .O ver-tical with the heel-seat ofl thisiinvention,.-as above described, the wearer walk-s normally anipin:the fcase oflgrowingj children, if theos calcis' 'is h'eld vertica1-long1enough during the weightbearingactivitiesrof :the foot, the surrounding muscles 'and tendons;strengthen-and the foot sets with a, proper normalfarch.

It:will be notedrlthat the top edge 2a of j the outer side wall 2 (Figs. :2sand:l0)-rslopes: downwardly from a point forward ofitheqrearz wall 4 at algreater degree of declinaitioni toaithe' front edge 1av ofthe platform than doesthe t'op edgefia of the inner side wall 3, the :front portions Ze'a'nd 3e:of.vthese'top. edgest'being rounded as indicated. Thus, thesforwar'dtiportion of the top edge 3a of the inner :or medialt wall' 3 maysbegenerally slightly higher than thatof the outerJor lateral wall 2, so thatthe top portion of the inner. wall 3' will extendsubstantially to a point opposite:the sustentaculum:tali y (see Fig.9) to afford an abutment surface for the top medial side ofthexos calcis, which abutment co'acts with the outerwall 2 to shiftthe'o's calcis when the device is applied to itheheel of the wearers fo'ot andthe foot-is supporting his weight.

It will 'also'be-obse'rved' that, due to the curved formatio'ns o'f the heel-seat; the"convex-con'cavo bulge 3c may notiappear -toopronounced. Nevertheless; this bulge 3c occupies an areaiextending fromjust'below'the top'e'dge 3a of the=wall 3 to theplatform 1- and is curved slightly inthe horizontal plan'eg- -a's ean-he seenxfrom' Figures. 5, "6 and '7. 'fl'he crest o'f this-"bulge 3c is positioned to lie 'oppositeandfollOW the contour of the depression x in theoscalcis'on its medial side to -exert pressure-thereon at thi's'point; as-abovementioned. 7 v

The most convenient manner in which to wear the heel-seaboft'his invention is in connection with a pair of boots; shoes" or soft shoes (such as tennis "shoes, bowlingshoes and the like), as such foot 'cov'eringshold the heel-sear implacedurin'g thedocom'otion of the wearer. When-boots 'or shoe's'are' employed having stifi hel counters; such countersgive added supportto hold-"the heel-seat'in'positi'onin the shoe; butthe wearing of 'tlie present invention with shoes having stiff 'heel' "counters is notaessentiahes #has b'eenabovepointed "out;

It will be-apparent"thataheel-seat for .use -with' 'a right-heel must be-formed as'ia mirror-image of "theme 'described' and 'illustratedwhich, as mentioned atroveyi's intended to be worn on a left heel.

The heel seats according to this invention can most conveniently be manufactured from plastic material or light metal alloys, and they may readily be moulded in known manner which would enable large numbers to be produced very cheaply. Only one pair of heel-seats is required at a time for any one person because they may be transferred as the shoes are changed, it taking from six to nine months before the average child outgrows any one size. The plastic material referred to may be a phenol formaldehyde resin, a vinyl resin, polystyrene, acrilic resin, cellulose acetate, cellulose nitrate or hard rubber. However, at the present time I prefer to construct the heel-seats of a so-called fiber glass with a binder such as a polyester resin.

While the heel-seat appliance of this invention may be used for adults with flat feet, it is intended that the heel seats should be utilized mainly for the strengthening of the feet of growing children which need correction for slight deformity, in order to prevent flat-footedness or knock-knees, and it has been found that with continuous wear the foot is forced into its natural position, and since the weight of the wearer is distributed and borne by the proper supporting surfaces, in time the muscles of the foot are strengthened, and the heel seat may be discarded when the deformity has been overcome. Any support under the arch of the foot in connection with the heel-seat device of this invention would be detrimental to the treatment. I find that the average time a child must wear constantly the heel-seat appliances of this invention, before the arch is set, is from two to two and a half years, by which time the muscular structure is sufficiently strong to maintain the arch permanently in its corrected position and no further treatment is required.

It will be apparent that the present invention provides a heel seat which is cheap to manufacture in large quantities from plastic material or metal and which may be worn with the minimum of discomfort in normal foot-wear. The heel seat ensures that the correct weight bearing surfaces of the foot are employed and since no weight is borne unnaturally by the arch of the foot, the wearing of the heel seat gradually strengthens the foot and eventually enables the heel seat to be discarded having reformed the foot into its correct shape.

For ordinary fiat feet these heel-seats could be prescribed by family and school doctors and dispensed by appliance makers, or by trained employees in any good shoe store. If the heel-seat fits the child's heel it is the right heel-seat. So prescribed, it would relieve some of the congestion in hospital orthopedic departments. It may also be used prophylactically in convalescence if the childs feet are weakened by illness or recumbency.

I claim:

1. An orthopedic appliance for correcting everted heels comprising a one-piece rigid scoop-shaped member of relatively thin material adapted to fit upon and receive only that area of the heel of the wearer occupied by the 0s calcis; said scoop-shaped member having a flat bottom wall the surfaces of which are substantially horizontal and parallel and having the opposing side walls and the rear wall joined with the bottom wall on a rounded curve and shaped internally to conform to the outline of a normal heel to encase and firmly grip said everted heel medially, laterally and rearwardly; the front portion of the medial side wall being formed on its inner surface with a curvilinear convexed bulge portion extending horizontally of said wall to conform with the depression in the os calcis underlying the sustentaculum tali thereof, whereby, under the weight of the wearer standing on his heel and forefoot, the bottom wall of said scoop-shaped member is held fiat on a supporting surface and the convexed portion acts to exert a pressure against the front portion of the medial side of the everted os calcis to invert it to normal vertical position and hold it against the lateral wall and force the talus and its associated bones of the arch of the foot upwardly to restore the foot to normal arched position.

2. The orthopedic appliance as set forth in claim 1, wherein the outer surfaces of said scoop-shaped member conform to the configuration of the inner surfaces thereof, and the rear portions of said side walls are substantially vertical above their curving juncture with the bottom wall and diverge outwardly and forwardly of the scoopshaped member.

3. An orthopedic device as set forth in claim 2, wherein the upper edges of said side walls gradually decline toward the forward end of the scoop-shaped member and merge with the front end of the bottom wall in a rounded curve, the upper edge of the lateral side wall being declined at a greater degree than the upper edge of the medial side wall.

4. The subject-matter of claim 3, wherein said side walls lie below the medial and lateral malleoli and, together with the bottom wall, extend no farther forward than the proximal edge portion of the navicular bone, when the heel-seat is worn.

5. The subject-matter of claim 1, wherein the forward edge portion of the bottom wall declines slightly from its fiat surface toward the forward edge thereof.

References Cited in the file of this patent UNITED STATES PATENTS 1,219,257 Cornet Mar. 13, 1917 1,299,983 Martyn et a]. Apr. 8. I919 2,572,860 Hipps et a1. Oct. 30, 1951

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