Method and apparatus for the treatment of plantar ulcers and foot deformities

Abstract

A custom-made ankle/foot orthosis for the treatment of patients having plantar ulcers and foot deformities is disclosed, which comprises a rigid L-shaped support member and a rigid anterior support shell hingedly articulated to the L-shaped support member. The plantar portion of the L-shaped member further comprises at least one ulcer-protecting hollow spatially located for fitted placement in inferior adjacency to a user's plantar ulcer, thus allowing the user to transfer the user's weight away from the plantar ulcer and facilitating plantar ulcer treatment. The anterior support shell is designed for lateral hinged attachment to the L-shaped member to take advantage of medial tibial flare structure for enhancing the weight-bearing properties of the disclosed orthosis. Leg securement structure attaches the anterior support shell to the L-shaped member in fixed, weight-bearing relation about the proximal, anterior portion of the user's lower leg.

1 - 82 . (canceled) 
   
   
       83 . A custom-made orthosis for the treatment of plantar ulcers and foot deformities, comprising:
 a substantially rigid, substantially L-shaped support member including a substantially vertical posterior support shell and a substantially horizontal plantar support platform comprising a horizontal foot support structure sized and shaped to support a user's foot;   wherein the substantially horizontal foot support structure, prior to any deformation caused by pressure exerted by the foot, includes a hollow, non-apertured portion located to correspond to an adjacent location of a plantar ulcer or other foot deformity on the user's foot, to reduce pressure on the plantar ulcer or other foot deformity when the user is standing or walking.   
   
   
       84 . The custom-made orthosis of  claim 83 , wherein the orthosis comprises a substantially L-shaped support member primarily made of a plastic material, including: a substantially vertical lower leg support structure sized and shaped to receive a portion of a user's lower leg; and the substantially horizontal foot support structure. 
   
   
       85 . The custom-made orthosis of  claim 84 , wherein the substantially vertical lower leg support structure comprises a substantially vertical, posterior support shell portion, and further comprising an anterior support shell portion connected to the substantially L-shaped support member. 
   
   
       86 . The custom-made orthosis of  claim 83 , wherein the substantially horizontal foot support structure comprises a plantar support platform portion. 
   
   
       87 . The custom-made orthosis of  claim 85 , wherein the anterior support shell portion is designed for lateral hinged attachment to the posterior support shell portion. 
   
   
       88 . The custom-made orthosis of  claim 84 , wherein the lower leg support structure is secured to the user's lower leg using one or more of a hinge, laces, Velcro® or straps. 
   
   
       89 . The custom-made orthosis of  claim 84 , wherein the lower leg support structure and foot support structure comprise a single, integral structure. 
   
   
       90 . The custom-made orthosis of  claim 84 , wherein the lower leg support structure and foot support structure are movably connected by a hinge or straps. 
   
   
       91 . The custom-made orthosis of  claim 83 , wherein the foot support structure is comprised of a polyester resin, including but not limited to molded polypropylene. 
   
   
       92 . The custom-made orthosis of  claim 84 , wherein the lower leg support structure is comprised of a polyester resin, including but not limited to molded polypropylene. 
   
   
       93 . The custom-made orthosis of  claim 83 , wherein the orthosis may be worn in combination with a modified shoe. 
   
   
       94 . The custom-made orthosis of  claim 83 , further comprising custom alignment wedges located adjacent the foot support structure for facilitating stabilizing of ankle and plantar foot surfaces. 
   
   
       95 . The custom-made orthosis of  claim 84 , wherein the substantially vertical, posterior support shell portion proximally terminates in a proximal flared posterior shell brim. 
   
   
       96 . The custom-made orthosis of  claim 84 , wherein the substantially vertical, posterior support shell portion distally terminates in a tarsal support structure. 
   
   
       97 . The custom-made orthosis of  claim 96 , wherein the tarsal support structure comprises a medial tarsal support portion, a lateral tarsal support portion, and a heel support portion intermediate the medial tarsal support portion and the lateral support portion. 
   
   
       98 . The custom-made orthosis of  claim 85 , wherein the anterior support shell portion includes a proximal flared anterior shell brim and a distal flared anterior shell brim, to accommodate and facilitate adjacent placement to the fibular head of the user's leg. 
   
   
       99 . The custom-made orthosis of  claim 83 , wherein the substantially horizontal foot support structure comprises a soft orthotic material. 
   
   
       100 . The custom-made orthosis of  claim 83 , wherein the substantially horizontal foot support structure comprises a rigid, vacuum form-molded polypropylene. 
   
   
       101 . The custom-made orthosis of  claim 83 , wherein the substantially horizontal foot support structure comprises a rigid resin material comprising either polyester resin or acrylic resin. 
   
   
       102 . The custom-made orthosis of  claim 83 , wherein the substantially horizontal foot support structure comprises a closed cell polyurethane foam.