The field of the invention is orthopedic braces (orthoses).
The following description includes information that may be useful in understanding the present invention. It is not an admission that any of the information provided herein is prior art or relevant to the presently claimed invention, or that any publication specifically or implicitly referenced is prior art.
Orthopedic braces (orthoses) usually need to be adjusted or customized in some manner to conform to the body part(s) being braced, and then properly positioned. A typical orthosis commonly has at least two portions, a rigid portion supporting a body part, and a flexible portion securing the orthosis to the body. The flexible portion is often a strap, and in many orthoses, multiple straps are required to adequately secure the orthosis. It can be time-consuming for a patient to repeatedly have to adjust the different straps.
U.S. Pat. No. 8,480,604 to Messer describes an ankle foot orthosis (AFO) which has a strap positioned around a calf region. Unfortunately, for some individuals a single strap might not be sufficient to secure the orthosis, given the complex ankle movements including dorsiflexion, plantarflexion, inversion, and eversion that occur during walking. Thus, the AFO could be mis-positioned during walking, providing a painful walking experience to the patient, and even potentially worsening a patient's medical condition.
U.S. Pat. No. 9,572,703 to Matthews describes an orthosis sock that utilizes a resilient material for restricting movement of a wearer's foot. Because the orthosis is a sock, it is relatively easier to wear than a typical AFO. However, resiliency of the material can be insufficient to provide adequate support.
It is known to create custom AFOs by creating a negative mold of a patient's lower leg, ankle, and foot, using the negative mold to create a positive mold, wrapping preheated flexible and hardenable materials about different portions of the positive mold, and then applying vacuum to the material-wrapped positive mold then allowing time for the materials to cool to the shape of the positive mold. Once cooled, the materials must be carefully cut off the model then all cut edges must be ground/smoothed to the final shape. Production of such custom AFOs is extremely manual and inefficient. Production is time consuming, requires considerable skill, and is therefore relatively expensive.
All publications identified herein are incorporated by reference to the same extent as if each individual publication or patent application were specifically and individually indicated to be incorporated by reference. Where a definition or use of a term in an incorporated reference is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply.
Thus, there is still a need for systems and methods for efficiently producing custom orthoses.
The inventive subject matter provides systems and methods in which a knitted orthopedic precast/orthosis has (a) a shell portion comprising a knitted strand of at least a first thermoplastic material; mechanically coupled with (b) a flexible portion including a knitted strand of a non-thermoplastic material.
As used herein, the terms “rigid” or “rigidity” with respect to an object or portion of an object means that the object or rigid portion will resist bending or deformation. According to this definition, different lengths of a given structure and composition can be rigid at a shorter length, and flexible at a longer length. As used herein, the terms “very rigid” or “high rigidity” with respect to an object or portion of an object means that the object or rigid portion will be permanently deformed if bent or twisted by at least 20° end to end.
As used herein, the term “resilient” with respect to an object or a portion of an object means that upon bending or stretching, the portion will automatically return to its substantially pre-bent ore pre-stretched shape. As used herein the term “bending” should be construed to include twisting.
As used herein, the term “flexible” with respect to an object or a portion of an object means that the flexible portion will not be permanently deformed by bending or twisting. As used herein, the term “permanently deformed” means that deformation remains unless the deformation is actively repaired. According to this definition, an object or a portion of an object could be rigid in one direction, and flexible in another direction. Unless otherwise specified in such cases, the object or portion of the object is deemed to be rigid.
As used herein, the term “elastic” with respect to an object or portion of an object means that if the elastic portion is stretched or compressed lengthwise by at least 10%, it will return to its resting length, without the need for application of an external force, and without permanent deformation.
As used herein, the term “shell” means a structure having a cavity, hollow, or lumen configured to impart rigidity that restrains movement of a part of a patient's body, wherein the structure is either rigid or will become rigid upon application of heat and cooling.
As used herein the term “patient” includes both humans and animals, independently of whether the patient is under the care of a medical or veterinary professional.
As used herein, the term “strand” means an elongate, thin length of one or more natural, artificial, or combined natural and artificial substances, collectively no more than 3 mm thick over a length of at least 1 cm. Strands includes threads and yarns.
In some embodiments, an orthopedic precast/orthosis is configured to have a tube that includes both the shell and flexible portions.
In some embodiments, the shell portion orients lengthwise along the tube. For example, the shell and flexible portions of a precast could correspond to the anterior and posterior portions of a lower leg respectively, and these portions can be directly connected to each other. For such a precast, the shell portion would be considered to be oriented lengthwise along the tube.
Alternatively, a shell portion can orient crosswise with respect to a tube. For example, a precast capable of accommodating a torso portion of a patient could have a shell portion that extends across the front of a patient, and flexible portions that also extend across the front of the patient, connected superiorly and inferiorly to the shell portion. For such a precast, the shell portion would be considered to be oriented crosswise along the tube.
As used herein, the term “crosswise” includes various degrees of diagonality.
A thermoplastic material used in a shell portion can be different from or the same as a thermoplastic material used in an additional shell portion. For example, the thermoplastic material used in a wrist part of a full arm wrist orthosis can be the same as or different from the thermoplastic material used in an elbow part. In preferred embodiments, the melting temperatures of different thermoplastic materials used in the same precast differ by 10°-20 C, by 10°-30° C., 30°-50° C., and even between 50°-150° C.
In some embodiments, the thermoplastic portion can comprise at least 30 wt % of a precast. In a preferred embodiment, the thermoplastic portion can comprise between 5 wt % and 90 wt % of the precast, more preferably between 50 wt % and 90 wt % of the precast, still more preferably between 80 wt % and 90 wt % of the precast.
Similarly, in some embodiments, the shell portion can comprise at least 30 wt % of a precast. In a preferred embodiment, the shell portion can comprise between 5 wt % and 90 wt % of the precast, more preferably between 50 wt % and 90 wt % of the precast, still more preferably between 80 wt % and 90 wt % of the precast.
In some embodiments, a shell portion of the precast can vary in nominal thickness by at least 50%. Similarly, a flexible portion of a precast can vary in nominal thickness by at least 50%.
In some embodiments, the flexible portion can be elastic. The elasticity can be achieved by a material itself having an elastic feature or knitting techniques being capable of having an elastic feature.
In some embodiments, the shell and flexible portion can be layered. For example, the flexible portion can be laminated with at least a layer of the shell portion to provide structural reinforcement. Alternatively, a shell portion can be laminated with at least one layer of a flexible portion to enhance skin comfort.
In some embodiments, a precast can include at least an eye and a mateable strap.
The inventive subject matter also includes methods of producing a custom orthosis, including the steps of:
Examples of thermoplastic with melting point temperature ranges can be found at https://www.plastikcity.co.uk/useful-stuff/material-melt-mould-temperatures, and http://polymerdatabase.com/polymer%20physics/Polymer%20Tm%20C.html.
Positive molds of a body part can be produced according to well-known techniques, including (a) using plaster or other materials to produce a negative cast of a body part, removing the negative cast from the body part, filing the cast with a hardenable casting material, and then removing the negative cast from about what is then the positive mold. It is also known to cut away or add material to the positive mold. Positive molds can be made from any body part or combination of adjoining parts, for example a positive mold could be made that mimics a hand, wrist and forearm.
In preferred methods the precast is somewhat tubular, with one or two open ends so that the precast can be pulled over a body part. In some embodiments the shell can include second or third thermoplastic materials with different melting points from the first thermoplastic material.
As used herein, and unless the context dictates otherwise, the term “coupled to” is intended to include both direct coupling (in which two elements that are coupled to each other contact each other) and indirect coupling (in which at least one additional element is located between the two elements). Therefore, the terms “coupled to” and “coupled with” are used synonymously.
As used in the description herein and throughout the claims that follow, the meaning of “a,” “an,” and “the” includes plural reference unless the context clearly dictates otherwise. Also, as used in the description herein, the meaning of “in” includes “in” and “on” unless the context clearly dictates otherwise.
All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g. “such as”) provided with respect to certain embodiments herein is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention otherwise claimed. No language in the specification should be construed as indicating any non-claimed element essential to the practice of the invention.
Various objects, features, aspects and advantages of the inventive subject matter will become more apparent from the following detailed description of preferred embodiments, along with the accompanying drawing figures in which like numerals represent like components.
The following discussion provides many example embodiments of the inventive subject matter. Although each embodiment represents a single combination of inventive elements, the inventive subject matter is considered to include all possible combinations of the disclosed elements. Thus if one embodiment comprises elements A, B, and C, and a second embodiment comprises elements B and D, then the inventive subject matter is also considered to include other remaining combinations of A, B, C, or D, even if not explicitly disclosed.
In some embodiments, the numbers expressing quantities of ingredients, properties such as concentration, reaction conditions, and so forth, used to describe and claim certain embodiments of the invention are to be understood as being modified in some instances by the term “about.” Accordingly, in some embodiments, the numerical parameters set forth in the written description and attached claims are approximations that can vary depending upon the desired properties sought to be obtained by a particular embodiment. In some embodiments, the numerical parameters should be construed in light of the number of reported significant digits and by applying ordinary rounding techniques. Notwithstanding that the numerical ranges and parameters setting forth the broad scope of some embodiments of the invention are approximations, the numerical values set forth in the specific examples are reported as precisely as practicable. The numerical values presented in some embodiments of the invention may contain certain errors necessarily resulting from the standard deviation found in their respective testing measurements.
The recitation of ranges of values herein is merely intended to serve as a shorthand method of referring individually to each separate value falling within the range. Unless otherwise indicated herein, each individual value is incorporated into the specification as if it were individually recited herein.
Unless the context dictates the contrary, all ranges set forth herein should be interpreted as being inclusive of their endpoints, and open-ended ranges should be interpreted to include only commercially practical values. Similarly, all lists of values should be considered as inclusive of intermediate values unless the context indicates the contrary.
Groupings of alternative elements or embodiments of the invention disclosed herein are not to be construed as limitations. Each group member can be referred to and claimed individually or in any combination with other members of the group or other elements found herein. One or more members of a group can be included in, or deleted from, a group for reasons of convenience and/or patentability. When any such inclusion or deletion occurs, the specification is herein deemed to contain the group as modified thus fulfilling the written description of all Markush groups used in the appended claims.
The one or more strands of the shell portion include at least one thermoplastic material, and can also be a composite, which includes at least two different thermoplastic materials. The various thermoplastic materials can have the same or a different melting temperature. Strands can also be a composite of one or more thermoplastic materials and one or more non-thermoplastic materials. The thermoplastic and non-thermoplastic materials can be selected using any combination of natural and synthetic materials to accomplish a desired characteristic, as for example, a desired degree of stiffness, compressibility, flexibility, bending, stretch, and resilience.
Preferred thermoplastic materials form flexible strands at room temperature, are non-toxic, melt between 140° C. and 350° C., and become rigid when strands are partially melted together into a sheet or mat having a thickness of 0.5 mm-6 mm. Contemplated thermoplastic materials include Polyethylene Terephthalate (PET), Polyether ether ketone (PEEK) Polyphenylene oxide (PPO), Polypropylene (PP), polyethylene (PE), polyvinyl chloride (PVC) and polystyrene (PS), poly(methyl methacrylate) (PMMA), Acrylonitrile butadiene styrene (ABS), Polylactic acid (PLA), Polybenzimidazole (PBI), Polycarbonate (PC), Polyether sulfone (PES), Polyoxymethylene (POM), Polyphenylene sulfide (PPS) , Polystyrene, Polyvinyl chloride (PVC), Polyvinylidene fluoride (PVDF), Polytetrafluoroethylene (PTFE), Polyamide 6 (PA6), Polybutylene terephthalate (PBT), Polyetherimide (PEI).
The one or more strands of the rigid portion can comprise thermoplastic and non-thermoplastic materials. For example, a PET strand could include Kevlar™, carbon fibers, nanotubes, glass fibers, ceramic, and/or metal fibers.
The one or more strands of the flexible portion can also comprise thermoplastic and/or non-thermoplastic materials, as long as no substantial quantity of such materials melt below the melting point of a substantial quality of the lowest-melting thermoplastic material used in the shell portion. One of the inventive concepts is that a precast will have (1) one or more knitted strands of a first material or set of materials, which upon heating, partially melt and therefore fuse together to form a rigid shell, and (2) one or more knitted strands of a different material or materials that remain flexible upon cooling, either because they do not melt, or they melt to an insubstantial amount at the temperature used to melt the shell materials. Accordingly, the terms “insubstantial” and “substantial” are used herein in that context.
It should be appreciated then, that the one or more knitted strands of a different material or materials that remain flexible upon cooling might or might not include a thermoplastic material. Preferably, however, the one or more knitted strands of a different material or materials that remain flexible upon cooling could mostly or entirely comprise a natural fiber such as cotton or wool. To avoid oxidation of such non-thermoplastic materials, heating can take place in an anoxic or low oxygen environment.
In production, precast 100 is placed over a positive mold and heated, such that at least some of the thermoplastic material(s) fuse, in what will become a rigid shell. This allows the shell portion to closely conform to whatever part(s) of the patient are to be motion-restrained.
Precast 100 has a tubular configuration, with superior and inferior open ends as depicted in
In
The flexible portions 120 and 122 are preferably elastic even after the heating and cooling processes. Elasticity is advantageous because it causes the corresponding orthosis to conform to different body shapes. Moreover, since the shell portion 110 of precast 100 only extends partway around the precast, flexibility of portion 124 could be sufficient to allow a user to pull the corresponding orthosis over his/her head, as an alternative means of placement.
Precast 100 includes a strap 140 to further secure the corresponding orthosis on a patient's body.
In a corresponding orthosis 200, the shell 210 and flexible 220 portions cooperate to support posterior and anterior parts of the lower leg respectively. The shell 210 and the flexible 220 portions are oriented lengthwise along the tube 230. In this configuration, the flexible portion 220 allows easy on-off of the corresponding orthosis, while the shell portion 210 provides dorsiflexion, plantarflexion, inversion, and eversion stability at the ankle.
Strategic use of elastic regions can enhance functionality. For example in
During the knitting process, the relative dimensions of the shell and flexible portions, and even areas of different thicknesses, can be easily customized, among other things to provide reinforcement where desired.
In
Shell portions and flexible portions can be coupled in any suitable manner, including lateral juxtaposition and overlapping (the inside of a part of the shell portion 352 is layered/laminated with the flexible portion).
A wrist orthosis corresponding to precast 500 would be effective in reducing wrist flexion, extension, abduction, adduction and rotational movement, while still being relatively easy to put on because of the flexible portion 520.
As with all examples herein where a first portion includes a thermoplastic material with a lower melting point than a second portion, it is contemplated that the difference in melting points can arise because the second portion has no melting point. In such cases, for example, the second portion could burn above the melting point of the thermoplastic material in the first portion (when in an oxygen environment), or pyrolyze above the melting point of the thermoplastic material in the first portion (when in an oxygen-free or oxygen-reduced environment),
In
Any suitably functional material(s) can be employed as the embedded self-heating composition 1526, including for example, magnesium metal powder, alloyed with a small amount of iron, such as that used in heating meals-ready-to-eat (MREs). Typically such materials generate heat during an exothermic chemical reaction when triggered by oxygen in the atmosphere, and in
Upon removal of precast 1500 from the bag 1550, the precast 1500 is placed on a human limb or other mold, where the embedded self-heating composition 1526 comes in contact with oxygen in the air, and a chemical reaction heats the thermoplastic threads or yarns 1522 to around the melting point. Upon cooling, the thermoplastic threads or yarns 1522 partially melt together to form a hardened shell from portion 1520.
The precast 1700 is stored in bag 1750, which excludes a polymerizing agent. Contemplated polymerizing agents include, for example, UV or other light, one or more chemicals, or other suitable energy source. Upon opening of bag 1750, precast 1700 is placed on a human limb or other mold, and subject to the polymerizing agent to polymerize the polymerizable material 1726 to form a hardened shell from portion 1720.
It is still further contemplated instead of thermoplastic threads or yarns being heated and then cooled to form a shell portion, material could be used in the threads or yarns that is hardened by polymerization, with the polymerizing energy coming from ambient or artificial light, an oxidizing or reducing agent, or any other suitable energy source.
It should be apparent to those skilled in the art that many more modifications besides those already described are possible without departing from the inventive concepts herein. The inventive subject matter, therefore, is not to be restricted except in the spirit of the appended claims. Moreover, in interpreting both the specification and the claims, all terms should be interpreted in the broadest possible manner consistent with the context. In particular, the terms “comprises” and “comprising” should be interpreted as referring to elements, components, or steps in a non-exclusive manner, indicating that the referenced elements, components, or steps may be present, or utilized, or combined with other elements, components, or steps that are not expressly referenced. Where the specification claims refer to at least one of something selected from the group consisting of A, B, C . . . and N, the text should be interpreted as requiring only one element from the group, not A plus N, or B plus N, etc.