Cable brace system

Abstract

A cable brace system that enhances the natural ligament of a human body to reduce the propensity of injury or re-injury. The invention is a cable system which acts very similar to the natural ligament of the human body and is capable of resisting the forces which cause excessive joint movement and injury. A control loop formed by the cable provides external over-stretching, bending, and rotational support as the ligament travels within the range of motion.

Description

[0001] This application is a divisional application of the Chinese invention patent application No. 202080049608.7, which has entered the Chinese national phase of the international application PCT / US2020 / 037078 with the invention name “Cable Support System” and the international application date of June 10, 2020.

[0002] Incorporate by Reference

[0003] This application incorporates by reference the following applications: US Patent Application Nos. 13 / 867,910, 12 / 987,084, 11 / 744,213, 62 / 682,560, and 62 / 718,529.

[0004] Priority declaration

[0005] This application claims priority to U.S. Application No. 16 / 436,786, filed on June 10, 2019, the entire contents of which are incorporated herein by reference as if fully set forth herein. Technical Field

[0006] The present disclosure relates to a cable brace system, which is a joint and ligament support system for strengthening the body's natural ligaments to reduce the tendency to injury or re-injury. Background Art

[0007] The human body consists of many complex mechanisms that are susceptible to injury. For example, the human knee is a complex mechanism that is highly susceptible to injury in sports like football, hockey, skiing, snowboarding, and motocross. In these types of physically demanding sports, the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) are commonly injured. The wrist, ankle, and elbow are also vulnerable in many of the same activities and for many of the same reasons. The wrist is made up of many ligaments that can hyperstretch, which is painful and a slow healing process. The ankles and elbows are also at risk for hyperextension events if not properly supported.

[0008] Most prior art (conventional) brace devices for ligament protection consist of rigid plates connected by hinges or straps on either side of the ligament or joint, or the brace device is simply two plates connected by a strap. These plates are tightly strapped to the leg or arm above and below the ligament / joint with straps that wrap around the leg / arm. For example, the current state of the art in functional knee braces typically relies on a hinged frame that is secured to the knee anatomy by an adjustable lacing system. Although adequate to control lower pathologically induced loads, these brace systems have not been shown to be effective in controlling the higher loads that are more clinically important. Therefore, current knee braces are not completely successful in preventing ligament injury or re-injury. There is a need for a brace design that more specifically addresses the mechanisms of ligament injury while maintaining comfort, fit, lightweight design, and unimpeded motion functionality. Summary of the invention

[0009] The object of the present invention is to provide a joint and ligament support system that strengthens the body's natural ligaments to reduce the tendency to injury or re-injury. In various embodiments, this is achieved by using a novel control loop strategy in which two or more cables are looped around separate points near the joint to provide precise control of the joint's motion. These control loops provide a higher level of adjustability and transmit their tightening force toward the center of the loop, thereby increasing the stability and effectiveness of the brace.

[0010] One embodiment of the present invention is a cable system that acts much like the body's natural anterior cruciate ligament (ACL) and medial collateral ligament (MCL). The cable is routed around the knee joint in a manner that resists forces that cause excessive joint motion and ACL and / or MCL injury. As the leg travels through a range of motion such that a first control loop extends, the opposing control loop portion of the cable tightens, thereby preventing the tibia from moving forward (hyperextension) or twisting (lateral rotation) or flexing laterally relative to the femur.

[0011] The cable system described herein can be customized or adapted to existing art (conventional) braces, thereby improving their effectiveness. BRIEF DESCRIPTION OF THE DRAWINGS

[0012] Figure 1 is an external frontal / lateral view of the right leg showing normal fully extended and hyperextended (torn ACL) views.

[0013] Figure 2 It is a top / front view of the right leg in full extension, showing normal and lateral rotation or lateral flexion (torn ACL and / or MCL) views.

[0014] Figure 3 is an external front / side view of the right leg fully extended, showing the main cables resisting hyperextension of the leg.

[0015] Figure 4 is a top / front view of the right leg fully extended, showing the main cables resisting lateral rotation of the leg.

[0016] Figure 5 is an external front / side view of the right leg in a flexed position showing the main cable knee brace system.

[0017] Figure 6 is an exploded isometric view showing the components of the main cable knee brace system.

[0018] Figure 7 is an external front / lateral view of the left leg fully extended, showing the auxiliary cables resisting hyperextension of the leg.

[0019] Figure 8 is a top / front view of the right leg fully extended, showing the auxiliary cables resisting lateral rotation and / or lateral bending of the leg.

[0020] Fig. 9 is an external front / side view of the left leg in a flexed position showing the auxiliary cables resisting lateral bending or lateral rotation.

[0021] Fig.10 is an exploded isometric view of the components of the auxiliary cable knee brace system.

[0022] Fig.11 is an inside front / side view of the auxiliary cable guide plate that guides the auxiliary cables through the pivot point.

[0023] Fig.12 Is an inside front / side view of an alternative cable guide plate that guides auxiliary cables below and above the pivot point.

[0024] Fig.13 is an inside front / side view of another alternative cable guide plate for guiding auxiliary cables above and below the pivot point.

[0025] Fig.14 is a top view of a portion of a Q-adjustable tibial shell according to an embodiment of the present invention.

[0026] Fig.15 is a three-quarter view of a Q-adjustable leg brace according to an embodiment of the present invention.

[0027] Fig.16 is a top-down view of a Q-adjustable leg brace according to an embodiment of the present invention.

[0028] Fig.17 is a top-down view of a Q-adjustable leg brace according to an embodiment of the present invention.

[0029] Fig.18 is an interior front / side view of a wrist brace shown on a right wrist in accordance with an embodiment of the present invention.

[0030] Fig.19 A detail view of an extension stop mechanism for a wrist brace according to an embodiment of the present invention is provided.

[0031] Fig. 20 is a top view of a wrist brace on a right wrist according to an embodiment of the present invention.

[0032] Fig.21 is a bottom view of a wrist brace according to an embodiment of the present invention.

[0033] Figures 22A-22C Several views of a wrist brace embodiment of the present invention are provided.

[0034] Fig.23 is an interior front / side view of an elbow brace on a right elbow in accordance with an embodiment of the present invention.

[0035] Fig.24 is a top view of an elbow brace on a right elbow according to an embodiment of the present invention.

[0036] Fig.25 is an exterior front / side view of an ankle brace on a right foot in accordance with an embodiment of the present invention.

[0037] Fig.26 is a rear view of an ankle brace on a right foot according to an embodiment of the present invention. DETAILED DESCRIPTION

[0038] Various embodiments of cable-adjusted joint and ligament braces with at least two control loops are described herein. The basic principles of the invention can be applied to support a variety of joints and corresponding ligaments, as desired. In each of the various embodiments, at least two control loops are formed by a cable system that is attached to one or more plates or shells near the joint or ligament that needs support.

[0039] Knee brace

[0040] To effectively prevent injury to the ACL 22 and / or MCL 23, the knee brace must prevent the tibia 26 from moving forward (hyperextension) relative to the femur 18 (see Figure 1 ) or lateral bending and / or rotation (torsion) (see Figure 2 ). For the sake of completeness, the patella 20 and the fibula 24 are shown. Figure 3-17The knee brace of the present invention, best shown, incorporates a novel cable system that more effectively prevents hyperextension, lateral flexion and / or lateral rotation of the knee joint. Like reference numerals refer to like elements throughout the several views.

[0041] Figure 3 The main cable system of the present invention is shown, which produces an effective differential force on the tibia 26 relative to the femur 18 and strengthens the ACL 22. When the main cables 1 of the system are properly tensioned, the brace acts like the body's own ACL 22, causing the brace to become taut as the leg extends, thereby resisting forward movement of the tibia 26 relative to the femur 18. Figure 4 The main cable system of the present invention is shown to resist lateral rotation of the tibia 26 relative to the femur 18. Figure 5 FIG. 2 shows the main cable system of the present invention when the leg is flexed. Figure 3 As shown, because the tibial plate 2 moves further away from the femoral plate 4 as the leg extends, the main cable 1 becomes progressively tighter as the leg approaches full extension. Figure 3 As shown, when a hyperextension force 28 is applied to the leg, the tibial plate 2, patellar plate 3 and femoral plate 4 are compressed together as the main cable 1 is subjected to progressively greater tension. The tension in the main cable 1 pulls the tibial plate 2 downward and the back plate 5 upward, thereby creating a differential resistance force on the knee joint to prevent the leg from hyperextension. Figure 7 The auxiliary cable system of the present invention is shown to produce an effective differential force on the tibia 26 relative to the femur 18 and strengthen the ACL 22 and MCL 23. The auxiliary cable 40 resists anterior movement of the tibia 26 relative to the femur 18 when the leg is extended. Figure 8 An auxiliary cable 40 is shown that resists lateral bending and / or lateral rotation of the tibia 26 relative to the femur 18. Fig. 9 The auxiliary cable system of the present invention is shown when the leg is bent, and the auxiliary cable 40 resists lateral bending and lateral rotation throughout the range of motion of the leg. When the leg is extended, the patellar plate 3 acts like a hinge for the tibial plate 2 and femoral plate 4 to rotate about pivot points 17a and 17b respectively to approximate the flexion-extension movement of the knee joint.

[0042] like Figure 4 As shown, when a lateral rotational force 30 is applied to the leg, the tibial plate 2, patellar plate 3, femoral plate 4 and back plate 5 are kept rigid by the tension generated in the main cable 1. The tension in the main cable 1 crosses behind the leg, so that when the tension passes through the back plate 5, a cable crossover point 31 is created, thereby resisting rotation and bending at the knee joint and preventing the leg from bending or rotating laterally. Figure 8As shown, when a lateral bending or lateral rotation force is applied to the leg, the tibial plate 2, patellar plate 3 and femoral plate 4 are kept rigid by the tension generated in the auxiliary cable 40. The tension in the auxiliary cable 40 prevents the brace from bending on the knee joint, thereby preventing the leg from lateral bending or rotation.

[0043] The present invention includes a main cable 1 and an auxiliary cable 40, which can be made of any flexible material with a sufficiently high tensile strength. The shape of the tibial plate 2, which can be made of any rigid or semi-rigid material, is designed to conform to the tibia 26, starting from just below the knee and ending at the approximate midpoint of the tibia 26. The tibial plate 2 is held in place by strips 11b and 11c. A foam pad 12 is attached to the underside of the tibial plate 2 for comfort and to provide a firm grip on the individual tibia 26. The patella plate 3, which can be made of any rigid or semi-rigid material, connects the tibial plate 2 to the femoral plate 4. The femoral plate 4, which can be made of any rigid or semi-rigid material, is located at the top of the thigh, from just above the knee to roughly the middle of the femur 18 and is held in place with strips 11a. The back plate 5 can be made of any rigid or semi-rigid material and is located behind the leg and just above the knee joint, thereby keeping the cable 1 in place, and thereby firmly holding the femur 18 as the differential force of the main cable 1 is transmitted through the joint. Foam pads 14 are attached to the inside of the back plate 5 to help comfortably distribute the force of the main cable 1 to the leg. The cable tensioner dial 6 and lock / release button 7 with spring 8 are attached to the femoral plate 4 with set screws 9. They can be made of any metal or rigid material that will withstand the force required to keep the main cable 1 locked in place during use. Other cable tensioning and locking mechanisms can be used, but the dial tensioning and locking system provides a very wide range of fine-tuning cable adjustability and ease of use.

[0044] The basic element of the present invention is the wiring of the cables. Figure 6 As best shown, the main cable 1 is initially attached to the femoral paddle 4 via the cable connector 15a, passes through the cable guide hole 13a and the cable guide hole 13b in the back plate 5 behind the leg, and extends through the cable guide hole on the opposite side of the tibial paddle 2. The main cable 1 then loops around the leg, reaches the other side of the tibial paddle 2, and passes through a cable guide hole. From this cable guide hole in the tibial paddle 2, the main cable 1 again passes through the cable guide hole 13c behind the leg, crosses itself, thereby forming a cable crossover point 31, and then passes through the cable guide hole 13d in the back plate 15 and is attached to the opposite side of the femoral paddle 4 via the second cable connector 15b.

[0045] In another embodiment, the main cable 1 is initially attached to the femoral plate 4 through the first cable connector 15a, passes through the first cable guide hole 13a and the second cable guide hole 13b in the back plate 5 behind the leg, and is attached to the opposite side of the tibial plate 2 with the clamping screw 10a. The main cable 1 is then looped over the leg and attached to the other side of the tibial plate 2 with the clamping screw 10b. From the clamping screw 10b, the main cable 1 is again passed through the third cable guide hole 13c and the fourth cable guide hole 13d in the back plate 5 behind the leg to form a cable crossover point 31, and is attached to the opposite side of the femoral plate 4 by the second cable connector 15b.

[0046] like Fig.10 As best shown, the auxiliary cable 40 begins by attaching to the outer or lateral side of the femoral paddle 4 through the femoral cable connector 42a and extending through the femoral cable guide hole 44a. The auxiliary cable 40 passes through the femoral pivot point 17a and the tibial pivot point 17b through the cable guide plate 48. From the cable guide plate, the auxiliary cable 40 extends through the tibial paddle guide hole 44b and attaches to the outer or lateral side of the tibial paddle 2 through the tibial cable connector 42b, completing the routing.

[0047] In some embodiments, a single cable is used which passes through each guide. In alternative embodiments, the cable may be composed of individual segments that are connected together to form a complete routing. For example, a first main cable segment 1a and a second main cable segment 1b may be connected together through the tibial plate 2 to complete the loop. The first main cable segment 1a begins by being attached to the femoral plate 4 through the first cable connector 15a, passes through the cable guide holes 13a and 13b in the back plate 5 behind the leg, and is attached to the opposite side of the tibial plate 2 with a clamping screw 10a. The second main cable segment 1b need not be looped around the leg, but is attached to the opposite side of the tibial plate 2 with a clamping screw 10b. From the clamping screw 10b, the second main cable segment 1b passes through the cable guide hole 13c behind the leg and crosses over itself, thereby forming a cable crossover point 31, then passes through the cable guide hole 13d in the back plate 5 and completes the loop by being attached to the opposite side of the femoral plate 4 with a cable connector 15b.

[0048] The segment of the cable extending from the cable crossover point 31 to the tibial paddle portion of the brace and back to the cable crossover point 31 forms the tibial control loop portion 32 of the cable. The segment of the cable extending from the cable crossover point 31 to the femoral paddle portion of the brace and back to the cable crossover point 31 forms the femoral control loop portion 33 of the cable. For example, Figure 6 These control loop portions 32 and 33 are shown. During use, for example when the knee stretches towards hyperextension, the tibial control loop will grow, causing the femoral control loop to tighten in the opposite direction.

[0049] The main cable 1 is adjusted by turning the cable tensioner dial 6 to take up the excess length of the main cable 1. The main cable 1 is automatically locked in place by a lock / release button 7 actuated by a ratchet gear 16 and a spring 8 on the cable tensioner dial 6. The button 7 is also used to release the tension in the main cable 1 to facilitate installation and removal of the brace.

[0050] Although cables can be routed across an unlimited number of pivot points, it is most desirable to route them directly through the pivot point, e.g. Fig. 9 46a to achieve optimal tension on the auxiliary cable 40 throughout the entire range of motion of the leg. Fig.11 A cable guide plate is shown which guides the cables directly through the pivot point, assisting in cable routing 46a, as described above. Fig.12 and 13 The alternative auxiliary cable guide plate configuration shown is used to guide the auxiliary cable around the pivot point. For example, a Fig.13 The illustrated cable guide plate implements an alternative auxiliary cable routing 46b, which directs the auxiliary cable 40 above or in front of the femoral pivot point 17a and below or behind the tibial pivot point 17b.

[0051] Fig.15 An alternative tibial shell arrangement is depicted. When configured in this manner, the tibial shell 2B is mounted to the tibial shell 2A at location 51, thereby forming an axis of rotation. The tibial shell 2B is secured to the tibial shell 2A using a tibial adjustment locking screw 52. The tibial shell 2B is rotated about the axis 51 to establish the desired Q angle, such as Fig.16 The relative rotation of the tibial shell 2B around the axis 51 is controlled by screws 53A and 53B on both sides of the tibial shell 2B. Fig.14 By lengthening or shortening the adjustment screws that push against the corresponding bearing surfaces 55A, 55B, the tibial shell pivots accordingly about the axis 51 .

[0052] Fig.14 The adjustment mechanism is best depicted showing adjustment screws 53A, 53B threaded through fixing nuts 54A, 54B in the tibial shell 2B. Fig.16 As best shown, after loosening the adjustment locking screw 52 and then shortening the adjustment screw 53A, the adjustment screw 53B is extended so that it pushes against the bearing surface 55B on the tibial shell 2A, thereby forcing the tibial shell 2B to rotate clockwise around the axis 51 until the adjustment screw 53A contacts the bearing surface 55A on the tibial shell 2A, and then the adjustment locking screw 52 is tightened.

[0053] The cable guide receives a cable, which consists of one or more segments, which transmits energy to the above-mentioned, for example Figure 2-6The invention provides a method for controlling knee motion and preventing hyperextension of the knee joint in the same manner as the other embodiments of the present invention. In the same manner as the above-described embodiments, the cable can be composed of one or more parts. Although the routing of the cable is not depicted, in a preferred embodiment, the cable starts from the intersection 31, extends to the first side of the tibial shell 2A, passes through one or more cable guide holes, then extends on the tibial shell 2B through one or more cable guide holes, then extends downward through one or more cable guide holes back to the opposite side of the tibial shell 2A, and then extends back to the cable intersection 31 to form a tibial control loop 32.

[0054] As the user's knee extends, the portion of the cable extending from the intersection 31 around the tibial shell 2B and back to the intersection, i.e. the tibial control loop 32, grows accordingly. This creates a direct response in the portion of the cable extending from the intersection 31 over and around the femoral paddle, i.e. the femoral control loop. This portion of the cable is tightened, thereby bringing the femoral paddle and back plate 5 into the leg and behind the knee joint, respectively, and preventing further extension of the knee by controlling the length of the tibial control loop.

[0055] Fig.15 Depicted are both the femoral shell 4 and tibial shells 2A, 2B of a knee brace according to an embodiment of the present invention. Notably, there is no back plate, straps, and cable routing to more clearly depict the arrangement of the adjustable tibial shell 2B. As depicted, the present invention according to this alternative embodiment retains many of the features described in the alternative embodiments herein, including: 4, 6, 17C, and 17D. Fig.15 Depicted Fig.14 The tibial shell 2B and its mounting surface 56 on the tibial shell 2A. The axis of rotation 51 is clearly depicted as extending through the location where the tibial shells 2A, 2B are connected.

[0056] Foam pads can be strategically placed Fig.15 At various locations on the medial portion of the brace shown. For example, placed on the side near the hinge points 17C and 17D, placed under the tibial shells 2A and 2B and the femoral shell 4. This foam provides increased comfort for the user.

[0057] Fig.16The adjustability of the tibial shell 2B is depicted, which produces a selected Q-angle 57. The angle between the tibia and the femur forms the quadriceps angle, referred to herein as the Q-angle 57. This angle varies depending on the physiology of the user. The tibial shell 2B is adjustable so that the Q-angle 57 can be customized to fit each user. By turning the adjustment screws 53A, 53B, the Q-angle 57 can change as the tibial shell 2B pivots 58. The Q-angle can be adjusted in either direction. In a preferred embodiment, the Q-angle 57 is adjustable up to 4 degrees ΔQ in either direction. A Q-angle less than the average is defined as varus. In this embodiment, the Q-angle 57 can be referred to as a negative value, for example, the brace can be adjusted -4 degrees ΔQ from the average, forming a sharper Q-angle 57. A Q-angle greater than normal is referred to as valgus and can be formed by adjusting the brace to increase the Q-angle, such as adjusting +4 degrees from the average. For example, Fig.16 The depicted arrangement shows a valgus arrangement, where the brace's Q angle Q2 is greater than the average angle Q1. To achieve this, the tibial plate 2B has been adjusted toward the outside of the user's leg (right side of the knee brace). Once the user is satisfied with their customized Q angle, they can lock the brace using the locking screw 52. This prevents the Q angle from changing while the user is wearing the device.

[0058] Fig.17 An embodiment of the present invention is depicted with a femoral back plate 5 installed. As shown, the back plate is located just above the knee joint and behind the user's knee. The back plate 5 guides the portions of the cable 1 to a crossover point 31 (not shown) located on its back side. Each portion of the cable 1 is then guided upwardly back toward the upper portion of the brace, such as to either side of the femoral paddle 4 and the first tibial paddle 2A. Cable guide holes along the periphery of the tibial paddle 2A are also shown, which receive the cable from the femoral back plate 5 and guide the cable 1 along the tibial paddle 2A toward and to the tibial paddle 2B, where the cable 1 enters another guide hole in the tibial paddle 2B, then traverses to the other side of the tibial paddle 2B and returns along the same path on the opposite side of the brace. This portion of the cable path from the crossover point 31 to the tibial paddle 2B and back forms a tibial control loop 32. A similar path may occur, with the cable 1 extending from the intersection 31 on the femoral back plate 5 all the way to the cable guides on either side of the femoral plate 4 and then connected to the adjustment mechanism 6 .

[0059] In another embodiment of the present invention, the tibial plate may include an additional portion that increases the hold of the wearer's tibia. Additional protection is provided by increasing tibial control, thereby preventing overextension. Since there is almost no tissue between the tibia and the outer portion of the leg, this area is ideal for leg control. In some embodiments, the underside of the tibial plate closest to the user's leg may include an additional semi-ridged portion. For example, as the cable system is tightened, the semi-ridged portion adapts to the shape of the user's tibia. This provides increased hold on the tibia.

[0060] In another embodiment of the present invention, the tibial plate may include an additional portion that increases the hold of the wearer's tibia. Additional protection is provided by increasing tibial control, thereby preventing overextension. Since there is almost no tissue between the tibia and the outer portion of the leg, this area is ideal for leg control. In some embodiments, the underside of the tibial plate closest to the user's leg may include an additional semi-ridged portion. For example, as the cable system is tightened, the semi-ridged portion adapts to the shape of the user's tibia. This provides increased hold on the tibia.

[0061] In a further embodiment of the invention, the tibial plate may be configured such that the tibial plate has varying flexibility on its own. For example, such varying flexibility would allow the tibial plate to adapt to the shape of the user's leg while also providing the necessary stiffness. In this example, the second semi-vertebrae may not be required, or alternatively, the second semi-vertebrae may be provided in addition.

[0062] In other embodiments of the present invention, the user may of course use the brace as a preventive device before any injury occurs rather than after. In this case, additional protection may be needed. For example, a user who engages in extreme sports may need additional impact protection. Therefore, embodiments of the present invention may include a knee cap that protects the knee from impact forces. In some embodiments, the knee cap portion is disposed between the tibial plate and the femoral plate so that the knee cap remains in place when the tibial plate and the femoral plate are pivoted away from each other. In such an example, the tibial plate and the femoral plate slide above or below the knee cap portion to allow the necessary flexibility. In addition, additional padding may be added in front of the knee to both support the knee and protect the knee from impact forces.

[0063] When force is applied to the knee joint, the cable tightens and resists excessive movement that can cause ligament injury. As the cable tightens, it squeezes the brace shell that grips the tibia and femur. The tibial shell is designed to grip the tibial tuberosity that controls the calf, while the femoral shell and tendon back plate grip the femur. The patellar cup incorporated into the hinge mechanism provides enhanced structural rigidity, which provides better protection to prevent collateral ligament injury. In addition, because the tibial plate is rigidly fixed to the patellar cup, which in turn is well fixed to the distal femur, resisting posterior translational forces against the tibia, the PCL is protected from the common mechanism of direct impact on the anterior proximal tibia on a flexed knee.

[0064] Changes and modifications can be easily made to adapt the tibial shell Q angle adjustment invention to a conventional knee brace. It is also contemplated that the invention could be adapted to an elbow brace by replacing the adjustable tibial shell with an adjustable radial shell. This allows a symmetrical elbow brace to be adjusted to fit the angle between the humerus and radius of the user's arm, and can be adjusted to fit either the right or left arm.

[0065] Wrist brace

[0066] Another embodiment of the present invention is a cable system for a wrist brace. The cable system supports the wrist without causing compartment syndrome. The cable system provides progressive flexion support for the wrist while having a low profile and taking up less space than traditional braces.

[0067] Another embodiment of the present invention provides a user with a wrist brace that uses one or more cables to provide progressive support through flexion of the wrist so that increased wrist motion is supported. Such an embodiment enables easy adjustment of extension while also providing increased support to the ligaments of the wrist. Many of the components discussed above are common to the wrist brace embodiments.

[0068] Conventional braces are limited in their effectiveness in resisting the excessive joint motion that can lead to wrist injuries. Even when the bindings are tightened to an uncomfortable degree, conventional braces are limited in their effectiveness in preventing excessive wrist motion. Prior art braces also fail to provide support, progressive support, throughout the full range of motion.

[0069] Additionally, prior art wrist braces often require expensive customization, such as sending a glove to a manufacturer to have the parts sewn onto it. Due to the way traditional braces fit onto the user's arm and the tightness required, wearers often complain of "compartment syndrome."

[0070] Furthermore, conventional braces do not allow the user to continue to use their hand, or provide extremely limited use. For this reason, users are very reluctant to wear such braces, and such braces cannot actually be worn as a preventive measure in many activities.

[0071] The wrist support device according to the present disclosure can be used after an injury, or to prevent an injury. This is unique because the present invention allows the user to retain the use of his / her hand.

[0072] Preferably, the wrist brace has a low profile and conforms to the user's lower arm and wrist area. One or more plates are located on the upper portion of the user's arm and hand. A smaller second plate is positioned toward the underside of the user's hand and arm. A cable extends between these plates. The guide plates themselves include small openings for receiving the cable to control the path of the cable. The cable can be tightened using an adjustment mechanism according to the disclosure herein. The cable can also provide adjustable progressive resistance while also providing a stop point through which movement of the wrist will be prevented or limited. Progressive resistance is provided so that when the user flexes his or her wrist, additional tension is generated on the wrist, thereby preventing overextension.

[0073] In various embodiments, the superior plate is comprised of the metacarpal shell and the radial shell, which may together form a single shell or separate shells, and the inferior plate is comprised of one or more dorsal tendon plates.

[0074] Various embodiments may include multiple smaller metacarpal shells and radial shells and multiple dorsal plates. For example, in embodiments employing separate metacarpal shells and radial shells and one or more dorsal plates, there may also be two cables.

[0075] The cable or cables may form two or more loops, with the upper and lower guide plates connected more anteriorly (towards the user's hand) (metacarpal control loop) and the upper and lower guide plates connected more posteriorly (towards the upper arm) (radial control loop). In embodiments with one cable, the cables may not be fully connected, such that the cable may include two discrete distal ends.

[0076] In various other embodiments, the shape of the metacarpal shell and the radial shell or the tendon back plate can be designed to achieve additional goals. For example, if the wrist needs to move upward, the radial shell may not extend as far as the back of the user's hand. In addition, the shape of the tendon back plate can be designed to conform to the underside of the wrist near the palm. Or, alternatively, depending on the use and activity, for example, if the user wishes to maintain some up and down movement of the wrist, but prevent twisting or lateral movement, the tendon back plate can be placed further back. In an alternative embodiment, the shape of the tendon back plate can be designed in an X-shaped pattern, starting near the palm and extending backward, wherein the legs of the X extend toward the metacarpal shell and the radial shell, respectively. These legs can provide guidance for the cable (or multiple cables).

[0077] The metacarpal shell or radial shell may also include a plurality of portions extending downward toward the dorsal plate to receive and guide the cable. In many embodiments, the metacarpal shell or radial shell portion will also include an adjustment mechanism according to the description and teachings herein that allows limited adjustment of the length of the cable. One or more straps may also be included (e.g., on the forearm) that extend via hook-and-loop fabric from the radial shell to form a loop around the forearm.

[0078] The metacarpal shell and the radial shell may also include one or more hinges. For example, the radial shell may be attached to the metacarpal shell via a hinge located near the wrist pivot. This may allow the wrist to be controlled in an upward and downward direction. In some aspects, the pivot may include a hinge or other similar mechanism that may be adjusted in degree, resistance, or both. In further embodiments, the hinge may be locked or not present. In addition to the hinge, the metacarpal shell and the radial shell may also include providing one or more straps. For example, the radial shell may include a relief to allow a strap to be wrapped around the underside of the user's arm. These straps may help position the brace on the arm and prevent the brace from moving or sliding on the arm during use.

[0079] In other embodiments, the metacarpal shell, the radial shell and the dorsal plate can be connected to a softer material that contacts the user's arm. This softer material can extend beyond the area covered by the upper plate or the lower plate. For example, in some embodiments, the radial shell includes this softer material on its underside, between the radial shell and the user's arm, and further, in some embodiments, this softer material can extend over one or more fingers of the user to provide increased stability for the device. The wiring of the cable preferably provides a safe and comfortable attachment to the user while also providing progressive support to the wrist.

[0080] As in the knee brace embodiment, the cables can be made of any flexible material with sufficiently high tensile strength. The upper and lower plates can be made of any rigid or semi-rigid material and shaped to conform to the intended area, such as extending to the top of the lower arm of the hand and the underside of the lower arm and palm.

[0081] The cable system along with these shells provides progressive support through extension as well as adjustable extension stops. This support throughout the range of motion can go a long way in preventing wrist injuries and hyperextension.

[0082] The wrist brace is a less expensive alternative and is relatively simple in design. It also has a low profile, allowing the user to actively wear the brace to prevent injury.

[0083] Various additional attachment mechanisms may be employed. For example, as shown, a strap may be included. In various embodiments, a strap may be included toward the rear of the brace and toward the upper arm. In other embodiments, the strap may be more forward.

[0084] The cable system of the present invention can extend from an upper plate (e.g., a radial shell), through a plurality of guides, through a base plate or a back plate back to an optional hinged portion, a metacarpal shell, and then turn around and end on the opposite side of the radial shell at the adjustment mechanism housing. When a lateral rotational force is applied to the wrist, the radial shell, separate or integrated metacarpal shell (optionally hinged), and the back plate are kept rigid by the tension generated in the cables. Because the main cables pass through the back plate, the tensile force in the main cables crosses behind the wrist, thereby preventing rotation and flexion of the wrist joint, thereby preventing lateral bending or rotation of the wrist. The force is applied from all points along each control loop created at either side of the intersection, applying the force toward the center of the loop. The tension in the cables prevents the brace from bending at the wrist joint, thereby preventing lateral bending or rotation of the wrist.

[0085] The back plate provides progressive support to the tendons in the wrist throughout the wrist's motion. For example, as the user's hand flexes upward, the posterior control loop (radial) portion of the cable tightens, which pulls the back plate toward the radial and metacarpal plates. This provides additional support to the wrist by unloading the tendons, and also prevents the anterior control loop (metacarpal) from continuing to extend. The more the user's wrist flexes, the more support is provided because the back plate is pulled into the tendon area.

[0086] like Fig.18 Shown, a brace is shown, which can stabilize the wrist of the user, thereby preventing overextension. As shown in the figure, the wrist brace is composed of a semi-rigid shell, preferably composed of a radius shell 104, a metacarpal shell 102 and a tendon back plate 105. These shells are preferably made of elastic material and are shaped to ergonomically conform to the wrist of the user. In certain embodiments, the material is moldable for the user, such as by heating. The shell can adopt any number of shapes to adapt to various design changes. For example, as shown in the figure, the radius plate 104 can include a small ear extending downward to guide the cable 101 towards the lower part. These ear pieces can be moved forward or backward to change the limit point. In certain embodiments, the ear pieces can be movable so that they can be adjusted, and in other embodiments, they can be permanent, fixed and / or rigid.

[0087] The adjustment mechanism 106 can be located on the radial shell 104, or alternatively on any other shell. The adjustment mechanism dial 106 and ratchet 107 allow the cable system to be tightened. The cable 101 engages the metacarpal shell 102, the radial shell 104 and the dorsal plate 105, and when tightened, brings these shells closer to each other.

[0088] The cable system also provides progressive support so that when the user's wrist is subjected to a hyperextension force 128, increased extension is increasingly limited. Two control loops are also formed by the cable portions. The metacarpal control loop 132 is formed by the portion of the cable that extends from the cable intersection 131 at the dorsal plate 105, travels along the dorsal plate through one or more guides, then toward the metacarpal shell 102, through additional guides in the metacarpal shell, and then returns along the same path on the opposite side of the brace. A radial control loop is formed in a similar manner, extending from the intersection 131 through one or more guides in the dorsal plate 105 toward the radial shell 104, and in some embodiments, into the adjustment mechanism 106 / 107.

[0089] Each shell may include a pad section to provide a degree of cushioning between the more ridged plate and the user's arm, wrist, and hand. In various embodiments, the pad section may also be constructed of a material that reduces movement of the device by providing a high level of static friction between the material and the user. In various embodiments, the pad section may conform almost identically to the plate. In other embodiments, the pad section may extend well beyond the plate and may provide additional benefits or features, such as mounting holes, restraints, or locations for guides.

[0090] 22 illustrates the routing of the cable 101, which begins attached to the radial shell 104, then passes through the dorsal plate 105, extends over and through the metacarpal shell 102, returns through the dorsal plate 105, crosses itself, returns up and attaches to the opposite side of the radial shell 104.

[0091] The cable system also provides progressive support, so that when the user's wrist is subjected to such Fig. 20 As lateral bending or rotational forces 130 are shown, increased bending and / or rotation is subject to increased restraint.

[0092] like Fig.18 and 19 22 , the radial shell 104 may be connected to the metacarpal shell 102 at at least one point 117. Preferably, the point at which the connection is made is allowed to pivot as shown. The pivoting may be adjusted with an adjustment screw 103 to provide a specified amount of motion, or alternatively, it may be locked to prevent motion. The pivoting may be controlled in one or both of the extent of motion and resistance. In other embodiments, the metacarpal plate may not be hinged at all, but may be constructed of a material with natural elasticity, as shown in FIG. 22 , so that the user's hand is allowed to move in an upward direction, but the movement is met with increasing forces as the spring tension (the material wants to return to its original shape) increases.

[0093] like Fig.18As depicted, the radius shell 104 can be connected to the metacarpal shell 102 at at least one point to form a unitary body. Preferably, the point of connection forms a hinge point 117 and is allowed to pivot as shown.

[0094] Various additional attachment mechanisms may be employed. For example, as shown, a strap 111 may be included, or no strap 111 may be included at all, as shown in FIG. Fig.18 and 20 As shown, the soft lining 112 can extend over one or more fingers of the user to increase the stability of the device. In various embodiments, additional straps can be included toward the back of the brace and toward the upper arm. In other embodiments, additional straps can be used, or the finger holes in the lining 112 can be replaced.

[0095] The semi-rigid shells are shaped so that they engage the user's bones, namely the radius 118, ulna 124 and metacarpals 126, through the skin in a manner that helps them to be rigid for movement during use. By properly engaging the bones, there is less deflection caused by skin, fat or other tissue.

[0096] Fig.21 A tendon backing plate 105 is shown in accordance with an embodiment of the present invention. The tendon backing plate 105 may include a plurality of guides to control the movement of the cable system. For example, the depicted embodiment includes four areas where the cables first contact the tendon backing plate. Additional guides may also be used. In addition, depending on the configuration, various embodiments may include guides on which the cable system crosses at intersections 131. For example, the depicted embodiment includes a central guide that allows the cables to cross as the cables extend diagonally. In other embodiments, the cables may not cross, but may simply extend close to each other, and additional or different guides may be used. In addition, the depicted embodiment is shaped so that the outward portion of the tendon backing plate 105 extends upward toward the upper shells 102 and 104.

[0097] Although the shape of the tendon back plate 105 is preferably designed to ergonomically conform to the contours of the lower wrist, arm and palm, the shape is not limited to this. In addition, additional plates or components can be added, for example, an articulated portion that supports the hand toward the hand. Alternatively, in an alternative embodiment, the tendon back plate 105 can be composed of two or more plates. For example, the depicted embodiment can be composed of three separate plates, one for the front guide, one for the central guide, and another for the rear guide. Many additional configurations are feasible and can be thought of herein.

[0098] Fig.21Also depicted is the routing of the cables forming two separate control portions 132 and 133, each on their respective sides of the cable intersection 131. Loops also appear in other figures. The metacarpal control loop 132 extends upward from the cable intersection and over the metacarpal shell 102, returning to the cable intersection 131 on the other side. The radial control loop 133 extends upward from the cable intersection 131 and over the posterior portion of the radial shell 104 away from the hand, returning to the cable intersection 131. In use, the lengths or control loops 132 and 133 are inversely related. For example, if the user's wrist flexes, thereby lengthening the metacarpal control loop 132, the radial control loop 133 shortens, which shortening draws the dorsal plate 105 and the radial plate 104 together, thereby stopping further growth of the metacarpal control loop 132 and thereby preventing hyperextension.

[0099] The routing of the cables may vary according to the embodiment of the invention. For example, at the articulation portion, i.e., the metacarpal shell, Figures 22A-22C In the fixed position shown, the wiring can move forward or backward. In addition, in some embodiments, there can be more than one adjustment mechanism. For example, there can be a front adjustment mechanism and a rear adjustment mechanism.

[0100] While the invention has been described and illustrated in connection with particular embodiments, it is susceptible to change and modification, and the appended claims are intended to cover any change, modification or adaptation that falls within the spirit and scope of the invention.

[0101] Ankle brace

[0102] In addition to the above embodiments, another embodiment of the present invention provides support for a user's ankle. The ankle brace embodiment incorporates many of the features described herein for alternative ligament braces.

[0103] like Figure 25-26 As shown, a brace is shown that can stabilize the user's ankle and prevent lateral flexion. As shown, the ankle brace combines a soft boot-type portion with multiple semi-rigid shells. The parts of the semi-rigid shell are preferably a fibula shell 305, a tibial shell 304, and a calcaneal shell 302. An adjustment mechanism 306 can be located on the tibial shell 304, or optionally on any other shell. The adjustment mechanism 306 allows the cable (or cables) 301 to be tightened. The cable 301 engages the fibula shell 305, the tibial shell 304, and the calcaneal shell 302, and when tightened, the cable brings these shells closer to each other. The cable system also provides progressive support so that when the user's ankle is bent, the increased flexion is subject to increased restriction.

[0104] As with the other embodiments, two control loops are formed: an upper loop 333 and a lower loop 332. These loops work together to prevent unwanted ankle motion, for example, when the lower loop 332 extends (when the ankle is flexed), the upper loop 333 shortens, thereby pulling the shells 304 and 305 into the leg. This in turn prevents the lower loop 332 from allowing the ankle / foot to continue its motion, thereby preventing lateral flexion.

[0105] The cable system can be routed in a variety of ways. For example, the cable can cross at the fibula shell 305, thereby forming a crossover point 331, and form a loop at both the tibial shell 304 and the calcaneal shell 302.

[0106] like Fig.25 As shown, the fibula shell 305 can be connected to the calcaneal shell 302 at a pivot point 317. Preferably, the point at which the connection is made is allowed to pivot. The pivot 317 can be adjusted to provide a specified amount of movement, or alternatively, the pivot can be locked to prevent movement.

[0107] These semi-rigid shells are shaped so that they engage the user's bones 318, 324, and 326 through the skin in a manner that helps them be rigid for movement during use. By properly engaging the bones, there is less deflection caused by the skin, fat, or other tissue. The cables 301 and control loops 332 and 333 assist by directing forces from points around the loops to the bones, thereby stabilizing the brace itself, which further increases its effectiveness.

[0108] While the invention has been described and illustrated in connection with particular embodiments, it is susceptible to change and modification, and the appended claims are intended to cover any change, modification or adaptation that falls within the spirit and scope of the invention.

[0109] Elbow brace

[0110] The brace system described above and its novel control loop system can be adapted to the elbow to prevent hyperextension of the arm.

[0111] In such an embodiment, compared to the above-described knee brace, the humeral plate 204 would replace the femoral plate 4, the ulnar plate 202 would replace the tibial plate 2, and the biceps plate would replace the femoral back plate 5, thereby generating a differential resistance on the elbow joint to prevent overextension of the arm. In much the same manner as the embodiment described herein, two control loops are formed, namely the ulnar control loop 232 and the humeral control loop 233, each extending from the intersection 231.

[0112] like Fig.23 and 24As shown, a brace is shown that can stabilize the user's elbow and prevent hyperextension. As shown, the elbow brace is composed of a semi-rigid shell, preferably composed of a humeral shell 204, an ulnar shell 202 and a tendon back plate 205. The adjustment mechanism can be located on the humeral shell 204, or optionally on any other shell. The adjustment mechanism dial 206 and ratchet 207 allow the cable system to be tightened. The cable 201 engages the ulnar shell 202, the humeral shell 204 and the tendon back plate 205, and when tightened, the cable brings these shells closer to each other.

[0113] The cable system also provides progressive support so that when the user's elbow is subjected to an overextension force 228, the increased extension is increasingly limited. For example, as the user's elbow extends, the control loop 232 grows. In response, the control loop 233 shortens, which pulls the dorsal plate 205 and humeral shell 204 toward the arm, thereby resisting and then stopping any further extension of the control loop 232, thereby preventing overextension. The cable system also benefits from these loops because the tightening force is directed from each point around the loop toward the center of the arm. This provides good brace stability and therefore provides good control over arm movement. Fig.24 The loops are depicted with the aid of arrows, showing their location around the user's arms.

[0114] like Fig.23 As shown, the ulna shell 202 can be connected to the humeral shell 204 at at least one point 217. Preferably, the point at which the connection is made is allowed to pivot as shown. The pivot can be adjusted to provide a specified amount of movement, or alternatively, the pivot can be locked to prevent movement.

[0115] Various additional attachment mechanisms may be employed. For example, as shown, straps 211A-211B may be included. In various embodiments, a strap 211B may be included toward the back of the brace and toward the upper arm. In other embodiments, additional straps may be used, such as the ulnar strap 211A. For example, another strap may be added to the ulnar shell 202, and one or more straps may be added to the humeral shell 204.

[0116] The semi-rigid shells are shaped so that they engage the user's bones, namely the ulna 226, radius 224 and humerus 218, through the skin in a manner that helps them to be rigid for movement during use. By properly engaging the bones, there is less deflection caused by the skin, fat or other tissue.

[0117] While the invention has been described and illustrated in connection with particular embodiments, it is susceptible to change and modification, and the appended claims are intended to cover any change, modification or adaptation that falls within the spirit and scope of the invention.

Claims

1. A ligament support brace, comprising: first shell; a second shell hingedly coupled to the first shell; third shell; a first control loop, the first control loop comprising a first cable portion extending from a first side of a junction on the third shell to a first side of the first shell, through a second side of the first shell, and back to a second side of the junction; A second control loop, the second control loop includes a second cable portion, the second cable portion extends from the first side of the intersection on the third shell to the first side of the second shell, passes through the second shell and returns down along the second side of the second shell to the second side of the intersection, wherein the first control loop and the second control loop are connected, and wherein the expansion of the second control loop causes the contraction of the first control loop.

2. The ligament support brace according to claim 1, wherein: The first cable portion and the second cable portion comprise a single piece of cable.

3. The ligament support brace according to claim 1, wherein: The first cable portion and the second cable portion include two or more cable segments.

4. The ligament support brace according to claim 1, wherein: An adjustment mechanism is positioned on the second housing and is coupled to the cable.

5. A ligament support brace, comprising: a first shell, the first shell being selected from the group of a metacarpal shell, a radial plate, a tibial plate, or a calcaneal shell; a second shell selected from the group consisting of an ulna shell, a humeral plate, a femoral plate, or a tibial shell, the second shell being hingedly coupled to the first shell; a third shell, the third shell being selected from the group consisting of a tendinous dorsal plate, a biceps plate, a femoral dorsal plate, or a fibular shell; a first control loop, the first control loop comprising a first cable portion extending from a first side of a junction on the third shell to a first side of the first shell, through a second side of the first shell, and back to a second side of the junction; A second control loop, wherein the second control loop includes a second cable portion, the second cable portion extending from the first side of the intersection on the third shell to the first side of the second shell, passing through the second shell and returning down along the second side of the second shell to the second side of the intersection, wherein the first control loop and the second control loop are connected, and wherein the extension of the second control loop causes the contraction of the first control loop.

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