Lower leg orthosis

Abstract

Lower leg orthosis (1) comprising a lower leg shell (11), a foot shell (12), a spring (13), and first and second prestressing elements (21), (22), wherein a first connecting element (19) is provided on the lower leg shell (11) and a second connecting element (20) is provided on the foot shell (12), the spring (13) has a first and a second spring end piece (16), (17) and an arcuate middle piece (18), which is arranged between the two spring end pieces (16), (17), and the two prestressing elements (21), (22) connect the spring (13) via the two spring end pieces (16), (17) to the two connecting elements (19), (20) of the foot shell (12) and the lower leg shell (11) in a form-fitting and force-fitting manner.

Description

[0001] The present invention relates to a lower leg orthosis, a spring for a lower leg orthosis, a connecting element for connecting the spring to a foot and lower leg shell of the lower leg orthosis, a mold for producing the connecting element and a tool for positioning the connecting element on the lower leg shell and / or a foot shell of the lower leg orthosis. STATE OF THE ART

[0002] Various manufacturers of orthopedic devices offer ready-made orthoses or components for the individual manufacture of an orthosis. These ready-made orthoses are inexpensive, but also manufactured in a generally suitable shape and stability. User-specific selection usually only refers to foot length, thus other relevant parameters such as height, weight, and activity level are not or insufficiently taken into account. Therefore, the level of support cannot be optimally selected. The lifespan of these products is often inadequate, and they frequently have to be replaced prematurely. The range of components available cannot meet the demands regarding aesthetics and energy efficiency. DESCRIPTION OF THE INVENTION

[0003] An object of the invention is to avoid at least one disadvantage known from the prior art.

[0004] This problem is solved by the invention defined in the independent patent claims.

[0005] The lower leg orthosis according to the invention is a so-called non-articulated lower leg orthosis, which must be distinguished from articulated lower leg orthoses. Furthermore, a distinction must be made between ready-made lower leg orthoses and custom-made lower leg orthoses. Furthermore, hybrid forms are also worth mentioning, in which individual parts are individually adapted for the user by the orthopedic company and prefabricated parts are purchased and then assembled into the desired lower leg orthosis. From the perspective of the orthopedic company, the present invention represents such a hybrid form.

[0006] The primary target group of the inventive lower leg orthosis are patients with a "foot drop problem", i.e. a weakening of the triceps surae muscle (posterior calf muscle). To compensate for this weakening or to replace the triceps surae muscle, a stable lower leg orthosis with both springy and dynamic properties is required. Patients with this condition are unable to lower their feet. Plantar flexion, i.e. bending the foot or toes towards the sole of the foot, is not possible. As a result, standing on tiptoes is not possible and standing for long periods is difficult. Walking on level ground is also severely affected, as the necessary resistance to dorsal extension (i.e. bending the foot towards the back of the foot) occurs from the mid-stance phase (MDS) of the gait cycle, and there is no or only minimal energy return in the swing phase preparation (PSW) of the gait cycle.

[0007] The inventive lower leg orthosis largely compensates for the lack of energy return from the mid-stance phase (MDS) to the pre-swing phase (PSW). This can enable rapid walking.

[0008] In general, the inventive lower leg orthosis supports the patient throughout the entire gait cycle. The gait cycle refers to the Perry gait cycle. The inventive lower leg orthosis provides energy return and supports foot lowering, foot elevation, and knee extension. The resulting energy return and the reduction of compensatory movement patterns improve the patient's endurance, allowing them to walk longer distances. The inventive lower leg orthosis also serves to secure the knee and hip joints during the mid-stance phase and stabilizes the knee during extension. Furthermore, the inventive lower leg orthosis limits lower leg forward movement during the mid-stance phase. In addition, the inventive lower leg orthosis enables lateral stabilization of the ankle joint, but with the necessary lateral flexibility.

[0009] The foot shell and lower leg shell are custom-made based on a positive model of the patient's lower leg. The springs themselves, as well as the molds for producing the so-called connecting elements that later connect the spring to the foot shell and lower leg shell, are sourced externally by the orthopedic company. The length and strength of the spring, however, depend on the individual needs of the patient, with the spring length being tailored to their body size, and the spring strength depending on the patient's weight, the condition, and the topography of the surface on which the patient primarily moves.

[0010] The lower leg orthosis according to the invention therefore includes a replaceable spring. The prosthetist or the patient themselves can replace this spring and thus individually adapt it to their activity (e.g., walking on uneven surfaces). Other reasons for adjustment may include changes in body size, particularly in children, and body weight, or changes in the course of a disease. The lower leg orthosis according to the invention offers a simple, quickly implemented, manually operable solution.

[0011] The lower leg orthosis according to the invention comprises a lower leg shell, a foot shell, a spring, and first and second prestressing elements. A first connecting element is provided on the lower leg shell, and a second connecting element is provided on the foot shell. The spring comprises first and second spring end pieces and an arcuate middle piece arranged between the two spring end pieces. The arcuate middle piece runs posterior to the two spring end pieces in a direction viewed from the side. The arrangement of the arcuate middle piece relative to the two spring end pieces can also be described as posterior in the direction of normal locomotion (i.e., a forward movement).

[0012] The two pre-tensioning elements connect the spring via the two spring end pieces to the two connecting elements of the foot shell and the lower leg shell in a form-fitting and force-fitting manner.

[0013] The spring, which has two spring end pieces and an arched middle piece, has a curved neutral line to ensure that the strains that occur during deflection are distributed as best as possible over the entire length of the spring.

[0014] The inventive lower leg orthosis improves walking on non-horizontal surfaces. The interaction between the spring and the foot shell results in a weaker restoring moment during heel strike than during toe strike. This is also referred to as a non-linear characteristic. This is also achieved by the foot shell having zones of varying component stiffness. The foot shell comprises a forefoot section, a middle section, and a rearfoot section, with the component stiffness in the forefoot section being up to five times greater than in the rearfoot section. The foot shell is preferably made of a fiber composite material.

[0015] For the positive and non-positive connections, the two spring end pieces and the two connecting elements each have two contact surfaces. The two contact surfaces of the first and second spring end pieces touch the contact surfaces of the first and second connecting elements, respectively. The positive and non-positive connection preferably results between these contact surfaces arranged on the spring end pieces and the connecting elements.

[0016] Furthermore, the two spring end pieces and the two connecting elements each have a third surface. When the spring end pieces are connected to the connecting elements, the third surface located on the first or second spring end piece is spaced apart from the third surface of the first or second connecting element. This creates a gap. The distance d is approximately 0.5 mm.

[0017] In a preferred embodiment, the first and / or second spring end piece has a trapezoidal cross-sectional area, preferably an isosceles trapezoid. A similar situation applies to a recess arranged on the first and / or second connecting element and serving to accommodate the spring end pieces.

[0018] In this preferred embodiment, viewed in cross section, the two contact surfaces arranged on the first and second spring end pieces or on the recess of the first and second connecting element form the legs of the trapezoidal cross-sectional area. The positive and non-positive connection results between the contact surfaces running along the two legs of the trapezoidal spring end piece and the contact surfaces running along the two legs of the trapezoidal recess of the connecting element. Viewed in cross section, the third surfaces on the first and second spring end pieces represent a base side of the trapezoid. The same applies to the third surfaces on the first and second connecting element. Viewed in cross section, these also form a base side, in this case, of the trapezoidal cross-sectional area of the recess.

[0019] The spring, which is preferably used in the lower leg orthosis according to the invention, has a constant cross-sectional area along its entire length. This requirement simplifies the manufacturing process, especially with regard to mass production. When the spring is made of fiber-reinforced material, the constant cross-sectional area allows, for example, unidirectional fibers to run seamlessly from the beginning of the spring to the end.

[0020] Preferably, the geometry of the cross-sectional area of the two spring end pieces is identical and the geometry of the cross-sectional area of the arcuate middle piece is different compared to the geometry of the cross-sectional area of the spring end pieces.

[0021] When viewed from the front, the spring is narrower in the area of the two spring end pieces than in the area of the curved center piece. When viewed from the side, the spring is wider in the area of the two spring end pieces than in the area of the curved center piece. This design prevents stress peaks, particularly at the spring end pieces, when the spring is bent.

[0022] A spring family, for example, comprises three springs. These three springs (strong spring, medium-strong spring, weak spring) are of equal length, meaning they have a constant length, but different cross-sections. In the strong spring, the two spring end pieces and the width of the arched middle piece are thicker when viewed from the front than in a weak spring. The spring end pieces preferably have a cross-sectional area in the shape of an isosceles trapezoid. In the spring end pieces of a strong spring, the height h of the trapezoidal cross-sectional area is greater ("thicker") than the height h of the trapezoidal cross-sectional area of a weak spring. Regardless of whether the spring is a strong, medium-strong, or weak spring, the interior angles of the trapezoidal cross-sectional area remain the same.

[0023] The length of the spring is determined by the size of the patient.

[0024] The spring connecting the foot shell to the lower leg shell is curved relative to a vertical plane in a front view. This allows the spring to be guided close to the patient's limbs.

[0025] In a preferred embodiment, the spring is constructed from unidirectional fibers and a fabric, preferably from a layer of unidirectional fibers and a layer of fabric. The fabric is oriented at an angle of less than 45° with respect to the unidirectional fibers; this angle is preferably between 20° and 35°.

[0026] In a preferred embodiment, in addition to the spring, the foot shell and preferably also the lower leg shell are made of a fiber composite material. The foot shell comprises a forefoot section, a middle section, and a rearfoot section, with the stiffness of the component being up to five times greater in the forefoot section than in the rearfoot section.

[0027] In a preferred embodiment of the lower leg orthosis according to the invention, the spring runs laterally or medially with respect to an anatomical median plane in connection with the foot and lower leg shell.

[0028] Whether the spring runs laterally or medially also depends on whether the patient wears the inventive orthosis on the left or right leg. If the inventive orthosis has been selected for the right lower leg and the spring runs laterally, the same spring can also be used for an orthosis on the left lower leg. The spring then runs medially. The foot shell and lower leg shell must be adjusted accordingly.

[0029] If the inventive orthosis has been selected for the left lower leg and the spring runs laterally, the same spring can also be used for the right lower leg. The spring then runs medially. The foot shell and lower leg shell must be adjusted accordingly.

[0030] The foot and lower leg shells are designed differently for use on the left lower leg and the right lower leg respectively.

[0031] By positioning the spring connecting the lower leg shell to the foot shell medially or laterally, there is no structural extension of the foot. Thus, normal shoes with sufficient volume for the orthosis and foot can be used.

[0032] The connecting element for connecting the spring to a foot and / or lower leg shell has a recess with two contact surfaces, whereby the contact surfaces are designed for a positive and non-positive connection with the spring end pieces. The recess has the shape of a trapezoidal prism; preferably, the cross-sectional area is an isosceles trapezoid.

[0033] The mold for producing the connecting element represents a negative of the recess arranged on the connecting element, preferably a trapezoidal prism. This trapezoidal prism particularly preferably has a cross-sectional area of an isosceles trapezoid. The mold serves to accommodate a composite material, preferably a prepreg material.

[0034] The shells are manufactured individually for the patient by orthotists; carbon fiber reinforced plastic (e.g. prepreg) is also preferably used. The connecting elements are pre-formed separately using a mold. The pre-formed connecting elements are then connected to the foot shell and the lower leg shell, i.e. the connecting elements are laminated onto the shells. A special tool is provided for positioning the two connecting elements on the foot shell and the lower leg shell. This tool comprises a rod and an elongated positioning element with a first and a second end, both ends having a trapezoidal cross-sectional geometry. This trapezoidal cross-sectional geometry corresponds to the trapezoidal cross-sectional geometry of the recesses arranged on the two connecting elements.The two ends of the positioning element determine the position of the connecting elements on the lower leg shell and the foot shell. At one end of the positioning element, an opening is provided for the rod. Another rod holder is integrated into the positive model. This opening runs through the ankle joint axis. The tool can be aligned this way. SHORT DESCRIPTION OF THE CHARACTERS

[0035] Aspects of the invention are explained in more detail with reference to the exemplary embodiments shown in the following figures and the associated description. They show: Fig. 1 the lower leg orthosis according to the invention in a side view, arranged on a positive model in a first embodiment for the right lower leg with lateral arrangement of the spring; Fig. 2 an iso-perspective view from the front of the lower leg orthosis according to the invention, without positive model in the first embodiment for the right lower leg with lateral arrangement of the spring; Fig. 3 a perspective view obliquely from behind of the lower leg orthosis according to the invention, without positive model in the first embodiment for the right lower leg with lateral arrangement of the spring; Fig. 4 a sectional view through the lower leg shell in the region of the first connecting element, wherein the connecting element and the spring end piece are shown partially in cross section; Fig. 5 a detailed view of the section from Fig. 4; Fig. 6 a view of the spring from the side and schematically the lateral positioning based on the positive model; Fig. 7 a view of the spring from the front and schematically the lateral positioning based on the positive model; Fig. 8 an exploded view of the spring, the connecting elements and the preloading elements (here: screws); Fig. 9 a side view of the positive model with tool for positioning the first and second connecting elements, laterally on the lower leg shell and the foot shell with the rod inserted into the positive model; Fig. 10 an exploded view of the tool according to Fig. 9 and a perspective view of the lower leg shell and the foot shell with the connecting elements and the positive model; Fig. 11 an exploded view of the tool alone with the rod not inserted; Fig. 12 an exploded view of the tool alone with the rod inserted; Fig. 13 schematic representation of an arrangement of fabric and unidirectional fiber for the production of the spring for the lateral arrangement between the lower leg shell and the foot shell; Fig. 14 a perspective view of the mold for producing the connecting elements; Fig. 15 a section through the form according to Fig. 14; Fig. 16 a schematic representation of the acting moments and the resulting bending-torsion coupling. WAYS TO IMPLEMENT THE INVENTION

[0036] Fig. Figure 1 shows the lower leg orthosis 1 according to the invention in a side view, arranged on a positive model. The lower leg orthosis 1 comprises a lower leg shell 11 and a foot shell 12 with a forefoot part 12 / 1, a rearfoot part 12 / 2, and a middle part 12 / 3. The lower leg shell 11 and the foot shell 12 are connected to one another via a spring 13. The spring 13 comprises a first spring end piece 16 and a second spring end piece 17. A first connecting element 19 is arranged on the lower leg shell 11, and the second connecting element 20 is arranged on the foot shell 12. The two spring end pieces 16, 17 are positively and non-positively connected to the two connecting elements 19, 20. With the help of preload elements 21, 22, screws in the illustration shown, the spring end pieces 16, 17 are pressed into the connecting elements 19, 20. The spring end pieces 16, 17 and the connecting elements 19, 20 have openings for receiving the preload elements 21, 22.The spring 13 is replaceable and can be replaced by a different spring (in .) either by the orthopaedic technician or by the patient himself if necessary. Fig. 1 not shown). The spring 13 has an arcuate middle piece 18. This middle piece 18 runs between the two spring end pieces 16 and 17. The arcuate middle piece 18 runs, in a direction viewed from the side, posterior to the two spring end pieces 16, 17. In the embodiment shown, the spring 13 runs laterally, i.e. on the side of the positive model of the lower leg facing away from the anatomical median plane. The embodiment shown is intended for use on the right foot. With appropriate adaptation of the foot shell, this embodiment can also be used for the left lower leg. The spring 13 then runs medially.

[0037] Fig. 2 and Fig. 3 show the embodiment from the Fig. 1 in a perspective view from the front ( Fig. 2) and from diagonally behind ( Fig. 3) without the positive model. Identical features have been designated with the same reference numerals. Visible in both figures is the foot shell 12 with the forefoot part 12 / 1, a middle part 12 / 3, and the rearfoot part 12 / 2. In a preferred embodiment, the stiffness of the forefoot part 12 / 1 is up to five times greater than that of the rearfoot part 12 / 2.

[0038] Fig. 4 shows a sectional view through the lower leg shell 11 in the area of the first connecting element 19 with the first spring end piece 16 inserted. The first spring end piece 16 is connected to the connecting element 19 arranged on the lower leg shell 11 via a pretensioning element 21, shown here as a screw.

[0039] Fig. Figure 5 shows the connection of the first spring end piece 16 to the first connecting element 19 in a sectional view. The section is made in an area in which the prestressing element 21 is not visible. The spring end piece 16 has a cross-section in the shape of a trapezoid, preferably an isosceles trapezoid. The first connecting element 19 comprises a recess 23 / 1. This recess also has a trapezoidal cross-section, preferably an isosceles trapezoid, and corresponds, as in Fig. 5, with the trapezoidal cross-sectional area of the spring end piece 16. The contact surfaces 16 / 1 and 16 / 2 arranged on the spring end piece 16 form, with the contact surfaces 231 / 1, 231 / 2 arranged in the first recess, a positive connection and a force connection due to friction. A distance d is provided between a third surface 16 / 3 arranged on the spring end piece 16 and the third surface 231 / 3 arranged on the recess 23 / 1. The spring end piece 16 does not lie completely, i.e. not flush, in the recess 23 / 1 of the connecting element 19. A gap d is recorded. With the aid of a prestressing element 21 (in Fig. 5 not visible), the spring end piece 16 is pressed into the recess. Correspondingly high forces act on the contact surfaces 16 / 1, 231 / 2, and 16 / 2 and 231 / 1 (see double arrow).

[0040] In the first embodiment, the connection of the second spring end piece 17 to the second connecting element 20, arranged on the foot shell 12, is the same as in Fig. 5 for the first spring end piece 16 with the first connecting element 19.

[0041] Fig. Figure 6 shows a side view of the spring and a schematic representation of the lateral positioning based on the positive model. Not shown are the lower leg shell 11, the foot shell 12, and the connecting elements 19, 20 arranged on the shells for connecting the spring 13 to them. Fig. The geometry of spring 13 is clearly visible in Figure 6. The spring 13 has a constant cross-sectional area with a varying geometric shape over its entire length. Fig. 6 shows the variation of the width of the spring 13. The two spring end pieces 16, 17 have the same width b2 / 2, which in the side view is larger than the width B2 / 2 of the middle piece 18.

[0042] Fig. 7 shows the representation from Fig. 6 in a front view. The width b1 / 1 of the spring 13 in the area of the spring end pieces 16, 17 is narrower than the width B1 / 1 of the middle piece 18. Furthermore, in the Fig. 7 is the plane Aq (for further explanation of Aq, see Fig. 16), which runs vertically. The spring 13 is curved relative to the plane Aq, meaning it does not run parallel to this plane.

[0043] In the presentation of the Fig. 6 and Fig. 7, the spring 13 is arranged laterally and thus away from the anatomical median plane. Fig. Figure 8 shows an exploded view of the spring, the connecting elements and the preload elements. Fig. 8, the prestressing elements are screws 21, 22. In this embodiment, two openings 24 / 1, 24 / 2 are provided on the spring end pieces 16, 17 and on the connecting elements 19, 20, for example, to accommodate the screws 21, 22. When mounting the spring 13 in the connecting elements 19, 20, the spring end pieces 16 and 17 are pressed into the connecting elements 19 and 20 and fixed with the prestressing elements 21, 22. Regarding the resulting force and form fit, please refer to the description of Fig. 4 and the Fig. 5 refer.

[0044] The spring 13 can be replaced by the patient or the orthopaedic technician. The spring used for the lower leg orthosis 1 according to the invention is made of Fig. 8 shows an embodiment of a spring 13. Further embodiments of the springs all have a trapezoidal cross-sectional geometry at the spring end pieces, which as in Fig. 4 and Fig. 5, interact with the connecting elements on the foot shell and the lower leg shell in a form-fitting and force-fitting manner. The connecting elements are permanently connected to the two shells and do not need to be replaced. Fig. The spring 13 shown in Fig. 8 has a width B1 / 1 in the area of the middle piece 18.

[0045] In a further embodiment, for example, a spring which is stronger than that of the Fig. 8, the width in the area of the curved middle piece is larger than the width B1 / 1 of the curved middle piece 18 of the spring 13. The same applies to the width B2 / 2 (see Fig. 6)

[0046] In a further embodiment, for example, a spring which is weaker than that of the Fig. 8, the width in the area of the arched middle piece is smaller than the width B1 / 1 of the spring 13.

[0047] Fig. Fig. 9 shows a side view of a positive model 10 of the lower leg with a tool 3 for positioning the first and second connecting elements 19, 20 on the lower leg shell 11 and the foot shell 12 with the rod 31 inserted into the positive model 10. The connecting elements 19, 20 are in the embodiment shown with the form 4 (in Fig. 14 and Fig. 15 visible), positioned on the lower leg shell 11 and the foot shell 12 using the tool 3, laminated on, and cured together with the shells and the tool 3. This is referred to as preforming. The tool 3 comprises an elongated positioning element 32. This positioning element 32 has a first end 33 and a second end 34 as well as an intermediate piece 35 (see Fig. 11), which runs between these two ends. The ends 33, 34 have, on the side facing the connecting elements 19, 20, a trapezoidal element T1, T2, e.g. a prism which corresponds to the positive of the trapezoidal cross-sectional recess in the connecting elements 19, 20. The tool 3 specifies the position of the connecting elements 19, 20 on the shells 11 and 12. The tool 3 itself is in turn aligned via the rod 31 which runs through a foot joint axis A.

[0048] Fig. 10 shows the representation of the Fig. 9 is an exploded view. Also visible are the lower leg shell 11 and the foot shell 12 with the connecting elements 19, 20 and the positive model 10 of the lower leg. Clearly visible in this view is the rod 31, which, when inserted, runs along the ankle axis A and is used to align the tool 3 on the positive model or on the shells 11, 12.

[0049] Fig. 11 and Fig. 12 release the tool 3 from the Fig. 9 and the Fig. 10 again, without depicting its positioning on the connecting elements of the lower leg or foot shell. Clearly visible in both illustrations is the trapezoidal element T1 and T2, which corresponds to the positive of the trapezoidal recess on the connecting elements, which will later be connected to the spring end pieces. Identical features have been designated with the same reference numerals.

[0050] In a preferred embodiment, the spring 13 is made of a textile fiber matrix semi-finished product which has been pre-impregnated with a reaction resin. Fig. Figure 13 shows the structure of such a semi-finished product. The fibers F are unidirectionally aligned. A fabric G which, according to Fig. 13 under the unidirectional fibers F, is aligned with the unidirectional fibers F at an angle α (alpha) < (less than) 45°. The length L of the fibers F corresponds to the length of the spring. The unidirectional fibers F are directed in the direction of the spring, i.e. along a spring chord S. The textile fiber matrix semi-finished product comprises a layer of unidirectional fibers F and a layer of fabric G and is subsequently rolled around the spring chord S to produce the spring and cured in a mold that reproduces the final geometry of the spring (in Fig. 13 not shown). The rolling direction is in relation to Fig. 13 from left to right. It is rolled around the unidirectional fibers. The unidirectional fibers are thus in the direction of the spring tendon S. The Fig. 13 shown structure of the semi-finished product concerns a spring 13, which is in a Fig. 1, Fig. 2, Fig. 3 is applied.

[0051] The structure of a semi-finished product for the production of a spring, which runs medially, ie on the side of the positive model facing away from the anatomical median plane and is used on the right lower leg, differs from the Fig. 13. A fabric G, which, for example, lies beneath a layer of unidirectional fibers F, is oriented relative to the unidirectional fibers F at an angle α (alpha) > (greater) 45°.

[0052] As with a spring intended for the lateral course in a right lower leg orthosis, the length L of the fibers F corresponds to the length of the spring. The unidirectional fibers F are directed in the direction of the spring, i.e. along a spring-tendon S. The textile fiber matrix semi-finished product comprises a layer of unidirectional fibers F and a layer of fabric G. To produce the spring, it is then rolled around the spring-tendon S and cured in a mold that reproduces the final geometry of the spring (in Fig. 13 not shown).

[0053] Fig. Figure 14 shows a perspective side view of a mold 4 for producing the connecting elements 19, 20. Clearly visible is an element 41 with a substantially trapezoidal cross-section. In a preferred embodiment, the connecting elements 19, 20 are made from a textile fiber matrix semi-finished product that has been pre-impregnated with a reaction resin (also called prepreg). The prepreg material is inserted into the mold 4 in individual layers. The element 41 represents the negative of the trapezoidal recess arranged on the connecting element 19, 20.

[0054] Fig. 15 shows the form Fig. 14 in a side view. Also element 41, which represents the negative of the recess on the connecting element.

[0055] Fig. 16 shows a lower leg orthosis according to Fig. 1, Fig. 2 and Fig. 3. Shown in more detail is the plane A q, in which a transverse force, the so-called ground reaction force F r , which causes a deflection of the spring 13. The ground reaction force results in the plane A q due to a deflection gamma. The ground reaction force F r is introduced from the foot shell 12 via the spring 13 and the lower leg shell 11 into the lower leg.

[0056] Due to the laterally positioned spring 13, the transverse force (ground reaction force Fr) does not act in a spring plane A F . The spring plane A F is by the distance d to the plane of the transverse forces A q This creates a torsional moment Mt. The In Fig. 16 Spring 13 is according to Fig. 13. As in Fig. 13, the fabric G is aligned at an angle α (alpha) of less than 45° with respect to the unidirectional fibers F (and also with respect to the spring neutral line). In a preferred embodiment, this angle is 20-35°. This arrangement results in a bending-torsion coupling and thus a bending-torsion moment M when the spring 13 bends. bd . As in Fig. 16, the bending-torsional moment ideally balances the torsional moment Mt. In other words, M bd . counteracts twisting of the spring (and thus of the patient's lower extremities) and thus improves gait.

[0057] In one embodiment of a lower leg orthosis with a laterally extending spring, which is used for a left lower leg, the structure of the spring differs from the structure of spring 13. The tissue G, which lies, for example, beneath a layer of unidirectional fibers F, is oriented at an angle α (alpha) > (greater) 45° relative to the unidirectional fibers F. The previously described mechanism regarding the bending-torsion moment and torsional moment, which arises when the spring deflects, also results in a comparable result in this embodiment. LIST OF REFERENCE SYMBOLS 1 lower leg orthosis 11 Lower leg shell 12 Footrest 12 / 1 forefoot part 12 / 2 rear foot part 12 / 3 middle section 13 spring 16 first spring end piece 16 / 1, 16 / 2, 17 / 1, 17 / 2 contact surfaces on the spring end piece 16 / 3, 17 / 3 third surface on the spring end piece 17 second spring end piece 18 Middle piece 19 first connecting element 20 second connecting element 21 first prestressing element 22 second prestressing element 23 / 1 Recess arranged on a first connecting element 23 / 2 Recess arranged on a second connecting element 231 / 1, 231 / 2 contact surfaces arranged in the first recess 232 / 1, 232 / 2 contact surfaces arranged in the second recess 231 / 3 third surface first connecting element 232 / 3 third surface second connecting element 24 / 1 opening(s) in the spring 24 / 2 opening(s) in the connecting element 3 tools 31 staff 32 elongated positioning element 33 first end of the elongated positioning element 34 second end of the elongated positioning element 35 intermediate piece 4 Shape 41 Negativ d Distance between connecting element and spring end piece F F Unidirectional fiber G tissue b1 / 1, B1 / 1 spring width in front view b2 / 2, B2 / 2 spring width in side view S spring-tendon

Claims

[1] Lower leg orthosis (1) comprising a lower leg shell (11), a foot shell (12), a spring (13) and first and second prestressing elements (21), (22), wherein a first connecting element (19) is provided on the lower leg shell (11) and a second connecting element (20) is provided on the foot shell (12), the spring (13) has a first and a second spring end piece (16), (17) and an arcuate middle piece (18) which is arranged between the two spring end pieces (16) (17), and the two prestressing elements (21), (22) connect the spring (13) via the two spring end pieces (16), (17) to the two connecting elements (19), (20) of the foot shell (12) and the lower leg shell (11) in a form-fitting and force-fitting manner. [2] Lower leg shell according to claim 1, characterized by that the arched central piece (18) extends in a direction viewed from the side posterior to the two spring end pieces (16), (17). [3] Lower leg orthosis (1) according to claim 1 or 2, characterized by that the first and the second spring end piece (16), (17) each have two contact surfaces (16 / 1, 16 / 2), (17 / 1, 17 / 2) and the first and second connecting element (19), (20) each have two contact surfaces (231 / 1, 231 / 2), (232 / 1, 232 / 2), the contact surfaces (16 / 1, 16 / 2), (17 / 1, 17 / 2), (231 / 1, 231 / 2), (232 / 1, 232 / 2) touch each other, preferably the positive and non-positive connection between these contact surfaces (16 / 1, 16 / 2), (17 / 1, 17 / 2), (231 / 1, 231 / 2), (232 / 1, 232 / 2) results. [4] Lower leg orthosis (1) according to one of the preceding claims, characterized bythat the two spring end pieces (16) (17) each have a third surface (16 / 3, 17 / 3) and the two connecting elements (19), (20) each have a third surface (231 / 3, 232 / 3), wherein the third surface (16 / 3) of the first spring end piece (16) and the third surface (231 / 3) of the first connecting element (19) as well as the third surface (17 / 3) of the second spring end piece (17) and the third surface (232 / 3) of the second connecting element (20) are arranged at a distance (d) from one another, for example this distance is approximately 0.5 mm. [5] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the first and / or the second spring end piece (16), (17) have a trapezoidal cross-sectional area. [6] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the first and / or the second connecting element (19), (20) have a recess (23 / 1), (23 / 2) with a trapezoidal cross-sectional area. [7] Lower leg orthosis (1) according to claims 3 to 6, characterized by that the contact surfaces (16 / 1, 16 / 2, 17 / 1, 17 / 2) on the first spring end piece (16) and on the second spring piece (17) form the legs of the trapezoid when viewed in cross section and the contact surfaces (231 / 1, 231 / 2), (232 / 1, 232 / 2) on the first and on the second connecting element (19), (20), when viewed in cross section, form the legs of the trapezoidal recess (23 / 1), (23 / 2). [8] Lower leg orthosis according to one of the preceding claims, characterized by that the positive and non-positive connection between the contact surfaces (16 / 1, 16 / 2, 17 / 1, 17 / 2), running along the two legs of the trapezoidal spring end piece (16), (17) and the contact surfaces running along the two legs of the trapezoidal recess (23 / 1, 23 / 2) of the connecting element (19), (20) results. [9] Lower leg orthosis (1) according to one of the preceding claims, characterized bythat the third surfaces (16 / 3) (17 / 3) on the first and second spring end pieces (16), (17) represent a base side of the trapezoid when viewed in cross section and the third surfaces on the first and second connecting elements (19), (20) represent a base side of the trapezoidal recess (23 / 1), (23 / 2) when viewed in cross section. [10] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the spring (13) has a cross-sectional area that is constant in size over its entire length. [11] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the geometry of the cross-sectional area of the two spring end pieces (16), (17) is identical and the geometry of the cross-sectional area of the arcuate middle piece (18) is different from the geometry of the spring end pieces (16), (17). [12] Lower leg orthosis (1) according to one of the preceding claims, characterized bythat the spring (13) is curved in a front view with respect to a vertical plane (Aq). [13] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the spring (13) is constructed from unidirectional fibers (F) and a fabric (G), preferably from a layer of unidirectional fiber (F) and a layer of fabric (G), particularly preferably these two layers are rolled. [14] Lower leg orthosis (1) according to claim 13, characterized by that the unidirectional fibers (F) run continuously from the first spring end piece (16) via the curved middle piece (18) to the second spring end piece (17). [15] Lower leg orthosis (1) according to claim 13 or 14, characterized bythat the fabric (G) is oriented at an angle of less than 45° with respect to the unidirectional fibers (F), preferably this angle is 20° to 35°, or that the fabric (G) is oriented at an angle of greater than 45° with respect to the unidirectional fibers (F), preferably this angle is 55° to 70°. [16] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the spring (13) in a view from the front in the area of the two spring end pieces (16), (17) has a smaller width (b1 / 1) than in the area of the arched middle piece (18). [17] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the spring (13) in a view from the side has a greater width (b2 / 2) in the area of the two spring end pieces (16), (17) than in the area of the arched middle piece (18). [18] Lower leg orthosis (1) according to one of the preceding claims, characterized bythat the foot shell (12) has a forefoot part (12 / 1), a middle part (12 / 3) and a rear foot part (12 / 2) and the foot shell (12) is made of one material, preferably a fiber composite material. [19] Lower leg orthosis (1) according to claim 18, characterized by that the stiffness of the forefoot part (12 / 1) is up to five times greater than that of the rearfoot part (12 / 2). [20] Lower leg orthosis (1) according to one of the preceding claims, characterized by that the spring (13) runs laterally or medially with respect to an anatomical median plane in connection with the foot and lower leg shell (11), (12). [21] Spring (13) for a lower leg orthosis (1) comprising the spring (13), a first and a second spring end piece (16), (17) and an arcuate middle piece (18) running between these two ends, preferably the first and the second spring end piece (16), (17) have a different cross-sectional geometry than the arcuate middle piece (18), wherein the cross-sectional area is the same over the entire spring (13). [22] Spring (13) according to claim 21, characterized by that the spring (13) in a view from the front in the area of the two spring end pieces (16), (17) has a smaller width (b1 / 1) than in the area of the arched middle piece (18). [23] Spring (13) according to claim 21 or 22, characterized by that the spring, in a view from the side, has a greater width (b2 / 2) in the area of the two spring end pieces (16), (17) than in the area of the arched middle piece (18). [24] Spring (13) according to one of the preceding claims 21 to 23, characterized by that the spring (13) is constructed from unidirectional fibers (F) aligned in the direction of the spring (13), ie along a spring tendon (S) and a fabric (G). [25] Spring (13) according to claim 24, characterized by that the fabric (G) is oriented at an angle of less than 45° with respect to the unidirectional fibers (F), preferably this angle is 20° to 35°, or that the fabric (G) is oriented at an angle of greater than 45° with respect to the unidirectional fibers (F), preferably this angle is 55° to 70°. [26] Spring (13) according to claim 24 or 25, characterized by that the unidirectional fibers (F) run continuously from the first spring end piece (16) via the curved middle piece (18) to the second spring end piece (17). [27] Spring (13) according to one of claims 24 to 26, characterized by, that the unidirectional fibers (F) and the fabric (G) are rolled around the spring tendon (S) and hardened in a shape which represents the desired final geometry of the spring (13). [28] Spring (13) according to one of the preceding claims 21 to 27, characterized by that the spring end piece (16), (17) has a trapezoidal cross-sectional geometry, preferably an isosceles trapezoid. [29] Connecting element (19), (20) for connecting a spring (13) according to claim 21 to 28 with a foot and / or lower leg shell of a lower leg orthosis, characterized by that the connecting element (19), (20) has a recess (23 / 1), (23 / 2) with two contact surfaces (231 / 1), (231 / 2), (232 / 1) (232 / 2), wherein the contact surfaces are designed for positive and non-positive connection with the spring end pieces (16), (17). [30] Connecting element (19), (20) according to claim 29, characterized bythat the recess (23 / 1), (23 / 2) has the shape of a trapezoidal prism, preferably the cross-sectional area of the trapezoidal prism is an isosceles trapezoid. [31] Mold (4) for producing a connecting element (19), (20) according to claim 29 or 30, characterized by that the mold (4) is designed to receive a prepreg material, a negative (41) of a recess (23 / 1), (23 / 2) arranged on the connecting element (19), (20), preferably a trapezoidal prism, particularly preferably this trapezoidal prism has a cross-sectional area of an isosceles trapezoid. [32] Tool (3) for positioning a connecting element (19), (20) on a lower leg shell and / or a foot shell comprising a rod (31) and an elongated positioning element (32) with a first and a second end (33), (34), wherein both ends have a trapezoidal cross-sectional geometry, the two ends are connected by an intermediate piece (35) and an opening for receiving the rod (31) is provided in the intermediate piece (35) in the region of one end (33), (34).

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