Lower leg orthosis

Abstract

The invention relates to a lower leg orthosis (1) comprising a lower leg shell (11), a foot shell (12), a spring (13), and first and second pretensioning elements (21), (22). A first connection element (19) is provided on the lower leg shell (11), and a second connection element (20) is provided on the foot shell (12). The spring (13) comprises 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). The two pretensioning elements (21), (22) connect the spring (13) via the two spring end pieces (16), (17) to the two connection elements (19), (20), which are arranged on the foot shell (12) and the lower leg shell (11), in a form-fitting and force-fitting manner.

Description

[0001] Lower leg orthosis

[0002] 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.

[0003] STATE OF THE ART

[0004] Various manufacturers of orthopedic aids offer ready-made orthoses or components for the individual production of an orthosis. These ready-made orthoses are inexpensive, but also manufactured in a generally suitable shape and stability. A user-specific selection usually only relates to foot length, thus other relevant parameters such as height, weight, and activity level are not or insufficiently considered. The degree of support cannot therefore be optimally selected. The service life 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. SUMMARY OF THE INVENTION

[0005] An object of the invention is to avoid at least one disadvantage known from the prior art.

[0006] This task is solved by the method defined in the independent patent claims

[0007] 5 invention solved.

[0008] 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 should be mentioned, 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 is such a hybrid form.

[0009] The primary target group of the inventive lower leg orthosis are patients with a "foot sinker 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 such a condition cannot lower their foot. Plantar flexion, i.e., bending the foot or toes toward the sole, is not possible. As a result, tiptoeing is impossible, and standing for long periods is difficult. Walking on level ground is also strongly affected, as the necessary resistance against dorsal extension (i.e., bending the foot in

[0010] 5 direction of the instep) from the middle stance phase (MDS) of the gait cycle and no or only a minimized energy return takes place in a swing phase preparation (PSW) of the gait cycle.

[0011] The inventive lower leg orthosis largely compensates for the lack of energy return from the mid-stance phase (MDS) to the swing phase preparation (PSW). This enables rapid walking.

[0012] 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 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 in the mid-stance phase and stabilizes the knee during extension. Furthermore, the inventive lower leg orthosis limits lower leg forward thrust in the mid-stance phase. In addition, the inventive lower leg orthosis enables lateral stabilization of the ankle joint, yet with the necessary lateral flexibility.

[0013] The foot shell and the lower leg shell are individually manufactured 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, which later connect the spring to the foot shell and the lower leg shell, are sourced externally by the orthopedic company. The length and strength of the spring, however, are based on the individual needs of the patient, with the spring length being tailored to their body size, and the spring strength to their

[0014] patient weight, the nature and topography of the surface on which the patient moves most of the time.

[0015] The lower leg orthosis according to the invention therefore comprises a replaceable spring. The orthopedic technician or the patient themselves can replace this spring and thus individually adapt it to their activity (e.g., walking on uneven ground). Other reasons for adaptation can be changes in body size, particularly in children, and in body weight, or during the course of the disease. The lower leg orthosis according to the invention offers a simple, quickly implemented, manually manageable solution. The lower leg orthosis according to the invention comprises a lower leg shell, a foot shell, a spring, and first and second preload 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 a first and a second spring.

[0016] 5 end piece and an arcuate middle piece, which is 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 usual locomotion (i.e., a forward movement).

[0017] 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.

[0018] The spring, which has two spring end pieces and an arched center 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.

[0019] 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 curve. 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.

[0020] 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 from these contact surfaces arranged on the spring end pieces and the connecting elements.

[0021] Furthermore, the two spring end pieces and the two connecting elements each have a third surface. If 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.

[0022] In a preferred embodiment, the first and / or second spring end piece has a trapezoidal cross-sectional area, preferably an isosceles trapezoid. The same applies to a recess which is arranged on the first and / or second connecting element and serves to accommodate the spring end pieces. 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. The third surfaces on the first and second spring end piece represent a base side of the trapezoid when viewed in cross section.A similar situation applies to the third surfaces on the first and second connecting elements. These, viewed in cross-section, also form a base side—in this case, the trapezoidal cross-sectional area of ​​the recess.

[0023] 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.

[0024] Preferably, the geometry of the cross-sectional area of ​​the two spring end pieces is identical, while the geometry of the cross-sectional area of ​​the curved center piece differs from the geometry of the cross-sectional area of ​​the spring end pieces. When viewed from the front, the spring has a narrower width 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 has a wider width 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.

[0025] 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, compared to the weak spring, the two spring end pieces and the width of the curved 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.

[0026] The length of the spring is determined by the size of the patient.

[0027] The spring connecting the foot shell to the lower leg shell is curved relative to a vertical plane when viewed from the front. This allows the spring to be guided close to the patient's limbs. In a preferred embodiment, the spring is constructed from unidirectional fibers and a fabric, preferably 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°.

[0028] 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.

[0029] 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.

[0030] Whether the spring runs laterally or medially also depends on whether the patient5 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. 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.

[0031] 5 The foot and lower leg shells are designed differently for use on the left lower leg and the right lower leg respectively.

[0032] By positioning the spring, which connects 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.

[0033] 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.

[0034] The mold for producing the connecting element reproduces a negative of the recess arranged on the connecting element, preferably a trapezoidal prism; more preferably, this trapezoidal prism has a cross-sectional area of ​​an isosceles trapezoid. The mold serves to accommodate a composite material, preferably a prepreg material. The shells are manufactured individually for the patient by orthopedic technicians; carbon fiber reinforced plastic (e.g., prepreg) is preferably used. The connecting elements are preformed separately using a mold. The preformed connecting elements are then connected to the foot shell and the lower leg shell, i.e., the connecting elements are laminated to 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 receiving the rod. Another receptacle for the rod is integrated into the positive model. This receiving opening runs through the ankle joint axis. The tool can be aligned in this way.

[0035] SHORT DESCRIPTION OF THE CHARACTERS

[0036] 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 shows a side view of the lower leg orthosis according to the invention, arranged on a positive model in a first embodiment for the right lower leg with a lateral arrangement of the spring;

[0037] Fig. 2 is 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;

[0038] Fig. 3 is a perspective view obliquely from behind of the lower leg orthosis according to the invention, without a positive model in the first embodiment for the right lower leg with a lateral arrangement of the spring; Fig. 4 is a sectional view through the lower leg shell in the area of ​​the first connecting element, with the connecting element and the spring end piece partially shown in cross-section;

[0039] Fig. 5 is a detailed view of the section from Fig. 4;

[0040] Fig. 6 a view of the spring from the side and schematically the lateral positioning based on the positive model;

[0041] Fig. 7 shows a front view of the spring and a schematic representation of the lateral positioning based on the positive model; Fig. 8 shows an exploded view of the spring, the connecting elements, and the preloading elements (here: screws);

[0042] 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 positive model inserted

[0043] Rod;

[0044] Fig. 10 is 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 is an exploded view of the tool alone with the rod not inserted;

[0045] Fig. 1 2 is an exploded view of the tool alone with the rod inserted;

[0046] Fig. 1 3 schematic representation of an arrangement of fabric and unidirectional fiber for the production of the spring for the lateral arrangement between

[0047] Lower leg shell and foot shell;

[0048] Fig. 14 is a perspective view of the mold for producing the connecting elements; Fig. 15 is a section through the mold according to Fig. 14;

[0049] Fig. 1 6 a schematic representation of the acting moments and the resulting bending-torsion coupling.

[0050] WAYS TO IMPLEMENT THE INVENTION

[0051] 5 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 1 1 and a foot shell 1 2 with a forefoot part 1 2 / 1, a rearfoot part 1 2 / 2 and a middle part 1 2 / 3. The lower leg shell 1 1 and the foot shell 1 2 are connected to one another via a spring 1 3. The spring 1 3 comprises a first spring end piece 1 6 and a second spring end piece 1 7. A first connecting element 19 is arranged on the lower leg shell 1 1 and the second connecting element 20 on the foot shell 1 2. The two spring end pieces 16, 1 7 are connected to the two connecting elements 1 9, 20 in a form-fitting and force-fitting manner. With the help of pre-tensioning 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 pre-tensioning elements 21, 22. The spring 13 is replaceable and can be replaced with a different spring (not shown in Figure 1) either by the orthopedic technician or by the patient themselves if necessary. The spring 13 has an arc-shaped middle piece 18. This middle piece 18 runs between the two spring end pieces 16 and 17. The arc-shaped 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. at the angle deviating from the anatomical median plane.

[0052] 5 reversed side of the positive lower leg model. The shown embodiment is intended for use on the right foot. With appropriate adjustment of the foot shell, this embodiment can also be used for the left lower leg. The spring 13 then runs medially.

[0053] Figures 2 and 3 show the embodiment of Figure 1 in a perspective view obliquely from the front (Figure 2) and obliquely from the rear (Figure 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.

[0054] Figure 4 shows a sectional view through the lower leg shell 11 in the region of the first connection element 19 with the first spring end piece 16 inserted. The first spring end piece 16 is connected to the connection element 19 arranged on the lower leg shell 11 via a prestressing element 21, shown here as a screw. Figure 5 shows the connection of the first spring end piece 16 to the first connection element 19 in a sectional view. The section is taken 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 connection element 19 comprises a recess 23 / 1. This recess also has a trapezoidal cross-section, preferably an isosceles trapezoid, and corresponds, as shown in Figure 5, to 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 frictional connection as a result of 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 (not visible in Figure 5), 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).

[0055] In the first embodiment, the connection of the second spring end piece 17 to the second connection element 20, arranged on the foot shell 12, is designed in the same way as explained in Figure 5 for the first spring end piece 16 with the first connection element 19. 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 connection elements 19, 20 arranged on the shells for connecting the spring 13 to them. The geometry of the 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. Figure 6 shows the variation in the width of the spring 13. The two spring end pieces 16, 17 have the same width b2 / 2, which is greater in side view than the width B2 / 2 of the middle piece 18.

[0056] Figure 7 shows the illustration from Figure 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 center piece 18. Also shown in Figure 7 is the plane Aq (for a more detailed explanation of Aq, see Figure 16), which runs vertically. The spring 13 is curved with respect to the plane Aq, meaning it does not run parallel to this plane.

[0057] In the illustration in Figures 6 and 7, the spring 13 is arranged laterally and thus facing away from the anatomical median plane. Figure 8 shows an exploded view of the spring, the connecting elements and the pre-tensioning elements. In the embodiment shown in Figure 8, the pre-tensioning elements are screws 21, 22. In this embodiment, for example, two openings 24 / 1, 24 / 2 for receiving the screws 21, 22 are provided on the spring end pieces 16, 17 and on the connecting elements 19, 20. When the spring 13 is mounted 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 pre-tensioning elements 21, 22. With regard to the resulting force and form fit, reference is made to the description of Figures 4 and 5.

[0058] 5 The spring 13 can be replaced by the patient or the orthopedic technician. The spring used for the inventive lower leg orthosis 1 shown in Figure 8 represents one embodiment of a spring 13. Other embodiments of the springs all have a trapezoidal cross-sectional geometry at the spring end pieces, which, as explained in Figures 4 and 5, interact positively and non-positively with the connecting elements on the foot shell and on the lower leg shell. The connecting elements are fixedly connected to the two shells and do not need to be replaced. The spring 13 shown in Figure 8 has a width B1 / 1 in the area of ​​the middle piece 18.

[0059] In a further embodiment, for example a spring which is stronger than that 5 of Figure 8, the width in the area of ​​the arcuate middle piece is made larger than the width B1 / 1 of the arcuate middle piece 18 of the spring 13. The same applies to the width B2 / 2 (see Fig. 6)

[0060] In a further embodiment, for example a spring that is weaker than that of Figure 8, the width in the region of the arched center piece is smaller than the width B1 / 1 of the spring 13. Figure 9 shows a side view of a positive model 10 of the lower leg with a tool 3 for positioning the first and second connection elements 19, 20 on the lower leg shell 11 and the foot shell 12 with a rod 31 inserted into the positive model 10. In the embodiment shown, the connection elements 19, 20 are pre-laminated with the mold 4 (visible in Figures 14 and 15), positioned on the lower leg shell 11 and the foot shell 12 with the aid of 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 Figure 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 recess in the connecting elements 19, 20 which has a trapezoidal cross-section. 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 an ankle joint axis A.

[0061] Figure 10 shows the representation of Figure 9 in 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.

[0062] Figures 11 and 12 depict tool 3 from Figures 9 and 10, without showing its positioning on the connecting elements of the lower leg and foot shell, respectively. 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 that will later be connected to the spring end pieces. Identical features are designated with the same reference numerals.

[0063] In a preferred embodiment, the spring 13 is produced from a textile fiber matrix semi-finished product which has been pre-impregnated with a reaction resin. Figure 13 shows the structure of such a semi-finished product. The fibers F are unidirectionally aligned. A fabric G which, according to Figure 13, lies beneath the unidirectional fibers F, is oriented at an angle α (alpha) < (less than) 45° with respect to the unidirectional fibers F. 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. To produce the spring, it is subsequently rolled around the spring chord S and cured in a mold which reproduces the final geometry of the spring (not shown in Figure 13). The rolling direction is from left to right with respect to Figure 13.It is rolled around the unidirectional fibers. The unidirectional fibers thus lie in the direction of the spring chord S. The structure of the semi-finished product shown in Figure 13 relates to a spring 13, which is used in an arrangement shown in Figs. 1, 2, and 3.

[0064] The structure of a semi-finished product for producing a spring, which runs medially, i.e., 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 structure shown in Figure 13. A tissue G, which, for example, lies beneath a layer of unidirectional fibers F, is oriented relative to the unidirectional fibers F at an angle a (alpha) > (greater) 45°.

[0065] As with a spring intended for lateral placement 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 reflects the final geometry of the spring (not shown in Figure 13).

[0066] Figure 14 shows a perspective view from the side of a mold 4 for producing the connecting elements 19, 20. Clearly visible is an element 41 which is essentially trapezoidal in cross section. In a preferred embodiment, the connecting elements 19, 20 are made from a textile fiber matrix semi-finished product which 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

[0067] 5 connecting element 19, 20 again.

[0068] Figure 15 shows the shape from Figure 14 in a side view. Also shown is element 41, which represents the negative of the recess on the connecting element.

[0069] Figure 16 shows a lower leg orthosis according to Figures 1, 2 and 3. In more detail, the plane A q , in which a transverse force, the so-called ground reaction force Fr , 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 into the lower leg from the foot shell 1 2 via the spring 13 and the lower leg shell 1 1.

[0070] Due to the laterally positioned spring 1 3, the transverse force (ground reaction force Fr) does not act in a spring plane A F . The spring level A F is by the distance d to the plane of the transverse forces A q This creates a torsional moment M tThe spring 13 shown in Figure 16 is constructed according to Figure 13. As can be seen in Figure 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's 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 Mbd when the spring 13 bends. As shown in Figure 16, the bending-torsion moment ideally balances the torsional moment M tIn other words, Mbd. counteracts twisting of the spring (and thus of the patient's lower extremities) and thus improves gait. In one embodiment of a lower leg orthosis with a laterally extending spring, which is used on 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 aligned at an angle a (alpha) > (greater) 45° with respect to the unidirectional fibers F. The previously described mechanism regarding bending-twisting moment and torsional moment, which arises when the spring deflects, results in a comparable result in this embodiment.

[0071] LIST OF REFERENCE SYMBOLS

[0072] I Lower leg orthosis

[0073] II Lower leg shell

[0074] 1 2 Footrest

[0075] 5 1 2 / 1 forefoot part

[0076] 1 2 / 2 rear foot part

[0077] 1 2 / 3 middle section

[0078] 1 3 spring

[0079] 1 6 first spring end piece 0 1 6 / 1 , 1 6 / 2, 1 7 / 1 , 1 7 / 2 contact surfaces on the spring end piece

[0080] 1 6 / 3, 1 7 / 3 third surface on the spring end piece

[0081] 1 7 second spring end piece

[0082] 1 8 Middle section

[0083] 1 9 first connecting element

[0084] 20 second connecting element

[0085] 21 first prestressing element

[0086] 22 second prestressing element

[0087] 23 / 1 Recess arranged on a first connecting element

[0088] 23 / 2 Recess arranged on a second connection element0 231 / 1 , 231 / 2 Contact surfaces arranged in the first recess

[0089] 232 / 1 , 232 / 2 contact surfaces arranged in the second recess

[0090] 231 / 3 third surface first connection element 232 / 3 third surface second connection element

[0091] 24 / 1 opening(s) in the spring

[0092] 24 / 2 opening(s) in the connecting element

[0093] 3 tools

[0094] 5 31 Staff

[0095] 32 elongated positioning element

[0096] 33 first end of the elongated positioning element

[0097] 34 second end of the elongated positioning element

[0098] 35 intermediate piece 0

[0099] 4 Shape

[0100] 41 Negative d Distance between connecting element and spring end piece F

[0101] F Unidirectional fiber

[0102] G Fabric b1 / 1 , B1 / 1 Feather width in front view b2 / 2, B2 / 2 Feather width in side view

[0103] S spring-tendon 0

Claims

PATENT CLAIMS 1. Lower leg orthosis (1) comprising a lower leg shell (11), a foot shell (12), a spring (13), and first and second pretensioning 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 arc-shaped central piece (18) which is arranged between the two spring end pieces (16) (17), and the two pretensioning elements (21), (22) connect the spring (13) to the two connecting elements (19), (20) of the foot shell (12) and the lower leg shell (11) in a form-fitting and force-fit manner via the two spring end pieces (16), (17).

2. Lower leg shell according to claim 1, characterized in that the arc-shaped central piece (18) extends posteriorly to the two spring end pieces (16), (17) when viewed from the side.

3. Lower leg orthosis (1) according to claim 1 or 2, characterized in 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), TI (232 / 1 , 232 / 2) touch each other, preferably resulting in a form-fit and force-fit between these contact surfaces ( 1 6 / 1 , 1 6 / 2), ( 17 / 1 , 17 / 2), (231 / 1 , 231 / 2), (232 / 1 , 232 / 2). Lower leg orthosis (1) according to one of the preceding claims, characterized in that 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 each other, for example this distance is approximately 0.5 mm.Lower leg orthosis (1) according to one of the preceding claims, characterized in that the first and / or the second spring end piece (16), (17) have a trapezoidal cross-sectional area. Lower leg orthosis (1) according to one of the preceding claims, characterized in that the first and / or the second connecting element (19), (20) have a recess (23 / 1), (23 / 2) with a trapezoidal cross-sectional area. Lower leg orthosis (1) according to claims 3 to 6, characterized in 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 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) form the legs of the trapezoidal recess (23 / 1), (23 / 2) in cross-section. Lower leg orthosis according to one of the preceding claims, characterized in that the form-fit and force-fit between the contact surfaces (16 / 1, 16 / 2, 17 / 1, 17 / 2), extending along the two legs of the trapezoidal spring end piece ( 16), ( 17) and the contact surfaces extending along the two legs of the trapezoidal recess (23 / 1, 23 / 2) of the connecting element (19), (20) results.Lower leg orthosis (1) according to one of the preceding claims, characterized in that the third surfaces ( 16 / 3) ( 17 / 3) on the first and second spring end piece (16), (17) in cross-section represent a base side of the trapezoid and the third surfaces on the first and second connecting element ( 19), (20) in cross-section represent a base side of the trapezoidal recess (23 / 1 ), (23 / 2).

10. Lower leg orthosis ( 1 ) according to one of the preceding claims, characterized in that the spring ( 13) has a cross-sectional area of ​​constant size over its entire length. 1 1. Lower leg orthosis ( 1 ) according to any of the preceding claims, 5 characterized in that the geometry of the cross-sectional area of ​​the two spring end pieces ( 1 6), ( 1 7) is identical and the geometry of the cross-sectional area of ​​the arc-shaped middle piece ( 18) differs from the geometry of the spring end pieces ( 16), ( 1 7). 1 2. Lower leg orthosis ( 1 ) according to one of the preceding claims, characterized in that 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 in that the spring ( 13 ) is made up of unidirectional fibers (F) and a fabric (G ), preferably of a layer of unidirectional fiber (F) and a layer of fabric (G ), these two layers are particularly preferably rolled.

14. Lower leg orthosis ( 1 ) according to claim 1 3, characterized in that the unidirectional fibers (F) run continuously from the first spring end piece ( 1 6) via the arc-shaped middle piece ( 18) to the second spring end piece ( 17). 1 5. Lower leg orthosis ( 1 ) according to claim 13 or 14, characterized in that the fabric (G) is oriented at an angle 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 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 in that the spring ( 1 3 ) in a front view in the area of ​​the two spring end pieces ( 16), ( 1 7 ) has a smaller width (b1 / 1 ) than in the area of ​​the arc-shaped middle piece ( 18 ).

17. Lower leg orthosis (1) according to one of the preceding claims, characterized in that the spring (13) has a greater width (b2 / 2) in a side view in the region of the two spring end pieces (16), (17) than in the region of the arc-shaped middle piece (18).

18. Lower leg orthosis (1) according to one of the preceding claims, characterized in that the foot shell (12) has a forefoot part (12 / 1), a middle part (12 / 3) and a rearfoot part (12 / 2) and the foot shell (12) is made of a material, preferably a fiber composite material.

19. Lower leg orthosis ( 1 ) according to claim 18, characterized in that the stiffness of the forefoot part ( 1 2 / 1 ) is up to five times greater than that of the rearfoot part ( 1 2 / 2 ).

20. Lower leg orthosis ( 1 ), according to one of the preceding claims, 5 characterized in that the spring ( 13) is related to an anatomical medial plane in conjunction with the foot and lower leg shell ( 1 1 ), ( 1 2) runs laterally or medially.

21. Spring (1 3) for a lower leg orthosis (1) comprising the spring (1 3), a first and a second spring end piece (16), (1 7) and an arc-shaped middle piece (18) extending between these at -o the ends, preferably the first and the second spring end piece (16), (1 7) having a different cross-sectional geometry than the arc-shaped middle piece (18) wherein the cross-sectional area is the same over the entire spring (13).

22. Spring ( 13) according to claim 21 , characterized in that the spring ( 13)5 in a front view in the area of ​​the two spring end pieces ( 1 6), ( 1 7) has a smaller width (b1 / 1 ) than in the area of ​​the arc-shaped middle piece ( 18).

23. Spring ( 1 3) according to claim 21 or 22, characterized in that the spring in a side view in the area of ​​the two spring end pieces ( 1 6), ( 17) has a greater width (b2 / 2) than in the area of ​​the arc-shaped middle section ( 18).

24. Spring (13) according to one of the preceding claims 21 to 23, characterized in that the spring (13) is made of unidirectional fibers (F), consisting of 5 is directed towards the spring ( 13), i.e., it is constructed along a spring tendon (S) and a tissue (G).

25. Spring ( 13) according to claim 24, characterized in that the fabric (G) is oriented at an angle 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 greater than 45° with respect to the unidirectional fibers (F), preferably this angle is 55° to 70°.

26. Spring ( 1 3) according to claim 24 or 25, characterized in that the unidirectional fibers (F) run continuously from the first spring end piece ( 16) via the arc-shaped middle piece ( 18) to the second spring end piece ( 1 7).

27. Spring ( 1 3) according to one of claims 24 to 26, characterized in that the unidirectional fibers (F) and the fabric (G) are rolled around the spring tendon (S) and cured in a shape which represents the desired end geometry of the spring ( 13).

28. Spring ( 1 3) according to one of the preceding claims 21 to 27, characterized in that the spring end piece ( 16), ( 1 7) has a trapezoidal cross-sectional geometry, preferably an isosceles trapezoid. 5 29. Connecting element ( 1 9), (20) for connecting a spring ( 1 3) according to claims 21 to 28 with a foot and / or lower leg shell of a lower leg orthosis, characterized in that the connecting element ( 1 9), (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 arranged for a form-fit and force-fit connection with the spring end pieces ( 1 6), ( 1 7).

30. Connecting element ( 1 9), (20) according to claim 29, characterized in that the recess (23 / 1 ), (23 / 2) is in 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 (1 9), (20) according to claim 29 or 30, characterized in that the mold (4) is configured to receive a prepreg material, represents a negative (41) of a recess (23 / 1), (23 / 2) arranged on the connecting element (1 9), (20), preferably a trapezoidal prism, particularly preferably has 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 5 (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).

Images