Intrepid Battlefield Exoskeleton (IBEX): A Portable, Non-Invasive Fracture Stabilization Orthosis for Prolonged Field Care (HJF 695-24)

Introduction

The Intrepid Battlefield Exoskeleton (IBEX) is a novel, lightweight, and portable exoskeletal device designed to stabilize serious lower leg injuries, such as open tibia fractures, in austere environments where rapid medical evacuation is not possible. Developed with support from the Defense Health Agency (DHA), The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), and Glacier Support Services (GSS), IBEX addresses critical capability gaps in prolonged field care scenarios anticipated in future multi-domain military operations. It enables injured personnel to regain mobility independently, reducing reliance on litter carriers and enhancing unit survivability and lethality.

Applications and Advantages:

Enables independent ambulation of wounded Service members with lower leg fractures during prolonged field care when evacuation is delayed or unavailable.
Designed for use in austere, resource-limited, and far-forward combat environments lacking air superiority and rapid evacuation capabilities.
Collapsible, and lightweight design facilitates easy transport, including potential delivery via unmanned aerial vehicles.
Universal (left or right) wear and a one-size-fits-most approach accommodates up to 90% of U.S. Army personnel, minimizing logistical burden.

Description of the Invention:

The IBEX was developed in response to the increasing likelihood of prolonged field care scenarios in future conflicts involving near-peer adversaries, where evacuation delays may extend beyond the traditional “Golden Hour.” Existing splinting and orthotic solutions are inadequate for enabling mobility after severe lower extremity injuries in these conditions. The invention stabilizes tibia/fibula fractures and offloads the injury site to enable independent mobility. Key components include (1) a rigid frame consisting of a height-adjustable, telescoping lateral rod, (2) a shoulder harness for suspension, (3) offloading components, (4) a titanium locking knee, (5) a fracture stabilization orthosis (FxO), and (6) a carbon fiber terminal device inspired by the All-Terrain prosthetic foot. The offloading components are an ischial sling and thigh corset that redirect load to the pelvis and thigh, respectively. The thigh corset and FxO are both soft materials that wrap circumferentially around that limb and contain rigid, carbon fiber stays for reinforcement. Additionally, there is an axially sliding interface between the FxO and frame which uniquely allows vertical movement without transmitting harmful forces to the fracture site. The device’s adjustability and portability make it suitable for rapid deployment and use by both trained medical personnel and untrained individuals in combat or remote settings. The IBEX integrates several known orthopedic and prosthetic principles—such as ischial weight bearing and shoulder strap suspension—but combines them innovatively into a single, portable system optimized for battlefield use and prolonged care. Its one-size-fits-most design contrasts with custom-fit prostheses, addressing logistical challenges in military deployments. The axially sliding interface that decouples frame and limb motion is a unique feature preventing secondary injury. Additionally, the collapsible knee joint enhances portability and usability in confined spaces like evacuation vehicles. These features collectively solve the problem of enabling mobility in severely injured personnel under austere conditions, which current devices do not adequately address.

Figure A: Anterior view of the Mark II prototype showing the telescoping lateral frame, Silesian belt, thigh corset, knee joint, fracture orthosis wrapped around the lower leg, and terminal device with rocker bottom sole
Figure B: A view of the Mark II prototype packed up and wrapped inside the thigh corset, illustrating device portability.
Figure C: A close-up view of telescoping frame and knee joint, which allow the device to be fully collapsible.