Surgery: splint – brace – or bandage – Orthopedic bandage – Splint or brace
Reexamination Certificate
2000-12-08
2004-08-10
Lucchesi, Nicholas D. (Department: 3624)
Surgery: splint, brace, or bandage
Orthopedic bandage
Splint or brace
C602S005000, C602S020000, C602S021000, C602S022000
Reexamination Certificate
active
06773410
ABSTRACT:
BACKGROUND OF THE INVENTION
Carpal Tunnel Syndrome (CTS) is defined as compression of the median nerve as it passes through the anatomical structures that form the carpal tunnel of the wrist.
CTS may be caused by any activity or condition resulting in a mechanical alteration of the carpal tunnel. This may be caused by repetitive activities of the wrist and arms. The change in orientation of the carpal tunnel may result in interference with the soft tissue structures within, most notably the median nerve. The carpal median nerve and nine tendons that pass from the forearm to the hand. The strength and stability of that passageway is maintained by bone structure and ligament integrity, as there are no muscles in the wrist. Repetitive use of the wrist during the course of the day naturally promotes laxity of the supportive ligaments, causing the compensating muscles to stabilize, the vulnerable carpal tunnel configuration will be altered. The proper juxtaposition of the radius and ulna is contingent upon a stable interosseous ligament. Separations of the radius and ulna from the middling will result in a migration of the lunate bone to the volar surface, protruding into the carpal tunnel itself and diminishing the available space within. This results in a structural alteration that is a decrease on flattening of the normally deep “u” shape of the carpal tunnel.
This distortion of the carpal tunnel, when present over an extended period of time will cause compression, irritation and inflammation of the soft tissue structures within, especially the median nerve, the subsequent symptoms of CTS directly related to the use of the wrist after the presence of this functions disrelationship.
The medical treatment of CTS usually begins with an immobilization splint. This splint might be used throughout the day or at night only. Upon this initial treatment protocol failing, a more aggressive approach might be taken. Physical Therapy in conjunction with flexibility exercise might then be used. More extreme forms of treatment include steroid injections and surgery to release the transverse ligaments, however the complications and instabilities that may result should place these treatments as a last resort. Common alternative approaches to traditional treatments might include chiropractic, acupuncture, nutritions, counseling, homeopathy and ergonomic recommendations. If a patient's condition is allowed to progress to the state of diseased tissue, conservative care may then be futile.
When inflammation is severe, immobilization may have limited short-term benefits. However, maintaining lack of motion is counter productive. Current management of soft tissue injuries advocates the rapid initiation of passive movement to prevent the development of adhesions and ultimately permanent scar formation.
Prior art devices do not incorporate concepts of tissue rehabilitation. Devices with elastic straps should be avoided because they compress the radius and ulna together, limiting proper translation upon flexion and extension, and expand the anterior to posterior dimension of the wrist by increasing inter-tunnel pressure. The median nerve is thereby further compressed, additionally, the Vernon forces of the elastic wrist splints are 360 degrees, directly pressuring the already protruding open anterior portion, worsening the symptoms the longer they are used. One big problem with volar designs is that hard material, such as a metal spoon or support, leather, vinyl or canvases make functional use of the hand difficult. One problem in this day and age is computer use. While using a computer one has to use their wrist and fingers, and the hand motion mentioned above would interfere or hinder the use of the wrist and fingers.
It is therefore a principal object of this invention to provide a dorsal carpal tunnel splint which limits wrist flexion and extension during repetitive hand motion.
A further object of the invention is to provide a dorsal design that frees the volar side of any hard material, which would interfere with everyday uses of the hand and which frees the volar side and does not interfere with the wrist and fingers.
A still further object of the invention is to provide a dorsal carpal tunnel splint which will permit the wearer to use their fingers for everyday activities such as writing, typing, driving and grasping, and which can be worn during any repetitive work without injury.
A still further object of the invention is to provide a dorsal carpal tunnel splint which allows the clinician to change the angle of the splint at the wrist to limit flexion or extension.
These and other objects will be apparent to those skilled in the art.
SUMMARY OF THE INVENTION
A dorsal carpal tunnel splint has an elongated stiff splint element having an upper end, a lower end and a center portion. The splint element is arcuate in cross section and has a length and lateral breadth sufficient to engage the outer surface of the lower forearm, the wrist, and the hand of the wearer. First straps are secured to the upper end and the center portion of the splint for securing the splint to the patient's forearm and wrist. A finger strap extends along the lower end of the splint and forms a loop thereunder to receive the fingers only of the wearer's hand and to provide a space for the wearer's thumb outside the loop. A resilient liner pad is secured to an inner surface of the splint element.
REFERENCES:
patent: 5205812 (1993-04-01), Wasserman
patent: 5358471 (1994-10-01), Klotz
patent: 5415623 (1995-05-01), Cherubini
patent: D371845 (1996-07-01), Varn
patent: 5637078 (1997-06-01), Varn
patent: 5746707 (1998-05-01), Eck
patent: 5766142 (1998-06-01), Hess
patent: 5778449 (1998-07-01), Spaulding et al.
patent: 6120471 (2000-09-01), Varn
Hamilton Lalita M
Lucchesi Nicholas D.
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