Surgery: splint – brace – or bandage – Orthopedic bandage – Splint or brace
Reexamination Certificate
2000-01-05
2002-08-27
Weiss, John G. (Department: 3761)
Surgery: splint, brace, or bandage
Orthopedic bandage
Splint or brace
C602S004000, C602S019000, C602S020000, C002S044000
Reexamination Certificate
active
06440094
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention relates to orthopedic braces, splints and bandages or the like, and, more particularly, to an elastomeric, orthopedic garment for disorders associated with the upper extremity, including the shoulder girdle. An orthopedic garment in accordance with the invention is provided for supporting and stabilizing the spine and/or one or more given articulations of the upper extremity that have a given disorder, malalignment and/or dysfunction, including without limitation dynamic scapular and acromio-clavicular stabilization, as well as dynamically enhancing proper posture. In other words, the given articulations include but are not limited to a group of joints or ligaments comprising the acromio-clavicular articulation, the coraco-clavicular ligaments, the shoulder joint, and the sterno-clavicular articulation. A central bone among this group of joints and ligaments is the shoulder blade bone, more properly called the “scapula.”
2. Prior Art
As various terms of art are used in this written description, some more difficult than others, what follows is a brief overview of the pertinent anatomy, as presented and explained with general reference to
FIGS. 1 through 5
.
The bones that constitute the “upper extremity” of the human body consist of those of the shoulder girdle, the arm, the forearm and the hand. The shoulder girdle itself consists of two bones, the clavicle and scapula.
FIG. 1
shows a rear view of a left scapula
20
. The left scapula
20
, as representative of a right scapula, is a large, generally flat or planar bone, triangular in shape, situated on the back of the rib cage (not shown) at an upper left border. The scapula
20
generally defines a plane; however, close examination reveals that the scapula
20
is slightly convex (from the rear view vantage point of FIG.
1
). The scapula
20
's rear surface is subdivided unequally by a spine
22
into two parts. The scapula
20
extends left to right in
FIG. 1
between an internal or vertebral border and an external or axillary (i.e., arm pit) border. The spine
22
originates near the internal or vertebral border, and increases in mass as it extends to the external or axillary border, to where, at the margin of the external border, the spine
22
diverges from the plane of the scapula
20
and projects outward or beyond the external border to terminate in a prominence of bone mass, or a bone process formally called the acromion process
24
.
The acromion process
24
is formed on its front surface with a concavity (not in view, but occurring at the position indicated by arrow
26
) that forms an articulation with the outer extremity of the left clavicle
34
(not shown in
FIG. 1
, but see FIG.
2
). The external or axillary border of the scapula
20
is formed with a cavity
36
called the glenoid cavity. The glenoid cavity
36
is spaced downwardly and slightly forwardly from the acromion process
24
and is the socket which forms the articulation with the humeral head
38
or “ball” (see
FIG. 2
) in the ball-and-socket joint of the shoulder. Above and in front of the glenoid cavity there is another prominence of bone mass or bone process, called the coracoid process
42
.
FIG. 2
shows various articulations of the upper extremity, including the acromio-clavicular articulation
44
, the coraco-clavicular ligaments
46
, and the shoulder joint. The acromio-clavicular articulation
44
is formed between the outer extremity of the clavicle
34
and the front surface of the acromion process
24
, and the ligaments of this articulation are collectively called the acromio-clavicular ligaments. The coraco-clavicular ligaments
46
serve to connect the clavicle
34
with the coracoid process
42
of the scapula
20
.
The shoulder joint, as previously mentioned, is a ball-and-socket joint formed by the large globular head of the humerus
38
, and the glenoid cavity
36
in the scapula
20
, which receives the humeral head
38
. The ligaments of the shoulder include a capsular ligament, a coraco-humeral ligament, a glenoid labrum (not shown), as well as the long tendon from the biceps. The capsular ligament generally encircles the ball-and-socket structure, and extends between the circumference of the glenoid cavity
36
in the scapula
20
and the anatomical neck of the humerus. The coraco-humeral ligament is a broad band which reinforces the upper part of the capsular ligament. The glenoid labrum (not shown) is a rim attached round the margin of the glenoid cavity. The long tendon of the biceps inserts as shown and becomes continuous with the glenoid labrum.
FIGS. 3
,
4
a
and
4
b
show the muscles of the upper trunk, in which
FIG. 3
shows the muscles of the upper back and
FIGS. 4
a
and
4
b
the front of the chest.
With reference to
FIG. 3
, the muscles of the back are numerous and are for classification purposes subdivided in five layers, only the outer two of which are pertinent here. In the outermost layer is the trapezius muscle
48
which covers the upper back and part of the neck and shoulders. It has an elongated inner border that has an upper termination at the base of the skull and a lower termination down at the base of the dorsal vertebrae, and thus spans the length therebetween adjunct to all the cervical and dorsal vertebrae. From this inner border, the fibers of the trapezius muscle
48
converge as they extend outwardly, to converge on the inner margin of the scapula
20
's spine
22
and acromion process
24
. In the next layer are the rhomboid muscles
52
, which extend in a flat band from an origin or inner border on the spinous process of generally the upper dorsal vertebrae, down and out to an outer extreme attached to the inner border of the scapula
20
.
FIG. 4
a
shows that the muscles of the chest and shoulder area include the pectoral and the deltoid muscles
54
,
56
and
58
. The pectoralis major muscle
54
has a curved origin or inner border ranging from about the mid-point of the clavicle, and from there arcing in and down about as far as half-way down the sternum
60
. The pectoralis major muscle
54
terminates in a flat tendon which is inserted into the humerus (see FIG.
2
). The pectoralis minor muscle
56
(see
FIG. 4
b
), which is covered by the pectoralis major muscle
54
, terminates in a tendon attached to the coracoid process
42
of the scapula
20
. The deltoid muscle
58
, as shown by
FIG. 4
a
, gives the rounded outline to the shoulder. Its name comes from its inverted-&Dgr; shape. The deltoid muscle
58
has an extensive origin that arises from (i) the outer third of the clavicle
34
, (ii) the acromion process
24
of the scapula
20
, as well as from, (ii) the spine
22
of the scapula
20
. From this extensive origin the fibers of the deltoid muscle
58
converge to form a tendon inserted in the shaft of the humerus.
FIG. 4
b
shows an inner layer of muscles of the chest, shoulder and arm area. The long tendon of the biceps attaches to the upper margin of the glenoid cavity
36
of the scapula
20
. The short tendon attaches to the coracoid process
42
. The serratus anterior (also serratus magnus) muscle
62
originates on the vertebral or inner border of the scapula
20
(refer to FIG.
1
), and from there hugs the rib cage to extend to an opposite end where it terminates in a series of fingers attached to the ribs. The subacromial bursa
64
(along with the rotator cuff, discussed below) occupies the interspace between the humeral head
38
and the acromion process
24
, and facilitates gliding therebetween. The subscapularis muscle
66
has a diverse origin, but it primarily originates in the subscapular fossa of the scapula
20
(see reference numeral
68
in FIG.
2
). From its diverse origin, the subscapularis muscle
66
converges into a tendon attached to the front of the humeral head
38
.
FIG. 5
shows the outer extremes of each of the supra-spinatus muscle
70
, the infraspinatus muscle
72
, and the teres major and teres minor muscles
74
and
76
. The outer extremes of each
Bay Jonathan A.
Truong Linh
Weiss John G.
LandOfFree
Orthopedic garment for dynamically enhancing proper posture does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Orthopedic garment for dynamically enhancing proper posture, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Orthopedic garment for dynamically enhancing proper posture will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2890070