Splint

Details Splint Splint

1997-03-05

2001-01-30

Yu, Mickey (Department: 3764)

Surgery: splint, brace, or bandage

Orthopedic bandage

Splint or brace

C602S005000, C128S878000

Reexamination Certificate

active

06179800

ABSTRACT:

BACKGROUND OF THE INVENTION
The present invention relates to a splint for a fractured limb and in particular to a more efficient method of holding a fractured limb, such as a wrist, in reduction. The most common used method of maintaining reduction of a stable Colles' Fracture is by the use of a plaster cast. It is inexpensive and can be efficiently applied to the patient's limb. However, it does not offer any indication to the clinician applying the cast of the intra-cast pressures that may lead to compartment syndrome. Once the cast is set it is difficult to adjust. If the clinician then finds the fracture site is misaligned the cast must be redone. There is no easily made adjustment that allows loosening to accommodate swelling of the forearm and wrist, or tightening of the cast as the swelling reduces.
BRIEF SUMMARY OF THE INVENTION
The proposed preferred method of maintaining of Colles' fracture, a specific type of fracture, involves the use of a modular adjustable outer casing. This casing has a locking mechanism which can easily be adjusted by the clinician, but tamperproof by the patient. The adjustment is in small steps to allow objective recording of the splint settings. There are preferably three sizes of casing, covering a similar anthropometric range to that of functional bracing commercially available. The common incidence of Colles' fracture across the population is a further factor in detailing the splint dimensions. The internal contours of the casing are designed so as to avoid creating a complete collar around the limb. This feature gives a path for the flow of fluid from the trauma site, avoiding pressure build up.
BRIEF SUMMARY OF THE INVENTION
There is also preferred stepped adjustment of the hand support in the lateral and median planes. This support incorporates some adjustment to allow limited movement of the hand in palmar flexion, but not dorsiflexion, and lateral movement in both adduction and abduction. The flexibility of cast positioning gives the clinician more options to balance the maintenance of reduction of the fracture components and allowing movement of the forearm and hand promoting muscle tone. It can also reduce swelling conventionally occurring with Colles' fractures by promoting vascular flow induced by hand movement.
Plaster casting is recognized as providing poor maintenance of reduction. Other treatments, such as external and internal fixation, pose other post-reduction problems especially in relation to the elderly who may have poor bone structure due to Osteoporosis which does not provide a suitable site to hold the fixtures.
GB-A-2,156,226 discloses a fracture splint, suitable for example for trochanteric fractures, comprising an adjustable girdle for locating it on the patient's body, the girdle supporting an elongate member including means for restraining limb movement and incorporating an anchorage enabling pressure to be applied to the fracture area. The girdle may comprise two adjustably interconnected, molded segments engageable with the patients iliac crest, one segment supporting anchorage points for straps, the tension in which urges a pressure pad against the fracture area, and the other segment having mounted on it a semi-rigid rod supporting along its length the pressure pad, a knee retainer and a foot clamp.
According to an aspect of the present invention, there is provided a splint for supporting a fractured limb comprising a rigid outer casing including a plurality of spaced pressure sites located at the inner surfaces of the casing and operative to apply pressure to a limb to be supported while retaining a vascular flow path; longitudinally spaced proximal and distal collars, each provided with one or more pressure sites, said proximal and distal collars being spaced so as to envelop a common bone of the limb and being independently adjustable relative to one another so as to provide independent adjustment of the internal dimensions of the casing. This splint can be designed so as not to hinder tendon function and to allow space for free vascular flow, which can reduce swelling. It can also reduce reflex sympathetic dystrophy, nerve entrapment and compartment syndrome. The proximal and distal collars can provide visual access to the limb.
The pressure sites are preferably provided by resilient pressure pads located on the inner surface or surfaces of the casing. Each pressure pad can be individually chosen or adjusted to provide the appropriate individual pressure for its particular point of application. For example, some points of the limb may benefit from more pressure than others and vice versa. This is not possible with a conventional cast.
In the preferred embodiment, the splint comprises means to support the limb so as to allow limited movement of the limb extremity or extremities. The term extremity is intended to include a hand or foot or the like. Allowing movement of these body segments can reduce swelling commonly occurring with Colles' fractures by promoting vascular flow through movement of the extremity.
The splint may include pressure sensing means for sensing pressure exerted on one or more of the pressure sites. The pressure sensing means may be incorporated in one or more pressure pads.
In one embodiment, the pressure sites are adjustable in dependence upon the sensed pressure to adjust the pressure produced thereby.
According to another aspect of the present invention, there is provided a splint for a fractured limb comprising longitudinally-spaced proximal and distal collars and means for supporting a hand, foot or other body segment in relation to another as appropriate at the side of the distal collar remote from the proximal collar.
In preferred arrangements the collars are individually adjustable; in addition there are rigid interconnections between the collars and between the distal collar and the hand, foot or other body segment support.
According to another aspect of the present invention there is provided a splint for a fractured limb comprising at least one collar, the collar comprising an internal pad or cell, and means for sensing the pressure exerted on said pad or cell.
Preferably there are at least two collars and each collar has a plurality of pressure sensing means. In the light of the pressure sensed, the size of the collars and/or the pressure applied by said pads or cells may be individually adjusted.
According to another aspect of the present invention there is provided a method of adjusting a splint in accordance with the second aspect wherein the adjustment is made in dependence upon the sensed pressures. This method may be used during development of a splint, to determine the pressure to be applied at the various pressure sites. Subsequent splints may then omit any pressure sensing means.
Preferred embodiments may have one or more of the following features:
A rigid outer casing which is adjustable by a measured amount to accommodate a variation in dimensions within a section of the anthropometric range of the population.
A number of standard component sections which may be added to for specific holding positions after treatment. These sections may be removed as part of rehabilitation therapy.
One or more axes of adjustment dependent upon the holding position required.
A measurable adjustment achieved through the use of a spigot locating within a number of recess options available. This will result in a change in dimension of the splint by a known amount. This allows objective records to be kept of treatment given to a patient.
An outer casing which can be adjusted and a pressure indicator/alarm which can be reset without removal or replacement of the splint.
Incorporated within the outer casing are a number of pressure indicators. These are located where the holding pressures will be applied to the fracture site and the surrounding areas where the splint is supported on the body. The pressure indicator may comprise a small electronic pressure sensor, a mechanical diaphragm, or a reservoir with liquid which above a specified pressure, tr

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