Swivelling fracture orthosis

Details Swivelling fracture orthosis Swivelling fracture orthosis

1999-12-10

2002-01-29

Lewis, Kim M. (Department: 3761)

Surgery: splint, brace, or bandage

Orthopedic bandage

Splint or brace

C602S005000, C602S016000, C602S020000

Reexamination Certificate

active

06342043

ABSTRACT:

BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention relates to a rolling fracture orthesis, especially a humerus fracture orthesis (upper arm orthesis), such as is for example applied after a fracture between the proximal and distal third of the humerus shaft, either on the day of the injury or during subsequent treatment after the initial immobilization dressing has been removed.
2.Discussed of the Prior Art
Ortheses of this type are, for example, described in the leaflet 2/90 “MANUAL for the functional conservative treatment of fractures with the Miami fracture orthesis system according to Sarmiento Latta” from the company Thämert, 30938 Burgwedel. The humerus fracture orthesis presented and described therein, the Miami system, comprises two gutter-shaped half shells that enclose the upper arm between the axilla and elbow and are held together by hook and pile fastener tapes together with plastic loops. These half shells are prepared from perforated, smooth, waterproof plastic and are applied over a double cotton tube previously pulled on from the elbow to the axilla. When applying, the anterior shell is first applied, then the posterior shell, after which two hook and pile fastener tapes set at a distance from each other along one long side are passed through plastic loops on the anterior shell and are then passed through other plastic loops attached at suitable intervals along the second long side of the posterior shell and are turned back by 180° and fastened. The tapes are thus firmly fixed on only one side so that, apart from painful drawing, displacement of the orthesis can be caused. In addition, the orthesis fixed in this way can displace along its longitudinal direction on the underlying cotton tube so that it slips downward, its seating becomes loose and an obstacle to bending the elbow is created. The orthesis then has to be constantly undone and pushed up to the correct position and the tapes fastened again, which can be painful and also may have an adverse effect on the fracture. In addition, the known orthesis provides no control over the movement of the upper arm. A previous plaster cast (immobilization dressing) that is also applied after the fracture possesses a cap that leads over the shoulder. When the patient comes up against the cap during movement of his arm, he knows that he must immediately lower his arm.
In this respect it is to be noted that humerus fracture ortheses, which are increasingly being applied in accident surgery departments and clinics to fractures not surgically treated, have to be manufactured and be available in three or four sizes (S, M, L and XL) and also in versions for the left and right arm. The storage space required for the voluminous shells or hollow bodies in the assembled state is certainly very great when it is considered that a total of eight models (four sizes, each for right and left) have to be stocked.
This leaflet also presents a tibia fracture orthesis (lower leg orthesis) which has a heel cap for fixed positioning of the tibia orthesis. After prior determination of position, the heel cap is fastened to the posterior orthesis shell by non-detachable adhesive strips. If this fixation is not undertaken correctly, readjustment with respect to height of the orthesis or cap angle is no longer possible.
U.S. Pat. No. 4,863,968 also presents an ulna fracture orthesis (forearm orthesis) in which an L-shaped moulded hand limitation cap is attached to the lower shell and ensures that the hand is held approximately perpendicular to the forearm. This hand limitation cap is fixed to the lower shell in the definitive position by ratchet rivets which provide an initial adjustment but do not allow subsequent readjustment.
A device for immobilization and provision of heat or cold to a bodily joint is known from U.S. Pat. No. 4,753,240, comprising a flexible textile cut-out that is placed around the arm or leg and is held together by hook and pile fasteners facing each other on the non-overlapping ends. This shell is very soft not only in the transverse direction but also in the longitudinal direction, except for a thin, central longitudinal segment, e.g. at the heel or shoulder, where an adapted, angled shape can, if required, be applied by the insertion of inelastic, bendable metal rods. A firm, even hold with great longitudinal rigidity that must be ensured on the day of injury or as a follow-up treatment can therefore not be achieved with this known device.
U.S. Pat. No. 4,492,225 describes neck supports and arm splints formed from multilayered material. Thus, for example, for an arm or leg splint some inelastic, easily deformable metal strips, e.g. thin aluminum strips, are applied to the inside of an external hard foam plate and are covered with a thick internal cushioning layer of foam to give a material thickness of at least 25 mm. In addition, the relatively wide-apart, broad margins of the applied supports are held together only by a few short hook and pile fasteners so that in all and not least because of the pliant inner padding about 20 mm thick, adequate longitudinal stability cannot be achieved with these known supports.
A portable buttock and leg splint is described in U.S. Pat. No. 4,580,555 that comprises a long, thin cut-out composed of two layers of Nylon material into which a row of parallel, flat rods are sown in longitudinal pockets. When applying, the patient sits on the orthesis and the two relatively short side margins that do not cover t upper surface of the leg are drawn up and, by means of upper tension bands, fix the leg to the base. Apart from the fact that the flat rods used appear to be relatively broad and are present in only one part of the support surface, the fact that the support incompletely surrounds a limb means that its use as an upper arm orthesis, for example, cannot be sensibly achieved.
U.S. Pat. No. 2,138,975 describes a surgical splint composed of several units, that can be optionally lined up against each other and, through double joints that can be fixed in any position, can be pushed together to form a solid, inflexible plate or folded to form a small packet. Due to the great width of the parts, this known splint cannot be used for a fracture orthesis with a shell that is bend-resistant in the longitudinal direction.
An inflatable arm splint is described in U.S. Pat. No. 1,101,076, composed of a flat, foldable part with long edges that, when wrapped around an injured leg for example, fit together like a tongue-and-groove joint and are held together by a clip to form a pneumatic cuff. This inflatable emergency splint can be used only for a short time until a plaster cast is applied and is not for longer use, especially as it does not ensure adequate longitudinal stability.
A dressing splint is known from DE-GM 1,750,875 with longitudinal metal bars connected by cross-pins and comprising elastic, mat-shaped plastic parts bearing large gaps, and which can be fitted together if required. This elastic dressing splint is applied directly to the limb requiring support, and is held in place by winding round with a bandage. This known dressing splint is not suitable as an orthesis that patients can apply themselves if necessary and that exhibits adequate longitudinal rigidity.
A splint is described in U.S. Pat. No. 2,273,028 that is composed of corrugated, perforated plastic material that is cut out as required, applied and fitted with appropriate bandages for fixation. A provisional splint made from this material cannot be worn for long periods and cannot be re-applied by patients themselves when necessary.
Finally, U.S. Pat. No. 1,964,694 discloses a surgical splint composed of several rigid, perforated shell parts, whereby the shells are aligned together in a transversely adjustable manner by means of a rectangular angle unit together with elongated holes and wing-nuts. This known orthesis cannot be used as a complete orthesis embracing the entire circumference of a limb and providing optimum immobilization.
SUMMARY OF THE INVENTION
The object of the invention is therefore

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