GB2135888A - Fracture reduction frame - Google Patents

Abstract

A fracture frame which comprises of a grip-like proximal device, a deflector device and a distal pulling force. A supporting cast of plaster of paris is put on the fracture limb first. Then about 10 to 20 days later after the swelling has subsided, the fracture frame is used to reduce the fracture. The fracture frame is used to hold rigidly the proximal cast which has been cut into two along where the fracture is. The lower fractured limb is manipulated under sedation or anaesthesia with the help of the deflector and the pulling force. After each attempt, a lateral and an antero-posterior X-ray is taken. Then further manipulation with the help of the X-ray enable the doctor to realign and reduce the fracture. A few attempts and X-rays may be necessary. The plaster is reunited and the frame removed when the plaster solidifies. <IMAGE>

Description

SPECIFICATION Fracture reduction frame So far doctors reduce broken bones by manual manipulation and then applying the plaster of paris onto the limb or they manipulate the bones by way of pins nailed through the broken bones and anchor ing these pins externally or they operate and plate and screw the bones internally.

My method which is new and requires a new instrument is described and obviously has many medical advantages. The broken limb bones are put in a plaster of paris cast without attempting reduc tion until around 10 - 20 days later when the patient has recovered from the initial shock of the accident, is more fit for anaesthesia or sedation and the limb swelling subsided. The plaster is then cut around completely (using a conventional plaster saw) along where the fracture is and both halves of the plaster casts are held by my instrument in such a way that manipulation of the bones can be attempted by holding on the plaster casts.The upper half of the cast is held in the vice like device (Figure 1,6 7 8 9 10 1112). The lower plaster cast is held in a leather/ canvas harness (Figure 8) (41) with buckles (42 43) and pulled by cord (45).

This device can be adapted to any long bones of the limbs and can be of various sizes depending on the age of the patient.

The bones through the cast can be 'locked' by screws (16) in any position after being deflected by the rods 14 & 15 (Figure 1) and x-rays can be taken with the casts in the frame. Then further manipula tions (using the rods 14 & 15) are attempted with the help of the x-rays taken until the best result is obtained. The plaster cast is reunited by adding more layers of plaster of paris to the cut area. The instrument is then removed from the casts after the added plaster has dried usually in half an hour.

The device has 4 main parts, each part may be modified to serve the same function.

(A) This part (1 2 3 4 5) is a rectangular frame on which the other parts are built.

(B) Thispart(6789101112)gripstheupper part of the plaster of paris cast and holds it firmly. It may consist of one moveable side (7 9 10 11 12) and one fixed side (6 8) or both moveable sides. The grip may be smooth or toothed. By screwing on the parts (12) the grip holds the plaster cast rigidly.

(C) A 'deflector' or deflectors (131415161718 192021 22) which can be locked in position by screws (22) and moveable on (19). Each deflector consists of a square rod (13) which has a square or circular cross section. One rod (15) is used for lateral displacement and the other (14) for anterior posterior displacement of the cast. The deflector can be moved along the frame (1) and anchored by screws (19). This deflector should preferably be made of x-ray translucent or transparent substance like wood, fibre, glass, aluminium or alloy. The deflector is used to 'push' the cast of the lower part of the cut cast and to hold this half of the cast in position. More than one deflector may be used.

(D) A pulling force (23 24 25 26 27) which may be rigid (Figure 6) (19) or non-fixed via weights.and pulley mounted on an adjustable rod (Figure 1). The pulley (26) can be slided along the rod (25) by screwing in (27) which holds the pulley in place. The rod (25) is adjustable by unscrewing (24) held in a bracket (23). The lower end of the plaster cast can be held in position via a leather or metal harness (41) attached to a cord (45). By pulling on the cord (45) the lower end of the plaster cast (46) can be pulled or distracted. The fixed traction consists of a screw (Figure 9) which has an enlarged head (49) fitting movably into a bracket (50) such that by screwing on (47) the cord (51) can be pulled without twisting the cord.A modification to the pulley (26) and weights (52 53) form of traction of the lower end of the cast (46) is as shown in Figure 6 and Figure 7. This consists of 2 rods (32 33) mounted onto the frame (3 and 2) and a connecting rod (39) which is attached to 2 cylindrical tubes (34 34). The horizontal rod (39) may be raised or lowered by locking the screws (35 35). A spool (36) is mounted movably around the rod (39) such that this spool (36) can be rotated to wind the cord (45) which is anchored on the hook (40) on the spool (36). The spool (36) can be locked in position by the screw (38). The spool can be rotated byturning a rod (37).

A major advantage of this fixed traction is that no weights or pulley is necessary.

Another modification (Figure 9) to the traction system consists of a screw (47) which is mounted into a nut (48). This nut (48) is mounted onto the rod (25) (Figure 1) such that by screwing on screw (47) the cord (45 and 51) can be pulled. This cord (45) is attached to the leather or metal harness (41) (Figure 8). The end of the screw (47) is enlarged (49) and is held movably inside a metal bracket (50) such that the cord (45) does not twist when the screw (47 is turned.

Figure 4 shows a modification by which the rod (25) is held. The bracket shown consists of 2 back brackets (28 30) welded together. Each bracket holds on a rod (1 25) such that each bracket individually can be unscrewed along the rods (1 25) by unscrewing the screws (31 29). This arrangement allows independent adjustments on the rods (25 1).

Claims (11)

1. An external bone anchoring element comprising of a vice-like device, a traction device and a deflecting device all holding onto the plaster of paris cast.

2. An element according to claim 1 wherein the plaster is applied to the fracture bones before reduction of the bones and subsequently manipulation is attempted by cutting the plaster cast comes pletely around at the fracture area.

3. An element according to claim 2 wherein the plaster is then reunited after reduction.

4. An element according to claim 1 wherein the reduction is done by holding and then manipulating the halves of the plaster cast on the fractured bones.

5. An element according to claim 1 wherein one or more defecting rods mounted on one or more are used to displace the cast and then used to lock the plaster cast (and the bone contained therein) in a given acceptable position and alignment

6. An element according to claim 2 wherein x-rays are used repeatly to adjust and 'see' to guide the direction of reset manipUlation until an acceptable position is obtained.

7. An element according to claim 1 wherein the traction force on the distal cast could be fixed rigidly or movable (via weights and pulley); the force being applied onto the cast and therefore the bone contained therein.

8. An element according to claim 3 wherein the device supports the cast and 'locks' the aligned bones in the proper position in order for the applied plaster to dry thus joining the 2 halves of the casts.

9. An element according to claim 5 wherein the 'deflecting' device or devices can be centred at the proper area by sliding along the frame and using locking screws.

10. An element according to claim 7 where the direction of the distracting force be adjusted by means of one or more screws.

New claims or amendments to claims filed on 11.10.83 Superseded claims 5-10 New or amended claims:

5. An element according to claim 1 wherein one or more deflecting rods mounted on one or more deflectors are used to displace the cast and then used to lock the plaster cast (and the bone contained therein) in a given acceptable position and align ment.

6. An element according to claim 2 wherein x-rays are used repeatedly to adjust and 'see' to guide the direction of the next manipulation until an acceotable position is obtained.

7. An element according to claim 1 wherein the traction force on the distal cast could be pulled movably (via weights and pulley); the force being applied onto the cast and therefore the bone contained therein.

8. An element according to claim 3 wherein the device supports the casts and 'locks' the aligned bones in proper position while waiting the reapplied plaster to dry thus joining the 2 halves of the casts.

9. An element according to claim 5 wherein the 'deflecting' device or devices can be centred at the proper area by sliding along the frame and using locking screws.

10. An element according to claim 7 where the direction of the distracting force can be adjusted by means of or more screws.

11. A fracture frame substantially as describes herein with reference to Figure 1 of the accompany drawing.