GB2156226A - Exo-skeletal splint for hip fractures - Google Patents

Abstract

A fracture splint, suitable for example for trochanteric fractures, comprising an adjustable girdle (1) for locating it on the patient's body, the girdle supporting an elongate member (5) including means (3, 4) for restraining limb movement and incorporating an anchorage enabling pressure to be applied to the fracture area. The girdle may comprise two adjustably interconnected, moulded segments (6, 7) engageable with the patient's iliac crest, one segment (7) supporting anchorage points (13) for straps (14), the tension in which urges a pressure pad (2) against the fracture area, and the other segment (6) having mounted on its semi-rigid rod (5) supporting along its length the pressure pad, a knee retainer (3) and a foot clamp (4). <IMAGE>

Description

SPECIFICATION Exo-skeletal splint for hip fractures This invention relates to splints for bone fractures and in particular to femeral (trochanteric) fractures and the avoidance of hip joint dislocations.

Exo-skelatal splints are known in which one or more elongate members are strapped around a patient's limb to provide support. Various support members have been used, such as rigid rods, rods having a limited flexibility or inflatable flexible tubes whose degree of rigidity can be adjusted. Such support members can be strapped directly to a patient's damaged limb or can be located within pockets provided in a flexible garment enclosing the damaged limb. When used for a trochanteric fracture, these support rods are extended and are strapped round the waist and below the knee of the patient. Such devices have however not been capable of providing a controllable support to the fracture area or a variable control over limb movement, these being highly desirable if the patient is to be allowed to become mobile as soon as possible after the fracture has occurred.

This invention therefore consists of a fracture splint comprising an adjustable girdle for locating the splint on a patient's body, said girdle supporting an elongate member which includes means for restraining limb movement and an anchorage enabling pressure to be applied to the fracture area.

The said girdle may conveniently comprise two moulded segments which are engageable with the iliac crest and which are adjustably interconnected.

In this embodiment, a first girdle segment may incorporate means for supporting the elongate member which in turn supports a trochanteric pressure pad and means for restraining limb movement, whilst a second girdle segment may incorporate one or more anchorage points from which extend straps the tension in which urges the pressure pad against the fracture area. The means for restraining limb movement may conveniently comprise a semi-rigid rod adjustably fixed to the first girdle segment and supporting at points along its length a knee retainer, whereby movement of the leg around the knee joint relative to the rod is restricted, and a foot clamp preferably incorporating a "Y-strap" whereby rotation of the foot is minimised. The semi-rigid rod may conveniently also support the pressure pad for applying pressure to the fracture area.

By way of example, one embodiment of the invention will now be described with reference to the accompanying perspective drawing of a splint constructed in accordance with the invention and adapted for use with a patient suffering from a fracture to the left femur.

The splint consists of pelvic reaction girdle 1, a pressure pad 2, a knee retainer 3 and a foot clamp 4 all adjustably mounted on a rod 5. The rod 5, which may be cut to a length suitable for the patient in question, is made of nylon (rtm) and is of square section so that the components mounted thereupon do not rotate easily about the axis of the rod. The rod conveniently passes through clamps (not shown) bolted or riveted to the other components of the splint, which incorporate locking screws which can be tightened to prevent movement of said components along the rod once the correct location for the particular patient has been established. The foot clamp may be bolted without means of adjustment directly to the lower end of the rod so that adjustment of the position of the other components is relative to the foot clamp.

The pelvic reaction girdle 1 consists of two polypropylene segments 6 and 7 heat-formed so as to engage the iliac crest of the patient in a similar manner to the "Boston Brace", and interconnected by four polypropylene straps 8, two on each side.

The segment 6 incorporates the bracket through which the rod 5 passes and also one polypropylene strip 9 mounted along each lateral edge. The strips 9 are each shaped to form two slots 10 when anchored to the segment 6 by three rivets 11.

The four polypropylene straps 8 are riveted at one end to the segment 7 and, when the girdle is worn by the patient, passed through respective slots 10. A nylon strap 12 mounted on each strip 8 also passes through the respective slot 10. Mating "velcro" portions are mounted on each nylon strap 12 so that after each strap 12 has been pulled through its respective slot 10, it may be doubled back and retained in position by the velcro fastener whereby the girdle is held snugly around the patient.

The girdle segment 7 has four anchorage studs 13 for four elastic straps 14 which pull the pressure pad 2 against the fracture site. The pressure pad 2 consists of a heat-formed curved polypropylene plate incorporating a bracket (not shown) for attachment to the rod 5, and four studs 15 to which the other end of the elastic straps may be attached.

The elastic straps 14 are each provided with two adjustable clasps 16 which can engage on the studs 13, 15: when worn by the patient, adjustment of the straps 14 within the clamps 16 varies the tension in the straps and hence the pressure exerted by the pressure pad on the fracture site. The loose ends 17 of the straps may conveniently be retained within loops 18 on the main portion of the straps.

The knee retainer 3 is heat-formed from an Hshaped polypropylene sheet incorporating the clamp (not shown) for the rod 5. Loops 19 are mounted on two of the arms of the retainer whilst straps 20 including two mating velcro (rtm) strips 21a, 21 are attached to the other arms. In use, the vertical position of the knee retainer is adjusted on the rod 5 so that the "arms" of the retainer are located respectively above and below the knee cap, and the straps 20 are pulled through the respective loop until the retainer is sufficiently tight. The straps 20 are then doubled back whereupon they are retained in place by the velcro fastener.

The foot clamp 4 consists of a rigid sheet of aluminium bent at right angles to form a heel plate 22 and base plate 23. The rod 5 is fixed to the heel plate 22 either directly by bolts or adjustably by passing through a bracket mounted on the heel plate. Three straps 24 are mounted on the foot clamp to form a "Y-strap" by which means rotation of the foot is reduced. Two straps, which may convenienily be formed as a single piece, are elasticated and fixed to studs mounted on the heel plate via adjustable clasps; the third strap 24 is riveted to the base plate and to the other straps. A rubber sole 25 is affixed to the underside of the base plate.

The entire inward-facing surfaces of the pelvic reaction girdle, pressure pad, knee retainer and foot clamp, i.e. the parts which are in contact with the body, are faced with a layer 26 of a closed polymeric cellular material such as that distributed under the name "Evazote" so as to reduce wearer discomfort, and are further covered by a removeable Iambswool cover (not shown).

It is found that if the rod 5 is about 15mm square, the splint has sufficient rigidity for most purposes.

For heavier patients or to give extra rigidity in the early part of the healing process, a sleeve of aluminium or other material having a big stiffness/ weight ratio may be affixed to the rod - this may be removed at a later date when control at the fracture site may be reduced.

Claims (6)

1. A fracture splint comprising an adjustable girdle for locating the splint on a patient's body, said girdle supporting an elongate member which includes means for restraining limb movement and an anchorage enabling pressure to be applied to the fracture area.

2. A fracture splint according to Claim 1 in which the said girdle comprises two adjustably interconnected, moulded segments which are engageable with the iliac crest of the patient.

3. A fracture splint according to Claim 2 in which a first girdle segment incorporates means for supporting the elongate member which in turn supports a trochanteric pressure pad and means for restraining limb movement, and a second girdle segment incorporates one or more anchorage points from which extend straps, the tension in which urges the pressure pad against the fracture area.

4. A fracture splint according to any preceding claim in which the means for restraining limb movement comprises a semi-rigid rod fixed to the girdle and supporting at points along its length a knee retainer, whereby movement of the leg around the knee joint relative to the rod is restricted, and a foot clamp incorporating straps for controlling rotation of the foot.

5. A fracture splint according to Claim 4 is which the semi-rigid rod also supports the trochanteric pressure pad.

6. A fracture splint substantially as herein before described with reference to the drawing.