GB2509801A - A splint comprising adjustable collar means and a pad - Google Patents

Abstract

A splint for the stabilisation of limb fractures comprising a spine 12, location means (Figure 1, 13) adapted to locate the spine 12 in alignment with a limb, and an adjustable collar 14, 24, 34. The collar 14, 24, 34 is located on the spine 12 and is adapted to exert pressure on the limb, capable of being applied and adjusted by a clinician. A skin/splint interface pad 14e is also provided that allows liquid and vapour phase water to escape from the skin. Preferably the pad 14e comprises a small mesh textile outer component and a larger mesh substrate. The textile may be on a moulded support that has vents for escaping water. Preferably the pad has an edge region that is curved in profile. The device may be used with a base unit.

Description

Splint This invention relates to splinis For the slahilisation of limb fractures.

IJS6 197800 discloses a splint, particularly for holding a Colles fracture of the wrist in reduclion, comprising First and second collars pivolally supported on a body member and adjustable so as to adjust the internal dimensions of the splint Spaced resilient pads are provided internally so as to exert pressure on the limb held in the splint while allowing vascular flow. Prcssure scnsors, such as electronic sensors, diaphragms and liquid rcservoirs expressing liquid into a visible chamber can warn of undesired pressure build-up so that the splint may he adjusted.

Ihe present invention provides further improved splint arrangements.

The invention comprises, in one aspect, a splint for the stahilisation of limb fractures, comprising a spine, location means adapted to locate the spine in alignment with a limb, and collar means on and adjusiable along the spine adapted to surround and exerl adjustable pressure on the limb at the fracture site, comprising a skin/splint interface pad 21) for direct contact with the skin that allows liquid and vapour phase water to escape from Ihe skin.

Pressure may be applied through a pad comprising the skin-splint intcrface at the fracture sue. Thc pad may contact a spring arrangement diaL moves a pointer to indicale ihe pressure. The spring arrangemeni may comprise a how-ed leaf spring thai Ilatlens under pressure and has a fixed end and a free end that determines the position of a pointer depcnding on the degree of flattening.

The pointer may indicate a pressure in a range centred on a pressure equivalent to 28mm Hg, which corrcsponds to a prcssure at which blood flow will not he undesirably resiricled.

Ihe pressure indicator may be used to adjust the collar during application of thc splint and to indicate the need for lighLening or relaxing as healing progresses. Swelling may reduce, for example, so that the fracture will not be stahilised properly. Swelling, on the other hand, may increase, restricting blood flow.

Desirably, the collar may be locked so as to preclude tampering, releasable by means of a key available to the clinician. lie pressure indication may, howevcr, be visible to thc paticnt alerting to the need to have the splint adjusted.

The pad may comprise a textile material, and Ihe splini including the pad maybe made of such material that it can he immersed in water and will dry off rapidly, permitting bathing or showering.

The splint may comprise a spine, ocation means adapted Lo locate the spine in aiignmenl with a limb, and a first adjustable collar on the spine adapted to immobilise and exert pressure at the fracturc site, in which said location means comprise a second adjustable collar on the spine adapted Lo hold the spine Lo the limb.

At least one of the collars may bc adjustablc lengthways of the spine. The collar or collars maybe slidahle along the spine, which may comprise a raichet into which a pawl of the collar sits releasably for locking. The pawl maybe released by a key.

11) A third adjustable collar may be provided, which may scrve to prevent the splint moving distally along a limb. For a Colles fracture splint, the third collar may comprise a hand support carriage, which may he located adjaceni the lirsi coflar, remoLe from the second collar, and which may he fixed to the spine. The spine may he curved between the fist and third collars correspondingly to the shape of the arm. Right arm and left arm splints will he different of course.

The collars may bc in the form of straps. The straps may locatc in slots and be lockable Lherein by a raichel mechanism, the siraps having raLchet perforations ihal can he slid over a sprung detent on the spine on tightening, hut held thereby against retraction. The 21) sprung detent may be released for adjustment or removal of the straps.

The splint may he used in conjunction with a base unit, to which it may he clamped for application and adjustmcnt of thc splint. Tie base unit may comprise a basc plate with at leasi one sliding carriage thai may bc altached to an adjusLable collar. On such atLachmenL, Lhe adjustable coflar may be released to he movable along the spine, as by use of a key as aforementioned, which may also serve to release the strap on the collar, as by releasing the sprung detent, again as aforementioned.

Such an arrangement may be adapted for single-handed operation by a clinician, insertion of a collar key both releasing the collar for sliding along the spine and releasing the collar sLrap. This leaves Ihe clinician's oiher hand free for LracLion of the limb. This, in turn, means that clinical staff may be used more effectively and efficiently. Treatment of a fracture is swifter and less traumatic for a patient.

The splint including the pad may be made of material that can he immersed in water and will dry off rapidly, permitting bathing or showering.

The splint may he made substantially if not entirely out of recyclable or disposable material. A splint of polypropylene may be incinerated after use, avoiding the risk of passing on infection. The increased cost of the splint as compared to conventional plaster casts is more than offset by the clinician time saved in application and the facility for adjusimenL allords both cflnical and linancial benefits.

One embodiment of a splint for the stabilisation of limb fractures according to the invenLion will now he described wiLh reference Lo Lhe accompanying drawings, in which: Figure 1 is a perspeclive view-@1 a spflni br slahilisalion oF a Colles fracture; Figurc 2 is an exploded view of a pressure pad arrangemcnt, with a pressure indicator, oF the splint oF Figure 1: Figurc 3 is an exploded view of anothcr pressure pad arrangement, with a prcssure indicator, oF the splint oF Figure 1: Figure 4 is a perspective view of a base on which the splint of Figure 1 is located 11) for application and adjustmcnt of the splint, showing the splint prior to location; and Figure 5 is a partial end view of the splint showing a locking arrangement.

The drawings illustrale a splint Ii For the siahilisation of limb fraclures, more specilically for Colles fractures, that is to say, fractures of the radius close to the wrist, comprising a spine 12, and location means 13 adapted to locate the spinc 12 in alignment with a limb, compnsing three adjuslable collars 14, 24, 34 mounied on the spine 12.

21) A Colles fracture is a fracturc of the radius close to the wrist, and adjustable collar 14 is adapted to exerl pressure al the fraclure site, and comprises a pressure indicaLor 17 giving a visible indication that the pressure exerted in relation to a reference pressure. In a Colles fracturc thcrc is posterior displacement and angulation of the wrist and hand, which is reduccd by traction on the hand and pressure al thc liacturc site, Lypically abouL 25mm from Lhe radio-carpal joint. A typical Colles fracture is illusiraled in US61 97800 aforementioned.

The collar 14 comprises a sirap 14a anchored alone end 14h in a base 14c slidable along the spine 12 and, at its other end 14d, inserted in a slot on the base 14c. The base 14c comprises a cushioned pad 14c beneath thc fracture sitc.

Pressure is applied at that site through pads 14f, 14g on the strap 14a by tightening the strap 14a. the pad 14f, shown in invcrted, exploded vicw in Figure 2, acts as the indicalor 17 oF the collar/skin pressure and comprises a spring arrangement 18 LhaL moves a pivoted pointer 19 to indicate the pressure. The spring arrangement comprises a bowed leaf spring iSa that flattcns under prcssure and has an end 1 Sb fixed in the pad 1 4f and a free end 1 Sc wiih a slol I Sd Ihal engages a pin I 9a on Lhe poinler and determines Ihe position of the pointer 19 depending on the degree of flattening. The leaf spring 18a is deprcssed by a spiral spring 22 formed in a covcr plate 21, which is the collar/skin intcrface.

The poinLer 19 is viewed ihrough a sma'l window, nol indicaLed on the drawing, in Lhe pad 14f and appears centrally thereof at a pressure of 28mm JIg, which corresponds to a pressure at which blood flow will not be undesirably rcstrictcd.

The pressure indicator is used to adjust the collar during application of the splint and to indicate the need for tightening or relaxing as healing progresses. Swelling may reduce, for example, so that the collar will bccomc loose and thc fracture will not bc stabiliscd properly. Swelling, on the other hand, may increase, efFectively tighiening the collar and restricting blood flow.

The collar 14 is locked to the spine 12, and the strap I 4a locked in the hase I 4c after application, and after any subsequent adjustment, so as to preclude tampering, especially by the wearer, and releasable, by means of a key available to the clinician, as will be further explained below. The pointer 18 is, however, visible to the patient, alerting to the nccd to have thc splint adjusted.

The pad 16 comprises a textile material, and the splint 11 including the pad 16 is made of such matcrial that all or any part of it can bc immersed in watcr and will dry off rapidly, I 5 permitting bathing or showering.

A sccond adjustablc collar 24 is provided on thc spinc 12, adaptcd to hold thc spinc 12 aligned Lo the limb and keep Lhe lirst collar 14 in correct position. The second collar 24 is similar to the first collar 14, hut larger, fitting the forearm closer to the elbow, and 21) compriscs a strap 24a anchorcd at onc cnd 24b in a base 24c slidable along thc spinc 12 and, at us oLher end 24d, inserLed in a slot on the carriage 24c. The base 24d comprises a cushioned pad 24f.

Pressure is applicd at that sue through an adjustable pad 24g on Uc strap 24a by Lightening the strap 24a in similar Fashion to that oF the coflar 14. The pad 24g, shown in greater detail in exploded view in Figure 3, incorporates a pressure indicator similar to that of collar 14, with a pointcr 19 moved by a leaf spring lSa that rcacts to prcssurc from a spring interface 21.

Collar 24 is locked to thc spinc 12 and thc strap 24a lockcd in thc base 24c in likc manner Lo collar 14.

At thc other cnd of thc spinc 12 is providcd a third adjustablc collar 34, a hand support carriage, adapted to constrain the patient's hand, the spine 1 2 being cranked appropriately -there will, of course, he right and left hand models. This third collar 34 need not be adjustable lcngthwise of the splint, as the othcr two collars can bc correctly positioncd with respect to ii. It serves, of course, to prevent movemenL of the entire splint along the patient's arm.

Whilc thc splint described with rcfcrence to Figures 1, 2 and 3 is clcarly useful on a stand-alone basis, it is dcsigncd to bc uscd in conjunction with a basc unit 51, as illustrated in Figure 4, to which it maybe damped for application and adjustment of the splint. The base unit 51 comprises a base plate 52 with sliding (as indicated by the double arrows) carriages 53, 54 that arc cach attachcd to an adjustable collar, carriagc 53 Lo collar 14, and carriage 54 to collar 24.

The carriages 53, 53 have locating posts 55 corresponding to recesses in the undersides of the collars 14, 24. Like posts 55 are on the base plate 52 to receive the collar 34. A lever 56 on the base plate 52 serves to lock the spine 12 to the base unit 51 for application and adjuslmenL Keyguides 57 are provided on carriages 52, 53 to receive keys 58 that engage sprung delenis or pawls 59 in ihe bases I 4a, 24a. One such pawl 50 is seen in Figure 5 normally biased to engage the serrations in the strap 1 4a to allow it to he tightened hut not relaxed When the key 58 is inserted, the pawl is held out of engagement so that the strap 14a can be relaxed.

Insertion of Ihe key 58 can also unlock the collar 14, 24 From the spine 12 so Ihat ii is capable of axial movement along the spine. however, simply placing the spine 12 on the base unit 51 may also unlock the collars 14, 24 for axial movement.

IS

Using the base unit 51 facilitates single-handed operation by a clinician. With the collars 14, 24 free to move along the spine 12 and the straps 14a, 24a free, the clinician can place Ihe coflars appropriatdy and place Ihe patieni's arm with Ihe straps loose. The siraps can now he tightened using just one hand, leaving the clinician's other hand free for traction of the limb particularly while tightening strap 14a and observing the pressure. This, in Lurn, means that clinical slaft may he used more effectively and ellicienily. Treatment of a fracture is swifter and less traumatic for a patient.

As already mentioned, Ge skinlsplint inLerface pad comprises a lcxLile malerial, nol shown, that aflows liquid and vapour phase water to escape from the skin. The pad component comprises a small mesh textile outer component and a larger mesh substrate.

the textile covers a moulded support that has vents for escaping water. the pad has an edge region 21 a, Figure 3, that is curved in prolile whereby Lo avoid pinch shear oF the underlying tissues. The splint as a whole is made of material that can he immersed in water with no ill effect, so that patients may bathe.

While the splint has been described with particular reference to a Colles fracture splint, it is clear that splints may be designed on like principles for other fractures of human or animal limbs and even for spinal Fractures.

though fairly complex in design, the splint and base unit can be inexpensively fabricated in inexpensive disposable or recyclable malerials such as polypropylene, avoiding the possibility of cross infection through reuse.

Claims (7)

1. Claims: 1 A splint for the stahilisation of limb fractures comprising a spine, location means adaptcd to locate the spine in alignment with a limb, and collar means on and adjustabic along the spine adapted to surround and exert adjuslable pressure on Ihe limb al Ihe fracture site, comprising a skin/splint interface pad for direct contact with the skin that allows liquid and vapour phase water to escape from the skin.
2. 2 A splint according to claim 1, in which the pad component comprises a small mesh texLile ouler component and a arger mesh substrale.
3. 3 A splint according to claim 1 or claim 22, in which the textilc is on a moulded I 5 support Ihat has vents for escaping water.
4. 4 A splint according to any onc of claims 1 to 3, in which the pad has an edge region Ihat is curved in prolile wherehy Lo avoid in use pinch shear oF underlying tissues.
5. 5 A splint according to any one of claim 1 to 4, in which the pad comprises a pad componenl br direcL conia a wiLh Lhe skin thai allows liquid and vapour phase waler to escape from the skin.
6. 6 A splini according Lo claim 5, in which Lhe pad component is made of texiile material.
7. 7 A splint according to claim 6, in which the pad component comprises a small mesh texLile ouler component and a hirger mesh substrale.S A splint according to any one of claims 1 to 7, made substantially or completely oF recydahle or disposable maieriaL 9 A splint according to claimS, made of polypropylene.