US14853A

US14853A - Surgical splint

Info

Publication number: US14853A
Authority: US
Publication date: 1856-05-13
Anticipated expiration: 1873-05-13

Description

UTE SATES PA N JOHN CLOUGH AND DANIEL M. CUMMINGS, OF NORTH ENFIELD, NEYV HAMPSHIRE.

SURGICAL SPLINT.

Specification of Letters Patent No. 14,853, dated May 13, 1856.

To all whom t may concern Be. it known that we, JOI-IN OLOUGH and DANIEL M.' CUMMAINGS, both of Enfield, in the county of Grafton and State of New Hampshire, have invented a new and useful Machine fo-r th-e Reduction and Setting of Fractured Limbs, which we call Clough and Cummingss Improved Splint and we do hereby declare that the following is a full, clear, and exact description of the same, reference being had to the annexed drawings, making a part of this specification, in which- Figure 1, is a perspective view of the entire machine. Fig. 2, is a view of the lower portion or bed-pieces, exhibiting in part the device by which the splint is expanded and contracted at the knee for the purpose of adapting it to the size of the limb to be operated upon. Fig. 3, is a view of the lower extension screws with their supports, traversing nuts and their attachments. Fig. 4, is a view of the elevating screw with its supports, the cross-bar through which it passes, and its connections and attachments. Fig. 5, is a view of one of the upper extension screws exhibiting' the forni of its head, with the bolster resting in it; which bears upon the perineum. Fig. G, is a view of one of the lower extension screws and its journals or bearings. Fig. 7 is a view of the femur or thigh splint. Fig. 8, is a view of one of the oblique standards composing a part of the foot frame. Fig. 9, is a view of the elongating arbor with the cancave flooring for the support of the femur attached, and also the movable braces constituting a part of the combination for the elevation and depression of the knee thereby causing a corresponding flexure and extension of the limb. Fig. 10 is a view of the` elongating arbor with its semi-circular complement, showing a mode for the indefinite extension of th-e arbor. Fig. 11, is a view of one of the clamps used in fastening the femur splint to the leg and femur side pieces. Fig. 1Q is a view of the wrench used in op? erating the various screws. Fig. 13, is a view of the splint as practically applied for a fracture of the limb below the knee. Fig. 14C, is a view of the splint as practically applied to the limb for a fracture, or dislocation, of the thigh. Fig. 15, is a view of the brass straps placed on each side of the ma chine at the joint corresponding with the knee, with slots at each end for the reception of straps attached to bandages applied above or below the knee.

The various letters represent identical parts of the machine in all the various tigures.

A, A', are the leg side pieces of the splint below the joints R, R. For lightness and convenience we make them of firm and durable wood, two feet four inches in length, one and a fourth inches in depth, and three fourths of an inch in width.

F, F, are the upper femur side pieces, made also of suitable wood, seven inches in length, and of the depth and thickness of A, A, to which they are connected by the joints BLR.

B, C, D, are the bed-pieces, made of the same material, two feet eleven inches in length, B, and D, being one and a tenth inches in depth and one and a fourth inches in width at their extremities, and C, being one and a tenth inches in depth and two inches in width. The bed-pieces B, and D, are connected with the leg side pieces A, A, by the braces t, t, and the supports m, m, and with the femur side pieces F, F, by the lsupports 0, 0, and the bed-piece O, is connected with the cross-bar M, by the supports y, y and the elevating screw c, and by them, with the leg` side pieces A, A.

E, is the femur or thigh splint, constructed of strong and durable wood, three feet in length, one and a fourth inches in depth, and three fourths of an inclrin width.

G, is an adjustable cushion of wood, attached to the femur splint E, by the clamp n at the lower end, and in the upper end having a wooden or metal pointl projecting from the back side, which moves in the groove s s. 'It may be made in the form represented in Fig. 7, live inches and a half in length, and two and a half inches in width; or the form and dimensions, and material may be varied as may be deemed best by the operator.

H, is a stationary cushion, of wood, permanently attached by screws to the upper end of the femur splint E, ten and a quarter inches in length and two and a half inches in width, having at its upper end two slots or apertures t t, t t, for the reception of straps attached to bandages. The form, dimensions, and material, of this cushion may also be varied at the pleasure of the operator.

I, I, are oblique standards composing thel sides of the foot rest, or frame, attached by the clamps a, a', to the leg side pieces A, A', upon which they are movableandmay be firmly fixed by means of the thumb screws g, g', as the length of the limb operated upon may require. They may be made of wood, and should project six inches and a half from the leg side pieces A, A'

P, is a wire bow attached to the oblique standards I, I', by the staples z, a', and assists in protecting the foot from the weight of the bed clothes.

` J, is a cross-bar at the foot of the splint, six and a half inches in length, which connects the leg side-pieces A, A', to the ends of which it is confined, not very firmly, by screws, or by tenons and mortises. It also supports the head bearings of the lower extension screws c, e', both of the latter passing through it. K, is another cross-bar, in which the extreme bearings of the lower extension screws c, e', are supported. Its tenons a a, a a', rest in loose mortises in the leg side pieces A, A', in order to allow of the expansion and contraction of the splint for the admission of limbs of diiferent sizes.

e, e' are what we denominate the lower extension screws. They are made of brass three and three fourths inches in length and one fourth of an inch in diameter, confined to the cross-bar J by the nuts or washers. They are used for the purpose of extending the limb, when fractured below the knee, to

that degree of tension which will enable the operator to adjust the fracture without difliculty.

y', j', 4are traversing nuts afiixed to the screws e, e', upon which they are movable, to which are attached the inferior extension straps m, connected by the buckles n n, n n', to the superior extension straps m" 00"', which are attached to the bandages Q.

76, k', are brass guides for the direction of the traversing nuts y', j'.

z', e", are brass supports for the bearings of the lower extension screws c, e', the screws and their various attachments and appendages being distinctly shown'in Figs.` 3, and 6, and the practical application and operation of the same in Fig. 13.

M is a cross-bar attached by the cross supports b, b', to the leg side pieces A, A', having in its center a nut or female screw b b, through which the elevating screw c, and upon which the cross-bar and nut traverse backward and forward, forming with the leg side pieces A, A', the femur side-pieces F, F', the joints R, R', the elongating arbor T, the concave flooring N, the supports m, m', and 0, o', and the braces t, t', and its own supports y, y', the combination or device by which the leg side pieces A, A', and the femur side pieces F, F', are raised and depressed, causing corresponding elevations and depressions of the limb operated upon,

at the knee joint, as the ease and comfort of the patient may require.

C, is the elevating screw, which, with its supports, nut, and cross-bar M, is more distinctly seen in Fig. 4. lts length is five and three fourths inches, and its diameter three eighths of an inch. It is also of brass, and in form precisely like the elongating screws e, e', as seen in Fig. 6.

f, f', f", are the heads of the screws e, e', and c, constructed in such form as to lit the apertures in the wrench shown in Fig. 12.

p, p, represent the superior and f f, the inferior bearings of the same screws.

u u is the cap by which the superior bearing of the screw c, is confined to its support y'. The supports y, y', the cap u u, the support-s b, b', and the nut o b, should be made of brass or other suitable metal.

CZ d, Z d', are mortises in the cross bar J, through which corresponding levers upon the leg side pieces A, A', pass, of sufficient size to allow of slight lateral mot-ion in the cross-pieces.

a a, a a', are tenons upon the cross-bar K, inserted in corresponding mortises in sidepieces, A, A', of sufficient size to allow of the easy lateral motion of the side pieces upon the tenons when necessary to expand or contact the splint.

R, R, are joints constructed like the joint of the common carpenters rule, connecting the leg side pieces A, A', with the femur side lpieces F, F', in precise juxtaposition with which the knee joint of the patient should be placed when his limb is operated upon.

1', r', are what are denominated the upper elongating screws. They are constructed o f brass, or other suitable metal, and are ive inches in length, and four tenths of an inch in diameter. They pass through the brass nuts m, m as', into the extremities of the femur side pieces F, F'. They are constructed with a circular' opening on their heads to admit the tenon of the bolster L, and with circular openings on the sides of their heads for the admission of the extremity of the handle of the wrench by which they are operated. The form of their construction, together with that of the bolster L, may be more distinctly seen in Fig. 5.

L, is a bolster of wood, resting against the perineum, the tenon of which is inserted in either of the upper extension screws as the right or left thigh is operated upon, and aiding in its extension.

N, is a concave flooring for the support of the femur, to which is attached a brass lip g g, by which it is confined to the elongating arbor T. n

m, m', are brass supports projecting two and three fourths inches from the joints R, R', at the lower extremities of the femur side pieces F, F', to which the upper ends are firmly fixed, the lower ends serving as supports for the bearings u, u', of arbor T.

0, o', are brass supports projecting three and a half inches from the lower side of the upper extremities of the femur side pieces F, F', in which their upper ends are firmly fixed, their lower ends being confined to the bed-pieces B, and D, by the screws o o, 0 0", the latter serving` as axes upon which they partially revolve.

T, is what we denominate an elongating arbor, composed in ordinary cases of the two pieces fw, w', constructed of iron or steel, in the form of half cylinders nearly their whole length, as seen in Figs. 9 and 10. )Vhen necessary for greater elongation in order to accommodate the splint to a large sized limb, we insert another half cylinder Q g, as seen in Fig. 10. The various parts of the arbor are compressed together firmly by the clamps m m, m m', operated by the thumb screws fu, o'. They serve also to confine the lip g g, projecting from the concave fiooring N.

u, u', are the spiral bearings of the arbor T.

t, t', are elevating braces, of brass, four and three fourths inches in length, attached at their upper extremities to the bearings u, u', upon which they partially turn as upon axles, the lower extremities being attached to the bed pieces VB, and D, by the screws Z Z, Z Z', upon which they partially revolve.

s, s', are nuts by which the upper ends of the braces t, t', are confined to the bearings u, u'.

The arbor T, with its various parts and connect-ions, together with the concave flooring N, are more particularly shown in Figs. 1, 9, and 10.

s s is agroove in the thigh splint E, in which the cushion G, is made to move, and to adapt itself to the limb operated upon, as seen in Fig. 7.

'17 n', are clamps used for rmly confining the thigh splint E, to either of the side pieces F, F', as the right or left leg is operated upon.

n" is the clamp by which the cushion G, is adjusted and confined to the splint E.

ZL, 7L', h', &c., are strips of strong cotton cloth passing through the slots um, ui", u", &c., in which their ends are confined by pins passing through the leg side pieces A, A', as represented by the points seen on their upper surfaces. They serve as the bed on which the limb reposes when the splint is applied. h h, is also a strip of strong cotton cloth passing through slots e' z', z' i', in the oblique standards I, 1', and confined in the same manner. foot.

V, V', are brass straps with slots for the It serves as a rest for the reception of attachments to bandages, fastened by screws, or rivets at the lower ends of the femur side pieces F, F, upon which they are allowed to revolve wholly, or partially, as necessity or convenience may require. A view of the form of one of them is given in Fig. 15.

(Z is an elongated tenon passing entirely through corresponding mortises in the bed pieces B, C, and D, to which the bed pieces. B and D, are confined by the pins r 1, r r', and upon which they partially turn, as it may be necessary for the expansion or contraction of the upper portion of the splint. In order to allow of this motion of B, and D, it is necessary that the latter should be confined to the tenon CZ, at a sufficient distance from C, and that the mortises through which the tenon passes should be loose enough to admit of free and easy motion.

y' y', j j', are double elongated tenons permanently fixed in bed pieces B, and D, and passing through the mortises w w, (which should be sufficiently loose to admit of easy motion) in the bed piece C, by which the bed pieces B, and D, may be expanded or contracted, as may be required for the admission of the limb to be operated upon, the tenons being fastened at the necessary point by the confining pin ,7a k, the tenon (Z, and the tenons j y', j j', and their mode of operation are more particularly represented in Fig. 2.

Q, is the ankle bandage connected by straps and (one of which only is seen) to the straps and 0a' attached to the reversing nuts j, j', by which the lower lip is extended, as seen in Fig. 13.

O, is the bandage applied below the knee when necessary for the extension of the lower leg as seen` in Fig. 13, and above the knee when nesessary for the extension of the thigh, as seen in Fig. 14.

S, S', (the latter not being seen) are straps attached. to the upper edge of the bandage O on the sides of the limb, and pass through the slots e' z' z', z' z' z", (the former only being represented) in which they are confined by wires or buckles as may be deemed best.

.e z, e e', are straps attached to the lower edge of the bandage O, on both sides of the limb, and are confined in the slots of the brass straps V, V', as seen in Fig. 14.

U, is a cushion bandage passing around the thigh, and through the slots t t, t t', in the cushion H, as seen in Fig. 14. It bears upon the perineum, and assists in extending the limb and keeping it securely in place.

Te apply our splint in the following manner: 1f the fracture is between the ankle and the knee, the limb is placed in the splint, the knee joint being placed precisely in juxtaposition with the joints R, R', and the bandages are attached as seen in Fig. 13. The limb being firmly confined below the knee by the bandage O, and above the ankle by the bandage Q, is then gently extended to the point necessary to enable the operator to adjust the fractured bones, by means of the extension screws e, e', and their various attachments, as above described. In this position it may be straightened, if necessary, by straps passing around the limb, and either of the leg side pieces A, A, as it may be necessary to draw the limb to the right or left. By the means above described, the limb is kept in the precise position desired by the operator.

If the fracture is of the thigh bone, or if the thigh is dislocated, the limb is placed in the splint, the femur splint E, being added, and the bandages are applied as seen in Fig. 14. lIhe limb, being firmly confined by the bandage :0, above the knee, is gently extended to the degree required, by means of the upper extension screws r, r, the former bearing upon the bolster L, which rests against the perineum and also the bandage U, which also aids in the extension of the limb, as seen in Figs. 1 and 14. The lower part of the femur splint E is allowed to slide in the clamps n, n', until the limb is sufliciently extended, and then it is firmly confined by the nuts q, Q, Q, q" The femur splint E, may be adjusted to either limb, as the case may require. After the reduction of the fracture, straps or cushions may be applied to straighten or flex the limb either way, as may be necessary.

If the comfort, or convenience, of the patient requires the iiexure or extension of the limb, it is accomplished by the use of the elevating screw c, which, acting upon the leg side pieces A, A, the femur side pieces F, F', the supports m, m, and 0, 0, the braces t, t', the elongating arbor T, and the concave flooring N, causes the upper portion of the splint to describe a double inclined piane the apex of which is at the joints R, R, thus effecting the required elevation or depression of the limb at the knee. In these three particulars, namely, the application and mode of operation of the splint when used for fractures of the legfor fractures or dislocations of the femur, and for flexing and extending the limb, we believe our splint to be different from, and superior to. all other splints heretofore known.

We also believe, that great benefits will be derived from the bed in our splint for the reception of the fractured limb, composed of the strips of cloth 71 h, 7L, &c. In splints heretofore constructed the limb has been required to be in a wooden trough, or upon a pillow, each of which it is dificult to remove without injury to the fractured limb, and great pain and discomfort to the patient, and which are liable to become filthy in consequence, more or less, of the application of washes and lotions to' the limb, which run down into the trough caus-v ing the flesh to boil, blister, and ulcerate. The use of our bed obviates all such objections. Any one of the strips comprising it, may be removed without in the least disturbing the limb, or causing pain to the patient, and a new and clean one applied. And the operator is thereby enabled to apply lotions, or any necessarymedicaments, to any part of the limb. VThe limb can be practically elevated by means of the strips composing the bed, and any position given to it which may be necessary for the comfort or welfare of the patient. The heel, which, in ordinary cases of fractured limbs, is the source of much discomfort and sometimes of very great suffering to the patient, may, by the use of the bed in our splint, be kept so far elevated as to avoid pressure on any part of it. Our bed also allows the air to circulate freely around the limb. It also furnishes greater facilities for reducing and dressing compound fracture than can be found in any other splint heretofore known. The foot frame composed of the oblique standards I, I, the bow P, and the bed h h, also secures an easy position for the foot, and protects it from the pressure of the superincumbent bed clothes. In these particulars, also, we believe our splint possesses facilities and advantages which are not to be found in any other hitherto discovered.

Having set forth above the peculiar form and construction of our splint, and its various parts, and their modes of operation, what we claim as our invention and desire to secure by Letters Patent, are

1. The bed, composed of the strips of cotton cloth It, 7L', 72,, &c., or other suitable material, passing through the slats z' z' im, iii", i z'v, &c. in the bed side pieces A, A', arranged and confined as above described, and for the uses and purposes above set forth.

2. The foot frame and bed composed of the oblique standards I, I, the bow I?, and the strip of cloth t 7L, or other suitable material, passing through the slats z' z, z' z", at- Y tached to and adjustable upon the leg side pieces A, A, and for the purpose and uses, as above described.

3. The device Afor vextending the leg by the employment of the lower extension screws c, e the traversing nuts j j, and their guide, 7c, c, with their connecting straps a', 03.', 00', in combination with the cross bars J, and K, the leg side pieces A, A', the femur side pieces F, F', the femur splint E, the cushions Gr andH, the bolster L, the bandages U and O, with their connect-- ing straps, and the brass straps V, Vf', constructed and operating in the form and manner above described.

4. The device for extending the thigh, by the employment of the upper extension Screws r, 1^', in combination With the femur side pieces F, F, the leg side pieces A, A', the femur splint E, the cushions Gr, and H, the bolster L, the bandages U, and O, with their connecting straps, and the brass straps V, V, constructed and operated in the form and manner above described.

5. The device for flexing and extending the limb, by the employment of the elevating screw c, and its supports y, y, in combination with the cross-bar M, the leg side pieces A, A', the femur side pieces F, F, the supports m, m', and o, 0, the braces t, t, the elongating arbor T, the concave flooring N, and the bed pieces B, C, and D, constructed and operating in form and manner above described.

6. The elongating arbor T, constructed and operating in form and manner, as above described.

7. The device for spreading and contractassinO' throu 'h a corres ondin' mortise in C b the upper end of the bed piece C, and the confining pin 7c le, in combination With the bed pieces B, C, and D, the supports m, lm

and 0, 0, the braces t, t, the elongated arbor T, the femur side pieces F, F, the leg side pieces A, A', and the cross-bars J, and K, constructed and operating in form and manner, as above described.

JOHN CLOUGH. DANIEL M. CUMMINGS.

Vitnesses:

AMos M. BRYANT, HORACE D. CLoUGI-I.