US2060173A - Scoliosis corrective brace - Google Patents

Description

Nov. 10, 1936. K. w. BUSCHENFELDT 2,

SCOLIOSIS CORRECTIVE BRACE Filed Jan. 29, 1936 2 Sheets-Sheet l INVENTOR 1 Karl W Bus hen Feldl ATTORNEY Nov. 10, 1936. K. w. BUSCHENFELDT 2,060,173

SCOLIOSIS CORRECTIVE BRACE Filed Jan. 29, 1936 2 Sheets-Sheet 2 INVENTOR Karl W. Buschenfclolk ATTORNiEY Patented Nov. 10, 1936 UNITED STATES PATENT OFFICE 2,060,173 SCOLIOSIS coimcc'rrvs BRAO'E Karl W. Buschenfeldt, Stoughton, Mass.

Application January 29, 1936, Serial No. 61,276

'7 Claims. (01. 128'l8) This invention relates to improvements in orthopaedic appliances for treating lateral curvature of the spine (scoliosis), and more particularly to scoliosis corrective braces which are continuously and truly adjustable.

Hitherto, in the treatment of scoliosis, it has been customary to utilize plaster jackets, such as the so-called Brewster jacket, to effect a lateral compression of a scoliotic torso with an accompanying partial straightening of the spine. Various modifications of the Brewster jacket are also in use, and include means for varying the size to fit different torsos. However, with all of these devices the amount of correction secured is relatively small, and appears to be due, in no small part, to the fact that the mechanical force which can be applied is essentially a lateral, shearing. force without the possibility of a pronounced, accompanying uplift, which is a major 29 factor in straightening a twisted, scoliotic spine.

It is a feature of novelty of the present invention to provide a scoliosis corrective brace having vertical uplift as well as lateral compressive action.

It is another feature of novelty of the present invention to provide an adjustable scoliosis brace.

A further feature of novelty of the present invention is a scoliosis brace adapted to provide an overcorrection for scoliosis spines.

It is also a feature of novelty of the present invention to provide a scoliosis brace having a novel mechanical leverage between the several parts whereby to simultaneously secure a flattening of the curve with accompanying free upward lift on the concavity and inward and upward pressure on the apex of the curve, together with a. downward thrust of the hip opposite to the apex of the curve.

These and other desirable features of novelty will be described in the accompanying specification and illustrated in the drawings, certain preferred embodiments being disclosed by way of illustration only, for, since the structural features may be incorporated in other specific de- 45, vices, it is not intended to be limited to the ones here shown, except as such limitations are clearly imposed by the appended claims. 7

In the drawings like numerals refer to similar parts throughout the several views, of which Fig. 1 is a rear elevation of a plaster torso with 'a scoliosis brace fitted thereto;

Fig. 2 is a left-side elevation of the device shown in Fig. 1;

Fig. 3 is a right-side elevation of the device shown in Fig. 1;

Fig. 4 is an elevation, viewed from the rear, of a finished brace with coverings applied thereto;

Fig. 5 is a dorsal view, taken from life, of a scoliosis patient having a left dorso-lumbar scoliosis; and

Fig. 6 is a view similar to Fig. 5 showing the scoliosis brace in use and the amount of correction obtained.

The scoliosis brace forming the subject-matter of the present invention, will now be described with particular reference to the showings in Figs. 1 to 3. In this showing a plaster model or torso I0 of a patient with a left dorso-lumbar scoliosis is shown. Applied and fitted to this plaster cast is the scoliosis brace of the present invention, and indicated generally by the numeral 20. The brace 20 comprises a pelvic shell 2|, including a central inverted Y section 22 having arms 23, 24, and a tail or extension 25 formed substantially continuous with the arm 23, and extending above the apex of the Y of the brace for a purpose to be described more in detail hereinafter. The pelvic shell is provided with a pair of hip-embracing sections 26, 21, which are secured to the arms 23, 24 in any suitable manner, as by means of spot welds or rivets, all designated generally by the numeral 28. The sections 26, 21, may be continued forwardly to grip the hips, as indicated generally at 29. The sections 26, 21, may be made up of a plurality of parts secured together by the usual rivets 28, or they may be autogenously joined as by means of welding, or brazed together. In addition, the invention comprehends the fabrication of such portions out of unitary metal constructions, when desired.

A chest pad 30 is secured to the upper end of fixed arm 25 in any suitable manner, as by means of a strip 3|, riveted or otherwise secured to the member 30, as indicated at 32, and being'mounted for free rotation on arm 25 by means of the axis or joint 33. A toggle bar 40 is linked to the apex of'the Y member 22 of the pelvic shell, as indicated at 4 I, and is adapted for free rotation at this joint. At its other end the toggle bar 40 is provided with a free-moving joint 42 to which excentric lever arm 5|) is secured. This arm carries a chest pad 5| by means of a strip or support member 52 adapted for free rotation about the joint 53. The toggle link 40 is provided with a screw mechanism 43 mounted in swivel joint 44, which, in turn, is mounted on extension 45 of the toggle bar. The screw thread spindle 46 of member 43 is connected to link joint by the toggle hinge 6| comprising toggle arms 62, 63, severally secured to the fixed arm 25 by a stud or joint 64, and to the movable arm 50 by another stud or joint 65. In operation pressure is applied to the thorax through the two hinged pads 30, 5I, moving excentrically with respect to each other so that a shearing or compression laterally does not take place. Rather, a further upward lift on the concavity and an inward and upward pressure on the convexity of the curve are easily obtained. As will be described more in detail hereinafter, when pressure is applied to the apex of the curve by the pad 30, force is also applied to the opposite side of the pelvis, inwardly and downwardly, thus tending to further flatten the curve. v

The movement of the arms 25 and 50 are controlled by the single toggle screw control member 43, which is connected to these two members through the free-moving joints 64, 65, previously noted. When screw 43 is tightened lever arms 25 and 50 are approximated with the following results. The pad 5i on the right is carried upwardly and inwardly to the left, the distance and force being governed by the relative lengths of the upper and lower segments or arms of excentric lever 50 moving on fulcrum 42. The relative lengths, it will be appreciated, are determined beforehand, for each individual case, and are calculated and set out by the surgeon in charge of the case to obtain the particular amount of correction desired. This holds true for the bar or extension 25 and the pelvic shell 2I moving on joint 4| as a fulcrum.

As noted, when the toggle screw 43 is tightened the arm 50 is lifted upwardly, carrying the chest pad 5| with it, moving it upwardly and inwardly, and tending to flatten the upper part of the curve, which, in the case illustrated herein and for which the particular brace shown was built, is a left dorso lumbar scoliosis. Pad 30 on the left, and fitted to the apex of the spinal curve, is carried inwardly and upwardly to the right, exerting pressure on the ribs at the apex of the curve. As lever arm or extension 25 is integral with the pelvic shell 2|, the inward motion of pad 30 mounted on the upper end of the arm 25, causes the lower end 23, or continuation of this arm 25, to move downwardly and inwardly, carrying the pelvic shell with it and thus moving the pelvis opposite to the convexity of the curve. This results in a flattening of the curve. The upper arm 50 by virtue of its long leverage, moves upwardly and inwardly, thereby lifting the right side of the thorax out of the line of force of pad 30.

The central toggle bar 40 which carries the mounting for the toggle-screw 45 of the swivel 43, is freely jointed at its top to arm 50, and at its bottom to arm 25, and although thus freely jointed at top and bottom, it does not move-it is a fixed point on the patient. Motion takes place above and below this toggle bar at joints 42 and M, respectively. The center of motion is the point where the screw 46 crosses the toggle bar 40. This observation is made as a result of the study of a number of X-rays and photographs.

In use the pelvic shell may have an inner girdle III of any suitable material such as padded leather or the like, fitted in position and the skeleton or framework of the shell may be provided with overlying leather coverings II secured to the girdle or corset 10, as by means of stitching. The pads 30 and 5| may be provided with leather or other suitable coverings I2, I3. Straps, desigat n ra ly by the numeral 14, may be attached to the pads and brought over the shoulders to provide improved support for the chest.

Referring more particularly to Figs. 5 and 6, there is shown in sketches copied from life photographs, the amount of correction obtained by use of the device of the present invention and in the manner in which this is accomplished. In the view shown in Fig. 5 the patient I is shown with a left dorsal lumbar scoliosis, the spine being indicated by the dots WI. The base of the spine is indicated by the numeral I02 and the head or top vertebrae by the numeral I03. A plumb line IIO held taut by the plumb bob III is shown hung so that the plumb line coincides with the base of the spine or the os sacrum. The pronounced twist in the spine can readily be seen by reference to this view. In Fig. 6 the same patient is shown in the same position but with the scoliosis brace 20 applied. Comparing this showing with that of Fig. 5, it will be noted that the center of the back head is almost in line with the plumb line and that this results from the lifting up and straightening out of the top of the spine, causing the levo-rotation of the thorax into the high, up-and-down position assumed by the normal spine. This remarkable correction can be further noted by comparing the downward thrust of the right arm I04,and particularly the tips of the fingers I05, in the two views. In the uncorrected Fig. view the tips of the fingers I05 extend below the right knee. In the corrected position shown in Fig. 6 the same fingers are raised to a normal position in the middle of the thigh.

The remarkable results discussed above, and illustrated in the drawings, are a distinct evidence of the utility of the device herein disclosed and claimed. The device may be Worn with comfort and for extended periods of time. By carrying the correction obtainable to a point beyond the normal from that of the original curvature, and maintaining it for a sufiicient period of time to train the muscles, a normally straight spinal position is more likely to be assumed when the device is removed. The period of time required for improved or total correction, will vary according to the severity of the case under treatment, and may, as a matter of fact, require the matter of several years continuous wearing to secure permanent, natural results.

It will now be appreciatedthat there has now been provided an improved scoliosis corrective brace adapted to effect the relief and correction of lateral curvatures of the spine by effecting a further upward lift on the concavity of the curve, accompanied by an inward and upward pressure on the convexity or apex of the curve, and a downward thrust on the hip on' the side opposite the convexity or apex of the spinal curve.

While certain novel features of the invention have been disclosed and are pointed out in the annexed claims, it will be understood that various omissions, substitutions and changes may be made by those skilled in the art without .departing from the spirit of the invention.

What I claim is:

1. A scoliosis brace comprising a pelvic girdle,

of said toggle bar and severally adapted to simultaneously exert an inward pressure on the apex of the curve and an upward lift and downward thrust on the concavity of the curve.

2. A scoliosis corrective brace comprising a pelvic girdle having an upwardly extending arm terminating at the apex of the curve of the trunk when the device is worn, a toggle bar rotatably fixed at its lower end to the girdle and approximating the normal position of the spine, an excentric lever arm rotatably mounted on the upper end of the toggle bar and divided thereby into an upper, outwardly extending long leg and a lower short leg, chest pads on the upper ends of the girdle arm and the lever arm, and toggle linkage mechanism on the toggle bar and secured to the girdle arm and to the short leg of the excentric arm respectively.

3. A scoliosis corrective brace comprising a pelvic girdle having an upwardly and laterally extending arm terminating at the apex of the curve of the trunk when the device is worn, a toggle bar rotatably fixed at its lower end to the girdle and approximating the normal position of the spine, an excentric lever arm rotatably mounted on the upper end of the toggle bar and divided thereby into an upper, outwardly extending, long arm and a lower short leg, chest pads on the upper ends of the girdle arm and the lever arm, and toggle linkage mechanism on the toggle bar and secured to the girdle arm and to the short leg of the excentric arm respectively.

4i A scoliosis corrective brace comprising a pelvic girdle having an upwardly and laterally extending arm terminating at the apex of the curve of the trunk when the device is worn, a toggle bar rotatably fixed at its lower end to the girdle at substantially the point of engagement of the lateral arm therewith, said toggle bar approximating the normal position of the spine, an excentric lever arm rotatably mounted on the upper end of the toggle bar and divided thereby into an upper, outwardly extending, long leg and a lower short leg, chest pads on the upper ends of the girdle arm and the lever arm, and toggle linkage mechanism on the toggle bar and secured to the girdle arm and to the short leg of the excentric arm respectively.

5. A scoliosis brace comprising a pelvic shell, a toggle bar rotatably mounted at its lower end on the pelvic shell, a lever arm mounted for excentric rotation about the upper end of the toggle bar and divided thereby into an upper, outwardly extending, long leg and a lower short leg, a separate arm fixed to the pelvic shell and laterally disposed with respect to the toggle bar, a toggle linkage joining the short arm of the excentric lever and the fixed arm of the pelvic shell, a swivel-jointed take-up for the toggle linkage mounted on the toggle bar, and chest pads mounted on the upper ends of the fixed arm and the excentric arm respectively.

6. A scoliosis brace comprising a pelvic shell, a toggle bar rotatably mounted at its lower end on the pelvic shell, a lever arm mounted for excentric rotation about the upper end of the toggle bar and divided thereby into an upper, outwardly extending, long leg and a lower short leg, a separate arm fixed to the pelvic shell and laterally disposed at an angle to the toggle bar, a toggle linkage joining the short arm of the excentric lever and the fixed arm of the pelvic shell, a

swivel-jointed take-up forv the toggle linkage.

mounted on the toggle bar, and chest pads mounted on the upper ends of the fixed arm and the excentric arm respectively, and severally adapted to engage the apex of the curve (convexity) and the upper end of the concavity.

7. A scoliosis brace comprising a pelvic shell, a toggle bar rotatably mounted at its lower end on the pelvic shell, a lever arm mounted for excentric rotation about the upper end of the toggle bar and divided thereby into an upper, outwardly extending, long leg and a lower short leg, a separate arm fixed to the pelvic shell and laterally disposed at an angle to the toggle bar, a toggle linkage joining the short arm of the excentric lever and the fixed arm of the pelvic shell, a swivel-jointed take-up for the toggle linkage mounted on the toggle bar, and chest pads mounted on the upper ends of the fixed arm and the excentric arm respectively, and severally

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