US2374163A - Orthopedic appliance - Google Patents

Description

April 24, 1945- F. i=. BURC STED 2,374,163

ORTHOPEDIC APPLIANCE Filed Jan. 6, 194g 2 Sheets-Sheet l 'April 24, 1945. F. F. BURCHSTED 2,374,163

\ I ORTHOPEDIC AP'IILIANCE F iled Jan. 6, 1942 2 Sheets-Sheet 2 HIM I Patented Apr. 24, 1945 UNITED STATES PATENT "OFFICE VORTHOPE'DIC APPLIANCE Frederic F. Burchsted, Beverly,Mass. Application January 6, 1942, Serial No. 425,755

(or. 5 92) f 7 Claims.

,My invention relates to equipment useful in treating fractures of the arms or legs, disease of joints and the like. It comprises an improved universal splint support and improved splints with self-contained tensioning mechanisms.

The modern technique of treating fractures involves stretching or tensioning the fractured member so that the natural secretion resulting in new bone structure will flow in even distribution 7 through the break and in order to maintain the separated bone members in proper alignment. Considerabledifficulty has been experienced in building splints which will not slip and permit the bones. to go out of alignment or come together at an improper angle; Furthermore no splint heretofore in use has provided means for determining the amount of tension :exerted on the fractured limb.

One object 'of my invention is to provide a universal splint support adapted to be clamped to a bed and making it possiblejto suspenda splint over any selected area ofthe bed and at any desired angle in order that the splint may be'disposed in the fashion most able for the patient. i

A further object of my invention is to provide a splint having self-contained tensioning mechanism including means for registering the amount of tension exerted on a fractured limb in order that the break in-a limb may be held apart sufficiently to permit the bone-forming secretion to be evenly and efiiciently distributed through the area of the fracture. v I

An important feature of my invention consists in an'improved splint combining in a self-contained unit improved means for supporting a leg in'bent position and means for exerting tension on the upper part of the leg, the pull being exerted in alignment with the bones of the upper leg.

effective and comfort Another feature of my invention resides in a" construction whereby the splints maintain the fractured limb in proper condition without resort to outside connections or supports, with the result that the splint can be applied to the patient at the fracture reducing table and the patient thereafter transported to a bed to which the universal support of my invention has been applied.

Among the several advantages resulting from the practice of o my invention are the saving in time of surgeons and attendants, greater comfort to the patient, less chance of maladjustment of the fractured limb, and the self-containednature of the splint which allows the patient to be moved to or from his bed without afiectingthe condition of the fracture.

These" and other objects and features of my in- I vention will be more readily understood and appreciated from the following detailed description of a preferred embodiment thereof, selected for purposes of illustration as the best mode'known to me by which my invention may be practised, and shown in the accompanying drawings, in which:

Fig. 1 is a view in perspective showing the universal splint support and four Splints assembled with a bed,

Fig. 2 is a view in cross-section through the bridge member and carriage,

, Fig. 3 is a view in front elevation of the adjustable splint hanger and hook,

Fig. 4. is a view in perspective showing a modified form of tensioning device for a leg splint,

Fig. 5 is a view inside elevation of a scale used to check slippage,

Fig.f6 is a view in perspective of a modified splint hanger,

Fig. 7 i a view in side elevation showing the joint between the hollow rods of a splint and the tensioning frame, and

Fig. 8 is a view in perspective of a splint-support for a wheel chair."

'The illustrated embodiment of my invention is shown'in Fig. 1 as assembled and mounted upon an iron hospital bed having the head board l0 and a foot'board llanda mattress l2. p The main frame of the apparatus comprises an upright member. I 3 having an intermediate, overhead track portion l4, and a second upright member' l5 which has a reduced tongue welded to its forward end, telescopically and adjustably received within the end of the track portion [4 and adapted to beclamped in the proper position by longitudinal adjustment of winged set screws 16 which pass through cross bars in the track portion I4 and bear against a tongue which pro- J'ects from the upright member IS. The upright members l3 and I5 are forked and are provided with any convenient form of clamping mechanism.,' That herein shown includes a cross bar shaped to rest on the bed rail and hooks that pass down throughthe cross bars andare provided with winged nuts by which they may be drawn into clamping engagement with the rail. The bridge member l5 which is secured to the foot ofthe bed is considerably longer than the bridge member I3 so that the intermediate track portion may be adjusted to a horizontal or level po- 'sition. These members are all of angle iron construction, and in assembled condition constitute a light, stifi and strong bridge member 'extending longitudinally over the patient and at'a suflicien height above him to afford free access.

Upon the track portion of the frame are adjustably mounted a pair of similar carriages IT and 30. The carriage H has two pair of truck rollers I8 running above the flange of the track member, and two pair of truck rollers 20 running below the flange of the track member. Flanges 24 on the rollers, as shown in Fig. 2, serve to guide the rollers along the track. Clamping bolts I9 are provided by which the carriage Il may be located in any desired adjusted position upon the track I4, or if desired, the clamping bolts may be left loose and the carrier allowed to move freely in the track. A strut 2| extends transversely between the sides of the bridge member I3 serving to reinforce this member and also to serve as a stop to prevent the carriage I! from running off the lower end of the track I4.

The carriage I! may be removed bodily from the track I 4 in the following manner. By loosening the wing nuts I9: the truck rollers 2Il are dropped down until the flanges 24 clear the bottom of the track I4, thus allowing the shaft carrying the rollers to be turned at right angles to its normal position. After this has been accomplished, the carriage Ilmay be lifted bodily and removed, the rollers 20 passing up between the sides of the track I4. t H

The carriage II extends transversely beyond the sides of the track I4. At each end itis provided with a downwardly extending clamping bolt 23, upon which is pivotally hung a double arm 22, that is to say, a arm comprising two spaced side members, and in' the outer side of each is formed a track. From each of the arms 22 of the carriage I1 is suspended an arm splint. In

Fig, 1 the connections between the arms 22 and this splint are omitted for the sake of deafness. The carriage 30, however, is similar in respect to the carriage I1. -It is provided with downwardly extending 'bolts 35 from which are suspended the double arms 34, and from each of thes arms a leg splint is suspend-ed by mechanism which will now be described and which it willbeunderstood may be similar to the corresponding suspension of the arm splints. It will'besen'that each arm 22 is supported so that it may swing freely beneath the track. At each side of the arm 34 is mounted ar anger h'aVihg'a substantialy triangular frame 35, and a pair of truck" rollers 31 running on the tracks in the rmed. The lower apex of each frame is formed as a rectangul'ar socket member 39, and these mem ers are connected by a transverse rod. A vertical bar 33 having teeth 40 in one'ed'ge slides in each of the v socket members 39. n

Journaled in the socket members 39 is a shaft 42 which carries two pa'wls44 normally engaging a pair of teeth 40 on the bars 38. A lever 46 secured to the shaft 42, Fig; 3, is urged in one direction by a spring 48, forcing the pawl's into firm contact with the teeth 40. The lever 46 may be moved by hand in the opposite direction to free the pawls from the teeth, thuspermittin'g' the bars '38 to be adjusted vertically. Bolted to the lower inturned ends of the bars 38 is a crosspiece 47 from which a hook 45 i pivotally suspended. Springs 43 surround the bolts securing the cross-piece 41 to the bars 38 to provide a spring-cushioned mounting for the cross-piece. The hook 45 is integral with a channel shaped flange 49 which, with the hook, forms along arrow pocket I From th' foregoing dSfC IiptlOli it U6 ZIP-- parent that I have invented an overhead suspension system for splints, which is capable of unlimited adjustment. The carriages I1 and 30 may be fixed at any desired point longitudinally of the bed, and the pivotally mounted arms 34 make it possible to locate the supporting point of a splint anywhere over the bed. The longitudinal adjustment of the hangers along the arms 34, and the vertical adjustment of the bars 38 under the system are still more flexible and capable of treating fractures of adults or children in any point in either arm or leg. I will now describe preferred embodiments of the improved splints of my invention, although the use of the suspension system heretofore described i not limited to employment with the said improved splints of my invention.

Splint for lower leg fracture The splint designated generally by the letter A is designed particularly for use with fractures at or below the knee. It comprises essentially two spaced hollow rods 50 connected at one end to a semi-circular ring 52' of steel covered with a cushioning material such as sponge rubber. At their other ends the rods 50 are securedto an arched cross member 54. A pair of leg-supporting slings 55 and 56 are supported between the rods .50 by straps encircling the rods, and each rod carries a strap 51 which straps pass around the leg of the patient to keep it properly aligned as it rests on the slings 55 and 56. An arched cover 5I is supported across the splint by legs 53 resting on the rods 50.

Fitting telescopically into the rods 50, are the ends of aheavy wire frame 58 and a set screw 59 permits the frame 58 to be set at a fixed. position with relation to the rods 50, as shown in Fig. '7. Slidably mounted on the frame 53 is a foot support 60 which comprises across bar BI and a reetangular upright portion 62 with loops B3 of webbing which encompass the foot to hold it firmly in position. The frame 58 also carries a sling 64 arranged to sup-port the heel andankle of the patient. A hook 65 is adjustably mounted in the end of the frame 58 and is threaded to receive an adjusting nut 53. A spring scale 8 is carried by Ellie hook 65 and a hook secured to the cross bar when the "splint A is to be used, the fracture is reduced and the splint is then placed under the leg so that it is supported on the slings 5 5, 53 and 64. The loops 51 and '53 are then applied to keep the leg in proper alignment. Then adhesive tape 61 is secured to the leg above the ankle Imounting of the frame 58 permits the splint to be adjusted to legs'of various lengths. The set screws 59 are then turned up tight and stop blocks, which are slidably carried on the frame 58, are fixed in position adjacent the foot support '60 to'prevent retrograde movement thereof. The nut 66 may be turned to apply a correction on the scale 8 on the cross bar and thus through the adhesive tape 5'! to "the leg of the patient. a i I An arcu'ate arm 58 mountedon the frame5-8 carries on its outer end. an adjustable finger 59 upon which is mounted a horizontal scale ii); the scale, 'I'Il extends between the arms o'f-a slotted upright member II which is taped to the .patients leg. When the splint has been applied to -the patient and the proper tension. obtained, the loblocks TI are provided behind each of the foot rest carriages 60 to safeguard excessive tension which might otherwise occur from movement of the patient.

-' As an alternative method of securing tension on the patients leg, I contemplate the use of a- Kirschner wire tractor, as suggested in Fig. 4. In this case'the frame '58 is utilized as before,

but a modified form of foot support is required.

It includes a cross bar I2 slidably carried by the frame 58, an upright member 14 to carry aligning strapsforthe foot (not shown). and a V- shaped frame I6 having a downwardl extending lug I8 at its outer end. After a Kirschner wire 80. has been inserted in the os calcis of the fractured leg, it is gripped by a Kirschner wire n cord. Obviously other methods of skeletal traction may be accommodated by the frame '58.

' Splint for upper leg fracture The splint shown generally'at B is particularly useful for the treatment of fractures above the knee. As in the splint A, the splint B comprises a pair of hollow rods 90 into which is telescopically fitted aframe -SZ; and a rubber covered-semi-circle of steel 94 connects the other ends of the rods 90. a

Also employed is an auxiliar frame 96 which has ends received in a pair of fittings 98 which secure the frame to the rods 90 and permit angular adjustment. The frame 96 provides a support for the uninjured lower leg, and is provided with a canvas sling 98, foot support I00 and loops or strap I02 which align the foot and leg as explained in the-description'of'the splint A.

Slidably carried on the frame 92 is a cross bar -I04, and safety stops I06 controlled by set screws are provided to limit movement in one direction of the bar I04 on the frame-92. A spring scale I08 is suspended betweenthe bar I04 and an adjustable hook carried in the end of the frame 92. A stout cord II 0 leads from the bar I04 to a Kirschner wire tractor I I2 which grips the ends of a wire passed through the femur.

A pair of straps II 4 connect the ends of the frames 92 and 96 to limit relative'angular movement thereof in one direction.

Fastened to one of the hollow rods 90 is an L-shaped arm II6 through the outer end of which is threaded a bolt UT; on the end of the bolt facing the patients leg is a pressure disk- II8 arranged to bear on the femur. After the tension on the patients leg has been adjusted and the foot and leg properly aligned, the disk similar arrangement may be applied to splint A.

Splint for lower arm fracture The splint .C is designed particularly for use in the treatment of fractures of: the lower arm and includes a pair of rods I connected to a ring I22 of steel covered with cushioning rubber I I 26 l being optional.

and to anarcuate crossbar I24. The cross bar I-24 is provided with a series of tapped holes into which may be threaded a bolt I26. carried by the hook 45, The suspension of the splintsfrom the overhead frame is the same in all cases, the bolt selecting a hole and tightening the bolt I26, the splint C may be made to hang at a, predetermined angle. Carried by. the telescoping rods I20 is a canvasstrap I28 adapted to passover the patients arm. I I, V I

'A frame I30 comprising a pair of upright legs and a horizontal U-shaped portion is adjustably clamp d to the rods I20 and is provided with a pair of clamps I32 which receive a vertical U- shaped frame I34. To keep" the patients arm in proper alignment I provide two straps I36 carried by the frame I34 and encircling the arm. A pulley or sheave I38 is journalled at the topof the frame I34, and a cord travelsover the pulley, being connected at one end to'a spreaderv bar I 40 from which lead strips of adhesive tape I42 which are wound about the'patients wrist. The other end of the cord is connected to a spring scale I44 secured to a turnbuckle I46 which is in turn secured to the U-shaped portion of the frame I30. A hand grip I48 is secured to the .upright portion of the frame I30 below the spreader barI40. After the fracture has been reduced and the -.lower arm immobilized the splint C is strapped in place with the arm at an angle. The adhesive tape I42 is applied to the arm and secured to the spreader bar I40. The set screws I32 are loosened and the frame I30 is raised until the de- Splint for fractures of the upper arm The splint designated by the character Dis particularly useful for the treatment of upper arm fractures. This splint comprises a pair of hollow rods I50 connected at one end to a rubbercovered steel ring I52 and to an arcuate cross bar I54. A frame I56 of metal has ends sliding telescopically in the hollow rods I50 and adapted to be locked in position by means of set screws I58 at the base of the crossbar I54. Slidably mounted in the frame I56 is a cross-bar I60 adapted to be locked in fixed position by means of stop blocks I62. A spring scale I64 is suspended between the bar I60 and a hook I66 threaded through the end of the frame I56. A hand grip l68 is also connected to the bar I60. The rods I50 and the frame I56 support a'pair of canvas slings II0. Ad

until the scale I 64 registers almost the tension desired. Then the hook I66 is adjusted to provide the exact tension required. The splint is then It will be obvious that by slipped over the hook #5 which has previously beenadjusted to the desired position. In order to counterweight the arm splints a pulley I80 may be connected to the bed frame, and a cord I82 connected at one end of the ring I52 runs through the pulley I88 and to a weight I84, The weight I84 is selected according to the amount of support desired.

In Fig. 6 I have shown an alternative form of hanger to take the place of the hanger 36. In the modified form the hanger comprises a pair of triangular supports I80 carrying truck rollers (not shown) adapted to fit on the tracks of the arms 34. A pair of vertical rods I82 slide freely in the members 180 and support a cross-bar I84 from which may be suspended a hook (not shown) to hold a splint. A shaft I86 is secured between the sheave I88. A weight I90 is suspended from a cord I92 which runs over the sheave I88 and is secured at its other end to the cross bar I84. After a splint has been secured to this modified form of hanger, additional weights may be placed on the weight I90 until the splint is properly counterbalanced. Thus the patient is relieved of the sensation of great weight and may move the injured limb slightly with-out discomfort. The cross bar I84 may be secured to the rods I32 by bolts I93,

which slide in the cross bar I84, are threaded into lugs on the end of the rods, and are surrounded by springs I94, thus providing a yielding connection between the splintand the hanger.

In Fig. 8, I have illustrated a support adapte to fit on a wheel chair and designed to receive any of the splints heretofore described. The support comprises a single length of wire 200 bent toflt over the foot board 202 of a wheel chair and presenting .lateral portions boundedby upri ht portions, in the rods of a splint may be received, as for example the rods '50 of the splint A. A splint may be detached from its hook 435 and then the patient can be placed in a wheel chair. All this can be accomplished Without disturbing the alignment of, .or tension upon, the fractured member, since the splints are self-contained units, maintaining tension and alignment Without resort to outside assistance. I

It will ,be understood that the arrangement and number of aligning straps or guides 5'I-63 may be varied at the discretion of the surgeon'in the various cases under treatment. The apparatus, of course, can be used for a single fracture or injury, :or for the treatment of both arms and both legs, being illustrated herein as working in that -manner to show its full capacity.

In conclusion, some additional features of my invention may be referred to. For example, the

parts of the splint are easily disassembled for cleaning .and sterilization. Furthermore the uniyersal splint support can be used simultaneously w-i'thua number of splints, while each splint is individually adjustable to accommodate the particular type of fracture involved. All of the parts of the splints and supporting frame are securely locked so that the bed may be moved about from place to place 'Without harm to the patient.

Having thus described my invention 'what I claim as new and desire to secure by Letters Patent of the United States is:

supports I80, and provides a mounting for a pivotally connected'to and suspended from said carriage, a track formed in the sides of each arm, hangers slidably mounted on said tracks, and a vertically adjustable hook suspended from each hanger.

2, A splint supporting structure, which comprises a pair of interlocking adjustably connected bridge members arranged to be secured to and above a bed, a carriage mounted on said bridge members for movement longitudinally thereof, means for immobilizing the carriage, a pair of arms suspended from-said carriage and pivotally connected thereto, a hanger slidably mounted on each arm, a pair of bars secured to said hangers, means providing vertical adjustment of said bars, and a hook suspended from said bars.

3. A splint support which comprises a pair of bridge members, means for clamping said bridge members to the head and foot of a bed, an adbed and having an adjustable track-carrying mounted onsaid bridge members, a pair of arms portion extending between their upper ends, and a carriage movable longitudinally upon said trackcarrying portion, said carriage being provided with track-engaging elements and clamping means whereby the carriage may be clamped in any selected position on the track or disconnected and removed from the track, and having also a vertical pivot extending downwardly below said track-carrying portion and a splint-carrying arm freelymovable about said pivot and beneath said track-carrying portion. I

5. A splint supporting structure comprising a bridge arranged to be secured in position above a bed, .a plurality of carriages mounted for independent movement longitudinally above the bed Qnsaid bridge, a pair of laterally adjustable arms .on each carriage and a hanger supported from each arm and by the movement of the carriages and arms being adapted for universal adjustment above the bed.

,6. Apparatus for hospital beds including a vertically adjustable bridge structure providing a longitudinal track above the bed, a carriage movable thereon, and extending transversely beyond the track on both sides thereof, a downwardly extending pivotal support at .each side of the carriage, an arm on each support arranged to swing freely and independently beneath said track, and a splint support depending from each arm.

'7. Apparatus for hospital beds including an overhead track, a carriage movable thereon, a

support extending downwardly from the carriage to a point below the track,'an arm pivotally mounted on the support and having spaced side walls, and a splint hanger comprising triangular frames suspended in spaced relation from the walls of said arm and connected together at a point below the arm.

FREDERIC F. BURCI-ISTED.

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