US2661000A - Surgical splint - Google Patents

Description

5 w. E. GAZELEY ETAL 2,661,000

SURGICAL SPLINT Filed June 5, 9 1 2 Sheets-Sheet 1 YE- Gan/6 1 Richard W. Meysner,

F r/f P. Graul,

The I H forngy.

1953 w. E. GAZELEY ETAL SURGICAL SPLINT 2 Sheets-Sheet 2 Filed June 25, 1951 harc/ W Mqgsner', 45/72 Gr'clul, Theirglfomgg.

fnverzlor's W/l/iczm Gaze/6 Patented Dec. 1, 1953 UNITED STATES PATENT OFFICE SURGICAL SPLINT William-E. oa ley, Richard W. Meysn'r', and Fritz P. Graul, Schenectady, N.IY.

Application June 25 1951, Serial No. 233,432 8 Claims. (Cl. 128 88) tive'to thebody. -Aeonventionai device for suchtreatment.is,an eirp1ane type splint or plaster 7 cast which tis'iiallifibihfiiises abody portion and an arm portionwith the, arm portion elevated to a near horizontal li/elhy means of a stint joinmg the eibowof the arm portion to the body portion. 7

' "The armds maintained in an elevated. or near horizontal positionfio event overstretching of the deltoid muscle which controls vertical abduction (elevation) oi theharm; that is,- ifan arm is permitted tddafigleifroma .t'vfak'ened shoulder for a considerable length of time, the muscle, controllin the elevation .of the arm is stretched beyond its elasticjlihiit o. the point Wl' ierev it may become permanently unable to regain its fun'ctio'n.

when the" arni isjiiiniobiiiied in-eri elevated position, however, the ,ideimia muscle is main.- tamed within'its nonnalleiigth, and it may be restoredvto a varying degrees of, function through exercise after themaximum amount of, regeneration of the nerve has been obtained.

It is to" be" uhders'tdqdot. course, that there is aparallel relationship; between a ri-ius'clev and the nerve" which oontrols'jits operation. The nerve is the s ignali-ngfdifi'ce that actuates the. muscle. A aralyzed 'deltoid'rntiscl', for example, which iseommon' inoiiomyeiitisis-e; result of damage to thejzierve -which-eoiitrols the operation of that: muscle.

vIn sup'porting ashoulder in an airplane spunt or o'astxto prevent-overstretching of the deltoid muscle, other uninvolved shoulder and armmus cles are rendered weak through lack of use. :For example, :the peetoralaand serratusmuscles which produce abductionrtand adduotion in the .;horizontal. plane (movement forward and backward relati'vto the;b6dy) become flabby through their immobilization.

.Whileamairplane typesplintpr cast is of as- Sistance in the regeneration of junction to a nerve and muscle, the regeneration is accom- 15ar'iied'ewaryingamount of ,discomf ort. Consider .tliebiflfiy plastefieast, for, example; itis a cumersor'iie uncomfortable. t ucture r duc n am aiid ,telii'6iifd ,tne .Weaier through its siieer weight. it is a structure that limits riot since this, fdfc 5 and x01" resili y the i cre n o he term t a of h patient, its weight rendering semi-amlou latory. 0

4 ideal ee mentfq be dame dd i e mu cle is to provide an eleyatedsupport for thearm which would permit limited mpver ent in all directions. Such a support would enable thear-m to be exercised, therehy givingltone to them-- affected muscles While waiting nerve re generation to the paralyzed muscles. 7'

In considering a support whichpermits limited movement in all'direetiofisl it hammemembered that during the period thattheI houlder muscles are weak an arin should not" be rotated in the horizontalplane too farlto the rear of the body; otheryvise the shoulder may be partiall'y dislocatediortvardly fia co tion known asanterior subluxation ofv the siicifiiderjoint), V One of the odern treatments which attempts to provide for limited movement of them-mien device which resiliently sjispends an amp a ceiling or otheii-oyerheari support. Such a uspension perim. s limited; jxercise ofunparal ed shou der museies andh s been .f' u'nd toiit great ssist 'ne uin restorin function; to a peraly'zed. muscle. It the. disadvantage, h ever; of rendering" a pa ient iniiholoile 1d 2 treatment. It r n ws: that' siuch re'smehtsiis ension the disadvantage of permitting eiii periodic tifa'trnehtof-th. patient.

The 6 o names r fim 'n e re 'nt is thate eiis'e of the par lyzed insole should be'started as early; as possible s'iiie itsejenisfthat the earlier that ieii'rcise i'riitiated, the g is the rate ane m te s of feevrywlfihiri the 'lim'its of nerve regener tion. c

he; ea en "e" of res l ent; e evated suspensio'n m an is" mamtcan .b' iii'oxfd' in vertioa'l'plarie min mum degree of e regen ration tamed. This istecause the iirv' iteeriera on o oih v t t re en hidibf r 1 moved. e S ffi i bell'a ,1 1 by th r suf suspension.

It ohje'ct of tlii's men" to pr n-d n an w means for s'ecur g the I "t 3 tion, thereby permitting limited exercise of the deltoid muscle even before there is sumcient nerve regeneration to move the arm against the force of gravity.

It is a still further object of this invention to provide an improved orthopedic brace which resiliently supports the arm in an elevated position while limiting rearward movement of the arm relative to the body, thereby preventing anterior subluxation of the shoulder joint.

It is a still further object of this invention to provide an improved shoulder brace having means for effecting a varying degree of resilient support to an arm, thereby permitting variation in the resistance offered to adduction (depression) of the arm in a vertical plane.

It is a still further object of this invention to provide an improved shoulder brace which resiliently supports an arm in an elevated plane, thereby facilitating the performance of the normal functions, such as eating, drinking, and brushing the teeth and helping the patient to help himself, with the resultant reduction of the hospital care which he would require.

It is a still further object of this invention to provide an improved shoulder brace which provides continual resilient support for an arm whereby treatment can be given to a patient, whether he be sitting, standing or reclining.

It is a still further object of this invention to provide an improved shoulder brace which provides resilient support for an arm and which may be worn by a patient either under or over the clothing he wears.

Further objects and advantages of this invention will become apparent and the invention will be more clearly understood from the following description referring to the accompanying drawing and the features of novelty which characterize this invention will be pointed out with particularity in the claims annexed to and forming a part of this specification.

Briefly, this invention comprises an orthopedic brace having a body portion including means for securing it to a human body, an arm portion including means for securing it to a human arm, a universal joint connecting the arm and the body portions including stops to limit the degree of rearward motion of the arm relative to the body and a resilient supporting means for elevating the arm portion relative to the body portion.

In the drawings, Fig. 1 is a front elevation of the new brace positioned on a patient shown in dotted outline; Fig. 2 is a perspective View of a portion of the brace; Fig. 3 is a bottom elevation of the brace elbow joint; Fig. 4 is a front cutaway view of the brace body portion and upper arm portion; Fig. 5 is a front elevation of a lock for maintaining the brace arm portion elevated relative to the body portion; while Fig. 6 is a top section of the stop means used for limiting the rotation of the brace arm portion relative to the body portion.

Referring to the drawings, in a preferred embodiment our new brace is shown as comprising a body portion I, an arm portion 2 which is connected by a universal joint 3 to the body portion, and a strut 4 which is employed to support the arm portion 2 relative to the body portion I.

The body portion I comprises a pair of bands 5 and 6 connected by a tubular spacer 9. Each of the bands has an adjusting buckle I, 8, respectively, and each of the bands is further provided with a covering ID of leather padding or the like. The bands 5, 6 are made of a metal which may be bent in conformity with the shape of the human body. Ideally, the lower band 5 is bent to conform to the waist of a person, while the upper band 6 is bent to conform to the chest. Spacer 9 is secured by brackets II to each of the bands 5 and 6. It is to be understood, however, that brackets II are simply a suggestive manner of connecting the spacer to the bands. Obviously, other means, such as screws, rivets and the like could also be employed.

Spacer 9, as shown in Fig. 4, comprises a tube or cylinder I2, a spring I3, a pair of collars I4, I5 and an adjusting screw I6 for varying the tension on spring I3. While the diameter of the tube II can be changed in accordance with the size of the spring required, it has been found that a steel tube having an internal diameter in the order of three-fourths of an inch is very satisfactory for use with children. To accommodate adjusting screw I6, a plug I'I having a threaded bore I8 is inserted into the lower end of tube I2. Plug I! may be secured to tube I2 by any conventional means, such as by the setscrew I9.

Spring I3, which is housed by tube I2 is positioned between the adjusting screw I6 and collar I4. Collar I4, which has an internal diameter adapted for sliding lit with the outer diameter of cylinder I2, is biased by spring I3 to assume a normal position which produces elevation of the brace arm portion 2. To insure proper engagement between spring I3 and collar I4, a plug 20 having one diameter small enough to fit within spring I3 is positioned on top of the spring for engagement with a pin 2I which is passed completely through collar I4. With such an arrangement, spring I3 acts on plug 20, which in turn supports pin 2I to bias collar I4 away from adjusting screw I6.

A plug 22, similar to plug 20, is positioned at the lower end of spring I3 for proper engagement with adjusting screw I6.

For controlling the vertical movement of collar I4, diametrically oposite elongated slots 23, 24 are positioned in cylinder I2 to register with the ends of pin 2 I. The pin and slot engagement, in addition to limiting the axial movement of collar I4, also effectively prevents its rotation relative to tube I2. I The universal joint 3 which supports the brace arm portion relative to the body portion comprises a yoke 25, an arm bracket 26 and a bearing pin 21 which supports arm bracket 26 for rotation in a vertical plane relative to yoke 25.

To provide support for yoke 25 on tube I2, a plug 28 is positioned on the upper end of tube I2. Plug 28 has one diameter engageable with the bore of tube I2 and a threaded bore 29 adapted to accommodate a screw 30 which is passed axially through yoke 25. Yoke 25, in turn, has a bottom cylinder 3| having one diameter small enough to rotatably fit within a registering bore 32 in plug 28.

Screw 30, which secures yoke 25 to plug 28, is formed to have a bearing shoulder whereby yoke 25 is free to rotate relative to plug 28 and tube I2 no matter how tightly screw 36 is driven into bore 29.

' Yoke 25 further has a pair of parallel arms 33, 34 which are integral with bottom cylinder 3| and which are spaced apart a distance suitable for the bearing support of arm bracket 26. To facilitate the rotation of arm bracket 26, a bearing pin 21 is passed through suitable openings in the arm 33 and bracket 26 to be engage- "a ria-co 5510 with. a threaded bd're "(not shown) in arm Through the use-oi universal joint 3, yoke 25 is rotatable relative to the tube l2 and arm bracket 28 ls rotatablerelative to the yoke '25. consequently, complete freedom or motion is given to the arm bracket 26, permitting it to ber'nov e'd in all planes relative to-the brace body fidrtl'dn.

wan s-uch a structure, however, the arm bracket 26 would be fi'ee to rotate too far to the read or tube [-2, with the resultant possibilityof producing an anterior subluxation of a patients 'shoulder joint. To prevent this, a stop 35 pro- 'v-id'ed to limit the motion of yoke 2-5. In one 'embod-irrien-t ess-e Figs- 4, Sand 6 the stop comprises a pin engage'able by opposite sides of a sector; specifically a 's'ect'or =36 is removed from the-cylindenfl 'l he-se'ctor hasa depth of about one-eighth of an inch and an arc conforming with-the desired arm'- movement. A'pin 3! is then -enrbe'dded in the plug 2-8 to be engageable with the 'opposite sides of the sector 3-6. Pin 31 strikes either side of the sector 36, thereby limiting the rotation of the yoke 25 relative to tube I 2.

I-o provide resilient support for arm bracket '26, relative to the-brace-bodyportion l, a strut 4 is connected from a bearing joint 38 on 'arm bracket 26' tocollar' T5 positioned on tube I2. Joint 38 can "bef any conventional structure so long as it provides-for rotation between strut 4 and arm bracket 26. Onero'rm-bf joint is illustrated particularly Fig. 4 wherein-a pair of parallel ears 39, 40 "extend downwardly from-the arm bracket 26 to be-'separated *bya distance greater than the thiokn'ess'of the struti.

A u shaped lock '4! is then'po'sitionedso that the freeends of 'its' legs are -located*on'e on either Side oftl'i'e s trut lbet'wen it am'lthe ears 39, 40, respectively. The base 42 'Of the U-sh'aped lock H isnotchedto engage aspace -between the arms 33', of yoke 25 and arm bracket 26. When properly positioned, as shown "in Fig. look 4| prevents downward movement of the arm bracket 2-8 -re1ative'-t0- tube F2. To' lock the arm bracket 26, it is first raised above a horizontalposition, and tli'elldtched-base 42 0f U-sh'aped lock II is placed in'engagem'eht withyo'ke 2 5'. bracket 28 "is-then iowered, but the notched base 42 pushes a'ga-ihst yoke 25 to prevent bracket 26 from fmovi-ng downwardly relative to tube l2 fnorethan 'a -fewdegrees. its lower end, strut 4 is connected to collar l5 by a pair ofpin's fi spaced 180apart. 'These pins donot completely-across collar l5; consequently, the collar 'which 'is in bearing fit with tube I2 is iree to rotate relative to the tube.

The requirement of a pair of collars l4 and I5 canenow beexplained. That isptorprovidefor rotation oi -the arm bracket 26--relative to the tube 2, co11a'r l5 be free to rotate about the tiibe as an axis. 'On the other hand, collars i-l and 15 must be biased 'bypring l3, but pin 2|, which fits*throughicollan lfl across the top of spring l3 and through slots. 23,24, prevents rotati'on of "collar icreiativeto tube T2, as has beenabovedescribed. By'placi'n'g collar l5-above collar I 4,-however, collar'l'i'is supported by and rotatable relative to the springjbiase'd' collar 4, therebyproviding the desired 'support for strut Fandarm bracket'Zli.

With a structureas described, the expansion and contraction of spring I3 is substantially enclosed. except for the width of slots 23, 24, thereby preventing the patients skin from being pihdhe'dor his clothes from being caught in the spring.

In a conventional "embodiment, an upper arm extension '44 is secured to-arin bracket '25. "I'he extension 44; preferably is interchangeable to accommodate various arm lengths.

Support is also required for the patients elbow and lower arm. To provide this support, the extension 44 is connected to a pivot joint =45 which in turn supports a lower arm member '46. Means such as -'-straps 41 and =48 are employed for securing the patients arm to the extension 44 and lower arm member 4-6, respectively. To limit the motions of the lower arm member in accordance with the hinge limits "of a patients elbow joint, a pin 49 is provided to be engageable by a prong 50 on lower arm member 46'. A wrist support 51 {of a conventionaliormisusually connected to the lower extremity of lower 'arin member 46 to position a patients-hand properly during treathient.

In operation, the bands 5 and '6 are placed around the patients body either over or imder clothing and secured by means of the buckles 1 and 8. When properly secured to a patients body, bands 5, '6 support spacer e-and universal joint 3 for free movement of 'a patients arm and shoulder joint. Strut "4 then connects arm bracket 26 to tube r2 to provide resilient support for the patients arm without impairing the movement allowed by the universal joiiit3.

This arrangement allows'the'a'rm to be 'exercised in accordance with regeneration of "the nerves controlling its motion. That is; as the arm is "strengthened, screw [*6 may be tightened to increase the bias on spring f3 an'dthe resultant force required for adduction o'i' thearm in "a'vertical plane.

While this new brace structure has been described for one arm, itisobvi'ous that'a doublearm brace could be supplied merelyby' duplicating the parts and connecting them in mirror likeness to the other side of thebrace.

While this invention has been described "in 'acr corda n'ce with the preferred embodiment, it is obvious that other modifications will occur to those skilled in "the art, and it 'i's"desired"tO be understocd;-therefore,tliat this invention isnot to be limited to the particular embodiment described, but thatitismeant to cover allmo'difi'cat-ionswhich are'withm' 'the true spirit and scope oft-his invention. 7

7 What 'we'claimas *newand'desire to securely Iiet'ters Patent of the United States is:

1. An improved surgicalisplint' comprising a body portion, "'meanson the body portion 'idris'ecu-ring the same to a? patients b'o d'y,. an arm por. tion, "means'on the body-portion forsecuring the same tOa 'patients arm, means including a joint mounted onfsaidbody portion iorsupportingsaid armportion'foruniversal movement; an elongated coil" spring having-a movable 'ire'e "endimeans on said body portion positioning said spring for movement of its free end parallel tothelongi tudina'l'axis of saidbo'dy portion; means interconnecting said spring has with said arm portion to=biasthe-sainein 'responsetotheinovem'ent of said "free end of "saidsprin'g, and screw means'for axiallyeompressing'said springtovary the tension thereof.

2. A surgical splint comprising a-bodyportion, an'arm portion, ajoint mounted on said body portion for supporting said arm portion for univer sal movement, a cylindrical tube, means on said body portion for mounting said tube coaxially with said joint with its axis parallel to the longitudinal axis of said body portion, an elongated coil spring having a movable free end within said tube, a collar positioned on said tube to be movable axially thereof, means interconnecting said collar and said spring free end, and means interconnecting said collar and said brace arm portion to bias the same in response to the movement of said free end of said spring.

3. A surgical splint comprising a body portion, an arm portion, a joint mounted on said body portion for supporting said arm portion for universal movement, a cylindrical tube, means on said body portion mounting said tube coaxially with said joint with its axis parallel to the longitudinal axis of said body portion, a spring including a movable free end positioned within said tube, a first collar positioned on said tube to be movable axially thereof, means interconnecting said first collar and said spring free end, a second collar juxtaposed on said tube above said first collar for axial movement therewith, said second collar being rotatable relative to said first collar, and strut means interconnecting said second collar and said brace arm portion whereby the latter is spring biased normally to an elevated position.

4. A surgical splint comprising a body portion, an arm portion, means including a universal joint interconnecting and supporting said arm portion for universal movement relative to said body portion, rotatable stop means on said portions for limiting the movement of said arm portion in a plane transverse to the axis of said body portion, a spring having a movable free end, means on said body portion mounting said spring coaxially of said joint for movement of its free end parallel to the longitudinal axis of said body portion, axial stop means positioned on said body portion for limiting the axial movement of said spring free end, and strut means interconnecting said spring free end with said arm portion to bias the same upwardly in response to the force exerted by said spring.

5. A surgical splint comprising a body portion, an arm portion, means including a universal joint interconnecting said portions and supporting said arm portion for universal movement relative to said body portion, rotatable stop means positioned on said portions for limiting the movement of saidarm portion in a plane transverse to the axis of said body portion, a spring having a movable free end, means on said body portion mounting said spring coaxially of said joint for movement of its free end parallel to the longitudinal axis of said body portion, axial stop means positioned on said body portion limiting the axial movement of said spring free end, strut means interconnecting said spring free end with said arm portion to bias the same upwardly in response to the force exerted by said spring, lock means, and means releasably positioning the same between said arm portion and said universal joint thereby locking said arm portion in an elevated position relative to said body portion.

6. A surgical splint comprising a body portion, an arm portion, means including a joint connecting said arm portion to said body portion, a spring supported by said body portion coaxially of said joint for compression and expansion parallel to the axis of said body portion, a tube substantially enclosing said spring, a collar positioned about said tube to be biased by said spring,

and a strut joining said collar tosaid arm portion whereby the same is biased normally to an elevated position by said spring.

'7. An improved surgical splint comprising a body portion, an arm portion, a universal joint interconnecting and supporting said arm portion on said body portion, a tube having a pair of diametrically opposite axially extending slots, means supporting said tube on said body portion, an axially compressible spring positioned in said tube, a collar, means including a diametral pin passing through said collar, said tube and through said tube slots to be in engagement with said spring thereby positioning said collar for axial movement along said tube in response to compression of said spring, screw means in said tube for adjusting the tension on said spring, and a strut joining said collar to a point on said arm portion removed from said universal joint whereby compression and expansion of said spring are transmitted through said collar and through said strut to said arm portion to bias the same normally in an elevated position relative to said body portion.

8. An improved surgical splint comprising a body portion and an arm portion, a universal joint mounting said arm portion on said body portion, a tubehaving a pair of diametrically op- -posits axially extending slots, means positioning said tube on said body portion, a spring positioned in said tube for axial compression and expansion, a first collar including a diametral pin passing through said tube and through said tube slots to provide for axial movement of said collar in response to compression and expansion of said spring, an adjustable screw engageable with said tube to regulate the compression of said spring, a second collar juxtaposed on said tube above said first collar to be axially movable with and rotatable relative to said first collar, a strut joining said second collar to a point on said arm portion removed from said universal joint whereby compression and expansion of said spring are transmitted to said second collar and through said strut to said arm portion to bias the same in an elevated position relative to said body portion, said universal joint including shoulders and a pin engageable therewith controlling the movement of said arm portion transverse to the axis of said body portion to prevent anterior subluxation of a patients arm, and lock means positioned on said strut to be engageable with said universal joint to lock said arm in an elevated position relative to said body portion.

WILLIAM E. GAZELEY. RICHARD W. MEYSNER. FRITZ P. GRAUL.

References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 1,961,118 Ettinge May 29, 1934 OTHER REFERENCES

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