Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
  • A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
  • A61F5/04—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints
  • A61F5/05—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints for immobilising
  • A61F5/058—Splints
  • A61F5/05841—Splints for the limbs
  • A61F5/05858—Splints for the limbs for the arms

Definitions

• the present invention relates to a device for treating limb fractures in the vicinity of joints, e.g. in the forearm radius or near the malleolus.
• Colles's fracture usually occurs after a fall with the hand outstretched, and gives a faulty attitude of the distal end- of the radius, with dorsal, i.e. towards the back of the hand, open angular fault in combination with length loss, so- called radial compression.
• this fracture is fixed in nearly all clinics with the use of a dorsal plaster-of-Paris orthosis which is kept in place by elasti- cated bandage. It takes about five minutes for the plaster orthosis to harden, and during this time the fracture must be kept still so that the repositioning attitude is not lost.
• the elasticated banda ⁇ ges surround the entire arm, they can give rise to stasis if it is pulled too tightly. It is probable that stasis prima- rily occurs where the amount of soft parts is least, i.e. round the wrist.
• the conventional plaster-of-Paris orthosis which is laid from the proximal part of the forearm to the junction between the fingers and metacarpus further has the disadvantage that it does not allow any movement in the wrist. After four weeks, which is the accepted treatment time, this gives rather severe stiffness, which can take up to several months of exercise to improve, particularly if the patient is getting on in years.
• a twisted foot landing is the usual cause of damage with varying degrees of difficulty. If a fracture occurs, some serious types must be operated. However, the greater number are of a simpler type with iso ⁇ lated fracture of the lateral malleolus. These have a small incorrect rotation attitude, but lack expansion of the ankle joint fork, and therefore do not need to be repositioned.
• This type of fracture is usually treated by means of a plas ⁇ ter-of-Paris boot without loading for three weeks and then a plaster-of-Paris boot with loading for a further three weeks.
• plaster-of-Paris is considered to have the function of preventing the lateral malleoulus from being further late ⁇ rally dislocated, which would give an expansion of the ankle joint fork with incongruence in the surfaces of the ankle joint and accompanying abnormal wear thereof.
• the greatest disadvantage with plaster-of-Paris in this type of fracture is that it locks the ankle joint, with resulting stiffness.
• the customarily used plaster-of-Paris fixation of such frac- tures thus has many disadvantages, and the present invention has the object of removing most of them.
• an orthosis the function of which is based on its supporting the fractured limb proxi ally and distally about the fracture in combination with a bolster action or abutment therebet ⁇ ween.
• an orthosis for treating such fractures of limbs close to joints, the orthosis including an elongate, substantially stiff support element with means for fixing this element to the limb.
• the orthosis is characterized in that the support element has first and second support portions arranged in their respective end portions of the support element for engagement against one side of the limb and on either side of the fracture with the first support portion substantially in association with the joint, and in that the fixation means have a third support portion for engagement against the oppo ⁇ sing side of the limb between said first and second support portions, the fixation means being substantially non-yield ⁇ ing at least in the transverse direction of the support element.
• the fixation means being substantially non-yield ⁇ ing at least in the transverse direction of the support element.
• the orthosis is intended for radius fractures, the distal support portion close to the joint being preferably provided with a bulge on the inside, intended for pressing against the distal, dorsal portion of the forearm, for keeping the fractured end of the radius in place.
• the support element also includes here distal, side portions close to the joint and arranged for being pressed against the radius or elbow bone with the aid of the fixation means for applying radial pressure, with the elbow bone providing bolster action or abutment. Further preferred embodiments of the invention are disclosed in the subclaims.
• the fixation proce ⁇ dure is simplified and improved considerably compared with the conventional plaster-of-Paris fixation, simultaneously as the risk of the repositioning attitude being lost is reduced.
• the inventive orthosis can also be made from material which is easy for X-rays to pass through, it has low weight and will be reusable.
• the orthosis only extends up to the joint adjacent the fracture in question, i.e. the wrist in Colles's fracture, or the ankle in lateral malleolus fracture, and for this reason the joint is given almost full mobility with the obvious advantages this brings with it.
• the risk of stasis is small due to the configuration of the orthosis.
• FIG. 1 is a perspective view of an orthosis in accordance with the invention, intended for treating radius fractures.
• Figure 2 is a central, longitudinal section through the orthosis of Figure 1, and
• Figure 3 illustrates the orthosis of Figures 1 and 2 applied to an arm.
• the orthosis illustrated in the Figures is, as mentioned above, intended for an ordinary radius fracture close to a joint, and includes an elongate saddle-like support body 1 adapted for engaging against and partially surrounding the dorsal side of the forearm.
• both long edges of the support body 1 are provided with two reces ⁇ ses 2, 3, so that three tongue-like side portions 4, 5, 6 are defined on either side of the orthosis, and such as to form support for a respective fastening device 7, 8, 9 for fixing the orthosis on the forearm.
• the fastening devices 7, 8, 9 are of the Velcro R type and include tension ribbons 10, 11, 12 which carry on their insides one part (the "matting” part) of the fastener, which can be fixed to bands 13, 14, 15 carrying the other part (the "hook” part) of the fastener, these bands being fastened right over each of the parts of the support element 1 provi ⁇ ded with a side portion.
• tension ribbons 10, 11, 12 which carry on their insides one part (the "matting" part) of the fastener, which can be fixed to bands 13, 14, 15 carrying the other part (the "hook” part) of the fastener, these bands being fastened right over each of the parts of the support element 1 provi ⁇ ded with a side portion.
• the distal end of the orthosis i.e. the wrist end
• the proximal end i.e. the elbow end
• the middle one 11 and the proximal one 12 each carry their respective support cushion 16, 17 which is movably fastened on the ribbon via slits 18,
• the support body 1 is made from shaped, stiff material la, preferably plastics, the inside of which is covered with a layer of softer material lb, e.g. foam plastics. Seen from one side, or in longitudinal section as in Figure 2, the support body 1 has its central portion weakly concave, so that it thus obtains a limited proximal support portion and a limited distal support portion for engagement against the dorsal side of the forearm with the central portion substan ⁇ tially free from engagement.
• a bulge 20 on the inside of the orthosis between both distal side tongues 4, and the function of this bulge will be described in more detail below.
• distal tongue portions 4 have sufficient length so that the tension ribbon 10 will not lie against the underside of the forearm when the orthosis is fastened to the arm, but will go free from this part of the forearm.
• the repositioned distal end of the fractured radius will be effectively and securely kept in an anatomically correct position using the described orthosis, by the special com ⁇ bination of different pressures which are exerted. Due to the configuration of the support element 1, dorsal pressure is thus applied at the distal part of the forearm close to the wrist via the bulge 20, and also on the opposing side of the fracture proximally below the elbow joint.
• the support cush ⁇ ion 16 via the tension ribbon 11 applies therebetween a bolster pressure on the underside of the arm.
• the pressure achieved in this way effectively prevents incorrect angular attitude at the fracture.
• the inner of both distal tongues 4 applies pressure on the radius (radial pressure) with the outer tongue portion 4 providing bolster action against the undamaged elbow bone, which in combination with the bulge 20 prevents both compression and incorrect attitude of the fracture.
• the orthosis Due to its configuration, the orthosis also does not lock the wrist, but allows almost full mobility during treatment. In addition, the orthosis gives considerably improved mobility directly after terminated fixation compared with the conven ⁇ tional plaster-of-Paris method. The early-obtained mobility can be expected to give less pain and shorter convalesence. The patient should also obtain more rapid return of wrist strength, which is also essential for rapid rehabilitation.
• distal tension ribbon 10 does not lie against the underside of the wrist, as mentioned above, and does not put pressure on it, free blood circulation is permitted with lessened risk of stasis, compared with conventional treat- ment.
• the patient can furthermore wash the hand on the fractured arm without hindrence, with all the hygienic advantages this offers.
• Further substantial advantages of the orthosis are its low weight and its reusability, and due to its configura- tion it can be utilized for both right and left wrists.
• An orthosis similar to the one illustrated in Figures 1-3 can be used for treating lateral malleolal fractures.
• the lateral malleolus is supported proximally and distally about the fracture with bolster action therebetween (against the shin) in the same way as with treatment of radius fractures. Fork expansion is thus prevented effectively.
• the patient obtains, thanks to the inventive orthosis, the possibility of freely moving the ankle joint during the treatment, with the obvious advantages accounted for above that this brings with it.
• the lower weight of the orthosis compared with the conventional plas ⁇ ter-of-Paris boot has of course special importance here, above all with respect to older people.

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• Health & Medical Sciences (AREA)
• Nursing (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Orthopedics, Nursing, And Contraception (AREA)

Applications Claiming Priority (2)

Publications (1)

Family

ID=20377230

Family Applications (1)

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Cited By (4)

Citations (4)

• 1989
  • 1989-10-20 SE SE8903481A patent/SE8903481L/sv not_active Application Discontinuation
• 1990
  • 1990-10-19 WO PCT/SE1990/000675 patent/WO1991005525A1/en unknown
  • 1990-10-19 AU AU66189/90A patent/AU6618990A/en not_active Abandoned

Patent Citations (4)

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