US 1950799 A
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Description (OCR text may contain errors)
March 13, 1934.
C. P. JONES FRACTURE APPLIANCE Filed April l5. 1933 y /If I IH,
A TTORNE YS.
atented Mar. 13, 19134 Nr retos l. laim.
My invention relates, in general, to surgical appliances; and, in particular, to devices for holding the ends of fractured bones together without motion until new bone has formed.
In common practise, the types of fracture appliances for this purpose are characterized either first by a plate which lies directly upon the bone and spans the fracture, the ends` of the plate being secured by screws, pins or other penetrating projections which go deeply into the bone on each side of the fracture; o-r second by a band directly upon and tightly encircling the fracture.
In cases where no infection is present, the use of the plate type with its bone-penetrating projections is not necessarily harmful, since proper healing may take place, the new bone covering the plate, which thus becomes a part of the bone. But cases of open or compound. fractures, there is always infection, and it seems poor technique to have screws or foreign parts going into the substance of the bone, as every new hole carries the infection into the bone.
Again, where in treating broken limbs say, for example, a fractured femur, by means of surgical splints, traction is applied by weights or other devices, the traction pull or drag falls upon the bone penetrating screws of the plate, thus tending to cause a necrosis of bone over the screws.
in cases where the band type is used in a transverse fracture, the callous formation covers the band entirely around the bone, and frequently such formation must be removed, a hard and long task.
Another fact, to which attention may be called is that if a transplat is used, that is, removing a piece of vbone with double circular saws, and taking the same sized piece of fresh bone from another bcne, it is necessary for success to hold the new piece in place firmly. This is commonly done by boring holes near the edge of the inlay and also near the edges of the bone itself. This practise as well as that in which the common types of fracture appliances above mentioned are used, muet inevitably lead to the recognition that in bone surgery t e success of an operation on bones depends upon the smallest amount of handling or bruising of parts.
It is, therefore, the object of my invention, to provide an appliance from the use of which such success will follow; and to this end :ity invention may be briefly stated to consist of a plate devoid of all bone penetrating projections, whether screws, pins or other impaling members, said plate being adapted to lie upon the bone, overlapping the fracture; and carrying at each end a band for embracing the bone on each side of the fracture with means for locking the bands in tight em-r brasure, all as will hereinafter fuly appear, to# gether with details of construction, it being understood that changes may be made without departing from the spirit of the invention as defined in the claim hereunto appended.
In the drawing, herewith accompanying,
Fig. l is a top plan view of the appliance showing a simple form of the plate and band assembly; v Fig. 2 is a section on the line 2-2 of Fig. 1'; Fig. 3 is a top plan view showing a modified assemblage; and Fig. 4 is a section on the line 4-4 of Fig. 3.
1 is a plate, in practise, of metal, withsuitable rigidity and cross-section, and of a length adapting it to lie upon the bone and to span the fracture with sufficient overlap to enable it to be securely fastened. 2 are the fastening members, consisting of piiant metal of suitable cross section, and of a length adapting them to embrace the bone with sufficient surplus to provide for readily tightening and locking them in their embrasure. In the present case they are shown as flat strips to which the term bands may be and is herein applied; but it is not intended to limit their cross sectional shape to this form, although in many respects it may be preferable. The manner of and means for mounting the bands 2 on the plate 1, though possibly varied or modified in detail must comprise what may be regarded as three essentials, rst, resistance to pulling stress to tighten them, second holding them to and guiding them on the plate while being pulled, and, third, locking them at the limit of pull. To these may be added, as will presently appear, the specific location of the guiding means in order to enable the tightening pull to be applied to the best advantage. The simplest form of the appliance is illustrated in Figs. l and 2. There are two bands 2, one near each end of the plate 1. One end of each band is secured, as by a screw 3 to the plate, and the other end is passed through and slidably guided in an aperture 4 of the plate, and said end after passing therethrough is long enough to be pulled upon, and suitably locked, 10o as, for example, by being doubled down upon itself, as shown at 5.
The application of the appliance to the fracture will now be readily understood. The plate l is laid directly upon the bone, which it ts closely, and spans the fracture with sufficient clearance of each side thereof for assuring firm connection. The bands 2 are then by means of a proper gripping instrument, unnecessary to show, passed around under the bone and through the k apertures 4 of the plate 1 which are shaped for a relatively snug band t, and after being pulled tight, said ends are locked in any suitable manner, such, for example, as being doubled down upon themselves at 5, thus insuring their tight embrasure and holding the plate securely and immovably to the bone. Though the apertures 4 in the plate may be variously located, it is to be especially noted that their best position is as here shown through the thickness thereof, so that they are perpendicular to the upper and lower plate faces, whereby the band ends pass upwardly through them, thereby projecting above the bone which is the best position to exert the pull to tighten the bands.
Referring now to Figs. 3 and 4, I have shown a further development of the appliance in providing for a change of position of the bands 2 along the length of the plate 1, as may in some instances be of advantage, and also, if desired, using' more than two bands, in order that one or more extra bands' may be placed in the immediate vicinity of and even over the fracture.
The change of position of the bands along the length of the plate requires, for convenience, that 'said bands be not permanently secured or pinned to the plate as heretofore indicated at 3 in Figs. 1 and 2. Accordingly I have shown in Figs. 3 and 4 that said bands may be readily removable for changing their positions, by providing both sides of the plates at intervals with apertures such as 4, and locking both ends of the bands by doubling them down as at 5. This will enable the same plate to be used with two or more bands. It is to be noted that the plate 1 is wholly devoid of bonepeiietrating members or projections such as sharp pins, or screws, since it is the intention to secure it to the bone only by means of the bands. It may be stated at this point that the holes shown at 6 at each end of the plate 1 are retained solely as a precaution in case screws are needed. All such bone-penetrating devices are wholly omitted, full immobility being secured solely by the bone-embracing members.
The outstanding advantage in this is the avoidance of infection if such be not initially present; or the successful use of the appliance, even in cases of compound fractures, Where infection is present. Furthermore, where broken limbs are treated by splints anchored to the limb above and below the fracture, and in which treatment traction isapplied, the traction stress instead of being directly and injuriously borne by pins or screws penetrating the bone, is carried by the bone itself through the bands 2, thereby avoiding the danger of infection, as hereinabove mentioned.
A fracture appliance comprising a plate devoid of bone penetrating projections and adapted to lie upon the bone in overlapping spanning relation to the fracture, said plate having a plurality of spaced guide apertures in its overlapping ends; circumferentially adjustable iiexible bands independent of said plate for embracing the bone, said bands slidably passing through the guide apertures of the plate adapting them to be pulled to a tight embrasure of the bone; and means for locking said bands in said embrasure to hold the plate tightly to the bone.
CARL P. JONES.