US 2080802 A
Description (OCR text may contain errors)
May 18, 1937- R. ANDERSON" v2,080,802
ANATOMC SPLNT Filed OCL. 10, 1935 2 Sheets-Sheet l ATTORN EY May 18, 1937- R. ANDERSON 2,080,802
' ANATOMIC SPLINT 2 Sheets-Sheet 2 Filed 0G11. lO, 1933 ATTORNEY Patented May 18,. 19.37
- UNITED STATES4 PATENT OFFICE 2.08am ANAToMrc sPLlN'r' Roger Anderson, Seattle, Wash. "Application ombel- 10, mais,y seriaiNo. ceases' g 14 claims. (ci. 12s-ss).
This inventionvrelates tofracture reducing splints and it has reference more particularly to splints designed for reduction of fractures of the arms; it being the principal object of this 5 invention to provide a substantial, light weight,
easily manipulated and quickly adjustable splint,
designed primarily for fracture reduction by direct Vskeletal attachment, and wherein provision is made for relative rotation and angular adjustment of the traction devices and for the me: chanical application of traction to a desired amount.
Another object ofthe invention is to provide an improved form of traction pin designed for a partial or limited piercing of a bone in the reduction of forearm fractures.
Another object resides in the construction of parts adapted to be used interchangeably on the main frame structure to. adapt the splint'to leg or to arm fractures.
Still further objects of the invention reside. in the details of construction and in the combination of parts of the splint and in their mode of operation, as will hereinafter be fully described.
, In accomplishing the .different objects of the invention, I have provided the improved'detailsof construction, the preferred forms of which are illustrated in the accompanying drawings Wherein- Fig. 1 is a. plan view of a fracture reducing splint embodied by the` present invention, especially for forearm fractures.
Fig. 2 is a side view of the same. Fig. 3 is an enlarged sectional detail of a traction yoke base as used in the arm splint. e Fig. liis a cross section on the line in Fig. 5 is a perspective view of the improved form `of traction pin fo'r limited piercing of the 0 skeletal parts and a retaining pad used therewith.
Fig. 6 is a perspective view of the arm splint.
owing the traction yokes adjusted to positions at right angles to each other. Fig. 'lis a plan view of the splint asapplied for reduction f a fracture in the forearm.
Fig..8 is a view of an alternative form of yoke and yo esupport'disposed laterally of the frame. Fig. a cross section on line 9-9 in Fig.'8. Fig. 10 sa cross section on line lil-I0 in- Fig. 8. Referring more in detail to the drawings- In a preferred form of construction the splint -comprises a rectangular base frame structure made up of transversely disposed, opposite e'nd bars i and 2 oined rigidly in spaced relation by the conical lug I2 in a manner whereby tight.
four longitudinal rods 3` arranged in pairs at opposite sides of the frame. The rods of eachv v pair are vertically spaced and are parallel to each other and the two pairs of rods also are parallel for adjustment therealong of a cross 5 bar 4 that isvmounted at its ends on the pairs o f rods for slidable adjustment in a direction longitudinally of the frame.
To adapt the device for reduction of arm fractures especially, brackets 5 and 6 are at- 10 tached to the end bar 2 and to the cross bar` 4` respectively, by bolts 5a and 6a. These brackets are curved upwardly and awayfrom eachother and are provided .at their upper ends with b earing portions 'i formed with conical sockets 8 as l5 'seen in Fig;l 3, opening 'to their `inner faces.
is formed with ya conical lug i2 adapted to .seat4 rotatably in the socket 8 of its mounting member 'l and a 'bolt I5 is-extended through an opening I6 in the bearing and is threaded axially into ening of the bolt by means of a cross pin lia at its outer end will draw the associated parts tightly togetherl and will thereby hold the base member 9 at any set position of adjusiprient. Loosening ofthebolt permits the base member- 3'0 to be rotatably adjusted to change the relative positions of the two yokes. For example they may be rotatably adjustedv from relative' right Y angular positions as in Fig. 6 to any position intermdiate thatv at which they ar'e both in the 35 same plane, as seen in Fig. 2. Also, each of the bases or yoke mountings 9 isformed with spaced anges'v l1' and l 1 vbetween which the' flatbas'e portions Illa' of the traction yokesd are contained.
'I'he yokes are of U-form and the positions of 40 the supports in which they are mounted are such that the yokes open toward each\other, a's seen best in Figs. 1l and. The flat base portions vof the yokes. are .evenly and arcuately curved and are held adjustably betweenythe 45 flanges' I'l-i'l of the base members for lateral adjustment. The outer edge of the base of the yoke is guided by seating against a pair of roll'O ers |8-I8', symmetrically spaced at opposite sides of the axis of the mounting piece and the inner 50 edge is engaged by a roller" 9 located in the axial line, thereby to hold the yoke steadyI and securely but permitting it to be laterally adjusted in eith r direction between the anges and the rollers. A bolt Il extends through the 55 anges for mounting thegroller I9 and this bolt is provided with a wing nut at one end which may be tightened on the bolt to clanip the :danses tightly against the yoke to hold it at anyiset position of adjustment. A
Each yoke is provided at the ends of its arms with transverse 'alined slots 25 for seatingthe ends of a cross rod 26, as illustrated at the right hand sidein Fig. l and Fig. 6, or to receive a traction pin 21 and stem of a retaining pad 29 as seen at the opposite end of the frame. Also there 'are set screws 29 threaded into the end portions of the yokes in a manner to be tightened against the ends of the rod or against the pin or stem of the pad to hold them securely. in the yoke arms. The cross rod 26 when applied through the bone of the arm, as seen in Fig. '1, and seated in the notches of the yoke arms, may serve as an anchor or as a member fordirect application of skeletal counter traction. The traction pin 21 mounted by one arm of the `opposite yoke is pointed at its end and is intended to pierce the limb only to a limited extent as permitted by a stop collar 3Il'that is iixed on the pin at a deiinite distance from its pointed end. There is also a ange 3| on the pin engageable with the inner face of the yoke arm to prevent slippage in the yoke of the pin under pressure and this is square or irregular in shape to prevent its rotating when enclosed in thecast.
The short pin 21 is used for setting lower arm fractures where it isy essential that it pierce the radius to a limited extent just suilicient to provide `the necessary holding traction and it is limited in its extent of piercing by the collar 30. A stem 32 extends from the base of the U-shaped member and may be clamped in the yoke arm opposite that which supports the traction pin. The purpose of this pad applied opposite the traction splint is to support the arm against slipping from the pin and the pin will then retain its holding connection with the bone to which it is partially applied. y The cross bar 4 is mechanically adjusted along the frame structure by means of an adjusting screw 40 that extends revolubly through an opening in the cross bar I and is threaded through' a lug 42 on the under side of the cross bar 4. This shaft has ahand wheel M fixed to its outer end for turning it, and it also has a nut I5 threadedA thereon and fitted against the outer face of the cross bar I, as seen in Fig. 2.
Assuming the device to be so constructed, in
using it for the reduction of a fracture ofthe forearm it is applied as illustrated in Fig. '1.
First, the counter traction rod 26 is extended" lthrough the enlarged upper end of the ulna near;
the tip of the olecranon and the ends of the rod are then applied to and secured by the set screws 29 within the arms of the yoke at one end of the frame ysupported by bracket 5. The
traction pin 21 isinserted through the center of the radius from its lateral aspect about two process, and is forcedin until limited by the stop collar 32; the pin 21 Vand the pad 33 then being applied to the opposite arms of the yoke supportedby bracket 6, at the other end of the frame. To reduce the fracture and properly set' the bones, the two yokes may then be rotatably adjusted relative to each other to bring the fractured bones into proper relationship for reducing the fracture and traction may be applied by ro tation of the adjushjngscilevgvln to adjustr the yokes apart to'. 4effect the latral adjustment.
Afteivsufcient traction has been applied to bring the fractured bones into position for setting, a cast or splint may then be applied about the arm and allowed to set.
While it is not'desirable nor necessary in the ordinary use of splints of this character using skeletal traction to provide for partial transiixion of a`. bone, it is necessary in the successful reduction of forearm fractures by reason of the complex anatomy of the forearm. While'the ulna is the larger of the twoI bones-in the upperforearm, it is the 'smaller at thej wrist and it is very undesirable that the smaller ends of either the ulna or the radius should be pierced by the traction rod or pin by reason of the close relation of the nerves and the blood vessels of these jaarts. Furthermore, the fact that the radius alone articulates atthe wrist and projects beyond the ulna has important clinical signiiicance. It is rather inexplicable that other skeletal meth`ods have entirely omitted consideration of the fact that in rotation of the forearm the radius moves, while the ulna remains stationary. For example, when the forearm is in supination, as shown in Fig. 7, the bones thereof are substantially parallel, but incident to rotation of thehand to pronation the radius rotates about the pivot connection with thev humerus through an angle of approximately one hundred and eighty degrees. and across over the ulna which remains stationary. n It should be apparent thatby reason of this relative movement of the bones, it would be impossible to transx both bones with a pin and still be able toobtain any rotation of the fractured portions of a bone. In fact, a pin extended through both bones would be an eiective lock against rotation and this would be contrary to the principle of the present device.
The anatomical axis of rotation of the radius about the ulna is coincident with a straight Jline through the styloid process oi the ulna and a point substantially intermediate the points of connection of the radius and ulna with the humerus. 'Ihis anatomical axis of rotation isdesignated by vthe dotted line in Fig. 7, and it is the intention that when a forearm is applied to the splint its anatomicalaxis will be disposed in coincidence With theaxial line of rotation of the two yokes which is alonga straight line through their mounting axes. The proper disposition of the forearm when applied to the yoke, as in Fig.
-of the frame, as seen in Fig. 2, upon which the palm of the hand may re'st if 4it is desired that the arm be retained in the splint for any vlength of time. K
In Fig. 8 1 have illustrated an alternative form of yoke and yoke support which betteradapts the splint to the setting of fractures of the upper arm, or for the leg. For application of this yoke, the bracket 5\ would be removed from cross bar 2 and the bracket 55 fixed to the .cross bar- 2 by the bolts 55a to extend to the side of the frame. This bracket 55 is equipped with a yoke mounting` 9' like the mounting 9 already described, and this mounts a yoke 56 that is arranged to open lat- The advantage in use of this laterally plaster casthapplied thereto has set, then the arm i may be removed from the splint. -When it'fis removed, the pin or rod 26 and also the pin 21 and pad 33 are left in place, and in this way eilecf tively anchor the arm relative to the cast. e
Splints of the various types above described for arm fractures, are easily and readily applied ior reduction of fractures and provide for direct ap plication of skeletal traction to any extent desired. They also'provide for rotative adjustment of th`e yokes while attached tothelimb so as to bring the fractured bones into proper position. The fact that the brackets are detachable permits easy arid quick replacement of one, type with the other to adapt the device to leg or arm Having thus` described my invention, what I claim as new therein and desire to secure by Letters' Patent is- 1. In a traction splint, a base structure, a pair of traction yokes, supports for said yokes whereby they'are held in positionsopening toward each other, said supports being mountedinthe base structure in axial alinement and rotatably adjustable relative to each other about their axes. means mounted by each yoke for eiecting skeletal attachment to a limb applied thereto. means for adjusting the spacing of said yokes for applying traction to the limb and means for xing the position of adjustment of the yokes abouttheir axes. .g
2. In a traction splint, a base frame, brackets iixed thereto, yoke'mounting bases rotatablyadjustable in said bxyackets in axial alinement. traction yokes of U-shaped form mounted in said bases and opening toward each other, means removably applied to the yokes across their open ends for effecting holding-connection with a skeletal part of a limb appliedwithin the yokes; said yokes having arcuatelycurved base portions mounted slidably tinguidesiof theirtres'pectiye mounting bases, thereby to p''rmit change in the angular relationship of the yokes relative to the axiall line about which they are rotatably adjustable.
3. In a splint o1' the character described, a pair of traction yokes adapted to embrace the forearm at points belowthe elbow andfabove the wrist.'
" respectively; the first of said yokes mounting a traction pin across the mouthrthereof for transxing thev ulna; the other yoke mounting alpin in one arm thereof for partial`tfansilxin of the radius and a pad in the other to support the arm and hold the radius against dispflacement from the pin, and means mounting the said pair of yokes to permit relative rotation thereof about -tn a splint of the characterl described, a supporting frame,-and a. pair of spaced traction tllenanatomic'al axis of the forearm.
rotation of the traction means. l
5. A traction splint comprising al base frame y rotatably the brackets.n tion yokes mounted bythe the yoke arms for eil'ecting skeletal attachment to a limb applied to the splint, andxa hand screw -mounted on and slidably adjustable along the longitudinal rods, a bracket fixed on the cross bar, a bracket ilxed on one oithevend bars, yoke mounting bases supported by the brackets, traction yokes adjustably mounted by the bases and opening toward each-other, devices removably applied to the arms across the open ends of the yokes lfor effecting skeletal attachment to a limb applied thereto. and a hand screw extended rotatably through an end bar of the frame and threaded into the cross bar whereby the latter may be adjusted to increase or decrease the spacing of the yokes; said yokes being laterally adjustable -in the bases and said bases being rotatably adjustable in their suDDOlting brackets about a-common axial line.
7. In a traction splint, the combination with a support, ot a yoke applied thereto having opposite side arms provided with passages at their ends, a traction pin removably applicable to the passage ot one arm to extend into the yoke mouth, means on the pin forlimiting its extent of piercing a skeletal part-oi' a limb applied to the yoke, releasable means for holding the pin in the yoke arm. a pad having a mounting stem applied to the opposite arm of the yoke and having parts for embracing the limb to retain it against displacement from the traction for holding the pad at diierent positions of ad- Justment r'elativejto the arm.
, 8 In a' splint fornthe reduction. ot, forearm fractures, means for for the reduction of a fracture. and a reduction means associated. therewith and including a transilxion pin rigidly supported from the said reduction means for transihdng the distal radius for reduction. of the fracture thereby and without extendingl beyond the transilxed fragment: said holding means and said reduction means being relatively rotatable of the a'm, as applied tothe splint. and adjustably mounted for change in their spaced relation.
9; A splint for the reduction oi' forearm fractures .comprising a support,
spaced reduction depin and releasable means about the anatomical axis vices. means mounting said -devices on the sup' port whereby they are relatively rotatable about a common axial line, a trasmdon means associated with one of the reduction devices for t the upper-end of the ulna, a transflxion pin ilxedly mounted by the other of said traction devices for transflxing the distal radius for manipulation thereof by movements of the traction device. and witiaut extending therebeyond, anda means for changing the spacing of said traction devices. f Y
1Q. A splint for the reduction of forearm fractures, comprising a supporting base, spaced reduction devices mounted on said supporting base, and relatively rotatable about a common yaxial line, means associated with one of the` said reduction devices for transxing the upper end of the ulna, a.v transxion pin, with one end rigidly fixed in the other of said reduction devices and extending therefrom for. transflxlng the distal radius near its styloid process, without extending therebeyond; said transilxion meansvofxjthe `two reductiondevices being Vso mountedandV so designed,l as to support an arm applied thereto in position that its anatomical axis through the styloid process of the ulna will coincide with the longitudinal axis of-the splint about Vwhich said reduction devices are rotatable; and an adjusting means for one of the reduction devices `for varying the spacing of said reduction devices on the supporting base. A
11. A splint. for the reduction of forearm fractures comprising a supporting base, a pair of ad- `ius'tablyspaced reduction devices, means xedly mounting said devices on the base for relative rotation thereof about acommon axial line and permitting independent adjustment in angular position relative to the said axis, means mounted by one of said devices for transxing the armthrough the upper portion of the ulna, a transxion pin xedly mounted by the other of said devices, for a partial transilxion of the arm. con
ned to the radius and adapted forenteringthe Y radius near the styloid process Yfrom the lateral v aspect, and having a transxion limitingshoulder thereon, and means operable `foradjusting the spacing ofthe reduction devices .for eiect- 4 ing extension and reduction ofthe fracture.
12. -Amethod of `treating Vforearm. fractures,
V comprising ,supporting-the upperv forearm for reduction, applying atransxion means to Athe distal fragment `oi the radius in a manner not to vxextend substantiallybeyond the cortex opposite that to which it is ilrst applied, applying the said transilxion means to an external splint, and then effecting reduction by manipulation of the splint.
13. A method of reducing forearm fractures,
comprising seguring'the upper forearm by skeletal attachment means to an externallsplint in .a man- -ner suitable for reduction, applying a rigid transxion means tothe distal fragment ofthe radius from the lateral aspect and to such extentthat it does not extend substantially beyond the oppo- Asite cortex, xedly mounting thetransflxion means in an adjustably xed part of the, splint, then reducing the fracture by changing the position- Ato the distal fragment of` the radius insuch manner that it does notjextend substantially beyond the opposite cortex, .then reducing the fracture and inallyv anchoring the transxion means to retain the' reduction and effect immobilization. 3