US 2166229 A
Description (OCR text may contain errors)
July 18, 1939. R. ANDERSON SPINAL REDUCTION SFLINT 5 Sheets-Sheet 1 Filed Jan. 18, 1937 INVENTOR. P0652 fi/vazks o/v Q 1 'WA TTORNEYS.
July 18, 1939.
R. ANDERSON SPINAL REDUCTION SFLINT Filed Jan. 18, 1937 3 $heets-Sheet 2 July 18, 1939. R ANDERSON 2,166,229
SPINAL REDUCTION SFLINT Filed Jan. 18, 1937 3 SheetsSheet 5 IN V EN TOR. Poaf/efln/aaeson B h 1 15M A TTORNEYS.
Patented July 18, 1939 UNITED STATES PATENT OFFICE 12 Claims.
This invention relates to improvements in splints, and has reference more particularly to improvements in splints or braces for the setting of vertebrae fractures and dislocations occurring in the spine and neck; it being the principal object of the invention to provide means whereby traction may be applied by direct skeletal connection with the zygomatic bones of the head in a manner providing an effective and safe application of traction in a line directly coinciding with the line of the spinal column and without pressure on fleshy parts, or in any way hindering jaw action.
Heretofore, splints and braces have been employed which are in the nature of harnesses and are applied to the patients head with straps extended beneath the jaws. Such braces are effective to a certain extent provided their application is for a limited period, but are extremely objectionable in that a head harness hinders the patients speech, prevents his taking nourishment with satisfaction and is painful after a few minutes application. Also certain splints have been utilized wherein skeletal attachment is made by piercing the skull, but this is extreme- 1y dangerous by reason of proximity to the brain.
In vew of the above and other objectionable features of the usual types of head splints, it has been the principal object of this invention to provide a splint which is designed to effect skeletal connection with the zygomatic bones in a manner to provide for an application of traction on the spinal column in a direct line therewith and thereby to leave the lower jawfree for normal use.
It is also an object to provide means in connection with a skeletal traction head splint to apply skeletal countertraction to the body in a direction opposed to the application of traction.
Still another object is to provide a head brace that is easily and quickly adjustable to suit different cases, which is simple, safe and painless in its application, and extremely desirable by reason of its capability of being quickly attached by one not necessarily a specialist in this line of work.
Other objects of the invention reside in the details of construction of the various parts; in their combination, and mode of use, as will hereinafter be described.
In accomplishing these and other objects, I have provided the improved details of construction, the preferred forms of which are illustrated in the accompanying drawings, wherein- Fig. 1 is a view illustrating a head brace embodied by the present invention and showing its application to a patient.
Fig. 2 is a diagrammatic illustration showing, in side view, the head of the patient and place of application of the traction hooks to the zygomatic bone.
Fig. 3 is a horizontal sectional view of the head, showing the place of application of the traction hooks and the formation of the bones to which the hooks are applied.
Fig. 4 is a view illustrating one method and means of applying a tractive force to the head brace.
Fig. 5 is a View diagrammatically illustrating the mode of application and use of the splint.
Fig. 6 is a similar View illustrating means for effecting a constant, yieldable application of tractive and countertractive forces to the patient.
Fig. '7 is a sectional detail of the traction spring used in the device of Fig. 6.
Fig. 8 is a view of the traction splint detached from the patient.
Fig. 9 is a side, or edge view of the same.
Fig. 10 is a horizontal section on the line l0I0 in Fig. 8.
Fig. 11 is a cross section on line ll--|l in Fig. 8.
Fig. 12 is an enlarged detail view of one of the traction hooks.
Referring more in detail to the drawings The present splint embodies a head brace, shown best in Fig. 1, and comprising a yoke made up of two complemental parts, respectively having side bars I and la, and top,.or cross bars 2 and 2a. The cross bars 2 and 2a longitudinally overlie each other, and cross bar 2a has a slot 3 extending substantially the length thereof through which screw bolts 4, seen best in Figs. 8 and 11, are extended and threaded into the bars 2. These screw bolts may be loosened to permit adjustment of the bars longitudinally relative to each other to obtain a desired spaced relation of the two side bars I and la and may be tightened to retain any adjustment thus made.
A longitudinally slotted plate 2.10 is interposed between the bars 2 and 2a and this has its slot registered with the bar slots and the screw bolts 4 pass therethrough. Centrally, on the top edge of the plate, is an car 48 with which a traction cable may be attached as will presently be understood.
With the parts thus assembled, the side bars I and la are substantially parallel and, when the splint is applied, they extend along opposite sides of the patients head, as in Fig. 1, with the cross bars 2 and 2a connecting them directly across the top of the head.
Slidably adjustable along the side bars I and la are clamp blocks 6, each of which mounts a pad I. As will be best understood by reference to Figs. 8 and 10, each block 6 has a laterally opening slot 8 within which its corresponding side bar I or Ia will be received, and a screw I0 is threaded through the block and across the open side of the slot to clamp the block at any position to which it may be adjusted on its bar. Each block 6 also mounts a stem |2 which may be adjusted inwardly or outwardly and also is held in any adjusted position by the tightening of the screw l0. At their inner ends, the stems |2 mount flat metal plates l3 and these serve as backing plates for the cushions orpads 1.
In using the head brace, it is applied to the head with the set screws Ill loosened so that the blocks 6 may be adjusted to a desired position along their bars I or la, also to permit the pads 7 to be seated against opposite sides of the patients head at a desired location. After the proper adjustment and placing of pads has been obtained, then the screws ID are tightened to clamp the blocks in place and against slippage, and also to hold the shanks l2 secure and the pads in position. An elastic adjustable head band I5 is then applied about the patients head, and this overlies the metal plates l3 and pads 1, and thus holds the brace in position.
In order that traction may be properly applied for the purpose of reducing a fracture or adjusting a dislocation, I have equipped the side bars and la of the yoke with traction hooks I6 and I6 respectively. It will be observed by reference to Figs. 1 and 8, that at their lower ends, the side bars have short, inturned portions and la. In each of these portions is a horizontal bore IT in which the shank portions |6a of traction hooks I6 are revolubly fitted. The inner ends of these hook shanks are sharpened, at at Him, and adjacent the ends, are bent to form hook seats 20, which seats are slightly below the axial lines of their corresponding mounting shanks. Fixed on the shanks, adjacent the seats and substantially perpendicular to the shanks are plates 22 whereby the extent of application of the hook to the patients head is limited and these are shaped to best fit the place of application. The upper portions of these plates are bent outwardly to better suit the patient.
In using the splint, it is first prepared for application by loosening the screw bolts 4. Then the traction hooks, removed from the brace, are applied to the opposite sides, of the patients head at a location that the hook seats will engage the lower edge of the zygomatic bone about two fingers breadth in front of the ear, as seen in Figs. 2 and 3. At that location, the hooks will seat within a natural notch which is in the bone, as indicated at 25 in Fig. 2, and their inner ends will only pierce muscular parts, not in a dangerous area.
After application of the hooks to the patient, the shank portions of the hooks are applied to the ends of the yoke legs I and la and the screws 4 tightened to hold the adjustment. Then by applying a tractive pull upwardly on the yoke, the pull will be applied to the patients head and will be transmitted to the spinal column me direct line therewith.
In Fig. 5 has been illustrated one means of obtaining traction. In this instance, the head yoke is attached to a suspended weight 30 by certain amount of tractive force.
means of a cable 30 passing over a pulley or guide 3| on a bracket, or the like, 3| that is fixed to the head of the bed frame 32 on which the patient is rested. A weight 35 may be suspended by means of a cable 36 which passes over a pulley 31 on the lower end of the bed frame, and is connected with a. cast, bandages, adhesive, or the like, 38, or by direct skeletal connection, to the patients legs. The bed may also be sloped by placing a support as at 40 under the upper end thereof so that the tendency of the body to slide down in the bed will also provide a The traction exerted in this instance would be dependent upon the slope of the bed and upon the pull of the weights applied.
In Fig. 6 has been illustrated another method in which a cable 4| is attached similarly to the patients legs and passes downwardly about pulleys 42 and 43 on the lower end of the bed, and then is connected through the mediacy of a spring device 44 with another cable 45 which extends upwardly and about pulleys 46 and 41, and is connected with the eyelet 48 on the plate 2x disposed between the cross bars 2 and 2a of the yoke. In this instance, the amount of traction would be dependent upon the pull of the spring device which, in a preferred construction, is like that of Fig. 7, wherein the cable 45 is attached to one end of a T-shaped rod 50 that is slidable within a longitudinally slotted sleeve 5| to which the cable 4| is attached. A coiled spring 53 encloses the sleeve and is seated at one end against a wing nut 55 threaded on the sleeve, and at its opposite end against a washer 5B which is slidable on the sleeve 48 and bears against the T-shoulder 50a. The natural tendency of the spring is to expand and thereby to place a pull on both cables.
At the end opposite to the threaded wing nut, a stationary grip 62, similar to the wing nut 55 is held by a pin 63, which also holds fixedly a short rod 64 in the end of the sleeve 5|. This grip 62 is adapted to be held in one hand so that the sleeve 5| may be held against rotation while the wing nut 55 is turned up to give the desired tension to the cables 38 and 42. It will be readily seen that the T-shoulder 50a of the rod 50 will slide in the slot of the sleeve 5| when a pull is exerted upon the cables 4| and 45.
If desirable, this sleeve 5| could be graduated as at 14 in Fig. 6, so that the exact pull exerted by the spring 53 could be read in units of pound weight equivalents as the T-shoulder 50a or the collar 56 advances along the sleeve. In this way a definite tension or tractive force could be applied, constantly or varied as necessary, to the fractured or dislocated bones.
In Fig. 4 I have illustrated means of applying traction through the mediacy of a leather, aluminum or plaster neck yoke 60. This yoke (preferably of 2-piece construction) res'ts against the shoulders of the patient and there are turn buckle connections GI and 62 extending between the opposite sides of the yoke and the lower ends of the bars I and la. It is apparent that by adjusting the turnbuckles, traction may be applied to any extent desired and that this will be sustained by a direct application of force against the patients shoulders. Universal locking joints would be used at the points of connection between the turnbuckles and yoke. It is also contemplated that the splint might be embedded directly in a plaster cast applied about the patients neck.
.Assuming the device to be so constructed, it is apparent that traction may be applied directly in the line of the spinal column. Furthermore, the traction will be applied skeletally and thereby overcome the disadvantages that are incident to the use of head splints of that type which are bound around the head and under the jaws of the patient. Furthermore, the present mode of application leaves the patients lower jaw free for use.
This device may be applied with only a local anesthetic and safely applied because the hooks enter only muscular parts of the head and are entirely away from the brain.
While I have shown the yoke as being so applied that the arms extend along the opposite sides of the head, it is apparent that the design of the yoke could be made such as to place the base portion across the forehead or back of the head without change in place of attachment of s the hooks 2D, and that connection could be made with the yoke in various ways so that traction would be applied in the desired manner. Therefore, it is not intended that the claims shall be limited to the details shown, but that they be given an interpretation commensurate with the scope of the invention disclosed.
Having thus described my invention, what I claim as new therein and desire to secure by Letters Patent is:
1. In means for the treatment of spinal injuries, a traction means, with parts disposed at opposite sides of the patients head, hook shanks mounted in the ends of said arms having hook seats at their ends adapted to seat therein the 5, lower edges of the zygomatic arches to effect a holding connection with the patients head for an application of tractive force in the direction of the axis of the spine.
2. In a means for the treatment of dislocations and fractures of the spine, a traction means including a yoke having spaced. arms arranged to extend along opposite sides of the patients head, hook shanks rotatably mounted in the ends of said arms having hook seats at their ends adapted to seat therein the lower edges of the zygomatic arches to effect a holding connection with the patients head for an, application of tractive force in the direction of the axis of the spine.
3. In a means for the treatment of spinal injuries, a traction yoke comprising a base bar and opposite side arms; said yoke being adapted to be applied about the patients head with the base bar thereof extending across the top and the opposite side arms disposed at opposite sides of the patients head, clamp block adjustable along the said arms, head engaging pads adjustably mounted by the blocks, and hooks mounted by the arms and adapted to holdingly engage the under edge of the zygomatic arches for an application of tractive force.
4. In a means for the treatment of spinal injuries, a yoke comprising a base bar and opposite side arms, said yoke being adapted to be applied over the patients head with the said arms extended to the opposite sides of the jaws, head pads adjustably mounted by the arms to be seated against opposite sides of the head, a band adapted to embrace the head of the patient and overlying said pads to hold the splint in place relative to the head, and hooks mounted by the ends of the said arms to engage with the lower edges of the zygomatic arches to effect a holding connection for the application through said yoke of a tractive force.
5. A means as in claim 4 wherein the said clamp blocks are adjustable along the yoke arms, and said head pads have mounting shanks adjustably mounted, in said blocks.
6. In a means for treatment of spinal injuries, a traction yoke applicable over the patients head and having its opposite arms adapted to depend along opposite sides of the head, hook shanks rotatably mounted in the ends of the said arms, hooks on the inner ends of the said shanks adapted for piercing the cheek and for engaging the zygomatic arches for an application of tractive force, and plates fixed on the shanks to engage the sides of the patients face as a means of limiting the extent of piercing by the said hooks.
A device as in claim i wherein the shanks of said hooks as rotatably mounted in said yoke arms are substantially perpendicular to the planes of the sides of the face and said hook seats at the inner ends of said shanks are offset below the axial lines of the shanks.
8. In a means for treatment of spinal injuries, a yoke adapted to be placed across the patients head and having opposite side arms spaced for depending along opposite sides of the head, a pressure pad adapt-ed to seat upon the patients shoulders and manually expandible means con necting the yoke and pad for effecting a relative lifting of the yoke, and hooks mounted by the yoke arms to engage with the lower edges of the zygomatic arches for effecting an application of tractive force to the spine through the skeletal connection when said connecting means are expanded.
9. A means for treating spinal troubles, comprising a yoke adapted to be applied over the patients head and having hooks on its opposite arms to engage with the zygomatic arches, means for effecting a counter-traction connection with the patients body, cable guide devices, a cable extended over said guide devices and connected at opposite ends to the yoke and said countertraction means, and included in the cable connection for shortening the effective length of the cable to cause an application of tractive and countertractive forces to the yoke and countertraction means.
10. A means as in claim 9 wherein said cable shortening means includes a spring whereby the said forces are yieldingly applied.
11. The method of treating spinal injuries which comprises exerting an extending tractive force thereon through the mediacy of a traction device including hooks arranged to engage, for the application of traction, the lower edges of the Zygomatic arches without piercing the arches.
12. The method of applying tractive forces to the spinal column, comprising effecting a holding skeletal connection, with the patients head through the mediacy of a traction yoke applied over the head and engaging the lower edges of the zyg-omatic arches in a holding connection and without piercing the arches, attaching a traction applying cable to the yoke, and extending the cable over guides to a counter-traction connection with the patients lower limbs, and including in said cable a link under tension whereby traction and countertraction are yieldably applied.