US 2783758 A
Description (OCR text may contain errors)
March 5, 1957 R. H. TROTT FRACTURE REDUCING DEVICE FOR THE ARM 2 Sheets-Sheet 1 Filed June 17, 1955 INVENTOR. RaymondH Trait ATTORNEYS:
March 5, 1957 R. H. TROTT FRACTURE REDUCING DEVICE FOR THE ARM 2 Sheets-Sheet 2 Filed June 17; 1955 INVENTOR. Rqymondfl Troifi ATTORNEYS.
United dtates Patent ice.
FRACTURE REDUCING DEVICE FOR THE ARM Raymond H. Trott, Providence, R. I.
Application June 17, 1955, Serial No. 516,151
3 Claims. (Cl. 128-84) This invention relates to surgical apparatus and more particularly to a mechanical device for reducing fractures by application of controlled traction and counter- -traction to the forearm of the human body.
The present invention is more particularly designed for reducing so-called Colles fracture in the bones of the wrist by applying the principle of straight traction and countertraction with ulnar deviation and palmar flexion of the wrist essential for proper fixation.
One object of the invention is to provide an improved fracture-reducing device or appliance of simplified construction, relatively light weight, readily transportable and easy and convenient to apply.
Another object is to provide a device or apparatus which may be applied to the patients forearm by a single operator without an assistant to maintain immobility of the affected parts essential for the application of splints or a plaster cast with bandages.
Another object is to provide an appliance of the type following specification which describes a preferred form ofconstruction of the device, by way of example, as illustrated by the accompanying drawings. In thedrawings: 'Fig. 1 is a side elevational view of the present improved device shown as applied to a patients forearm for supporting it in vertical position and applying traction to the bones;
Fig. 2 is an end elevation of the same viewed fromthe left in Fig. 1 and indicating the forearm of the patient by dotted lines;
Fig. 3 is a composite view of the several parts of the device shown in disassembled relationship; and
Fig. 4 is a detailed view illustrating a modified form of the arm-brace or holder to provide maximum clearance for applying splints and bandages.
Previous attempts have been made to produce an apparatus adapted for reducing Colles fracture, but heretofore it was not possible to apply ulnar deviation and flexion of the wrist with such devices. Most of these earlier devices have been extremely complicated in structure, heavy and cumbersome to transport and erect in surgeons ofiices and hospital operating rooms and inconvenient to apply. Moreover, such prior devices require certain mechanical skill for adjusting their mechanisms and usually necessitate employing an assistant besides the operator for applying them to use. In addition, their complicated mechanisms are subject to deterioration 2,783,753 Patented Mar. 5 1957 2 and disarrangement while being expensive to manufacture and costly to acquire.
A particular object of the present invention, therefore, is to provide an extremely simple device without pulleys, weights or other extraneous attachments and one which is more convenient to apply by a single operator without need for an assistant.
Referring to the drawings, the present improved apparatus consists in a relatively rigid standard or upright 2- mounted on a flat rectangular base 3 that may be seated on the operating table or other support as indicated in Fig. 1. Conveniently, the upright or standard 2 may be constructed from a flat bar of stainless steel of aluminum, bent to form a lower horizontal extension 4 welded, riveted or otherwise suitably fastened to the top of the base-plate 3. A reinforcing member or brace 5 of the same material may be provided extending angularly from :the arm 4 to the upright or standard 2 with its ends bent to engage therewith and welded or riveted thereto. Usually, the patient to be operated upon is placed in recumbent position and it has been determined that the most convenient method of reducing a fracture of the wrist is by supporting the affected forearm in vertical relationship and applying traction to the hand. For this purpose the present device comprises a horizontal member or arm-support 8 which is adjustable vertically on the upright or standard 2 and provided with an arm-rest 13 at its outer end.
As herein shown the member 8 is provided at one end with a bifurcated bearing element 9 straddling the standard or upright 2 with a thumb-screw 10 for binding it against the standard to clamp the member in adjusted position thereon. The member 8 is preferably constructed in two parts, the main section 11 being of tubular form to adapt it to receive a rod or member 12 for telescopic connection therewith. Fastened to the end of the rod 12 is the arm-rest 13 which may be constructed of sheetmetal and shaped with a relatively fiat portion curved around at one end to partially enclose the patients arm (indicated member 8 is slidable within the main tubular member 11" to adapt it for longitudinal extension therefrom for adjusting the position of the arm-rest '13. A set-screw 15. screwed through a boss at the end of'the'main portion 1 1; of the member 8 may be used for clamping the extensionrod 12 in adjusted relationship with therest 13 bearing.
against the patients arm as shown in Fig. l; r
Adjustable vertically on the standard'z above thememher 8 is a shorter arm or member 20 for attachingthe means which applies traction to the thumb of the hand; The member 20 has a'bifurcated bearing 21 at one end "for enclosing the standard 2 with a thumb-screw 22 for As shown in Fig. 1, traction is applied to the thumb of the patient by the use of a contractible cot 25 such' as the so-called Chinese finger-trap fastened to the adjustable member 20 located against the top of the stand-' ard 2. Several different forms of this type of finger-f h trap are shown in Fig. 3 of the drawings as being constructed in tubular tapering shape from reticulated cords braided or otherwise fabricated in an open mesh. The" smaller end of'the'cot or finger-trap 25 may be held in a clip 26 formed with a hole for connection to an S-shaped hook or clevis 27 adapted to hook into the end of the member 20 as shown in Fig. 1. Thus, when the cot or trap 25 is expanded by reducing its length and then applied to the thumb and drawn out to extend its length it will bind tightly therearound to securely grip the thumb for applying traction thereto.
It will be observed from the above description that the present apparatus is extremely simple in structure, relatively inexpensive to manufacture and also easily transportable while being convenient for applying the device to the patients wrist as next explained. With the patient in recumbent position a relatively small sandbag S, such as commonly used by surgeons, is laid across the arm over the anterior surface of the elbow, as shown in Fig. l, and the forearm raised to substantially vertical posture. The standard 2 is placed in operative position by supporting its base 3 on the operating table or any other suitable support with its longer arm or extension 4 below the patients elbow. The arm-support or member 8 is then adjusted to the proper height on the standard or upright 2 with the armrest 13 against the patients arm slightly below the wrist; the extension-rod 12 being adjusted for this purpose by sliding it in the main member 11 and clamping it in place by means: of the set-screw 15. The set-screw 10 is likewise tightened against the standard 2 to fixedly secure the member 11 in adjusted position on the standard 2.
The contractible cot or trap 25 is next applied to the thumb and its end attached to the member by hooking the clevis 27 through the hole in said member. The member 20 may be adjusted up or down on the standard 2 to exert a pull on the trap whereby to apply the desired amount of traction to the wrist. It is to be especially noted by reference to the drawings that by applying relatively straight traction through the trap 25 to the thumb of the patient the direction of the force exerted thereby draws the thumb to the left as shown in Fig. 2 so that the desired palrnar flexion of the wrist and ulnar deviation is secured as the hand assumes the offset or inclined relationship indicated in Fig. 2.
With the parts adjusted in this manner the weight of the arm produces an appreciable amount of traction and additional traction may be applied by placing a small sandbag S across the anterior surface of the elbow. With a five-pound sandbag used for this purpose actual measurement has demonstrated that approximately fifteen pounds of traction is produced which will hold the wrist satisfactorily in fiexion with ulnar deviation. Plaster may be applied while the hand is held by the apparatus to produce immobilization and it has been demonstrated that the whole procedure can be accomplished easily by one person with only ten or fifteen minutes of preparation. The plaster may be applied in slab-like layers, as represented at a and b in Fig. 4, moulded about the wrist and bound by an Ace bandage without interference by the operating parts of the device. To make this possible the arm-holder or rest 13 may take the form shown in Fig. 4 with its support or rod 12 offset at one side by bending the rod as shown at 30. Through this simple yet ingenious arrangement of the several members of the device for supporting the forearm in vertical position and applying traction to the thumb, the area of fracture is properly located and the wrist held in immobilization to facilitate reduction of the fracture. The fracture is reduced and maintained until the plaster sets.
It will be observed from. the foregoing specification that the present improved apparatus is extremely simple in structure and easy to adjust for performing its required function of applying traction with ulnar deviation and fiexion of the wrist most essential for reducing Colles fractures; use being made of the patients own arm to produce most of the traction without pain or undue discomfort to the patient. The present improved device has been applied successfully in many cases without the need for anesthesia or a sedative. As another advantage of the present device, the area of fracture remains available for post-operative examination with X-rays or iluoroscope while the wrist is still immobilized. As a still further advantage, the device is universally adjustable for arms of varying lengths to adapt it for application to children or adults.
While the device is herein illustrated and described as embodied in a preferred form of construction, it is to be understood that variations may be made in the shape and arrangement of the parts thereof without departing from the spirit or scope of the invention as expressed in the accompanying claims. Therefore, without limiting.
myself in this respect, I claim:
1. In a fracture-reducing appliance, a horizontal base,
a standard connected to said base and projecting vertically upward therefrom, an arm-support fastened at one end to said standard and projecting laterally therefrom,
. a rest at the outer end of said support shaped to engage the forearm of a patient for supporting it in substantially vertical relationship, an expansible and contractible finger-trap adapted to fit the thumb of a patient, and means fastened to said standard above said arm-support and connected to the end of the finger-trap to maintain it under tension for applying traction to the wrist of a patient.
2. In a traction device for reducing fractures, the combination of a base, a rigid standard connected to said base and extending vertically thereabove, a two-part armsupport comprising a main member fastened at one end to said standard to extend laterally therefrom and an extension-member telescopically connected to said main member, an arm-rest fastened to the outer free end of said extension-member, means for fixedly securing said parts of the arm-support in extended relationship, means fastened to the standard above the first-named arm and extending laterally therefrom, and an expansible and contractible finger-trap connected to the end of said last-named means.
3. In a traction device for reducing fractures in the bones of the wrist of a patient, the combination of a base formed by a relatively flat plate, a support constructed of fiat metal strip-material formed with a portion overlying said base and fastened thereto and a standard extending vertically thereabove, a tubular member having a bifurcated end enclosing the sides of the standard, a set-screw in the bifurcated end of said arm fastening it in position extending laterally therefrom, an extension comprising a rod slidable in said tubular member, a rest at the end of said extension formed to par.- tially enclose the arm of the patient, a second member having a bifurcated portion at its end enclosing. the sides of the standard, a set-screw fastening said second memher in fixed position on the standard above the first named member, and an expansible and contractible finger-trap adapted to grip the thumb of a patient and having means at its free end connected to the end of said second arm.
References Cited in the file of this patent UNITED STATES PATENTS Stearns May 27, 1941