US 3095875 A
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Description (OCR text may contain errors)
July 2, 1963 l. DAVIDSON ETAL SURGICAL ,BRACE Filed Aug. 28, 1961 Ill INVENTOR5 EUGENE AJJE'WETT mym 2 Sheets-Sheet 1 y 1963 l. DAVIDSON ETAL 3,095,875
SURGICAL BRACE Filed 1961 2 Sheets-Sheet 2 INVENTORS EUGENE 4.. \JEwEz-r ATTORNEYS 3,ee ,8?5 Patented July 2., 1963 ice 3,995,875 SURGHCAL BRACE Ian Davidson, Toronto, Ontario, Canada, and Eugene L.
Jewett, Maitland, Fla, assignors to Florida Brace Corporation, Winter Park, Fla., a corporation of Florida Filed Aug. 28, 1961, Ser. No. 134,426 8 Claims. (Cl. 123-78) This invention relates to a surgical brace.
The brace embodying the invention has a lower portion which can be fitted with accuracy to encircle the pelvic region of a patients body to provide a firm support with respect to which the upper portion of the brace is accurately adjustable to maintain the thoracic-lumbar spine and lumbosacral area immobilized against undesirable backward movement or extension while keeping the spine in varying degrees of forward bending or flexion. A brace of this character has been found to be particularly desirable in numerous conditions such as inter-vertebral disk rupture, facet malalignment, pathological conditions, soft tissue disability, and other conditions affecting the lumbar spine and lumbosacral area. It is also useful following certain operative procedures in this region.
The brace as hereinafter disclosed provides excellent pelvic and lumbosacral stabilization and effectively anchors a girdle or base section of the brace to the pelvis and sacrum, thereby providing positive support, while giving fixedly adjustable control of the lumbosacral joint and nevertheless permitting substantially instant removal and replacement without affecting the adjustments. In many of the conditions in which this brace is used, it is not only permissible but desirable that the patient have some freedom of forward movement or flexion but none in the backward or extension direction. The facility of removal or replacement of the brace by the patient is desirable. However, it is important that the adjustment made for medical or surgical reasons shall not be altered by the patients removal or replacement of the brace.
As will be pointed out more particularly hereinafter, anchorage to the pelvis and sacrum is achieved by pubic support bars which partially encircle the patients pelvis anteriorly and laterally and connect to a pubic pad at the front, and to posterior or buttocks pads at the sides and rear. These buttocks pads are connected to each other by an adjustable strap having a detachable anchorage at least at one of its ends, and completing the enclosure of the pelvic region. On the lower girdle or pelvic section thus formed, upwardly extending frame arms are mounted which are disposed at the sides of the patients body and have angularly adjustable connections with a forwardly open upper frame section. This upper frame section, which partially encircles the lower thoracic spine anteriorly comprises lateral bars or side pads attached to the upper frame arms, these being in pivotally adjustable connection with the frame arms of the lower section. By adjustable and non-extensible straps the lateral or side components of the upper frame section support a thoracic lumbar pad which imposes any desired limitation on the backward bending or extension of the thoracic lumbar spine and the lumbosacral junction.
In the drawings:
FIG. 1 is a view in perspective of a complete surgical brace embodying the invention, including an apron attachment used therewith.
FIG. 2 is a front elevational view of the assembled frame sections of the surgical brace, without the apron.
FIG. 3 is a rear elevational view of the brace structure shown in FIG. 2.
FIG. 4 is a side elevational view of the brace.
FIG. 5 is a View in front elevation of the apron.
FIG. 6 is an enlarged detail view taken in section on the line 66 of FIG. 2.
FIG. 7 is an enlarged detail view of a preferred latch device taken in section on the line 7--7 of FIG. 4.
FIG. 8 is an enlarged detail view in perspective fragmentarily illustrating separate parts of the lock joint between the lower and upper frames of the brace.
FIG. 9 is an enlarged detail view in section through separated anchorage parts used to connect the rear strap portion of the brace.
As already indicated, the brace is made in two sections, the lower section being in the nature of a girdle anchored about the patients pelvis as securely as is possible consistent with freedom of bodily movement, the lower section providing a secure basis for positively fixing the upper section in a position to maintain the thoracic lumbar spine against backward movement or extension beyond the desired angle.
The lower section of the brace completely encircles the pelvic region of the patient. At the front there is a pubic pad 10 connected with buttocks pads 11 and 12 by pubic support bars 13, 14 which are curved to extend over the lower lateral abdominal or groin region and have downwardly and inwardly curving forward end portions 15, 16 adjustably connected to the pubic pad 10.
The pubic pad 10 has an internal metal reinforcing plate 17 enclosed in a moisture and soilproof covering with any desired padding.
' The buttocks pads 11 and 12 are similarly made. From their connection with the bars 13 and 14, they extend downwardly and backwardly, being relieved at 18 to clear the lateral pelvic area of the wearer and extending thence backwardly and downwardly to substantially the level of the pubic pad 10. They are provided with hooklike fixtures at 19 and 20 with which the eyes 21, 22 of the adjustable strap 23 are connected to complete the encirclement of the patients pelvic region.
Extending upwardly from the end portions 24 of the bars 13, 14 are rigid frame arms 25, 26, one of which is shown in detail in FIG. 8. At its upper end, each such arm is provided with a coupling head 27 having a boltreceiving aperture at 28 and radial serrations or the like at 29 complementary to a similar head and serrations of a frame bar of the upper section. In practice these serrations are five degrees apart whereby the flexion is controllable with precision. In the upper section the bars 30 and 32 have holes 280 threaded to receive the securing bolt 31 which adjustably connects the coupling head 270 of each upper frame bar to that of the respective lower frame bar, the serrations 290 of the upper bar mating with those of the lower bar to secure the upper frame bar rigidly in any desired angular relationship to the lower frame at five degrees intervals.
Obviously, a variety of other expedients may be used to provide the necessary angular adjustment of pivotal connection between the upper frame section and the lower frame section of the brace. That disclosed is preferred because of its simplicity and compactness and the rigidity of the joints achieved when the desired adjustment is locked by tightening the screw 31 in the threaded opening at 280.
The bars 30 and 32 of the upper frame carry side pads 35 and 36 respectively. The preferred cross sectional construction of these pads is shown in FIG. 6. Each comprises a fairly stifi but resiliently bendable sheet 37 which carries sponge rubber or similar padding at 38 and is confined within outer and inner facing plies 39 and 40 of suitable soil and moisture resistant flexible material. The outer and inner facing plies 39 and 40 are stitched together at 41 through the padding 38, such stitching serving to position an inner reinforcing plate at 42 in which the screws 43 connecting the lateral pad to the upright bar 30 or 32 are anchored. Thus only the forward portion of each of the side pads 35' and 36 is made relatively rigid by the plate 42, the rearward sections 350 and 360 being relatively flexible, although still? rather than limp.
The rearward sections 350 and 360 of the side pads 35 and 36 lap or meet a large thoracic lumbar pad 50 which includes within its outer covering a somewhat still? but resiliently flexible sheet 51 having padding of sponge rubber or the like 52 on its inner face. Stitched externally to the covering 53 is a pocket ply 54 which anchors a stiff and relatively unyieldable plate 55 and the flexible but unstretchable straps 56, 57 and 58. At one side of the brace, usually on the wearers left, the straps 56 and 57 are adjustably fixed to the upper frame by means of the screws 43, strap 58 desirably being fixed to the arm 26 of the pelvic frame. It has been found quite important to. use three straps rather than two, to position the thoracic lumbar pad.
At the other side, usually at the Wearers right, an upwardly open bracket 60 is provided for each strap. One bracket is shown in detail in FIG. 6. The bracket has an overhanging hook at 61 and receives detachably a sleeve 62 which is adjustable along the strap by means of a Worm 63 rotatably journaled in the sleeve and meshing with teeth out in the strap as disclosed in United States Patent 2,582,930 and other patents therein identified. A handle 64- is provided for rotation of the worm for adjustment purposes. The connection of the strap to the bracket is readily released and re-established by the patient. The actual adjustment ordinarily requires little or no alteration by the patient.
If no restraint whatever is to be imposed upon the forward movement of the patients upper body about the lumbosacral junction, the device as disclosed is complete. In practice, however, it is ordinarily preferred to employ a supplemental apron such as that separately illustrated in FIG. and shown in position of use in FIG. 1. The apron 70 is provided with internal rib reinforcement 71 to any desired extent. It has a pocket at 72 in which the lower portion of the pubic pad is receivable. The upper portion of the apron is connected by straps and buckles 76, 760 with the frame elements. This apron encircles the patients abdomen. It may be laced at 73 for adjustment. It is desirably made of stretchable material to accommodate consider-able yielding under pressure of the patients body. Yet it cooperates with the other elements of the lower frame to fix the lower frame securely to the patients pelvic region.
Also used optionally to assist in positioning the lower frame are the elastic straps 77, 78 which are detachably hooked either to the lower frame bars 13 and 14 or the pubic pad and extend downwardly and rearwardly beneath the patients perineum and buttocks and attach to the buttocks pad. These perinea-l straps will be relatively loose when the patient is standing but the patient will sit upon them when he is seated and they will then tighten to hold the lower frame from working up upon the body of the patient.
While the bars 13, 14, 26, 27, 30, 32 are somewhat flexible they are resilient and nearly rigid. They will normally be made of Duralu-min or steel alloy and will be "sufficiently rigid to withstand, without perceptible yieldunder bodily pressure but are quite resiliently stiif, so
1. A surgical brace comprising a pelvic section and a thoracic-lumbar section in pivotally adjustable connection, the pelvic section comprising pad means and body encircling means for positively fixing the position of the pad means on a patients body, and having pintlesupporting frame means; the thoracic-lumbar section of the brace comprising lateral frame means in pivotal connection with the pintle-supporting frame means of the pelvic section aforesaid, a lumbar pad, means for connecting said lumbar pad with said lateral frame means; pintle means for pivotally connecting said sections, and means for positively fixing the lateral frame means of the thoracic-lumbar section of the brace in selected pivotal adjustment regarding the pintle-supporting frame means of the pelvic section thereof.
2. A surgical brace comprising a pelvic section and a thoracic-lumbar section in pivotally adjustable connection, the pelvic section comprising buttocks pads, a pubic pad, pubic supporting bars connecting the pubic pad with the buttocks pads, and strap means for connecting the buttocks pads with each other at the rear of the patients body; the thoracic-lumbar section comprising a lumbar pad, side pads, frame bars connected with the side pads, and means for connecting the lumbar pad with the said frame bars; and means for providing a fixedly adjustable pivotal connection between the pelvic and the thoracic-lumbar sections aforesaid.
3. A surgical brace comprising a pubic pad, buttocks pads, pelvis encircling means including frame elements for connecting the pubic and buttocks pads, a thoraciclumbar pad, side pads, means including frame members for connecting respective side pads with the thoracic- -lu-mbar pad and with the frame elements aforesaid, said connecting means including pintles pivotally connecting respective frame elements and respective frame members, and means for positively fixing the angular position of each frame member respecting the frame element with which it is in pivotal connection upon the respective pintle.
4. A surgical brace comprising the combinationwith a pelvic section including a pubic pad and buttocks pads and pelvis-girdling means connecting the pubic pad and buttocks pads and including lateral frame elements provided with pintle apertures and serrations; of a thoraciclumbar section comprising 'a lumbar pad, frame bars connected with the lumbar pad and having apertured ends complementary to the frame elements aforesaid, and pintle bolts passing through respective bars and frame elements and constituting clamping means for pressure engagement of the clamping bars and elements to hold them in adjusted position of pivotal movement upon the respective pintle bolts.
5. The combination set forth in claim 4 in which the bars of the thoracic-lumbar section have side pads, each of which has a reinforced portion connected with :1 respective bar and a stiffened portion extending rearwardly therefrom and lapping the lumbar pad.
6. The combination set forth in claim 4 in further combination with apron means connected with the pubic pad and the respective bars of the thoracic-lumbar section and constituting a resiliently stretchable Web spanning the thoracic-lumbar section opposite said lumbar pad.
7. The combination set forth in claim 4 in which the bars and frame elements have complementary surfaces provided with radial ribs and serrations at pre-determined angular intervals whereby the adjusted position fixed by said clamping means can be accurately pre-determined.
8. A surgical brace comprising pelvic and thoraciclumbar sections in pivotally adjustable connection, the said sections including lateral frame means, the pelvic section of the brace including buttocks pads, a pubic pad and pelvic encircling means connecting said buttocks pads and pubic pad, said thoracic-lumbar section comprising a thoracic-lumbar pad having upper, intermediate and lower non-extensible straps in adjustable connection with the lateral frame means of the brace.
References Cited in the file of this patent UNITED STATES PATENTS 6 2,760,486 Ward Aug. 28, 1956 2,808,050 Ward Oct. 1, 1957 FOREIGN PATENTS 931,975 Germany Aug. 22, 1955 OTHER REFERENCES A T hree-Point Hyperextension Back Brace, Griswold, Journal of Bone and Joint Surgery, pages 784-786, July 1936, on file in Div. 55.
Journal of Bone and Joint Surgery, Brace for Extension of the Spine, July 1948, pages 784 and 785 relied upon. O;n file in Div. 55.