US 3703894 A
A light foam polyurethane hand burn splint designed as a single unit consisting of a broad, concave arm-piece, a thicker-but-narrower wrist section, and a pistol grip hand portion to support the hand in a position to prevent scar contractures from causing postburn deformities.
Description (OCR text may contain errors)
United States Patent Galloway et al. 51 Nov. 28, 1972 RIGID FOAM POLYURETHANE HAND 1,177,398 3/1916 Dorang ..l28/87 SPLINT 1,328,598 l/ 1920 Schilling ..l28/87 2 318 864 5/1943 Jackson ..l28/87  Inventors: Dwight V. Galloway, West Billings, 1 7
Mom; Gordon E. g 2,794,638 6/1957 Rasher et a1 28/ 7 X Calif.; Charles C. Asbelle, Oakland, FOREIGN PATENTS OR APPLICATIONS 5:3? Mlchae Berkeley 629,745 10/1961 Canada ..l28/89 574,529 l/1946 Great Britain ..l28/89  Assignee: The United States of America! as represented by the Secretary of the Primary ExammerR1chard A. Gaudet Navy 4 Assistant Examiner-J. Yasko AttomeyR. S. Sciascia and Charles D. B. Curry  Filed: Feb. 16, 1971 211 Appl. No.2 115,458  ABSTRACT A light foam polyurethane hand burn splint designed as a single unit consisting of a broad, concave arm- [g2] :J.S.((:il ..l28/77,A16218f/857l13 piece, a flfickebbubmower wrist section and a I nt. pistol portion to support the in a posi-  Field of Search ..128/77, 87 R, 87 A, 89 tion to prevent scar contracmres from causing posh bum deformities. [56'] References Cited 5 Claim, 3 Drawing Figures UNITED STATES PATENTS Basso ..l28/87 PATENTEU rm 2 8 I972 INVENTORS Y RIGID FOAM POLYURETHANE HAND SPLINT The invention described herein may be manufactured and used by or for the Government of the United States of America for governmental purposes without the payment of any royalties thereon or therefor.
BACKGROUND OF INVENTION The present invention relates generally to a hand burn splint and more particularly to a rigid foam polyurethane hand splint to support the hand in a position in such a manner as to prevent scar contractures from causing postburn deformities.
Thermal burns to the hands are not a new problem and principles of their care have received much attention in the past. Despite this existent knowledge and teaching, a burned hand often results in considerable permanent disability, to the despair of the physicians and surgeons caring for the late results of hand burns. The pillow or flat arm-board continues to be the most common hand splint, probably more because of availability than the lack of knowledge. In the midst of the multitude of severe and life-threatening problems in the severely burned patient, building special devices to ensure the position of function of the limb has been ignored. In the emergency room and offices, where less extensive burns are cared for, the rush of other patients again often precludes real thought in positioning.
Since the introduction of topical chemotherapy into burn care, deep second degree burns are healing without skin grafts, but with considerable deep dermal scar tissue. This scar tissue very frequently constricts motion severely, particularly if allowed to form while the hand is held in the typical cripple position of the pillow, armboard splint or wrap dressing.
It is often stated that attempts to pre-design splints for specific problems are bound to fail because of the individuality of cases. Despite this, the multitude of problems developing without splinting or with our present splints led the inventors to further attempts at a more perfect design, and it is believed that the use of this unique splint will be distinctly beneficial.
The great majority of burns to the hand occur on the dorsum and contractures cause reduced mobility in the area between the fingers. The web space between the thumb and index finger is the most severely affected because of its great mobility. Much less recognized but still functionally very significant are the other interdigital web spaces, which contracture can cause severe disability in certain specific burn cases. The loss of the transverse arch of the hand can occur from flat splinting, whether on an arm-board or over a roll in the palm or from contracting scars on the dorsum of the hand and interdigital skin length secondary to scar contracture, but may also be from joint capsular fibrosic or extensor tendon adhesions.
The previously mentioned splints have been recognized to be inadequate and not beneficial in treatment of severe bum cases of the hand. A hand that stiffens in the position of fracture is still a useful extremity and whatever motion remains will be used in daily activities after healing, thereby serving as the best possible type of physical therapy. In contradistinction, the cripple position of proximal joints extended with palm flat and thumb adducted makes use awkward and any amount of effort and physical therapy rather unrewarding.
The present invention is an improvement over previous attempts to prevent development of the aforemen tioned deformities while making it simple enough to be used by untrained personnel and inexpensive enough to be available in the facilities of caring for initial burns. It is much more difficult treating deformities after they have occurred than preventing their occurrence by proper positioning during the first few days. Moreover, the unique device provides the physician with an eff cient and effective means that eliminates common problems in cosmesis when older methods are used, such as wooden splints with a bandage roll in the palm of the hand.
The primary object of the invention is to provide a burn splint to support the hand in a position and in such a manner as to prevent scar contracture from causing common post-bum deformities.
Another object of the invention is to provide a device that will position the hand and wrist so that useful function is retained and the cripple appearance of the hand is avoided.
Another object of the invention is to provide a device which will prevent the webs of the fingers growing together due to burn scar contracture.
Other objects and features will be apparent from the following description of the invention and from the accompanying drawings of the preferred embodiment of the present invention wherein:
FIG. 1 is a right hand side view of the hand splint showing palmar contact surface;
FIG. 2 is the top view with arm and hand in place; and
FIG. 3 is the side view showing arm and hand in place.
Referring to FIG. 1, wherein splint 11 is a single unit, consisting of a broad concave arm piece 13, a thickerbut-narrow wrist portion 15, pistol grip hand portion 17 and metal inserts 35. The piston grip hand portion 17 includes four concave gutter splints 21, 23, 25, and 27 and flared cylindrical section 31 for positioning the thumb and index finger. The construction of the splint causes the wrist to be dorsiflexed about 25 degrees and the thumb to be folded around interior wall 33 of cylindrical section 31. The index and middle metacarpals are folded into their respective gutter splint 21 and 23 and are positioned to hold the dorsal wrist position while the ring and middle metacarpals of the hand are further wrapped around the semi-circular shaped gutter splint 25 and 27 in a nearly maximum volar flexion. The four concave gutter splints comprise index finger cutter 21, middle finger gutter 23, ring finger gutter 25, little finger gutter 27, and separation ridges 29 between each of the concave gutter splints. The individual gutter splints give support to the fingers as well as provide a nominal separation between the fingers and thumb.
Referring to FIG. 3, when the respective fingers of the hand are cupped around the gutter splints, the web space separations due to the flared walls of the gutter splints will cause the fingers to be separated. Because of the frequent flexion contractures to the ulnar side of the little finger, the gutter splint'27 retaining the little finger is constructed nearly straight, or approximately 20 flexion, at the middle joint of the little finger. The splint 11 should be held to the hand and forearm with a wrap bandage 37, and can be used in conjunction with the treatment of any type burn therapy. It should be noted that complete wrapping of the burned hand is not necessary. Retaining wrap 37 swathed around the forearm and arm-piece 13 of hand splint 11 will suffice. Referring again to FIG. 1 wherein cylindrical section 31 is constructed to enable grasping by the hand, as one would grasp a handle of a pistol. The paddle-like projection, or concave armpiece 13, is rounded to contact the volar surface of the forearm.
Referring to FIG. 3, the cylindrical section 31 comprises a fairly thick flared section 33 separating the thumb and fingers. This flared separation section 33 prevents the fingers and thumb from forming webs. Referring to FIG. 2, when the prehensile hand grasps cylindrical section 17, the hand assumes the position of rest. The concave arm-piece l3 and the forearm extension contacts the forearm and wrist to flex the wrist when the hand assumes the gripping position of rest.
Referring to FIGS. 1 and 2, semi-rigid inserts 35 may be molded into the polyurethane splint 11. Moreover, the semi-rigid inserts 35, as well as polyurethane splint 1 1, may be made flexible especially in the narrow wrist portion 15 to allow the attending physician to adjust splint l l for better positioning.
The splint 11 is constructed of rigid foam polyurethane and can be made for either the right or left hand and arms. The entire hand burn splint weighs about 300 grams. Moreover, the polyurethane material is relatively inexpensive to mold and produce, whether in a single or varying sizes. It has also been found that the hand splint can be made adjustable at the wrist portion 15 for better selection of hand positioning.
Though designed primarily for early care of the common deep second degree burn to the dorsum of the hand, this splint would obviously have many other applications. lts modification from the standard position of function are minor enough that sprains, fractures, tendon and nerve injuries could be splinted for emergency treatment in situations when adequate medical facilities and treatment are not immediately available.
In summary, the unique hand burn splint will overcome some of the common post-bum deformities due to improper positioning of a burned hand.
What is claimed is: l. A polyurethane hand burn splint to support the hand in a position to prevent scar contractures between the individual fingers of said hand said splint comprising in combination:
a. a rigid pistol grip shaped hand positioning means;
b. a rigid concave paddle-shaped forearm retaining section;
c. a flexible wrist supporting means joining said shaped hand positioning means to said forearm retaining section wherein said wrist supporting means is thicker but narrower than said forearm retaining section and narrower than said hand positioning means;
d. said hand positioning means comprises a first, second, third and fourth semicircular individual concaved gutter splints with flared separation ridges and a semicircular thickly flared cylindrical section adjacent to and forming said first gutter splint for separating the thumb and index fingers of said had and said fourth gutter splint being further constructed substantially at a right angle to the longitudinal axis of the hand splint so that the middle joint of the little finger is positioned at about 20 flexion.
2. The hand burn splint recited in claim 1 wherein said first, second and third concave gutters are constructed in such a manner so that when the prehensile hand grasps the splint, the fingers fit into the ridged gutters while said hand assumes the natural position of rest on said hand positioning means.
3. The device recited in claim 1 further including deformable inserts are molded into said forearm retaining means and said wrist supporting means.
4. The device recited in claim 3 wherein said deformable inserts extend through said forearm retaining means and into said wrist supporting means and is flexible at said wrist supporting means whereby said wrist supporting means is adjustable.
5. The device recited in claim 1 wherein said forearm retaining means supports and retains the forearm in a