US 3707963 A
A hand brace secured to a patient's forearm including a support maintaining the patient's hand in an extended position. A connection between the portion of the brace fastened to the forearm and the support permits relative motions between the two along a path approximating the radial and ulnar paths of the patient's hand. A second joint permits relative motions of the hand support in up and down directions in combination with or instead of motions in the radial and ulnar directions. Thumb and finger guides for the patient are movably mounted to the hand support, engage the thumb and fingers of the patient and permit movement of the thumb and fingers towards and away from each other for the grasping and releasing of objects. Means responsive to up and down motions of the hand support move the finger guides.
Claims available in
Description (OCR text may contain errors)
United States Patent [1 1 Keropian 51 Jan. 2, 1973 [541 ARTICULATED HAND BRACE  Filed: Jan. 21, 1970  Appl. No.: 4,646
 US. Cl. ..128/77, 128/26, 3/1, 3/12.4  Int. Cl. ..A6lf 5/10  Field of Search .......128/77, 87-90, 128/26; 3/1-1.2, 12, 12.6, 12.7, 12.4, 12.5; 272/67  References Cited UNITED STATES PATENTS 2,382,404 8/1945 Eberle ..3/12.6 3,020,908 2/1962 Daniels et al ..128/26 2,767,708 10/1956 Keropian ..128/77 2,553,277 5/1951 Robinson et al ..3/1
FOREIGN PATENTS OR APPLICATIONS 502,687 2/1920 France ..128/77 112,265 4/1918 Great Britain ..128/77 306,715 7/1918 Germany ..128/77 312,103 5/1919 Germany ..128/77 OTHER PUBLICATIONS A Plastic Tenodesis Splint by C. L. Sabine et al., Journal of Bone & Joint Surgery, Vol. 47-A, No. 3,
April 1965, pages 533-536 Development of Useful Function In Severely Paralyzed l-Iand" by V. L. Nickel et al., The Journal of Bone & Joint Surgery,'Vol. 45-A, No. 5, July 1963, pages 933-943 relied upon.
Wrist Powers Fingers," Medical World News, Jan. 3, 1964, page. 25.
Primary ExaminerRichard A. Gaudet Assistant Examiner-Ronald L. Frinks Attorney-Townsend and Townsend [5 7 ABSTRACT are movably mounted to the hand support, engage the thumb and fingers of the patient and permit movement of the thumb and fingers towards and away from each other for the grasping and releasing of objects. Means responsive to up and down motions of the hand support move the finger guides.
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ARTICULATED HAND BRACE BACKGROUND OF THE INVENTION Hand braces are widely employed to support temporarily or permanently, partially or fully incapacitated or paralyzed hands of patients. Aside from providing support and preventing the patients hand from hanging loosely from the patients arm such braces should prevent deformity and allow maximum function by providing guidance for the hand through its possible natural motions. Moreover, the braces should provide a therapeutic effect by utilizing all existing muscle function to help restore the hand to its healthy condition to the greatest possible extent.
There are a variety of prior art hand braces which provide support for paralyzed hands and, to some extent, enable hand motions while the hand is restrained to the support. Most conventional hand braces provide a rigid or fixed support or only provide upward and downward motions of the hand which are not truly anatomical. Furthermore, such braces provide for only one motion up and down only, or side to side only, but not a combination of all, including circumduction motions, in a truly anatomical manner at the wrist joint. Additionally, prior art braces do not provide means for motoring or assisting weakened muscles in one or more directions at the same time. Sideward motions in a radial or ulnar direction of a hand supported by prior art braces have generally not been possible because such motions are along a compound path that is difficult to duplicate with mechanical braces. The usual provision of a simple pivot axis about which the hand support can move in the radial and ulnar directions results in a path for the hand support which does not conform to the natural path prescribed by the wrist joint so that the utility of such braces is limited or nonexistant.
Prior art hand braces usually lack means for conditioning and training or otherwise recapacitating these muscles since most hold the wrist in a fixed position thus limiting treatment to relatively short therapeutic sessions while the wrist and hand remain passive between treatment periods.
SUMMARY OF THE INVENTION The present invention provides a hand brace for supporting partially or fully paralyzed hands in general alignment with the patients forearm. The hand brace permits movement of the hand in the radial and ulnar directions and/or in up and down directions so that circumduction motions of the supported hand are possible. The invention incorporates means for biasing the supported hand in one or the other directions to thereby train partially paralyzed or weakened muscles and to utilize existing muscles in order to provide a continuous therapeutical or functional effect. Means are also provided for positioning the thumb of the supported hand and fingers thereof opposite each other and for moving them towards and away from each other in response to predetermined motions of the full hand to enable the grasping and release of objects and render the hand useful even while it is in the brace.
In its broadest aspect the present invention provides a hand brace which includes means for securing the brace to the forearm of the patient and a support connected to the securing means for supporting the patients hand. Joint means connect the support to the securing means and permit a generally arcuate, noncircular movement of the support in substantial conformity with movements of the patients hand in the radial and ulnar directions.
The brace preferably includes means between the securing means and the support permitting relative motion of the support in up and down directions. To achieve the aforementioned muscle training spring means are provided and connected to the securing means and the support for biasing the support in one or the other direction or for centering the support in the alignment with the patients forearm for instances of severe weakness or total paralysis of the patients hand.
In one embodiment of the invention, the thumb and finger guides are movably mounted to the hand support and position the thumb and fingers opposite each other. Means are provided for moving the guides towards and away from each other in response to a predetermined motion of the hand support with respect to the securing means as actuated by the existing muscles of the extensors of the wrist. This enables the use of the thumb and fingers, even if they are paralyzed, for grasping and releasing objects. Preferably, the guides are articulated at about the point of the proximal and medial finger joints to enable frequent exercise of the joints and prevent them from stiffening due to nonuse.
The hand brace of the present invention provides guidance for a severely weakened or paralyzed hand through motion paths which closely approximate the natural motion paths of the patients wrist, hand and fingers. The brace can thus be used in a truly functional manner without discomfort and loss of function as encountered in some prior art hand braces. The brace of the present invention enables the maximum utilization of the patients wrist, hand and fingers, even when paralyzed, by further addition of motoring devices, e.g. cables, pistons, etc., to restore the afflicted hand to its maximum usefulness and/or to prevent stiffness which results in attendant physiological and psychological improvements of the patients condition. Moreover, the hand brace of the present invention enables the continuous training of the weakened or paralyzed hand to hasten the improvement, allow maximum hand function and help achieve as much recovery of the hand as is possible.
The various embodiments of the hand braces described herein can be manufactured so that the securing means, the joint means, and the hand support means are interchangeable and the accessories for particular functions of the brace can be freely mounted thereto as required. This substantially reduces the cost of the brace, since much lower inventories are necessary to supply the demand.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a plan view of the hand brace constructed in accordance with the present invention and provided with guides enabling the grasping of objects with the thumb and fingers, the hand being shown in phantom lines;
FIG. 2 is a side elevational view of the hand brace illustrated in FIG. 1 and shows the finger guides in open position; I
FIG. 3 is a side elevational view similar to FIG. 2 but shows the finger guides in a closed position;
FIG. 4 is a perspective plan view similar to FIG. 1 of a simplified embodiment of the invention; and
FIG. 5 is a side elevational view of the hand brace illustrated in FIG. 4.
DESCRIPTION OF THE PREFERRED EMBODIMENTS To facilitate the understanding of the hand braces disclosed in the drawings and in the specification the following terms and expressions are clarified and given the indicated meaning.
The forearm is that portion of the arm of a human which includes the radius and ulna and the wrist is the area occupied by the carpal bones. The term hand is employed as descriptive of the metacarpal area and comprises a palm, the back of the hand, the inner side from which the thumb extends and an opposite, little finger or outer side. The fingers of which the bones are phalanges are divided into three sections which hinge at the knuckles and these sections will be referred to as proximal, medial and distal.
Starting from the anatomical position, the motions of the wrist relative to the forearm are in the ulnar direction, that is motions of the hand toward the body;
in the radial direction, that is motions of the hand away from the body; up and down motions of the hand and the wrist, that is motions in the direction of the back or with the forearm in a vertical direction as prescribed by the up and down motions of the hand.
Referring now to FIGS. 4 and 5, a hand brace 12 constructed in accordance with a first, simplified embodiment of the invention for use in instances of radial nerve injuries or the like, in which all wrist and finger extensors are paralyzed is illustrated. Brace 12 comprises securing means 14 for strapping the brace to a patients forearm 16, a hand support 18 and a joint 20 interconnecting the securing means and the hand support. Joint 20 permits movements of support 18 along a path generally coincident with the path prescribed by the hand moving from its aligned position in the ulnar of radial directions (indicated by arrow 22).
The securing means comprises a generally H-shaped member 24 having opposing pairs of arcuately formed legs 26 that extend part way around the patients forearm. Straps 28, constructed of a flexible material 7 such as leather or webbing, are riveted to the free end of one leg of each opposing leg pair, are wrapped around the patients forearm and are fastened to buckles 30 on the free end of the other leg of each opposing leg pair. Tightening of the straps securely fastens the securing means to the patients forearm.
A generally V-shaped connector 32 extends from the forward end of the H-shaped member 24 towards the patients hand 34. A pair of guide bars 35, 36 are pivotable about threaded bolts 38 which connect the bars to the free ends of the V-shaped connector.
Hand support 18 comprises a main supporting member 40 which includes a pair of arcuate, relatively long forward support bars 41, 42 and a pair of relatively short aft connection lugs 44. The outer forward support bar 41 extends over substantially 180 so that it reaches under the palm of hand 34. The inner support bar 42 curves through about and terminates in a substantially straight, downwardly extending portion 46.
A strap 48 is riveted to one of the aft lugs 44, wrapped around the palm portion of hand 34 and is secured to a buckle mounted to the other one of the aft lugs.
A yoke 50 for connecting support 18 and securing means 14 is adjustably secured to supporting member 40 via a bracket 52 and a set screw 54. The yoke includes a pair of spaced apart openings (not separately shown) through which threaded bolts 56 extend. The bolts also extend through bores (not shown) in guide bars 35, 36 and pivotally connect the free ends of the guide bars to the yoke. Thus, the yoke and guide bars secure the securing means to the hand support. The pivotal connections of the guide bars by bolts 38 and 56 enables relative movement of the hand support with respect to the securing means through a path closely approximating the path prescribed by hand 34 when the hand moves in the radial or ulnar directions. To minimize friction during relative movements between securing means 14 and support 18, low friction bearing plats 57, such as ball bearing discs as flat teflon washers, are preferably disposed between the opposing faces of yoke 50, guide bars 35, 36 and V-shaped connector 32 at the pivotal connections 38 and 56.
The exact spacings between the pivots defined by bolts 38 and 56 will vary from patient to patient. However, a'spacing of about 1 inch between the axes of bolts 56, of about 2 /4 to about 2% inches between the axes of bolts 38, and a guide bar length between the a trough shaped support bar 60 which has a sufficient width to enable the placement of the 'patients fingers 62 thereon. The support bar is fastened to a cantilever arm 64 that is adjustably secured to harid supporting member 40 by a bracket 66 and a set screw 68.
A web spreader 70, preferably constructed of a nonabrasive, smooth material such as plastic, is secured to the straight portion 46 of inner support bar 42 with a mount 72 and a threaded bolt 74. The web spreader has a configuration and shape as illustrated in FIGS. 4 and 5. The web spreader mount 72 includes extensions 73 which embrace downwardly extending portion 46 and permit slidable movement of the mount which is fixed and positioned by tightening bolt 74. This permits adjustments in the spreader position ,to adapt the brace for use on hands of differing thickness.
For strength and durability the securing means, as well as the joint means and hand support 18 are preferably constructed of light weight, malleable metal such as soft aluminum. To prevent skin irritation while the hand brace is worn the surfaces of the brace facing the patients forearm or hand are preferably padded with a suitable soft material 76 such as felt, foam material, and the like.
Hand brace 12 is applied by slipping it over the aligned hand 34 and forearm 16 towards the patient so that the patients hand passes through the outer for-. ward supporting bar 41 until fingers 62 rest on finger guide 58. Thereafter, straps 48 and 28 are wrapped about the patients hand and forearm, respectively, and tightened with the buckles to secure the hand support to the patients hand and the securing means to the patients forearm. The weight of the hand is now transferred from the hand support'to the securing means via joint 20. Thus, in spite of paralysis or unusability of the muscles for raising and lowering the hand, the latter is maintained in an extended position while joint permits it to move in the radial and ulnar directions if muscle function on the radial or ulnar side is present and are assisted or opposed by springs.
Guide 58 provides support for the fingers. If the fingers are usable, the guide can be temporarily or permanently removed to enable the use of the fingers and the thumb of the patient. Finger paralysis, however, dictates the permanent retention of the phalangeal support.
Web spreader 70 abducts the thumb 78. Paralysis or damage to the thumb musculature usually causes retraction of the thumb towards the palm. To maintain the thumb in an abducted or generally downward position of the fingers, web spreader 70 is used. If the thumb has a tendency to bend inward at the distal joint, a sling 80 is placed over the thumb and attached to a spring 82 secured to a mounting assembly 84 embracing straight portion 46 of inner forward supportbar 42 in the same manner as mount 72 to provide adjustability. Spring 82 biases the sling, and with it thumb 78 in a clockwise direction, as viewed in FIG. 4, in opposition to the thumbs tendency to contract inward. This positioning of the thumb prevents it from suffering flexion deformities and enables the use of the hands grasping function in instances where only'the thumb is partially paralyzed and one or more of the remaining fingers remain usable.
In many instances of paralysis of the hand, the radial or ulnar muscles are weak or nonusable. This impairs or prevents movement of the hand in the radial or ulnar directions. Under total paralysis the patient has no control over the ulnar or radial deflection of the hand while under partial paralysis, of either the ulnar or radial deflectors, for example, the patient cannot return the hand once the hand is in a deflected position.
To aid the hand, the present invention provides means for maintaining the hand in an aligned position when the ulnar and radial deflectors are not usable. Referring again to FIGS. 4 and S, yoke 50 includes lips 86 which extend outwardly from bolts 56 and include a pluralityof small diameter bores. A spring mount 88 is adjustabiy connected to the H-shaped member 24 of securing means 14 with a bracket and set screw arrangement. The spring mount also includes small bores into which one end of a helical tension spring 90 is anchored. The other end of the spring is anchored in one of the small diameter bores in yoke lip 86. A second, identical helical tension spring (not shown in FIGS. 4 and 5) is anchored to spring mount 88 and the other yoke lip 86..The two springs exert equal forces and thus bias hand support 18 into a neutral position. When the hand brace is applied to a paralyzed arm, the
helical compression springs maintain the hand support, and therewith the paralyzed hand in alignment with the patients forearm.
If only one of the radial or ulnar muscles is incapacitated, only one helical tension spring 90 is applied to yoke 50 and spring mount 88 so that hand support 18 is spring biased in opposition to the movement induced by the working muscle. Should one of the ulnar or radial muscles be substantially weaker than the other one, a helical tension spring can be employed to aid the weaker muscle.
Referring now to FIGS. 1 through 3, a hand brace 92 constructed in accordance with another embodiment of the invention is illustrated. Those portions of hand brace 92 which are identical with the hand brace illustrated in FIGS. '4 and 5 are given the same reference numerals as in FIGS. 4 and 5 are not again described except to the extent necessary for an understanding of the construction and operation of hand brace 92.
Hand brace 92 comprises securing means 14 for attachment of the brace to the patients forearm 16, a hand support 18 and a joint 20 permitting relative motion of the hand support along a path prescribed by the patients ,hand when moving in the radial or ulnar direction. Hand brace 92 includes second joint means 94 permitting up and down motion of the hand support means 18 and hand 34. Additionally, hand brace 92 is fitted with thumb and finger guides 96, 98 actuated by a linkage 100 in response to a predetermined relative motion between the securing means 14 and hand support 18. The thumb and both of the second and third fingers are thereby positively guided towards and away from each other to enable the grasping of objects.
Hand support 18 includes outer and inner forward support bars 41, 42 and the latter again terminates in a downwardly extending straight portion 46. Aft lugs 44 of the hand support mount strap 48 for securing the hand support to the patients hand in the above described manner.
The movable connection between the securing means and the hand support is defined by joint means 20 including a yoke 102 pivotally secured to the free ends of guide bars 35, 36 by a pair of spaced apart bolts 56. Yoke 102 includes a pair of downwardly curved legs 104 which extend over the patients forearm in substantial alignment with the wrist joint between hand 34 and forearm 16. The lower ends of legs 104 are pivotally connected to a second, forward yoke 106 by conventional threaded bolts 108 defining a pivot axis in substantial alignment with the pivot axis for the hand for up and down motions of the hand. Forward yoke 106 includes upwardly extending legs that span over the patients hand, meet at a center point and form a forwardly projecting tongue 110 adju'stably secured to hand support 18 by bracket 52 and set screw 54.
Thus, hand support 18 is vertically pivotable with respect to securing means 14 about pivot bolts 108 and is movable in a general horizontal plane along a path defined by joint means 20. Low friction bearing means are placed between the opposing sides of the yokes and guide bars in the above described manner to minimize friction drag when the brace is moved.
In use, hand brace 92 is applied to the patients hand in the same manner as is brace 12. The patient, however, can now move his hand without restraint in all directions. To align the patients hand with his forearm when either one or both of the radial and ulnar musclesare incapacitated, one or two helical tension springs 90 are connected to yoke lips 86 of yoke 102 and a spring mount 112 secured to securing means 14. The tension springs bias the hand support 18 in one or the other direction or center it in alignment with the patients forearm.
In instances where the muscles for the raising and lowering of the patients hand are incapacitated, so that the weight of the hand would cause hand support 18 to pivot about bolts 108, a helical tension spring 114 is anchored to lugs 115, 116 projecting from yokes 102 and 106, respectively. The spring force biases the hand support about bolts 108 in an upward direction in opposition to the weight of the patients hand to maintain the hand extended and/or to aid the patient in raising his hand when his muscles are weak or imbalanced during a state of recovery.
Severe or fatal paralysis of the patients thumb and fingers usually renders the hand useless for the duration of such paralysis. The present invention provides means for restoring at least partial utility to a paralyzed hand by utilizing the wrist extensor as a motor. The paralyzed thumb and fingers are activated by guides 96, 98 that force them towards or away from each other to enable the grasping of objects such as a cube 118 illustrated in- FIG. 2. Any function in the thumb abductors and finger flexors assists the motoring of the device via a linkage 100.
Finger guide 98 is constructed for the simultaneous engagement of a pair of fingers, namely, the patients index and middle fingers, and comprises a base 120 mounted to inner support bar 42 of hand support 18 by a bracket 122 and a set screw 124. The bracket and set screw permits adjustment of the finger guide for use in the varying finger lengths. The base extends forward of the support bar and a threaded bolt 126 pivotally connects a center link 128 to the free end of the base. An end member 130 of the finger guide is pivotally mounted to the outermost end of link 128 by a threaded bolt 132.
Referring particularly to FIGS. 1 and 3, center link 128 comprises a flat cover plate 134 integrally constructed with the link and extending across the width of the index and middle fingers where the cover plate terminates in a downwardly extending, generally U- shaped support bar 136 for the fourth and fifth fingers of the patient (see particularly FIG. 1).
Referring to FIGS. 1 through 3, end member 130 also includes a cover plate 138 (illustrated as demountably secured to the end member) extending across the width of the patients index and middle fingers and which terminates in a support bar 140 that projects downwardly and back towards end member 130 substantially across the full width of the index and middle fingers. A second support bar 142 issecured to the cover plate 138 adjacent a forwardmost end thereof and extends downwardly to provide further guidance for the finger tips engaged by finger extensor 98.
Referring now to FIGS. 2 and 3, linkage 100 is employed for pivoting the center link 128 and the end member 130 about pivot bolts 126, 132 in response to an upward motion of the hand support 18 with respect to securing means 14 whereby the index and middle fingers of the patient are forcibly bent at their respective knuckles. The linkage comprises a base 144 affixed to yoke 102 adjacent pivot bolt 108 to which an end of a push bar 146 is pivotally connected as with a threaded bolt 145. Push bar 146 extends forward and is pivotally connected at 147 to the upper end of an upright post 148 integrally constructed with center link 128. When the hand support is pivoted about bolt 108 in an upward direction push bar 146 pivots center link 128 about pivot bolt 126 in a clockwise direction as seen in FIGS. 2 and 3.
A connecting member 150 is secured to center link 128, or integrally constructed therewith (not shown), and mounts a center portion of a rocker arm 152 for pivotal movements about a bolt 153. The upper end of the rocker arm is pivotally connected at 155 to an arcuate bar 154. The other end of the arcuate bar is pivotally connected at 157 to a bracket 156 secured to end member 130. Upon upward pivotal motion of the hand support about pivot bolt 108, which pivots center link 128 about pivot bolt 126, arcuate bar 154 is retracted in an aft direction (towards the patients body) by rocker arm 152 to thereby pivot end member 130 about pivot bolt 132 in a clockwise direction as viewed in FIG. 3. The medial and distal sections of the fingers restrained in finger guide 98 are thereby further bent about the medial knuckle as generally illustrated in FIG. 3 so that the fingers have a pronounced arcuate, inwardly curving position.
The ring and little fingers rest on support bar 136 of center link 128. They are free 'to curve with the index and forefinger to a limited extent since support bar 136 moves with center link 128. However, the ring and little fingers are not forceably deflected about their knuckles.
Still referring to FIGS. 2 and 3, thumb guide 96 comprises a restraining member 158 pivotally mounted to the straight portion 46 of inner support bar 42 adjacent the lowermost end thereof by a pivot bolt 160 and terminating in a tubular'section 162 through which the patients thumb extends. A mounting bracket 164 is secured to the restraining member and is pivotally connected to the lower end of rocker arm 152 by a pivot pin 165.-Pivotal movement of the hand support about pivot bolts 108 in an upward direction causes pivotal movement of the rocker arm in a counterclockwise direction, as viewed in FIGS. 2 and 3, and pivotally moves the thumb restraining member 158 about pivot bolt 160 in a counter clockwise direction towards finger extensor 98.
When hand brace 92 is applied to a patient's arm and he moves his hand in an upward direction whereby hand support 18 pivots about pivot bolt 108, linkage 100 curves the fingers engaged by finger guide 98 in,-
wardly and, at the same time, moves the thumb and the complete straightening of all the fingers and the thumb by linkage 100 to thereby move the fingers and the thumb to a distal position and release any objects retained therebetween.
As illustrated in FIGS. 1 through 3, the members of linkage 100 each include a plurality of spaced openings for placement of the respective pivot points. This enables adjustment of the linkage to account for manufacturing tolerances and permits the use of the linkage for various relative wrist and finger guide positions while maintaining the spacing between the finger and the thumb substantially constant for a given position of the hand support with respect to the securing means. Furthermore, low friction bearing means (not separately shown) such as teflon washers, are placed between the opposing faces of the member of linkage 100 and guides 96, 98 at pivot points 126, 132, 145, 147, 153,
155, 157, 160 and 165 to minimize friction forces developed by the linkage and thus enable the use of the brace with relatively weak motor muscles and low tension springs.
To maintain the position of the hand with respect to the thumb and finger guides 96, 98, a web spreader 166 is adjustably mounted to the straight support bar portion 46 with a set screw 167 in the above described manner. Web spreader 166 is preferably a round bar and extends sufficiently across the width of the patients palm to prevent the patients hand from sliding forward with respect to the thumb and finger extensors.
l. A hand brace comprising: means for securing the brace to a forearm of a patient, a support connected to the securing means for supporting the patients hand, and joint means between the support and the securing means and permitting a generally arcuate, noncircular movement of the support in substantial conformity with radial and ulnar movements of the patients wrist and hand, the joint means comprising pivot means attached to the securing means and the support, the pivot means defining a plurality of substantially parallel, spaced apart pivot axes disposed essentially perpendicular to a plane within which said movements take place, and bar means interconnecting some of the pivot axes to positively define a motion path for the support which is in substantial conformity with the motion paths of the hand during radial and ulnar movements.
2. A brace according to claim 1 including means biasing the support about the joint means in one direction.
3. A brace in accordance with claim 1 including guide means for engaging the patients thumb and one of more of the patients fingers, means permitting movement of the guide means towards and away from each other by moving the thumb and the fingers to place the thumb and the finger in proximal and distal positions, and means for moving the guide means between the proximal and distal positions in response to a predetermined relative movement between the securing means and the support.
4. A brace in accordance with claim 3 wherein the guide means comprises a pair of members secured to the support and pivotable about a pair of pivot axes spaced to approximate the spacing between the patients knuckles, and including means for positively moving the members about the pivot axes to move the fingers to their proximal and distal relative positions.
5. A brace for supporting a patients hand providing guidance for the wrist and hand for movement in at least the radial ar rd ulnar directions comprising: means for securing t e race to the patient 5 forearm, a hand support, and means connecting the support to the securing means and permitting relative movements between the support and the securing means along a path approximating the radial and ulnar movement paths of the patients wrist and hand, the connecting means including a pair of spaced apart first pivot means on one of the hand support and the securing means, second pivot means on the other one of the hand support and the securing means, the first and second pivot means having substantially parallel axes, bar means connecting the first pivot means with the second pivot means, and means permitting pivotal movement of the bar means about the first and second pivot means.
6. A brace for a patients hand comprising: means for securing the brace to the patients forearm, a support for the patients hand, motion permitting means connecting the support to the securing means, the motion permitting means including means defining a plurality of unidirectional pivot axes on the support and the securing means, a plurality of bar means extending between the support and the securing means and interconnecting preselected ones of the pivot axes to positively guide the support through a relative motion path which closely resembles the relative motion path of a hand in the radial and ulnar directions, guide means for positioning and holding the patients thumb and fingers in opposing relation, and means connected to the guide means and the brace for moving both the thumb and at least one finger towards and away from the other in response to relative movements between the securing means and the support, whereby relatively large objects can be placed between the patients extended thumb and finger for grasping and releasing by moving the patients wrist and hand with respect to the forearm.
7. A brace in accordance with claim 6 wherein the guide means includes means for pivoting the guide means about a pair of spaced apart pivot axes, and
wherein the means for moving the guide means includes means varying the rate of the relative pivotal movement of the guide means at the two pivot points.
8. A brace in accordance with claim 6 wherein the guide means moving means is constructed to move the thumb and the finger simultaneously towards each other as the patients wrist and hand moves in an upward direction and to separate the finger and the thumb as the patients wrist moves in a downward direction and wherein the brace includes means connected to the securing means and the support biasing the support into a raised position.
9. A brace in accordance with claim 6 including means permitting repositioning of the finger guide means with respect to the support, and wherein the finger guide means moving means includes means permitting their adjustment in response to the repositioning of the finger guide means, whereby the spacing between the finger and the thumb guide means remains substantially constant for a given relative position between the securing means and the support.