US 3765411 A
A portable traction apparatus provides a patient with mobility in bed as well as freedom to use a wheelchair, or otherwise move about as by stretcher, while maintaining substantially constant tractive force on the fractured member. An articulated support is provided for cradling the leg above and below the knee with locking means provided for pre-setting the knee angle. Traction is applied to the fractured member by means of a traction bow and surgical pin connected to a pulley system incorporating a spring scale for adjusting tractive force thereon. Tractive force is applied in line with the fractured member. The support and the traction producing elements are pivotally supported in such a fashion as to balance the leg irrespective of shifting about by the patient whereby the fractured members will not be disturbed from a preset fixed position. When used in the bed, the pivotal support is mounted on a carriage which is free to move longitudinally to permit the patient to be raised and lowered from a prone to a sitting position without changing traction force. The device is detachably connected to the carriage to permit transfer to a wheelchair provided with a cooperating attachment whereby the patient may be wheeled about without changing traction force or leg support.
Claims available in
Description (OCR text may contain errors)
[ Oct. 16, 1973 MOBILE TRACTION APPARATUS  Inventor: George Dewey Ward, Jr.,
 Assignee: Medical Controls, Inc., Boston,
 Filed: Jan. 3, 1972  Appl. No.: 215,039
 US. Cl 128/84 C  Int. Cl. A61! 3/00  Field 01 Search [28/84, 85, 71, 75
 References Cited UNITED STATES PATENTS 2,374,163 4/1945 Burchsted 128/84 R 2,413,053 12/1946 Kolarik 128/84 R 2,511,659 6/1950 Wilson 128/84 R FOREIGN PATENTS OR APPLICATIONS 1,068,590 4/1902 France 128/84 C 713,701 11/1941 Germany 123/84 C Primary Examiner-Richard A. Gaudet Assistant Examiner-J. Yasko Attorney-Gerald Altman et al.
57 ABSTRACT A portable traction apparatus provides a patient with mobility in bed as well as freedom to use a wheelchair, or otherwise move about as by stretcher, while maintaining substantially constant tractive force on thefractured member. An articulated support is provided for cradling the leg above and below the knee with locking means provided for pre-setting the knee angle. Traction is applied to the fractured member by means of a traction bow'and surgical pin connected to a pulley system incorporating a spring scale for adjusting tractive force thereon. Tractive force is applied'in line with the fractured member. The support and the traction producing elements are pivotally supported in such a fashion as to balance the leg irrespective of shifting about by the patient whereby the fractured members will not be disturbed from a preset fixed position. When used in the bed, the pivotal support is mounted on a carriage which is free to move longitudinally to permit the patient to be raised and lowered from a prone to a sitting position without changing traction force.'The device is detachably connected to .the carriage to permit transfer to a wheelchair provided with a cooperating attachment whereby the patient may be wheeled about without changing traction force or leg support.
7 Claims, 10 Drawing Figures PAH NI FUUCI 16 I975 SHEET BUY 3 MOBILE TRACTION APPARATUS BACKGROUND OF THE INVENTION 1. Field of the Invention This invention relates generally to traction equipment' for use in treating bone fractures, especially leg bones, and more particularly is directed towards an apparatus-adapted to provide dynamic traction while allowing the patient greater mobility in bed as well as mobility in a wheelchair, stretcher, or the like, without altering the traction or the fractured member.
2. Description of the Prior Art When a person suffers a broken leg, such as a fractured femur, the treatment entails an extended period of immobilization of the member during which time the leg is placed in traction. This is done typically by a system of weights and pulleys which create and maintain the necessary tractive force to keep the fractured ends of the bone in proper relationship against the contractive forces of the large muscles. Traction techniques heretofore have kept the patient confined and virtually immobilized in bed for extended periods of time, typically on the order of two to three months. The side effects of such extended periods of almost total physical immobility are often as serious as the injury itself. Inability to exercise and move about greatly weakens the patient physically making him more susceptible to contraction of disease and necessitates constant attention to avoid development of bed sores and the like.
Attempts have been made heretofore to provide a mobile traction apparatus but nonehas been satisfactory from the standpoint of compactness and more especially from the standpoint of maintaining substantially constant tractive force as well as support for the fractured member irrespective of movement by the patient.
Accordingly, it is an object of the present invention to provide improvements in traction equipment. A more specific object of this invention is to provide a mobile traction'apparatus adapted to provide a substantially constant traction and supporting force on the fractured member regardless of reasonable body motion or. transfer of the patient from the bed to a wheelchair. A further object of this invention is to provide a compact, readily adjustable, mobile traction apparatus having a wide variety of adjustments.
SUMMARY OF THE INVENTION This invention features a mobile traction apparatus, comprising an articulated leg support adapted to cradle the upper and lower portions of the leg against collapse and adjustable traction means connected to the support employing a pulley system and scale for applying an adjustable, constant tractive force on the fractured member. The support and the traction applying components are pivotally mounted in such a fashion that the patient may be shifted about with a certain amount of freedom. When the appliance is used in a bed, the support is mounted to a carriage which is freely movable along tracks in a guideway. The support is detachably connected to permit the transfer of the patient together with the traction applying components to a wheelchair equipped with a cooperating bracket to receive and support the appliance.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. I is a view in perspective of a mobile traction apparatus made according to the invention for use in a bed,
FIG. 2 is a view in perspective showing the apparatus as used on a patient,
FIG. 3 is a view in perspective showing the apparatus connected to a wheelchair,
FIG. 4 is a detailed perspective view showing the carriage and detachable fulcrum,
FIG. 5 is a detailed perspective view showing the wheelchair bracket attachment, and,
FIG. 6 A, B, C, D and E are diagramatic representations illustrating operating principles for explanatory purposes.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT The mobile traction appliance of the illustrated embodiment is comprised of a pair of articulated members 10 and 12, the member 10 being in the form of a Thomas splint fabricated as a continuous length of stiff metal rod or tubing bent in a U-shaped configuration to define parallel rails 14 and 16. The lower member 12 is in the form of a Pierson attachment and typically is fabricated by an elongated section of stiff metal tubing or rod stock bent into a U-shaped configuration to form a pair of parallel rails 18 and 20. The right-hand end of the Pierson attachment 12 is provided with a handle 22 for use in assisting the transfer of a patient as from a bed to a wheelchair. The Thomas splint 10 is connected to the Pierson attachment 12 by means of pivotal joints 24 and 26 which are slidable along the rails 14 and 16 and are lockable in a selected position by means of clamping screws 28 and 30. The pivotal joints 24 and 26 each connect to the left-hand end of the Pierson attachment by means of pivot pins 32. The connection is such that the Thomas splint 10 may be slidably adjusted relative to the Pierson attachment and clamped in position and yet remain angularly movable with respect to the Pierson attachment.
The angle between the Thomas splint l0 and the Pierson attachment 12 may be adjusted and locked by means of a pair of rods 34 and 36 connected respectively between the rails 14 and 18 and the rails 16 and 20. Each of the rods 34 and 36 is pivotally'connected at each end to a clamp 38 adapted to be moved along the rails. A locking screw 40 is threaded to each of the clamps for use in clamping the clamps at any selected position along the rails. In this fashion, either or both ends of the rods 34 and 36 may be moved along the rails to selectively vary the angle between the Thomas splint and the Pierson attachment. This capability allows the physician to pre-set any selected knee angle for the patients leg in a manner best suited to allow proper setting of the fractured members.
In order to provide comfortable leg-conforming support for the limb, the Thomas splint 10 is provided with a flexible web 42 connected to the rails 14 and 16 at the left-hand end of the appliance as viewed in FIG. 1. The web 42 serves to support the underside of the upper leg and cross webs 44 and 46 between the rails 18 and 20 of the Pierson attachment serve to support the lower end of the injured limb. The webs typically may be of fabric such as pillow ticking or the like as is often used in the hospitals.
At the right-hand end of the Pierson attachment there ismounted an upright post assembly 48 which is adjustable as to height'and which is adapted to apply 3 traction on the fractured member through a cord and pulley system. The post 48 is mounted to the Pierson attachment by means of a cross-piece 50 rigidly mounted to a pair of blocks 52 and 54 which are clamped tightly in position over the rails 18 and 20. Screws are provided'to permit the blocks and post as sembly to be clamped at any selected position along the rails 18 and 20.
The'cross-piece 50 is provided on-its left-hand face, as viewed in FIG. 1, with a pulley 56 substantially in the plane of the Piersonattachment. This pulley is used .when the appliance is employed to apply traction to a fracture of a lower leg member.1The cross-piece 50 is formed with an arcuate slot 58 adapted to receive a bolt 60 extending therethrough as well as through the lower end of the post. The pulley 56 is held in position by means of a bolt also extending through the crosspiece 50 as well as through the lower end of the post directly below the bolt 60. In this fashion, the angular position of the post may be selectively altered by relieving the bolt 60 and biasing the post to either sidejwithin the range of the arcuate slot 58 andthen re-tightening the bolt 60. This capability permits the attending physician to adjust the direction of traction force where needed. i
The post assembly 48 includes upper and lower telescopic members 62 and 64, respectively, and the upper member 62 may be raised or lowered with respect to the lower member 64 by means of a threaded locking collar 66 connecting the two members.
Mounted to the right-hand or rear face of the upper portion 62 is an adjustable pulley assembly comprised of a block 68 carrying a pulley 70 at its upper end and slidably mounted to the post assembly by means of a guide 72 fixed to the upper post portion 62. The lower end of the block 68 engages an adjustment screw 74 extending through a fixed plate 76 and provided at its lower end with a knob 78. Rotation of the knob '78 serves to raise or lower the block 68 together with its pulley 70 to selectively vary the tension applied to a cord 80 roven about a pulley 82 mounted in the uppermost part of the post assembly and through the pulley 70. The cord is brought back through an opening formed in the upper member 62 and its free end is secured by forming it into a knot 83. The cord is attached to one end of a tension measuring device preferably a.
spring scale 85. The opposite ends of the scale 85 is connected by a section of cord 84 to a traction bow 86. The presence of the spring scales 85 in the traction line not only offers a direct indication of traction force but also provides a certain amount of elasticity to the system. Thus no appreciable change in traction will occur 7 despite limited movement of the limb.
The traction bow 86 is provided with a surgical pin 88 which, in practice, is connected by the physician to the end of the fractured bone. Typically, this is done by drilling a hole through the bone, inserting the pin 88 and then attaching the bow or a harness to the ends of the pin. The harness may be of fixed configuration or may be of the adjustable bow type adapted toaccommodate legs of different widths. In any event, once the pin has been inserted, the bow 86 attached to the cord 84 and with the limb suitably supported by theThomas splint and Pierson attachment, the cord is tensioned to apply the appropriate amount of traction on the fractured member. This tension may be read directly on the scale 85 and is adjusted by the operation of the knob 78. Typically, the traction force might be on the order of 15 pounds or so. The knee angle will, of course, have been pre-set through the manipulation of the rods 34 and 36.
In the arrangement shown in FIG. 1, the appliance is set up to apply traction to the femur, or upper leg bone, the cord being aligned with the length of the bone that has been fractured to apply a substantially straight line traction. If the lower leg bone has been fractured, the cord is roven down through the lower pulley 56 and attached to the bow or harness 86 which will be positioned substantially between the rails 18 and 20, again to apply a substantially straight-line traction force on the lower leg. The pin 88 is normally attached through the heel for this type of traction. The scales may be between the pulley 56 and 82 or between the pulley 56 and the bow 86, as is most convenient.
The Thomas splint, the Pierson attachment and the post assembly are carried by a fulcrum member 90 which, in the illustrated embodiment, is in the form of a U-shaped bracket comprised of parallel legs 92 and 94 adjustably connected to a U-shaped cross-piece 96 by means of threaded couplings 98 and 100 which permit the legs 92 and 94 to be raised or lowered within a certain range in order to raise or lower the traction assembly. The upper end of each leg 92 and 94 is provided with a clamp 102 and 104 engaging the rails 18 and 20. The clamps are locked at selected positions along the rails by means of screws l06'by which the physician may balance the leg on the traction assembly to compensate for the particular traction force applied to the cord 80. The balancing of the limb on the traction appliance is important in order to prevent collapse of the fractured member which may result if the limb is not properly balanced. I
The cross-piece 96 pivotally engages a hub 108 which is detachably connected to a carriage 1 10 which, in turn, is movable along a base 112. The cross-piece 96 is locked against axial displacement by means of a screw in the hub extending into an annular groove formed in the center of the cross-piece. The base 112 is provided with parallel guidways 114 and 116 to receive rollers 1 18 mounted to the under side of the carriage 110. The'carriage is movable along the length of the guideways to allow certain freedom of movement of the patient confined to a bed. Thus, if a hospital bed is used and the head of the bed is raised in order to allow the patient to sit up, the patients body will shift towards the foot of the bed. This motion is freely accommodated by the carriage which moves the entire traction appliance without changing either the tractive force or the support on the injured limb. Again when the patient retums to a fully prone position the carriage returns to its initalposition without altering either the support or the traction applied to the limb.
The hub 108 is formed with a dependent male plug connector 120 (FIG. 4) which is formed with an annualar groove 122. The connector 120 engages the carriage 110 by inserting it in a cooperating socket 124 formed in the upper face of the carriage. A springloaded latch 126 is mounted in the body of the carriage and its inner end locks into the annular groove 122 when the connector 120 is in position. The connector can be rotated in the socket to permit the fulcrum to move about a vertical axis. The fulcrum member may be released from the carriage by pulling the latch 126 out sufficiently to allow the release of the connector.
The base 112 may be secured to the bed, if desired, to eliminate any possibility of tipping the appliance by passing a belt or the like through slots 128 and 130 formed in the sides of the base. The belt may be carried around the mattress or the bed and ends connected.
The patient together with the traction appliance may be transferred to a wheelchair, for example, without disturbing traction or leg support. This is done by releasing the connector 120 from the carriage 110 and seating the patient in a wheelchair as suggested in FIG. 3. The wheelchair is equipped with a reversible bracket 132, best shown in FIG. 5, adapted to receive the plug connector 120 for attaching the traction appliance.
The bracket 132 in the illustrated embodiment of FIG. Sis comprised of an L-shaped arm 134 typically of tubular metal stock, square in cross-section, the long leg of which is provided with a clamp 136 adapted to lock against an upright frame member 138 of a wheelchair 140. The clamp 136 typically is provided with four levers or handles 142 each connected to a clamping screw 144 extending through two pairs of blocks 146 and 148 on either side of the long leg of the bracket. This permits the bracket to be tightly clamped at any selected height along the frame member 138 or to be removed therefrom for transfer to the opposite side of the wheelchair, depending upon which leg of the patient is in traction. The short leg of the L-shaped bracket 134 extends upright and carries a sleeve 150 which is clamped in position by means of a locking screw 152. Fixed to the sleeve 150 is a holder 154 comprised of upper and lower plates 156 and 158 joined by a center core 160. Each of the plates 156 and 158 is formed with a central socket 162 adapted to receive the plug connector 120 depending from the hub 108. The plug connector thus can be attached to either side of the holder whereby, if the bracket is to be used for a left leg fracture, the sleeve 150 and the bracket may be transferred to the left-hand side of the wheelchair and the sleeve 150 removed and inverted so that the holder will extend inwardly of the wheelchair. The holder is provided with a spring-loaded latch 164 having a knob 168 extending from the side thereof. The latch functions in the same manner as the latch 126 for the carriage 110 serving to lock the plug connector to the holder.
Constant traction force is applied to the fractured member by means of the pulley system which has been pre-set to the desired tension. This traction force remains almost constant irrespective of the patient changing from a prone to a sitting position on the bed or being transferred to a wheel chair, stretcher, ambulance or the like. When in bed or in a wheelchair, the patient has greater mobility since the fulcrum member not only is free to move with the sliding carriage in the base plate but also is pivotally connected thereto, both about a horizontal axis as well as about a vertical axis whereby the patient may move from side to side on the bed to a certain extent as well as lengthwise of the bed.
Since it is necessary to maintain proper upward support for the injured limb as well as proper traction to prevent the knitting bones from collapsing, the apparatus is adapted to balance the upper and lower portions of the leg so that the support below the fractured limb remains proper at all times. A correct uplift is thus provided especially to the upper part of the break to prevent collapse. In the event that the traction force is changed by the attending physician, it is also necessary weight of the lower leg will provide counter traction.
to change the fulcrum position in order to rebalance the leg. This may best be demonstrated by reference to FIGS. 6A through 6E. For purposes of illustration, FIG. 6A shows an unbalanced beam mounted on a fulcrum.
The beam is centrally pivoted and the weight on theright-hand side is greater than the weight on the lefthand side causing the right-hand end of the beam to move down. The beam may be brought into balance by moving the fulcrum towards the heavy end as suggested in FIG. 613. Similar principles apply to the traction apparatus disclosed herein. In FIGS. 6C, D and E, the Pierson attachment is indicated at 12, the Thomas splint is indicated at 10, the post assembly is indicated at 48 and the fulcrum is indicated at 90. If traction is applied to a limb this, in effect, causes a pulling on the post 48 in the direction of the arrow marked 1. This will cause the beam or Pierson attachment to tip downwardly from the balanced condition of FIG. 6C in the direction of the arrow 2 as shown in FIG. 6D. In FIG. 6D the ring end of the Thomas splint is forced down in the direction of arrow 2 by the traction force on the post 48. This imbalance is counteracted by moving the fulcrum towards the heavy end as in FIG. 6E thereby returning the system to a balanced condition. Hence, when traction is applied through a spring scale from the post 48 at arrow 1, the fulcrum can be adjusted so that the Uplift at the ring end of the Thomas splint can be adjusted by moving the fulcrum as required. Also, each time the traction is changed, the fulcrum or balance adjustment should be likewise changed to maintain a properly balanced system.
Having thus described the invention what I claim and desire to obtain by Letters Patent of the United States 1. Apparatus for applying traction to a limb, comprising a. a first limb supporting member,
b. a second limb supporting member articulated to 'said first member and slidably and lockably connected thereto,
c. angle adjustment means connecting said first and second members for setting a preselected angle between said members,
(I. fulcrum means pivotally supporting said members,
e. fulcrum position means connecting said fulcrum means to said members for selectively balancing said members,
f. adjustable spring traction means engagable with a limb supported by said members,
g. a height adjustable upright member mounted to one of said first and second members andjsupporting said traction means,
11. said upright member being adjustably movable lengthwise along one of said first and second members,
i. said traction means including pulley means connected to said one member, a limb engaging device, a cord connected to said pulley means and said device and tension adjustment means connected to said cord for adjusting the tension thereon.
2. Apparatus according to claim 1 including slide means supporting said fulcrum means for limited movement thereof.
6. Apparatus according to claim 1 including height adjustment means connected to said fulcrum means for selectively raising and lowering said first and second members.
7. Apparatus according to claim 1 wherein said upright member is angularly adjustable with respect to one of said first and second members through a plane perpendicular to the length of said one member.