GB2068234A - Exo-skeletal fracture splint - Google Patents

Abstract

An orthopaedic splint for use particularly in connection with femoral and hip fractures comprises a flexible fabric body (10, 12, 14) which fits around one leg only of a patient so as to surround that leg from below the knee upwards. A beam or support is attached to the fabric body and is positioned to extend laterally of the patient's thigh and leg from a position below the knee to approximately waist level. In order to enable the flexibility of the beam or support to be selectively increased or decreased with the splint in its operational position on the patient, the beam or support comprises either a plurality of selectively removable, flexible rods disposed in pockets 26 in the fabric body or a plurality of pressurisable elastic tubes. A bracing means (not shown), prevents the patient's leg from being rotated about its longitudinal axis. <IMAGE>

Description

SPECIFICATION Exo-skeletal fracture splint The present invention relates to exo-skeletal splints and is particularly concerned with such splints for use in connection with femoral and hip fractures.

Orthopaedic splints are already known which comprise a flexible garment which is strapped around a patient's damaged limb and which contains a number of longitudinally extending flexible tubes which become substantially rigid when inflated with compressed air whereby to provide a support for the damaged limb. Other splints are of course known which comprise one or more rigid elongate rods strapped to a patients damaged limb. Such known splints have not, however, been wholly suitable for use with fractures'of the upper thigh and hip with which special problems are encountered, particularly in the elderly.

An objective of the present invention is therefore to provide an orthopaedic splint which reduces the problems incurred with the known splints and which is, in particular suitable for use in connection with femoral and hip fractures.

In accordance with the present invention, there is provided an orthopaedic splint comprising a flexible fabric body which is adapted to be fitted around one leg only of a patient (in the manner of a hip spica) so as to surround that leg from below the knee upwards, and a beam attached to the fabric body and positioned to extend, in use, laterally of the patient's thigh and leg from below knee level to approximately waist level, the beam being constructed so that its flexibility can be selectively increased or decreased with the splint in its operational position on a patient.

Preferably, the beam comprises a plurality of flexible rods disposed in one or more pockets in the fabric body so as to be selectably removable from said pockets to enable the flexibility of the beam to be altered.

Alternatively, the beam can comprise a plurality of pressurisable elastic tubes disposed in one or more products on the fabric body.

Advantageously, the splint includes a bracing means which prevents or at least severely restricts the ability of the wearers leg to be rotated about its longitudinal axis.

In a preferred embodiment, the bracing means comprises a pair of straps adapted to extend obliquely across the front and back of the wearers body respectively from the opposite iliac crest to the two sides of the beam whereby to apply equal and opposite forces to the beam preventing rotation of the splint about the wearers body.

The principal advantages of the aforegoing splint are that it enables the patient to be mobilised almost immediately and obviates the necessity for operations. Previously, this has not been possible and the patient has been obliged to remain immobile for a considerable period with the consequent well known problems, such as pneumonia, which are often fatal with the elderly..

The invention is described further hereinafter, by way of example, with reference to the accompanying drawings, in which: Figure 1 is a perspective view of one embodiment of an orthopaedic splint in accordance with the present invention when in its operational position on a patient; Figure 2 is a diagrammatic, partically cutaway plan view of the splint of Fig. 1 when laid out flat and viewed from the side which lies remote from the patients body; Figure 3 is a plan view, to a reduced scale, of a strap harness worn in conjunction with the splint of Figs. 1 and 2; Figure 4 is a view of the splint in its operational position and with the harness of Fig. 3 in place; Figure 5 is a diagrammatic plan view of a second embodiment of an orthopaedic splint in accordance with the present invention, when laid out flat and viewed from the side which is to be placed against the patients body; and Figure 5a is an enlarged sectional end view of part of the splint of Fig. 5.

As best seen in Fig. 2, the splint of Figs. 1 to 4 is formed in three principal component parts 10, 12, 14 which are adapted to be disposed, in use, against the front, the side and the rear, respectively, of a patient's leg, and which are connected together by two sets of laces 16, 18. The intermediate part 12 comprises an elongate rectangular strip 20 of a heavy grade nylon material, the inner surface of which (i.e. the surface which, in use, will lie against the patient's body) carries a rectangular strip (not visible in Fig. 2) of fibrous material forming one half of a two-part fastening sold under the trade mark "Velcro" The longitudinal edges of the strip 20 are reinforced with lengths of nylon tape 22 and contain a plurality of metal eyelets 24 for receiving the laces 16, 18.

The outer surface of the strip 20 carries a plurality (four in this embodiment) of discrete longitudinally extending pockets 26 which extend over substantially the whole of the length of the intermediate member 12. These pockets 26 are permanently closed at one end (the top end in this embodiment) and selectably accessible at the other end (the lower end) by means of a fabric flap 28 which is normally held by a velcro fastener in a position in which it closes the lower end of the pockets 26 but which can be manually released by breaking the velcro connection so enabling access to the pockets to be gained. Each pocket is adapted to receive a respective elon gate rod (not shown) made of a material with a predetermined desired flexibility, e.g. a plastics material such as nylon which is light and flexible yet strong.

The rods form the main longitudinal bracing beam part of the splint and are held in their operational position by means of the parts 10, 12 so as to extend vertically from approximately waist level to at least below knee level, at the side of the patients damaged limb.

One longitudinal side edge of the front part 10 of the splint carries a further plurality of eyelets for receiving the lacing 16. The other longitudinal side edge 29 of the part 10 extends obliquely, as shown in Fig. 2, and has one half 30 a zip fastener spaced slightly inwardly thereof. The upper end of the part 10 is formed as one half 32 of a pelvic band, the inner surface of which carries a strip of fibrous velcro material. As shown in Fig. 2, the pelvic band portion 32 is connected to the obliquely extending side edge 29 by way of a cut-away portion 34 to enable the front part 10 to be fitted snugly around the front of the patient's leg. The front part 10 also has a hooked or fibrous velcro strip 36 extending vertically in the region of the cut-away portion 34 for attaching a lambswool pad (not shown) to prevent chaffing in the latter region.

As apparent from Fig. 2, the posterior part 14 is substantially identical to the front part 10. At its obliquely extending longitudinal edge 38 it carries the other half 40 of the zip fastener which enables the parts 10, 12 and 14 to be mounted in position on the patient's leg. The upper end of the part 14 is formed as the other half 42 of the pelvic band and carries the mating hooked part of a velcro fastener for engaging with the fibrous material on the pelvic band part 32.

In order to hide the laced areas when the splint has been applied to a patient, the intermediate part 12 carries on its outer side two elasticated flaps 44, 46 which can be drawn over the laced areas and fastened respectively to the parts 10 and 14 by means of a plurality of hooks and eyes, one pair of which is indicated at 48.

To assist the reduction of discomfort to the wearer of the splint, the inner surface of the intermediate part carries in a detachable manner by means of the aforementioned rectangular strip an elongate pad (not visible in Fig. 2 but indicated at 50 in Fig. 1) which can comprise one or more sheets of foam and/or solid sheets of plastics material. Normally the latter sheets would be arranged to provide more stiffness to the pad at its upper end compared with its lower end. The latter pad can also be arranged to keep the laces out of direct contact with the wearer.

The lower ends of the intermediate part 12 and one of the other parts 10, 14 (in this case the part 10) carry respective strips 52, 54 having velcro material on them. These strips can be passed beneath the patient's foot for preventing riding up of the splint along the patient's leg.

For a purpose explained further below, the intermediate part 12 also carries at spaced locations along its length pairs of loops 56a, 56b (four pairs in this example), the two loops in each pair being adjacent opposite edges of the part 12, respectively.

Figs. 1 and 4 show diagrammatically the splint when fitted to a patient. The zip lies along the inside leg and the stiffened beam lies laterally of the leg. The pelvic band halves 32, 42 are drawn tight around the wearer's pelvis so as to engage over the wearer's left hand iliac crest in the case of the splint being worn in connection with a damaged right leg as in the drawing. A pad, (not shown) can be worn between the iliac crest and the waistband to prevent discomfort to the wearer.

As shown in Fig. 4, the harness 58 of Fig.

3 is worn to prevent unwanted rotational movements of the supported leg. The harness 58 comprises a waistband part having velcro fastener members (not shown) enabling the harness to be firmly fitted around the wearers waist in a similar manner to the pelvic band halves 32, 42. Obliquely extending straps 60, 62 are attached to a central region of the harness which is again arranged to lie over the aforementioned iliac crest, preferably with a resilient pad therebtween, to provide a firm supporting location. The straps 60, 62 each carry on their two sides the two halves of a velcro fastener whereby when passed through one of the loops 56 as shown in Fig. 4 they will adhere to themselves to form a firm and reliable connection. As shown in Fig. 4, one strap 60 extends across the front of the body from the left-hand iliac crest to a selected one of the loops 56.The other strap 62 (not visible in Fig. 3) extends from the same iliac crest across the rear of the body to the other loop 56 of the pair. The harness thus uses the iliac crest on the opposite side of the body to the damaged limb to provide a firm support point for the obliquely extending straps 60, 62 so that the latter can be sufficiently tensioned to effectively resist rotation of the damaged leg about its own longitudinal axis.

A velcro strip 57 at the top of the beam is used to locate the harness 58 which has a mating velcro shrip (not shown) on its inside surface.

When the splint is first applied and maximum stiffness is needed, all four rods are provided in the pockets 26. However, it is usually important to the rapid recovery of the patient that mobility should be returned progressively to the leg whilst maintaining primary.

support. The present arrangement facilitates the attainment of this characteristic in that the rods can be selectively withdrawn at intervals of a few days or weeks, as appropriate in order to progressively reduce the stiffness of the beam and allow a certain amount of flexing of the knee joint. It will be appreciated that this variability of stiffness is achieved in a particularly convenient and simple manner by this construction.

The same splint can be applied equally well to either leg. In the event the splint is applied to the left leg then the identification of the "front" and "rear" parts in the aforegoing description would be reversed.

Preferably a conventional undergarment is worn beneath the splint for comfort to the wearer.

Figs. 5 and 5a show another embodiment of splint in accordance with the present invention which is similar in many major aspects to the splint of Figs. 1 to 4. Thus, the splint of Figs. 5 and 5a is formed in three principal component parts 110, 112, 114 which are adapted to be disposed, in use, against the front, the side and the rear, respectively, of a patient's leg, and which are connected together by two sets of laces 116, 118. The intermediate part 112(see Fig. 5a) comprises an elongate rectangular strip 120 of a heavy grade nylon material, the inner surface of which (i.e. the surface which, in use, will lie against the patient's body) carries a rectangular strip 122 of fibrous material forming one half of a two-part fastening sold under the trade mark "Velcro".The edges of the strip 120 are reinforced with lengths of nylon tape and contain a plurality of metal eyelets 124 for receiving the laces 116, 118. The outer surface of the strip 120 carries two longitudinally extending, channel-sectioned lengths 126, 128, of the heavy duty nylon material which are stitched to the strip 120 as shown in Fig. 5a to form three contiguous longitudinally extending cells 130, 132, 134. Each of the latter cells contains a respective tube 136 of elastic material which are connected together in a known manner at their upper ends by means of juxtaposed rubber manifold blocks (not shown) which can be selectably connected to a source of compressed air via a non-return valve in order to inflate the tubes to a pressure sufficient to render the tubes 136 substantially rigid.In practice a pressure of about 2 atoms. is necessary for this purpose.

When the tubes 136 are inflated they thus form a rigid beam which, as described below, is adapted to be strapped to the patient by means of the parts 110, 114 so as to extend vertically from approximately waist level to below knee level, at the side of the patient's damaged limb.

One longitudinal side edge of the front part 110 of the splint carries a further plurality of eyelets for receiving the lacing 116. A further strip 138 of fibrous Velcro material extends alongside the latter edge, substantially over its whole length. The other longitudinal side edge 1 39 of the part 110 extends obliquely as shown in Fig. 1 and carries another strip 140 of fibrous Velcro material. The upper end of the part 110 is formed as one half 142 of a pelvic band, the inner surface of which carries a a further strip 144 of fibrous Velcro material.

Advantageously, the pelvic band part 142 contains an elasticated rouched portion 146 to assist in holding the splint on the patient.

As shown in Fig. 1, the pelvic band portion 142 is connected to the obliquely extending side edge 139 by way of a cut-away portion 148 to enable the front part 110 to be fitted snugly around the front of the patient's leg.

The Velcro strip 138 is used to mount a stiffening strut 150 formed, for example, by flat strips of flexible plastics material placed one on top of the other and together sewn into an enclosure made of the heavy duty nylon material. One flat surface of the latter enclosure carries the mating part of a Velcro fastener in the form of a plurality of tiny hooks which become engaged with the fibrous material of the strip 138 for holding the strut 150 in position on the part 110. The arrangement is such that, in use, the strut lies vertically along the front of the patient's thigh, terminating at a position above the knee.

The rear part 11 4 of the splint is very similar to the front part 110 except that it does not need a portion corresponding to the Velcro strip 140. Thus, one longitudinal side edge carries a further plurality of eyelets for receiving the lacing 118. A further strip 152 of fibrous Velcro material extends alongside the latter edge, substantially over its whole length. The other longitudinal side edge 154 of the part 11 4 extends obliquely as shown in Fig. 5 and carries one half of a zip fastener 1 56, the other half of which (not shown) is attached to the outer surface of the front part 110 at a position spaced somewhat from the obliquely extending side edge 139.The upper end of the part 11 4 is formed as the other half 158 of the pelvic band, the outer surface of which carries a further strip 160 of fibrous Velcro material. The pelvic band portion 158 can again contain a rouched portion 162. The pelvic band portion 158 is connected to the obliquely extending side edge 154 by way of a cut-away portion 164 to enable the rear part 11 4 to be fitted snugly around the rear of the patient's leg.

The Velcro strip 152 is used to mount a second stiffening strut 166 which can be formed in the same manner as strut 150, the arrangement being such that, in use, the strut 166 lies substantially vertically along the rear of the patient's thigh. In general, the strut 166 can be considerably shorter, but possibly wider and softer, than the strut 150.

In addition to the parts described above, the splint preferably includes a substantially triangular strip 168 of heavy duty nylon material which fits over the inner facing surfaces of the beam part 112, the lacings 116, 118 and the areas mounting the struts 150 and 166 for keeping the latter components out of direct contact with the patient. The strip 168 is therefore primarily to increase the comfort of the wearer of the splint. It is fitted in place by means of further Velcro strips positioned to co-operate with the strips 122, 138, 152.

144 and 160 already mentioned. Advantageously, the strip 168 contains a strip of padding for lying directly over the inflated beam portion, again to increase the comfort of the wearer.

Although not shown, the rear waistband portion 158 can, again using Velcro fasteners, carry a further firm padded member for gripping the patient's pelvis beneath the iliac crest.

In order to enable the splint to be used on legs of differing girths, a plurality of different sized triangular gussets (not shown) are provided which can be zipped between the obliquely extending side edges 139, 156 to extend the width of the splint. Similarly, an extension piece (not shown) can be provided for enabling the pelvic band to be extended to suit different waist measurements. Velcro strips can again be used for this purpose.

Similar extension pieces and gussets can be used in the first embodiment. A strap (not shown) can be attached to the bottom of the strip 11 2 for passing under the foot of the wearer to assist attachment.

In use, the splint is zipped on to the patient with the pelvic band portions overlapping around the patient's back. The longer strut 150 lies over the front of the thigh bone to strengthen the support in this area and the softer strut 166 strengthens the posterior region. It will be appreciated that the precise positions of these struts can be varied using the Velcro fastenings. The laces are used to adjust the splint to the contours of the patient's body, the shape of the splint being such that the pubic and perineal areas are left free.

It will also be appreciated that the construction of the splint provides for a three-point support on the patient's body, namely at the waist, side of the leg and on the inner side of the knee just above it, thereby enabling substantially complete support for an injured thigh or high and enabling substantially immediate mobilisation of the patient.

Clearly, many variations are possible in the positioning and shape of the various component parts. Thus, the length of the parts 110, 112, 114 is variable to suit patients of different height, the struts can be of different shapes and materials, different numbers of tubes can be provided in the inflatable beam, a base material other than nylon can be used, and additional supporting struts might be provided.

As in the case of the first embodiment, the intention is that initially the splint will be used with the inflatable beam rigid. However, as the patient recovers and becomes more mobile, the pressure in the tubes 136 can be gradually lowered to levels which permit sufficient flexibility of the beam to allow a permitted bending of the knee.

The harness of Fig. 3 can of course be used in a similar manner in connection with the embodiment of Figs. 5 and 5a by the provision of suitable loops corresponding to the loops 56.

Claims (20)

1. An orthopaedic splint comprising a flexible fabric body which is adapted to be fitted around one leg only of a patient (in the manner of a hip spica) so as to surround that leg from below the knee upwards, and a beam attached to the fabric body and positioned to extend, in use, laterally of the patient's thigh and leg from below knee level to approximately waist level, the beam being constructed so that its flexibility can be selectively increased or decreased with the splint in its operational position on a patient.

2. An orthopaedic splint as claimed in claim 1 wherein the beam comprises a plurality of flexible rods disposed in one or more pockets in the fabric body so as to be selectably removable from said pockets to enable the flexibility of the beam to be altered.

3. An orthopaedic splint as claimed in claim 2 wherein the pockets are arranged such that the rods can be individually withdrawn longitudinally if the beam to enable a desired beam flexibility to be selected.

4. An orthopaedic splint as claimed in claim 1 wherein the beam comprises a plurality of pressurisable elastic tubes disposed in one or more pockets on the fabric body.

5. An orthopaedic splint as claimed in claim 4 in which the pressure in the tube is selectably controllable.

6. An orthopaedic splint as claimed in any preceding claim wherein a supporting strut is attached to the fabric body so as to lie in front of the femur of a wearer of the splint.

7. An orthopaedic splint as claimed in any preceding claim wherein a supporting strut is attached to the fabric body so as to lie behind the femur of a wearer of the splint.

8. An orthopaedic splint as claimed in any preceding claim including a portion for engaging around the wearer's pelvis to hold the upper part of the splint in place and to exert lateral pressure onfthe beam to pull the beam against the upper part of the leg and pelvis.

9. An orthopaedic splint as claimed in any preceding claim wherein the fabric body is formed in three sections adapted to lie over the front, outer side and rear parts of the wearer's leg, respectively, with the front and rear parts carrying the two halves of a zip fastener which come together over the inner side of the leg.

10. An orthopaedic splint as claimed in claim 9 wherein the intermediate part of the fabric body is attached to the front and rear parts by respective lacings which enable the fabric body to be adjusted to the contours of the wearer's leg.

11. An orthopaedic splint as claimed in claim 10 including elasticated flaps disposed on the intermediate part of the body and engageable respectively with the front and rear parts so as to cover the laced regions from external view.

12. An orthopaedic splint as claimed in claim 9, 10 or 11 wherein the intermediate part carries the beam.

13. An orthopaedic splint as claimed in claim 12 including a padded member detachably mounted on the inner surface of the intermediate part so as to lie between the beam and the laced regions and the wearer to reduce discomfort to the wearer.

14. An orthopaedic splint as claimed in any preceding claim including a foot strap for engaging under the wearer's foot to prevent riding up of the splint along the wearer's leg.

15. An orthopaedic splint as claimed in any preceding claim further including a bracing means which prevents or at least severely restricts the ability of the wearer's leg to be rotated about its longitudinal axis.

16. An orthopaedic splint as claimed in claim 15 wherein the bracing means comprises a pair of straps adapted to extend obliquely across the front and back of the wearer's body respectively from the opposite iliac crest to the two sides of the beam whereby to apply equal and opposite forces to the beam preventing rotation of the splint about the wearer's body.

17. An orthopaedic splint as claimed in claim 16 wherein the straps are attached obliquely to a central region of a belt which is adapted to be fastened about the wearer's waist so that the junction of the straps with the belt lies over said opposite iliac crest.

18. An orthopaedic splint as claimed in claim 17 wherein there is disposed between said junction and said opposite iliac crest a resilient pad.

19. An orthopaedic splint substantially as hereinbefore described with reference to and as illustrated in Figs. 1 and 4 of the accompanying drawings.

20. An orthopaedic splint substantially as hereinbefore described with reference to and as illustrated in Figs. 5 and 5a of the accompanying drawings.