Field of the Invention
This invention relates to removable hand and wrist splints used when the fourth or fifth metacarpel bone, one of the outside long bones of the hand, is broken, or the fourth or fifth finger is broken.
Background of the Invention
When the long bone of the hand which leads to the little finger is broken, often referred to as a "boxer's fracture", a plaster cast is normally used to tiqhtly encompass a substantial portion of the wrist, hand, and fingers. This cast usually encompasses a substantial portion of the little finger (fifth finger), adjacent finger (fourth finger), palm of the hand and wrist. Therefore, the cast allows little, if any, beneficial use of the hand or fingers. In addition, this cast cannot be removed until total mending of the break. Due to the lack of mobility during this period, the wrist, hand and fingers become substantially weak.
A splint applied to the hand and wrist to assist it in overcoming injury should provide for the maximum mobility of hand and fingers to allow the hand to carry most of the normal functions. Splints possessing such characteristics prevent the wrist and hand from getting substantially weak or stiff. However, too much mobility may cause further pain or injury to the injured bones or joints, and prevent the broken bone from mending. Therefore, a desirable splint should provide for 1) a secure and tight support for the outside long bone of the hand, fourth and fifth fingers and forearm, and 2) beneficial use of the hand and the remainder of the fingers and thumb during the immobilization period. Conventional plaster of paris cast splints allow very little mobility. The lack of mobility disrupts most of the functions of the hand. Further, due to the lack of mobility, the hand and wrist are substantially weakened when in a cast for a long time. Other splints that allow some mobility have failed to provide sufficient support to prevent further pain or injury.
Current wrist and hand splints do not provide the necessary support in the appropriate places or are so bulky that the benefits of using them are greatly diminished. A brief review of the prior art reveals these shortcomings.
The U.S. Pat. No. 4,382,439 to Shen discloses a "thumb spica" for use by persons requiring wrist and hand support. The brace forms a sleeve that provides a longitudinal support for the wrist and hand. Although the wrist and hand are sufficiently supported, the brace fails to support the fourth and fifth fingers. Supporting these fingers is an essential feature of a brace used for the treatment of an injured hand bone which leads to the fourth and fifth fingers. This drawback of the "Shen" patent in failing to adequately support the fourth and fifth fingers and outer portion of the hand is shared by U.S. Pat. No. 1,227,700 to Tucker, U.S. Pat. No. 4,441,490 to Nirschl, U.S. Pat. No. 4,584,994 to Nelson, U.S. Pat. No. 4,183,098 to Knowles, U.S. Pat. No. 3,598,408 to Kloss, U.S. Pat. No. 2,206,404 to Jones, and U.S. Pat. No. 4,677,971 to Lindemann.
Accordingly, a principal object of the present invention is to provide a hand and wrist splint which adequately supports the outside long bone of the hand, the fourth and fifth fingers, and forearm, and which will allow partial use of the hand and full use of the thumb, index, and middle fingers.
Summary of the Invention
In accordance with the present invention, an orthopaedic soft goods splint assembly for immobilizing the wrist, the fourth and fifth fingers and outer portion of the hand includes, among other elements, a splint means for substantially immobilizing the wrist, fourth and fifth fingers and outer portion of the hand, a sleeve, and fastening means for holding the assembly in place.
The splint assembly includes support means for providing rigid support for the wrist, fourth and fifth fingers and outer portion of the hand. The support means may include a plurality of stiff aluminum stays that support the wrist, fourth and fifth fingers and outer portion of the hand. The aluminum stays are housed within pockets that are secured to the sleeve. The aluminum stays are sufficiently bendable that they may be adjusted or bent to fit the form of the wrist, fourth and fifth fingers and outer portion of the hand. This adjustability is a desirable feature for the stays particularly if both the forearm and fingers are injured and need to be properly supported. The splint may include four stays, having various lengths and bent differently to accommodate the needs of a particular application.
The first stay normally extends from the middle of the forearm to the middle of the palm. For a comfortable and secure support, the first stay may be bent towards the palm of the hand as the stay passes over the pad of the thumb.
The second stay normally extends from the middle of the forearm to the fourth and fifth fingers. The second stay is also normally bent such that the fourth and fifth fingers cup around it. With the fingers cupped around it, the second stay securely supports these fingers and prevents them from moving towards the palm of the hand.
The third stay extends along the back of the forearm to the back of the fourth and fifth fingers. The third stay is bent to cup around the fourth and fifth fingers. With the third stay being cupped around the fourth and fifth fingers, it securely supports these fingers and prevents them from moving away from the palm of the hand.
Finally, the fourth stay extends along the back of the forearm and hand. It is positioned opposite the first stay and bent slightly over the back of the hand, and ends at the middle of the hand.
The splint assembly also includes a flexible soft goods sleeve for at least partially enclosing the forearm and the fourth and fifth fingers. The sleeve encompasses, and provides further support for, the forearm, fourth and fifth fingers and outer portion of the hand. The sleeve also provides a padding between the support means and the forearm and fingers. Further, the sleeve may include two portions attached to each other by a flexible hinge. Normally, one portion of the sleeve includes the first and second stays, while the other portion includes the third and fourth stays. The flexible hinge allows the sleeve to be readily wrapped around the wrist. Normally, the sleeve includes such soft covering as a vinyl covering. The wrist, hand and fingers come in contact with this soft covering when the splint is wrapped around the wrist. The splint assembly may be fastened to the wrist, hand, and fingers using straps, metal loops and Velcro type material, on the surface of the sleeve, that securely engage mating Velcro type material on the surface of the straps. The straps and sleeve contribute to the immobilization of the forearm, fourth and fifth fingers and their radial aspects.
The fastening straps may include a wrist strap, a hand strap, and a finger strap to adjustably fasten the splint to the forearm, hand and fingers, respectively. The straps may include Velcro type material on their surface to securely engage mating "Velcro" type material on the surface of the sleeve, as noted above.
The finger strap is situated between the third and fourth fingers, and helps to further immobilize the fourth and fifth fingers. The hand strap is normally situated between the thumb and second finger, and securely holds the splint to the hand. The forearm straps may include three separate straps for securely holding the splint to the forearm.
In summary, the aluminum stays cooperate to provide a firm support for the forearm, fourth and fifth fingers and the outer portion of the hand. Further, the stays may have varying length and width to accommodate varying degrees of support for the forearm, hand, and fingers. In addition, the stays may be housed within pockets that secure the stays to the sleeve. The sleeve provides for padding between the forearm, hand and fingers and the aluminum stays. The sleeve also provides further support for the injured forearm, hand and fingers. The manner in which the aluminum stays are housed within the pockets provides for a splint that is flexible and may readily encompass the wrist, fourth and fifth fingers and their radial aspects.
The assembly has been informally called an "ulna gutter", as it extends along the ulna side of the forearm and includes a U-shaped configuration which encompasses the two little fingers.
The adjustability of the assembly allows for expansion to accommodate swelling, and the capability of reducing the size of the assembly when the swelling goes down.
Other objects, features and advantages of the invention will become apparent from a consideration of the following detailed description and from the accompanying drawings.
Brief Description of the Drawings
FIG. 1 is a perspective view of the removable orthopaedic splint when applied to the wrist, fourth and fifth fingers and the outer portion of the hand;
FIG. 2 is a perspective view of the splint of FIG. 1 showing the straps and housing;
FIG. 3 is a perspective view of the splint with cut-away zones showing a pair of aluminum stays held in pockets;
FIG. 4 is a perspective view of the splint with two additional pockets with cut-away areas showing another pair of aluminum stays; and
FIGS. 5-8 are perspective views of four different aluminum stays.
Detailed Description
Referring more particularly to the drawings, FIG. 1 is a perspective view of a removable orthopaedic splint assembly 12 as applied to the wrist, hand, fourth and fifth fingers. As shown, sleeve 16 supports the forearm, hand, fourth and fifth fingers. Further, straps 14 and 18 enhance this support by securely tightening sleeve 16 around the forearm and hand, respectively. In addition, strap 20 helps to immobilize the fourth and fifth fingers. As shown in FIG. 1, splint assembly 12 achieves our dual goals of 1) providing sufficient support for the forearm, hand and fingers, and 2) allowing maximum possible use of the hand, thumb, index and middle fingers. These dual goals are achieved because, while the forearm, hand and fourth and fifth fingers are substantially immobilized to help recovery, the thumb, middle and index fingers are virtually free to perform such important and routine tasks as writing or driving. Further, to enhance recovery and comfort for the user, the fourth and fifth fingers may be immobilized at any desirable position. Finally, and as shown in FIG. 2, splint 12 is easy to remove and put back on.
FIG. 2 is a perspective view of splint assembly 12 of FIG. 1 showing the straps 14, 18, and 20, and sleeve 16. As shown in FIG. 2, splint 12 may easily be put back on by placing the injured forearm inside the sleeve such that the forearm, hand and fourth and fifth fingers are encompassed within the sleeve 16. Then, the forearm and hand may be secured within sleeve 16 by using straps 14 and 18, respectively. Further, the fourth and fifth fingers may be secured within the sleeve 16 using strap 20. Finally, straps 14, 18 and 20 may include Velcro type material 15 on their surface to accommodate a quick and easy engagement of the straps to the mating Velcro type material 17 secured to the surface of sleeve 16, or to the back of the straps following looping of some of the straps through the metal loops or rings 21.
VELCRO is a trademark, and the products sold under the VELCRO trademark are mating fabric pads, with one of the pads having its surface provided with a fine array of closely spaced outwardly protruding hooks, and the other of the mating pads being outwardly extending loops or other material with which the hooks may engage.
Further, the shape of sleeve 16 may be varied to accommodate the shape of the injured hand. The shape of sleeve 16 may be varied by changing the shape of the supporting aluminum stays partially shown in FIG. 3. FIGS. 5 through 8 display stays, used in a typical splint, having various shapes and sizes. Before discussing the configuration of the individual stays, their application within a typical splint will be reviewed.
FIG. 3 is a perspective view of splint 12 with portions of the drawing being cut away, thereby showing two aluminum stays 22 and 24. As shown, the aluminum stays 22 and 24 are housed within the designated pockets 26 and 28, respectively, secured to sleeve 16. Normally, stays 22 and 24 support the front of the forearm, hand, fourth and fifth fingers. Stay 22, also shown in FIG. 8, is extended from approximately middle of the forearm to approximately middle of the hand to support the forearm and hand. As shown in FIG. 8, stay 22 is substantially flat throughout the length of the forearm, and is bent slightly over the back of the hand. In addition, stay 24 cooperates with stay 22 to provide further support for the back of the forearm and hand. Stay 24, also shown in FIG. 7, also supports the hand, and the fourth and fifth fingers because it extends along the back of the forearm to the back of the fourth and fifth fingers. As shown in FIG. 7, Stay 24 is substantially flat throughout the length of the forearm and is bent such that it cups around the fourth and fifth fingers.
In summary, stays 22 and 24, in cooperation with sleeve 16, and straps 14, 18, and 20 firmly support the back of the forearm, hand, and fourth and fifth fingers. Similarly, stays 30 and 32, in cooperation with sleeve 16, and straps 14, 18, and 20 firmly support the front of the forearm, hand, and fourth and fifth fingers, as shown in FIG. 4.
FIG. 4 is a perspective view of splint 12 of FIG. 1 with portions of the drawing being cut away to show two aluminum stays 30 and 32. As shown, the aluminum stays 30 and 32 are housed within the designated pockets 34 and 36, respectively, secured to sleeve 16. Normally, stays 30 and 32 support the front of the forearm, hand, fourth and fifth fingers. Stay 30, also shown in FIG. 6, is extended from approximately middle of the forearm to approximately middle of the hand to support the forearm and hand. As shown in FIG. 6, stay 30 is substantially flat throughout the length of the forearm, and is bent slightly as it passes over the pad of the thumb. In addition, stay 32 cooperates with stay 30 to provide further support for the front of the forearm. Stay 32, also shown in FIG. 5, also supports the hand, fourth and fifth fingers because it extends along the front of the forearm to the front of the fourth and fifth fingers. As shown in FIG. 5, stay 32 is substantially flat throughout the length of the forearm and is bent such that the fourth and fifth fingers cup around it. In summary, stays 30 and 32, in cooperation with sleeve 16, and straps 14, 18, and 20 firmly support the front of the forearm, hand, and fourth and fifth fingers.
Incidentally, concerning dimensions of the aluminum stays, they may be about 1/2 inch wide, 1/16 inch thick, and will vary in length from about 6 to 12 inches. These dimensions would vary, of course, depending on the material used and the size of the assembly.
It is to be understood that the foregoing description, and the embodiments shown in the drawings relate to illustrative embodiments of the invention. Various changes may be accomplished without departing from the spirit and scope of the invention. Thus, by way of example but not of limitation, the splint may include one or more stays; the stays may have various sizes and shapes; the stays may be made of aluminum or other appropriate metals, metal alloys, plastics, or other non-metals. The stays may be parallel to each other, or may be angled. Instead of aluminum stays, the splint may employ water activated or two component activated support means. The water activated support means is disclosed in related case, Ser. No. 198,152, filed May, 1988, and assigned to the assignee of this invention. When such water activated splinting arrangements are used, a front and a back water activated stay assembly could be employed, along with one or two aluminum stays to provide initial shape. Therefore, reference is made to this related case for a description of water activated support means. The splint may also employ a combination of aluminum stays and water activated support means. Further, the sleeve may have a vinyl surface or alternatively, it may have a surface made from other soft material. The sleeve may also include two portions that are connected together with a flexible hinge, or alternatively, it may have a single continuous portion. Finally, the sleeve may include more than two portions that are connected to each other using flexible hinges. Accordingly, the present invention is not limited to the embodiments precisely as shown or described hereinabove.