US2443106A - Apparatus for reducing and holding fractures in position - Google Patents

Description

June 8, 1948. P. P. GROSSO APPARATUS FOR REDUCING AND HOLDING FRACTURES IN POSITION Filed May 10, 1945 4 Sheets-Sheet 1 INVENTOR.

*x k PAT/P/CK P $90550 BY I %W.

P. P. GROSSO June 8, 1948.

APPARATUS FOR REDUCING AND HOLDING FRACTURES IN POSITION Filed May 10 1945 4 Sheets-Sheet 2 LNVENTOR. P4 T/P/C'A P G/FOSSO J1me 1948- P. P. GROSSO APPARATUS FOR REDUCING AND HOLDING FRACTURES IN POSITION Filed May 10, 1945 4 Sheets-Sheet 5 IN VEN TOR. PATP/c/r P 6/?0550 W 2% @mii P. P. GROSSO June 8, 1948.

APPARATUS FOR REDUCING AND HOLDING FRACTURES IN POSITION 4 Sheets-Sheet 4 Filed May 10, 1945 INVENTOR.

HTTOP/VA'TV Patented June 8, 1948 UNITED STATES ATENT OFFICE APPARATUS FOR REDUCING AND HOLDING FRACTURES IN POSITION 16 Claims. 1

This invention relates to improvements in an apparatus for reducing and holding fractures in position, and more particularly to a mechanical splint which can be used to reduce almost any type of bone fracture, so that the device may quite properly be described as a universal fracture splint.

The objects of this invention are an ambulatory fracture splint which: substantially reduces trauma of the tissues; can be readily applied to virtually any part of the body; is adaptable to the reduction of most any type of bone fracture; is self-contained and eliminates the need for accessories; can be adjusted and readjusted in situ when necessary; and which is adapted to securely hold any bone to which it is applied without puncturing the bone, and with minimum trauma of the bone structure.

In accordance with this invention the fragments of -a fractured bone are gripped crosswise of the long axis of the bone, between the points of two spaced sets of adjustable pins, which engage the bone from opposite sides thereof at spaced points preferably arranged in intersecting planes, and the pins are then moved inwards to grip or clamp the bone between the pin points with suflicient tension to permit the pins to be utilized in manipulating the bone and setting the fracture, without substantial penetration of the bone structure, whereby trauma of the bone is substantially reduced. For purposes of manipulation, each set of pins may be yoked and mounte'd upon a ball-socket connection for universal adjustment and said connections may in turn be mounted for compound relative movement, a to vary the distance between the fractured ends of a clamped bone, to dispose the yoked sets of pins in the same or difierent horizontal planes, and when necessary to vary the degree of angulation between the yoked sets of pins so as to conform with any degree of angulation required, for example as at a bone joint.

In the drawings comprising four sheets of nine figures numbered Figs. 1 to 9 inclusive, certain embodiment of the invention are set forth,

Fig. l is a plan view of an apparatus embodying one form of the invention as applied to a fractured bone;

Fig. 2 is a side view of the apparatus only;

Figs. 3 and 4 are vertical cross sectional views taken along the lines 3--3 and 4-4 respectively of Fig. 2 looking in the direction of the arrows;

Fig. 5 is an end view of the splint with the bone and tissue shown in dotted outline;

Fig. 6 is a horizontal cross sectional view taken along the line 5-6 of Fig. 2 looking in the direction of the arrows;

Figs. '7 and 8 are vertical cross sectional views taken along the line 'l--'l and 8-8 respectively of Fig. 2 looking in the direction of the arrows; and

Fig. 9 isa cross sectional view of a modified form as applied to a section of a bone which is shown in dotted outline.

Like reference characters designate corresponding parts throughout the several figures of the drawings.

The invention will be better understood from Figs. 1 and 2 of the drawings which illustrate one suggested embodiment thereof. The bar [8 is longitudinally slotted to form a keyway 23 wherein a traveler 22 (Fig. 8) is longitudinally movable under control of lead-screw I9. One end of bar I8 is bentsubstantially at right angles and is provided with an opening forming a bearing 29 whereinone'end of the lead-screw I9 is journaled. The'opposite end of the lead-screw I9 is journaled in a bearing-block 32 which may be adjustably mounted adjacent the opposite end of the keyway 20. The bearing-block 32 is provided with a threaded shank 33 adapted to receive a lock nut 34 whereby the bearing-block 32 may be securely locked in spaced relation to the bearing 29. The traveler 22 is threaded to receive the double-threaded worm of lead-screw 19. The worm is preferably provided with a left-handed thread. An operating handle 2| for operatin the lead-screw l9 tomove traveler 22, is mounted upon the outer end of the lead-screw l9 and is locked inposition by means of a grub-screw 28. A collar 30 is mounted upon the lead-screw I 9 adjacent the bearing 29, and is locked in position by a grub-screw 3|. Adjacent the opposite end of lead-screw 19 an annular groove 35 is provided, and a grub-screw 36 is threadably mounted in the bearing-block 32 to engage in the annular groove 35, thus locking the lead-screw [9 against sliding movement relative to the bearing- blocks 32 and 29.

The traveler 22 (Fig. 8) is keyed in the keyway 23, and is provided witha threaded shank 83 which eng'agesin a threaded opening in a ballsocket plate 25 of a travelling ball and socket mounting 23. The socket-plate 25 is adapted to receive the ball portion 24 of an L-shaped bracket 6|. The .ball and socket mounting 23 may be U-shaped or otherwise formed for attachment to the socket-plate 25'. The ball-socket mounting 23 is female threaded'to accommodate the lockingscrew 26 which engages the ball 24 to lock the universal joint'in any selected position. The

19-19. The wing-plate 10 of the brace 65 supports a horizontal guide plate 11 which is provided with spaced openings forming guideways for the horizontally spaced bone pins 1'5-15 secured to the horizontal yoke 14. The horizontal yoke 14 and the vertical yoke 18 and the bone pins 15-15 and 19-19 carried by the respective yokes, may beadjusted in and out by the manipulation of their respective wing-nuts 12-12. Each wing-nut 12 is provided with an annular groove 16 adapted to receive a bifurcated follower 13 suitably anchored to one of the yokes 14 or 18. In this manner the manipulation of the wing-nut 12 causes the bifurcated follower 13 to slide the yoke 14 or 18 as the case may be, towards and away from its wing-plate 18, thereby increasing or decreasing the depth of penetration of the bone pins 15-15 or 19-19 in the tissue until thepoints of the bone pins engage the bone at four spaced points without however penetrating the bone substantially, and without puncturing the bone structure, the bone pins being arranged in intersecting planes upon opposite sides of the bone, whereby said bone is tightly clamped with. minimum trauma between the points of the bone pins, against movement in any direction.

Thus after one end of a fractured bone has been clamped at four spaced points between one set of pins 15-15 and 19-19, and the other end of a fractured bone has been similarly clamped between the other set of bone pins 15-15 and 19-19 at four spaced points, the ball and socket joints 24-25 and 54-55 may be adjusted and locked at any desired angle relative to their respective mountings 23 and 51 and thereafter ad justed and locked by means of pivot 31 and wing bolt 38 either in longitudinal axial alignment or in any other desired position, by thumb-pressure on the butterfly handle 41 the bracket 52 may be raised or lowered relative to the bar I8, and by operating the handle 2| the spacing between the two sets of bone pins may be varied at will to increase or decrease the distance therebetween, thus retracting the fractured portions of the bone until the ends of the fractured bone are brought into the correct position for reduction of the fracture, whereupon the splint as adjusted and locked, may be retained in position as an ambulatory splint until the fracture is properly healed. In this manner the immobilization of the injured member may frequently be entirely eliminated.

The device may also be used for treating and correcting deformities of the bones, ankylosis, joint fixation, and in bone-grafting surgery. It is especially of value'in those cases where a fracture requires traction for a period of time before reduction can be accomplished, as well as in those cases where manipulation of the bones is required. In those cases Where an X-ray or a fluoroscopic examination discloses that reduction is not perfectly satisfactory, the locking screws may, if necessary, be loosened, the fracture manipulated, the splint readjusted in situ, and tension again applied to the locking screws.

The pins 15-15, 19-19 penetrate the body tissue M, and the points engage the fractured pieces [-16 of the bone upon opposite sides of the fracture line I1, to clamp the fractured pieces i5-l6 of the bone between the pins 15-19 by pressure applied at spaced points arranged in intersecting planes. This is accomplished without puncturing the bone, and with minimum trauma of the tissue [4 and of the bone structure.

Fig. 9 shows a modified form of the brace, and

of the ball-socket assembly. The base plate 8| and screws 82 replace the yoke 51 and screws 88.

The tongued and grooved braces 64 and 65 which make up the adjustable bifurcated yokes may also be replaced by the bifurcated yokes 85. Each yoke 85 is made in one single piece in the general form of a horse-shoe, and is provided with a curved slot 85 for receiving one or more threaded studs 61 whereby the yoke is rockably adjustable in the curved track =88 which is formed in the curved brackets 81. Thecurved bracket 81 is in turn mounted upon the ball and socket joint 24-25 (or 54-55). The curved overhanging shoulder 89 of the bracket 81 engages the curved brace 85 and aligns it in the track 88. One or more wing-nuts B6 lock the brace 85 in the desired position relative to the curved bracket 81.

The universal splint may also be constructed in different sizes, for example three-small, medium, and large, equipped with bifurcated yokes and bone pins 1'5-15 and 19-19 of different sizes, dependent upon the size of the splint or the character of the use for which it is designed. This modified form of the device provides a universal kit with the splints graduated as to size, weight and strength according to the intended use.

In practising the method, the braces are adjusted to straddle the fractured limb above and below the point of fracture l1. The bone pins 15-15 and 19-19 are then inserted through the tissue Hi from opposite sides of each of the bone fragments 15 and I6 and crosswise the long axis of the bone, until the bone pins engage the bone structure at spaced points preferably arranged in intersecting planes. By rotating the winged nuts 12-12 the bone pins 15-15 and 19-19 move towards each other until the bone fragment IE (or IE) is gripped between the points of the bone pins with sufficient tension to hold the bone securely. The bone pins 15-15 and 19-19 and their associated braces or pin carriers may now be utilized preferably as a part of the mechanical splint, to retract the bone fragments 15 and i 6 and bring their fractured ends into alignment or setting position, whereupon the bone is set. Trauma of the tissues is substantially reduced, and since the points of the pins 1'5-15 and 19-19 penetrate the bone structure but slightly without puncturing it, trauma of the bone is substantially reduced.

The splint is a self-contained unit, which can be fitted without the use of wrenches, drills, extra pins, or any other accessories. It can be readily disassembled, cleaned, sterilized, and reassembled ready for further use.

Other modifications will be obvious to those skilled in the art.

What is claimed is:

1. A fracture splint comprising a plurality of pin carriers, a bar comprising a plurality of sections pivotally connected together, said pin carriers being spacedly mounted upon said bar sections with ball and socket connections, means for varying the horizontal distance between said pin carriers, and means for varying the relative level of the pin carriers, each of said pin carriers carrying oppositely disposed sets of pins with the ends of one set directed towards the ends of the other set but located in mutually intersecting planes.

2. A fracture splint comprising a bar, said bar comprising two end sections with an intermediate section therebetween, a pivotal connection behallend se lset cQnnee i etwe n saii aear- 3 endathe QI Gx QQfiQQS of; se d: ha t ead: ser Wa er. mWinaneefseidmin ca ri rs-alert t eetxd l e ted ewamsx he s fine eth r? se but h a n m tu lly. e e ine la es. 1

3-15-59 reeture-spl e eempri mg. a ae aid-har in ludi g We: e d eee ie e; mavennt m diat ee i e etn qiel e eee tien be w enaid nte meqia e t e nd, en ndee ti mav r ieall s i e ndz uid en ee ie etw enis alle e-p Pin s.; h; f s id" n a rie s hene1- adjustable to difierent widths, ball and e lseteenn eti ns; etw n s minea ie s n teese t esefe ei n a '11: Q W @1- m v e nea d-rein a ie song, its. s eiei qi ed ee nd z e ds tew fer fi isin' edde e ing -V- the n ee t en ud ass ciated pin carrier relative to the intermediate ee ieni eehe re e e r earr ineo p site y die eede rm n hhe nds of on set direptegl towards the; ends of the other set but lgeategiumufillally intersecting planes.

eifi ewr pl t emprieine a ar s idsber iaelu tiee weends t ns, a ai of in fl me s Been -Pi er i being: qiusteb arflne id hs, iversal n s e tta hin said a a rier iehe, s end cti ns. "Qf said .bar inle aeed e o a: et. ine di-eet h Supported b eeaeh; in; s men and with he ts; dir c edtoward e eeh o her: n mutuall e ndi ular plan s aid ins; bein ha p ned t penet a tissue. and; engage oppqsite sides of 'a;bQne:-at a 2 ;E l i "Qff Q s na ed es wise o amp t e hone withoutsubstantial trauma thereof, and

o.- d eetien and nte mediat i e al' e ne ien be we n idi terme ie e-seetion and one f h nd. sections, a ball of p i s, eaehxpinzeartierheing adiusta zle; t ar-vine; wid hs. i e al; J i e ie said pinea ier o he. en isectiens of a1 i ete l w me f edh ach. P ar ier; end {with the s directed qwerdsi ,aeh, o he inmutualw mene di u-lar p n s, said: pins; bein harpe to penetrate tissue and engage an;1 ;e ahqne from opposite sides without Sub e e e ae i z evi e'w .nz' in a ie cute; p ehs m er alz in the ipinz arr' rs.

endzse iem h -v ne paeedz elet qni-a etof; ins ldmeans fer, re ulatin -.5 t fe vsiep th of; pgne tratign f: mt-he ne amnin i Arte?! butts? nd .we rieezeeoe ether and ier ena at eefseid pain of; pin carriers, each 1 pin;- xearrienhe d,- justablevtomuarying widths, universal-rd ntssm attaching. said. pin carriers to theiend: rsectiqns of saidbar in spaced/relation, a. .set, of qpm sfl-zadjustably. supported; by each; pin carrier and with the sets directed towardseach. other. immutual-ly perpendicular. planes, esaid pinsr: beipg gsharpened topenetrate tissue and-engage andclamp ,a home between said pins at a pluralityv :of spaeedtpoints without substantial: trauma or -the; bone, means for regulating;- the depth I ofpenetration of; and the clamping pressure exe'rted by, the pins, and means for raising ana -lowering .one ofl saidupin carriers relative to the other andfor .vary-ingnthe horizontal; distance separating said' pin-carriers.

8. A rapture splint compnisinga ban-said bar inelu cling e two end sections, a pair-of pin canniers,

' a eirl a -r e te e a i ste e e e Wiqtl'xs, universqa l joints fqr attaching -saidpin carriers totheend-segtions Qf-said'barf'in spaced relation, a set; of; 'pins; adjustably; supportedmy 842 Pin car er ane't wit ithe s. .deq ed' t ward eaehother inmutually'pe 'pendicular planes, said pins b eing sharpened' to penetrate tissueand engage opposite sigles of a bone at-a;p1ura 1-ityof, points spaced; crosswisejto clarnp the bone with? out; substantial; trauma; thereof, means including leaebserews for regulating the depth of penetration of, algd the damping-pressure exerted by, the pins and means 'inelud'ing lead-screws, for moyingsaid pin carriers; to vary thehoriZontal and the ver t ieagl distance between Said SetS-Of a i sfiab enin 9 A"; in ict r splint-comprising;an= L-shaped ba having'keyways extending alongitslong-itugiinal and ve1=tica 1;.arms,- travellers assoeiated with angl moyable alongeach -ofsa id -'l eyways, leagi serews associated; with each; of saideti'a vele .lers f o t' regulating the direction andextentof their movenie t aleng their respective keyways, and-pin carriersrockably mounted on'saidetravellers.

l Q A; fracture Splint Comprising an- -h shape'd par "haying keyways extending along eaoh arm thereof; travellers associated with and ymovable along; eagh ;of-saidkeyways, lead-screwsassoeiated with eaqh' of -said-travl1ers for regulating; the V direetion anele xtsnna; of their movemenhalong their respective -keyways, pin: carriers .mckably mounted en said-travellersa setof pins" adjust ably-supported -by ea ch pin-carrier, said' pfins being sharpenedto penetrate tissueand -engage a bone at ur ee di ei isyth h l m n h e an ie i amar he eei and meen I eii iefii tiee he eie fl e trt n we .theP ieeleepi elamninemess ewted with? ,ll, A freetmrefeplint rcgmpri m aminmxqamgrj mfimirmy emste si pqsedrens ee ne fnys e ,1 r

bone from opposite sides to clamp the bone without substantial trauma.

12. A fracture splint comprising a, forked brace, a plurality of pins slidably mounted adjacent the forked ends of the brace, said pins being pointed and aligned in intersecting planes with the points of the pins facing inwards, so that when the forked portion of the brace straddles the tissue about the fractured bone the pins may be moved inwards to penetrate the tissue and engage spaced points of the bone from opposite sides thereof to clamp the bone without substantial trauma thereof, means operable to regulate the extent of penetration of the pins mounted on one side of the forked brace, and means operable to regulate the extent of penetration of the pins mounted on the other side of the forked brace.

13. A fracture splint comprising a pin carrier, and oppositely disposed pairs of pins with the pins of one set mounted in a transverse plane with respect to the pins of the opposite set, means for adjustably mounting the pairs of pins for movement towards and away from each other while maintaining them in intersecting planes to penetrate the tissues and immobilize a section of bone when engaged between said pairs of pins without puncturing the bone or substantial trauma thereof.

14. A fracture splint comprising a, pin carrier, oppositely disposed pairs of pins with the pins of one set mounted in a plane which intersects the plane of the other set, means for mounting said pairs of pins for movement towards and away from each other while maintaining them in intersecting planes to penetrate the tissues and immobilize a, section of bone when engaged between said pairs of pins without puncturing or substantial trauma of the bone, and means for adjusting the depth of penetration of the pairs of pins to engage and immobilize the bone.

15. A fracture splint comprising an adjustable pin carrier, oppositely disposed pairs of pins with the pins of one set mounted in a plane which intersects the plane of the other set, means for mounting said pairs of pins for movement towards and away from each other while maintaining them in intersecting planes to penetrate the tissues and immobilize a section of bone when engaged between said pins without puncturing the bone or substantial trauma thereof, and means for adjusting the depth of penetration of the pins to engage and immobilize the bone.

16. A fracture splint comprising a plurality of pin carriers individually adjustable for width, oppositely disposed pairs of pins supported by each of said carriers, means for mounting said pairs of pins on said carriers in mutually intersecting planes, means for efiecting movement of said pairs of pins towards and away from each other to penetrate the tissues and engage opposite sides of a section of fractured bone at four spaced points to immobilize said bone when so engaged without puncturing or substantial trauma of the bone, two of the said points lying along the long axis of a bone and the other two upon opposite sides of the said axis, said pin carriers being relatively adjustable in the same longitudinal plane into and out of parallel longitudinal planes and into and out Of angularly disposed planes, and means operable to impart said relative adjustments to said pin carriers.

PATRICK P. GROSSO.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 583,455 Bush June 1, 1897 1,662,758 Nicholson et a1 Mar. 13, 1928 2,002,021 Rouse May 21, 1935 2,238,869 Haynes Apr. 15, 1941 4 2,371,519 Haynes Mar. 13, 1945 OTHER REFERENCES A Practical Treatise .on Fractures and Dislocations, by L. A. Stimson (l905)

Images