Abstract:
An articulated, adjustable, and lockable alignment arm, and associated extensions and accessories, which are user manipulable to model the size and shape of the fractured limb of a patient in the field. The alignment arm is adjusted for proper orientation by setting it over the injury, and then locking the arm into a selected orientation which models the patient&#39;s limb around the area of the injury. Next, first and second arm extenders and protective end pads are used to expand the effective size of the alignment arm to form a custom splint structure. Lastly, the splint structure is secured to the patient&#39;s injured limb through the use of flexible cravats. The cravats are self-sterilizing, stored so that their sterility is maintained, and deployed so that only the sterile portion of the cravat comes into contact with a patient&#39;s skin.

Description:
PRIORITY CLAIM 
       [0001]    Pursuant to the provisions of 35 U.S.C. § 119(e)(1), Applicant claims the priority of U.S. Provisional Patent Application Serial No. 60/897,165, filed Jan. 23, 2007. 
       CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0002]    This application is a continuation-in-part of Ser. No. 12/009,479, filed Jan. 18, 2008. 
     
    
     BACKGROUND OF THE INVENTION 
       [0003]    1. Field of the Invention 
         [0004]    The invention relates generally to improvements in apparatus and methods providing medical splinting for fractured or broken human limbs, joints, and body parts. More particularly, the invention pertains to an articulated, adjustable, and lockable alignment arm, and associated extensions and accessories. These components are user manipulable in the field, to create a rigid, padded, structural model which emulates the shape of the fractured limb of a patient. 
         [0005]    By securing the structural model and the limb together with fabric tensor cravats, the injured patient may be transported comfortably and safely to a medical center. Each fabric cravat is made and maintained sterile by first impregnating its inner side with a silver-based chemical composition. Then, the inner side is folded back upon itself, followed by folding the outer side back upon itself, until the cravat assumes a compact configuration for storage and eventual deployment in the field in a sterile condition. 
         [0006]    2. Description of the Prior Art 
         [0007]    Medical splinting apparatus is used in treating and transporting patients who have suffered a bone or joint injury, such as a fracture or dislocation. The task of the splint is to stabilize the broken or fractured body parts quickly and with minimal pain and discomfort to the patient. One recognized problem stems from the wide variety of injuries encountered, ranging from a broken arm or leg, to a dislocated shoulder. Each of these injuries calls for a splint having a different size and configuration. Consequently, the paramedic or doctor must have splints of different sizes and configurations available in the field, so they can be adapted to the patient&#39;s injury and used effectively. 
         [0008]    Other problems encountered include patient discomfort and possible aggravation of the injury resulting from improper splinting. The splints must be designed so they can be applied with minimal discomfort to the patient, who is likely already in pain. At the same time, an effective splint must stabilize the joint or fracture so that further injury does not occur either during transport or as a consequence of unexpected patient movement during transport to a medical facility. 
         [0009]    Where the injury has occurred in the field or under the conditions of a traumatic accident, the job of splinting the injury and transporting the patient to a hospital in a remote location is particularly challenging. The patient may have to be extracted from a damaged motor vehicle, or moved up a steep cliff, even before primary transport has begun. Thus, the splinting apparatus must be lightweight, quick to apply to the patient, and effective in immobilizing the broken or fractured body part. 
         [0010]    In U.S. Pat. No. 4,608,971, issued to Borschneck, an emergency leg splint is shown. This device was designed as a single or double leg traction splint for treatment of fractured femurs. This splint worked well clinically. In addition, its use necessitated that the body of the splint extended beyond the patient&#39;s feet. This extended length prevented unrestricted use in confined spaces, such as helicopters and ambulances used in patient transport. 
         [0011]    There remained a need for a device that would both splint and apply traction to injured limbs, in circumstances where both femurs were fractured. It was also desirable that such a splint would be confined entirely within the lower body profile, to make patient transport easier and safer. Lastly, a review of the anatomy and pathophysiology of fractured femurs and related pelvic structures indicated an improvement was needed in the proximal end of the splint, where it rested against the ischial tuberosity. The ischial tuberosity is located at the distal end of the pelvis, and is distal to the perineal body in both the male and female sexes. These skeletal hard points protect the perineum and form the base platform for the lower torso when a human sits. 
         [0012]    To address these needs, an ischial perineal cushion for emergency traction splint was developed. This cushion is shown in U.S. Pat. No. 4,941,465, granted to Borschneck. The cushion, located at the proximal end, seats the splint comfortably and reliably against the ischial perineal protuberances. The distal end of the splint does not extend beyond the lower body profile, facilitating easier transport of the patient. In those respects, the traction splint of the &#39; 465  Pat. represented an improvement in the performance and safety of the prior art splints used to stabilize human limbs, joints, and body parts. 
         [0013]    Nevertheless, current medical requirements indicate the need for an improved splint device or system that is small, light and compact, for transport to remote and difficult to reach accident locations. There is also a need for a splint which is radiolucent, particularly in the region of the patient&#39;s injury. This feature affords the option of leaving the device intact on the patient during X-ray, CAT scan and MRI studies. And, there remains a need for a device which can be configured to splint any fracture of any limb, joint or body part of any size adult or child. More specifically there is a need for a single splint apparatus or system, that can be adapted to accommodate a variety of fractures or dislocations with a minimum of pain and/or movement, and can be applied to the patient&#39;s appendages or torso with sterile tensor cravats. 
       SUMMARY OF THE INVENTION 
       [0014]    The present invention provides for improvements in splints used for transporting injured patients from a field location to a treatment facility. Such improvements include: (1) splints with radiolucent properties around and along the region of the injury, thus allowing X-ray, Cat Scan and MRI imaging of the injury without the need for removing the splint; (2) a portable splint kit which may be packaged, transported, disassembled, or reassembled in the field, quickly and efficiently; (3) splint assemblies which provide both a splinting function and apply a quantifiable and dynamic traction force to one or two broken femurs; (4) a splint modeling system having adjustment and fixation features allowing the splinting of any limb, joint or body part on any human of any size or age; and, (5) fabric tensor cravats for use with the splint assemblies and the splint modeling system, which are maintained in a sterile condition both during storage in the portable splint kit and while being deployed over open wounds on a patient&#39;s body. 
         [0015]    The heart of the splint modeling system is an articulated, adjustable, and lockable, alignment arm. The alignment arm is comprised of two arm segments, each having one respective end pivotally attached to a respective end of an intermediate connector body. The axes for the pivotal attachments are perpendicular with respect to each other. The arm segments may be independently adjusted and selectively locked into a plurality of rotational positions about a respective axis. In use, the alignment arm is shaped adjacent and parallel to any fractured bone or joint, thereby producing a modeled structure having the same configuration and orientation as the injured limb. The procedure affords accurate splinting of the fractured member without movement or production of pain. Rotating locking knobs on the connector body ensures that the alignment arm retains the shape of the injury. Once the alignment arm is locked into the desired configuration, the arm segments are lengthened through the use of arm extenders fitted with padded material. End pads may also be installed into the free ends of the arm extenders. The assembly is then gently placed on the limb or body, and secured in position with two or more fabric cravats of variable lengths and widths. This affords safe movement of the patient, while securing the injured limbs and joints of the patient in the same position they were found by medical personnel. 
         [0016]    The outer surface of the flexible cravats is provided with a dynamic composite elasticized loop fabric, marketed under the trademark BREATH-O-PRENE. The inner surface is provided with an opened cell foam material, embedded with nano-crystals of a silver compound, namely, silver chloride. For the purpose of securing the cravats around the limb and the modeled splint, one end of each cravat includes a short length of hook Velcro sewn thereon. The cravats are folded for storage in a unique manner which completely sterilizes the inner surface to be applied over a patient&#39;s open wounds or appendage. When deployed for use, another method of unfolding and applying the cravat, ensures that the sterility of the inner surface is maintained as the cravat is applied to the patient. These sterile cravats create a quick, secure closure member, either for binding the limb to the splint structure, or for restraining or supporting a limb, or for enclosing a wound. 
         [0017]    Another application for certain components of the invention is to splint, for example, leg injuries also needing a pre-determined amount of traction. In this application, a bilateral traction splint assembly is provided, including a spring pulley and cable structure, entirely mounted and enclosed within a telescopic housing at the distal end of the assembly. The same arm extenders used in the articulated splint are coupled together to form a straight splint shaft, extending between a base cushion seated against the user&#39;s ischial tuberosity at the proximate end of the assembly, and an ankle cravat secured to the user&#39;s ankle at the distal end of the assembly. The splint shaft is padded on both lateral surfaces lying along the inner sides of the user&#39;s leg, providing enhanced patient comfort. 
         [0018]    A carrying case is also provided, housing a kit comprising a disassembled bilateral traction splint, an articulated alignment arm, padded arm extenders, end pads, and a plurality of sterile fabric cravats of varying widths and lengths. In the hands of properly trained medical personnel, this kit is capable of quickly and correctly providing a traction splint, if needed, for fractured femurs, or providing a modeled splint for stabilizing a limb extending from the body of any sized adult or child. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
         [0019]      FIG. 1  is a side elevational view, showing a prior art leg splint; 
           [0020]      FIG. 2  is a perspective view, showing the assembly of various components comprising the portable splint kit of the present invention; 
           [0021]      FIG. 3  is a perspective view of the articulated alignment arm; 
           [0022]      FIG. 4  is a top plan view of the alignment arm, showing a range of rotation for a first arm segment; 
           [0023]      FIG. 5  is a side elevational view of the alignment arm, showing a range of rotation for a second arm segment; 
           [0024]      FIG. 6  is an exploded perspective view of the alignment arm, including the first and second arm segments and the intermediate connector means; 
           [0025]      FIG. 7  is a perspective view, showing the alignment arm placed on the injured portion of the patient&#39;s leg for modeling; 
           [0026]      FIG. 8  is an exploded perspective view of the alignment arm being assembled with arm extenders and protective end pads; 
           [0027]      FIG. 9  is a perspective view, showing the rotational adjustable feature of an end pad and a first type of coupler means between the pad and the extender; 
           [0028]      FIG. 10  is a perspective view, showing the same rotational feature for the other end pad and a second type of coupler means between the pad and the extender; 
           [0029]      FIG. 11  is a perspective view showing a typical assembled splint, the phantom representation showing an alternative configuration for the splint; 
           [0030]      FIG. 12  is a perspective view showing the splint of  FIG. 11  placed over the patient&#39;s injured limb; 
           [0031]      FIG. 13  is a perspective view, showing the splint of  FIG. 12  attached to the patient&#39;s limb through the use of a plurality of fabric cravats; 
           [0032]      FIG. 14  is a perspective view of an articulated ischio-perineal cushion; 
           [0033]      FIG. 15  is a top plan view of a patient with a straight leg injury, such as a dislocated knee, fitted with the field adjustable splint of the present invention; 
           [0034]      FIG. 16  is a side elevational view of a patient with a foot or ankle injury, fitted with the splint; 
           [0035]      FIG. 17  is a side elevational view of a patient with an elbow or arm injury, fitted with the splint; 
           [0036]      FIG. 18  is a perspective view of an open carrying case, displaying the components of the splint kit in a stowed condition; 
           [0037]      FIG. 19  is a perspective view showing the first step of folding up the elongated cravat for storage, an inner side of a first length being folded over and in contingent relation with the inner side of a second length, forming a sterile segment, a connector end of the cravat being left exposed; 
           [0038]      FIG. 20  is a perspective view showing the second step of folding up the sterile segment of the cravat of  FIG. 19  over itself, so two outer side portions will be in contingent relation; 
           [0039]      FIG. 21  is a perspective view showing the third step of folding up the sterile segment again partly over itself, to form a more compact package; 
           [0040]      FIG. 22  is a perspective view showing the fourth step of folding the connector end over an exposed outer side portion, completing the method of preparing the cravat for storage; 
           [0041]      FIG. 23  is a perspective view of a sterile cravat folded up into a compact configuration for storage; 
           [0042]      FIG. 24  is a perspective view of a sterile cravat deployed from a storage configuration by detaching the connector end from the outer side, and carefully unfolding and positioning the cravat so that the sterile, inner side is ready for application over a patient&#39;s wound; 
           [0043]      FIG. 25  is a perspective view, showing the sterile, inner side of the cravat of  FIG. 24  partially wrapped around the patient&#39;s arm, the arrow indicating the direction of the next wrap over the arm; 
           [0044]      FIG. 26  is a perspective view, showing the continued wrapping motion for the cravat, so that only the sterile, inner side will come into contact with the arm; 
           [0045]      FIG. 27  shows the completed application of the sterile cravat over a patient&#39;s arm, covering the wound; 
           [0046]      FIG. 28  is a fragmentary, cross-sectional view taken on the line  28 - 28  in  FIG. 19 ; and, 
           [0047]      FIG. 29  is a fragmentary, cross-sectional view taken on the line  29 - 29  in  FIG. 20 . 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0048]    The splint apparatus  11  of the present invention comprises an articulated alignment arm  12 , for modeling the orientation and configuration of an injured human limb. Alignment arm  12  includes a first elongated arm segment  13  having a longitudinal axis  14  and a respective pivot end  16 , and a second elongated arm segment  17  having a longitudinal axis  18  and a respective pivot end  19 . Alignment arm  12  also includes a dual-axis connector body  21  for interconnecting first arm segment  13  to second arm segment  17 . Connector body  21  is provided with a first receiver  22  adapted to couple with respective pivot end  16  of first arm segment  13  and lock it at a first selected orientation about a first transverse axis  23 . Connector body  21  is also provided with a second receiver  24  adapted to couple with respective pivot end  19  of second arm segment  17  and lock it at a second selected orientation about a second transverse axis  26 . As is evident from  FIGS. 4 ,  5 , and  6 , first transverse axis  23  and second transverse axis  26  are perpendicular with respect to each other, and each transverse axis is also perpendicular to the longitudinal axis of a respective arm segment. 
         [0049]    First receiver  22  is provided with a disc portion  27 , a first receiver pivot aperture  28 , and a plurality of ribs  29  extending radially from the pivot aperture  28 . Similarly, second receiver  24  is provided with a disc portion  31 , a second receiver pivot aperture  32 , and a plurality of ribs  33  extending radially from the pivot aperture  32 . For the purpose of coupling with first receiver  22 , pivot end  16  of first arm segment  13  includes a respective disc portion  34  provided with a segment pivot aperture  36  and a plurality of ribs  37  extending radially from pivot aperture  36 . Similarly, pivot end  19  of second arm segment  17  includes a respective disc portion  38  provided with a segment pivot aperture  39  and a plurality of ribs  41  extending radially from segment pivot aperture  39 . 
         [0050]    A pair of threaded fasteners  42  is provided for selectively securing the receivers of the connector body in interlocking relation to the pivot ends of the first and second arm segments. Fasteners  42  comprise a shaft  43  having a knob  44  on one end, a resilient barb  46  on the other end, and threads  47  therebetween. Complementary threads are also provided in first receiver pivot aperture  28  and in second arm segment pivot aperture  39 . 
         [0051]    Fasteners  42  are installed so that the threads in the respective apertures are in a location remote from the knobs  44 , so that when the knobs are rotated in clockwise fashion, contingent ribs of the arm segments and the connector body are drawn together in interlocking relation. The location of the threads can easily be reversed, between the pivot apertures in the segments and the connector body, providing identical results and functionality. The barbs  46  act to keep the arm segments and the connector body together, even when the fasteners  42  are completely disengaged from the threads in the apertures. This prevents the loss of parts and assures quick assembly and use of the splint apparatus  11 . 
         [0052]    In use of the articulated alignment arm  12 , the medical personnel first loosens the knobs  44 , so the arm segments  13  and  17  can be pivotally adjusted through a range of motion as generally depicted in  FIGS. 4 and 5 . The alignment arm is then placed over the critical area of the patient&#39;s injured limb or body part. This critical area will vary, depending upon the nature of the injury. For example, in  FIG. 7 , a bent leg injury such as a bone fracture calls for the alignment arm to be placed generally over the patient&#39;s knee cap. In  FIG. 15 , another bent leg injury such as a dislocated knee requires that the alignment arm be placed along the medial side of the knee cap.  FIG. 16  shows the alignment arm  12  in a pre-determined 90° locked orientation, located at the patient&#39;s heel for ankle and foot injuries. As yet another example,  FIG. 17  shows the alignment arm  12  in a pre-determined 90° locked orientation, located at the patient&#39;s elbow, for elbow and lower arm injuries. 
         [0053]    Other types of limb and body part injuries which can be accommodated by the splint apparatus include, without limitation, dislocated shoulder injuries, forearm injuries, fracture dislocations of the knee, and straight leg knee injuries. Each of these injuries may call for different orientations and placements for the splint apparatus  11 , depending upon the circumstances of the injury and the condition of the limb as the medical personnel finds the patient. Therefore, no attempt will be made to describe each and every potential orientation and placement for the splint apparatus  11 , as these will vary widely and the specific applications are within the experience and training of the medical personnel to determine in the field. 
         [0054]    Returning to  FIG. 7 , it is assumed that the injured human limb  48  has a first part  49  with a longitudinal axis  51 , and a second part  52  with a longitudinal axis  53 . It is further assumed that the human limb  48  has been found by the medical personnel in the same orientation as shown in  FIG. 7 , upon first encountering the patient. Alignment arm  12  is manually adjusted by the medical personnel so that a first selected orientation places the longitudinal axis  14  of first arm segment  13  in generally parallel relation to the longitudinal axis  51  of first part  49 . Then, alignment arm  12  is manually adjusted so that a second selected orientation places the longitudinal axis  18  of second arm segment  17  and the longitudinal axis  53  of the second part  52  in generally parallel relation. Lastly, knobs  44  are both rotated clockwise to secure and lock the alignment arm in an orientation which emulates the configuration of the injured limb  48 , in and around the critical area where the first part and the second part join. Now that the alignment arm has a fixed configuration, the rest of the splint apparatus  11  can be assembled and then secured to the injured limb. 
         [0055]    For the purpose of expanding the physical size of the alignment arm so it can become a useful splint, a first arm extender  54  and a second arm extender  56  are provided. First arm extender  54  has one end  57  provided with a coupler  58  and another end  59  provided with a coupler  61 . Second arm extender  56  has one end  62  provided with a coupler  63  and another end  64  provided with a coupler  66 . Foam padding  67  is provided entirely around and along arm extender  54 , between couplers  58  and  61 . Similarly, foam padding  68  is provided entirely around and along arm extender  56 , between couplers  63  and  66 . 
         [0056]    Resilient and flexible bias means  69 , for drawing arm extenders  54  and  56  together, interconnects one end  57  with one end  62 . Bias means  69  is preferably comprised of two stretchable cords  71  being stretchable to the extent shown in  FIG. 8 . With the alignment arm removed from the injured limb, coupler  58  on one end  57  of first arm extender  54  is detachably coupled to an end fitting  72 , located on first arm segment  13  remote from pivot end  16 . The inner size and configuration of coupler  58  is such that it slides over fitting  72 . Stretching out bias means  69  as shown in  FIG. 8 , coupler  63  on one end  62  of second arm extender  56  is detachably coupled to an end fitting  73 , located on second arm segment  17  remote from pivot end  19 . Coupler  58  and fitting  72  and coupler  63  and fitting  73 , are preferably sized so they will only mate with each other, so that the alignment arm  12  and the arm extenders  54  and  56 , can only be assembled one way. The cords  71  of resilient bias means  69  are dressed around knobs  44 , ensuring a clean splint structure as the arm extenders are pulled into engagement with alignment arm  12 . (See,  FIG. 11 ). 
         [0057]    Other features designed to extend the length and adaptability of the splint apparatus  11  include a first end pad  74  and a second end pad  76 . First end pad  74  includes a foam padded portion  77 , a shaft  78 , and an end coupler  79 . Coupler  61  includes a resiliently biased finger  81  which engages apertures  82  to secure end pad  74  to the splint assembly  11  in a selected longitudinal position. First end pad  74  is thereby adapted, adjustably and detachably, to interconnect with coupler  61  on first arm extender  54 . Second end pad  76  includes a foam padded portion  83 , a shaft  84 , and a plurality of resiliently biased protuberances  86  spaced along shaft  84 . Coupler  66  includes an aperture  87  sized and located for engagement by protuberances  86 . Second end pad  76  is thereby adapted, adjustably and detachably, to interconnect with coupler  66  on second arm extender  56  at a selected longitudinal location at the end of splint apparatus  11 . 
         [0058]    First end pad  74  and second end pad  76 , both include means for rotational adjustment of their respective foam padded portions  77  and  83 . As shown in  FIGS. 9 and 10 , foam padded portions  77  and  83  may be rotated into a selected location about the axis of their respective supporting shafts. This feature allows the medical personnel to adjust these end pads into a location which will be most effective and comfortable, when the splint apparatus is fitted to the patient. 
         [0059]    The resulting custom fitted splint apparatus  11  is carefully lowered over the patient, and arranged in alignment with the injured limb. The medical personnel then employs a plurality of flexible, resilient, and adjustable cravats  88 , having different lengths and widths. These cravats are passed over and around the splint apparatus  11  and adjacent portions of the patient&#39;s body, above and below the injured critical area, to secure the splint to the patient. The outer surface  89  of the cravats is provided with a dynamic composite elasticized loop fabric, marketed under the trademark BREATH-O-PRENE™. The inner surface  91  is provided with an opened cell foam material, embedded with nano-crystals of silver chloride to provide bacteriostatic and bactericidal qualities to the cravats. For the purpose of securing the cravats around the limb and the modeled splint apparatus  11 , one end of each cravat  88  includes a short strip  92  of hook VELCRO® sewn thereon. These cravats  88  create a quick, secure closure member, binding the injured limb to the rigid structure of the splint apparatus  11 . 
         [0060]    Treatment of a straight knee injury or a dislocated knee injury may call for a special adaptation of the splint apparatus  11 . For example, in  FIG. 15 , the splint apparatus has been fitted on one end with an ischio-perineal cushion  93 , including a receiver  94 . As shown in  FIG. 14 , coupler  66  is inserted into receiver  94 , thereby securing the cushion  93  to the splint apparatus. Cushion  93  includes a hinged, adjustability feature, described in more detail in U.S. Pat. No. 4,941,465, hereby incorporated by reference as if fully set forth herein. The medical personnel applies the modified apparatus to the patient, seating the ischio-perineal cushion against the ischio-perineal protuberances of the pelvis. Cravats  88  are selectively applied around the splint apparatus  11  and the patient&#39;s leg, both above and below the knee injury. 
         [0061]    It is also possible to eliminate the use of the alignment arm  12  altogether, by simply sliding first arm extender  54  into second arm extender  56 . This can be done easily, as couplers  58  and  63  are sized and configured to mate. This mated configuration is shown in  FIG. 2 . This arrangement, in combination with the ischio-perineal cushion  93  on one end of the splint, and a first end pad  74  on the other end of the splint, would be appropriate when it is desired to have an entirely straight splint apparatus. 
         [0062]    It should also be noted that with the exception of special applications requiring use of the ischio-perineal cushion  93 , the splint apparatus  11  is end-to-end reversible. In other words, the splint can be used by placing the second arm extender  56  and the second end pad  76  in a proximate relationship with respect to the patient&#39;s body, as shown in  FIGS. 16 and 17 , or in a distal relationship with respect to the patient&#39;s body, as shown in  FIG. 13 . 
         [0063]    The portable splint apparatus  11  of the present invention is preferably carried in a cordura case  96 . Case  96  is capable of housing as a kit  97 , all of the components necessary to make a wide variety of splint structures in a compact and easily accessible manner. In addition to the components discussed above, the kit  97  may also include a traction device  98 , for applying a predetermined amount of pulling tension to the splint. For that purpose, traction device  98  includes a coupler  99  on its end, adapted to engage with coupler  61  on the end of first arm extension  54 . In other words, the second end pad is replaced with the traction device  98 . In addition, such an arrangement would require a straight line splint, and would not rely upon use of the alignment arm  12 . Typically, this arrangement may be employed where the patient&#39;s injury is a fractured femur. 
         [0064]    It has been determined that by folding the cravats  88  into a compact configuration for storage using a particular method, the nano crystals embedded in the inner surface  91  will begin to kill all microorganisms therein. Using this method, the inner surface of the folded cravat is essentially made sterile within 30 minutes. And, providing the cravat  88  is carefully deployed for use employing the reverse of the folding method, the sterilized inner surface  91  of the cravat may be applied directly upon the wounded limb or body of the patient, substantially reducing the chance of infection. 
         [0065]    Making particular reference to  FIG. 19 , the cravat  88  comprises a band  101  having an outer surface  89  and an inner surface  91 . The outer surface  89  of the cravat  88  is comprised of a dynamic composite elasticized loop fabric, marketed under the trademark BREATH-O-PRENE™. This elasticized fabric includes an open cell structure, allowing air and moisture to pass relatively freely therethrough. Such a material facilitates cooling of the skin, while allowing moisture to escape from the wound area. The inner surface  91  is provided with an open cell foam material, impregnated with nano-crystals of silver chloride (AgCl). This provides bacteriostatic and bactericidal qualities to the inner surface of the band  101 . BREATHE-O-PRENE provided with this foam layer of embedded silver chloride nanocrystals on one side is marketed under the trademark SILVERtec. 
         [0066]    In practicing the method of storing such a flexible tensor cravat so that it is maintained in a sterile condition, the inner side  91  of band  101  is first folded back over itself to form a sterile cravat segment  102 . In this condition, only the outer surface  89  of the cravat  88  is exposed, and the inner surface  91  of the band is in a sealed, contingent relation with itself. This relationship is best illustrated making reference to  FIGS. 20 and 29 . The silver chloride nanocrystals immediately work to kill all bacteria which may exist in the inner surface  91 , essentially rendering it sterile in a number of hours. It is apparent that the sterile cravat segment  102  could also be rolled up upon itself and enjoy the same beneficial result. However, this second method results in a less compact configuration. 
         [0067]    Of course, the length of sterile cravat segment  102  will depend upon the initial length of the band  101 . Since cravats of varying lengths may be required for different applications, the number of successive steps required to complete the method and prepare the cravat for storage will vary depending upon the cravat length. In any event, the method herein contemplates that the sterile cravat segment  102  is successively folded back over itself, as shown in  FIGS. 21 and 22 , until it assumes a storage configuration as shown in  FIG. 23 . At that juncture, the strip  92  having hook material is extended over an underlying portion of the outer side  89  of cravat  88 , having loop material. Using such connector means, the band  101  is maintained in a compact configuration for storage. 
         [0068]    When it becomes necessary to deploy the cravat  88  for use on an appendage or body portion of a patient, the method set forth above is reversed, carefully maintaining the sterile inner surface of the cravat  88  in a sterile condition. To that end, the strip  92  is first removed from the underlying portion of the outer side  89  of the cravat  88 . The cravat is then unfolded, reversing the steps shown in  FIGS. 22 ,  21  and  20 . This is most easily accomplished by grasping the strip  92  at the end of the band  101  and holding it in a substantially fixed relation. Then, the sterile cravat segment  102  is successively unfolded from a stored configuration until it assumes the configuration shown in  FIG. 20 , with the inner side  91  still folded upon itself in contingent relation. 
         [0069]    While grasping the strip end with one hand and grasping the other end of the band  101  with the other hand, the sterile cravat segment  102  maybe pulled apart, extending the cravat to its full length. Then, as shown in  FIG. 24 , the medical technician places a portion of sterile inner side  91  over a patient&#39;s arm, and continuously wraps the inner side of said band around the patient&#39;s appendage over the outer side  89  of the band until the full length of the band is wrapped up. (See,  FIGS. 25-26 ). Lastly, the strip  92  is folded over and connected to the outer side  89  of the band, making the installation of the cravat  88  complete. 
         [0070]    Employing this method of storage and deployment, cravats  88  of different lengths and widths, as appropriate, may be used to bind patients wounds over sterile dressings or to strap fractured limbs to splints. By stretching the fabric of the band  101 , pressure is applied to the wound or limb as required, securing the limb in place and helping to control any bleeding. Different sizes and thicknesses and lengths of the cravats  88  provided with the hook and loop connector system, allow these cravats to be used as bandage usable in a wet environment. The cravats  88  may also be washed, dried, and reused up to 30 times, without losing the ability to self sterilize using the bactericidal and bacterostatic properties of the band  101 . 
         [0071]    It will be appreciated, then, that I have disclosed an articulated alignment arm which is used in conjunction with associated extensions and accessories, to create a custom splint apparatus. This splint assumes the exact configuration and orientation of the injured limb in the position found by medical personnel. The splint apparatus fits closely to the silhouette of the fractured limb and becomes an excellent tool for removing injured patients from confined spaces. The splint apparatus disclosed herein will fit any adult or child, any size, any weight, and can be used to splint any limb injury, including fracture dislocations of the shoulder, elbow, knee and ankle. 
         [0072]    It will be appreciated that I have also disclosed a method for folding up cravats into a compact configuration for storage, in which bactericidal and bacterostatic properties of the inner surface of the cravat will kill all microorganisms therein in short order. For later deployment and use of the cravat, the method disclosed herein is reversed, and the sterilized inner surface of the cravat is applied directly upon the wounded limb or body of the patient, substantially reducing the chance of infection.