Abstract:
An adjustable wrist orthotic suitable for the treatment of wrist fractures and similar injuries. The orthotic preferably includes a top panel joined to a bottom panel. The top and bottom panels are preferably joined by a radius connector which spans a “radius gap” between the top and bottom panel. An “ulna gap” may optionally be provided between the top and bottom panels as well. If an ulna gap is present, then an ulna connector is preferably provided to span this gap. A radius lace assembly is provided for adjusting the closure of the radius gap. The radius lace assembly is secured by placing a radius tab attached to a radius lace in a desired position on the exterior of the orthotic. Varying the placement position of the radius tab varies the taper of the radius gap so that the orthotic can accommodate wide variations in forearm geometry.

Description:
CROSS-REFERENCES TO RELATED APPLICATIONS 
       [0001]    This application is a non-provisional application claiming priority to U.S. Provisional Application No. 61/642,663 filed on May 4, 2012. 
     
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
       [0002]    Not Applicable. 
       MICROFICHE APPENDIX 
       [0003]    Not Applicable 
       BACKGROUND OF THE INVENTION 
       [0004]    1. Field of the Invention 
         [0005]    This invention relates to the field of medical products. More specifically, the invention comprises a wrist orthotic which may be adjusted to accommodate a wide variety of anatomical differences. 
         [0006]    2. Description of the Related Art 
         [0007]    Wrist fractures were traditionally placed in plaster casts in order to immobilize the affected anatomy. In recent years, more flexible orthotic devices have replaced plaster casts. These usually encircle the wrist and palm with fabric material. One or more rigid stays are incorporated in the device in order to provide the requisite immobilization of the joint. 
         [0008]    Elastic panels are used to adapt the orthotic to a range of sizes. Adjustable securing straps also aid proper fitting of the device. However, these adjustments have typically been limited to a relatively narrow range of sizes. Additionally, the geometry of the wrist and forearm varies widely from individual to individual. Some individuals have a moderate wrist diameter but very little expansion in the forearm when proceeding in the direction toward the elbow. Other individuals have similar wrist geometry but very rapidly expanding forearms. 
         [0009]    The physician is thereby compelled to maintain a stock of orthotic devices in different sizes and geometries. Even with such a stock on hand, a patient with atypical wrist and forearm geometry may present for treatment. It would therefore be advantageous to provide a single wrist orthotic which could span a wide range of sizes and geometries. The present invention provides such a solution. 
       BRIEF SUMMARY OF THE PRESENT INVENTION 
       [0010]    The present invention comprises an adjustable wrist orthotic suitable for the treatment of wrist fractures and similar injuries. The orthotic preferably includes a top panel joined to a bottom panel. The top and bottom panels are preferably joined by a radius connector which spans a “radius gap” between the top and bottom panel. A second “ulna gap” may optionally be provided between the top and bottom panels as well. If an ulna gap is present, then an ulna connector is preferably provided to span this gap. A thumb strap is preferably provided to secure a portion of the device over the palm. 
         [0011]    A radius lace assembly is provided for adjusting the closure of the radius gap. A second adjustable closure mechanism—such as an ulna lace assembly—is preferably provided for adjusting the closure of the ulna gap when one is present. Both these adjustment features can be used to adjust the overall diameter of the brace. In addition, the radius lace assembly is secured by placing a radius tab attached to a radius lace in a desired position on the exterior of the orthotic. Varying the placement position of the radius tab varies both the width and the taper of the radius gap, so that the orthotic can accommodate wide variations in forearm geometry. 
     
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS 
         [0012]      FIG. 1  is a perspective view, showing a wrist splint made according to the present invention. 
           [0013]      FIG. 1B  is an elevation view, showing the attachment of the top and bottom panels using the radius and ulna connectors. 
           [0014]      FIG. 2  is a perspective view, showing the ulna gap. 
           [0015]      FIG. 3  is a perspective view, showing the closure of the ulna gap. 
           [0016]      FIG. 4  is a perspective view, showing the closure of the radius gap. 
           [0017]      FIG. 5  is a perspective view, showing the wrist splint installed on a patient. 
           [0018]      FIG. 6  is a perspective view, showing the use of the radius lace. 
           [0019]      FIG. 7  is a perspective view, showing how pulling the radius tab toward the elbow helps conform the splint to a large forearm. 
           [0020]      FIG. 8  is a perspective view, showing how pulling the radius tab toward the hand helps conform the splint to a small forearm. 
           [0021]      FIG. 9  is a plan view, showing the splint placed on a patient having a large hand and forearm. 
           [0022]      FIG. 10  is a plan view, showing the splint placed on a patient having a small hand and forearm. 
           [0023]      FIG. 11  is a perspective view, showing an alternate embodiment of the ulna gap closure mechanism. 
       
    
    
     REFERENCE NUMERALS IN THE DRAWINGS 
       [0024]      
         [0000]    
       
         
               
               
               
               
             
           
               
                   
               
             
             
               
                 10 
                 wrist splint 
                 12 
                 radius tab 
               
               
                 14 
                 radius lace 
                 16 
                 bottom panel 
               
               
                 18 
                 top panel 
                 20 
                 ulna connector 
               
               
                 22 
                 radius connector 
                 24 
                 bottom thumb relief 
               
               
                 26 
                 top thumb relief 
                 28 
                 thumb strap 
               
               
                 30 
                 tab 
                 31 
                 hook tab 
               
               
                 33 
                 first lace anchor 
                 34 
                 fourth eye 
               
               
                 36 
                 fifth eye 
                 38 
                 second lace anchor 
               
               
                 40 
                 first eye 
                 42 
                 third eye 
               
               
                 44 
                 sixth eye 
                 46 
                 eighth eye 
               
               
                 48 
                 second eye 
                 50 
                 seventh eye 
               
               
                 52 
                 hook panel 
                 54 
                 ulna gap 
               
               
                 56 
                 radius gap 
                 58 
                 central passage 
               
               
                 60 
                 ulna tab 
                 62 
                 ulna lace 
               
               
                 64 
                 loop covering 
                 66 
                 ulna eye 
               
               
                 68 
                 ulna tab eye 
                 70 
                 bottom stay pocket 
               
               
                 72 
                 top stay pocket 
                 74 
                 thumb 
               
               
                 75 
                 wrist 
                 76 
                 first finger 
               
               
                 78 
                 forearm 
                 80 
                 divergence angle 
               
               
                 82 
                 hand end 
                 84 
                 forearm end 
               
               
                 86 
                 strap ring 
                 88 
                 strap 
               
               
                 90 
                 strap anchor 
                 92 
                 strap ring anchor 
               
               
                   
               
             
          
         
       
     
       DETAILED DESCRIPTION OF THE INVENTION 
       [0025]    The wrist splint of the present invention is preferably provided in separate right hand and left hand configurations. The two configurations are mirror images of each other. The following descriptions pertain to a right hand configuration. 
         [0026]      FIG. 1  shows an overall view of wrist splint  10  in an unsecured state. Top panel  18  is intended to lie over the top of the patient&#39;s forearm, wrist, and hand. Bottom panel  16  is intended to lie beneath the same anatomy. 
         [0027]    The top and bottom panels are preferably shaped to allow at least a portion of the base of the thumb to remain outside the splint. Thus, bottom panel  16  is provided with bottom thumb relief  24  while top panel  18  is provided with top thumb relief  26 . The shape of these thumb reliefs may vary according to the treatment modality. If it is desirable to largely immobilize the thumb, then the thumb reliefs will be limited in size. If on the other hand it is desirable to allow the thumb to move, then the thumb reliefs will be larger. 
         [0028]    Thumb strap  28  is positioned to pass between the thumb and first finger when the splint is installed. The thumb strap is then suitably secured to the balance of the brace. One way to accomplish this objective is through the use of hook and loop fasteners. In such an embodiment, the exterior of top panel  18  (or at least an appropriate portion thereof) is covered in loop material. Thumb strap  28  is provided with hook tab  31 , which is used to secure the thumb strap to the top panel. Tab  30  provides an anchor point for joining hook tab  31  to thumb strap  28 . Whenever hook and loop (“VELCRO”) fastenings are discussed in this application, the reader should understand that the hook panels and loop panel may be reversed as a matter of design choice. 
         [0029]    Radius connector  22  and ulna connector  20  are preferably provided to retain the top and bottom panels in the desired orientation when the wrist splint is not installed and during the installation process itself. In the embodiment shown, the radius and ulna connectors are elastic panels. The term “elastic” in this context simply means that the panels are preferably made of a material that will stretch. 
         [0030]      FIG. 1B  shows an end view of the wrist splint. The reader will observe that the top and bottom panels are separated by a radius gap  56  and an ulna gap  54 . Radius connector  22  spans the radius gap while ulna connector  20  spans the ulna gap. 
         [0031]    The combination of top panel  18 , radius connector  22 , bottom panel  16 , and ulna connector  20  creates an enclosed central passage  58 . This is useful when installing the brace as the patient may simply insert his or her hand through the central passage  58  and pull the wrist splint into the desired position. 
         [0032]    One or more stays may be added to the top and/or bottom panels to stiffen them. Two top stay pockets  72  are shown in the illustrated embodiment. A single bottom stay pocket  70  is also shown (more bottom stay pockets could be included). The stay pockets receive stiffening stays (such as aluminum bars) which shape the splint in a desired configuration to properly retain the injured skeletal structures. 
         [0033]    It is desirable to provide two or more stay pockets in many embodiments so that at least one of the pockets will lie over the desired portion of the patient&#39;s anatomy. A top stay is typically placed over the dorsal mid-line of a patient&#39;s wrist. As the orthotic is adjusted to accommodate differing patient wrist diameters, the stay pockets will move relative to this dorsal mid-line. Multiple stay pockets are preferably provided so that the practitioner may relocate the stay to the correct pocket for the particular patient (the pocket which places the stay over the mid-line). 
         [0034]    Returning now to  FIG. 1 , additional features will be described. As discussed previously, the radius gap is spanned by radius connector  22 . It is also spanned by radius lace  14 , which may be used to selectively adjust the width and shape of the radius gap. Radius tab  12  is connected to the radius lace. It includes features that allow it to be fastened to the rest of the wrist splint. In the embodiment shown, hook panel  52  serves this purpose. 
         [0035]    The two ends of the radius lace are attached to top panel  18 . The first attachment point is first lace anchor  33 . From there the radius lace passes through first eye  40  (in bottom panel  16 ), second eye  48  (in radius tab  12 ), third eye  42  (in the bottom panel), fourth eye  34  (in the top panel), fifth eye  36  (in the top panel), sixth eye  44  (in the bottom panel), seventh eye  50  (in the radius tab), eighth eye  46  (in the bottom panel), and then to second lace anchor  38  (in the top panel). The portion of radius lace  14  passing between fourth eye  34  and fifth eye  36  passes beneath the top panel  18  in the embodiment shown. 
         [0036]    Using this configuration for radius lace  14  allows the lace to be tightened by pulling on radius tab  12 . The operation of the device is dependent to some extent on the type of lace used. The illustrated embodiments use a cord-type lace which has a round cross section and is relatively slick. Grommets or other suitable friction reducing devices are preferably provided for each of the eyes so that the cord-type lace may smoothly pass through the eyes when it is tightened. Other embodiments of the invention may use a band-type lace having a rectangular cross section. A band-type lace produces significantly more friction between the lace and the eyes through which it passes. This phenomenon alters the operation of the invention. 
         [0037]    In general, the embodiments using a cord-type lace may be adjusted by the patient using only one hand. The embodiments using a band-type lace must often be adjusted using two hands—requiring assistance by a second person. The cord-type embodiments would therefore seem to be inherently superior. However, there are instances where the band-type lace is preferred, since it allows a practitioner to set a particular desired geometry. The use of both lace types for the adjustment of the orthotic will be described in detail subsequently. 
         [0038]    One object of the present invention is to provide a wrist splint which may be adjusted to fit a wide variety of patients. The provision of a radius gap  56  (as shown in  FIG. 1B ) provides a significant adjustment capacity. This gap may be selectively closed to reduce the circumference of the orthotic—and in fact the edges of the top and bottom panels may be overlapped to produce an even smaller circumference. 
         [0039]    The adjustment range provided by the radius gap will be sufficient for many patients and it is therefore appropriate to provide an embodiment which only includes a radius gap. For such an embodiment, top panel  18  and bottom panel  16  could be formed as one integral piece. However, an even greater range of adjustment can be obtained by providing a second gap in the circumference of the orthotic.  FIG. 1B  shows an embodiment providing a second gap—denoted as ulna gap  54 . 
         [0040]      FIG. 2  shows the wrist splint from a vantage point where ulna gap  54  may be readily seen. The width of the ulna gap is preferably made variable by an adjustable closure mechanism. The closure mechanism is preferably adjusted and secured using only one hand (so that the patient may operate the mechanism without assistance). 
         [0041]    In the version shown in  FIG. 2 , ulna gap  54  is spanned by ulna lace  62 . The two ends of this continuous lace are attached to ulna tab  60 . The ulna tab is provided with an attachment feature allowing it to be selectively attached to the balance of the wrist splint. In the embodiment shown, the side of the ulna tab facing away from the user includes a VELCRO hook panel. This engages loop covering  64  on the exterior of the wrist splint. Thus, if the user presses ulna tab  60  against the wrist splint it will become engaged and remain in position. 
         [0042]    Ulna lace  62  is threaded through a series of ulna eyes  66  flanking ulna gap  66 —in a manner analogous to the lace on a shoe. A cord-type lace is desirable so that friction is minimized. When the user pulls ulna tab  60  to the right in the orientation shown in the view, ulna lace  62  will tighten and draw the top and bottom panels closer together across ulna gap  54  (and may in fact completely close the ulna gap or even cause the edges of the ulna gap to overlap).  FIG. 3  shows the view of  FIG. 2  after ulna tab  60  has been pulled to the right. The reader will observe the closure of ulna gap  54 . Grommets or other suitable friction reducing devices are provided in the ulna eyes and in ulna tab eye  68  to reduce friction as the ulna lace is being tightened. 
         [0043]    The configuration shown allows one handed operation so that the user may install the wrist splint and adjust it without assistance. The splint shown is intended for the right wrist. Once the splint is over the wrist, the user may use his or her left thumb and forefinger to grasp ulna tab  60  and pull it to create the desired degree of closure of ulna gap  54 . Once this is achieved the user presses the ulna tab against loop covering  64 . 
         [0044]    Of course, many other adjustable closure mechanisms could be used for the ulna gap.  FIG. 11  shows a second embodiment. Adjustment of the ulna gap in this embodiment is provided by a pair of straps  88 . Each strap  88  is attached to the orthotic via a strap anchor  90  on a first side of the ulna gap. Two strap rings  86  are attached on the opposite side of the ulna gap by a pair of strap ring anchors  92 . The straps are provided with VELCRO hook and loop coverings similar to those used for shoe closures. 
         [0045]    In operation, the user grasps a free end of a strap  88  and pulls it tight. He or she then presses the strap back upon itself to secure it in place. The two straps may be adjusted individually to produce a desired configuration. 
         [0046]      FIGS. 4 through 10  illustrate the configuration of the radius side of the wrist splint during installation of the splint on a patient&#39;s wrist and subsequent adjustment. In  FIG. 4 , hook panel  31  is secured to a suitable position on the exterior of the splint so that tab  30  and thumb strap  28  are properly positioned. The user may then selectively close radius gap  56  by pulling upward on radius tab  12  as indicated. 
         [0047]    As mentioned previously, the actual operation of the radius lace assembly is influenced by the type of radius lace used. There are two general types of radius lace which may be used in the device. The first is a cord-type lace. This is a lace having a round cross section and a relatively small diameter. The exterior of a cord-type lace is often provided with a low-friction surface so that it passes easily through the lace eyes. 
         [0048]    The second type of lace is a band-type lace which has a flat rectangular cross section. The surface of a band-type lace typically has a higher friction surface. Band-type laces are traditionally uses in shoes like canvas basketball sneakers. They allow a lace passing through many eyes to be progressively tightened, since the lace does not easily slip back through an eye even when tension is removed. The operation of the orthotic splint will be described initially using a cord-type lace. The operational differences produced when using a band-type lace will then be explored. 
         [0049]      FIGS. 5-10  illustrate the installation of the wrist splint on a patient. In  FIG. 5 , the splint has been pulled over the patient&#39;s wrist  75  into position. Thumb strap  28  is passed between thumb  74  and first finger  76 . Hook tab  31  is then pressed against the loop covering on the exterior of top panel  18  to secure the thumb strap in position. The user will next adjust the position of radius tab  12  to selectively close the radius gap around wrist  75 . 
         [0050]    The top and bottom panels each have a hand end  82  and a forearm end  84 . The hand end is closest to the fingers while the forearm end is closest to forearm  78 . The position of the radius tab  12  when it is attached to the rest of the orthotic determines the overall width of the radius gap and the taper between the top and bottom panels. 
         [0051]    When using a cord-type lace, the lace will slide easily through the eyes so that constant tension is maintained even when radius tab  12  is pulled in different directions. If the user pulls straight up on radius tab  12 —as indicated in FIG.  6 —the top and bottom panels will be drawn evenly together. The lace position and the configuration of the panels are preferably set so that a taper suitable for the average patient is produced by drawing the radius tab straight upward. Thus, a moderate taper will be assumed between the top and bottom panels to accommodate the moderately expanding shape of the forearm in the example of  FIG. 6 . This will allow the splint to conform to an average individual. 
         [0052]      FIG. 7  shows the application of the wrist splint to a stocky, muscular individual. This individual has a muscular forearm with a wide divergence angle  80 . If the wrist splint is tightened conventionally, it will cinch tightly at forearm end  84  while remaining too loose at hand end  82 . However, the fact that radius tab  12  may be repositioned allows the user to adjust both the distance between the upper and lower panels and the taper between them. 
         [0053]    For the patient shown in  FIG. 7 , radius tab  12  is pulled toward forearm end  84 . Lace  14  passes continuously through the eight eyes on the top panel, the bottom panel, and the radius tab. The use of a cord-type lace allows the lace to pass through the eyes with relatively little friction. Thus, when the radius tab is deliberately pulled toward forearm end  84  as shown, this motion tightens the portions of lace  14  lying proximate hand end  82  before the portions lying proximate forearm end  84  draw tight. The lace tends to “adjust itself” by portions passing through some of the eyes so that tension is evened out. 
         [0054]    Once the radius tab is pulled in this direction and the desired degree of taper is achieved, it is pressed down against the loop material covering the exterior of the wrist splint. The hook panel on the radius tab then holds the radius tab in position.  FIG. 9  shows a top view of the wrist splint with the radius tab  12  pressed into position. The wrist splint is thereby appropriately adjusted to accommodate a stocky forearm. 
         [0055]    Returning to  FIG. 7 , the reader will observe that the top and bottom panels are drawn more tightly together in the vicinity of the wrist than in the vicinity of the forearm. This produces a taper in the wrist splint as shown. The top and bottom panels are further apart when moving in the direction of the forearm, which produces a taper consistent with divergence angle  80  of forearm  78 . 
         [0056]      FIG. 8  shows the example of an individual with a slim forearm. If the wrist splint is conventionally tightened for such an individual it will tighten around the wrist while remaining slack near forearm end  84 . In order to adjust the orthotic for a patient having a slim forearm, radius tab  12  is pulled toward hand end  82  while it is pulled upward to tighten radius lace  14 . This motion causes the portion of radius lace  14  lying proximate forearm end  84  to tighten first, while the portion lying proximate the hand tends to remain slack. The use of a cord-type lace again allows the lace to “adjust itself” in order to create nearly uniform tension. Thus, the top and bottom panels are pulled more tightly together near the forearm. This tends to reduce the “average” taper built into the radius gap and creates a near zero divergence angle  80 . Thus, the wrist splint accurately conforms to the slender forearm of the patient shown in  FIG. 8 . 
         [0057]    The radius tab is then pressed down against the top panel to lock it in position. A top view of this configuration is shown in  FIG. 10 . The reader will observe how the radius tab is offset in the direction of the hand. The wrist splint is thereby adjusted to conform to the slender forearm geometry of this particular patient. 
         [0058]    When using a cord-type lace, the angular offset created by the placement of radius tab  12  must be repeated each time the orthotic is applied. In a sense, the orthotic must be adjusted every time it is applied. A patient will often remove the orthotic to wash, etc. When it is reapplied, radius tab  12  will not be biased toward one position or another (as the relatively low-friction cord-type lace allows it to be easily moved). Thus, the user must properly position radius tab  12  each time. 
         [0059]    The use of a band-type lace alters the application process for the orthotic. The band-type lace will not adjust itself by the simple operation of moving the radius tab toward the wrist end or forearm end. Instead, a person must manually pull the lace through the eyes in order to obtain the proper distribution. This step is typically performed by a technician when the orthotic is fitted. 
         [0060]    The technician places the splint on the patient and manually applies tension to the portion of the lace protruding between adjacent eyes to obtain the desired taper of the splint (much like manually pulling on the lace of a tall shoe to obtain a desired fit). Once the desired lace arrangement is obtained, radius tab  12  will naturally be offset toward the hand end or the forearm end (It will move toward the correct position when the user pulls on it to draw the lace tight). The user then presses radius tab  12  against the orthotic to secure it in position. 
         [0061]    When the orthotic using a band-type lace is removed, lace  14  must be slackened sufficiently to allow the patient&#39;s hand to be pulled free. However, the offset of radius tab  12  will tend to remain intact. When the orthotic is next placed on the wrist, the patient can simply pull on the radius tab (without having to pay too much attention to where it should be placed) and the radius tab will tend to return to the position originally set by the technician. Thus, the use of a band-type lace allows the orthotic to be adjusted initially by a technician and retain the configuration set by the technician. The use of a cord-type lace requires that the configuration be set each time the device is applied. 
         [0062]    The selection of one type of lace over the other is a question of individual preference. The offset of radius tab  12  (whether set by a technician or the patient) retains the desired taper between top panel  18  and bottom panel  16 . 
         [0063]    Having thus received a description of a preferred embodiment of the invention, those skilled in the art will immediately recognize that many more alternate embodiments are possible. As an example, the radius tab is attached to the orthotic by hook and loop fasteners in the preferred embodiment described. An array of plastic snap closures could be substituted for this approach. In another embodiment, the ulna gap could be eliminated altogether with the top and bottom panels being formed as one continuous piece broken only by the radius gap. 
         [0064]    Although the preceding description contains significant detail, it should not be viewed as limiting the invention but instead as providing illustrations of the preferred embodiments of the invention. Many other alterations could be made to the embodiments illustrated without altering the substance of the invention. Thus, the scope of the present invention should be defined by the following claims rather than any specific examples given.