Abstract:
The present invention provides the method for placing the patient&#39;s wrist in traction to alleviate symptoms of carpal tunnel syndrome. The preferred apparatus utilizes a harness to connect the patient&#39;s hand to a traction device and a stabilizing attachment to restrain the patient&#39;s arm in an anatomically neutral position while isolating the patient&#39;s soldier and elbow from the traction device.

Description:
This application is a continuation of U.S. patent application Ser. No. 08/758,210 filed Nov. 26, 1996, now abandoned. 
    
    
     FIELD OF THE INVENTION 
     The present invention provides a method for placing a patient&#39;s wrist in traction for the purpose of treating carpal tunnel syndrome, and provides a device such as the illustrated embodiment to hold the patient&#39;s arm in an anatomically neutral position while a harness connects the patient&#39;s hand to a traction unit. 
     BACKGROUND OF THE INVENTION 
     The carpal bones or carpus of the wrist form a deeply concave gutter through which the Median Nerve and flexor tendons pass. The gutter is converted into a tunnel by a ligament, the flexor retinaculum. The crowded long flexor tendons emerge from the carpal tunnel and diverge as they pass down the hand. Usually, the flexor tendons are very slick and glide against each other in the carpal tunnel as the hand is used to grasp objects. However, any condition which causes irritation or inflammation of the tendons or surrounding tissue increases the pressure in the carpal tunnel because the carpal bones and flexor retinaculum ligament are not able to stretch in response to the swelling. Increased pressure in the carpal tunnel begins to squeeze the Median Nerve and the hand will feel numb or ache. This is commonly referred to as carpal tunnel syndrome. 
     The traditional treatments in the early stages of carpal tunnel syndrome include administering anti-inflammatory medication and splinting or immobilizing the wrist to allow the inflammation and swelling to subside. In more advanced cases, the flexor retinaculum ligament is cut, thereby opening a wall of the carpal tunnel and allowing sufficient space in the wrist to prevent the median nerve from being squeezed. 
     Obviously, surgery is to be avoided if possible, and to further that goal, the present invention provides an additional method to treat carpal tunnel syndrome, particularly in less advanced cases. The invention preferably consists of an attachment to exiting traction devices that will to enable a patient&#39;s wrist to be placed in traction. This wrist traction provides a slight longitudinal separation between the carpal bones in the wrist and the lower heads of the lower arm bones, the radius and the ulna. The slight separation provides some space to relieve compression in the carpal tunnel area. 
     A need exists to provide a therapeutic device which is distinguishable from a surgical traction splint. Surgical traction splints require surgery and often are associated with the surgical implantation of skeletal pins which is an invasive procedure. Skeletal pins are not natural to the body and may result in infection, or at least discomfort, to the patient. Therapeutic devices are devised to operate without the need to first perform surgery on the patient. 
     SUMMARY OF THE INVENTION 
     In accordance with the present invention, an attachment for existing traction devices is provided with three principal components. The first component is an arm restraining segment that immobilizes the patient&#39;s arm in an anatomically neutral position and protects the patient&#39;s shoulder and elbow from injury during traction. The second component is a sling or harness to engage the patient&#39;s hand and connect it to the traction units. The final component is a mechanism to hold the arm immobilizing portion substantially stationary relative to the traction unit so that tension is applied to the patient&#39;s wrist. 
     With this device it is an object and advantage of the invention to apply traction to a patient&#39;s wrist to relieve symptoms of carpal tunnel syndrome, other tendon problems and muscle tightness. 
     It is a further object of the invention to provide a wrist traction attachment that is compatible with existing traction units. 
     It is a further object of the invention to provide a wrist traction device which may be used by patients with a substantial range of muscular strength and bone size with only simple adjustments. 
     It is yet another object of the invention to protect the patient&#39;s shoulder and elbow from strain during wrist traction and to position the patient&#39;s lower arm bones (the radius and ulna) in a generally parallel alignment. 
     These and other objects and advantages of the invention will become apparent from a study of the drawings and from a review of the specification following hereinafter describing the preferred embodiment which has been given by way of illustration only. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 depicts an anterior view of the palm of hand and lower arm bones showing the flexor sheaths, flexor retinaculum ligament, and the position of a harness to secure the patient&#39;s hand according to the present invention. 
     FIG. 2 shows a wrist cross section taken along line  2 — 2  in FIG.  1  and shows the carpal tunnel formed by carpal bones and the flexor retinaculum ligament. 
     FIG. 3 is a perspective view of the principal components of a preferred embodiment of the invention. 
     FIG. 4 is a side view of an embodiment of the invention connected to a traction device and in use on a patient. 
    
    
     DETAILED DESCRIPTION 
     Turning first to FIG. 1, the lower arm  28  and hand  29  of a patient are illustrated. The lower arm  28  is shown in an anatomically neutral position where the radius  26  and ulna  27  in the lower arm  28  are substantially parallel and do not cross one another. In addition, the patient&#39;s hand  29  is shown with a harness  10  according to the present invention. The harness  10  has a midsection  14  upon which rides metal O-ring  15 . Harness  10  also has a first end  11  which proceeds around a first loop section  12  (shown in FIG. 3) and back to a first joinder segment  13 . In the present embodiment, the first end  11  is simply sewed to the harness at the first joinder segment  13 , however, adjustable buckles or straps might be used to allow the harness to adapt to a wider range of patient hand sizes. After the mid-section  14  proceeds from the first joinder segment  13  through O-ring  15 , it then proceeds to second joinder segment  16 , second loop section  17  and second end  18 , all as shown in FIG.  3 . 
     A harness  10  according to the present invention is easily and inexpensively made, however, it will be understood that many variations of this structure will be suitable, so long as they grasp the patient&#39;s hand  29  below the interface of the carpal bones  20  with the radius  26  and ulna  27 . 
     FIG. 2 provides another illustration of patient&#39;s hand  29  taken along the line  2 — 2  in FIG.  1 . Specifically illustrated in FIG. 2 is the gutter formed by carpal bones  20 , including hamate  21 , capitate  22 , trapezoid  23 , and ridge of trapezium  24 . Several other carpal bones are not illustrated. The top of the gutter is formed by flexor retinaculum  31 , which thereby encases the Median Nerve  30  and several flexor tendons including flexor digitorum superficialis  32 , flexor digitorum profundis  33 , flexor carpi radialis  35 , and flexor pollicis longus  36 . Flexor synovial sheath  34  also encompasses some of these flexor tendons. From the illustration in FIG. 2, it can be seen how pressure within the tunnel formed by flexor retinaculum  31  and carpal bones  20  will place pressure on median nerve  30 . 
     FIG. 3 illustrates a preferred embodiment of the invention including the previously described harness  10  and a patient stabilizer attachment  40 . The stabilizer attachment  40  consists primarily of the stabilizer bar  42  and elbow cup  50 . The stabilizer bar  42  has at its distal end a mating segment  41  which is used to attach the stabilizer attachment either to a traction device or another relatively immovable object. A stabilizer bar  42  also has a distancing segment  43  to distance the mounting segment  44  at a position suitable for patient positioning. 
     Mounting segment  44  is secured to elbow cup  50  which generally conforms to the shape of a patient&#39;s bent elbow. Elbow cup  50  is adapted to receive an elbow pad  53  which is preferably comprised of covered foam padding. Elbow cup  50  also has two upper arm strap holes  51  and two lower arm strap holes  52 . Upper arm strap  54  can be passed through upper arm strap holes  51  and the first strap end  55  secured to second strap end  56  to secure the patient&#39;s upper arm in the elbow cup  50 . Securing the patient&#39;s upper arm  25  in this fashion, as shown in FIG. 4, will isolate the patient&#39;s shoulder from the traction device. Applying traction to the patient&#39;s shoulder might cause injury to that joint. 
     Similarly, lower arm strap  57  can be received through lower arm strap holes  52  and first lower arm strap end  58  fastened to second arm strap end  59  to at least partially restrain the patient&#39;s lower arm  28  (shown in FIG. 4) and thereby reduce any tension applied by the traction device to the patient&#39;s elbow. The elbow is generally a more stable joint than the shoulder, so complete isolation from the traction device is not as critical with this joint. 
     FIG. 4 shows the preferred embodiment of the present invention in use with a traction device  60 . Traction device  60  exerts tension on cord  61  which proceeds through pulleys  62  mounted on adjustable height cross bar  63  to S-hook  65 , which in turn is fastened to O-ring  15  on harness  10 . The harness  10  in turn engages the patient&#39;s hand  29 . Adjustable bar  63  can be raised and lowered on vertical bar  64  so that the angle of traction applied by cord  61  is appropriate for the patient&#39;s position. Patient  68  is shown sitting in chair  67  with upper arm  25  secured in elbow cup  50  by upper arm strap  54  and lower arm  28  secured in elbow cup  50  by lower arm strap  57 . 
     In practice, a programmable traction device such as the TX-7 Mobile Traction Unit or TX-8 Stationery Traction Unit manufactured by Chattanooga Group, Inc. is preferred. A typical treatment will apply traction for a ten-minute period consisting of cycles of thirty seconds of traction and fifteen seconds of rest. In typical cases, between seven and twenty pounds of traction will be applied to the patient&#39;s wrist, depending upon the patient&#39;s condition. Daily treatment in accordance with the present invention over a period of two months has resulted in significant diminution of carpal tunnel syndrome symptoms in patients. 
     While particular embodiments of the present invention have been illustrated and described, it would obvious to those skilled in the art that various other changes and modification can be made without departing from the spirit and scope of the invention. It is therefore intended to cover in the appended claims all such changes and modifications that are within the scope of the invention.