Abstract:
There is a mulifunctional finger, hand and wrist splint which includes a slab support member. In a position of use the slab support member extends along the underside of, and substantially follows the contours of, a wearer&#39;s lower forearm wrist and palm so that the wrist is immobilized. The slab support member in the area of the wearer&#39;s palm forms an anchor plate for a fracture support which is releasibly attached to the anchor at a range of positions to align with one or more finger or metacarpal fractures.

Description:
FIELD OF THE INVENTION 
     This invention relates to medical apparatus. More particularly it discloses an improved multifunction splint for treatment of fractures of fingers, metacarpal and wrist fractures. It can also be used to support the wrist in a neutral position that is required for carpal tunnel syndrome and post operative care of scaphoid, metacarpal fracture and wrist fracture. 
     BACKGROUND TO THE INVENTION 
     Splints currently used for setting finger fractures include those disclosed in the applicant&#39;s Australian patent application 21183/99. Such existing devices however cannot be adequately used to immobilize metacarpal, small hand joints (such as the scaphoid, lunate, hamate, triquetral, trapezoid, capitate, pisiform), or wrist fracture or to stabilize the wrist for treatment of carpal tunnel syndrome. Existing devices also do not offer mulifuctionality that can treat most fractures of the hand. For example, existing splints for 5th metacarpal fracture (commonly called boxer fracture) typically use plaster of paris/fiberglass to mould the shape of the palm and wrist in slight extension and the finger and palm in 90 degree flexion as this is the angle that allows maximum healing and minimal complication of joint stiffness. It is even more difficult to treat a fracture of 4th, 3rd or 2nd metacarpal fractures as it is often very difficult technically to stabilize the carpal-metacarpal joint in isolation by using plaster of paris and aluminum strip supports to hold the finger in 90 degree flexion. Therefore surgery is often contemplated. Furthermore the use of such existing splints is time consuming and often requires a doctor or physiotherapist to apply them. Such splints can often cause allergies due to sweating of the skin. In circumstances such as the sport field or in war zones it is desirable to have a splint that can be easily and quickly applied to stabilize any finger, metacarpal, or wrist fracture of either left or right hand. Other disadvantages of using molded splints such as those of plaster of paris is that they must be worn for the duration of the treatment which is usually 4 to 6 weeks. Therefore joint stiffness, allergies and unpleasant odors often result. It is also considered by some medical practitioners that allowing the finger or wrist to be easily moved for active mobilization, at least once or twice per day during the treatment period achieves better bone healing and reduces complications from stiffness and skin allergies. This is not feasible with existing splints. 
     SUMMARY OF THE INVENTION 
     It is an object of this invention to ameliorate the aforementioned disadvantages and accordingly a combination mulifunctional finger, hand and wrist splint is disclosed, said splint including a slab support member which in a position of use extends along the underside of and substantially follows the contours of, a wearer&#39;s lower forearm, wrist and palm whereby the wrist is immobilized in extension and said slab support member in the area of the palm forms an anchor plate for a finger support which is releasibly attached to said anchor plate at any one of a range of positions to align with one or more finger or metacarpal fractures. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The currently preferred forms of this invention will now be described with reference to the attached drawings in which: 
     FIG. 1 shows an upper side perspective view of a splint according to a first embodiment of the invention, 
     FIG. 2 shows an underside perspective view of the splint of FIG. 1, 
     FIGS. 3 and 4 show perspective views of the splint fitted to a wearer&#39;s wrist and finger. 
     FIGS. 5 and 6 show part of a splint according to a second embodiment of the invention, and 
     FIG. 7 shows part of a splint according to a third embodiment of the invention. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     Referring first to FIGS. 1 and 2 the splint is adapted to fit either arm and may comprise a one piece slab support member constructed from a shape retaining sheet material  1  such as plastic or aluminium which is nevertheless able to be contoured to closely fit the wearer&#39;s forearm, wrist and palm. The inside of the support member is lined with a soft foam material  2  or the like and there are ventilation slots  3  for comfort against the wearer&#39;s skin. One end portion  4  of the support member is rounded to cradle the forearm. It merges into a central section  5  which abuts the heel of the hand and supports the wrist at an inclination with this embodiment of about 30 degrees. This invention however is not limited to this angle. 
     The opposite end portion of the support member forms an anchor plate  6  which abuts the wearer&#39;s palm. The edge  7  of the plate may be squared off and a number of sockets provided adjacent to said edge which allow the finger support  8  to be fitted at different positions  9 ,  10 , and  11 , depending upon the finger to be immobilized. There are also laterally directed sockets  12  and  13  for the left and right thumbs. While the embodiment shown is provided with only five socket positions for the fingers and thumbs additional positions may be provided according to design preference. 
     The finger support  8  preferably comprises a strip  14  of aluminium or other reasonably stiff yet pliable material which is adapted at one end for a close tolerance push fit into a selected one of the sockets. The strip  14  at the other end mounts an elongated channel  15  with hinged side panels  16  to cradle the wearer&#39;s finger or thumb. There are also velcro fasteners  17 ,  18  fitted to the underside of the channel which may be tightened to close the panels around the finger and immobilize it. The inside of this channel  15  is preferably also preferably lined with soft foam  18 A and there are ventilation slots  19  for comfort. The angle at which the fracture is immobilized can be adjusted by bending the strip  14 . 
     As shown in FIGS. 3 and 4 the slab support member  1  is attached to the wearer&#39;s forearm and hand by means of VELCRO® straps  20 ,  21  and  22 . While in this case the ring finger  23  is being immobilized the finger support  8  could alternatively be inserted into any of the sockets for fractures of the other fingers or thumb. 
     With the second and third embodiments of the invention the components of the splint shown which correspond in function to those of FIGS. 1 to  4  are indicated by the same numbers which are primed (′) and (″) to distingush them. 
     Referring FIG. 5 there is an additional forward directed socket  24  formed in the support member to provide for each finger position. The end of the support member is also rounded to form a lip  25 . 
     The connector strip  14 ′ is shown fitted into socket  9 ′ which would correspond to a wearer&#39;s left hand index finger. The digit splint fitted comprises a set of three segments  26 ,  27  and  28  which are arranged on a connecting linkage formed by a U shaped metal wires  29  and the aforementioned connector strip  14 ′. Preferably the segments are identical in shape with each having a concave upper surface  30 , rounded underside and planar ends  31 ,  32  through which three apertures  33 ,  34  and  35 , pass. These apertures are spaced symmetrically about the center-lines of each segment and extend completely through the length thereof. The central rectangular apertures  35  in segments  26  and  27  are shaped to receive the connecting strip  14 ′ as a close tolerance push fit. The other apertures  33  and  34  receive the wires  29  which pass through segments  27 ,  28 . The assembly is thus longitudinally adjustable but resistant to lateral deflection. The length of the digit splint can be easily and quickly adjusted by the practitioner without the aid of tools. 
     As shown in FIG. 6 the splint, after adjustment for length, is fitted with the segment surfaces  30  engaging along the underside or dorsal surface of an injured finger  35 . Preferably the splint is held in place by VELCRO® straps  36  or the like. As mentioned earlier the upper surfaces  30  of the segments are preferably concave so as to follow the contour of the dorsal surface and cradle the finger. 
     The finger shown in FIG. 6 is held straight as is required for some phalangeal fractures. The malleable nature of the mild steel wires  29  and connecting strip  14 ′ used with this embodiment however enables the splint to be bent so as to alternatively put the finger in flexion or in extension as required for mallet finger injuries. In the latter case the splint would also be modified from the example shown to use only two segments to hold the distal phalangeal joint in extension. 
     As an alternative to the digital splint and in accordance with a third embodiment of the invention a multiple finger support plate  37  could be fitted as shown in FIG. 7 using the connecting strips referred to earlier. The support plate would simultaneously immobilize two or fingers. There are ventilations holes  38  distributed over the surface of the plate and transverse notches  39  are provided to assist cutting the plate to suit the wearers requirements. 
     It will thus be appreciated that this invention at least in the form of the embodiments disclosed provide a novel and low cost adjustable splint for finger, metacarpal and wrist fractures. The advantages of a splint according to this invention include the following: 
     practical 
     multifunctional 
     water resistant 
     non allergic 
     can be easily applied in emergencies without assistance of medical personnel 
     provides immobilization of finger joints, small joints of the hand and wrist to minimise pain and discomfort 
     provides better and easier immobilization of thumb and all other digits due to multiple slot adaptability 
     can immobilize any joint fracture from the tip of the finger to the distal aspect of the forearms 
     allows the finger to immobilize at variable angles with better stabilization at the wrist joint 
     suitable for post operative care of hand or wrist surgery 
     VELCRO® strapping allows the splint to be removed and reapplied easily for early active mobilization of joints 
     removal of the splint is simple and painless as no adhesive or plaster of paris is used and hence no cutting equipment is required 
     increased comfort reduces patient resistance to full term use of the splint. 
     Clearly however the examples described are only the currently preferred forms of the invention and a wide variety of modifications may be made which would be apparent to a person skilled in the art. For example the shape and configuration of the slab support member and the means of attaching the fracture support thereto may be changed according to design preference. The slab support may also be made extendible to suit different sizes of forearm. Finally, while a low cost and easily molded plastic is currently preferred the invention at this stage is not restricted to the use of any specific materials as this is to be the subject of further research by the inventor.