Patent GB-470579-A (GB)
Title: Improvements in or relating to splints for use in the reduction of fractures of bones having ball and socket articulation
IPC: A61B17/64
Filed: 1936-02-18
Abstract: 470,579. Surgical fracture appliances. ANDERSON, R. Feb. 18, 1936, No. 4957. [Class 81 (ii)] In a splint for use in the reduction of fractures of bones having ball and socket articulation wherein means are provided for direct fixed connection with the superior fragment of the bone for positive manipulation thereof, the said means are capable of universal rotation about the centre of articulation. The device shown in Figs. 1 and 3, which is adapted for reduction of fractures of the femur consists of a frame formed of side bars 1, 1a joined by end members 3. A plate 4 is affixed to one end, and upon it is pivoted a curved arm 5 which may be locked in any position by a bolt 9 engaging a slot 8. A sacral rest is also mounted on the plate 4, and consists of a post 30 slidably mounted on a rod 35 which is clamped to any desired part of the periphery of the plate 4 by lock bolt 37. A plate 32 mounted on a threaded pillar 31 is adjustable vertically by means of a wing nut 33. A block 12 is rotatably mounted on the arm 5 and may be clamped in any position by a wing nut 13a engaging a threaded shank 13. Slidably mounted in block 12 is an arcuate rack bar 15, formed with gear teeth 15a meshing with a pinion 27 operated by a hand wheel (not shown). The rack bar 15 carries a bar 16 formed with a socket 17 in which is clamped a short bar 18. Bone transfixion pins 22 are clamped in bar 18, each pin having a squared outer end for the application of a tool, and being shouldered at 22a to limit the extent to which they may transfix the bone. Fig. 3 shows the pins in position in the superior fragment F, the ball joint of the femur being indicated at F<2>. A traction bar 40 slidably mounted at the end of the frame remote from the plate 4 carries a block 41 rotatable about a vertical axis and capable of being locked by bolt 49. A yoke 42 is slidably mounted in block 41. Gear teeth 42c on the yoke are engaged by a pinion mounted in the block 41 as described with reference to the rack bar 15. A wire 43 for transfixing the distal end of the fractured femur is clamped in the yoke 42. Traction is applied through a threaded rod 47 engaging the traction bar 40 and end member 3. A foot rest 72 is mounted on rods 70 slidable in the bar 40. A rest 73 for the other leg is mounted on bracket 74 clamped in a socket 76 in plate 4, Fig. 3. When twopin transfixion of the distal fragment is desired, two brackets carrying an additional wire are screwed in holes 52 in yoke 42. Each bracket, Fig. 15, comprises a bar 54 upon which is slidably mounted a block 55 adjustable along the bar by means of screwed rod 56. Vertically adjustable in each block is a threaded rod 58 co-operating with an adjusting nut 59 and carrying a clamping device 60 for the second traction wire 50. When the fracture has been reduced, a cast is applied around the limb incorporating the bar 18, countertraction pins 22 and traction wire(s) 43. In Fig. 13, the rack 15, &c., is replaced by a yoke 82 and wire 85. The arms of the yoke are laterally offset at 82a, Fig. 13A. The yoke is applied through an extension piece 83 pivotally mounted on arm 5 and clamped by nut and bolt 64. In applying the device for reduction of fractures of the humerus, the plate 4 and sacral rest are removed, and the curved arm 5 is pivoted directly on the cross member 3, Fig. 10. The pin mounting bar 18 is carried by an extension piece 16x clamped in socket 17 of the bar 16. Block 41 is replaced by a pivoted curved arm 95 carrying a mounting block 12 for the yoke 42<1>. The traction wire 43 may be replaced by a bracket 18x carrying a mounting bar 18<1> carrying half-pins 22<1>. In Fig. 14, a modified appliance is shown. The arm 5, rack 15, &c. are similar to the device shown in Fig. 1, but are pivotally mounted on an arm 108 vertically adjustable with reference to bracket 100 which is clamped by lever 106 and hand wheel 107 to a fracture table 105. Any suitable traction means may be employed with this device. Specification 437,130 is referred to.