Abstract:
An arm support garment with an integral arm sling pouch for comfortably supporting and immobilizing the upper extremity on either the inner or outer surfaces of the front of the garment is disclosed. The sling pouch in the garment of the invention is accessed from the front exterior portion of the garment through vertical slits oriented in the garment material near each end of the pouch. Additional slits may also be provided to aid in ventilation. The pouch is preferably made with an expandable inside layer to allow usage by individuals with different forearm sizes. A separate support pouch of this configuration can also be used with traditional arm slings.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     N/A 
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     N/A 
     BACKGROUND OF THE INVENTION 
     In current orthopedic practice, sling devices to support the shoulder, forearm, wrist and hand following the occurence of an injury are worn with the forearm supported in an exterior position relative to, and typically separate from, the patient&#39;s clothing. Such slings are typically equipped with numerous adjustable straps and buckles. 
     BRIEF SUMMARY OF THE INVENTION 
     The present invention relates to an arm support garment with an integral arm sling pouch for comfortably supporting and immobilizing the upper extremity on either the inner or outer surfaces of the front of the garment. The sling pouch in the garment of the invention is accessed from the front exterior portion of the garment through vertical slits oriented in the garment material near each end of the pouch. Additional slits may also be provided to aid in ventilation and serve as additional access openings. The pouch is preferably made with an expandable inside layer to allow usage by individuals with different forearm sizes. A separate support pouch of this configuration can also be used with traditional arm slings. 
     The arm support garment, which is preferably in the form of a T-shirt or a vest, is generally made from a material, e.g., a heavy cotton, with limited stretch capacity to resist the deforming effect of the weight of the forearm on the material of the clothing. Alternatively, additional support can be provided on the inside of the garment in the form of sewn-in over-the-shoulder support straps. 
     With traditional arm slings, the entire weight of the upper extremity is supported by the neck. The arm support garment of the invention allows this weight to be spread throughout the garment so as to be distributed over the shoulders of the patient. Additionally, keeping the supported extremity on an inside pouch, as in this invention, supports the injured extremity close to the chest as is usually desired for optimum immobilization, e.g., after a shoulder dislocation. Overall application of this garment is easy, particularly by a patient with an injured extremity. It takes same effort as putting on a standard article of clothing as the supporting pouch needs none of the numerous straps and buckles of existing devices. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     Other features and advantages of the invention will be apparent from the following description of the preferred embodiments thereof and from the claims, taken in conjunction with the accompanying drawings, in which: 
     FIG. 1 is a front exterior perspective view of the arm support garment of the invention; 
     FIG. 2 is a perspective view of the interior of the arm support garment of FIG. 1 showing an integrally placed arm support pouch; 
     FIG. 3 is a plan view of the arm support pouch of FIG. 2 showing a multiply folded segment; 
     FIG. 4 is a perspective view of the interior of the front portion of an alternate embodiment of the arm support garment of the invention showing an integral strap support; 
     FIG. 5 is a perspective view of the interior of the rear portion of the support garment of FIG. 4; and 
     FIG. 6 is a perspective view of an alternate embodiment of the arm support garment of the invention showing an optional accessory restraining strap and attachment. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Referring to FIGS. 1 and 2, the arm support garment of the invention  10  includes an integral sling pouch  12  incorporated on the inside of the garment, and accessible, from the outside of the garment, through vertical slits  14  near each end of the pouch, for supporting an injured upper extremity  16 . The sling pouch consist of one or more panels  18 ,  20  of preferably double layers of cotton cloth, or similar fabric material. 
     When the pouch is made of two panels, the first panel  18 , closest to the inner surface of the front of the garment, is either an integral part of the garment or is sewn on to the inner surface of the garment. The second panel  20 , further away from the inner wall of the front of the garment, is secured at its lower and upper edges by sewing, or any other means, to the edges of the first panel, and/or to the wall of the garment. The upper edge  22  of the second panel may be left open, although it is preferable to close it. The length of the panels ranges from, e.g., seven to twenty inches, to accommodate a wide range of forearm lengths, and to allow the use of vertical ventilating slits  24  in the panels. The width of the panels ranges between, e.g., three and eight inches to allow for placement of different diameter extremities. 
     The support pouch can be made to be expandable. Referring also to FIG. 3, in another embodiment, second panel  20 ′, viewed from the inside of the support pouch, preferably has one or more folded segments  30 , adjacent to the upper and lower edges of panel  20 ′, which are secured with a snap grommet or Velcro tab  32 , or by any similar means. The folded segment can be released to give a greater girth or volume to the space enclosed by the two panels in order to accommodate an extremity that may be bearing a cast. In this configuration, such a support pouch can also be used with traditional arm slings, as it allows a single sleeve to accommodate medium, large, and extra large sized extremities. 
     Referring again to FIGS. 1 and 2, it can be seen that the support pouch panels  18 ,  20  are positioned at an optimum level to allow easy insertion of an arm  16 , through slits  14 , into the enclosure formed by the panels. This position is typically between one and three inches below the level of the lower seam  26  of the sleeve attachment. The panels are also positioned symmetrically in the central section of the garment to provide easy access and use by either the left or the right upper extremities. The distance between the lateral edges of the panels and the side seams of the garment could range from one to five inches depending on the length of the extremity and the size of the garment. 
     The arm support garment of the invention can be reversed as it is a dual surface outfit. The design of a reversible garment will be compatible with design modifications existing currently in the fashion industry. Reversing the garment will also allow the second panel on the inside to be exposed for use as an exteriorly positioned sling. This would be particularly useful in hot and humid weather. 
     The two panels  18  and  20 , and the front surface of the garment  10  itself in the case of an integral first panel, are provided with multiple slit openings  24  that run from the upper borders to the lower borders of the panels. Preferably, these vertical slits, e.g., from two to four in number, are placed in each panel  18 ,  20  and spaced from one to three inches apart to minimize a tendency to tear. The first and the last of this vertical slit openings in inner panel  18  coincide with access window  14  for insertion of either the right, or the left arm. The position of these vertical slits may, or may not, be at the same level in the two panels of the garment. The vertical slits serve two purposes. First, they serve as vents to ensure good air circulation to the inner aspect of the garment. Secondly, they serve as variable access windows for insertion of the forearm into the enclosed inner pouch. In other words, when the most lateral vertical slit is not suitable for a particular individual, the forearm can be inserted into the next slit in line. This flexibility permits a large size garment to be worn by someone with a fairly short forearm. 
     The material between the vertical slits is further reinforced by sewing the two layers constituting the panels, or, if preferred, by interposing additional layers of reinforcing material. The amount of material between the vertical slits is also such that it can withstand tensile stresses greater than 2 Newton per square meter exerted by the upper extremity and not tear. Also, as the overall weight is shared uniformly along the length of the pouch, this further limits the tensile stress on individual strips of cloth between the vertical slits. 
     The opposing edges of each vertical slit can be securely closed if desired by attaching a securing means in the form of Velcro tags, snap-on grommets, or any other attachment means. This is important as this garment can be converted to regular clothing after it has served its therapeutic purpose. By closing off the vertical slits, the patient may convert the enclosure to a form of pocket that may hold light material objects. It also allows for sealing of the exteriorly connecting vertical slits when the weather is cold. 
     Referring now to FIG. 4, in an alternate embodiment, on the inner aspect of both the front and back portions of support garment  10 , narrow strips of strap-like cloth  40  are either sewn in separately, or manufactured as an integral part of the garment itself. These straps are on either side of the garment and run from the superior aspect of panels  18 ,  20  over the shoulder of the garment and end at any level on the inner surface of the back of garment  10 , ranging from the superior seams of the garment to the lower edge of the garment. Referring to FIG. 5, on the inner wall of the back of the garment, straps  40  may be connected for additional strength by, e.g., a transversely running strap  42  of similar or greater size. Alternatively, straps  40  may, e.g., be crossed. These strap-like modifications, preferably manufactured as an integral part of the clothing, further strengthen the garment to withstand any tensile stresses that may be generated by the weight of a suspended upper extremity. This modification is preferred in garments for large individuals but may not be necessary, particularly for small sized individuals, as the secured pouch alone should withstand the weight of the extremity. 
     Additional accessories can be added to the arm support garment as completely detachable attachments, which may be necessary for a selected number of patients. Referring to FIG. 6, such accessories include a restraining strap  46  that can be attached to the exterior surface of the garment to secure the exposed elbow of the enclosed forearm in the pouch and prevent it from sliding outward. Strap  46  can be fixed to the rear of the garment (permanently or detachably) on the side where needed, placed around the patient&#39;s elbow and secured in the front of the garment, e.g., near the vertical slit bearing the extremity, and secured by using a snap-on button, Velcro, or any other attachment means. This restraining strap can be applied either to the standard form of use of this garment or to the reversed form of this garment. 
     The sizing of the arm support garment ranges from the petite size to an extra-large size in consistence with established standardized sizing dimensions. The garment can be worn as a primary garment, or as over clothing. When the garment is worn over other clothing, the appropriate sizes will be larger than those that the individual normally wears. 
     The arm support garment of the invention can be in the form, e.g., of a shirt, T-shirt, jacket or a gown with necessary modifications to allow for this invention. The color and design can be those of any textiles selected by the manufacturer. 
     The choice of material for the arm support garment is such that it can withstand mechanical deformation in the form of twisting, stretching, shearing, and abrasion. The material used should have a reasonable tensile strength (over a relatively wide temperature, particularly with washing) and a high modulus of elasticity, as well as abrasion resistance, particularly when used with an extremity bearing a cast. Cotton or surgical fiber fabric material, or any other material or combination of materials that satisfy one or more of these criteria, may be used for the purpose of this invention. Textile design modifications in line with current practice will be necessary to make this garment wearable in its reversed form. 
     While the present invention has been described in conjunction with a preferred embodiment, one of ordinary skill, after reading the foregoing specification, will be able to effect various changes, substitutions of equivalents, and other alterations to the compositions and methods set forth herein. It is therefore intended that the protection granted by Letters Patent hereon be limited only by the definitions contained in the appended claims and equivalents thereof.