US3461864A - Traction device - Google Patents

Description

Aug- 9, 1959 R. L. coss 3,461,864

TRACTION DEVICE Filed Aug. 1, 1966 3 Sheets-Sheet 1 INVENTOR. 1; RAYMOND 1.. coss Aug. 19, 1969 R. L. cbss L 3,461,864

TRACTION DEVICE Filed Aug. 1, 1966 3 Sheets-Sheet 2 1 mvam'bn RAYMOND L. c o 55 Aug. 19, 1969 R. L. 0055 v TRACTION=DEVICE 5 Sheets-Sheet. 3

Filed Aug. 1. 1966 INVENTOR RAYMOND L-COSS BY A I United States Patent 3,461,864 TRACTION DEVICE Raymond L. Coss, 3503 Stoughton Road, Erie, Pa. 16506 Filed Aug. 1, 1966, Ser. No. 569,130 Int. Cl. A61f 5/04 US. Cl. 128-85 17 Claims ABSTRACT OF THE DISCLOSURE A traction device made up of two spaced track members that are adapted to be supported in a generally horizontal member, a Thomas splint adapted to receive a thigh of a person between its spaced legs, the one end of the tracks being attached to an intermediate part of the Thomas splint, a car-like member supported on the tracks and a Steinmann pin attached to the car, a tension member supporting the distal ends of the tracks and supporting the distal ends of the Thomas splint and a tension member connected to the car and to the distal end of the tracks.

This invention relates to surgical devices and, more particularly, to a mechanical device for angulation, rotation, and foot drop control in patients with fractures between the knee and ankle.

This device finds its application on patients with fractures between the knee and the ankle which are unsuitable, for various reasons, for closed reduction and casting because of (a) instability, (b) open fractures, (c) patients with associated injuries which pre-empt early definitive fracture treatment, and (d) burns or wounds of the leg which require in addition to treatment of the fracture, frequent dressing changes and/ or wound inspections.

It has been noted that there are widespread implications concerning applications of the device disclosed herein for such problems as upper extremity fractures including supracondylar and humeral shaft fractures.

A problem which develops with patients under treatment for tibial fractures in skeletal traction is foot drop. It is generally recognized that patients immobilized for extended periods of time in skeletal traction with a Steinmann pin or Kirschner wire passed through the os calcis develop the problem of foot drop which, in turn, becomes a serious rehabilitative problem in correction of the deformity. Presently available devices for the control of foot drop are, in general, clamped to the member which supports the leg. Skeletal traction delivered through the Steinmann pin or Kirschner wire then draws the foot distally until it makes contact with the foot plate, and, as it does so, traction is blocked from being delivered to the traction site while the foot plate supports the foot, Furthermore, migration of the patient in relation to the traction device cannot only cause the foot to press more firmly against the foot plate and actually deliver compressive or overriding forces to the tibial fracture site, but can also cause a continual variation in the mechanics of the skeltetal traction delivered to the fracture site, causing lack of traction control of the fracture site. Patients characteristically do adjust themselves in the traction because of discomfort caused by the Thomas ring as it bears on the genitalia or the perineum, or caused by discomfort under the leg by the supporting slings. The prin- Patented Aug. 19, 1969 "ice ciple involved in foot drop control in the device to be described below is that the foot drop support must travel freely proximally and distally on the member supporting the leg to transmit axial skeletal traction to the fracture site while still supporting the foot, maintaining steady traction allowing for changes in position of the patient in relation to the suspension-traction apparatus.

Rotation of the distal fragment.It is readily apparent that it is necessary to maintain a steady and efficient control of rotation of the distal fragment in fractures between the knee and the ankle treated in balanced skeletal traction suspension. This rotation control is readily obtained through use of the Steinmann pin as the primary rotation controlling element. It simply requires that the traction bow to which the Steinmann pin or Kirschner wire is attached and/or supported be provided with a mechanism for accurately obtaining and securely holding the proper degree of rotation to allow for anatomic reduction of the fractures.

Angulation at the fracture site.Presently popular methods of treatment of patients with fractures between the knee and the ankle qualified as in paragraph 1 employ the use of a Thomas splint and Pearson attachment with a Steinmann pin passed through the os calcis. The skeletal traction is then delivered by means of a rope which passes through a pulley which is attached to the overhead frame. It can be readily demonstrated that because of the fixation of the pulley to the overhead frame, instead of the member which supports the leg (i.e. the flexion attachment that the hip and knee of the injured extremity must move in perfect synchrony and in a predetermined fashion in order that anterior or posterior bowing forces are not brought to play at the fracture site. Seldom does the patient achieve this synchronous movement, and many times throughout the day and night, angulation forces are brought to play solely because of the attachment of the pulley to the overhead frame, instead of to the member supporting the fractured leg. The answer to this problem, of course, is to place the pulley at the end of the flexion attachment, allowing skeletal traction to be always in the axial line, no matter the position of flexion or extension of the hip or knee. A wide range of motion is allowable with many varied combinations of flexion at the hip and knee without change in the mechanics at the fracture site. Also, medial and lateral migration of the patient in bed is possible without disrupting the fracture.

Medical and nursing care problems resulting from anchoring the patient to the bed and limiting physical activity of the patient.0f the many devices presently available for the care of patients described in paragraph 4 of page 1, a characteristic common to most is the limitation of the amount of physical activity that the patient can carry out, and importantly, the amount of activity which can be allowed in the lower extremity itself. In addition, the location of the foot in bed is fixed at a single spot, not allowing the patient to shift about in bed at all. Further problems include nursing care problems such as linen changes and moving the patient on and off bed pans, massage of the skin and care of pressure sores which may develop over extended periods of bed confinement.

Purpose of the mechanical device for angulation, rotation and foot drop control.--As implied in the name of the device, this mechanical device is designed to control angulation, rotation, and foot drop in patients described afore while allowing for a much greater than previously achieved amount of mobility of the patient in the bed and freeing the patient from anchoring him for long periods of time to the bed in order to control the mechanics of the injured lower extremity.

It is accordingly an object of the invention to provide an improved traction device.

Another object of the invention is to provide an improved traction device, which is simple in construction, economical to manufacture and simple and efficient to use.

Another object of the invention is to provide a mechanical device for agulation, rotation, and foot drop control in patients having fractures between the knee and ankle.

With the above and other objects in view, the present invention consists of the combination and arrangement of parts hereinafter more fully described, illustrated in the accompanying drawings and more particularly pointed out in the appended claims, it being understood that changes may be made in the form, size, proportions, and minor details of construction without departing from the spirit or sacrificing any of the advantages of the invention.

In the drawings:

FIG. 1 is a schematic view of the traction device according to the invention;

FIG. 2 is an enlarged view of the trolley and associated parts;

FIG. 3 is an enlarged view of the end of the parallel bars remote from the splints;

FIG. 4 is an enlarged side view of a part of the trolley; and

FIG. 5 is an enlarged view of the clamp.

Now with more particular reference to the drawings, the traction device is suitable to be supported on a bed as shown in FIG. 1 with the weights W attached to the ropes shown and supported on a member M over the top of the bed. Suitable pulleys are shown for connecting these ropes thereto.

The major parts of the devices are the Thomas splints 13, the parallel rod 11 and trolley 18. The parallel rods are supported by means of a rope indicated and having a weight W on the distal end thereof and attached to clamps at bifurcated ends 61. The Thomas splint is supported by the rope R and has a suitable weight W on the distal ends while the rope K is attached to the loop L indicated and likewise has a weight on the distal end thereof.

Description of the mechanical device for angulation, rotation and foot drop control.(a) Angulation control mechanism: This mechanism consists mainly of two parallel stainless steel rods 11 which attach proximally by means of a hinge 12 to the Thomas splint 13 at the axis of the knee joint. The two parallel rods 11 extend in parallel fashion beyond the foot 14 of the bed, and are attached distally by means of a cross member 15 which provides for widening and narrowing of the width of the above mentioned steel rods 11 so that they may fit universally any sized Thomas splint 13. The cross member supports a pulley through which passes the rope 16 which delivers the skeletal traction to the injured leg 17.

(b) Description of the external rotation foot drop con- 'trol device.This device consists of a trolley 18 which passes proximally and distally on the angulation control device above mentioned by means of eight wheels 19, four above and four below. These wheels are brought to bear on the rods 11 of the flexion device in such a fashion that freedom of motion is attained in a proximal and distal direction, but complete stability of the trolley 18 is attained because of a grasping effect, not allowing the trolley to disengage the angulation control device. The trolley is provided with a cross member 20 which is adjustable as concerns width, so that it can, in concert with the flexion device be made adjustable to be used with any sized Thomas splint. The cross member supports a post 21 through which passes an eye bolt 22. The skeletal traction rope 16 is attached to the eye portion 23 of the eye bolt. The eye bolt then passes through a slot 26 in the above mentioned post 21 which is capable of being adjusted for raising and lowering the line of skeletal traction to be in the axial line of the injured member. After passing through the post 21, the eye bolt member 22 then passed through the bore 27 of the quadrant post member 28 serrated, proximally at 29 in a transverse fashion. This is the member which allows for adjustment in rotation and raising and lowering the eye bolt member 22, so that the proper degree of rotation can be attained, and so that the axial pull can be aligned perfectly and anatomically maintain the fracture in reduction. The eye bolt arrangement then passed through a traction bow 31 which has been modified to engage the quadrant post member with a quadrant which allows rotation. By placing a nut 32 on the end of the eye bolt member, one can tighten the nut 32, causing the rotation and foot drop control device to lock both in the proper degree of elevation and depression and in the proper degree of rotation to suit anatomic reduction of the fracture. The traction bow 31 itself, in addition to being modified as above described, provides a terminal member 44 having a slot 43 on each side into which is slipped the Steinmann pin 33 or a Kirschner wire, and a set screw 34 on the medial and lateral extremity to secure the pin 33. The foot drop control mechanism consists of a foot drop control device 35 which maintains an attitude perpendicular to the trolley 18 above described and parallel to the planar surface of the foot. The foot drop control device 35 is capable of sliding proximally and distally on the traction how 31. This allows the foot to be placed in the traction bow 31 and secured by means of the above described set screws 34 and then allows the foot plate to he slid into contact with the foot until the proper attitude of foot attitude is attained through contact of the foot on the foot plate. The foot drop control device 35 is then secured and locked to the traction how by means of set screws.

The foregoing specification sets forth the invention in its preferred practical forms but the structure shown is capable of modification within a range of equivalents without departing from the invention which is to be understood is broadly novel as is commensurate with the appended claims.

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. A surgical device comprising track means,

attaching means on a first end of said track means for attaching said track means to a splint,

a slidable member slidably supported on said track means,

attaching means for attaching said slidable means to a fractured body member of a patient,

tension means having a first end and a second end,

means attaching said first end of said tension means to said slidable means,

and means on said track means for attaching a second end of said tension means whereby said slidable means may be urged toward said second end tension means,

a splint comprising spaced rods,

means on one end of said spaced rods to receive a thigh of a person with the knee of said person extending between said rods,

tension means attached to said rods at the end thereof remote from said thigh receiving members,

and said attaching means being attached to said rods intermediate said ends of said splint.

2. The device recited in claim 1 wherein said tension means is a rope and said track means comprises two spaced parallel rods.

3. The device recited in claim 2 wherein said slidable means is a trolley and said trolley has spaced wheels thereon engaging said rods and supporting said trolley thereon.

4. The device recited in claim 3 wherein means is provided on said trolley for supporting a foot plate.

5. The device recited in claim 3 wherein said means attaching said first end of said rope to said trolley comprises an eye member,

and means to adjust the position of said eye member relative to said trolley, up and down relative thereto.

6. A surgical device comprising track means,

means on a first end of said track means for attaching said track means to a splint,

a slidable member slidably supported on said track means,

attaching means for attaching said slidable means to a fractured body member of a patient,

tension means having a first end and a second end,

means attaching said first end of said tension means to said slidable means,

means on said track means for attaching a second end of said tension means whereby said slidable means may be urged toward said second end tension means,

said means attaching means comprises a Steinmann pin and said Steinmann pin is attached to said slidable member by means of a traction bow,

said traction bow being rotatable relative to said slidable member about an axis parallelto said parallel rods,

and means to lock said traction bow to said slidable member.

7. A surgical device comprising track means,

means on a first end of said track means for attaching said track means to a splint,

a slidable member slidably supported on said track means,

attaching means for attaching said slidable means to a fractured body member of a patient,

tension means having a first end and a second end,

means attaching said first end of said tension means to said slidable means,

and means on said track means for attaching a second end of said tension means whereby said slidable means may be urged toward said second end tension means,

said slidable member has means thereon to adjust its width.

8. The device recited in claim 7 wherein said means to adjust the width of said trolley comprises a plate like cross member,

said trolley having wheel supporting members disposed generally parallel to said parallel rods,

a slot in each side of said cross member,

and means disposed in said slot for clamping said trolley members to said wheel supporting members.

9. The device recited in claim 7 wherein said trolley has four pairs of wheels,

each said pair of wheels having one wheel above said parallel rod and another wheel below a said parallel rod.

10. A surgical device comprising track means,

means on a first end of said track means for attaching said track means to a splint,

a slidable member slidably supported on said track means,

attaching means for attaching said slidable means to a fractured body member of a patient,

tension means having a first end and a second end,

means attaching said first end of said tension means to said slidable means,

andmeans on said track means for attaching a second end of said tension means whereby said slidable means may be urged toward said second end tension means,

said slidable member has means thereon to adjust its width,

said means to adjust the width of said trolley comprises a plate like cross member,

said trolley having wheel supporting members disposed generally parallel to said parrallel rods,

a slot in each side of said cross member,

and means disposed in said slot for clamping said trolley members to said wheel supporting members,

said means attaching said rope to said trolley comprises a post,

said post being pivotally supported on said cross memher,

a vertically disposed slot in said post,

means on said eye member extending through said slot,

and means on said eye member for locking said eye member in adjusted position relative to said slot.

11. The device recited in claim 10 wherein means is provided on said trolley to adjust said Steinmann pin up and down relative to said parallel rods,

and means comprises a post like member,

means supporting said post like member on said post for vertical adjustment thereon.

12. The device recited in claim 11 wherein means is provided on said trolley for adjusting the angular position of said Steinmann pin relative to said rods.

13. The device recited in claim 11 wherein said means to adjust the angular position of said pin comprises a said traction bow,

means pivotally attaching said traction bow to said post like member,

an arcuate slot in said traction bow,

locking means on said post like member extending through said slot,

and means to lock said locking means on the distal end of said locking means.

14. The device recited in claim 10 wherein said means to adjust the angular position of said pin comprises a said traction bow,

means pivotally attaching said traction bow to said post like member,

an arcuate slot in said traction bow,

locking means on said post like member extending through said slot,

and means to lock said locking means on the distal end of said locking means.

15. The device recited in claim 6 wherein means is provided for adjusting said Steinmann pin up and down relative to said parallel rods.

16. A surgical device comprising track means comprising horizontally spaced track rods adapted to freely receive a part of the leg of a person therebetween,

a splint having spaced splint rods, said track rods having means at one end for attaching to intermediate portions of the splint rods,

means on a first end of said track rods for attaching said track means to a splint,

a slidable member slidably supported on said track means,

attaching means comprising a tension member for attaching said slidable means to a fractured body member of a patient,

tension means having a first end and a second end,

7 v 8 means attaching said first end of said tension means References Cited saldshdablemeans, UNITED STATES PATENTS and means on said track means for attachlng a second end of said tension means whereby said slidable 439:255 10/1890 Ruebsam 128-434 means may be urged toward said second end tension 5 2920362 11/1935 Longfellowmeans 2,024,325 12/1935 Ailen 128-84 XR and a tensile force is exerted on said body member. 2,052,990 9/1936 Slebrandt 12885 17. The surgical device recited in claim 16 wherein a. FOREIGN PATENTS foot drop control device 1s fixed to said slidable member 470,579 6/1936 Great Britain.

and adapted to have the sole of the foot of a person rest- 10 ing against foot drop control. L TRAPP, Primary Examiner

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