Note: Descriptions are shown in the official language in which they were submitted.
1299951
- 2 - 64283-7
The present invention relates to a splint device for
the spinal immobilization of a patient and more particularly to
such a splint device wherein the majority of the splint is formed
integrally from a synthetic plastics material.
Splints of the type to which the present invention
relates are frequently used in emergency situations such as auto-
mobile accidents in which the patient has suffered injury, or
suspected injury, to the back or neck areas. The handling of such
injured patients requires special care in order to avoid further
injury to the patient during the patient's extrication from the
site of the accident and his transference to a hospital. Conven-
tional stretchers do not meet the needs of such patients as it is
often necessary to extricate the patient from a wrecked auto-
mobile, building site or some similar location where the patient
cannot be disposed easily onto a stretcher. In these cases it is
conventional to endeavour to immobilize the spinal column of the
patient. Conventional splints of the type to which the present
invention relates are made from a plurality of pieces such as wood
and flexible fabric materials (see United States Patent 4,211,218).
It has not previously beèn considered possible to form such a
splint from a single unitary plastic moulding due to the require-
ments that a central portion of the splint is required to be sub-
stantially rigid and inflexible while wings extending laterally
from the central support portio~ are required to be flexible such
that they may be wrapped around portions of the body of the patient
to hold the spine of the patient against the central support
~29995~
3 642~3-7
portion of the splint.
The present invention consists in a splint device for
the spinal immobilization of a patient, comprising a generally
rigid central support portion adapted to extend from the lumbar
region to the head region adjacent the spine of a patient, two
pairs of laterally extending flexible wings attached to the side
edges of the support portion, a first pair of the wings being
adapted to extend about the head of a patient, and a second pair
of the wings being adapted to extend about at least one of the
thoracic and lumbar region of the patient, first engagement means
adapted to retain the first pair of wings about the head of a
patient and second engagement means adapted to retain the said
second pair of wings about at least one of the thoracic and lumbar
regions of a patient, the splint device being characterized in
that the central support portion is formed integrally with the
wings from a synthetic plastic material and has a longitudinal
cavity and includes within the cavity a plurality of longitudinal
and diagonal stiffening ribs adapted to render the central support
portion substantially inflexible laterally along its length.
~299951
- 4 - 64283-7
rrhe stiftenlng ribs positioned wlthin the concavlty
serve to give the central support portion rigldity and
inflexibility suf~icient to adequately support the splne
of the patient from movlng in a way which could dan,age the
patient's spinal cord if the patient's vertebrae have been
damaged. These stiffening ribs serve to mechanically
rigi~ify the plastics material which has been selected
specifically to give flexibility to the wings whlch are
formed integrally with the central support portion. The
central support portion itself, is preferably concave on
the side proximal to the side which will come into contact
with a patient in use and the integrally formed ri~s, or
at least some of them, preferably run diagonally of the
central support portion. The use of at least some
diagonal ribs in the concavlty provides improved torsional
rigidity as compared with ribs which only run
longitudinally and~or transversely of the central support
portion of the splint device. In a particularly preferred
embodiment of the invention two sets of substantially
parallel diagonal ri~s are provided in the concavity, ribs
of the respective sets intersecting. Such an array of
intersecting diagonal ribs may be combined with one or
more longitudinal and/or transverse ribs.
In a particularly preferred embodiment of the
invention a closure panel is provided on the central
support portion to cover the concavity and the integrally
formed stiffening ribs contained therein. I'he closure
panel is preferably so connected with the central support
portion that its outer surface is flush with the outer
surface of the central support portion or any other
portion of the device with which it is contiguous. In
this way the splint device may be given a smooth exterior
shape such that it may readily be positloned about a
patient even if it has to be slid between the patient and
`~ 129995~
a car seat or the like on whlch the patlent wac positlonea
when the accident occurred.
The wings must have sufficient flexibillty to allow
them to be freely posltioned about the patient. In one
em~odiment of the invention each wing of at least one palr
of wings is formed with a plurality of spaced apart,
substantially parallel and longitudinally extendlng,
integral hinges. These hinges need to be qulte numero~s
in order to provide the wings with the desired
flexibility. In a more preferred em~odiment of the
invention the wings of at least one pair are each tormed
of a moulded sheet (formed integrally with the central
support portion) of the synthetic plastics material and is
of such a thickness and the synthetic plastics materlal is
so selected that the wing is inherently flexible. It is
particularly preferred that the thic~ness of the wing
tapers, continuously or discontinuously, from a position
adjacent the central support portion to a position
adjacent the free end of that wing. It is particularly
preferred that each wing tapers from a thickness of from 3
to 5mm adjacent the central support portion to a thic~ness
of from 0.5 to 2 5mm adjacent the free end of that wlng.
It is also particularly preferred that the wings, and
therefore the whole splint device, is formed ot
polypropylene.
The wings of at least one pair are, in a most
preferred emoodiment of~this invention, formed of such a
sheet of synthetic plastics material which tapers slightly
towards its free end as has been described and whicn is
formed wlth an array of longitudinally extending,
su~stantially parallel, corrugations, each of which
extends part way across the width of the wing but without
making contact with the edge thereof. Each of these
corrugations preferably extends through the full thickness
of the wing. Each corrugation lS prefera~ly separated
` 12999S~
~,
from the next a~jacent corrugation by a planar portlon o~
the wing which portion has a width of from ~.3 to 3.0
times the width of the corrugation. These corrugations
provide to the wings a longitudinal stiftness wlthout
inhibiting the treedom with which the wing may ~e wrappe~
around the appropriate region of the patlent's anatomy.
This longitudinally stiffness is desirable to stop one
wing "riding" up or down on the patient's body relatlve to
the other wing to which it is connected by the respective
one of the engagement means.
In a preterred embodiment of the invention the tirst
engagement means comprise a pair of straps adapted to ~e
passed around the forehead and chin respectively of a
patient an~ connected at each end to one or other oi the
first pair of wings. The second engagement means
preferably comprises straps adapted to pass around the
legs and abdomen of a patient. The straps are prefera~ly
connected to the second wings by releasable clips or
buckles or are formed in two parts each of which is
connected to one of the second pair of wings, the strap
parts being connectable together oy releasable clips or
buckles.
There are situations where a patient's anatomy is
such, or where the patient's position after an accident is
such, that it is not appropriate or desirable that the
part of the central support portion in the region of the
head of the patient be in axial alignment wlth the part o~
the central support portion in the thoracic or lumbar
region of the patient. The second aspect of the present
invention addresses this problem by providing a hinge
between these parts of the central support portion. 'rhis
hinge can preferably operate over a range of about 30
with the parts in alignment at one end o~ the range and
out of alignment by the full 30 at the other end o~ the
range. It is important that locking means are provided to
299951
- 7
releasably retain the two parts in s~bstantlally any
desired relative angular relationship.
In a preferred embodiment of the invention the n1nge
comprises tubular members on each part adapted to ~e
arranyed in axial alignment such that they lnterdlgltate
with one another, the locking means comprising bolt means
extending axially through the interdigitated tu~ular
members and means on the bolt means to releasably clamp
the tubular members together by axial pressure on the
opposite end ones thereof.
Hereinafter described by way of example only, are
preferred embodiments of the present invention described
with reference to the accompanying drawings, in which:-
Figure 1 is a perspective view of a splint according
to the present invention in position on a patient;
Figure 2 is a front elevational view of the splint ofEigure 1 without fastening means and with the cover plate
removed;
Figure 3 is a cross-sectional view along III-III of
the splint according to Figure 2;
Figure 4 is a cross-sectional view along IV-IV of the
splint according to Figure 2;
Figure 5 is a rear elevational view of the ~.ead
portion of the splint according to Figure 2;
Figure 6 is a cross-sectional view along VI-VI of t~,e
splint according to Figure 2,
Flgure 7 is a longitudlnal sectional view through a
cover plate for attachment to the splint of Figure 2
showing an enlargement of a nipple for connection of the
3~ cover plate to the splint;
Figure 8 is an exploded perspective view of a portion
of a splint according to this invention showing a hinged
connectlon between the head portion and the thoracic
portion of the support portion thereof; and
Figure 9 is a cross-sectional view through the hinge
~ 1299951
of the embodiment of the inventlon depicted in Figure ~.
The splint device 10 according to Eigs. 1 to 7
comprises a central support portion 11, a first pair o~
wings 12 and 13 adapted to extend abo~t the head of a
wearer, a second pair of wings 14 and 15 adapted to exten~
about the body of a wearer, a first pair of straps 16 and
17 adapted to hold wings 12 and 13 about the wearer's head
and a second pair of straps 18 and 19 adapted to hold
wings 14 and 15 about the wearer's body.
The central support portion 11, as is best seen in
Fig. 2, is rectangular and concave, being recessed on its
side proximal to the patient. The central support
portion 11 comprises a pair of inclined end walls 21 and
22, a pair of inclined side walls 23 and 24, and a bacK
wall 25. ~ithin the recess formed by the end walls 21 and
22, the side walls 23 and 24, and the back wall 25 are a
plurality of stiffening ribs. One stiffening ri~ 26
extends longitudinally of the recess; one set of ribs 27
extend diagonally across the recess in one direction; and
a second set of ribs 2~ extend diagonally across the
recess in a direction transverse to the set of ribs 27
such that there is a minimum included angle therebetween
of approximately 60. Each of the ribs 26, 27 and 28 is
formed integrally with the central support portion and
extends from the back wall 25 up to a level flush with a
ledge 29 WhiCh surrounds the recess. At the point of
intersection of some of,the ribs 27 and 2~ an enlarged
boss 31 is formed. Each ~oss is formed with an axially
extending bore ~2. At it upper end each bore 32
is constricted by an annular, inwardly directed flange 33.
The back wall 25 is itself provided with two
indentations 20, one spaced eguidistantly on each side of
rib 26 midway between the zones over which the wings 12
and 13 join the central support section 11. The
indentations 20 are of such a depth that the back wall 25
,~ .
129995~
- 9 - 64283-7
is, over the areas of the indentations 20, flush with the free
edges of the ribs 26, 27 and 28 and the ledge 29. These indenta-
tions 20 add further to the stiffening of the central support
portion provided by ribs 26, 27 and 28.
The central support portion 11 includes a substantially
planar extension 34 at its head end in which is formed an aperture
35 by which the splint 10 may be carried. The aperture 35 is
strengthened by a peripheral rib 36.
The first pair of wings 12 and 13 are substantially
planar having a thickness adjacent to the central support portion
11 of 3mm and tapers to 1.5mm adjacent its free edge. The outer
face of each wing is provided with two pads 37 of a "hook and
loop" fastener material such as that sold under the trade mark
"VELCR0". Each of the straps 16 and 17 is provided on its inside
surface adjacent its ends with a complimentary pad (not shown) of
the fastener material.
The second wings 14 and 15 are each provided adjacent
their free ends with two pairs of apertures 38, 39, 40 and 41,
each of which is surrounded by a stiffening rib 42. The strap 18
is adapted to be connected at its ends to a respective pair of
apertures 38, or, in the case of a patient of slight build, to the
apertures 40. Similarly, strap 19 is adapted to be connected at
its ends to apertures 39 or 41. Each of the straps 18 and 19 is
provided with a buckle, 43 and 44 respectively, allowing the strap
to be rejoinably broken intermediate their respective ends.
129995~
- 9a - 64283-7
The lower edge of each of the wings 14 and 15 is provi-
ded with a pair of apertures 45 and 46 which are each surrounded
by a strengthening rib 47. These apertures 45 and 46 are adapted
to be connected to straps encircling the patient's thighs if that
is required for the safe handling of the patient.
1299951.
1 (,
~ ach of the wings 14 and 15 is providea with a
plurality of elongate, substant1ally parallel corrugations
47. Each corrugation 47 stops short o~ the free edge ot
the wing 14 or 15 and serves to provide lonyitudlnal
stiffening to the wing which not restricting its
flexibility as it is wrapped around the body o~ a
patient. The wlngs 14 and 15 taper in thicKness trom
about 5mm adjacent `the central support portion ~1 to a~out
2.5mm adjacent its free edge.
A cover plate 48 is provided to cover over the recess
in the central support portion 11. Tne plate 4~ is
provided on one face with detent devices 49 made up of a
pair of divergent f1ngers 51 each of whlch is provided
adjacent its free end with a radially outwardly projecting
protruberance 52. The detent devices 49 are adapted to
project into the bores 32 in bosses 31 of the central
support portion 11. The protruberances 52 on fingers 51
engage behind respective flanges 33 to hold the plate 48
in place on the central support portion 11. The free
edges of plate 48 nest into the ledge 29 surrounding the
recess in the central support portion 11 and the face of
the plate 48 carrying the detent devices 49 lies flush
with the free edges of the ribs 26, 27 and 28 and the back
wall 25 in the region of indentations 20.
The central support portion 11 and wings 1~, 13, 14
and 15 are formed integrally in a single moulding from
polypropylene which is by its nat~re reasonably flexi~le.
By providing the central support portion 11 with a recess
containing the array of ribs 26, 27 and ~ the central
support portion 11 is rendere~ sufficiently stiff to allow
a patient's bac~ to be immobilized while the wings retain
the resilience and flexibility to be wrapped around a
patient. The fact that the whole splint 10 is formed of
essentially X-ray transparent materials allows a patient
to be examined by X-rays without being removed from the
2999Sl
splint.
The second aspect of the invention will now be
described wlth reference to Figs. 8 an~ g. Slmilar parts
of the splint 1~ o~ this e~odlment will receive the sanle
nu~ers as they received in the description relating to
Figs. 1 to 7. In all respects except the provislon of a
hinge the splint 10 is identical with the splint 10
earlier described and for this reason the whole splint 1
is not described.
The hinge 60 is provided in the central support
portion 11 between the indentations ~0 and the start o$
the wings 12 and 13. The head part 61 of central support
portion is provided with an end wall b2 and projecting
from the end wall is a transversely extending tube 63
having a hexagonal bore 64. The tu~e ~3 has its axis
parallel to the plane of the ~ac~ wall 25 and at right
angles to the axis of the central support portion 11. The
tube 63 is centrally disposed on wall 62 and is
su~stantially shorter than it.
The body part b5 of the central support portlon is
provided with an end wall 66 from which extend a pair of
spaced apart transversely extending tubes b7 and b8 each
of which has a hexagonal bore 69 and 71 respectively.
The hinge includes four tu~ular locking pieces 72,
25 73, 74 and 75 formed of structural plastics material such
as nylon. Each of the locking pieces 72, 73, 7~ and 7
includes a hexagonal body part 76 and a flange 77
extendlng radially fronl one end of the body part. 'rhe
face of each flange 77 distal to the body part 76 includes
a plurality of radially directed teeth 78. A circular
section bore 79 extends longitudinally through each of the
locking pieces 72, 73, 74 and 75.
q'he locking piece 72 is positioned within ~ore 69 of
tube 67 with its flange 77 facing inwardly and similarly
locking piece 75 is positioned within bore 71 of tu~e b8.
1~951
Loc~lng pleces 73 and 7~ are pos1tloned witr~ln opposlte
ends of bore 64 ln tube 63 wlth the tlanges 77 facing
outwardly.
~hen assem~led the teeth 78 ot respective palrs of
5 loc~ing pieces 72 and ~3 and 74 and 75 interdigltate.
rod 81 which is threaded at each end extends throug~,
respective bores 79 in locKing pieces 7~, 73, 74 and 7~.
A wing nut 82 is threadedly engaged with each end oi
rod 81. Each wing nut 8~ includes a irusto-conical tace ~3
1~ surrounding bolt 81 which engages with a corresponding
frusto-conlcal face surroundlng the bore 79 of the loc~ing
pieces 72 and 75.
In use, when it is desired to change the relative
angular inclination between the head part 61 and the body
15 part 65 o$ the central support portion 11 the wing nuts 8
are loosened to enable the locking parts 73 and 74 to
rotate relative to loc~ing parts 72 and 75 as the head
part 61 and body part 65 are rotated relatlve to one
another. ~hen the desired angular inclination has been
achieved the wing nuts 82 are again tightened forcing
ilanges 77 of loc~ing parts 7~ and 73 and 74 and 7~
together such that their interdigitatlng teeth 78 prevent
further relative rotatlon Detween head part 61 and body
part 65.
The positioning of tuoes 63, 67 and 6~ on the head
part 61 and body part 65 is sucn that the parts 61 and 65
may rotate relative to one another between a positlon ln
which they are in axlal align~ent to a positlon in whlch
they are 25 out o$ alignment.
