US2325300A - Fracture appliance - Google Patents

Description

July 27, -1943. H. L. BlsNoFF 2,325,300

FRACTURE APPLIANCE Filed Nov. 2, 1942 5 Sheets-Sheet l INVENTOR #Af/ y MA/OFF A TORNEYv July 27, 1943- H. L. BlsNoFF 2,325,300

FRACTURE APPLIANCE Filed Nov. 2, 1942 5 Sheets-sheet 2.

INVENTOR @www ,QW

ATTORNEY July 27, 1943. H. BlsNoFF FRACTURE APPLIANCE Filed Nov. 2, 1942 3 Sheets-Sheet 3 54m/OF5 ATTORNEY Patented July 27, 1943 FRACIUREAPBLIANC y Harry L. Bisno, JamaicapN. Y.A

" 'Application November 2, 1942, seriall No. Genes j 6cialmsfl.'` 12e-e7) l This,inventionrelatesto anappliance for use in the treatment of, malformations; dislocations, fractures and diseases of the jaws, 'as well as bone structures contiguous thereto;

An important object 'of thepresent invention is to provide an appliance ofthe character alv luded to, which is simple in construction, permits of a Wide range of adjustment' andusage, enables a ready shifting of the accessory appended elements customarily employed in conjunction with apparatus of this character, and is capable of such diverseand numerous applicationsas to substantially preclude the use' of other appliances heretofore employed.v Y

`More specifically, the present Vinvention involvesa headband adaptedby very simple means andv equally' simple manipulation, to engage or receive in anyone -of a plurality of! positions therealong, supporting,Y traction, retention or oompressionwires or implements, and other instrumentalities usually availed of in the treatl ment of fractures, dislocations, malformations, etc., ofthe bone structures above referredtol For instance, fractures of the `mandible `and maxilla are of commonY occurrence, and yfre'- quently accidents producing such fractures also produce fractures,v impactions, etc., of the palate, maler and nasal' bones.y Furthermore, these fractures may be simple, singular, multiple, `bilateral, Cempound'orcomminuted. They may be transverse; vertical', or oblique; or the "parts may b'e'separated 'bylcrushing or there may be loss of bone due to the incursion of vbony necrosis, and so on. It will be apparent that the number and diversity o'i'devices and instrumentalities,required tdhandle such variegated pathological and surgi, calI states wouldfordinarily be imposingyto say the least'. l

It the commendable virtue of my appliance that 'it provides an instrumentality for simply copine- With a large number' of such conditions which have vheretofore required sometimes cumbersome, if not multipla-apparatus, as well `as requiring' val very expert technique` It will be apparentjthere'iore, that an appliance sogarnenableto readyfadaptability under such -diverse complications isof the utmost profes-f sional utility, and it is this Veryv adaptability and versatility that is stressednherein as of the essence of thev present invernzion., v

For example; iii-any case where fractures or separations, etc.; occur,` it isthe common procedure toresort to what is known as intradental orv interden-tal wiringgorjto apply a splint made of-varieus materials,er to` employ bandages.- In

the'case ofswiring', a Wire `is looped yaround 'one` or moreteeth on feachside' of thev `fracture as well zas around one: or'fmoreteeth of the opposite jaw vto vlering;-` theparts into propenpositive occlusion. Where. there is displacement of a fragmentsor partofrthe `jaw, laterally7 anteriorly,-or4 posteriorly, or overriding,zfit isxthe practic'efto rst endeavor to reset the so-displacedy part into 'its' normal position, and apply. xation in the manner above described; Enterdental -wiringnis only one or themeansemployedfor splintingl l the 4fracturedfmemloer.; casting, ligation and other means vfor,bringing thelpa'rts .into alignment bej ingemployed; co'ordingto the necessities ofl the case.r Interdental wiring frequentlyv is ,not enoughtraction pressure; or whatever, must be applied irl-order to assureproper occlus'alap; postion'betweenthe teethof the upper andlower jaws; hence) .the upper and lower jaws are usually Wired together; as by interdental v-wirin'gwith traction, etc. Butv this tractio-nvis. ordinarily no simple business; sovvhe're interdentalv wiringv is.

employed auxiliary to external traction,a 'loop is twisted in ,theA linterdental wiringl and made to project through' the 'mouth inY order thatf-itv may proper degree and-direction i of traction" (support,v Y

retention or' pressure)v may beeiected, without change `in'"structure ofrm'yappliancefas ywill'be presently-illustrated. 1

In. the accompanying drawings, my appliance is 'showmboth in detail construction, and as applied to thecor'rection or treatment of various `bone l structures of the face. 1

YFig; -1 isa front View'oil'my device arranged'to eect lateral "traction on the'maxilla or mandible, as the; case may b'ewith the chin support' in position. l l

Fig; 2 is aside-View of Fig. l, showing inaddition Aa I lateroposteriorly*disposed traction Wire. 'Fi'gf Lluis a `partially"pseudcsaggfital section of a human skull with my appliance in'sectional View on'the-line 3--3 of Fig; 1;

Fig.V 45'-`ifs-a"threequarter rear view of 4my de-l vice i-nwhich thechin and head straps havelbee'n dispensedv'vithlV V Fi-g. frisl a frontupperthreequarter'view show-'1 mg' rey-headband with chin strapsl attaehed, and carrying 'l al s lidable bracket or 'yoke supporting attachments for' correcting nasal deformities;

tion, a latero-posterior traction Wire or device.

Fig. '7 is a side View of my headband, in part, with a suitable attachment supported by overhead tape'or strap, which attachment supports tension or traction wire, elastic, etc., for exerting traction or tension of the maxillae or malar bone or other structures.

Fig. 8 is'a partial side view of my headband with attachment for use in the support, retention or alignment of thepalate. y i

Fig. 9 is a partial side view of my headband with attachment for correcting nasal deformities and the like.

Fig. 10 is a modification of Fig. 7, and showing a smaller attachment for use closer to the face, and used similarly to Fig. '7.

y Throughout the drawings, like .numerals indicate like parts.

My device comprises a headband I not quite entirely encircling the head. At the rear, the headband is bifurcated'at both ends, the upper extensions 2,-"2, embracing vthe back of the head on' a line, approximately, withthefront portion of the headband," or the back part `of the crown of the headjfwhile the lower extensions 3, 3, slant downwardly Vand underneath the back or vocciput of the' head. Adjustablestraps 4, 4, pivotally rivetedat one end as at 4a, unite the respective extensions to each other, and enable the headband to `be adjusted to a wide range of sizes and variable inclinationsof extension 3, 3. The inorder to provide right, left, or directly forward (anterior) traction. The member I5a extending from the traction wire I5 to the loop ISa of the interdental wiring I6 may consist of a rubber band or wire If the member I5a -be a rod, obviously the traction wire I5 may also be adjusted for compression or retention.

In Fig. 2, there is shown another traction wire I'I, the ends of which are disposed in perforations 8, 8, toward the rear ofthe band 1. Said device I'I also extends downwardly. The function thereof, as clearly illustrated in said Fig. 2, is to exert traction on the posterior portion I8 of the mandible, fractured as shown, substantially across the angle of that bone, or for any fracture in the mandible or maxilla. requiring backward traction. A screw ISI is shown as temv porarily embedded in the bone Structure of fragside `oiE :the headband is lined with felt, cotton,

.9: is also ystitched or otherwise attached to the frontof theheadband, extendingvertically above and.v between theleyes, theperforations therein being rlocatedzone abovethe other.

`In, order more securely to position or stabilize theheadband on the head, straps VIl),.are provided (see Figs. 1,2, 3, 5, 7, 8, 9 and 10, for example). ,In order to provide for further possible implementation of the device,two pieces of leather VII,-are stitched tothe headband in such a wayas to provide means thro-ugh which wires, ligature, tape or the like may be-passed andthus stored for ready access (seeparticularly Figs. 1

and 5). l v 5 A chin cupA I2is also provided for supporting the mandible or lower 'jaw and is connected to the headband by straps I3a,- I3b, respectively, two on each side. The posterior straps I3?) may be. attached at their upper ends to buckles/or loops I4, Which are in turn pivotally attached to the headband, so as to enable the said rear strapsISb, to swivel and thereby permit oblique orA vertical. support.` There are also provided loops I4c to which the straps I3b may be attached, if so desired. v l;

It will be seen from the several figures that the prime purpose of the perforated band 1 is to provide a convenientinstrumentality forI receiving, engaging or accommodating-the laterally bent ends of traction wire I5, and other similarly bent attachments, which maybe inserted into any pair of holes in the-series of perforations 8, 8, in said band. The traction wire I5 may be readily shifted .from one side to therother in nient I8, which screw is connected by a traction| tie Wire, rod or rubber band 20, to the traction device i l. rThis latter arrangement is usually employed where there has been what is known as an overriding fracture, traction being required to be placed on thev posterior fragment to vmaintain or bring the latter into alignment with the main body of themandible. For this purpose also a hole may be drilled through the bone and a wire passed through and connected toy the traction bar-51;

It should be noted that the traction wire which I employis preferably of such character as .to be readily lbent intodesiredfform or shape and yet resilient enough to apply the necessary degree of traction or compression as andfwhen required.

In the vertical perforations of the strip 9 ink the fore-part of theheadband (see Figs. 1, 3, 5 and 8),` are adapted tobe inserted, as shown in Fig. 3v particularly, the two ends of a wire 2| which` has been yformed with a loop 22 by twisting the saidwire. This loop 22 may be used for attachment of either a nasal or a palatal yappliance. l 1 y The ends of wire 2I are inserted in the vertically spacedapart apertures in the strip 9, and passing through the loop'22 is a, rod 23, the lower end of which is bent inwardly and upwardly and then rearwardly, so as to provide a support for the palate. The upper portion ofthe member 23 is `threaded as shown at 23a, A knurled, internally threaded collar 24 is engaged to ride up andldown the threaded portion of member 23 soa-s to ,adjust the necessary tension or 'traction onvthe palatal structure. 1 E, Referring now more particularly to Figs. 5 and 5: there is disclosed an arcuately formed, horizontally-disposed rod y25, the ends of which are 'disposed in apertures 8, inthe band l. Along the rod 25 ride perforated bracket members 2B, adapted to receive severally the arms of a U- shaped yoke or member 2'I. Depending from, but attachedV to said U-shaped member, are two hookedmembers 28, adapted to enter the nasal orices, so that when the yoke member 2l is properly raised or lowered, the essential uplift or traction or tension will be applied. When this position has been determined, set screws 29, are tightened. Lateral movement is prevented by tightening set screws 29a. v

InFig. 9 only a'single bracket 30 is shown and a single rod 3I fornisposition in the nasal orice. Set screws 32-and33 are provided` for maintaining the threaded rod 3i securelyin place.` Referring-to Figf'lz the headband may be Aemployedv to receive a. horizontally disposed metal loopor clip 35, the en ds -ofwhichare disposed L.in Figs. 2, 4 and 6, respectively, the bifurcated portion 3 is pro-vided with a leather strip 4l, one end of which may be Stitched or otherwise attached to the band beneath, while the other end may be attached preferably by means of a snapfastener da, so as to facilitate kthe reception of an arm of traction wire 4S, as clearly shown in Fig. 6.

It is quite apparent from the above exhaustive disclosure that my device is susceptible of use in divers connections which will readily suggest The numerous apthemselves to oral surgeons.

ilperiiures 3, of band '1.k This arrangement, as 1 band having an underlying band and an overlying band having a series of perforations therein` through which the ends of a wire are adapted to be inserted and between which bandssaid ends are adapted to be maintained.

2. An appliance for use in the `treatment of fractures, malformations, etc., of the jaws and contiguousbone structures, comprising aheadband having an underlying band of leather and an overlying band of leather having a series of perforations therein, through which the ends of awire are adapted to be inserted and between which bands said ends are adapted to be maintained.

3. An appliance for, use in the treatment of fractures and malformations, etc., of the jaws and contiguous bone structures, vcomprising a headband having an underlying band and a perforated overlying band, and a device having its y ends passing through a pair of said perforations l and disposed between said overlapping bands.

plications disclosed are intended to suggest tothe art the manifold possibilities of the foregoing 'ap-- paratus. Other applications will readily occur to those operating in the field, and having indicated them, applicant proceeds to claim what he deems n to be his invention. Before doing so, applicant wishes to point out that the most satisfactory material out of which to make his headband consists of a base layer of felt, with successive layers of leather, overlaid; but applicant has no in- 4. An appliance for use in the treatment of fractures andl malformations, etc., of the jaw and contiguous bone structures,y comprising a headband having an underlying leather band and a perforated overlying leather band, and traction and retention wires and appliances having the ends passingthrcugh said perforations and accommodated between said bands, with supplemental attachments, contained on or attached to4 said wire. c

5. vAn appliance for use inv oral, plastic or repair surgery comprising a headband i having a medial strip provided'with vertically arranged perforations.

6. An appliance vfor use in oral, plastic or repair surgery comprising a headband having a medial strip provided with vertically arranged-perforations, and alooped wire having its ends disposed in said perforations. y

" HARRY L. BISNOFF.

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