US2397648A - Splint - Google Patents

Description

. April 2, 1946;

J. C. BUTLER sPLm'r Filed Jan. 21. 1943 2 Sheets-Sheet l V April 2, 1946. J. c. BUTLER 2,397,648

- SPLINT' Filed Jan. 21, 1943 2. Sheets-Shet 2 QJacoZ [7877? Beaver" Patented Apr. 2, 1946 UNITED STATES PATENT OFFICE 2,s97,c4s SPLINT Jacob Clem Butler, Milford, Del. Application January 21, 1943, Serial No. 473,122

' (c1. 12s s7) 11 Claims.

The present invention relates to splints, and more particularly to a two-piece external splint for use in the treatment of a broken, dislocated, or fractured mandible.

The principal object of the invention is to provide a practical splint adapted for universal use in the treatment of mandibular injuries and which splint is capable of use for such treatment irrespective of the size and/or shape of the mandible and which can be adjusted to apply various ypes of stress, as required.

Another object of the invention is to provide an external mandibular splint that can be used in combination with interdental typ s of splints, particularly where it is desired to maintain immobility of the mandible.

Another object of the invention is to provide an external mandibular splint adapted for use in either edentulous or dentulous types of fractures.

Still another object of the invention is to provide an external mandibular splint that may be quickly applied and adjusted for either emergency use until the patient is hospitalized, or for permanent use.

Still another object of the invention is to provide a mandibular splint that may be easily and quickly removed, if necessary, even by the patient himself in case of nausea, thereby avoiding possible strangulation.

A further object of the invention is to provide an adjustable externalmandibular splint contoured to fit the curve of the lower jaw and thus support the mandible during the bone-knitting st ge.

Still a further object of the invention is to provide a mandibular splint which will permit X- rays to be taken of the mandible while the splint is held in placel A still further object of the invention is to provide a mandibular splint made of plastic, hard rubber, etc., that may be readily cut orfiled away to permit access for surface treatment, particularly in case where the fracture of the mandible is due to a gunshot wound or shell fragment.

A still further object of the invention is to provide an external mandibular splint that may be attached to the head by means of straps or buckles, or by means of ordinary bandage.

Other and further objects of the invention will be apparent from the following description, taken in conjunction with the accompanying drawings, in which:

Figure 1 illustrates the two section mandibular splint of the present invention held in place on a patients face by attaching means comprising suitable straps and buckles cooperating ing the splint and attaching means as they appear in a full-face view;

Figure 3 is an enlarged sectional viewthrough one of the splint sections, taken on the line 3-3 of Figure 1, and particularly illustrating one manner in which the loops or fastening members may be embedded in the splint material; I

. Figure 4 is an enlarged sectional view through one of the splint sections, taken on the line 4-4 of Figure 1; q

Figure 5 is a view of the splint sections as viewed from the side thereof which engages thechin and lower jaw; and v v Figurefi illustrates the manner in which the splint sections may be attachedby ordinary bandage material to apply protrusive stress. w

Referring now to the drawings, the splint is generally indicated by the numeral I, and comprises two sections 2 and 2a which normally are identical in shape and configuration, except that one is generally contoured to fit the right side of the chin and jaw and the other is contoured to fit the left side. As will be apparent from Figures 1 and 2, each of the splint sections 2 and 2a includes a chin-engaging portion 3 at its forward end adapted to be positioned in engagement with the frontal portion of the chin, and a temple portion 4 at its rear end and including a part; 4a extending upwardly to a point adjacent the ears (not shown). Each of the splint sections also includes a lower inwardly curved portion 5 extendw ing rearwardly from the chin-engaging portion 3 toward the temple portion 4 and. adapted engage the underside of the jaw. H I

The distance between the chin-engaging portions 3 of the splint sections 2 and Z'a is adapted to be varied to suit the width of the chin and lower jaw angle of various patients. Thus, a fastening member 6 is preferably embedded in each of the splint sections 2 and 2a at a point a short distance inwardly from the edge of the chin-en gaging portions 3, the fastening members being substantially staple-shaped and providing external loops adapted to be used in connecting the sections 2 and 2a together. A second fastening member 1 is mounted in each of the sections 2 and 2a in the curved portion 5 intermediate the ends of said sections, the fastening members 1 being arranged to provide loops at an angle to the fastening members 6. I I

In applying the splint to a patient, the splint sections 2 and 2a can be readily positionedinwith said tape, taking up or providing slack, and then fastening said end in place again. In order toadjust the splint sections'2 and 2a; for the proper angle in the distal area ofthe mandible, a second strip of adhesive tape 9 is passed through the fastening loops 1 and its ends then overlapped below the chin of the patient to adjust or secure the sections 2 and 2a in proper angularrelation.

It will be clear from the foregoing that the invention provides a practical splintcapable of substantially universal use in that bysuitable adjustment of the tape 8, the splint sectionsz and M can be spaced to suit any width of 'chin and by suitable adjustment of the tape 9,v said splint'sect'ions can be connected together on any angle to accommodate the angularity of the mandible in the distal area.

The fastening members I, as has been previously noted, are positioned at an angle, so that when the splint is in use the adhesive tape 9 secured to said fastening members is positioned,

so that it has no tendencyto choke or constrict thebreathing of the patient. Any further adjustment of the tape 9- to change the angle of adjustment of the sections l and 2 can be made inthe same manner described in connectionwith the tape 8'.

The temple portions 4a of the sections 2 and 2acarry fastening loops or members H], H and I2 which, for convenience, are arranged in stepped relation, as best illustrated in Figure 1; The loops f, H and I 2 are also horizontally orlaterally spaced relative to eachother to permit thea'ppli'cation of retrusive, vertical, and protrusivestress; respectively, as will be pointed out more fully hereinafter. The manner of embedding the fastening members H), H and l2fi'n the splint sections 2 and 2a is best' shown in Figure 3, wherefrom it" will benoted that the extremities of said fastening members carry an enlargement [3* which, upon being embedded, prevents said fastening membersfrom being pulled out of the splint sections. It will be understood that the fastening-members 6 and Tare preferably similarly" secured in the splint sections 2 and 2a.

It will be noted that, while the fastening members l-D H and I2 are" arranged at different ver-' ti'cal heights relative to the respective temple portions 4a, they are also spaced horizontally enabling each to be used independently as a means for attaching the splintas a whole to the head. Figure 1 illustrates the manner in which the splint may be applied when it is desired to exert a vertical stress upon the mandible. In such instance, the middle fastening members [I have; the headgear attaching means secured I thereto. A convenient-means for attaching the splint ishere illustrated as comprising a strap- M'; which extends transversely of the head, and through the loops II, the free ends l5 of said straps passing through suitable buckles i6, whereby asuitable stress can be applied to the mandi ble: by adjusting the strap ends l'5 upon the opposite sides of the head. The strap I4 is fastened by a rivet I! or other suitable means to a second strap l8 which extends around the head and is provided with a suitable buckle i9, prefer thereof extend through the: loops H3 or l2,

so: that stressi may be applied to the: mandible through the splint to meet other conditions. For

. example, by passing the ends l5 through the trusivedislocation or displacement.

loops IU of each of the splint sections, a retrusive stress may be applied in the case of a prothe strap ends I 5 may be passed through the loops E2 to apply protrusive stress to overcome the natural displacing tendencies of the throat and any muscles thereof which may have become spastic due to injury.

' It will be apparent from the foregoing; that. the present splint, by virtue of its two-piece construction, is adapted for universal use andenables the necessary and proper stress tov be applied for breaks, fractures or dislocations of cated at 20, to expose said ailment.

manner, it possible to render the necessary the mandible. The use of adhesive strips 8 and 9 for chin and angular adjustment not only provides a sort of flexible hinge for the splint sections 2 and 2a, but'also' enables the splint sections to be adjusted with a minuteness of accuracy that could. not be attained with leather straps or similar strap fastening means. Once the strips ofadhesive tape have been properly adjusted, there is no danger of slippage and the" adjustment, therefore, remains permanent for the individual.

Figure 1 further illustrates" the adaptability of the present splint for use in treating. patients having. jaw wounds', cuts or infections that normally would be difficult to" treat. without disturbing the adjustment of the splint; Thus, in

the case of a surface? ailment. requiring treat ment in the region of the mandible; a portion ofthe' spiin'tsection 2 can be removed, aszindi- In this surface treatment without removing or changing the adjustment of the splint. i

The"- splint comprising the present" invention maybe made of any suitable material, such as light metal or hard rubber, but'is preferably made of transparent plastic material, with the exception of the loop elements 6, 1, I0, I i and [2 which,

for convenience, are preferably made of metal and embedded in the plastic. When the splint sections are made of non-metallicmaterial they afford the advantage of permitting X-rays to be taken. However, it is to beunderstood that the present invention is not to be limited or restricted to fabrication by any particular materialor combination' of materials, nor'to the particular manner' in which the loop elements are secured to the splint sections; 7

Figure 6 further illustrates" the adaptability of the invention for either emergency or perma-- nentuse, in that it shows one manner of secur ing the splint to the head by use of ordinary bandage? As is hereshown, a stay banda e 25 is wrapped around the head. and its free end secured by adhesive or any other means (not shown). A second strip of bandage 26 is threaded under the loops or fastening members. I2 to apply a protrusive stress to'the: mandible. The: I free'endsof the'I'strip-of' bandage zs ar'e -tid-to:

Similarly,

gether at the top of the head, and a strip of adhesive 21 is applied across the strip of bandage 26 adjacent the temples to prevent its displacement relative to the stay bandage 25. In this manner, the mandibular splint may be applied and attached to a patient without using the headgear-comprising the straps and buckles shown in Figures 1 and 2.

Fig. 6 still further illustrates the adaptability of the present splint for use in applying stabilizing tension in cases of extreme displacement of the mandible due to spasm, frequently resulting from delay in treatment. In this connection, each of the splint sections 2 and 2a is provided with an additional loop or fastening member 33 positioned below and forwardly of the loop H! at a point about midway of the length of the splint sections. As will be noted, the loop 33 is so arranged that a rubber band 34 may be passed therethrough and its ends 35 secured by a safety pin 36 to the bandage 25. The rubber band 34 will apply the auxiliary, constant upward tension necessary to maintain the mandible in place until the spasms subside.

Obviously, the loop 33 and a rubber band or any other-suitable tension means may also be used to apply a stabilizing tension in the treatment of maxiallary fractures when greater or supplemental pressure is required in the anterior region. The'loop 33 is also adapted to be used to provide auxiliary pressure when a constant occluding pressure is essential to hold the fragments of the mandible in their correct normal anatomical position.

It will be manifest that the splint of the present inventionis adapted'for use in the treatment of edentulous or dentulous mandible cases, and also readily usable with interdental types of splints without conflict. It will be further manifest that the feature of variously positioned fastening members'to apply retrusive, vertical or protrusivestress as well as auxiliary stabilizing stress is not limited to a two-piece splint but may also be advantageously used in certain onepiece splints.

' While the splint comprising the invention has been illustrated and described as having a certain shape and configuration, and the fastening means have been described as mounted in certain portions of the splint sections, it will be understood that variations may be made in the construction of the splint sections and in the character and arrangement of the fastening members without departing from the spirit or scope of the invention.

What I claim is:

1. An external mandibular splint, comprising: left and right sections of complemental shape generally contoured to fit the lower jaw, each of said sections including a chin-engaging portion at the forward end thereof and a temple portion at the rear end thereof; means operatively connecting said splint sections together; and a series of spaced fastening members carried by each of said temple portions, said fastening members being arranged to cooperate with suitable strap or band means for securing the splint sections in place, one of said fastening members being positioned in said temple portion for application of retrusive stress, another for vertical stress, and another for protrusive stress.

2. An external mandibular splint, comprising: left and right sections of complemental shape generally contoured to fit the lower jaw, each of said sections including a chin-engaging portion at the forward end thereof and a temple portion at the rear end thereof; flexible means connecting said chin-engaging portions together; three horizontally spaced temple loop members carried by each of said temple portions; and attaching means adapted to be connected with corresponding loop members on said splint sections for securing the splint sections in place, one of said temple loops being positioned and cooperable with said attaching means for application of retrusive stress, another for vertical stress, and another for protrusive stress.

3. An external mandibular splint, comprising: left and right transparent plastic sections of complemental shape generally contoured to fit the lower jaw, each of said sections including a chin-engaging portion at the forward end thereof and 'a temple portion at the rear end thereof; and a metallic loop member embedded in each of said chin-engaging portions, said loop members being arranged to be flexibly connected together with said chin-engaging portions spaced apart a distance depending upon the width of the chin.

4. An external mandibular splint, comprising: left and right sections of complemental shape generally contoured to fit the lower jaw, each of such sections including a chin-engaging portion at the forward end thereof and a temple portion at the rear end thereof, each of said sections having a lower inwardly curved portion extending rearwardly from said chin-engaging portion toward said temple portion and adapted to engage the underside of the ja a loop member carried by each of said chin-engaging portions, said loop members being arranged to be flexibly interconnected with said chin-engaging portions spaced apart a distance depending upon the width of the chin; and a loop member carried by each of said inwardly curved portions at a point intermediate the ends of said sections, said last-mentioned loops being adapted to be flexibly interconnected with said sections angularly disposed in accordance with the width of the lower jaw in the distal area.

5. An external mandibular splint, comprising: left and right sections of complemental shape generall contoured to fit the lower jaw, each of such sections including a chin-engaging portion at the forward end thereof and a temple portion at the rear end thereof, each of said sections having a lower inwardly curved portion extending rearwardly from said chin-engaging portion toward said temple portion and adapted to engage the underside of the jaw; a loop member carried-by each of said chin-engaging portions, said loop members being arranged to be flexibly interconnected with said chin-engaging portions spaced apart a distance depending upon the width of the chin; a loop member carried by each of said inwardly curved portions at a point intermediate the ends of said sections, said last-mentioned loop members being adapted to be flexibly interconnected with said sections angularly disposed in accordance with the width of the lower jaw in the distal area; and at least one loop member carried by each of said temple portions arranged to cooperate with suitable headgear means for securing the splint sections in place.

6. An external mandibular splint, comprising: left and right sections of complemental shape generally contoured to fit the lower jaw, each of said sections including a chin-engaging portion: at the forward end. thereot and a; temple portion at therear end thereof, each ofsaidsections also having a-l'ower inwardly curved portion extend ing rearwardly from said chin-engaging. portion toward said temple portion and adapted to engage the under side of the jaw; flexible means in front of said chin-engaging portions interconnecting said chin-engaging portions, with said chin-engaging. portions spaced apart a distance depending upon the width of the chin; flexible meansb'elow said inwardly curved portions interconnecting said inwardly curved portions at a point intermediate the ends of said sections with said sections angularly arranged in accordance with thewi'dth of the lower jaw in the" distal area; and head gear nieans'interconnecting said temple portions arranged to serve as an attaching means for securing the splint sectionsin place.

7. An external mandibular splint, comprising: left and right sections of complemental shape generally contoured tofit the lower jaw, each of said sections including a chin-engaging portion atthe forward end thereof and a temple portion at the rear end. thereof, each of said sections also having a lower inwardly curved portion extending rearwardly from said chin-engaging portion toward said temple portion and adapted to engage the under side of the jaw; a fasteningmember carried by each of said chin-engaging portions arranged to be interconnected with said chinengaging, portions spaced apart a distance depending upon the width of the chin; afasteningmember carried by each of said-inwardly curved portions at a point intermediate the ends of said sections and being arranged. to be interconnected at: the rear end thereof,- each or said sections also having a lower inward-1y curved portion: extending rearwardly from said chin' enga-ging ortion toward said temple portion and adapted to engage the'under side of the jaw; a lo'opmemb'er carried: by each of. said chin -engaging portions; adjustable means interconnecting said loopmembers with said chin-engaging portions spacedapart a distance depending upon the width of the chin, a second: loop member carried by each oi said inwardly curved portions at apoint intermediate the ends of said sections adjustable means inter connecting said second=mentioned loop": members to an'gularly space said. sections in accordance with the width of the lower jaw the distal area; and a series of laterally spaced temple l'oop members carriedby each of said temple'portions, said temple 1001) members being arranged to on operate with suitable fastening means for secur 'ing the splint sections in' place, one of said templel'oop's being positioned insaid temple portion for application of retrusive stress, another for var: tical stress, and another for protrusive stress.

10. An external mandibular splint,v comprising:

left and right sections of complemental' shape generally contoured to'fit the lower jaw, each of said sections including a chin=engaging portion at the forward end thereof and a temple portion: at the rear end thereof, each of said sections-also having a lower'inwardly curved portion extending rearwardly from said chin-engaging portionto toangularly space said sections in accordance with the width of the lower jaw in the distal area; and at least one fastening. member carired by eachof said temple portions arranged to cooperate with suitable head gear means for securing the splint sections inplace.

8. Anexternal mandibular splint, comprising: left and right sections of complemental shape generally contoured to fit the lower jaw, each of said sections including a chin-engaging. portion at the forward end thereof and a'temple portion a the rear end thereof, each of said sections also having a lower inwardly curved portion extends ing rearwardly from said chin-engaging portion towardysaid temple portion and adapted to engage the under side of the jaw; a loop member carried by each of said chin-engaging portions, .djustable means interconnecting said loop meme bers with said chin-engaging portions spaced apart a distance depending upon the width of the chin;- a second loop member carried by each of said inwardly curved portions at a point intermediate the ends of said sections; and adjustable means interconnecting said second lo'opfmembers to angularly' space" said sections.

' 9. external mandibular splint, comprising: left and right sections of complemental' shape enerally contoured to fit the lower jaw, each of said sections including a chin-engaging portion at the forward end thereof and a temple portion ward said temple" portion. and adapted. to engagethe underside of thejavv; al'oopmember carried by each of said chin-engaging portions;i'adjust able means interconnecting? said loop members with said chin-engaging portions spaced apart a distance depending upon the width of the a second loop member carried by each of said inwardly curved portion's at a point intermediate the" ends of said sections; adjustable m'e'ans inter connecting said second-mentioned loop members" to angularly space said sections in accordance with the'wid'th: of the lower jaw in the distal area; a seriesofi laterally spacedtempl'e loop members carried by each of said temple portions; and head gear means adaptedto be connected with corresponding loop members on said splint sections for securing? the splint sections in place, one or: said temple loops being-positioned for applica tion of retrusive-stress, another for vertical stress,- and another for I protrusive stress l 'l. Ari-external mandibular splint, comprising: a plurality of splint members, eachof saidsplint members being generally contoured to fit the" lower jaw and including a chin engaging portion and a temple portion; and a plurality of fastening means carried by said temple portion said fastening means being arranged to be connected with suitable headgear means for securing said splint member in place, saidfastening means being selectively connectible with'said headgear means and cooperable with: said headgear means for applying either a ret'rusive stress, a vertical stress, or a protrusive stress;

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