U.S. patent number 3,815,588 [Application Number 05/301,517] was granted by the patent office on 1974-06-11 for apparatus and methods relating to support of the forearm.
Invention is credited to Bracha Klausner.
United States Patent |
3,815,588 |
Klausner |
June 11, 1974 |
APPARATUS AND METHODS RELATING TO SUPPORT OF THE FOREARM
Abstract
An apparatus and methods are disclosed which relate to
supporting the forearm by means of a resilient, semi-rigid support
member adapted to partially encircle and conform generally to the
shape of said forearm when said forearm is positioned adjacent to
the chest wall or body with the forearm pronated and the wrist and
hand held in a functional position, said support member also
including means adapted to retain said support member generally
against the body or chest wall.
Inventors: |
Klausner; Bracha (New York,
NY) |
Family
ID: |
23163726 |
Appl.
No.: |
05/301,517 |
Filed: |
October 27, 1972 |
Current U.S.
Class: |
602/4;
602/20 |
Current CPC
Class: |
A61F
5/05858 (20130101) |
Current International
Class: |
A61F
5/04 (20060101); A61F 5/058 (20060101); A61f
005/10 () |
Field of
Search: |
;128/77,87,89,94,83,84 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Yasko; J.
Claims
I claim:
1. An apparatus for supporting the forearm, including the elbow and
hand, of a patient which comprises a resilient semi-rigid support
member constructed from a polymeric foam material and adapted to
partially encircle and conform generally to the shape of the
partially encircled forearm when said forearm is pronated with the
wrist and hand held in a functional position, said support member
having for receiving the elbow an extension that is narrower than
the width of the support at its widest point, means adapted to
detachably affix said support member to the forearm, including the
hand and elbow of a patient, means for securing the fingers and
thumb to the surface of said support, said support member having
means attached to the support member for retaining said support
member against the body with the forearm supported in a generally
orthogonal position to the upperarm.
2. An apparatus as defined in claim 1 wherein said means attached
to the support member comprise an elongated strap which is adapted
to be affixed to the support at the area wherein the elbow is
supported and extends around the neck of the patient down to and
around the distal end of said support.
3. An apparatus as defined in claim 1 wherein said resilient
semi-rigid support member is perforated by a plurality of apertures
extending from the upper to the lower surface thereof.
4. An apparatus as defined in claim 1 wherein the means for
securing the fingers and thumb to the surface of said support
comprise loops of fabric sized to the individual fingers and
thumb.
5. An apparatus as defined in claim 1 wherein said polymeric foam
material is a polyethylene foam material.
6. A method of supporting the forearm, including the elbow and
hand, of a patient, which comprises supporting said forearm in a
support as defined in claim 1.
7. A method as defined in claim 6 wherein the forearm, including
the elbow and hand, are supported so that the hand is elevated
above the elbow.
8. A method as defined in claim 6 wherein the support member is
retained generally in said position by an elongated strap which is
affixed to the support at the area wherein the elbow is supported
and extends up and around the neck of the patient and down to the
distal end of said support.
9. A method as defined in claim 6 wherein the fingers and thumb are
secured to the surface of said support by loops of fabric.
Description
This invention relates to a novel support for the forearm,
including the elbow and hand. The support inherently relieves
stress on the shoulder joint by transferring a part of the weight
of the arm to the collar bone, neck or other part of the body to
which retaining means may be affixed. While not limited thereto, it
is especially useful in supporting the arm of a hemiplegic as its
resilient characteristics and configuration provide an excellent
means of supporting the affected limb of such an individual.
BACKGROUND OF THE INVENTION
It is well known in the prior art to employ a sling for supporting
the forearm of a patient who has almost any type of injury or
disability which restricts the normal manipulation of the arm and
may induce a painful sublaxation of the shoulder. Many prior art
slings are constructed of fabric or straps which have permitted the
arm to hang limply with the weight of the arm causing pressure to
be applied around the sides of the arm by the fabric or straps of
the sling which pass upwardly to engage the neck or shoulder. The
structure of these slings has usually resulted in the arm being
positioned with the palm facing towards the body of the patient.
These factors contribute to the discomfort associated with
prolonged use of a sling. In addition with hemiplegic patients they
do not provide adequate shoulder support or any relief from the
spasticity frequently noted in these patients. The wrist and hand
have not been supported in the functional position in prior art
slings, if in fact they have been supported at all.
The present invention provides a support for the forearm, including
the elbow and hand which is lightweight and may be made to conform
generally to the shape of an individual patient's limb. The hand is
maintained in a natural relaxed and functional position. In
hemiplegic patients, shoulder sublaxation, wrist drop and flexion
deformities may be prevented and deformities resulting from
spasticity are prevented or relieved as the forearm, including the
elbow, the wrist and the hand are supported in the functional
position. Shoulder pain is also relieved.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is a front view of a patient who is fitting himself with the
novel support according to the invention.
FIG. 2 is a front view of a patient with the support of the
invention fitted in place.
FIG. 3 is a top plan view of the support of the invention.
FIG. 4 is a bottom plan view of the support of the invention.
FIG. 5 is a sectional view of the support of the invention taken
along line 5--5 of FIG. 3.
FIG. 6 is a sectional view of the support of the invention taken
along line 6--6 of FIG. 3.
FIG. 7 is a sectional view of the support of the invention taken
along line 7--7 of FIG. 3.
FIG. 8 is a sectional view of the support of the invention taken
along line 8--8 of FIG. 3.
DESCRIPTION OF THE INVENTION
The invention provides an apparatus which relieves stress on the
shoulder by supporting the forearm; including the elbow, the wrist
and the hand; said apparatus comprising a resilient semi-rigid
support member adapted to partially encircle and conform generally
to the shape of the partially encircled forearm when the forearm is
positioned against the chest wall or body preferably in a generally
orthogonal position relative to the upper arm with the forearm
pronated with the wrist and hand in a functional position. The
support member also includes means adapted to retain said support
member generally in said position.
The preferred means for retaining the support member in an
orthogonal position or in any position against the chest wall or
body is an elongated strap which is adapted to be affixed to the
support at the area where the elbow is supported and extends around
the neck of the patient down to and around the distal end of the
support. By the distal end of the support is meant the end at which
the hand is supported. The straps may be attached preferably by a
pressure sensitive device such as a Velcro pile and Velcro hook to
facilitate connection of the support by the patient without the aid
of others.
The main structural part of the support may be constructed
exclusively of a polymeric foam material that is resilient and
semi-rigid. By the term resilient is meant to describe the physical
property of a material which is deformable by the pressure exerted
by the weight of a limb and which will tend to recover its size and
shape after the weight of the arm is removed. By the term
semi-rigid is meant to describe the physical property of a material
which is flexible but which has sufficient stiffness to provide
substantial support to a limb. Suitable foams having these
properties include selected polyurethanes foams, polyethylene
foams, vinyl foams and the like.
The end of the support which is intended to be used at the upper
end of the forearm and around the elbow is preferably constructed
so that it is approximately from one-fourth to three-fourths, or
one-half as wide as the width of the support at its widest point.
The narrowed, elbow receiving end, facilitates the shaping of the
semi-rigid material so that it may be custom fitted to the length
of each individual patient's forearm. This feature also prevents
the distortion of the shape of the main part of the support between
the hand and the upper forearm.
The support of the invention may be custom fitted to each patient
as described hereinafter or may be made in three or four or more
standard sizes which will be adjustable to practically any
individual by means of the specially shaped elbow portion.
The main structural part of the support may be optionally provided
with a plurality of apertures which extend from the upper to the
lower surface thereof. These apertures provide a means of reducing
the total weight of the support although the primary objective is
to allow the evaporation of perspiration from the supported limb
while allowing air to circulate and keep the limb cool.
The apertures may be made by drilling or punching holes in the main
structural part. The configuration of the holes and spacing thereof
is not critical provided that the size, number and spacing should
not adversely affect the structural integrity of the support so
that the support will lose its desired configuration.
The support is advantageously provided with suitable means to
retain the forearm within the main structural part. These means
will usually comprise one or more straps which are spaced at
strategic locations on the support. These straps may be provided
with suitable fasteners to permit the patient to secure the forearm
within the support in an optimum position without assistance. For
this purpose, a pressure sensitive device may be employed. The
support may be made in any color with any design or may be covered
with printed fabrics to secure patient acceptance. The hand may
also be secured to the support by means of a single or multiple
loop arrangement of fabric or other suitable material such as
plastic strips, elastic webbing and the like. When the support is
to be used by a hemiplegic individual such as a victim of a
cerebral vascular accident, the use of means to secure the finger
and thumb to the surface of the main structural support is believed
to be especially advantageous as it helps to prevent and treat the
spasticity of the hand commonly seen in such individuals.
This invention also provides a novel method of supporting the
forearm, including the elbow and hand, of a patient. The method
comprises supporting the forearm in a resilient, semi-rigid support
member adapted to partially encircle and conform generally to the
shape of said partially encircled forearm when said forearm is
positioned against the chest wall or body preferably in an
orthogonal position relative to the upper arm with the forearm
pronated and the wrist and hand in a functional position and
employing means to retain said support member generally in said
orthogonal position by attaching said support to the patients'
clothing or body.
Generally it is preferred to position the support so that the hand
will be elevated slightly above the level of the elbow. This is
done to assist circulation and prevent undue stress on the
shoulder, wrist or hand. The term "functional position" refers to
the position of the wrist and hand where the wrist is articulated
so that the hand is slightly raised and the fingers slightly
flexed.
The term "generally orthogonal" is used to describe an optimum
position for the forearm in relation to the upper arm. It is not
used to define a right angle but an angle which approximates a
right angle and may vary from an acute to an obtuse angle of
inclusion between the forearm and upper arm.
When the hand is immobilized, the preferred geometric articulation
for the joints of the shoulder and arm are as follows; the wrist
should be in about 20.degree. dorsiflexion, the
metacarpo-phalangeal joints in about 45.degree. flexion (at about
135.degree.), the proximal interphalangeal joints at about
30.degree. (at about 150.degree.), and the distal interphalangeal
joints at about 20.degree. flexion (at about 160.degree.). The
thumb should be in half palmer abduction and half opposition, the
interphalangeal joint in a few degrees of flexion. The elbow should
be at 90.degree. flexion and the mid-prone position and the
shoulder at about 45.degree. abduction, about 30.degree. flexion
and in neutral rotation.
Pronation or pronated as used herein is meant to describe the
position of the forearm when it is rotated toward the midline of
the body with the thumb of the hand next to the body.
A novel method for the prevention and relief of deformities
resulting from spasticity in the hand of a hemiplegic patient is
also provided by this invention. This method is based on supporting
the forearm, including the albow, wrist and hand by means of a
resilient semi-rigid support member which is adapted to encircle
and conform generally to the shape of said partially encircled
forearm when said forearm is positioned against the body or chest
wall preferably orthogonal to the upper arm with the forearm
pronated and the wrist and hand in a functional position with the
fingers and thumb held to the support member by retaining means and
employing means adapted to retain said support member generally in
said orthogonal position.
The hand is preferably elevated above the level of the elbow as in
the method of providing support to the forearm but individual
patients may prefer alternate positions.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring to FIGS. 1 and 2, wherein a patient is shown with the
support apparatus of the invention, the main structural part 10 or
support member, is shown fitted to the forearm, including the elbow
and hand. The strap 12 is shown in FIG. 2 in the normal use
position where it extends around the elbow 14 up and over the
shoulder to where it is fastened at the wrist area 16. FIG. 3 shows
a top plan view of the support apparatus. This apparatus is
constructed from a cross-linked polyethylene foam of closed cell
construction having a specific gravity of 0.04, and having
three-sixteenths inch holes on a 1 inch square grid. It is first
cut to the general outline of FIG. 3 and then heated to
200.degree.F. Thereafter it is shaped to conform to the forearm of
a patient who is protected from the heat by suitable clothing.
After the support cools and sets it is removed and support strap 12
and retention straps 14 are riveted in place. Also en elbow
retaining strap 16 is provided to permit custom fitting of the
support to different individuals who have different size arms.
These straps are of lightweight woven cotton or nylon and are
provided with pressure or contact sensitive Velcro hooks and pile
for fastening to the patient. Thereafter, (or before) spaced loops
18 for the fingers and individual loop 20 are sewn, adhesively
bonded or riveted in place.
FIGS. 4, 5, 6, 7 and 8 provide details of the construction of the
support by sections taken through the indicated points of FIG.
3.
A male patient, age 53, who was a right hemiplegic (CVA) was fitted
with the support shown in FIGS. 1-3. He reported that this shoulder
did not sublux and increased comfort was noticed as compared to
prior use of a conventional sling made of an open mesh fabric.
A female patient, age 53, who was a left hemiplegic as a result of
an embolic blockage at the bifurcation of the right common carotid
artery was fitted with the support shown in FIGS. 1-3. Contracture
did not develop and wrist and shoulder pain, which had been a
previous problem, subsided so as to eliminate the necessity for
analgesics.
The term "forearm" as used hereinabove is meant to include the
distal portion of the arm, including the area from the elbow to the
wrist.
Although the preferred embodiments of the invention have been
described hereinabove, there is no intent to limit the invention
thereto, but it is intended to cover all variations thereof within
the purview of those skilled in the art and as defined by the
appended claims.
* * * * *