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New splint for pelvic fractures
NEW SPLINT FOR PELVIC FRACTURES JOSEPH K. NARAT, M.D Attending
Surgeon, St. Elizabeth CHICAGO,
F
RACTURES of the peIvis, especiaIIy those with a separation of the symphysis pubis are usuaIIy treated in such a
HospitaI
ILLINOIS
of the brackets can be shifted or by consisting of teIescopic tubings. The brackets have a series of hoIes into which a screw
FIG. I. SpIint for peIvic fractures.
manner that the patient is pIaced on a canvas strip which is attached to cords running over puIIeys with weights attached. This method of treatment has the foIIowing disadvantages : I. It requires proIonged hospitalization. 2. It requires a so-caIIed fracture bed; the number of such beds in an average hospita1 is Iimited and sometimes none is avaiIabIe. 3. The immobiIization of the patient is not perfect, especialIy when the patient moves. As, to my knowIedge, there is no other device on the market for the treatment of such fractures, I have constructed the foIlowing apparatus. A bracket is attached to each end of a crossbar, the bracket and the bar forming an angIe of 90 degrees. The crossbar can be shortened or Iengthened, either by being threaded so that one
can be fitted; the centraI end of the screw carries a swiveIed arch-shaped meta pIate which is perforated so that a padding can be attached to it. (Fig. I.) The apparatus is appIied in such a way that the pads are pIaced over the iIiac bones; by means of the screws a suflicient compression is obtained. The entire frame can then be turned over upward towards the umbilicus or downward and placed on the thighs. This apparatus can be used at the patient’s home; it does not require any specia1 bed; in Iater stages of the treatment the patient can be up and around wearing the apparatus. The efficiency of the spIint has been tested on a 14 year oId boy (A. S.), admitted to St. EIizabeth HospitaI September 3, 1937. The boy had faIIen from a truck and sustained injuries of the pelvis, 443
444
American Journal of Surgery
Narat-New
described by the roentgenoIogists in the folowing manner: “There is a compIete tear of the symphysis pubis with marked outward separation and rotation of the right haIf of the peIvic girdIe. There is an actua1 go degree rotation of the pubic bone and a separation resuIts at the epiphysis of the pubic bone with the iIiac
SpIint
NOVEMBER, 1938
bone. In addition, the Ieft sacro-iliac joint is definiteIy disIocated aIso. Marked peIvic deformity resuIts.” The spIint was appIied, and on September 2 I the Roentgen report read as foIIows: “Most of the dispIacement and deformity has been overcome; considering the nature of the origina injuries the resuIt is very good.”
THERE is great variation in the length of time required for heaIing of fractures of the bones of the leg and union is not infrequentIy deIayed unti1 the end of three or four months or even longer. From-“Experience in the Management of Fractures and DisIocations” by the Staff of the Fracture Service, Massachusetts Genera1 HospitaI (Lippincott).
Surgeon, St. Elizabeth CHICAGO,
F
RACTURES of the peIvis, especiaIIy those with a separation of the symphysis pubis are usuaIIy treated in such a
HospitaI
ILLINOIS
of the brackets can be shifted or by consisting of teIescopic tubings. The brackets have a series of hoIes into which a screw
FIG. I. SpIint for peIvic fractures.
manner that the patient is pIaced on a canvas strip which is attached to cords running over puIIeys with weights attached. This method of treatment has the foIIowing disadvantages : I. It requires proIonged hospitalization. 2. It requires a so-caIIed fracture bed; the number of such beds in an average hospita1 is Iimited and sometimes none is avaiIabIe. 3. The immobiIization of the patient is not perfect, especialIy when the patient moves. As, to my knowIedge, there is no other device on the market for the treatment of such fractures, I have constructed the foIlowing apparatus. A bracket is attached to each end of a crossbar, the bracket and the bar forming an angIe of 90 degrees. The crossbar can be shortened or Iengthened, either by being threaded so that one
can be fitted; the centraI end of the screw carries a swiveIed arch-shaped meta pIate which is perforated so that a padding can be attached to it. (Fig. I.) The apparatus is appIied in such a way that the pads are pIaced over the iIiac bones; by means of the screws a suflicient compression is obtained. The entire frame can then be turned over upward towards the umbilicus or downward and placed on the thighs. This apparatus can be used at the patient’s home; it does not require any specia1 bed; in Iater stages of the treatment the patient can be up and around wearing the apparatus. The efficiency of the spIint has been tested on a 14 year oId boy (A. S.), admitted to St. EIizabeth HospitaI September 3, 1937. The boy had faIIen from a truck and sustained injuries of the pelvis, 443
444
American Journal of Surgery
Narat-New
described by the roentgenoIogists in the folowing manner: “There is a compIete tear of the symphysis pubis with marked outward separation and rotation of the right haIf of the peIvic girdIe. There is an actua1 go degree rotation of the pubic bone and a separation resuIts at the epiphysis of the pubic bone with the iIiac
SpIint
NOVEMBER, 1938
bone. In addition, the Ieft sacro-iliac joint is definiteIy disIocated aIso. Marked peIvic deformity resuIts.” The spIint was appIied, and on September 2 I the Roentgen report read as foIIows: “Most of the dispIacement and deformity has been overcome; considering the nature of the origina injuries the resuIt is very good.”
THERE is great variation in the length of time required for heaIing of fractures of the bones of the leg and union is not infrequentIy deIayed unti1 the end of three or four months or even longer. From-“Experience in the Management of Fractures and DisIocations” by the Staff of the Fracture Service, Massachusetts Genera1 HospitaI (Lippincott).