Dynamic splint for carpal tunnel syndrome treatment
First Claim
1. An orthopedic appliance adapted to be worn on a forearm and a hand of a person exhibiting symptoms of carpal tunnel syndrome, the appliance comprising:
- a. a biasing means alignable with the ulnar side of the forearm and not with the dorsum of the forearm, the biasing means having a supporting end and a torquing end, the torquing end disposed to apply a continuous, low level force to the hand over time and in a direction encouraging dorsal glide;
b. a palmar component coupling the torquing end to the carpal-metacarpal complex of the hand, the palmar component comprising;
i. an ulnar gutter clasp having a dorsal end and a palmar end, the ulnar gutter clasp being sized and configured to the hand such that the dorsal end extends from the ulnar side of the hand to approximately the midpoint of the dorsal side of the hand and the palmar end extends from the ulnar side of the hand to approximately the midpoint of the palm;
ii. a palmar strap having a fixed end and a attachable end, the fixed end permanently secured to the palmar end of the ulnar gutter clasp, the attachable end passing from the palmar end across the thenar web between the thumb and forefinger to the dorsal end and being removably secured to the dorsal end so as to secure the ulnar gutter clasp firmly to the ulnar side of the hand, and iii. a connection means fixedly attached to the ulnar gutter clasp at a point proximal to the ulnar side of the hand, whereby the torquing end of the biasing means is coupled to the palmar component at a point outboard of the ulnar side of the hand so as not to interfere with normal activities of daily living; and
, c. a forearm component sized and configured to be rigidly and removably attached to the forearm, the forearm component providing a stable platform for the supporting end and maintaining alignment of the torquing end with the ulnar side of the carpal-metacarpal complex during movement of the forearm and hand.
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Accused Products
Abstract
A method and appliance for the application of a continuous, low level force tending to oppose rotational movement of the hand about the carpus. This opposing force tends to relieve contractatures of the transverse carpal, volar carpal, and intra carpal ligaments over time, thus relieving the pain caused by carpal tunnel syndrome and correcting altered kinematics associated therewith. This opposing force tends to increase the carpal volume. According to the principles of the invention, a dynamic splint appliance is described which provides free movement of the patient'"'"'s wrist with minimal impediment during activities of daily living, both at home and at work, while simultaneously applying this opposing force. The appliance consists of a forearm component to maintain alignment and to provide support and stabilization for a biasing means positioned on the ulnar side of the forearm, the biasing means consisting of a double coil spring located at approximately the ulnar side of the carpus and connected to a palmar component fastened to the ulnar side of the hand. The biasing component provides resistive force to volar glide in a manner which accurately models the kinematics of the carpus and forearm.
17 Citations
29 Claims
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1. An orthopedic appliance adapted to be worn on a forearm and a hand of a person exhibiting symptoms of carpal tunnel syndrome, the appliance comprising:
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a. a biasing means alignable with the ulnar side of the forearm and not with the dorsum of the forearm, the biasing means having a supporting end and a torquing end, the torquing end disposed to apply a continuous, low level force to the hand over time and in a direction encouraging dorsal glide;
b. a palmar component coupling the torquing end to the carpal-metacarpal complex of the hand, the palmar component comprising;
i. an ulnar gutter clasp having a dorsal end and a palmar end, the ulnar gutter clasp being sized and configured to the hand such that the dorsal end extends from the ulnar side of the hand to approximately the midpoint of the dorsal side of the hand and the palmar end extends from the ulnar side of the hand to approximately the midpoint of the palm;
ii. a palmar strap having a fixed end and a attachable end, the fixed end permanently secured to the palmar end of the ulnar gutter clasp, the attachable end passing from the palmar end across the thenar web between the thumb and forefinger to the dorsal end and being removably secured to the dorsal end so as to secure the ulnar gutter clasp firmly to the ulnar side of the hand, and iii. a connection means fixedly attached to the ulnar gutter clasp at a point proximal to the ulnar side of the hand, whereby the torquing end of the biasing means is coupled to the palmar component at a point outboard of the ulnar side of the hand so as not to interfere with normal activities of daily living; and
,c. a forearm component sized and configured to be rigidly and removably attached to the forearm, the forearm component providing a stable platform for the supporting end and maintaining alignment of the torquing end with the ulnar side of the carpal-metacarpal complex during movement of the forearm and hand. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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16. An orthopedic appliance adapted to be worn on a forearm and a hand of a person exhibiting symptoms of carpal tunnel syndrome, the appliance comprising:
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a. a palmar component sized for attachment to the carpal-metacarpal complex of the hand;
b. a biasing component alignable with the ulnar side of the forearm, the biasing component formed of a continuous wire with a supporting end and a torquing end, the torquing end coupled to the palmar component and having a plurality of adjoining coils formed along its length; and
,c. a forearm component sized and configured to be rigidly and removably attached to the forearm, the forearm component providing a stable platform for the supporting end and maintaining alignment of the torquing end with the ulnar side of the carpal-metacarpal complex during movement of the forearm and hand, the coils disposed thereby to apply a dorsally-directed force to the hand.
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28. An orthopedic appliance adapted to be worn on a forearm and a hand of a person exhibiting symptoms of carpal tunnel syndrome, the appliance comprising:
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a. a palmar component sized for attachment to the carpal-metacarpal complex of the hand, the palmar component comprising;
i. an ulnar gutter clasp having a dorsal end and a palmar end, the ulnar gutter clasp being sized and configured to the hand such that the dorsal end extends from the ulnar side of the hand to approximately the midpoint of the dorsal side of the hand and the palmar end extends from the ulnar side of the hand to approximately the midpoint of the palm;
ii. a palmar strap having a fixed end and a attachable end, the fixed end permanently secured to the palmar end of the ulnar gutter clasp, the attachable end passing from the palmar end across the thenar web between the thumb and forefinger to the dorsal end and being removably secured to the dorsal end so as to secure the ulnar gutter clasp firmly to the ulnar side of the hand, and iii. a connection means fixedly attached to the ulnar gutter clasp at a point proximal to the ulnar side of the hand;
b. a biasing component alignable with the ulnar side of the forearm, the biasing component formed of a continuous wire with a supporting end and a torquing end, the torquing end coupled to the connection means of the palmar clasp, the torquing end having a plurality of adjoining coils formed along its length; and
,c. a forearm component sized and configured to be rigidly and removably attached to the forearm, the forearm component providing a stable platform for the supporting end and maintaining alignment of the torquing end with the ulnar side of the carpal-metacarpal complex during movement of the forearm and hand, the coils disposed thereby to apply a dorsally-directed force to the hand.
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29. A method of relieving the pain associated with carpal tunnel syndrome and increasing the carpal volume through use of an appliance sized and configured to a forearm and a hand of an individual person manifesting pain, the appliance having a forearm component, a palmar component, and a biasing component formed of a wire having a supporting end, a torquing end, and a plurality of adjacent coils formed therebetween, the method operating to relieve contractatures of the volar carpal ligaments and to restore the cocontraction ratio between the flexor and extensor muscle tendons of the forearm, without interfering with normal activities of daily living, the method comprising the steps of
a. releasably attaching the forearm component in fixed relation to the dorsal side of the forearm, the forearm component serving to position the supporting end of the biasing component in fixed relationship to the ulnar side of the forearm; -
b. releasably attaching the palmar component of the appliance in fixed relationship to the ulnar side of the hand associated with the forearm upon which the forearm component is positioned, so that the palmar component permits free movement of the hand during normal activities of daily living;
c. fixedly connecting the torquing end of the biasing component to the ulnar side of the palmar component;
d. positioning the coils of the biasing component adjacent to the ulnar side of the ulnar-radial/metacarpal and intra-metacarpal joints;
e. Adjusting the biasing component to support the hand at about 20°
dorsiflexion where no force is exerted upon the metacarpal complex of the hand by the biasing component;
f. adjusting the biasing component to provide low level resistance against dorsally- or volarly-directed volitional hand movement diverging from the 20°
dorsiflexion point;
g. maintaining alignment of the biasing component in the position on the ulnar side of the ulnar-radial/metacarpal and intra-metacarpal joints during supination and pronation of the forearm and during ulnar/radial deviation of the carpal-metacarpal complex; and
h. permitting unobstructed flexion of the fingers and opposition of the thumb with the fingers.
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Specification