The subject invention relates to a device for use by orthopedic physicians or surgeons in connection with patient bone fracture and ligament management. More particularly, the invention relates to a novel orthopedic cast spacing and spreading device operable to relieve pressure in connection with the use of an immobilizing cast structure.
When a patient fractures an arm or a leg, or damages a ligament to the point that casting is indicated, it is important to insure relative immobility of the member. Accordingly, cast materials are designed to be rigid and do not permit deformation or play in the damaged member.
If the soft body tissue of an arm or leg which has been traumatized during an injury, severe enough to fracture a bone and/or damage a joint, swells from the injury within a confined space created by a cast, post casting pressure can cause skin erosion or sores. If such pressure is permitted to persist in muscle compartments, it is possible to actually cause death of the muscle and damage to arteries and/or nerves. This is commonly referred to as compartment syndrome and most references and literature refer to it as "Volkmann" disease and contractures. Contractures can result in a significant loss of function of an extremity as well as shortening and cosmetic deformities.
In the past, if a surgeon or physician suspected that an extremity was swelling within a cast, the cast was often completely removed and a new cast applied. In many situations, however, it is preferable to simply use a saw to longitudinally cut the cast material and temporarily spread the cast to relieve pressure due to internal swelling. When swelling subsided, the cast could be closed back around the member and rebound with a top layer of plaster cloth.
A cast spreader device which has previously been known in the art is depicted in a U.S. Pat. No. 3,426,752. The disclosure of this cast spreader instrument is hereby incorporated by reference as though set forth at length for purposes of disclosing the background of the instant invention. Another cast spreader device is disclosed in U.S. Pat. No. 2,757,666. The disclosure of this cast spreader device is also incorporated by reference to further illustrate cast spreading devices existing in the prior art.
With conventional plaster cast materials, a cast spreading tool, such as identified above, could be used to separate the cast and the plaster material would remain in a separated or open posture without tending to collapse back to its original configuration. With newer fiber glass and resin materials, however, a physician can spread a cast but as soon as the separating instrument is removed from between the two sides of the cast, the cast to its original configuration tightly around a patient's limb.
Although it has been known, as an expedient, to insert bits of tape or rubber stoppers from syringes into the kerf of a spread apart cast, problems exist with this procedure. More specifically, there is no standard width with such devices and no reliability that pressure on the body member will be relieved. Moreover, such expedient structures have a tendency to fall into a kerf of the cast creating local skin necrosis or further damage.
The difficulties suggested in the proceeding are not intended to be exhaustive, but rather are among many which illustrate a need for a device for uniformly providing spacing capability for an orthopedic cast. Other noteworthy problems may also exist, however, those presented above should be sufficient to demonstrate that devices to facilitate orthopedic cast management will admit to worthwhile improvement.