BACKGROUND OF THE INVENTION
One of the most difficult problems encountered by
health care providers is the successful treatment of the
so-called "carpal tunnel syndrome". This syndrome is
defined as a median nerve compression neuropathy at
the volar (palmer) aspect of the wrist where the nerve
passes beneath the transverse carpal ligament. In gen-
eral, carpal tunnel syndrome occurs when the median
nerve is compressed as it passes through a narrow tun-
nel of bone and ligaments at the wrist. This median
nerve conducts sensation from part of the hand, up the
arm, to the central nervous system. When the nerve is
compressed, the result is numbness, tingling, burning
and pain in the fingers and the hand. Some of the causes
of carpal tunnel syndrome include nerve compression
when the lubricating lining around the tendons becomes
thick and sticky due to the normal wear and tear of
aging, or from repetitive hand movements, thus press-
ing the nerve against the tunnel. Another cause is bone
dislocation and fracture due to previous dislocation or
fracture of the wrist, causing bone to protrude into the
tunnel and press against the nerve. Arthritis may also be
present and consequently the tunnel becomes too nar-
row and puts pressure on the nerve. Another cause of
the syndrome is fluid retention which causes swelling of
the tissue in the carpal tunnel including, perhaps, the
nerve itself. This occurs most often during pregnancy
with the symptoms subsiding after the baby is born.
Since the space in the carpal tunnel is limited, the injury
to the structures is further aggravated by friction with
other elements in the tunnel. The carpal tunnel is
formed by the anterior concavity of the carpal bones
and the flexor retinaculum (transverse carpal ligament).
It is a space that has a cross-section that is approxi-
mately oval-shaped. This space is almost completely
occupied by flexor tendons and the median nerve so
that there is very little extra space when an injury oc-
curs. The result is, therefore, that in this tightly con-
stricted space, the median nerve and tendons further
injure themselves by rubbing against each other. Pre-
scribed treatment for the syndrome is, in general, to
allow the swollen structures to heal up and thereby
have its swelling reduced. However, since the hand is in
use at all times and the structures move back and forth
as the fingers and hand are articulated, it is difficult not
to re-irritate the injured structures. Therefore, in the
past, the treatment has been to provide a fL~ation of the
important parts of the hand that cause the structures to
move through the tunnel. The immobilization has been
accomplished by the use of splints such as the "cockup
splint" or by the use of a band tightly wrapped around
the wrist. The inadequacies of both of these splints are
that they limit the use of the hand which is being
treated, they do nothing to support the normal biome-
chanics of the wrist, and they compress the anterior
surface and, thereby, allow for further injury. U.S. Pat.
No. 4,966,137 to Davini (the inventor of the present
invention) presents a splint which obviates these and
other difficulties that existed in prior art devices. The
embodiment of the splint presented in the earlier Davini
peter. vhile very effective, has a number of practical
draw s. It involves a number of individual parts. It
also req`~res a significant amount of material. Further-
more, the device must be provided in a number of sizes
in order to adapt to various wrist sizes. Finally, the
device can be somewhat difficult to apply and some-
what conspicuous in use.
It is, therefore, a principal object of the present inven-
tion to provide an improved splint system which gives
improved successful treatment of carpal tunnel syn-
drome.
Another object of the invention is to provide an im-
proved splint system for the prevention of carpal tunnel
syndrome.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome without requiring immo-
bilization of the hand and fingers.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome, which system can be
worn during many activities that commonly cause the
syndrome.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome, which system maintains
and/or restores the size and shape of the carpal tunnel,
thus allowing decompression of the involved injured
structures and maintenance of normal structural rela-
tionships.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome, which system can be
readily removed by the patient for washing and the like.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome in which the compo-
nents of the system are constructed so as to form a
unitary device, at least at the time of application of the
system, instead of a device with more than one individ-
ual part.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome, which system is simple
in construction, inexpensive to manufacture, and capa-
ble of a long life of useful service with a minimum of
maintenance.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome, which system can be
readily applied without the use of special equipment.
A further object of the invention is to provide an
improved splint system for the treatment and preven-
tion of carpal tunnel syndrome, which system can fit a
wide range of wrist sizes.
SUMMARY OF THE INVENTION
In general, the invention consists of a brace formed of
semi-rigid material which exteriorly cradles either the
radius or the ulna in the wrist of a human being. The
brace is held in place by an attached flexible strap which
embraces the other of the two bones. The brace and
strap act to approximate the radius and ulna toward one
another to support the carpal tunnel without allowing
compression of the anterior surface of the carpal tunnel.
More specifically, the brace is made of semi-rigid
material and has a V-shaped cross section. In the pre-
ferred embodiment, a cushion is adhered to the inside
surface of the brace so that the cushion and not the
brace comes in direct contact with the human being's
skin.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of an improved splint
system embodying the principles of the present inven
tion, shown in use with a human arm;
FIG. 2 is a vertical cross-sectional view taken along
line II-II in FIG. 1 and looking in the direction of the
arrows; and
FIG. 3 is a perspective view of the improved splint
system.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring to the drawings, it can be seen that the
improved splint system, indicated generally by the ref-
erence number 10, includes a flexible elongated strap 17
and a brace 11. In FIG. 3, it can be seen that the brace
11 has a V-shaped cross section having adjacent sides 18
and 19 which are joined by a rounded corner 12. The
strap 17 is joined with the brace 11, either permanently
or removably. In the permanent mode, a first free end
30 of the strap 17 is inserted through a small opening 21
on a first free end 26 of the brace 11 and affixed to itself
as shown in FIGS. 1 and 3 by stitching 32 or the like. In
the removable mode, the first free end 30 of the strap 17
is inserted through the small opening 21 on the first free
end 26 of the brace 11 and affixed to itself by a snap or
the like. The strap 17 has a second free end 31 which
extends through a small opening 22 on a second free end
27 of the brace 11 and is fastened to itself by means of a
hook-and-loop system of the type sold under the trade
mark "VELCRO" consisting of a hook portion 24 and
a loop portion 25. The strap 17 and brace 11 are shown
in FIG. 1 in place on the wrist 14 of a person, for the
treatment or prevention of carpal tunnel syndrome.
Referring to FIG. 2, it can be seen that the improved
splint system 10, used for the treatment and prevention
of carpal tunnel syndrome, includes the brace 11 and the
strap 17. The brace 11 exteriorly cradles the radius 15 in
the wrist 14 of the person and is shown in cross-section
along with the ulna 16. The brace 11 is formed of a
semi-rigid material, such as a thermoplastic resin, and
has a V-shaped cross section. In the preferred embodi
ment, the splint system 10 includes a cushion 20 which
is formed from a generally rectangular sheet of a resil-
ient polymenc material approximately t" in diameter.
The cushion 20 is adhered to the inside surface of the
brace 11 so that the cushion 20 and not the brace 11
comes in direct contact with the person's skin. The
cushion 20 is somewhat smaller in size than the brace 11
so that the openings 21 and 22 on the first free end 26
and the second free end 27, respectively, of the brace 11
are not obstructed. While the brace 11 exteriorly cra
dles the radius 15 at corner 12 at a first narrow side 28
of the wrist 14, the fastened strap 17 exteriorly embraces
the ulna 16 at edge 13 at a second narrow side 29 of the
wrist 14 to approximate the two bones toward one an
other. When placed on the wrist of a person requiring
treatment for or prevention of carpal tunnel syndrome,
the second free end 31 of the strap 17 is inserted through
the small opening 22 on the second free end 27 of the
brace 11 on side 19 and is fastened to itself by the hook
portion 24 and the loop portion 25.
The operation of the invention will now be readily
understood in view of the above description. The brace
11 is placed on a person's wrist 14 to exteriorly sur-
round the radius 15. The strap 17 is then exteriorly
wrapped around the ulna 16 and is pulled enough to
cause a proper support of the wrist 14 and to cause a
slight approximation of the radius 15 and the ulna 16
toward one another. Since the carpal tunnel (indicated
generally by the reference numeral 23) lies between
these two bones and contains the tendons and nerves,
etc. that cause the problem in the carpal tunnel syn-
drome, the effect is to support the tunnel by maintaining
or restoring its normal dimension in a line perpendicular
to a line joining the centers of the ulna 16 and the radius
15. This relieves any pressure that may exist in the car-
pal tunnel 23 and allows the injured element to heal. At
the same time that healing is taking place, the fact that
the carpal tunnel dimension has been supported in this
way means that the hand can be used for normal opera-
tion without associated ligament fatigue, without com-
promising the tunnel dimension and without endanger-
ing the healing process.
Obviously, minor changes may be made in the form
and construction of this invention without departing
from its spirit. Thus, it is not desired to confine the
invention to the exact form shown and described,but it
is desire to include all such as properly come within the
scope claimed.
The invention having thus been described, what is
claimed as new and desired to secure by Letters Patent
is:
1. An improved splint system for the treatment and
prevention of carper tunnel syndrome in the wrist of a
human being, said wrist having a radius, an ulna and
first and second narrow sides, said splint system com-
prising:
(a) a substantially V-shaped brace of semi-rigid mate-
rial consisting of a pair of generally planar panels
joined along a corner and diverging therefrom to
provide a first free end and a second free end, said
panels being dimensioned and angularly oriented to
embrace a first narrow side of the wrist of a human
being;
(b) a strap connected to one of said free ends of said
brace and dimensioned to extend about the second
narrow side of the wrist;
(c) means on the other of said free ends for engage-
ment by said strap; and
(d) means for securing said strap in an adjusted length
between said free ends to cooperate with said brace
to apply pressure upon the opposite narrow sides of
the wrist of the patient to press the radius and ulna
of the wrist toward one another, said brace retain-
ing its V-shaped configuration when said splint
system is secured about the wrist of the patient.
2. The improved splint system as recited in claim 1,
wherein the semi-rigid material of said brace is a ther-
moplastic resin.
3. The improved splint system as recited in claim 1,
wherein said corner is rounded.
4. The improved splint system as recited in claim 1,
wherein said strap is of a generally elongated rectangu-
lar configuration and wherein said securing means is a
hook-and-loop fastener system.
5. The improved splint system as recited in claim 1,
wherein each panel has an aperture adjacent its free end
through which said strap extends.
6. The improved splint system as recited in claim 5,
wherein said strap has a loop at one end fastened in the
aperture of one panel, and slidably extends through the
aperture in the other of said panels, and wherein said
strap is releasably fastened to itself by said securing
means.
7. The improved splint system as recited in claim 1,
wherein the inner surface of said brace is provided with
a cushion of a resilient polymeric material.
8. A method of treating and preventing carpal tunnel
syndrome in the wrist of a human being, said wrist
having a radius, an ulna, and first and second narrow
sides, comprising:
(a) providing a splint system including a substantially
V-shaped brace of semi-rigid material, consisting of
a pair of generally planar panels joined along a
corner and diverging therefrom with a first free
end and a second free end, and at least one strap
extensible between said free ends, wherein the
method comprises:
(b) placing said brace to embrace the first narrow side
of the wrist of a human being;
(c) extending said strap about the second narrow side
of said wrist between said free ends; and
(d) adjusting said strap so that said strap and brace
bear upon opposite sides of said wrist to press said
radius and ulna of the wrist toward one another.