Title of Invention	A UNIVERSAL OPERATING HAND SPLINTING DEVICE
Abstract	This invention relates to a hand splinting device for splinting the forearm and hand during surgery. It consists of four metal plates, successively linked by hinge-type joints, which move in vertical angles. Each joint of the splint is fitted with interlocking gears to arrest the movement of the joint at any desired angle. Winged nuts are used to tighten the gears. The device supports the hand and forearm not only during horizontal movement of the wrist and metacarpophalangeal joints, but also during the vertical movement of the elbow, wrist and metacarpophalageal joints by varying the angles of it's joints, which move in a vertical direction. A single such hand splinting device may be sufficient for variety of hand operations requiring support to the hand with it's joints at different angles. It eliminates the need for a separate type of device for each such operation.

Title of Invention

A UNIVERSAL OPERATING HAND SPLINTING DEVICE

Abstract

This invention relates to a hand splinting device for splinting the forearm and hand during surgery. It consists of four metal plates, successively linked by hinge-type joints, which move in vertical angles. Each joint of the splint is fitted with interlocking gears to arrest the movement of the joint at any desired angle. Winged nuts are used to tighten the gears. The device supports the hand and forearm not only during horizontal movement of the wrist and metacarpophalangeal joints, but also during the vertical movement of the elbow, wrist and metacarpophalageal joints by varying the angles of it's joints, which move in a vertical direction. A single such hand splinting device may be sufficient for variety of hand operations requiring support to the hand with it's joints at different angles. It eliminates the need for a separate type of device for each such operation.

Full Text	This splmting device is intended to splint (prevent movement of the joints of) the forearm and hand during surgery. A splinting device is used for preventing movement of a joint or for the fixation of displaced or movable parts. The hand has got many joints viz. wrist {Between forearm and palm), metacarpophalangeal (between palm and fingers), and interphalangeal (between the finger segments called phalanges). During surgical operations, the individual jomts have to be held in different angles depending on the procedure. Certain types of splinting devices for hand surgery are either commercially available or are m use. The Prendiville hand table is a square table of wire mesh with fixing hooks to which the palm and fingers can be fixed with elastic bands. The deficiency is lack of vertical variation of angles of the joints of hand. Tapper"s universal hand holder and retractor set is a rigid flat plate fixed on legs. The deficiency is lack of vertical variation of angles of the joints of the hand. A rigid fixed angle wooden hand splinting device has been used for claw hand correction especially for leprosy patients. It is commercially not available. The deficiencies are lack of scope for variation of both vertical and horizontal angles of the joints of the hand and lack of faciUty for self retraction of the wound. The lead hand is a malleable splinting device without any joints. On this, the angles of the wrist and metacarpophalangeal joints can be varied vertically. The deficiencies are ; 1. Lack of facility for horizontal variation of angles of joints of the hand. 2. Lack of facility for self retraction of the operation woimd. 3. Lack of strong support, since the material is malleable. 4. It is less durable because it becomes brittle and breaks down after sometime due to repeated bending and autoclaving. During hand surgery without the help of a splinting device, whenever the vertical angle of the wrist and the metacarpophalangeal joints have to be varied, an assistant has to support the forearm and hand with his own hand or hands in order to maintain the angle. It is difficult and tiresome for an assistant to support the hand in a particular position, with different joints at different vertical angles, for a long time. Hence, some amoimt of shaking wUl be there, causing the following possible difficulties: a. Disturbance to the smooth conduct of surgery. b. Damage to fine structures like small blood vessels of hand through the surgeon"s instruments. c. Compromise in precision of operation, thereby, leading to an inferior result. Further, presence of the assistant"s hand or hands makes the operating field crowded, causing inconvenience to the surgeon. Also, the assistant"s hands are likely to get injured form accidental needle pricks and cut by sharp instruments during surgery, which may infect him or her with deadly microorganisms like AIDS and serum helpatitis virus. Statement of invention The present invention pertains to a hand splinting device comprising of multiple plates ; the said plates extending firm support to the forearm and hand for smooth performance of different types of hand surgery; the said plates connected in succession through joints capable of moving through different vertical angles facilitating the variation of vertical angles of the overlying elbow, wrist and metacarpophyanlangeal joints ; the said joints of the splinting device fitted with arrangement for firm fixation at any desired vertical angle ; the said plates havmg arrangement for horizontally varying the angle of wrist and metacarpophalanged joints ; the said splinting device capable of providing both vertical and horizontal variations of the wrist and metacarphalangeal joints either separately or concurrently ; the said plates having arrangement for fastening the forearm, palm and fingers ; the said plates having arrangement for self retraction of the operation wound through sutures ; the said hand splinting device having having facilities for elevation of forearm and hand through variation of angle of the elbow joint ;the said hand splinting device having combination of faciUties for vertical variation of the angles of the elbow joint and joints of the hand , horizontal variation of angles of joints of the hand , fastening and fixing of forearm and hand, self retraction of the wound through use of sutures,and elevation of forearm and hand during surgery. The invention is not restricted to any particular material. The material can be of any rigid substance which can support the forearm and hand , is skin friendly and can be sterilized in order to prevent transmission of infection. The present one is made of stainless steel. It consists of four metal plates . They are successfully linked by three hinge type joints , each fitted with interlocking gears for arresting movement at any desired angle. Each shcift is fitted with a winged nut which helps in tightening and fixing the gear at any desired angle. The plates are provided with multiple holes, which facilitate passing of fastners and sutures tying the body parts and retracting the wound margins for the purpose of fixing the body parts to prevent their movement for varying the angles of the wrist and metacarpophalangeal joints by pulling the body parts in opposite directions, and retracting the wound margins by pulling them in opposite directions by securing the said fasteners and sutures underneath the plates. There is a supporting rod attached to one plate for providing extra support to the splint. The functions of the four plates are the following : Plate 1 : This is the basal plate which supports the whole splint. This plate rests flat on the hand table. A set of holes are provided in the center to hold the supporting rod. Plate 2 ; This supports the forearm. The support rod is attached to the under surface of this plate. Plate 3 : This supports the palm. Plate 4 : This supports the fingers All the plates can be disassembled. Though, presentIy,only four plates are incorporated, the number of plates can vary according to the need. For example- additional plate or plates can be added along with extra joint or joints to conform to the interphalangeal (In the finger) joints. Similarly the number of plates used can be less, if variation of joints of the hand is not necessary in a limb which is short. This invention will now be described with reference to the two figures in the accompanying drawing in the only page. Fig.l is the plan view and Fig. 2 is the assembled side view. PI is the plate which is the base plate that lies on the hand table and supports the structure of the splint. P2, P3 and P4 are the plates supporting the forearm, palm and fingers respectively. Jl, J2 and J3 are the first, second and third joints respectively. Gl, G2 and G3 are the interlocking gears for Jl, J2 and J3, second and third joints respectively. WNl WN2 and WN3 are winged nuts used for fixing the Gl, G2 and G3 gears tightly. All the joints move in vertical angles. All the plates are provided with holes to fasten the overlying part viz. the forearm or the hand lying on it. In addition to fixing the forearm and hand, the fasteners can be used to horizontally alter the angle of the wrist and metacarpophalangeal joints by pulling the hand and fingers in opposite direction. Sutures passed through the wound margins can be passed through the holes in the plates and pulled in opposite directions retracting the wound. The elbow joint moves on the Jl, the wrist joint on J2 and the metacarpophalangeal on J3 joints. Method of using the device : The splint is placed on the hand table. The interlocking gears are loosened. The angles of the individual joints viz. elbow, wrist and metacarpophalangeal are decided. Then the plates are positioned in corresponding angles between them, the gears are locked and then tightened through the winged nuts, The support rod is allowed to stand on the base plate adding extra support. The arm of the patient is allowed to rest on the hand table. Now the forearm, palm and fingers are placed over the P2, P3 and P4 plates respectively. The elbow, the wrist and the metacarpophalangal joints assume the vertical angles of Jl, J2 and J3 joints respectively. If necessary, the angles of the wrist and the metacarpophalangeal joints can be varied horizontally by pulling them in opposite direction with the help of fasteners. The forearm, hand and fingers can be kept elevated above the horizontal by adjusting the angles of the joints of the splint. Elevation minimizes bleeding during surgery and also after the release of tourniquet, Less bleeding offers a clear field for the surgeon to operate. As such, minimizing blood loss is the aim of any surgical operation. When firm fixation of forearm , palm or fingers is necessary sutures can be passed through the palm or fingers; these sutures are then passed through the holes in the plates and held underneath the plates with the help of artery forceps, which, while exerting the necessary pull, will lie away from the field of operation. The fingers can be spread horizontally by this technique and this will facilitate operatioiis on them. This technique of fixing the sutures can also be used to retract a wound by pulling it"s margins with sutures, thus eliminating the need for an assistant to retract the wound. This will save the assistant from getting accidental pricks and cuts and aiso make the operating field less crowded, facilitating the work of the surgeon. For preventing movement of the foreairm, palm and fingers, they are fastened to the plates with the help of sterile fasteners passed through the holes provided in the plates and then secured under the plates. The advantages of this splint over the rigid flat splints are : 1. A single splint can be used for variety of hand operations by just varying the angles of the joints between the plates. 2. This device eliminates the use of an assistant to support the joints of the forearm and hand in different vertical angles during surgery. This eliminates the effects of shaking of and crowding of the operation field by the assistant"s hands and accidental injury to them. 3. Elevation by this device, of forearm and hand during surgery and also after the release of tourniquet, will minimise the bleeding which offers double benefit of saving the patient"s blood and also offering a clear view of the operating field to the surgeon. It is to be understood that the present invention is by no means limited to the particular construction herein disclosed and / or shown in the drawings but also comprises any modification or equivalent within the scope of the disclosure. WE CLAIM 1. A hand splinting device comprising of multiple plates; the said plates extending firm support to the forearm and hand for smooth performance of different types of hand surgery; the said plates (PI, P2, P3 & P4) connected in succession through joints (Jl, J2 & J3) capable of moving through different vertical angles facilitating the variation of vertical angles of the over lying elbow, wrist and metacarpophyangeal joints; the said joints of the splinting device fitted with arrangement for firm fixation at any desired vertical angle; the said plates having arrangement for horizontally varying the angle of wrist and metacarpophalanged joints ; the said splinting device capable of providing both vertical and horizontal variation of wrist and metacarphalangeal joints either separately or concurrently; the said plates having arrangement for fastening the forearm, palm and fingers; the said plates having arrangement for self retraction of operation wound through sutures; the said hand splinting device having facilities for elevation of forearm and hand through variation of angle of the elbow joint; the said hand splinting device having combination of facilities for vertical variation of the angles of the elbow joint and joints of the hand , horizontal variation of angles of joints of the hand , fastening and fixing of forearm and hand, self retraction of the wound through use of sutures, and elevation of forearm and hand during surgery. 2. The device as claimed in claim 1, wherein the plates (PI, P2, F3 & P4) are provided with multiple holes, which facilitate passing of fastners and sutures tying the body parts and retracting the wound margins for the purpose of fixing the body parts to prevent their movement, for varying the angles of the wrist and metacarpophalangeal joints by pulling the body parts in opposite directions, and retracting the wound margins by pulling them in opposite directions by securing the said fasteners and sutures underneath the plates. 3. The device as claimed in claims 1 and 2, wherein the plates are detachable and replaceable with plates of different dimension. 4. The device as claimed in claims 1 to 3 wherein the said arrangements for firm fixation are interlocking gears {Gl, G2, G3) the tightening of which prevents movement of the joints 01, ]2, ]3). 5. The device as claimed in claim 4, wherein the nuts used for tightening the interlocking gears are winged nuts (WNl, WN2, WN3) 6. The device as claimed in claims 1 to 5, wherein the plates are provided v/ith a support rod (SR) to impart additional support to the splint. 7. The device as claimed in claim 1 to 6, wherein the material used is any rigid substance that can be sterilized. 8. The device as claimed in claims 1 to 7, wherein the material used is skin friendly. 9. A hand splinting device for splinting the forearm and hand during surgery substantially as herein described with particular reference to the figures in the accompanying drawings.

Full Text

This splmting device is intended to splint (prevent movement of the joints of) the forearm and hand during surgery.
A splinting device is used for preventing movement of a joint or for the fixation of displaced or movable parts.
The hand has got many joints viz. wrist {Between forearm and palm), metacarpophalangeal (between palm and fingers), and interphalangeal (between the finger segments called phalanges). During surgical operations, the individual jomts have to be held in different angles depending on the procedure.
Certain types of splinting devices for hand surgery are either commercially available or are m use. The Prendiville hand table is a square table of wire mesh with fixing hooks to which the palm and fingers can be fixed with elastic bands. The deficiency is lack of vertical variation of angles of the joints of hand. Tapper"s universal hand holder and retractor set is a rigid flat plate fixed on legs. The deficiency is lack of vertical variation of angles of the joints of the hand. A rigid fixed angle wooden hand splinting device has been used for claw hand correction especially for leprosy patients. It is commercially not available. The deficiencies are lack of scope for variation of both vertical and horizontal angles of the joints of the hand and lack of faciUty for self retraction of the

wound. The lead hand is a malleable splinting device without any joints. On this, the angles of the wrist and metacarpophalangeal joints can be varied vertically. The deficiencies are ;
1. Lack of facility for horizontal variation of angles of joints of the hand.
2. Lack of facility for self retraction of the operation woimd.
3. Lack of strong support, since the material is malleable.
4. It is less durable because it becomes brittle and breaks down after sometime due to repeated bending and autoclaving.
During hand surgery without the help of a splinting device,
whenever the vertical angle of the wrist and the metacarpophalangeal joints have to be varied, an assistant has to support the forearm and hand with his own hand or hands in order to maintain the angle.
It is difficult and tiresome for an assistant to support the hand in a particular position, with different joints at different vertical angles, for a long time. Hence, some amoimt of shaking wUl be there, causing the following possible difficulties:
a. Disturbance to the smooth conduct of surgery.
b. Damage to fine structures like small blood vessels of hand through
the surgeon"s instruments.
c. Compromise in precision of operation, thereby, leading to an
inferior result.

Further, presence of the assistant"s hand or hands makes the operating field crowded, causing inconvenience to the surgeon.
Also, the assistant"s hands are likely to get injured form accidental needle pricks and cut by sharp instruments during surgery, which may infect him or her with deadly microorganisms like AIDS and serum helpatitis virus.
Statement of invention
The present invention pertains to a hand splinting device comprising of multiple plates ; the said plates extending firm support to the forearm and hand for smooth performance of different types of hand surgery; the said plates connected in succession through joints capable of moving through different vertical angles facilitating the variation of vertical angles of the overlying elbow, wrist and metacarpophyanlangeal joints ; the said joints of the splinting device fitted with arrangement for firm fixation at any desired vertical angle ; the said plates havmg arrangement for horizontally varying the angle of wrist and metacarpophalanged joints ; the said splinting device capable of providing both vertical and horizontal variations of the wrist and metacarphalangeal joints either separately or concurrently ; the said plates having arrangement for fastening the forearm, palm and fingers ; the said plates having arrangement for self retraction of the operation wound through sutures ; the said hand splinting device having

having facilities for elevation of forearm and hand through variation of angle of the elbow joint ;the said hand splinting device having combination of faciUties for vertical variation of the angles of the elbow joint and joints of the hand , horizontal variation of angles of joints of the hand , fastening and fixing of forearm and hand, self retraction of the wound through use of sutures,and elevation of forearm and hand during surgery.
The invention is not restricted to any particular material. The material can be of any rigid substance which can support the forearm and hand , is skin friendly and can be sterilized in order to prevent transmission of infection. The present one is made of stainless steel. It consists of four metal plates . They are successfully linked by three hinge type joints , each fitted with interlocking gears for arresting movement at any desired angle. Each shcift is fitted with a winged nut which helps in tightening and fixing the gear at any desired angle. The plates are provided with multiple holes, which facilitate passing of fastners and sutures tying the body parts and retracting the wound margins for the purpose of fixing the body parts to prevent their movement for varying the angles of the wrist and metacarpophalangeal joints by pulling the body parts in opposite directions, and retracting the wound margins by pulling them in opposite directions by securing the said fasteners and sutures underneath the plates. There is a supporting rod attached to one plate for providing extra support to the splint.

The functions of the four plates are the following :
Plate 1 : This is the basal plate which supports the whole splint. This plate rests flat on the hand table. A set of holes are provided in the center to hold the supporting rod.
Plate 2 ; This supports the forearm. The support rod is attached to the under surface of this plate.
Plate 3 : This supports the palm.
Plate 4 : This supports the fingers
All the plates can be disassembled. Though, presentIy,only four plates are incorporated, the number of plates can vary according to the need. For example- additional plate or plates can be added along with extra joint or joints to conform to the interphalangeal (In the finger) joints. Similarly the number of plates used can be less, if variation of joints of the hand is not necessary in a limb which is short.
This invention will now be described with reference to the two figures in the accompanying drawing in the only page. Fig.l is the plan view and Fig. 2 is the assembled side view. PI is the plate which is the base plate that lies on the hand table and supports the structure of the splint. P2, P3 and P4 are the plates supporting the forearm, palm and fingers respectively. Jl, J2 and J3 are the first, second and third joints respectively. Gl, G2 and G3 are the interlocking gears for Jl, J2 and J3, second and third joints

respectively. WNl WN2 and WN3 are winged nuts used for fixing the Gl, G2 and G3 gears tightly. All the joints move in vertical angles. All the plates are provided with holes to fasten the overlying part viz. the forearm or the hand lying on it. In addition to fixing the forearm and hand, the fasteners can be used to horizontally alter the angle of the wrist and metacarpophalangeal joints by pulling the hand and fingers in opposite direction. Sutures passed through the wound margins can be passed through the holes in the plates and pulled in opposite directions retracting the wound. The elbow joint moves on the Jl, the wrist joint on J2 and the metacarpophalangeal on J3 joints.
Method of using the device :
The splint is placed on the hand table. The interlocking gears are loosened. The angles of the individual joints viz. elbow, wrist and metacarpophalangeal are decided. Then the plates are positioned in corresponding angles between them, the gears are locked and then tightened through the winged nuts, The support rod is allowed to stand on the base plate adding extra support. The arm of the patient is allowed to rest on the hand table. Now the forearm, palm and fingers are placed over the P2, P3 and P4 plates respectively. The elbow, the wrist and the metacarpophalangal joints assume the vertical angles of Jl, J2 and J3 joints

respectively. If necessary, the angles of the wrist and the metacarpophalangeal joints can be varied horizontally by pulling them in opposite direction with the help of fasteners. The forearm, hand and fingers can be kept elevated above the horizontal by adjusting the angles of the joints of the splint. Elevation minimizes bleeding during surgery and also after the release of tourniquet, Less bleeding offers a clear field for the surgeon to operate. As such, minimizing blood loss is the aim of any surgical operation. When firm fixation of forearm , palm or fingers is necessary sutures can be passed through the palm or fingers; these sutures are then passed through the holes in the plates and held underneath the plates with the help of artery forceps, which, while exerting the necessary pull, will lie away from the field of operation. The fingers can be spread horizontally by this technique and this will facilitate operatioiis on them. This technique of fixing the sutures can also be used to retract a wound by pulling it"s margins with sutures, thus eliminating the need for an assistant to retract the wound. This will save the assistant from getting accidental pricks and cuts and aiso make the operating field less crowded, facilitating the work of the surgeon.
For preventing movement of the foreairm, palm and fingers, they are fastened to the plates with the help of sterile fasteners passed through the holes provided in the plates and then secured under the plates.

The advantages of this splint over the rigid flat splints are :
1. A single splint can be used for variety of hand operations by just varying the angles of the joints between the plates.
2. This device eliminates the use of an assistant to support the joints of the forearm and hand in different vertical angles during surgery. This eliminates the effects of shaking of and crowding of the operation field by the assistant"s hands and accidental injury to them.
3. Elevation by this device, of forearm and hand during surgery and also after the release of tourniquet, will minimise the bleeding which offers double benefit of saving the patient"s blood and also offering a clear view of the operating field to the surgeon.
It is to be understood that the present invention is by no means limited to the particular construction herein disclosed and / or shown in the drawings but also comprises any modification or equivalent within the scope of the disclosure.

WE CLAIM
1. A hand splinting device comprising of multiple plates; the said plates extending firm support to the forearm and hand for smooth performance of different types of hand surgery; the said plates (PI, P2, P3 & P4) connected in succession through joints (Jl, J2 & J3) capable of moving through different vertical angles facilitating the variation of vertical angles of the over lying elbow, wrist and metacarpophyangeal joints; the said joints of the splinting device fitted with arrangement for firm fixation at any desired vertical angle; the said plates having arrangement for horizontally varying the angle of wrist and metacarpophalanged joints ; the said splinting device capable of providing both vertical and horizontal variation of wrist and metacarphalangeal joints either separately or concurrently; the said plates having arrangement for fastening the forearm, palm and fingers; the said plates having arrangement for self retraction of operation wound through sutures; the said hand splinting device having facilities for elevation of forearm and hand through variation of angle of the elbow joint; the said hand splinting device having combination of facilities for vertical variation of the angles of the

elbow joint and joints of the hand , horizontal variation of angles of joints of the hand , fastening and fixing of forearm and hand, self retraction of the wound through use of sutures, and elevation of forearm and hand during surgery.
2. The device as claimed in claim 1, wherein the plates (PI, P2, F3 & P4) are provided with multiple holes, which facilitate passing of fastners and sutures tying the body parts and retracting the wound margins for the purpose of fixing the body parts to prevent their movement, for varying the angles of the wrist and metacarpophalangeal joints by pulling the body parts in opposite directions, and retracting the wound margins by pulling them in opposite directions by securing the said fasteners and sutures underneath the plates.
3. The device as claimed in claims 1 and 2, wherein the plates are detachable and replaceable with plates of different dimension.
4. The device as claimed in claims 1 to 3 wherein the said arrangements for firm fixation are interlocking gears {Gl, G2, G3) the tightening of which prevents movement of the joints 01, ]2, ]3).
5. The device as claimed in claim 4, wherein the nuts used for tightening the interlocking gears are winged nuts (WNl, WN2, WN3)

6. The device as claimed in claims 1 to 5, wherein the plates are
provided v/ith a support rod (SR) to impart additional support to the
splint.
7. The device as claimed in claim 1 to 6, wherein the material used is
any rigid substance that can be sterilized.
8. The device as claimed in claims 1 to 7, wherein the material used is
skin friendly.
9. A hand splinting device for splinting the forearm and hand during
surgery substantially as herein described with particular reference to
the figures in the accompanying drawings.

Documents:

0075-mas-1999 abstract-duplicate.pdf

0075-mas-1999 abstract.pdf

0075-mas-1999 claims-duplicate.pdf

0075-mas-1999 claims.pdf

0075-mas-1999 correspondence-others.pdf

0075-mas-1999 correspondence-po.pdf

0075-mas-1999 description (complete)-duplicate.pdf

0075-mas-1999 description (complete).pdf

0075-mas-1999 drawings-duplicate.pdf

0075-mas-1999 drawings.pdf

0075-mas-1999 form-1.pdf

0075-mas-1999 form-19.pdf

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Patent Number

200714

Indian Patent Application Number

75/MAS/1999

PG Journal Number

8/2007

Publication Date

23-Feb-2007

Grant Date

31-May-2006

Date of Filing

21-Jan-1999

Name of Patentee

DR. SATYANARAYAN MISHRA,

Applicant Address

B-2, RANI SEETHAI ACHI HOUSING COMPLEX, ANNAMALAINAGAR - 608 002

Inventors:

#	Inventor's Name	Inventor's Address
1	DR. SATYANARAYAN MISHRA,	B-2, RANI SEETHAI ACHI HOUSING COMPLEX, ANNAMALAINAGAR - 608 002

PCT International Classification Number

A61B 17/68

PCT International Application Number

N/A

PCT International Filing date

PCT Conventions:

#	PCT Application Number	Date of Convention	Priority Country
1			NA