Tires, splinting

Tires, splinting. Bus - devices intended for immobilization parts of the body with injuries and diseases of bones, joints and soft tissues.
Splinting - immobilization using tires.
Transport standard tyres are used for temporary immobilization when providing first aid and transporting them to a surgery or trauma hospital (as in the military field conditions - on the stage of rendering qualified, specialized surgical care). Medical tyres are used for long-term fixation in the best position to heal the damaged area, sometimes with traction bone; fragments. Immobility can be reached also the transport and treatment of tire dressings (a splint and circular), bursting discs from plaster or plastic (vinyl plastic and others). When providing first aid is sometimes invoked in the absence of standard: tyres to improvised the tyre (for example, plywood, plates, reeds, etc.,): Transport tires often rely on several types of damages (for example, the same bus for fractures of the hip, thigh and knee joint); treatment for fixing and treatment of damage to one certain type and localization (for example, of abduction bus for treatment of injuries of the shoulder). For splinting in injuries of extremities have the following requirements: in fractures of the bus must be of such length that it took at least two of the neighboring joints (one to the center and the other to the periphery from the place of the fracture); transport immobilization limb if possible give physiological position (provided at least part of reposition of fragments) with respect to the direction of the axis of the joints and planes, in which there are movements; the bus must be durable and at the same time not have anywhere to provide traumatic pressure on the underlying tissues. To this end it shall be covered with soft bedding, especially in those areas where it is in contact with bone ribs (for example, ankles, madelchai).

Fig. 1. Tyres Capitol records for phalanxes of fingers: 1 - wire bus; 2 - 4 - bus, wrapped a plaster bandage.

Fig. 2. Drum tyre fingers.

A separate fractures of fingers phalanx fix improvised or standard buses (for example, type Capitol records; Fig. 1). The fingers should be recorded on a cylindrical bearing surface, which is achieved the so-called drum bus (C. A. Gusynina; Fig. 2) or simple tight bandage on spherical or cylindrical ball of wool or on the bottle with warm water as physiotherapy agent (Fig. 3). When flexion contractures fingers I use medical tyres, for example lyre of Mommsen (Fig. 4). For immobilization of different kinds of fractures, phalanges of the hand and wrist bones in WEIHAI developed a set of tires of different sizes (Fig. 5 and 6). The set includes bus Phillips, zheloboobraznogo, wedge-shaped, plate, tires cyto, tires for giving physiological provisions for traction (C. A. Mikhalenko). Tyres bent on installed in physiological position of the fingers healthy brush, and then put on the damaged fingers and fix the bandages. Plate dural tyres set immobilizer fingers in fractures of the nail and middle phalanxes, cross cover finger on four sides zheloboobraznogo - Palmar and dorsal sides, tapered - Palmar and side surfaces, bending her end on the rear nail phalanx. Tyres for giving physiological provisions used during immobilization of fractures of limbs and metacarpal bones after surgery on hand. For the treatment method skeletal traction in the set is a pin stainless steel and tires made of aluminium.

Fig. 3. Improvised fixation brush: 1 - at the lump of cotton; 2 - the bottle.

Fig. 4. Therapeutic bus - lyre of Mommsen when flexion contractures fingers.

Fig. 5. A set of tire VNIIA for immobilization of fractures of the brush: 1 - set the plate tires, 2 - pins for skeletal traction; 3 - tires for traction (Mikhalenko); 4 - bus l-shaped; 5 - bus wedge; 6 - bus dural with foam coating to give the brush physiological position; 7 - Shyla-drill; 8 - bus cross; 9 - bus zheloboobraznogo; 10 - bus T-shaped cyto.
Fig. 6. The application of tyres from the set of VNIIA for immobilization of fractures of fingers phalanx and metacarpal bone: 1 - immobilization finger zheloboobraznogo bus; 2 - immobilization toe wedge bus; 3 - the use of plate tires to give brush physiological position; 4 - immobilization of the finger of G-shaped bus; 5 - treatment of fractures phalanxes of fingers on the bus for traction; 6 - immobilization toe long bus.
Longuet in case of damage of joints
Fig. 7. Longuet if the damage in the joints: 1 - plaster or viniplast the Paris splint is placed at the damage in the area of the beam-carpal joint; 2 - plaster or plastic Paris splint is placed at the damage in the brush.
the triangle of Hacker
Fig. 8. The triangle of Hacker wire bus Kramer (part of the tire, designed for the forearm, is set in position pronation).

Fig. 9. Fixing shoulder in the designated position bus Kramer.

Fig. 10. The imposition of transport bus Kramer at damage of shoulder and elbow and shoulder bones: 1 and 2 - strengthening the upper end of the bus; 3 - tire imposed.
abduction bus Capitol records
Fig. 11. Abduction bus Capitol records, made of five bands bus Kramer.
abduction bus Korneva
Fig. 12. Abduction bus Korneva from one lane bus Kramer: 1 - the method of manufacture; 2 - imposed bus with retaining its straps.

Plaster and vinyl Longuet necessary in injuries in the area of the beam-carpal joint and brushes (Fig. 7). Fractures of the forearm and elbow record in the provision of first aid at the triangle of Hacker made of wire stair bus Kramer (Fig. 8). Strip that bus have the sizes 100h10 cm or 75x7 see the same bus used for the transport and treatment of immobilization of fractures of upper arm and shoulder joint in the designated position (Fig. 9). When providing first aid impose bus Kramer (Fig. 10). Abduction bus Capitol records bandage, having created its five bands bus Kramer (Fig. 11). Similar bus P. G. Korneva simpler (Fig. 12).
When clavicle fractures are bus Capitol records, representing the plywood Board with a half-oval cutouts at each end (Fig. 13.1 and 2). More perfect mystery S. I. Kuzminskiy (models for adults and for children), representing a sliding frame with arcs, have soft skin (Fig. of 13.3). Various therapeutic bus, enabling a reduction in fractures of the bones of the upper limb, the proposed Century I. Ivanov, A. Y. Sauzon-Yaroshevich, V. S. Aleinikova and other

tyres fracture of the clavicle
Fig. 13. Tyres fracture of the clavicle: 1 - bus Capitol records; 2 - imposed bus Capitol records; 3 - tire Kuzminsky.
transport immobilization
Fig. 14. Transport immobilization in injuries of the foot, ankle and lower leg.
bus Thomas
Fig. 15. Bus Thomas with a free and open ring: 1 - skeleton of a bus; 2 - the tyre wears a canvas hammock.

Transport splinting in injuries of the foot, Golino-ankle joint and lower leg exercise usually Cramer, plywood, cardboard tires and a plaster splint imposed to mid thigh. It is necessary to bend tyres respectively convexity heel and calf muscles (Fig. 14). Fractures of the middle and upper third of the tibia are bus Thomas (Fig. 15), and its modifications (Ternovskiy, Lardennois, Vinogradova, Goncharova). It consists of wrapped in soft bedding pop-metal rings and two outgoing metal rods, United on the lower end of the bus. Between these rods stretched fabric gamucci that support the thigh and the lower leg while the ring is worn on the foot, based on the sciatic mound and the pubic bone in the crotch area. Bus Thomas is usually worn over the dress and shoes and strengthen the bandages. Stretching limbs produce footwear in the field of the ankles with hinges and cuffs. However, the bus Thomas and its modifications, as a rule, do not give reliable immobilization or give only brief and incomplete. So for fractures of the lower extremities, hip and knee joints should be used for splinting standard tires type Diterikhs, Teofilo. Thorn Diterikhs (Fig. 16) consists of two sliding (pegs) wooden strips of different length: long adjacent to the outer side of the thigh and torso to the armpit, and the short - to the inside of the thigh to the perineum. On the peripheral end of the short runway has a movable plate attached to the hinge. It serves to connect with long, thin tires, where there is a peg. At the foot of the ends of the wooden strips are connected with a wooden sole side brackets. To the sole attached dual string with spin for traction.

bus Diterikhs
Fig. 16. Bus Diterikhs: 1 - General view; 2 - imposed bus.
tire Tovilo
Fig. 17. Tire Tofile (plantar part of the tire is not shown).
bus Pankova
Fig. 18. Bus Pankova to commit limb fractures of the femur and tibia.
bus Capitol records
Fig. 19. Therapeutic bus Capitol records for fixation of fractures of the femur and tibia.
therapeutic bus Pankova
Fig. 20. Therapeutic bus Pankova to commit limb fractures of the femur and tibia; traction.
transport bus Pankova
Fig. 21. Transport bus Pankova to immobilize the spine: 1 - a separate section of the bar; 2 - the tyre is mounted in three sections.

Fig. 22. Transport immobilization of penetrating wounds of the skull: 1 - the imposition of tires, 2 - side view.
the possible expansion bus
Fig. 23. The possible expansion bus for transport immobilization of the head.

The lack bus Diterikhs - sagging legs - fixed in tricuspid the tyre Tofile (Fig. 17). In contrast to bus Thomas and its modifications, transport bus Pankov (Fig. 18) commits a limb in posture and with a small lead. However limb simultaneously recorded and to the body, and to a healthy limbs. The bus consists of a sliding donaciones frame with telescopic base, equipped with brakes, screw clamps, and two folding bars. Therapeutic bus with skeletal traction in fractures of the femur and tibia, Belair, widespread (Fig. 19). Another type is therapeutic bus Pankov, unlike belaruskoy, allows you to change the position of the limbs in the hip and knee joints with the purpose of reduction of fractures and medical gymnastics while maintaining compliance direction thrust along the axis of the tibia and femur (Fig. 20). Bus Pankov sliding and can therefore be used in adults and in children. For the transport of immobilization of the spine in WEIHAI developed (on the proposal of the Century A. Pankov) bus in the form of a shield made of three identical interchangeable corrugated sections of duralumin (Fig. 21). When connecting sections ledges one of them are open another. The middle section is always shifted to the longitudinal axis relative to the side sections; the amount of displacement set the length of the body of the patient. Protruding end of the middle section is simultaneously the head restraint. Lower niche between two side sections allows the patient to use a ship without removing the bus. Depending on the testimony of the tyre is mounted in the form of a shield to immobilize the spine or in the form of long outdoor section and short internal - with fixation of fractures of the lower extremities. In injuries to the skull produce transport immobilization two tyres Kramer. One model in the sagittal direction (from brow to waist), and the second lay in the frontal direction through the top and to both shoulder girdle (Fig. 22). The tire with good cotton bedding tight bandage. Another type of transport bus for the same purpose - folding wooden possible expansion bus (Fig. 23).

Cm. Traction, Plaster technique, Immobilization.

transport bus
Fig. 1. Transport bus: a - Diterikhs; b - Kramer; and Mr. plywood; d - W - impromptu.

Tires are fit for immobilization in injuries and diseases of bones, joints and soft tissues. Splinting - the imposition of tires to prevent the displacement of bone fragments, comfort, reduce pain. There are bus transport, used for the provision of first aid, and tires treatment, ensuring peace limbs at carrying out of special treatment. Transport bus can be standard or improvised. Standard tires, the most common wire stair bus Kramer, bus Diterikhs, wooden or plywood plates (Fig. 1, a - g). Wire bus Kramer has a certain flexibility and can be bent in the right direction, providing strong fixation in any position. Standard transport tires are produced of different length and width so that it can be used for immobilization in case of damage of any location and at any age. Improvised transport bus (Fig. 1, d-g) are made directly at the scene of the material at hand - boards, plywood, metal cane, stick bundles of twigs, sheaf, cardboard, etc. Set of tyres is necessary accessory set for first aid.
The bus must be of such length that could record not less than two joint - above and below the injury site. In some cases, we have to capture a larger number of joints (for example, when shinravii of the spine). Peace can only be ensured if the bus is firmly and securely attached to the undamaged parts of the body. Before imposing bus (whether standard or she improvised) you need to wrap it with a thin layer of cotton wool.
Splinting when the spine fracture is provided by putting the victim on the hard shield that produce carefully, without turning or buckling of the patient. Lay the casualty three: two become on the knee to the side of the victim, shoved his hands - one under the pelvis and thighs, another of the back and the back - and slightly raise, third, while on the opposite hand, pushes the patient under the shield.
At fracture of the pelvis patient is placed on a Board with your back, legs bent at the knee and hip joints and several bred. In the popliteal fossa enclose roll roller from the service or the pillow. At the turn of the violation of the history of pelvic ring to prevent the displacement of bone fragments splinting produce as at fracture of both hips.