THE ANTERIOR SPLINT 
OF 
DR. NATHAN R. SMITH, 
OF BALTIMORE, MD. 
BY EPHRAIM CUTTER, M.D. 
OF WOBURN. 
This splint is brought forward under the conviction 
that it possesses features new and worthy the attention 
of the surgeon. It is a recent production of its distin- 
guished inventor, and was obtained, by the writer, on a 
late visit to Baltimore. It is intended for fractures of 
the lower extremities, and presents the following pecu- 
liarities : - 
(1) It is made of iron wire. 
(2) It is applied to the anterior surface of the limb. 
(3) It is a suspensory splint. 
(4) The splint does not touch the limb. 
(5) It may be bent to different angles, thus giving re- 
lief by shifting the obtuseness or acuteness of the inclina- 
tion of the leg with the thigh. 
(6) The counter-extension is effected by the weight of 
the body-the extension by the obliquity of the suspen- 
sory cord. 
(7) It is simple. 
(8) It is easy. 
(9) It is cheap. 12 
DR. N. R. SMITH'S ANTERIOR SPLINT. 
Fig. I. 
6 ' 
a 
a 
b 
a j 
a 
b 
Mechanical drawing from above. Anterior splint for the thigh. Scale, 3-8 in. to one foot. 
a, the transverse pieces with eyes, b, eyeless cross-bars, showing their slight convexity. 
(1) The splint is made of iron wire about r3K inch in 
diameter. There are two sizes. The larger (for the thigh) 
is about 4 feet long and 3 J inches wide. The smaller (for 
the leg) is about 2| feet by 3 inches. The first is made 
by bending on itself at two right angles a wire, as above, 
8 feet and 7 inches in length. It is then crossed by 8 
transverse pieces | inch in diameter, four of which are 
provided with eyes for the insertion of hooks. These 
bars are segments of a circle, in order to give a convex 
surface to the splint. The bars with eyes are movable. 
The smaller splint is similarly made, but with a shorter 
wire and with two bars having eyes. 
Fig. II. 
b I® 
£ wa 
Mechanical drawing of the anterior splint for the leg, viewed from above. Scale, 3-4 in. to 
one foot, a, cross-bars, b, eyeless cross-bars. 
(2) 11 Anterior Splint." This property is the distin- 
guishing original feature of the splint, I believe. It is 
applied not to the posterior or lateral portions of the 
limb, but, as the name indicates, to the anterior sur- 
face. It is, in fact, an inclined plane, like many other 
splints; but it is an anterior, not a posterior inclined 
plane. For use, it is bent at three points - at one end 
to about a right angle, to fit the back of the foot and leg; 
at another point, near the middle, to an obtuse or acute DR. N. R. SMITH'S ANTERIOR SPLINT. 
13 
angle, to adapt itself to the obliquity of the limb at the 
knee joint; and at a third point, near the other end, to 
suit the angle made with the trunk by the thigh. 
(3) It is a suspensory splint. This feature is striking, 
but not original. By means of a cord provided with two 
hooks, which are inserted into the eyes made in the trans- 
verse bars of the splint, a loop is formed. This is attach- 
ed to another cord depending from some support over 
head, generally the ceiling. This cord, by a simple con- 
trivance (a block of wood bored with three holes through 
which the string passes), is lengthened or shortened till 
the limb is elevated sufficiently, or to gratify the patient 
with a change. The limb is thus hung in air. 
(4) The bandages whereby the member is confined to 
the splint, alone come in contact with the limb. Thus a 
perfect adaptation to the inequalities of the leg is at- 
tained, and a uniform support is ensured by the sling so 
made. 
(5) The metallic nature of the splint admits of a change 
in its angles. It is sometimes a relief to the patient to 
have his limb supported in different positions. An obtuse 
angle of the leg and thigh may with comfort be made an 
acute one, and vice versa. This is done in the present 
instance simply by bending the splint. The same indica- 
tion is fulfilled in Roe's posterior inclined splint by means 
of a screw. 
(6) The counter-extension is made by the weight of 
the body, the extension by the suspending cord. The 
more oblique the direction of suspension, the greater the 
extension. By raising the foot of the bed, the patient 
will tend to move towards the head, and thus the counter- 
extension is increased. 
(7) It is simple. A man of common ingenuity can 
fashion one. A piece of wire is merely bent on itself at 14 
DR. N. R. SMITH'S ANTERIOR SPLINT. 
two right angles and fitted with cross-bars. The eyes in 
the bars are made by one turn of the wire on itself. 
(8) Its ease is considerable. The patient can move in 
bed. He can sit up. He is made portable without dis- 
placing the fracture - for by keeping the limb suspended 
by the cord in the hand, an assistant can lift the patient 
from his bed without trouble. 
The writer saw a man with fracture of the thigh at the 
middle third, of three weeks standing, removed from his 
bed in the ward and conveyed to a clinical amphitheatre 
some distance off, without inconvenience - his limb being 
supported by this splint, in the manner just mentioned. 
The patients treated expressed satisfaction with the splint. 
(9) It is cheap. Mr. Taylor, a wire-worker of Balti- 
more, furnishes the splints for $1.00. This gentleman 
stated that it was adopted in the U. S. Navy, and that he 
provided the government with brass models for ships. 
The splints are no longer an experiment. They have 
been used in Baltimore for two years. 
Mode of Application. - Having bent the splint to fit 
the limb, and arranged the suspensory cords, the surgeon 
covers ^he splint with bandages and attaches it to the 
apparatus of suspension. The limb is then confined by 
adhesive straps passing round the splint at the ankle, knee 
and thigh, assistants also affording support. Rollers are 
then applied, the adhesive straps removed, and the opera- 
tion is complete. DR. N. R. SMITH'S ANTERIOR SPLINT. 
15 
The thigh splint in situ. The bandages are not shown, a a, the splint bent and laid on, 
b b, the suspensory loop connected by hooks to the eyes of the cross-bars, c, the suspensory 
cord, which may be lengthened or shortened by moving the perforated block d. The line of 
suspension is represented oblique. 
Fig. III. 16 
DR. N. R. SMITH'S ANTERIOR SPLINT. 
The leg splint in situ. References the same as in Fig. III. Practically the splints do not 
lie so close to the limb as represented in the cuts. 
Fig. IV.