US 2612891 A
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Description (OCR text may contain errors)
Oct. 7, 1952 M. c. SMITH ADJUSTABLE SUPPORT FOR FINGER SURGERY Filed July 10, 1950 VTV H49 5y H15 Arramvsrs c# 7-55 'mi f//A/w/s Patented Oct. 7, 1952 UNITED Fries ADJUSTABLE SUPPORT FOR FINGER SURGERY lli Claims.
This invention relates to surgical appliances and more particularly to a device adapted to position and support a finger of the human hand for surgical operation thereon.
Surgical incisions in the fingers are freequently delicate and complex operations, the performance of which may be materially aided by the presentation and maintenance of the area to be incised in a firm and convenient position for an extended period of time. an important object of my invention to provide a device which is adapted to elevate a finger in a suitable position for operation thereon and firmly support the digit in such position during the entire operative period, in order that it may be at all times most accessible to surgery, irrespective of any muscular activity of the patient.
It is another object of my invention to provide a device of this character in which the finger to be worked upon (hereinafter frequently termed the affected finger or the subject iinger) is isolated from the remaining fingers and thumb of the hand and separately presented in a convenient location for incision, the remaining or idle digits being restrained to prevent any interference with the operation, either voluntary or involuntary, or contamination of an open incision on the subject finger.
A further object is to provide in a device of this character an adjustable finger positioning platform which is pivoted to facilitate manipulation and variation of the angle of inclination of the finger resting thereon, thus enabling the surgeon to position and support the affected finger at the most favorable acclivity for the expeditious performance of the operation during all stages thereof, irrespective of the portion or part of said finger to be incised.
Another object is to provide a surgical device which may be employed for operating on either hand, and on either the upper or lower surface of an affected finger, with the hand itself resting either palm downword or upward on the device.
Still another object is the provision of a device of this character which does not require in its function the assistance or cooperation of the patient but may be employed while the patient is under general or local anesthesia to position and support the subject finger and facilitate the surgeons operative procedure.
Still another object of the invention is to provide a surgical appliance for finger operations which may be easily sterilized as an entire unit and manipulated and adjusted during surgery It is, accordingly,
without danger of contamination to the operator. I In a large number of finger operations the surgeons work is performed in the deep subcutaneous areas of the digit, necessitating the cutting and drawing back of skin or skin flaps adjacent the incised area in order to expose various inner regions of the finger to View. It is essential that this skin on either side of the incision be securely maintained in retraction during the course of the operation Without injury thereto and it is a further object of my invention to provide, in a device of the aforementioned type, self-retaining skin rectraction means to facilitate the convenient exposure of the subcutaneous area to be worked upon by the surgeon. Another object ofthe invention is to provide spring-biased skin retractors which are adjustably secured to permit variation of the setting thereof, in order that skin flaps of Varying sizes and in diverse locations on the finger may be firmly retracted under a suitable tension at all times and without injury to the skin which is so withdrawn.
Other advantages will be apparent from the following description of an exemplary embodiment, as illustrated by the drawing, in which: Fig. 1 is a plan view of the device with a right hand and fingers, palm upward, shown in phantom in operative position;
Fig. 2 is a partly sectional side view of same; Fig. 3 is a transverse partly sectional view taken as indicated by the broken line 3 3 of Fig.
1 1; and v Fig. 4 is an enlarged transverse view taken on the line 4-6 of Fig. 3 showing details of an individual skin retractor.
The surgical appliance, as shown in the drawing, includes a rectangular base member indicated generally at Il preferably'fabricated vof metal, for vease of sterilization', and having a peripheral depending iiange AI 2 supporting a base platform portion i3 in spaced relation from a table or similar support (not shown) in the operating room. Rigidly secured to the base platform I3 at a central portion thereof, by means of a plurality of bolts lli, is a double-ended nger restraining member i5, comprising a channelshaped central portion i6 having integrally formed therewith vlaterally extending restraining bars l'lsubstantially parallel to the base platform I3 and in spaced relation therewith."
Adjacent the outer end of each of the nger restraining bars l1 there is mounted a -skin retraction assembly I8 including a binding post I9, a coil spring and a skin retractor 25. The binding post I9 is adapted to adjustably secure an extension 2| of the spring 20, which is retained in a binding post aperture 22 by means of a binding post screw 23 having a knurled head 23a. The opposite end of the spring 20 is looped through an aperture 24 of the skin retractor 25, which, as shown in detail in Fig. 4, has a plurality of truncated prongs 25 which may be curved inwardly to best retain the skin in retracted position without puncturing same.
Positioned transversely of the finger restraining member I 5 and having a segment of its length lying within the channel-shaped central portion I6 thereof, is a three-bar-link finger positioning and supporting assembly 28. An inclined finger supporting platform 29, in the form of a relatively narrow metal strip, comprises the upper link. The lower yend of the platform 29 is`hinged by means 'of la `hinge 3l to a hinge butt 32 which in turn is secured to the base platform I3 by ymeans-of a pairof the :bolts I4 which pass through the butt 13-2 as well as the central portion IIB `of the finger restraining member I5. 'I'he upper end'of the iingersupporting platform 29 is similarly hinged .by means of a hinge 33 to an 'intermediate bar 34 of the three-bar-link, such bar 534 having aspatulate outer end portion 35 which :is positioned to form a binder link, indicated `alt-36, vwith aisimilarly spatulate outerend portion 38 o'f a lower bar 31. The lower bar v31 is in turn hinged 'at Vits inner end by a hinge`39 to a hinge 'butt -40' which-is secured to the base :platform .Iz3 by means of bolts 4I as best vshownin Fig.t2. The spatulate end portions 35 and 38 of the intermediate and lower bars 34 and 31 -are adjustably secured together by means ofa'screw'42and :a Wingnut 43. The iintermediate'and lower Ybars34 and 31, respectively, togetherwith thenger supporting platform 29 form .the three-bar-link which is maintained in any desired position of elevational adjustmerit 'of means of .the :adjustable binder .link 36.
In -crder to restrain the thumb against movement :toward `the yaffected finger, thumb loops and 45a `are 'adjustably afxed to the base platform I3 adjacent'corners 46 and 46a thereof. respectively. vEach such loop is biased toward its corner by means of a coil spring 4.1 which 'at one end engages the thumb 'loop and at fthe other .is :adjustably ,retained by a screw 48, having a knurled head 48a, ina binding post aperture 50 of a binding post 49 afxed to the 'base member II adjacent thecorner thereof.
The device described may .be employed with either hand positioned :palm `.upward or downward, as Emay vbe-required to best present .to view the Aportion of the affected nger .requiring surgery. In usage, Athe patient may be under general or local anesthesia. In either event, .the affected .hand yis vplaced partially on the `base platform :I3 .of `the .previously sterilized device, with the .fingers extended substantially perpendicularto thefingerrestraining member I5 and with -the tip of the subject finger resting on the lower end .of the .finger supporting platform 29. .'Ilhelatter maybe initiallyrse'tat 4a relatively low inclination as illustrated in the drawing.
.The .hand and .lingers are then moved into position bya forward sliding of the hand which carries tall the :fingers-except the .one .on which the `roperation is `to be performed, .beneath v.the
finger depressing bars I1. Such movement will also bring the affected finger up on the finger supporting platform 29 where it is positioned with the tip at or adjacent the hinge 33. In the event the affected nger is the first or fourth, all the remaining fingers will be beneath one bar only of the nger restraining member; and in this connection it is to be noted that each of the individual fingerrestraining bars extends laterally la sufficient distance 'to overlie the width of any three adjacent fingers of a normal hand.
With the subject finger thus positioned on the nger .supporting platform 29 and the remaining fingers disposed beneath one or more of the nger restraining bars I1, the inclination of the finger supporting platform may be suitably adjusted tobest present the affected finger to the surgeon. Such adjustment may be easily accomplished by loosening the wing nut 43 and pushing backward at the binder link 36 to increase ;the inclination of the finger supporting platformj29 or-conversely pullingforwardzto decrease same. -Such push orpull maybe .transmitted by the-operatorthrough the wing nut 43 itself, so that .the-looseningand .tightening nf .the binder link 36 and `the forward or backward movement imparted may -be easily .effected in one Vadjustment .operation -to achieve the vde sired setting of the supporting-platform, ormay be accomplished by applying force vertically at hinge 33.
After the fingers are -positionedin vthe manner described,.a thumb loop 4 5 or 45ais slipped .over the thumb. Two such thumb locpsare provided in order that in .either gpalm-.upror :palm-.down position of the .right ,or flefthand, a thumbloop will 'be suitably `located Ifor :such engagement. The thumb thus -encircled .by :the .thumb loop is .urged 'toward the `.corner :46 .or 46a, as .the case .may be, by .means ofrespective spring 41, which may be adjusted after loosening .of its binding -post screw 48, to vary Athetension on the loop as may .berequired inaccommodating differentsize .hands ,in :varying ipositions.
Prior to the commencementof Athe operation the hand is thus positioned with .all the lingers, except vthe one to vbe incised, underlying .the nger depressing lbars -If1 where they 4are restrained fromconscious or subconscious interfering movement ,toward the .affected finger into the .zone of operation. IBy the zonebf .operation or the operative Yzon e,.1.hav,e reference to .the centrally located .area ;of the .apparatus occupied by and -adjacent `to .the finger supporting platform. Similarly, the .thumb is yrestrained from movement toward the ,operative zone and biased toward a .spread .finger position. The affected nger is supported on ythe inclinedplatform iin va position mostfsuitablezfor-the surgeons work in the zone of operation.
Intl-1e event the operation performed 'on the nger, thus supported and isolated, Irequires-the cutting of vskin flaps to :exposefsubcutaneous regions, such flaps may be conveniently drawnback and .held out vvof the way by means of the skin retractor assemblies I8fof my device. ,Each individual inwardly inclined retractor 25 .is 1designed to engage `theskin .without puncturing 'the same and to maintain it .in a retracted .position with a #minimum outward pull thereon, .during the major portion of I.the.surgf21;y, ythe spring 20 providing the required @tension .on Ithe retractor.
Such tension .may be adjusted to accommodate skin flaps of varying .dimensions orin different locationson the finger yby loosening .of the bindng'post screw 23 and 'moving' the spring extension 2^! to the left or right in the binding post aperture 22 so as to exert only suiiicient tension by means of the spring to maintain retraction.
If, during the course of the operation, it becomes desirable to alter the inclination of the finger supporting platform 29 in order to expose to better View or more convenient working position additional portions of the affected finger, the wing nut i3 may be loosened and the inclination of the supporting platform then varied by forwarder backward force exerted thereon as heretofore described.
Thus it will be seen that I have provided' a surgical appliance for use in finger surgery which not only adjustably supports and positions the subject finger for maximum eiciency in operation thereon, but also restrains the idle digits and isolates the subject finger to prevent any interfering'movement into the Zone of operation. Moreover, I have provided conveniently adjustable self-retaining skin retraction means for use in connection with my device.
The embodiment of my invention herein described in specific detail for the purposes of disclosure and to illustrate an application of the principles involved will suggest to those skilled in the art various modifications and substitutions that do not depart from the underlying inventive concept and I do not desire to be limited to the specific illustration disclosed herein and do hereby reserve the right to all such modifications and substitutions that properly come within the scope of the following claims.
I claim as my invention:
1. In an appliance for finger surgery the coinbination of z finger supporting means for positioning a subject finger of the human hand in an elevated position relative to the remainder of the hand for surgery thereon; and a linger depressing bar adapted to limit the movement of the remaining fingers of the hand toward said subject finger.
2. A surgical appliance for use in finger operations including: a base member for supporting a hand thereon; finger supporting means disposed in an operative Zone centrally located with respect to said base member and extending obliquely upwardly therefrom, said finger positioning means being adapted to support a subject finger of the hand in an upwardly inclined position relative to the remainder of the hand during surgery thereon; and finger restraining means for limiting movement of the remaining fingers of the hand toward said operative Zone.
3. A surgical appliance for use in operations on an affected finger of the human hand includ'ng:
a base member; a movable finger positioningy platform pivotally secured to said base member and extending obliquely upwardly therefrom, said platform being adapted to support the affected finger in an elevated position during an operation thereon; nger restraining means for limitingr movement of the remaining fingers of the hand toward the affected finger; and thumb restraining means for engagement with the thumb of the hand to limit movement of the thumb toward the affected finger.
4. A surgical appliance for use in operations on an affected finger of the human hand including: a base platform; a finger positioning assembly pivotally mounted on said base platform comprising a linger supporting platform adaptedl to support the affected finger during an operation 6 thereon and means for varying the inclination of said finger supporting platform; and a-iingerdepressing bar for limiting movement of theremaining fingers of the hand toward the affected finger.
5. A surgical appliancev for use in operations.
on an affected finger of the human hand including: a base member; a movable finger supporting platform adjustably secured to said base member and adapted to support `the affected finger during an operation thereon; nger restraining means for limiting movement ofthe balance of the fingers of the hand toward the affected finger; and thumb restraining means to limit the movement of the thumb toward the af'- fected nger, such means including a thumb engaging receptacle adjustably'secured to said base member. l
6. A surgical appliance for use in operations on an affected finger of the human hand including: a base member; a movable finger'supporting platform pivotally mounted on said base member and adapted to support the affected finger during an operation thereon; adjustable skin retraction means for retaining the skin adjacent an incision in the affected finger in retracted position during surgery thereon; finger restraining means for limiting movement of the balance of the fingers of the hand toward the affected finger; and thumb restraining means for engagement with the thumb of the hand to limit movement of the thumb toward the affected fiinger.
'i'. A surgical appliance for use in operations on a finger of the human hand including: a base platform; a movable finger supporting platform pivotally mounted on said base platform and adapted to support said finger during an operation thereon; spring-biased skin retractors adjustably secured to said base member at opposite sides of said finger supporting platform; a finger depressing bar for limiting the movement of the balance of the fingers of the hand toward the finger on which the operation is performed; and a thumb engaging receptacle adjustably secured to said base platform adapted to limit the movement of the thumb toward the finger on which the opera-tion is performed.
8. A surgical appliance for use in finger operations including: a base member; a movable finger supporting platform centrally disposed with respect to said base member and pivotally mounted thereon; a finger restraining member including a central channel portion receiving one end of said supporting platform and having integrally formed on both sides of said channel portion finger restraining bars extending transversely of said finger supporting platform and in spaced relation from said base member;v a spring-biased skin retractor adjustably secured adjacent the outer end of each of said finger restraining bars; and a pair of spring-biased thumb engaging receptacles each adjustably secured to said base member adjacent a corner thereof.
9. A surgical appliance for use in operations on a subject finger of the human hand including: a base member; a nger positioning assembly pivotally mounted on said base member comprising a finger supporting platform adapted to support said finger in an inclined position during an operation thereon and binder link means for setting said finger supporting platform at any desired position of inclination; a finger restraining member including a central channel--portion adapted to :receive Va vsegment of .said :supporting ,platform and Vhaving integrally formed Atherewith .a linger .restraining bar extending laterally in spaced relation from said base member and adapted to overlie the remainingfingers of the hand; a self-retaining springbiased skinretractor adjustably secured adjacent the outer end of Vsaid nger restraining bar adapted to retract the skin adjacent an incision in the :subject finger toward the outer end of the nger restraining bar; and a thumb retractor for engagement with thethumb of the hand to bias said thumb toward a spread-finger position.
10. A surgical appliance .for use in Voperating on asubject .finger of the human hand including: fa base member; an adjustable vfinger positioningfassembly comprising Ja plurality of pivotally connected bars, one of said bars being adapted to support the subject finger .in an ele- -vated position for surgery thereon and another ofsaid-barsbeingsecured .to said base member;
and ngerrestrainingsmeans comprising anngor depressing bar adapted to limit the movement The following references are of .record inthe lle of this patent:
UNITED STATES PATENTS Number Name Date 806,681 Kursheedt ..-Dem 5, :1905 2,237,251 Longfellow Apr. Vl, 1941 2,291,125 'Wilkinson 1\ .July 28, 1942 2,444,491 Berry July T1948 FOREIGN PATENTS Number Country .Date
293,622 Germany Aug. 12, 1915 589,416 vGreat', Britain June w19, 19.47