US 3090381 A
Description (OCR text may contain errors)
May 21, 1963 w. s. WATSON SURGICAL COMPONENTS FOR OPERATING TABLES 2 Sheets-Sheet 1 Filed Dec.
WLLL 1AM s. WATSON 'J/JINVENTOR y 1, 1963 w. s. WATSON 3,090,381
SURGICAL COMPONENTS FOR OPERATING TABLES Filed Dec. 50, 1960 2 Sheets-Sheet 2 'KII) d-i INVENTOR WLLLLAM S. WATSON ATTZDRNEYS United States Patent 3,090,381 SURGICAL COMPONENTS FOR OPERATING TABLES William S. Watson, Rochester, N.Y., assignor to The Pelvic Anchor Corporation, Rochester, N .Y., a corporation of New York Filed Dec. 30, 1960, Ser. No. 79,735 Claims. (Cl. 12884) This invention relates to orthopedic accessories permitting the use of unilateral traction, as distinguished from bilateral traction and countertraction, in the reduction of bone fractures and/ or dislocations and for like purposes as disclosed in my prior U.S. Patent No. 2,691,979. More particularly, the invention resides in equipment of the foregoing type having a novel design and construction that is especially adapted for use as components of a general operating table of any of the types found in hospital operating theaters and well known to those skilled in the The usual operating table is divided longitudinally into several sections that are adjustable vertically to various angles relative to one another so as to support the body of the patient in the various positions required for surgery. Side rails and slidable brackets at the edges of the table provide for mounting various accessories at any desired points. As hereinafter set forth in detail, equipment embodying the present invent-ion is especially designed for use with such an operating table.
A major objection to the use of a general operating table for the performance of traumatic surgery is the difiiculty in positioning the body of the patient laterally so that the hip is exposed over the side of the table. Such laterally offset positions are very desirable for better ex posure of the operative side, and also practically imperative so that the surgeons arms need not be extended to the center of the table and so that his hands may be below the table top when necessary.
It is an important object of the present invention to provide novel operating components which eliminate the foregoing difiiculty and at the same time preserve the advantages of unilateral traction as set forth in my prior patent.
For the benefit of the anesthesiologist, moreover, it is desirable to provide a mobile carriage for the patients body which can be shifted longitudinally of the table to the desired position and there locked in place. Another object is to provide novel means as characterized in the preceding object which are also capable of the desired longitudinal mobility relative to the operating table.
For the above reasons and others such as the frequent necessity of applying plaster casts before the patient is removed from the operating table, it has been thought necessary in most cases to use orthopedic or fracture tables for traumatic surgery instead of general operating tables, and these special tables have customarily been moved from the operating theaters to plaster rooms for the final application of casts and then either left in the plaster room or otherwise stored until needed again. The return of such equipment to the operating theaters, often under emergency conditions, provides opportunities for staphylococcic invasion with potentially dangerous consequences. Surgical components embodying the present invention, on the other hand, are part of the standard furice 2 nishings of the operating room so that contamination by introduction of foreign equipment is avoided. Also such components, when furnished with each operating table, make possible the immediate use for orthopedic surgery of the first operating room to become available.
One embodiment of the invention has been illustrated in the accompanying drawings, but it is to be understood that said drawings are for purposes of illustration only and are not to be construed as a definition of the limits of the invention reference being had to the appended claims for this purpose.
In the drawings,
FIG. ;1 is a plan view of apparatus embodying the in- Vention;
FIG. 2 is a side view of FIG. 1;
FIG. 3 is an exploded perspective view of the apparatus of FIG. 1; and
FIG. 4 is a perspective view illustrating one use of the apparatus shown in FIGS. 13.
The drawings show a typical operating table schematically, but not in detail, since the details of construction are not part of the present invention. As shown the table comprises a plurality of articulated sections :1, 2, =3, 4 and 5 which are adjustable to various relative positions. At least some of these sections are mechanically operated by a suitable system of mechanical linkage, parts of which are indicated at 6 and 7. Preferably the table is power operated, and 8 indicates generally a motor assembly of any desired type, the main power control being provided by the foot lever 9 and the desired amount of articulation being controlled through suitable means indicated generally at 10 and control handle 11. The table is provided with the usual side rails 12 on which suitable brackets 13 and clamping knobs 14 are slidable.
It will be understood that a detailed understanding of the mechanism thus far described and its use for general surgical procedures is not necessary for an understanding of the present invention. For present purposes it may be assumed that the articulated table sections 1-5 are disposed edge to edge in a substantially common plane so as to make up an integral table surface which need not be disturbed while the present invention is in use.
When it is desired to employ a table such as described above for orthopedic surgery, and for bone X-rays and plaster casts as usually required in such cases, then the surgical components of the present invention are mounted on the table. As already stated, these components will preferably be part of the standard operating room equipment, and for convenience these components will preferably be mounted slidably on the side rails 12 by means of the brackets 13 so that they can be moved longitudinally on the table and then secured by the knobs 14 in dilferent positions thereon as may be desired for positioning the body of the patient initially for anesthesia and thereafter for moving the body of the anesthetized patient to operating position.
With the foregoing objectives in view, the basic component of the present invention comprises a generally T- shaped base or support which may be molded from Formica, for example, but can be made in any other desired Way from any suitable material. The stem portion of the T-shaped base is of substantial width for reasons set forth hereinafter and is provided with any suitable spacer means for maintaining it at a desired elevation above the surface of the operating table, this spacing being suflicient to receive therebetween the usual X-ray cassette. The base also comprises at the upper end of the stem a cross head portion including cross arms which extend substantially the width of the operating table so that their ends are located in convenient positions for mounting them on the brackets 13.
More specifically, the support or base may suitably comprise a stem portion provided with spacers in the form of transverse bars 16 and 17 on its underside, these bars being secured to the stem in any suitable way as by means of screws or the like. As shown, the spacer bar 16 is longer than the width of the stem portion so that its ends 18 extend outwardly beyond the sides of the stem for a. purpose described hereinafter. An additional bar or bracket 19 extends transversely underneath the cross head 20 and cross arms 21, being secured thereto in a manner similar to the spacer bars 16 and 17. At each of its ends, the bracket 1% is provided with a groove 22 on its side adjacent the cross arms 21 of the base, these grooves thus forming sockets to receive the tongue-like ends 23 of suitable supporting brackets 24 having arms 25 which can be clamped in the brackets 13 by means of the knobs 14 or otherwise. Thus the cross head end of the base is not only supported by the brackets 23, 24, 25 but also the entire base can be clamped in any desired position longitudinally of the operating table and can be moved back and forth along the table simply by loosening the knobs 14.
The cross arms 21 are each provided with grooves 26 which extend inwardly from their outer ends and are preferably undercut so as to have the approximate cross section of the head of an inverted T. These grooves each serve for adjustably mounting an iliac post 27, preferably each being provided with a scale of measurement indicated generally at 23 to facilitate the accurate adjustment of the posts to required positions laterally of the cross head.
For positioning the patients body centrally on the supporting base 15, a perineal post 29 is used which is preferably similar to the iliac posts 27 and also to the perineal post described in my aforesaid prior patent. This post 29 can be mounted in desired positions in the center line of the stem portion of the supporting base by means of a groove 30 which is preferably undercut like the grooves 26 except at points 31 which provide for insertion of the head of the post 29 into the groove. This central position of the post 29 may be used for positioning the patients body for anesthesia, for example, and on occasion for bi-lateral traction or for post-operative plaster work in which a suitable elevated sacral rest is used similar to that shown in FIGS. 18 and 19 of my prior patent.
For the comfort of the patient, moreover, removable femoral supports or leg boards 32 are preferably furnished which enlarge the width of the stem portion of the support. As shown, two such femoral supports can be used, one along each side of the stem 15. They are suitably supported by means of pins 33 which extend into corresponding sockets 34 formed in the side edges of the stem. As shown in FIG. 1, moreover, the ends of femoral supports rest on and are supported by the ends 18 of the spacer bar 16.
For traumatic surgery, however, the central position of the perineal post 29 in the slot 30 is not usable because of the excess width of the operating table. As already stated, the body of the patient must have a laterally offset position in order to expose the hip over the side of the operating table and to permit the surgeon to operate in a more relaxed position and to lower his hands below the plane of the table top when necessary. To permit such lateral offsetting while applying unilateral traction to the injured limb, the stem 15 of the base is also grooved adjacent each edge with lateral undercut grooves 35 and 36, each provided with an enlarged portion 37 like the portion 31 of the slot 39.
It will now be understood that the additional length of the iliac post grooves 26, which is provided by the extended cross arms 21 of the base enables the iliac post 27 to be located near one end of one of the grooves 26, say near the top of FIG. 1, in which position it cooperates with the perineal post in the upper lateral groove 36 to permit application of unilatreal traction to an injured left leg with the body of the patient supported by the base 15 but offset laterally so that the left hip is exposed over the edge of the table. The anchoring of the pelvis by the two posts takes place as described in my prior patent, when traction is applied to the injured limb by means of any suitable traction unit 38.
During surgery, the well leg is supported out of the way by any suitable means, but preferably by a device as shown in the drawings which is especially designed to co-operate with the support 15 and to maintain proper alignment with the perineal post 29 in either of the slots 35 or 36. Such means takes the form of a vertical frame work comprising uprights 39 carrying a supporting shelf 40 at a suitable elevation thereon to support the well leg as shown in FIG. 3. At the bottom of the frame work, the ends of the said uprights 39 form feet which are insorted in corresponding openings 41 in the stern portion 15 of the base. As shown-in FIGS. 1 and 4, the pair of openings 41 adjacent one side of the stem 15 is duplicated by a corresponding pair of openings 41 adjacent the other edge of the stem, and each pair of openings 41 is aligned with one of the pair of lateral grooves 35 and 36 described above. In order to strengthen the vertical support, moreover, a cross brace 42 extends between the vertical side members of the framework near its bottom, and a suction cup device 43 extends laterally from this brace 4-2 in position to be secured to the stem 15 underneath the supporting shelf 40 thereon. As shown in FIG. 3, the well leg support is mounted in line with the perineal post along one side of the stem, with the shelf 49 and the suction cup 43 both turned inwardly toward the central portion of the stem. Thus any tendency of the weight of the well leg to overturn the vertical frame is resisted by the firm support of the suction cu 43 on the stem 15. It will be understood, of course, that the reverse arrangement takes place when the right leg is in traction and the left leg elevated on the support.
As described in my prior patent, the posts 27 and 29 are preferably of plastic translucent to X-rays for the benefit of X'ray photography. They can be provided with suitable clamping devices for holding a cassette tray 44 (FIG. 3) and with directional rods 45 to show the desired direction of the X-ray beam.
The invention is not restricted to the details of the example described above and illustrated by the drawings, and reference should be had to the appended claims for a definition of its limits.
What is claimed is:
1. Orthopedic accessory apparatus for use with oper ating tables comprising a generally T-shaped horizontal support adapted to be mounted on an operating table in a plane parallel to and above the table surface, the cross arms of the head of the T having a combined length substantially equal to the width of the table, an iliac post, means on each of said cross arms for mounting said post thereon in an upright position on one side of the center line of the support, said mounting means providing for adjustment of said iliac posts longitudinally on the respective cross arms, a perineal post, the stern of the T having substantial width, and means on both sides of said center line for mounting said perineal post in an upright position near either side of the stem, said perineal post mounting means both providing for adjustment of said perineal post longitudinally on the stern, said iliac post when located on the same side of said center line as said perineal post co-operating with said perineal post to provide means for anchoring the pelvis of a human body in a position that is offset laterally with respect to .5 said center line against unilateral traction applied to one leg.
2. Apparatus as defined in claim 1, said support including means for mounting it on a table in said position which comprise a mounting device secured to the underside of the end of each cross arm, said devices each having bracket-connecting parts for co-operation with a bracket on an adjacent side rail of the table, the stem of the support having spacer means extending downwardly by an amount equal to the vertical spacing of the head of the support above the table when supported by said mounting devices.
3. Apparatus as defined in claim 1, the stem of said T-shaped support having a third mounting means for said 6 perineal post and said third means providing for adjustment of said perineal post longitudinally in the center line of the stem.
4. Apparatus as defined in claim 1, together with femoral supports detachably secured to the sides of said stem, the combined Width of the stem and of said supports being substantially the same as the combined length of said cross arms.
5. Apparatus as defined in claim 1, the stem of said support having mounting means for a Well leg support aligned longitudinally with each of said perineal post mounting means.
No references cited.