US 3135257 A
Abstract available in
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Description (OCR text may contain errors)
R. ANDERSON FRACTURE TABLES June 2, 1964 4 Sheets-Sheet 1 Filed D60. 1, 1961 INVENTOR. E0655 Awe/e s'oA W A rroems-KS' June 2, 1964 Filed Bee. 1, 1961 R. ANDERSON 3,135,257
FRACTURE TABLES 4 Sheets-Sheet 2 INVENTOR. 0651? ANDEEfiO V June 2, 1964 R. ANDERSON 3,135,257
FRACTURE TABLES Filed Dec. 1, 1961 4 Sheets-Sheet 3 IN VEN TOR. 2065/? ANDEEfiO/V A r TOEA/fYJ' June 2 1 Filed Dec, 1 1961 RACTURE TABLES 4 Sheet 4 INVENTOR Z06? Aumses'a rams/5 y;
i United States Patent O 3,135,257 l FRACTURE TABLES Roger Anderson, 4221 E. Lee St., Seattle, Wash.
Filed Dec. 1, 1961, Ser. No. 156,369
17 Claims. (Cl. 128--84) Myin vention relates to a fracture table and primarily a table with manipulatable mechanical means to be employed by' orthopedic surgeons in connection with operatlons involving chiefly bones of an extremity, as a tibia or a .femur. Examples of specific other uses will involve operations of a knee joint and at times of a humerus.
' Other types of orthopedic operations in which the tables of myinvention are well adapted include: operations on limbs while in flexion, and with or without traction; cast applications; and open bone operations, as grafting.
It is an object of my invention to provide mechanism (which maybe likened to mechanical hands), which can be caused to duplicate every motion that can be made by the hands of the physician in positioning bones and holding or fixing any desired position including maintainng a desired degree of tension or traction while with or without the changing of the degreeof bending at the knee of the patent.
Also in the cases of deformities great versatility in the motions of the manipulation means of the fracture table are necessary to fit a particular patient andat the same time to provide tension-in the line coinciding with the anatomical axis of the tibia and/ or femur of a patient.
It is a further object of my invention to provide a fracture table which involves a tibia support which is adjustably connected with a foot plate so that a predetermined relationship can be established between a tibia support and a foot plate and which will be maintained regardless of whether or not the extent of bending of a patients knee supported by such structure is changed.
It is a further object of my invention to provide structure whereby a foot plate may be secured to the foot of ap'atientand thereafter as the knee of the patient is bent the foot plate will have the desired relationship to the foot of the patient.
I Other objects and advantages of my invention will become apparent as the description of the same proceeds and the invention will be best understood from a consideration of the following detailed descriptions taken in connection with the accompanying drawings forming a .part of the specification, with the understanding, however, that the invention is not to be limited to the exact ldetailsof construction shown and described since obvious modifications will occur to a person skilled in this art.
FIG. 1 is a somewhat schematic and somewhat dia- ,grammatic' view in side elevation and showing by full lines bone structure and by dash lines the outline of the flesh of a leg being treated in adevice of my invention;
FIG. 2 is a view similar to FIG. 1 showing, by full and dot and dash lines, various positions the parts may take ,when the knee of a leg is raised different amounts;
'- FIG. 3 illustrates, a view similar to FIG. 1 but illustrates adjustments which may be made to accommodate a leg which cannot normally be positioned similar to FIG. 1 because of a malformationof the leg;
' FIG. 4is a plan view and illustrates schematically adjustments which may be made to accommodate for malformed legs, such as a leg having characteristics generally termed as knock-kneed;
ll. FIG. 5 is an'enlarged fragmentary perspective view illustrating the adjustable mechanism used in connection with my invention;
FIG. 6 is a fragmentary view partially in section and .partially in elevation, with parts broken away, taken substantially on broken line 66 of FIG.,5;
3,135,257. Patented June 2., 1964 ice partly in section taken substantially on broken line 8-8 of FIG. 7. i
Referring now to-FIGS. 1 to 4 inclusive, various positions are illustrated of one leg of a patient, such as the right leg. In use the device preferably will comprise mating parts for simultaneously supporting both a right and a left leg. The buttocks of the patient is supported by any suitable table '10 and counterpressure is effected by the usual perineal post 12.
In accordance with'common technique, where traction is to be applied to a leg of a patient, the perineal post 12 is against pelvic bones of a patient sothat as traction is applied to one or both legs (generally bothlegs) the said perineal post, in accordance with usual practice, pro- ,vides for counterpressure against parts hereinafter described. 1
One form of a perineal post is illustrated and described in my previous Letters Patent 2,266,296 issued December 16, 1951. I p,
After the device is adjusted in accordance with structure hereinafter described, the patient is positioned on the table with the buttocks supported by the table 10and with the support or pedestal 14 positioned on the, underside of the knee of the patient and supportingflesh of thepatient covering the tibia of the patient. Then the foot is strapped to the foot plate 16 and a suitable foot plate is illustrated in my Patent 2,469,361, issued May 10,
The support 14 may be. positioned to support other bones and at various locations, as desired, and functions as an intermediate support between traction and counter-traction means. a
The foot plate 16 (see FIG. 5) carries a plate 18, which may bereleasably connected to a tongue or plate 20 on block 24 by a screw 21. The locking screw 21 (shown dotted in FIG; 5) carries a turning means, as a knurled head 22. Thus foot plate 16 is detachably connected with traction rod 26. Openings 25 in block 24 willsup- .port other accessories, as a skeletal pin'transfixion unit ,(not shown). j f
A sleeve 37 (see FIG. 6) is rotatable in block 44 and held against lengthwise movement thereof by collars 39 and 41. The sleeve 37 is rotatable relative to said collars 39 and 41. r The said collars 39 and 41 are attached .to the block 44 by any suitable means. I
Threadedly mounted on the tractionrod 26 is.'a' locking and impaction nut 30. Nut. 30 can be turned in one direction to prevent traction rod 26-from moving to the right in FIG. 6 and in the other direction to inove.trac- .tion rod 26 to the left. Such later movement will cause imp-action of afracture. The traction rod'26 is keyed to sleeve member 37 by key means 32 (see FIG. 6) and is thusmounted for sliding movement in the sleeve 37. Coil spring 34 isslidable on lead screw 26 and one end portion abuts collar 39 and the other end portion abuts a tubular member 36. 'The tubular member '36 abuts a traction'providing nut 38. In the eventLthat a counter-traction force is effected against block .44,.the traction nut 38 can-be rotatedinthe appropriate-direc- -tion to provide pressure and this in turn will causeconn pression of the coil spring 34. More specifically tension .on traction rod 26 is transmited through coil spring 34 28 can be readily read on the calibration scale 42 (FIG. 5) on the sleeve member 28.
The sleeve 37 is mounted for rotary movement in block 44. Means to lock said sleeve member 37 and in turn the traction rod 26 against rotation is provided by locking screw 46 carrying any suitable manual manipulation means, such as handle 48. By the means just described, angular movement of the traction rod 26 may obtain or any angular position thereof may be maintained, thus a bone fragment connected with the traction rod 36 may be rotated and any position obtained thereof may be maintained. Lateral-or sidewise movement of the traction rod 26 is provided. Block 44 is pivoted about pivot means 52 relatively to adjusting block 50. A set screw 54 engages adjusting block and said set screw 54 passes through an arcuate slot 56 (see FIG. 4) in block 44 and upon tightening of set screw 54, movement between block 44 and adjusting block 50 is prevented. Turning movement of block 44 and in turn lateral movement of traction rod 26 is indicated by the indicia line 58 (see FIG. 4).
In view of the structure just described, lateralmove- V ment of the traction rod 26 and any bone connected therewith may be obtained and any desired position may be locked against further lateral movement.
Besides the rotary and lateral movement of the traction rod 26 justdescribed, a third movement is provided by my device. This movement is a vertical or up and down movement so as to provide for universal movement of, the traction rod 26 and parts connected therewith including the bone of a patient.
Such vertical angular movement (depicted by indicia line 63 in FIG. 3) of the traction rod 26 is provided by pivotally mounting adjusting block 50 (see also FIG. 5) on pivots 62 carried by U-shaped yoke 64. This permits adjusting block 50 to move arcuately in generally a vertical plane relative to yoke 64. The amount of such movement can be adjustably locked by pivoting a rod 66 (see FIG. 6) to block 50, as by pivot means 68. A clamping member 70 is pivotally mounted to yoke 64 and may be moved into locked or released positions by locking screw and handle means 72.
Thus from the foregoing it is now obvious that if the foot of' a patient is secured to foot plate 16, the foot plate 16 and the leg of a patient may have imparted thereto the various movements just described in connection with the traction rod 26. In other words, an extremity, as a leg, can be rotated about the anatomical axis of the tibia or humerus, or the knee of the patient can be moved angularly in a'vertical plane Or angularly in a horizontal plane and all of the various movements described including, but not limited to traction and impaction, can be separately or collectively locked in an adjusted relative position. All of the various movements described provide for universal movement and about a center which is on the axis of traction rod 26.
In order to provide for ready manipulation of the various movements of the traction rod 26, I provide handle means 74 so that manual manipulation toobtain the various movements is convenient. Thus for example if the locking nut 30 is released (moved toward the left in FIG. 5), a manual pull may be provided on the handle means 74 or the traction nut 38 may be rotated in the desired direction, either of'which, will provide tension or traction on the leg of a patient whose foot is secured to the foot plate 16 against counter traction which may be provided, as by perineal post 12. Also by the use of said handle 74, angular movement about either the pivot 52 or the pivots 62 may obtain in either a horizontal or a vertical plane, that is sidewise or up and down. Also the traction rod 26 can be rotated. Such move ments can be obtained regardless of whether or not locking is provided against any or all of the other movements.
As will be observed the various movements may be locked or left free. It is often desirable to have all of them free so that by hand manipulation of the handle 74 a doctor can obtain any desired mechanical position of the traction rod 26 and parts connected therewith. When all movements are free to be made, it is desirable to minimize the weight which the doctor may handle and thus allow the doctor to feel the conditions of the reduction or apposition. It is very helpful for a doctor to be able to steer with a minimum effort on his part the position of the bones in reducing a fracture.
Ithus provide link 73 which is rotatable relative to and mounted by the traction rod 26. Suspended from the link 73 is a weight carrying rod 75 and the weight 77 may be selected and the amount thereof used depending upon forces tending to move the traction rod 26 angularly up or down. Some of these forces will be the gravity pull because of the, weight of the patient and the part thereof involved, and the weight of mechanical appliances that may be employed at the time of the reducing of the fracture. The mechanical appliances include the foot plate 18 and tibia support means 14, 76, 80, 88, etc., extending away from the yoke 64 on what may be termed the inboard side thereof (i.e., the side of yoke extending toward the center of table). The counterweight means 73, 75, 77, is preferably connected with the traction means adjacent the end of that portion of said traction means that extends outwardlyof the yoke 64, such as adjacent the outboard end of traction rod 26, as illustrated in FIG. 5, for example.
Bracket 76 (see FIG. 5) is connected with block 24 and preferably detachably connected therewith as 'by looking set screw 78. Two tubular members 80 are connected with said bracket 76 and preferably detachably connected as by locking screws 82. The tubular members 80 are slidably received in a head 84 and the relative length between the bracket 76 and the head 84 can be set by loosening set screws 86, longitudinally positioning the head 84 on the tubular members 80 and then tightening the set screws 86. This is for the purpose of moving the tibia support 14 relative to the foot plate 16 to adjust for patients having different lengths of tibias. Also it may be desired to use a plurality of supports 14 to support a tibia or other bones at various locations which can be readily done by supporting the same on tubular members 80. 1
Preferaby the tubular members 80 are each made from two telescopic members with a sleeve 81 and set screw 83 to provide for any desired adjustable length of the tubular members 80.
The head 84 mounts rotatable means to provide for general horizontal movement (see FIG. 5). Rod 88, which is generally of U-shape, has, a portion thereof pivoted to head 84 to provide for general vertical movement. Support 14 is pivoted to a horizontal portion of rod- 88. The structure just described provides for universal movement of support 14 relative to head 84.
Thus despite any deformities or any particular size of patient and the like, the knee or tibia support 14 may be positioned against the flesh of a patient under the tibia, diztal to or under the knee joint, or otherwise support a one.
Thus it will now be. apparent that the support 14 is positioned under the knee of a patient and if there upon bending the knee of the patient. It is an object of this invention to maintain substantially the same traction even thoughthere is subsequent bending of the knee of a :patient either upwardly or downwardly. Hence the reasontorthe structure next to be described.
Thebase of supporting table 92 (FIGS. 2 and 4) supports the buttocks table and also supports a tube 94. A block 96 (FIG. 5) is slidable' on tube 94 and to providefor maintaining a relative adjusted position, a locking screw 98 is employed to maintain any'adjusted position or the block 96longitudinally of the tube 94.
The block 96 slidably mounts a'rod 100, which ,rod 100 mounts a support 102 for supporting the head 84. Thus when the head 84 is in the lowermost position (shown in FIG. 1 of the drawings) the relative elevation ofthe adjusted position ofthe support 102 will support the head 84 and parts connected therewith and associatedtherewithincluding the leg of the patient. Also the rod 100 has a horizontal portion 101 to provide a third movement of support102. Support 102 will move vertically upon vertical movement of rod 100, longitudinally upon sliding of block 96 on tube 94, or sidewise upon turning of rod 100, thussupport 102 may always support head 84, regardless of bend of the knee of the patient. At times chiseling action on bones is required and a direct support obtains through support 14, rod 88, head 84, support 102, rod 100, block 96, tube 94 to table 92. I
Preferably support 102 is provided with means to support other accessories, as a unit including skelatal transfixion pins, and holes 103 are provided for this purpose. Support 102 may be positioned on tube 94 'to function as an anchor for counter-traction means. By having therear links 112 slightly longer than the front links 110 andby having the lower pivotal connections thereof further spaced than the'upper pivotal connections, a given point such as 114 (FIG. 2 on the block 50 will follow a path indicated by the broken line 116 of FIG. 2. It is desired that said arc 116 be of a relatively large diameter so as to provide a relatively flat path. However, the table must be made in practical proportions and I obtain a relatively flat arc by the use of the modified form of pantograph described.
In 'order' to maintain any adjusted position of the yoke '64by movement of said links 110 and 112, I pivotally mounta rod 118 (see FIG. 5) on the yoke64 and extend the same downwardly'toward one of the links 110 and 112, such as a link 112, and slidably mount the same in a sleeve 120, which sleeve 120 is pivoted on the link 112, and the extent of longitudinal movement of the rod '118 may be selectively locked'or unlocked by locking screw means 122.
The tube 94- is pivoted to move in a horizontal plane by pivot means 124 shown dotted in FIG. 2 of the draw,- -ings. 'The center of rotation is about a vertical axis passing through the center. of articulation 126 of the head of a femur of a patient. This permits the whole assembly 'to be turned in a horizontal plane about a desired axis and thus the legs of a patient may be moved together or separated as desired without change of degree of traction. I e
1 The mode of operation in general comprises placing a patient with the buttocks on the buttocks table or sacral'rest 10 and with the patient properly disposed as respects the perineal post'12 or other means of countertraction. The patientmay have the right leg positioned 'as indicated in FIG. 1 of the drawings and with the tibia and femur positioned as indicated. The other leg will be supported, in most instances, by paired mechanism (not illustrated). The relative length of rods 94 and 104 (see .FIG. 5) will be adjusted depending upon the length of a particular leg involved. Tibia support means or knee support 14 will be adjusted to support the tibia of a patient and below or under and distal to the knee joint. ,Adjustments of the position of tibia support means 14 may be made for patients having not only different lengths of tibias, for patients having malformations, or fractures or other abnormal conditions.
"The support 14 is'secured in place and the foot secured to the foot plate 16 and with the thigh and lower leg bones' appropriately positioned, the traction rod 26 is rotated or moved in a horizontal plane or in a vertical plane as may be indicated for a particular patient. There may be a plurality of supports, if desired, andsupported in the same manner.
The support 102 is properly positioned relative to the head 84.. Then the desired traction is placed and the traction will be along dot and dash line 128 (FIGS."1", 2, 3 and 4). Also the traction will be along the anatomical axis of the tibia of the patient, as along dot and dash line 130. The traction along the femur will be along dot and dash line 132. Obviously the length of dot and dash line 130 between the foot plate 16 and 123. and the length of dot and dash line 132 between 123. and 126 will 'not' change. One of the. principal accomplishments of the present invention is to predetermine the amount, if any, of traction and thereafter'bend the knee of the patient to a desired angle and at the same time to maintain substantially the original adjusted traction. This permitsbende ing of a knee about its center of articulation 123 after adjustments have been made, which is desired in many operations.
There may be changes in traction due to unusual conditions of a patient and my device readily provided for any relative minor adjustments. If during the bending of a knee, the indicating pawl 40 indicates on the. calibration scale 42 a change of traction, the physician can readily make necessary adjustments through appropriate manipulation of nuts 30 or 38, or handle 74. i i
As will appear in FIG. 2 of the drawings, any given point 114 on adjusting block 50 moves along the are 116 and the distance from the point 114 to the ankle of the patient remains the same even though the arigularity of flexing of the knee of the patient is changed. Also it will be noted that the lengths of the lines 130 and 132 between 114,123 and 123, 126 remain the same. Thus there is substantially no change in tension even though the knee of the patient is bent to expedite'any particular operation. p The block 44 will maintain its same angular relation to the foot plate 16 regardless of whether the parts are in the position shown'in FIG. '1 or.FIG.'2 of the drawings. Thus as the block 44 angularly moves relative to the vertical because of the modified pantograph involving links links 112 and base 108 as well as block"64lsupporting the same, there is a turning movement imparted'to the foot plate 16prelative to the vertical and' this turning movement tends to support a knee as it moves vertically, both against any tendency to move up or 'downJAt the same time the under knee support or tibiasupport maintains its same relative position to the foot plate 16 and thus there is no change in traction; In other words, maintaining the same relative position betweentheknee joint and the support 14 relative to the foot plate 16,
to andat; the desired relative position to the footplate 16. Then the said handles 60 and 48 and 72 are tightened to maintain the desired fixed angular relationshipbetween the yoke 64 and the block' 44. This in turn fixes the relationship between the foot plate 16 and the .yoke 64. As the yoke 64 is mounted by the modified pantograph, involving links 110 and 112 and base 108, the foot plate 16 is angularly moved as the knee of a patient rises or is bent and by such action there is a pushingfor supporting'movement of the foot tending to push or pull the knee. i 5 Referring now to FIGS. 7 and 8 of the drawings, there useful where all of the various features and advantages of the structure shown in FIGS. 1 to 6 inclusive are not desired. 1
The tube 140 is shown broken awayv and will have a function similar to tube 94 to support similar parts. Any suitable mounting means for the tube 140 may be employed. The tube 140 preferably telescopically mounts a rod 142 and the clamping means 144 provides for ad justable engagement so a suitable extension in length of 140142 may obtain. Base means 146 is connected to rod 142 and said base means 146 supports column 148. Key means 150 is provided to prevent turning motion between base 146 and column 148. A yoke 152 is pivotally mounted on column 148 and retainer screw 154 joins yoke 152 and column 148 together for relative rotary motion between the two.
'- Column 148 terminates in a shaft portion 156 and column 148 is rotatably mounted relative to the yoke 152 through a suitable bearing in yoke 152 mounting shaft portion 156.
A locking shaft 158 is mounted for sliding movement in a suitable opening in yoke 152. Boltand handle means, threadedly connected with yoke 152, are suitable for moving the locking shaft 158 into and out of locking position with shaft portion 156. Locking shaft 158 has an inclined portion 161 so that upon longitudinal movement of said locking shaft 158 it may be moved into and out of a wedgingposition, thus into and out of locking position.
: The yoke 152 has spaced apart upwardly projecting plate portion 162 which mount spaced apart pivot means 164 which pivotally mount block 166 for up and down movement about a horizontal axis.
The block 166 mounts therein parts described in connection with FIG. 6 of the drawings and the parts correspond as follows: sleeve 168 to 37; collar 170 to 41; collar 172 to collar 39; from such parts and from the description of their counterparts in FIG. 6, sleeve 168 is mounted for rotary movement in block 166. p
The traction rod 174 and key means 176 are the counterparts of traction rod26 and key means 32 of FIG. 6. Thus the traction rod 174 will turn whenever the sleeve 168 turns but the traction rod 174 is slidable in the sleeve 168.
Coil spring 178 is mounted on traction rod 174 and one end portion thereof abuts against collar 172 and the other end portion thereof against nut 181. Link '180 corresponds to link 73; rod 182 to rod 75; counterweights 184 to counterweights 77; and handle 186 to handle 74. Locking and counter-traction nut 188 corresponds to locking and counter-traction nut 30.
In order to selectively lock the sleeve 168 from ro tation and in turn the traction rod 174, I may provide locking means having the identical construction described in connection with locking column 148 from turning relative to the yoke 152. Thus in the parts illustrated, locking shaft 190 corresponds to 158 and locking shaft 192 to 158 and bolt means 192 and any suitable handle (not shown) corresponds to 160.
Yoke 152 has spaced apart plate portions 194 and one thereof is threaded and receives threaded portion of a locking bolt 198. Suitable bolt turning means are provided as by handle 200. A locking yoke 202 is rotatively mounted on the locking bolt-198. A rod 204 is slidable through an opening in the locking yoke 202. Upon tightening of the locking bolt 198 sliding movement of the rod 204 relative to the locking yoke 202 is prevented. An end portion of the rod 204 is pivotally connected with the block 166 as by pivot means 206. When the said rod 204 is free to slide in the locking yoke 202, then the block 166 is free to pivot on pivot means 164. As the traction rod 174 moves with the said block 166,this will permit up and down movement of the traction rod.
The traction rod 174 may carry the same accessories as were carried by the lead screw 26 and thus the parts correspond as follows: tongue 208 to 18, tongue 210 to 20,
knurled head 212 to 22, foot plate 214 to 16, block 216 to 24, and openings 218 to. 25. Said openings are designed to be a part'of the mounting means for usual skeletal transfixion pins (not shown) and thus function as an anchor to a distal end portion of a bone. Hole 219 is designed to receive the locking set screw 78 (FIG. 5) and support the parts 76, 80, 81, 82, 83, 84, 86, 88, and 14 which are not illustrated in FIGS. 7 and 8 but are incorporated by reference.
Many complications may be involved infracture and other bone cases. For example, in fracture cases we may have multiple fractures and the location of the fracture or fractures requires a device which can mechanically (with or Without mechanicaladvantage) take substantially all positions that the hands of a surgeon can take. Also in fracture cases it is highly desirable to be able to manually or mechanically push or pull and .to rotate sidewise as well asup and down or a combination of these. Also it is desirable to have mechanical means to maintain a particular position or positions obtained while making another or others. The device of this invention permits a combination of the various conditions which may arise in fracture cases.
In the structure of FIGS. 1 to 6, particularly 1 to 4, a usual perineal post is depicted as an illustration of a counter traction means. vIt is to be understood that other usual counter traction means may be employed, such as a saddle or skeletal transfixion pins.- When a saddle is employed it is normal for a patient to be a lateral position, or on one side. In FIGS- 6 and 7 no counter-traction means is illustrated as only a fragment of the tube 140 is shown, however the same counter-traction means described in connection with FIGS. 1, 2 and '5 may be employed in connection therewith. Also as to traction, this may be applied through foot plates 16 or 214 or through transfixion pin means supported by blocks 24 or 216 by employing openings 25 or 218. I I
The traction means of the various forms of my invention all provide for a shaft or rod, as traction rod 26 of FIGS. 1 to 6, or the traction rod 174 of FIGS. 7 and 8. In both forms of the invention shown, the rod (such as the traction rod is movable up and down, in and out or sideways, and is rotatable. The advantage of using a traction rod is to be able to employ the traction nut 38 or 181 and locking and impaction nut 30 or 188 to provide respectively for mechanical pull and push movements. All the various movements are about a center which is on the axis of the traction rod and there is universal movement about such center.
In addition to the movements which are common to both FIGS. 1 to 6 and to FIGS. 7 and 8, the structure of FIGS. 1 to 6 inc. provide the additional movement obtained by the modified pantograph embodying links and 112 and associated parts. j
In the forms of my invention illustrated, a counterweight may be employed so that a physician is-not required to support weight and thus is in a position to delicately manipulate a fracture and feel" and precisely guide exactly as the conditions of the bones under treatment necessitate.
Also there is universal movement about the anatomical centers of a limb of a patient and this is maintained despite the various manipulations which are being made.
, In the event impaction is desired (pushing together fractured end portions of bones), the nut 30 of FIGS. 1 to 6 or the nut 188 of FIGS. 7 and 8, may be moved toward the block 44 or block 166 and a distal bone fragment may be moved by the device to cause impaction between the same and a proximal bone fragment.
While I have illustrated traction, rods 26 and 174, shafts, rods or tubes with. friction locking couplings to maintain an adjusted position may be employed to advantage. A very definite advantage of the present invention is that a physician is able to employ mechanical devices, obtain mechanical leverages and locking results, individually or 9 collectively'thereof and also to be able to hand manipulate any movement as desired. A
Obviously changes may be made in the mechanical parts illustrated without departing from the principle of; my lIlVeHtiOIl. i
I claim: I
1. A fracture table comprising therein components designed particularly for utility in connection with orthopedic' treatment of the leg of a patient comprising a pelvic engaging means functioning as counter-traction means; adjustable traction means including an element connectible ,With the lower end portion" of a leg of a patient, said traction means offering traction in said leg away from said p'elvic engaging means; support means for said traction means including a base; a rigid frame member extending between and rigidly connecting said counter-traction means with said base; tibia supporting means connected and movable in fixed relation with the element of said traction means that is connectable with the lower end portion of the leg; and means mounting said element and said tibia supporting means forxlongitudinal rotational, sideways and up and down movement of a lower end portion of a leg of a patient connected to. said'element and supported by said tibia supportingmeans, relative to said support means. g 9
2 A fracture table comprisin'gtherei'n components designed particularly for utility in connection with orthopedic treatment of the leg of a patient comprising a pelvic engaging means functioning as counter-traction means and relatively positionable against thepelvic bones of a patient; adjustable traction 'rneans connectible with the lower end portion of a tibia of the patient and affording traction in the leg of the patient away from said-pelvic v engaging means, supporting means for said traction means comprising fixed baseme ans, continuous links pivotally connecting with said fixed base means at th'eirlower end portions, and yoke rneans pivotally connecting withrthe upper end portions of said links and also connecting with said traction means; and means mounting said traction means for at least sideways movement relative-to said yoke. 3. A fracture table comprising therein components designedparticularly for utility in connection with. orthopedic treatment of the legs of a patient comprising a pelvic engaging means functioning as counter-traction means and relatively positionable against the pelvic bones of a patient; adjustable traction means connectible with a lower end portion of the tibia of the patient and affording traction in the leg of the patient away from the said pelvic engaging means; movable supporting means for said traction means comprising base means, continuous links pivoted at their lower end portions to said base means, and yoke means pivoted to the upper end portions of said links and connecting to said traction means; tibia supporting means connected with and movable in fixed relation with said adjustable traction means; and means mounting said traction means and said tibia supporting means for rotational, sideways and up and down movement relative to said yoke.
4. A fracture table comprising therein components designed particularly for utility in connection with orthopedic treatment of the legs of a patient comprising pelvic engaging means functioning as counter-traction means and relatively engageable with the pelvic bones of the patient; adjustable traction means including a foot plate connectible with the foot of a patient and affording traction in the leg of the patient away from said pelvic engaging means, said adjustable traction means further including an elongated member connecting at one end with said foot plate; support means for said adjustable traction means including a yoke; tibia supporting means connected with and movable in fixed relation with said foot plate and -said elongated member; and means for mounting said elongated member, said foot plate and said tibia support- 10 ing means for rotational, sideways and up and down movement relative to 'said yoke.
5. The combination of claim 4, wherein said tibia supporting means includes a rod means carried by and posi tioned below the axis of said elongated member.
.6. The combination of claim 5, wherein said tibia supporting means further includes a tibia supporting member and adjustable means for mounting said supporting member onto said rod means. 1
7. A fracture table comprising a fixed support; counter-traction means relatively fixed on said support; and a traction means carried by said fixed support, thetraction means including a traction rod and means mounted on one end thereof and connectible to the limb of a patient, said traction rod having a longitudinal axis; a first adjustable means mounting said traction rod for rotational movement about its longitudinal axis; a second adjustable means providing for sideways rotary movementof said traction rod about an axis intersecting at right angles the longitudinal axis of said traction rod; and third adjustable means providing for up and down rotary movements of said traction rod about a horizontal axis intersecting the longitudinal axis of said traction rod.
8. The-combination of claim 7, wherein the traction rod is threaded and means cooperating with said threaded traction rod are provided for increasing and decreasing the amount of traction in the leg of a patient.
9. A fracture table comprising a counter-traction means engageable with the proximal end portion of a bone of a patient; traction means including an element engageable with the distal end portion of said bone of the patient; bone supporting means positionable between said countert'raction means and said traction means and carried by said traction means; and adjustable means providing for rotary movement of said traction means and the bone supporting means as a unit about a first axis and sideways and up and down movements about axes intersecting said first axis at points passing through said traction means outboard of the element engageable with the distal end portion of the bone of the patient. p 10. A fracture table comprising a counter-traction means engageable with the proximal end portion of alimb of a patient; traction means engageable with the distal end portion of said limb of the patient, said traction means including a threaded traction rod and means cooperating with said traction rod for increasing and decreasing the amount of traction put on the bone of said limb; support means for said traction means including a yoke, with a portion of said traction means extending inboard of said yoke and another portion thereof extending outboard ofthe yoke; adjustable means providing for sideways, up and down and rotary movement of said traction rod relative to said yoke; handle means connected with an outboard portion of said traction means; and counterweight means connected with the outboard end portion of said traction means and counterweighting the combined weights of the inboard portion of the traction means and the limb of the patient during up and down movement of the traction means.
11. A fracture table comprising a counter-traction means engageable with the proximal end portion of a bone of a patient; traction means engageable with the distal end portion of said bone of the patient; support means for said traction means including a mounting member; adjustable means for said traction means providing for rotation thereof about a first axis and sideways and up and down movements thereof about separate axes which intersect said first axis and pass through said mounting member, thereby allowing from a predetermined position for sideways, up and rotary movements of said traction means without lessening the amount of traction on the bone of the patient, and separate locking means to lock each one of said movements individually.
12. A fracture table comprising pelvic engaging means functioning as counter-traction means and relatively en'- gageable with the pelvic bone of a patient; means con meeting said pelvic engaging 'meanswith an elongated support member situatedsubstantially at right angles to said pelvic engaging means; base means connected with the end of said elongated support member situated away from said pelvic engaging means; adjustable traction means situated above said base means and including a foot supporting means; support means for said traction means located above said base means; a mounting member for the adjustabletraction means forming a part of said support means; tibia supporting means cantilevered from said foot supporting means and including an element on which the undersurface of a leg of a patient rests; and means interconnecting said support means and said base means and providing for movement of said foot supporting means and said tibia supporting means as a unit during flexion and extension of the .knee of the patient, said support means further including means providing for rotation of the traction means about a first axis and sideways and up and down movement thereof about separate axes which intersect said first axis and pass through said mounting member.
13. The combination of claim 12, wherein a telescoping rod means is carried by the elongated support member andextends to contact and support said tibia supporting member.
14. A fracture table comprising a counter-traction means engageable with the proximal end portion of a bone of a patient; traction means including a traction rod and means engageable with the distal end portion of said bone of the patient; a first adjustable means providing for rotary movement of said traction means about the longitudinal axis of said traction rod including a sleeve surrounding said traction rod; a support block surrounding said sleeve; sleeve locking means in said support block; second adjustable means providing for sideways movement of said traction means about an axis passing through the longitudinal axis of said traction rod and through the sleeve and the support block; and third-adjustable means providing for up and down movement of said traction means about a transverse axis passing through the longitudinal axis of said traction rod.
15. The combination of claim -14,'wherein a handle means connects with said adjustable traction means and extends a substantial'distance from said transverse axis on the side thereof away from said bone engaging means.
16. The combination of claim 15, wherein counterweight means connected adjacent said handle means, such counterweight means lessening the amount of patient and apparatus weight which the doctor must move and thereby making it possible for the doctor to steer with a minimum effort on hispart the position of the bones in reducing a fracture.
17. A fracture table comprising therein components designed particularly for utilityin connection with orthopedic treatment of the leg of a patient comprising a pelvic engaging means functioning as counter traction means and relatively positionable against the pelvic bones of a patient; adjustable traction means connectable with the lower end portion of a tibia of the patient and affording traction in the leg of the patient away from said pelvic engaging means; movable supporting means for said traction means comprising base means, continuous links pivotally connecting with said base means at their lower end portions, and yoke means pivotally connecting with the upper end portions of said links and also connecting with said traction means; and tibia supporting means connected with and movable'in fixed relation relative to said traction means, said base means, the links and the yoke means together forming a trapezium, with the side thereof formed by the yoke means being shorter than the side thereof formed by the base means and the side thereof formed by the links nearest to the pelvic engaging means being shorter than the side thereof formed by the links furthest from the pelvic engaging means.
References Cited in the file of this patent UNITED STATES PATENTS