Patent Application
20070271701
1. Field of the Invention
This invention relates to orthopedic surgery and, more particularly, to a device and method of positioning and maintaining a joint in place during surgery.
2. Description of the Prior Art
During orthopedic surgery it is very important to maintain a constant position for the patient's appendage, especially if the surgery is to replace portions of a natural joint with a prosthesis. This constant position results in the prosthesis closely fitting onto the remaining natural bones and providing a good functional equivalent of the natural joint. Some surgeons assign an operating room nurse to exclusively monitor and manipulate the position of the patient's appendage and flexure of the joint during the entire surgical procedure. The ability of the nurse to maintain the appendage depends on the nurse's strength, stamina, and ability to anticipate movement. For instance, if a knee prosthesis is the basis of the surgery then the nurse may be used to hold an individual's leg during the surgery. The nurse may also be expected to assist in the surgery which may lead to disruptions should the leg move while the nurse is attending to other functions. Clearly, this is an inefficient use of manpower and operating room resources.
Other conventional devices for supporting and restraining a patient on an operating table include U.S. Pat. No. 5,560,728 issued to McFadden which discloses a head rest mounted on a frame with arms that are attached to a bracket attached to the table; U.S. Pat. No. 5,369,827 to Parke et al which discloses foot stirrups mounted on arms held on an operating table rail; U.S. Pat. No. 5,020,525 to Ewing et al which discloses a series of straps with Velcro fasteners wrapped about an appendage and connected to a cable system attached to an operating table; and U.S. Pat. No. 4,766,891 to Schultz which discloses a belt with patient leg connectors worn by the surgeon so that, by changing position, the surgeon can dictate the position and flex of the patient's leg.
All of these devices have attachments that extend outwardly from the operating table and are subject to accidental movement of the patient's appendage because of interference with the device by operating room personnel.
What is needed in the art is a method and apparatus for positioning and restraining a patient's appendage in a fixed orientation on the surface of the operating table.
The instant invention is an apparatus for positioning and restraining a patient's appendage in a desired attitude during surgery. The apparatus includes a tray movable along a rail on the operating table, the tray extends over the patient receiving surface of the operating table. The tray is formed from either a rigid or soft surface having hook and loop fastener which cooperates with a hook and loop fastener on a wrap enclosing the patient's appendage. By adjusting mounting brackets along the length of the operating table rail, the tray can be placed anywhere along the length of the table. Once appendage tray is positioned longitudinally along the table, based on the patient's appendage position, the tray is secured in position for the surgical procedure. The surgeon can now flex and secure the patient's appendage to the tray. Alternatively the surgeon can separate the appendage fastener from the tray fastener and flex and reposition the patient's appendage to anywhere on the tray zone that is an appropriate position.
Therefore, it is an objective of this invention to provide a method of fixing a joint at a desired degree of flexion/rotation, during the surgical procedure, with the ability to reposition the patient's appendage anywhere in the tray zone throughout the surgical procedure.
It is another objective of this invention to provide an apparatus for attachment to a conventional operating table for adjustably supporting a patient restraint on the surface of the table.
It is a further objective of this invention to provide a patient wrap for fitting about an appendage and connecting with a patient restraint on an operating table.
Still another objective of the invention is to provide a frame that can be sterilized through various means such as an autoclave and have disposable drapes, that is, patient wrap and tray which is in sterilized condition prior to use and disposable after surgery
Other objectives and advantages of this invention will become apparent from the following description taken in conjunction with the accompanying drawings wherein are set forth, by way of illustration and example, certain embodiments of this invention. The drawings constitute a part of this specification and include exemplary embodiments of the present invention and illustrate various objects and features thereof.
The surgical operating table 10 has a patient receiving surface 11 and a longitudinal rail 12 extending along the longitudinal edge of the table. The operating table accessory 13 is slidably and adjustably mounted on the rail 12 by brackets 14 and 16. As shown in
The brackets 14 and 16, sown in
The arms 25, 26 form end portions of a frame 30 which includes a longitudinally adjustable stretcher bar 31 which is connected to the free ends of the arms. As shown in
The material 32 has a tunnel hems 34, 35 at opposite ends through which the arms 25, 26 are inserted. Once the arms are in the hems, the stretcher bar is adjusted by the linear actuator 36 to make the material taunt. The material 32 has a fastener 47 on the upper surface which, in the preferred embodiment, is one component of the hook and loop fastener “Velcro” though other fasteners, such as snaps, ties, buttons, adhesives, etc. could be employed. As an alternative, the material may be a self sustaining plate with the fastener laminated to the upper surface.
Further, the tray 33 including the supports 22, 23, the arms 25, 26, the stretcher bar 31 and material 32 could be molded or otherwise formed as a unitary component with the fastener. The arms would not require adjustment and the entire tray would be disposable.
A wrap 50 is used to enclose an appendage of a patient. As shown in
In preparing for a knee replacement, for example, the wrap 50 would be placed on a patient's foot. With the patient on the receiving surface of the operating table, the brackets would be adjusted along the operating table rail to an approximate desired position. The patient's foot and wrap would be fastened to the fastener on the tray. The brackets could then be finally adjusted to place the knee in the proper attitude for the operation and locked in place for the surgical procedure. The patient's foot and wrap would be fastened to the fastener on the tray. The entire tray zone can be used for securement of the appendage to the tray.
The apparatus provides a method of orthopedic surgery for use on a surgical table having a patient receiving surface and a side rail extending along the side of the table. The apparatus of the invention includes an adjustable bracket that is adapted to the side rail, the bracket having a clamp for temporarily securing the bracket at a desired location along the rail. A support extends upwardly from the bracket toward the patient receiving surface. The tray is coupled to the bracket by a frame. The tray has a restraining surface including at least a portion covered with a hook and loop fastener. A appendage wrap is provided for enclosing a portion of a patient's appendage, the wrap having a fastener on a surface thereof cooperating with the tray located fastener. The patient is placed on the table and a portion of an appendage is covered with the wrap. The position of the appendage is placed in the desired surgical position which places the joint to be operated on in the desired surgical position. The frame is reusable through sterilization and the drape material is provided in a sterilized condition and disposable after surgery.
A number of embodiments of the present invention have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the invention. Accordingly, it is to be understood that the invention is not to be limited by the specific illustrated embodiment but only by the scope of the appended claims.
