US2232952A - Fracture table - Google Patents

Description

1941- E. E. LOBIGFELLOW FRACTURE TABLE 3 Sheets-Shet 1 Filed July 2, 1938 Feb. 25, 1941 E. LONGFELLOW FRACTURE TABLE Filed July 2, 1938 s Sheets-Sheet 2 Q NW W N 1941; I E. E. LONGFELLOW 3 95 FRACTURE TABLE Filed July 2, 1938 3 Sheets-Sheet 3 fzz/v/ezozoz' ZZJfZ Elozgfi law ywuwm Patented Feb. 25, 1941 UNITED STATES;

PATENT OFFICE FRACTURE TABLE Application July 2, 1938, Serial No. 217,230

9 Claims.

My. invention relates to surgical apparatus, and more particularly to fracture tables utilized in the reduction of fractures,

I An object of my invention is to provide a frac- 'ture table that is adjustable to meet varying conditions of use in applying tractive force to and maintaining proper location of the fractured parts during the application of splints, bandages or casts, and which is so constructed and arranged that fluoroscopic, therapeutic and other apparatus may be easily used therewith.

Another object of my invention is to provide a portable fracture table that is adapted to be 1nounted on conventional forms of hospital and examining tables and carrying carts, and which includes means for adjustably supporting some of the parts thereof in positions beyond the limits of the table or cart upon which it is;

mounted.

Another object of my invention is to provide a fracture table particularly adapted to maintain proper setting of the fractured bone during formation; and hardening of a cast, the parts of which apparatus are constructed and arranged to minimize interference with the formation of the cast and so as to be separable from'the cast after it has hardened. 7

Another object of my invention is to provide fracture reducing apparatus having fulcrumed traction bars and which provides lateral adjustment of the fulcrums for the traction bars to compensate for various lateral pelvic dimensions of different patients, so as to bring the fulcrums for the traction bars substantially into alignment with the hip pivot axes of the patient.

Other objects, features and advantages of my invention will be apparent from the following .description and the drawings wherein a preferred embodiment of my invention is clearly shown and described.

In the drawings:

Fig. 1 is a perspective view of a fracture table embodying a preferred form of my invention;

Fig. 2 is a fragmentary sectional view taken substantially on the line 2-2 of Fig. l and in the direction indicated by arrows;

Fig. 3' is a fragmentary view of a'portion of the fracture table embodying a preferred form of the present invention and'has parts thereof shown in section, the section being taken substantially on the line 3--3 of Fig. 2 and in the direction of the arrows;

Fig. 4 is a fragmentary sectional view with the section taken substantially'on the line 4-4 of 55. Fig. 3 and in the direction-of the arrows; and

Fig. 5 is a fragmentary sectional view with the section taken substantially on the line 55 of Fig. 3 and in thedirection of the arrows.

With particular reference to the drawings, a central or main support I comprisesa base plate 2, a flanged coupling 3 secured to the base plate 2 by rivets or other suitable fastening means 4,

a coupling post 5 that is preferably threadedly connected at its ends to the flanged coupling 3, v and a double-T coupler 6, as well as a flanged 10 member I and a base support post 8 which are secured to the side of the double-T coupler 6 opposite the couplingpost 5. Clamps 9 and I0 are provided for securing the main or central support I toany ordinary or conventional type 15 of hospital or examining table or to a carrying cart.

The clamps 9 and. I0 each include a pair of strips II and I2, I3 and I4, respectively, which strips areslidably connected to the base plate 2 20 by rivets such as I5 or other suitable means, which are secured to the base plate 2 and extend through slot such as IS in the strips H, [2, i3 and I4. The strips ll, l2, l3 and 14 have upwardly extending end portions l1, l8, l9 and 20, 25 respectively, which support clamps 2| and 22 that extend longitudinally of the strips and are provided for determining the adjustment of the strips, The clamps include threaded rods 23 and 24 which extend through the portions I1 30 and I 9'01 the strips l l and i 3, respectively, and telescopically engage tubular members 25 and 26, which tubular members are secured at their ends to the portions l8 and 20 of the strips l2 and l'4,'re'spectively, by bolts 21 and 28 or other 35 suitable means.

- Manually operable set screws 29 and 30 are threaded into the walls of the tubular members 25 and 26, respectively, and are adapted to engage the threaded rods 23 and 24 to secure the 40 positions of the rods with respect to the tubular members and accomplish quick rough adjustment of the clamps 9 and I0. Thumb nuts 3| and 32 are threaded onto the rods 23 and 24 on the outside of the portions l1 and I9 of the strips 45 II and I3 to accomplish the final adjustment of the clamps 9 and Ill. Downwardly extending portions 33, 34, 35 and 36 on the strips H, l2, l3 and 14, respectively, engage the sides of a table 31. A pad 38 of felt or some suitable ma- 5 terial is provided to prevent the base plate 2 from marring the top of the table 31.

As most clearly shown in Fig. 2, laterally extending arms 39 and 40 are threaded into opposite sides of the double-T coupler 6, so that they are substantially oppositely disposed perpendicular to the axis of the base support post 8. The arm 39 has openings therein such as 4| that are spaced at different distances from the basesupport post 8, and the arm 48 has openings therein such as 42 which are also spaced at different distances from the base support post 8. The openings 4| are provided to accommodate a screw 43, ,or. other suitable means, upon which a traction bar 44 is fulcrumed through a coupling unit 45, which is threaded onto the end of the traction bar 44 and has a portion 46 of reduced section through which the screw 43 extends. The openings 42 are adapted to accommodate a screw or other suitable means 41 to fulcrum a traction bar 48 through a coupling unit 49, which isthreaded onto the traction bar 48 and has a portion 50 of reduced section through which the screw 41 extends. p

The oppositely extending arms 39 and 46 are preferably substantially perpendicular to a median line between the traction bars 44 and 48,

so that movement of the fulcrum for either of the traction bars 44 or 48 by changing the opening through which one of the screws 43 or 41 extends varies the lateral distance between the traction bars 44 and 48 at their fulcrums. Wing nuts 5| and 52 are preferably threaded onto the screws 43 and 41, respectively, on the side of the arms 39 and 46 opposite the traction bar coupling units 45 and 49. The fulcrum supports for the traction bars 44 and 48 which are provided by the arms 39 and 4|] and the screws 43 and 41 support an end of each of the traction bars so hat the other ends of the bars may be swung laterally to a desired position.

Auxiliary supports 53 and 54 are slidably mounted on the traction bars 44 and 48, respectively, and have feet 55 and 56 which are roatable with respect to the traction bars and slidable in a channel track 51. The channel track 51 extends transversely across the top of the table 31 and preferably extends beyond the limits of the top of the table, particularly if the table is narrow, to support the traction bars 44 and 48 in positions such as that indicated by dot and dash lines at 44a for the traction bar 44 in which the auxiliary supports are outside the limits of the table top. This feature makes possible a wider range of movement of the traction bars on a narrow table without having the auxiliary supports too close to the fulcrums for the traction bars. The engagement of the feet 55 and 56 by the side walls of the channel track 51 also provides an additional factor of stability of support and prevents the feet from slipping off of the track. Furthermore, since the auxiliary supports 53 and 54 are slidable on the traction bars, and the feet 55 and 56 are rotatable with respect to the traction bars, the track is movable to a wide variety of positions on the table and to various angles with respect to the traction bars, so that the ends of the track are easily kept out of the way of any accompanying apparatus and the surgeon or attending personnel.

Extensible struts 58 and 59 are fulcrumed to the main or central support by a screw or other suitable means 69, which extends through the openings 6| and 62 in the struts 58 and 59, respectively, and through an opening 63 in a coupling unit 64 that is secured to the double-T coupler 6 intermediate the traction bars 44 and 48. The struts 58 and 59 are also fulcrumed to the traction bars 44 and, respectively, through clamps 65 and 66 which engage the respective traction bars and have screws such as 61 extending therethrough and through the struts 58 and 59. The strut 58 preferably includes telescopically engaged members 98 and 69, and the strut 59 preferably includes telescopically engaged members 10 and 1|. The longitudinal extension of the telescopically engaged parts of the struts 58 and 59 is fixed or locked by a clamp including a wing nut such as 12, so that when the traction bars are swung about their respective fulcrums to .a predetermined position, the positions of those bars may be fixed by locking the struts 58 and 59 at that position of the respective traction bar.

Leg supports 13 and 14 are adjustably secured to the traction bars 44 and 48, respectively. Since the structure of the leg supports 13 and 14 is similar, like reference numerals apply to similar parts of the two supports.

In these leg supports 13 and 14, cradles 15 have standards secured thereto for supporting the cradles which preferably comprise a pair of strips 16 and 11. The strips 16 and 11 are fulcrumed to clamps 18 and preferably have wing bolts 19 for clamping the strips 16 and 11 in an adjusted angular position with respect to the clamps 18. The clamps 18 are adjustable longitudinally and angularly with respect to the traction bars by loosening a clamping bolt 89 while the adjustments are made. The cradles preferably have pads 8| of felt or other suitable material secured to the leg supporting surfaces thereof.

Footpiece support brackets 82 and 83 are adjustably secured to the traction bars 44 and 48. Since the structure of the footpiece support brackets 82 and 83 and their cooperating footpieces are similar, like reference numerals will be applied to the similar parts of each.

Vertical supports 84 have clamping portions 85 which preferably include cooperating parts engaging the traction bars and connected to them by hinges such as 86. The clamping portions 85 are secured in position with respect to the traction bars by bolts such as 81 and cooperating wing nuts 88. Tubular clamps 89 eX- tend through openings in the vertical supports 84 and are secured in position by set screws or other suitable fastening means 99. Rotation of the tubular clamps 89 is prevented by a flattened surface 9| which engages a flat surface in the openings through the vertical supports. The tubular clamps 89 have a partially split side and wings 92 adjacent the split portion and providing openings through which clamping screws 93 extend. Wing nuts 94 cooperate with the clamping screws 93 to effect a clamping action. Sub-- stantially T-shaped members 95 have threaded stems 96 which extend through the tubular clamps 89, sothat the stems 96 are disposed in substantially parallel relation with respect to the traction bars 44 and 48. The inner surfaces of the split portions of the tubular clamps 89 are preferably threaded to engage the threads on the stems 96 when the wing nuts 94 are tightened. Upon loosening the wing nuts 94, the stems 96 are preferably slidable longitudinally within the clamps 89 for applying tractive force to a patients limb and effecting a rough longitudinal adjustment of the T-shaped members 95. The stems 96 are also preferably rotatable within the clamps 89 when the wing nuts 94 are loosened to provide a rotatable adjustment of 5 tudinal adjustment of the T-shaped members 95.

Cross bar portions 98 of the T-shaped members 95 have a pair of spaced and substantially parallel openings through which legs of inverted substantially U-shaped members 99 extend. The

10 U-shaped members 99 are slidably adjustable with respect to the cross bars 98 and are secured in position by wing bolts I which are threaded into the ends of the cross bars. Ties or links IOI have substantially parallel openings there- 15 through through which the other legs of the U-shaped members extend. These ties or links IOI are slidable with respect to the U-shaped members and are secured in position by wing bolts I02. The substantially U-shaped members 099 and the ties or links IOI comprises footpieces which are vertically adjustable with respect to the footpiece support brackets 82 and 83.

A pelvic support I03 has a tubular portion I04 that fitsover the base support post 8. The tubu- 25lar portion I04 is notched at I05 to engage the flanged member 1 to prevent turning of the pelvic support with respect to the base support post 8. An upper support post I 06 is threaded into the base support post 8 at one end and has an extension post I01 secured to the other end thereof by a coupling I 08. A perineal support I09 is slidably mounted on the upper support post I06. The pelvic support I03 and the perineal support I09 are cooperatively notched at II 0 to prevent 35' the perineal support from turning with respect to the pelvic support. To provide greater comfort to the patient, the perineal support has a longitudinally extending opening at III, the edges of which opening are smooth and rounded 40 to prevent chafing or discomfort.

Sling supports I I2 and I I3 are secured to bearings H4 and H5, respectively, which are slidably fitted to the extension post I01. The sling supports H2 and H3 extend outwardly substantially 4,; at right angles to the extension post I01 and are slidably adjustable longitudinally of the extension post I01, as well as rotatable about the extension post I01 to a desired angular position with respect to the traction bars 44 and 48. The

50 sling supports H2 and H3 are held in a desired position by tightening wing bolts IIS and H1 that are threaded into the bearings H4 and H5, respectively, and engagetthe extension post I01.

A back and head support I I8 includes a back 55 rest plate H9 and a head rest plate I20 that are adjustably secured together. Pads I2I and I22 of felt or other suitable material are secured to,

the surfaces of the back rest plate H9 and head rest plate I20, respectively. Since the base plate 60 pad and clamps for securing the back and head 70 gether as at I24 and fulcrumed to a hinge plate I25 as at I26; the hinge plate I25 being secured to the base plate 2. The links I23 and fulcrums I24 and I26 are so constructed and arranged that the height of the back support plate I I9 and 75 head support plate I20 is adjusted by turning a bolt I21; the construction and arrangement also being such that substantially parallel relation is maintained between the top of the table 31 and the back support plate I I9 and head support plate I20.

In the use of the fracture table disclosed, the upper support post I06 and perineal support I09 are removed to increase the ease of placing the patient upon the table and are replaced to the I positions illustrated after the patient has been placed upon the table. The patient is first so placed that the pelvic support supports the patients pelvis; the leg supports support the patients legs, and the back and head support suports the patients back and head at a height determined by the adjustment thereof. The fulcrums for. the traction bars 44 and 48 are then adjusted to substantial alignment with the patients hip joints by movement of the screws 43 and 41, most clearly shown in Fig. 2, to the openings M and 42, respectively, which most nearly effect such alignment. The patients feet are secured in desired angular and vertical positions by bandaging the feet to the U-shaped members 99 and adjusting the vertical and angular positions of those members. It is to be noted that by utilizing the U-shaped members 99 as foot supports, the vertical position to which the feet can be adjusted can be varied through a wide range without interference from the footpiece support brackets 82 and 03. Also, by wrapping or extending the binding, which secures the feet in place, around both legs of the U-shaped members, the resilience of those members aids in I02 and withdrawing the U-shaped members up-- wardly. The desired angular positions of the patients legs are secured by swinging the traction bars about gheir respective fulcrums and securing the traction bars in their proper angular position by tightening the. wing nuts such as 12 on the struts 58 and 59. If it is desirable to support one or both of the patients legs in slings, those slings may be supported by the sling supports H2 and H3 and those sling supports may be adjusted to the proper angular and vertical position.

While I have illustrated and described these specific embodiments of my invention, I contemplate that many changes may be made thereover without departing from the scope or spirit of my invention.

I claim: p I

1. In portable fracture reducing apparatus adapted to be mounted on and clamped to a table, the combination comprising a main support adapted to be mounted on the table, traction bars fulcrumed to the main support, a movable channel track adapted to be supported solely by the table and providing a continuous trackway from end to end, and auxiliary traction bar supports movable longitudinally of the traction bars, said auxiliary traction bar supports having feet rotatable with respect to the traction bars and guided by the channel, and said track being slidable on the table lengthwise of and angularly with respect to said traction bars and having a length such that said auxiliary traction bar supports may be supported thereon beyond the sides of the table.

2. In portable fracture reducing apparatus adapted to be secured to a table, the combination comprising a main support, means for securing the main support on a table, traction bars fulcrumed to the main support, a movable track adapted to be supported by the table, said track being slidable on the table lengthwise of and angularly With respect to the traction bars, and auxiliary traction bar supports having feet supported by and movable relative tothe track, whereby the track may be placed invarious positions both angularly and lengthwise with respect to the table for given placements of the traction bars.

3. In portable fracture reducing apparatus adapted to be secured to a table, the combination comprising a main support having means securing it in position on the table, a pelvic support 'secured to the main support, traction bars fulcrumed to the main support, a track transverse to the table and extending beyond the sides of the table, extensible struts fulcrumed at their ends to the main support between the traction bars and adjustably secured at their other ends to the traction bars and auxiliary traction bar supports having base portions slidable on the track and guided thereby, said track being adapted to support the traction bars beyond the sides of the table.

4. In fracture reducing apparatus, the combination comprising, a support, a traction bar fulcrumed at one end to the support, a straight track transverse to the traction bar and movable to various angular positions with respect to the traction bar for all angular positions of the latter, and an auxiliary traction bar support movable longitudinally of the traction bar, said support having a foot rotatable with respect to the traction bar, and said foot being slidably supported and guided by said track.

5. In fracture reducing apparatus, the combination comprising, traction bars and cooperating adjustable parts for each of the bars comprehending a foot piece support bracket secured to the bar and longitudinally adjustable with respect thereto, said bracket including a member rotatable with respect to the rest of the bracket and adjustable in a line substantially parallel to the bar, said member having a pair of parallel openings therein, a pair of resilient substantially U-shaped foot pieces slidably mounted in said openings and having substantially parallel legs, and means for holding the U-shaped foot pieces in a fixed position with respect to said member.

6. In fracture'reducing apparatus, the combination comprising a main support, a traction bar fulcrumed at one end to the main support, a foot piece support bracket secured to the traction bar and movable longitudinally thereof, said bracket including a rotatable and longitudinally adjustable member extending substantially parallel to the traction bar and means for clamping said member to prevent rotation and longitudinal movement thereof, a pair of resilient substantially U-shaped foot pieces each having one leg adjustably secured to said member and the other leg disposed between the bracket and the fulcrumed end of the bar, said legs extending transversely with respect to the traction bar and a cross bar adjustably mounted on and connecting said lastmentioned legs of said U-shaped foot pieces, whereby a foot support is formed.

'7. In fracture reducing apparatus, the combination comprising a main support, a traction bar secured to the main support, foot piece support means rotatable and longitudinally adjustable with respect to the traction .bar, means supporting said foot piece supporting means mounted on and at a fixed distance from said traction bar, means for securing the position of said foot-piece supporting means with respect to the traction bar, and a pair of resilient U-shaped foot pieces each having a pair of legs of substantially equal length, one of which. legs is supported by said foot piece support means and adjustable toward and away from the traction bar and the other of which legs is disposed intermediate the foot piece support means and the main support, and a cross bar adjustably mounted on and connecting the intermediate legs of said pair of U-shaped foot pieces, whereby a foot support is formed.

8. Fracture reducing apparatus comprising, in combination, a main support, an adjustable back support, a pelvic support secured to the main support, a perineal support removably secured to the main support adjacent the pelvic support, oppositely disposed laterally extending arms secured to the main support below the pelvic support, a pair of traction bars each having one end fulcrumed to and supported by one of the arms, the fulcrum being movable longitudinally of the arms, a single track movably disposed with respect to the traction bars, auxiliary supports for the traction bars mounted for longitudinal movement on said bars and slidable on the track and guided thereby, and foot supports adjustably secured to the traction bars, said foot supports each including a pair of adjustably mounted substantially U-shaped foot pieces having substantially parallel sides.

9. In fracture reducing apparatus, the combination including, a main support, a traction bar secured to the main support, a supporting member extending transversely of said traction bar, a foot piece provided with a threaded portion, and means adjustably mounting said foot piece on said member, said last-mentioned means including a clamping member on said member releasable to permit angular and longitudinal movement of the foot piece, and rotatable threaded means associated with said clamping member and threaded portion of said foot piece for effecting longitudinal movement of the foot piece when the clamping means is tightened to a predetermined degree.

EARL E. LONGFELLOW.

Images