US1576781A - Fluoroscopic fracture apparatus - Google Patents

Description

March 16 1926.

H. B. PHILIPS FLUOROSCOPI C FRAGTURIEIl APPARATUS 2 Sheets-Sheet 2 Filed April 22, 1924 .MY NQ o INVENTOR Mm B ATTORNEY Patented Mar. 16, 1926.

g kiwi/1x21).l sra-rss- HERMAN B. PHILIPS, -NEW-YORK N; .Y.

FL'UOIROSCOPIC FRACTURE APPARATUS Applicationled April 2 2, 1924; 'Serial No.` 708,108.l

Be' itknown that'li,A HERMAN BS PHILIPS, a'citizenof the Unitedl Sta-tes, residing at NewY York city, borough. of Manhattan, in

the VcountyofNeW York and State of New York,l have invented certain new and useful Improvements in Fluoroscopic Fracture Apparatus, of whichy the followingz is a specification.

This invention relates to hospital apparatus or. surgical'appliances and has partie# ularl'reference to mechanisms or apparatus for'the reduction of broken bones andthe detection or' correctionsv ofr` any malposition or deformity incident to such cases.`

Ainong'theobjects of the invention is to provide ac oinb'iiied fracture lstretcher and table designed to reduce deformities or mal'- posit-ioii'of fragments of broken bones under fluoi'oscopic guidance,-both in horizontal andr vertical planes, and eithercalone` or simultaneously; to ailord means forl traction on any limb or extremity atany'angle, and with any desired|` countertraction:orvr tractionorpressurelat any angle tothe main traction; to providemeans assetv forth inthe yforegoingjtoreduce' deformities from fractures `or disease and retain" them inV any desired position While immobilizing firmly in plaster. Vcasts. or splints; to provide: a stretcher'on; vvhichY a patientv maybe supported -notonly for the purpose of the appli-V cationv o ftheytraction and reducing operations above referred to but alsoupon which he may"bemoved for thel purpose of fluoroscopy orra'dio'graphy, but especially to provide! means whereby. the l observation through fuoroscopy` or .the making of recor'ds through the radiographic or Roentgenograpliie'stepsmaybe practised at the saine time that? the reduction of thepbones: or the like i'sftakingplaceso that the operator may he guided in his operations by the k.visual results obtained; through' either of '..the means just referredto'. l. l still Vfurther ohjectoflthe invention is to provide" substantial'.facilities' for simultaneous use with the stretcher aforesaid'so as1jto .aiford either. vertical or horizontal iiuorosjcopy or both at thezsaine time vWhile the' treatment ofthe limb is .in progress.

With the foregoing.andl other: objects in `viewrtlie.invention consists'in the` arrangement and combination' of-parts .hereinafter described and claimedV andy While the invention is not restricted'Y to'thepexact/ details of construction disclosed or suggestedv` herein, still for the purpose of illustrating"a practicalA embodiment thereof reference is: had to the accompanying drawings,Y in which like reference characters designate thejsame 'parts inthe several views,` and'in Figurel isa side elevation showing one adaptation of my improvement.

Fig. 2vis aplan'view of the same.

Fig;v 3 isa sectional fdetail on the line 3;-3 Y,

of Fig. l. Y

Fig; 4 isa plan view ofa detail described inconnection with Fig. 5i e Fig;v is a vertical detail partly inse-c;A tion of the crotch mechanism.

Fig. Gis adetail perspective' vievv` of the transformer mechanism for the horizontal fluoi'oscopy, its#meansofsupport, and the liofertical and horizontalscreens carried there'- Referring now more specifically tothe dravvingsly shovvy a frame or'stretcher comprisingtvvo side bars 10,`twoend"bars 11,

and corner 'coimectionsf 12. These corner pieces may constitute or carryhandles 13 for manipulating the stretcher as such',V in

-a Well known manner.VThe side rails 10 andeither orboth ofthe enol-l rails fare provided vvith vertical holes llispacedat regularl intervals fromv one` another. The/end rails'or at least one of them areopenended forythe accommodatien onty slidable`rodsV4 15 which normally telescope or maybe drawn o utvvard'tolany desired length andlocked as byineans ofa a-springpin 16 or its equivalent through the adjacent corner pieces for iixing the position of the extensions. The-corner piecesy may have doWnWardfextensions l2 serving as feet for supporting the stretcher.

17 indicatesl al'plate shown as, substantially rectangular and extending across the stretcher and supported at its Vends onk theside rails 10` and ,along which they plate is movable endWiseL ofthe device, the ends "of around: the axis of the pedestal to lie either longitudinally or'tiansversely ofthe stretcherY accordingv to its immediatel purpose. Q0 indicates the crotch piece or pin detachably connected as bythreads 21 1n the upper end et the pedestal and may serve as a binding means or loclr for holding the disk from rotation. The upper end ot the crotch pin is screw threaded to receive a stein 22 :tor holding one or more horizontally extending arms Q3 having slides or brackets 2li tor such purposes as support ing traction or countcrtraetion means or bandages or slings such asindicated at 25. Thedisk 18 may be used as a support for the hips as shown or may be used for other purposes such as a clamp tor the patients shoulder and for this purpose the patient may be supported at the saine level as indicated in Fig. 1 or may be lowered to the plane of the stretcher itranie. ln the former case the disk or shel't 1S may bc clamped between the crotch pin and thestem 22 or it may be otherwise attached to the pedestal.

2G indicates a bed plate ot wood oil any suitable composition and which like theplate 17 is preferably transparent to lsloeut gen rays. llhe hed plate Q6 is reetzuigular and supported 'for cndwise adjustment upon the rails lO. Pillows orpadding 27 will be employed lor their usual purpose in bolsterine` up the patientai; any desired point.

The pedestal is connected adjustably to Y theplate 17 as by means o't bolts 2S cooperating with slots S9. Theplate 17 is held from endwise movement under traction on the patient along the stretcher as by means o't'clamps 30 adjustable along therails 10.

In connection with the stretcher i'raine or extensions thereo't l employ one ormore traction units 31 cach comprising an arm adjustable vertically in aclamp 33 carried by either end or side bar ot the iframe, though usually it is connected to the foot rail 11 for the reduction oit a broken lee". The unit includes also a nut or head Sil along which a threaded shank or screw is slidahle but held 'from rotation by any well known ineans such as a spline. The traction is produced by means o't ahand Wheel 36 or its equivalent co-operating with the threaded screw and bearing against the head 3l in a well known manner. The extremity, as the toot, ot the patient is secured, as by bandaging or lacing, to a yoke or clamp piece 37 having universal ball joint connections in aclamp 38 fixed to the adjacent end oit thescrew 35. The open structure et the yoke `provides `for easy access to the patients extremity 'for the purpose indi cated. Theclamp 33 may be secured to the rail either by means gripping the same or by means ot pins passing therethrough and through the holes 111-. For attaching the unit or any olf them to the 'traine extensions 15 aclamp 33 may be employed. This provides an anchorage for the traction unit ported or manipulated in any convenientv manner.

As an illustration ot the many accessories., l indicate at 39 a torln oit clamp adapted especially lor connection to and interloclo ing with the perforated laile oli the stretcher. lllatending upward from this Clamp and gripped thereto by a hand piece l0 is a post all which obviously may be adj usted around its own axis in the clamp as may be desired. .fit the top oi this post is a huh d2 in which is adjustably mounted a horizontal arni lil and locked as by means oit a set screw /l-l. t one end oi' this arm is a clamp or joint l5 which carries au arm 1 1'6 :u'ljustahle in any desired angle with respect in the arni il?) and in all other respects taku ing into consideration the manner ot connectine` the arln 4? to the post, and the post in turn to theclamp 39. The arm 116 may be provided with any suitable 'lorin of yoke i7 'for usc ttor traction7 countertraction, or other analogous purposes, and having practically universal joint connection with the. inain support has a wide range of adjustnient anywhere along` the stretcher and at any position alter being so adjusted Another important 'feature of my inechauisin comprises a. table having a top 48, corner uprights or legs 4:9, and a plurality ot longitudinal bars not only for stiening the table. but 'tor purposes soon to appear. Some of these hars, as indicated at :10. extend lengthwise along the sides of the table approximately midway between the floor and the top 418 and in the same horizontal plane. 51 indicates conventionally an `Ill-ray apparatus or transformer arranged with its axis in vertical position and mounted slid ably upon a pair oftransverse rails 52, said rails being mounted uponrunners or shoes 5? co-operating directly With therails 50. so that the apparatus as a whole may be moved bodily endwisc of therails 50 and also independently of therails 50 transversely of the table along therails 52 so as to bring thetransformer 51 beneath any point or part of the table top. The action et this transformer is upward or vertical through the table top and through the patient. Hence it is designed to give an image directly upon the horizontal screen 51n or for the making of a radiograph upon a plage similarly located above the patient.

At either side of the table is a `carlil() riage 54 comprising a pair of verticalhollow posts 53 with anysuitable tie bars 56 between them. This carriage is mounted upon a rail 58 near the floor. The posts at any convenient place as just below the table top are provided with hangers 59 which eX- tend beneath the table top and carry pairs of rollers 60 which embrace a bar 61 eX- tending between the corner posts 49 of the table. Thus the carriage 54 is movable freely along the rails 58 and 61 and consequently at any desired position along the table from one end to the other. 62 indicates a second X-ray tube or transformer arranged with its axis in horizontal position and supported upon a pair ofhorizontal arms 63 extending through a similar number 0f sleeves 64- slidable or movable up and down along theposts 55.The'arms 63 are movable laterally so as to position thetransformer 62 at any desired position with respect to the center of the table and it of course is movable along the posts as well as with thc posts or carried longitudinally of the table. This transformer is designed to throw the image horizontally where it may be observed on the vertical screen 62L or a plate may be made at such position for a radiograph. As shown in Fig. 6 the screens are connected to aframe 65 slidable horizontally inguide ways 66 at the top of thetransformer 62 so that the screen 5la may be moved directly over thetransformer 62. Thescreen 62a is hinged at 67 to the other screen or itsv frame and may be swung upward into the same plane as thescreen 51a where it may be locked by spring catches 68 or their equivalent. With the two screens adjusted as shown in Fig. 6 the operator or surgeon may observe fluoroscopically on either or both of the screens simultaneously the image thrown upward and horizontally from both of the transformers while at work upon the patient. Obviously, after the reduction has been completed thetransformer 62 may be moved out of the way for the purpose of facilitating the bandaging of the extremity. Thetransformer 62 is counterbalanced in a well known manner by the use of suspendingcables 69 to the other ends of which arecounterweights 70 movable within the posts.

From the foregoing it will be appreciated that the objects above indicated are attained in a practical apparatus, and by means of the universality of the various devices and connections the extremity or any part of the patient can be put and kept in any position, such as flexion, extension, inversion, eversion, abduction, or adduction. It will be appreciated also that the apparatus, `having reference especially to the fluoroscopic facilities, may be utilized for general diagnosis, as for the localization of any foreign body or particles that may seem to be present in the body, and independently of reduction of fractures.

I claim:

1. Apparatus for making fluoroscopic observations, which include transformers arranged with their aXes at an angle to each other, and screens to co-operate with the .individual transformers to permit a patient to be observed from a plurality of directions without changing the adjustment of the apparatus, said screens being secured together at an angle, one of said screens having movable engagement with one of the transformers to permit the screens tobe nested close against the transformer or to'be moved outwardly therefrom for the taking of observations in conjunction with saidtransformers. v 2. Apparatus, for the making of fiuoroscopic observations which include transformers arranged with their axes at an angle to each other, and screens to co-operate with the individual transformers to permit a patient to be observed from a plurality of directions without changing the adjustment of the apparatus, one of said transformers carrying a plurality of screens secured at an angle to each other and operative in connection with one of said screens, while the other transformer is operative in connection with the other screen.

In testimony whereof I afx my signature.

HERMAN B. PHILIPS.

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