US20040167455A1

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Info

Publication number: US20040167455A1
Application number: US10/679,513
Authority: US
Inventors: Kenneth Smart
Original assignee: Individual
Current assignee: Individual
Priority date: 2001-03-06
Filing date: 2003-10-07
Publication date: 2004-08-26
Also published as: US20020128577A1; US6629944B2

Abstract

A limb-positioning device is adapted for use in an operating room and is attachable to an operating room table. The limb-positioning device includes a full motion arm, a patient-receiving surgical device and a tension controller. The full motion arm has a plurality of pivotally connected arms with a plurality of joints therebetween. One end of the full motion arm is adapted to be attached to an operating room table. The patient-receiving surgical device is attached to a block joint at the distal end of the full motion arm. There is a tension controller for each joint. Preferably the tension controller concurrently controls the tension in each joint. The patient-receiving surgical device may be a forearm tray, a lower leg tray, a distraction harness or a Chinese finger trap assembly. There is provided a method of using the limb-positioning device. In addition, a patient-receiving surgical device includes a patient-receiving portion and a bar attached thereto. The bar is attachable to a receiving channel on an attachment block that is attached to a ball joint at the distal end of a full motion arm of a limb-positioning device.

Description

FIELD OF THE INVENTION

This invention relates to limb-positioning and traction devices and in particular limb-positioning and traction devices that can be adapted for use for a variety of surgical procedures, a variety of positions and a variety of limbs.[0001]

BACKGROUND OF THE INVENTION

In the performance of surgery or other medical procedures it is often desirable to support a limb or other part of the patient's body in a particular position during the procedure. Since no two patients' bodies are alike, it is important that a device which facilitates such positioning can accommodate a diverse group of patient sizes. The positioning of the limb is of particular importance during orthopaedic surgery, particularly with regard to arthroscopic surgery wherein the patient's joint is manipulated to provide access to the arthroscope.[0002]

To date some limb-positioning devices have been suggested. However, typically these devices are large devices that are difficult to use and often they are single purpose or essentially single purpose devices. One such device is shown in U.S. Pat. Nos. 4,579,324 and 4,702,465 both issued to McConnell on Apr. 1, 1986 and Oct. 27, 1987. This device is for use in an operating room for positioning a limb. It is a large unwieldy device that would be difficult to store and more difficult to sterilize. Further, there are a number of different adjustments that need to be made to secure the device. Thus it would be difficult to easily adjust the position of the limb. Further it would be difficult for one person to adjust the position on their own. Accordingly, it is not widely used in operating rooms. Another device is shown in U.S. Pat. No. 5,961,512 issued to Purnell on Oct. 5, 1999. This is a single purpose device for positioning an arm during shoulder surgery. Similarly this device is large, difficult to store and more difficult to sterilize. In addition, as with the above device there are a number of adjustments that must be made to position the limb. Thus a number of adjustments need to be made to move the limb.[0003]

Accordingly, it would be advantageous to provide a device that is easy to store, easy to sterilize and can be used for a number of different procedures.[0004]

SUMMARY OF THE INVENTION

The present invention is a limb-positioning device that is adapted for use in an operating room and is attachable to an operating room table. The limb-positioning device includes a full motion arm, a patient-receiving surgical device and tension controller. The full motion arm has a plurality of pivotally connected arms with a plurality of joints therebetween. One end of the full motion arm is adapted to be attached to an operating room table. The patient-receiving surgical device is attached to a block joint at the distal end of the full motion arm. There is a tension controller for each joint. Preferably the tension controller concurrently controls the tension in each joint. The patient-receiving surgical device may be a forearm tray, a lower leg tray, a distraction harness or a Chinese finger trap assembly.[0005]

In another aspect of the invention there is provided a method of using the limb-positioning device. The method for positioning a portion of a patient's anatomy includes the steps of providing a limb-positioning device; attaching the limb-positioning device to an operating room table; adjusting the tension controller; supporting the portion of the patient's anatomy on the patient-receiving surgical device; positioning the patient-receiving surgical device; and tightening the tension controller. The limb-positioning device includes a full motion arm having a plurality of pivotally connected arms with a plurality of joints therebetween and one end of the full motion arm being adapted to be attached to an operating room table: a patient-receiving surgical device attached to a block joint at the distal end of the full motion arm; and a tension controller for controlling the tension of each joint.[0006]

In a further aspect of the invention, a patient-receiving surgical device includes a patient-receiving portion and a bar attached thereto. The bar is attachable to a receiving channel on an attachment block that is attached to a ball joint at the distal end of a full motion arm of a limb-positioning device. The patient-receiving portion may be a forearm tray, a lower leg tray, a distraction harness or a Chinese finger trap assembly.[0007]

The limb-positioning described herein is relatively easy to store and sterilize. It has a single fixation point and a plurality of joints with variable friction level so that a surgeon can position patient limb without the aid of an assistant. Once positioned the device can be secured in that position. The device can accommodate limbs of varying weight. The device is designed so that if it is draped in a disposable drape and used with a disposable patient-receiving device no large part need be placed in the autoclave. This reduces the cool down times and lowers device inventory requirements since units need not be cycled through infection control. The device herein is adapted to be used with different patient-receiving surgical devices whereby the device can be used for shoulder, knee, ankle, elbow, hip and wrist surgery.[0008]

Further features of the invention will be described or will become apparent in the course of the following detailed description.[0009]

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will now be described by way of example only, with reference to the accompanying drawings, in which:[0010]

FIG. 1 is a perspective view of a forearm tray embodiment of the limb-positioning and traction device constructed in accordance with the present invention;[0011]

FIG. 2 is an enlarged cut-away top view of the detachable forearm tray as viewed in the direction of[0012]

arrow

2 in FIG. 1;

FIG. 3 is a perspective blown apart view of the coupling portion of the limb-positioning and traction device showing the detachable forearm tray detached from the female portion of the block;[0013]

FIG. 4 is a perspective view of the limb-positioning and traction device showing an alternate embodiment of the forearm tray and showing a drape over the full motion arm;[0014]

FIG. 5 is a sectional view of the attachment portion of the limb-positioning and traction device including a drape showing the detachable forearm tray attached to the block;[0015]

FIG. 6 is a sectional view of the attachment portion of the limb-positioning and traction including a drape device similar to that shown in FIG. 5 but showing the detachable forearm tray detached from the mount;[0016]

FIG. 7 is a side view of the limb-positioning and traction device attached to an operating table in a beach chair configuration;[0017]

FIG. 8 is a perspective view of a distraction harness embodiment of the limb-positioning and traction device constructed in accordance with the present invention;[0018]

FIG. 9 is a perspective view of a Chinese finger trap assembly embodiment of the limb-positioning and traction device constructed in accordance with the present invention; and[0019]

FIG. 10 is a perspective view of a lower leg tray embodiment of the limb-positioning and traction device constructed in accordance with the present invention.[0020]

DETAILED DESCRIPTION OF THE INVENTION

Referring to FIG. 1, a limb-positioning device is shown generally at[0021]10. The limb-positioning device includes afull motion arm12 and a patient-receivingsurgical device14.

The[0022]

full motion arm

12 is a stainless steel device with three points of motion that are locked and unlocked by a centrally located tensioning knob. Thefull motion arm12 includes adistal arm16, aconnection arm18 and anattachment arm20. Preferably theattachment arm20 is a Clark post. The Clark post is a solid metal rod that allows the device to be attached to a standard operating room table via a Clark attachment. Between each pair of arms16.18 and20 there is a joint which allows movement of one arm relative to the other. Betweenattachment arm20 andconnection arm18 there is an attachment ball joint22. Between theconnection arm18 and thedistal arm16 there is a central joint24 that has one degree of freedom and the arms can rotate 360 degrees. Apost25 extends outwardly from the central joint24 and atension adjustment knob26 is removably attached to thepost25.

Preferably the[0023]

surgical device

14 is releasably attachable to themotion arm12. Anattachment block28 is used as the interface between the patient-receivingsurgical device14 and themotion arm12.Attachment block28 has amale portion30 and afemale portion32.Female portion32 is attached to themotion arm12 with a block ball joint34. A pair of pins36 (as best seen in FIGS. 3, 5 and6) extend outwardly from themale portion30 and are received into a corresponding pair ofapertures38 infemale portion32. A spring loadedtension clip40 holds thepins36 in place.

Preferably[0024]

surgical device

14 is releasably attachable to themale portion30 of theattachment block28. A receivingchannel42 is formed in themale portion30 of theattachment block28 on the opposed side from thepins36, as best seen in FIG. 2. Abar44 is attached to thesurgical device14. Thebar44 has a trapezoidal shaped cross section that slides into thechannel42.Channel42 has anend stop46 and alateral channel48.Lateral channel48 facilitates easy cleaning of themale portion30. Amount pin50 holds thebar44 in place. Themale portion30 of the attachingblock28 and thebar44 together provide a sterile interface between thefemale portion32 of the attachingblock28 and the patient-receivingsurgical device14.

Preferably the[0025]

tension adjustment knob

26 is a round, detachable knob that provides a sterile interface with which the surgeon can adjust the tension and holding strength of themotion arm12 during the surgical procedure. Themotion arm12 is constructed such that adjustingknob26 controls the tension and hold strength of attachment ball joint22, the central joint24 and the block ball joint34. An example of a full motion arm that is adaptable to this application is shown in U.S. Pat. No. 4,431,329 issued to Baitella on Feb. 14, 1984

To use the limb-positioning and[0026]

traction device

10 shown herein in surgery it needs to be either autoclaved or draped, in accordance with today's standards. Accordingly, if the limb-positioning andtraction device10 is to be autoclaved it must be made of the appropriate materials. Alternatively, if it is to be draped anappropriate drape52 is shown in FIGS.4 to6. Thedrape52 includes asleeve drape54 and a skirt drape (not shown). Typically these drapes are disposable. Thesleeve drape54 has a pair of burst points58 that correspond toapertures38 infemale portion32 ofattachment block28 and afenestration60 that is positioned such thatpost25 extends therethrough. Accordingly, in use thesleeve drape54 is pulled over thefull motion arm12 and the burst points58 andfenestration60 are positioned as described above A sterile or autoclavedtension adjustment knob26 is then attached to thepost25 of central joint24. Similarly the sterilesurgical device14 will be attached to sterile or autoclavedmale portion30 ofattachment block28. The skirt drape slides over the draped motion arm and the Clark attachment to provide a sterile barrier between unautoclaved of limb-positioning andtraction device10 and the surgical field.

Preferably patient-receiving[0027]

surgical device

14 is a disposable device. A wide variety of different devices could be attached to themotion arm12. A few such different devices are shown in the drawings herein. Aforearm tray62 is shown in FIGS. 1 and 2 wherein the tray is shaped to receive the forearm. Theforearm tray62 includes aforearm portion64, ahand portion66 and athumb portion68. The side of thetray62 is cut away such that the patient's wrist bone will not touch the tray. Analternate forearm tray70 is shown in FIG. 4 wherein the tray has aforearm portion64 and ahand portion66 but no thumb portion. Typically once the forearm is positioned in theforearm tray70 the forearm will be secured in place with surgical tape such as Koban™ tape.

Referring to FIG. 8 a distraction harness or ankle strap[0028]72 is shown attached to bar44. Ankle strap72 includes aheel strap74 and anarch strap76. It will be appreciated by those skilled in the art that thefull motion arm12 can be manipulated such that tension is exerted on the ankle.

Referring to FIG. 9 a plurality of Chinese[0029]

finger trap assembly

78 are shown attached to bar44. Similar to the ankle embodiment, thefull motion arm12 can be manipulated such that upward tension is exerted on the arm. Note that an upper arm retention strap will likely also be used during wrist surgery.

Referring to FIG. 10 a[0030]

lower leg tray

80 is shown attached to bar44. It will be appreciated by those skilled in the art that once the patient's leg is secured in the tray. As with the forearm, the patient leg is typically secured in place with surgical tape. Thefull motion arm12 may be manipulated to achieve flexion, extension, varus, vulgus, abduction and adduction. This is of particular importance when conducting orthopaedic surgery. In addition, the ease of manipulating the lower limb will also be advantageous when conducting gynecological procedures.

Alternatively, the patient-receiving[0031]

surgical devices

14 described above may be autoclavable. This may be of particular importance in jurisdictions where there are severe limitations on the amount and composition of materials that may be included in the garbage.

In use after the patient has been positioned on the operating table, the[0032]

full motion arm

12 is attached in the desired position by sliding the Clark post orattachment arm20 into therail clamp82 and tightening the clamp. Before or after the affected limb has been prepped, themotion arm12 is locked in a vertical position and thedrape52 is arranged over themotion arm12. Thesterile sleeve drape54 is slid over themotion arm12. The burst points58 are positioned overapertures38 in thefemale portion32 of theattachment block28. Thefenestration60 is positioned over thepost25 extending outwardly from the central joint24. The sterile skirt drape is then pulled over the draped arm and the wings are extended to cover the patient. Thesterile adjustment knob26 is pushed onto thepost25 through afenestration60 in the side of thesleeve drape54. Themale portion30 of theattachment block28 is fastened to thefemale portion32 by pushing thepins36 through thesleeve drape54 into thetension clip40 in thefemale portion32. The appropriate patient-receivingsurgical device14 is attached to theattachment block28 by sliding thebar44 into the receivingchannel42 and locking it in place withmount pin50. Where appropriate the patient's limb is secured to the patient-receivingdevice14. To loosen the device for positioning, thetension adjustment knob26 is rotated counterclockwise until the necessary motion is obtained. Thendevice10 is positioned into the desired position by rotating the tensioning knob clockwise. A mid-point adjustment will allow the limb to be moved into any position under tension and maintain that position until the tension can be locked. There is a wide variety of tension options available to the user. For example the device can be positioned in the general area with minimal tension. Thereafter the finer positioning can be done at a much higher tension. Further, it will be appreciated by those skilled in the art that if the position of the limb need be moved during surgery, the knob can easily be loosened, the limb moved and the knob resecured. Alternatively themount pin50 can be easily removed and thesurgical device14 can be removed from thepositioning device10 and then thesurgical device14 can be reattached so that the limb is back to the same position.

It will be appreciated by those skilled in the art that there are a number of advantages that can be achieved, particularly in an operating room, by using the limb-positioning[0033]

device

10 described herein. Most importantly the limb-positioning device is easy to use. It is attachable to a standard Clark rail clamp commonly used in operating rooms throughout the world. The limb-positioningdevice10 has a single fixation point and an adjustable friction level. Therefore a surgeon or other healthcare professional can position patient limb without the aid of an assistant. In addition, thedevice10 can easily be adjusted for varying weight of limbs. Further the device can easily be adapted for use in a number of configurations. Specifically there is

forearm tray

62,70, ankle strap72, Chinese finger traps78, andlower leg tray80. These differentsurgical devices12 allow the surgeon to do procedures on shoulders, knees, ankles, elbows, hips and wrists with asingle device10.

The device herein has a number of advantages in the operating room. For example when the limb-positioning[0034]

device

10 is used in the draped configuration with a disposable patient-receivingsurgical device14 few parts need to be sterilized and the whole device need not be sterilized. Specifically only thetension adjustment knob26 and themale portion30 of theattachment block28 need to be sterilized or autoclaved. Thesurgical device14 with thebar44 attached thereto is a disposable sterile unit. Therefore no large parts need to be placed in the autoclave and the cool down times are reduced. The fitteddisposable drapes52 is a generally accepted method of rendering a piece of equipment sterile. The drape is provided with burstpoints58 andfenestration60 for connection of the autoclaved parts. Further there is a lower device Inventory requirement since units need not be cycled through infection control. In addition, the compact design of thedevice10 fits easily into a drawer for storage in over-crowded operating rooms.

As discussed above, preferably the patient-receiving[0035]

surgical devices

14 are disposable. This reduces the chance of patient burn on an autoclaved device that has not cooled sufficiently. Disposable devices allow for a quick turn-around between procedures. Further the disposable devices reduce the chance of contamination.

It will be appreciated by those skilled in the art that the device herein was described using a[0036]

drape

52 and a disposable patient-receivingsurgical device14. However, it would also be manufactured so that thedevice10 is autoclavable and thesurgical devices14 are autoclavable. This will be advantageous in jurisdictions that have sereve restrictions regarding waste disposal. Further, although the device is described for use in the operating room it could also be used in other therapeutic settings.

It will be appreciated that the above description related to the invention by way of example only. Many variations on the invention will be obvious to those skilled in the art and such obvious variations are within the scope of the invention as described herein whether or not expressly described.[0037]

Claims

What is claimed as the invention is:

1. A limb-positioning device adapted for use in an operating room and attachable to an operating room table comprising:

a full motion arm having a plurality of pivotally connected arms with a plurality of joints therebetween one end of the full motion arm being adapted to be attached to the operating room table:

a patient-receiving surgical device attached to a block joint at the distal end of the full motion arm: and

a tension means for controlling the tension of each joint.

2. A limb-positioning device as claimed inclaim 1 wherein the tension means concurrently controls the tension of all of the joints.

3. A limb-positioning device as claimed inclaim 2 wherein the tension means includes a variable tension control whereby rotating a handle in one direction increases the tension on the joints and rotating the handle in the opposite direction decreases the tension.

4. A limb-positioning device as claimed inclaim 3 wherein the handle is detachable.

5. A limb-positioning device as claimed inclaim 4 wherein the patient-receiving surgical device is detachable.

6. A limb-positioning device as claimed inclaim 5 wherein the full motion arm includes a connection arm having an attachment arm connected at one end thereof and a distal arm connected at the other end thereof and wherein a ball joint is connected between the connection arm and the attachment arm and a central joint is connected between the connection arm and the distal arm and the block joint is a ball joint.

7. A limb-positioning device as claimed inclaim 6 further including a drape having a knob fenestration and a burst point whereby the drape covers the full motion arm and both the handle and the patient-receiving surgical device are attached to the full motion arm after the drape has been placed thereon.

8. A limb-positioning device as claimed inclaim 7 further including an attachment block having a male portion and a releasably attachable female portion and wherein one of the male portion and the female portion is attached to the block joint and the other of the male portion and the female portion has one of a receiving channel and a bar formed therein the receiving channel is adapted to receive the bar and the other of the receiving channel and the bar is attached to the patient-receiving surgical device.

9. A limb-positioning device as claimed inclaim 8 wherein the patient-receiving surgical device is a forearm tray.

10. A limb-positioning device as claimed inclaim 8 wherein the patient-receiving surgical device is a lower leg tray.

11. A limb-positioning device as claimed inclaim 8 wherein the patient-receiving surgical device is a distraction harness.

12. A limb-positioning device as claimed inclaim 8 wherein the patient-receiving surgical device is Chinese finger trap assembly.

13. A limb-positioning device as claimed inclaim 3 wherein the patient-receiving surgical device is detachable.

14. A limb-positioning device as claimed inclaim 3 wherein the patient-receiving surgical device is a forearm tray.

15. A limb-positioning device as claimed inclaim 3 wherein the patient-receiving surgical device is a lower leg tray.

16. A limb-positioning device as claimed inclaim 3 wherein the patient-receiving surgical device is a distraction harness.

17. A limb-positioning device as claimed inclaim 3 wherein the patient-receiving surgical device is Chinese finger trap assembly.

18. A method for positioning a portion of a patient's anatomy comprising the steps of:

providing a limb-positioning device comprising a full motion arm having a plurality of pivotally connected arms with a plurality of joints therebetween and one end of the full motion arm being adapted to be attached to an operating room table, a patient-receiving surgical device attached to a block joint at the distal end of the full motion arm, and a tension means for controlling the tension of each joint;

attaching the limb-positioning device to an operating room table;

adjusting the tension means;

securing the portion of the patient's anatomy on the patient-receiving surgical device;

positioning the patient-receiving surgical device; and

tightening the tension means.

19. A method according toclaim 18 wherein the patient-receiving surgical device is a forearm tray and the portion of the patient's anatomy is a forearm.

20. A method according toclaim 18 wherein the patient-receiving surgical device is a lower leg tray and the portion of the patient's anatomy is a lower leg.

21. A method according toclaim 18 wherein the patient-receiving surgical device is a distraction harness and the portion of the patient's anatomy is an ankle.

22. A method according toclaim 3 wherein the patient-receiving surgical device is Chinese finger trap assembly and the portion of the patient's anatomy is the fingers.

23. A patient-receiving surgical device comprising a patient-receiving portion and one of a bar and a receiving channel attached to the patient-receiving portion, the one of the bar and the receiving channel being attachable to the other of the bar and the receiving channel on an attachment block that is attached to a ball joint at the distal end of a full motion arm of a limb-positioning device.

24. A patient-receiving surgical device as claimed inclaim 23 wherein the patient-receiving portion is a forearm tray.

25. A patient-receiving surgical device as claimed inclaim 23 wherein the patient-receiving portion is a distraction harness.

26. A patient-receiving surgical device as claimed inclaim 23 wherein the patient-receiving portion is a Chinese finger trap assembly.

27. A patient-receiving surgical device as claimed inclaim 23 wherein the patient-receiving portion is a lower leg tray.