EP2311423A1 - Orthopaedic adapter for an operating table - Google Patents

Abstract

The orthopedic adapter (4) comprises a coupling unit (5) for coupling the orthopedic adapter with a coupling device (6) to the coupling points of an operation table (1). A central arbor (7) is connected with the coupling unit, where the central arbor is made from a non-metallic material. A universal mounting (8) has another coupling device. An independent claim is included for an operation table with a leg level hinge.

Description

The invention relates to an orthopedic adapter for an operating table, in particular an orthopedic adapter, which is suitable for a three-dimensional imaging.

Operating tables essentially consist of an operating table column and a patient support plate.

The column is either freely positionable with its own base plate or fixed to the floor of an operating room. The known columns may be height adjustable and / or inclinable so that the patient support plate mounted thereon is height adjustable and / or tiltable about one or more axes.

The patient support plate is either fixedly connected to the column or designed removable. The patient support plate is either formed as a one-piece bed surface, or has several table top segments. The tabletop segments are usually connected to each other by means of coupling points and Ankoppeleinheiten, so that a patient support plate is configurable in a desired size, which extends in a longitudinal direction.

In addition to the tabletop segments, which serve as lying surfaces, additional functions can be integrated into the tabletop segments. For orthopedic surgery, extension units, e.g. Orthopedic adapter, provided. With these extension units, for example, in the presence of a fracture in the leg area of the broken bone is pulled against the tension applied by the muscles in the original position, aligned by the orthopedist, and then fixed. The extension units are usually made of stainless steel and have a strength that is suitable both for applying a nearly horizontal tensile force and the moments that occur, as well as for other force applications, e.g. is sufficient by a lower leg or a gypsum aggregate, in which the force is applied in a different direction to the extension unit.

By intraoperative examination methods that create three-dimensional representation of the human body, such as computed tomography or an application of a C-arm, with an angle of rotation of about 135 ° per degree of angle, an image is generated, which is then assembled into a three-dimensional representation is placed the requirement on the operating table to have no metallic components in the receiving area. The presence of metallic components in the recording area causes disturbing artifacts such as e.g. bright spots in the representation generated, and thus rendering useless.

For this reason, at least parts of patient support surfaces made of non-metallic fiber composites and components of extension units for operating tables made of non-metallic materials have already been produced. This results However, the problem that the strength of the extension units, which have for the investigation method with the three-dimensional representation suitable non-metallic materials, is not sufficient for the possibilities of a conventional extension unit, namely the cultivation, etc. of all the accessories of the conventional extension unit.

This results in the task of providing an orthopedic adapter that, without sacrificing the application possibilities of a conventional extension unit, enables three-dimensional imaging examination methods.

The object is solved by the features of claims 1 and 11. Further developments of the invention are the subject of the dependent claims.

An adapter of the type mentioned is designed so that a central spar consists of a non-metallic fiber composite material which extends in the longitudinal direction of the operating table to the foot end, and to which a separately formed universal receptacle is coupled.

• Fig. 1 zeigt eine Gesamtansicht eines Operationstischs mit einem Orthopädieadapter ohne die ersten Koppelstellen, mit Zubehör, das an die zweite Koppelstelle ankoppelbar ist;
• Fig. 2 zeigt eine vergrößerte Ansicht des Orthopädieadapters und der separaten ankoppelbaren Universalaufnahme;
• Fig. 3 zeigt eine von dem Universaladapter lösbare Koppelstelle in einer vergrößerten Ansicht.

The invention will now be explained with reference to the accompanying figures with reference to an embodiment.

• Fig. 1 shows an overall view of an operating table with an orthopedic adapter without the first coupling points, with accessories that can be coupled to the second coupling point;
• Fig. 2 shows an enlarged view of the orthopedic adapter and the separate connectable universal receptacle;
• Fig. 3 shows a detachable from the universal adapter coupling point in an enlarged view.

Fig. 1 shows an operating table 1 with a patient support surface 2, which is mounted on an operating table column 3. The patient support surface 2 is shown here in the form of two bearing surface segments 2 a, 2 b, which are arranged in a longitudinal direction of the operating table 1. The bearing surface segment 2b is connected to the operating table column 3. At the bearing surface segment 2b opposite the end of the bearing surface segment 2a, a coupling point for coupling additional bearing surface segments is provided. An orthopedic adapter 4 is arranged in the direction of a foot end of the operating table 1 at the end of the bearing surface segment 2b opposite the bearing surface segment 2a.

The orthopedic adapter 4 has a coupling unit 5, which extends in a vertical direction transverse to the longitudinal axis of the operating table 1. At the outer lateral edges of the coupling unit 5 first coupling devices 6 are provided to couple the orthopedic adapter 4 at corresponding coupling points of the operating table 1, not shown. From the coupling unit 5 extends in the longitudinal direction of the operating table 1 to its foot towards a central spar 7, which is attached to the coupling unit 5. At the docking unit 5 opposite end of the central spar 7 a separate universal receptacle 8 is arranged. The universal receptacle 8 has later-described first and second coupling points, as well as a second coupling device. In alternative embodiments, the universal receptacle 8 may have only one coupling point, or else a plurality of coupling points of one or more different types. The coupling unit 5 has at its lower end in the corner regions two third coupling points 9, which are provided for coupling an extension spar 10 described below.

The orthopedic adapter 4 has at least one extension spar 10, wherein alternatively a plurality of extension bars 10 may be provided. The extension spar 10 is shown here in a non-coupled state. The extension spar 10 is made of a non-metallic material, here of carbon fibers. The extension spar 10 has a substantially square cross-section, the corners of which are rounded, and has at one end a uniaxial joint 11, the axis of which is arranged vertically, and subsequently a third coupling device 12. The hinge 11 has a locking device, so that within a limited by the structural design of the joint horizontal pivot angle range, the direction in which the extension spar 10 extends, starting from the joint is horizontally adjustable and lockable. At the end of the hinge 11, which lies opposite the extension spar 10, the third coupling device 12 is provided. The third coupling device 12 has at its upper end a hook-shaped strip, with which the third coupling device 12 can be hooked into the third coupling point 9. Furthermore, it has an adjustable hook-shaped plate at the lower end, which can be adjusted by turning a handwheel up and down. Between the hook-shaped strip and the hook-shaped plate, approximately centrally, a not shown protruding strip is attached. The third coupling device 12 is hooked into the third coupling point 9, and, with the help of the hook-shaped plate, clamped from below to the third coupling point 9 and thus secured. The central strip engages in a rectangular opening of the third coupling point 9 and serves as a coding, so that only suitable accessories can be coupled to the corresponding coupling device at the coupling point. At the third coupling device 12 of the extension spar 10 opposite End can be attached as accessories, for example, not shown Zugspindelaggregat.

The bearing surface segment 2b of the patient support surface 2 of the operating table 1 has, at its end facing the orthopedic adapter 4, two leg plate joints 13 in the corner regions. The leg plate joints 13 are usually provided so that not shown leg plates for further forming the patient support surface 2 are coupled there. The leg plate joints 13 each have a fourth coupling point 14. The fourth coupling points 14 are designed so that the functional characteristics for the coupling correspond to those of the third coupling point 9, so that the extension spar 10 can be coupled with its third coupling device 12 at the fourth coupling point 14.

Furthermore, in Fig. 1 Accessories of the orthopedic adapter 4, such as a lower leg counter 15 and a plaster unit 16, shown, which can be coupled to the universal receptacle.

FIG. 2 shows the orthopedic adapter 4 and the separate universal receptacle 8 in an enlarged view. The orthopedic adapter 4 has a support plate 17 with padding. The support plate 17 has substantially the shape of a triangle, wherein on the underside in the region of two corners in each case a fourth coupling device 18 is mounted, wherein in FIG. 2 only one is shown. The coupling device 18 is essentially formed of two components, the one, as in FIG. 2 shown formed as a hook. The hook is attached to the support plate and has an opening. The other component of the coupling device 18 consists of a guide in the form of an inverted U's. The guide is pivotally mounted on the hook about a horizontal axis. The guide is stored that way and has such dimensions that the hook in its locked position, together with the guide, surrounds the bolt, as will be described in detail later. Thus, a positive connection between the coupling unit 5 and the support plate 17 is formed. At the fourth coupling means 18 opposite corner in the direction of the foot end, the support plate 17 has an attached support 19. With this edition 19, the support plate 17 is due to their weight on the central spar 7. The support 19 also carries a Gegenzugstab 20 with an ergonomically adapted pad that provides the application of a tensile force on a leg of the patient using the orthopedic adapter 4, the required counterforce for the trunk of the patient, so that the patient on the patient support surface 2 also at Applying the tensile force does not slip.

The central spar 7 of the orthopedic adapter 4 has a substantially square cross section with rounded corners. The central spar 7 consists of a non-metallic fiber composite material, here of carbon fiber. The central spar 7 is fixedly connected to the coupling unit 5 and its length is chosen so that its end is slightly above the support plate 17 also.

In the FIG. 2 the universal receptacle 8 is shown separated from the central spar 7. At the lower end of the universal receptacle 8, a part of a second coupling device 21 is shown. The second coupling device 21 consists essentially of the inner cavity of the universal receptacle 8 and a leaf spring which presses a pin from below through a hole in the cavity of the universal receptacle 8. The cavity is designed so that it substantially corresponds to the contour of the cross section of the central spar 7, wherein the dimensions are small are larger to ensure easier assembly. The cavity is open on the central spar 7 facing side of the universal receptacle 8. This opening is not shown. Adjacent to the side with the opening a cylindrical portion 29 is provided on the top of the universal receptacle 8, at the axial ends of each of which a first coupling point 22 is arranged.

The first coupling points 22 essentially have the shape of an angle. One leg of the angle is provided with a rectangular aperture 30 with an upwardly extending recess in its upper corner region at the end of the aperture 30 remote from the cylindrical body. The opening 30 forms with the upper edge in this illustration and the lower edge of the leg, the functional surfaces of the first coupling point 22. The opening 30 and the recess are formed as an encoder, so that only approved accessories can be coupled here. The other leg of the angle extends in each case laterally of the cylindrical portion 29 and is provided with a bore, not shown here, so that it can be attached to the cylindrical body with a fastening means.

At the opening of the central spar 7 opposite side of the universal receptacle 8, a second coupling point 23 is arranged. The second coupling point 23 has a tubular portion which is fixed by means of a spacer strip on a vertical surface of the universal receptacle 8. The tube is arranged vertically and serves eg for receiving the in Fig. 1 shown accessories, the lower leg counter 15 and the plaster unit 16. The housing of the universal receptacle 8, the first coupling point 22 and the second coupling point 23 are made of stainless steel.

According to Fig. 3 the universal receptacle 8 is mounted on the central spar 7. The support 19 of the support plate 17 rests on the universal receptacle 8. Due to the arrangement and the shape of the support 19 is formed between the support 19 and the universal receptacle 8 a positive connection, so that, in addition to the attachment of the universal receptacle 8 by the second coupling device 21, the universal receptacle 8 is prevented from the central spar. 7 to slide down. The support 19 is shown here without the counter pull rod 20.

On the cylindrical portion 29 of the universal receptacle 8, a first Hirth serration 24 is provided on each of its end faces in circumferential direction. The first Hirth serrations 24 are each axially opposite a second Hirth gearing 25 disposed on a leg of the angle of the first coupling point 22. In the center of the first Hirth toothing 24 and second Hirth toothing 25, a bolt 26 is arranged, which is rotatably connected at one of its ends with a hinged handle 27 in the axial direction of the bolt 26.

On the pin 26, a rectangular plate 28 is shown at the height of the first Hirth serration 24, whose width in the horizontal direction is slightly less than the diameter of the bolt 26 and whose length in the vertical direction is greater than the diameter of the bolt 26. This plate 28th is firmly connected to the bolt 26. In the cylindrical portion 29, one of the first Hirth serration 24 inwardly offset disc 31 is provided in the axial direction of the bolt 26. The disc 31 has a rectangular recess 32, wherein the contour of the recess 32 corresponds to the contour of the plate 28, but has slightly larger dimensions to facilitate the penetration of the plate 28 through the recess 32. The bolt 26 is guided behind the plate 28 by an introduced into the cylindrical portion 29 bore. Between the disc 31 and the bore in the cylindrical portion 29, a clearance is provided which allows rotation of the bolt 26 with the plate 28. By pushing the pin 26 into the hole so that the plate 28 penetrates the disc 31 through the recess 32 and enters the free space, and by turning the pin 26 by means of the handle 27 by an angle which is smaller than 90 °, In one direction is formed by the rectangular plate 28 as a connecting element and the disc 31 is a positive connection, so that the bolt 26 can not be pulled out of the hole. As a result, a rotary joint for the first coupling point 22 is formed. The pivot joint for the first coupling point 22 is by turning the lever 27 by the same angular amount in the opposite direction, whereby the positive connection between the plate 28 and the disc 31 is released again, dissolved, and the pin 26 can from the cylindrical portion 29th be pulled out. Against unintentional loosening a securing device is present, which prevents twisting of the lever 27.

The dimensions of the bolt 26 are selected so that the first serration 24 and the second serration 25 are not engaged when the lever 27 is folded in the axial direction of the bolt 26, so that the first coupling point 22 with the universal receptacle 8 on the Rotary joint is rotatably connected. By folding the handle 27 by 90 °, so that it is at right angles to the bolt 26, the first coupling point 22 is moved toward the universal receptacle 8, and the first Hirth toothing 24 comes with the second Hirth toothing 25 into engagement. Thus, the serrations 24 and 25 in conjunction with the lever 27 act as a locking device.

In operation, after any leg plates have been removed from the leg plate joints 13, the orthopedic adapter 4 is coupled to the operating table 1 by inserting the first coupling devices 6 into corresponding coupling points of the operating table 1 and locking them by twisting according to a bayonet closure. Subsequently, if not already present, the universal receptacle 8 attached to the central spar 7 and automatically fastened by the second coupling device 21. In the next step, the support plate 17 is coupled with the pad with its fourth coupling devices 18 to the lateral bolts of the coupling unit 5 and stored on the central spar 7, so that the support 19 rests on the universal receptacle 8. For this purpose, the support plate 17 is mounted in a vertical orientation from above with the now downwardly directed U-shaped open guides of the fourth coupling devices 18 on the lateral bolts. Subsequently, the support plate 17 is pivoted from the vertical orientation by approximately 90 ° in the direction of the foot end of the operating table 1, wherein the guides remain in the orientation with the downwardly directed opening, the hooks but the lateral bolts enclose by the pivoting operation, and between the lateral bolts, the downwardly open fork-shaped guides and the hook creates a positive connection. The U-shaped guides prevent movement of the support plate 17 in the longitudinal direction of the operating table and the hooks prevent movement of the support plate 17 upwards. By placing the support 19 on the universal receptacle 8 creates a positive connection between the support 19 and the universal receptacle 8, which additionally secures the universal receptacle 8 against pulling down. On the support 19 then the Gegenzugstab 20 can be attached to apply a counterforce to the extension force.

The extension spar 10 for receiving e.g. a Zugspindelaggregat for applying the extension force can be coupled either at one of the third coupling points 9 or, if the Extensionsholm 10 is disturbing at this point, also at the fourth coupling point 14 at a Beinplattengelenk 13.

In order to obtain the functionality of the conventional orthopedic adapter, in the universal receptacle 8 in the second coupling point 23 accessories such. the lower leg counter 15 or the plaster unit 16, are coupled. Furthermore, it is possible for certain storage situations in addition to docking at the fourth coupling points 14 on the leg plate joints 13, to couple leg plates to the first coupling points 22, wherein the joints for the leg plates individually adjusted upwards and downwards and can be found. In the case of interfering influences of the joint even in conventional imaging, the joint with the first coupling points 22 is released from the universal receptacle 8 by turning the handle 27 and can be removed.

To create three-dimensional representations, the universal receptacle 8 can be easily removed by lifting the support plate 17 with pad and releasing the second coupling device 21 from the central spar 7, the orthopedic adapter 8 then down from the hip of the patient no longer has metallic parts that the creation of three-dimensional representations, although the patient's legs, still under the action of an extension, can undergo a three-dimensional diagnostic procedure intraoperatively.

Claims (11)

Orthopedic adapter (4) for an operating table (1), comprising: a coupling unit (5) for coupling the orthopedic adapter (4) with a first coupling device (6) to corresponding coupling points of the operating table (1), a central spar (7) which is connected to the coupling unit (5) and extends in a longitudinal direction of the operating table (1) towards its foot end, a universal receptacle (8) having at least one coupling point (22, 23), characterized in that the central spar (7) is made of a non-metallic material, and the universal receptacle (8) is designed as a separate component and has a second coupling device (21) with which it can be coupled to the central spar (7). Orthopedic adapter (4) according to claim 1, characterized in that the universal receptacle (8) has at least one first coupling point (22) and at least one second coupling point (23). Orthopedic adapter (4) according to one of claims 1 or 2, characterized in that the coupling unit (5) has at least one third coupling point (9). The orthopedic adapter (4) of claim 3, further comprising: at least one elongate spar (10) made of a non-metallic material, wherein the spar (10) has a third coupling device (12) and at one of the third coupling points (9) of the coupling unit (5) can be coupled. Orthopedic adapter (4) according to claim 4, characterized in that the central spar (7) and / or the spar (10) are formed from a fiber composite material / is. Orthopedic adapter according to one of claims 4 or 5, characterized in that the spar (10) has a uniaxial joint (11) with a locking device, so that the direction in which the spar (10) extends, is horizontally adjustable. Orthopedic adapter (4) according to one of the preceding claims, characterized in that at least one of the first coupling points (22) has a pivot (26, 27, 28, 31) with a locking device, and the first coupling point (22) via the hinge with the Universal receptacle (8) are connected, so that the first coupling point (22) is rotatable about an axis and lockable. Orthopedic adapter (4) according to claim 7, characterized in that the rotary joint has a connecting element (26) which connects the first coupling point (22) releasably connected to the universal receptacle (8). Orthopedic adapter (4) according to claim 8, characterized in that the connecting element (26) has a locking element (28) which enters into a positive connection with the universal receptacle (8). Orthopedic adapter (4) according to one of the preceding claims, further comprising a support plate (17), which in turn has a fourth coupling device (18) for coupling the support plate (17) to the coupling unit (5). Operating table (1) with an orthopedic adapter (4) according to one of Claims 4 to 10, characterized in that the operating table (1) has leg plate joints (13) with fourth coupling points (14), and the fourth coupling points (14) are designed such that the third coupling device (12) of the spar (10) can be coupled thereto.

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