US1549922A - Stretcher for fluoroscopy - Google Patents

Description

Patented Aug. 18, 1925..

OFFICE.

r #HERMAN "a. rmnrrs, or NEW You, H. Y.

F srnn'ronnnron rnuonoscor z. Y

To all {that/concern: I

a citizen of'the United States,residing at New York jcity,"borough of Manhattan, in the county of New York and State of New York, have invented certain new and useful Improvements "in Stretchers .for lFluoroscopy, of which the'following is a specification. i l a This, invention relates to hospital apparatus or surgical appliances and has particular reference to mechanisms or apparatus for the reduction, of broken bones and the detection or correction of anymalposition or deformity incident to such cases.

Among the objects of the invention is to provide a combined fracture stretcher and table designed to reducedeformities or malposition of fragments of broken bones under fluoroscopic guidance,-both in horizontal andvertical planes, and either alone or simultaneously; to afford means for traction on any limb or extremity at any angle, and

with any desired counter traction or traction or pressure at any angle to the main traction; to provide means as set forth in the foregoing to reduce deformities from fractures or disease and retain. them in an desired position while immobilizing firm y in plaster casts orsplintsjto rovidea stretcher on which a patient may e supported 'not only for the purpose of the application oi. the traction referred to but also upon w ich he'may be moved for the purpose of. fluoroscopy or radiography, but especially to provide means whereby the observation through fluoroscopy or the making of records through the radlographic or roentgenographic steps may be practiced at the same time that the reduction of the bones or the like is taking place so thatthe operator maybe guided in. his operations by, the visual results obtained through either ofvthe means just referredto, and, furthermore, the stretcherlme'chaf 3 nism combined with the traction means in} sures that the'traction may bemaintained or preserved irrespective of the .movement or manipulation .o tient thereon.

' to provide a stretcher having traction ape paratus associated therewith and, so designed as not to obstruct either the 'fiu'o'ro scopi'ck vision and reducing o erations abovestretcher an f the stretcher with the' [paview the invention consists ment'and combination of, parts hereinafter described and claimed, and whilethe invention is not restricted to the exact details of Withheforegoing .and other objects in in the arrangeconstruction disclosed or suggested herein,

still for the purpose of illustrating a ractical embodiment thereof reference is ad to the accompanying drawings, in which like reference characters designate the same parts in the several views, and in which- Figure 1 is a side elevation showing one adaptation of my improvement.

Flg. 2 is a plan view of the same.

Fig. 3 is a sectional detail on the line 3-3 of Fig. 1.

Fig. 4 is a plan view of a detail described in connections with Fig. 5.

Fig. 5 is a vertical detail partly in section of the crotch mechanism.

Fig. 6 is a detail perspective view of the transformer mechanlsm for the horizontal fluoroscopy, its means of support, and the vertical and horizontal screens carried thereby.

Referring now more specificall to the drawings I show a frame or stretc er comprising two side bars 10, two end bars 11, and corner connections 12. These corner pieces may constitute or carry handles 13 or manipulating the stretcher as such, in a well known manner. The side rails 10 and either or both of the end rails are provided with vertical holes 14 spaced at re ular intervals from one another. The end rails the accommodation of slidable rods 15 which normally telescope or may be drawn outward to any desired length and looked as by means of a spring pin 16 or its equivalent through the adjacent corner pieces for fixing the position of the extensions. The corner pieces may have downward extensions12' serving as feet for supporting the stretcher.

17 ndicates a plate shown assubstantiallylrect angular and extending across the movable endwise of the device,the endsof the plate being turned downward around the rails. for self retention. As mdlcated ported at itsends on the side rails 10 an along which the plate 1s this plate constitutes the main support or 7 bridge for. supporting the patients hi s througha disk or shelf 18 fixed adJuStab y upon the upper end' of the pedestal 19. That is to say, the disk maybe swung around the axis of the pedestal to lie either longitudinally or transversely of the stretcher according to its immediate puror counter traction means or bandages or slings such as indicated at 25. The disk 18 may be used as a support for the hips as shown or may be used for other purposes such asa clamp for the patients shoulder and for this purpose the patient may be supported at the same level as indicated in ig. 1 or may be lowered to the plane of the stretcherframe. In the former case the disk or shelf 18 may be clamped between the crotch pin and the stem 22 or it may be otherwise attached to the pedestal.

26 indicates a, bed plate of wood of any suitable composition and which like the plate. 17 is preferably transparent to Roentgen rays. The bed plate 26 istrecta'ngular and supported for endwise adjustment upon the rails 10. Pillows or padding 27 will be employed for their-usual purpose in bolster-' ing up the patient at any desired point.

The pedestal is connected adjustably to the plate 17 as by means of bolts 28 co-o crating with slots 29. The plate 17 is he (1 from endwise movement under traction on the patient along the stretcher as by means of clamps 30 adjustable along the rails 10.

In connection with the stretcher frame or extensions thereof I employ one or more traction units 31 each comprising an-arm 32 adjustable vertically in a clamp 33 carried by either end or side bar of the frame,

though usually it is connected to the foot.

rail 11 for the reduction of a broken leg. The unit includes also a nut or head 34 along wh1ch a threaded shank or screw is slidable but held from rotation by any well known means such as a spline. The traction is produced by means of a. hand wheel 36 or its equivalent co-operating with the threaded screw and bearing against the head 34 in a well known manner. The extremity, as the foot, of the patient is secured, as by bandaging or lacing, to a yoke or clamp piece 37 having universal ball-joint connection in a clamp 38 fixed to the-adjacent'end of the screw 35.

The open structure of the yoke provides for easy access to the patients extremity for the purpose indicated. The clamp .33 may be secured to-the rail eitherby means gripping the same or by means of pins passing therethrough and through the holes 14.. For at taching the unitor any'of them to the frame extensions 15 a clamp 33 ma be employed. This provides an anchorage or the traction unit at an angle to the length of the stretcher for use in connection with lateral traction or for other purposes. As thus far described the stretcher is free and open for not only the purposes of the traction apparatus and bandaging of the atient, but also for observation as soon to e described. Moreover, with the patient in position on the stretcher and even with the traction apparatus in use under tension the stretcher may be transported or manipulated in any convenient manner.

As an illustration of the many accessories, I indicate at 39 a form of clamp ada ted especially for connection to and interloc ing with the perforated rails of the stretcher.

Extending upward from this clamp and gripped thereto by a hand piece 40 is a post 41 which obviously may be adjusted around its own axis inthe clamp as may be desired. At the top of this post is a hub 42 in which is adjustably mounted a horizontal arm 43 and looked as b means of a set screw 44. At one end of t isarm is a clamp or 'oint 45 which carries an arm 46 adjustable in any desired angle with respect to the arm 43 and in all other respects takinginto consideration themanner of connecting the arm 43 to the post, and the post in turn to the clamp 39. The arm 46 ma be provided with any suitable form of yo e 47 for use for traction, counter traction, or other'analogous urposes, and having practically universa joint connection with the main support has a 'wide range of adjustment anywhere along the stretcher and at any position after being so adjusted.

Another important feature of my mechanism comprises a table having a top 48, corner uprights or legs 49, and a plurality of longitudinal bars not only for stlflening the table, but for purposes soon to appear.

Some of these bars, as indicated at 50, extend lengthwise along the sides of the table approximately midway between the floor and the to 48 and in the same horizontal plane. 51 indicates conventionally an X-ray apparatus or transformer mounted slidably upon a pair of transverse rails 52, said rails being mountedeupon runners or shoes 53 cooperating directly with the rails 50, so that the apparatus as a whole may be moved bodily endwise of the rails 50 and also independently of the rails 50 transversely of the table along the rails 52 so as to bring,

the transformer 51 beneath any point or part of the table top. The action of 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 51' or for the making of a radiograph upon aplate similarly located above the patient. I

At either side of the table is a carriage 54 comprising a pair of vertical hollow posts 55 with any suit-able 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 extend beneath the table top and carry pairs of rollers 60 which embrace a bar 61 extending 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 .d esired position along the table from one 1 longitudinally of the table. This transformer is designed to .throwuthe image horizontally where it may be observed on the vertical screen 62 or a plate may be made at such position for a radiograph. As shown in Fig. 6 the screens are connected to a frame 65 slidable horizontally in guide ways 66 at the top of the transformer 62 so that the screen 51 may be moved directly over the transformer 62. The screen 62 is hinged at 67 to the other screen or its frame and may be swung upward into the same planeas the screen 51 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 the transformer 62 may be moved out of the way for the purpose of facilitating the bandaging of the' extremity. The transformer 62 is counter balanced in a well known manner'by the use of suspending cables 69 to the other ends of which are counter weights 7O 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. 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 It will be.

be present in the body, and independently of reduction of fractures.

I claim:

1. The combination with a main support having a plurality of corner posts, of a stretcher body consisting of a plurality-of rails, said rails being united to each other by corner connections, said corner connections having downward extensions to cooperate with said corner posts to retain said stretcher body in predetermined position thereon, said corner connectionshaving handles extending along the .plane of the stretcher and outwardly thereof whereby said stretcher may be lifted from said support while a patient reposes thereon.

2. In a stretcher of the character set forth, the combination of a frame including side and end rails, traction means secured to one of said rails, and counter traction devices including a plate adjustable transversely of the side rails and an engagement member for the patient projecting upward from and having rigid connection with the plate adjustable clamping devices being provided co-operating with the side rails and said plates for supporting and holding the plate in adjusted position for resisting the traction and to permit the plate to be moved transversely of the rails as'aforesaid.

stretcher rails, and an accessory for additional traction or countertraction, said accessory comprising a clamp adjustable along one of the rails, an upright support connected thereto, an arm movably connected to said support, and a yoke having universal connection with said arm.

4. In a device as set forth, the combination with a stretcher having side rails and traction means adapted to act at an angle to the stretcher, of a rod located at an end of the stretcher and slidable transversely relative thereto within a rail thereof and beyond the side of the stretcher, and means borne upon the railsv co-operating with the rod to hold it adjustably in position as aforesaid,

said rod being adapted to adjustably engage said traction means along the length there- .of for the purpose of the angular traction aforesaid. p

5. The herein described counter traction devices for stretchers, the same comprising

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