US1697121A - Fracture table - Google Patents

Description

Jan. 1, 1929.

W. J. KNEBEL FRACTURE TABLE Filed Dec. 18, 1926 5 Sheets-Sheet 1 Zvwmtoz attozwug Jan. 1, 1929. 1,697,121

w. J. KNEBEL FRACTURE TABLE Filed Dec. 18, 1926 Jan. 1, 1929. 1,697,121 w. J. KNEBEL FRACTURE TABLE Filed Dec. 18 1926 5 MdKrz'eel Patented Jan. 1, 1929.

UNITED STATES PATENT OFFlCE.

FRACTURE TABLE.

Application filed December 18, 1926. Serial No. 155,730.

This invention relates to operating tables and particularly to tables designed for orthopedic work and the work of repairing orsetting fractures.

The general object of the invention is to provide a table which is particularly designed to permit the proper adjustment of broken bones which will keep the bones in a fixed posit-ion so that splints, bandages, or plaster casts may be applied with ease and accuracy and a proper coaptation of the fractured ends of the bones may be secured, and which will permit the use of a fluoroscope in setting the fractures.

Another object is to provide a fracture table of this character which is very simple in construction, which may be readily folded into small compass, which will support the body in a position where the fracture may be properly set and which will permit adjustment for use by different sized persons.

A further object is to so construct the table that traction can be had on the head or upon the lower extremities and further provide means whereby traction may be secured on the arm, forearm, and shoulder.

A. still further object is to so construct the table that it will permit of adduction to thereby apply dressing to a fractured hip, thigh, leg or other part and to secure either internal or external rotation of the limb or flexion or expansion thereof.

Other objects will appear in the course of the following description.

My invention is illustrated in the accompanying drawings wherein:

Figure 1 is a top plan view of a fracture table constructed in accordance with my invention showing various adjustments of the parts;

Fig. 2 is a side elevation of the construction shown in Figure 1; v

Fig. 3 is a longitudinal section through the base;

Fig. 1 is a fragmentary section on the line 14 of Figure 3; v

Fig. 5 is a detailed elevation of the arm and hand supporting mechanism, the block 28 being shown in section;

Fig. 6 is a fragmentary section of one of the leg supports;

Fig. 7 is a top plan view of the leg supporting portion of the table;

Fig. 8 is a section on the line 88 of Figure 6.

Referring to these drawings 10 designates the base frame which is preferably formed of tubing of suflicient size to give proper strength to the frame. This tubing is connected in any suitable manner so as to form a rectangular frame preferably provided with feet 11 at the corners. This frame has a longitudinally extending, medially disposed rod or tube 12 at the middle of the frame At one end of this tube there is disposed the vertical post 13 which at its lower end is provided with a split clamp 14 heldin engagement with the rod or tube 12 by means ofthe clamp screw 15. This clampl l permits the upright 13 to swing in either direction or to be shifted longitudinally upon the rod or tube 12. The upper end of this upright 13 supports a body'rest plate 16 designed to support the body at the buttocks. This" plate is preferably curved upward and rearward and is relatively thin, particularly at its edge.

Also mounted upon the medial tube 12 is i post or upright 17 which is likewise held upon the-tube 12 by means of a clamp 14 such as previously described. Thus this body rest 17 may shifted longitudinally or swung by means of the set screw or clamp 21. The Y lower end of this post 19 is also provided with a split clamp 14- whereby it may be shifted longitudinally along the pipe 12 or swung to the right or left. i j

The upper end of the section 20 carries a head rest 22. Also mounted upon the pipe 12 is an adjustable rod 23whereby, as will be later explained, traction may be secured upon the head, this rod at its lower end being formed with a clamp 14 so that it may be adjusted longitudinally'on pipe 12, or swung laterally thereon. p

Mounted upon the lateral rods or pipe 'sec tions of the frame 10 are the posts oruprights 24:, each formed in twosections, the upper sections 25 telescoping into the lower section and being held in adjusted position by any clamp, such as the set screw 26. The lower end of each post24 is provided with a clamp 14 whereby the post may be adjusted longitudinally of the frame'or swung laterally inward or outward. The upper end of each section 25 carries a longitudinally adjustable rod 27 which is designed to fit within the armpit of the patient and curved to support the arm.

Also mounted upon the section 25 of the arm supporting base 24, is a block 28, this block being apertured for the passage of the section .25 and being held in any elevated or rotatively adjusted position by means of the set screw 29. This block 28 is carried in a socketmember 30 which is rotatively adj ustable. upon the block and held in adjusted positionb-y means of the nut 31. This socket member 30 is provided witha pivot 32 extending at. right angles to the axis of the block 28 and mounted upon this pivot is an angularly adjustable tubular section 33 which is heldin. its adjusted position by means of the binding nut 34.

Telescoping into the section 33 is a section 35 which is heldin any longitudinally adjusted or rotatively adjusted position by means of the clamp collar 36. The extremity of the section 35 is flattened to form a joint 37 and coaeting with this joint is the flattened end of anarm 38. A binding nut 39 engagesthe screw-threaded pivot for the sections 38 and 35 so that the section 38 may be held in any desired relation to the section 35. Slidinglymounted upon the section 38 is a collar. 40 having an outwardly projecting member 41. This collaris heldinlongitudinali or rotatively adjusted position by means ofthe set screw 42. Mounted upon the extremity of the member 41 is a U-shaped wrist support 43 or hand support 43, the extremity ofwhich is angularly bent to face againstthe member 41 and is held in adjusted position thereon by means of an adjusting screw 44. Aswill be seen from Figure 1, this mechanism, which may be adjusted into practically any position, is so designed as to secure a proper support for the forearm and hand and at the same time to apply traction thereon by means of the traction bandage 45.

Mounted upon the post 13 below the body supporting plate 16, is a toothed segment 46 and pivotally mounted upon this toothed segment for lateral swinging, movement are the two leg supporting rods 47. The segment 46 is provided with two racks 48, each of which is concentric to the pivotal center of the corresponding rod and mounted upon each rod is a spring actuated latch 49 having an outwardly extended handle 50 whereby the latch may be retracted against the force of a spring. This latch, of course, holds the rod 47 in its adjusted position.

Slidingly and rotatively mounted upon the rod- 47 is a leg rest consisting of a vertical rodv 51 with a U-shaped support 52 at its upper'end. This rod 51 passes downward through a collar 53 through which the support 47'passes and this collar is provided with means for clamping upon the rod 47 and for clamping the rod 51 in its vertically adjusted position, this means being shown as a set screw 54. A heel supporting plate 55 is mounted upon a vertically adjustable rod 56 which passes through a collar 57 slidingly mounted upon the rod 47 and rotativc. around this red and held in adjusted position by the clamp screw 58. Thus the heel support may be adjusted up or down and swung inward or outward and the heel support may also be rotated in a horizontal plane around the axis of the rod 56. The same is true of the leg support 52 which thus has three adjustments.

Mounted upon each of the rods 4'? is an adjustable traction rod 59 which extends through a clamping collar 60 having a set screw 61. Pivotally mounted upon the upper end of, this rod 59 is a foot traction plate 62 which is held in adjusted positions by means of the wing nut 63 or any other suitable means. Crossed bandages 64 may be secured to this traction plate and brought over the instep of the foot and around the heel of the foot, as shown, and by shifting the collar 60 longitudinally along the rod 47 or by varying the inclination of the plate 62, any desired traction may be secured. This rod 59 is also adjustable longitudinally of rod 47 vertically, laterally, or rotatively.

For the purpose of securing traction on the head, which is necessary in treating fractures of the cervical vertebra with fixation dressing, I provide the rod 23 previously described, to which the crossed bandages 65 may be applied, and one of these bandages extending around the chin and the other around the head at its unction with the neck. By adjusting the rod 23 upon the pipe section 12, any desired traction may be secured.

It will be seen that this fracture table is particularly designed to meet the requirements of a table by which broken bones may be adjusted and kept in a fixed position so that splints, bandages, or plaster cast-s can be applied with ease and accuracy, and the fractured ends of the bones brought into proper register and alignment. The table is adjustable so that it may be used for different sized persons and the arm supporting posts 24 may be shifted longitudinally or outward or inward and the upper sections thereof rotated so as to hold the upper body in proper position while making traction on the arm, forearm, and shoulder. The head rest formed of the parts 19, 20, and 22 is adjustable for any sized patient and the head rest can be used or not used as desired. It is particularly useful, however, in applying casts to head, neck and shoulder, particularly Where the cervical vertebra have been fractured. It will be particularly noted that the upright post 13, which like all of the posts is preferably formed of tubing, extends upward in the crotch and between the legs so as to permit traction to be made on the lower extremities. The forearm traction mechanism illustrated in detail in Figure 5 permits traction to be secured on the arm, forearm, and shoulder. It is adjustable to any desired position and can hold the arm in any fixed position requisite for properly setting the fractures of arm bones and dressing these fractures.

By providing the segment 46 with its racks and mounting the leg supporting rods upon this segment and providing the parts 51 and 56 adjustably mounted thereon, the leg can be rotated in or out either adducted or abducted and proper traction on the legs may be secured by means of the parts 19 and 62. This leg supporting mechanism is adjustable and allows the fracture to be properly set and kept in an immovable position so that proper fixation dressings may be applied. The leg rest 51 secures support for the leg and internal or external pressure at any desired point to secure proper coa-ptation of the fractured ends of the bones, holding the ends of the bones in proper alignment and in fixed position while the dressing is being applied. The traction applying device formed of the parts 59 and 62 permits traction of the leg to be secured, permits internal or external rotation of the limb, and permits flexion, extension, adduction, and abduct-ion of the foot.

. The traction bandage 64 permits the desired traction to be secured on the foot and casts can be applied over and between the bandage and the terminal ends of the bandage can be cut when cast is applied. By mounting the leg supporting rods 47 for swinging movement, adduction or abduction of the limb may be secured in any position.

Attention is particularly called to the fact that the heel rest plate 55, the body supporting plate 16, the body supporting plate 18, and the head rest plate 22 are each formed so that a cast may be applied over the plate either above or below the supporting rod therefor, and that then the plate may be slipped out after the cast is applied. It is also to be noted that the supporting plate 16 does not interfere with extending the cast down either leg or with the removal of the cast.

All of the uprights 13, 17, 19, 23 and 24: may be turned down flat on the frame and the adjustable lower limb supporting rods 47 may be turned back upon the frame so as to allow the frame to be folded into an extremely compact form. The table will preferably be of such height that it can be placed upon an office operating or X-ray table, permitting adjustment of all fractures and convenient use of the fluoroscope or other implements in securing accurate treatment of fractures.

While I have described a complete table, I do not wish to be limited to the use of all of the various parts shown, as a table might be constructed having fewer adjustable parts and yet secure in some sort the advantages of a complete table. Furthermore, I do not wish to be limited to the details shown as these may be varied in many ways without departing from the spirit of the invention as defined in the appended claims. Thus, other forms of clamps 14 might be used and other forms of clamping means be used for the adjustments of the parts 38 and 33, or other forms of clamps might be used in place of the parts 53, 58 and 60.

I claim 1. A fracture table including av base dis posed in a horizontal plane, a middle row of separated body rest supports, each carrying rest, one for the head, one for the hips and one for the trunk, the head and trunk rests being longitudinally adjustable toward or from each other, and all of said supports being adjustable transversely into angular relation to the plane of the base in either direction, I

2. A fracture table including a base disposed in a horizontal plane, a. middle row of body rest supports, each carrying a rest,

one for the head, one for the hips and one for the trunk, the head, hip and trunk supports being longitudinally adjustable toward or from each other, and all of said supports beingadj ustable transversely into angular relation to the plane of the base in either direction, the head support having a vertically adjustable section carrying a head rest, said section being rotatively adjustable in a horizontal plane.

3. A fracture table including abase, a midsection being rotatively adjustable in a horizontal plane, a head traction rod longitudinally and laterally adjustable upon the base and adapted to support head bandages.

4. A fracture table including a base having a longitudinally extending, medially disposed circular bar, a middle row of body rest supports each carrying a rest, one for the head, one for the hips, and one for the trunk, the head support, hipsupport, and trunk support having clamp-s at their lower ends embracing said bar and independently longitudinally adjustable therealong or swingably. adjustable transversely of the base, the head support having a vertically adjustable section carrying a head rest, the section being rotatively adjustable in a horizontal plane, a. head traction rod having a clamp at its lower end embracing the bar whereby the traction rod may be longitudinally adjusted or swung transversely of the base, the traction bar being adapted to support head bandages.

5. A fracture table including a base disposed in a horizontal plane, a middle row of body rest supports, each carrying arcst, one for the head, one for the hips, and one for the trunk, the head and trunk supports being longitudinally adjustable toward or from each other and adjustable in either direction into angular relation to the plane of the base, the head support having a vertically adj ustable and rot-atively adjustable section carrying the head rest, arm supports pivotally mounted upon the base for swinging movement laterally in either direction,.the arm and shoulder supports l eing composed each of, a plurality of vertically and rotatively adjustable sections, and the arm supports being longitudinally adjustable upon the base.

6. A fracture table including a base termed of laterally disposed parallel bars, and a medially disposed bar, the bars being circular in cross section, a plurality of body supporting members mounted upon the middle bar, certain of said members being longitudinally adjustable therealong and having swinging adjustment in either direction thereon, and arm and shoulder supports each having a clamp at its lower end embracing a lateral bar, the clamp permitting the arm supports to be longitudinally adjusted each upon its corresponding bar and transversely swung into different angular relations, each of the shoulder and arm supports having an upper sect-ion having telescopic engagement with the lower section and being rotatively or vertically adjustable with relation thereto.

7. A fracture table including a base formed of laterally disposed parallel bars, and a medially disposed bar, the bars being circular in cross section, a plurality of body supporting members mount-ed upon the middle bar, certain of said members being longitudinally adjustable therealong and having swinging adjustment in either direction thereon, and shoulder and arm support-s each having a clamp at its lower end embracing a lateral bar, the clamp permitting the arm supports to be longitudinally adjusted each upon its corresponding bar and transversely swung into different angular relations, each of the arm supports having an upper section having telescopic engagement with the lower section and being rotatively or vertically ad justable with relation thereto, and a head tract-ion bar having a clamp at its lower end embracing the medially disposed bar and adj ustable therealong or swingable thereon int-o different angular relations and adapted to support head bandages.

8. A fracture table including a base formed of laterally disposed parallel. bars and a medially disposed bar, the bars being circular in cross section, a. middle row of body supports mounted upon the medial bar for longitudinal and,angular adjustment relative to the base, a hip supporting post mounted at one end of the medial bar and carrying a hip supporting plate, the post extending upward beyond the plate at the middle thereof, a pair of leg supporting members operatively pivoted upon the post for swinging movement horizontally into or out of divergent relation, means for locking said members in adjusted position, separate and independent knee and heel supporting rods mounted upon each of said leg supporting members for vertical, rotative, and angular adjustment, and means upon. each leg supportingmember for applying traction to the leg.

9. A fracture table including a base formed of laterally disposed parallel bars and a medially disposed bar, the bars being circular in cross section, a middle row of body supports mounted upon the medial bar for longitudinal and angular adjustment relative to the base, a hip supporting post mounted at one end of the medial bar and carrying a hip supporting plate, the post extending upward beyond the plate at the middle thereof, a pair of leg supporting members operatively pivoted upon the post for swinging movement horizontally into or out of divergent relation, means for locking said members in adjusted position, separate and independent knee and heel supporting rods mounted upon each of said leg supporting members for vertical, rotative, and angular adjustment, means upon each leg supporting member for applying traction to the leg, and means adjustably mounted upon the medial bar for applying traction to the head.

10. In a portable fracture table, a base, body supporting means and means for supporting the arm in a fixed adjusted position including a vertical support extending upward from the base and carrying a member adapted to be disposed within the armpit, a member having vertical adjustment on the post, said member being composed of two arms pivotally connected to each other, one of said arms being composed of two telescopic sections, one section being rota-tively and longitudinally adjustable with reference to the other section, a hand support longitudinally and rotatively adjustable upon the outer arm and extending at an angle thereto, and an adjustable hand supporting plate mounted upon the extremity of the last name d member.

11. In a fracture table, body supporting means, and an arm supporting means includ ing a post formed in two sections, one of which is vertically and rotatively adjustable with relation to the other, both of said sections being in alignment, a supporting block slidably adjustable upon the upper section of the post and extending at an angle thereto and rotatively adjustable upon the post, said bloc-l: being circular in cross section, a member clamped upon said block for adjustment around the axis thereof, an arm pivoted to said member and adapted to be clamped in adjusted positions, said arm being formed of two sections having telescopic engagement with each other, the outer section of the arm being rotatively adjusted with reference to the inner section, an outer arm pivoted to the first named arm for angular adjustment in a plane parallel thereto, a hand support having a clamp embracing the second named arm and longitudinally shiftable thereon and rotatively adjustable around the axis thereof, and a. hand supporting plate extending at an angle to said support and pivotally mounted thereon for adjustment into angular relation thereto.

12. In a fracture table, body supporting means, and an arm supporting means including a post formed in two sect-ions one of which is vertically and rotatively adjustable with relation to the other, both of said seo tions being in alignment a supporting block slidably adjustable upon the upper section of the post and extending at an angle thereto and rotatively adjustable upon the post,

said block being circular in cross section, a member clamped upon said block for adj ustment around the axis thereof, an arm pivoted to said member and adapted to be clamped in adjusted positions, said arm being formed of two sections having telescopic engagement with each other, theouter section of the arm being rotatively adjusted with reference to the inner section, an outer arm pivoted to the first named arm for angular adjustment in a plane parallel thereto, a hand support having a clamp embracing the second named arm and longitudinally shiftable thereon and rota- 'tively adjustable around the axis thereof, and a hand supporting plate extending at an angle to said support and pivotally mounted thereon for adj ustment into angular relation there to, a base for supporting said body supports and the post, the base including a longitudina-lly extending bar circular in cross section, and the post having a clamp engaging said bar whereby the post may be shifted longitudinally of the bar or shifted into angular relations to the base.

In testimony whereof I hereunto aifix my signature.

WALTER JOSEPH KNEBEL, M. D.

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