US1963897A - Table for surgical and like uses - Google Patents

Description

June 19, 1934. G, EW 1,963,897

TABLE FOR SURGICAL AND LIKE USES Filed Oct. 5. 1931 2 Sheets-Sheet 1 Frgz- June 19, 1934. G 3 1,963,897

TABLE FOR SURGICAL AND LIKE USES Filed 001;. 5. 1931 2 Sheets-Sheet 2 FF Per Patented dune 19, 1934 ijftiilE STATES ArsN orrrcr.

Application October 5, 1931, Serial No. 567,020 In Great Britain May 28, 1931 18' Claims. (o1. 128-84) This invention relates to surgical apparatus, more particularly orthopaedic and fracture tables of the kind comprising a basic supporting frame structure carrying suitable adjustable supports for the patient, including pelvic and back rests, perineal support with suspension bars and the like, and fitted with pivoted traction bars carrying suitable appliances for exerting traction on the injured limbs ofthe patient.

In known tables of this kind, the frame structure is usually provided with a permanent top which is capable of being lowered as a whole or in transverse sections, so that the patient remains supported only on the pelvic and back rests to afford access for the application, for example, of plaster casts.

In such apparatus, the framework and the lowered table top are liable to impede the movements of the surgeon, and preclude satisfactory 'X-ray examinations and exposures of the trunk.

Moreover, the traction arms are so pivoted on the frame structure that they similarly prevent satisfactory X-ray examinations and exposures being made from positions below the limbs.

Furthermore, considerable manipulation, with consequent loss of time, is required to adjust the apparatus to suit particular conditions.

In the apparatus according to the invention, the various rests and supports are slidably mounted on a bed forming a common carrier for said appliances, which are adjustable along the bed.

Moreover, in the apparatus according to the invention, the appliances are readily interchangeable.

The bed may be in the form of an H-section girder or a solid rod or bar formed with longitudinal channels therein slidably to receive tongues or keys on the various supports and rests to be mounted on the bed, clamping screws being provided to hold the supports and rests in the set positions.

The bed is conveniently supported in the raised position on end standards, thus aifording a free space beneath and allowing the surgeon to come into close proximity with his work without being impeded by any framework.

The bed is preferably mounted for rotation about a longitudinal axis in bearings on its supporting standards, so that a patient fixed in position on the apparatus can be turned bodily from a fiat position into any desired angular position to facilitate the surgeons examination or operations.

The table top is mounted on the apparatus so that it can be raised and lowered and is removable. It is conveniently made in separable parts to facilitate removal.

Thus, the patient can be placed on the table top while said table top is in the raised position, and when the required adjustments of'the pa tients position have been made on the supports and rests employed for the particular case, the table top can be lowered and removed entirely, so that the patient is supported on the rests and supports alone. These being carried on the cen-' tral bed and there being no impeding framework or table top, free access is thereby afforded to all parts of the body of the patient from below, and X-ray examination and exposures can be made without interference or difficulty.

Traction arms, capable of lengthwise adjustment and carrying the usual traction appliances, are pivotally supported on a saddle or like fitting, slidably mounted on the bed, the pivotal centres of the arms being capable of adjustment in known manner, so that they can be made to correspond substantially with the hip joints of the patient supported on the apparatus.

One embodiment of the invention 1s shown in the accompanying drawings.

In the drawings:

Figure 1 is a perspective view.

Figure 2 is an elevation on a larger scale of part of the bed, with the saddle employed to secure the traction arms and support the perineal appliances shown in position thereon.

Figure 3 is a cross section on the line III-III of Figure 2, and,

Figure 4 is a cross section on of Figure 2.

In the example illustrated, a round metal bar 1 of comparatively large diameter of the order of several inches is employed to form the bed. The bar or bed 1 is mounted horizontally at the ends in bearings 2 carried by spaced supporting standards 3, one beneath each end of the bar.

The standards are connected by cross braces 4 to form a rigid structure, the braces meeting at a common central point to aiford free access below the bar.

The bar l'is provided with longitudinal channels or grooves5 extending from end to end to receive slidably, tongues or keys 6 on half-round saddle-like bases '7 of the appliances to be mounted on the bar, so that said appliances can be slid along the bar, and are guided in their sliding movement by engagement of the tongues or keysfi thereon in the channels orgrooves 5 in the bar;

The bar 1 may be mounted eccentrically in its bearings, if desired.

the line IV-IV Vertically movable frames 8 are carried by the standards 3 to support a table top 9, notched levers 10 being pivoted on the standards to support the frames 8 in the raised position.

The table top is divided longitudinally, so that it can be readily removed entirely by separating its parts laterally on lowering it with the supporting frames 8.

The table top is cut away in parts as at 11 to permit the various appliances or supports therefor applied to the bar 1 to pass through said top 9 and to be adjusted to the patient.

The appliances include inter alia longitudinally adjustable traction bars 12jwith their traction elements, such as screw devices 13, a pelvic support 14, perineal post 15 carrying a rod 19 with suspension bars 16, back or head rest 17 and other interchangeable rests or supports (not shown) of usual character, that may be required and will be readily appreciated by those skilled in the art without necessitating illustration.

One of the frames 8 is' provided with a substantially U shaped support 8' for the table top 9, thereby permitting the appliances to be readily applied to, and removed from the bed or bar 1,

or interchanged, the bearings for the bar 1 being d'imensionedso as not to obstruct the ends of the grooves or channels 5 in said bar.

The pelvic support 14 is carried by an upper saddle 18, mounted to slide along the channelled rod 1.

In the embodiment shown, the pelvic support 14 is removably mounted on the upper saddle 18by means of a hollow boss 32 which fits on a socketed stem 33 of the saddle, a stem 34 in the perineal post 15 passing through the boss '32 into the socketed stem 33. The perineal post 15 is bored to receive the rod 19.

The traction bars 12 are pivotally supported at '20 on a lowersaddle 21 which also carries pivoted struts 22 for the traction bars.

The upper saddle 18 carrying the pelvic rest 14 and perineal post 15 and the lowersaddle 21 carrying the traction bars 12 with all their adjustments can, therefore, be moved along the channelled bed 1 independently of each other and fixed in their relatively adjusted positions by clamping screws 24. The pivotal-supports 20 of the traction bars 12 can be placed immediately. below the pelvic rest 14 so that they correspond with the pivot joints of the hip joint for traction on, the lower extremities, the upper and lower saddles 18 and 21 then being prevented from relative displacement by ,a spring pressed bolt 22' mounted to slide in a bayonet slot 23 in the lower saddle 21 and adapted to be shot in a hole in the upper saddle 18. Should it be necessary to take an X-ray photograph or screen view of an injured lower limb, the lower saddle 21 may .be slid independently of the upper saddle 18 towards the foot end of the channelled bed and fixed, by its clamping screw 24 so that when traction on the lower extremity is applied, the line of the traction bar and the line of the limb do not correspond, thus leaving a clear field beneath the limb for an X-ray tube or for any other purpose for which 'such a clear field may be required. Again should it be required to exert traction on an upper extremity, the lower saddle 21 may be slid along the bed towards the head I end thereof independently of the upper saddle. 18 so as to assume a position approximating the shoulder joint suitable to the operator.

For this manoeuvre in other tables so far as I am aware, it is either necessary to move the patient so that his head is towards the foot end of the table or else disconnect the traction bars entirely and re-set them in a fixed position which again allows little or no latitude for adjustment.

The pivotal mountings for the traction bars 12 are laterally adjustable, so that the pivotal centres 20 can be varied to bring them into positions corresponding substantially to the hip joints of a patient placed on the table.

For this purpose, the pivots 20 for the traction bars 12 are mounted in relatively slidable brackets 25 supported in a slideway 26 on the lower saddle 21 and operable by a left and right hand screw '27 provided with a hand wheel 31.

The channelled bar 1 is fitted at one end beyond its bearing with a toothed quadrant or sector 28, engaging with a worm 29 operable by a hand wheel 30, so that by rotating the hand wheel 30, the bar 1 with the supports and rests thereon can be turned as a whole about a horizontal axis.

A patient fixed on the rests and supports can thus be moved bodily from a fiat position into any angular position to suit the convenience of the surgeon.

The tongues 6 on the various appliances to be the example illustrated by inwardly projecting flanges or ribs on the half round bases of said appliances. In use, the vertically moving frames 8 are secured in the upper position by the notched levers 10 with the divided table top 9 resting on said frames, so that the patient can be placed on the table top 9 and positioned on the selected rests and supports such as 14 and 1'7 arranged on the channelled bar 1, the table top 9 then lying flush or nearly flush with said rests and supports.

When the patient has been positioned, the end frames 8 are released by the notched levers 10 table top 9 then being removed entirely by separating one part thereof from the other, thus leaving the patient supported on the selected rests and supports alone, and aifording free access below the patient for any desired operations to be conducted.

By turning the hand wheel 30, the patient is moved bodily into an angular position to facilitate operation on, for instance, the hip joint of 'the patient, this part of the patient then being freely accessible.

The appliances applied to the channelled bar are fitted with clamping screws for enabling them to be clamped in any set position.

It will be appreciated from the foregoing description that the appliances may be readily interchanged, applied to, removed from and adjusted independently of each other along the channelled bar forming the main support or-bed, in a short space of time.

and below the to the surgeon patient, so permitting free access for operation, or plaster casting in the case of fractures or other injuries.

The traction bars can be swung about their pivots through a wide angle and clamped in any desired position to suit the particular surgical operation or treatment to be performed, including fractures of the legs, arms and other parts of the body.

I claim:

1. A surgical table comprising a bed consisting of asingle longitudinal member supported in .a

raised position, and appliances carried by said bed for supporting a patient placed on the table, said appliances being slidably mounted on said bed for adjustment along the same.

2. A surgical table comprising a bed consisting 'of a single longitudinal member supported in a raised position, appliances carried by said bed .for supporting a patient placed on the table, said appliances being slidably mounted on said bed for adjustment along the same, and a removable table top situated above said bed temporarily to support the patient.

3. A surgical table comprising a bed consisting of a single longitudinal member, standards at the ends of said bed, on which standards said bed is supported rotatably, appliances carried by said bed for supporting a patient placed on said table, said appliances being slidably mounted on said bed, for adjustment along the same.

4. A surgical table comprising a bed consisting of a single longitudinal member, standards at the ends of said bed, on which standards said bed is supported rotatably, appliances carried by said bed for supporting a patient placed on the table, said appliances being slidably mounted on said bed for adjustment along the same, and a removable table top situated above said bed temporarily to support the patient.

5. A surgical table comprising a bed consisting of a single longitudinal channelled bar, appliances carried by said bed for supporting a patient placed on the table, said appliances having saddle-like bases which partially embrace said bed and members on said bases which engage slidably in the channels of said bed.

6. A surgical table comprising a bed consisting of a single longitudinally channelled bar, appliances carried by said bed for supporting a patient placed on the table, said appliances having saddle-like bases which partially embrace said bed and members on said bases which engage slidably in the channels of said bed, and a removable table top situated above said bed temporarily to support the patient.

'7. A surgical table comprising a bed consisting of a single longitudinal member supported in a raised position and pivotal traction arms and a perineal post together with a pelvic support, slidably mounted on said bed for relative adjustment along the same.

8. A surgical table comprising a bed consisting of a single longitudinal member supported in a raised position, pivotal traction arms and a perineal post together with a pelvic support, slidably mounted on said bed for relative adjustment along the same, and a removable table top situated above said bed temporarily to support the patent.

9. A surgical table comprising a bed consisting of a single longitudinal member supported in a raised position, pivotal traction arms carried by a lower saddle on said bed and a perineal post together with a pelvic support, carried by an upper saddle on said bed, said saddles being slidably adjustable forward and away from each other in either direction along said bed for the purposes of positioning them relatively to suit the length of the patient, and of permitting said traction arms to be employed in connection with the application of traction to the upper extremities of the patient without removing said traction arms from said bed and without reversing the position of said patient on said bed.

10. A surgical table comprising a bed consisting of a single longitudinal member supported in a raised position, pivotal traction arms and a perineal post together with a pelvic support, said traction arms being carried by a lower saddle and said perineal post together with said pelvic support being carried by an upper saddle both saddles being slidably mounted on said bed, and means for locking said saddle parts together.

11. A surgical table comprising a bed consisting of a single longitudinally channelled bar supported in a raised position, pivotal traction arms on said bed, a support for mounting said traction arms on said bed, said support having members for slidable engagement in the channels of said bed, and means for efiecting relative adjustment between the pivotal centres of said traction arms, carried by said support.

12. A surgical table comprising a single longitudinally channelled bar to form a bed, standards for supporting said bar at its ends rotatably and appliances slidably mounted on said bar for supporting a patient on the table, said appliances having saddle-like bases which partially embrace the bar, and members on said bases for sliding reception in the channels of said bar.

13. A surgical table comprising a single longitudinally channelied bar, to form a bed by standards at the ends of said bar to support it in a raised position, interchangeable appliances for supporting a patient on the table, said appliances having saddle-like bases to embrace said bar, and members on said bases for sliding reception in the channels of said bar, vertically movable frames carried by said standards and a table top removably supported on said frames above said bar, temporarily to support the patient.

14. A surgical table comprising a longitudinally channelled bar rotatably supported in a raised position on standards at its ends, gearing for rotating said bar, interchangeable appliances for supporting a patient on the table, said appliances having saddle-like bases with inturned ends to embrace and establish a sliding tongue and groove connection with said bar, and a table top removably supported above said bar.

15. A surgical table comprising a longitudinally channelled bar of circular cross section rotatably supported in a raised position on standards at its ends, gearing for rotating said bar, pivotal traction arms, a perineal post together with a pelvic support and other interchangeable supports for a patient placed on the table, said traction arms and other supports having saddle like bases with inturned ends to embrace said bar and engage slidably in the channels thereof, means for fixing said saddle-like bases in any position on said bar, vertically movable frames carried by said standards, and a longitudinally divided table top removably supported on said frames.

16. A surgical table comprising a bed of relatively narrow width divided into juxtaposed upper and lower portions in permanently fixed relationship, and patient-supporting appliances slidably mounted on said upper and lower portions of said bed, said appliances on the lower portion of said bed being slidable along the whole length of said bed independently of and without fouling theappliances on the upper portion of said bed.

17. A surgical table comprising a bed of relatively narrow width divided into juxtaposed upper and lower portions in permanently fixed relationship, and patient-supporting appliances slidably mounted on said upper and lower portions of said bed, said appliances on the lower portion of said bed being slidable along the whole length of said bed independently of and without fouling the appliances on the upper portion of said bed, and av removable table top supported in raised position 'above said bed'to temporarily support thetrunk in either direction along said bed for the purpose of positioning them relatively to suit the iength of the patient and of permitting said traction arms to be employed in connection with'the application of traction to the upper extremities of the patient without removing said traction arms from said'bed and without reversing the position --'ofsaid patient on said bed, said traction arms being 'otherwisenormally employed in connection with the-application of traction to the lower extremities.

ERNEST GORDON GREVILLE.

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