US2584412A - Occipital patient supporting device - Google Patents

Description

1952 R. ANDERSON 2,584,412

OCCIPITAL PATIENT SUPPORTING DEVICE Filed July 26, 1949 2 SHEETSSHEET l v li vnnnnmu l L l o Is :1 my.

IN VEN TOR.

BY Rogzrflnder'son M y m I Feb. 5, 1952 I R: ANDIERSON 2,584,412

OCCIPITAL. PATIENT SUPPORTING DEVICE Filed July 26, 1949 2 SHEETS-SHEET 2 INVEN TOR. R0967 Anderson BY Mq ATTORNEYS Patented Feb. 5, 1952 UNITED vSTATES PATENT OFFICE 2,584,412 'OCCIPITAL'PATIENT SUPPORTING DEVICE Roger-Anderson, Seattle, -Wash. Application July 26, 1949, Serial No. 106,953

My invention relates to an occipital patient supporting device for application of a plaster or a plaster cast. More particularly, my invention relates to a cup-shaped support for theback of the head of a patient, which cup-shaped support is connected at an end portion with an arm so that the head of a patient may be supported durin the application of a plaster or a plaster cast which includes a head cast, and the cupshaped support member can be removed, after the cast has been completed, and out through the opening in the cast which is generally left at the top of the cast.

My invention is a continuation, in part, of myco-pending application entitled Orthopedic Table and Fracture Reducing Apparatus, Patent No. 2,477,562, filed October 17, 1945, issued August 2, 1949 (hereinafter referred to as my orthopedic table patent).

While my present invention may be used in connection with other orthopedic tables than that illustrated in my said orthopedic table patent, for purposes of illustration and to 'better understand the present invention, the same, by way of example and not by Way of limitation-will be explained and illustrated-in connection with the orthopedic table of said'patent and without unnecessary detailed. consideration of the said orthopedic table.

A plastic or a plaster cast for the head of a patient ore. head cast for apatient, as the terms are used herein, include casts which include the head of thepatient and the cast may extend to include the upper chest of the patient and even moreofthepatient. Such head casts normally include within the cast .all the patients head except the patients face and'the top of the patients head,"and also include the neck of the patient, and the upper trunk of the patient.

In theprior art 'of'applying such head casts to patients, oneprocedure was to support the head of thepatient by a suitable rest until the casthad been extended over the upper chest of the patient, the neck of the patient, and part ofthe patients head. Then the rest for the patients head was removed and the patients head was manually supported and manipulated by assistants during the application of the head portion of the cast. In case of a patient with-sufiicient hair on the head, such as with a woman, the hair was-utilized v area means to be grasped so the neck and head could be angularly positioned and at the same time tension could be applied, Difiiculties involved in this technic include: angular corrective adjustments of the neck of the patient were difficult toapreeiselyachieve and to maintain; de-

4 Claims. (Cl. 128 71) head of the patient. 10*

sults were not often obtained because of the personal element involved in the manual adjustment and maintenance of the relative position of the head and neck of a patient by an assistant.

Another prior art practice was to employ a narrow board or slat to support'the backbone'and Such boards or slats generally extended from the pelvic area to the head of the patient and such boards were supported at opposite end portions. Obviously, the boards were non-conforming to the contour of the back of the patient and non-conforming casts, par:

ticularly around the neck area, were very common. v

Another prior art practice often employed in the attempt to properly position thehead and A neck of a patient during the application of a head corrections. Normally when slings and bandages were so usedthe patient was placed in a sitting or standing position as these were deemed the most suitable positions to obtain most accurate results. Difficulties involved in this techn-ic include: the patient must be insuch physical shape and not anaesthetized so the patient can-cooperate'during the application of the cast; such technic required several trained assistants as well as the surgeon'in charge of the operation; any

angular corrections of the neck and head are exceedingly diificult to obtain and to maintain; and

resultant shock or extreme discomfort to the patient which usually obtains. because of such technic. 9 r

While other technics have been employed to support and position the head and neck of a' patient during the application of a head cast, the

two mentioned examples will illustrate standard prior art practices and some of the difi'iculties ob- The above-mentioned, and many other, difficulties are overcome by my inventions herein as the patient, with my said inventions, maybe supported in a supine position with the occiput disposed in a cup shaped support and with the patient mechanically held and maintained in a desired position, and then the head cast may be applied over the occipital supporting means while the position of the patient is so maintained, and after the completion of the cast the occipital support and supporting arm therefor may be removed from within the cast by angularly moving the occipital support following the contour of the head of the patient until the occipital support is pedic table in connection with which is employed the occipital support means of this invention;

Fig. 2 is a fragmentary detached plan view on a larger scale, illustrating generally a frame means shown in Fig. l, and taken substantially on broken line 2-2 of Fig. l;

Fig. 3 is a detached fragmentary view on a still larger scale, partly in elevation and partly in section and taken substantially on broken line 33 of Fig. 1, of an occipital support embodying the present invention and illustrating supporting means therefor;

Fig. 4 is a fragmentary view (somewhat similar to the right end portion of the structure shown in Fig. 1 of the drawings) on a larger scalethan Fig. 1, and showing a modified form of the present invention;

Fig. 5 is a fragmentary view showing parts indicated in Fig. 4, on a larger scale than Fig. i, and illustrating by full line and dash line positions the manner in which the occipital support is removed after the head cast has become sumciently set or hardened so that the occipital support may be removed;

Fig. 6 is a detached perspective view of an occipital support embodying this invention; and

Fig. 7 is a fragmentary plan view illustrating a position which the parts shown in Figs. 4 to 6 inclusive may assume.

While my present invention may be employed with other orthopedic tables, by way of illustration and as an explanation of such invention, the same is illustrated and will be described in connection with the table of my said orthopedic table patent. portions 8, provide a suitable supporting base.

Preferably the upper structure of the fracturetable carried by the base T8 is adjustably movable relative to such base structure both for vertical and tilting movements. The housing structure to include the mechanism to adjust the upper structure of the fracture table may include a rectangular box-like base 9, which is supported by bars Iii. Two hydraulic cylinders H and 12 are secured to the box-like base 9 and extend upwardly therefrom. Suitable pistons are provided in the respective cylinders H and I2 and said pistons are connected by pivot members l3 and I4 with a mounting block H5. The said hydraulic means may be operated by four pedals [8,11, l8 and i9 and such pedals are responsive to the lower extremities of the operator, such as the operators feet. Various desired movements of the upper structure of the table can be controlled by suitable manipulation of the foot Thus legs I having downturned end 4 The extension frame provided by tubes 2! and bracket 22 is adapted to support a plurality of different devices that contribute to the utility of the fracture table, including the supporting of the occipital support of this invention and the supporting of devices which cooperate therewith.

A lead screw 24 (Fig. 2) is provided to longitudinally adjust the extension frame 2|-22. One end portion of the lead screw 24 is threaded into themounting block 15 and the othergend portion thereof extends into gear box 25. Suitable gears are disposed in said gear box 25 so that upon turning of crank 25 shaft 21 may be angularly moved and in turn the lead screw 24 may be angularly moved. -The bracket member 22 is provided with a plurality of openings 28, '29, 30, 3!, 32, 33 and 34, into which are inserted tubes to support various appliances from the bracket member 22. In my said orthopedic table patent and in my co-pending application for an inter-scapular supporting device, Serial No. 106,954, filed July 26,-

1949, these various openings and the parts I to 2'! herein, are more fully disclosed and described. Preferably the openings 30, 31, 32 and 34 are provided with a keyway slot 31 so that shafts with a mating key or pin may be inserted in said openings and held againstv angular movement.

Traction frames 40 (left hand end portion Fig. 1) comprise tubular members 4|,- which telescopically interfit with removable tubular members 42. The inner ends of the tubular members 4| are rigidly secured to a yoke 43, which is substantially U-shaped in plan. The yoke 43 carries a rack member 44 which isv mounted for longitudinal sliding movement in, a housing member 45. Within the housing member 45 are suitable worms and gears so as to provide for longitudinalmovement of the rack 44 in opposite directions in response to movement in opposite directions of the crank means 46.

The housing member 45 is secured by bolt, means 41 to a bracket 48.. Bracket 48 is pivotally.

connected with a .bracket 49 and is mounted for pivotal movement as respects the same on a vertical axis. The bracket 49 is rigidly connected with mounting block l5. Again the details of construction of parts, including parts 31 to 49, inclusive, is best shown in my said orthopedic table patent and thus no further detailed description of said parts is given herein.

The removable tubular members 42 carry a bracket 50. The purpose of such bracket 50 is to provide means which may be secured to the feet of a patient and thus to provide for traction or counter-traction on the feet of a patient. Thus bracket 56 is preferably detachably and adjustably connected to the tubular members 42 by split sleeves 5| and locking screws 52. By loosening a locking screw 52, each of the sleeves 5| may be longitudinally adjusted relative to a tubular member 42.

Preferably, leg boards 53 are provided for supporting the legs of a patient and such legs boards may be 'angularly and vertically adjusted by means of'threaded shafts 54 and 55. In order to provide for desired angular movement, one of the shafts 54 or 55, such as each shaft 55, is connected with the leg. board 53 by means of-- Thus leg board 53 may be tilted as well as vertically adjusted'so'that' cross pin 55 and slot 5?.

said leg board-is either horizontal or is at an incline to the horizontal and either end may be higher than the other, and sufficient movement,=:

anemia isprovlded to accomplishsuch purpose by reason 0fthe cross pin 56 movable in a general horit zontal direction in the slot 51. and extend downwardly through carriage housings 58 and 59, respectively. Carriage hous ings 58 and 59 are supported and preferably releasably locked to tubular members 42 and H.

The shafts 54-;

The trunk of a patient may be Supported by an inter-scapular support or rest 60 which, in

carried by bracket 22.

member Bi and relative angular movement be; J tween said tubular member 6! andshaft 62 may;

be prevented as by pin means 63 carried. by shaft 62, which pin means 63' interfits with a longitudinal slot in the tubular member 6!.

This construction may be identical with the construction Q;

shown in Fig. 3, wherein pin 63 is carried by threaded shaft 68 and slot 55 is disposed in tn,-

bular member 55 for supporting the occipital support of the present invention. Hence the def tails regarding the pin 63 and the slot 64, so far as the inter-scapular support is concerned, are not illustrated in detail herein. Nut means 65 is threaded on shaft 62 to adjust the elevation of the inter-scapularsupport 69, all of which is shown more in detail in my said co-pending application for'an inter-scapular supporting device. The use of this. inter-scapular supporting device Gills closely allied with the occipital support'of the present invention in that they are often used together. Whenever a head is to besupported for the application of a cast, generally a chest is likewise to be supported as most head; casts extend down over the chestarea. As both devices are of a nature where a patientmay be supported and a cast applied about the supportingdevic'es, their association in use will become apparent.

In the form of my present invention as shown a in Figs. 1 to 3, I provide tubular member 66- car ried by bracket 22 and more particularly in hole 39 of said bracket. 'By reason of the. keyway '31 and a key or pin carried by tubular memberifi, angular movement of the tubular member 69. is prevented. A nut 61 is threaded on'shaft 98 and shaft 69 is telescopically received within tubular member 65. Tubular member-66 is provided with a, longitudinal slot 64 and shaft 68 is provided with a pin 63. slidahle therein to prevent relative rotarymovement between tubular member 66 and shaft 68. Obviously, shafts having sauared ior otherpatterned portions and mating patterns' in the tubular members may be employed in lieu of the pin and slotmeans described in con-nee? tion with tubular member 69 and shaft 68-. {Ihe shaft 58 supports. an L.-shaped bracket 69 (rugs. l and 3) which, in turn. supports a cup-shaped head rest 19, and the said head rest- HI and L..-shap'ed bracket 69 are preferably detachably connected with said shaft as. by reduced end-port.- tion. 95 which is rotatable. in av recess in bracket 69. .Any desired angular adiustment of bracket 59 maybe maintained. by set screw 81. I

An extension member 1| is suitably connected with the bracket member 22 as by bolt and. nut means 12 operating in opening 34 in bracket 22, and stud 13 operating in opening 33 in {said bracket 22. Extension member 11 carriesQjafn upright post. 14., which upright post carries threaded shaft andv nut 'means15. The threaded shaft and nut means 15 are mounted on post 14 preferably so the shaft will not rotate butpcan. be moved horizontally by rotary movement oi'th'e nut means 75. The. end of the threaded shaft toward the patient carries a hook member 16 which, in turn, may be connected to a head sling 11.

In theevent that tension is placed on the head of the patient through head sling 11, countertraction may be placed on the feet of the patient by structure illustrated in my said orthopedic table patent. Generally, said structure (upper left hand portionof. Fig. 1) comprises a threaded shaft 18 and a nut means 19 which are supported for longitudinal movement by the bracket 59 so that the threaded shaft 18 may move longitudinally but will not turn relative to the bracket 59. Theinner end of. the threaded shaft 18 sup- 7 portsa bracket 89 which, in turn, supports a foot plate 8i. Strap means 82 are wrapped about each foot of a patient and thus connect each foot of a patient to a foot plate 8 I.

In the foregoing description the various parts here illustrated and described have been illustrated and described more fully in my said orthopedic table patent, of which the present application is a continuation-impart, and hence many of the details which show one operative environment of the present invention have not been fully described and illustrated in detail in the interest of brevity.

In general itmay be stated that a patient can be supported at the buttocks on sacral rest 83 and maintained there by the leg boards, or foot plates, etc. The trunk and intermediate portions of. the body are supported by the inter"- scapular support 59 and the head is supported by the head rest 10 and thus a'cast can be applied, when; desired, about the head rest- 19 "aswell as the intei--scapular support 69,. and said supports can be later removed from the cast after the cast has sumci'ently set or hardened.

In Figs. 45 and 5 of the drawings, I have shown a modified form of the head rest wherein the head. rest isstillsupported by a tubular member fifiirom the bracket member 22. Also in Figs. land 5 of the drawings there is illustrated threaded shaft 93 and connector 94 which is mounted for angular movement on shaft 93 and any adjusted position can be maintained by reason of screw 95 having a suitable and readily engageable wing nut thereon. An opening is provided in the connector 94 to slidably receive bar 99.. Screw 91 with a suitable wing nut head thereon adjusts any desired relative position between. the connector 94 and the bar 96 (see also Fig. '5) 1 One end portion of the: bar 96 is provided with aprojecting pin 98, which pin 98 mounts bracket 9%} for relative angular movement thereon. A set. screw I99 with a suitable wing nut thereon is provided to maintain. any adjusted position. Thus desired angular position between bar 96 and. the bracket 99 may be provided, and then by tightening. of screw IM such adjustment may be maintained. The bracket 9.9 'carriesa cup-shaped head rest l-lll which is similar in function to the cup-shaped head rest- 19. The said head rest H" is shown in elevation in Figs. 4 and 5 and inperspective in. Fig. 6. i

A. patient may be placed on the orthopedic table as is illustrated in Fig. 1 of the drawings. In such a position a patient will be supported at the buttocks on the sacral rest 83,. legs on boards 53, trunk supported by inter-scapular support 69,. and the head will be supported by either the head rest [Elf or 19. Also the sling 11 and foot plates 8! may be used when desired, After a cast 84 has been applied about the head of a patient and the cast has sufficiently set or hardened so it is desired to remove the occipital support 10 or m, the occipital support may be angularly moved out the head cast with the contacting surface portion of the occipital support following the contour of the head of the patient, until the occipital support'is removed as is best indicated in Fig. of the drawings. In this connection it is to be noted that the occipital support of Figs. 1 and 3 of the drawings isremoved with the bracket 69 by first loosening set screw 81 and that the occipital support Illl is removed with the bracket 99 by first loosening set screw I00. While it is possible to remove an occipital support with more or less of the supporting apparatus connected with the same, it is convenient to remove an occipital support with the bracket 69 connected therewith.

From the foregoing it will now be apparent that I have provided an occipital support over which a head cast may be appilied and the occipital support later removed when the head cast has reached a desired state or set or hardness, and at the same time without weakening or otherwise modifying normal or standard head casts. Also it will be apparent that if the neck of a patient is not normal but extends at an angle to one side or the other that the extension member I! may be pivoted by loosening a bolt and'nut means 12 and the angular position of the extension member H may be alined with a particular angle of a patients neck (illustrated in Fig. 7). If very minor adjustments are needed, it may be necessary to remove the stud 13 from the extension member I! and the bracket 22.' However, as I provide nut and bolt means 12, any desired adjustment of the angular relation between the extension member II and the bracket 22 may be provided. Next the relative angular position between the connector 94 and.

the shaft 93 may be made by loosening of screw 95. Also any desired angular relation between the bracket 99 and the bar 96 may obtain uponloosening of set screw I90. Thus desired angular; relationships may be made to support the head of a patient on a head rest I!!! even though.

the neck of a patient is not normal so far as the angle of the head of the patient to the chest of V the patient is concerned. If a head rest I0! is.

From, the foregoing it is apparent that either the cup-shaped head rest 19 or the head rest I91 comprises an occipital support on which the head of a patient may be supported for the application of a plastic or a plaster cast which includes a head rest having a top opening out which the head rest may be removed after the head cast is formed and has sufiiciently set or hardened so that the patient can be moved without fear of injury to the head cast. The end portion of the head cast toward the patient extends slightly over the convexed curve of the,

occiput of a patient and thus provides all of the support that isnecessary without unnecessary support on the neck of the patient and if the .70 occipital support were to extend toward the'neck so far as the head of a patient is'concerned, over said convex curved occiput and the opposite end which may include the L-shaped bracket 69 or may include the bracket 99, bar 96 and threaded bar 93, connects with the opposite end portion of the head rest. head rest 10 and with the L-shaped bracket 69 as well as the bracket 99 and bar 96 extend away from and generally follow the plane of a head rest. Also in said construction the L-shaped bracket 69 'is detachably connected with the head rest 10 while the following parts are detachably connected from each other: shaft 93, bar 96 and bracket 99 carried by head rest lfll. Regardless of whether or not the construction embodying head rest 19 or that embodying head rest 10! is followed, I have provided a head rest to support a patients head at the occiput and which head rest will not interfere with the operator in applying a head cast, the head cast maybe applied or formed about the head rest and after'the cast is sufficiently set or hardened so the patient may be moved, the head rest may be angularly moved so the same can be moved out of the cast and out through a usual opening which is left at the top of the head cast.

Obviously changes may be made in the forms,

' dimensions and arrangements of the parts of my invention without departing from the principle thereof, the above setting forth only preferred forms of embodiment of my invention.

I claim:

1. An occipital support on which the head of a patient may be supported for application of a plastic or a plaster cast which includes a head cast having a top opening out of which the head rest is adapted to be 'angularly removed after formation of the cast comprising a concave head rest, one end portion'of which is adapted to extend over and terminate'in the-area of the convex curve of the occiput of a patient and the opposite end portion of which is adapted to extend toward'and terminate in the area of the top of the head of a patient; and a bracket supporting member adapted to be connected to a suitable external supporting means, connected with said opposite end portion of said head rest support is adapted to be angularly removed' generally following a path conforming to the curvature of the top of the head of a patient,

said bracket supporting memberbeing detachably connected with said head rest.

2. An occipital support on which the head of a patient may be support for application of a plastic or a plaster cast which includes a head cast having a top openingout of which the head rest is adapted to be'angularly removed after formation of the cast comprising a concave head rest, one end portion of which is adapted to extend over and terminate in the area of the convex curve. of the occiput of a patient and the opposite end portion of which is adapted to extend toward and terminate in the area of the top of the headof a patient; and a bracket supporting member adapted to beconnected to a suitable external supporting means, connected with said opposite end portion of said head rest and extending away from said head rest, whereby after formation of such cast, which includes a A bracket connected with the head cast having a top opening, the occipital support is adapted to be angularly removed generally following a path conforming to the curvature of the top of the head of a patient, said bracket supporting member comprising an L- shaped member, one leg of which is substantially at right angles with said head rest and the other leg of which is substantially at right angles to said first-mentioned leg.

3. An occipital sup-port on which the head of a patient may be supported for application of a plastic or a plaster cast which includes a head cast having a top opening out of which the head rest is adapted to be angularly removed after formation of the cast comprising a concave head rest, one end portion of which is adapted to extend over and terminate in the area of the convex curve of the occiput of a patient and the opposite end portion of which is adapted to extend toward and terminate in the area of the top of the head of a patient; and a bracket supporting member adapted to be connected to a suitable external supporting means, connected with said opposite end portion of said head rest and extending away from said head rest, whereby after formation or" such cast, which includes a head cast having a top opening, the occipital support is adapted to be angularly removed generally following a path conforming to the curvature of the top of the head of a patient, said 0 a patient may be supported for application of a plastic or a plaster cast which includes a head cast having a top opening out of which the head rest is adapted to be angularly removed after formation of the cast comprising a concave head rest, one end portion of which is adapted to extend over and terminate in the area of the convex curve of the occiput of a patient and the opposite end portion of which is adapted to extend toward and terminate in the area of the top of the head of a patient; and a bracket supporting member adapted to be connected to a suitable external supporting means, connected with said opposite end portion of said head rest and extending away from said head rest, whereby after formation of a cast, which includes a head cast having a top opening, the occipital support is adapted to be angularly removed generally following a path conforming to the curvature of the top of the head of a patient.

' ROGER ANDERSON.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 1,239,789 Hawley Sept. 11, 1917 1,258,246 Rink Mar. 5, 1918 1,697,121 Knebel Jan. 1, 1929 FOREIGN PATENTS Number Country Date 829,390 France Mar. 28, 1938

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