US2822802A

US2822802A - Surgical retractor

Info

Publication number: US2822802A
Application number: US634777A
Authority: US
Inventors: William P Corriero
Original assignee: Individual
Current assignee: Individual
Priority date: 1957-01-17
Filing date: 1957-01-17
Publication date: 1958-02-11
Anticipated expiration: 1975-02-11

Description

Feb. 11, 1958 w. P. CORRIERO 2,822,802

SURGICAL RETRACTOR Filed Jan. 17, 1957 2 Sheets-Sheet 1 3e :4 30 as;

INVENTOR. Mum/v fife/M54 0 Feb. I1; 1958 w. P. CORRIERO SURGICAL RETRACTOR 2 Sheets-Sheet 2 Filed Jan. 17, 1957 INVENTOR. MLL/AW (om/mo .BY

United States Patent SURGICAL RETRACTOR William P. Corriero, Garden City, N. Y. Application January 17, 1957, Serial No. 634,777

9 Claims. (Cl. 128-20) This invention relates generally to surgical implements and, more particularly, is directed to a surgical retractor for use in amputations of limbs, especially in mid-thigh amputations.

The need for cutting the femur adequately high in order to form a good stump in mid-thigh amputations is well-known to all surgeons. However, this desired condition is often unattainable by reason of poor or diificult retraction of the soft parts of the limb above the point where the bone is to be severed. Although surgical retractors have been proposed for use in the amputation of limbs, such retractors are not completely satisfactory in that their application and use are either complicated and time consuming or their effectiveness, in retracting, and holding retracted the soft parts, is limited.

Accordingly, it is an object of this invention to provide an improved surgical retractor which is particularly useful in mid-thigh amputations for effectively retracting the soft parts, and wherein the retractor is simple in construction and in operation.

Another object is to provide a surgical retractor of the described character which acts as a support for the limb being amputated during severing of the bone.

A further object is to provide a surgical retractor of the described character which exerts a clamping action on the bone following retraction of the soft parts so that, during severing of the bone, the soft parts are securely held in retracted condition.

A still further object is to provide a surgical retractor of the described character which can be easily applied about the bone following the making of an incision in the fleshy or soft parts of the limb, and which is easily removed after the bone has been severed.

According to an aspect of the present invention, a surgical retractor particularly useful in-mid-thigh amputations consists of two plate members-which are generally of triangular configuration and which are provided with separably engageable hinge elements along two mating edges thereof, such hinge elements being arranged so thatthe two plate members can be hingedly connected, or separated from each other, only when the plates lie substantially in the same plane.- The mating edges of the plate members are further provided with semi-circular cut-outs which, when the plate members are hingedly.

connected, define a circular opening for receiving the bone of the limb to be amputatedn Thus, after an incision has been made in the soft or fleshy parts around the bone of the limb to be amputated, the two generally triangular plate members are inserted, from the opposite sides, into the incision with the bone being received in the semicircular cut-outs of their mating edges and the hinge elements are then engaged with each other. Thereafter, the retractor is grasped above and below the limb, at 10- cations along the hinge axis of the plate members, and is drawn toward the proximal end of the limb to be amputated thereby to retract the soft or fleshy parts and to expose the bone for severance thereof at a high location. After the soft parts have been retracted, the'plate members are folded or angularly displaced relative-to Patented Feb. 11, 1958 each other to enclose an angle of less than 180 degrees, so that the lateral dimension across the opening receiv. ing the bone ,is reduced and the bone is clamped in the opening thereby to ensure that the fleshy or soft parts will be held in the retracted condition during cutting of the bone. Further, when the plate members are folded or angularly displaced relative to each other to enclose an angle of less than 180 degrees, the lower edges of the plate members provide a base on which the retractor firmly rests for securely supporting the clamped bone during the cutting thereof.

The above, and other objects, features and advantages of the invention, will be apparent in the following detailed description of an illustrative embodiment thereof which is to be read in connection with the accompanying drawings forming a part hereof, and wherein:

Fig. l is a front elevational view of two separate plate members forming a surgical retractor embodying the present invention;

Fig. 2 is a fragmentary, enlarged sectional view taken along the line 22 of Fig. l

Fig. 3 is a view similar to that of Fig. 2, but showing the manner in which the hinged connection between the plate members is effected;

Fig. 4 is a view similar to that of Figs. 2 and 3, but showing the arrangement of the plate members when the latter are folded or angularly displaced relative to each other;

Fig. 5 is a view similar to that of Fig. 1, but showing the plate members hingedly connected to each other;

Fig. 6 is a perspective view illustrating the use of the surgical retractor embodying the present invention during a mid-thigh amputation; and

Fig. 7 is a fragmentary enlarged sectional view taken along the line 77 of Fig. 5, but showing the clamping of a bone in the surgical retractor.

Referring to the drawings in detail, and initially to generally triangular configuration in which the three angles thereof are all preferably less than degrees.

The lower edges 14a and 14b, and the outside edges 16a and 16b of the plate members 12a and 12b, respectively,

are preferably outwardly concave, as shown, while the inside or mating edges 18:; and 18b are generally straight and, in the upper portions thereof, are provided with semi-circular notches or cut-

outs

20a and 20b, respec-' tively. I

In order to effect the separable hinge connection of the plate members 12a and straight edges 18a and with the mating parts or elements of three come apart hinges which are formed tion, the straight edge 18b apart

hinge pins

22, 24 and 26 having their axes-in are formed in the platemember '

barrels

34, 36. and 38 are edge 18a of plate member with the

hinge pins

22, 24

hinge barrels

34, 36 and is formed of suitably heavy' 12b along their mating or 18b, such edges areprovided integrally with the plate mern- 3 bers. Thus, in the illustrated embodiment of the inven-fof plate member is provided with three longitudinally extending and spaced

slots

28, 30 and 32 12b along the inside of the

hinge pins

22, 24 and 2 6, respectively. Open hinge provided along the, straight 12a at locations registeringand 26, respectively, of the plate member 12b. As seen in Fig. 2, each of the open j 38 is of generally semi-cylin; drical configuration and opens at one sideof the-plate.- member 12atin a direction'extending at an acute anglef, to the plateof the plate member'away from the edge 18a toward the main body of the plate member, with the center of curvature of each hinge barrel lying substantially in line with the edge 18a. Further, the hinge barrels have lengths slightly smaller than the lengths of the related slots 28, '30 and 32 so that the hinge barrels may extend through such slots to embrace the hinge pins (Fig. 5) in a manner hereinafter described in detail.

Further, as seen in Fig. 1, the plate members 12a and12b may be provided with

notches

40a and 40b extending downwardly from, the cut-outs 20a and 201) respectively, adjacent the edges 18a and 18b and at acute angles to the latter. The plate members 12a and 1211 are also provided with finger receiving holes 42a and 42b adjacent their outside edges 16a and 16b, and by which the plate members may be grasped during the below described use of the surgical retractor.

In using the surgical retractor for retracting the soft or fleshy parts of a limb during amputation of the latter, an incision is first made in the soft or fleshy parts about the bone and the latter is stripped away up to level of amputation. The plate members 12a and 12!) are then inserted, from the opposite slides, into the incision with the plate members being held in substantially the same plane and positioned so that the bone to be out will be received in the cut-

outs

20a and 20b. While the plate members 12a and 12b are held parallel to each other, the

hinge pins

22, 24 and 26 on member 12b are passed in front of the

open hinge barrels

34, 36 and 38 to the relative positions of Fig. 3, whereupon, further displacement of member 12b relative to member 12a in the direction of the arrow 44 of Fig. 3 will cause the hinge pins to enter the related open hinge barrels while the latter extend through the

related slots

28, 30 and 32 (Fig. 5). Thus, the plate members 12a and 12b are hingedly connected to each other with the bone received in the circular opening 46 defined by the cut-

outs

20a and 20b which are dimensioned so that clearance will exist between the bone and the edge of opening 46.

After the plate members 12a and 121) have been connected together around the bone, the plate members are grasped above and below the limb to be amputated, as at 48 and 50 (Fig. 5), and are jointly pulled in the direction toward the proximal end of the limb while being maintained in the same plane to retain the circular configuration of opening 46. Thus, the soft parts of the limb are retracted. When the desired degree of retraction has been achieved, the plate members 12a and 12b are folded or angularly displaced relative to each other to enclose an angle of less than 180 degrees at the side of the retractor opposed to that at which the

hinge barrels

34, 36 and 38 open, as Figs. 4, 6 and 7.

Such angular displacement of the plate members 12a.

and 12b produces a reduction in the lateral dimension d (Fig. 7) of the opening 46 so that the bone b, shown in broken lines, is then clamped, at its opposite sides, between the plate members. The plate members 12a and 12b may be grasped at the finger holes 42a and 42b, as shown in Fig. 6, and thus held in their angularly displaced position. The resulting clamping action of the plate; members 12a and 12b on the bone 1: will securely hold the soft or fleshy parts in the retracted condition, thereby requiring no further manual pull on the plate members.

'It will be apparent that, when the plate members 12a and 12!; are angularly displaced out of the same plane,

the engagement of the

hinge barrels

34, 36 and 38 in the

slots

28, 30 and 32, respectively, and the interference between the intermediate portions of edges 18a and 18b prevent the disengagement of the mating hinge elements, as can be seen in Fig. 4. Further, the edges 18a and 18b are preferably bevelled at the side of the retractor toward which the plate members are intended to be angularly displaced so that, although such edges-are disposed close toeach when the plate members arehingedly con 4 nected and the latter are formed of relatively thick sheet metal, the closely adjacent edges 18a and 18b will not interfere with relative angular displacement of the plate members.

It will also be appreciated that, when the plate members 12a and 12b have been angularly displaced, as previously described, to clamp the bone in the opening 46 following retraction of the soft parts, the corners of the plate members at the junctions of the edges 18a, 14a and 16a of plate member 12a and at the junctions of the edges 18b, 14b and 16b of plate member 12b form a steady three-point support or rest for the retractor so that the latter can securely and firmly hold the limb during cutting of the bone (Fig. 6). Further, as can be seen in Fig. 7, the angular displacement of plate members 12a and 12b brings the notches 40a and 4015 into lateral alignment with each other so that, when a bone saw or other instrument is used to sever the bone close to the retractor 10, the lower toothed edge of the instrument can enter the aligned

notches

40a and 40b at the end of the cutting operation to avoid damage either to the cutting instrument or to the retractor.

After the bone has been severed, the clamping action of the plate members on the bone 12 is relaxed and the plate members are returned to the same plane so that, when member 12b is bodily displaced relative to member 12a in the direction in which the

hinge barrels

34, 36 and 38 open, that is, in the direction opposed to arrow 44 on Fig. 3, the hinges come apart to permit lateral separation and removal of the plate members. Thus, it will be apparent that the retractor 10 is both easily installed andremoved, and that, following use, the members 12a and 12b, which constitute the retractor, can be easily cleaned and sterilized by reason of the absence of any small securing members, such as, bolts and the like, which would present small crevices for the collection of foreign particles.

Further, as has been pointed out above, the retractor 10 is adapted to maintain the retracted soft or fleshy parts in their retracted condition merely by effecting angular displacement of the plate members 12a and 12b and, when thus manipulated, the retractor 10 also Provides a firm support for the limb during the cutting of the bone.

Although an illustrative embodiment of the invention has been described in detail herein with reference to the accompanying drawings, it is to be understood that the invention is not limited to that precise embodiment, and that various changes and modifications may be effected therein without departing from the scope or spirit of the invention, except as defined in the appended claims.

What is claimed is:

1. A surgical retractor for use in limb amputations comprising first and'second plate-members each having a generally semi-circular cut-out in one edge thereof, and separable, interengageable hinge defining means on said one edge of said first member and. on said one edge of saidsecond member to hingedly connect said first and second, members for swinging. relative to each other about an axis, corresponding to said one edges of the plate membersandwith said cut-outs registering to define an opening for the reception of the bone of the limb to be amputated', said hinge defining means being separable and interchangeable only when said plate members lie in substantially the same plane.

2. A surgical retractor for use in limb amputations comprising first and second plate members each having a generally semi-circular cut-out in one edge thereof, and separable, interengageable hinge defining means on said one edge of said first member and on said one edge of said second member to hingedly connect said first and second members for swinging relative to each other about anaxis corresponding to said one edges of the plate membersand with said cut-outs registering to define an openingforthe reception of the bone of the limb to be amputated, saidhinge defining means being separable and'interengageable only when said plate members lie in substantially the same plane, so that, when said plate members are angularly displaced relative to each other about said axis, said plate members are held together and the lateral dimension across said opening is reduced for clamping a bone received therein.

3. A surgical retractor for use in limb amputations comprising first and second plate members each having a generally semi-circular cut-out in one edge thereof, at least one generally semi-cylindrical hinge barrel extending along said one edge of the first plate member and opening at one side of the latter, and a hinge pin for each hinge barrel extending along said one edge of said second plate member and joined to the latter only at its opposite ends so as to be adapted to be received in the related hinge barrel for pivotally connecting said piate members to each other with said cut-outs in lateral registration to define an opening in which a bone can be received, the lateral dimension of said opening being reduced by angular displacement of said plate members out of the same plane thereby to clamp a bone in said opening.

4. A surgical retractor for use in limb amputations comprising first and second plate members each having a generally semi-circular cut-out in one edge thereof, at least a portion of said one edge of the first plate member having a generally semi-cylindrical extension defining a hinge barrel which is open at one side and has its center of curvature aligned with the remaining portions of said one edge of said first member, and a hinge pin for each hinge barrel extending along a corresponding portion of said one edge of said second plate member and joined to the latter with the axis of said hinge pin being substantially in axial alignment with the remaining portions of said one edge of said second member and with a longitudinal slot separating said second plate member from said hinge pin along substantially the entire length of the latter so that, with said first and second plate members lying in substantially the same plane, said open barrel can extend through said slot to embrace the related hinge pin and thereby hingedly connect said plate members to each other With said cut-outs registering to define an opening for the reception of a bone which is clamped therein by relative angular displacement of the hingedly connected plate members.

5. A surgical retractor for use in limb amputations comprising first and second plate members each having a generally semi-circular cut-out in one edge thereof, at least a portion of said one edge of the first plate member having a generally semi-cylindrical extension defining a hinge barrel which is open at one side and has its center of curvature aligned with the remaining portions of said one edge of said first member, and a hinge pin for each hinge barrel extending along a corresponding portion of said one edge of said second plate member and joined to the latter with the axis of said hinge pin being substantially in axial alignment with the remaining portions of said one edge of said second member and with a longitudinal slot separating said second plate member from said hinge pin along substantially the entire length of the latter so that, with said first and second plate members lying in substantially the same plane, said open barrel can extend through said slot to embrace the related hinge pin and thereby hingedly connect said plate members to each other with said cut-outs registering to define an opening for the reception of a bone which is clamped therein by relative angular displacement of the hingedly connected plate members, said first and second plate members having equal, generally triangular configurations with at least the angle enclosed by said one edge and an adjoining edge of each plate member being an acute angle so that, when said plate members are angularly displaced relative to each other out of the same plane, the corners of the triangular plate members defined by said one edge and said adjoining edge of each plate member and the corners subtended by said one edge of each plate member, respectively, define a stable tripod support for the clamped bone.

6. A surgical retractor for use in limb amputations comprising first and second plate members having separable, hinged connecting elements on mating edges thereof to permit angular displacement of said plate members about an axis extending along said mating edges, said mating edges further having cut-outs therein which register when said plate members are hingedly connected to define an opening for the reception of a bone with the lateral dimension of said opening being reduced by angular displacement of said plate members out of the same plane thereby to clamp the bone in said opening, said plate members having lower edges extending at acute angles from the lower ends of said mating edges so that, when said plate members are angularly displaced out of the same plane to clamp a bone in said opening, said lower edges form a stable base on which the retractor can rest for firmly supporting the clamped bone during severance of the latter.

7. A surgical retractor for use in limb amputations comprising first and second plate members each having a generally straight edge with a substantially semi-circular cut-out therein, a plurality of longitudinally spaced apart, generally semi-cylindrical, hinge barrels extending along said straight edge of the first plate member and integral with the latter, each of said hinge barrels being open along its length at one side of said first plate member in a direction away from said straight edge at an acute angle to the plane of said first plate member with the center of curvature of each semi-cylindrical hinge barrel being in axial alignment with said straight edge of the first plate member, and a plurality of longitudinally spaced apart hinge pins corresponding to said hinge barrels and extending along said straight edge of the second plate member, each of said hinge pins being integral, at its opposite ends, with said second plate member and having its axis substantially aligned with said straight edge of the second plate member, said second plate member having an elongated slot extending along each of said hinge pins between said opposite ends of the latter so that, when said plate members lie in substantially the same plane, said hinge barrels can pass through said slots to embrace the related hinge pins for hingedly connecting said plate members along said straight edges with said cut-outs registering laterally to define an opening for the reception of a bone which is clamped therein in response to angular displacement of said plate members out of the same plane.

8. A surgical retractor for use in limb .amputations as in claim 7; wherein each of said plate members is of generally triangular configuration and has a lower edge which, with said straight edge, encloses an acute angle so that, when said plate members are angularly displaced out of the same plane, said lower edges of the plate members form a stable base for the retractor with said opening having a bone clamped therein lying within the vertical projection of said base to provide a firm and secure support for the bone during the cutting thereof.

9. A surgical retractor for use in limb amputations as in claim 8; wherein each of said plate members further has a slot opening upwardly into said cut-out at the lower portion thereof, said slots opening upwardly into the cutouts being in lateral registration with each other when said plate members are angularly displaced out of the same plane so that a cutting tool used for severing a bone clamped in said opening can enter the registered slots at the conclusion of the severing operation.

1,550,403 Turkus Aug. 18, 1925 Hipps Nov. 30, 1954