US2829640A

US2829640A - Surgical leg holders

Info

Publication number: US2829640A
Application number: US453750A
Authority: US
Inventors: Joseph C Moorman
Original assignee: Individual
Current assignee: Individual
Priority date: 1954-09-02
Filing date: 1954-09-02
Publication date: 1958-04-08
Anticipated expiration: 1975-04-08

Description

April 8, 1958 J. c. MOORMAN SURGICAL LEG HOLDERS Filed Sept. 2. 1954 INVENTOR ATTORNEY United States Patent Ofifice 2,829,640 Patented Apr. 8, 1958 SURGICAL LEG HOLDERS Joseph C. Moorman, Rushville, Ind. Application September 2, 1954, Serial No. 453,750 4 Claims. (Cl. 128--86) This invention relates to improvements in surgical leg holders of the character used for holding the foot and leg of a patient during a surgical operation, particularly the repair of a hip fracture.

Where a fracture or break has been caused in the bone of the leg at the hip joint, it has been the practice heretofore to insert a surgical nail into the bone to hold the parts thereof in correct alignment. A nail of the character known as the Smith-Peterson nail is often used for this purpose. It must be inserted through the side of the leg and into the leg bone at the hip joint to secure the parts together. This is often accomplished under X-ray examination and subjected to X-ray examination from time to time thereafter.

No satisfactory means has been provided heretofore for holding the leg in place during the setting of the fracture and the insertion of the nail, and it has been the practice for a nurse to hold the leg during the operation and the examination. Inasmuch as the operation may take as much as twenty to thirty minutes, the requirement for an added nurse for this purpose not only is objectionable because such a nurse is not always available but frequently takes the added nurse away from other duties. Moreover, a person cannot hold the leg entirely satisfactorily, because it should be retained in a fixed position throughout the operation, and this is not possible by a manual holding action due to the natural tendency of a person to relax the grip on the extremity or to shift the position thereof during the holding action, which would allow the leg to change its position, thus interfering with the proper setting of the fracture.

One object of this invention is to provide a holder which will receive and hold the leg of a patient during such an operation, to dispense with the necessity for manual holding thereof and to provide for an effective and secure holding of the leg in place.

Another object of the invention is to improve the construction of surgical holders of the character used, for example, to hold the leg of a patient, to provide for the proper and absolute positioning of the leg and the assurance that it will be maintained in such position when set, with traction applied thereto if desired, and without interfering with the other steps in the operation, such as X-raying, pinning, etc.

Still another object of this invention is to simplify the construction of leg holders, to enable these to be made practically and inexpensively for the use intended, having provision for shifting from one leg to the other according to the required disposition of the leg during the operation. r Y

These objects may be accomplished according to one embodiment of the invention by providing a leg holder capable of receiving and maintaining in place the calf, foot and knee, that will hold these parts securely, and preferably having provisions for adjustment to accommodate persons of different sizes. The gripping devices for these parts of the leg should be constructed as a unit and preferably are mounted on a base for lateral shifting 2 with respect thereto, not only for the proper positioning of the parts of the leg relative to the body of the patient, but also to accommodate the respective opposite legs. This holder is sufliciently light in weight that it will secure and hold the parts of the leg properly and some light traction may be applied thereto, if desired, without the necessity for the constant attendance of a nurse to hold the leg securely.

Certain embodiments of the invention are illustrated the accompanying drawings in which:

Fig. 1 is a top plan view of the surgical leg holder according to the invention;

Fig. 2 is a side elevation thereof;

Fig. 3 is an end elevation thereof;

Fig. 4 is a transverse section therethrough on the line 44 in Fig. 1; and

Fig. 5 is a bottom plan View illustrating a modification.

The holder illustrated as an embodiment of the invention, merely for purpose of illustration, is shown as having a base 1 of suflicient length and width to accommodate the holder and to support the same securely on an operating table, bed or other support for the patient. Transverse members 2 are secured beneath opposite ends of the base 1 and are connected therewith not only to brace the base, but to form supports therefor.

Gripping devices are mounted upon the base 1, adapted to receive and hold the leg, knee and foot. These gripping devices are carried by a bottom 3 which extends throughout the length of the holder and of sufficient width relative thereto for mounting of the gripping devices thereon.

The leg holder has a trough provided by a pair of sides4 which extend upwardly from the bottom3 and it is preferred that these sides 4 be disposed in lateral diverging relation at a small angle to the vertical, so as to form substantially a V-shaped trough for wedging of the calf of the leg therebetween. At one end of the leg gripping device formed by the sides 4 is a knee gripping device formed by a pair of sides 5 which are in longitudinal alignment with the sides 4. The knee gripping sides 5 preferably extend vertically from the bottom 3, adapted to embrace the opposite sides of the knee and to hold the latter in adjusted position relative to the bottom 3. At the opposite end of the leg gripping sides 4 are foot sides 6, arranged in a pair to embrace opposite sides of the foot. The sides 6 preferably extend vertically at right angles to the bottom 3, like the knee gripping sides 5.

Each of the pairs of sides 4-6 is shown as held in place by one or more bracket members, indicated gen orally at 7 in the illustrated embodiment, secured rigidly to the sides 46 as by holding screws, bolts or other fastenings generally indicated at 8. These brackets are shown as of angular form, the lower end portions of which are seated upon the bottom 3 and have provisions for lateral adjustments relative to each other with respect to the bottom 3. In this embodiment shown in Figs. 1 to 4, this adjustment is provided by a bolt 9 connected with the olfset lower end portion of each bracket 7 and extending downwardly through a slot 10 in the bottom 3, preferably having a Wing nut thereon for. secure tightening of the bolt to hold the connected side in the proper adjusted position with respect to the bottom. This permits the adjustment of the gripping device, additionally, to accommodate persons of different sizes and to offer a tight clamping of the gripping devices at the different parts of the leg for a proper adjustment thereof and holding of these parts of the leg securely in place during the operation.

Furthermore, provision is made for lateral the gripping devices with respect to the base shifting of 1. This is accomplished by hingedly mounting the bottom 3 on the base. A pair of hinges, generally indicated at 11, are shown in this embodiment for .adjustably mounting the bottom 3 and the gripping devices on the base.

Provision should be made also for locking the gripping devices in their adjusted positions. To provide therefor I have shown an adjusting bar 12, pivotally connected at one end at 13 with the base 1, and having a slot extending lengthwise in this bar 12 for receiving therethrough a bolt 14 secured to a bracket 15 on the bottom 3 of the gripping devices to provide for the proper adjustment thereof with respect to the base and for tightening of this adjustment to maintain the gripping devices in the proper positions with respect thereto.

A modified form of adjustment is shown in Fig. 5 in which each of the brackets 7 has a portion extending through the adjacent slot in the bottom 3, with an internally threaded member connected therewith as indicated at 16. A shaft 17 extends transversely of the bottom 3,

being anchored at 18 intermediate its ends and having its opposite end portions threaded in different directions through the threaded member 16. A hand wheel is shown at 19 on one end of the shaft 17, capable of adjustment in either direction, as desired, for moving the adjusting sides of the gripping device inward or outward relative to each I other uniformly relative to the bottom 3 and by one operation, upon rotation of the shaft 17 by the hand wheel 19.

Provision may be made, if desired, for the appplication of suitable traction to the leg. An eyelet is shown at 20, connected with one end of the base 1 for attachment thereto of a cable 21, having a weight 22 thereon which may be dropped over the end of the X-ray or operating table to apply longitudinal pressure to the leg holder and to the leg received therein to hold it in place.

The holding device may be constructed of any suitable material, as desired, such for instance as wood, metal, aluminum, etc., and may be of light weight capable of lifting or carrying around, and yet should be sufiiciently heavy to stay in place on the X-ray or operating table during the operation. When not required, it can be stored in the property room of the hospital ready for immediate use when required. Any suitable lining or covering material may be applied thereto, as desired, and it may or it may not be padded, as may be found needed.

In use the holder is applied to the X-ray or operating table or other point of support for the patient, and the entire lower portion of the leg is received and held therein during the operation. Normally, the holder will not be maintained in the upright position shown in Figs. 3 and 4, but will be shifted to one side or the other of the vertical plane therethrough, as indicated generally in dotted lines in Fig. 3, according to whether it is applied to the right or the left leg of the patient. The degree of shifting will depend upon the normal position of the leg with respect to the hip, and when the proper position is determined by the surgeon, the gripping devices or clamps may be secured rigidly in place relative to the base 1 by the adjustment device 12-15, to lock these parts against accidental shifting.

The respective clamps 4-6 may be adjusted to the required extent transversely relative to each other to secure the foot and knee in place and for proper adjustment thereof with respect to the fracture joint. The parts of the leg will be held securely by the holder without requiring a seperate nurse to stand and hold the leg during the operation. If traction be required, this may be provided by the cable and weight 21-22.

The holder has been found extremely beneficial not only because of the advantages pointed out above, but also as having radiologic aspects, as follows:

(1) The hip is maintained in a fixed position, thus allowing a portable X-ray unit to likewise be placed in a constant position and thereby permitting the lateral views of the hip to be taken without any movement of the patient. This shortens the time of the operative procedure and guarantees that the hip will be in the correct position for each lateral film that is taken.

(2) The device does not interfere in any way with the movement of the fluoroscopic screen on the X-ray spot film device with which the antero-posterior films of the hip are taken.

(3) Since the leg of the patient does not need to be moved there is no chance of bending the guide wire that has been inserted to direct the course of the Smith-Peterson nail. This is very important since the bending of the guide is all too frequent when the leg is held by hand and Frogged for the lateral view.

While the invention has been illustrated and described in certain embodiments, it is recognized that other variations and changes may be made therein without departing from the invention as set forth in the claims.

I claim:

1. A surgical leg holder comprising an elongated base, a trough-shaped structure extending lengthwise of the base, a pair of hinges mounted on the base and spaced apart lengthwise thereof and supporting the trough-shaped structure thereon for lateral swinging movement about an axis extending lengthwise of the base and relative thereto.

2. A surgical leg holder comprising an elongated flat base adapted to be seated upon a table, a trough-shaped structure extending lengthwise of the base adapted to hold in place a leg of a patient lying on the table, and means pivotally mounting the trough-shaped structure on the base for swinging movement about an axis extending lengthwise of the base and from side to side relative thereto.

3. A surgical leg holder comprising an elongated base, a trough-shaped structure extending lengthwise of the base, said trough-shaped structure comprising a plurality of sections having transversely adjustable sides, means mounted on said trough-shaped structure for adjusting the spacing between said sides, and means pivotally mounting said trough-shaped structure on said base for swinging movement about an axis extending lengthwise of the base.

4. A surgical leg holder comprising an elongated flat base adapted to be seated upon a table, a trough-shaped structure extending lengthwise of the base and adapted to hold in place a leg of a patient lying on the table, said trough-shaped structure comprising a plurality of sections having transversely adjustable sides, and a pair of hinges mounted on said base and spaced apart lengthwise thereof and supporting said trough-shaped structure thereon for lateral swinging movement about an axis extending lengthwise of said base.

References Cited in the file of this patent FOREIGN PATENTS 206,281 Germany Jan. 30, 1909