US3840014A - Retractor for hip joint surgery - Google Patents

Retractor for hip joint surgery Download PDF

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Publication number
US3840014A
US3840014A US29115972A US3840014A US 3840014 A US3840014 A US 3840014A US 29115972 A US29115972 A US 29115972A US 3840014 A US3840014 A US 3840014A
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Prior art keywords
pin
members
hook
ends
direction
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
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R Ling
A Lee
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National Research Development Corp UK
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National Research Development Corp UK
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025Joint distractors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/2812Surgical forceps with a single pivotal connection
    • A61B17/2833Locking means

Abstract

Surgical apparatus for separating the femur from the acetabulum, such as in total hip joint replacement by the Southern Approach, takes the form of an inverse pair of tongs which open when the handles are closed. More particularly, the free ends of the tongs respectively carry a pin and a hook which extend in a generally orthogonal direction relative to their respective tong arms and the plane of movement therebetween, while the bight of the hook extends away from its arm.

Description

ilnited States Patent 1191 Ling et al. Oct. 8, 1974 RETRACTOR FOR HIP JOINT SURGERY 815,907 3/1906 A Davis 128/17 1751 Robin Sydney Mackwwd Ling, 333231223 3113?? ifiiiill ii:.............i.....:::::::: 133153 Teignmouth; Alan John Clive Lee, Exeter, both of England FOREIGN PATENTS OR APPLICATIONS 73 Assigneez National Research Development 5l1,203 9/1920 France 128/20 Corporation, London, England Primary Examiner-Channing L. Pace [22] Flled' Sept' 1972 Attorney, Agent, or Firm-Cushman, Darby & [21] Appl. No.: 291,159 Cushman [30] Foreign Application Priority Data [57] ABSTRACT Sept. 24, 1971 Great Britain 44709/71 Surgical apparatus for separating the femur from the Mar. 8, 1972 Great Br1ta1n 10796/72 acetabulum, such as in total joint replacement the Southern Approach, takes the form of an inverse u 6 v a 1 6 1 6 i 303 R More particularly, the free ends of the tongs respec- 1 0 care I 1 1 tively carry a pin and a hook which extend in a generally orthogonal direction relative to their respective 56 R f d tong arms and the plane of movement therebetween, 1 UNITE]; 522%; :ZTENTS while the bight of the hook extends away from its arm.

569,839 lO/l896 Roeloffs 128/17 7 Claims, 1 Drawing Figure RETRACTOR FOR HIP JOINT SURGERY This invention concerns surgical apparatus and more particularly such apparatus for use in part or total hip joint replacement by way of the so-called Southern or Posterior approach.

This approach is advantageous in affording good exposure of and access to the acetabular cavity, but difficulty can sometimes arise in effecting the required separation of the femur and acetabulum. In any case, it is normal for the surgeon to employ an assistant simply to maintain this separation during operation.

An object of the invention is to reduce this difficulty and, to this end, there is provided surgical apparatus for separation of the femur and acetabulum during the Southern approach, which apparatus comprises a pair of elongate members coupled together for mutual separating and closing movement of one pair of corresponding free ends thereof, a pin extending from one of said ends in a direction generally transverse to that of said movement and also to the longitudinal direction of the respective one of said members, and a hook extending from the other one of said free ends in a generally corresponding direction to that of said pin and with the bight of said hook facing generally outwardly from the respective one of said members.

The coupling of said members can be such that the members are conveniently of a pivotal form at corresponding intermediate portions of the members such that the other corresponding ends can serve as handles. in this case it is preferred that at least one of said members is of a bent configuration coupled so that closure of the handles opens the pin and hook carrying ends.

Whatever the coupling arrangement, it is preferred that the pin has an intermediate cranked portion which extends laterally relative to the respective elongate member and away from the other such member.

Similarly, it is preferred that the apparatus comprise a locking or biassing member co-operable with said elongate members to hold said pin and hook separated.

In order to clarify the form of such apparatus, one embodiment thereof is diagrammatically illustrated, by way of example, in the accompanying drawings.

The illustrated embodiment comprises two elongated members and 11 which are curved in a similar manner and coupled at 12 for mutual pivotal rotation about a fixed axis 13 perpendicular to the plane defined by the members. This assembly is such that closure of one pair of corresponding ends of the members, which serve as handles 14, causes mutual opening of the other corresponding ends. One of these other ends carries a pin 15 and the other a hook 116, which pin and hook extend from their respective members 10 and 1 1 in corresponding directions substantially parallel to the axis of rotation of the members. The bight of the hook faces outwardly from its member 11, and the pin is formed with an intermediate cranked portion 17 which extends laterally relative to its member 10 and in the direction away from the member 11.

In use of this embodiment, the pin is pushed into the ischium behind the sciatic nerve, the nerve being eased to one side for this purpose and thereafter released to accommodate itself in the cranked portion of the pin. The hook is engaged in the surface of the femoral neck. These engagements are effected with the handles open,

and are such that subsequent closure of the handles separates the femur from the acetabulum while rotating the femur to expose the femoral head. When this retraction is attained, it can be maintained by holding the handles closed with a simple slotted member or bracket such as indicated at 18.

The embodiment as illustrated will be handed relative to the hip joint with which it is usable if the pin and hook are permanently connected or integrally formed with their respective members. However, interchangeable pin and hook arrangements can be provided so that a single embodiment is usable for left or right hand hip joint retraction.

Also, it is not essential that the members of the apparatus pivot in an inverse manner compared to conventional pliers or tongs. However, if the handles and the other ends open and close together, it may be preferred to employ a spring to bias the apparatus towards a normally open condition so that manual control of the retraction procedure is facilitated, it being easier to grip around the handles and control by squeezing than an opposite action.

We claim:

1. A surgical apparatus for separation of the femur and acetabulum comprising a pair of elongated members pivotally connected to one another so that one pair of ends thereof can be opened and separated with respect to one another, a pin adapted for piercing the acetabulum attached to and extending from one end of one of saidelongated members in a direction transverse to that of said movement and to the longitudinal direction of the member from which it extends, and a hook adapted for embracing the femoral bone connected to and extending from the companion end of the other elongated member in the same direction as said pin, said hook having a bight which opens away from said pin, and means cooperating with said elongated members for holding said ends having said pin and hook separated.

2. Apparatus according to claim 1 wherein said members are pivotally coupled at corresponding intermediate portions therealong to provide another pair of corresponding free ends which serve as handles.

3. Apparatus according to claim 2 wherein at least one of said members is of a bent configuration coupled to the other one of said members so that closure of said handles separates said ends having said pin and hook.

bers pivotally connected to one another so that one pair of ends thereof can be opened and separated with respect to one another, a pin adapted for piercing the acetabulum attached to and extending from one end of one of said elongated members in a direction transverse to that of said movement and to the longitudinal direction of the member from which it extends, said pin having an intermediate generally U-shaped cranked portion adapted to accomodate a sciatic nerve and which extends laterally relative to the respective one of said members and away from the other of said members, a hook adapted for embracing the femur bone attached to and extending from the companion end of the other elongated member in the same direction as said pin,

said hook having a bight which opens away from said pin, and means cooperating with said elongated members for holding said ends having said pin and hook separated.

6. The use of a surgical apparatus of the type including a pair of elongated members pivotally connected to one another so that one pair of ends thereof can be opened and separated with respect to one another, an acetabulum bone-piercing pin attached to and extending from one end of one of the elongated members in a direction transverse to the direction of movement of said members and to the longitudinal direction of the member from which the pin extends, and a femoral bone embracing hook attached to and extending from the companion end of the other elongated member in the same direction as said pin, said hook having a bight which opens away from said pin, the use comprising the steps of inserting said pin into the acetabulum, positioning said hook about the femur and separating said acetabulum and said femur by separating said ends having said pin and said hook from one another.

7. The method of claim 6 further comprising the step of positioning the sciatic nerve in a cranked portion of said pint

Claims (7)

1. A surgical apparatus for separation of the femur and acetabulum comprising a pair of elongated members pivotally connected to one another so that one pair of ends thereof can be opened and separated with respect to one another, a pin adapted for piercing the acetabulum attached to and extending from one end of one of said elongated members in a direction transverse to that of said movement and to the longitudinal direction of the member from which it extends, and a hook adapted for embracing the femoral bone connected to and extending from the companion end of the other elongated member in the same direction as said pin, said hook having a bight which opens away from said pin, and means cooperating with said elongated members for holding said ends having said pin and hook separated.
2. Apparatus according to claim 1 wherein said members are pivotally coupled at corresponding intermediate portions therealong to provide another pair of corresponding free ends which serve as handles.
3. Apparatus according to claim 2 wherein at least one of said members is of a bent configuration coupled to the other one of said members so that closure of said handles separates said ends having said pin and hook.
4. The apparatus of claim 1 wherein said means for holding said ends having said pin and hook separated is a latching member.
5. A surgical apparatus for separation of the femur and acetabulum comprising a pair of elongated members pivotally connected to one another so that one pair of ends thereof can be opened and separated with respect to one another, a pin adapted for piercing the acetabulum attached to and extending from one end of one of said elongated members in a direction transverse to that of said movement and to the longitudinal direction of the member from which it extends, said pin having an intermediate generally U-shaped cranked portion adapted to accomodate a sciatic nerve and which extends laterally relative to the respective one of said members and away from the other of said members, a hook adapted for embracing the femur bone attached to and extending from the companion end of the other elongated member in the same direction as said pin, said hook having a bight which opens away from said pin, and means cooperating with said elongated members for holding said ends having said pin and hook separated.
6. The use of a surgical apparatus of the type including a pair of elongated members pivotally connected tO one another so that one pair of ends thereof can be opened and separated with respect to one another, an acetabulum bone-piercing pin attached to and extending from one end of one of the elongated members in a direction transverse to the direction of movement of said members and to the longitudinal direction of the member from which the pin extends, and a femoral bone embracing hook attached to and extending from the companion end of the other elongated member in the same direction as said pin, said hook having a bight which opens away from said pin, the use comprising the steps of inserting said pin into the acetabulum, positioning said hook about the femur and separating said acetabulum and said femur by separating said ends having said pin and said hook from one another.
7. The method of claim 6 further comprising the step of positioning the sciatic nerve in a cranked portion of said pin.
US3840014A 1971-09-24 1972-09-22 Retractor for hip joint surgery Expired - Lifetime US3840014A (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
GB4470971A GB1409051A (en) 1971-09-24 1971-09-24 Hip joint prostheses
GB1079672 1972-03-08

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Cited By (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4457306A (en) * 1982-05-05 1984-07-03 Howmedica, Inc. Tool and method for engaging two members of a joint prosthesis
WO1992016151A1 (en) * 1991-03-20 1992-10-01 Jettman, Per A surgical retractor
US5312403A (en) * 1991-05-03 1994-05-17 Synthes (U.S.A.) External fixation device
US5431653A (en) * 1993-07-06 1995-07-11 Callaway; George H. Knee joint flexion-gap distraction device
US5649929A (en) * 1995-07-10 1997-07-22 Callaway; George Hadley Knee joint flexion-gap distraction device
US20030181912A1 (en) * 1997-02-11 2003-09-25 Michelson Gary K. Anterior cervical plating system and bone screw
US20040172040A1 (en) * 2001-10-19 2004-09-02 Heggeness Michael H. Bone compression devices and systems and methods of contouring and using same
US20050080320A1 (en) * 2003-08-14 2005-04-14 Lee Andrew Max Multiple-blade retractor
US20060004380A1 (en) * 2004-07-02 2006-01-05 Didomenico Scott R Compressor-distractor
US20060074432A1 (en) * 2004-10-06 2006-04-06 Depuy Spine, Inc. Modular medical tool and connector
US7288095B2 (en) 2004-08-12 2007-10-30 Atlas Spine, Inc. Bone plate with screw lock
US7322984B2 (en) 2005-01-06 2008-01-29 Spinal, Llc Spinal plate with internal screw locks
US7438715B2 (en) 2005-01-06 2008-10-21 Spinal Llc Spinal implant kit
US7468069B2 (en) 2004-02-10 2008-12-23 Atlas Spine, Inc. Static anterior cervical plate
US7651497B2 (en) 1997-02-11 2010-01-26 Warsaw Orthopedic, Inc. Segmentable plate with locking element
US7736380B2 (en) 2004-12-21 2010-06-15 Rhausler, Inc. Cervical plate system
US20100312179A1 (en) * 2009-03-17 2010-12-09 Julian Nikolchev Method and apparatus for distracting a joint, including the provision and use of a novel joint-spacing balloon catheter and a novel inflatable perineal post
US20110166579A1 (en) * 2008-06-13 2011-07-07 Mark Deem Devices and methods for minimally invasive access into a joint
US8721649B2 (en) 2009-12-04 2014-05-13 Pivot Medical, Inc. Hip joint access using a circumferential wire and balloon
US8956365B2 (en) 2009-03-17 2015-02-17 Pivot Medical, Inc. Method and apparatus for distracting a joint
US8986311B2 (en) 2008-06-13 2015-03-24 Pivot Medical, Inc. Methods and apparatus for joint distraction
US9186181B2 (en) 2009-03-17 2015-11-17 Pivot Medical, Inc. Method and apparatus for distracting a joint

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5147408A (en) * 1988-10-07 1992-09-15 Pfizer Hospital Products Group, Inc. Prosthetic device and method of implantation

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US569839A (en) * 1896-10-20 John t
US815907A (en) * 1905-03-27 1906-03-20 Cleveland G Davis Dental expander or dilator.
FR511203A (en) * 1920-03-08 1920-12-20 Lucas Rojas Pineiro New surgical instrument
US3038467A (en) * 1960-08-29 1962-06-12 Sklar Mfg Co J Surgical instrument
US3750652A (en) * 1971-03-05 1973-08-07 J Sherwin Knee retractor

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Publication number Priority date Publication date Assignee Title
US569839A (en) * 1896-10-20 John t
US815907A (en) * 1905-03-27 1906-03-20 Cleveland G Davis Dental expander or dilator.
FR511203A (en) * 1920-03-08 1920-12-20 Lucas Rojas Pineiro New surgical instrument
US3038467A (en) * 1960-08-29 1962-06-12 Sklar Mfg Co J Surgical instrument
US3750652A (en) * 1971-03-05 1973-08-07 J Sherwin Knee retractor

Cited By (48)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4457306A (en) * 1982-05-05 1984-07-03 Howmedica, Inc. Tool and method for engaging two members of a joint prosthesis
WO1992016151A1 (en) * 1991-03-20 1992-10-01 Jettman, Per A surgical retractor
US5429121A (en) * 1991-03-20 1995-07-04 Per Jettman Surgical retractor
US5312403A (en) * 1991-05-03 1994-05-17 Synthes (U.S.A.) External fixation device
US5431653A (en) * 1993-07-06 1995-07-11 Callaway; George H. Knee joint flexion-gap distraction device
US5649929A (en) * 1995-07-10 1997-07-22 Callaway; George Hadley Knee joint flexion-gap distraction device
US7625381B2 (en) 1997-02-11 2009-12-01 Warsaw Orthopedic, Inc. System and method for stabilizing a portion of the spine
US20030191472A1 (en) * 1997-02-11 2003-10-09 Michelson Gary K. Multilock anterior cervical plating system
US20030191471A1 (en) * 1997-02-11 2003-10-09 Michelson Gary K. Multilock anterior cervical plating system
US6712818B1 (en) 1997-02-11 2004-03-30 Gary K. Michelson Method for connecting adjacent vertebral bodies of a human spine with a plating system
US8641743B2 (en) 1997-02-11 2014-02-04 Warsaw Orthopedic, Inc. Orthopedic implant with locking element
US8480717B2 (en) 1997-02-11 2013-07-09 Warsaw Orthopedic, Inc. Orthopedic implant with locking element
US6926718B1 (en) 1997-02-11 2005-08-09 Gary K. Michelson Multilock anterior cervical plating system
US6936051B2 (en) 1997-02-11 2005-08-30 Gary K. Michelson Multilock anterior cervical plating system
US6936050B2 (en) 1997-02-11 2005-08-30 Gary K. Michelson Multilock anterior cervical plating system
US6969390B2 (en) 1997-02-11 2005-11-29 Michelson Gary K Anterior cervical plating system and bone screw
US8262708B2 (en) 1997-02-11 2012-09-11 Warsaw Orthopedic, Inc. Single-lock plating system
US8048075B2 (en) 1997-02-11 2011-11-01 Warsaw Orthopedic, Inc. Orthopedic implant with locking element
US7651497B2 (en) 1997-02-11 2010-01-26 Warsaw Orthopedic, Inc. Segmentable plate with locking element
US7704255B2 (en) 1997-02-11 2010-04-27 Warsaw Orthopedic, Inc. Threadless multi-lock anterior cervical plating system
US8123788B2 (en) 1997-02-11 2012-02-28 Warsaw Orthopedic, Inc. Plating system having retaining member that permits movement of at least one bone fastener
US20030181912A1 (en) * 1997-02-11 2003-09-25 Michelson Gary K. Anterior cervical plating system and bone screw
US20040172040A1 (en) * 2001-10-19 2004-09-02 Heggeness Michael H. Bone compression devices and systems and methods of contouring and using same
US20050080320A1 (en) * 2003-08-14 2005-04-14 Lee Andrew Max Multiple-blade retractor
US7481766B2 (en) 2003-08-14 2009-01-27 Synthes (U.S.A.) Multiple-blade retractor
US7468069B2 (en) 2004-02-10 2008-12-23 Atlas Spine, Inc. Static anterior cervical plate
US8753348B2 (en) 2004-07-02 2014-06-17 DePuy Synthes Products, LLC Compressor-distractor
US9351773B2 (en) 2004-07-02 2016-05-31 DePuy Synthes Products, Inc. Compressor-distractor
US20060004380A1 (en) * 2004-07-02 2006-01-05 Didomenico Scott R Compressor-distractor
US7288095B2 (en) 2004-08-12 2007-10-30 Atlas Spine, Inc. Bone plate with screw lock
US20060074432A1 (en) * 2004-10-06 2006-04-06 Depuy Spine, Inc. Modular medical tool and connector
US8979857B2 (en) 2004-10-06 2015-03-17 DePuy Synthes Products, LLC Modular medical tool and connector
US7736380B2 (en) 2004-12-21 2010-06-15 Rhausler, Inc. Cervical plate system
US7322984B2 (en) 2005-01-06 2008-01-29 Spinal, Llc Spinal plate with internal screw locks
US7438715B2 (en) 2005-01-06 2008-10-21 Spinal Llc Spinal implant kit
US20110166579A1 (en) * 2008-06-13 2011-07-07 Mark Deem Devices and methods for minimally invasive access into a joint
US9526486B2 (en) 2008-06-13 2016-12-27 Pivot Medical, Inc. Methods and apparatus for joint distraction
US9179904B2 (en) 2008-06-13 2015-11-10 Pivot Medical, Inc. Methods and apparatus for joint distraction
US8974462B2 (en) 2008-06-13 2015-03-10 Pivot Medical, Inc. Devices and methods for minimally invasive access into a joint
US8986311B2 (en) 2008-06-13 2015-03-24 Pivot Medical, Inc. Methods and apparatus for joint distraction
US9532864B2 (en) 2008-06-13 2017-01-03 Pivot Medical, Inc. Devices and methods for minimally invasive access into a joint
US9033992B2 (en) 2008-06-13 2015-05-19 Pivot Medical, Inc. Methods and apparatus for joint distraction
US8900243B2 (en) 2009-03-17 2014-12-02 Pivot Medical, Inc. Method and apparatus for distracting a joint, including the provision and use of a novel joint-spacing balloon catheter and a novel inflatable perineal post
US9186181B2 (en) 2009-03-17 2015-11-17 Pivot Medical, Inc. Method and apparatus for distracting a joint
US9492152B2 (en) 2009-03-17 2016-11-15 Pivot Medical, Inc. Method and apparatus for distracting a joint
US20100312179A1 (en) * 2009-03-17 2010-12-09 Julian Nikolchev Method and apparatus for distracting a joint, including the provision and use of a novel joint-spacing balloon catheter and a novel inflatable perineal post
US8956365B2 (en) 2009-03-17 2015-02-17 Pivot Medical, Inc. Method and apparatus for distracting a joint
US8721649B2 (en) 2009-12-04 2014-05-13 Pivot Medical, Inc. Hip joint access using a circumferential wire and balloon

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