WO1993007807A1

WO1993007807A1 - Device for x-ray photography

Info

Publication number: WO1993007807A1
Application number: PCT/FI1992/000275
Authority: WO
Inventors: Rolf Eero Aleksander Gullichsen
Original assignee: Gullichsen Rolf E A
Priority date: 1991-10-25
Filing date: 1992-10-16
Publication date: 1993-04-29
Also published as: GB2275593A; AU2768792A; FI923207A; GB9407553D0; DE4293569T1; FI923207A0

Abstract

The object of the invention is a device (20) used in X-raying, in which the limb (50) to be X-rayed is placed. The device comprises either a rack (32, 33 and 34) in which the X-ray film cassette (40) is placed vertically, or slots (72, 73, 74, 75, 76) are formed in the vertical walls of the device for inserting the X-ray film cassette (40). The device is intended to be used as an aid to simplify and speed up the outpatient X-ray photography performed during surgery on fractures especially of the ankle and foot.

Description

DEVICE FOR X-RAY PHOTOGRAPHY

The object of the invention is a device intended to be used as an aid in the X-ray photography of limbs in connection with surgery or outpatient procedures.

Different types of limb injuries often have to be treated in operating theatres and outpatient departments. In treating fractures, it is important that the fractured bones can be placed as accurately as possible in the position they were in before sustaining the injury. Once the corrective procedure has been performed, the position of the bones is checked by means of X-ray photography. In severe cases, the injured part may have to be X-rayed several times, even during the operation.

The problem in such operations is that it is difficult to place the limb to be X-rayed in exactly the right position for X-raying. It is even worse if the position of the part of the body being X-rayed varies when several X-ray pictures are taken in succession. As a result, the comparability of the pictures taken at different stages of the operation is poor, and the interpretation of the pictures may thus even lead to incorrect analyses.

Difficulties in X-raying occur especially in operations concerning the ankle and the foot. In these parts of the body there are many small bones, the position of which cannot be assessed accurately without X-raying the bone by means of an X-ray machine. Producing the appropriate X-ray pictures from the front and side repeatedly during surgery has, however, been unreliable, and thus the positions of the ankle and foot are not necessarily always the same in pictures taken at different stages of an operation.

An additional problem in operations of the lower limbs is that the amount of time available is limited. This is because the leg is in a bloodless state during the operation. The time available for the operation is only about two hours. Taking an X-ray picture and developing the film during an operation usually takes about 15 minutes. If the X-ray picture taken in connection with an operation is found to be difficult to interpret, the X-raying can be repeated. There is, however, no room for a second failure, because the time available for the operation does not allow it.

Successful X-ray photography requires that all the factors affecting the photography can be accurately determined in advance. The most important factor is for the part of the body to be X-rayed to be located and positioned exactly right. It must also be possible to repeat it as many times as required. It must obviously also be possible to place the cassette containing X-ray film always in the same place with respect to the part to be X-rayed in order to render the pictures fully comparable with each other.

The known auxiliary equipment intended for solving the above problem is insufficient. In practice there is no predetermined place for the limb for the X-raying. Surgical cloth packages and other miscellaneous material available in the operating theatre, such as the film cassette holder tripods on wheels, have been used to support the limb during X-raying. It is obvious that X-raying with the help of this type of equipment is slow and inaccurate.

Another considerable disadvantage in this connection is that the tripods moving on wheels and other similar operating theatre equipment are not sterile. Such objects should not be brought near the part to be operated. Thus the known X-raying practice is also a great threat to the sterility of the operation.

German patent publication DE 2017159 describes a device in which the part of the body to be X-rayed is placed for the X-raying. This publication does not, however, concern a device for X-raying limbs, but is a device used in X-raying skull injuries. It should also be noted that it is not suitable for use in connection with surgery.

German patent publication DE 2920394 concerns a device for taking stress X-rays for the purpose of examining ligament injuries. This patent publication does not discuss problems relating to X-ray photography during surgery, and nor does it present a device solution for positioning the X-ray film cassette.

The purpose of the present invention is to achieve a device for solving the above problem. The device belongs within the scope of radiology and operative orthopedics and traumatology, and is intended to simplify and speed up X- raying performed during surgery on fractures of a limb, ankle or foot, and X-raying in outpatient circumstances.

It is characteristic of the invention that the device comprises a base on which the limb to be X-rayed can be placed and, connected to the base, at least one rack into which the X-ray film cassette can be placed, or that in at least one of the side walls, or the rear wall, of the device a slot is formed, into which the X-ray film cassette can be inserted. The device comprises a place for the part to be operated on and a place for the cassette containing X-ray film. In this way the part to be X-rayed can always be positioned in the same place and position in the device, and the X-ray film cassette can be placed in a specifically determined place and position with respect to the part to be X-rayed.

When the device is used, for example, for repeated X-raying during surgery, the pictures are comparable, as all pictures show the same projections. In this way can be ensured that, for example, the articular process, fractures and osteosynthesis material, such as screws, plates, etc are in the corresponding positions and the desired radiological change has been achieved.

According to one embodiment of the invention, the base forms a trough together with the vertical walls, in which the foot to be X-rayed can be placed for X-raying the ankle and/or metatarsus. In X-raying fractures, the preferable device used is a half-open plastic prism in structure. According to one embodiment it comprises at least one cassette rack limited by a vertical wing on the outer side of the prism, in which the sterile X-ray cassette is placed. In this type of a device the foot to be operated on is also well protected from impurities.

Preferably the side walls and rear wall of the device are provided with slots, in which the X-ray film cassette can be placed. The accuracy of X-raying is particularly good with this device because the plastic layer through which the X rays must pass is thin in this solution.

The device is either disposable or sterilizable. Since the device can be made, for example, of plastic, it does not show in an X-ray picture.

The invention is described in the following by means of examples, with reference to the appended drawings in which

Figure 1 shows a perspective view of the device relating to the invention. Figure 2 shows the device of figure 1 as seen from above during X-raying of the ankle.

Figure 3 shows a cross-section of figure 2 along line

III-III. Figure 4 shows a cross-section of figure 2 along line

IV-IV. Figure 5 corresponds to figure 3 and shows a second embodiment of the device relating to the invention. Figure 6 shows the device shown in figure 5 as seen from above during X-raying of a limb. Figure 7 corresponds to figure 1 and shows a third embodiment of the device relating to invention. Figure 8 shows a cross-section of figure 7 along line VIII-VIII.

Figure 9 shows a cross-section of figure 7 along line

IX-IX. Figure 10 shows the devices of figure 7 stacked one on top of another. Figure 11 shows a fourth embodiment of the device. Figure 12 shows the device of figure 11 as seen from another angle.

Figure 1 shows a perspective view of the device 20 relating to the invention. The figure shows that the device 20 comprises a bottom 21, side walls 22 and 23 and a rear wall 24. This embodiment has been made for X-raying the ankle. The limb to be X-rayed is placed in the support so that the ankle rests in the trough 25 formed by the walls 22, 23 and 24, on the bottom 21. Cassette racks 32, 33 and 34 formed by the bottom surfaces 26, 27 and 28 and the vertical surfaces 29, 30 and 31, are formed on three sides of the device for the X-ray film cassette used in the X-raying. Depending on which direction the X-ray picture is to be taken from, the film cassette can be placed alternatively in any of these racks, between one of the vertical surfaces 29, 30 or 31, and the corresponding side or rear wall of the trough 25.

The device 20 shown in figure 1 is made of plastic, thus rendering its structure light but, however, sufficiently sturdy to give stable support for the duration of the X- raying. All the edges of the device are rounded, because sharp edges might tear the surgical gloves or the patient's skin. Similarly, all the interior corners are also rounded. Thus no such cavities are formed which might collect impurities. It is important that any blood clots that have adhered to the surface of the device during surgery are easily removable and the device can be sterilized for further use.

Figure 2 shows the device 20 of figure 1 as seen from above in a situation where the ankle 51 is X-rayed. The foot 50 is placed in the device 20 so that the ankle 51 rests in the trough limited by the side walls 22 and 23 and the rear wall 24. The direction of the X rays used in taking the X- ray pictures is shown in the figure by an arrow 42. The X rays penetrating the ankle 51 thus form a side view of the ankle bones on the film 40. By means of the device shown in figure 2, both the part 51 to be X-rayed 51 and the X-ray film cassette 40 stay in their precisely defined places, which means that successive pictures taken at different stages are also fully comparable.

The size of the film normally used in X-ray photography is 18 x 24 cm. The X-ray film cassette 40 made for this film size is somewhat larger and its thickness is about 13 mm. In the embodiment shown in figure 2, the distances between the vertical walls 22, 23 and 24 and the vertical surfaces 29, 30 and 31 of the device 20 are about 20 mm, so that a sterile X-ray film cassette 40 enclosed in a plastic bag will fit well into any of these spaces. The length of the space intended for the ankle 51 in the device 20 is 20 - 25 cm, or about one third of the length from the sole to the knee.

Figure 3 shows a cross-section of the device 20 as shown in figure 2. The figure shows that the foot 50 rests in its accurately determined place in the trough 25, on the bottom 21 and between the side walls 22 and 23. Thus the cut surfaces of the foot 50 are protected between the walls of the sterile device 20. No adjustments are required in the device 20, because the foot 50 to be operated on will always stay firmly in place in the trough between the vertical walls 22 and 23 of the device 20 relating to the invention. If required, however, any filler material can be used in the trough to support the foot 50.

In figure 3, an X-ray film cassette 40 has been placed in the cassette rack on the left-hand side of the device 20, and the direction of the X rays is shown by reference number 42. Obviously, the film cassette 40 can alternatively also be placed on the opposite side of the device 20, in cassette rack 32. Due to the structure of the device, both the part 50 to be X-rayed and the film 40 are always in accurately determined positions, thus rendering pictures taken at different stages fully comparable with each other.

Figure 3 shows that in device 20, the bottom 21 of the trough 25 intended for the limb 50 to be X-rayed is higher than the bottom level 26 of the cassette rack 32. This arrangement ensures that the part to be X-rayed will definitely be shown completely on the X-ray film 40. If the bottom 21 of the trough 25 was on the same level as the bottom of the cassette rack 32, a part of the heel of the foot 50 to be X-rayed might remain outside the picture.

Figure 4 shows a longitudinal section of the device 20 as shown in figure 2. The foot 50 is placed in the device 20 so that the heel rests on the bottom 21 of the trough and the sole rests against the vertical rear wall 24. The foot will thus always remain at a 90° angle. The X-ray film cassette 40 has been placed in the cassette rack between the rear wall 24 and the vertical plane 31 parallel with it. The mainly horizontal X rays are marked by reference number 42. In this way, the metatarsus 52 can be photographed from above.

Figure 5 shows a second embodiment of the device relating to the invention, which is intended for the general X- raying of a limb or its joints. The device 60 shown in figure 5 does not comprise a trough formed by three vertical walls, as the embodiment shown in the previous figures, but instead the device is open. In figure 5, the limb to be X-rayed is only shown diagrammatically by a broken line 50 and is, for example, the knee area on a leg, but the joint surfaces of the wrist or elbow can equally well be X-rayed with the device 60. The leg 50 rests supported on the bottom 61 of the device 60 and rests against the vertical wall 62 on the side. The weight of the leg thus keeps the device 60 well in place. The X-ray film cassette 40 is placed in the cassette rack which remains between the vertical wall 62 and the vertical plane 63 parallel with it. The X-ray film cassette 40 is always placed on the inner side of the leg 50.

Figure 5 shows that the bottom 61 of device 60 incorporates a support part 65, which meets the base 43. In addition, the bottom 61 forms an angle with the base 43. The inclination is not a prerequisite for the functioning of the device, but in this embodiment the purpose of the inclination is that the leg 50 falls automatically into place against the vertical wall 62.

Figure 6 shows, from above, a situation where two such devices 60 as shown in figure 5 are used to aid in X-raying the leg 50. This arrangement can be used especially where there is a tendency for the limb to rotate during X-raying. In this case, the leg 50 rests on the bottoms 61 of the devices 60a and 60b, supported between the vertical walls 62 of the devices 60a and 60b placed on both sides of the leg 50. The X-ray film cassette 40 is positioned in place in figure 6 on the left side of the leg 50, between the vertical wall 62 and vertical plane 63. The X rays 42 are directed towards the leg from the side opposite to the X- ray film cassette 40.

Figure 7 shows an embodiment of the device of figure 1 which is made of a single plate, such as a plastic plate, by bending. In this case the bottom 21, side walls 22 and 23, and rear wall 24 of the trough 25 of the device 20, and the bottom planes 26, 27 and 28, and vertical planes 29, 30 and 31 of the X-ray film cassette racks are all of the same plate. This solution is preferable from the point of view of both manufacture and storage. This type of a device 20 is also light. All corners can also be suitably rounded to prevent damage to the tissue of the possibly swollen foot to be X-rayed during surgery.

Figure 8 shows a cross-section of the device 20 of figure 7. The figure clearly shows the structure of the device bent from a single plate and its rounded corners. Figure 9 correspondingly shows a longitudinal section of the device. For the sake of illustration, the plate material of the device 20 has been shown to be relatively thick in the figures. In practice, however, the thickness may vary considerably. Also for the sake of illustration, the inclination of the vertical walls 22, 23, 29, 30 and 30 has been slightly exaggerated. In practice they may be almost vertical.

Figure 10 shows the devices 20 of figures 7 - 9 stacked on top of each other for storage or transportation. The figure shows that the devices take up little space. In practice it should be possible to pack them even tighter than shown in figure 10. Otherwise, too, all the embodiments shown in the figures of the drawings can in practice always be designed to suit the need.

Figure 11 shows a fourth embodiment of the device. In the vertical walls of the device slots 72, 73, 74 have been formed, into which the X-ray film cassette can be inserted. The horizontal slot 74 has been continued as vertical slots 75, 76 on both side walls. This structure is particularly advantageous, because it ensures that the X-ray film cassette, the upper part of which is wider than the distance between the slots 75 and 76, stays well in place. Figure 12 also shows a horizontal slot 77, made on the lower edge of the rear wall, in which the X-ray film cassette can be placed when the limb is to be X-rayed from below.

It is obvious to a person skilled in the art that the different embodiments of the invention may vary within the scope of the claims presented below.

Claims

1. A device for X-ray photographing limbs, characterized in that the device (20, 60) comprises a base (21, 61) on which the limb (50) to be X-rayed can be placed, and at least one rack (32, 33 and 34), connected to the base, in which the X-ray film cassette (40) can be placed, or that in at least one of the vertical side walls (22, 23), or the rear wall (24), of the device a slot is formed (72, 73, 74), into which the X-ray film cassette can be inserted.

2. A device as claimed in claim 1, characterized in that the base (21, 61) is mainly horizontal, and the X-ray film cassette rack (32, 33 and 34) comprises two mainly vertical and parallel walls (22 and 29, 23 and 30, 24 and 31), between which the X-ray film cassette (40) can be placed vertically.

3. A device as claimed in claim 1, characterized in that the base (21, 61) is located higher in the device than the bottom (26, 27, 28) of the X-ray film cassette rack (32, 33 and 34) .

4. A device as claimed in claim 1, 2 or 3 characterized in that the base (21) forms together with the vertical walls

(22, 23, 24) a trough (25) into which the foot (50) to be X-rayed can be placed to X-ray the ankle and/or metatarsus.

5. A device as claimed in claim 4, characterized in that on three sides of the trough (25) racks (32, 33 and 34) are formed, in any of which an X-ray film cassette (40) can be placed in a vertical position.

6. A device as claimed in any of the claims 1 - 5, characterized in that the device (20) is made from a single plate, preferably a plastic plate, by forming.

7. A device as claimed in claim 6, characterized in that the device (20) can be stacked on top of other similar devices so that the devices partly overlap inside each other.

8. A device (20) as claimed in claim 1, characterized in that a slot (72, 73, 74) is formed on at least one vertical side wall (22, 23), or the rear wall (24), of the device (20) for inserting the X-ray film cassette (40).

9. A device (20) as claimed in claim 8, characterized in that slots (72, 73) are formed on both side walls (22, 23) and a slot (74) is formed on the rear wall (24) for inserting the X-ray film cassette (40).

10. A device (20) as claimed in claim 9, characterized in that the slot (74) has been continued as vertical slots (75, 76) on both side walls (22, 23).

11. A device as claimed in claim 1, 2 or 3, characterized in that the base (61) of the device (60) forms an angle with the vertical plane so that the limb (50) to be X- rayed, which is placed on the base, comes to rest against the vertical wall (62) .