WO2019173536A1 - Leg ramp for radiology - Google Patents

Abstract

A device for supporting a patient's limb, such as a patient's lower leg, includes a base section and a separate insert section configured to be positioned within the base section and to be longitudinally translatable within the base section. The base section includes a bottom surface and a pair of opposing sidewalls disposed on opposite sides of a longitudinal axis. The support device includes longitudinal slots and transverse slots for beneficially holding x-ray cassettes.

Description

LEG RAMP FOR RADIOLOGY

BACKGROUND

[0001] Radiological imagery of an injured limb is often required before, during, and after surgery. To obtain good images, the limb must be appropriately positioned. Typically, a C-arm x-ray machine is used during surgery for fluoroscopic intraoperative imaging. X-ray cassettes are also utilized to obtain various different views of the limb. An x-ray cassette is placed next to the limb in the orientation of the view needed, and the limb and cassette are then exposed to x-ray radiation sufficient to obtain the desired images.

[0002] Often, there are challenges in obtaining suitable images. For example, it may be difficult to properly position the targeted limb with respect to an x-ray cassette or C- arm. Other limbs may lie in the x-ray path and interfere with the imagery. Often, personnel will be required to manually hold an x-ray cassette next to the limb to obtain the desired imagery. This undesirably exposes the personnel to x-ray radiation.

[0003] Further, the patient’s limb is typically injured and care must be taken to adjust its position. In light of these challenges, there is a long felt and ongoing need to provide devices and methods capable of supporting a patient’s limb, providing easy adjusting of limb position, and enabling better positioning of the limb for obtaining radiological images.

BRIEF SUMMARY

[0004] The present disclosure describes support devices for supporting a patient’s limb, such as for supporting a patient’s lower leg. In one embodiment, a support device includes a base section and a separate insert section. The insert section is configured to be capable of being positioned within the base section and to be longitudinally translatable relative to the base section. The insert section has a width that is smaller than a width of the base section so that when the insert section is placed within the base section at least one longitudinal slot is formed.

[0005] The base section may include a bottom surface extending along a longitudinal axis and a pair of opposing sidewalls each disposed on opposite ends of the longitudinal axis. When the insert section is placed within the base section, the space between the sides of the insert section and the sidewalls of the base section define the one or more longitudinal slots. The one or more longitudinal slots function to hold an x-ray cassette for obtaining lateral views of the patient’s limb. [0006] The base section and insert section may include structural alignment features that aid in properly aligning the separate sections and/or maintain alignment of the separate sections when the insert section is translated relative to the base section. For example, the base section may include a rail extending substantially parallel to the longitudinal axis, and the insert section may include a corresponding groove allowing the insert section to be received into the base section and to ride along the rail.

[0007] The ability to adjust the relative longitudinal positions of the separate pieces allows a surgeon or other user to easily adjust the way the patient’s leg is oriented upon the device. For example, during surgery the surgeon may want to adjust the position or elevation of the leg by sliding/translating the insert piece.

[0008] The ability of the device to be separated into separate pieces also aids in cleaning and sterilization of the device. Each separate section may be easily sprayed, washed, exposed to ultraviolet light, or otherwise sterilized. Because the sections are separable, the different surfaces of the device may be fully exposed and easily cleaned. In contrast, a patient support device having slots or grooves but not having separable pieces will have areas capable of collecting fluids or debris.

[0009] In some embodiments, the base section includes a pair of transverse slots disposed near a distal end and aligned with one another on opposite sides of the longitudinal axis. The transverse slots may be configured to hold an x-ray cassette. For example, the transverse slots can beneficially allow an x-ray cassette to be held in position next to the patient’s foot for obtaining A/P views of the foot.

[0010] When an x-ray cassette is in position within the transverse slots, it can also act as a support surface for holding the patient’s foot in a proper upward orientation. Without support, the patient’s leg may tend to rotate outwardly away from vertical. The transverse slots beneficially allow the cassette to be positioned right up against the foot so that it can support the foot and minimize or prevent outward rotation.

[0011] In some embodiments, the base section, the insert section, or preferably both sections are formed of a foam material coated with a water-impermeable polymer. The foam material provides comfortable and soft tactile properties while the coating can prevent contamination and allows for easy cleaning.

BRIEF DESCRIPTION OF THE DRAWINGS

[0012] To further clarify the above and other advantages and features of the present disclosure, a more particular description will be rendered by reference to specific embodiments illustrated in the appended drawings. It is appreciated that these drawings depict only illustrated and exemplary embodiments of the disclosure and are therefore not to be considered limiting of its scope. Exemplary embodiments of the disclosure will be described with additional specificity and detail through the use of the accompanying drawings in which:

[0013] Figures 1A and 1B illustrate separate sections of an exemplary ramp device for supporting a patient’s limb;

[0014] Figure 2 illustrates the ramp device with the separate sections assembled, showing translation of the insert section relative to the base section;

[0015] Figure 3 illustrates a patient’s lower leg positioned on the ramp device with an x-ray cassette securely held in place by a longitudinal slot to enable a lateral view x- ray; and

[0016] Figure 4 illustrates a patient’s lower leg positioned on the ramp device with an x-ray cassette securely held in place by a pair of transverse slots to enable an A/P view x-ray.

DETAILED DESCRIPTION

[0017] Figure 1A illustrates a view of an exemplary ramp device 100. The ramp device includes a base section 104 and a separate insert section 102. The insert section 102 is configured to fit within the base section 104. As shown, the insert section 102 includes a groove 108 and the base section 104 includes a corresponding rail 118. The groove 108 and the rail 118 are sized to match one another so that when the insert section 102 is positioned within the base section 104, the groove 108 of the insert section 102 fits over the rail 118 of the base section 104. This beneficially allows the insert section 102 to ride upon the rail 118 and enables the insert section 102 to be longitudinally translated relative to the base section 104 in a controlled fashion. Figure 1B illustrates the insert section 102 with a view of its bottom surface to better show the slot 108.

[0018] Other embodiments may other structural features that allow the insert section 102 to longitudinally translate relative to the base section 104 in addition to or as an alternative to the illustrated groove 108 and rail 118. For example, other embodiments may reverse the positions of the groove 108 and rail 118 such that the insert section 102 includes a rail and the base section 104 includes a corresponding groove sized to receive the rail. Some embodiments may additionally or alternatively include one or more notches, detents, tabs or other structural positioning features.

[0019] The insert section 102 is formed with an angled surface 106 at its proximal end and a flat surface 109 extending to the distal end. In the illustrated embodiment, the flat surface 109 makes up approximately 60 to 90% of the length of the insert section 102, with the angled surface 106 making up the remainder. The overall length of the device may range from about 18 to 48 inches, or more preferably about 24 to 36 inches. The angled surface 106 preferably forms an angle of about 20 to 70 degrees, or about 30 to 60 degrees, or about 40 to 50 degrees from horizontal. The height of the device 100 may be within a range of about 3 to 10 inches, or more preferably about 4 to 8 inches. While the foregoing dimensional features have been found to meet typical application needs, these features may be adjusted as needed to better meet other particular application circumstances or patient requirements (e.g., younger patients).

[0020] The device height, the angle of the angled surface 106, and the relative lengths of the flat surface 109 and angled surface 106, when provided within the foregoing ranges, provide effective elevation of the leg at the knee without overly raising the leg. The flat surface 109 is preferable to a continually angled/tapering surface because it allows the lower leg to be oriented in a flat, horizontal position during surgery. A surgeon may want the targeted leg to be raised enough to provide easier access while on the operating table and to separate it from the non-targeted leg, but may simultaneously prefer or require that the lower leg remain substantially horizontal. The flat surface 109 is therefore preferably substantially horizontal, but in some embodiments may have an angle that varies by ± 5 to 10 degrees from horizontal.

[0021] The base section 104 includes a substantially flat, bottom surface 105. The rail 118 is disposed in the approximate center of the bottom surface 105, though may be alternatively positioned, as described above, and extends along a longitudinal axis of the base section 104. A pair of vertically extending sidewalls 110 are joined to the bottom surface 105 on opposite sides of the longitudinal axis. The sidewalls 110 preferably have a flat surface 111 and an angled surface 112. Preferably, the sidewalls 110 rise to a height that substantially matches the height of the insert section 102 when the insert section 102 is placed within the base section 104, and the angled surface 112 preferably has an angle that substantially matches that of the angled surface 106 of the insert section 102. In this manner, each section will form matching surfaces when the insert section 102 is placed within the base section 104 and the angled ends of each separate section are aligned with one another.

[0022] The base section 104 also includes a pair of transverse slots 114 located near the distal end of the base section 104 and substantially aligned with one another on opposite sides of the longitudinal axis. Each transverse slot 114 extends transversely through each respective sidewall 110. As explained in more detail below, the transverse slots 114 allow for an x-ray cassette to be securely positioned within the base section 104 at an orientation useful for obtaining x-ray images of the foot. For example, the transverse slots 114 can beneficially allow an x-ray cassette to be held in position next to the patient’ s foot for obtaining A/P views of the foot.

[0023] Figure 2 illustrates the ramp device 100 with the insert section 102 positioned within the base section 104. The base section 104 is sized so that the width between each opposing sidewall 110 is at least slightly greater than a width of the insert section 102. This provides sufficient space so that when the insert section 102 is placed within the base section 104, there is sufficient space on either side of the insert section 102 to form a pair of longitudinal slots 115. The longitudinal slots 115 are also preferably configured in size and shape to function to hold an x-ray cassette for taking lateral view x-rays of the leg.

[0024] Figure 2 also illustrates adjustment of the device by longitudinal translation of the insert section 102 relative to the base section 104. The rail 118 and corresponding groove 108 (and/or other structural positioning features) function to align the separate pieces and ensure that the insert section 102 is properly centered within the base section 104. The ability to adjust the relative longitudinal positions of the separate pieces allows a surgeon or other user to easily adjust the way the patient’s leg is oriented upon the device. For example, during surgery the surgeon may want to adjust the position or elevation of the leg by sliding/translating the insert piece 102.

[0025] The illustrated ramp device 100 may be formed of any material or combination of materials suitable for use in an operating room, hospital, doctor’s office, physical therapy center, and the like. In preferred embodiments, the separate pieces are each formed of a foam material that is coated in a water-impermeable polymer coating. The foam construction makes the device light in weight and allows it to be comfortable, soft, and supportive of the patient’s limb. The waterproof polymer coating prevents contamination of the underlying foam and allows for easy cleaning and sterilization of the device.

[0026] Further, the ability of the device to be separated into separate pieces aids in cleaning and sterilization of the device. Each separate section may be easily sprayed, washed, exposed to ultraviolet light, or otherwise sterilized. Because the sections are separable, the different surfaces of the device may be fully exposed and easily cleaned. In contrast, a patient support device having slots or grooves but not having separable pieces will have areas capable of collecting fluids or debris. These areas will also be more difficult to wash or clean, and will therefore be at higher risk of being contaminated/unsterile, which can be a significant problem in medical settings such as operating rooms.

[0027] For example, a patient support device having slots for holding x-ray cassettes but not having separable sections exposing the slots will be a challenge to clean. In such devices, the cassette slots may act as reservoirs for collecting fluids and debris. Further, even if such slots remain free of fluids or debris, they will still be difficult to access and clean properly. In the context in which the ramp device 100 is intended to be used, it is important that a clean and sterile environment be consistently and easily obtained.

[0028] Figures 3 and 4 illustrate exemplary use of the device for supporting a patient’s lower leg 10 and for positioning corresponding x-ray cassettes. Figure 3 illustrates the leg 10 in position upon the device and an x-ray cassette 12 positioned securely within one of the longitudinal slots 115 for obtaining a lateral view x-ray.

[0029] As shown, the longitudinal slot 115 has a depth sufficient to securely hold the cassette 12. Because of the shape of the flat surface of the insert section, the depth of the longitudinal slot 115 is also substantially the same across most of its length (e.g., across greater than 60%, 70%, 80%, or 90% of its length). This allows the cassette 12 to be approximately equally secured at all points along the portion of its length within the slot 115. In contrast, a slot adjacent to angled or variable height sidewalls would hold some portions of the cassette less firmly than others. For example, where the sidewalls are relatively lower, the slot will be shallower and will therefore hold corresponding portions of the cassette less securely.

[0030] Figures 3 and 4 also illustrate that the ramp device 100 is preferably sized to support a single leg, and not both patient legs. For example, the overall width of the device is preferably no more than about 24 inches, more preferably no more than about 18 inches, and even more preferably no more than about 12 inches. As a minimum, the width of the device should be at least about 6 inches.

[0031] Sizing the device to support a single leg provides sufficient space for the other leg to be positioned next to the supported leg in a position lower than the supported leg. This removes lateral interference when viewing the supported leg. For example, during surgery a C-arm x-ray machine is used to perform fluoroscopic intraoperative imaging. This imaging is made more effective by raising the targeted leg and allowing the non-targeted leg to remain in a lower position. The ramp device may additionally or alternatively be used to obtain lateral views using an x-ray cassette 12, as shown in Figure 3.

[0032] Figure 4 illustrates use of the ramp device 100 to obtain an anterior/posterior (“A/P”) view of the targeted leg 10. As shown, the x-ray cassette 11 is securely held within the transverse slots 114 where it may be positioned adjacent to the bottom of the patient’s foot. The insert section may be adjusted relative to the base section as needed to move the foot to a desired position relative to the cassette 11.

[0033] When the cassette 11 is in position within the transverse slots 114, it can also act as a support surface for holding the patient’s foot in a proper upward orientation. Without support, the patient’s leg 10 will tend to rotate outwardly away from vertical. The transverse slots 114 beneficially allow the cassette 11 to be positioned right up against the foot so that it can support the foot and minimize or prevent outward rotation. In some embodiments, a groove or depression (not shown) for holding and stabilizing the patient’s heel may be formed near the end of the insert section. Such a feature may be additionally or alternatively utilized to prevent the patient’s foot from rotating outward.

[0034] As shown in Figures 3 and 4, the ability of the ramp device 100 to securely hold the cassettes 11 and/or 12 beneficially allows x-ray imaging to take place without the need for personnel to manually hold the cassette in place. Often, particularly when obtaining A/P views, an assistant is required to manually hold the cassette in place while x-ray radiation is passed through the patient. The ramp device 100 therefore beneficially reduces exposure of personnel to harmful x-ray radiation.

[0035] As the transverse slots 114 and the longitudinal slots 115 are configured in size and shape to be capable of holding x-ray cassettes, the transverse slots 114 and longitudinal slots 115 are preferably dimensioned with a width that substantially matches the width of a typical x-ray cassette. For example, the slots 114 and 115 may have a width of about 0.25 to 2 inches, or about 0.5 to 1.5 inches, or about 0.75 to 1.25 inches.

[0036] Although the illustrated embodiment is described above in the context of use on a lower leg, other implementations may include other imaging applications. For example, some embodiments may be configured for supporting a patient’s arm during surgery and/or radiological imaging. In such embodiments, the device size and relative dimensions may be adjusted accordingly to better match the appropriate patient anatomy.

Claims

1 A device configured for supporting a patient’s limb, the device comprising:

a base section, the base section including

a bottom surface extending along a longitudinal axis, and

opposing sidewalls each extending upward from the bottom surface, the opposing sidewalls each being disposed on opposite sides of the longitudinal axis; and

an insert section configured to be positioned within the base section,

wherein the insert section has a width that is smaller than a width of the base section such that when the insert section is placed within the base section at least one longitudinal slot is formed.

2. The device of claim 1, wherein the insert section and the sidewalls of the base section define a pair of longitudinal slots when the insert section is placed within the base section.

3. The device of claim 1 or 2, wherein the insert section includes an angled surface and a flat surface.

4. The device of claim 3, wherein the flat surface makes up approximately 60 to 90% of a length of the insert section.

5. The device of claim 3, wherein the angled surface has an angle of about 20 to 70 degrees from horizontal.

6. The device of any one of claims 1 to 5, wherein the device has a length ranging from about 18 to 48 inches.

7. The device of any one of claims 1 to 6, wherein the device has a height of about 3 to 10 inches.

8. The device of claim 3, wherein the sidewalls of the base surface each include a flat surface and an angled surface.

9. The device of claim 8, wherein the angled surfaces of the sidewalls have an angle that substantially matches an angle of the angled surface of the insert section.

10. The device of any one of claims 1 to 9, wherein the longitudinal slots are sized to hold an x-ray cassette for obtaining lateral views of the patient’s limb.

11. The device of any one of claims 1 to 10, wherein the base section further comprises a rail extending along a line substantially parallel to the longitudinal axis, and wherein the insert section further comprises a corresponding groove allowing the insert section to be received into the base section and to ride along the rail, and/or wherein the base section further comprises a groove extending along a line substantially parallel to the longitudinal axis, and wherein the insert section further comprises a corresponding rail allowing the insert section to be received into the base section and to ride along the groove.

12. The device of any one of claims 1 to 11, wherein the insert section is longitudinally translatable relative to the base section when positioned within the base section.

13. The device of any one of claims 1 to 12, wherein the insert section and the base section are formed of a foam material coated with a water-impermeable polymer.

14. The device of any one of claims 1 to 13, wherein the base section further comprises a pair of transverse slots disposed near a distal end and aligned with one another on opposite sides of the longitudinal axis, and wherein the transverse slots are configured to hold an x-ray cassette.

15. The device of any one of claims 1 to 14, wherein the device is configured to support a single leg.

16. The device of claim 15, wherein the device has a width of at least about 6 inches and no more than about 18 inches.

17. A device configured for supporting a patient’s limb, the device comprising:

a base section with a proximal end and a distal end, the base section further including

a bottom surface extending along a longitudinal axis,

opposing sidewalls each extending upward from the bottom surface, the opposing sidewalls each being disposed on opposite sides of the longitudinal axis, wherein the sidewalls of the base surface each include an angled surface near the proximal end and a flat surface, and

a pair of transverse slots configured to hold an x-ray cassette, the transverse slots being disposed near the distal end and aligned with one another on opposite sides of the longitudinal axis; and

an insert section configured to be positioned within the base section, the insert section including an angled surface near a proximal end and a flat surface, wherein the angled surface of the insert section substantially matches an angle of the angled surface of the insert section,

wherein the insert section has a width that is smaller than a width of the base section such that the insert section and the sidewalls of the base section define a pair of longitudinal slots when the insert section is placed within the base section, the longitudinal slots being sized to hold an x-ray cassette.

18. A method of supporting a patient’s limb during a radiology procedure, the method comprising:

providing a support device comprising

a base section including a bottom surface extending along a longitudinal axis, and opposing sidewalls each extending upward from the bottom surface, the opposing sidewalls each being disposed on opposite sides of the longitudinal axis, and

an insert section configured to be positioned within the base section and longitudinally translatable relative to the base section,

wherein the insert section has a width that is smaller than a width of the base section such that when the insert section is placed within the base section at least one longitudinal slot is formed; and

positioning a lower leg of the patient upon the device.

19. The method of claim 18, further comprising positioning one or more x-ray cassettes in a longitudinal slot of the device.

20. The method of claim 18 or 19, wherein the base section of the support device further comprises a pair of transverse slots disposed near a distal end and aligned with one another on opposite sides of the longitudinal axis, the method further comprising positioning an x-ray cassette within the transverse slots.