WO1994005227A1 - Dispositif de traction et de support du poignet - Google Patents

Dispositif de traction et de support du poignet

Info

Publication number
WO1994005227A1
WO1994005227A1 PCT/AU1993/000461 AU9300461W WO9405227A1 WO 1994005227 A1 WO1994005227 A1 WO 1994005227A1 AU 9300461 W AU9300461 W AU 9300461W WO 9405227 A1 WO9405227 A1 WO 9405227A1
Authority
WO
WIPO (PCT)
Prior art keywords
rest
traction device
support
extensible member
limb
Prior art date
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.)
Ceased
Application number
PCT/AU1993/000461
Other languages
English (en)
Inventor
David Peter Bolliger
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
ILEYELLOW Pty Ltd
Original Assignee
ILEYELLOW Pty Ltd
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by ILEYELLOW Pty Ltd filed Critical ILEYELLOW Pty Ltd
Priority to AU48093/93A priority Critical patent/AU4809393A/en
Priority to GB9504457A priority patent/GB2284995A/en
Priority to JP6506688A priority patent/JPH08504609A/ja
Priority to DE4394199T priority patent/DE4394199T1/de
Publication of WO1994005227A1 publication Critical patent/WO1994005227A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/04—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints

Definitions

  • the present invention relates to traction devices and, more particularly, to a device adapted to provide support for, and traction to, a part of a patient's limb, such as a wrist, during orthopaedic surgery.
  • the present invention consists in a support and traction device for use with a limb, the limb having a proximal part, a distal part, a joint connecting the proximal part to the distal part, and a virtual joint pivot axis about which the proximal and distal parts of the limb pivot, the device comprising: a rest to which the proximal part of the limb may be secured; an extensible member having a length and being member may be pivoted relative to the rest about a member pivot axis which is not coincident with the virtual joint pivot axis; connection means for attaching the extensible member to the distal part of the limb at a position distant from the joint; extension means for increasing or decreasing the length of the extensible member such that a selectable tractive force may be applied to the joint; and force providing means for maintaining the selectable tractive force substantially constant notwithstanding pivotable movement of the extensible member relative to the rest.
  • the extensible member is connected pivotably and lockably to the rest, the extensible member being pivotable about a member pivot axis which is distant from the virtual joint pivot axis.
  • the device further comprises a platform attached to the extensible member, the extensible member being connected rotatably and lockably to the rest such that the distal part of the limb may rest on the platform and may be rotated by rotation of the platform.
  • Fig. 1 is a top view of a first preferred embodiment of a wrist support and traction device in accordance with the present invention
  • Fig. 2 is a side elevatioh of the device of Fig. 1;
  • Fig. 3 is a top view of a first preferred embodiment of the present invention in use;
  • Fig. 4 is a side elevation showing a first preferred embodiment of the present invention in use
  • Fig. 5 is an exploded perspective view of a universal joint used in a first preferred embodiment of the present invention
  • Fig. 6 is a side elevation of a second preferred embodiment of the present invention.
  • Fig. 7 is a plan view of a second preferred embodiment of the present invention.
  • Fig. 8 is a perspective view of a particularly preferred embodiment of the present invention.
  • Fig. 9 is a perspective view of a cuff for use in the particularly preferred embodiment of the present invention
  • Fig. 10 is an exploded perspective view of a particularly preferred embodiment of the present invention, illustrating a preferred method of assembling the invention.
  • Fig. 11 is an exploded perspective view of an alternative particularly preferred embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • a first preferred embodiment of the wrist support and traction device 10 essentially comprises rest 12 and extensible member 14.
  • a patient's forearm 16 is secured to rest 12 by forearm strap 20.
  • Digit trap 22 secures one of the patient's fingers to L-shaped section 26 of extensible member 14.
  • Extensible member 14 may be a jack which is supplied with a substantially constant pneumatic or hydraulic pressure through pipe 32. This maintains a substantially constant tractive force on wrist 28, thus enabling a surgeon to perform orthopaedic or arthroscopic surgery on the wrist.
  • device 10 applies traction to wrist 28 by attempting to increase the length of extensible member 14 such that digit trap 22 pulls the patient's finger away from forearm 16.
  • Jack 30 supplies the force necessary to extend member 14.
  • jack 30 is operated by hydraulic or pneumatic pressure, but it may also be operated by electrical, mechanical, or other means.
  • the force supplied by jack 30 remains substantially constant, independent of the length of extensible member 14, and the surgeon can control the amount of force by adjusting the hydraulic or pneumatic pressure supplied to jack 30 through pipe 32 via pressure regulator 33.
  • Stalk 34 is attached to jack 30 to form part of extensible member 14, and is pivotably mounted at universal joint 36 (shown in Fig. 5) which is secured within rest 12.
  • universal joint 36 comprises section 39 which is attached, at one of its ends, to rest 12 and, at its other end, to cup 40.
  • Ball 38 is attached to stalk 34 and is held in cup 40 by shell 42.
  • shell 42 is clamped against ball 38 by screw clamp 44 which passes through hole 46 and screws into threaded hole 48 in section 39.
  • screw clamp 44 is loose, this arrangement allows stalk 34, and hence extensible member 14, to pivot about a member pivot axis which is substantially coincident with the centre of ball 38.
  • jack 30 can also rotate about its longitudinal axis which passes substantially through the centre of ball 38. Attached to the body of jack 30 is platform 18, and rotation of jack 30 causes platform 18 to rock. As shown in Fig. 3, hand 29 rests on platform 18 so that rotation of platform 18 causes rotation of hand 29, and hence pronation or supination of wrist 28. Thus, by rotating platform 18, the surgeon can place wrist 28 in an orientation which is convenient for surgery. If the degree of pronation or supination thus obtained is insufficient, forearm strap 20 may be loosened, forearm 16 can be repositioned, and finally forearm strap 20 may be re-tightened.
  • elbow 52 should be bent so that forearm 16 forms an angle of approximately 40 degrees with upper arm 54, and upper arm 54 is secured to rest 12 by upper arm strap 56, as shown in Fig. 3.
  • the angle of 40 degrees is large enough to ensure that traction is resisted by the humerus through the biceps, but small enough to allow the arm to be located on a standard arm table and to allow the surgeon to be seated at either side of the arm.
  • rest 12 is flared at its end proximate the patient's shoulder.
  • upper arm strap 56 is used to secure upper arm 54 in the position shown in Fig. 3
  • alternative upper arm strap 56A can be used for the volar aspect of the same arm, or for the other arm.
  • Rest 12 may also include depression 66 which ensures that the elbow region is not subject to pressure. Rest 12 may be manufactured from an autoclavable vacuum-formed plastic.
  • device 10 can be placed upon conventional arm table 50 as shown in Fig. 3. Rest 12 may be placed in a wide range of positions on arm table 50. Thus, wrist 28 can be placed in a position and orientation which is convenient for surgery, whilst still being subjected to a substantially constant tractive force.
  • Device 10 is preferably a free-standing device which is introduced beneath wrist 28 and forearm 16 after a sterile field has been established.
  • the use of arm table 50 provides a working surface on which surgeons can rest their arms or arrange their instruments. If necessary, device 10 may be removed altogether, leaving a standard arm table and an uncluttered sterile field.
  • Device 10 is suitable for use in both arthroscopic and open wrist surgery, and can be used conveniently if an arthroscopic procedure develops into an open procedure. In this case, if the open procedure does not require traction, device 10 can be removed simply and easily, and the procedure can be continued on the standard arm table beneath.
  • Figs. 6 and 7 show a second preferred embodiment of the present invention which includes substantially all of the features and benefits of the embodiment shown in Figs. 1 to 4.
  • wrist support and traction device 72 comprises extensible member 76 which is pivotably attached to rest.74.
  • Extensible member 76 comprises ball 38, platform 80, and piston 82.
  • One end of piston 82 can slide into and out of hole 86 in platform 80, and piston 82 forms a slidable, substantially air-tight seal against the walls of hole 86 so as to create chamber 88.
  • Pneumatic or hydraulic pressure can be coupled into chamber 88 through inlet 90 so as to exert a force on piston 82.
  • piston 82 may be part of a conventional pneumatic jack mounted within, or on, platform 80.
  • Ball 38 and cups 40 mounted within cavity 93 in rest 74, form a lockable universal joint which can allow platform 80 to pivot about an axis which passes substantially through the centre of ball 38.
  • Removable lever 92 is adapted to operate lockably upon cups 40 such that, in a first position of removable lever 92, cups 40 are moved away from ball 38 such that platform 80 may pivot relative to rest 74 and, in a second position of removable lever 92, cups 40 clamp onto ball 38 to arrest pivotal motion of platform 80.
  • Cups 40 may be held within cavity 93 by end caps 94.
  • Substantially all components of device 72 are preferably made from a radio-lucent plastic. This will allow x-rays to be taken of the wrist without the need to remove the arm from the device.
  • Rest 74 preferably includes slot 96 which allows device 72 to be mounted on a stand.
  • rest 74 may be shaped to include depression 95 to allow, for example, for better traction on the wrist.
  • Device 72 may be used in a number of modes. For example, in a first mode, the device may be placed horizontally on a standard arm table. In this mode, the wrist may be extended and deviated laterally, but it may not be flexed. In a second mode, the device may be mounted horizontally on the edge of a mounting device such that extension, lateral deviation, and flexion of the wrist are all possible. In a third mode, the device may be mounted on a vertical stand in a traditional position.
  • Figures 8 to 10 illustrate a particularly preferred embodiment of a traction device 98 according to the present invention.
  • Traction device 98 operates in substantially the same way as other embodiments but, in this embodiment, the patient's forearm is secured within cuff 100 which is held on posts 102 attached to rest 12.
  • digit traps 22 secure the patient's fingers to extensible member 14, and extensible member 14 may be a jack which is supplied with a substantially constant pneumatic or hydraulic pressure to maintain a substantially constant tractive force on the patient's wrist.
  • Stalk 34 is attached to jack 30 to form part of extensible member 14, and is pivotably mounted at universal joint 36 which is secured within rest 12.
  • universal joint 36 comprises ball 38 which is held within a recess of rest 12 by bar 120.
  • Bar 120 is mounted eccentrically in hole 122, and is attached to lever 104 such that rotation of lever 104 causes bar 120 to push against ball 38, thereby allowing the surgeon to lock the traction device in a suitable orientation.
  • pivotal movement of extensible member 14 causes pivotal movement of the patient's hand about a virtual joint pivot axis which is substantially coincident with the centre of the patient's wrist.
  • the pivotal movements of extensible member 14 and the hand are coupled, they do not occur about the same pivot axes; that is the member pivot axis is distant from the virtual joint pivot axis. Therefore, during these pivotal movements, extensible member 14 must vary in length in order to maintain a substantially constant tractive force on wrist 28. This length variation is accommodated by elongation or contraction of jack 30 under the influence of the substantially constant hydraulic or pneumatic pressure.
  • Jack 30 can also rotate about its longitudinal axis which passes substantially through the centre of universal joint 36. Attached to the body of jack 30 is platform 18, and rotation of jack 30 causes platform 18 to rock. The patient's hand rests on platform 18, so that rotation of platform 18 causes rotation of the hand, and hence pronation or supination of the wrist. Thus, by rotating platform 18, the surgeon can place wrist 28 in an orientation which is convenient for surgery.
  • Cuff 100 is preferably disposable, and is preferably made from a length of material which comprises a flexible, elastic, substantially non-slip base onto which is laminated, or otherwise attached, a soft fibrous layer.
  • the base is neoprene and the fibrous layer is a one-way stretch velour fabric.
  • Cuff 100 comprises a length of such naterial with means for attaching the cuff to posts 102.
  • cuff 100 and the attachment means preferably comprise two tubes 110 made by forming two loops in a length of fabric, and by sewing together, or otherwise closing, the necks of the loops. The loops are slid over posts 102, thereby removably holding cuff between posts 102.
  • other attachment means can be provided for removably attaching a cuff to posts 102.
  • Cuff 100 includes a means for securing the cuff around the forearm. Preferably this means comprises strips of hook-and-eye fastener 112 (such as that sold under the trade name Velcro) attached to the one end of the strip of fabric.
  • cuff 100 preferably includes tongue 114 which is draped over depression 116 in rest 12 to provide a comfortably cushioned and contoured surface for supporting the forearm.
  • Substantially all components of traction device 98 are preferably made from a radio-lucent plastic to allow x-rays to be taken of the wrist without the need to remove the arm from the device.
  • Figure 10 is an exploded perspective view of the particularly preferred embodiment of the invention.
  • a preferred method for assembling the invention comprises the following steps:
  • Clamp pressure regulator 33 to a convenient vertical post 130, such as an I.V. stand, which may be brought close to the operating table so that guage 132 is in the view of the surgeon.
  • hand may now be secured to hand plate 18 by attaching straps 146 to spigots beneath hand plate 18.
  • a pressure of 35kPa is approximately equal to the force exerted by the weight of half a house brick.
  • a flexion stand may be assembled by pushing posts 106 into base 108 and sliding block 12 onto the stand as shown.
  • base 108 may be used without its posts:
  • Deviation of the wrist is accomplished by loosening locking lever 104, repositioning cylinder 138 and then locking again. If a substantial change in pronation or supination becomes necessary, it may be helpful to zero the pressure and loosen the cuff so that the arm can be relocated. If required, X-Rays or I.I. images may be taken through the device, which is sufficiently radio-lucent.
  • Ball chains should not be removed from spreader bar without zeroing pressure. Do not use this device on subjects with very weak skin. Where the skin is moderately weak, consider carefully how many digit traps to use, which fingers should spread the load, and monitor the distraction force carefully.
  • Figure 11 illustrates an alternative particularly preferred embodiment of the invention in which the force providing means is spring 160 which acts to extend the extensible member by pushing piston 142 away from cylinder 138.
  • the force exerted by spring 160 is determined by its degree of compression.
  • piston 142 may be inscribed with calibration marks to enable the surgeon to adjust the- tractive force on the wrist. The surgeon may do this by pushing piston 142 into cylinder 138 until a desired force is obtained. The surgeon may then adjust the position of the ball chains 21 in spreader bar 144 such that the desired degree of compression of spring 160 is maintained.
  • the tractive force caused by spring 160 remains substantially constant as set by the surgeon notwithstanding such rotation.
  • the alternative particularly preferred embodiment of Figure 11 also includes groove 162 in piston 142, and screw 164 which screws into hole 166 in cylinder 138.
  • screw 164 which screws into hole 166 in cylinder 138.
  • a wrist support and traction device has been described on which a wrist can- be placed easily and simply in a position and orientation which is convenient for surgery, whilst still being subjected to a substantially constant tractive force.

Landscapes

  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)
  • Massaging Devices (AREA)
  • Manipulator (AREA)
  • Knitting Machines (AREA)

Abstract

L'invention se rapporte à un dispositif de traction et de support du poignet utilisé au cours de la chirurgie arthroscopique ou orthopédique. Le dispositif comprend un appui (12) servant à retenir l'avant-bras, un élément d'accouplement (22) servant à retenir les doigts, ainsi qu'un élément extensible (14) relié pivotant entre l'appui et l'élément d'accouplement. Une force de traction sensiblement constante est appliquée au poignet par l'intermédiaire d'une force d'extension régulée appliquée à l'élément extensible (14). Le dispositif est construit de façon que ses parties ne pivotent pas nécessairement autour d'un axe coïncidant avec tout axe de pivotement potentiel du poignet.
PCT/AU1993/000461 1992-09-08 1993-09-07 Dispositif de traction et de support du poignet Ceased WO1994005227A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
AU48093/93A AU4809393A (en) 1992-09-08 1993-09-07 Wrist support and traction device
GB9504457A GB2284995A (en) 1992-09-08 1993-09-07 Wrist support and traction device
JP6506688A JPH08504609A (ja) 1992-09-08 1993-09-07 手首の支持牽引装置
DE4394199T DE4394199T1 (de) 1992-09-08 1993-09-07 Handgelenk-Stütz- und Zieh-Vorrichtung

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
AUPL4574 1992-09-08
AUPL457492 1992-09-08
AUPL9789 1993-07-05
AUPL978993 1993-07-05

Publications (1)

Publication Number Publication Date
WO1994005227A1 true WO1994005227A1 (fr) 1994-03-17

Family

ID=25644324

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/AU1993/000461 Ceased WO1994005227A1 (fr) 1992-09-08 1993-09-07 Dispositif de traction et de support du poignet

Country Status (5)

Country Link
JP (1) JPH08504609A (fr)
AU (1) AU4809393A (fr)
DE (1) DE4394199T1 (fr)
GB (1) GB2284995A (fr)
WO (1) WO1994005227A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20020072631A (ko) * 2001-03-12 2002-09-18 강종만 의료용 피부 확장 펼침기
FR2862207A1 (fr) 2003-11-14 2005-05-20 Philippe Daury Systeme de traction pour table d'operation comprenant un dispositif d'asservissement.
CN103300954A (zh) * 2013-05-15 2013-09-18 赵德利 半自动多功能气杆式牵引机
CN104510552A (zh) * 2013-09-28 2015-04-15 沈阳新松机器人自动化股份有限公司 一种骨折牵引装置
CN104510553A (zh) * 2013-09-28 2015-04-15 沈阳新松机器人自动化股份有限公司 手部夹持机构及牵引装置
CN105232202A (zh) * 2015-11-23 2016-01-13 黄瑞平 椎间盘牵引器
US11771581B1 (en) * 2022-08-23 2023-10-03 Traktus Llc Surgical jig and method for using same

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106510923B (zh) * 2016-10-18 2019-04-02 中南大学湘雅医院 骨外科用骨折矫正装置

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU8821482A (en) * 1981-07-23 1983-03-17 G.R. Hepburn Adjustable splint
FR2551650A1 (fr) * 1983-09-09 1985-03-15 Clyburn Terry Fixateur externe dynamique pour traitement des fractures, et procede d'utilisation
US4538600A (en) * 1983-10-27 1985-09-03 Dynasplint Systems, Inc. Adjustable splint
US4719906A (en) * 1987-05-07 1988-01-19 Deprospero Rose Universal articulated splint
EP0276162A2 (fr) * 1987-01-23 1988-07-27 Andronic Devices, Ltd. Dispositif pour positionner le membre d'un patient et bouclier chirurgical torique
AU4219189A (en) * 1988-08-09 1990-03-05 Dynasplint Systems, Inc. Adjustable splint
US5020524A (en) * 1989-08-03 1991-06-04 Donohue Patrick T Modular digital traction system
US5074291A (en) * 1990-09-17 1991-12-24 Carter Peter R Hand traction surgical table
EP0503182A1 (fr) * 1991-03-08 1992-09-16 Patrick T. Donohue Système d'exercice de force de traction pour les doigts

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU8821482A (en) * 1981-07-23 1983-03-17 G.R. Hepburn Adjustable splint
FR2551650A1 (fr) * 1983-09-09 1985-03-15 Clyburn Terry Fixateur externe dynamique pour traitement des fractures, et procede d'utilisation
US4538600A (en) * 1983-10-27 1985-09-03 Dynasplint Systems, Inc. Adjustable splint
EP0276162A2 (fr) * 1987-01-23 1988-07-27 Andronic Devices, Ltd. Dispositif pour positionner le membre d'un patient et bouclier chirurgical torique
US4719906A (en) * 1987-05-07 1988-01-19 Deprospero Rose Universal articulated splint
AU4219189A (en) * 1988-08-09 1990-03-05 Dynasplint Systems, Inc. Adjustable splint
US5020524A (en) * 1989-08-03 1991-06-04 Donohue Patrick T Modular digital traction system
US5074291A (en) * 1990-09-17 1991-12-24 Carter Peter R Hand traction surgical table
EP0503182A1 (fr) * 1991-03-08 1992-09-16 Patrick T. Donohue Système d'exercice de force de traction pour les doigts

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20020072631A (ko) * 2001-03-12 2002-09-18 강종만 의료용 피부 확장 펼침기
FR2862207A1 (fr) 2003-11-14 2005-05-20 Philippe Daury Systeme de traction pour table d'operation comprenant un dispositif d'asservissement.
CN103300954A (zh) * 2013-05-15 2013-09-18 赵德利 半自动多功能气杆式牵引机
CN104510552A (zh) * 2013-09-28 2015-04-15 沈阳新松机器人自动化股份有限公司 一种骨折牵引装置
CN104510553A (zh) * 2013-09-28 2015-04-15 沈阳新松机器人自动化股份有限公司 手部夹持机构及牵引装置
CN104510552B (zh) * 2013-09-28 2017-01-18 沈阳新松机器人自动化股份有限公司 一种骨折牵引装置
CN105232202A (zh) * 2015-11-23 2016-01-13 黄瑞平 椎间盘牵引器
US11771581B1 (en) * 2022-08-23 2023-10-03 Traktus Llc Surgical jig and method for using same
WO2024044496A3 (fr) * 2022-08-23 2024-05-10 Traktus Llc Gabarit chirurgical et son procédé d'utilisation

Also Published As

Publication number Publication date
DE4394199T1 (de) 1995-09-21
GB2284995A (en) 1995-06-28
AU4809393A (en) 1994-03-29
GB9504457D0 (en) 1995-04-26
JPH08504609A (ja) 1996-05-21

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