US1516795A - Limb support for operating tables - Google Patents

Description

- Nov. 25; 1924 Filed July 14,

L SCHWARTING LIMB SUPPORT FOR OPERATING TABLES Patented Nov, 25, 1924.

UNITED STATES PATENT OFFICE.

LOUISE scnwam'me, or s'r .rosnrn, mrssormr.

LIMB s'nrroze'r Fen OPERATING TABLES.

Application filed July 14,

' means adapted to facllitate the proper positioningr of a patient upon the table and the comfortable maintaining'of such position for the period of time consumed by the operation.

-To this end I have devised a practical and efficient supporting structure designed for fulfilling thenecessary supporting and' bracing functions, and also'having provision for ample'adjustment to meet the vary- 1 ing requirements of difl'erent types of operations necessitating different positions of the patient and correspondin changes in the application of the supporting means.

It is'also sought to provide an improved device of few and comparatively simple parts which may be easily manipulated and adjusted, and also be manufactured at relatively small cost. 7

With these general objects in view, the

invention will now be described "by reference to the accompanying drawing illustrating" laterally extending arm 18, to which is con- ,85 one form of construction which I have devised for embodying the proposed improvements, after which those features deemed to be novel will be particularly set forth and claimed. w a

In the drawing' Figure -1 is a perspective view of a limb supporting'structure embodying the present improvements and shown in operative rela- ,,tion to a table;

Figures 2 and '3 are similar views on a smaller scale and illustrating diflerent operative positions ofthe device;

Figure 4 is an enlarged sectional elevation illustrating one position of adjustment l0 of the limb' rest to bring the same close to the table, the dotted linesv representing another position *of adjustment; and

Figure 5 is a sectional detail view of the 1922. Serial No. 575,012.

limb rest and its connections to the supporting arm. n

Referring now to the drawing in detail,

this illustrates the improved supporting device in its relation to an operating table, indicated at 6, to one edge of which the device is adapted to be securely clamped in position. For this purpose, a portion of the devicecomprisesa bracket structure, including a block element 7 provided with a pair of spaced, parallel arms '8, so arranged that the block element 7 may be engaged with the edge of the table 6, with the arms 8 extending above and below the latter, as illustrated in Figures 1 to 3. The upper arm 8 carries a suitable clamping element 9, the stem portion 10 of which is secured to the end of the arm 8 by means of a clamping screw 11, while the inner end of the lower arm'8 is fitted with a thumb-operated clamping screw 12 for engagement with the under surface of the table. 1

The bracket structure is further provided with spaced parallel lugs or projections formed as outward extensions from the arms 8 and having registering openings 15 for adjustably and rotatably accommodating the vertical shank portion 16 which forms a part of the adjustable limbsupporting structure proper. The lower lug or projection 14; car- IlQS G/ thumb-operated clamping screw 17,

whereby the shank 16 may be securely held in any position to which it maybe set.

The upper end of the shank 16 carries a nected, as by means of a short vertical arm 19, one end of a horizontal supporting arm 20 extending parallel to the arm 18. As will be seen in Figures 1 to 3, that end portion of the arm 20 which is .connected to the arm 18 forms with the latter a relatively short arm extending in one direction from the shank 16, while the remaining portion of said arm 20 forms a materially longer supporting arm projecting in a direction opposite from that of the arm 18. The supporting structure just described thus assumes the general outline of the letter .T, with one of its lateral arms longer than the other, and either of which may be swung into overlying relation vto the table 6, and also adjusted to difierent elevations above-the table.

For supporting and adjusting'the limb its adapted for releasable engagement with the arm 20, the middle porticns'of the clamping elements 22 being provided with a thumb screw 24 for efi'ectin the clamping action of the elements. ese elements 22 are also formed with a split spherical bearing structure 25 for receiving and supporting a spherical bearing member 26 which carries a post 27 having its outer end provided with a socket for accommodating .the stem- 28 projecting from the middle portion of the limb rest 29, as shown in Figure 5.

This limb rest 29 is constructed of an approximatelysemi-cylindrical shell :aiiordmg a concave limb supporting surface, the sides of the member 29 projecting slightly past, its longitudinal middle portion at the ends of the rest, as indicated at 30, this beingfor a purpose hereinafter explained. The stem 28 of the limb rest secured to the post 27 by means of a clamping'screw 31. By means of the described connections between the limb rest 29 and the arm 20, it is, apparent that the, limb rest is adapted to be supported at any point along said arm, including thatend of the arm which extends adjacent to and parallel to the arm 18, on account of the clearance afforded by the connectin portion 19; it is also ap: parentthat t e limb restsupporting connections may be adjusted angularly about the longitudinal axis of'vthe arm 20, and by virtue of the universal joint structureafforded by the bearing parts 25 and 26, the limb,rest may also be adjusted at-any supplementary angle which may be required, different positions of adjustment being illustrated in Figures 1, 2 and 4. I

j As has already been stated, the shank 16 carrying the supporting arm 20 may be rotated within the bracket structure to bring either end of said arm 20 into overlying relation to the table 6, and said shank ad justed to different elevations within the lugs 14. In Figure '1, this adjustment has been so made as to bring the longer end portion of the arm 20 above the table 6, and the shank 16 lowered within the bracket so as to bring the, arm 20 .close to the top surface of the'table. -The position of the limb rest 29 shown in Figure 1 is that designed for engagement with the thigh of a patient, as, for example, in am utation of the limb above the knee, the t igh being elevated at an angle from the hip of the atient. In such operations, it is desirable requently to locate the limb rest' as close to the hip as possible, which makes apparent the necessity for the supplemental angular adjustments of said limb rest, as in icated in Figure 4, these adjustments enabling the limb rest to be not only tilted at the required angle for conforming to the inclination of the limb, but also permit" ting the limb rest to be positioned as close to the table surface as may be required.

The dotted lines in Figure 4 simply represent an intermediate position of adjustment of the limb rest or support, to illus' trate the adjustable character of the device. In the case of an operation for amputation below the knee, the limb rest would be positioned about as indicated by the full or unbroken lines in Figure 4, but at a slightly lower angle to the table and the whole supporting structure would be shifted toward the foot of the. table. a

The adjustment of the supporting structure illustrated in Figure 2 is that designed for use in connection with kidney or posterior chest wall operations. The supporting arm 20 is rotated about the axis of the shank 16 to bring the shorter end portion of said arm into overlying relation to the table 6, in addition to which said arm is elevated by raising the shank 16 through the openings 15 to whatever height is required for accommodating the size of the patient. In

such operations the patient is placed on his side, facing outwardly or away from the table and that'arm which is then uppermost is supported by the limb rest 29, the latter being shifted toward the end of theloop formed between the arms 18 and 20 and hence into supporting position in engage ment with the patients arm adjacent his shoulder. As before, any slight angular adjustnients of the limb. rest 29 may now be made for the convenience of the patient, whose arms are both extended outwardly in the directionof the free end of the arm 20. In this operation of the device, I use a supplemental limb rest member 35 of approximately concave form, the under side of which is provided with a lug, 36 having an opening whereby the member may he slipped over the free end of the arm 20, as shown, and secured thereto by a clamping screw 37. The sides of the member 35 are provided with slots 38 to permit a suitable hand sling or bandage (as indicated by dotted lines at 38 in Figure 2) to be looped therethrough into depending relation beneath the arm 20. By this means a convenient support is provided for accommodatingthe outer extremities of both arms in the most comfortable manner, the upper hand being carried in the limb rest' member 35 and the other being securely retained in the sling 38 beneath said rest member, andv said supporting means being easily adjusted for arms of difl'erent length. The construction of the arm 20 with the loop portion at itsishorterend is such as toleave said arm unobstructed from end to end, and. thereby permits the limb rest 29 to be freely shifted into either of the positions illustrated in Figures 2 and 3. The adj ustment of the support to bring the shorter or loop end of the arm 20 over the table also allows the patient to be located nearer to the edge of the table without interfering with the use of the remaining portion of said arm 20 for supporting the outwardly extended arms andhands of the patient. In this use of the device, the same serves to support the'patient in proper position, keeping him from rolling forward or backward, and, what is more important, relieves the respiratory muscles of the Weight of the arm and shoulder supported by the device, thus insuring that the patients respiration will remain free and easy. In practice, the sup-porting structure is adjusted and the patient allowed to place himself in that position which is most comfortable to him before the anaesthetic is administered;

this not only insures the adjustment of the device into the position best suited to the patient, but also obviates the necessity of lifting him into the required position and any movements necessary to complete the proper positioning of the patient after he has passed under the influence of the anaesthetic, which is not only an inconvenient and diflicult procedure .but one that actually necessitates a deeper anaesthesia.

The use of the device where the patient is placed in 'a supine position, as for axilla or breast operations, is illustrated in Figure 3. The support'is again adjusted as low as possible by lowering the shank 16 in the bracket, and the limb rest 29 is shifted toward the outer free end of the arm 20 for supporting the out-stretched arm of the patlent. In this case it is also evident that the rest member 29 m'ay, if desirable, be adjusted forward, backward'or an ularly to any extent which may serve to into that position best suited to the needs of the patient.

In both types of operations for which the device is illustrated in Figures 2 and 3, the support. of .the arms and hands in outstretched position by the outer end of the arm 20 is of importanceinsuch work, since this operates to prevent any constriction of the blood vessels in the arms, such as tends to take place when the arms are simply al= lowed to hang with the elbows bent at more or less of an angle.

The recesses formed by the projections 30 at the ends of the limb rest adapt the same to conform to the limb better than would straight edges at these points by tending to equalize the pressure over the blood-vessels and tendons and avoiding stagnation of circulation and subsequent soreness at the points of support; also by affording a more effective retaining engagement with the arm this construction (when used in the posiring the rest.

simple, practical and eflicient construction for embodying the proposed'features'of improvement, and while I have illustrated what I now regard as the preferred form of embodiment of the invention, I desire to reserve the right tomake all such changes or modifications as may fairlyfall within the scope of the appended claims.

What I claim is:

1. A limb supporting structure for oper ating tables comprising a bracket adapted for attachment to the table, a horizontal supporting arm having a shank portion vertically adjustable within said bracket and also rotatable therein about a vertical axis to permit said arm to be swung horizontally into. different positions over the table, a supporting element carried by said arm and adjustable longitudinally thereon and also angularly with reference to the horizontal axis of said arm, means for fixedly securing said element in any of its adjusted positions, a limb rest carried by said supporting element and adjustable thereon a'ngularly in any direction, and clamping means independent of said first means for fixedly securing said limb rest in any of its angular positions relative to said supporting element.

2. A limbisupporting structure for operating tables comprising a bracket adapted for attachment to the table, a supporting member of approximately T-form having its upright portion vertically adjustable within said bracket and also rotatable therein ble, a supporting element carried by said horizontal portion and adjustable lon 'tudinally along the entire length of sai 'hori zontal portion and also angularly with-reference to the horizontal axis of said portion, means for fixedly securing said supporting element in any of its adjusted positions, a limb rest carried by said supporting element and adjustable thereon angularly in any direction, and means for fixedly securing said limb rest in any of its angular positions relative to said supporting element.

3. A limb supporting structure for operating tables comprising a bracket adapted for attachment to the table, a supporting member of approximately T-form having 1ts upright portion adjustably mounted in said said upright portion of the supporting member being provided with a; connection to one of the e ds of 'said horizontal portion and leaving he latter clear for unobstructed justably mounted in said bracket, a laterally extending arm and a horizontal supporting Karin havlng one end thereof connected to the outer end of said laterally extending arm and in spaced and parallel relation thereto,

the connected end of said supporting arm I forming with said laterally extending arm a loop materially shorter than the remaining portion of said sup rting arm, said supporting member being rotatable in said racket to permit either end of said supportv ing arm to be swung intoposition overlying the table, and a limb rest mounted adjustably on said supporting arm.

5. A limb supporting structure for operating tables comprising a bracket adapted for attachment to the table, a horizontal supporting, arm carried by said supporting bracket and adapted to be-swung either into overhanging relationvto said table or outwardly away from the table, and a limb rest comprising an elongated approximately semi-cylindrical shell mounted on said supporting arm, one of the endedgesof said shell being inwardly curved from top to bottom of the'rest, thereby forming side projections extending beyond the central lower portion of the rest.

In witness whereof I hereunto afiix my signature. a

LOUISE; SCHWARTING.

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