US2366972A - Crutch for surgical tables - Google Patents

Description

Jan. 9, 1945.

H. J. LAWRENCE CRUTCH FOR SURGICAL TABLEs Fi l-ed Nov. 5, 1941 2 Sheets-Sheet 1 EVTOR.

ATTORNEY;

Jan. 9, 1945. H. J. LAWRENCE 2,366,972

} CRUTCH FOR SURGICAL TABLES Filed Nov.- 5, 1941 2 Sheets -Sheet 2 mmmmw w t iflllllllHHH a MM IATTORNEY: B

Patented Jan. 9, 1945 UNITED ;PATEN.-T .o r cE esscsiz zioR 'roH Fort SURGICAL Harold'J, Lawrence, Mariemont, Ohio, assignor to TABLES jihe. Liebel -Flarsheim Company, Cincinnati, ;'Ohio, a-corporationof Ohio 5, 241.1 se iai s 41.19

Thisinvention-relates tcii'mnr v m nts inope *ati-ngand surgical. tables ofsthetypeemployed to support an-patient undergoing an. operation or diagnosis. and, while the'invIentionmay-be, applied to a operating .-.tables= cfor. varying. purposes, it. has been devised particularly for use. .inrconjunction withtables :used for genitourinary operations and for the attendant to arrangethe patientl and make theadiusimcntswh e. the. qe s paring for the operation orth dia n s, dspi the a t th tt pa ie t. there f r qu n must remain in the most uncomiortableposition arelatively longperiodoif time awaiting the docexaminations;and-in the specification which fo'llows the use of the apparatus i's illustratedin this environment. v I

theuse of= tab1esof-thi"stype the patient lies on hisback; with-ilegsspread-and supported in so-called crutches located .usually adjacent the knee joints. The present invention is directed or diagnostic position at the proper timeM-By the present improvement the patient remainsin; the least; comfortable: position during the; shortest D'ossibletime, that is,;only during the operation or examination, and at other times, for example, 'while awaitingthe;do'ctor," .the patient is com- .fortabl'y supported.

A further objectfis to provide, crutches or supports which rnay be raised or lowered readily to any desired height andalso to provide means u o t ecrutch sor sunp r s whe eby h xm y .bie movedinw rd rqoutwa yto fit t k iointsin the mostcornfortable position.

' l .A ffur h mhie t 1 t e men ion h e to provide ast usz u e nm "h,..t e.erut h s li supporting the 'patients legsgat the knee portions arev swung within a yoke. or cradle in suchf 'rnanh rth t.the patien isi imbs. aresus clnd dl n t m st comicrta lems t n cren wh n c l s spread. w i

; .It. is also the purposetoproyide separate locks .iq .t va iou .adins ab emem er T the 1 a all ad ust en s. avebe enzcontrqll d fro i ..lock and .it has been. very difiicult to locate .all parts .in their desired, prearranged positions and m m e s. 'whmhmay be exte i t r a m tors' preparations. Minor alterations cannot conveniently be made after an operation is begun. Brifimirijthe, preferred structures ofthepresent invention, the crutch or supports invyhich the patientsknees are rested. are carried, by bracket 'ttach 7 Side vIailsof ,thetableor to the side and endrail's, as icorner pieces one crutch for I each leg. Ho t a e s i ab r Su ort d r t e brac theconnections preferably beingthrough leaved m io s soer an d h ed s 19 th leaves tend to, bite into the surfaceot the post Ito withhold; it again5t downward movement. A irom the bracketis pennitthe. P

arranged to lift the leaves t, e lowered. I

Atitsumper endseach post .rotatably carries a hub tojzwhich the main supportarmbf therlcrutch is, fastened The {rotatable hubs. of .the,.posts, however, cooperate with stationaryhubsv fixed firmlytoithepposts-the meeting faces constituting a ratchet permit-ting movement of the .arms only 'in' an outwardsdirectio The i h t arsenlocked by .separatingtthehubs therebyperm tt ng the armstobeswung inwardly; Duringthe preoperative period the arms are in the .tion, extending endwisely fromthe table sothat the patientstlegs supported inthe crutches. are inrelaxed position, straight out. By pushing out- 'ward'ly. upon :each armthe crutch and thus the patients leg, iscarriedwith ityandprevented from have the remains during the, period that the been such that it is usually conventional practice 1 returning inwardly by the ratchet apparatus.

The crutch elements are Ut-shaped eIernents adapted to fit the underneath parto f theknee ioints-or-calves-of the legs, the torward'and rearwardportionszofthe crutches-being appropriately splayed to avoid cutting-the. flesh. Ihe-crutches, in turn; are pivotally carried .incradles :which extend-upwardly. from the arms; and are slidable thereon aswell as rotatable about axes extending laterally of the arms. In the preferred structure the crutches are suspended in the yokes or cradles on an axis above the centerof gravity and-therefore,- the crutches constituteimovable suspension units iorthepatientslegs. lBy virtueof this arrangement the patient is permittedsome latitude fin flexing; the-knees andin'permitting' the. ffeet to hang in th most-comfortableposition,

deither to the inward posiand the t crutches being movable conform with the leg contours to provide support therefor substantially regardless of the limb positions. Thus it will be seen that the apparatus is completely adjustable yet the major adjustments, spreading of the crutches and lowering of the legs, may be performed by the doctor or attendant prior to or during the operation or diagnosis so that the patient is enabled to .remain in the most comfortable position until such time. 7

Other features and advantages are shown in the drawings in which a preferred embodiment of the present invention is disclosed.

Figure 1 is a perspective view showing a genitourinary table equipped with typical crutch support apparatus of the present invention.

Figure 2 is a side elevation of a crutch unit.

Figure 3 is a cross sectional view taken on the line 33 of Figure 2.

Figure 4 is a fragmentary sectional view taken on the line 44 of Figure 2.

Figure 5 is a fragmentary elevation taken along the line 55 of Figure 2.

Figure 6 is a cross sectional view taken on the line 6-6 of Figure 2.

Figure 7 is a cross section taken on the line 1-4 of Figure 6.

Figures 8 and -9 are diagrammatic views illustrating the operation of the leaved lock shown in Figures 6 and 7.

The table shown in Figure l is comprised of a chassis indicated generally at 2 and a table member 3 which is pivotally mounted to the chassis through the journals 4. Elevatin apparatus designatedj is provided for tilting the table to various angular positions. For-diagnostic purposes and for use in X-ray photography the table is sometimes equipped at its forward edge with a bucky diaphragm which is adapted to receive an X-ray film in a cassette. Also, in some instances, gentitourinary tables are provided with an arm extending upwardly from one side thereof to carry an X-ray tube over the cassette. The details of the table proper form no part of the present invention and are therefore not described in detail in the specification.

The knee crutch units, indicated generally at 1, to which the present invention particularly i addressed, are located at the forward end of the table at opposite sides thereof, one crutch for each leg, each unit being carried by a bracket 9 which is bolted to the table frame as at H). Brackets 9 may be corner brackets, as shown, 'or may be fastened to the end or side walls of the table frame, as the case may be. Corner brackets may be fastened directlyto most tables now in use and it is to be noted therefore that the crutch units of the invention may be manufactured as table accessories or may be built'permanently into the table structure.

Each corner bracket 9 carries a housing or clamp block H having a passageway extending vertically therethrough for the reception of a post I 2. The post preferably is of square or rectangular configuration or so arranged as to present a relatively flat clamping surface l3 which is adapted to be engaged by clamp leaves l4 residing angularly with respect thereto. The clamp leaves fit within a cavity liextending part way across the clamp block; terminating at the for ward edge thereof in a lever recess 16. Each of the clamp leaves contains an aperture conforming approximately to the external configuration of the post I2 whereby the post may be slid through the 75 leaves after they have been nested and fitted within the passageway 15.

.Additional bores I! are provided in the leaves at the rearward side of the post l2 to receive a presser pin I 8. The pin 18 resides in a bore IQ of the clamp block with a compression spring 20 interposed between the top of the pin and a set screw 2| which is threaded into the clamp block. The bore, l9, is.carrie'd through the block into a recess below the passageway l5 to provide clearance for the lower portion of the pin. At the opposite side of the post l2, the upper leaf of the series I4 is configurated to provide a foot portion 22 and a compression spring 23 is confined withs in a cavity 24 to press downwardly upon the foot.

The springs 20 and 23 press upon the pile of leaves at opposite sides of the post to seat the leaves on an arm 25 of a lever 26. Handle portion 21 of the lever extends outwardly beyond the clamp housing and is bent downwardly so that the knee portion of the lever constitutes a fulcrum cooperating with the terminal edge of the passageway I6 whereby the rearward extremity of the lever arm 25 is elevated when the handle 21 is depressed. The arm 25, like the leaves, is provided with clearance openings for the post [2 and the pin l8; and a boss 28 is struck from the face of the lever arm to reduce the friction incidental to the movement of the arm.

In the preferred structure the clamp block is a two-piece member, the main passageway for the post l2 being located in one section and the other constituting a cover plate 29 attached thereto by means of screws 30 for holdin all the parts in assembled relationship.

It will be seen from Figures 7, 8 and 9 that the openings in the clamp leaves and the angular relationship of the leaves with respect to the axis of the post are such that the edges of the leaves tend to bite into the face l3 (and the opposite face of the post if desirable). By operating the lever 21 the angularity of the leaves is so decreased that they reside more nearly perpendicular to the post. This movement has the eifect of increasing the width of the openings and causing the edges of the leaves to be moved out of engagement with the clamping edge l3 of the post l2. When this i done the post readily may be lowered. By releasing lever 21 the leaves drop back into the more inclined position and again clamp the post with respect to the clamp block.

While other locks may be used in conjunction with the present apparatus the post clamp unit shown in the drawings is preferred because it provides positive locking in a simple and expedient manner. In certain operative or diagnostic positions considerable Weight is thrown on the post and it is necessary that the lock be arranged to hold the post firmly and positively against downward movement lest an accident happen during an operation. It is also to be noted that if the post is .to be lowered the doctor or attendant may press downwardly upon the lever 21 with the elbow to make the adjustment.

At the upper part of each post the inching adjustment apparatus for the crutches is located. A preferred embodiment of this feature of the invention is as follows:

A hub 3| is pinned to the post in a position adjacent its upper end by means of pin 32. Guide pins 33 extend upwardly from the hub into bores 34 located in spaced positions annularly in the face of a slidable and non-rotatable ratchet member 35, the latter being journalled on a counterturned portion 36 of the post l2. The ratchet the lower face of a central s asm member- 9s isxheldjagainstfrotatio nabbut the-pbst' 55 therebetween are locaite d' beneath'the-head" of "uporr the fjournall portiontfithereof *H-ub" 3 1'- is= ce'unter'bored as-at 31 and "aycompression spring 3 8 1's seatedwitiiin the' coun'terbere around theiiournal portion or the 'pos't,' the upper end "of the spring being -=in i abutment wi'th "the lower asses:- the slidable-ratchet member.

"*"I-he post ts'als'o'counterturnedas at 39th carry a rotatable-rathet member- 4o 'so iocated -fthat its lewer face rests against a shoulder?! "The seating a -washer 42 through which a screw '43 passes' into tlrre'adedeng-a'gement 'witnthemounscreamed arameter the'p'ost. T-he -washer '42 restshpon the'end-oI the -s-haft portion? 38 and 'the" clearances are such that when'fthe bolt is "tightened the iratchet-member =41] may'rota te' Themeeting faces-of elements and lfl are configurated to"constitute a ratchet, *the teeth being cut therein over a portion of the meeting raees, the balance being counterboredto*proifide Withbutdamag-ing "the crutch.

"through appropriate sleeves 58 in the cradle and constitute journals for the stud-'-bo1ts, with-the dge's of the sleeves extending inwardly "beyondtlrefaces of "the cradle amrssoas to pr'o vide"clearanceforthe-crutch.

"tatable with respect to the p'os't -but h-0t"infovalcvle longitudinally thereof while th ratchet element '35 is not rotatable with respect to "the post but is movable longitudinally thereof "The spring *3 8 urges the' non-rotatable element 35 upwardly against the ratchet member 40.

Rubber bumpers are slipped over the posts and against the lower face of the hub 3| so as to act as shock absorbers in the event that the post is permitted to drop freely under a heavy load.

Support arms 46 extend rigidly from each'rof tatable ratchet element and the teeth of the ratchet elements of each set arearrange-d as to slide over one another when the supporting arms 46 are swung in a direction outwardly from the table and to lock with one another to prevent the arms from swinging inwardly.

The crutches in which the patients knees are supported are pivotally swung in cradles, the. cradles, in turn, are rotatably carried on saddle blocks, and the saddle blocks are slidable longitudinally of the support arms 46 to obtain latitude in the adjustability of the apparatus. In the preferred structure the saddle blocks, designated 41, have apertures therein for receiving the support arms 46 and clamp screws 48 are providedon the saddle blocks whereby the blocks may be fastened rigidly to the arms once'they have been moved to the desired position. The upper face of each saddle block constitutes a journal 49 for seating boss 50 which has arms 5| extending outwardly and upwardly therefrom in spaced relationship to constitute a cradle crutch. A sleeve 52 is located in a bore within the boss 50 and a bolt 53 is passed through the sleeve and into threaded engagement with the saddle block for assembly of the cradle with the saddle block. i

It is to be noted that the crutches. are suspended in thecradles, the center of gravity of each crutchbeing somewhat below its pivotal axis. The lower limbs of a patient lying on a table hang down from the forward edges of the crutches while the thighs rest on the rearward portion. It is to be seen, therefore, that the crutches natural inwhichthey offer the utmost support for the patients limbs and, yet being swung within the cradles, permit the patients lower limbs to move about somewhat freely.

Metal washers 54-54 carrying a rubber washer ly tend to assume the posit on the legs enforcin'gmembers -5'9 "are riveted thereto. 1 The studsarethreade'dthroughthe reenforcing mem- "hersandthecrutch walls. Y Y

It is" preferredtha't the -'axis of rotation df' t-he cradles be"inclined outwardly' upwardly with respect" to-thetable so that the crutches are "posi- "ti'o'ned' to 'con'form more "nearly to the positionof when thelegs-are in thespread position. 'It willbe seen that the crutches are free to move with respect to the cradle and the cradles in turn are free to move pivotally about the saddle blocks so that the parts may be adjusted to support the legs comfortably regardless of the position in which the patient may reside, The slidable adjustment of the saddle blocks along the arms enables patients of various size to be accommodated. In the normal operation of the device the patient may resideon the table with legs straight out in the relaxed and most comfortable position, with the knees supported in the crutches. When preparations have been made the doctor may simply nudge each arm outwardly, for example, by pushing upon it with his shoulder or elbow. The ratchets act to prevent inward movement of the arms under the pressure inserted upon them by the patients legs. When the operation or diagnosis is completed th attendant simply presses downwardly upon the slidable ratchet elements35 withdrawing the teeth thereof from engagement with the teeth of the rotatable element 40, thereby permitting the support arms to bereleased to permit the patients legs to move to retracted position.

The invention has been disclosed particularly in relation to its use upon a genitourinary table, but the invention is not limited to this particular usage and may be employed for other diagnostic or operative purposes. Claims directed particularly to the pivotal suspension of the crutch supports are disclosed and claimed in a copending application SerialNo. 476,100 which is a division hereof.

Having described my invention, I claim:

1. An accessory for a table comprising crutch support. apparatus including a bracket adapted to be attached to the table, a post extend ng upwardlyfrom the bracket, an arm rotatably supported by the post and extending laterally therefrom, and ratchet meansconstituted by a nonrotatable member slidably carried by said post and a non-slidable member rotatably carried by said post, said members having cooperating ratchet teeth normally permitting the arm to be swung in the one direction of rotation thereof and preventing the arm from being rotated or swung in the opposite direction.

2. An accessory for a table comprising crutch support apparatus including a bracket adapted to be attached to the table, a post extending upwardly from the bracket, an arm rotatably supported by the post and extending laterally therefrom, ratchet means constituted by a non-rotatable member slidably carried by said post and a non-slidable member rotatably carried by said post, said members having cooperating ratchet teethnormally permitting the arm to be swung in the one direction of rotation thereof and preventing the arm from being rotated or swung in the opposite direction, and means for separating said members so that the arm may be swung in either direction.

3. A crutch support apparatus adapted for use in conjunction with an operating table comprising a bracket, a post, a hub attached to the post at one end thereof, a ratchet member rotatably journalled on the post'and held against movement longitudinally thereof, a second member arranged to be moved longitudinally of the post and held against rotation with respect thereto, the said ratchet members having their meeting faces constituting a ratchet, an arm carried by the rotatable ratchet member and means for normally holding the meeting faces of the members in engagement, whereby the arm may be swung in one direction of rotation but is prevented by the ratchet member from being swung in an opposite direction of rotation, the said post at its opposite end being adapted to be attached to the genitourinary table so as to be supported therefrom.

4. An apparatus adapted for use in conjunction with an operating table comprising a post, a member fixed to the post adjacent one end thereof, a first ratchet member journalled on the post adjacent the fixed member, means interconnecting the fixed member and the first ratchet member to permit the first ratchet member to be moved longitudinally of the post but not rotated with respect thereto, a second ratchet member rotatably journalled on the post adjacent the first, the said ratchet members having cooperating ratchet teeth thereon, spring means for urging one of the ratchet members toward the other for engagement of the teeth thereof, an arm carried by the second ratchet member so as to extend laterally of said post and a crutch support carried by said arm, the said post being adapted to be attached to a genitourinary table for support thereof, and the said ratchet members permitting the arm carried by the post to be swung in one direction and locking the arm against rotation in an opposite direction.

HAROLD J. LiflWRENCE.

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