Surgical appliance
United States Patent Burris et al.  
 [ 1 SURGICAL APPLIANCE [76] Inventors: Lenard A. Burris; Theodore L.  
 Burris, both of 15310 Ashworth Ave. North, Seattle Wash, 98133 [221 Filed: Feb. 4, 1974 [21] Appl No.: 439,001  
 [52] U.S. Cl. 269/328; 5/327 R [511 Int. Cl l. A61g l3/00 [58] Field of Search 269/328; l28/l33, [34; 5/327 R, 92  
 [56ml References Cited UNITED STATES PATENTS l4529l5 4/1923 Kennedy 7. 5/327 R 1 51 Apr. 29, 1975 1.516.795 11/1924 Schwarting 269/328 FOREIGN PATENTS OR APPLICATIONS 1.377.482 9/1964 France 5/327 R Prirmlr E.\&#39;uminer-R0y Lake Assistant E.ruminerNeil Abrams 1 1 ABSTRACT An appliance for attachment to a surgical table is dis closed as a pivoted arch member for adjustable restraight of a patients lower leg while it is bent to facilitate access to the region of the knee for surgical operations 6 Claims, 4 Drawing Figures 1 SURGICAL APPLIANCE SUMMARY OF THE INVENTION BACKGROUND During knee surgery considerable difficulty is en countered in presenting and maintaining a patients knee in a desired immobile, bent condition giving ready access for the surgeon. A common practice has been to assign an assitant or operating room technician to physically grasp and place his body upon the patient&#39;s foot and lower leg and remain there throughout. This is very fatiguing, crowds the surgical arena, and does not always insure against unwanted changes in the bent condition of the knee during the often protracted periods of surgery. An effort at providing mechanical restraint has involved securing the bent leg in upright position by elastic means tensioned between posts at the opposite sides of the surgical table. The elasticity of the restraint does not always insure immobility, and this system complicates draping the patients leg for surgery. When release is desired, undraping is usually required, violating the aseptic area.  
  It has therefore been among the principal objects of this invention to provide a surgical restraining appliance for bent-knee surgery which is simply to construct and adapt to a surgical table; which can be covered by the surgical drapes without imposing limitations on the surgical area; and which can be released without undraping of the site of surgery.  
 DESCRIPTION OF THE DRAWINGS FIG. I is a side view depicting the surgical appliance of this invention as it may appear in use;  
  FIG. 2 is an enlarged vertical face view of the surgical appliance showing it in association with a portion of a surgical table;  
  FIG. 3 is an enlarged vertical section taken on line 3-3 of FIG. 2; and  
  FIG. 4 is a vertical sectional detailed view taken on line 4-4 of FIG. 2.  
 DESCRIPTION OF A PREFERRED EMBODIMENT This appliance is used in association with the surgical table which is usually supplied with a side rail 12 on which may be attached clamps 14 the details of which are best seen in FIG. 2. Clamps 14 comprises a U- shaped member that straddles rail I2 and includes the clampscrew 16. Base plate 18 has a downturned leg 20 which passes through slot 22 of clamp 14 into juxtaposition to side rail 12 to which it is secured by a tightenable clamp screw 16.  
  Base bar 24 is attached in superposed relation to base plate 18 by means of screw 26. Member 24 in this preferred embodiment supports upstanding journals 28 and 30 in which, by means of trunnions 32 and 34, the arch member 36 is pivotally associated with base member 24.  
  Referring to FIG. 4, base block 44 is outstanding from the rear of the concavo-convex saddle 42. It has a socket 46 therein. Block 44 has cap block 48 secured thereto by screws 50,50 and the assembly comprises clamping means about the journal portion 40 of arch member 36. In the socket 40 is a Teflon friction-block 52 pressed by spring 54 against portion 40 to function as a braking means to hold saddle 42 in an adjusted angular relationship with respect to arch member 36.  
  Securement means between the base member 24 and one of the legs 38 of the arch member 36 is provided for maintaining the arch 36 in a selected angular relationship relative the upper surface of table I0. This is accomplished by providing the lower part of leg 38 and trunnion 34 with a toothed or notched segment 56 as shown in FIG. 3. Member 56 is secured to and rotates with trunnion 34 as the arch 36 is swung to one or the other of the angular positions. Member 56 has a plurality of notches 58 on its periphery, one of which, in a selected position, is engaged by latch tongue 60 on the end of lever or latch arm 62 that, by means of pivot 64, is pivotally mounted in the upwardly open U-shaped member 66. The tongue end 60 of lever 62 is guidedly moved in a slot 66 in the upstanding arm 68. Pivot pin 64 is journalled in the other upstanding arm 70 of member 66. Hold-down spring 72 is anchored at its lower end to base structure and at its upper end to lever 62 as best shown in FIG. 3. Lever 62 extends outward to provide a pad 72 whereby the latching lever may be depressed to raise its latch end 60 out of one of the notches 58. The appliance may be used on either the right or left hand side of the table simply by rotating the saddle 42 I&#34;.  
  This appliance is particularly useful in surgery involving a person&#39;s knee structure as suggested in FIG. 1 where circumstances require that the patient&#39;s leg be adjusted during surgery or maintained in the adjusted, usually bent, position and immobile. The patient reclines on the table 10. The leg is raised and bent to a condition where the foot rests on base structure 24. Arch member 36 is adjusted to an angular position that will bring saddle 42 close to the shin of the patient to hold it against any movement which would tend to straighten out the leg. Normally a member of the surgical team makes this adjustment of the appliance and determines the positioning of the knee which is to be operated on. The patients knee is draped in the customary manner. Usually the area of surgery is exposed through an opening in the draping cloths.  
  Should it become necessary after draping has taken place to readjust the patients leg or, as will occur during and at the other end of the operation, to release the patients leg from the restraining influence of this appliance, the protruding outward end of lever 62 can easily be pressed upon through the drapes to raise the latch tongue 60 out of a notch 58 without necessarily breaching the sterile zone of surgery that has been established in the immediate vicinity of the patients knee. To reestablish the original restraint position on the leg or in the case of selecting a new position during surgery the saddle 42 is grasped through the drapes and pulled up. The latch tongue 60 automatically engages notch 58.  
  It has been found that this appliance is particularly useful, also, during hand and arm surgery. In such event the device is mounted on the side rail of the surgical table 10 in a position more closely related to the upper arm, elbow or forearm and hand of a patient. This may be by raising the leg 20 in clamp 14 so that the base structure is disposed over the patients body. Or its relation to the table top may be reversed, from that shown in FIG. 2, so that the arch 36 extends laterally from the table at the side of the patient. The saddle 42 is then adjusted to the substantially horizontal disposition to receive that portion of the patients arm which is most practical to support.  
  In compliance with the statute. the invention has been described in language more or less specific as to structural features. It is to be understood however, that the invention is not limited to the specific features shown. since the means and construction herein disclosed comprises a preferred form of putting the invention into effect. The invention is. therefore. claimed in any of its forms or modifications within the legitimate and valid scope of the appended claims, appropriately interpreted in accordance with the doctrine of equiva lents.  
 What is claimed is:  
  l. A surgical appliance for use on a surgical table during leg surgery. comprising:  
 a base member including means for attachment to one side of a surgical table and shaped to extend inward of the table edge in overlying relation to said table;  
 an unobstructed arch member pivotally associated at the lower ends of its legs with said base member and disposed laterally of said table edge above said base member at a location on said table to traverse the lower portion of a patients limb and the patients foot to be placed therein and resting on said base member;  
 securement means between said base member and one of the said legs of said arch member for maintaining the latter in a selected angular relationship (ill to the upper surface of said table and with respect to a selected angular disposition of a patients limb bent at the knee as for surgery in the region of the knee; and  
 a saddle pivotally mounted on said arch member at its apex of a size and shape to bear on an appropriate surface area of the front lower portion of the patients limbv 2. An appliance according to claim 1 in which the securement means comprises a quick-release latchmechanism.  
  3. The appliance according to claim 2 in which the latch-mechanism includes at least a pair of notches and a latch dog selectively engageable therein.  
  4. The appliance according to claim 2 in which the latch-mechanism is associated with that leg of the arch member most readily accessible from the table edge from which the base member extends inward.  
  5. The appliance according to claim 1 in which the pivotal mount of the saddle on the arch member in cludes frictional brake means operable to normally maintain said saddle member in a selected angular dis position relative its axis of pivot.  
  6. The appliance according to claim 5 in which said frictional brake means includes a spring-pressed Teflon friction member to press on said arch member at its apex.