US2035869A - Spinal fracture-reducing table - Google Patents

Description

March 31, 1936. c. D. DENISON SPINAL FRACTURE REDUCING T ABLE Filed June 12, 1954 3 Sheets-Sheet l March 31, 1936. c. D. DENISON SPINAL FRACTURE REDUCING TABLE Filed June 12, 1934 3 Sheets-Sheet 2 Patented Mar. 31, 1936 UNITED STATES PATENTIVOFFICE 9 Claims.

This invention relates to an improvement in spinal fracture-reducing tables, and particularly to tables for reducing fractures or dislocations of the dorsolumbar or cervical vertebrae, the ob- 5 ject being to produce a table on which a patient may comfortably lie and be rigidlyheld in' position, and in which strain may be applied to the back or neck to bring the vertebra: into proper alignment. 7 w The invention consists in the construction as hereinafter described and particularly recited in the claims.

In the accompanying drawings:

Fig.1 is a side view of a fracture-reducing 15 table constructed in accordance with my invention:

Fig. 2 is a plan view thereof;

Fig. 3 is a sectional view on the line 3-3 of Fig. 1;

20 Fig. 4 is a sectional viewon the line 4-4 of Fig. 1;

Fig. 5 is a sectional view on the line 5 -5 of Fig. 2; and i Fig. 6 is a sectional view on the line .6-6 of 25 Fig. 3.

In carrying out my invention, I employ a frame consisting of a head-end I and a footend ll. These are connected together on oppo- 30 site sides by upper tracks l2 and lower tracks Supported on the upper tracks is a traveler I4 and this traveler is connected by a link IS with the upper end of a lever I 6 which is pivoted at its lower end to the base I! of the head-end I0.

35 Each lever is coupled by a series of connectingrods H! with the lower ends IQ of brackets 20, mounted on and longitudinally movable upon the upper tracks l2.

On one side a handle 2| is connected with a rockshaft 22 and the handle is connected with the lever l6 by a link 23. At the opposite side, a link 51 is fixed to the rockshaft 22 and this is connected with a link 58 corresponding to the link 23, and this is connected with a lever 59 like the lever 18 which, in turn, is connected by a link 60 with the traveler i4, so that the movement of the handle 2| will move the traveler and the parts connected with it. On the rockshaft is a rack 50 24 adapted to be engaged by a pawl 25 mounted in the headend ID of the frame.

Above the brackets 20 are slats 26 of varying widths forming a platform, and below the slats are two longitudinally-arranged springs, each 55 consisting of an upper leaf 2'! and a lower leaf 28.

Two of the leaves are attached at one end to a shoulder-brace 29 and the other leaves are attached to a portion 30 of a table, which has lugs 3 I, connected by bolts 32 to lugs 33, at the top of the foot end H of the frame. Each slat is mounted at the upper end of an angular guide-rod 60 extending downward through an angular guideopening 6| in the center of the brackets 20, so as to guide the slats vertically.

Pivotally connected with the table 30 are hipbraces 34, the upper parts of which are adapted to be clamped by screws 35 with posts 36 carried by links 31. The links 31 are mounted on a pivot 68 and are connected together by a bolt 38 for longitudinal adjustment, and when adjusted may be locked by a nut 69 on the pivot 68, and between the links and upon the bolt is a spring 39, the tendency of which is to separate the links.

To lift the slats, lifters 40 have their ends directly beneath the springs, and these lifters extend outward and downward through supportingmembers 62, and their lower ends are connected by links 4| with blocks 42, rightand left-hand threaded for engagement with the rightand lefthand threaded screw-shaft 43, mounted in bearings 65 at opposite ends, the screw-shaft being provided at one end with a hand-wheel 44, by which the screw-shaft may be turned so as to move the blocks 42 toward or away from each other, and correspondingly raise or lower the lifters 40, the members 62 being formed with clearance-slots 63 and connected together by a tie-rod G4, which also acts as a guide for the blocks 42.

The support for the lifters is movably mounted on the lower tracks l3, so that the lifters may be moved beneath either of the slats, according to the point where the fracture or dislocation has occurred.

The shoulder-braces 29 are coupled with the traveler l4 by bolts 45, so that the shoulder-braces may be turned with respect thereto. The traveler l4 carries a ball 66, and connected with the ball is a head-rest 46 having clamping-jaws 61 engag- 5 ing the ball'66, the head-rest comprising a rest 41 ,for the back of the head, and an upwardlyextending arm 48 to which is pivoted a pair of chinsupports 49 which'may be drawn together by a screw 50, the chin-supports being formed at the 50V znntally, and held in position by a set-screw 531. The head-rest is rotatably movable upon the ball end of a stem! of the ball-and-socket joint before referred to, and longitudinally movable therewith and coupled with this stem is a screw 55 provided with a hand-wheel 56, the turning of which will move the head-rest forward or backward upon the stem 54. The head-rest, chin-supports, forehead-clamp, shoulderand hipbraces will be suitably padded.

In operation, the, patient is placed upon the table, the shoulder-braces adjusted to properly fit the shoulders, and the hip-braces adjusted to engage the body justabove the hip bones, the legs being supported by any suitable means. The head-rest, shaped to fit the occipital portion of the head, will also be adjusted according to the patient,so as to properly support the head The chin-supports will be adjusted to bear upon the chin, and the forehead-clamp 52 pressed upon theforehead, and this head-rest may be turned up or down, onto right or left, and also may be rotated, as desired for any particular case.

If the fracture or dislocation is of the dorsolumbar vertebrae, the lifter will be moved to a position below the slat within the range of the broken or dislocated vertebrae, and by turning the wheel 44, the lifters will raise the slats at the desired point, the springs arching to permit such movement, the adjacent slats and the apex of the arch being below the fracture, giving a support above and below the point of contact with the lifters, and arching the entire back.

If it is necessary or desirable to stretch the dorsolumbar vertebrae, the handle 2| will be moved so as to move the slats longitudinally, and at the same time'moving the head-rest, including the shoulder-braces as those are carried by the traveler, while the position of the hips and pelvis will remain stationary.

In case of fracture or dislocation of the cervical vertebrae, the body will be held as before described, with the shoulder-braces in the fixed position and the head-rest moved outward, so as to stretch the cervical vertibra, and the head. may be turned by the operator one way or the other, as necessary, to reduce the fracture.

The hip-braces; turning on the pivot 68. will move laterally and longitudinally in relation to the platform, so as to conform to a body on the platform.

I know of no table embodying the mechanics necessary to hold a torso and head under fixed traction and posture, and yet have the mobility required to adjust the patient to the proper positions for treatment. The vertical supportingsurface of my table consists of aplatform built of a series of lateral slats, longitudinally and vertically movable to a fixed position The longitudinal motion is obtained from a main traction and length-adjusting lever which moves them equally distant with relation to each other at all times, and this also serves to adjust the platform to the size of the patient. The vertical motion is obtained by a thrust-bar working upward against two flexible strips which run longitudinally and directly under the'series of lateral slats. As this thrust-bar is movable longitudinally as well as vertically, and as the flexible strips are held down at either end, it is possible, by raising the thrust-bar, to warp the platform into an arch with the apex at any desired point, and arrangements are provided to hold the platform as set. 'This combination is of vital importance in setting lumbar and dorsal fractures, as two forms of traction are required in this type of use. One is direct longitudinal and the other is also longitudinal, but is accomplished by making the distances between two points greater through arching, and if the apex of the arch is directly under the fracture, the stress will be the greatest at this point, where it is desired.

It is impossible to get this mechanical com-.

- higher up on the table. This serves as a length adjustment in coordination with the longitudinal traction levers, as well as a width. adjustment. The pads are so shaped that when adjusted, they fit both the anterior and upper and lateral surfaces of the anterior spine, thus firmly grasptraction. Any other form of unit which does not hold the patient absolutely fixed at the pelvis would destroy the effectiveness of the table and v the setting of the fracture, in that it would permit motion at the point of fracture by possible movement of the patient and variations in the amount of traction applied.

In conjunction with the hip pads are shoulder pads, which form the main longitudinal countertraction in the setting of cervical fracture, and an equal vertical counter-traction with the'hip pads when the arching traction is applied. In

.order to accomplish this, thepads are swivelly mounted to swing upward and downward to conform to various sizes of shoulders and also to the patients position when the back is arched, and also a length adjustment is obtained by this swivel as the downward motion brings the pad nearer to the lower end of the table and the upward motion further from the end.

The pads are so shaped as to bear on the top and anterior surfaces of the shoulder, thus preventing the shoulders. from moving upward or vertically under traction, and they also keep the patient immobile at this point, which is imlever in a longitudinal direction only. The cervical traction is exerted through them from the shoulders in any conceivable direction or in rotation of approximately 45 to right or left. The.

entire unit is mounted on a lockable ball-andsocket joint to give this freedom of direction and fixed traction; The advantageof this flexibility is that the head may be grasped in any position which it has been placed by the cervical fracture, and motion and traction applied in any sequenoe for the proper setting of the fracture and freeing of impinged nerves. It is rigidly lockable in any position.

The whole unit acts as a lever swinging from the ball-and-socket joint, thus facilitating the motion of reduction and the traction force is exerted by a handscrew in the unit.

The grasping-pads are designed to distribute the pressure of traction over the greatest possible area, and consist of one pad fitted to the occiput portion of the head, one to each side of the lower jaw, and one on the forehead and temples. All are fixedly adjustable to the head, so that it cannot be moved or rotated except as the entire head-unit is moved.

' quires it.

Special padding is provided at all supporting points and the design is particularly arranged to give accessibility to the body for X-ray, bathing and other medical treatments.

I thus provide means for comfortably supporting a body and stretching either or both the dorsolumbar or cervical vertebrae and holding the parts in position as long as necessary.

It will be understood by those skilled in the art that my invention may assume varied physical forms without departing from my inventive concept and I, therefore, do not limit my invention to the specific embodiments herein chosen for illustration.

I claim:

1. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets individually longitudinally movable on said tracks, slats over said brackets and vertically movably connected therewith, means for moving said brackets and slats longitudinally, means for raising and fixing said slats, and hip-braces carried by the frame and adjustable vertically, laterally and longitudinally, whereby counter-traction is provided longitudinally from the head.

2. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets individually longitudinally movable on said tracks, slats over said brackets and connected therewith, means for moving said brackets and slats longitudinally, means for arching said slats, adjustable non-flexible hip-braces carried by the frame, means for adjusting the same vertically, longitudinally or laterally, and means for rigidly holding the same when adjusted, and adjustable shoulder-braces swivelly adjustable, and means for rigidly holding thesame when adjusted also carried by the frame.

3. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets longitudinally movable on said tracks, slats over said brackets and connected therewith, travelers on said tracks, levers connected with said travelers, each lever coupled by a series of connectingrods with the said brackets, means for moving said travelers longitudinally, a ball carried by said travelers, a head-support mounted on said ball, and means for moving the head-rest in any direction.

4. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets longitudinally movable on said tracks, slats over said brackets and connected therewith, means for individually moving said brackets and slats longitudinally, and longitudinally movable means for raising and fixing said slats, and hip-braces mounted on the frame and adjustable vertically, laterally and longitudinally, whereby countertraction is provided longitudinally from the head.

5. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets longitudinally movable on said tracks, slats over said brackets and connected therewith, means for individually moving said brackets and slats longitudinally, longitudinally-movable means for arching said slats, swivelly-adjustable shoulderbraces mounted on the frame, adjustable hipbraces also mounted on the frame, and means for adjusting said hip-braces vertically, longitudinally or laterally, and means for rigidly holding the same when adjusted.

6. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets longitudinally movable on said tracks, slats over said brackets and connected therewith, means for individually moving said brackets and, slats longitudinally, longitudinally-movable means for arching said slats, longitudinallyand laterallyadjustable hip-braces mounted on the frame with means for rigidly holding the same when adjusted, and swivelly-adjustable shoulder-braces also mounted on the frame with means for rigidly holding the same when adjusted, whereby counter-traction is provided at the shoulders, through the cervical spine, and vertically on anterior portions of the shoulders.

7. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets longitudinally movable on said tracks, a slat over each bracket and connected therewith, longitudinally-arranged springs below said slats, means for individually moving said brackets and slats, longitudinally, and longitudinally-movable means for vertically adjusting and fixing a series of said slats to a definite arch, with the apex at any desired point.

8. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets longitudinally movable on said tracks, slats over said brackets and connected therewith, travelers on said tracks, levers connected with said travelers, each lever coupled by a series of connectingrods with the said brackets, and means for moving said travelers longitudinally.

9. A fracture-reducing table comprising a frame, tracks at the top of the frame, brackets movable on said tracks, slats over said brackets and connected therewith, longitudinally-arranged springs on which the slats rest, travelers on said tracks, levers connected with said travelers, each lever coupled by a series of connectingrods with the said brackets, and means for moving said travelers longitudinally.

CEDRIC D. DENISON.

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