US2672146A - Apparatus for plastic surgery - Google Patents

Description

March 16, 1954 1. TOUSON APPARATUS FOR PLASTIC SURGERY 3 Sheets-Sheet 1 Filed Nov. 10, 1952 INVENTOR. BY ,4

March 16, 1954 l. TOUSQN APPARATUS FOR PLASTIC SURGERY 3 Sheets-Sheet 2 Filed Nov. 10, 1952 I INVENTOR. ZMCELJ BY March 16, 1954 1. TOUSON 2,672,146 APPARATUS FOR PLASTIC SURGERY Filed Nov. 10, 1952 3 Sheets-Sheet 3 INVENTOR. BY qz'wwam discomfort to the patient. willfbe 'providedrmth adjusting means allowing Patented Mar. 16, 1954 UNITED STATES PATENT OFFICE 2,672,146 APPARATUS FOR. PLASTIC SURGERY Isaac Touson, Buenos Aires, Argentina Application November 10, 1952, Serial No. 319,691

8 Claims.

.This invention relates to apparatus for use in surgery, and more particularly in plastic surgery. When it is necessary to restore the loss of nasal substance in the region of the wings and lobes, it is possible to resort to the auricular substance of the same patient and carry out a sort of transplantation. However, certain operatory conditions should be met so as to deal with the behaviour of the tissues, and in order to obtain the union of the transplanted auricular tissue with the previously quickened borders of the loss of nasal substance, it is necessary, in order to avoid the necrosis of the auricular flesh, to join same before trimming, for example with the patients thumb, and to only remove the thumb from the tissue after the latter has become joined to the edges of the loss of nasal substance.

In order-toeifect digito-auricular and nasoauricular unions the mere juxtaposition and suture of the parts is not sumcient, and it is necessary to avoid displacements and separations thereof, which would unavoidably occur, even when the patients hand is immobilized throughout the time required to complete the process of uniting the parts.

Prior toithis invention, such fastening of the hand has been done through the use of bandages and strapsamethod which leaves the patient ina very uncomfortable condition, particularly during the step of naso-auricularsuture. On the other hand, in view of the long time during which the patient must keep the bandages on, it is practically impossible to use thesame bandages and straps again, so that a material which must be specially prepared is lost each time. Also, it is obvious that a bandage cannot secure the absolute immobilization of the tip of the thumb, either during the digito-auricular step or'the naso-auricular step, with the consequent dangerfailure of the operat'on, at least from the a'esthetical point of view. Finally, during the 'na'so-auricular suture step the face and the nasal partition are the only bearing points for the patients hand and thumb, which besides being highly uncomfortable could cause the occlusion of the nasal fossa upon completion of the nascauricular suture, thus requiring a rectifying operation when circumstances permit.

Therefore, the'object of this invention is to provide an apparatus afiording clamping surfaces and supporting members suitably arranged and allowing the immobilization of the thumb and hand in a very'simple manner and with minimum Also, the apparatus an almost universal use thereof, and due to its mechanical construction it can be made of materials which may be readily rendered sanitary so as to allow the use thereof in an indefinite number of cases. On the other hand, as will be seen hereinafter, the novel apparatus allows the efficient airing of the patients head and transfers the supporting pressures from the head to the shoulders.

Generally, the novel apparatus for plastic surgery comprises a shoulder fitting member or yoke, a central support for a head clamping ring and a pair of lateral supports extending from said shoulder fitting member and capable of being adjustably attached to the ends of a hand supporting half hoop and of a jaw support, there being provided also a thumb rest capable of being adjustably secured to said half hoop, and securing elements adjustably secured to the shoulder fitting member.

In order that the invention may be more clearly understood, a preferred embodiment thereof has been illustrated by way of example in the accompanying drawings, wherein:

Fig. 1 is a perspective view of an embodiment of a plastic surgery apparatus in accordance with this invention.

Fig. 2 is a side view of the hand supporting half hoop thereof.

Fig. 3 is a perspective view of the half hoop supporting plate.

Fig. 4 is an end view of the thumb rest.

Fig. 5 is a plan view of the thumb rest shown in Fig. 4.

Fig. 6 is a forward end view of the jaw ring.

Fig. '7 is a plan view of the ring shown in Fig. 6.

Fig. 8 is a side view of the jaw ring; and

Figs. 9 and 10 are views showing the back and palm sides of a gauntlet constituting an accessory of the apparatus of this invention.

Referring first to Fig. 1, it will be seen that the apparatus of this invention comprises a shoulder fitting member or yoke I including a back portion 2 and a pair of suitably shaped shoulder ends 3, there being provided also a pair of auxiliary securing elements 4 secured either permanently or detachably to said yoke. A main support 5 extending from the central portion of said yoke 1 supports a head clamping ring 6 designed to surround the patients head. While this ring 6 may be integral with the support 5, it is preferred to form same as a separate member and connect it in an adjustable manner to said support, so as to allow a graduation of the spacing between the ring and the yoke. For this purpose, the support is formed with a slot I engaged by a screw-threaded pin 8 secured to the ring 6, preferably in a permanent manner, and capable of receiving a washer 9 and a wingnut iii constituting the means for securing the head clamping ring 5 with respect to the main support 5. Diametrically opposite the support 5, said ring 6 is divided and provided with a pair of projections 5! formed with holes l2 through which a tape or cord (not shown) may be passed for the purpose of fastening the ring to the patients head by tying.

Extending from each shoulder end 3, there is provided a lateral support l3 having a longitudinal slot it capable of receiving fastening means for fixing a supporting half hoop l5 in a desired position, said lateral support 13 serving also as a complementary fixing point for the head clamping ring as an anchoring point for a jaw support It. By means of this construction it is possible to adjust the main parts as to height and also, as regards the half hoop and jaw support, as to the spacing from the main support 5. By using the lateral supports l3 for the three purposes indicated above, it is possible to reduce to a minimum the number of parts and therefore the weight of the apparatus, while retaining the universal applicability thereof.

Suitable fastening means are provided for the supplementary side holding of the head clamping ring 5, which may for example take the form of a bolt ll, washer l8 and wing-nut it.

By inspecting Figs. 1, 2 and 3, it will be seen that the half hoop l5 comprises a supporting portion approximately semi-circular and frusto conical in shape, as clearly shown in Fig. 2, this supporting portion havin' a lon itudinal slot 2i. The half hoop [5 comprises also a pair of fastening ends 22 preferably somewhat wider than the supporting portion and provided with a pair of narrow slots 23 extending parallelly at either side of a wider fastening slot 24 extending longitudinally of the fastening ends 22.

As shown in Fig. l, the half hoop i5 is adjustably secured at the fastening ends 22 thereof to the lateral support l3 by means of a bolt 25 having an enlarged head 25 seated against the inner face of the corresponding lateral support l3, said bolt 25 being passed throu h the support slot Hi and through the fastening 24 at the supporting end 22 of the half hoop [5. An immobilizing plate 2! is applied against the outer face of the supporting end 22. The construction of this place 2? is more clearly shown in Fig. 3 from which it will be seen that it is generally rectangular in shape and is cut away and bent so as to provide a pair of tongues 28 parallel to each other and located at each side of a central opening 25 designed for fitting over the bolt 25, so as to engage the narrow slots 23 in the fastening end 22. By cutting and bending the tongues 28, arms 32 are formed at each side thereof, the free ends of which are flanged as indicated at 3| so as to extend in the same direction as the tongues 28, the assembly being proportioned so that the flanges 3! will fit on the upper and lower edges 32 and 33 (Fig. 2). The plate 2'! is secured by means of a wing-nut 36 screwed onto the bolt 25, whereby the plate 2? will cooperate with the respective lateral support it in securing the fastening ends 22 of ring 55 and also in preventing the oscillation thereof, since the tongues 28 are of sufficient length to enter the longitudinal slot [4 in the side supports it after having been slot whereas the tongues 28 are arranged :1

thumb passed through the narrow slots 23 in the fastening ends 22, as clearly seen at the right-hand portion of Fig. 1.

The slot 2! in the half hoop serves for fastening a finger rest at any peripheral point of the half hoop, the construction of said finger rest being clearly shown in Figs. 1, 4 and 5. It comprises a supporting curved portion 35, suitably shaped so as to allow the resting thereon of a finger, preferably the thumb, and a fastening projection 5'! having a hole 38 for allowing the passage of a screw 39 by means of which and a wing-nut 4f! the thumb rest may be secured to the half hoop, as shown in Fig. 1. Obviously, a

rest for each hand will be provided, although in practice only one will be used at a time, but it is necessary to consider the possibility of operating on. both nose wings.

Considering now Figs. 1, 6, '7 and 3 it will be seen that the apparatus includes also a jaw support 15 comprising a concave portion 4| designed for supporting the patients lower jaw, and divergent arms 42 which may have an angular shape and are preferably inclined away from the general plane of the concave portion, so that the ends of arms 42 having a deep notch 43 may be fastened, for example by means of a bolt 44 and a wing-nut 45 (see Fig. 1) to the lateral supports l3 below the fastening ends 22 of the half hoop I5. For reasons of safety, the free ends of arms 42 are flanged as indicated at 46, so as to provide abutments adjusting against the rear edges of lateral supports l3.

Inasmuch as the effective lever resulting from fastening the jaw support [6 to the lateral arms 13 is important, if necessary the free end of said jaw support represented by the concave portion may be reinforced by means of a sling-like piece made of leather, linen or other suitable material, which will be passed under the concave portion and the ends of which may be connected to the head clamping ring 6; for this purpose, the ring 6 is provided with pins 48. Also, other pins 49 may be provided on the head clamping ring for holding a support for the patients arm. The sling-like element for the jaw has been indicated at 41 in Figs. 1 and 8.

The apparatus is completed with an accessory shown in Figs. 9 and 10, having the form of a gauntlet and serving for fastening the patients hand to the half hoop 15, for which purpose the palm face of the gauntlet 50 is provided with a screw 5| with a corresponding wing-nut 52, the back face of the gauntlet being provided with eyelets 53 and a cord 54 for fastening same. As in the case of the thumb rest 35, a gauntlet will be provided for each hand.

It will be understood that the parts of the apparatus, and particularly the head clamping ring, the yoke and the concave portion of the jaw support may be lined with resilient material such as sponge, felt or the like, so as to increase the comfort to the patient, this possibility having been indicated only for the head clamping ring at 55 in Fig. 1.

When it is found advisable to resort to rhinoplasty, for the first step the apparatus is placed on the patients shoulder with the head clamping ring around the head, making the necessary adjustments as to height.

The gauntlet 55 is applied to the corresponding hand and connected loosely to the half hoop l5 by means of the screw 5| and wing-nut 52, the half hoop being adjusted to a suitable position with the aid of the fastening system comprising the ends 22, the immobilizing plates 21 and-wing nuts 34,; the jaw support lfifbelng also placed in a position which is comfortable to the patient; wherein it is fixed by means of the wing-nuts 45. The fastened hand is then moved to the half hoop I5, to a position suitable for the surgical operation necessary for causing the digito-auricular adhesion, whereupon the hand if fixed definitely in the desired position by means of the wing-nut 40 (Fig. 4). The patient is thus arranged comfortably for the time required for the digito-auricular suture, with the assurance that the finger (thumb) cannot be moved from its proper position.

After the required period of time, the second rhinoplasty step will be carried out, said step comprising the sectioning of the auricular tissue, suture of the borders of the notch in the external ear and naso-auricular suture. For this purpose, the wing-nut 40 is loosened so as to allow the movement of the corresponding hand along the half hoop l5 at the proper time, in order to bring th finger with the auricular tissue to the position required for the naso-auricular suture, in which position it will be fastened again by tightening the wing-nut 60. With the same assurance as before that the hand cannot move, it will, with a fair amount of comfort to the patient, be held in place during all the time necessary for joining the tissue to the edges of the nasal substance loss.

Once the rhinoplasty is completed, the apparatus may be easily removed from the patient and after separatin the interposing pads, it may be cleaned and sterilized. The apparatus may thus serve for another patient. since it may be readily adjusted to the physical characteristics of the latter, as explained above.

It is evident that several changes, modifications and/or alterations will occur to those skilled in the art, in carrying out the invention, without departing from the scope thereof as defined in the appended claims.

I claim:

1. An apparatus for use in plastic surgery comprising a shoulder fitting member, a central support extending from said member, a head clamping ring mounted on said central support, a lateral support extending from said member on either side of said central support, a hand supporting half hoop having ends adjustably secured each to a respective lateral support, a jaw support having ends adjustably secured each to a respective lateral support, a thumb rest adjustably mounted on said half hoop and securing elements adjustably secured to said shoulder fitting member.

2. An apparatus for use in plastic surgery comprising a shoulder fitting member, a central support extending from said member, a head clamping ring mounted on said central support, a lateral support extending from said member on either side of said central support, a hand supporting half hoop of frusto-conical shape having ends adjustably secured each to a respective lateral support, a jaw support having ends adjustably secured each to a respective lateral support, a thumb rest adjustably mounted on said half hoop and securing elements adjustably secured to said shoulder fitting memher.

3. An apparatus for use in plastic surgery comprising a shoulder fitting member, a central support extending from said member, a head clamping ring mounted on said central support, a lateral support extending from said meme her on eitherside of said central support, a'; handsupporting half hoop slotted lengthwise todefine a, longitudinal slot, said half hoophavn end a iust lr s cured each to a s c ive late a u port, a aw su r h ving, ends a r justab ly secured each to a respectivelateral sup, port, a thumb rest including a fixing screw, said thumb rest being adjustably mounted on said half hoop with said fixing screw extending hr h aid lo i d na ot and c in e ements adjustably' secured to said shoulder fitting member.

4. An apparatus for use in plastic surgery comprising a shoulder fitting member, a central support extending from said member, a head clamping ring mounted on said central support, a lateral support extending from said member on either side of said central support, each lateral support being slotted to define an adjustment slot, a hand supporting half hoop having ends, each end being dotted to define a central slot and a lateral slot on either side of said central slot said slots extending lengthwise of said half hoop ends a fixing plate having a pair of offset lugs of a size to extend through said lateral slots and through said adjustment slot, said fixing plate being perforated to provide a bolt hole, bolt means for locking the ends of said half hoop to respective lateral supports, said bolt means being of a size to pass through said bolt hole said central solt and said adjustment slot, a jaw support having ends adjustably secured each to a respective lateral support, a tumb rest adjustably mounted on said half hoop and securing elements iadjustably secured to said shoulder fitting member.

5. An apparatus for use in plastic surgery according to claim 4 in which said fixing plate comprises oppositely disposed ofiset lugs and a gripping arm extending from said plate on either side of each lug, the ends of said gripping arms being bent over for gripping the edges of said half hoop.

6. An apparatus for use in plastic surgery comprising a shoulder fitting member, a central support extending from said member, said central support being slotted to define a lengthwise extending slot, a head clamping ring including a fixing screw of a size to pass through said lengthwise extending slot and means for said fixing screw for securing said head clamping ring in adjusted position to said central support, a lateral support extending from said member on either side of said central support, a hand supporting half hoop having ends adjustably secured each to a respective lateral support, a jaw support having ends adjustably secured each to a respective lateral support, a thumb rest adjustably mounted on said half hoop and securing elements adjustably secured to said shoulder fitting member.

7. An apparatus for use in plastic surgery according to claim 6, in which each lateral support is slotted to define an adjustment slot and said head clamping ring further includes screw threaded fixing means of a size to pass through said adjustment slots.

8. An apparatus for use in plastic surgery comprising a shoulder fitting member, a central support extending from said member, a head clamping ring mounted on said central support a lateral support extending from said member on either side of said central support, a hand sup porting half hoop having ends, each end being recessed to provide a pair of spaced tongues defining between them a deep notch, the ends of said tongues being bent over to form stops for engaging the edges of said lateral supports nearest said central support, each lateral support being slotted lengthwise to define an adjustment slot, bolt means of a size to pass through said deep notches and said adjustment slots for adjustably securing said half hoop to said lateral supports, a jaw support having ends adjustably secured each to a respective lateral support a thumb rest adjustably mounted on said half loop and securing elements adjustably secured to said shoulder fitting member.

ISAAC TOUSON.

References Cited in the file of this patent UNITED STATES PATENTS 10 Number Name Date 1,301,276 Kroetz Apr. 22, 1919 1,803,556 Nugent May 5, 1931

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