Other Classes:
600/219, 606/86R, 600/235, 600/227
Other References:
Girard, P. M. "A Self-Retaining Retractor Useful In Open Operations On Bone," In Jour. Bone and Joint Surg. 1934, p. 612..
Parent Case Data:
CROSS REFERENCE TO RELATED APPLICATION
This application is a continuation-in-part of U.S. Ser. No. 773,750 filed Nov. 6, 1968 and now abandoned.
Claims:
I CLAIM
1. A self-retaining muscle retractor comprising:
2. A self-retaining muscle retractor as set forth in claim 1 wherein:
3. A self-retaining muscle retractor as set forth in claim 1 that includes:
4. A self-retaining muscle retractor as set forth in claim 1 wherein:
5. A self-retaining muscle retractor comprising:
6. A self-retaining muscle retractor as set forth in claim 5 that includes:
7. A self-retaining muscle retractor as set forth in claim 5 wherein:
8. A self-retaining muscle retractor as set forth in claim 5 that includes:
9. A self-retaining muscle retractor as set forth in claim 5 wherein:
10. A self-retaining muscle retractor as set forth in claim 9 wherein:
11. A self-retaining muscle retractor as set forth in claim 9 wherein:
12. A self-retaining muscle retractor as set forth in claim 9 that includes:
Description:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates generally to muscle retractors for maintaining an incision open for convenient access to a bone.
2. Description of the Prior Art
Muscle retractors have been proposed which include a pair of arms having interconnecting ends whereby the arms may be inserted in an incision, extended along opposite sides of a bone, then spread apart and interconnected underneath the bone to hold such arms spaced apart and the incision open. A retractor of this type is disclosed in U.S. Pat. No. 2,695,607. Muscle retractors of this type suffer the disadvantage of necessitating stripping flesh from the underside of the bone for receipt of the interconnecting arms thus increasing the amount of surgical work required and prolonging the operating time.
SUMMARY OF THE INVENTION
The present invention is characterized by a pair of elongated retractor members formed on their lower ends with bone-engaging portions and having their upper extremities defining lever arms. A brace is pivotally connected on one end to the upper extremity of one of the lever arms and has its free end engageable with latching elements on the other lever arm whereby the bone-engaging portions may be inserted in an incision, engaged on opposite sides of a bone, the lever arms spaced apart and the free end of the brace engaged with a latching element to maintain the incision open for convenient access to the bone.
An object of the present invention is to provide a self-retaining muscle retractor which eliminates the necessity of stripping the bone around its entire periphery thus enabling use in the hip area and other areas where the underside of the bone cannot be readily stripped.
Other objects and advantages of the present invention will be made apparent from the consideration of the following description when taken in conjunction with the accompanying drawing.
DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of one arm member included in a self-retaining muscle retractor embodying the present invention;
FIG. 2 is a transverse sectional view of a patient's thigh having a self-retaining muscle retractor embodying the present invention being utilized to hold an incision open;
FIG. 3 is a top view, in reduced scale, of the self-retaining muscle retractor shown in FIG. 2;
FIG. 4 is a partial perspective view of a second embodiment of the self-retaining muscle retractor of present invention;
FIG. 5 is a partial perspective view of a modification of the self-retaining muscle retractor shown in FIG. 2;
FIG. 6 is a perspective view of a second embodiment of the self-retaining muscle retractor of present invention;
FIG. 7 is a vertical sectional view taken along the line 7--7 of FIG. 6 and partially broken away;
FIG. 8 is a detailed view, in enlarged scale, of a portion of the muscle retractor shown in FIG. 6; and
FIG. 9 is a detailed view, in enlarged scale, of another portion of the muscle retractor shown in FIG. 6.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The self-retaining muscle retractor shown in FIGS. 1, 2 and 3 includes arm members A and B formed with bone-engaging tabs 11 and 13 on their lower ends and having their upper extremities in the form of respective lever arms 15 and 17. Connected to the upper end of the lever arm 15 is a rigid bail type brace, generally designated 21 which has its free end 23 engageable with serrations 25 included in the lever arm 17. Thus, the retractor may be utilized by inserting the bone-engaging portions 11 and 13 into an incision 29 and on opposite sides of a bone 31, the arms 15 and 17 then spread apart to retract the muscles away from such bone and to enable the free end 23 of the brace 21 to be engaged with a selected one of the serrations 25 to maintain such arms A and B spaced apart and the incision 29 open for convenient access to the bone 31.
The tabs 11 and 13 are curved downwardly and inwardly for complemental engagement with the arcuate-in-cross section bone 31. Included above the tabs 11 and 13 are respective enlarged pad portions 35 and 37 which serve to hold the flesh and skin back from the incision 29. The pad portions 35 and 37 include apertures 39 spaced along their peripheries for receipt of towel clamps 44 (FIG. 3). The lever arms 15 and 17 bend outwardly as they extend upwardly above the respective pad portions 35 and 37 so they will be spaced apart when installed as shown in FIG. 2, to provide sufficient maneuvering room for the surgeon operating on the bone 31.
Pivotally attached to the upper end of the lever arm 17 is a bail type brace 41 similar to, but longer than, the brace 21 and having its free end 43 engageable with serrations 45 included in the upper extremity of the lever arm 15. Thus, the brace 41 may be utilized as shown in broken lines in FIG. 2 to hold the arms 11 and 13 spaced farther apart than would the brace 21 to thereby maintain the incision 29 farther open.
Referring to FIG. 5, a coupling 47 is formed from sheet material and defines a through passage 49 which receives the free ends 23 and 43 of the respective braces 21 and 41 whereby the arms A and B may be spread apart and such free ends of the braces received in the coupling 47 and butted together to maintain the upper ends of the lever arms 15 and 17 spaced apart even farther than the brace 41.
The arm 51 shown in FIG. 4 is similar to the arm shown in FIG. 1 except that a brace 53 is received within a cutout 55 and is pivotally connected on its upper end to the arm 51 by means of a transverse pivot pin 57.
In operation, the subject retractor may be utilized on a hip or femur and the incision 29 for gaining access to the bone 31 is made and the top portion of the bone 31 stripped, such stripping extending downwardly along the sides 61 and 63 (FIG. 2) as shown in FIG. 2 for receipt of the bone-engaging tabs 11 and 13. The arms A and B are then inserted, the tabs 11 and 13 positioned at the sides 61 and 63 of the bone 31, and the lever arms 15 and 17 grasped to pull the muscles and flesh 67 and 69, on opposite sides of the incision 29, apart. A selected one of the braces 21 or 41 may then be pivoted into locking position with the serrations 25 or 45 in the opposed arm to maintain the incision 29 open to the desired degree. The surgeon can then perform his operation on the bone 31 without the necessity of an assistant holding the arms A and B apart.
Also, the towel clamps 44 may be inserted through the skin and through the apertures 39 to maintain the arms A and B stationary.
The muscle retractor shown in FIGS. 6-9 is similar to that shown in FIG. 1 except that the lever arm 15 is formed in its upper extremity with an upwardly opening slot 75 which receives one end of a rigid brace, generally designated 77, such brace being pivotable supported therein by means of a transverse pivot pin 79 (FIG. 8). The upper extremity of the lever arm 17 is also formed with an upwardly opening slot 81 for receipt of the free end of such brace 77, such free end of the brace 77 being formed with a series of downwardly opening slots 85 for receipt over the lever arm 17 and cooperating to form downwardly projecting teeth 87.
Referring to FIG. 9, a U-shaped locking clasp 91 is formed at its open end with inwardly turned confronting pivot legs 93 which are received in opposite ends of a bore formed in the lever arm 17 to provide for free pivoting of such clasp. The free extremity of the clasp 91 is formed on its opposite sides with transverse inwardly projecting bearing elements 95 which are selectively received in a latching groove 97 formed on the side of the lever arm 17 opposite that to which the clasp 91 is connected.
In operation, the self-retaining muscle retractor shown in FIGS. 6-9 is utilized by inserting the bone-engaging tabs 11 and 13 in an elongated incision 101 to be engaged on opposite sides of the injured bone 103 to separate the muscles therefrom. The upper ends of the lever arms 15 and 17 may then be spread apart the desired distance to spread the muscles away from the injured bone 103 and the free extremity of the brace 77 swung downwardly into the upwardly opening slot 81 to engage the appropriate notch 85 with the lever arm 17 to maintain the arms 15 and 17 in the desired spaced apart relationship. If desirable, the locking clasp 91 may be swung over to the position shown in FIGS. 6 and 7 to lock the brace 77 in its retaining position.
From the foregoing it will be apparent that the self-retaining muscle retractor of present invention provides a convenient means for holding an incision open to gain access to a bone without the necessity of having an assistant present. This is of frequent advantage in outlying areas where assistants and interns are not readily available. Also, the bone need only be stripped on the top side. This decreases the operating time and makes it feasible, if desirable, to shift the retractor longitudinally along the bone during the operation. Further, there are no holding members, such as chains, which must be extended around under the member in which the incision is made thus eliminating the likelihood of infection and decreasing the amount of body area that must be prepared for surgery.
Various modifications and changes may be made with regard to the foregoing detailed description without departing from the spirit of the invention.