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WO2018102879A1 - Dispositif botte et procédé pour déterminer un écart de longueur de jambe peropératoire et post-opératoire pour une chirurgie de la hanche à l'aide dudit dispositif botte - Google Patents

Dispositif botte et procédé pour déterminer un écart de longueur de jambe peropératoire et post-opératoire pour une chirurgie de la hanche à l'aide dudit dispositif botte Download PDF

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Publication number
WO2018102879A1
WO2018102879A1 PCT/AU2017/051352 AU2017051352W WO2018102879A1 WO 2018102879 A1 WO2018102879 A1 WO 2018102879A1 AU 2017051352 W AU2017051352 W AU 2017051352W WO 2018102879 A1 WO2018102879 A1 WO 2018102879A1
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WO
WIPO (PCT)
Prior art keywords
patient
boot
surgeon
heel
leg
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/AU2017/051352
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English (en)
Inventor
Jonathan Peter CABOT
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
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Individual
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Filing date
Publication date
Priority claimed from AU2016905087A external-priority patent/AU2016905087A0/en
Application filed by Individual filed Critical Individual
Publication of WO2018102879A1 publication Critical patent/WO2018102879A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/10—Parts, details or accessories
    • A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
    • A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
    • A61G13/125—Ankles or feet
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/04—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints
    • A61F5/042—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints for extension or stretching
    • A61F5/048—Traction splints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/0036—Orthopaedic operating tables
    • A61G13/0081—Orthopaedic operating tables specially adapted for hip surgeries
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/10—Parts, details or accessories
    • A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
    • A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
    • A61G13/1245—Knees, upper or lower legs

Definitions

  • This invention relates to a simple and unique arrangement and method for being able to determine leg length discrepancy of a patient undergoing hip surgery and more particularly a method and arrangement that will allow both intra-operative and post-operative determination of any leg length discrepancy of the patient undergoing hip surgery, by allowing the surgeon access to bony landmarks that generally would be inaccessible using conventional equipment and apparatus used in carrying out hip surgery.
  • hip surgery wherein the ball and socket of the hip joint are replaced with artificial implants, requires that the patient's foot be placed within a boot that is connected to a traction device so that when the patient lies upon a surgical table during the hip replacement surgery, the traction device is designed to pull on the patient's leg to open up the hip joint.
  • leg length discrepancy is established then the patient is often left with no other choice but to undergo further hip replacement surgery or be restricted from being able to carry out certain activities to prevent problems that may arise from the discrepancy between the length of one leg with the other, if the integrity of the artificial implants of the hip replacement are to be maintained.
  • a boot arrangement when used for determination of leg length discrepancy intra-operatively and post-operatively for hip surgery, said boot arrangement including: [016] a boot, said boot adapted to receive a foot of a patient undergoing hip surgery wherein the boot is fastenable to a traction device configured to pull on a patient's leg, in which the foot of said patient's leg has been received in said boot, so as to open a hip joint between a thigh bone and a socket of a pelvis of the patient undergoing hip surgery;
  • said boot including an ankle aperture providing access for at least one hand digit of a surgeon undertaking the hip surgery upon the patient, so as to engage a bony feature on or around an ankle of the patient such that said engagement with the bony feature on or around the ankle of the or each hand digit of the surgeon provides an ability of the surgeon to align a corresponding hand digit or digits of the surgeon upon a bony feature on or around the ankle of another leg of the patient undergoing hip surgery such that the aligning of the or each hand digit of the hands of the surgeon upon the respective bony features on or around the ankle of the leg and the other leg of the patient enables a determination of length discrepancy between legs of the patient undergoing hip surgery.
  • the hand digit is a thumb.
  • the bony feature on or around the ankle includes a medial malleolus at a side of the ankle, wherein thumbs on each hand of the surgeon undertaking the hip surgery are able to access the medial malleolus through the ankle aperture of the boot for aligning of the thumbs to provides a determination of leg length discrepancies.
  • boot arrangement when used for determination of leg length discrepancy intra-operatively and postoperatively for hip surgery, said boot arrangement including:
  • a boot said boot adapted to receive a foot of a patient undergoing hip surgery wherein the boot is fastenable to a traction device configured to pull on a patient's leg, in which the foot of said patient's leg has been received in said boot, so as to open a hip joint between a thigh bone and a socket of a pelvis of the patient undergoing hip surgery;
  • said boot including an heel aperture providing access for at least one hand digit of a surgeon undertaking the hip surgery upon the patient, so as to engage a bony feature on or around an heel of the patient such that said engagement with the bony feature on or around the heel of the or each hand digit of the surgeon provides an ability of the surgeon to align a corresponding hand digit or digits of the surgeon upon a bony feature on or around the heel of another leg of the patient undergoing hip surgery such that the aligning of the or each hand digit of the hands of the surgeon upon the respective bony features on or around the heel of the leg and the other leg of the patient
  • the hand digit for access to a bony feature on or around the heel is a finger, fingers and/or thumb.
  • the bony feature accessible through the heel aperture is the heel bone or a calcaneus of the foot.
  • the boot adapted to receive the foot of the patient undergoing hip surgery includes both the ankle aperture providing access for at least one hand digit of the surgeon undertaking the hip surgery upon the patient to engage a bony feature on or around the ankle, and the heel aperture providing access for at least one hand digit of the surgeon undertaking the hip surgery upon the patient to engage a bony feature on or about the heel of the patient undergoing hip surgery.
  • this invention has been able to rely upon, for the most part, existing surgical techniques, instrumentation and apparatus that notably includes a boot that secures the patient's foot therein wherein the boot is then fastened to a traction device which is importantly responsible to pull on the leg of the patient so as to assist in opening up the hip joint so that when the patient is surgically opened the top of the thigh bone and the socket of the pelvis can be shaped so that the artificial implants can be appropriately introduced as a stable hip joint replacement.
  • a boot that engages to the boot is then fastened to a traction device which is importantly responsible to pull on the leg of the patient so as to assist in opening up the hip joint so that when the patient is surgically opened the top of the thigh bone and the socket of the pelvis can be shaped so that the artificial implants can be appropriately introduced as a stable hip joint replacement.
  • conventional traction device includes the ankle aperture, heel aperture or both, this means that while the hip joint remains surgically opened, as the surgeon makes the selection and adjustment of the artificial implants to maximize stability during surgery, the surgeon is still able to determine whether the leg lengths remain symmetric by way of not being inhibited from accessing bony features on or around the ankle, heel or both, so that the thumbs and/or fingers on the respective hands of the surgeon can be used on these bony features to make sure that there are no leg length
  • the boot arrangement includes a second boot, wherein the second boot is adapted to receive a foot of another leg of the patient undergoing hip surgery wherein the second boot is fastenable to a traction device, wherein the traction device is configurable to pull on the patient's another leg to open a hip joint between a thigh bone and a socket of the pelvis of the another leg of the patient undergoing hip surgery, wherein said second boot includes an ankle aperture
  • the arrangement further includes a cushion member, wherein the cushion member is positionable around a crotch of the patient while the patient is lying on a surgical table undergoing the hip surgery, wherein the cushion member includes a cushioning position for cushioning and stability of the patient during the hip surgery and a non-cushioning position, wherein the non-cushioning position is characterised by allowing the leg and the another leg of the patient to be drawn together without substantial impact upon said cushion member.
  • the cushion member in the non cushioning position is adapted to be retracted away from the crotch area of the patient undergoing hip surgery when the surgeon requires to make a determination of leg length discrepancy during hip surgery by bringing the respective legs of the patient together without impacting upon the cushion member.
  • the cushion member in the cushioning position includes a main body having a width longer than said cushion lenght so that the cushion member is adapted to be rotatable such that when then patient undergoing hip surgery requires cushioning to the crotch, the body structure of the cushion member is rotatable to provide for a broad length of the cushion member engagement with the crotch area of the patient and wherein when the legs of the patient are to be drawn together for a determination on leg length discrepancy of the patient while the hip joint remains surgically opened during the hip surgery, the cushion member is rotatable to configure the shorter width of the cushion member between the legs of the patient, to allow the respective legs of the patient to be drawn together without substantial impact upon the cushion member.
  • the arrangement further includes a resilient sheath or film across the openings of the ankle aperture, heel aperture or both the ankle and heel apertures.
  • the resilient sheath or film is transparent.
  • Figures 1 a, 1 b and 1 c show a perspective, side and front views of the boot of the arrangement for determining leg length discrepancy intra-operatively and postoperatively for hip surgery in a preferred embodiment of this invention.
  • Figures 2a, 2b and 2c show schematic representations of the use of the arrangement for this invention in a preferred embodiment as the surgeon determines leg length discrepancy while the hip joint remains surgically opened during hip surgery.
  • Figures 3a and 3b show a further preferred embodiment of the invention schematically utilising an alternative cushion member.
  • the boot includes the main body structure (12).
  • the main body structure (12) encloses padding (19) to comfortably rest the foot of the patient within the boot wherein the boot (10) is fastenable through fastening straps (20).
  • the boot (10) includes a general access opening (18) where the toes of the foot (not shown) of the patient are extendable out therefrom if required. [045] For the most part these features just introduced in relation to the boot (10) are conventional features used as part of the standard traction boot required during hip replacement surgery.
  • the boot (10) includes additional openings, which in this preferred embodiment, include both the ankle aperture (13) providing for open access area (14) and the heel aperture (15) providing for open access area (16).
  • the preferred embodiment includes the two apertures, that being the ankle aperture (13) and the heel aperture (15), other preferred embodiments may require just one of these respective aperture (13) and (15) openings.
  • the boot (10) includes block type feature (17) which generically represents a structural member which allows the boot (10) to engage with the traction device shown generally as (32) in Figures 2a, 2b and 2c.
  • the structural member (17) which allows the mounting of the boot (10) to the traction device (32) is away from the heel section of the boot (10) which thereby allows the boot (10) to include the heel aperture (15) providing for the opening (16) which would allow the fingers and/or thumbs of the surgeon undertaking the hip surgery to engage that heel area in order to access the relevant bony features on or around the heel which can assist the surgeon in making comparisons by aligning fingers and/or thumbs of the surgeon up to establish leg length discrepancy of the patient, albeit the hip joint remains surgically opened.
  • the purpose of this invention is to allow surgeons to perform hip replacement surgery using, for the most part, conventional techniques, instrumentation and apparatus, however by uniquely introducing the ankle aperture (13) and/or the heel aperture (15) to the boot (10) this means that despite the fact that the hip joint is surgically opened, the surgeon will still be able to utilise those conventional leg length discrepancies means of placing hand digits directly over bony features around the ankle or heel to carry out the leg length measurement.
  • the cushioning member (30) is a retractable device.
  • the cushion member (30) is configured around the crotch area (32) of the patient (22) to provide the requisite comfort and stability to the patient (22) as they lie upon the surgical table (24).
  • the surgeon (34) places his or her hands (36) and (38) on opposing boots (10) wherein the respective thumbs (40) and (42) on each of the hands (36) and (38) of the surgeon (34) are able to access the bony features around the ankle bones through the opening (14) provided for by the ankle aperture (13) of the boot (10).
  • the surgeon (34) is able to compare the ankle bones, notably the medial malleolus at the side of the ankle by placing thumbs (40) and (42) of the hands (36) and (38) of the surgeon directly over this bony feature on each foot (29) and (27) to see if the thumbs (40) and (42) are at an even level, thereby providing a determination if there is any discrepancy between the leg lengths (26) and (28) of the patient (22).
  • FIGS 2a, 2b and 2c for the most part illustrate the surgeon (34) accessing the ankle aperture (13) of the boot (10) through the access opening (14), in alternative embodiments the heel aperture (15) and the associated opening (16) can be utilised by the surgeon (34) in order to access various bony features within the foot around the heel which can be used to establish the existence, or lack thereof, of any leg length discrepancies of the patient (22).
  • Figures 3a and 3b illustrate an alternative embodiment of the cushion member (30) as shown in Figures 2a to 2c.
  • the body structure of the cushion member (50) in Figures 3a and 3b is such that when the patient requires the cushion member (50) to provide cushion stability around the crotch area (32) of the patient (22), the broad length as shown in Figure 3a is longer than the width shown in Figure 3b when the cushion member (50) is rotated shown by way of arrow (52).
  • Figure 3a shows the cushion member (50) in the cushioning position and when the surgeon is required to bring the legs (26) and (28) of the patient (22) together, shown by way of arrows (54) and (56) in Figure 3b, so that the thumbs (40) and (42) of the hands (36) and (38) of the surgeon (34) can be aligned, as in the case of Figure 2c, the legs (26) and (28) of the patient (22) come together without any substantial impact or poor orientation caused by the cushion member (50).

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Nursing (AREA)
  • Dentistry (AREA)
  • Vascular Medicine (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)

Abstract

Un dispositif botte pour déterminer un écart de longueur de jambe peropératoire et post-opératoire pour une chirurgie de la hanche ayant une botte qui comprend une ouverture au niveau de la partie de cheville et/ou de talon pour fournir un accès pour un chirurgien pour engager une caractéristique osseuse autour de la cheville et/ou du talon d'un patient portant la botte de telle sorte que l'alignement du ou de chaque doigt des mains du chirurgien sur les caractéristiques osseuses respectives sur ou autour de la cheville ou du talon de chaque jambe du patient permet de déterminer un écart de longueur entre les jambes du patient subissant une chirurgie de la hanche.
PCT/AU2017/051352 2016-12-09 2017-12-08 Dispositif botte et procédé pour déterminer un écart de longueur de jambe peropératoire et post-opératoire pour une chirurgie de la hanche à l'aide dudit dispositif botte Ceased WO2018102879A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AU2016905087 2016-12-09
AU2016905087A AU2016905087A0 (en) 2016-12-09 An arrangement and method for determining leg length discrepancy intra-operatively and post-operatively for hip surgery

Publications (1)

Publication Number Publication Date
WO2018102879A1 true WO2018102879A1 (fr) 2018-06-14

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PCT/AU2017/051352 Ceased WO2018102879A1 (fr) 2016-12-09 2017-12-08 Dispositif botte et procédé pour déterminer un écart de longueur de jambe peropératoire et post-opératoire pour une chirurgie de la hanche à l'aide dudit dispositif botte

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN115813698A (zh) * 2022-11-20 2023-03-21 成都真实维度科技有限公司 一种用于腿部粉碎性骨折的辅助定位装置

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US937354A (en) * 1907-11-11 1909-10-19 William Amos Apparatus for setting the fractured bones of the leg.
US4620698A (en) * 1985-03-04 1986-11-04 Professional Medical Products, Inc. Orthopedic support device
US20120305006A1 (en) * 2011-06-02 2012-12-06 Darwin Keith-Lucas Surgical foot support with tightener system
US20130019883A1 (en) * 2011-07-22 2013-01-24 Stryker Corporation Multi-position limb holder
US20140283845A1 (en) * 2013-03-22 2014-09-25 Smith & Nephew, Inc. Boot with lockable strap
US20140324056A1 (en) * 2013-04-24 2014-10-30 Pivot Medical, Inc. Apparatus and method for distracting the hip joint

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US937354A (en) * 1907-11-11 1909-10-19 William Amos Apparatus for setting the fractured bones of the leg.
US4620698A (en) * 1985-03-04 1986-11-04 Professional Medical Products, Inc. Orthopedic support device
US20120305006A1 (en) * 2011-06-02 2012-12-06 Darwin Keith-Lucas Surgical foot support with tightener system
US20130019883A1 (en) * 2011-07-22 2013-01-24 Stryker Corporation Multi-position limb holder
US20140283845A1 (en) * 2013-03-22 2014-09-25 Smith & Nephew, Inc. Boot with lockable strap
US20140324056A1 (en) * 2013-04-24 2014-10-30 Pivot Medical, Inc. Apparatus and method for distracting the hip joint

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
SABHARWAL, S. ET AL.: "Methods for Assessing Leg Length Discrepancy", CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, vol. 466, no. 12, December 2008 (2008-12-01), pages 2910 - 2922, XP055509915 *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN115813698A (zh) * 2022-11-20 2023-03-21 成都真实维度科技有限公司 一种用于腿部粉碎性骨折的辅助定位装置
CN115813698B (zh) * 2022-11-20 2024-05-24 成都真实维度科技有限公司 一种用于腿部粉碎性骨折的辅助定位装置

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