Abstract:
A foot retractor includes an elongated body portion, a handle curving away from the body portion, and a tapered blade portion extending at an angle from the body portion, distal from the handle portion. The blade portion comprises a curvature therein.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    The present application claims priority from U.S. Provisional Patent Application Ser. No. 60/738,627, filed on Nov. 21, 2005. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The present invention relates to foot retractors that are designed specifically to optimize retraction of soft tissues about the bones of the foot, while maintaining the assistant&#39;s hands comfortably outside the operating field. 
       BACKGROUND OF THE INVENTION 
       [0003]    The anatomy of the foot is unique within the human body. As in the hand, there is a complex inter-relationship between bones, ligaments, tendons, and vessels. Unlike the hand, however, the foot is wider and, while triangular posteriorly, becomes flat toward the forefoot. Corrective osteotomy in the foot often requires that retractors fit around the tarsal bones to protect soft tissues on the side opposite the incision (the blind side). Retractors, however, need to fit between bones into small spaces such as the sinus tarsi or the posterior ankle, and under the neck of the talus. Existing devices do not hook around bones, are prone to slipping out of position, and create operating fields that are awkward to work in, such as are found in the foot. It would be beneficial to develop retractors that may be used specifically in the foot. 
       SUMMARY OF THE INVENTION 
       [0004]    Briefly, the present invention provides a foot retractor. In accordance with one aspect of the invention, a foot retractor includes an elongated body portion, a handle curving away from the body portion, and a tapered blade portion extending at an angle from the body portion, distal from the handle portion. The blade portion comprises a curvature therein. 
         [0005]    In accordance with another aspect of the invention, a foot retractor includes a generally elongated body portion extending between a proximal end and a distal end and a handle extending from the proximal end. The handle extends on one side of the body portion. A blade portion extends from the distal end. The blade portion further comprises a blade having a curvature therein and a blade tip extending distally from the blade. The retractor tapers from the handle to the blade tip. 
         [0006]    In accordance with another aspect of the invention, a foot retractor includes a tapered body portion extending in a plane, a handle extending away from the tapered body portion on a first side of the plane, and a tapered blade portion extending away from the body portion, distal from the handle, on the first side of the plane. 
         [0007]    The present invention also provides kits comprising a plurality of retractors according to the present invention. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
         [0008]    The accompanying drawings, which are incorporated herein and constitute part of this specification, illustrate exemplary embodiments of the invention, and, together with the general description given above and the detailed description given below, serve to explain features of the invention. In the drawings: 
           [0009]      FIG. 1  is a perspective view of a foot retractor according to a first embodiment of the present invention; 
           [0010]      FIG. 2  is a side elevation view of the foot retractor of  FIG. 1 ; 
           [0011]      FIG. 3  is a top plan view of the foot retractor of  FIG. 1 ; 
           [0012]      FIG. 4  is a distal elevation view of the foot retractor of  FIG. 1 ; 
           [0013]      FIG. 5  is a perspective view of a foot retractor according to a second embodiment of the present invention; 
           [0014]      FIG. 6  is a side elevation view of the foot retractor of  FIG. 5 ; 
           [0015]      FIG. 7  is a top plan view of the foot retractor of  FIG. 5 ; 
           [0016]      FIG. 8  is a distal elevation view of the foot retractor of  FIG. 5 ; 
           [0017]      FIG. 9  is a perspective view of a foot retractor according to a third embodiment of the present invention; 
           [0018]      FIG. 10  is a side elevation view of the foot retractor of  FIG. 9 ; 
           [0019]      FIG. 11  is a top plan view of the foot retractor of  FIG. 9 ; 
           [0020]      FIG. 12  is a distal elevation view of the foot retractor of  FIG. 9 ; 
           [0021]      FIG. 13  is a perspective view of a foot retractor according to a fourth embodiment of the present invention; 
           [0022]      FIG. 14  is a side elevation view of the foot retractor of  FIG. 13 ; 
           [0023]      FIG. 15  is a top plan view of the foot retractor of  FIG. 13 ; 
           [0024]      FIG. 16  is a distal elevation view of the foot retractor of  FIG. 13 ; 
           [0025]      FIG. 17  is a side elevation view of a kit comprising foot retractors shown in each of  FIGS. 1 ,  5 ,  9 , and  13 ; 
           [0026]      FIG. 18  is a perspective view of retractors according to the present invention prior to a first exemplary application; 
           [0027]      FIG. 19  is a perspective view of the retractors of  FIG. 18  being used in the first exemplary application; 
           [0028]      FIG. 20  is a perspective view of retractors according to the present invention prior to a second exemplary application; 
           [0029]      FIG. 21  is a perspective view of the retractors of  FIG. 20  being used in the second exemplary application; and 
           [0030]      FIG. 22  is a perspective view of retractors according to the present invention being used in a third exemplary application. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0031]    Certain terminology is used in the following description for convenience only and is not limiting. As used herein, the term “distal” refers to a section or area of the device positioned toward the patient during use, and the term “proximal” refers to a section or area on the device positioned toward the user of the device during use. The terminology includes the words above specifically mentioned, derivatives thereof and words of similar import. The embodiments illustrated below are not intended to be exhaustive or to limit the invention to the precise form disclosed. These embodiments are chosen and described to best explain the principle of the invention and its application and practical use and to enable others skilled in the art to best utilize the invention. 
         [0032]    Foot retractors according to the present invention are designed specifically to optimize retraction of the soft tissues around the unique shapes of the bones of the foot while maintaining the assistant&#39;s hands comfortably outside of the operating field. The present invention provides different sizes and shapes of retractors to fit the unique shape and contours of the human foot and to accommodate the varied locations between bones and small spaces in the foot for both infant and adult sized feet. For example, foot surgeries, such as corrective osteotomy, often require that retractors fit around the tarsal bones to protect soft tissues on the side opposite an incision. The retractors must fit into small spaces not found in other anatomic locations, such as the sinus tarsi, the anterior tibialis tendon, and under the neck of the talis. 
         [0033]    Different sizes of retractors of the present invention may be used for different sized patients. For example, a foot retractor for use with an infant or small child may be significantly smaller than a similarly shaped foot retractor used on an adult. The dimensions described in this specification are for illustration only, and represent exemplary dimensions. Other dimensions may be suitable for purposes of practicing the invention. 
         [0034]    A foot retractor  100  according to a first embodiment of the present invention is shown in  FIGS. 1-4 . Foot retractor  100  is of unitary construction and includes a generally elongated body portion  110  extending in a plane “P 1 ” between a proximal end  112  and a distal end  114 . A handle  120  extends from proximal end  112 . Handle  120  extends on one side  116  of plane P 1 . A blade portion  130  extends from distal end  114 . Blade portion  130  extends on the one side  116  of plane P 1 . 
         [0035]    In an exemplary embodiment, body  110  is approximately 2 millimeters thick. Proximal end  112  is approximately 12 millimeters wide and may taper to distal end  114 , which is approximately 6 millimeters wide. Handle  120  includes an attached end  122  that curves from proximal end  112  of body  110  in a curve having a radius of curvature of approximately 15 millimeters. Handle  120  terminates at a free end  124 . 
         [0036]    Blade portion  130  includes a blade  132  having an attached end  134  that curves from distal end  114  of body and a blade tip  136 . Blade portion  130  also includes a curvature  138  therein between attached end  134  and blade tip  136 . Curvature  138  has a radius of curvature of between approximately 10 and 15 millimeters. Attached end  134  has a radius of curvature of approximately 13 millimeters. Blade portion  130  includes a straight portion  139  extending between attached end  134  and curvature  138 . Straight portion  139  extends between approximately 12 and 23 millimeters at an angle of approximately 77 degrees from plane P 1 . Straight portion  139  also has a thickness of approximately 1.5 millimeters. Blade tip  136  tapers at an angle θ 1  of between approximately 4 and 9 degrees. 
         [0037]    Retractor  100  includes a top face  101  that changes in contour along the length of retractor  100 . In the area of blade  130 , top face  101  transitions from a generally flat surface adjacent body portion  110  to a convex curvature at attached end  134 . Top face  101  returns to a generally flat contour at straight portion  139 , and then transitions to a concave curvature at curvature  138 . Top face  101  transitions to a generally flat contour at blade tip  136 . Curvature  138  provides an approximate 34 degree bend between straight portion  139  and blade tip  136 . 
         [0038]    Referring to  FIG. 3 , the top plan view of retractor  100  has a Length L 1  of approximately 130 millimeters. Referring to  FIG. 4 , retractor  100  has a height H 1  of between approximately 34 and 41 millimeters. 
         [0039]    A foot retractor  200  according to a second embodiment of the present invention is shown in  FIGS. 5-8 . Foot retractor  200  is of unitary construction and includes a generally elongated body portion  210  extending in a plane “P 2 ” between a proximal end  212  and a distal end  214 . A handle  220  extends from proximal end  212 . Handle  220  extends on one side  216  of plane P 2 . A blade portion  230  extends from distal end  214 . Blade portion  230  extends on the one side  216  of plane P 2 . 
         [0040]    In an exemplary embodiment, body  210  is approximately 2 millimeters thick. Proximal end  212  is approximately 12 millimeters wide and may taper to distal end  214 , which is approximately 6 millimeters wide. Handle  220  includes an attached end  222  that curves from proximal end  212  of body  210  in a curve having a radius of curvature of approximately 8 millimeters. Handle  220  terminates at a free end  224 . 
         [0041]    Blade portion  230  includes a blade  232  having an attached end  234  that curves from distal end  214  of body and a blade tip  236 . Blade portion  230  also includes a curvature  238  therein between attached end  234  and blade tip  236 . Curvature  238  has a radius of curvature of between approximately 5 and 20 millimeters. Attached end  234  has a radius of curvature of approximately 6 millimeters. Blade portion  230  includes a straight portion  239  extending between attached end  234  and curvature  238 . Straight portion  239  extends for approximately 23 and 32 millimeters at an angle of approximately 75 degrees from plane P 2 . Straight portion  239  also has a thickness of approximately 1.5 millimeters. Blade tip  236  tapers at an angle θ 2  of between approximately 5 and 8 degrees. 
         [0042]    Retractor  200  includes a top face  201  that changes in contour along the length of retractor  200 . In the area of blade  230 , top face  201  transitions from a generally flat surface adjacent body portion  210  to a convex curvature at attached end  234 . Top face  201  returns to a generally flat contour at straight portion  239 , and then transitions to a second convex curvature at curvature  238 . Curvature  238  provides an approximate  19  degree bend between straight portion  239  and blade tip  236 . 
         [0043]    Referring to  FIG. 7 , the top plan view of retractor  200  has a length L 2  of approximately 114 millimeters. Referring to  FIG. 8 , retractor  200  has a height H 2  of between approximately 35 and 45 millimeters. 
         [0044]    A foot retractor  300  according to a third embodiment of the present invention is shown in  FIGS. 9-12 . Foot retractor  300  is of unitary construction and includes a generally elongated body portion  310  extending in a plane “P 3 ” between a proximal end  312  and a distal end  314 . A handle  320  extends from proximal end  312 . Handle  320  extends on one side  316  of plane P 3 . A blade portion  330  extends from distal end  314 . Blade portion  330  extends on the one side  316  of plane P 3 . 
         [0045]    In an exemplary embodiment, body  310  is approximately 2 millimeters thick. Proximal end  312  is approximately 15 millimeters wide and may taper to distal end  314 , which is approximately 6 millimeters wide. Handle  320  includes an attached end  322  that curves from proximal end  312  of body  310  in a curve having a radius of curvature of approximately 13 millimeters. Handle  320  terminates at a free end  324 . 
         [0046]    Blade portion  330  includes a blade  332  having an attached end  334  that curves from distal end  314  of body and a blade tip  336 . Blade portion  330  also includes a curvature  338  therein between attached end  334  and blade tip  336 . Curvature  338  has a radius of curvature of between approximately 20 and 25 millimeters. Attached end  334  has a radius of curvature of approximately 11 millimeters. Blade portion  330  includes a straight portion  339  extending between attached end  334  and curvature  338 . Straight portion  339  extends for between approximately 20 and 28 millimeters at an angle of approximately 90 degrees from plane P 3 . Straight portion  339  has a thickness of approximately 1.5 millimeters. Blade tip  336  tapers at an angle θ 3  of approximately 6 degrees. 
         [0047]    Retractor  300  includes a top face  301  that changes in contour along the length of retractor  300 . In the area of blade  330 , top face  301  transitions from a generally flat surface adjacent body portion  310  to a convex curvature at attached end  334 . Top face  301  returns to a generally flat contour at straight portion  339 , and then transitions to a concave curvature at curvature  338 . Top face  301  transitions to a generally flat contour at blade tip  336 . Curvature  338  provides an approximate 50 degree bend between straight portion  339  and blade tip  336 . 
         [0048]    Referring to  FIG. 11 , the top plan view of retractor  300  has a length L 3  of approximately 130 millimeters. Referring to  FIG. 12 , retractor  300  has a height H 3  of between approximately 51 and 62 millimeters. 
         [0049]    A foot retractor  400  according to a fourth embodiment of the present invention is shown in  FIGS. 13-16 . Foot retractor  400  is of unitary construction and includes a generally elongated body portion  410  extending in a plane “P 4 ” between a proximal end  412  and a distal end  414 . A handle  420  extends from proximal end  412 . Handle  420  extends on one side  416  of plane P 4 . A blade portion  430  extends from distal end  414 . Blade portion  430  extends on the one side  416  of plane P 4 . 
         [0050]    In an exemplary embodiment, body  410  is approximately 2 millimeters thick. Proximal end  412  is approximately 12 millimeters wide and may taper to distal end  414 , which is approximately 6 millimeters wide. Handle  420  includes an attached end  422  that curves from proximal end  412  of body  410  in a curve having a radius of curvature of approximately 15 millimeters. Handle  420  terminates at a free end  424 . 
         [0051]    Blade portion  430  includes a blade  432  having an attached end  434  that curves from distal end  414  of body and a blade tip  436 . Blade portion  430  also includes a curvature  438  therein between attached end  434  and blade tip  436 . Curvature  438  has a radius of curvature of between approximately 10 and 15 millimeters. Attached end  434  has a radius of curvature of approximately 9 millimeters. Blade portion  430  includes a straight portion  439  extending between attached end  434  and curvature  438 . Straight portion  439  extends for between approximately 20 and 24 millimeters at an angle of approximately 70 degrees from plane P 4 . Straight portion  439  also has a thickness of approximately 1.5 millimeters. Blade tip  436  tapers at an angle θ 4  of between approximately 4 and 9 degrees. 
         [0052]    Retractor  400  includes a top face  401  that changes in contour along the length of retractor  400 . In the area of blade  430 , top face  401  transitions from a generally flat surface adjacent body portion  410  to a convex curvature at attached end  434 . Top face  401  returns to a generally flat contour at straight portion  439 , and then transitions to a concave curvature at curvature  438 . Top face  401  transitions to a generally flat contour at blade tip  436 . Curvature  438  provides an approximate 40 degree bend between straight portion  439  and blade tip  436 . 
         [0053]    Referring to  FIG. 15 , the top plan view of retractor  400  has a length L 4  of approximately 133 millimeters. Referring to  FIG. 16 , retractor  400  has a height H 4  of between approximately 33 and 35 millimeters. 
         [0054]    Exemplary retractors  100 ,  200 ,  300 ,  400  are all constructed from a biocompatible material, such as surgical stainless steel, and may be part of a kit, such as kit  500 , shown in  FIG. 17 , in which all four of retractors  100 ,  200 ,  300 ,  400  are packaged. Alternatively, kit  500  may feature only some of retractors  100 ,  200 ,  300 ,  400 . Still alternatively, kit  500  may include two or more of each retractor embodiment shown in  FIG. 17 . 
         [0055]    Retractors  100 ,  200 ,  300 ,  400  and/or kit  500  may be used to retract bones, tendons, muscles, nerves, and vessels of the foot during surgery. The narrow profile of the retractors minimizes visual obstruction of the surgeon by allowing the user&#39;s hands to remain outside of the operating field. The thin shape and weight of each retractor allows the retractor to stay in place in a patient&#39;s foot if the user releases the retractor. 
         [0056]    The forward/concave curvatures  138 ,  338 ,  438  hook each respective retractor  100 ,  300 ,  400  under/around bones, while the backward/convex curvature  238  of retractor  200  retracts soft tissue, and protects vessels, tissues, and nerves. Such features benefit the surgeon by allowing the surgeon to gently, yet effectively access the surgical site and also benefit the patient by minimizing trauma to the patient, thereby reducing pain and recovery time for the patient. 
         [0057]    The retractors are designed to expose bones and joints of the foot but can, in addition, go between and around the bones of the foot, permitting isolation and exposure of individual tarsal and metatarsal bones for corrective osteotomy, and protection of the soft tissues (arteries, veins, nerves, muscles, etc) on the deep side of the foot bones from damage from sharp saws, osteotomes and displaced bone fragments. 
         [0058]    By way of example, in a procedure of retracting the first metatarsal M 1 , as shown in  FIGS. 18 and 19 , any of retractors  100 ,  300 ,  400  may be used. The selection of which of retractors  100 ,  300 ,  400  to use may depend on the anatomy of the particular foot. As shown in  FIG. 19 , retractors  300 ,  400  are placed on either side of metatarsal M 1 , with respective blade tips  336 ,  436  worked under metatarsal M 1 . Blade portion  330  engages second metatarsal M 2  proximate to attached end  334 . Second metatarsal M 2  is used as a fulcrum to assist in retracting first metatarsal M 1 . 
         [0059]    Other applications of retractors according to the present invention are shown in  FIGS. 20-22 . In procedures, such as medially exposing the foot, retractor  100  may be placed over the dorsum of the talar neck, head, or navicular, but under the anterior tibialis tendon and the dorsalis pedis artery. Retractor  200  may be used to retract all four layers of plantar-medial muscles, nerves, and veins to allow exposure of the mid tarsal bones and joints medially. Medial exposure of the subtalar joint may be aided by placement of retractor  300  over the dorsum of the talar neck, retracting and protecting the posterior tibialis tendon, the dorsalis pedis neurovascular bundle, and the anterior tibialis tendon. An additional retractor  100  may be placed under the neck of the talus between the talar neck and the calcaneus, retracting and protecting the abductor hallicus origin, medial muscles, medial plantar nerve, and vessels. Retractor  400  may be placed around the posterior ankle and subtalar joints, retracting and protecting the flexor digitorum longus, the flexor hallucis, and the posterior tibial neurovascular bundle. 
         [0060]    Applications for this type of procedure include, for example, treatment of club foot, medial facet talocalcaneal coalition, accessory naviculars, infections of the midtarsal bones, osteotomy of the midtarsal bones and proximal first metatarsal, exposure of the plantar fascia, exposure of the posteromedial ankle and subtalar joints, repair of the soft tissues (tendons, nerves, and vessels of the midfoot), and fractures of the talus, sustentaculum talus, navicular and other bones of the midfoot. 
         [0061]    By way of another example, in a procedure of laterally exposing the foot, retractor  100  is placed over the dorsum of the midfoot, but under the extensor brevis muscle, under the dorsal pedis neurovascular bundle and over the talar neck, exposing the sinus tarsi. The lateral aspect of the calcaneus is accomplished by placing retractor  100  subperiostally, around the plantar aspect of the calcaneus retracting the peroneus brevis and longus tendons. Retractor  400  is placed subperiostally, around the dorsal aspect of the calcaneus. Retractors  100 ,  400  may be placed all-the-way around a calcaneo-navicular coalition, protecting the soft tissues medially, as well as preventing medial displacement of bone fragments which can lead to recurrence, pain, and soft tissue damage. Retractors  100 ,  300 ,  400  may be placed around the posterior ankle, exposing the posterolateral subtalar and ankle joints. 
         [0062]    Applications for this type of procedure include, for example, treatment of calceneus osteotomy (flatfoot, cavus, etc.), excision of calcaneo-navicular coalitions, excision of os trigone, fractures of the calcaneus, cuboid, and base of the fifth metatarsal. 
         [0063]    While exemplary uses for each of retractors  100 ,  200 ,  300 ,  400  are discussed above, those skilled in the art will recognize that retractors  100 ,  200 ,  300 ,  400  may be used for other purposes, and on other parts of the body besides the foot. 
         [0064]    Although the invention is illustrated and described herein with reference to specific embodiments, the invention is not intended to be limited to the details shown. Rather, various modifications may be made in the details within the scope and range of equivalents of the claims and without departing from the invention.