Surgical retractor assembly and associated method of use

A surgical retractor assembly is disclosed that includes a bone plate and a retractor. The bone plate has a tapered end portion. The retractor includes a base having (i) a body defining a bottom surface and a distal portion, the distal portion defining a distal surface, (iii) a first pair of tabs extending from the body that are spaced apart from each other, and (iv) a second pair of tabs extending from the body that are spaced apart from each other. The retractor further includes a handle attached to the base. The first pair of tabs and the bottom surface define a first plate space. The second pair of tabs and the distal surface define a second plate space.

BACKGROUND

The present disclosure relates generally to a surgical retractor assembly and an associated method of using of the retractor assembly.

In a surgical procedure in which a bone plate is attached to a fractured long bone, a surgeon creates an incision in a patient to expose a portion of the fractured long bone. Thereafter, the bone plate is advanced through the incision to a location adjacent to the long bone. Then, a drill is advanced in alignment with one of the central screw openings in the bone plate and a hole is drilled in the bone in alignment with the central screw opening. A screw is thereafter advanced through the incision and screwed into the bone through the central screw opening.

After the bone plate is partially attached to the fractured long bone with the bone screw as described above, it may be necessary to pull a patient's tissue to expose the other screw openings in the bone plate such as the terminal screw openings. Common Hohman surgical retractors have been used achieve the above exposure. For example, a Hohman surgical retractor has a finger at a distal end of the retractor. The retractor is then oriented transverse to the axis of the long bone, and the finger of the retractor is urged against the fractured bone and/or side edge of the bone plate. Then, the retractor is pivoted to act as a second class lever to pull the patient's tissue in a direction transverse to the axis of the long bone so as to expose a portion of the bone plate. By using a number of Hohman retractors simultaneously, the surgeon can typically expose enough of the bone plate and fractured bone to access all the bone screw holes of the bone plate including the terminal ones at its most extreme proximal end portion and distal end portion to carry out the above-described bone drilling and bone screw placement.

When performing a minimally invasive surgical procedure to attach a bone plate to a fractured long bone, a surgeon may create an incision that is significantly shorter than the bone plate which is being implanted. Working through the relatively small incision, a drill may be advanced in alignment with one of the central screw openings in the bone plate and a hole is drilled in the bone in alignment with the central screw opening. A screw is thereafter advanced through the small incision and screwed into the bone through the central screw opening in typical fashion. However, retraction of the patient's tissue in a direction transverse to the axis of the long bone with Hohman retractors often times is not adequate to expose the terminal bone screw holes located in the distal and proximal end portions of the bone plate.

What is needed therefore is an improved retractor that is able to be used with a bone plate to adequately expose all the bone screw openings of the bone plate including the terminal openings. What is further needed is an improved retractor that is able to be used with a bone plate to adequately expose all the bone screw openings of the bone plate when the bone plate is implanted through a relatively small incision.

SUMMARY

In accordance with one embodiment of the present disclosure, there is provided a surgical retractor assembly that includes a bone plate and a retractor. The bone plate has a tapered end portion. The retractor includes a base having (i) a body defining a bottom surface and a distal portion, the distal portion defining a distal surface, (iii) a first pair of tabs extending from the body that are spaced apart from each other, and (iv) a second pair of tabs extending from the body that are spaced apart from each other. The retractor further includes a handle attached to the base. The first pair of tabs and the bottom surface define a first plate space. The second pair of tabs and the distal surface define a second plate space. The retractor is positionable in relation to the bone plate between a first position and a second position. When the retractor is positioned in the first position, (i) the bone plate is positioned in the first plate space, and (ii) the bone plate is located outside of the second plate space. When the retractor is positioned in the second position, (i) the bone plate is positioned in the second plate space, and (ii) the bone plate is located outside of the first plate space.

Pursuant to another embodiment of the present disclosure, there is provided a surgical retractor that includes a base having (i) a body defining a bottom surface and a distal portion, the distal portion defining a distal surface, (iii) a first pair of tabs extending from the body that are spaced apart from each other, and (iv) a second pair of tabs extending from the body that are spaced apart from each other. The surgical retractor further includes a handle attached to the base. The first pair of tabs and the bottom surface define a first plate space configured to receive a first portion of a bone plate therein. The second pair of tabs and the distal surface define a second plate space configured to receive a second portion of the bone plate therein.

In accordance with yet another embodiment of the present disclosure, there is provided a method of retracting tissue near a bone plate exposed through an incision defined in a body. The method includes providing a retractor that has a base which includes (i) a bottom surface, (ii) a distal surface, (iii) a first pair of tabs that are spaced apart from each other, and (iv) a second pair of tabs that are spaced apart from each other, the first pair of tabs and the bottom surface defining a first plate space, the second pair of tabs and the distal surface defining a second plate space. The method further includes positioning the retractor in relation to the bone plate in a first position in which (i) the bone plate is located in the first plate space, and (ii) the bone plate is located outside of the second plate space. Also, the method includes advancing the retractor in relation to the bone plate along an axis of the bone plate after the positioning step from the first position to an intermediate position while the bone plate is located in the first plate space. The method additionally includes moving the retractor in relation to the bone plate from the intermediate position to a second position in which (i) the bone plate is positioned in the second plate space, and (ii) the bone plate is located outside of the first plate space. The method also includes retracting tissue in relation to an end portion of the bone plate in response to the moving step.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

While the retractor, associated assembly, and associated method described herein is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that there is no intent to limit the retractor, associated assembly, and associated method to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.

Referring now toFIGS. 1-6, there is shown a retractor10configured in accordance with the present disclosure. The retractor10includes a base12and a handle14that are attached together. The base12includes a body16that defines a bottom surface18and a top surface20. The bottom surface18defines a first plane P1as shown inFIG. 2. The handle14defines a second plane P2that is aligned with the axis of the handle. The first plane P1and the second plane P2intersect to define an angle Θ. Preferably, the angle Θ is between 120° and 160°. More preferably, the angle Θ is between 130° and 150°. And most preferably, the angle Θ equals 141°. The base12further includes a proximal portion22and a distal portion24. The handle14is attached to the proximal portion22. The distal portion24defines a distal surface26.

The base12further includes a pair of tabs28,30. The tab28is spaced apart from the tab30. Each tab28,30includes a portion that extends downwardly in relation to the bottom surface18of the body16as shown in FIGS.2,3, and5. More specifically, the tab28is configured as an L-shaped member that includes a connecting portion28C and a guide portion28G. The connecting portion28C extends laterally outwardly from a lateral side surface of the body16. The guide portion28G is attached to the connecting portion28C and extends perpendicularly thereto in a downward direction in relation to the bottom surface18. Similarly, the tab30is configured as another L-shaped member that includes a connecting portion30C and a guide portion30G. The connecting portion30C extends laterally outwardly from another lateral side surface of the body16. The guide portion30G is attached to the connecting portion30C and extends perpendicularly thereto in a downward direction in relation to the bottom surface18. The pair of tabs28,30and the bottom surface18define a first plate space36as shown inFIGS. 3 and 5.

The base12further includes another pair of tabs32,34that extend distally from the body16as shown inFIGS. 1-6. The tab32is spaced apart from the tab34. The pair of tabs32,34and the distal surface26define a plate space38as shown inFIGS. 3-6.

Referring now toFIGS. 7-9, there is shown a bone plate40configured in accordance with the present disclosure. The bone plate40ofFIGS. 7-9and the retractor10ofFIGS. 1-6cooperate with each other in a beneficial manner to form an assembly5as will be discussed further below. The bone plate40is configured so that its bone contacting side may be received in juxtaposition to a patient's bone such a fibula, humerus, radius, ulna, tibia, or clavicle.

The bone plate40includes a tapered end portion42and defines a lateral side wall44and another lateral side wall46. The tapered end portion42defines a suture hole47. The bone plate40further includes another tapered end portion48that defines another suture hole50. The bone plate defines a bone contact side52and an opposite top side54. A plurality of screw holes56are also defined in the bone plate40. The screw holes56may be all threaded or non-threaded or may be a combination of threaded and non-threaded holes as is common in the art. In any event, the screw holes56are configured to receive bone screws therein.

The assembly5is shown being used inFIGS. 10-14in accordance with the present disclosure. In particular,FIG. 10shows the bone plate40partially secured to a radius bone58of a patient59by a bone screw60passing through one of the screw holes56defined in the bone plate40. The bone plate40is partially exposed through an incision I defined in the patient.FIGS. 10 and 11also show the retractor10positioned in relation to the bone plate40in a first position in which the bone plate40is positioned in the first plate space36. When the retractor10is located in the first position as shown inFIGS. 10 and 11, the bone plate40is located outside of the second plate space38.FIG. 11is a side elevational view of the assembly5and associated radius bone58ofFIG. 10, with the other portions of the patient's body removed for clarity of description.

After the retractor10is positioned as shown inFIGS. 10 and 11, the retractor10is advanced in sliding contact with the bone plate40in the direction of arrow A1along an axis X of the bone plate40to an intermediate position shown in phantom inFIG. 13. It should be appreciated that during movement of retractor10from its first position shown inFIG. 10to its intermediate position shown in phantom inFIG. 13, the bone plate40is interposed between the tabs28and30. When the retractor10is positioned in the intermediate position, the second plate space38is positioned over the tapered end portion48of the bone plate40.

Thereafter, the retractor10is pivoted in relation to the bone plate40to a second position as shown in solid inFIG. 13. In particular, the retractor10is pivoted in the direction of arrow A2to the second position as shown inFIG. 13. During such pivoting, the retractor10and the bone plate40are continuously in contact with one another. Note that during a latter part of such pivoting, the tabs32,34are respectively in contact with both of the lateral side walls44,46. Also note that when the bone plate40is positioned at the second position as shown in solid inFIG. 13, the retractor10is positioned in contact with both of the lateral side walls44,46.FIG. 13is a side elevational view of the assembly5and associated radius bone58ofFIG. 12, with the other portions of the patient's body removed for clarity of description. Note thatFIGS. 12 and 13shows the retractor10positioned in relation to the bone screw40in the second position in which the bone plate40is positioned in the second plate space38. When the retractor10is located in the second position, the tapered end portion48of the bone plate40is interposed between the tabs32and34. In addition, when the retractor10is located in the second position as shown inFIGS. 10 and 11, the bone plate40is located outside of the first plate space36.

In response pivoting the retractor10in relation to the bone plate40as discussed above, tissue T of the patient's body59is retracted in relation to the tapered end portion48of the bone plate40thereby exposing a terminal screw hole56T of the bone plate40. The retractor10is in effect utilized as a lever to retract the patient's tissue T in relation to the bone plate40. Notice that prior to interaction between the patient's tissue T and the retractor10, the terminal screw hole56T is covered up by the patient's tissue T as shown inFIG. 10.FIG. 14shows the retractor10pivoted slightly further in relation to the bone plate40if necessary to further retract the patient's tissue T in relation to the bone plate40.

There is a plurality of advantages arising from the various features of each of the embodiments of the retractor, associated assembly, and associated method described herein. It will be noted that alternative embodiments of the retractor, associated assembly, and associated method may not include all of the features described yet still benefit from at least some of the advantages of such features. Those of ordinary skill in the art may readily devise their own implementations of the retractor, associated assembly, and associated method that incorporates one or more of the features and fall within the spirit and scope of the present invention as defined by the appended claims.