Abstract:
A surgical boot includes a shell shaped to receive a patient&#39;s foot and a main strap assembly. The main strap assembly includes at least two straps that secure a patient&#39;s foot in the shell and that are pulled downwardly by a tensioner unit located behind the shell to tighten a patient&#39;s foot with the shell.

Description:
BACKGROUND 
       [0001]    The present disclosure relates to a patient support apparatus for supporting a patient during surgery. More particularly, the present disclosure relates to a surgical boot for supporting a patient during surgery. 
         [0002]    Often, when a patient is sedated for a surgery, the patient is supported by and secured to braces or supports coupled to a surgical table. Sometimes, unique supports are provided for a patient&#39;s extremities such as arm boards, leg supports, hand boards, stirrups, and boots. 
         [0003]    Supports known in the art sometimes secure patients to resist patient movement. Such supports can sometimes allow excessive patient movement relative to the supports. 
       SUMMARY 
       [0004]    A surgical boot has one or more of the features recited in the appended claims and/or the following features which, alone or in any combination, may comprise patentable subject matter: 
         [0005]    A surgical boot is disclosed and includes a shell shaped to receive a patient&#39;s foot and a main strap assembly. The main strap assembly includes at least two straps that secure a patient&#39;s foot in the shell and that are pulled downwardly by a tensioner unit located behind the shell to tighten a patient&#39;s foot with the shell. 
         [0006]    In some embodiments, the tensioner unit may include a ratchet and a toothed belt coupled to the at least two straps. The toothed belt may be advanced in a forward direction through the ratchet to pull the at least two straps of the main strap assembly. The ratchet may include an actuator lever operable by a caregiver to advance the toothed belt through the ratchet and a release lever configured to selectively release the toothed belt from the ratchet so that the toothed belt is free to move in a backward direction through the ratchet. The ratchet may include a ratchet pawl engaging the toothed belt to advanced the toothed belt in a forward direction and a keeper pawl configured to engage the toothed belt and block the toothed belt from moving in the backward direction. 
         [0007]    The at least two straps may extend across an upwardly-facing channel formed by the shell and through a left side and a right side of the shell. The surgical boot may include a strap guide assembly configured to guide the at least two straps of the main strap assembly from left and right sides of the shell toward a heel end of the shell. The shell may include a sole and the strap guide assembly may be coupled to a bottom side of the sole. 
         [0008]    It is contemplated that the shell may have a toe end and a heel end. The shell may include a sole, a calf support extending up from the sole near the heel end of the shell, and a rear guide beam situated behind the calf support and forming the heel end of the shell. The rear guide beam may be configured to guide the at least two straps from below the sole toward the calf support. The calf support may be formed to include a guide channel configured to receive and guide the at least two straps along the calf support. 
         [0009]    The surgical boot may include a heel strap assembly configured to extend around the back side of a patient&#39;s foot over a patient&#39;s heel bone. The heel strap may have a first end coupled one of the at least two straps of the main strap assembly and a second end coupled to another of the at least two straps of the main strap assembly. The first end and the second end of the heel strap may be slidably coupled to independent ones of the at least two straps of the main strap assembly. 
         [0010]    A surgical boot may include a shell, a main strap assembly, a heel strap, and a tensioner unit. The shell may be sized to receive a patient&#39;s foot and may include a sole and a calf support. The main strap assembly may be configured to extend over a patient&#39;s foot near a patient&#39;s lower leg. The heel strap assembly may have a first end coupled to the main strap assembly and a second end coupled to the main strap assembly. The heel strap assembly may be configured to extend around the back side of a patient&#39;s foot above a patient&#39;s heel bone. The tensioner unit may be coupled to the shell and may be configured to pull the main strap assembly toward the sole of the shell to tighten a patient&#39;s foot with the shell. 
         [0011]    The main strap assembly may include a left strap and a right strap. The tensioner unit may include a ratchet and a toothed belt coupled to the left strap and the right strap. The left strap and the right strap may extend through the shell. 
         [0012]    The first end and the second end of the heel strap assembly may be slidably coupled to the main strap assembly. In some embodiments, the surgical boot may include a receiver configured to couple the surgical boot to a surgical table. 
         [0013]    A method of securing a patient&#39;s foot in a surgical boot may include the steps of placing a patient&#39;s foot in a channel formed by a shell of the surgical boot, guiding a first strap and a second strap across the patient&#39;s foot near a patient&#39;s ankle, coupling the first strap to the second strap, and operating a tensioner unit coupled to a back side of a calf support included in the shell. Operating the tensioner unit may be performed to pull the first strap and the second strap down through the shell so that a patient&#39;s foot is tightened with the shell. 
         [0014]    In some embodiments of the method, the surgical boot may include a heel strap coupled at a first end to the first strap and at a second end to the second strap. The heel strap may be configured to extend around the back side of a patient&#39;s foot above the heel bone 
         [0015]    Additional features, which alone or in combination with any other feature(s), such as those listed above and those listed in the claims, may comprise patentable subject matter and will become apparent to those skilled in the art upon consideration of the following detailed description of various embodiments exemplifying the best mode of carrying out the embodiments as presently perceived. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0016]    The detailed description particularly refers to the accompanying figures, in which: 
           [0017]      FIG. 1  is a front perspective view of a surgical boot including a shell sized to receive a patient&#39;s foot and formed to include handles for use by a caregiver, several straps for securing a patient&#39;s foot and lower leg to the shell as shown in  FIG. 5 , and a receiver coupled to the bottom of the shell for connecting the surgical boot to a surgical table as shown in  FIG. 9 ; 
           [0018]      FIG. 2  is a rear perspective view of the surgical boot of  FIG. 1  showing that the surgical boot includes a tensioner unit coupled to a back side of the shell for tightening a patient&#39;s foot with the shell by pulling a main strap assembly down toward the shell as shown in  FIG. 6 ; 
           [0019]      FIG. 3  is an exploded front perspective view of the surgical boot of  FIGS. 1 and 2  showing that the surgical boot includes a toe strap assembly that extends over a patient&#39;s foot near a toe end of the shell, the main strap assembly that extends over a patient&#39;s foot near a heel end of the shell, a heel strap assembly that extends around the back side of a patient&#39;s foot above a patient&#39;s heel bone, and a calf strap assembly that extends over a front side of patient&#39;s lower leg; 
           [0020]      FIG. 4  is a front perspective view of the surgical boot of  FIG. 1  showing buckles of the toe strap assembly, the main strap assembly, and the calf strap assembly opened so that a patient&#39;s foot can be lowered into a channel formed by the shell; 
           [0021]      FIG. 5  is a front perspective view of the surgical boot of  FIG. 4  after a patient&#39;s foot has been lowered into the channel formed by the shell showing the patient&#39;s foot secured to the shell by the toe strap assembly, the main strap assembly, and the calf strap assembly; 
           [0022]      FIG. 6  is a partially cutaway side elevation view of the surgical boot of  FIG. 5  showing the main strap assembly being pulled down toward the shell by the tensioner unit in response to a ratchet being operated by a caregiver; 
           [0023]      FIG. 7  is a partially cutaway side elevation view of the surgical boot of  FIG. 6  showing the main strap assembly being loosened when the tensioner unit is disengaged in response to a release lever being operated by a caregiver; 
           [0024]      FIG. 8  is a partially cutaway bottom perspective view of the surgical boot of  FIG. 1  showing that the surgical boot includes a strap guide assembly coupled to the bottom of the surgical boot and configured to direct a left strap and a right strap of the main strap assembly from the sides of the surgical boot back toward the heel end of the surgical boot; 
           [0025]      FIG. 9  is a partially diagrammatic view of a surgical table with a pair of couplers each secured to a surgical boot suggesting that the surgical boot is configured for use in a surgical setting and adapted to be supported by a surgical table; 
           [0026]      FIG. 10  is a front perspective view of another surgical boot similar to the surgical boot of  FIG. 1  showing that the surgical boot includes a shell without handles, several straps for securing a patient&#39;s foot and lower leg to the shell, and a receiver coupled to the bottom of the shell; and 
           [0027]      FIG. 11  is a rear perspective view of the surgical boot of  FIG. 10  showing that the surgical boot includes a tensioner unit coupled to a back side of the shell for tightening a patient&#39;s foot with the shell by pulling a main strap assembly down toward the shell. 
       
    
    
     DETAILED DESCRIPTION 
       [0028]    In one illustrative embodiment, a surgical foot support is embodied as a surgical boot  10  including a shell  12  providing support structure for the surgical boot  10 , a securing system  14 , a quick disconnect receiver  15  coupled to shell  12 , and a tightener system  50  for tightening and retaining a patient&#39;s foot in surgical boot  10  as shown in  FIG. 6 . Shell  12  includes a main body  16  and a plurality of handles  18 ,  20 ,  22 ,  24  sized and arranged for gripping by a caregiver during surgery to reposition a patient&#39;s foot and/or leg, for example when a caregiver is distracting a patient&#39;s hip joint or performing surgery on the patient&#39;s leg as shown in  FIG. 1 . Securing system  14  is configured to couple a patient&#39;s foot and lower leg to shell  12  of the surgical boot  10  as shown in  FIG. 5 . Quick disconnect receiver  15  is configured to couple surgical boot  10  to another surgical support as shown diagrammatically in  FIG. 9 . Tightener system  50  is configured to tighten a patient&#39;s foot with shell  12  and to retain a patient&#39;s foot in surgical boot  10  during repositioning of a patient&#39;s foot as shown in  FIG. 6 . 
         [0029]    Shell  12  includes a sole  25  configured to underlie a patient&#39;s foot and a calf support  26  configured to support the lower leg of a patient as suggested in  FIG. 1 . Shell  12  has a toe end  28 , a heel end  30 , a left side  32 , and a right side  34 . Main body  16  of shell  12  forms an upwardly-facing channel  36  that opens along sole  25  as shown, for example, in  FIG. 1 . A patient&#39;s foot may be lowered into upwardly-facing channel  36  of surgical boot  10  without bending the patient&#39;s foot relative to the lower leg of the patient as suggested by arrow  36 L in  FIG. 4 . Calf support  26  is coupled to sole  25  and extends up from sole  25  near heel end  30  of shell  12 . 
         [0030]    Tightener system  50  includes a main strap assembly  52  configured to extend over a patient&#39;s foot in front of the patient&#39;s ankle, a tensioner unit  53  coupled to shell  12 , a heel strap assembly  54  configured to extend around a back side of a patient&#39;s foot above the patient&#39;s heel bone, and a strap guide assembly  56  for guiding main strap assembly  52  from the sides  32 ,  34  of shell  12  to the heel end  30  of shell  12  as shown in  FIG. 6 . Main strap assembly  52  is configured to be pulled down toward sole  25  of shell  12  to tighten a patient&#39;s foot with shell  12  as suggested by arrow  52 T in  FIG. 6 . Tensioner unit  53  is configured to be operated by a caregiver to pull main strap assembly  52  over a patient&#39;s foot down toward sole  25  of shell  12  as shown in  FIG. 6 . Heel strap assembly  54  is coupled to main strap assembly  52  and blocks a patient&#39;s heel from lifting up from sole  25  when a caregiver is repositioning a patient foot so that the patient&#39;s foot is retained in surgical boot  10 . Strap guide assembly  56  cooperates with a rear guide beam  110  included in shell  12  to guide main strap assembly  52  from over a patient&#39;s foot to the tensioner unit  53 . 
         [0031]    Main strap assembly  52  includes a left strap  55 , a right strap  57 , a foot pad  101 , and a buckle  59  for securing left strap  55  to right strap  57  of main strap assembly  52  over a patient&#39;s foot as shown in  FIG. 3 . Buckle  59  is movable between an open configuration allowing a patient&#39;s foot to be lowered into channel  36  of surgical boot  10 , as shown in  FIG. 4 , and a closed configuration blocking a patient&#39;s foot from being lifted out of channel  36  of surgical boot  10  as shown in  FIG. 5 . Foot pad  101  is situated between buckle  59  and a patient&#39;s foot when main strap assembly  52  extends over the patient&#39;s foot as suggested in  FIG. 1 . Left strap  55  and right strap  57  of main strap assembly  52  extend through left side  32  and right side  34  of surgical boot  10 , respectively, and are both secured to toothed belt  58  by a fastener  61  as shown in  FIGS. 2 and 3 . 
         [0032]    Tensioner unit  53  is illustratively coupled along heel end, or back side,  30  of calf support  26  and includes a toothed belt  58 , a ratchet  60 , and a locator handle  103  as shown, for example, in  FIG. 3 . In other embodiments, tensioner unit  53  may be coupled to a bottom side  39  of sole  25 . Toothed belt  58  is coupled to main strap assembly  52  by a fastener  61  as shown in  FIG. 3 . Ratchet  60  is coupled to calf support  26  of shell  12  and is configured to advance toothed belt  58  in a forward direction indicated by an arrow  58 F in  FIG. 6  to pull main strap assembly  52  down toward sole  25  of shell  12 . Locator handle  103  is coupled to ratchet  60  and is configured to hang down from ratchet  60  so that a caregiver can tactilely locate and/or operate ratchet  60  during a surgery. In other embodiments, other tightening devices such as reels, worm gears, gear sets, or motors may be used to pull main strap assembly  52 . 
         [0033]    Ratchet  60  illustratively includes an actuator handle  31 , a keeper pawl  33 , and a release lever  35  as shown, for example, in  FIG. 6 . Actuator handle  31  includes an actuator lever  37  and a ratchet pawl  39 . Actuator handle  31  is illustratively operated by a caregiver pivoting actuator lever  37  as suggested by arrow  31 A in  FIG. 6  so that ratchet pawl  39  advances toothed belt  58  through ratchet  60 . Keeper pawl  33  is configured to block toothed belt  58  from moving backward through ratchet  60  while actuator handle  31  advances toothed belt  58 . Release lever  35  is configured to be operated by a caregiver pivoting release lever  35 , as suggested by arrow  35 A in  FIG. 7 , so that keeper pawl  33  and ratchet pawl  39  are moved out of engagement with toothed belt  58  thereby allowing toothed belt  58  to move backward through ratchet  60  as suggested by arrow  58 B in  FIG. 7 . 
         [0034]    Heel strap assembly  54  includes a strap  106  and a heel pad  108  as shown in  FIG. 3 . Strap  106  is slidably coupled at a first end  105  to left strap  55  of main strap assembly  52  and at a second end  107  to right strap  57  of main strap assembly  52  as suggested in  FIG. 3 . Heel pad  108  is situated between strap  106  and a patient&#39;s heel to cushion the patient&#39;s heel as suggested in  FIG. 2 . When a patient&#39;s foot is secured in surgical boot  10 , main strap assembly  52  and heel strap assembly  54  cooperate to extend around a patient&#39;s ankle and to retain a patient&#39;s heel in surgical boot  10  during repositioning of the patient&#39;s foot by a caregiver. 
         [0035]    Strap guide assembly  56  receives left and right straps  55 ,  57  of main strap assembly  52  from left and right sides  32 ,  34  of shell  12  and redirects left and right straps  55 ,  57  out from strap guide assembly  56  toward heel end  30  of shell  12  as shown in  FIG. 8 . Strap guide assembly  56  is coupled to sole  25  of shell  12  between sole  25  and quick disconnect receiver  1 . Strap guide assembly  56  includes a top plate  63 , a bottom plate  65 , a top guide pin  67 , and a bottom guide pin  69 . 
         [0036]    Top guide pin  67  is supported by top plate  63  and engages right strap  57  of main strap assembly  52  to direct right strap  57  from the right side  34  of shell  12  back toward heel end  30  of shell  12  as shown in  FIG. 8 . Bottom guide pin  69  is supported by bottom plate  65  and engages left strap  55  of main strap assembly  52  to direct left strap  55  from the left side  32  of shell  12  back toward heel end  30  of shell  12 . Guide pins  67 ,  69  are oriented to form an X-shape with each guide pin  67 ,  69  angled about forty-five degrees from an axis extending from the toe end  28  to the heel end  30  of shell  12 . Top plate  63  is coupled to bottom plate  65  by fasteners  86 , as shown in  FIG. 3 . 
         [0037]    Rear guide beam  110  included in shell  12  forms heel end  30  of shell  12  arranged behind the calf support  26  as shown in  FIG. 6 . Calf support  26  of shell  12  is formed to include a channel  112  for guiding left and right straps  55 ,  57  of main strap assembly  52  and toothed belt  58  along calf support  26  as shown in  FIG. 2 . Rear guide beam  110  directs main strap assembly  52  from heel end  30  of shell  12  up along channel  112  formed in calf support  26 . Rear guide beam  110  includes a pair of beam guide pins  114  as shown in  FIGS. 3 and 6  for engaging and directing left and right straps  55 ,  57  of main strap assembly  52 . Surgical boot  10  also includes a channel guide pin  118  as shown in  FIGS. 2 and 3  for holding left and right straps  55 ,  57  of main strap assembly  52  in position relative to channel  112  along calf support  26 . 
         [0038]    Plurality of handles  18 ,  20 ,  22 ,  24  is made up of lower left handle  18 , lower right handle  20 , upper left handle  22 , and upper right handle  24  as shown in  FIG. 1 . In the illustrative embodiment, shell  12  is made from a monolithic plastics material and thus each of the plurality of handles  18 ,  20 ,  22 ,  24  is integrally formed with main body  16  of shell  12 . Illustratively, shell  12  may be made from an ABS polycarbonate blended material. Further, the plurality of handles  18 ,  20 ,  22 ,  24  have a thickness similar to a thickness of main body  16  as shown in  FIG. 1 . Illustratively, the handles  18 ,  20 ,  22 ,  24  and the main body  16  have a thickness of about 0.2 inches. In other embodiments, other thicknesses of shell  12  may be used. 
         [0039]    Lower left handle  18  and lower right handle  20  extend from calf support  26  near heel end  30  of shell  12  to sole  25  near toe end  28  of shell  12  so that lower left and lower right handles  18 ,  20  are arranged to extend along the length of a patient&#39;s foot as suggested in  FIG. 2 . Lower left handle  18  and lower right handle  20  form corresponding lower handhold openings  18 H,  20 H that extend through shell  12 . Lower handhold openings  18 H,  20 H are sized to allow a caregiver&#39;s hand to pass through shell  12 . Lower left handle  18  and lower right handle  20  are arcuate and extend away from channel  36  of main body  16  along left side  32  of shell  12  and right side  34  of shell  12 , respectively, so that a caregiver can grip lower left handle  18  and lower right handle  20  with a portion of his hand situated between a patient&#39;s foot and shell  12 . 
         [0040]    Upper left handle  22  and upper right handle  24  are arcuate and extend away from channel  36  along calf support  26  from a top end  37  of calf support  26  down toward sole  25  of shell  12  so that upper left and upper right handles  22 ,  24  are arranged to extend along the length of a patient&#39;s lower leg as suggested in  FIG. 1 . Upper left handle  22  and upper right handle  24  form corresponding handhold openings  22 H and  24 H that extend through shell  12 . Upper handhold openings  22 H,  24 H are sized to allow a caregiver&#39;s hand to pass through shell  12 . Upper left handle  22  and upper right handle  24  are arcuate and extend away from channel  36  of main body  16  along left side  32  of shell  12  and right side  34  of shell  12 , respectively, so that a caregiver can grip upper left handle  22  and upper right handle  24  with a portion of his hand situated between a patient&#39;s lower leg and shell  12 . 
         [0041]    Securing system  14  is configured to couple a patient&#39;s foot and lower leg to shell  12  of the surgical boot  10  and includes a foot securing system  38  and a calf securing system  40  as shown in  FIG. 1 . Foot securing system  38  is configured to couple a patient&#39;s foot to sole  25  of shell  12  and illustratively includes a toe strap assembly  42  and a sole pad  44  as shown in  FIGS. 1 and 3 . Sole pad  44  is coupled to sole  25  of shell  12  to cushion a patient&#39;s foot when a patient is secured to surgical boot  10  as suggested in  FIG. 1 . Calf securing system  40  is configured to couple a patient&#39;s lower leg to calf support  26  of shell  12  and illustratively includes leg strap assembly  46  and a calf pad  48  as shown in  FIGS. 1 and 3 . Calf pad  48  is coupled to calf support  26  of shell  12  to cushion a patient&#39;s lower leg when a patient is secured to surgical boot  10  as suggested in  FIG. 1 . 
         [0042]    Quick disconnect receiver  15  is illustratively coupled to a bottom side  39  of sole  25  and extends downwardly from sole  25  as shown in  FIG. 2 . Quick disconnect receiver  15  is configured to couple to a coupler  41  attached to a surgical table  43  as shown diagrammatically in  FIG. 4 . In the illustrative embodiment, quick disconnect receiver  15  includes a receiver body  45 , a release handle  47 , and a retainer lug  49  as shown, for example, in  FIG. 3 . Retainer lug  49  is configured to engage coupler  41  when quick disconnect receiver  15  is coupled to coupler  41 . Release handle  47  is configured to disengage retainer lug  49  from coupler  41  so that surgical boot  10  can be moved away from coupler  41 . 
         [0043]    Coupler  41  may include one or more of a handle, a post, a spar, a clamp, and a carriage as is known in the art. In some embodiments, quick disconnect receiver  15  may be movably coupled to coupler  41  so that a caregiver can position surgical boot  10  at different positions along coupler  41 . In some embodiments, quick disconnect receiver  15  may be configured to couple directly to surgical table  43 . Quick disconnect receiver  15  allows surgical boot  10  to be positioned for surgery, traction, and other applications of the surgical boot  10 . 
         [0044]    Calf support  26  includes a left leg  62 , a right leg  64 , and a calf plate  66  supported near heel end  30  of shell  12  as shown in  FIG. 2 . Left leg  62  and right leg  64  extend up from sole  25  along left and right sides  32 ,  34  of shell  12  and support calf plate  66 . Left leg  62 , right leg  64 , and calf plate  66  cooperate to form an opening  68  between sole  25  and calf plate  66  near heel end  30  of shell  12 . 
         [0045]    Toe strap assembly  42  of foot securing system  38  is configured to extend across a patient&#39;s foot near the toe end  28  shell  12  when a patient is secured to surgical boot  10  as shown, for example, in  FIG. 5 . Toe strap assembly  42  includes a left strap  70 , a right strap  72 , a buckle  74 , and a toe pad  76  as shown in  FIG. 3 . Left strap  70  of toe strap assembly  42  has a first end  78  coupled to left side  32  of shell  12  by a fastener  79  and a second end  80 . Right strap  72  of toe strap assembly  42  has a first end  82  coupled to right side  34  of shell  12  by a fastener  83  and a second end  84  coupled to buckle  74 . Buckle  74  of toe strap assembly  42  is configured to move between an open configuration allowing a patient&#39;s foot from being lifted out of channel  36  of surgical boot  10  and a closed configuration blocking a patient from lifting his foot out of channel  36 . Buckle  74  is slidably coupled to left strap  70  so that toe strap assembly  42  may be tightened or loosened over a patient&#39;s foot by a caregiver. Toe pad  76  is situated between buckle  74  and a patient&#39;s foot to cushion a patient&#39;s foot when toe strap assembly  42  extends over a patient&#39;s foot as shown in  FIG. 1 . 
         [0046]    Leg strap assembly  46  of calf securing system  40  is configured to extend over a patient&#39;s lower leg near the top end  37  of calf support  26  when a patient is secured to surgical boot  10  as suggested in  FIG. 5 . Leg strap assembly  46  includes a left strap  90 , a right strap  92 , a buckle  94 , and a leg pad  96  as shown, for example, in  FIG. 3 . Left strap  90  of leg strap assembly  46  has a first end  98  coupled to calf plate  66  by a fastener  99  and a second end  100 . Right strap  92  of leg strap assembly  46  has a first end  102  coupled to calf plate  66  by a fastener  105  and a second end  104 . Buckle  94  of leg strap assembly  46  is configured to move between an open configuration allowing a patient&#39;s lower leg to be lowered into channel  36  of surgical boot  10  and a closed configuration blocking a patient&#39;s lower leg from being lifted out of channel  36  of surgical boot  10 . Buckle  94  is slidably coupled to left strap  90  so that leg strap assembly  46  may be tightened or loosened over a patient&#39;s lower leg by a caregiver. Leg pad  96  is situated between buckle  94  and the patient&#39;s lower leg to cushion a patient&#39;s lower leg when leg strap assembly  46  extends over a patient&#39;s lower leg as shown in  FIG. 1 . 
         [0047]    In illustrative operation, a caregiver moves buckle  59  of main strap assembly  52 , buckle  74  of toe strap assembly  42 , and buckle  94  of leg strap assembly  46  to the open position to allow a patient&#39;s foot to be lowered into channel  36  of surgical boot  10  as shown in  FIG. 4 . A caregiver places a patient&#39;s foot into channel  36  of surgical boot  10 . A caregiver guides straps included in toe strap assembly  42 , leg strap assembly  46 , main strap assembly  52 , and heel strap assembly  54  over a patient&#39;s foot and lower leg. A caregiver moves buckle  59  of main strap assembly  52 , buckle  74  of toe strap assembly  42 , and buckle  94  of leg strap assembly  46  to the closed position to block the patient&#39;s foot from being removed from surgical boot  10  as shown in  FIG. 5 . Then the caregiver operates ratchet  60  of tensioner unit  53  to advance toothed belt  58  through ratchet  60  thereby pulling main strap assembly  52  down over a patient&#39;s foot so that a patient&#39;s foot is tightened with shell  12  of surgical boot  10 . The caregiver may then couple quick disconnect receiver  15  with coupler  41  to support surgical boot  10  at a location or for movement along coupler  41 . A caregiver may then manipulate the position or arrangement of the patient by gripping one or more of the plurality of handles  18 ,  20 ,  22 ,  24 . During repositioning of the patient&#39;s foot, heel strap  54  is configured to engage the back side of a patient&#39;s foot above the heel bone to hold the patient&#39;s heel in contact with shell  12  of surgical boot  10  resisting movement of the patient&#39;s foot relative to shell  12 . 
         [0048]    Another surgical boot  210  is shown in  FIGS. 11 and 12 . Surgical boot  210  is similar to surgical boot  10  shown in  FIGS. 1-10  and like reference numerals are used to denote similar parts. However, surgical boot  210  includes a shell  212  formed to include a sole  225  and a calf support  226  without handles as shown in  FIGS. 11 and 12  thereby leaving the sides of shell  212  open so that a caregiver can access a patient&#39;s foot or lower leg from the side. In some embodiments, surgical boot  210  may be used with other surgical supports including mechanical devices for moving surgical boot  210  in order to distract a patient&#39;s hip joint or perform surgery on the patient&#39;s leg. 
         [0049]    Although certain illustrative embodiments have been described in detail above, variations and modifications exist within the scope and spirit of this disclosure as described and as defined in the following claims.