Patent Publication Number: US-2023157916-A1

Title: Distraction frame for effecting hip distraction

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a divisional of U.S. Pat. Application No. 15/890,124, filed Feb. 6, 2018, which claims the benefit of U.S. Provisional Application No. 62/455,238, filed Feb. 6, 2017, and U.S. Provisional Application No. 62/546,686, filed Aug. 17, 2017, the entire contents of each are hereby incorporated herein by reference. 
    
    
     FIELD OF THE INVENTION 
     This invention relates to medical apparatus in general, and more particularly to medical apparatus for effecting hip distraction. 
     BACKGROUND OF THE INVENTION 
     When performing surgical procedures on the hip joint, it is common to distract the hip joint prior to the surgery in order to provide additional room within the hip joint during the surgery and in order to better present selected anatomy to the surgeon. This hip distraction is commonly achieved by applying a distraction force to the distal end of the leg of the patient. Currently, a surgical boot is placed on the foot and lower leg of the patient, the surgical boot is connected to a distraction frame, and then the distraction frame is used to apply a distraction force to the surgical boot, whereby to apply a distraction force to the leg of the patient, whereby to distract and position the hip joint. 
     The present invention is intended to provide a new and improved distraction frame for applying a distraction force to the leg of the patient so as to effect hip distraction and to allow for leg positioning. 
     SUMMARY OF THE INVENTION 
     The present invention provides a new and improved distraction frame for applying a distraction force to the leg of the patient so as to effect hip distraction and to allow for leg positioning. 
     In one form of the invention, there is provided a distraction frame for use with a surgical table, wherein the surgical table comprises a base for positioning on a floor, the distraction frame comprising a table mount for fixation to the base of the surgical table; at least one horizontal strut mounted to the table mount; at least one vertical strut mounted to the at least one horizontal strut; and at least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient; wherein the table mount is configured to transfer to the floor a force moment imposed on the table mount when the at least one distraction mechanism applies a distraction force to a limb of a patient. 
     In another form of the invention, there is provided a method for distracting a limb of a patient, the method comprising: providing a distraction frame for use with a surgical table, wherein the surgical table comprises a base for positioning on a floor, the distraction frame comprising: a table mount for fixation to the base of the surgical table; at least one horizontal strut mounted to the table mount; at least one vertical strut mounted to the at least one horizontal strut; and at least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient; wherein the table mount is configured to transfer to the floor a force moment imposed on the table mount when the at least one distraction mechanism applies a distraction force to a limb of a patient; positioning the patient on the surgical table; connecting the limb of the patient to the at least one distraction mechanism; and applying a distraction force to the limb of the patient using the at least one distraction mechanism. 
     In another form of the invention, there is provided a distraction frame comprising: a table mount for fixation to a surgical table; at least one horizontal strut mounted to the table mount; at least one vertical strut mounted to the at least one horizontal strut; and at least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient; wherein the table mount comprises a surface for selectively contacting the floor, and further wherein the table mount comprises at least one wheel for selectively supporting the surface of the table mount above the floor; and wherein the at least one horizontal strut comprises at least one caster for selectively rollably supporting the at least one horizontal strut on the floor, and further wherein the table mount comprises at least one foot peg for selectively supporting the at least one caster above the floor; such that (i) the distraction frame can be moved to the surgical table supported by the at least one wheel and the at least one caster, and (ii) the distraction frame can be fixed adjacent to the surgical table supported by the surface of the table mount and the at least one foot peg. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       These and other objects and features of the present invention will be more fully disclosed or rendered obvious by the following detailed description of the preferred embodiments of the invention, which is to be considered together with the accompanying drawings wherein like numbers refer to like parts, and further wherein: 
         FIGS.  1  and  2    are schematic views showing a novel distraction frame formed in accordance with the present invention; 
         FIGS.  3 - 14    are schematic views showing details of the table mount of the novel distraction frame shown in  FIGS.  1  and  2   ; 
         FIG.  14 A  is a schematic view showing how a distraction force applied to the leg of a patient creates a force moment at the table mount which is transferred to the operating room floor; 
         FIG.  14 B  is a schematic view showing a foot pedal mechanism which may be used in place of the adjustable supports of the table mount shown in  FIGS.  3 - 14   ; 
         FIGS.  15 ,  15 A- 15 C,  16 - 21 ,  21 A- 21 C and  22 - 27    are schematic views showing details of the adjustable horizontal struts, the adjustable vertical struts, and elements attached to these struts, of the novel distraction frame shown in  FIGS.  1  and  2   ; 
         FIGS.  28 ,  29 ,  29 A- 29 C and  30 - 33    are schematic views showing further details of the adjustable vertical struts (and elements attached to these struts) of the novel distraction frame shown in  FIGS.  1  and  2   ; 
         FIGS.  34  and  35    are schematic views showing how the novel distraction frame of  FIGS.  1  and  2    can be positioned in transport mode for movement about a facility; 
         FIG.  36    is a schematic view showing how table tilt can be used to influence distraction after a patient’s leg has been secured to a distraction frame; and 
         FIG.  37    is a schematic view showing another novel distraction frame formed in accordance with the present invention, wherein the distraction frame comprises a leg rest for supporting the non-operative leg of a patient. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The New And Improved Distraction Frame In General 
     The present invention provides a new and improved distraction frame for applying a distraction force to the leg of a patient so as to effect hip distraction. 
     More particularly, and looking first at  FIGS.  1  and  2   , there is shown a novel distraction frame  5  formed in accordance with the present invention. Also shown in  FIG.  1    is (i) a surgical table  10  for supporting a patient during surgery, wherein surgical table  10  comprises a base  15 , and (ii) a pair of surgical boots  20  for disposition on the feet and lower legs of the patient. Surgical table  10  may be of the sort well known in the art. Surgical boots  20  may be the novel surgical boots shown in the aforementioned  FIGS.  1  and  2    and described and illustrated in detail in co-pending U.S. Pat. Application Serial Nos. 62/455,154 (Attorney’s Docket No. FIAN-118 PROV), 62/546,629 (Attorney’s Docket No. FIAN-124 PROV), and 15/889,998 (Attorney’s Docket No. FIAN-118124), and/or surgical boots  20  may be conventional surgical boots of the sort well known in the art. 
     If desired, surgical table  10  may also comprise a novel table extender  23  which is configured to be mounted to the foot of surgical table  10 , whereby to provide additional support for the patient during a surgical procedure. Novel table extender  23  is preferably substantially radiolucent, so that X-ray imaging can be conducted on anatomy supported by novel table extender  23 . Novel table extender  23  is described and illustrated in detail in co-pending U.S. Pat. Application Serial Nos. 62/455,143 (Attorney’s Docket No. FIAN-122 PROV), 62/546,600 (Attorney’s Docket No. FIAN-125 PROV) and 15/890,047 (Attorney’s Docket No. FIAN-122125). If desired, table extender  23  may comprise a distraction post  24 , which is the traditional means for facilitating hip distraction (e.g., by providing counter-traction to stabilize the patient on the surgical table and by levering the upper end of the leg of the patient against the distraction post so as to dislocate the femoral head from the acetabular cup). Such distraction posts are well known in the art of hip distraction. 
     Distraction frame  5  generally comprises a table mount  25 , a pair of adjustable horizontal struts  30  and a pair of adjustable vertical struts  35 . 
     Table Mount  25   
     Table mount  25  ( FIGS.  1 - 14   ) generally comprises a body  40  and an extension assembly  43 . 
     Body  40  generally comprises a vertical surface  45 , a horizontal surface  50  and a recess  53 . 
     Vertical surface  45  of body  40  is intended to sit adjacent to, but slightly spaced from, base  15  of surgical table  10 . Alternatively, vertical surface  45  of body  40  may be in contact with base  15  of surgical table  10 . Or, alternatively, vertical surface  45  of body  40  may be set a distance off base  15  of surgical table  10 . Note that the ability to space vertical surface  45  of body  40  from base  15  of surgical table  10  can be advantageous, since it allows distraction frame  5  to work with a wide range of surgical tables. 
     Horizontal surface  50  of body  40  is intended to engage the operating room floor during hip distraction. 
     Recess  53  is intended to receive a retractable wheel assembly  205 , wherein retractable wheel assembly  205  is configured for selectively (i) projecting out of recess  53  so as to engage the floor and movably support body  40  of table mount  25  above the floor, such that distraction frame  5  may be moved about a facility (for example, to move distraction frame  5  to another operating room or to a storage area), and (ii) retracting into recess  53  so as to disengage from the operating room floor and lower horizontal surface  50  of body  40  onto the operating room floor so as to prevent movement of distraction frame  5  (e.g., during a surgery). 
     In one preferred form of the invention, and looking now at  FIGS.  1 - 12   , retractable wheel assembly  205  generally comprises a mount  210  for mounting to body  40  of table mount  25  ( FIGS.  6  and  8   ), and a base  215  movably mounted to mount  210 . A spring  220  spring biases base  215  upward into the interior of mount  210 . An axle  225 , supporting wheels  230 , passes through base  215 . As a result of this construction, when base  215  moves upward and downward relative to mount  210 , wheels  230  move upward and downward relative to body  40  of table mount  25 . 
     An actuation lever  235 , together with a linkage  240  and a bar  245 , cooperate with a recess  250  ( FIG.  11   ) on mount  210 , such that stepping down on actuation lever  235  forces wheels  230  downward, whereby to engage the floor and raise up body  40  (and hence table mount  25 ) off of the floor, with bar  245  slipping into recess  250  so as to lock wheels  230  in their “down” position. Note that in this “down” position, table mount  25  is supported on wheels  230  such that distraction frame  5  may be moved about on a floor. A release lever  255 , also connected to linkage  240  ( FIG.   10   ), is provided for retracting wheels  230 , i.e., by stepping down on release lever  255 , linkage  240  moves bar  245  out of recess  250 , thereby allowing wheels  230  to retract upwards off of the floor, and hence allowing body  40  to settle onto the floor (i.e., with horizontal surface  50  of body  40  engaging the floor). 
     Note that when wheels  230  are in their “retracted” position ( FIG.  6   ), the arm  257  ( FIG.  12   ) of actuation lever  235  and linkage  240  project “off-center” towards bar  245  ( FIG.  7   ), and when wheels  230  are in their “down” position, with bar  245  slipped into recess  250 , arm  257  of actuation lever  235  and linkage  240  project “off-center” away from bar  245  ( FIG.  10   ). Note also that when release lever  255  is to be used for retracting wheels  230 , release lever  255  essentially moves linkage  240  “over center”, from its “off-center” position away from bar  245  ( FIG.  10   ) towards its “off-center” position towards bar  245  ( FIG.  7   ). Once release lever  255  moves linkage  240  “over center”, the weight of the structure(s) being supported by wheels  230  (e.g., the weight of distraction frame  5 ) provides the major force for retracting wheels  230  into recess  53 . 
     It will be appreciated that, in view of the foregoing construction, (i) stepping down on actuation lever  235  locks wheels  230  in their “down” position, so that table mount  25  is movably supported on wheels  230 , and (ii) stepping down on release lever  255  retracts wheels  230  into recess  53  of body  40 , whereby to allow horizontal surface  50  of body  40  to seat on the operating room floor. 
     In an alternative embodiment, retractable wheel assembly  205  may comprise a single-pedal mechanism of the sort well known in the art of material transport, with the single-pedal mechanism alternately moving wheels  230  between their upward and downward positions. 
     Recess  53  also serves to receive the proximal ends of adjustable horizontal struts  30  as will hereinafter be discussed. 
     Extension assembly  43  ( FIGS.  3 ,  6 ,  8 ,  13  and  14   ) comprises a mount  54  which is mounted to body  40 , and a pair of L-shaped extensions  55  which extend away from mount  54  (and which extend away from body  40 ). L-shaped extensions  55  are intended to extend on either side of base  15  of surgical table  10 . Thus, L-shaped extensions  55  essentially constitute “outriggers” which extend on either side of base  15  of surgical table  10 . Mount  54  (and hence L-shaped extensions  55 ) is secured to body  40 . L-shaped extensions  55  are adjustably secured to mount  54  with clamps  57  ( FIG.  3   ), i.e., so that L-shaped extensions  55  are laterally adjustably securable relative to mount  54  (and hence body  40 ). Thus, the laterally-adjustable L-shaped extensions  55  essentially constitute laterally-adjustable outriggers which extend on either side of base  15  of surgical table  10 . Note that laterally adjustably securing L-shaped extensions  55  to mount  54  is advantageous, since it allows distraction frame  5  to accommodate different widths of bases  15  of surgical tables  10 , i.e., by allowing the outriggers (i.e., L-shaped extensions  55 ) to be laterally adjusted so as to straddle bases  15  of different widths. Although clamps  57  are shown in the figures as extending with a vertical orientation, clamps  57  could also be mounted to the side of mount  54  so that they extend with a horizontal orientation. 
     A pair of L-shaped brackets  60  are slidably mounted to L-shaped extensions  55  and extend under base  15  of surgical table  10  so that the lower ends of L-shaped brackets  60  may be captured beneath table feet  62  ( FIGS.  13  and  14   ) of surgical table  10  (surgical tables  10  typically comprise rollers and retractable/extendable table feet, with the table feet being retracted so that the surgical tables are able to move on their rollers when the surgical tables are to be moved about a floor, and with the table feet being extended when the surgical tables are to be fixed in position on a floor). More particularly, L-shaped brackets  60  are slidable along extensions  55  so that L-shaped brackets  60  may be positioned beneath table feet  62  when the table feet are in their retracted position, and L-shaped brackets  60  each comprise a latch  63  for locking L-shaped brackets  60  in position along L-shaped extensions  55  ( FIGS.  13  and  14   ) when L-shaped brackets  60  are to be captured under the table feet when the table feet are extended to the floor. Positioning L-shaped brackets  60  under table feet  62  of surgical table  10  effectively holds distraction frame  5  in a fixed position relative to surgical table  10  by using the weight of surgical table  10  on L-shaped brackets  60 . Thus, with the present invention, distraction frame  5  does not need to be bolted to, or clamped to, surgical table  10  in order to effectively hold distraction frame  5  in a fixed position relative to surgical table  10 . This is a substantial advantage over prior art distraction frames. 
     Alternative constructions can include L-shaped extensions  55  of different lengths or of different cross-sectional shapes and sizes. L-shaped brackets  60  may be similarly varied in construction, for instance, they may not necessarily be positioned under table feet  62  of base  15  of surgical table  10 , but may engage elsewhere under base  15  of surgical table  10  so as to achieve the same engagement between the floor, L-shaped extensions  55  and base  15  of surgical table  10  (i.e., with L-shaped extensions  55  being captured to the floor by base  15  of surgical table  10 ). By way of example but not limitation, L-shaped brackets  60  may be captured beneath another portion of base  15  of surgical table  10 . Note that L-shaped brackets  60  may also have a height adjustment feature so that the vertical distance between (i) the portion of the L-shaped bracket which is mounted to the L-shaped extensions  55 , and (ii) the portion of the L-shaped bracket which mounts to the surgical table  10 , can be varied. This feature can accommodate uneven floors where the distance between each of the L-shaped extensions  55  and the floor may vary. 
     A pair of adjustable supports  65  ( FIG.  14   ) are mounted to L-shaped extensions  55  and also engage the floor upon which surgical table  10  sits. Adjustable supports  65  are preferably positioned at the ends of L-shaped extensions  55  which are opposite to body  40 , however, adjustable supports  65  may alternatively be located anywhere along the length of L-shaped extensions  55 , possibly with the overall length of L-shaped extensions  55  varying. Adjustable supports  65  preferably comprise a threaded engagement with L-shaped extensions  55 , and preferably further comprise a locking nut  66  ( FIG.  14   ) to lock adjustable supports  65  relative to L-shaped extensions  55  once adjustable supports  65  are in their desired positions. 
     It will be appreciated that, on account of the foregoing construction, when table mount  25  of distraction frame  5  is mounted to base  15  of surgical table  10  (e.g., by way of L-shaped brackets  60  being captured under table feet  62  of base  15  of surgical table  10 , and by adjustable supports  65  being positioned securely against the floor), and distraction frame  5  is thereafter used to apply a distraction force to the leg of a patient (e.g., via adjustable horizontal struts  30 , adjustable vertical struts  35 , etc.), any force moment produced at table mount  25  will be to transferred to the operating room floor via L-shaped extensions  55  and adjustable supports  65 , and via L-shaped extensions  55  and L-shaped brackets  60 . See, for example,  FIG.  14 A , which shows how a distraction force 400 applied to the leg of a patient creates a force moment 405 at table mount  25  which is transferred to the operating room floor as a force 410 via L-shaped extension  55  and adjustable supports  65 , and as a force 415 via L-shaped extensions  55  and L-shaped brackets  60 . This is highly advantageous since the force moments are transferred to the operating room floor and are not imposed on any mechanical connections between the distraction frame and the surgical table. Indeed, as noted above, the construction of the distraction frame of the present invention does not need to create a mechanical connection with the surgical table, the distraction frame of the present invention simply has its L-shaped brackets  60  clamped beneath table feet  62  of surgical table  10 . 
     Note that modifications to the materials of construction, or to the configuration of the design elements (e.g., L-shaped brackets  60 , adjustable supports  65 , etc.) may be made to alter the stiffness and performance of distraction frame  5  while still maintaining the same overall design to transfer the patient distraction forces to the floor of the operating room. For example, although adjustable supports  65  are generally shown in the figures as having a threaded adjustment, adjustable supports  65  could also be actuated (e.g., raised and lowered, and locked in place) with a foot pedal mechanism (see, for example, the foot pedal mechanism  67  shown in  FIG.  14 B ). In this alternative construction, foot pedal mechanism  67  may comprise a mechanism generally similar to the retractable foot pegs  97  discussed below. 
     Adjustable Horizontal Struts  30   
     Each of the adjustable horizontal struts  30  ( FIGS.  1 - 6 ,  8 ,  14 ,  15 ,  15 A- 15 C,  16 - 21 ,  21 A- 21 C and  22 - 27   ) comprises a proximal portion 75 and a distal portion  80 . Proximal portions 75 and distal portions  80  telescope relative to one another. A locking screw  85  ( FIG.  15   ) is provided to lock proximal portions 75 and distal portions  80  in position relative to one another. If desired, proximal portions 75 and distal portions  80  can be limited to discrete telescoping positions (e.g., to 3 discrete telescoping positions) or proximal portions 75 and distal portions  80  can be continuously telescopically variable relative to one another. In one preferred form of the invention, and looking now at  FIGS.  15 A- 15 C , rollers  87  are mounted to proximal portions 75 of adjustable horizontal struts  30  and roll against the inside surfaces of distal portions  80 . This provides low friction movement as proximal portions 75 telescope relative to distal portions  80 . 
     Adjustable horizontal struts  30  are pivotally mounted to body  40  of table mount  25 . More particularly, proximal portions 75 of adjustable horizontal struts  30  are mounted to body  40  of table mount  25  with pivot mounts  90  ( FIG.  5   ). Pivot mounts  90  allow proximal portions 75 of adjustable horizontal struts  30  to be adjusted to the desired angular dispositions relative to body  40  of table mount  25 . 
     Adjustable horizontal struts  30  are detachable from body  40  of table mount  25  with locking pins  92  ( FIG.  5   ). When locking pins  92  are raised, adjustable horizontal struts  30  can be detached from body  40  of table mount  25 , providing the ability to disassemble distraction frame  5  so as to allow, for example, easier transport of distraction frame  5  to another location. In an alternative construction, adjustable horizontal struts  30  may be permanently attached to body  40  of table mount  25 . 
     Adjustable horizontal struts  30  comprise castors  95  which are disposed at the distal ends of distal portions  80  of adjustable horizontal struts  30 . Distal portions  80  of adjustable horizontal struts  30  also comprise retractable foot pegs  97 . When retractable foot pegs  97  are in their retracted positions ( FIGS.  16  and  17   ), the distal ends of distal portions  80  of adjustable horizontal struts  30  are supported on castors  95  such that the distal ends of distal portions  80  of adjustable horizontal struts  30  may roll relative to the floor. When retractable foot pegs  97  are in their extended positions ( FIGS.  20  and  21   ), the distal ends of distal portions  80  of adjustable horizontal struts  30  are supported on retractable foot pegs  97  such that the distal ends of distal portions  80  of adjustable horizontal struts  30  may not roll relative to the floor. 
     In one preferred form of the invention, and looking now at  FIGS.  16 - 21  and  21 A- 21 C , retractable foot pegs  97  may comprise a shaft  300  which is movably mounted to a housing assembly  305  (which is, in turn, mounted to distal portion  80  of adjustable horizontal strut  30 ). One end of shaft  300  comprises a foot  310  for selectively engaging the floor. The other end of shaft  300  comprises a pedal  315  for selective engagement by the foot of a user. A spring  317  ( FIG.  21 B ) biases shaft  300  upward, so that foot  310  is normally withdrawn from the floor. 
     Shaft  300  also comprises a track  320 , and housing assembly  305  also comprises a finger  325  which rides in track  320 . One end of finger  325  is pivotably mounted to housing assembly  305  while the other end of finger  325  comprises a projection  327  ( FIG.  21 A ) which rides in track  320 . Track  320  and finger  325  are configured so that when a user steps on pedal  315 , driving foot  310  downward, finger  325  rides upward in a portion  328  ( FIG.  21   ) of track  320  until finger  325  hits a peak  330  ( FIG.  17   ) in track  320 . When the user thereafter steps off of pedal  315 , finger  325  settles into a recess  335  ( FIG.  17   ) formed in track  320 , whereby to lock foot  310  in its extended position ( FIGS.  19  and  20   ), with distal portion  80  of adjustable horizontal strut  30  supported on retractable foot peg  97  (i.e., with castors  95  not in contact with the floor). When the user thereafter steps on pedal  315  again, finger  325  rides out of recess  335  and down a portion  338  ( FIG.  17   ) of track  320  until finger  325  settles into a well  340  ( FIG.  17   ), whereby to lock foot  310  in its retracted position ( FIGS.  16  and  17   ), with distal portion  80  of adjustable horizontal strut  30  supported on castor  95 . In this way, pedals  315  may be used to cycle retractable foot pegs  97  between their extended and retracted positions. 
     In one preferred form of the invention, shaft  300  comprises a gas shock assembly  345  ( FIG.  21 A ) so that foot  310  can adjustably contact the floor. More particularly, in this form of the invention, gas shock assembly  345  comprises a rod  350  ( FIG.  21 A ) which is secured to pedal  315 , and a cylinder  355  ( FIG.  21 A ) which is movably mounted to rod  350 . Foot  310  is secured to cylinder  355 . As a result of this construction, the separation between pedal  315  and foot  310  can adjust to some extent as needed, e.g., when distraction frame  5  is applying a distraction force to the leg of the patient, distal portion  80  of adjustable horizontal strut  30  can tend to lift upward relative to the floor, and gas shock assembly  345  can act to keep foot  310  firmly engaging the floor, with a certain minimum amount of force (which can be varied by adjusting the gas shock force and overall travel). 
     Adjustable horizontal struts  30  also comprise bearing rails  99  ( FIGS.  15 ,  15 A- 15 C,  16 ,  20  and  22 - 27   ) and gear racks  100  disposed on distal portions  80  of adjustable horizontal struts  30 . Bearing rails  99  and gear racks  100  serve as a means to selectively lock adjustable vertical struts  35  at a specific location along distal portions  80  of adjustable horizontal struts  30  as will hereinafter be discussed. 
     Adjustable Vertical Struts  35   
     Each of the adjustable vertical struts  35  ( FIGS.  1 ,  2 ,  16 ,  20 ,  22 - 29 ,  29 A- 29 C and  30 - 33   ) comprises a lower portion  105  ( FIG.  2   ), an intermediate portion  107 , and an upper portion  110 . Lower portions  105  comprise mounts  115  ( FIG.  22   ) for adjustably securing adjustable vertical struts  35  to bearing rails  99  and gear racks  100  disposed on distal portions  80  of adjustable horizontal struts  30 . Lock/release mechanisms  120  ( FIG.  24   ) are provided for locking/releasing adjustable vertical struts  35  at particular dispositions along bearing rails  99  and gear racks  100  disposed on distal portions  80  of adjustable horizontal struts  30 . Note that the lock/release mechanisms  120  are normally “locked” when in their “default” condition, such that mounts  115  and gear racks  100  prevent unintentional travel of adjustable vertical struts  35  along adjustable horizontal struts  30 , e.g., such as when performing a hip distraction. 
     In one preferred form of the invention, mounts  115  comprise bearings  121  ( FIG.  22   ) which roll along bearing rails  99 , allowing adjustable vertical struts  35  to travel along the length of distal portions  80  of adjustable horizontal struts  30 . This is for the purpose of allowing the user to adjust the positions of adjustable vertical struts  35  on distal portions  80  of adjustable horizontal struts  30  in order to provide different configurations for the distraction frame during a hip arthroscopy procedure (e.g., to flex or extend the leg of a patient). 
     Lock/release mechanisms  120  are used to lock (or release) adjustable vertical struts  35  to (or from) adjustable horizontal struts  30 . More particularly, lock/release mechanisms  120  each comprise a control  122  ( FIGS.  24  and  25   ) which is used to engage/disengage a gear lock  123  (which is housed in mount  115 ) to/from gear rack  100 . Control  122  may be disposed within a handle  124 . In one embodiment, when control  122  (e.g., a trigger) is activated, a cable  125  ( FIG.  25   ) is pulled which disengages gear lock  123  from gear rack  100  (e.g., by pivoting a lever  126  which pivots gear lock  123  away from gear rack  100 ). A spring (not shown) returns gear lock  123  back to its engaged state when control  122  (e.g., a trigger) is released, i.e., when lock/release mechanism  120  is in its “default” condition. 
     Upper portions  110 , intermediate portions  107  and lower portions  105  telescope relative to one another. Locking screws  127  ( FIGS.  28  and  29   ) are provided to lock upper portions  110  relative to intermediate portions  107 . If desired, upper portions  110  and intermediate portions  107  can be limited to discrete telescoping positions (e.g., to  5  discrete telescoping positions) or upper portions  110  and intermediate portions  107  can be continuously telescopically variable relative to one another. Handles  130  may be provided for lifting or lowering upper portions  110  and intermediate portions  107  of adjustable vertical struts  35  relative to lower portions  105  of adjustable vertical struts  35 . In one preferred form of the invention, and looking now at  FIGS.  29 A- 29 C , rollers  128  are mounted to intermediate portions  107  and roll along the inner surfaces of lower portions  105 . This provides low friction movement as intermediate portions  107  telescope relative to lower portions  105 . 
     In one form of the invention, gas shocks  132  ( FIG.  26   ) may be provided within the bodies of lower portions  105  of adjustable vertical struts  35  to help carry the loads of upper portions  110  and intermediate portions  107  of adjustable vertical struts  35  (and any loads carried thereby, e.g., the leg of a patient). In one embodiment, gas shocks  132  are housed within inner lumens of vertical struts  35 , with one end of gas shocks  132  being mounted to mount  115  and the other end of gas shocks  132  being mounted to intermediate portions  107 . However, it should be appreciated that gas shocks  132  may be used across all three portions of adjustable vertical struts  35  (i.e., lower portions  105 , intermediate portions  107  and upper portions  110 ), or between a pair of portions 105/107/110, preferably between lower portions  105  and intermediate portions  107 , but gas shocks  132  may also be used between upper portions  110  and intermediate portions  107 . 
     By way of example but not limitation, where gas shocks  132  are provided to assist in adjusting the dispositions of upper portions  110  and intermediate portions  107  of adjustable vertical struts  35 , gas shocks  132  are configured to apply an upward force on intermediate portions  107  of adjustable vertical struts  35  (and hence on upper portions  110 , which are connected to intermediate portions  107 ), and gas shocks  132  include lock mechanisms  133  ( FIGS.  26  and  27   ) for locking gas shocks  132  in a particular disposition. A button  134  ( FIGS.  26  and  27   ) is depressed to disengage lock mechanism  133  such that gas shocks  132  are free to apply an upward force to upper portions  110  and intermediate portions  107  of adjustable vertical struts  35  (and any loads carried thereby) relative to lower portion  105  of adjustable vertical struts  35 . More particularly, the depression of button  134  pushes a rod 134A ( FIGS.  26  and  27   ), which then pivots a wheel 134B, which then pulls cable 134C, which then lifts one end of a finger  135 , whereby to force the other end of finger  135  to depress lock mechanism  133 . When button  134  is released, a spring (not shown) biases the foregoing elements in the opposite direction so as to release lock mechanism  133 . 
     In lieu of a gas shock, alternative constructions may include springs or counter-weight systems to balance the loads carried by adjustable vertical struts  35 . 
     Hinge joints  137  ( FIGS.  1 ,  2  and  30 - 33   ) are disposed at the upper ends of upper portions  110  of adjustable vertical struts  35 . Distraction mechanisms  140  are mounted at the top ends of upper portions  110  of adjustable vertical struts  35  via hinge joints  137 . Universal joints  145  are disposed at the ends of distraction mechanisms  140 . Mounts  150  are configured to releasably engage surgical boots  20 , such that surgical boots  20  can be releasably secured to distraction mechanisms  140  (and hence to distraction frame  5 ). Levers  155 , disposed at the opposing ends of distraction mechanisms  140 , are used by the user to operate distraction mechanisms  140 . More particularly, the user rotates lever  155  which, in turn, advances or retracts mount  150 , and hence advances or retracts surgical boot  20 . Distraction mechanisms  140  are of the sort well known in the art and generally comprise a mechanism which provides a significant mechanical advantage for the user. With this mechanical advantage, the user can apply a significant amount of distraction force to the leg of the patient. In one form of the invention, distraction mechanisms  140  comprise a force gauge  157  ( FIGS.  30 - 33   ) which indicates the actual force being applied by distraction mechanisms  140  to the leg of a patient. The user can, for example, minimize potential injury to the patient if the force does not exceed a certain threshold. Force gauge  157  may be mechanical (e.g., a simple “fish scale” device with lines and numbers) or electronic (e.g., with a digital readout). 
     In one preferred form of the invention, the various components of distraction frame  5  are constructed so that distraction frame  5  can be “collapsed” into a compacted form, e.g., with adjustable horizontal struts  30  being telescoped into a reduced length and with adjustable vertical struts  35  being telescoped into a reduced length; and with adjustable vertical struts  35  being disposed parallel to adjustable horizontal struts  30 ; and with distraction mechanisms  140  being disposed parallel to adjustable vertical struts  35  and adjustable horizontal struts  30 ; and with L-shaped extensions  55  being inverted so that L-shaped brackets  60  and adjustable supports  65  face upward and with L-shaped extensions  55  being reversed relative to body  40  of table mount  25  so that L-shaped extensions  55  are set back over adjustable horizontal struts  30 . In addition, wheels  230  of table mount  25  are in their “down” position, and retractable foot pegs  97  of adjustable horizontal struts  30  are in their “up” position so that adjustable horizontal struts  30  rest on castors  95 , such that distraction frame  5  rides on wheels  230  and castors  95 . See  FIGS.  34  and  35   . In this configuration, distraction frame  5  can be transported to another operating room or other location in the hospital (e.g., a storage location). Effectively, in this configuration, distraction frame  5  does not require a separate piece of equipment for mobility (e.g., a tote, a dolly, etc.). This provides significant convenience for the hospital staff. 
     Use Of Distraction Frame  5   
     Distraction frame  5  is preferably used as follows. 
     First, distraction frame  5  is assembled so that adjustable horizontal struts  30  are mounted to table mount  25 , adjustable vertical struts  35  are mounted to adjustable horizontal struts  30 , and distraction mechanisms  140  are mounted to upper portions  110  of adjustable vertical struts  35  (if these components are not already mounted to one another). In addition, L-shaped extensions  55  are set so that L-shaped brackets  60  and adjustable supports  65  face downward, and L-shaped extensions  55  are attached to body  40  of table mount  25  so that L-shaped extensions  55  extend away from adjustable horizontal struts  30  (if these components are not already set in this position). 
     Then distraction frame  5  is wheeled up to surgical table  10  on wheels  230  of retractable wheel assembly  205  and castors  95  of adjustable horizontal struts  30 , and distraction frame  5  is assembled to surgical table  10  by mounting table mount  25  to base  15  of surgical table  10 , e.g., by setting L-shaped extensions  55  on both sides of base  15  of surgical table  10 , positioning L-shaped brackets  60  beneath table feet  62  of surgical table  10 , retracting wheels  230  of retractable wheel assembly  205  so that horizontal surface  50  of body  40  seats on the floor, and then lowering feet  62  of surgical table  10  onto L-shaped brackets  60 . Adjustable supports  65  are also adjusted as necessary to make secure contact to the floor. 
     Next, distraction frame  5  is approximately configured for the size of the patient, the size of the surgeon, and the procedure to be conducted. This is done by setting the angles of adjustable horizontal struts  30  relative to table mount  25  (and hence relative to surgical table  10 ), setting the lengths of adjustable horizontal struts  30 , setting the dispositions of adjustable vertical struts  35  on adjustable horizontal struts  30 , and setting the heights of adjustable vertical struts  35 . 
     Then the patient’s feet and legs are placed into, and secured to, surgical boots  20 . Surgical boots  20  are secured to distraction mechanisms  140  disposed at the top ends of upper portions  110  of adjustable vertical struts  35 . Further adjustments may be made to distraction frame  5  as necessary. 
     Distraction may occur with the surgical table set in a horizontal position or in an inclined position (e.g., with the patient in the so-called Trendelenburg position). For purposes of example but not limitation, distraction will now be discussed in the context of the patient having their leg distracted while in the Trendelenberg position. 
     The patient is tilted on the surgical table to the Trendelenburg position. This is accomplished with the surgical table controls. Preferentially the amount of Trendelenburg angle is 15 degrees or less. To accommodate this change in patient position, distraction frame  5  may be adjusted again as needed. In particular, the height of adjustable vertical struts  35  might be increased to maintain the patient in a planar position (relative to the table top) or with a small amount of hip flexion; horizontal struts  30  may then be adjusted so as to minimize distraction forces applied to the hip. It is also beneficial that during the application and removal of the Trendelenburg angle, lock/release mechanism  120  of mount  115  is able to be maintained in an unlocked position. This allows for the change in angle relative to distraction frame  5  without putting undue stresses on the patient as the leg length changes relative to the horizontal plane of adjustable horizontal strut  30 . 
     Next, distraction frame  5  is more precisely configured to begin the procedure to be conducted. This is done by more precisely setting the angles of adjustable horizontal struts  30  relative to table mount  25  (and hence relative to surgical table  10 ), more precisely setting the dispositions of adjustable vertical struts  35  on adjustable horizontal struts  30 , and more precisely setting the heights of adjustable vertical struts  35 , more precisely setting the length and angle of the distraction mechanisms  140 , and more precisely setting the angle of surgical boots  20 . 
     The patient’s hip may then be distracted by the surgical team by unlocking lock/release mechanism  120  of mount  115  and pulling distally on adjustable vertical struts  35 , e.g., via handle  124 . From this starting position, at least 8 inches of travel along the horizontal struts  30  is provided for the surgical team to apply this pulling force to the patient. Then distraction mechanisms  140  (disposed at the top ends of upper portions  110  of adjustable vertical struts  35 ) are adjusted as needed so as to apply the desired distraction force to the distal end of the patient’s leg. From the starting position, at least 4 inches of additional travel is provided within distraction mechanism  140  to apply force to the patient’s leg. Any combination of these applications of traction is envisioned, as needed for the patient’s treatment. 
     Once the patient’s hip is appropriately distracted, a surgical procedure may then be conducted on the distracted hip. 
     It should be appreciated that distraction frame  5  of the present invention provides the ability to attain more C-arm positions than prior art distraction frames. This is due to the fact that distraction frame  5  mounts to base  15  of surgical table  10  and not to the end of the surgical table. Therefore, the space immediately under table extender  23  and above table mount  25  and adjustable horizontal struts  30  is open and allows the C-arm X-ray machine to be manipulated with a high degree of freedom. 
     It should also be appreciated that distraction frame  5  of the present invention has 8 degrees of freedom: (1) gross traction extension/retraction (moving adjustable vertical struts  35  away from/toward the patient); (2) adduction/abduction of adjustable horizontal struts  30  pivoting about body  40 ; (3) adjustable vertical struts  35  raising and lowering; (4) distraction mechanisms  140  (fine traction) pivoting on adjustable vertical struts  35 ; (5) distraction mechanisms  140  (fine traction) retracting/advancing; and (6), (7) and (8) surgical boots  20  rotating and pivoting about universal joints  145 . The 8 degrees of freedom provided by distraction frame  5  are superior to the 3-5 degrees of freedom typically provided by the prior art, thereby providing the surgeon with the ability to position the patient’s leg in a greater number of positions and orientations. This allows the surgeon to access anatomy that they could not previously be accessed with the distraction systems of the prior art. 
     The distraction frame of the present invention also allows for more deep flexion of the patient’s hip due to the increased degrees of freedom provided by the distraction frame and due to the disassociation of the height of the distraction frame (where the patient’s foot connects to the distraction frame) relative to the top of the surgical table. Because the patient’s foot can be raised (by adjustment of the vertical struts) independently of the patient’s horizontal position, additional flexion can be achieved by the distraction frame of the present invention. 
     In addition to the foregoing, it should also be appreciated that distraction frame  5  is able to accommodate a wide range of patient heights, i.e., from approximately 4′ 10″ to approximately 6′ 10″. This ability to accommodate a wide range of patient heights is due to the more numerous degrees of freedom combined with the adjustable nature of various components of distraction frame  5 , e.g., the adjustability of adjustable horizontal struts  30 . 
     Significantly, adjustable vertical struts  35  can be positioned away from surgical table  10 ; this provides more space for the surgical staff to maneuver at the end of the table during surgical preparation, including while a patient is being transferred onto the surgical table. 
     It should also be appreciated that, in addition to manipulating distraction frame  5  to effect hip distraction, the surgical table may also be manipulated to effect hip distraction. More particularly, and looking now at  FIG.  36   , the bed  160  of surgical table  10  can typically be moved up/down, moved cephalad/caudal, tilted head-to-toe, and tilted side-to-side. If a patient is positioned on bed  160  of surgical table  10  and the patient’s feet are attached to distraction frame  5 , then movement of bed  160  of surgical table  10  in a cephalad direction will have the same effect as applying tension to the leg by means of turning levers  155  of distraction mechanisms  140  so as to move the foot in a caudal direction. 
     It should be appreciated that a patient can be in either a lateral decubitus position or a supine position on surgical table  10 . In a lateral decubitus position, the patient lays on their side on the surgical table with the non-operative leg supported by the table and the operative leg supported by distraction frame  5 . In the supine position, the operative leg is supported by distraction frame  5  and the non-operative leg would rest on surgical table  10  and table extender  23 . However, table extender  23  typically stops above the knee of the patient, so the non-operative leg has limited support. 
     To this end, in an alternative construction, one of adjustable vertical struts  35  may replace its hinge joint  137 , distraction mechanism  140 , universal joint  145 , mount  150 , force gauge  157  and lever  155  with a leg board  165  ( FIG.  37   ) which is mounted to one of the adjustable vertical struts. Since the non-operative leg sees no force during distraction and is typically not manipulated, the non-operative leg does not need to be secured to distraction frame  5  but can simply be supported by leg board  165 . 
     It should also be appreciated that distraction frame  5  may be used for orthopedic procedures other than hip arthroscopy, e.g., distraction frame  5  may be used for hip trauma, total hip replacement, etc. 
     Modifications Of The Preferred Embodiments 
     It should be understood that many additional changes in the details, materials, steps and arrangements of parts, which have been herein described and illustrated in order to explain the nature of the present invention, may be made by those skilled in the art while still remaining within the principles and scope of the invention.