Patent ID: 12193958

Generally, the sizes and relative scales of elements in Drawings may be set to be different from actual ones to appropriately facilitate simplicity, clarity, and understanding of the Drawings. For the same reason, not all elements present in one Drawing may necessarily be shown in another. While specific embodiments are depicted in the figures with the understanding that the disclosure is intended to be illustrative, these specific embodiments are not intended to limit the scope of invention the implementations of which are described and illustrated herein.

DETAILED DESCRIPTION

Embodiments of the present invention include apparatus and methods directed to resolving the issue and standardizing the methodology of repositioning a patient's dislocated hip in a safe and codified manner using a lightweight, sturdy, reusable, easily maintained, comfortable, pneumatically or hydraulically and/or manually driven apparatus that makes for ease in reliably applying a lifting traction force to the lower extremity of patients of almost any size who have suffered a recent hip dislocation. The apparatus is lightweight, lends itself to easy adjustment to the size of the patient and the patient's extremity, is quickly applied and may be operable by the only, single medical attendant with minimal additional distress to the patient, and moveable within desired limits to assist in relocation once the hip relocation device assembly is applied to the patient's dislocated limb.

An example of the embodiment300of the apparatus structured according to the idea of the invention is shown inFIGS.3A and3B, and includes three main portions that are reversibly assembled with one another along the axis304: a leg gutter portion or section310, a middle axially extendable portion or section320(which may be interchangeably referred to herein as a middle assembly) and a lower structural assembly (lower assembly, for short)330, which may optionally be additionally secured to the lower base apparatus plate340(which, when present, has sufficient spatial extent to be placed under the patient's injured hip and between the patient's injured hip and the firm surface of an emergency room bed or gurney as illustrated inFIG.3C. As can be seen from the illustration ofFIG.3Cand understood from the discussion below, the leg gutter section310(which may be optionally padded, to add comfort to the patient) is structured as a leg-securing component of the apparatus300; the middle assembly320is configured as a leg lifting component; and the lower assembly330is designed to provide for spatial orientation of the leg of the patient that has been secured in the leg gutter section of the assembled apparatus300. Additional belts or straps, when used with the leg gutter section310and/or in the arc of pelvis (FIG.3C) may be used to spatially secure the patient and at least to restrict the movement of the patient and/or his/her leg. The axis344of the apparatus300is schematically illustrated with a dashed line. Various portions of the embodiment300are now discussed below in more detail.

FIGS.4A,4B, and5A through5Eillustrate the leg gutter portion310in various views. Specifically,FIGS.4A and4Bprovide perspective views (without and with the securing straps),FIGS.5A,5B,5C,5D, and5Eprovide, respectively, side view, top view, front view, bottom view, and back view. The leg gutter portion310generally includes a first leg-supporting elongated member410and a second leg-supporting elongated member420that are connected at respective ends at an approximately right angle the vertex of which—as can be seen fromFIG.3C—is intended to be placed under the bent injured leg of the patient. Preferably, at least one of the first and second leg-supporting elongated members410,420is shaped as a substantially semitubular channel to comfortably accommodate the appropriate portion of the leg (whether the posterior of the thigh or the posterior of the calf) of the patient. (In addition, the inner surfaces of such semitubular channels may be padded—not shown—to prevent injury to skin or underlying structures that would support the flexed and dislocated limb safely and relatively comfortably.) The leg gutter portion may additionally optionally include a console or gutter spine430projecting from both the first and second supporting elongated members410,420in a plane in which the approximately right angle formed by the member410,420is defined to rigidly connect the first and second leg-supporting elongated members to one another. (The term console is defined as and refers to a structural element projecting from a surface to form a bracket.) In order to mechanically cooperate the portion310with the middle axially extending portion320—as discussed below—the leg gutter portion310may be equipped with a substantially cylindrically-shaped tubular element440that is transversely affixed to one of the members410,420. (The tubular element or tube440may be optionally rigidly connected with the console430, as shown in the example ofFIGS.5A through5E). As shown inFIG.4B, the leg gutter portion310has provisions for straps or belts450structured to accommodate and confine the leg within the structure of the portion of the rigid leg gutter310so that lifting forces may be applied to the structure of the leg gutter310containing the patient's dislocated limb (from below, via the use of the middle axially extending portion320, as discussed below) rather than to the limb itself (as is currently done during the Allis maneuver). Such straps or belts are passed through the gutter strap anchors portions of the leg gutter310(which are shown in the Figures shaped as through slots). In at least one implementation, the mechanical connection between the leg gutter section310and the middle assembly320is arranged via a thread, in which case the tubular member440may be internally threaded.

FIGS.6A,6B,6Cprovide perspective views of related embodiments of the middle axially extendable portion or assembly320of the apparatus310. The middle assembly320is equipped with a pneumatic or hydraulic reservoir606. The middle assembly320also includes at least one pneumatic or hydraulic piston610carrying a spatially expandable upper threaded end614. InFIG.6A, both the piston610and the upper threaded end614are shown in a withdrawn (with respect to the reservoir606) positions, while inFIG.6Bboth the piston610and the upper threaded end614are shown extended from the reservoir606. When at least one of the piston610and the upper end614is in a corresponding withdrawn position, the middle assembly310operates to lower the leg gutter section310(the substantially cylindrical tubular element440of which is threadingly affixed to the end614) with respect to the reservoir606, thereby reducing the axial extent of the middle assembly320altogether along the axis619of the assembly320. When at least one of the (one or more) piston(s)610and the upper end614is in a corresponding extended position, the middle assembly310operates to, respectively, raise the leg gutter section310, thereby increasing the axial extent of the middle assembly320. The operation of axial extension and/or withdrawal of the piston(s)610may be achieved with the used of the built-in pump622of the assembly310.

In the specific embodiment shown inFIGS.6A,6B, the pump622may be complemented with the pump handle portal626, the pump handle630dimensioned to be reversibly inserted into the portal626, and a reservoir release valve634. As seen in a perspective view of a related embodiment ofFIG.6C, the reservoir606may be equipped with a pneumatic or hydraulic connector640configured to be attached to an outside source of pneumatic or hydraulic pressure, manual air pump or compressed air, or an external manual or electric hydraulic pump (not shown for simplicity of illustration). In either of the embodiments ofFIG.6A,6B or6C, the pneumatic or hydraulic pump reservoir606may also be complemented with a pressure gauge connector (shown in the example ofFIG.6Cas650) that allows a pressure gauge654to monitor pressure within the pneumatic or hydraulic pump reservoir606, with a hand-operated reservoir pressure relief valve658that is accessible to the operator at any time. Notably, substantially every embodiment of the middle assembly320may be additionally equipped with the threaded shaft (shown as660) at the base of the pneumatic or hydraulic reservoir606dimensioned to facilitate structural mating of the assembly320with the appropriate portion (such as a substantially cylindrical threaded metal tubing) of the rigid lower structural assembly330. In the specific case when the middle assembly310includes a multiplicity of pneumatic pistons610, such pistons may be configured as a set of bodies (shown inFIG.6Das set650including pistons650(1) through650(N), N≥2, which may have different lengths and/or different outer diameters) with cylindrically shaped respective inner hollows dimensioned such that a smaller member of the set650fits inside a larger member of the set650to extend/withdraw the pistons650(i) telescopically from one another along the axis618.

Overall the skilled person understands that the middle axially extendable portion or assembly320may generally include an airjack component and/or a hydraulic jack component and/or a mechanical jack component as well as a telescopic mechanical component that is complemented at a free upper end thereof with an upper axially repositionable bolt and/or that is configured to be extending axially from a lower base portion of the middle axially extendable section310. (When the upper axially repositionable bolt such as the upper threaded end614is present, the leg gutter portion310may be structured to include the internally-threaded cylindrically-shaped tube such as the tubular element440transversely affixed to one of the first and second supporting elongated members410,420of the leg gutter310. In this case, a thread of the axially repositionable bolt and an internal thread of the cylindrically-shaped tube are preferably mating threads.)

As used in this disclosure and for the purposes of the appended claims, the term airjack (device) component or a similar term is defined as and refers to a mechanism configured to extend a length of a chosen element or section with the use of an inflatable support; the term hydraulic jack component or a similar term is defined as and refers to a device configured to extend the length of the section by applying a force via a hydraulic cylinder; the term mechanical jack component is defined as and refers to: a mechanism configured to extend the length of the second with physical means, such as a motor or hand-operated lever (examples are provided by a screw jack, a house jack, a scissor jack as known in related art).

One example of construction of the lower assembly330of the embodiment300of the apparatus of the invention is now discussed in reference toFIGS.7A,7B,7C,8A,8B,8C,8D,9A,9B, and10A,10B.

In reference toFIGS.7A,7B, and7C, presenting in different perspective views the implementation of the lower assembly330(the local Cartesian system of coordinates is as indicated), such lower assembly may be in at least one case affixed to (supported from below by) the generally rigid base apparatus plate710carrying generally chamfered rises714on both sides of the assembly330. Further discussion is that of such specific case when the base apparatus plate710is present, for certainty, but describes the structure of the lower assembly in general as well.

The lower assembly330generally includes a swivel bracket720and a bracket axle724(which in one case may be dimensioned as a bolt and/or a threaded member) about which the swivel bracket720(and everything that is affixed to it) is configured to be reversibly rotatable. The bracket axle may have, at an end thereof that is distal/opposing to the swivel bracket720, an opening728that extends through the axle724substantially transversely to the axle724.

The following portion of the disclosure describes a specific implementation of the lower assembly330, which employs a component referred to as a tilt axle. The skilled artisan will readily appreciate, however, that alternatives to the tilt axle can be employed which, structurally, may be dimensioned as a variety of a ball-and-socket joint, for example (whether a condyloid joint, or a saddle joint, or a hinge joint, or a pivot joint, as known in the art). Overall, therefore, the construction of the lower assembly330according to the idea of the invention employs a tilt joint (which in one implementation may be structured with the use of a tilt axle, as discussed below, and in another—with the use of a conventional ball-and-socket joint).

The swivel bracket724is made to be not only rotatable about the axle724(that is, about the axis732that is substantially parallel to the bracket axle724) but also reversibly tiltable about the tilt axle736that is passing through the opening728. To this end,FIG.7Billustrates the situation in which the combination of the swivel bracket720and the bracket axle724of the lower structural assembly330is tilted about the tilt axle when the tilt axle736to the point that the side surface of the bracket720is substantially parallel to and/or in contact with the surface of the base apparatus plate710. The bracket axle and a lower end of the middle assembly320are made modifiably connectable to one another along the axis732, as discussed below in more detail.

The bracket axle724may be held by a cylindrical threaded metal tubing portion740and a nut744and, optionally, may be stabilized with thick rubber washers748and stabilizing panels (support elements)752that may be irreversibly welded to the base plater710and held as a group by an appropriate set of affixing elements (one of which, as shown, is the tilt axle736).

In the example ofFIGS.7A-7C, the swivel bracket is shown to include a top bracket plate756and at least one (as shown—two) side bracket plate760connected to the top bracket plate756transversely parallel to the bracket axle724, with the bracket axle724passing substantially through a center of the top bracket plate756.

The lower edges of the swivel bracket720are designed to engage the chamfered risers714during the rotation of the swivel bracket about the axle724to temporarily/reversibly immobilize/stabilize/lock the lower assembly330—and, with it, the overall hip reduction apparatus300—with respect to its rotational motion in the azimuthal plane that is, about the axes618,732. The base apparatus plate710may contain indicia (such as a centering directional arrow, as shown) devised to guide the provider in locating placement of the plate710directly beneath the dislocated hip (seeFIG.3C); the leading edge of the base apparatus plate710in this case may be tapered (as shown) to facilitate insertion of the base plate between the patient and the underlying supporting surface.

FIGS.8A,8B,8C, and8Dillustrate the lower assembly in different spatial positions and/or orientations, with the arrow808schematically showing one possible direction of rotation of the bracket720(together with the cylindrical tubing portion740and, therefore, together with the middle assembly320and the leg gutter portion310when the apparatus330is fully assembled) about the axis732.

As shown inFIG.8A, the lower assembly330is oriented such that the plane defined by edge surface of the bracket720(which corresponds to the plane ofFIG.8A, the yz-plane) is substantially parallel to the longitudinal extent of the riser(s)714along the local z-axis, while the axis732(and the bracket axle724being substantially perpendicular to the upper surface of the base apparatus plate710. In this position, the bracket720(and, with it, the lower assembly330) is substantially “unlocked” as dimensions of the side bracket plate(s)760of the swivel bracket720provide for a gap812between free end(s) of the side bracket plate(s) and the nearest surface. Being unlocked, the swivel bracket720is free to be both rotated about the axis732(and the axle724) and tilted about the axle736.FIG.8Billustrates this position/orientation of the assembly330in a plan view as seen along the z-axis. When, during the azimuthal rotation (arrow808) the free end(s) of the side bracket plate(s)760encounter the riser(s)714and are moved on top of the riser(s)—as shown inFIGS.8C,8D—the free end(s) of the side bracket plate(s)760of the swivel bracket720are releasingly retained on top of the riser(s)714(due to friction, for example). In this orientation/position, any further rotational motion of the bracket720(together with the cylindrical tubing portion740and other portions of the apparatus300attached to the bracket720via such tubing portion740) in the azimuthal plane (the local xy-plane) is temporarily prevented and/or frictionally restricted (that is, at least the lower assembly330is in a “locked” position) at least until a rotational force, applied to the lower assembly330(the bracket720) exceeds a force of static friction. (In static friction—as is well recognized and accepted in related art—the frictional force resists a force that is applied to an object, and the object remains at rest until the force of static friction is overcome by the applied force.)

FIGS.9A,9Bschematically illustrate the lower assembly330in an unlocked position when swivel bracket720together with the bracket axle724are tilted about the axle326at a substantially right angle, whileFIGS.10A,10Bprovide top views of the lower assembly330respectively corresponding to the views ofFIGS.8A and8D. The reversible affixation/assembly of the lower assembly portion330and the middle assembly portion320of the apparatus300may be carried out by bolting the threaded member660into the matingly corresponding inner thread of the tubular element740.

The skilled person now understands that the combination of the structure of the lower assembly330and the presence of the motion restricting elements such as riser(s)714affords the assembled apparatus at least degrees of rotational freedom that correspond to yaw and pitch, while the reversible extension of the axial length of the middle assembly320provides for rise or lowering of the leg gutter portion310. Aggregately, these degrees of freedom of movement allow the provider slowly and without applying any substantial force to manipulate the injured leg of the patient, secured in the leg gutter, to align the head of the dislocated femur at the level of the pelvic acetabular fossa, prior to repositioning it into the proper position with a substantially small laterally applied force.

The skilled person will readily appreciate that use of the embodiment of the hip relocation apparatus may be optionally simplified if, prior to handling the injured leg of the patient, the target working axial extent of the assembled apparatus300is approximated or assessed by positioning the assembled apparatus with its axis344being substantially vertical, orienting the thigh of the uninjured leg of the laying patient substantially vertically along the axis344of the apparatus and along the vertically-extending semitubular (that is, shaped substantially as half a tube divided longitudinally) channel portion of the leg gutter310, placing the calf of this uninjured leg in the horizontal semitubular channel of the leg gutter portion310, and withdrawing or extending the piston(s)610and/or upper threaded end614of the middle assembly320until the crus of this leg is also substantially horizontal. The degree to which the middle extendable section was adjusted during such a procedure provides the person operating the apparatus with a good approximation of the length of the middle extendable section that would be required when employing the apparatus on the injured leg to align the pelvic acetabular fossa and the femoral head displaced from it due to the hip injury at approximately the same level prior to correcting the hip displacement by inserting the femoral head into the acetabular fossa.

Overall, a skilled artisan having the benefit of this disclosure can readily appreciate that embodiments of the invention provide a hip relocation apparatus that generally includes a leg gutter portion or section, a middle axially extendable portion or section, and a lower structural assembly. The leg gutter section includes a first supporting elongated member and a second supporting elongated member (which supporting elongated members are connected at respective ends thereof to one another at an approximately right angle). The middle axially extendable section has an axis and is structured to reversibly change a spatial extent thereof along the axis. The lower structural assembly has a swivel bracket, and a bracket axle (here, the swivel bracket is rotatable about the bracket axle, and the bracket axle has an opening extending therethrough transversely to the bracket axle; the bracket axle and a lower end of the middle axially extendable section are configured to be modifiably connectable to one another along the axis with the bracket axle being substantially parallel to the axis; an upper end of the middle axially extendable section is configured to be disengagingly connected to the leg gutter section to have one of the first and second supporting elongated members be transverse to the axis. In at least one specific embodiment of the apparatus, the first supporting elongated element may include a substantially semitubular channel and the second supporting elongated element includes a second substantially semitubular channel and/or at least one of the following conditions may be satisfied: (a) the leg gutter section includes a console projecting from both the first and second supporting elongated members in a plane in which the approximately right angle is defined and rigidly connecting the first and second supporting elongated members to one another; and (b) the leg gutter section comprises a cylindrically-shaped tube transversely affixed to one of the first and second supporting elongated members. (When condition (b) is satisfied, such cylindrically-shaped tube is preferably internally threaded. When the leg gutter section includes the internally-threaded cylindrically-shaped tube transversely affixed to one of the first and second supporting elongated members, a thread of the axially repositionable bolt and an internal thread of the cylindrically-shaped tube are preferably mating threads.) Alternatively or in addition, and substantially in every implementation of the apparatus, the middle axially extendable section may be structured to be telescopically extendable along the axis (and, to effectuate such telescopic extension, may optionally include an airjack, a hydraulic jack, and/or a mechanical jack. In at least one specific implementation of the apparatus, a telescopic mechanical component of the middle axially extendable section may be complemented with an upper axially repositionable bolt and/or may be structured to extend axially from a lower base portion of the middle axially extendable section. In at least one implementation, when the middle axially extendable section includes a threaded shaft, the lower structural assembly preferably includes a nut affixed to the swivel bracket (the nut has a nut thread that is dimensioned to be mated with a thread of the threaded shaft. Additionally or in the alternative—and substantially in every implementation—the apparatus may include a base apparatus plate configured to carry support elements secured on a surface thereof (the support elements being configured to removably secure a tilt axle substantially parallel to and separated from the base apparatus plate), and the combination of the swivel bracket and the bracket axle of the lower structural assembly is configured to be reversibly tilted about the tilt axle when the tilt axle is passed through the opening and removably secured at the support elements of the base apparatus plate. Alternatively or in addition—and substantially in every implementation of the apparatus—the swivel bracket may be structured to include a top bracket plate and at least one side bracket plate connected to the top bracket plate transversely parallel to the bracket axle (the bracket axle passing substantially through a center of the top plate with the opening being distal to the top bracket plate). When the swivel bracket is so structured, the base apparatus plate preferably additionally includes at least one motion restricting element affixed to the surface of the plate, and relative spatial coordination of the at least one motion restriction element and the support elements is such that the at least one side bracket plate is reversibly stopped by the at least one motion restricting element during rotation of the swivel bracket about the bracket axle when of the following conditions are met: (i) the swivel bracket includes a top bracket plate and at least one side bracket plate connected to the top bracket plate transversely parallel to the bracket axle, and (ii) the combination of the swivel bracket and the bracket axle of the lower structural assembly is reversibly attached to the base apparatus plate by having the tilt axle pass through the opening and removably secured at the support elements of the base apparatus plate. In at least the latter case the swivel bracket and the at least one motion restricting element may be configured to ensure that (when the lower structural assembly is reversibly secured to the base apparatus plate via the tilt axle) a free end of the at least one side bracket plate, during the rotation of the swivel bracket about the bracket axle, is positioned on top of the at least one motion restricting element and is frictionally restricted from sliding off of or being separated from the at least one motion restricting element unless a rotational force (applied to the swivel bracket) exceeds a force of static friction.

Examples of dimensions of at least one practical implementation of the apparatus discussed above are as follows: the vertical extent of the reservoir606is about 9.5″ (and generally from 8″ to 10″); the overall distance between the top of the reservoir6006and the horizontal surface of the leg gutter310on which a leg is positioned (which includes an typical extent of the piston610) is about 12″ (and generally between 10″ and 14″) and the vertical extent of the lower structural assembly is about 5″ (and generally between 4″ and 6″) such that the overall axial extent of the assembled apparatus, measured between the surface of the board340and the horizontal surface of the leg gutter310, is about 26.5″ (generally, between 24″ and 28″). The size of the board340is about 6″ by 20″, while the width of the swivel bracket720limited by the bracket plates760is about 3.5″ (generally, between 3″ and 5″). While specific values chosen for this embodiment are recited, it is to be understood that, within the scope of the invention, the values of all of parameters may vary over wide ranges to suit different applications.

References throughout this specification to “one embodiment,” “an embodiment,” “a related embodiment,” or similar language mean that a particular feature, structure, or characteristic described in connection with the referred to “embodiment” is included in at least one embodiment of the present invention. Thus, appearances of the phrases “in one embodiment,” “in an embodiment,” and similar language throughout this specification may, but do not necessarily, all refer to the same embodiment. It is to be understood that no portion of disclosure, taken on its own and in possible connection with a figure, is intended to provide a complete description of all features of the invention.

Understandably, structural variations of components of the apparatus that do not substantially change its operational performance remain within the scope of the invention. For example, the lower structural assembly can be constructed with the use of a ball-and-socket joint1010, as schematically shown inFIG.10, for example.

It is also appreciated that removable connections and mechanical engagements between constituent components of an given embodiment of the apparatus—such as, for example, a mechanical engagement between a piston610and the leg gutter310—can be configured both with the use of a thread (in a discussed example—with the use of the bolt614) and without a thread, via an unthreaded fitting as recognized in related art.

For the purposes of this disclosure and the appended claims, the use of the terms “substantially”, “approximately”, “about” and similar terms in reference to a descriptor of a value, element, property or characteristic at hand is intended to emphasize that the value, element, property, or characteristic referred to, while not necessarily being exactly as stated, would nevertheless be considered, for practical purposes, as stated by a person of skill in the art. These terms, as applied to a specified characteristic or quality descriptor means “mostly”, “mainly”, “considerably”, “by and large”, “essentially”, “to great or significant extent”, “largely but not necessarily wholly the same” such as to reasonably denote language of approximation and describe the specified characteristic or descriptor so that its scope would be understood by a person of ordinary skill in the art. In one specific case, the terms “approximately”, “substantially”, and “about”, when used in reference to a numerical value, represent a range of plus or minus 20% with respect to the specified value, more preferably plus or minus 10%, even more preferably plus or minus 5%, most preferably plus or minus 2% with respect to the specified value. As a non-limiting example, two values being “substantially equal” to one another implies that the difference between the two values may be within the range of +/−20% of the value itself, preferably within the +/−10% range of the value itself, more preferably within the range of +/−5% of the value itself, and even more preferably within the range of +/−2% or less of the value itself. The use of these terms in describing a chosen characteristic or concept neither implies nor provides any basis for indefiniteness and for adding a numerical limitation to the specified characteristic or descriptor. As understood by a skilled artisan, the practical deviation of the exact value or characteristic of such value, element, or property from that stated falls and may vary within a numerical range defined by an experimental measurement error that is typical when using a measurement method accepted in the art for such purposes.

The use of these terms in describing a chosen characteristic or concept neither implies nor provides any basis for indefiniteness and for adding a numerical limitation to the specified characteristic or descriptor. As understood by a skilled artisan, the practical deviation of the exact value or characteristic of such value, element, or property from that stated falls and may vary within a numerical range defined by an experimental measurement error that is typical when using a measurement method accepted in the art for such purposes.

For the purposes of this disclosure and the appended claims, the expression of the type “element A and/or element B” is defined to have the meaning that is equivalent to “at least one of element A and element B”.

While the invention is described through the above-described exemplary embodiments, it will be understood by those of ordinary skill in the art that modifications to, and variations of, the illustrated embodiments may be made without departing from the inventive concepts disclosed herein. Disclosed aspects, or portions of these aspects, may be combined in ways not listed above. Accordingly, the invention should not be viewed as being limited to the disclosed embodiment(s).