US347024A - Stjrgucal chair - Google Patents

Description

(No Model.)

' E. BONNEFOY.

SURGICAL GHAIB..

Patent 4 Sheets-Sheet 1.

' Aug.. 1o, 1886..

by@ my Q (No Model.) I Lammsmi 2.

E. BONNBFOY. A

SURGIG'AL CHAIR. No. 347,024. Patented Augl 10. 1886.

- mvaNTnR; WITN'EssEYs.

N. PETERS, Pholvulhognphcr, Washington, D. C.

(No Mdel.)

E. BONNBPOY. 4 Sheets-Sheet SURGICAL CHAIR.

-INVENTDR;

W11' N asses g UNITED LSivifins- PATENT Grinch.;

EUGNE BONNEFOY, OF ROANNE, FRANCE.

SURGICAL CHAIR.

SPECIFICATION forming part of Letters Patent No. 347,024, dated August 10, 1886.

Application filed July 27, 1883. Serial No. 102,095. (No model.) Patented in France August 2, 1881, No. 144,221 5 in England August Zi, 1881, No. 3,395, and inBelgium December 12, 1882, No. 59,836.

To all whom it may concern,.-

Be it known that l', EUGNE BoNNEFoY, a citizen of the French Republic, and a resident of Roanne, (Loi re,) France,have invented eertain neivand useful Improvements in Surgical Apparatus for the Treatment of Fractures,

Diseases of the Joints, dsc., of which the following is a specication.

Heretofore in the treatment of fractures,

coXalgies, and osseous regenerations it has' What I have said of plaster is equally true of all other methods of this character.

In my present invention I have sought to avoid the above inconveniences by substituting for the mold or splint a mechanism Which offers important advantages.

By means of my apparatus I am enabled to fix immovably and in an instantV the fractured or injured parts, so as to insure a perfect joining of the fragments until complete consolidation is effected,pwith the possibility of ilexing the joints Without the least reaction on the injured parts.

My apparatus also provides, in addition to the holding of the osseous fragments in the axis of the member-,a means whereby the member may, according to requirement,be lengthened or shortened-that is to saythe fractured parts, While being firmly held, may be moved toward or from each other. Free access may be had lto the injured part-at all times, and the progress of the healing and knitting noted.

Withmy apparatus I am able not only to treat simple fractures of the members, but multiple fractures of the vertebral column and basin or pelvic region, as Well as osseous regenerations and coxalgies.

My apparatus comprises, in general, a litter provided with hinges which correspond to the hip, knee, and and ankle joints of the patient, straps to hold the members down firmly to the couch of the litter, mechanism for varying the angles at the hinges, and mechanism for 'elongating and shortening the parts, all as will be hereinafter more fully described.

In the drawings, which serve to illustrate my invention, Figure l is a side elevation of my apparatus as adapted for use in general, and especially for ambulance or outdoor use. Fig. l is a detached elevation of the box or cushion-receptacle I and its cushion, shown as lowered. Fig. 2 is a plan of the same. Fig. 3 is a side elevation similar to Fig. l, showing my apparatus for indoor use, provided with additional conveniences for the patient, and Withcaste1s,whe1eby it may be wheeled about conveniently. The main features of construction are the same as those seen in Figs. l and 2. Figs. 4 to 25 are detached fragmentary detail views, on a larger scale, that illustrate the working parts. These will be referred to more particularly hereinafter.

The base of my apparatus is a stout frame made of vsheet-steel, of U shape in cross-scc tion, and comprising side rails, A A, connected by transverse bars B B. The rails A are hinged at their middles at a. Figs. et and 5 show, respectively, a side elevation and a plan of the hinge. This hinging at the middle enables the frame to be folded for convenience of transportation. The frame has legs C C, which are hinged to shorter legs b b, riveted to the rails A at c c. The legs C are connected to the shorter legs b by means of clamping thumb-screws d d, as clearly shown in the two detached elevations, Figs. 6 and 7. rIlhe legs C are provided with feet of rubber D, as shown in Fig. l, or casters D, as shown in Fig. 3. At the ends of the side rails, A, are mounted hinged or folding handles E E, for convenience in carrying the litter. On this frame is hinged at a a, Figs. 1, 3, 4, and 5, the movable back F of the couch, the movement of which lon its hinges is eilected by mechanism (best seen in Figs. 8, 9, and 10) which are respectively a longitudinal vertical section of rail A on line 8 8 in Fig. 9, a plan of rails A A, and a transverse section on line 10 10 in Fig. 8.

G is a linkbrace hinged at its upper end to the back F, and at its lower end to a slide-nut, g, mounted on rail A.

T is a screw mounted in bearings in the hollow of the rail and engaging nut y.

'1" is a worm-wheel on the end of screw T.

r is a worm or screw mounted rotatively in the rail A, and engaging wheel 1", and f is a crank fixed on the axis of the worm 9'.

The operation of raising and lowering theA back F by means of the crank f will be readily understood. Fach side rail is provided alike, and the two worms 1' are on a shaft in common, which extends across the frame in the hollow of the transverse bar B. \Vhen the patient reclines on the couch, the hinging axis of the back F corresponds exactly with the axis of articulation of the hip-joints, and it is at this point also that I hinge those parts of my apparatus which support the inferior members, and take the points of counter-extension which support the basin in front ou the rest lI. This rest is padded and fixed, and its shape may be represented by a curved line litted in front to the ischions and the superior and inferior parts of the thighs, and by a right line which traverses the basin and passes through the axes ofthe hip'joints. The hinge at the middle maintains the perfect symmetry of the two parts of the body by permitting the necessary play or :llexure at the hips. 1t is this which gives me pelvic counter-extension-that is to say, the immobilization of one of the fragments or parts to adapt it to the other, which otherwise would not be possible. The basin rests on a small cushion or mattress, I', in a box or receptacle, l', which is hinged at one end between the rails A by means of arms 11., hinged on a cross-shaft, j", as seen in Figs. lt), 1 1, and 1.2, the former of which are elevations and the latter a plan of the part. The cushion-box I is supported on straps 71. 71, attached at one end to the rest Ylf and at the other end to the shaft; j, on which they are wound by rotating said shaft through the medium of a crank, fi. The shaftj5 is provided with an ordinary ratchet, '17', and pawl it, to prevent it from rotating backward inadvertently. l'y means of this supporting device the cushion l may bc raised or lowered for convenience in treating the patient.

For supporting the inferior members and forming a part of the couch, l. provide two concave supports, l( l, for the thighs, which arc hinged at u. (c, and are perfectly independent of each other. To these are hinged similar concave supports, L L, for the inferior portions of the legs, the hinges being at the knees. Fach leg-rest l( L rests on two points of support. The part 1i is supported by the braee-link )l and the part L bythebracelink N. The upper end of link Nis hinged direct ly to the rest L at a, and the upper end of link M is connected indirectly (in a manner that will be hereinafter described) to the rest K at m.

Figs. 13, 14, and 15 illustrate themcchanism for raising and lowering the rests 1i L, Fig. 13 being alongitudinalverti cal section through a side rail, A, Fig. 14- a sectional plan, and Fig. l5 a transverse section. The link M is controlled by a crank,j, and the link N by a crank, 7.'. The crank 7' bears on its axis or shaft two worms or screws, s s, which drive each a long screw, p, arranged in the hollow of a rail, A, through the medium of a worm wheel, s', one on each screw 7). The screws j in `turning cause to advance or retreat nuts s, connected by a cross-piece, sf, to which are hinged the lower ends of the links M. The parts I have called nutszfc' are merely sliding boxes mounted in the rails A A, andin each is rotatively mounted a sleeve-like nut, c" the functions of which will be hereinafter explained. The crank transmits movement to the screwsl through the medium of the worms Z' and the worm-wheels Z2. The nuts l are traversed by the screws Z, and as these screws are journaled in the rails A, (sce at the left in Figs. 1.3 and 14,) it follows that the screws will drive the nuts l? back and forth along the rails A. The crank ,7' and its axis or shaft arc mounted in the nuts 1,),and the screws 11 have collared bearings in the sa me, consequently the screw lwill also, under certain conditions, hereinafter described, impart motion to the nuts .2', as will be seen from inspec tion of Fig. 1,3. \Vhen the rests l( L have been properly adjusted, the parts may be lixed by turning the shaft ffl, through the medium ofthe milled head L". Theshalt el' has screwthreads c, which engage a female screw in a fixed nut, s", in the cross-piece s.

Ou the shaft are collars fr", arranged in pairs, (see Fig. 1.4,) and between each pair of collars the slotted lower ends ol' two plates, a, straddle the shaft c. The plates m' are pivoted or fulerumed in the sliding nut lata."l (see Fig. 15,) and by the movement of the screw back and forth the plates are made to oscillate. The upper ends ofthe plates are toothed to lit into the teeth of racks zu, fixed on the lower faces of the crowns of the rails A. \\`hen the teeth of plates ./v"Z are in engagement with the teeth of rack af, the parts above described are locked fast to rails A, as seen in Fig. 15. The crank 7u cannot now be turned. As for the crank y',this can be turned, but the sleeve-nut c on screw j), which is collarcd in the slide-nut c, turns with the screw, and no endwise movement is obtained. This sleevenut z" has teeth like a long pinion, and on the plate is formed a projection or tooth, zi, (see Fig. 15,) which engages these teeth on the sleeve-nut when thc plate is not in engagement with rack :ligand holds the nut from turning. \Vhcn the plate fr is engaged with the rack, as in Fig. 15, the tooth al is out of engagement with the sleeve-nut and the latter will rotate with the screwp. The side rails of the rests K are constructed telescopic, so as to be lengthened and shortened to suit the IIO requirements of the surgeon. The part hinged at a has a'graduated bar, o, (see Fig. 1,) which slides in the side rail of the rest K.

The extension of the rest K is effected by the mechanism shown detached and enlarged in Figs. 16, 17, and 18. Fig. 16 is a longitudinal section on line 16 16 in Fig. 18. Fig. 17 is a cross-section on line 17 17 in Fig. 16, and Fig. 18 is a plan. This device is in the nature of telescopic bars coupled at one end to the frame which supports the rest H, (see Fig. 1,) and at the other end to leg-rest K L, where the two parts are hinged together, and provided with screw'mechanism for sliding the telescoping parts on each other.

Y Z is a hollow bar,` U-shaped in section. This bar is coupled to the leg-rest at the hinge, as seen in Fig. 1. In this bar Z slides another similar bar, o', which is graduated on top, as seen in Fig. 18. This bar is hinged to the frame which supports rest H. In the hollow of bar o is rotatively mounted a screw, p2, the thread on which engagesa thread in a nut, p7,ixed to bar Z. On screw p2 is fixed a worm- Wheel, p",which is driven, through a worm on Screw p5 from a crank, p', through suitable gear-wheels, p4. To the bar Z the links M are coupled at m.

The links N are constructed to be lengthened and shortened at will, as illustrated in Figs. 19 and 20, the former of which is a side elevation and the lattei` a crosssection. The part o2 slides telescopically into the otherpart, and asetfscrew, o3, is employed to clamp the two together when properly adj usted.

The part L of the leg-rest is provided with means for varying its length, which are similar to those before described. This construction is illustrated in Figs. 21 and 22, the former being a longitudinal section of one of the rails of the rest L and the latter a cross-section. The bar u* slides telescopically in L, and is graduated, as seen in Fig. 1.

On the crank-shaft t is a worm, u, which meshes with a worm-wheel, u, on a screw, u2, which is rotatively mounted in collared bearings in L. The thread on this nut engages the thread in anut, u, fixed in bar u".

The operation will be readily understood.

The sandals or footrests O of the couch are hinged at y to the leg-rests L, and their inclination can be varied by means of slotted braces y2, hinged at their upper ends to the sandals, and secured to L at their lower ends by set-screw or clamp-screw ys. In Fig. 23 I have shown one of these sandals vO in front elevation.

In the more elaborate Vform of my apparatus (illustrated in Fig. 3) I have shown it provided with means whereby the patient may himself effect the proper or desired adjustments, 'and also provided with other conveniences that will be hereinafter described. Inthis form P is a tubular sheath attached at its lower end to a rail, A, and projecting back to within reach of the patient. Vithin this sheath is mounted a shaft, Q, provided with a hand-wheel or crank, Q', on its upper projecting end, and provided with a toothed wheel on its lower end, which meshes with a toothed wheel on the screw Z. This mechanism is shown clearly in the enlarged sectional view, Fig. 23a. Through this mechanism the patient is enabled to effect the rotation of screw Z. In a similarly-arranged sheath, It, (see Figs. 3 and 24,) is mounted a shaft, R, which has a crank, S, on its upper end within reach of the patient. This shaft bears a toothed wheel, which meshes with another toothed wheel on the screw T, whereby the patient is enabled to raise or lower the back F.

U is a small table mounted on the litter at the side of the patient for his convenience, and V V are cushion supports or rests for his arms.

Fig. 25 is a detached view showing rings x4,

arranged along the side rails of the back-rest F,`the leg-rests K L, and the footrests O. Extending across the said rests from rail to rail, and attached by means of these rings, are, rst, an upper set of rubber bands, X X, next to the body of the patient, and, second, a set of bands, X', below these, to support a mattress, on which the body of the patient rests. When it is desired to remove the mattress for any reason, the bands X are drawn tight, when they will be firmly held by the grip of th'e attaching-rings, as clearly illustrated in Fig. 25. The lower series of bands, X, supporting the mattress, may now be slacked up and the mattress lowered, leaving the patient resting for the time on the bands K. By this means the bedding on which the patient rests may be removed from below and changed without disturbing his position. This is very important in some cases. The bands or straps m2', for securing a limb in position,for example, are attached to the rings seen in Fig. 25. By the slacking or tightening of the bands X the body of the patient may be raised or lowered at will. The rings so* are in couples, and the attachment of the band X01' X is made by passing the end of the band up through both rings, around the upper ring, and then back under the lower ring, whereby the said end is clamped between the ring and the band. This forms awell-known fasteninghitch, that will at once give way as soon as the band is slackened, but will hold its grip while there is tension on the band. It will be seen that the body of the patient is suspended between the rails of the back F, and that the bar H supports the body against any endwise movement, especially when the back F is inclin ed. The cushion I forms a support for the buttocks and heavier part of the body, and it may be lowered very conveniently to make room for a vessel or commode, when such is required.

I am enabled to provide my apparatus with all that is necessary for treatment with irrigations without soiling the mattress, and to IOO employ irrigation with phenol without touching the wound or member, which may be held iixed in au atmosphere of phenol vapor, as in renewing the dressings or performing an operation.

The form of apparatus seen in Figs. l and 2 carries with it all the operating parts. The cranks are under the control of the surgeon only,in order that the position he gives to the patient may not be changed through ignorance. The cranks are made removable, so that the surgeon may carry them in his pocket.

In Fig. l, y represents two rolls of some thin material which may be used to form an awning` to shade the patient on the battle-field or in the open air. In forming a tent or awning of these one is placed on the other to insure warmth in cold weather. One is made impermeable or water-proof, and this 011e is placed above. A light bow or frame, afghinged at a, and capable of being raised up or turned down, like a carriage-top,is employed to support the awning-cover. The sheets, when stretched over the bow u, may be secured to the frame of the litter in any convenient way. The frame or bow will be held erect bythe fabric stretched over it.

The form of litter shown in Fig. S may also be provided with a bow,fu, to support an awning, if such is desired. At each end of the frame of the litter may be arranged lockboxes o r, Fig. l, to hold bandages, &c., for the surgeons use.

In Figs. l and 3 the position of the bands X and X is indicated on the back F by dotted lines, and in Fig. 2 the bands X are shown in full lines. It will be understood, however, that these bands are not, ordinarily, attached permanently to the couch.

Having thus described my invention, I claiml. The combination, with the stout frame of the apparatus hinged at its middle, a, for folding, of the adjustable couch mounted on said frame, and comprising the back F, hinged to the frame also at a, the' jointed leg-rests K L, hinged to the frame also at a, and means, substantiall y as described, for supporting said back and leg-rests in an inclined position, whereby the frame and couch may be folded on a common hinge-axis, as described.

2. The back F and leg-rests K L of the couch, constructed of side rails and flexible bands, which latter hang down between the side rails, so as to bring the hinging-axis a coincident with the axis of the hip-joint of the patient, and the rigid curved rest or bar II, mounted as shown, and arranged to take under and support the upper portions of the thighs, as set forth.

3. The combination, with the back F,hinged at a t-o the main frame, and the said main frame, of the screw T, mounted in bearings in the hollow rail A, the nut g on said screw, the link G, coupled at one end to the back and at the other end to said nut g, the worm-wheel 1" on said screw T, the worm 1, engaged with wheel 1", and the crank f on the axis of said worm, all substantially as described.

4. The combination, with the main frame, of the boX I,hnged in the same atits one end, its cushion I', the su] )porting-straps h h under said cushion, the winding-shaft j, on which said straps are wound at their one ends, the crank t', and the pawl and ratchet for preventing the backward rotation of shaft j, substantially as set forth.

5. The combination, with the hollow rail A of the main frame, and the screw Z, mounted therein, of the sheath P', fixed to rail A, the oblique shaft Q, mounted in said sheath, and provided with a crank, Q', and the intermeshing gear-wheels on shaft Q and screw l, respectively, whereby the patient may operate the said screw, as set forth.

6. The combination, with the hollow rail A of the main frame and the screw T, mounted therein, of the sheath It, fixed to rail A, the oblique shaft R,mounted therein, and the intermeshing gear-wheels on the shaft R and screw T, respectively, whereby the patient may operate said screw, as set forth.

In witness whereof I have hereunto signed my name in the presence of two subscribing witnesses.

EUGNE noNNEFoY.

Witnesses:

AUGUsTE BONNEFOY, VICTOR RIBOLET.

Images