Frame

Abstract

To provide a frame for supporting a finger, which can be used to lift the finger during surgery.SOLUTION: The frame 21 includes a plate 24 having two wings 22, 23, the wings defining a plane and a space between the wings, an engagement site 28 on each wing for removable engagement with a retaining tie 45, and an elevated support surface 32 between the wings for supporting a finger. The frame provides a stable base for supporting the finger during hand surgery surgery.SELECTED DRAWING: Figure 8

Description

[Technical Field]

[0001] The present invention provides a frame for supporting a finger during surgery, a fixation device, a kit including the frame, the fixation device, a method of preparing a hand for surgery, and a method of surgery. [Background technology]

[0002] During surgery, it may be necessary to hold down a flap of skin or other tissue to allow the surgeon access to the underlying tissue.

[0003] There are several options for holding the tissue down, including physical support by an assistant, clamps, sutures, and frames. These strategies are often used in combination. Frames for holding tissue down are supplied by June Medical Limited (9 York Way, High Wycombe, Buckinghamshire, England, HP12 3PY) under the trademark Galaxy II®. These products are sometimes called retractor frames. In these products, the frame surrounds the tissue during surgery. The skin flap is held down by hooks attached to rubber ties. As the hooks engage the tissue, the rubber ties are pulled taut, and then the ends of the rubber ties engage notches on the outer edge of the frame. This type of device is shown in Figure 1.

[0004] During surgery on fingers, such as fingers of the hand, it is advantageous for the finger being operated on to be supported in an elevated position (relative to the hand) so that the surgeon can operate. A difficulty with this is that when one finger is elevated, other fingers often naturally tend to assume an elevated position as well. Fingers that assume a bent position may need to be straightened before surgery can be performed. Other fingers (or the finger undergoing surgery) may be held down by lead weights or an assistant during surgery. These solutions may be unstable, cumbersome, crowded, and / or time-consuming. Summary of the Invention [Problem to be solved by the invention]

[0005] An object of the present invention is to solve one or more of these problems. [Means for solving the problem]

[0006] In a first aspect, the present invention provides a frame for supporting a hand during a surgical procedure, the frame comprising: a plate having two wings, the two wings defining a plane and a space between the two wings; a support portion positioned between the two wings, the support portion having a support surface for one or two fingers that is lifted relative to a plane defined by the two wings; Includes:

[0007] In some embodiments, each wing includes an engagement site for releasably engaging a retaining tie.

[0008] The support surface provides an elevated surface for accommodating one finger, or in some embodiments, two fingers. One finger, or in some embodiments, two fingers, of the hand undergoing surgery can be positioned and secured on the support surface. For embodiments in which two fingers can be positioned and secured on the support surface, this is useful when surgery is required on any two fingers, or when lifting the first finger undergoing surgery tends to cause the second finger to bend, making it more convenient to lift both fingers. This provides a more versatile frame. The wings of the plate allow the other fingers of the hand to be supported underneath the plate. This allows the surgeon to see the one finger, or in some embodiments, two fingers, in a properly lifted position, while simultaneously supporting the other fingers of the hand out of the way so that the surgeon can reach the surgical area, which is located in the space created between the two wings during use. The location of the wings, the space between them, and the location of the support surface provide a suitable base when engaged with the hand, while also allowing the one finger, or in some embodiments, two fingers, to be properly positioned for hand surgery. An engagement site may be provided on each wing to allow a retention tie to engage with the engagement site. The retention tie may include a hook at one end for engaging a flap of skin in the surgical area. The other end of the retention tie may be engaged with the engagement site to hold the flap of skin in a retracted position, thereby allowing the surgeon to more easily access the surgical area in the space between the wings.

[0009] In some embodiments, the width of the support surface is between 10 mm and 30 mm. In some embodiments, the width of the support surface is greater than 30 mm. In some embodiments, the width is between 30 mm and 100 mm, or between 30 mm and 60 mm, or between 60 mm and 100 mm. In some embodiments, the length of the support surface is between 30 mm and 100 mm, more preferably between 70 mm and 85 mm. In some embodiments, the support surface is generally rectangular in plan view. In some embodiments, the support surface is generally square in plan view. In some embodiments, the axis of extension of the support surface is oriented generally perpendicular to the direction in which the wings extend. In some embodiments, the support surface defines a sloped portion inclined relative to a plane defined by the plate. The sloped portion aids in sliding the fingers on the frame when the hand is engaged with the frame. It also provides a stable surface on which one finger, or in some embodiments, two fingers, can be secured.

[0010] In some embodiments, the width of one or more of the wings is between 10 mm and 100 mm, more preferably between 20 mm and 60 mm, preferably 40 mm.

[0011] In some embodiments, the engagement portion includes a notch into which a rubber tube of the retention tie can be clamped. In some embodiments, the notch has a tapered entrance portion and a groove portion into which the tube can be clamped.

[0012] In some embodiments, the frame is formed from a single piece of material. In some embodiments, the frame is formed from a metal or a polymer. The metal may be aluminum. In some embodiments, the frame is formed from a MABS (methyl methacrylate acrylonitrile butadiene styrene) polymer, such as Terlux®. In some embodiments, the frame is sterilizable.

[0013] In some embodiments, the wings taper from a wide end adjacent the support surface to a narrower end distal to the support surface, thereby increasing the stiffness of the frame while minimizing its size and the material required for its manufacture.

[0014] In some embodiments, the distance between the high end of the support surface and the distal end of the wing is between 100 mm and 200 mm.

[0015] In some embodiments, the support portion is connected to the plate by side walls that have engagement sites for releasably engaging the retention ties. This provides high flexibility at the engagement points for engaging the retention ties, which means high flexibility in the direction in which the skin flap is restrained. These engagement sites may be used with the fixation device of the present invention to securely restrain the finger on the support surface. In some embodiments, the outer edges of the wings do not have a lip or high flange.

[0016] In some embodiments, the plate has an inner edge that defines a space between the two wings, and the support surface defines a slope that is inclined relative to a plane defined by the plate, the slope extending to the inner edge of the plate. These features facilitate sliding the operative finger, or in some embodiments, multiple fingers, over the slope. They also provide an ergonomic position that minimizes stress on the operative finger, or in some embodiments, multiple fingers, and the fingers supported under the plate during use.

[0017] In some embodiments, the slope defined by the ramp is between 5° and 40°. This configuration aids in engagement of a finger, or in some embodiments, multiple fingers, with the support surface and supports the finger, or in some embodiments, multiple fingers, in an appropriate elevated position for surgery.

[0018] In some embodiments, the support surface includes a recess, concave shape, or raised portion to securely accommodate a single finger, or in some embodiments, multiple fingers. This configuration helps prevent a single finger, or in some embodiments, multiple fingers, from slipping off the support surface during a surgical procedure. In some embodiments, the support portion includes two recesses, two concave shapes, or raised portions, or a combination thereof, to accommodate two fingers. These portions may be oriented parallel to the length of the support surface. To prevent fingers from slipping off the support surface, the raised portions may be protrusions or raised sidewalls extending along the edge of the support surface. In these and other embodiments, the support surface may be planar / flat. This makes the frame suitable for a wider range of surgical procedures and more versatile in terms of being able to accommodate a wider variety of patients' fingers.

[0019] In some embodiments, the support surface comprises protrusions, corrugations, or grooves in the support portion adapted to support, secure, or hold a finger, such as a finger, or in some embodiments, multiple fingers, and these may be oriented parallel to the length of the support surface.

[0020] In some embodiments, the support portion has or includes a W-shape, e.g., a W-shaped face, a W-shaped face with square top / bottom, or a W-shaped face with rounded top / bottom, which provides a suitable arrangement for accommodating two fingers and is also easy to manufacture, e.g., as a one-piece frame, e.g., by injection molding.

[0021] In some embodiments, the edge of the support portion includes two or three engagement sites for releasably engaging the retention ties, providing flexibility and several useful locations where the retention ties can be attached to hold two of the patient's fingers.

[0022] In some embodiments, the area of ​​the support portion is 30 cm 2In some embodiments, the area of ​​the support portion is greater than 30 cm 2 From 100cm 2 In some embodiments, the area of ​​the support portion is between 35 cm 2 From 60cm 2 , 70cm 2 , 80cm 2 , 90cm 2 , or 100cm 2 This provides a surface large enough to stably accommodate two fingers.

[0023] In some embodiments, the plate has a horseshoe, arrow, or triangular shape. In some embodiments, the plate shape may be generally semicircular, generally U-shaped, or generally V-shaped. These shapes provide a stable base that can be engaged by hand during surgery.

[0024] In some embodiments, the plate has an inner edge that defines a space between the two wings and an outer edge that defines an outer portion of the two wings, hi some embodiments, the length of the inner edge is between 50 mm and 100 mm.

[0025] In some embodiments, the space between the wings is generally U-shaped or V-shaped, or has a semicircular shape. In some embodiments, the space has a generally horseshoe shape, a generally arrow shape, or a generally triangular shape. These shapes provide a preferred space to accommodate a surgical field in hand surgeries, particularly surgeries selected from carpal tunnel release, Dupuytren's fasciectomy, trigger finger release, tendon repair, ganglionectomy, metacarpal joint (MCP) replacement, and trapezoidectomy (removal of the trapezium bone).

[0026] In some embodiments, the engagement sites are located on the outer edges of the two wings, which facilitates the attachment of retention ties to hold down the skin flaps. Preferably, multiple engagement sites are located on the outer edges of the wings. Preferably, there are two or more, five or more, or ten or more engagement sites located on each wing.

[0027] In some embodiments, the frame further includes a retaining rib protruding from the plate opposite the support portion of the plate. The retaining rib is useful for securely retaining the finger opposite the finger resting on the support surface of the plate. The rib can also provide rigidity to the plate, which can help the plate resist forces associated with constraining the finger in a desired manner. In some embodiments, the rib allows a portion of the support surface to extend adjacent the inner edge of the plate and below the plane of the plate relative to a majority of the support surface (i.e., a majority of the support surface that is higher than the plane of the plate). This allows the support surface to have a smaller slope relative to the plane of the plate than if the support surface did not extend below the plate. This results in an ergonomic frame that reduces stress on the fingers during surgery.

[0028] In some embodiments, the frame further includes two retaining ribs projecting from the plate on opposite sides of the support portion of the plate, the two retaining ribs being positioned on either side of the support portion, which provides a stable frame when engaged with a hand.

[0029] In some embodiments, the frame is formed from a single piece of material, which provides a rigid frame well adapted to handle the forces associated with constraining the fingers during a surgical procedure. The frame is preferably injection molded.

[0030] In some embodiments, the frame has a plane of symmetry perpendicular to the plane defined by the wings, which provides a stable frame when engaged with a hand. In some embodiments, the plane of symmetry passes through the support surface, which provides a stable frame when engaged with a hand.

[0031] In another aspect of the present invention, a fixation device is provided for fixing one finger, or in some embodiments two fingers, on a frame during a surgical procedure, the fixation device comprising: a rigid body having a contact surface for contacting a finger supported on a frame; Elongated retention ties extending from both sides of the rigid body and the elongated retention tie is longitudinally stretchable.

[0032] In some embodiments, the length of the contact surface is at least 3 cm, or at least 4, 5, or 6 cm.

[0033] Such a contact surface length is useful for accommodating two fingers of a patient's hand so that two of the fingers can be held down to the frame with a single fixation device. This makes it easier and faster to prepare the hand for surgery. It also provides a more stable restraint of the hand and provides more options for restraining the hand during surgery.

[0034] In some embodiments, the area of ​​the contact surface is 5 cm 2 Larger or 6cm 2 , 8cm 2 , 10cm 2 , 16cm 2 , or 25cm 2 This provides an area where two fingers can be stably engaged.

[0035] In some embodiments, the body includes two openings in a face of the body through which the elongated tie members extend to form elongated retention ties, resulting in a sturdy body that is easy to manufacture and assemble.

[0036] In some embodiments, the securing device includes a groove for receiving the elongated tie member, the groove being on the opposite side of the body to the contact surface and between the two openings, resulting in a non-bulky securing device that is still easy to manufacture and adjust.

[0037] In use, the rigid body can be positioned against the tip of a finger, or in some embodiments, the tips of two fingers, placed on the support surface of a frame according to the present invention. The contact surface is stably engaged with the finger, or in some embodiments, multiple fingers. Elongated retention ties can then be engaged with engagement sites on the frame to hold the tip of the finger, or in some embodiments, the tips of the fingers, in a desired position. The longitudinal stretchability of the elongated retention ties is useful because they can be engaged with the engagement sites in a stretched state. Thus, strain on the stretched tie securely holds the tip of the finger, or in some embodiments, the tips of multiple fingers. In some embodiments, the elongated retention ties have low stretchability. That is, the elongated retention ties may be highly elastic so that a high level of force applied to the finger, or in some embodiments, multiple fingers, can restrain the finger / fingers.

[0038] In some embodiments, the elongated retention tie includes or is formed of a polymeric tube. In some embodiments, the elongated retention tie is formed from a single piece of material. In some embodiments, the contact surface is concave to provide secure engagement with the tip of one finger, or in some embodiments, the tips of two fingers.

[0039] In some embodiments, the surface area of ​​the contact surface is between 2 cm 2 and 5 cm 2 . This large surface area is preferred to maintain blood flow to the finger when the finger is constrained under high constraining loads. In some embodiments, the contact surface includes a non-slip portion. This non-slip portion may cover the entire contact surface. In some embodiments, the contact surface is non-slip to provide secure engagement with the tip of one finger, or in some embodiments, the tips of two fingers.

[0040] In some embodiments, the elongated retention tie is radially resiliently compressible, which aids in engagement of the retention tie with an engagement site such as a notch, because the resiliency allows the retention tie to be pinched into the notch.

[0041] In some embodiments, the rigid body has an opening through which the monolithic material can be threaded to form an elongated retention tie, the monolithic material being threaded so that it is held in place relative to the rigid body.

[0042] In some embodiments, the elongated retaining tie has a free end length of at least 90 mm. Preferably, the rigid body has an oval shape.

[0043] In some embodiments, the elongated retention ties include or consist of a polymer. The elongated retention ties are preferably tubular. They preferably have a diameter between 1 mm and 5 mm.

[0044] In a further aspect of the invention, there is provided a kit comprising a frame as described herein and a fixation device as described herein.

[0045] In some embodiments, the kit includes two fixation devices described herein. In some embodiments, the kit includes one or more, preferably four, retention ties described herein. In some embodiments, the kit includes one or more, preferably four, non-hook-shaped retention ties that can be engaged with engagement sites on the frame to restrain the finger or entire hand in a desired manner (without holding down a flap of skin).

[0046] In a further aspect of the present invention, there is provided a method of preparing a hand for surgery, the method comprising: providing a frame as described herein; engaging a hand with the frame; Includes:

[0047] In some embodiments, the surgical procedure for which hand preparation is performed is selected from finger and / or wrist, nerve, or vascular surgery. The surgical procedure for which hand preparation is performed may be selected from carpal tunnel release, Dupuytren's fasciectomy, trigger finger release, tendon repair, ganglionectomy, metacarpal joint (MCP) replacement, and trapezoidectomy (removal of the trapezium bone).

[0048] In some embodiments, the step of engaging the hand with the frame includes engaging one finger, or in some embodiments two fingers, of the hand with the frame. so that one finger, or in some embodiments two fingers, are supported on the support surface; and so that the other fingers of the hand remain on the opposite side of the planar support surface defined by the plate. The method includes inserting the frame into the space between the wings.

[0049] In some embodiments, the method further includes the step of securing one finger, or in some embodiments, two fingers, on the support surface by engaging elongated retention ties of a securement device described herein with engagement portions of the frame such that a contact surface of the securement device contacts the one finger, or in some embodiments, two fingers, supported on the support surface of the frame.

[0050] In a further aspect, the present invention provides methods of surgery, including preparing a hand for surgery as described herein, followed by performing a surgical procedure. In some embodiments, the surgical procedure may be selected from surgery on the fingers and / or wrist, nerves, or vascular system. The surgical procedure may be selected from carpal tunnel release, Dupuytren's fasciectomy, trigger finger release, tendon repair, ganglionectomy, metacarpal joint (MCP) replacement, and trapezoidectomy (removal of the trapezium bone).

[0051] Next, an embodiment of the present invention will be described with reference to the drawings. [Brief explanation of the drawings]

[0052] [Figure 1] 1A and 1B show a retractor frame according to the prior art. [Figure 2] 1 is a perspective view of a frame according to a first embodiment of the present invention; [Figure 3] FIG. 3 is a second perspective view of the frame of FIG. 2. [Figure 4] FIG. 3 is a front view of the frame of FIG. 2. [Figure 5] FIG. 10 is a plan view of a frame according to a second embodiment of the present invention. [Figure 6] FIG. 6 is a perspective view of the frame of FIG. 5. [Figure 7] FIG. 6 is a front view of the frame of FIG. 5. [Figure 8] FIG. 8 is a schematic plan view of the frame of FIGS. 5 to 7 in use with a fixation device according to the present invention. [Figure 9A] 1 is a plan view of a fixation device according to the present invention; [Figure 9B] 1 is a side view of a fixation device according to the present invention; [Figure 10] FIG. 1 shows a frame according to the present invention. [Figure 11] 1 shows a frame according to the present invention; [Figure 12] FIG. 1 shows a frame according to the present invention. [Figure 13] 1 shows a fixation device according to the present invention; [Figure 14] 1 shows a fixation device according to the present invention; DETAILED DESCRIPTION OF THE INVENTION

[0053] Figures 2-9 show frames and fixation devices according to the present invention. Further embodiments of the present invention may combine any of the features shown in Figures 1-9 with features shown in Figures 10-14 and / or features disclosed in the preceding description of the invention.

[0054] FIG. 1 shows a frame 1 having two thin arms 2. The arms 2 are curved with notches 3 around their outer edges. The retractor frame is positioned so that the tissue to be operated on is located below the space 4 between the arms. An incision is made in the tissue, and the edges of the incision are engaged by hooks (not shown) attached to ties. The ties are pulled taut to tension the edges of the incision and then engaged with the notches 3. Between the two arms is an adjustable track 5 and cam-lock fastener 6. The track and fastener allow the surgeon to adjust the relative distance between the two arms, providing more space between them. Thus, the frame can be adjusted for use in operating on tissue areas of various sizes.

[0055] 2-4 show a frame 21 according to the present invention. The frame is manufactured from Terlux®, a methyl methacrylate acrylonitrile butadiene styrene (MABS) polymer. This polymer is suitable for injection molding, and in this example the frame is injection molded. Terlux® is available from Ineos Capital Limited, 38 Hans Crescent Knightsbridge, London, UK.

[0056] The frame includes a flat plate 24 formed with two wings 22, 23 that define a space 25 therebetween. The plate 24 has a generally U-shaped configuration with an outer edge 26 and an inner edge 27. The frame is formed from a plastic material. The inner edge 27 has a U-shape, defining an elongated semicircular space 25 between the wings 22, 23. The outer edge 26 of each wing includes a series of notches 28 regularly spaced along the outer edge. Each notch includes an enlarged entrance portion 30 and a narrower groove portion 30. The distal end portion 31 of the outer edge of each wing is free of notches, forming tabs that allow the surgeon to easily support and properly position the frame.

[0057] Between the two wings, the frame has a raised support surface 32. The support surface is a ramp that extends from near the inner edge 27 of the plate 24, with a gap 35 between the ramp and the inner edge of the plate. The ramp is rectangular in plan view. The ramp has a V-shaped cross section 33 formed by a bend 34 along its center. The ramp is inclined at an angle of 25° relative to the plane (AA) defined by the plate 24. The support surface is connected to the wings 22 and 23 of the frame by a sidewall 36. The sidewall 36 is formed from the same piece of material that forms the wings 22 and 23. The sidewall has an edge that continues to the outer edge 26 of the wing. The edge of the sidewall also has a notch 37, which in this example is identical to the notch 28 on the outer edge of the wing. The upper end of the support surface also includes a notch 38 which is adapted to engage a retaining tie in the same manner as notch 28 is adapted to engage a retaining tie.

[0058] 5-8 show a frame according to a second embodiment of the present invention. This frame is manufactured from Terlux®. Similar parts to those of the first embodiment are given corresponding reference numerals. The sidewall 36 connecting the support surface 32 to the wings 23 and 22 differs from the sidewall shown in the first embodiment. The sidewall 36 extends from the support surface 32 toward a plane (AA) defined by the plate 24. The sidewall 36 penetrates the plane AA to the opposite side of the plane from the support surface 32. On the opposite side of the plane, the sidewall 36 intersects with a rib wall 39, which forms a rib projecting from the plane AA of the plate 24. The rib wall 39 defines a rib 40 that extends along both sides of the support surface only on the opposite side of the plane AA from the support surface. The exemplary (non-limiting) dimensions shown in this embodiment are in millimeters; however, other dimensions may be used.

[0059] FIG. 8 shows a hand 41 engaged with the frame 21 during a surgical procedure. One finger 42 is undergoing surgery. The hand is engaged with the frame so that one finger 42 rests on the support surface 32. The remaining fingers 43 of the hand and the thumb (not shown) are positioned below the wings 22 and 23 of the plate 24. A surgeon's incision 43 is shown in the space between the wings 22 and 23. The edge of the incision is engaged with a hook 44, which is attached to a retention tie 45. The end of the retention tie 45 engages with a notch 28 on the outer edge of the wings 22 and 23, holding down the edge of the incision and allowing the surgeon to access the underlying tissue. A rib 40 protruding from the opposite side of the support surface 32 of the plate 24 prevents the finger 43 from moving behind or toward the finger 42, thereby ensuring that the hand is held in the proper position relative to the frame. A fixation device 50 is engaged with the tip of the finger 42 undergoing surgery. This secures the fingers 42 in an elevated position on the support surface 32. The fixation device includes two stretchable polymer ties 51 attached to a central rigid body 52. ​​The rigid body is formed from a curved piece of plastic adapted to match the curvature of the tips of the fingers 42. The elongated ties are radially compressible so that they can be threaded through and engaged / clamped into the notches 28. The stretchable nature of the ties allows pressure applied to the tips of the fingers to prevent them from bending upward or falling off the support surface 32 during surgery.

[0060] Another embodiment of a fixation device is shown in Figures 9A and 9B. Figure 9A shows a plan view of the fixation device, and Figure 9B shows a side view of the fixation device. The fixation device has a rigid plastic body portion 52 that is generally oval in plan view. The body portion is curved to form a concave bottom surface 54 that matches the shape of the tip of a finger, such as a human finger. The top convex surface 55 of the body portion includes two loops 53. A stretchable polymer tube 56 is threaded through the loops, with free ends extending from the loops. These free ends of the tube can be engaged with engagement features, such as notches, on the frame. To facilitate this engagement, the tube is radially compressible. The position of the body portion on the tube can be adjusted by sliding the body portion along the tube. This allows one end of the tube to engage, the body to the appropriate position for engaging the finger, and the other end of the tube to engage the second engagement feature. Dimensions shown in the figures are in millimeters, but other dimensions may be used.

[0061] Figures 10 to 12 show a frame according to the present invention, with parts corresponding to parts of the embodiment shown in Figures 1 to 9 being indicated with corresponding reference numerals.

[0062] Figures 10-12 show the frame 21. Figure 10 is a plan view of the frame. Figure 11 is a front view of the frame. Figure 12 is a rear view of the frame. The frame is manufactured from Terlux®, a methyl methacrylate acrylonitrile butadiene styrene (MABS) polymer. This polymer is suitable for injection molding, and in this example the frame is injection molded. Terlux® is available from Ineos Capital Limited, 38 Hans Crescent Knightsbridge, London, UK.

[0063] The frame includes a flat plate 24 formed with two wings 22, 23 that define a space 25 therebetween. The plate 24 has a generally U-shaped configuration with an outer edge 26 and an inner edge 27. The frame is formed from a plastic material. The inner edge 27 has a U-shape, defining an elongated semicircular space 25 between the wings 22, 23. The outer edge 26 of each wing includes a series of notches 28 regularly spaced along the outer edge. Each notch includes an enlarged entrance portion 29 and a narrower groove portion 30. The distal end portion 31 of the outer edge of each wing is free of notches, forming tabs that allow the surgeon to easily support and properly position the frame.

[0064] Between the two wings, the frame has a raised support surface 32. The support surface is a sloped portion extending from the inner edge 27 of the plate 24. The width of the support portion is 4 cm, although other widths greater than 3 cm may be used. The area of ​​the support portion is 40 cm. 2 However, in other embodiments, 30 cm 2Areas greater than 100 mm may be used. The ramps are squashed rectangles in plan view. In other embodiments, the support portion may be approximately square when viewed from above. The support portion has a W-shaped profile 33 formed by three indentations 34 along the ramps. The indentations form two depressions / recesses, each adapted to provide a stable base for a finger resting on the support surface. In other embodiments, raised portions, such as protrusions, may be provided along the outer edges of the support portion and optionally along the center of the support portion, extending along the length of the support portion to keep multiple fingers apart and retain them on the support portion. The ramps are inclined at a 25° angle with respect to the plane (AA) defined by the plate 24. The support surface is connected to the frame wings 22 and 23 by sidewalls 36. The sidewalls 36 are formed from the same piece of material that forms the wings 22 and 23. The sidewalls have edges that continue to the outer edges 26 of the wings. The edge of the side wall also includes a notch 37, which in this embodiment is identical to the notch 28 on the outer edge of the wing. The upper end of the support surface also includes a notch 38, which is adapted to engage a retention tie in the same way that notch 28 is adapted to engage a retention tie. In other embodiments, the support surface may include two notches 38.

[0065] Sidewall 36 extends from support surface 32 toward a plane (AA) defined by plate 24. Sidewall 36 passes through plane AA to the opposite side of that plane relative to support surface 32. On the opposite side of that plane, sidewall 36 meets rib wall 39, which forms a rib projecting from plane AA of plate 24. Rib wall 39 defines ribs 40 that extend along both sides of the support surface only on the opposite side of plane AA relative to the support surface.

[0066] Figures 13 and 14 show the body of a fixation device according to the present invention, which utilizes the retention ties shown in Figures 9A and 9B, or the like.

[0067] Figure 13 shows a perspective view of the body of the fixation device from above. Figure 14 shows a perspective view of the body of the fixation device from below. The fixation device has a rigid plastic body portion 52 that is generally oval in plan view. This body portion is curved to form a concave bottom surface 54 that matches the shape of the tips of two fingers, such as a finger. The length of the portion of bottom surface 54 that is adapted to contact a finger fixed to the frame is 4 cm. The area of ​​the portion of bottom surface 54 that is adapted to contact a finger fixed to the frame is 8 cm. 2 is.

[0068] The top convex surface 55 of the body portion includes two openings 53 formed within the plane of the body 52. ​​No portion protrudes beyond the top surface 55 of the body 52. ​​The inside corners of the openings are rounded. Both openings are spaced the same distance from their respective ends of the body. The openings are located on tabs 80 at each end of the body, which are oriented flat and planar relative to the concave / convex surfaces 55 and 54 of the body. In a manner similar to the arrangement shown in FIGS. 9A and 9B, a stretchable polymer tube is threaded through these openings 53 with its free end extending from the underside of the openings 53. The polymer tube thus exits through the opening adjacent the bottom surface 54. The portion of the polymer tube between the openings 53 is positioned within a groove 88 in the convex surface 55 of the body. The groove 88 has a U-shaped cross section. The free end of the tube can engage with an engagement feature, such as a notch on the frame. To facilitate this engagement, the tube is radially compressible. The position of the body portion relative to the tube can be adjusted by sliding the body portion 52 along the tube. This allows one end of the tube to be engaged, the body to be moved to the appropriate position for finger engagement, and the other end of the tube to be engaged with a second engagement location. The concave surface 54 includes an array of gripping sites 82. These gripping sites may be protrusions or areas of non-slip material.

Claims

1. A frame for supporting the hand during surgical procedures, A plate having two wing portions, wherein the two wing portions define a plane and a space between the two wing portions, A support portion positioned between the two wings has a support surface for a finger that is lifted relative to the plane defined by the two wings, and Includes, Each wing section is provided with an engagement portion for detachably engaging a retaining tie, The frame further includes retaining ribs protruding from the plate on the side of the plate opposite to the support portion of the plate.

2. The frame according to claim 1, wherein the support surface defines an inclined portion that is inclined with respect to the plane defined by the plate.

3. The frame according to claim 2, wherein the plate has an inner edge that defines the space between the two wing portions, and the inclined portion extends to the inner edge of the plate.

4. The frame according to claim 2, wherein the gradient defined by the inclined portion is between 5° and 40°.

5. The frame according to any one of claims 1 to 4, wherein the support surface includes recesses, concave shapes, or raised portions to securely accommodate fingers.

6. The frame according to any one of claims 1 to 4, wherein the plate has a horseshoe shape, an arrow shape, or a triangle shape.

7. The frame according to any one of claims 1 to 4, wherein the plate has an inner edge portion that defines the space between the two wing portions and an outer edge portion that defines the outer portions of the two wing portions.

8. The frame according to any one of claims 1 to 4, wherein the space between the wing portions is substantially U-shaped, substantially V-shaped, or semicircular.

9. The frame according to any one of claims 1 to 4, wherein the engagement portion is provided on the outer edge of the two wing portions.

10. The frame according to any one of claims 1 to 4, further comprising two retaining ribs protruding from the plate on the side of the plate opposite to the support portion, the two retaining ribs being positioned on both sides of the support portion.

11. The frame according to any one of claims 1 to 4, wherein the frame is formed from a single material.

12. The frame according to any one of claims 1 to 4, wherein the frame has a plane of symmetry perpendicular to the plane defined by the wing portion.

13. The frame according to claim 12, wherein the plane of symmetry penetrates the support surface.

14. The frame according to any one of claims 1 to 4, wherein the support surface is for two fingers.

15. The frame according to claim 14, wherein the support portion comprises two recesses, or two concave shapes, or raised portions for accommodating the two fingers.

16. The frame according to claim 14, wherein the support portion is approximately square when viewed from above.

17. The frame according to claim 14, wherein the width of the support portion is greater than 30 mm.

18. The frame according to claim 14, wherein the width of the support portion is between 30 mm and 60 mm.

19. The frame according to claim 14, wherein the support portion has a W-shaped surface.

20. The frame according to claim 14, wherein the edge of the support portion is provided with three engagement portions for removably engaging a retaining tie.

21. The area of ​​the support portion is 30 cm². ２ A larger frame according to claim 14.

22. A kit comprising a frame and a fixing device according to any one of claims 1 to 4, wherein the fixing device is A rigid body having a contact surface for contacting a finger supported on the frame, Elongated retaining ties extending from both sides of the rigid body and Includes, The aforementioned elongated retaining tie is stretchable in the longitudinal direction, as per the kit.

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