Surgical Hand Wraps and Sterile Connectors

Abstract

A device is disclosed for securing a patient's hand to a limb positioning device while evenly distributing applied traction loads across the patient's hand and wrist. The hand is placed in an open position within a soft mitten, while an anatomically shaped plate is attached to the mitten to support the palm in an open position. Straps are then secured around the patient's wrist and hand. Finally, the entire device is wrapped in an elastic bandage and secured to the limb positioning device. The shape of the plate, the configuration of the mitten, and the straps combine to allow low contact pressure across the patient's hand and wrist when traction is applied. [Selected Figure] Figure 2

Description

[Technical field]

[0001] The present disclosure relates generally to devices used to position a patient's limbs during medical procedures, and more specifically to devices used to position a patient's shoulder and arm during shoulder surgery. [Background technology]

[0002] Orthopedic shoulder surgery involves complexities not encountered in other surgical procedures, such as knee surgery. For example, during shoulder surgery, ports or incisions are placed through the patient's shoulder joint to provide access for instruments such as light sources, visual scopes, and surgical tools. However, it may be desirable for the surgeon to gain access to a different area of ​​the joint by rotating the operative limb and holding it in a new position without creating a new port. This transformation is accomplished by applying traction to the arm via the hand and / or forearm while secured in a limb positioning device.

[0003] Traction loads of up to 30 pounds generally require the hand to be firmly secured in a limb positioner. To accomplish this, the hand may be resting on a handle or bar and secured in a fist on the bar. The arm and hand are typically covered or encased in a sleeve, with the entire arm wrapped in an elastic bandage. The distal end of the sleeve is then attached to the limb positioner. However, this method of securing the hand can result in numbness in the patient's hand and fingers, as well as reduced control of hand and wrist rotation.

[0004] Another problem inherent in the use of limb positioners is that non-sterile limb positioners are typically clamped to the operating room table. A sterile connection is typically made to the patient by threading a sterile rope with a hook attached to its distal end through the limb positioner while a sleeve covering the patient's arm and hand is attached to the hook. However, this procedure requires a non-sterile operating assistant outside the sterile field to pass the rope to a sterile operating assistant in the sterile field, which introduces the potential for cross contamination. Summary of the Invention

[0005] Described herein is an apparatus for securing a patient's hand to a limb positioning device while evenly distributing the applied traction load across the patient's hand and wrist. The hand is placed in an open position into a soft mitten, and an anatomically shaped plate is attached to the mitten to support the palm. Straps are then secured around the patient's wrist and hand. Finally, the entire apparatus is wrapped in an elastic bandage and secured to the limb positioning device. The shape of the plate, the configuration of the mitten, and the straps advantageously combine to allow low contact pressure across the patient's hand and wrist as traction is applied. Further described herein is a sterile drape having a sterile connector and its distal end, which advantageously allows a sterile operating assistant to connect and disconnect the surgical hand wrap of the present disclosure to the limb positioning device. This allows for faster turnover between procedures by eliminating the need for a reusable (i.e., autoclavable) interface.

[0006] Further examples of the surgical hand wraps and sterile connectors of the present disclosure may include one or more of the following in any suitable combination:

[0007] In examples, a surgical hand wrap of the present disclosure includes a flexible mitten portion having an inner side and an outer side. The mitten portion is configured to encapsulate at least one of a patient's hands in an open position. The hand wrap also includes an anatomically shaped plate for supporting the palm in an open position, and at least one closeable strap for wrapping around the outer side of the mitten portion. When traction is applied to the patient's arm, the plate, mitten portion, and at least one strap combine to enable low contact pressure across the patient's hand.

[0008] In further examples, the mitten portion is comprised of at least one of urethane foam and woven polyester. In examples, the inside of the mitten portion includes a non-slip material, which may be one of SBR bonded foam, rubber, and urethane foam. In examples, an end of the at least one strap is attached to the mitten portion. In other examples, the at least one strap is free floating. In further examples, the at least one strap is secured to the plate and the hand wrap is encapsulated within the bandage. In examples, the plate is made of a polycarbonate plate. In examples, the plate has a distal portion configured to attach to a limb positioner and a curved central portion that supports the hand in an open palm position. In examples, the plate includes at least one slot configured for passage of the at least one strap. In further examples, a pad is disposed within the mitten portion for securing around the patient's wrist. The thickness of the pad is selected to be greater than the thickness of the mitten portion.

[0009] In examples, the sterile connector of the present disclosure includes a T-joint at a distal end configured to connect to a support member of a sterile hand wrap, and a shaft at a proximal end configured to mate with a receiver of a limb positioner. The connector is attached to a flexible dam portion at a distal end of a sterile cover, the cover configured to cover at least a portion of the limb positioner. In examples, the connector is made of a polymer or metal. In examples, the cover is made of a clear, polyethylene plastic. In examples, the flexible dam portion is made of rubber. In examples, the proximal end of the cover is open to cover at least a portion of the limb positioner. In examples, the cover is configured to retract and fold. In examples, the connector is attached to the flexible dam portion in an interference fit. In other examples, the connector is attached to the distal end of the cover.

[0010] These and other features and advantages will be apparent from a review of the following detailed description and associated drawings. It is to be understood that both the foregoing general description and the following detailed description are intended to be illustrative and are not restrictive of aspects of the claimed subject matter. [Brief description of the drawings]

[0011] The present disclosure will become more fully understood by reference to the detailed description in conjunction with the following figures. [Figure 1A] FIG. 1A shows a prior art surgical hand wrap. [Figure 1B] FIG. 1B shows a prior art surgical hand wrap. [Figure 1C] FIG. 1C shows the pressure distribution across the hand and wrist under a typical traction load. [Diagram 2] FIG. 2 is a cutaway view of an exemplary mitten portion of a hand wrap of the present disclosure. [Figure 3A] FIG. 3A illustrates an exemplary palm support plate of a hand wrap of the present disclosure. [Figure 3B] FIG. 3B illustrates an exemplary wrist support of a hand wrap of the present disclosure. [Figure 4] FIG. 4 illustrates an exemplary wrapping method for a hand wrap of the present disclosure. [Figure 5A] FIG. 5A is a schematic diagram of a limb positioning device for applying traction to a hand wrap of the present disclosure. [Figure 5B] FIG. 5B illustrates an exemplary sterile connector and drape for connecting a hand wrap of the present disclosure to the limb positioning device of FIG. 5A. [Figure 5C] FIG. 5C illustrates an exemplary sterile connector and drape for connecting a hand wrap of the present disclosure to the limb positioning device of FIG. 5A. [Figure 5D] FIG. 5D illustrates an exemplary sterile connector and drape for connecting a hand wrap of the present disclosure to the limb positioning device of FIG. 5A. [Figure 5E] FIG. 5E illustrates an exemplary sterile connector and drape for connecting a hand wrap of the present disclosure to the limb positioning device of FIG. 5A. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] In the following description, identical components are given the same reference numbers, whether shown in different examples. In order to illustrate the examples in a clear and concise manner, the drawings may not necessarily be to scale and certain features may be shown in some schematic form. Features described and / or illustrated with respect to one example may be used in the same or similar manner in one or more other examples and / or in combination with or instead of features of the other examples.

[0013] As used herein and in the claims, for purposes of describing and defining the present invention, the terms "about" and "substantially" are used to express the inherent degree of uncertainty that may result from any quantitative comparison, value, measurement, or other representation. The terms "about" and "substantially" are also used herein to express the degree to which a quantitative representation may vary from a specified reference without resulting in a change in the basic functionality of the subject matter in question. "Comprises," "including," and / or each plural are open-ended and include the recited parts and may include additional parts not recited. "And / or" is open-ended and includes one or more of the recited parts and combinations of the recited parts.

[0014] 1A and 1B show a prior art surgical hand wrap for attaching a patient's arm 2 and hand 4 to a limb positioner. Typically, as shown in FIG. 1A, the patient's hand 4 is rested on a handle or bar 6 and secured in a fist before being secured to the limb positioner. Portions of the arm 2 and hand 4 are placed over or covered by a flexible sleeve 8 and secured with straps 5. The entire arm 2 is then wrapped in an elastic bandage 9 as shown in FIG. 1B. The distal end of the bandage 9 is attached to a weight via a rope 7 and a series of pulleys on a limb positioner, such as the limb positioner shown in FIG. 5A. However, this method of securing the hand 4 can lead to numbness of the patient's hand 4 and fingers 1. FIG. 1C shows high contact pressure points over the patient's fingers 1 and wrist 3 under a traction load when the hand 4 and arm 2 are attached to the limb positioner in this manner. Such high contact pressure points can lead to numbness of the hand 4 and fingers 1.

[0015] Referring now to FIG. 2, a cutaway view of an exemplary surgical hand wrap 10 of the present disclosure is shown. As shown in FIG. 2, the hand wrap 10 may include a flexible mitten portion 12 having an inner side 14 and an outer side 16. The mitten portion 12 may be made of a variety of flexible plastic or cloth materials, including, but not limited to, urethane foam and woven polyester. The mitten portion 12 is configured to encapsulate at least the patient's hand 4 in an open state, which advantageously reduces the likelihood of numbness developing in the patient's hand 4 and fingers 1 during a surgical procedure. In an example, the inner side 14 of the mitten portion 12 adjacent the palm of the hand 4 includes a non-slip material, such as a styrene-butadiene rubber (SBR) bonded foam, rubber, or urethane foam. The hand 4 is secured within the mitten portion 12 by at least one closable strap 20 (such as a Velcro® strap) wrapped around the outer side 16 of the mitten portion 12. For example, straps 20 may be wrapped around mitten portion 12 adjacent the patient's hand 4 and wrist 3. Straps 20 may be secured at one end to mitten portion 12 or they may be free floating. Straps 20 are used to hold hand 4 and wrist 3 securely within mitten portion 12, but are not so tight as to prevent substantial movement of hand 4 and wrist 3, either in rotation or translation.

[0016] Once the hand 4 is secured within the mitten portion 12, the mitten portion 12 may be attached to an anatomically shaped plate 22, shown in more detail in FIG. 3A. The plate 22 is configured to support the palm of the hand 4 in an open position. In an example, the plate 22 is made of a material having adequate strength and resistance to sterilization using radiation, such as a polycarbonate plate. Notably, the plate 22 may take on a variety of sizes and shapes, so long as it is configured to hold the palm of the hand in an open position. In the example of FIG. 3A, the plate has a distal portion 23 configured to be attached to a limb positioning device. The plate 22 also includes a central portion 24, which is a curved shape that supports the fingers 1 of the hand 4. Finally, the plate 22 includes a proximal portion 25. The proximal portion 25 may include one or more slots 27 through which the strap 20 may pass to attach the mitten portion 12 to the plate 22 near the patient's wrist 3. To reduce slippage and pressure on the ulnar and radial sides of the wrist that may lead to nerve damage, the hand wrap 10 may include additional padding 29 within the mitten portion 12 that wraps around the patient's wrist, as shown in FIG. 3B. In an example, the padding may be a foam padding and may be secured to the wrist by a strap 31 wrapped around the wrist. The thickness of the padding 29 is selected to be greater than the thickness of the mitten portion 12. Finally, the hand wrap 10 is wrapped with an elastic bandage 26, as shown in FIG. 4. It is also contemplated by this disclosure that the patient's hand 4 may be secured to the plate 22 without the use of the mitten portion 12.

[0017] 5A, a limb positioner 28 is shown, the component parts of which are described in more detail below. In FIG. 5A, a patient 30 is shown lying on a standard operating table 32 and prepared for surgery. The forearm of the arm 2 to be operated on is wrapped within a hand wrap 10 of the present disclosure. The distal end of the hand wrap 10 is then attached to a weight 40 via a series of ropes 42 and pulleys 44 on the limb positioner 28. Advantageously, the shape of the plate 22, the configuration of the mitten portion 12, and the straps 20 combine to allow low contact pressure across the hand 4 and wrist 3 of the patient 30 as traction is applied to the hand wrap 10 by the limb positioner 28. In an example, the various components of the limb positioner may include telescopic or other features to lengthen or shorten the components, and / or height adjustment features to raise and lower the components.

[0018] As shown in FIG. 5B, once the hand wrap 10 is secured to the plate 22, the distal portion 23 of the plate 22 is connected to the limb positioner 28 by an exemplary sterile connector 34 of the present disclosure, shown in more detail in FIG. 5C. The sterile connector 34 may be made of a polymer, metal or other suitable material and is intended to be disposed of after use. As shown in FIG. 5C, the sterile connector 34 has a T-joint 36 at its distal end and a keyed shaft 38 at its proximal end. The T-joint 36 is configured to couple to the distal portion 23 of the plate 22 of the limb positioner 28. The shaft 38 is configured to mate with a receiver 40 permanently attached to the distal end of the limb positioner 28, as shown in FIG. 5D.

[0019] Also shown in FIG. 5D, attached to the sterile connector 34 is a flexible dam portion 42 of a sterile drape or cover 44. In an example, the proximal end of the cover 44 is open such that the cover 44 is configured to cover at least a portion of the limb positioner 28. The cover 44 may be manufactured from a variety of different materials that may be sterilized, and is preferably latex-free, such as polyethylene plastic. In an example, the cover 44 may be formed from a preformed tubular sheet of plastic material, or from multiple sheets of plastic material formed into a tube by longitudinal seams. It will be appreciated that the dimensions and configuration of the cover 44 will vary depending on the type and structure of the limb positioner or other device that the cover 44 is designed to cover. The dam portion 42 is attached to the cover 44 in an appropriate manner, such as by sonic welding or adhesive. The dam portion 42 may be manufactured from any number of flexible, non-slip materials, such as rubber. In an example, the sterile connector 34 is held within the dam portion 42 in an interference fit due to the elastic nature of the rubber. As shown in FIG. 5E, in use, the cover 44 may be telescopically folded to allow visualization of the shaft 38 of the sterile connector 34 to facilitate insertion into the receiving portion 40 of the limb positioning device 28.

[0020] In other examples, not shown, the shape of the T-fitting 36 and shaft 38 may be altered to accommodate different applications. For example, the shaft 38 may be reconfigured to be symmetrical with respect to the T-fitting 36. In other examples, the sterile connector 34 may be clamped or glued or held by a clamping ring. Additionally, the dam portion 42 may be removed, allowing the cover 44 to be attached directly to the sterile connector 34. Advantageously, the sterile connector 34 of the present disclosure allows a sterile operator to attach a sterile hand wrap 10 to the limb positioner 28 in the sterile field without the need for a non-sterile operator. This allows for faster turnover between procedures by eliminating the need for a reusable (i.e., autoclavable) interface.

[0021] Although the present disclosure has been particularly shown and described with reference to preferred embodiments thereof, those skilled in the art will understand that various changes in form and details may be made therein without departing from the spirit and scope of the present application as defined by the appended claims. Such variations are intended to be within the scope of the present application. Thus, the foregoing description of embodiments of the present application is not intended to be limiting, but rather the full scope is to be conveyed by the appended claims. [Additional note 1] 1. A surgical hand wrap for attaching a patient's arm to a limb positioning device, said hand wrap comprising: a flexible mitten portion having an inner side and an outer side, the mitten portion configured to enclose at least one hand of the patient in an open position; an anatomically shaped plate for supporting the open palm of the hand; at least one closeable strap for wrapping around the exterior of the mitten portion; A surgical hand wrap, wherein the plate, the mitten portion, and the at least one strap combine to allow low contact pressure across the patient's hand when traction is applied to the patient's arm. [Additional note 2] 2. The surgical hand wrap of claim 1, wherein the mitten portion is made of at least one of urethane foam and polyester fabric. [Additional note 3] 2. The surgical hand wrap of claim 1, wherein the inside of the mitten portion comprises an anti-slip material. [Additional note 4] 4. The surgical hand wrap of claim 3, wherein the anti-slip material is one of SBR bonded foam, rubber, and urethane foam. [Additional note 5] 2. The surgical hand wrap of claim 1, wherein an end of the at least one strap is attached to the mitten portion. [Additional note 6] 2. The surgical hand wrap of claim 1, wherein the at least one strap is free floating. [Additional note 7] 2. The surgical hand wrap of claim 1, wherein the at least one strap is secured to the plate. [Additional note 8] 2. The surgical hand wrap of claim 1, wherein the hand wrap is enclosed within a bandage. [Additional note 9] 2. The surgical hand wrap of claim 1, wherein the plate is made of polycarbonate. [Additional Note 10] 2. The surgical hand wrap of claim 1, wherein the plate includes a distal portion configured for attachment to the limb positioning device. [Additional Note 11] 2. The surgical hand wrap of claim 1, wherein the plate includes a curved central portion for supporting the palm in an open position. [Additional Note 12] 2. The surgical hand wrap of claim 1, wherein the plate includes at least one slot configured for passage of at least one strap. [Additional Note 13] 2. The surgical hand wrap of claim 1, further comprising a pad disposed within the mitten portion for securing around the patient's wrist, the thickness of the pad being selected to be greater than the thickness of the mitten portion. [Additional Note 14] 1. A sterile connector for attaching a surgical hand wrap to a limb positioning device, said connector comprising: a T-fitting at a distal end adapted to connect to a support member of a sterile hand wrap; a shaft at a proximal end configured to mate with a receiver of the limb positioning device; A sterile connector, the connector being attached to a flexible dam portion at a distal end of a sterile cover, the cover being configured to cover at least a portion of the limb positioning device. [Additional Note 15] 15. The connector of claim 14, wherein the connector is made of a polymer or metal. [Additional Note 16] 15. The connector of claim 14, wherein the cover is made of a transparent, polyethylene plastic. [Additional Note 17] 15. The connector of claim 14, wherein the flexible dam portion is made of rubber. [Additional Note 18] 15. The connector of claim 14, wherein a proximal end of the cover is open to cover at least a portion of the limb positioning device. [Additional Note 19] The connector of claim 14, wherein the cover is configured to be folded in a telescopic manner. [Additional Note 20] 15. The connector of claim 14, wherein the connector is attached to the flexible dam portion in an interference fit.

Claims

1. A surgical hand wrap (10) for attaching a patient's arm to a limb positioning device and holding the arm in traction during a surgical procedure, the hand wrap comprising: a flexible mitten portion (12) having an inner side (14) and an outer side (16), the mitten portion being configured to encircle at least one of the patient's hands in an open position; a plate (22) for holding the palm in an open position, said plate having a distal portion (23) for attachment to said limb positioning device and a proximal portion (25); at least one closeable strap (20) for wrapping around the exterior of the mitten portion; when traction is applied to the patient's arm via the distal portion of the plate, the plate, the mitten portion, and the at least one strap combine to enable low contact pressure across the patient's hand; the plate (22) includes a curved central portion (24) for holding the palm in an open position; At least one of the straps (20) is secured to the plate (22); A surgical hand wrap, wherein the central portion (24) is disposed between the distal portion (23) and the proximal portion (25) of the plate (22).

2. The surgical hand wrap of claim 1, wherein the mitten portion (12) is comprised of at least one of urethane foam and woven polyester.

3. The surgical hand wrap of claim 1, wherein the inner side (14) of the mitten portion includes an anti-slip material.

4. The surgical hand wrap of claim 3 , wherein the anti-slip material is one of SBR bonded foam, rubber, and urethane foam.

5. The surgical hand wrap of claim 1, wherein an end of at least one of said straps (20) is attached to said mitten portion.

6. 2. The surgical hand wrap of claim 1, wherein the hand wrap (10) is surrounded by a dressing (26).

7. The surgical hand wrap of claim 1, wherein the plate (22) is made of polycarbonate.

8. The surgical hand wrap of claim 1, wherein the plate (22) includes at least one slot configured for passage of at least one strap.

9. 10. The surgical hand wrap of claim 1, further comprising a pad (29) disposed within the mitten portion for securement around the patient's wrist, the pad having a thickness selected to be greater than a thickness of the mitten portion.

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