Lower-limb traction device

Abstract

[Problem] To provide a lower-limb traction device comprising a boot that can firmly hold the range from around the calf to the toes of a patient. [Solution] A brace boot (10) adapted for a lower-limb traction device (1) is configured such that a calf holding unit (46) that holds the calf area of a patient and a sole holding unit (47) that holds the sole of the foot of the patient are connected to each other so as to rotate freely around a pair of support pins (92) and (92). Said configuration enables the brace boot (10) to firmly hold the range from around the calf to the toes of a patient, even for a patient suffering from, for example, ankle plantar flexion contracture in which the toes are flexed and contracted.

Description

Lower limb traction device

[0001] The present invention relates to a lower limb traction device for traction of the lower limbs of a patient on an operating table, which is used mainly for femoral fracture surgery and the like, and in particular to a boot used in the lower limb traction device, which supports the patient in the area from near the calf to the toes.

[0002] Patent Document 1 discloses a boot used in a lower limb traction device. Specifically, the surgical boot described in Patent Document 1 includes a shell body having a sole configured to support the sole of a patient's foot and a calf support configured to support the patient's calf, the sole and calf support being integrated into a generally L-shaped shell body in a side view so that the sole and calf support are perpendicular to each other. The calf support is integrally connected to the sole and extends above the heel end of the sole.

[0003] U.S. Patent No. 9,655,764

[0004] However, in the surgical boot described in Patent Document 1, the sole configured to support the sole of the patient's foot and the calf support portion supporting the patient's calf are integrated into a generally L-shaped configuration in a side view, perpendicular to each other. Therefore, for example, in the case of a patient suffering from ankle plantar flexion contracture, in which the toes are plantar flexed and contracted, it is not possible to firmly support the area from the patient's calf to the toes. In other words, even if the boot is tightened with a tightening band or the like, the patient's sole cannot be brought into contact with or into close contact with the support surface of the sole, resulting in instability and the risk of not being able to firmly support the area from the calf to the toes. As a result, the lower limb cannot be sufficiently tractioned, which may cause inconvenience during surgery. In short, boots used in lower limb traction devices are required to firmly support the area from the calf to the toes, even for patients suffering from ankle plantar flexion contracture.

[0005] The present invention has been made in consideration of the above points, and has as its object to provide a lower limb traction device equipped with a boot that can firmly hold the patient in the area from near the calf to the toes.

[0006] As a means for solving the above problems, the invention of claim 1 relates to a lower limb traction device that is attached to an operating table and traction the lower limb of a patient on the operating table, and is characterized in that it includes a boot having a calf holding unit that holds the area around the patient's calf and a sole holding unit that holds the sole of the patient's foot, the sole holding unit and the calf holding unit being rotatably connected to each other. In the invention of claim 1, the sole holding unit and the calf holding unit are rotatably connected to each other, so that the sole holding unit and the calf holding unit can be rotated relative to each other to match the shape (form) of the patient from the area around the calf to the toes. This allows the sole of the patient's foot to be closely attached to the support surface of the sole holding unit, and the calf holding unit and the sole holding unit can firmly hold the area from the area around the calf to the toes of the patient.

[0007] The invention of claim 2 relating to the lower limb traction device is the invention of claim 1, characterized in that the sole holding unit and the calf holding unit are connected to be rotatable in a range of an intersection angle of 90° to an intersection angle of 120° in side view. In the invention of claim 2, particularly in the case of a patient suffering from ankle plantar flexion contracture in which the toes are plantar flexed and contracted, the sole of the patient's foot can be brought into close contact with the support surface of the sole holding unit, and the calf holding unit and sole holding unit can firmly hold the area from near the calf to the toes of the patient.

[0008] The invention of claim 3 relating to the lower limb traction device is the invention of claim 2, characterized in that the sole holding unit and the calf holding unit are configured to be lockable at a plurality of positions within a range of an intersection angle of 90° to an intersection angle of 120° in side view. In the invention of claim 3, the intersection angle (rotation angle) between the sole holding unit and the calf holding unit can be selected and fixed according to the degree of ankle plantar flexion contracture of the patient undergoing surgery, particularly in which the toes are plantar flexed and contracted. This allows the sole of the patient's foot to be brought into close contact with the support surface of the sole holding unit, and the calf holding unit and sole holding unit can firmly hold the area from the calf to the toes of the patient.

[0009] The invention of claim 4 relating to the lower limb traction device is the invention of claim 1, characterized in that the sole holding unit includes an elastically deformable thin-walled sole holding portion, and the calf holding unit includes an elastically deformable thin-walled calf holding portion. In the invention of claim 4, when the patient's toes are placed in the sole holding unit and the toe restraining bands that restrain the patient's toes are tightened, the thin-walled sole holding portion elastically deforms to encase the toes, thereby allowing the toes to be pressed (compressed) over an area rather than locally, and the entire toes to be firmly held. Meanwhile, when the patient's calf area is placed in the calf holding unit and the calf restraining bands that restrain the patient's calf area are tightened, the thin-walled calf holding portion elastically deforms to encase the calf area, allowing the calf area to be pressed (compressed) over an area rather than locally, and the entire calf to be firmly held.

[0010] The invention of claim 5 relating to the lower limb traction device is the invention of claim 4, characterized in that toe restraint bands that restrain the toes of the patient are respectively fixed to the outside of the sole-holding-side thin portions, and calf restraint bands that restrain the area near the patient's calves are respectively fixed to the outside of the calf-holding-side thin portions. In the invention of claim 5, since the toe restraint bands are respectively fixed to the outside of the sole-holding-side thin portions, by tightening the toe restraint bands, the pressure (pressure) from the toe restraint bands can forcibly elastically deform the sole-holding thin portions toward the feet, thereby enveloping and holding the toes. Meanwhile, since the calf restraint bands are respectively fixed to the outside of the calf-holding-side thin portions, by tightening the calf restraint bands, the pressure (pressure) from the calf restraint bands can forcibly elastically deform the calf-holding side thin portions toward the calves, thereby enveloping and holding the area near the calves.

[0011] The invention of claim 6 relating to a lower limb traction device is the invention of claim 1, characterized in that the tarsal restraint bands that restrain the patient's tarsal are each rotatably supported by support pins that rotatably support the sole support unit and the calf support unit relative to each other. In the invention of claim 6, the biasing force of the tarsal restraint bands can accurately press and hold the tarsal (near the ankle) toward the heel, thereby firmly holding the area from the patient's calf to the toes. Furthermore, because the tarsal restraint bands are rotatably supported by the support pins, they can be positioned at any angle to match the patient's tarsal.

[0012] The boots employed in the lower limb traction device according to the present invention can firmly hold the area from the calf to the toes of a patient, even if the patient suffers from ankle plantar flexion contracture, in which the toes are plantar flexed and contracted.

[0013] FIG. 1 is a schematic perspective view of a lower limb traction device according to this embodiment. FIG. 2 is a schematic perspective view of a traction unit employed in the lower limb traction device according to this embodiment. FIG. 3 is a schematic perspective view of a fitted boot employed in the lower limb traction device according to this embodiment. FIG. 4 is a schematic perspective view of a fitted boot employed in the lower limb traction device according to this embodiment. FIG. 5 is a schematic perspective view of a fitted boot employed in the lower limb traction device according to this embodiment. FIG. 6 is a schematic perspective view of a calf supporting member of a calf supporting unit employed in the fitted boot employed in the lower limb traction device according to this embodiment. FIG. 7 is a schematic perspective view of a sole supporting member of a sole supporting unit employed in the fitted boot employed in the lower limb traction device according to this embodiment. FIG. 8 is a side view of a fitted boot employed in the lower limb traction device according to this embodiment when the intersection angle θ between the calf supporting unit and the sole supporting unit is 90°. FIG. 9 is a cross-sectional view showing an angle adjustment mechanism in a state where the intersection angle θ between the calf supporting unit and the sole supporting unit of the fitted boot employed in the lower limb traction device according to this embodiment is locked at 90°. Fig. 10 is a cross-sectional view showing the angle adjustment mechanism in an unlocked state when the intersection angle θ between the calf support unit and the sole support unit of the fitted boot employed in the lower limb traction device according to this embodiment is 90°. Fig. 11 is a side view showing the angle adjustment mechanism when the intersection angle θ between the calf support unit and the sole support unit of the fitted boot employed in the lower limb traction device according to this embodiment is 120°. Fig. 12 is a cross-sectional view showing the angle adjustment mechanism in a locked state when the intersection angle θ between the calf support unit and the sole support unit of the fitted boot employed in the lower limb traction device according to this embodiment is 120°. Fig. 13 is a perspective view showing the state in which the patient is wrapped in cushioning material or the like from the calf to the toes and set in the fitted boot employed in the lower limb traction device according to this embodiment.

[0014] Hereinafter, an embodiment of the present invention will be described in detail with reference to FIGS. 1 to 13. Referring to FIG. 1, a lower limb traction device 1 according to this embodiment is attached to an operating table 5 and traction the lower limbs of a patient placed on the operating table 5. The lower limb traction device 1 is used for surgery, mainly for fractures of the patient's femur. The lower limb traction device 1 includes a pair of lower limb traction bodies 3, 3 corresponding to both legs of the patient. Each of the pair of lower limb traction bodies 3, 3 is attached to the operating table 5. Note that FIG. 1 shows only one lower limb traction body 3 of the lower limb traction device 1. The lower limb traction body 3 includes a support pipe 8 having one axial end attached to the operating table 5, a traction device 9 detachably attached to the support pipe 8, and a fitting boot 10 detachably attached to the traction device 9.

[0015] 1, the support pipe 8 is configured to be rotatable in any direction around a connecting portion (ball joint) 12 with the operating table 5, which is located at one end in the axial direction. An operating handle 14 is provided at the other end in the axial direction of the support pipe 8. An operator such as a surgical staff member in the operating room can grasp the operating handle 14 to move the support pipe 8 to a desired position and then fix it at that desired position. Referring to FIGS. 1 and 2, the support pipe 8 is provided with a slider 16 that is slidable along its axial direction.

[0016] The slider 16 is provided with an axial position handle 18 and a vertical position handle 19. The axial position handle 18 is operated when restraining or releasing the position of the slider 16 along the axial direction relative to the support pipe 8. The vertical position handle 19 is operated when restraining or releasing the position of a crankshaft 21 of the traction device 9 (described later) along the vertical direction relative to the support pipe 8. By operating the axial position handle 18 and the vertical position handle 19 by an operator such as a surgical staff member in an operating room, the axial and vertical positions of the traction device 9 relative to the support pipe 8 can be set, respectively.

[0017] 2, the traction device 9 includes a crankshaft 21 bent into a crank shape, and a traction shaft 22 connected to the upper end of the crankshaft 21 and extending horizontally. The crankshaft 21 includes a lower vertical shaft portion 24, a horizontal shaft portion 25 having one axial end connected to the upper end of the lower vertical shaft portion 24, and an upper vertical shaft portion 26 connected to the other axial end of the horizontal shaft portion 25. The upper end of the upper vertical shaft portion 26 of the crankshaft 21 is connected to the traction shaft 22. The lower vertical shaft portion 24 of the crankshaft 21 is connected to the slider 16 so as to be slidable up and down.

[0018] The traction shaft 22 is configured by connecting multiple shaft members 22A, 22A, and includes a traction mechanism 29, a rotation mechanism 30, an ankle direction adjustment mechanism 31, and a boot attachment / detachment unit 32. Although a detailed structural description of the traction mechanism 29 is omitted, the traction mechanism 29 is configured to extend or retract the entire traction shaft 22 along the axial direction by an operator, such as a surgical staff member in an operating room, rotating a traction handle 35 provided at one axial end of the traction shaft 22 in forward or reverse directions. Although a detailed structural description of the rotation mechanism 30 is omitted, the operator, such as a surgical staff member in an operating room, loosens a first rotation handle 37 and turns a second rotation handle 38 to rotate (pivot) the entire traction shaft 22 around its axis, and then tightens the first rotation handle 37 to fix the traction shaft 22 at a desired position along the rotation direction.

[0019] Although a detailed description of the ankle direction adjustment mechanism 31 will be omitted, an operator, such as a surgical staff member in an operating room, loosens the adjustment handle 40 to rotate the other axial end of the traction shaft 22, including the boot attachment / detachment portion 32, in any direction around the ball joint portion 41, and then tightens the adjustment handle 40 to fix the other axial end, including the boot attachment / detachment portion 32, in any position. The boot attachment / detachment portion 32 is provided at the other axial end of the traction shaft 22. The boot attachment / detachment portion 32 is composed of a detachment plate portion 43 that is generally rectangular in front view. By attaching this boot attachment / detachment portion 32 to a traction shaft attachment portion 76 (see FIG. 3 ) provided on the fitting boot 10, which will be described later, the fitting boot 10 is firmly fixed to the boot attachment / detachment portion 32.

[0020] Next, the fitting boot 10 will be described in detail with reference to Figures 3 to 13. The fitting boot 10 can firmly encase and support the area from the patient's calf to the sole of the foot. The fitting boot 10 can be adapted to fit the patient's shape (form) from the calf to the toes. In more detail, with reference to Figures 3 to 5, the fitting boot 10 includes a calf support unit 46 that supports the area around the patient's calf, a sole support unit 47 that supports the sole of the patient's foot, and an angle adjustment mechanism 48 that can adjust the intersection angle θ (rotation angle θ) between the calf support unit 46 and the sole support unit 47. The calf support unit 46 and the sole support unit 47 are rotatably connected around a pair of support pins 92, 92, which will be described later.

[0021] Specifically, the calf support unit 46 and the sole support unit 47 are connected so as to be rotatable within a range from a position where they form an L-shape that is perpendicular to each other in side view, i.e., a position where the crossing angle θ is 90° (see FIG. 8), to a position where they form an inverted V-shape that separates them, i.e., a position where the crossing angle θ is 120° (see FIG. 11).More specifically, within the above-mentioned rotation range, the calf support unit 46 and the sole support unit 47 can be locked by the angle adjustment mechanism 48 at four different crossing angles θ in side view: 90°, 100°, 110°, and 120°.

[0022] 3 to 6, the calf support unit 46 includes a calf support member 51 that is generally U-shaped in front view and supports the area around the patient's calves from below, and a calf restraint band 52 that is connected to the calf support member 51 and restrains the area around the patient's calves. The calf support member 51 is made of a nylon resin. Referring to FIG. 6, the calf support member 51 is formed with a calf support side thin-walled portion 54 that is easily elastically deformable on the longitudinal head side of the calf support member 51, except for an area to which a pair of connecting holes 57, 57 (described below) are connected. The opposing wall of the calf support side thin-walled portion 54 is formed in a gentle mountain shape in side view. The opposing wall of the calf support side thin-walled portion 54 (head side) is formed with fixing holes 64, 64 for fixing the calf restraint band 52. Connecting holes 57, 57 for connecting the angle adjustment mechanism 48 (described below) are protruded from the outer surface of the bottom of the calf support side thin-walled portion 54. A pair of connecting holes 57, 57 are provided at an interval along the width direction of the calf holding member 51.

[0023] A calf holding side thick section 55 that is thicker than the calf holding side thin section 54 is formed longitudinally from the calf holding side thin section 54 toward the toes. In side view, the calf holding side thick section 55 is shorter than the calf holding side thin section 54 and is inclined slightly upward toward the toes. The calf holding side thick section 55 of the calf holding member 51 has an inwardly recessed relief recess 59 formed in the bottom of the toe-side end. Insertion holes 62, 62 are formed in the opposing wall sections of the calf holding side thick section 55, closer to the toes. A pair of support pins 92, 92 (see Figures 3 to 5) that rotatably connect the calf holding unit 46 and the sole holding unit 47 to each other are inserted into the pair of insertion holes 62, 62, respectively.

[0024] 3 to 5, the calf restraint bands 52 restrain the area around the patient's calves. The calf restraint bands 52 employ a ratchet mechanism. The calf restraint bands 52 are comprised of a rack-shaped band 66, a long, thin, flat plate with numerous teeth (claws), and a buckle band 67 that restrains and releases the rack-shaped band at any position along its length. The rack-shaped band 66 and buckle band 67 of the calf restraint band 52 are fixed to a pair of fixing holes 64, 64 (see FIG. 6) that form opposing walls of the calf-holding-side thin-walled portion 54 of the calf holding member 51 so as to abut against the outer surfaces of the walls. The rack-shaped band 66 of the calf restraint band 52 is not shown in FIG. 5. The buckle 67A of the buckle band 67 is only shown in FIG. 13.

[0025] 3 to 5 and 7, the sole support unit 47 includes a sole support member 69 that supports the sole of the patient's foot, and a toe restraining band 70 that is connected to the sole support member 69 and restrains the toes (sole) of the patient. Referring to Fig. 7, the sole support member 69 is made of a nylon resin. The sole support member 69 includes a sole support plate 72 that supports the sole of the foot, a pair of toe clamping plates 73, 73 that stand upright from both widthwise ends of the sole support plate 72 and sandwich the toes on both the left and right sides, and a curved support plate 74 that is connected to the heel-side ends of the pair of toe clamping plates 73, 73 and supports the angle adjustment mechanism 48 (see Figs. 3 to 5), which will be described later.

[0026] The sole support plate 72 is formed in a generally rectangular shape when viewed from the front. Referring to Fig. 4, a traction shaft mounting part 76 is fixed to the outer surface of the sole support plate 72. The traction shaft mounting part 76 is detachably mounted with the boot attachment / detachment part 32 (detachable plate part 43) (see Fig. 2) provided at the other axial end of the traction shaft 22. The traction shaft mounting part 76 includes a pair of mounting guide parts 77, 77 that guide the boot attachment / detachment part 32 (detachable plate part 43) of the traction shaft 22, and a fixture 78 that fixes the boot attachment / detachment part 32 guided between the pair of mounting guide parts 77, 77. When an operator such as a surgical staff member in the operating room attaches the fitted boot 10 to the boot attachment / detachment portion 32 of the traction shaft 22 of the traction device 9, the operator inserts the attachment / detachment plate portion 43 (see Figure 2), which is the boot attachment / detachment portion 32 of the traction shaft 22, between the pair of attachment guide portions 77, 77 of the traction shaft attachment portion 76 of the fitted boot 10, and tightens the fixing device 78, thereby attaching the fitted boot 10 to the boot attachment / detachment portion 32 of the traction shaft 22 of the traction device 9.

[0027] Referring to Figure 7, the entire toe clamping plate 73 is formed with a thin sole-holding section 79 that is easily elastically deformable. Each of the pair of toe clamping plates 73 (thin sole-holding sections 79) has fixing holes 81 formed near the toes for fixing the toe restraining band 70. Referring to Figures 3 to 5, the toe restraining band 70 restrains the toes of a patient. The toe restraining band 70 employs a ratchet mechanism, similar to the calf restraining band 52. The toe restraining band 70 is composed of a rack-shaped band 83 having a large number of teeth (claws) formed on a thin, elongated plate, and a buckle-equipped band 84 that restrains and releases the rack-shaped band 83 at any position along its length. The rack-shaped band 83 and the buckled band 84 of the toe restraining band 70 are fixed to a pair of fixing holes 81, 81 (see FIG. 7) so as to abut against the outer surfaces of the pair of toe clamping plates 73, 73 (thin portions 79, 79 on the sole holding side). Note that the buckle 84A of the buckled band 84 is only shown in FIG. 13.

[0028] Referring to Figure 7, the curved support plate portion 74 is thicker than the toe clamping plate portion 73 (sole-supporting-side thin portion 79). Insertion holes 86, 86 are formed in opposing walls of the curved support plate portion 74 near the connection portion with the pair of toe clamping plates 73, 73. A pair of support pins 92, 92 (see Figures 3 to 5) that rotatably connect the calf support unit 46 and the sole support unit 47 are inserted into the pair of insertion holes 86, 86, respectively. Support holes 88, 88 protrude outward from the approximate circumferential center of the curved support plate portion 74 for supporting the angle adjustment mechanism 48 (see Figures 3 to 5), which will be described later. A pair of support holes 88, 88 are provided at a distance along the width direction of the sole support unit 47. A space 90 is formed between the curved support plate portion 74 and the heel side of the sole support plate portion 72.

[0029] 3 to 5, the calf supporting side thick portion 55 of the calf supporting unit 46 is positioned inside the curved support plate portion 74 of the sole supporting unit 47, and a pair of support pins 92 are inserted through a pair of insertion holes 62 (see FIG. 6) formed in the calf supporting side thick portion 55 of the calf supporting unit 46 and a pair of insertion holes 86 (see FIG. 7) formed in the curved support plate portion 74 of the sole supporting unit 47. As a result, the calf supporting unit 46 and the sole supporting unit 47 are connected to each other so that they can rotate freely around the pair of support pins 92. At this time, referring to FIG. 5, a heel accommodation space 94 is formed by the relief recess 59 formed in the calf supporting side thick portion 55 of the calf supporting unit 46 (calf supporting member 51) and a space 90 between the curved support plate portion 74 and the heel side of the sole supporting plate 72.

[0030] The tarsal restraint bands 96 restrain the patient's ankles. Like the calf restraint bands 52, the tarsal restraint bands 96 also employ a ratchet mechanism. The tarsal restraint bands 96 are also comprised of a rack-shaped band 98, a long, thin, flat plate with numerous teeth (claws), and a buckle-equipped band 99 that restrains and releases the rack-shaped band 98 at any position along its length. The rack-shaped band 98 and the buckle-equipped band 99 of the tarsal restraint band 96 are rotatably supported by a pair of support pins 92, 92 that extend into the gap between the calf-supporting-side thick portion 55 of the calf support unit 46 and the curved support plate portion 74 of the sole support unit 47. This allows the tarsal restraint band 96 to be positioned at any angle to match the patient's ankles. Note that the rack-shaped band 98 of the tarsal restraint band 96 is not shown in FIG. 5 . The buckle 99A of the buckle band 99 is only shown in FIG.

[0031] 3 to 5, the angle adjustment mechanism 48 is disposed between a pair of connecting holes 57, 57 on the calf support unit 46 side and a pair of support holes 88, 88 on the sole support unit 47 side. Referring to FIGS. 4 and 9, the angle adjustment mechanism 48 includes a telescopic shaft 100 that extends telescopically between the pair of connecting holes 57, 57 on the calf support unit 46 side and the pair of support holes 88, 88 on the sole support unit 47 side, a slide piece 101 that slides radially relative to the telescopic shaft 100 to telescopically release the telescopic shaft 100 and lock it in a predetermined position, and a lock spring 102 that biases the slide piece 101 in a direction that locks the telescopic shaft 100. The telescopic shaft 100 is made of a stainless steel alloy. One end of the telescopic shaft 100 is fixed to a small-diameter support shaft 104 by a fixing pin 105. The small diameter support shaft 104 is rotatably supported in a pair of connecting holes 57, 57 on the calf support unit 46 side. The small diameter support shaft 104 is made of an aluminum alloy. The telescopic shaft 100 has a plurality of annular locking grooves 106 formed on its outer circumferential surface at intervals in the axial direction. In this embodiment, the locking grooves 106 are formed in four locations at equal intervals.

[0032] In this embodiment, four locking grooves 106 are formed in the telescopic shaft 100, sequentially from the pair of connecting holes 57 on the calf support unit 46 side toward the pair of support holes 88 on the sole support unit 47 side, and correspond to the intersection angles of 120°, 110°, 100°, and 90° between the calf support unit 46 and the sole support unit 47. A radially protruding anti-detachment flange 108 is formed on the other end of the telescopic shaft 100. The sliding piece 101 is an operation button used to adjust the intersection angle θ between the calf support unit 46 and the sole support unit 47, and is composed of a cylindrical sliding piece main body 111 and a positioning shaft portion 112 extending from one end face of the sliding piece main body 111. The sliding piece 101 is made of a stainless steel alloy.

[0033] The positioning shaft portion 112 is formed with a diameter considerably smaller than that of the sliding top body 111. A through hole 114 is formed in the sliding top body 111 in the radial direction. The through hole 114 is formed to be slightly longer in the axial direction. A locking claw 116 is provided at the radial center of the inner circumferential surface of the through hole 114 on the side where the positioning shaft portion 112 extends, protruding inward along the circumferential direction within a predetermined range (within a central angle of 180°). The locking claw 116 can engage with each locking groove 106 provided on the outer circumferential surface of the telescopic shaft 100.

[0034] A large-diameter support shaft 118 is rotatably supported in the pair of support holes 88, 88 on the sole support unit 47 side. The large-diameter support shaft 118 is made of an aluminum alloy. The large-diameter support shaft 118 has a larger diameter than the small-diameter support shaft 104, which is rotatably supported in the pair of connecting holes 57, 57 on the calf support unit 46 side. The large-diameter support shaft 118 is formed in a cylindrical shape with both axial ends closed. A shaft insertion hole 120, through which the telescopic shaft 100 is inserted, is provided radially at approximately the center of the large-diameter support shaft 118 in the axial direction. A large-diameter recess 122, which is larger in diameter than the shaft insertion hole 120, is formed on the outer circumferential surface of the large-diameter support shaft 118 and continues from one end of the shaft insertion hole 120.

[0035] Furthermore, a large diameter insertion hole 125 is formed in the large diameter support shaft 118 so as to be perpendicular to the shaft insertion hole 120. A small diameter insertion hole 126, which is continuous with the large diameter insertion hole 125 and has a smaller diameter than the large diameter insertion hole 125, is formed in the large diameter support shaft 118. The slide piece main body 111 is slidably inserted into the large diameter insertion hole 125 of the large diameter support shaft 118, and the positioning shaft portion 112 is slidably inserted into the small diameter insertion hole 126.

[0036] The telescopic shaft 100 is inserted into the shaft insertion hole 120 of the large-diameter support shaft 118 and into the through-hole 114 provided in the slide-top body 111 of the slide-top 101, with its retaining flange 108 positioned in the large-diameter recess 122 provided on the outer circumferential surface of the large-diameter support shaft 118. This retaining flange 108 prevents the telescopic shaft 100 from slipping out of the shaft insertion hole 120 provided in the large-diameter support shaft 118. A locking spring 102 is disposed between the wall surface around the small-diameter insertion hole 126 provided in the large-diameter support shaft 118 and one end surface around the positioning shaft 112 of the slide-top body 111. The locking spring 102 biases the slide-top body 111 away from the wall surface. The locking spring 102 is made of a stainless steel alloy.

[0037] Next, the operation of the angle adjustment mechanism 48 will be described. First, referring to Figures 8 and 9, in the initial state, when the calf support unit 46 and the sole support unit 47 are in a generally L-shaped position in side view (a position perpendicular to each other), the biasing force of the locking spring 102 causes the slide-top body 111 of the slide top 101 to slide in the locking direction, i.e., in the direction in which the slide top body 111 protrudes from the outer circumferential surface of the large-diameter support shaft 118, whereby the locking claw 116 of the slide top 101 engages with the locking groove 106 closest to the anti-detachment flange 108 of the telescopic shaft 100, and the telescopic shaft 100 is locked in this position, i.e., at its most extended position between the pair of connecting holes 57, 57 on the calf support unit 46 side and the pair of support holes 88, 88 on the sole support unit 47 side. In this locked state, the slide body 111 of the slide 101 , which is the operation button, is in a state of being largely protruded outward from the outer circumferential surface of the large diameter support shaft 118 .

[0038] Next, when adjusting the intersection angle θ between the calf holding unit 46 and the sole holding unit 47 from this initial state, for example, to set the intersection angle θ to 120°, an operator such as a staff member in the operating room presses the slide body 111 of the slide 101 (operation button) that protrudes significantly from the outer circumferential surface of the large-diameter support shaft 118, as shown in Figure 10. This causes the slide 101 to slide in the unlock direction against the biasing force of the locking spring 102, i.e., in the direction in which the slide body 111 is pushed into the large-diameter insertion hole 125 of the large-diameter support shaft 118, causing the locking claw 116 of the slide 101 to come out of the locking groove 106 of the telescopic shaft 100, and the telescopic shaft 100 to become free along its axial direction.

[0039] 11 and 12 , while pushing in the slide body 111 of the slide piece 101, the sole holding unit 47 is tilted away from the calf holding unit 46, and the pushing operation on the slide body 111 of the slide piece 101 is released just before the telescopic shaft 100 reaches its most contracted state between the pair of connecting holes 57, 57 on the calf holding unit 46 side and the pair of support holes 88, 88 on the sole holding unit 47 side. Then, due to the biasing force of the locking spring 102, the slide piece 101 slides in the locking direction, and the locking claws 116 of the slide piece 101 abut against the outer circumferential surface of the telescopic shaft 100. Next, when the inclination (intersection angle θ) of the sole holding unit 47 relative to the calf holding unit 46 is finely adjusted so that it gradually increases, the force of the locking spring 102 causes the locking claw portion 116 of the slide piece 101 to engage with the locking groove portion 106 located fourth from the anti-detachment flange portion 108 of the telescopic shaft 100 (the locking groove portion 106 closest to the pair of connecting holes 57, 57), and it is locked in that position.

[0040] When adjusting the intersection angle θ between the calf support unit 46 and the sole support unit 47, for example, when setting the intersection angle θ to 100° or 110°, the same operation as described above can be performed. That is, when the intersection angle θ is set to 100°, the above-described operation can be performed so that the locking claw 116 of the sliding piece 101 engages with the locking groove 106 located second from the anti-removal flange 108 of the telescopic shaft 100, and when the intersection angle θ is set to 110°, the above-described operation can be performed so that the locking claw 116 of the sliding piece 101 engages with the locking groove 106 located third from the anti-removal flange 108 of the telescopic shaft 100.

[0041] In other words, when adjusting the intersection angle θ between the calf holding unit 46 and the sole holding unit 47, an operator such as a surgical staff member in the operating room pushes the slide body 111 of the slide 101 to free the telescopic shaft 100. Then, when the sole holding unit 47 is tilted away from the calf holding unit 46 and reaches near the desired intersection angle θ, the operator releases the pushing operation on the slide body 111 of the slide 101 and fine-tunes the intersection angle θ. Then, due to the bias of the locking spring 102, the locking claw 116 of the slide 101 engages with the desired locking groove 106 of the telescopic shaft 100, completing the locking operation.

[0042] 13 , when the patient's body from the calf to the toes is placed in the fitted boot 10, the patient's body from the calf to the toes is wrapped in cushioning material 130 (cushioning material) or the like. Next, in the case of a patient suffering from ankle plantar flexion contracture, in which the toes are plantar flexed and contracted, an operator, such as a surgical staff member in the operating room, roughly adjusts the intersection angle θ between the calf support unit 46 and the sole support unit 47 according to the degree of plantar flexion using the procedure described above. Next, with the patient's body from the calf to the toes wrapped in cushioning material 130, the patient is placed on the calf support member 51 of the calf support unit 46, and the sole of the patient's foot is placed in close contact with the sole support plate 72 provided on the sole support member 69 of the sole support unit 47. At this stage, if the intersection angle θ between the calf support unit 46 and the sole support unit 47 needs to be adjusted again, the procedure described above is used.

[0043] Next, the rack-shaped band 98 of the tarsal restraint band 96 is inserted into the buckle 99A of the buckled band 99 over the patient's tarsal (the cushioning material 130) and tightened. This presses the tarsal region toward the heel, so that the sole of the foot, including the cushioning material 130, is tightly fitted to the sole support plate 72 of the sole support unit 47 (sole support member 69) without any large gaps, and the heel is firmly held within the heel accommodation space 94 (see FIG. 5).

[0044] Next, the rack-shaped band 66 of the calf restraint band 52 is inserted into the buckle 67A of the buckled band 67 above the patient's shin (the cushioning material 130) and tightened. Then, due to the pressure (pressure) from the calf restraint band 52, the opposing wall of the calf-holding-side thin-walled portion 54 of the calf holding unit 46 (calf holding member 51) elastically deforms to forcibly encase the area near the calf, allowing the calf-holding-side thin-walled portion 54 to press (press) the entire area near the calf in a planar manner rather than locally, thereby firmly holding the entire calf.

[0045] At approximately the same time, the rack-shaped band 83 of the toe restraining band 70 is inserted into the buckle 84A of the buckled band 84 on the instep (buffer material 130) of the patient's foot and tightened. Then, due to the pressure (pressure) from the toe restraining band 70, the pair of toe clamping plates 73, 73 (sole-holding-side thin portions 79, 79) of the sole-holding unit 47 (sole-holding member 69) elastically deform to forcibly encase the toes, and the pair of toe clamping plates 73, 73 can apply pressure (pressure) not locally but in a planar manner, particularly on both the left and right sides of the toes. In this way, the patient's calves and toes can be firmly held by the calf-holding unit 46 (calf-holding member 51) and the sole-holding unit 47 (sole-holding member 69). In addition, the order in which the calf restraint band 52 and the toe restraint band 70 are fastened can be any order; in other words, the order in which the tarsal restraint band 96, the calf restraint band 52 and the toe restraint band 70 are fastened is not limited to the order described above, and the order can be changed as appropriate.

[0046] In the fitting boot 10 employed in the lower limb traction device 1 according to the present embodiment described above, the calf holding unit 46, which holds the area around the patient's calves, and the sole holding unit 47, which holds the soles of the patient's feet, are rotatably connected to each other about a pair of support pins 92, 92. As a result, the sole holding unit 47 and the calf holding unit 46 can be rotated relative to each other to match the shape of the area from the area around the patient's calves to the toes. This allows the soles of the patient's feet to be closely fitted to the sole support plate portion 72 of the sole holding unit 47 (sole holding member 69) without a large gap, and therefore the calf holding unit 46 and the sole holding unit 47 can firmly hold the area from the area around the calves to the toes.

[0047] Furthermore, in the fitting boot 10 employed in the lower limb traction device 1 according to this embodiment, the calf holding unit 46 and the sole holding unit 47 are connected to each other so as to be rotatable within a range of an intersection angle θ of 90° to an intersection angle θ of 120° in a side view. This allows the sole of the patient's foot to be brought into close contact with the sole support plate portion 72 of the sole holding unit 47 (sole holding member 69) without a large gap, particularly in the case of a patient suffering from ankle plantar flexion contracture, in which the toes are plantar flexed and contracted, and therefore the calf holding unit 46 and the sole holding unit 47 can firmly hold the area from near the calf to the toes of the patient.

[0048] Furthermore, in the fitting boot 10 employed in the lower limb traction device 1 according to this embodiment, the angle adjustment mechanism 48 can lock the calf holding unit 46 and the sole holding unit 47 at multiple positions (four positions in this embodiment, with crossing angles θ of 90°, 100°, 110°, and 120°) within a range from a position where the crossing angle θ is 90° to a position where the crossing angle θ is 120° in a side view. As a result, the crossing angle θ (rotation angle θ) between the calf holding unit 46 and the sole holding unit 47 can be selected, particularly depending on the degree (condition) of ankle joint plantar flexion contracture in which the toes are plantar flexed and contracted, and the calf holding unit 46 and the sole holding unit 47 can be locked. This allows the patient's sole to be tightly fitted to the sole support plate portion 72 of the sole holding unit 47 (sole holding member 69) without any large gaps, and ultimately the calf holding unit 46 and sole holding unit 47 can firmly hold the area from the patient's calf to the toes.

[0049] Furthermore, in the fitting boot 10 employed in the lower limb traction device 1 according to this embodiment, the calf holding unit 46 is configured with an elastically deformable calf holding side thin portion 54 on the calf holding member 51. As a result, when the patient's calf area is placed on the calf holding member 51 and the calf restraint bands 52 are tightened, the calf holding side thin portion 54, including the opposing wall portion, elastically deforms to envelop the calf area, thereby applying pressure (to the entire area around the calf) in a planar manner rather than locally, thereby firmly holding the entire calf. Meanwhile, in the sole holding unit 47, the pair of toe clamping plates 73, 73 are configured as elastically deformable sole holding side thin portions 79, 79. As a result, when the patient's toes are set on the sole holding member 69 and the toe restraining band 70 is tightened, the pair of toe clamping plate portions 73, 73 elastically deform to encase the toes, and in particular, both the left and right sides of the toes can be pressed against each other in a planar manner rather than locally, thereby firmly holding the entire toes.

[0050] Furthermore, in the fitting boot 10 employed in the lower limb traction device 1 according to this embodiment, the calf restraining bands 52 are fixed to the outside of the opposing wall portions of the elastically deformable calf-holding-side thin-walled portions 54 provided on the calf holding member 51. By tightening the calf restraining bands 52, the pressure (pressure) from the calf restraining bands 52 forcibly elastically deforms the opposing wall portions of the calf-holding-side thin-walled portions 54 toward the calf, thereby enveloping and holding the area around the calf. Meanwhile, the toe restraining bands 70 are also fixed to the outside of the pair of toe clamping plates 73 (sole-holding-side thin-walled portions 79). By tightening the toe restraining bands 70, the pressure (pressure) from the toe restraining bands 70 forcibly elastically deforms the pair of toe clamping plates 73 toward the foot, thereby enveloping and holding the toes.

[0051] Furthermore, in the fitting boot 10 employed in the lower limb traction device 1 according to this embodiment, the tarsal restraining bands 96 are rotatably supported by a pair of support pins 92, 92 that rotatably support the calf support unit 46 and the sole support unit 47 relative to one another. The biasing force of the tarsal restraining bands 96 can accurately press the tarsus (near the ankle) toward the heel. As a result, the patient's heel can be firmly held within the heel accommodation space 94 (formed by the relief recess 59 provided in the calf-side thick portion 55 of the calf support unit 46 and the space 90 between the curved support plate 74 and the heel side of the sole support plate 72), and ultimately, the area from near the calf to the toes of the patient can be firmly supported. Furthermore, since the tarsal restraint band 96 is supported by a pair of support pins 92, 92 so that it can rotate freely, the tarsal restraint band 96 can be positioned at any angle to match the patient's tarsus, and as a result, the pressing force from the tarsal restraint band 96 can be applied to the appropriate position on the patient's tarsus.

[0052] Although the lower limb traction device 1 according to this embodiment employs the angle adjustment mechanism 48 described above, other angle adjustment mechanisms may employ a rack-and-pinion mechanism or a rotary-to-linear conversion mechanism such as a screw mechanism that converts the rotational movement of the operating handle operated by the operator into linear movement of the telescopic shaft 100 and can lock the telescopic shaft 100 at any position. In short, this angle adjustment mechanism does not have a set lock position and can adjust the intersection angle θ between the calf holding unit 46 and the sole holding unit 47 continuously and steplessly.

[0053] 1 Lower limb traction device, 5 Operating table, 10 Fit boot (boot), 46 Calf support unit, 47 Sole support unit, 48 Angle adjustment mechanism, 51 Calf support member, 52 Calf restraining band, 54 Thin portion on calf support side, 69 Sole support member, 70 Toe restraining band, 79 Thin portion on sole support side, 92 Support pin, 96 Tarsus restraining band

Claims

1. A lower limb traction device that is attached to an operating table and that traction the lower limbs of a patient placed on the operating table, comprising a boot having a calf holding unit that holds the area around the patient's calf and a sole holding unit that holds the sole of the patient's foot, wherein the sole holding unit and the calf holding unit are rotatably connected to each other.

2. A lower limb traction device as described in claim 1, characterized in that the sole holding unit and the calf holding unit are connected so as to be freely rotatable within a range from an intersection angle of 90° to an intersection angle of 120° when viewed from the side.

3. A lower limb traction device as described in claim 2, characterized in that the sole holding unit and the calf holding unit are configured to be lockable at multiple positions within a range from an intersection angle of 90° to an intersection angle of 120° when viewed from the side.

4. A lower limb traction device as described in claim 1, characterized in that the sole support unit has a thin-walled portion on the sole support side that is elastically deformable, and the calf support unit has a thin-walled portion on the calf support side that is elastically deformable.

5. A lower limb traction device as described in claim 4, characterized in that toe restraint bands that restrain the toes of the patient are fixed to the outside of the thin-walled parts on the sole holding side, and calf restraint bands that restrain the area around the patient's calves are fixed to the outside of the thin-walled parts on the calf holding side.

6. A lower limb traction device as described in claim 1, characterized in that the tarsal restraint bands that restrain the patient's tarsal are rotatably supported on support pins that rotatably support the sole support unit and the calf support unit relative to each other.

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