1. Field of the Invention
This invention is in the field of clinical procedures involving the wrist and upper extremity, with particular application to wrist arthroscopy and to methods and devices for applying traction to the hand and wrist.
2. Description of the Prior Art
Wrist arthroscopy is a surgical technique of increasing popularity due to the fact that it is only minimally invasive and affords a thorough and accurate means of diagnosing and treating disorders of the wrist. Diagnostic arthroscopy enables the physician to evaluate the wrist joint to determine whether a problem exists and to identify the nature of the problem, while with corrective arthroscopy the physician can both identify the problem and perform the procedure or procedures necessary to treat or eliminate the problem. Among the various types of problems that can be evaluated and in many cases corrected by wrist arthroscopy are sources of chronic wrist pain, the presence of bone fragments and debris resulting from a fracture, the misalignment of bone pieces broken in a fracture, the presence of growths between wrist bones called ganglion cysts, the presence of torn ligaments or tears in the triangular fibrocartilage complex, and synovitis or inflammation of the lining of the wrist joint. In the typical arthroscopic procedure, the surgeon makes small incisions in the wrist and inserts an arthroscope, which is a small instrument containing a lens, a miniature camera, and a lighting system. The arthroscope produces three-dimensional images that are viewed on a television monitor, allowing the surgeon to accurately identify the cause of the problem so that appropriate corrective action can be taken. Surgical tools such as probes, forceps, knives, radiofrequency devices or electrocoagulation devices can then be inserted to correct the problem while the arthroscope is still in place. In addition to its use on the wrist, arthroscopy can be used on smaller joints as well, such as those in the hand.
To perform arthroscopy, the surgeon must stabilize the hand and upper extremity so that traction can be applied. With the patient lying on a hospital bed, the upper extremity is typically extended outward from the patient's body and bent 90° at the elbow so that the forearm is perpendicular to the floor with the hand pointed upward toward the ceiling. Traction is achieved by applying an upward force to the fingers through mesh finger traps that are attached to a tower. The tower is arranged to allow the traps to be moved up and down to control the tension being applied to the joints in the wrist and hand. The tension is closely controlled so that the amount applied is sufficient to open the joint spaces so that the surgeon can insert the tools and instruments safely, and once they are inserted, manipulate them to perform the desired functions effectively. The instruments can then be withdrawn at the end of the procedure without inflicting damage to the joint. The application of tension requires an upward force on the finger traps together with a stabilizing force at the elbow. The stabilizing force must not be so constrictive that it causes discomfort to the patient or affects circulation to the extremity being treated. Other considerations are the need for the surgeon to have access to surgical tools and equipment that are typically used during surgical procedures in general, as well as the ability to perform these functions without requiring an operating table of specialized design.
These and other concerns are addressed by the present invention.