Method and Apparatus for Multidirectional Positioning of a Shoulder

Abstract

The invention relates to a method and apparatus for manipulating a shoulder joint, by independently manipulating the upper arm in two directions. One direction is “longitudinal”, wherein the upper arm moves substantially along its longitudinal axis. The second is “lateral”, in which the upper arm moves laterally from a first to a second position, with the second position being spaced apart from the first and such that the longitudinal axes of the upper arm in the two positions are substantially parallel. The apparatus is adjustable, but includes two parts stationary during use; an elongate yet platelike “upper arm supporting plate” configured to be situated under the upper arm of the patient (extending proximate the armpit and extending proximate the elbow) and an elongate “forearm member” configured to be positioned proximate the forearm of the user when the user's arm is in position bent approximately 90 degrees. Two other elements cause controlled movement of the arm relative to the structure so the surgeon may perform the desired procedure. These inflatable bladders may be selectively inflated or deflated to provide a desired effect. These can be referenced as an “upper arm bladder” and a “forearm bladder”, although they may be also referenced as first and second bladders, although not necessarily in that order. By inflating the upper arm bladder, the upper arm is moved away from the upper arm supporting plate, causing perpendicular (a.k.a., “lateral”) force to occur to elevate the humerus perpendicularly from the glenoid to allow good clean glenoid work.

1 . An apparatus for manipulating an arm and shoulder extending from a torso of a patient positioned on a support surface, said arm of said patient including an upper arm extending from said shoulder to an elbow, and a forearm extending from said elbow to a hand, said apparatus comprising:
 a frame member assembly configured for being positioned relatively stationary relative to said support surface;   a structural upper arm support member attached relative to said frame member assembly;   a structural forearm support member attached relative to said structural upper arm member and configured to be positioned proximate said forearm when said arm is bent at said elbow;   a forearm retention member configured to pass around and at least partially contain said forearm and said structural forearm support member; and   a forearm bladder member configured to be positioned relative to said forearm support member, said forearm retention member, and said forearm of said patient such that inflation of said forearm bladder member tends to place said forearm retention member in tension and to cause said forearm to be urged towards said structural forearm support member, such that said upper arm is moved substantially along the longitudinal axis of said upper arm and away from said shoulder joint as said forearm bladder member is inflated.   
   
   
       2 . The apparatus as claimed in  claim 1 , wherein said forearm bladder member is a sleeve encircling a portion of said forearm and said forearm support member, and wherein said forearm bladder member is positioned between a portion of said sleeve and a portion of said forearm, such that inflation of said sleeve causes said bladder member to push relatively against said forearm to cause said forearm and upper arm movement. 
   
   
       3 . The apparatus as claimed in  claim 1 , wherein said forearm retention member is a sleeve encircling a portion of said forearm and said forearm support member, and wherein said forearm bladder member is positioned between a portion of said sleeve and a portion of said forearm support member, such that inflation of said forearm bladder causes said forearm bladder member to push relatively against said forearm support member to cause said sleeve to pull on said forearm to cause said forearm and upper arm movement. 
   
   
       4 . The apparatus as claimed in  claim 1 , wherein said forearm retention member is adjustable relative to said upper arm support member along an axis substantially parallel to the longitudinal axis of said upper arm, such that different forearm positions may be provided as needed. 
   
   
       5 . The apparatus of  claim 1  further comprising an upper arm cuff having a retention tab, said upper arm cuff configured to encircle said upper arm proximate said elbow such that said retention tab is secured relative to said forearm retention member so as to discourage movement of said forearm retention member in a direction substantially parallel to the longitudinal axis of said forearm. 
   
   
       6 . The apparatus of  claim 5 , wherein said retention tab is secured to said forearm retention member using a hook and loop fastener. 
   
   
       7 . The apparatus as claimed in  claim 5 , further comprising a handle member attached relative to said forearm support member to allow said patient to grasp said handle member with said hand of said patient. 
   
   
       8 . A method for manipulating an arm and shoulder extending from a torso of a patient positioned on a support surface, said arm of said patient including an upper arm extending from said shoulder to an elbow, and a forearm extending from said elbow to a hand, said method comprising the steps of:
 A) positioning said patient relative to said support surface;   B) positioning an inflatable upper arm bladder between said torso and said upper arm of said patient and attaching said bladder relative to said patient such that said bladder is in contact approximate a proximal first portion of said upper arm;   C) securing a distal second portion of said upper arm relative to said torso of said patient such that said upper arm is discouraged from abduction relative to said torso of said patient, said distal second, portion being located distal relative to said proximal first portion; and   D) inflating said upper arm bladder so as to provide opposing first and second forces, said first force being against said upper arm of said patient and said second force being against said torso of said patient, said opposing forces being applied while said upper arm is discouraged from abduction relative to said torso of said patient pursuant to said securing step “C” such that a third force is applied proximate said distal second portion of said upper arm, said first and third forces combining to create a torque on said upper arm so as to elevate the humerus of said patient away from the glenoid of said patient due at least in part to said torque.   
   
   
       9 . The method as claimed in  claim 8 , wherein said step “A” of attaching said bladder relative to said patient includes the use of at least one strap to strap said bladder relative to said patient. 
   
   
       10 . The method as claimed in  claim 9 , wherein said step “A” of positioning said inflatable upper arm bladder between said torso and upper arm of said patient includes positioning said bladder in an armpit of said patient. 
   
   
       11 . The method as claimed in  claim 8 , wherein said step “A” of attaching said bladder relative to said patient includes the use of at least one strap to strap said bladder relative to said supporting surface. 
   
   
       12 . The method as claimed in  claim 11 , wherein said step “A” of positioning said inflatable upper arm bladder between said torso and upper arm of said patient includes positioning said bladder in an armpit of said patient. 
   
   
       13 . The method as claimed in  claim 8 , wherein said step “A” of attaching said bladder relative to said patient includes the use of at least one strap to strap said bladder relative to said supporting surface and said patient. 
   
   
       14 . The method as claimed in  claim 13 , wherein said step “A” of positioning said inflatable upper arm bladder between said torso and upper arm of said patient includes positioning said bladder in an armpit of said patient. 
   
   
       15 . The method as claimed in  claim 8 , wherein said step “C” of securing said upper arm relative to said torso such that said upper arm is discouraged from abduction includes the use of a tension cuff and cable apparatus. 
   
   
       16 . The method as claimed in  claim 15 , wherein said step “B” of positioning said inflatable upper arm bladder between said torso and upper arm of said patient includes positioning said bladder in an armpit of said patient. 
   
   
       17 . The method as claimed in  claim 8 , wherein said step “B” of positioning said inflatable upper arm bladder between said torso and upper arm of said patient includes positioning said bladder in an armpit of said patient.