fig1 illustrates an operating table a , having side rails b , to which frame supports c are attached . various types of frames 10 , 11 are utilized on which are mounted a predetermined number of retractors to be hereinafter described . as shown in fig1 the frames 10 , 11 are of tubular construction . frame 10 is of an inverted l configuration and has the depending leg 10a thereof connected to one of the side rails b by a suitable clamp 13 . the other leg 10b of the frame is in an elevated position with respect to the patient lying on the table a . frame 11 , on the other hand , has a u - shape and is disposed in an elevated , horizontal position above the table - supported patient . the frame 11 is maintained in the desired elevated position by a pair of upright supports 14 , 15 , one disposed on each side of the table a and secured to the table frame , not shown , by suitable clamps or the like , of conventional design . to the upper end of each support is adjustably connected an extension arm 16 or 17 . the extension arm is normally formed of conventional flat bar stock . once the arm has been properly positioned , it is retained in place by a turnbolt 18 which extends through an opening in the arm and is threaded into the end of the upright support . both tubular frames 10 , 11 are provided with at least one exterior , longitudinally extending indentation such as a groove 20 . the groove is parallel to the axis of the tubular frame and the function of the groove will become apparent from the description to follow . secured to the frames 10 , 11 by various types of holders , to be hereinafter described , are various types of retractors . one retractor 21 , shown connected to the upper leg 10b of frame 10 , includes an elongated stem 22 which is provided with a hinge 23 at approximately mid - length thereof . the hinge 23 forms the stem 22 into an outer section 24 and an inner section 25 . both sections are provided with a plurality of exposed circumferential grooves g of like configuration arranged in axially spaced relation . the hinge 23 serves a dual function : ( 1 ) it permits the outer section 24 to assume a right angle position with the inner section and thus , not interfere with the movements of the surgeon and his or her assistants ; and ( 2 ) when in a right angle position , the outer section 24 provides a convenient handle to enable the retractor to be manually rotated about the axis of the inner section 25 thereby facilitating removal of the blade 26 from the inner end of section 25 without disturbing the patient . the shape and size of the blade 26 will depend upon the size and location of the incision and the physical dimensions of the patient . as shown in fig1 a second retractor of the same construction as retractor 21 is adjustably mounted on an extension arm 27 , the latter being secured by a turnbolt 28 to the upper end of an upright support 30 . support 30 is similar to supports 14 , 15 and is secured to a side rail b by a suitable clamp or attaching device 31 . attachment of the retractor 21 to the extension arm 27 is effected by a holder 32 which is shown more clearly in fig7 . the holder 32 as illustrated includes a bifurcated central body 33 , a clip segment 34 extending laterally in one direction from a lower segment 33a of the body 33 , a thumbscrew 35 mounted on an upper segment 33b of the body ; and a stop segment 36 extending laterally from the body lower segment 33a and in a direction opposite from that of the clip segment 34 . the clip segment includes a channel portion 37 which is sized to accommodate a portion of the extension arm 27 as will be described more fully hereinafter . overlying the body lower segment 33a , stop segment 36 and clip segment 34 is an elongated flat spring 38 . the portion 38a of the spring adjacent the stop segment is attached thereto by suitable pins or rivets 40 . the opposite end portion 38b of the spring is free and extends a short distance beyond clip segment 34 . when attaching the holder 32 on the arm 27 , the spring end portion 38b is brought into engagement with an edge of the extension arm and is distorted thereby , when manual pressure is applied , so as to allow the arm to slide between the spring end 38b and the clip segment 34 until it is aligned with the channel portion 37 whereupon a portion of the extension arm will be accommodated therein , see fig1 . the depth of the channel portion 37 is such that when the arm 27 is accommodated therein , the spring 38 will automatically return to its normal flat condition . the thumbscrew 35 and flat spring 38 coact with the bifurcated central body 33 to secure an adapter piece 41 to the central body . the adapter piece facilitates connecting the round stem section 25 of the retractor 21 to the holder 32 . as seen in fig7 adapter piece 41 includes a flat base 42 which is sized so as to readily slide between the upper and lower segments 33b , 33a , respectively , of the body when thumbscrew 35 has been loosened a predetermined amount . once the base 41 has been secured in place by the thumbscrew being drawn up tight against the base , the latter will overlie a substantial portion of the spring end portion 38b and press the latter into frictional engagement with the arm portion accommodated in the channel portion 37 and retain the holder in a fixed , selected position on the extension arm . an elongated depression 42a is provided in the upper surface of base 42 which is adapted to accommodate the concealed end of thumbscrew 35 . the base 42 has an exposed edge which is in the form of an elongated sleeve 43 . the interior dimension of the sleeve permits the stem section 25 of the retractor 21 to readily slide endwise therein . pivotally connected to the exterior of the sleeve and adjacent an end 43a of the sleeve furthest removed from the retractor blade 26 , is a spring - loaded latch or lever 44 . one end 44a of the latch is biased towards the sleeve axis so that it will automatically engage one of the external grooves g formed in the stem and restrain movement of the stem in a direction towards the patient &# 39 ; s incision . the opposite end 44b of the latch 44 is in an exposed , raised position and , when manually depressed will cause the latch to pivot about axis x thereby releasing the latch end 44a from the stem groove allowing the stem to be moved in either direction within the sleeve . the latch end 44b , when not depressed , will allow the stem the patients &# 39 ; incision and then be automatically locked in a desired position by the latch end 44a engaging a stem groove g . notwithstanding that the stem is locked in a selected position , the retractor 21 can still be rotated about the stem section axis by reason of latch end 44a being disposed in a circumferential groove , thereby facilitating replacement of the blade 26 without having to disengage the entire retractor from the holder 32 or adjusting the position of the patient on the table a . locking a retractor 45 having a conventional flat elongated stem 46 on a tubular frame 11 is accomplished by a modified form of holder 47 as seen in fig2 - 4 . the stem 46 normally is provided with an elongated longitudinally extending slot 46a . holder 47 is provided with a center body 48 , a clip segment 50 extending laterally in one direction from a lower segment 48a of the center body . a stop segment 51 projects laterally from the opposite side of the lower segment 48a . it will be noted in fig2 that the lower segment 48a and the clip segment 50 include parallel side walls v and w which are interconnected by a transverse base wall k . the portions of the side walls constituting the clip segment 50 are provided with semi - circular cutouts 50a . the shape of the cutouts corresponds substantially to the curved exterior of the tubular frame 11 . a flat spring 52 is secured at one end 52a by pins or rivets 53 to the stop segment 51 and the opposite end 52b is free and overlies in spaced relation the base wall k of the clip segment 50 . as seen in fig2 the flat spring 52 is sized so as to fit between the side walls v and w . spaced above the flat spring and extending in a cantilever relation from the side wall v of the center body is a flange 54 on which is mounted a thumbscrew 55 . the space between flange 54 and flat spring 52 is adapted to accommodate the flat stem 46 of the retractor 45 , see fig3 . upon the thumbscrew 55 being drawn up tight against the stem 46 , the latter will cause the free end 52b of the spring to be deflected downwardly thereby frictionally locking the holder 47 at selected position on the tubular frame 11 . the thumbscrew 55 also locks the retractor stem in a fixed , selected position relative to the holder 47 . rotation of holder 47 about tubular frame 11 is prevented by providing cutouts 50a of clip segment 50 with inwardly extending nubs 50b adapted to engage the external groove 20 formed in the tubular frame 11 . alternatively , the inward side of end 52b of spring 52 may be provided with an elongated protuberance adapted to engage the external groove of tubular frame 11 in order to prevent rotation of holder 47 about tubular frame 11 . holder 47 is possessed of a feature wherein it may be readily snapped onto the tubular frame at any selected location without any adjustment of other holders previously mounted on the frame . fig5 depicts another embodiment of a holder 56 which includes a body section 57 having a pair of spaced , substantially parallel flange segments 57a , 57b which are interconnected at one end by a bail segment 58 . each flange segment is provided with a substantially round opening 60 through which a portion of the tubular frame 11 is adapted to slidably extend . a corresponding peripheral portion of each opening is provided with an inwardly extending nub 60a . the nubs are adapted to engage the external groove 20 formed in the tubular frame and thus , prevent rotation of the holder relative to the frame . disposed between the bail segment 58 and the flange openings 60 and affixed to the flange segments 57a , 57b is a transversely extending anchor piece 61 . affixed to the anchor piece at approximately the mid - length thereof is an upwardly extending stud bolt 62 . the bolt terminates a substantial distance above the upper edges of the flange segments 57a , 57b , wee fig5 . the stud bolt is adapted to extend through the elongated slot 46a formed in the flat stem 46 of the retractor 45 shown in fig3 . the spacing between flange segments is slightly greater than the width of the flat stem 46 thus , enabling the flat stem to be disposed therebetween . it will be noted that the upper edge 58a of the bail segment 58 is recessed a slight amount from the upper edges of the flange segments the amount of the recess is approximately the same as the distance each opening 60 is from the upper edge of the respective flange segment . the upper end 62a of the stud bolt is threadably engaged by a wing nut 63 . when the nut 63 is drawn up tightly against the upper surface of the flat stem 46 , the latter , in turn , will clamp the portion of the tubular frame 11 disposed within the openings 60 between the underside of the flat stem and the lower perimetric portions of the openings . because of the serrated underside of the flat stem , as seen in fig3 a positive non - slipping contact is made between the stem and the tubular frame . as seen in fig1 the elongated slot 46a in the flat stem 46 of the retractor 45 is provided with one or more enlargements 46b which will allow the wing nut 63 and end 62a of the stud bolt to pass therethrough when the wings 63a of the wing nut are aligned with the slot . another embodiment of a holder 64 is shown in fig6 for securing the retractor 21 to the upper leg 10b of the tubular frame support 10 , see fig1 . holder 64 is fabricated of a deformable material , preferably aluminum , and includes a body section 65 having a cylindrical passage 65a formed therein and disposed adjacent one side thereof . the passage 65a is provided with a longitudinally extending key or protuberance 66 . the passage 65a is sized to slidably accommodate therein a portion of the tubular frame support 10 . the protuberance 66 is adapted to slidably engage the external groove 20 formed in the support 10 and thus , prevent relative rotation between the holder 64 and the frame support . a cut or open end slot 67 is formed in the body section 65 . the cut has three exposed open sides 67a and a concealed fourth side which terminates at the wall defining the passage 65a . disposed transversely of the plane of cut 67 is a stud bolt 68 . one end of the bolt is concealed within the body section 65 and is anchored to the portion 65b of the body section subtending the cut . the shank of the bolt spans the cut 67 and slidably extends through an opening formed in the portion 65c of the body section overlying the cut . the exposed end 68a of the bolt shank is threadably engaged by a wing nut 70 . when the nut 70 is drawn up tightly against the exposed surface of body portion 65c the latter will be distorted downwardly towards body portion 65b with the result that the frame support portion accommodated in passage 65a will be fixedly held in place within the passage . formed in body portion 65c and offset with respect to the bolt shank is a second cylindrical passage 71 . passage 71 is disposed above passage 65a and is substantially perpendicular thereto . passage 71 is sized so as to slidably accommodate the stem section 25 of the retractor 21 . pivotably connected to body portion 65c and adjacent the end of passage 71 furthest removed from the blade 26 of the retractor 21 is a spring biased latch 72 . the construction and function of latch 72 are the same as aforedescribed with respect to the latch 44 of the adapter piece 44 of holder 32 . in holders 32 and 47 , the thumbscrews thereof and in holders 56 and 64 , the wing nuts thereof cannot be disassembled from the remainder of the holder ; thus , eliminating the possibility of the thumbscrew or wing nut becoming lost or misplaced . from the above description , it is apparent that the objects of the present invention have been achieved . while only certain embodiments have been set forth , alternative embodiments and various modifications will be apparent from the above description to those skilled in the art . these and other alternatives are considered equivalents and within the spirit and scope of the present invention .
a surgical retractor for adjustable mounting on a supported holder includes an elongated stem of cylindrical cross - sectional configuration and blade means attached to one end of the stem , the stem being optionally provided with a plurality of spaced circumferential first means for selective engagement by adjustable complemental second means for restraining longitudinal movement of the stem in one direction , and optionally including an inner section hingedly connected to an outer section , providing a handle for pulling or rotating the retractor . a holder for a surgical retractor and frame support for the holder assume a nonrotating relation where the frame support has a section of substantially cylindrical cross - sectional configuration and has a longitudinally extending indentation , a portion of the frame support is encompassed by a section of the holder , and the holder section has protruding means for engaging the indentation of the frame support section .