Upper Extremity Positioner

Abstract

An apparatus and technique for supporting and securing a human upper extremity suitable for diagnostic and surgical procedures with the apparatus comprising a base plate coupled to moveable proximal and distal platforms. The distal platform supports the hand and wrist while pivoting about a ball and socket (universal) joint. The proximal platform is attached to a moveable support that variably elevates the upper extremity between the shoulder and the wrist (ie the distal platform) whilst travelling longitudinally along the base plate. These upper platforms attach to a common lower platform (ie the base plate) and function independently yet complimentarily to variably elevate and position the entire upper extremity above the base plate thereby achieving reproducible medical (or user) access to any discrete site from the shoulder to the digits. The proximal and distal platforms may also function as a bridge for a third upper platform converting an apparatus with two relatively short supportive surfaces to an apparatus having one relatively long supportive surface.

Claims

1. An apparatus for holding serviceable positions of an upper extremity, comprising; a) a base plate with sufficient strength to support the weight of a plurality of platforms and the weight of an upper extremity, b) a plurality of platforms with a minimum of; 1) a distal elevated platform for receiving a hand and a wrist coupled to the base plate by a pillar, and 2) a proximal elevated platform coupled to the base plate by means to adjustably receive anatomy proximal to the distal elevated platform.

2. Distal elevated platform of claim 1 wherein restraining ties can secure the hand and wrist at the periphery (of the distal elevated platform) by an array of notches, and through the interior by a series of slots.

3. Distal elevated platform of claim 2 further including a pair of holes for connecting pins that receive the connecting pins of an intercalating platform.

4. Pillar of claim 1 further including a universal joint providing means for the distal elevated platform to be moved through a multiplicity of spatial positions.

5. Universal joint of claim 4 wherein a ball and socket mechanism directs motion of the distal elevated platform.

6. Ball and socket mechanism of claim 5 further providing long axis displacement of the distal elevated platform relative to the base plate.

7. Ball and socket mechanism of claim 6 wherein a detent mechanism, threadably coupled to the pillar, releasably prevents motion of the ball within the socket thereby securing a desired angle of the distal elevated platform relative to the base plate.

8. Upper extremity table of claim 1 wherein a hinge means provides vertical and pivotal motion to the proximal elevated platform.

9. Hinge means of claim 8 wherein a first hinge lies proximal to the pillar and has an upper bar and a lower bar coupled at a single pivot point providing vertical and long axis movement of the proximal end of the upper bar with respect to the base plate, and couples to the base plate by the lower bar which aligns with the long axis of the base plate.

10. Hinge means of claim 9 further including a second hinge that couples the upper arm of the first hinge to the proximal elevated plate providing means for rotation for the proximal elevated plate with respect to the base plate.

11. Means for rotation of claim 10 further including a mount plate for the proximal platform which couples the proximal elevated platform to the upper arm of the first hinge by having pivot holes that encircle upper arm mounting tabs that rotate within the confines of said pivot holes thereby guiding the proximal elevated plate in a substantially perpendicular direction with respect to an axis line drawn from the center of one pivot hole to another pivot hole.

12. First hinge of claim 9 wherein a locking pin can engage the lower arm to prevent motion of a sliding clasp along said lower arm which in-turn holds the upper arm at a predetermined position.

13. Intercalating platform of claim 3 wherein means for bridging the space between the proximal elevated platform and the distal elevated perform can be implemented when the surface of said proximal elevated platform lies substantially in the same plane (uniplanar) as the surface of said distal elevated platform.

14. Means for bridging the space between the proximal elevated platform and the distal elevated platform of claim 13 wherein elongated peg-like members extending from a first end of said intercalating platform engages the distal elevated platform through receiving holes until the intercalating platform lies substantially flush against said distal elevated platform, whereupon the proximal elevated platform can then be vertically and rotationally adjusted to contact and lie flush against the undersurface of a second end of the intercalating support segment thus producing an arm board configuration.

15. An adjustable arm board for supporting a human upper extremity, comprising; a) a base support that may be placed on a table or other suitable supportive surface, b) a distal elevated platform; (1) having suitable form for receiving and holding the baud and the wrist, (2) coupled to the base plate by a pillar, and (3) having a universal joint that tiltably adjusts said distal elevated platform relative to the base plate, c) a proximal elevated platform coupled to the base support by means for elevational, longitudinal, and rotational movement of the proximal elevated platform relative to the base support to adjustably receive anatomy between the shoulder and the wrist, and d) an intercalating platform with means to provide a bridging surface between the distal elevated platform and the proximal elevated platform.

16. Intercalating platform with means to provide a bridging surface of claim 15 wherein a supportive surface having a length, a width and a thickness is formed from stout material that integrates peg-like extensions that cat couple to an elevated platform.

17. Elevated platform of claim 16 wherein holes are placed at the interior of the distal elevated platform to receive peg-like extensions from the intercalating plate at a predetermined angle.

18. Predetermined angle of claim 17 wherein the intercalating platform is supported by a portion of the distal elevated platform that lies substantially uniplanar to a portion of the proximal elevated platform, with the angle of the intercalating platform, relative to the base plate, determined by the height differential between the distal elevated platform and the proximal elevated platform.

19. Means for elevations, longitudinal and rotational movement of the proximal elevated platform relative to the base support of claim 15 wherein a series of hinges coordinate motion of said proximal elevated platform; a first hinge is an adjustable pivot hinge providing vertical and longitudinal movement of the proximal end of the upper bar with respect to the plane of the base plate, by an upper bar and a lower bar, with said lower bar coupled to the base plate proximal to the pillar and aligned along the longitudinal axis of the base plate, and the pivoting end of said first hinge positioned closest to the pillar, wherein a locking pin can engage the lower arm and prevent relative motion between the lower arm and the upper arm at a predetermined position by halting the movement of a transitioning hinge arm; and a second hinge that couples the upper arm of the first hinge to the proximal elevated plate, providing rotational motion to the proximal elevated plate in a substantially perpendicular plane to the short axis of the base plate with said second hinge further including a mounting bracket for the proximal elevated platform with receiving holes that allow the contoured extensions of the upper arm to pivot within the confines of the receiving holes.

20. A method for performing upper extremity procedures so as to facilitate ready access of the anatomy thereto by a surgeon or other practitioner, comprising: Placing the patient in a desired lying, sitting or standing orientation, Positioning the upper extremity by enacting the ideal serviceable alignment, Utilizing a table for positioning the upper extremity having; a base support that may be supported on a surgical table or other suitable support, a distal elevated platform, with suitable form for receiving the hand and the wrist, mounted on a pillar attached to the base support, said pillar having means for tiltable adjustment of the distal elevated platform relative to the base plate, a proximal elevated platform coupled to the base support to adjustably receive anatomy between the shoulder and the wrist, having means for elevation, longitudinal and parallel rotational movement relative to the base support. Placing the table for positioning the upper extremity on a support surface, Moving the table for positioning the upper extremity beneath the positioned extremity, Adjusting the distal elevated platform hand to achieve proper length relationships of the arm and the apparatus, Lifting the proximal elevated platform toward anatomy proximal to the wrist, Applying restraining ties as needed to secure the upper extremity to the proximal elevated, platform and to the distal elevated platform, whereby an upper extremity lies in a serviceable position to begin a procedure.

Description

BRIEF DESCRIPTION OF THE FIGURES

[0037] FIG. 1. The Upper Extremity Positioner at a side view. The distal end of the apparatus is to the left of the picture.

[0038] FIG. 2. The Upper Extremity Positioner at a side view with the distal end of the distal platform in a downward tilted position and the proximal platform fully reclined.

[0039] FIG. 3. The Upper Extremity Positioner at a side view with the distal platform in an upwardly tilted position and the proximal platform fully reclined.

[0040] FIG. 4. The Upper Extremity Positioner at a side view with the distal platform in a neutral position, the upper arm of the hinge nearly fully elevated, and the proximal platform in a tilted position.

[0041] FIG. 5. The upper extremity positioner holding an upper extremity in a surgical position.

[0042] FIG. 6. The distal platform holding a hand and wrist by restraining ties.

[0043] FIG. 7. A patient in a supine position with the upper extremity lying upon the Upper Extremity Positioner which has been placed on a table.

[0044] FIG. 8. Exploded view of the distal platform and its attachments to the pillar.

[0045] FIG. 9. The (dual) hinge assembly with the upper arm in an elevated position and the proximal platform in a tilted position.

[0046] FIG. 10. Exploded view of the (dual) hinge assembly (inferior-oblique perspective).

[0047] FIG. 11. A patient in a sitting position with the right arm lying on the Upper Extremity Positioner.

[0048] FIG. 12 The intercalating board with connecting pins.

[0049] FIG. 13 Exploded view of the intercalating board positioned so that the connecting pins align with holes at the proximal end of the distal platform.

[0050] FIG. 14 A patient in a supine position with the arm held at an angle by the Upper Extremity Positioner with the intercalating board in place.

[0051] FIG. 15 A patient lying in a right lateral decubitus position.

[0052] FIG. 16 A patient lying in a right lateral decubitus position with the left arm elevated away from the body.

[0053] FIG. 17. A patient lying in a right lateral decubitus position, the arm elevated away from the body, and the Upper Extremity Positioner lying on a table, in a position prior to adjustment to receive the arm.

[0054] FIG. 18. A patient lying in a right lateral decubitus position with the left arm positioned on the upper extremity positioner in preparation for a procedure

DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0055] Before explaining the disclosed embodiments of the present invention in detail it is to be understood that the invention is not limited in its application to the details of the particular arrangements shown since the invention is capable of other embodiments. [0056] 40 Restraining tie [0057] 50 Base plate (distal end) [0058] 51 Base plate (proximal end) [0059] 60 Single arm lower arm of hinge [0060] 70 Locking pin (for hinge) [0061] 75 Lower arm hole (for locking pin) [0062] 80 Proximal attachment plate for lower arm of hinge [0063] 81 Rivet for attaching proximal attachment plate to single arm lower hinge [0064] 90 Distal attachment plate for lower arm hinge [0065] 100 Sliding clasp [0066] 105 Rivet attachment for sliding clasp [0067] 110 Transitioning hinge arm [0068] 120 Rivet attachment for transitioning hinge arm to double arm upper hinge [0069] 130 Double arm upper arm of hinge [0070] 135 Upper Arm mounting tabs [0071] 140 Rivet attachment for hinge arms [0072] 150 Pivot holes (in mount for elbow plate) [0073] 160 Mount plate for proximal platform [0074] 170 Proximal platform [0075] 171 Proximal platform screw [0076] 172 Hole for proximal platform screw [0077] 173 Hole in mount for proximal platform [0078] 174 Washer for elbow proximal platform [0079] 200 Hole in proximal platform for restraining tape [0080] 210 Pillar support assembly [0081] 230 Pillar [0082] 240 Socket [0083] 245 Notch in socket [0084] 250 Locking mechanism for ball (in socket) [0085] 260 Distal platform [0086] 265 Hole in distal platform for ball and socket assembly [0087] 270 Ball and Stem assembly [0088] 275 Washer (for ball and stem assembly ) [0089] 280 Hole for connecting pins [0090] 290 Notch in distal platform for restraining tape [0091] 300 slot for restraining tape [0092] 340 Intercalating board [0093] 350 Connecting Pins

DETAILED DESCRIPTION OF THE FIGURES

[0094] FIG. 1. The Upper Extremity Positioner at a side view. The distal end is to the left of the picture. The distal platform (260) lies in a neutral position relative to the plane of the base plate (50,51). The base plate is constructed of sturdy materials sufficient to support the weight of its attachments (as shown) and of a human upper extremity. The distal platform (260) attaches to the pillar (130) by a ball, stem and socket assembly (240, 270) and the pillar (130) attaches to the support board (50) by a pillar support assembly. A hinge mechanism with an upper arm (130) and a lower arm (60) attach to the support board by proximal (80) and distal (90) mounts. The upper arm (130) is shown in an elevated position. The proximal platform (170) lies us a neutral position parallel to the support board (51).

[0095] FIG. 2. The Upper Extremity Positioner is placed at a side view with the distal platform (260) in a tilted position. Functions of the ball-and-socket joint during flexion (distal end of the distal platform downward towards the base plate) necessarily cause some long axis (ie referring to long axis of the base plate) translation as shown by the more distal position of the proximal side of the distal platform. The wide range of flexion is demonstrated by the distal platform (260) with the ball and stem (270) attached in a preferred position at the proximal one-third of the distal platform (260) allowing a near complete range of motion for the wrist and hand. The proximal platform (170) lies in a neutral position parallel with the support board (51). The proximal platform (170) is shown fully reclined; the upper arm (130) of the working hinge lies parallel to and partially covers the lower arm of the hinge.

[0096] FIG. 3. The Upper Extremity Positioner is placed at a side view with the distal platform in an upwardly tilted position and the proximal platform fully reclined. The wide range of possible positions is further demonstrated and implied by the degree of extension (ie distal end of the distal platform deflected upward). The distal platform (260) has its distal end in an elevated position with the proximal platform in a fully reclined and otherwise neutral position. The position of the ball and stem (270) within the proximal one-third of the distal platform allows the distal end of the distal platform to be elevated to a nearly vertical position.

[0097] FIG. 4. The Upper Extremity Positioner is placed at a side view with the distal platform in a neutral position and the upper arm (130) of the hinge in near full elevation with the proximal platform in a tilted position. The wide range of available positions for the portion of an arm lying proximal to the wrist is demonstrated and otherwise implied by the elevated upper arm (130) and by the distal platform (260) that lies in a maximally forward tilted position. The locking pin (70) maintains the position of the arm by presenting the sliding clasp (100) from moving proximally, along the base plate, by the weight of a patients arm (upper extremity).

[0098] FIG. 5. The upper extremity positioner is viewed holding an upper extremity in a surgical position. Restraining ties (40) hold a portion of the arm proximal to the elbow at the proximal platform and portions of the hand to the Upper Extremity Positioner at the distal platform (260). The wrist is positioned in flexion and the proximal platform (170) accommodates and holds a comfortable and utilitarian position of the elbow as well as the entirety of the upper extremity proximal to the wrist.

[0099] FIG. 6. The distal platform holding a hand and wrist by restraining ties. Slots at the interior of the distal platform, for the restraining ties (300) allow selective restraint of one or all of the digits. Holes (280) for the restraining ties at the proximal platform give the option for restraining the wrist (40, restraining tie) as might be done for a procedure on a finger. Notches (290) are indentations at the periphery of the distal platform and can also be used to secure a restraining tie (40) as demonstrated for the thumb in this drawing. Receiving holes for connecting pins (280) can also be used to pass restraining ties to secure the wrist.

[0100] FIG 7. A patient in a supine position with the upper extremity lying upon the Upper Extremity Positioner which has been placed on a table. A position of the entire upper extremity upon the upper extremity positioner apparatus is shown in this picture. This view teaches a three point upper extremity support principle with support for the arm in this supine position by 1) the shoulder as the most proximal support and then by 2) the proximal platform and 3) the distal platform. The embodiment shown requires that the table be used to support the apparatus whilst a patient lies on a standard patient support appliance.

[0101] FIG. 8. Exploded view of the distal platform and its attachments to the pillar without the pillar support assembly. The view clearly shows the universal joint mechanism, (270 and 240, the ball-and-socket assembly) eccentrically placed toward an edge of the table in a preferred position for the purpose of producing a rotation of axis for the upper plate as close to the same edge as possible. The distal platform is flat, smooth and is suitable for hand-wrist contact and support. The edges of the distal platform are lined with notches (290) that serve to hold digital restraint ties (40). The proximal end of the distal platform (260) in this embodiment has a conspicuous expansion of the proximal end designed for a right or left thumb to be anchored by digital restraint ties (40) that can be anchored through notches (290) at the periphery of the platform. Several small holes (280) are the receiving holes for the connecting pins of the intercalating platform or for restraint ties (40) so that the wrist can be secured to the plate in this way, if needed. The distal platform (260) contains an opening (265) near an edge through which a threaded washer (275) is placed. A ball-and-stem (270) assembly screw into the threaded washer, specifically, by the threaded portion of the stem. The ball fits into the socket (240), that attaches to a pillar. The socket can be notched (240) for the purpose of allowing the stem, when necessary, to gain additional motion in a desired plane with a maximum of 90 degrees of motion in any plane. The socket is threaded and receives the pillar (130). Rotation of the plate is theoretically infinite and (240) can be rotated to the desired position by placing the notch at the desired location. The locking mechanism (250) is a modified L shaped screw that increases pressure against the ball within the socket by clockwise rotation.

[0102] FIG. 9. The hinge assembly is shown with the upper arm in art elevated position and the proximal platform in a tilted position. This view is an enlarged view of the hinge which is created by joining (140, rivet) an upper arm (130) to a lower arm (60) (60,140,130). The locking pin (70) prevents the sliding clasp (100) from moving proximally under the weight of an arm. The proximal platform (170) moves freely by a mounted attachment to the upper arm.

[0103] FIG. 10. Exploded view of the (dual) hinge assembly. The proximal platform (170) attaches to the mount for the platform (160) by a pair of screws and washers. The mount for the proximal platform has a pair of extensions with holes (150, pivot holes) for the upper arm mounting tabs (135). The ability of the proximal platform (170) to rotate is restricted only by the size of the plate, the position of the plate relative to the base support (51) and the degree of elevation of the upper arm. The otherwise freely rotating proximal platform (170) accommodates any position of that portion of an arm proximal to the wrist, once the wrist has been placed against the hand plate (260). The upper arm is joined to the lower arm by a rivet (140) and also by a transitioning arm (110) that moves a sliding clasp (100) along the lower arm (60) as the hinge opens and closes. The lower arm is attached to a support board by screw mounts placed proximally (80) and distally (90).

[0104] FIG. 11. A patient sitting in a chair with the right arm lying on the Upper Extremity Positioner depicts the versatility in positioning opportunities of the entire patient relative to the apparatus. The apparatus rests upon a table.

[0105] FIG. 12. The intercalating board (340) with connecting pins (350). The intercalating board is made to span the distance between the distal platform (260) and the proximal platform (170). The embodiment as shown is a flat shape constructed from a substantially supportive material not to exclude wood, glass, plastic, or metal. The pins are measured to match the distance between the receiving portion of the proximal hand plate. Drill holes are made in the intercalating plate and the pins are press fitted into position with an option of using an adhesive for additional binding strength.

[0106] FIG. 13 Exploded view of the intercalating board positioned so that the connecting pins align with holes at the proximal end of the distal platform. The intercalating board is made to span the distance between the distal platform (260) and the proximal platform (170). The moveable parts of the Upper Extremity Positioner allow planar alignment of the proximal and the distal platforms such that a flat or contoured intercalating piece can be placed. The intercalating board (340) is placed over the distal platform (260) and the connecting pins are placed through the holes for the connecting pins (280). The proximal platform (170) is initially placed in a lowered position as shown so that the intercalating board (340) can be placed against the distal platform (260) without obstruction. As a final adjustment the proximal platform would be lifted so that it provides support for the intercalating plate and an upper extremity.

[0107] FIG. 14 A patient in a supine position with the arm held at a predetermined angle by the Upper Extremity Positioner with the intercalating board in place. The desired angle of the upper extremity can be accommodated by adjustments in the distal platform (260) and the proximal platform (170) with the flat intercalating (340) plate placed in between. In this embodiment the intercalating plate (340) rests passively upon the proximal platform (170) while being joined to the distal platform (260). In this way, a generous portion of the upper extremity is supported by a flat support surface as would be found with a traditional upper extremity board. Adjustments of the angle of The Upper Extremity Positioner with the intercalating board can easily be made by uniplanar adjustments of the distal platform and the proximal platform.

[0108] FIG. 15 A conscious patient lying in a right lateral decubitus position in preparation for positioning of the left arm on the Upper Extremity positioner.

[0109] FIG. 16 A conscious patient lying in a right lateral decubitus position with the arm elevated away from the body. The patient is enacting a preferred position of the left upper extremity which can be held in the position by the cooperative patient or at assistant.

[0110] FIG. 17. A conscious patient lying in a right lateral decubitus position, the arm elevated away from the body, and the Upper Extremity Positioner lying on a table in a position prior to adjustment to receive the arm. The proximal platform (170) is in a lowered position and the distal platform (260) is adjusted to match the position of the postured hand and wrist of the patient.

[0111] FIG. 18. A patient lying in a right lateral decubitus position with the left arm positioned on the upper extremity positioner in preparation for a procedure. The arm has been lowered to lie against the apparatus with the hand and wrist against the distal platform (260) and a portion of the arm proximal to the wrist lying against the proximal platform (170). The proximal platform has been elevated to support the position of the arm in a desired position.

GLOSSARY

[0112] Abovesynonym is higher than; see definition Motion relates to a position of a named element (of the presented embodiment of the Upper Extremity Positioner) with respect to another named element.

[0113] Anatomygeneral term for any portion of an upper extremity including connecting portions of the shoulder girdle (see shoulder, shoulder girdle)

[0114] Arm boardsynonymous with arm board configuration; a term given to an upper extremity support apparatus providing a substantially planar deck designed to provide surface beneath a portion of an extremity proximal to the elbow and also including the elbow, forearm, wrist and hand; An example of this type of device is shown in U.S. Pat. No. 6,336,412-B2.

[0115] Axis linea line drawn to illustrate or define an axis of rotation

[0116] Base Platea substantially planar support surface for attachments of pillars, hinges, fasteners and other devices that aid in supporting an upper extremity.

[0117] Depression of the Upper armmovement of the upper arm of the pivot hinge of the proximal platform toward a parallel position of the upper arm and the lower arm. it is important to note that the hinge as a part of the apparatus can only achieve such a position by movement in one direction (see FIG. 2).

[0118] Detentstructure of a machine that purposefully prevents motion of a part until the part is released

[0119] Distal1. toward the finger tips when describing anatomy of the upper extremity; 2. towards the distal end of the apparatus as described in FIG. 1

[0120] Distal Elevated Platformdistal platform; that portion of the presented embodiment of the upper extremity positioner that holds the wrist and hand.

[0121] Elevated platformsprovides a perch for supporting an upper extremity by a pillar, column hinge, fastener, or other device aiding in the support of an extremity and coupled to the base plate. Each elevated platforms is considered to be independently moveable unless otherwise specified. The elevated platforms of the presented embodiment of the upper extremity positioner (ie, the distal elevated platform and the proximal elevated platform) are independently moveable and otherwise unconnected in space. A proximal elevated platform may have more elevation from the base plate than a distal elevated platform.

[0122] Enactact out as if in a role or play on stage. Refers to a method step where the upper extremity is positioned in the air so that a surgeon or other practitioner can visualize the ideal serviceable position.

[0123] HandAnatomy distal to and including the carpometacarpal joints, not to exclude the digits

[0124] Height Differential (between the proximal and distal elevated platforms)refers to the relative vertical displacements of the platforms, however, since both platforms are also pivotal there can be ambiguity about which portion of the platform is being referenced. When this type of ambiguity occurs the default reference point would be the most proximal nonpivotal element which for the proximal elevated platform (in the depicted embodiment) would be the mounting tabs of the upper arm of the hinge and for the distal elevated platform (in the depicted embodiment) would be the midpoint of the ball.

[0125] Long axis (of the Base Plate)refers to the rectangular shape of the base plate as shown in the preferred embodiment (FIGS. 1-5,7,11,13-14,17-18) indicating the base plate shape has two equal length short sides and two equal length long sides. The long axis of this plate is created by drawing a line on the plate parallel to one of the long sides or by drawing a line on the plate perpendicular to one of the short sides.

[0126] Longitudinal Movementmovement of a support platform, hinge or other coupling device along the long axis line

[0127] Motionalso see Upper1. Vertical Motionsynonym is elevational motion; motion in the ground to sky plane (while on Earth) or referring to motion of a hinge, platform or anatomic site closer versus farther from the base plate, where vertical movement would be farther from the base plate.

[0128] Perpendicular Rotational Axiscircular rotation of an object substantially around an axis line having a constant radius from the axis line; an example is the contact (street) surface of a tire rotating perpendicularly around the axle of the tire.

[0129] Pillarthe most generic term for any load hearing structure that serves to sustain elevation of a platform above the base plate; the term as applied to the presented embodiment of the upper extremity positioner refers specifically to the structure that sustains elevation of the distal elevated platform

[0130] Platformany load bearing structure (other than the base plate) designed to contact anatomy

[0131] Proximal1. towards the shoulder when describing anatomy of the upper extremity; 2. towards the proximal end of the apparatus as described in FIG. 1

[0132] Proximal Elevated Platformproximal platform; that portion of the presented embodiment of the upper extremity positioner that holds anatomy proximal to the distal elevated platform

[0133] Restraining Tie(s)a ligature or other rope like binding used for securing anatomy to the UEP

[0134] Serviceableuseable (as can be related to a given profession)

[0135] Short Axis (of the Base Plate)refers to the rectangular shape of the base plate as shown in the preferred embodiment (FIGS. 1-5,7,11,13-14,7-18) indicating the base plate shape has two equal length short sides and two equal length long sides. The short axis of this plate is created by drawing a line on the plate parallel to one of the short sides or by drawing a line on the plate perpendicular to one of the long sides.

[0136] Shoulder (shoulder girdle)synonym shoulder girdle. In the field of orthopedics the shoulder is generally considered to be the glenohumeral joint, the acromioclaviculr joint and their nearby (otherwise undefined precisely in literature) attachments. The shoulder girdle concept more fully embraces the all of the attachments relevant to shoulder function not to exclude, for example, the pectoralis major. The pectoralis major insertion along the proximal humerus could be considered a landmark for the proximal platform of the upper extremity positioner apparatus.

[0137] Universal jointgeneral term used for a mechanism providing at least two planes of motion for another device or tool component

[0138] Uppersynonymous with higher in the context of the vertical motion (see Motion) definition ie, the nearer to the sky (while on Earth) and the farther from the base plate of a hinge part, platform or anatomic site.

[0139] Vertical motionsee Motion

[0140] Wristthe segment along the axial plane of the upper extremity between the more proximal of the distal radius and ulna articular surface and the carpometacarpal joint