The invention disclosed herein relates to a multipositional ratchet device for use in conjunction with a surgical retractor assembly. The ratchet device of the invention permits both independent and simultaneous adjustment of the longitudinal axial positioning of a retractor blade stem relative to the device as well as the vertical tilt position of the retractor blade. Furthermore, the device is structured with the adjustment tabs positioned to permit the aforementioned adjustments using continuously maintained finger contact on the tabs using a single hand. The device affords the user improved ergonomics and accuracy of use by virtue of its structural and functional features.