DE102021116402A1 - BONE FIXATION SYSTEM AND METHOD - Google Patents

Abstract

A bone fixation system includes a buckle having a plurality of locking bars and a hook. A strap can connect the hook to an opposite end of the buckle and around a bone. The buckle may include locking bars at the opposite end of the buckle to accommodate the strap and allow frictional resistance to loosening of the strap around the bone to facilitate fracture reduction of the bone.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims priority from U.S. provisional application serial no. 63 / 043.841 , filed June 25, 2020, U.S. Provisional Application No. 63 / 115.460 (Attorney Docket No. 3768.098P2), filed Nov. 18, 2020, and U.S. Provisional Application No. 63 / 185.761 (Lawyer reference number no. 3768.098P3 ), filed on May 7, 2020, all of which are incorporated herein by reference in their entirety.

The present application relates to US application serial no. 16 / 910,328 (Attorney Docket No. 3768.085A), filed June 24, 2020, which took advantage of U.S. Provisional Application Serial No. 62 / 865,676 (Lawyer reference number no. 3768.085P ), filed June 24, 2019 and U.S. Provisional Application No. 62 / 905.017 (Lawyer reference number no. 3768.085P2 ), filed on September 24, 2019, which are incorporated herein by reference in their entirety.

Field of invention

This application relates generally to bone fixation devices, devices, and methods, and more particularly, cerclage devices, devices, and methods in connection with the fixation and instrumentation of skeletal fractures to facilitate fracture reduction.

background

Femoral fractures can occur naturally or iatrogenically during total hip replacement. Depending on the fracture pattern, cerclage alone, cerclage with a plate or plates, cerclage with a strut, cerclage with an elongated hip stem, or cerclage with a combination of plates, braces, and / or elongated hip stems can be used for bone fixation. One problem with cerclage, however, is that it can create poor bone bonds without the use of additional support devices. In particular, total hip replacement using additional support may not be desirable or possible.

In femoral fractures, this can place high stress on the cerclage wires, leading to adjacent bone erosion and loss of fixation due to wire migration.

Fracture reduction of long bones often involves realignment of spiral fractures and multiple pieces. Bone clamps are often folding devices (e.g., forceps) with special tips or spurs to grip (e.g., engage and hold) bone. Closing such a clamp applies force to the fragments, pushing them closer together. Limitations of conventional clamps are that they generate forces linearly or very close to linear. Such clamps can also be bulky, and when multiple clamps are used, as is common practice, access to a fracture site for placement of hardware (e.g., plates or screws) may be restricted. Even individual planar forces generated by a clamp cannot sufficiently reduce some fractures. Furthermore, clamps must be removed after fixation, and sometimes such removal can result in a disadvantage of reduction and misalignment.

In another example, solid cerclage wire was used to provide circumferential forces to reduce fractures. There are several disadvantages to using such a wire, including that the wire can be so stiff that the wire can be very difficult to manipulate. Also, unless the wire is ideally placed initially, it is almost impossible to reshape the wire so that it will fit elsewhere. Furthermore, the conventional method of tensioning the solid ceria wire involves twisting the ends in a tight spiral. This requires special bulky tools, and the resulting twisted wire can be extremely stiff and often cannot be flattened to machine both all around. If the twisted wire is left in place, the wire can irritate soft tissue. These limitations have resulted in the decline in the use of a fixed temporary wire fixation, so this technique is rarely used.

There is a need for an apparatus that provides improved bone bonds while minimizing bone erosion and loss of fixation due to wire migration.

Figure list

• 1 ist eine perspektivische Ansicht eines Systems zur Knochenfixierung, das eine Schnalle und einen Gurt gemäß der vorliegenden Erfindung einschließt;
• 2 ist eine Querschnittsansicht eines Teils der Schnalle von 1, die Verriegelungsstangen bzw. Riegelstangen einschließt;
• 3 ist eine seitliche Querschnittsansicht der Schnalle von 1, die Verriegelungsstangen einschließt und die einen Weg des Gurts von 1 um die Verriegelungsstangen zeigt;
• 4 ist eine Seitenansicht eines distalen Endes des Gurts von 1, das eine Schlaufe bzw. Lasche zur Befestigung an der Schnalle einschließt;
• 5 ist eine Seitenansicht einer Umführungseinrichtung, die den Gurt von 1 einschließt, der in einem Hohlraum darin aufgenommen ist;
• 6 ist eine Seitenansicht der Umführungseinrichtung von 5;
• 7 ist eine Seitenansicht des Systems von 5, das den Gurt, der an einem proximalen Ende der Schnalle befestigt ist, und eine Lasche des Gurts einschließt, die an der Schnalle befestigt ist;
• 8 ist eine Seitenansicht des Systems von 7, wobei die Schnalle und Lasche aneinander befestigt sind;
• 9 ist eine Seitenansicht des Systems von 8, das weiterhin einen Spanner einschließt;
• 10 ist eine Seitenansicht des Systems von 9, wobei das proximale Ende des Gurts in einem Durchgang des Spanners aufgenommen ist;
• 11 ist eine Seitenansicht des Systems von 10, wobei der Spanner ausgerichtet ist, sich mit der Schnalle zu verbinden;
• 12 ist eine Seitenansicht des Systems von 11, das die Drehrichtung eines Griffs des Spanners zeigt, um dem Gurt zum Festziehen des Gurts relativ zur Schnalle und zum Knochen zu ziehen;
• 13 ist eine Seitenansicht des Systems von 11, das den zu schneidenden Gurt zeigt;
• 14 ist eine perspektivische Ansicht des Spanners von 13;
• 15 ist eine perspektivische Ansicht eines anderen Beispiels einer Schnalle, die anstelle der Schnalle von 1 nützlich ist,
• 16 ist eine Draufansicht auf die Schnalle von 15;
• 17 ist eine perspektivische Ansicht einer Platte mit mehreren Schnallen gemäß der vorliegenden Erfindung;
• 18 ist eine Draufsicht auf die Platte von 17, und
• 19 ist eine perspektivische Ansicht einer Unterlegscheibe mit einer Vielzahl von Verriegelungsstangen gemäß der vorliegenden Erfindung.

The present invention will be more fully understood from the detailed description given hereinafter and from the accompanying drawings of the preferred embodiment of the present invention, which, however, should not be construed as limiting the invention, but are for illustration and understanding only.

• 1 Figure 4 is a perspective view of a bone fixation system including a buckle and strap in accordance with the present invention;
• 2 FIG. 11 is a cross-sectional view of a portion of the buckle of FIG 1 which includes locking bars;
• 3 FIG. 14 is a side cross-sectional view of the buckle of FIG 1 , which includes locking bars and which has one path of the belt from 1 around the locking bars;
• 4th FIG. 13 is a side view of a distal end of the strap of FIG 1 which includes a loop for attachment to the buckle;
• 5 FIG. 13 is a side view of a bypass device engaging the belt of FIG 1 which is received in a cavity therein;
• 6th FIG. 13 is a side view of the bypass device of FIG 5 ;
• 7th FIG. 3 is a side view of the system of FIG 5 that includes the strap attached to a proximal end of the buckle and a tab of the strap attached to the buckle;
• 8th FIG. 3 is a side view of the system of FIG 7th wherein the buckle and tab are attached to one another;
• 9 FIG. 3 is a side view of the system of FIG 8th which further includes a tensioner;
• 10 FIG. 3 is a side view of the system of FIG 9 wherein the proximal end of the strap is received in a passage of the tensioner;
• 11th FIG. 3 is a side view of the system of FIG 10 wherein the tensioner is oriented to connect to the buckle;
• 12th FIG. 3 is a side view of the system of FIG 11th Fig. 13 shows the direction of rotation of a handle of the tensioner to pull the strap to tighten the strap relative to the buckle and bone;
• 13th FIG. 3 is a side view of the system of FIG 11th showing the strap to be cut;
• 14th FIG. 3 is a perspective view of the tensioner of FIG 13th ;
• 15th FIG. 13 is a perspective view of another example of a buckle used in place of the buckle of FIG 1 is useful
• 16 FIG. 8 is a top view of the buckle of FIG 15th ;
• 17th Figure 3 is a perspective view of a multiple buckle panel in accordance with the present invention;
• 18th FIG. 8 is a top plan view of the plate of FIG 17th , and
• 19th Figure 4 is a perspective view of a washer having a plurality of locking bars in accordance with the present invention.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The present invention will hereinafter be discussed in detail in terms of various exemplary embodiments according to the present invention with reference to the accompanying drawings. In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the present invention. However, it will be apparent to those skilled in the art that the present invention can be practiced without these specific details. In other instances, well-known structures are not shown in detail in order to avoid unnecessarily obscuring the present invention. Accordingly, all of the implementations described below are example implementations that are provided to enable those skilled in the art to make or use the embodiments of the disclosure, and are not intended to limit the scope of the disclosure, which is defined by the claims.

The following description relates to systems, methods, and devices for use in femoral fixation. However, those skilled in the art will appreciate that other bone fixation is suitable for use with the foregoing systems, methods, and devices. Likewise, the various figures, steps, procedures and workflows are only shown as examples and in no way limit the systems, methods or devices described for carrying out their respective tasks or effects in different time frames or orders. The teachings of the present invention can be applied to fixation with respect to any bone.

Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary, or the following detailed description. It should also be understood that the specific devices and processes illustrated in the accompanying drawings and described in the following description are merely illustrative are exemplary embodiments of the inventive concepts defined in the appended claims. Therefore, specific dimensions and other physical features relating to the embodiments disclosed herein are not to be considered limiting, unless expressly stated otherwise.

A system 10 for fixation or reduction of a bone 20th can be a connector or buckle 30th include the one with a band, strap, or strap 40 connected around bones 20th extends, as in 1 shown.

buckle 30th can use a variety of locking bars 70 and a link end or hook 50 include, as in 2-3 shown. The locking rods can have a teardrop-shaped or teardrop-shaped cross section, as shown in the figures, or can have a round cross-sectional shape. hook 50 can be at a distal end of the buckle 30th be arranged and can have an opening 55 have to be a belt (e.g. belt 40 ) through a receiving opening 60 to pass through that of the inner surfaces of the hook 50 is limited. belt 40 can be a tab 42 have that with a distal portion 32 the buckle 30th is connectable when an opening 44 the tab 42 the distal portion receives therein. If with the buckle 30th connected, may have a distal end 46 of the belt 40 in cavity 60 be included. belt 40 can with buckle 30th can also be connected in other ways besides a tab such as a knot, sleeve or ring, non-eyelet splice, yoke or pulling device, or an embedded internal stopper knot or fastener.

buckle 30th may be made of stainless steel, surgical grade plastic, titanium, PEEK, or cobalt chrome, for example. belt 40 can also be made of a material that can be left in a body for a period of time to allow a bone to heal, such as ultra high molecular weight polyethylene (UHMWPE) for example. belt 40 can be, for example, a 50 cm tape with a width of 3.5 mm and a thickness of 0.6 mm. Furthermore can strap 40 be flexible (e.g. a seam tape) and can be made of strands or braided strands of fine wires made of metal or metallic alloys such as cobalt chrome, stainless steel, titanium and titanium alloys.

One proximal end 48 of the belt 40 can with a proximal end 31 the buckle 30th be or be connected. For example can strap 40 on locking bars 70 be connected, as in 2-3 shown. After stretching around bones 20th , as in 1 shown, can strap 40 distal towards the hook 50 under locking bars 70 extend and extend from the bone 20th Extend upward away before reversing a course and proximally from the hook 50 around a distal rod 72 the locking bars 70 turns away. belt 40 can move from distal rod 72 proximal of the hook 50 away and then down towards the bone 20th extend before it extends distally so that strap 40 around a proximal rod 74 the locking bars 70 goes. From a bottom 75 the proximal rod 74 can get the strap 40 upward and distal toward a top 73 the distal rod 72 extend. belt 40 can move up over the top 73 extend and / or contact with a first strap section 80 of it, while a second strap section 82 an opposite side of the first strap section 80 relative to the top 73 can contact. belt 40 can be seen from the top 73 distal towards the hook 50 , then down towards the bone 20th while contacting the rod 72 extend. The first strap section 80 and the second strap portion can be in contact with each other as strap 40 proximal of rod 72 off hook 50 extends. The proximal end 48 of the belt 40 may extend over a distal portion 49 be arranged facing away from the locking bars 70 away to bones 20th towards the hook 20th extends. The proximal end 48 can be dragged by a user in a direction corresponding to the hook 50 is opposite to the strap 40 through and on the locking bars 70 to pull by as described above. One way of the belt 40 over and against bars 70 can provide frictional resistance to a release of the belt 40 of rods 70 deploy so that the strap 40 tightened and maintained in such a position to cover broken sections of bone 20th hold for a period of time or remain in place to allow reduction of a fracture.

As described, System 10 for fixation or reduction of the bone 20th can be used, and a process for such fixation or reduction is described as follows.

belt 40 can around bones 20th and under tissue and muscle 11th using a bypass device 100 as in 5-7 shown. Bypass device 100 may have a curved extension section 102 with a cavity 104 along an inner circumferential side for receiving the belt 40 in front of a procedure, so that bypass device 100 who have favourited the strap 40 in cavity 104 holds to the bone 20th and under tissue and muscle 11th can be manipulated so that the distal end 46 to an opposite side of the bone 20th relative to a handle portion 101 the Bypass device 100 can be performed. Bypass device 100 can be made from bones 20th removed with strap 40 around the bone 20th remains so that the distal end 46 and the proximal end 48 on an equal side of the bone 20th can be arranged.

As schematically in the 7-9 shown, the tab 42 of the belt 40 with the hook 50 connected and in cavity 55 be included. The belt 40 can be as described above to the locking rods 70 be threaded and connected to them, shown in 1-3 , and shown schematically in 7-9 . A user can use the strap 40 about bones 20th tighten to a fracture 14th of the bone 10 by holding the buckle 30th while pulling the proximal end 48 to reduce.

In one example, the buckle 30th a pair of slots 35 include those on opposite axial or longitudinal sides of the buckle 30th relative to bones 20th are arranged as in 1 shown. The slots 35 can be configured (e.g., shaped and sized) to be arms 210 of a tensioner 200 record, in 14th shown and in 9-13 shown schematically. After the strap 40 about bones 20th led around and with the buckle 30th connected, may be the proximal end 48 of the belt 40 through an intake pass 230 in the tensioner 200 be guided to the strap 40 to allow from tensioner 200 to be pulled or pulled. poor 210 can in the slots 35 added to tensioner 200 with buckle 30th connect to.

One handle 240 of the tensioner 200 Can be rotated by a user to allow pulling of the strap 40 by tensioner 200 away from the bone 20th and towards a proximal end 250 of the tensioner 200 to effect as in 12th shown. A force attached to the strap 40 by pulling through tensioners 200 is provided, the strap 40 around locking bars 70 the buckle 30th pull to the strap 40 around the bone 20th tighten as described above so that the strap 40 is held at a certain tightness by friction caused by the path of the belt 40 around locking bars 70 is provided to for example a reduction of the fracture 14th to allow.

Stretcher 200 can have a rod 260 include the one with the handle 240 connected and passage 230 includes pulling the strap 40 to be provided as described.

After strap 40 about bones 20th is tightened, e.g. if fracture 14th is placed in a desired position determined by a user or surgeon, the strap can 40 be cut so that the proximal end 48 at or adjacent to the proximal end 31 the buckle 30th is like in 1 shown. All sutures in the area around the fracture can be buckled 30th and the remaining strap 40 getting closed.

As indicated, can buckle 30th and strap 40 for the temporary fixation of a bone (e.g. fracture 14th of the bone 10 ) can be used, with the buckle and strap removed after a period of time (e.g. after the bone has healed) or buckle 30th and strap 40 can remain in vivo after the bone has healed. In one example, a bone plate can be attached to a strap (e.g., belt 40 ) to allow such a plate to be placed on appropriate sections of a bone (e.g. bone 10 ) strap to be attached 20th and buckle 30th are in place to resolve a fracture (e.g., fracture 14th ) to reduce. belt 40 can be cut and removed when the plate is suitable to hold the bone and strap 40 also is not needed. Such plates can also be applied to another bone other than over a belt to hold such bone in place to reduce a fracture, for example. Such plates or other surgical metal parts can also be used in vivo with or without such a buckle and strap (e.g. buckle 30th and strap 40 ) Metal parts remain around a bone (such as a fracture 14th ) to stabilize it during a consolidation or fusion thereof.

In one example, multiple examples of a buckle and strap (e.g., buckle 30th and strap 40 ) used to break a fracture (e.g., fracture 14th ) to fix or otherwise fix a bone (e.g. bone 10 ) to hold together at different longitudinal points along such a bone. A fracture can thus be broken down in segments by gradually contracting fragments of the bone (e.g. bone 10 ) can be reduced. Such fracture reduction can be a dynamic operation and forces may need to be redirected due to an often complex geometry of mating surfaces created by manipulating a series of buckles and strap (e.g. several examples of the buckle 30th and strap 40 ) can be adjusted together and moved back again.

In another example, not shown, instead of the tensioner 200 a retaining element (not shown) may be used, the retaining element including arms, which act as arms 210 configured above for the tensioner 200 but not a mechanism for pulling the belt 40 lock in. Instead, the retaining element may include a retaining portion extending away from the arms to allow a user to hold the retaining element, thereby the buckle 30th holding over the arms. While holding the retaining member to hold the buckle, a user can use the proximal end 48 of the belt 40 pull to strap 40 about bones 20th to reduce the fracture 14th to secure, for example.

In another example that is in 15-16 shown may be a buckle 300 instead of the buckle described above 30th can be used and a hook 310 with two outwardly directed prongs 320 that are configured to attach to the tab 42 of the belt 40 to be attached. Locking bars 350 can be used to hold up with the strap 40 to be connected as above for locking bars 70 described.

In an in 17-18 example shown can be a plate 120 Buckles 130 with locking bars 170 and a variety of openings 140 for receiving screws through it to the plate 120 to allow on a bone (e.g. bone 10 ) to be moored. A strap (e.g. strap 40 ) can be attached to a first buckle 131 and a second buckle 132 the buckles 130 attached as above for strap 40 described on the buckle 30th is attached. In an example not shown, the second buckle 132 by a hook similar to the hook described above 50 replaced, and a belt (e.g. belt 40 ) can be attached to locking bars 171 the buckle 131 and the hook, as for locking bars 70 , Hook 50 and strap 40 described. Several examples of such buckles can be found along a length of a plate (e.g., plate 120 ) to be available. Any example of a strap (e.g., strap 40 ) on opposite buckles (e.g. first buckle 131 and second buckle 132 ) attached can be an equal or different amount around a bone (e.g. bone 10 ) stretched to a special therapeutic purpose to reduce a fracture (e.g. fracture 14th ) to reach. Screws can go through openings 140 be introduced after one or more such straps on one or more buckles 130 along the plate 120 are attached to one or more buckles along the plate 120 to secure and a fracture in a bone (e.g., bone 10 ) to reduce.

In an in 19th example shown can be a washer 400 Locking bars 470 and an opening 440 to accommodate bolts through it, thus enclose the washer 400 on a bone (e.g. bone 10 ) is attached. The washer 400 can be in a desired location on a bone (e.g. bone 10 ) on which no other metal parts are placed, or the washer 400 can be arranged on a plate, so that the opening 440 aligned with a hole in the plate to allow a screw to pass through opening 440 and pass through the opening of the plate to the washer 400 to connect with such a plate. A strap (e.g. strap 40 ) can be attached to locking bars 470 and locking bars or a hook of another washer, buckle, or plate attached to portions of a bone (e.g. bone 10 ) to hold together to reduce a fracture, for example. In other examples, locking rods can be incorporated into other fracture fixation metal parts such as washers, plates, serrated washers, and bone anchors. In these cases, buckles can be used at both ends of a belt (e.g. belt 40 ) secured, or the strap can be sandwiched between two discrete pieces of metal (e.g. first buckle 131 , second buckle 132 and washer 400 ) must be secured.

While this invention has been described with respect to at least one embodiment, the present invention can be further modified within the spirit and scope of this disclosure. It is therefore intended that this application cover all variations, uses, or adaptations of the invention using its general principles. Furthermore, this application is intended to cover such departures from the present disclosure as come within known or common practice in the art to which this invention pertains and which are within the limits of the appended claims.

QUOTES INCLUDED IN THE DESCRIPTION

This list of the documents listed by the applicant was generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Patent literature cited

• US 63/043841 [0001]
• US 63/115460 [0001]
• US 63/185761 [0001]
• WO 3768098 P3 [0001]
• US 62/865676 [0002]
• WO 3768085 P [0002]
• US 62/905017 [0002]
• WO 3768085 P2 [0002]

Claims (20)

Fracture fixation system, comprising: a connector having a proximal end for connecting to a first end of a strap configured to extend around a bone for providing fixation to a fracture of the bone, the proximal end having a plurality of locking bars having slots for engaging constraining the strap to tighten the strap to provide fixation of the fracture; and wherein the connector has a distal connection end opposite on the connector relative to the proximal end for attachment to a second end of the strap that extends around the bone. System according to Claim 1 wherein the connection end comprises a hook or tab. System according to Claim 1 wherein the connector further includes slots on opposite longitudinal sides of the connector and longitudinally aligned relative to the connector, the slots configured to engage arms of a tensioner. System according to Claim 3 , further comprising a tensioner engaged with the slots to hold the connector to allow a user to provide tension on the strap to hold the fracture in place. System according to Claim 4 wherein the tensioner has a handle connected to a rod having a passage for receiving the strap such that rotation of the handle provides tension on the strap to fix the fracture. System according to Claim 1 wherein a first locking bar of the plurality of locking bars has a teardrop-shaped cross section. System according to Claim 1 , further comprising a bone plate with a plurality of openings for receiving screws to connect the plate to the bone, and wherein the connector comprises a first portion of the bone plate such that the proximal end and the distal end are located on opposite transverse sides of the bone plate are so that the belt is aligned approximately perpendicular to a longitudinal dimension of the bone plate. System according to Claim 7 wherein the bone plate has a second connector having a second proximal end connected to a first end of a second strap, the second proximal end having a plurality of locking bars defining slots for engaging the second strap, the second connector a second distal connection end for attachment to a second end of the second strap extending around the bone. System according to Claim 1 with the strap threaded around the locking bars and tightened so that the strap is held at a certain tension to allow fixation of the fracture. A method of fixing a bone, comprising: Aligning opposing portions of a broken bone to set the bone; Attaching a first end of a strap to a distal connection end of a connector; Attaching a second end of the strap to a proximal end of the connector by threading the strap through a plurality of slots defined by a plurality of locking bars of the proximal end; Applying force to pull the strap around the locking bars so that the strap is held at a certain tension to hold the bone in place. Procedure according to Claim 10 wherein attaching the first end comprises attaching the first end to a hook or tab of the distal end. Procedure according to Claim 10 , further comprising engaging arms of a tensioner with slots of the connector to hold the connector, wherein the slots are located on opposite longitudinal sides of the connector and are longitudinally aligned relative to the connector. Procedure according to Claim 12 , further comprising receiving the strap in a passage of the post of the tensioner and wherein the user rotates a handle connected to the post to provide tension on the strap to fix the fracture. Procedure according to Claim 10 wherein a first locking rod of the plurality of locking rods has a teardrop-shaped cross section. Procedure according to Claim 10 , further comprising threading the strap around the locking bars and tightening the strap so that the strap is held at a certain tightness to allow fixation of the fracture. Procedure according to Claim 10 , wherein the connector has a first portion of a bone plate, so that the proximal end and the distal end on opposite transverse sides of the Bone plate are arranged so that the belt is aligned approximately perpendicular to a longitudinal dimension of the bone plate, and further comprising connecting the bone plate to the bone via a plurality of bone connection openings. Fracture fixation system, comprising: a connector having a distal opening for receiving a screw to allow connection of the connector to a bone; wherein the connector has a proximal end for connecting to a first end of a strap configured to extend around a bone for providing fixation of the fracture of the bone, the proximal end having a plurality of locking bars having slots for engagement limit in the strap to tighten the strap to provide fixation of the fracture. System according to Claim 17 , wherein a first locking rod of said plurality of locking rods has a teardrop-shaped cross section. System according to Claim 17 with the strap threaded around the locking bars and tightened so that the strap is held at a certain tension to allow fixation of the fracture. System according to Claim 17 wherein the connector is a first connector and further comprising a second connector having a second distal opening for receiving a second screw to allow a second connection of the second connector to the bone, the connector having a second proximal end for connection to a second End of the strap configured to extend around the bone to provide fixation of the fracture of the bone.

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