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WO1988006022A1 - Attaches chirurgicales - Google Patents

Attaches chirurgicales Download PDF

Info

Publication number
WO1988006022A1
WO1988006022A1 PCT/US1988/000477 US8800477W WO8806022A1 WO 1988006022 A1 WO1988006022 A1 WO 1988006022A1 US 8800477 W US8800477 W US 8800477W WO 8806022 A1 WO8806022 A1 WO 8806022A1
Authority
WO
WIPO (PCT)
Prior art keywords
sleeve
grooves
lands
sternum
device defined
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1988/000477
Other languages
English (en)
Inventor
Edward M. Farrell
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO1988006022A1 publication Critical patent/WO1988006022A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • A61B17/823—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage for the sternum
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00004—(bio)absorbable, (bio)resorbable or resorptive

Definitions

  • This invention relates to fastening devices, and especially to devices for use in closing a severed sternum following thoracic surgery.
  • a known procedure is to use suture wires, the suture wires being threaded through tissue on each side of the severed sternum through a portion of the cartilage of the sternum located between the ribs. The ends of the wire are twisted together and snipped above the twist.
  • the technique disclosed above suffers from a number of disadvantages. Not the least among these is that it is very hard for the surgeon to select the appropriate tension on the suture wire to hold the sternum together. Further, the severed ends of the wires can result in macerative damage to the cartilage or the thin layer of tissue above the sternum and can even cut into the sternum. The strength of such sutures is also of critical import ⁇ ance, because quite frequently following chest surgery the patient has a need to cough. Coughing creates considerable strain in the rib structure, and tends to disturb the integrity of sutures applied in the above manner. Still further, the severed ends of the wire irritate the patient and indeed can cause infection in some cases. The wire can damage bone and surrounding tissue which of course is also highly undesirable, and sets up a fracture site.
  • the article is desirable for the article to be formed from a biodegradable plastic.
  • the present invention provides a sternal tie comprising: (i) an elongated body having a first end and a second end; (ii) needle means at the first end for perforating tissue adjacent the sternum; (iii) a central portion of the body being formed with a series of alternating lands and grooves; (iv) a sleeve integral with the second end of the body; (v) the sleeve having an inside surface formed with a plurality of alternating lands and grooves matching in shape the lands and grooves on the body; (vi) the sleeve having a length greater than its thickness; (vii) at least the sleeve and the body being formed from a suitable plastic material; whereby the body may be placed around the two halves of a sternum, the needle and the first end threaded through the sleeve so that the lands and grooves on the body engage the lands and grooves in the sle
  • Figure 1 is a side view of a fastening device prior to use
  • Figure 2 is an illustration of a portion of the device of Figure 1, with the connection completed;
  • Figure 3 is an illustration of the device of
  • Figure 1 about to be placed in position about the sternum following surgery
  • Figure 4 illustrates the device after mating of the male and female portions and after removal of the needle; and Figures 5 and 6 are illustrations of alternative forms of the fastener.
  • the main body 10 of the fastener or tie has an exterior surface comprising a series of alternating lands 13 and grooves 14.
  • the body 10 has a relatively thin cylindrical portion 20, to which there is connected, at end 19, by conventional means, e.g. swaging, a curved needle 11 having a point 18.
  • a sleeve 12 Integral with the body 10 of the connector, and joined thereto to by a connecting element 17, is a sleeve 12 having an interior surface comprising lands 15 and grooves 16 that mate with the grooves 14 and the lands 13 of the body 10. It is desirable but not necessary that the lands and grooves merge into each other smoothly to avoid damage to the tissue as the clamp is passed around the sternum.
  • FIG 3 an article according to the invention is shown just after the needle 11 has been passed around the sternum halves 22, 22* to form a loop resulting in the sleeve 12 and the needle 11 being more or less aligned anterior to the sternum.
  • the needle 11 is then passed through the sleeve 12, and it can readily be understood that the narrow portion 20 of the element 10 can be passed without interference through the sleeve 12.
  • a conventional clamping tool is used to grip portion 20 and forceably draw it through the sleeve 12; the resistance created by the lands and grooves in both of the elements is overcome by the tool, of a type known in the art, and precise regulation of the amount of tension applied to the portion 20 can be achieved by the tool to achieve a carefully measured tightness of the element 10 around the severed halves of the sternum 22, 22' .
  • TE SHEET article according to the invention lies relatively flat against the sternum. Further, if the article is manufactured from a biodegradable material, after a predetermined length of time, established by the nature of the biodegradable material, the fastener will disintegrate after the sternum has healed.
  • the configuration of the interior of the sleeve namely the lands and grooves 15 and 16, can be formed with a retractable tool as is known in the art.
  • the sleeve may be formed in two halves, which are later joined together to form a unitary sleeve.
  • a third possibility, perhaps desirable with certain forms of plastic materials, is to form the lands and grooves on the interior of a very thin sleeve slit axially, the axial slit being closed by the later placement of a sleeve of resilient material surrounding the first formed portion.
  • a soluble core can be used and dissolved after the tie is formed.
  • Suitable biodegradable plastic materials include polyorthoester, polyglyconate and its copolymers, and polydioxanone and its copolymers.
  • Nonbiodegradable plastics such as polyethylene terephthalate, polybutylene and its copolymers, and isotactic polypropylene can be used.
  • Other suitable materials will be known to those skilled in the art and the specific nature of the materials can be selected according to the specific requirements for the fastener. Since the materials used do not form part of this invention a detailed discussion of the materials is not believed necessary. It will readily be seen that the invention provides a fastener having a low outside diameter that makes it highly suitable for use in surgical applications. Discomfort to the patient is minimized, and the work of the surgeon substantially reduced.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Materials For Medical Uses (AREA)
  • Surgical Instruments (AREA)

Abstract

L'attache sternale est destinée à rattacher après une opération chirurgicale les moitiés sectionnées d'un sternum. L'attache comprend un corps allongé avec une aiguille (11) à une extrémité et un manchon (12) à l'extrémité opposée, l'extérieur du corps présentant une série de plats (13) et de rainures (14) s'adaptant aux plats (15) et aux rainures (16) ménagées sur l'intérieur du manchon (12). L'attache est constituée de préférence avec un matériau plastique biodégradable et est conçue pour être serrée à l'aide d'un outil approprié. L'attache est moins irritante pour le patient que les dispositifs des techniques connues de jointure du sternum après opération chirurgicale.
PCT/US1988/000477 1987-02-20 1988-02-19 Attaches chirurgicales Ceased WO1988006022A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US3129187A 1987-02-20 1987-02-20
US031,291 1987-02-20

Publications (1)

Publication Number Publication Date
WO1988006022A1 true WO1988006022A1 (fr) 1988-08-25

Family

ID=21858631

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1988/000477 Ceased WO1988006022A1 (fr) 1987-02-20 1988-02-19 Attaches chirurgicales

Country Status (2)

Country Link
AU (1) AU1684788A (fr)
WO (1) WO1988006022A1 (fr)

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5196022A (en) * 1988-12-12 1993-03-23 Ethicon, Inc. Ligature system for use in endoscopic surgery, ligature and handling instrument for said system
EP0596277A1 (fr) * 1992-10-09 1994-05-11 United States Surgical Corporation Boucle résorbable pour enserrer le sternum
US6575741B2 (en) * 1997-05-09 2003-06-10 Zygomatics Limited Oral anchorage
WO2005094708A1 (fr) 2004-04-01 2005-10-13 Synthes Gmbh Dispositif de fixation externe pour osteosynthese ou manipulation d'interstice osseux
WO2007010092A1 (fr) * 2005-07-18 2007-01-25 Bioretec Oy Systeme de bande bioabsorbable, bande bioabsorbable, procede de realisation d'une bande bioabsorbable, systeme d'aiguille d'une bande bioabsorbable et mecanisme de blocage
WO2009086022A1 (fr) * 2007-12-19 2009-07-09 Avery Dennison Corporation Ensemble de fixation fabriqué à partir d'un matériau durable et procédé apparenté
US8231626B2 (en) 2009-05-12 2012-07-31 Synthes Usa, Llc Self-retaining cable tie
US9084644B2 (en) 2011-02-02 2015-07-21 DePuy Synthes Products, Inc. Bone fixation assembly
US9474553B2 (en) 2013-01-25 2016-10-25 DePuy Synthes Products, Inc. Caps for implants, implant assemblies, and methods of use
US9585705B2 (en) 2012-03-28 2017-03-07 DePuy Synthes Products, Inc. Bone fixation member systems and methods of use
US9603646B2 (en) 2014-05-30 2017-03-28 DePuy Synthes Products, Inc. Bone fixation assembly
WO2020030656A1 (fr) * 2018-08-08 2020-02-13 Brook Orthopaedics Ltd Clamp et câble
US11272961B2 (en) * 2013-03-14 2022-03-15 Spinal Elements, Inc. Apparatus for bone stabilization and distraction and methods of use
US11304733B2 (en) 2020-02-14 2022-04-19 Spinal Elements, Inc. Bone tie methods
US20220183671A1 (en) * 2019-03-21 2022-06-16 New York Society for the Relief of the Ruptured and Crippled, Maintaining the Hospital for Special S Interosseous coupler
USD958366S1 (en) 2011-10-26 2022-07-19 Spinal Elements, Inc. Interbody bone implant
US11457959B2 (en) 2019-05-22 2022-10-04 Spinal Elements, Inc. Bone tie and bone tie inserter
US11464552B2 (en) 2019-05-22 2022-10-11 Spinal Elements, Inc. Bone tie and bone tie inserter
US11464551B2 (en) 2011-02-24 2022-10-11 Spinal Elements, Inc. Methods and apparatus for stabilizing bone
US11478275B2 (en) 2014-09-17 2022-10-25 Spinal Elements, Inc. Flexible fastening band connector
US11517354B2 (en) 2013-09-27 2022-12-06 Spinal Elements, Inc. Method of placing an implant between bone portions
US11918258B2 (en) 2013-09-27 2024-03-05 Spinal Elements, Inc. Device and method for reinforcement of a facet
US12369952B2 (en) 2021-12-10 2025-07-29 Spinal Elements, Inc. Bone tie and portal
US12533167B2 (en) * 2020-03-23 2026-01-27 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery Interosseous coupler

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2987062A (en) * 1956-07-23 1961-06-06 Arthur E Ellison Bone splint with absorbable section
US3570497A (en) * 1969-01-16 1971-03-16 Gerald M Lemole Suture apparatus and methods
US3971384A (en) * 1971-03-12 1976-07-27 Hasson Harrith M Surgical closure
FR2357229A1 (fr) * 1976-07-06 1978-02-03 Partridge Anthony Attache utilisable en chirurgie orthopedique
US4201215A (en) * 1977-09-06 1980-05-06 Crossett E S Apparatus and method for closing a severed sternum
EP0238219A1 (fr) * 1986-03-03 1987-09-23 Pfizer Hospital Products Group, Inc. Dispositif pour fermer le sternum

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2987062A (en) * 1956-07-23 1961-06-06 Arthur E Ellison Bone splint with absorbable section
US3570497A (en) * 1969-01-16 1971-03-16 Gerald M Lemole Suture apparatus and methods
US3971384A (en) * 1971-03-12 1976-07-27 Hasson Harrith M Surgical closure
FR2357229A1 (fr) * 1976-07-06 1978-02-03 Partridge Anthony Attache utilisable en chirurgie orthopedique
US4201215A (en) * 1977-09-06 1980-05-06 Crossett E S Apparatus and method for closing a severed sternum
EP0238219A1 (fr) * 1986-03-03 1987-09-23 Pfizer Hospital Products Group, Inc. Dispositif pour fermer le sternum

Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5196022A (en) * 1988-12-12 1993-03-23 Ethicon, Inc. Ligature system for use in endoscopic surgery, ligature and handling instrument for said system
EP0596277A1 (fr) * 1992-10-09 1994-05-11 United States Surgical Corporation Boucle résorbable pour enserrer le sternum
US6575741B2 (en) * 1997-05-09 2003-06-10 Zygomatics Limited Oral anchorage
WO2005094708A1 (fr) 2004-04-01 2005-10-13 Synthes Gmbh Dispositif de fixation externe pour osteosynthese ou manipulation d'interstice osseux
US8512379B2 (en) 2005-07-18 2013-08-20 Bioretec Oy Bioabsorbable band system, a bioabsorbable band, a method for producing a bioabsorbable band, a needle system of a bioabsorbable band and a locking mechanism
WO2007010092A1 (fr) * 2005-07-18 2007-01-25 Bioretec Oy Systeme de bande bioabsorbable, bande bioabsorbable, procede de realisation d'une bande bioabsorbable, systeme d'aiguille d'une bande bioabsorbable et mecanisme de blocage
WO2009086022A1 (fr) * 2007-12-19 2009-07-09 Avery Dennison Corporation Ensemble de fixation fabriqué à partir d'un matériau durable et procédé apparenté
US8231626B2 (en) 2009-05-12 2012-07-31 Synthes Usa, Llc Self-retaining cable tie
US9084644B2 (en) 2011-02-02 2015-07-21 DePuy Synthes Products, Inc. Bone fixation assembly
US9084645B2 (en) 2011-02-02 2015-07-21 DePuy Synthes Products, Inc. Bone fixation assembly
US10307196B2 (en) 2011-02-02 2019-06-04 DePuy Synthes Products, Inc. Bone fixation assembly
US12343048B2 (en) 2011-02-24 2025-07-01 Spinal Elements, Inc. Methods and apparatus for stabilizing bone
US11464551B2 (en) 2011-02-24 2022-10-11 Spinal Elements, Inc. Methods and apparatus for stabilizing bone
USD979062S1 (en) 2011-10-26 2023-02-21 Spinal Elements, Inc. Interbody bone implant
USD958366S1 (en) 2011-10-26 2022-07-19 Spinal Elements, Inc. Interbody bone implant
US9585705B2 (en) 2012-03-28 2017-03-07 DePuy Synthes Products, Inc. Bone fixation member systems and methods of use
US9474553B2 (en) 2013-01-25 2016-10-25 DePuy Synthes Products, Inc. Caps for implants, implant assemblies, and methods of use
US11272961B2 (en) * 2013-03-14 2022-03-15 Spinal Elements, Inc. Apparatus for bone stabilization and distraction and methods of use
US11918258B2 (en) 2013-09-27 2024-03-05 Spinal Elements, Inc. Device and method for reinforcement of a facet
US11517354B2 (en) 2013-09-27 2022-12-06 Spinal Elements, Inc. Method of placing an implant between bone portions
US9603646B2 (en) 2014-05-30 2017-03-28 DePuy Synthes Products, Inc. Bone fixation assembly
US11478275B2 (en) 2014-09-17 2022-10-25 Spinal Elements, Inc. Flexible fastening band connector
US11998240B2 (en) 2014-09-17 2024-06-04 Spinal Elements, Inc. Flexible fastening band connector
US12440242B2 (en) 2014-09-17 2025-10-14 Spinal Elements, Inc. Flexible fastening band connector
WO2020030656A1 (fr) * 2018-08-08 2020-02-13 Brook Orthopaedics Ltd Clamp et câble
US20220183671A1 (en) * 2019-03-21 2022-06-16 New York Society for the Relief of the Ruptured and Crippled, Maintaining the Hospital for Special S Interosseous coupler
US11464552B2 (en) 2019-05-22 2022-10-11 Spinal Elements, Inc. Bone tie and bone tie inserter
US11457959B2 (en) 2019-05-22 2022-10-04 Spinal Elements, Inc. Bone tie and bone tie inserter
US12496101B2 (en) 2019-05-22 2025-12-16 Spinal Elements, Inc. Bone tie and bone tie inserter
US12232778B2 (en) 2020-02-14 2025-02-25 Spinal Elements, Inc. Bone tie methods
US11304733B2 (en) 2020-02-14 2022-04-19 Spinal Elements, Inc. Bone tie methods
US12533167B2 (en) * 2020-03-23 2026-01-27 New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery Interosseous coupler
US12369952B2 (en) 2021-12-10 2025-07-29 Spinal Elements, Inc. Bone tie and portal

Also Published As

Publication number Publication date
AU1684788A (en) 1988-09-14

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