US3650274A - Retention suture bridge - Google Patents

Retention suture bridge Download PDF

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Publication number
US3650274A
US3650274A US3650274DA US3650274A US 3650274 A US3650274 A US 3650274A US 3650274D A US3650274D A US 3650274DA US 3650274 A US3650274 A US 3650274A
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Prior art keywords
suture
bridging element
slot
surgical apparatus
capstan
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Expired - Lifetime
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Leon C Edwards
Harvey B Mandel
Carl R Tillstrom
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Ethicon Inc
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Ethicon Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0466Suture bridges
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B2017/0496Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures

Abstract

Apparatus for controlling and distributing the tension of retention sutures used in abdominal surgery has a bridging element that may be placed across the surgical incision underneath the loosely tied suture. The surgeon obtains the desired suture tension by placing the tied suture within a slot in a positive locking capstan that is mounted on the bridging element, and rotating the capstan to take up the slack. An increase in the suture tension caused by swelling of the wound may be released by turning the capstan in the reverse direction.

Description

United States Patent Edwards et al.

[451 Mar. 21, 1972 [54] RETENTION SUTURE BRIDGE [72] Inventors: Leon C. Edwards, Somerville; Harvey B.

Mandel, North Brunswick; Carl R. Tillstrom, East Windsor Twps., Mercer City,

all of NJ.

[73] Assignee: Ethicon, lnc., Somerville, NJ.

22 Filed: on. 20, 1970 [2]] Appl. No.: 82,255

[51] Int. Cl. v ..A61b 17/04 [58] Field of Search ..128/334 R, 335

[56] Relerences Cited UNITED STATES PATENTS 815,264 3/1906 Chambers ..128/334 R 1,852,098 4/1932 Anderson ..128/335 3,014,483 12/1961 McCarthy ..128/334 R OTHER PUBLICATIONS Broaddus Surgery, Gyne., & Obstet. Vol. 124, Feb. 1967, pp. 359- 361.

Primary Examiner-Dalton L. Truluck Attorney-Robert W. Kell and Robert L. Minier s71 ABSTRACT Apparatus for controlling and distributing the tension of retention sutures used in abdominal surgery has a bridging element that may be placed across the surgical incision undemeath the loosely tied suture. The surgeon obtains the desired suture tension by placing the tied suture within a slot in a positive locking capstan that is mounted on the bridging element, and rotating the capstan to take up the slack. An increase in the suture tension caused by swelling of the wound may be released by turning the capstan in the reverse direction.

6 Claims, 12 Drawing Figures PATENTEUHARZI I972 3,650,274

sum 1 BF 3 INVENTORS 5 QTTORNE'Y a PATENTEUMARZI I972 Y sum 2 or 3 w m3 owms m M Z. m m2 (/0 f ms yw PATENTEDHARZ] I972 I ,550, 7

SHEET 3 OF 3 ATTORN'E RETENTION SUTURE BRIDGE BACKGROUND OF THE INVENTION Retention sutures (stay sutures) are frequently employed in abdominal and thorasic surgery when the surgeon is concerned with wound dehiscence because of age or condition of the patient. Such sutures are placed through the skin a distance away from the incision, downwardly through the fatty and muscular layers by means of a curved needle, then upwardly through both layers and the skin at the opposite side of the incision, and tied in a knot to draw the edges of the skin together. A preferred surgical technique is to apply the suture in a figure-of-eight configuration in which the lower loop of the suture surrounds the severed portions of muscular tissue and the upper loop is completed by tying a knot above the skin layer. In either case the knotted suture crosses the incision and rests on the sensitive skin adjacent to the wound. As swelling frequently occurs after surgery, it is customary for the comfort of the patient to provide a device to release and distribute the stress applied as the suture tension increases.

Makeshift devices for use with retention sutures have proliferated as surgeons have tried bridges, stents, cushions, sleeves, splints, bolsters, bars, shields, buffers, rolls, pads, buttons, tubing, pants, bumpers, boots, and booties. Perhaps the most widely used devices in the United States are rubber or plastic tubes which are generally available and easy to use because they can be quickly cut to the desired length. Such tubes have the advantage of simplicity, flexibility, and softness, but the tubing itself can cause skin necrosis and there is no way of adjusting the suture tension.

Surgeons have also used bridges, shields, and bars in conjunction with retention sutures. Such devices are placed across the wound and the retention suture is tied over it. A suture bridge has the advantage over a tube of better distribution of pressure over the skin surface and acts as a strut thereby preventing cutting as the suture comes through the skin. One such device that is adaptable to varying breadth of the retention suture line is described in Surgery, Gynecology, and Obstetrics, Volume 124, pages 359-361, Feb. 1967.

The basic design of suture bridges is important as high arched bridges tip or topple; flat bridges press on the incision; wide bridges obscure the wound; narrow bridges invite skin necrosis; hard bridges cut into the skin; and soft bridges buckle. A bridge suitable for one patient may not be suitable for the next or even for the next or even for the next retention suture in the same patient. A major disadvantage of most suture bridges however, similar to the problem encountered with rubber or plastic tubes, is the inability to adjust suture tension. A suture bridge that will support the suture in such manner that it will not bear on the wound while permitting adjustment of the suture tension following surgery is described in U.S. Pat. No. 1,852,098.

In view of the above it will be understood that an object of the present invention is to provide an improved surgical suture bridge. More specifically it is an object of the invention to provide a bridge with adjustable means to .either increase or decrease suture tension at any time following placement of the suture by the surgeon.

SUMMARY OF THE INVENTION The suture bridge of the present invention may be molded of a transparent plastic material in two parts. The bridging element has a plurality of openings spaced longitudinally so that when placed across the incision after suturing, each end of the suture as it exits through the skin will be in approximate registration with an opening and therefore may pass through the bridge and be tied above a longitudinal slot therein, adapted to receive the suture.

The suture when tied in position above the bridge engages a positive locking capstan that is mounted on the bridge for rotation. The tension of the tied suture may be adjusted at any time by rotating the capstan as will be better understood from the following descriptions when read in conjunction with the accompanying drawings wherein:

FIG. 1 shows the suture bridge in place and in locked position;

FIG. 2 is a vertical cross section, thereof and taken along lines 2-2 of FIG. 1;

FIG. 3 is an enlarged fragment in cross section of FIG. 2 showing the locking post in elevation;

FIG. 4 is a plan view thereof;

FIG. 5 is a vertical cross section of FIG. 3 taken along lines 5-5;

FIG. 6 is a perspective of the locking post;

FIG. 7 is a plan view similar to FIG. 4 and of the suture placed in position prior to tightening and locking;

FIG. 8 is a vertical cross section thereof taken along lines 88 of FIG. 7;

FIG. 9 shows the surgeon placing the bridge in position after the retention suture has been placed;

FIG. 10 illustrates the appearance of the suture after it is tied, with the retention bridge in place across the surgical incision;

FIG. 11 shows the surgeon engaging the suture in the positive locking capstan; and

FIG. 12 illustrates the manner in which the surgeon can adjust suture tension by rotating the capstan.

Referring first to FIGS. l-3 which best illustrate the construction of the bridge element 10, it will be noted that it is constructed with a slightly concave lower surface 11 adapted to conform with the abdomen of a patient. The bridge 10 has a thickened central portion 12 and a first cylindrical bore 13 in the upper surface 14 of said thickened portion that is perpendicular to the longitudinal axis of the bridge. A second cylindrical bore 15 in the bridge is concentric with said first bore and of smaller diameter. The thickened portion of the bridge and the first and second bore are transversed by a slot 16 that extends along the upper surface of the bridge parallel to its longitudinal axis. Openings 17 are spaced centrally and longitudinally from each end of the bridge toward the central portion in line with the slot and extend through the bridging element from the upper surface 14 to the lower surface 11.

A positive acting capstan 20 is positioned within the bore 15. The construction of this capstan and its mode of operation will be best understood by referring to FIGS. 4, 5, and 6. The capstan is constructed with a flange 21 at the upper end and has a cylindrical body portion 22 that is received by the bore 15 of the bridging element for slidable and rotary motion thereto. The flange at the upper end of the capstan has cogs 23 spaced around the circumference thereof. Both the capstan and cogged flange are bisected by a slot 24 characterized by a V-shaped entrance.

Stop pins 25 are spaced around the circumference of the bore 13 and engage the cogs 23 when the capstan is pressed downwardly toward the lower surface of the bridge. These pins are disengaged when the capstan is pulled upward.

The capstan may be secured within the bore 15 by a bolt 26.

Further details of the present invention are best understood within the framework of its use by the surgeon. Referring now to FIG. 9, there is shown the hand of a surgeon passing one end of a retention suture through the bridge. The other end of the suture is passed through an opening chosen so that when the bridge is in position across the incision as shown in FIG. 10, the section of the bridge between the-suture ends closely approximates the suture spacing, i.e., so that the openings used to receive the suture 30 are in approximate registration with the bridge as best shown in FIG. 10. The suture is tied by the surgeon to complete a loop above the points of emergence of the suture from the skin.

After the suture is properly tied, the surgeon lifts the capstan upwardly in the direction of the arrow in FIG. 8 so that it is free of the stop pins 25 and rotates the cogged flange to align the slot 24 in the capstan with the slot 16 of the bridge. The suture is then laid in the slot 24 as best shown in FIG. 11 and the capstan is rotated clockwise as shown in FIGS. 7 and 8 until the tension of the suture is that desired by the surgeon (see FIG. 12). The capstan is then pressed downward to engage the cogs 23 with the stop pins 25 thus locking the suture in position.

If the wound should swell thereby increasing suture tension, the surgeon may relieve the tension by moving the capstan to its upper position above the stop pins 25, rotating the capstan in a counterclockwise direction to unwind the suture and again depressing the capstan to engage the stop pins 25 when the proper tension is approximated.

It will be noted from FIGS. 1 and 2 that the ends of the bridging element are turned upwardly which prevents the bridge from cutting into the skin of the patient. The bridge may be molded from any thermoplastic material such as methyl methacrylate. The preferred material is a polycarbonate resin such as that manufactured by the General Electric Co. under the trademark Lexan because this material is flexible, has exceptional clarity and will withstand autoclavmg.

As best illustrated in FIG. 2, the bridge distributes the stress resulting from the tension of the suture over a relatively large skin area while the appreciable width of the suture and the proximity of the suture to the surface of the patients body imports lateral stability to the bridge and prevents it from tipping over.

From the foregoing description of the invention it will be readily apparent that an improved surgical bridge is made available to the surgeon that will reduce the incidence of disfiguration by wound scars and contribute to the comfort of the patient undergoing surgery.

What is claimed is:

l. A surgical apparatus for use in controlling and distributing the tension of transverse retention sutures comprising:

a surgical incision bridging element, having a thickened central portion;

a cylindrical bore in said thickened portion perpendicular to the longitudinal axis of said bridging element, said cylindrical bore being transversed by a slot extending parallel to said longitudinal axis;

openings spaced centrally and longitudinally beyond each side of said slot and extending through the bridging element;

a positive locking capstan characterized by a cogged flange at the outer end, positioned within said bore for slideable and rotary motion relative thereto;

a slot transversing said cogged flange; and,

a stop adjacent the wall of said bore and integral with the bridging element, adapted to engage the cogged flange when slideably moved to its inward position.

2. The surgical apparatus of claim 1 wherein said bridging element is molded of a transparent plastic material.

3. The surgical apparatus of claim 2 wherein said plastic material is stable at elevated temperatures whereby the apparatus may be repeatedly sterilized by autoclaving.

4. The surgical apparatus of claim 1 wherein the bridging element is characterized by a concave lower surface.

5. The surgical apparatus of claim 1 wherein a plurality of stops are positioned around the circumference of said bore.

6. The surgical apparatus of claim 1 characterized by a V- shaped entrance to the slot transversing the cogged flange, whereby the placement of a suture in the slot is facilitated.

UNITED STATES PATENT OFFICE I CERTIFICATE OF CORRECTION Patent No. 3,650,271 Dated March 21,1972

Inventor(s) Leon C. Edwards; Harvey B. Mandel; Carl R. Tillstrom It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

In Column 1, line #5, "for the next or even for the next or even for the next retention" should read --for the next or even for the next retention--.

Signed and sealed this 12th day of September 1972.

(SEAL) Attest:

EDWARD M.FLETCHER ,JR. Attesting Officer ROBERT GOTTSCHALK Commissioner of Patents

Claims (6)

1. A surgical apparatus for use in controlling and distributing the tension of transverse retention sutures comprising: a surgical incision bridging element, having a thickened central portion; a cylindrical bore in said thickened portion perpendicular to the longitudinal axis of said bridging element, said cylindrical bore being transversed by a slot extending parallel to said longitudinal axis; openings spaced centrally and longitudinally beyond each side of said slot and extending through the bridging element; a positive locking capstan characterized by a cogged flange at the outer end, positioned within said bore for slideable and rotary motion relative thereto; a slot transversing said cogged flange; and, a stop adjacent the wall of said bore and integral with the bridging element, adapted to engage the cogged flange when slideably moved to its inward position.
2. The surgical apparatus of claim 1 wherein said bridging element is molded of a traNsparent plastic material.
3. The surgical apparatus of claim 2 wherein said plastic material is stable at elevated temperatures whereby the apparatus may be repeatedly sterilized by autoclaving.
4. The surgical apparatus of claim 1 wherein the bridging element is characterized by a concave lower surface.
5. The surgical apparatus of claim 1 wherein a plurality of stops are positioned around the circumference of said bore.
6. The surgical apparatus of claim 1 characterized by a V-shaped entrance to the slot transversing the cogged flange, whereby the placement of a suture in the slot is facilitated.
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Cited By (55)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2193622A1 (en) * 1972-07-25 1974-02-22 Technalytics In
US3831608A (en) * 1972-11-24 1974-08-27 Bio Medicus Inc Suture bridges
US4667675A (en) * 1986-03-06 1987-05-26 Davis Emsley A Retention suture apparatus
US4773421A (en) * 1986-03-06 1988-09-27 Davis Emsley A Retention suture apparatus
US4938760A (en) * 1989-03-29 1990-07-03 American Medical Systems, Inc. Female suspension procedure
US4950284A (en) * 1987-11-03 1990-08-21 United States Surgical Corporation Fascia clip
US5127412A (en) * 1990-03-14 1992-07-07 Cosmetto Aristodeme J Skin tensioning
EP0506992A1 (en) * 1990-03-07 1992-10-07 Detlef Behrend Abdominal wall closure multipart plate
WO1993004633A1 (en) * 1991-08-29 1993-03-18 Tufts University Method and kit for accelerating the closing of open skin wounds
US5441540A (en) * 1993-09-20 1995-08-15 Kim; Paul S. Method and apparatus for skin tissue expansion
EP0894474A1 (en) * 1997-07-28 1999-02-03 Thomas Prof. Dr. Ischinger Tension holder e.g. for vascular suture or plug device
US6471715B1 (en) * 1998-01-19 2002-10-29 Wisebands Ltd Suture tightening device for closing wounds and method for its use
US20030139776A1 (en) * 1998-08-10 2003-07-24 Anthony Paolitto Suture retention device
US20040193187A1 (en) * 2003-01-25 2004-09-30 Boehringer John R. Device and method for treating a wound
WO2005039429A1 (en) * 2003-10-24 2005-05-06 Karl Storz Gmbh & Co. Kg Device for fixing and tensioning at least one pulling thread for applying a neovagina
US20060271080A1 (en) * 2003-01-17 2006-11-30 Loubert Suddaby Flexible Wire Transection of the Transverse Carpal Ligament
US20100185236A1 (en) * 2004-11-04 2010-07-22 Wound Care Technologies, Llc Wound closure product
US20110077671A1 (en) * 2006-05-02 2011-03-31 Ethicon Endo-Surgery, Inc. Suture management
US20120059418A1 (en) * 2006-02-03 2012-03-08 Biomet Sports Medicine, Llc Method and Apparatus for Tensioning a Suture
US8876845B2 (en) 2010-09-30 2014-11-04 Loubert Suddaby Sling blade transection of the transverse carpal ligament
US20150112227A1 (en) * 2013-10-18 2015-04-23 Leonard DiGiovanna Phlebotomy aid device
EP2572649A3 (en) * 2011-09-23 2015-06-24 Karl Storz GmbH & Co. KG Skin stretching device
US9381033B2 (en) 2012-04-30 2016-07-05 Joseph Guo Method and apparatus for thread transection of a ligament
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US9402621B2 (en) 2006-02-03 2016-08-02 Biomet Sports Medicine, LLC. Method for tissue fixation
US9408599B2 (en) 2006-02-03 2016-08-09 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9414833B2 (en) 2006-02-03 2016-08-16 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
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US9463020B2 (en) 2004-09-13 2016-10-11 Wound Care Technologies, Inc. Wound closure product
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US9498204B2 (en) 2006-02-03 2016-11-22 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US9504460B2 (en) 2004-11-05 2016-11-29 Biomet Sports Medicine, LLC. Soft tissue repair device and method
US9510819B2 (en) 2006-02-03 2016-12-06 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US9532777B2 (en) 2006-02-03 2017-01-03 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9539003B2 (en) 2006-09-29 2017-01-10 Biomet Sports Medicine, LLC. Method and apparatus for forming a self-locking adjustable loop
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US9572655B2 (en) 2004-11-05 2017-02-21 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9603591B2 (en) 2006-02-03 2017-03-28 Biomet Sports Medicine, Llc Flexible anchors for tissue fixation
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US9724090B2 (en) 2006-09-29 2017-08-08 Biomet Manufacturing, Llc Method and apparatus for attaching soft tissue to bone
US9757119B2 (en) 2013-03-08 2017-09-12 Biomet Sports Medicine, Llc Visual aid for identifying suture limbs arthroscopically
US9763656B2 (en) 2006-02-03 2017-09-19 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US9788876B2 (en) 2006-09-29 2017-10-17 Biomet Sports Medicine, Llc Fracture fixation device
US9801620B2 (en) 2006-02-03 2017-10-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US9833230B2 (en) 2006-09-29 2017-12-05 Biomet Sports Medicine, Llc Fracture fixation device
US9861351B2 (en) 2007-04-10 2018-01-09 Biomet Sports Medicine, Llc Adjustable knotless loops
US9918827B2 (en) 2013-03-14 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US9918826B2 (en) 2006-09-29 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US10004588B2 (en) 2006-02-03 2018-06-26 Biomet Sports Medicine, Llc Method and apparatus for fixation of an ACL graft
US10022141B2 (en) 2012-04-30 2018-07-17 Joseph Guo Method and apparatus for thread transection of a ligament
US10022118B2 (en) 2006-02-03 2018-07-17 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
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Cited By (78)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2193622A1 (en) * 1972-07-25 1974-02-22 Technalytics In
US3831608A (en) * 1972-11-24 1974-08-27 Bio Medicus Inc Suture bridges
US4667675A (en) * 1986-03-06 1987-05-26 Davis Emsley A Retention suture apparatus
US4773421A (en) * 1986-03-06 1988-09-27 Davis Emsley A Retention suture apparatus
US4950284A (en) * 1987-11-03 1990-08-21 United States Surgical Corporation Fascia clip
EP0615725A1 (en) * 1989-03-29 1994-09-21 American Medical Systems, Inc. Suspension of female urethrovesical junction and anchoring means therefor
US4938760A (en) * 1989-03-29 1990-07-03 American Medical Systems, Inc. Female suspension procedure
EP0390469A1 (en) * 1989-03-29 1990-10-03 American Medical Systems, Inc. Suspension of female urethrovesical junction and anchoring means therefor
EP0506992A1 (en) * 1990-03-07 1992-10-07 Detlef Behrend Abdominal wall closure multipart plate
US5127412A (en) * 1990-03-14 1992-07-07 Cosmetto Aristodeme J Skin tensioning
WO1993004633A1 (en) * 1991-08-29 1993-03-18 Tufts University Method and kit for accelerating the closing of open skin wounds
US5441540A (en) * 1993-09-20 1995-08-15 Kim; Paul S. Method and apparatus for skin tissue expansion
US5549713A (en) * 1993-09-20 1996-08-27 Kim; Paul S. Method for skin tissue expansion
EP0894474A1 (en) * 1997-07-28 1999-02-03 Thomas Prof. Dr. Ischinger Tension holder e.g. for vascular suture or plug device
US6471715B1 (en) * 1998-01-19 2002-10-29 Wisebands Ltd Suture tightening device for closing wounds and method for its use
US20070179511A1 (en) * 1998-08-10 2007-08-02 Coroneo, Inc. Suture retention device
US20030139776A1 (en) * 1998-08-10 2003-07-24 Anthony Paolitto Suture retention device
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US20060271080A1 (en) * 2003-01-17 2006-11-30 Loubert Suddaby Flexible Wire Transection of the Transverse Carpal Ligament
US7887564B2 (en) 2003-01-25 2011-02-15 Boehringer Technologies, L.P. Method for treating a wound
US20090088708A1 (en) * 2003-01-25 2009-04-02 Boehringer Closure Properties, L.P. Method for treating a wound
US20040193187A1 (en) * 2003-01-25 2004-09-30 Boehringer John R. Device and method for treating a wound
US7850713B2 (en) 2003-10-24 2010-12-14 Karl Storz Gmbh & Co. Kg Device for fixing and tensioning at least one pulling thread for applying a neovagina
US20060229676A1 (en) * 2003-10-24 2006-10-12 Frank Doll Device for fixing and tensioning at least one pulling thread for applying a neovagina
WO2005039429A1 (en) * 2003-10-24 2005-05-06 Karl Storz Gmbh & Co. Kg Device for fixing and tensioning at least one pulling thread for applying a neovagina
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US20100185236A1 (en) * 2004-11-04 2010-07-22 Wound Care Technologies, Llc Wound closure product
US9597079B2 (en) 2004-11-04 2017-03-21 Wound Care Technologies, Inc. Wound closure product
US8864796B2 (en) * 2004-11-04 2014-10-21 Wound Care Technologies, Inc. Wound closure product
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US9801708B2 (en) 2004-11-05 2017-10-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US9572655B2 (en) 2004-11-05 2017-02-21 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
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US9801620B2 (en) 2006-02-03 2017-10-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US9763656B2 (en) 2006-02-03 2017-09-19 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US9402621B2 (en) 2006-02-03 2016-08-02 Biomet Sports Medicine, LLC. Method for tissue fixation
US10004489B2 (en) 2006-02-03 2018-06-26 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
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US9642661B2 (en) 2006-02-03 2017-05-09 Biomet Sports Medicine, Llc Method and Apparatus for Sternal Closure
US9510821B2 (en) 2006-02-03 2016-12-06 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US9468433B2 (en) 2006-02-03 2016-10-18 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
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