WO1988006022A1 - Attaches chirurgicales - Google Patents
Attaches chirurgicales Download PDFInfo
- 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
Links
- 210000001562 sternum Anatomy 0.000 claims abstract description 30
- 239000000463 material Substances 0.000 claims abstract description 15
- 210000001519 tissue Anatomy 0.000 claims description 10
- 229920003023 plastic Polymers 0.000 claims description 6
- 239000004033 plastic Substances 0.000 claims description 6
- 239000002184 metal Substances 0.000 claims description 2
- 238000001356 surgical procedure Methods 0.000 abstract description 7
- 229920000704 biodegradable plastic Polymers 0.000 abstract description 3
- 238000000034 method Methods 0.000 abstract description 3
- 210000000845 cartilage Anatomy 0.000 description 4
- 229920001577 copolymer Polymers 0.000 description 3
- -1 polyethylene terephthalate Polymers 0.000 description 3
- 206010011224 Cough Diseases 0.000 description 2
- 210000000115 thoracic cavity Anatomy 0.000 description 2
- 210000001835 viscera Anatomy 0.000 description 2
- 229920001710 Polyorthoester Polymers 0.000 description 1
- 239000004743 Polypropylene Substances 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 210000000038 chest Anatomy 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000002788 crimping Methods 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 230000008676 import Effects 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 230000007794 irritation Effects 0.000 description 1
- 230000013011 mating Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 239000002745 poly(ortho ester) Substances 0.000 description 1
- 229920002463 poly(p-dioxanone) polymer Polymers 0.000 description 1
- 229920001748 polybutylene Polymers 0.000 description 1
- 239000000622 polydioxanone Substances 0.000 description 1
- 229920000139 polyethylene terephthalate Polymers 0.000 description 1
- 239000005020 polyethylene terephthalate Substances 0.000 description 1
- 229920001155 polypropylene Polymers 0.000 description 1
- 239000012858 resilient material Substances 0.000 description 1
- 230000000284 resting effect Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- 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, e.g. tourniquets
- 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, setting implements or the like
- 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, e.g. tourniquets
- 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.
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 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 (21)
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 |
US9084645B2 (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 |
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 |
US11464551B2 (en) | 2011-02-24 | 2022-10-11 | Spinal Elements, Inc. | Methods and apparatus for stabilizing bone |
US11464552B2 (en) | 2019-05-22 | 2022-10-11 | Spinal Elements, Inc. | Bone tie and bone tie inserter |
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 |
Citations (6)
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 |
-
1988
- 1988-02-19 AU AU16847/88A patent/AU1684788A/en not_active Abandoned
- 1988-02-19 WO PCT/US1988/000477 patent/WO1988006022A1/fr unknown
Patent Citations (6)
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 (26)
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 |
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 |
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 |
US9084645B2 (en) | 2011-02-02 | 2015-07-21 | DePuy Synthes Products, Inc. | Bone fixation assembly |
US9084644B2 (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 |
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 |
WO2020030656A1 (fr) * | 2018-08-08 | 2020-02-13 | Brook Orthopaedics Ltd | Clamp et câble |
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 |
US11304733B2 (en) | 2020-02-14 | 2022-04-19 | Spinal Elements, Inc. | Bone tie methods |
Also Published As
Publication number | Publication date |
---|---|
AU1684788A (en) | 1988-09-14 |
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