WO2024044201A1 - Système d'implantation de fil orthopédique - Google Patents

Système d'implantation de fil orthopédique Download PDF

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Publication number
WO2024044201A1
WO2024044201A1 PCT/US2023/030845 US2023030845W WO2024044201A1 WO 2024044201 A1 WO2024044201 A1 WO 2024044201A1 US 2023030845 W US2023030845 W US 2023030845W WO 2024044201 A1 WO2024044201 A1 WO 2024044201A1
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WO
WIPO (PCT)
Prior art keywords
implantation
shuttle
bone
cable
cerclage wire
Prior art date
Application number
PCT/US2023/030845
Other languages
English (en)
Inventor
Charles R. Bennett
Nicholas S. Ritchey
Haden JANDA
Adam ZYSK
Original Assignee
Smith & Nephew, Inc.
Smith & Nephew Orthopaedics Ag
Smith & Nephew Asia Pacific Ptd. Limited
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 Smith & Nephew, Inc., Smith & Nephew Orthopaedics Ag, Smith & Nephew Asia Pacific Ptd. Limited filed Critical Smith & Nephew, Inc.
Publication of WO2024044201A1 publication Critical patent/WO2024044201A1/fr

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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
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/842—Flexible wires, bands or straps
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8861—Apparatus for manipulating flexible wires or straps
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8872—Instruments for putting said fixation devices against or away from the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect

Definitions

  • the present disclosure is directed to orthopedic implants for stabilizing one or more portions of a bone, and more specifically, to a cabling system used in orthopedic fixation.
  • Bone fractures are often repaired by securing an orthopedic device to one or more patient bones, such as a bone fastener or screw, plates, implants, and/or the like.
  • an orthopedic device may not be a viable option or may require fracture stabilization before being installed.
  • a wire or other extendable structure for instance, a cerclage wire
  • an incision is made at or near a portion of the fracture and a cable or cerclage wire passer is inserted through the incision.
  • Conventional passers are typically formed of one or more rigid tubes or channels, generally formed into the shape of a hook, extending from a handle.
  • the hook is inserted into the surgical site and the passer is manipulated within the patient until the hook is arranged around the bone, for instance, a shaft of a femur.
  • a surgeon may then feed a cerclage wire into one end of the passer (e.g., at an end of the handle opposite the hook, facing away from the incision), through the tube arranged around the bone, through an open end in the tube, and out of the patient via the incision.
  • the passer may then be manipulated to remove the passer from around the bone and the cerclage wire and passer are separated, leaving the cerclage wire behind, encircling the bone.
  • the surgeon may tension the cerclage wire to secure it to the bone, thereby forming a cable-based “clamp” around the fractured bone.
  • the present disclosure describes an implantation or passer (terms used interchangeably herein without the intent to limit) device for implanting a cable, wire, cerclage wire, fixation wire, or orthopedic wire (terms used interchangeably herein without the intent to limit) around the bone of a patient.
  • the implantation device may be configured for full cerclage wiring of a bone, for example, a 360-degree circumferential placement of a cerclage wire around a bone at a fracture site.
  • a nonlimiting example of a bone may include a femur, for instance, the shaft portion of a femur.
  • a femur may be used in examples of implantation procedures using an implantation device in the present disclosure, examples are not so limited, as implantation devices configured according to some examples may be used to implant cerclage wires around various other patient bone anatomy.
  • an implantation device may include a body configured to house an implantation cable operative to push or pull a cerclage wire around a bone of a patient.
  • an implantation device may include an at least partially hollow body having a distal or implantation end, configured to be implanted within a patient at least partially around a portion of a bone, and a proximal or handle end opposite the distal end.
  • distal may refer to an end of the implantation device that is closer to a target bone when implanted within a patient and the term “proximal” may refer to an end of the implantation device that is closer to an operator of the implantation device.
  • the body of the implantation device may be configured as a hooked or curved cannula or tube.
  • an implantation cable may be arranged within the body.
  • a proximal or handle end of the implantation cable may be coupled to an extension structure.
  • the extension structure may be configured to be pushed within the body toward the bone to extend the implantation cable outside of an opening at the distal end of the body, and to be pulled within the body toward the proximal end of the body to retract the implantation cable into the body.
  • the extension structure may include a handle and/or a shaft coupled to the proximal end of the implantation cable.
  • the extension structure may be, may include, or may be operated by an electric, motorized, computer-implemented, or otherwise automated extension/retraction system.
  • the implantation cable may be configured to encircle or loop around the bone when extended out of the distal end of the body.
  • the implantation cable may be formed of a memory material.
  • the implantation cable may be formed of a memory material configured to form a loop having a predetermined radius or radius range when extended outside of the body. The radius or radius range may be configured to correspond to the outer diameter of the bone.
  • the implantation cable may be formed of various materials, including, without limitation a shape memory material (SMM), a shape memory alloy (SMA), future developed SMMs and SMAs, nickel (Ni), titanium (Ti), copper (Cu), zinc (Zn), aluminum (Al), Ni-Ti materials, nitinol, Cu-Zn-Al materials, Cu-Al-Ni materials, mixtures thereof, alloys thereof, and/or the like.
  • the implantation cable may be formed of nitinol or a material that contains nitinol.
  • the implantation cable may not be formed of a memory material.
  • the implantation cable may be formed of a metal material, a polymer material, a fibrous material, and/or combinations thereof.
  • the implantation cable may be a flat or substantially flat structure.
  • the implantation cable may have a rectangular cross section, for instance, with a flat, ribbon- or band-like shape.
  • the implantation cable may have a width of about 0.5 mm, about 0.75 mm, about 1.0 mm, about 1.25 mm, about 1.5 mm, about 1.75 mm, about 2.0 mm, about 3.0 mm, about 5.0 mm, and any value or range between any two of these values (including endpoints).
  • a distal end of the implantation cable may be coupled to a shuttle.
  • the implantation cable may be releasably coupled to the shuttle.
  • Non-limiting examples of releasable connections may include a magnetic connection, a trigger lock/release connection, snap-fit connection, a gear-based connection, a release pin-or rod-based connection, and/or the like.
  • the implantation device may be configured to pull or push the shuttle in a path around the bone as the implantation device is retracted or extended into/out of the body.
  • the shuttle may be formed of various materials, including, without limitation, metals, polymers, magnets, and/or the like.
  • the shuttle may have a length and/or width of about 0.25 mm, about 0.5 mm, about 1 mm, about 1.5 mm, about 2.0 mm, about 3.0 mm, about 5.0 mm, and any value or range between any two of these values (including endpoints).
  • the shuttle may have one or more shapes, including, without limitation, a square or substantially square shape, a rectangular or substantially rectangular shape, a round or substantially round shape, a triangular or substantially triangular shape, combinations thereof, variations thereof, and/or the like.
  • a face of the shuttle may have a shape and/or elements configured to facilitate movement of the shuttle within the patient and around the bone.
  • the face may be or may have elements that are angled, pointed, faceted, and/or sharp to pierce or cut through tissue (for instance, the linea aspera attached to the femur).
  • the face may be or may have elements that are rounded, beveled, square, angled, pointed, protruding, faceted, sharp, curved, straight, combinations thereof, and/or the like.
  • the shuttle may be a leading edge of the implantation device moving within the patient.
  • the shuttle may be integral in the function of positioning the implantation device around the bone.
  • a cerclage wire may be arranged in or on a component of an implantation device.
  • the cerclage wire may be formed of various materials, including metal materials, polymer materials, fibrous materials, bio-compatible materials, and/or the like.
  • the cerclage wire may be a flexible, monofilament structure.
  • the implantation device may be configured to operate in a “push” or “pull” mode.
  • a push mode for instance, the implantation cable may pull the cerclage wire around the bone as the implantation cable extends around the bone responsive to pushing the shaft within the body.
  • a pull mode for instance, the implantation cable may be extended around the bone responsive to pushing the shaft within the body toward the bone without the cerclage wire being attached to the shuttle, then the shuttle may be attached to the cerclage wire.
  • the implantation cable and/or shuttle may pull the cerclage wire around the bone when the implantation cable is retracted back into the body via pulling the shaft out of the body in a direction away from the bone.
  • the implantation device may include a locking mechanism.
  • the locking mechanism may be or may include a button, toggle, and/or the like that may be actuated to cause a locking element (e.g., a locking pin or other elongated structure) to engage a portion of the shuttle to couple the shuttle to the body after the shuttle has encircled the bone (i.e., maintaining the implantation cable in a loop around the bone).
  • the locking element may be or may include a magnet configured to attach the shuttle to the body.
  • the locking element may be or may include a pin or rod that may engage a corresponding portion (e.g., a slot, ridge, groove, and/or the like) of the shuttle to hold the shuttle at the body after the shuttle has encircled the bone.
  • a push implantation process may be performed using an implantation device configured according to some examples.
  • the push implantation process may include inserting an implantation end of a body of the implantation device into an incision of a patient adjacent to a target bone portion, with a curved implantation end of the body arranged around the target bone portion.
  • the implantation device may include a shuttle coupled to an implantation cable and a cerclage wire.
  • a handle may be coupled to a handle end of the implantation wire.
  • the handle may be pushed into the body, toward the bone, to extend the implantation cable out of an implantation end of the body.
  • the implantation cable may extend and form a loop around the target bone portion, thereby pushing the shuttle and the cerclage wire to travel around the target bone portion.
  • the shuttle may be coupled to the body and the implantation cable may be released from the shuttle and retracted back into the body.
  • the implantation device may be manipulated out of the body of the patient, leaving the cerclage wire encircling the target bone portion.
  • a pull implantation process may be performed using an implantation device configured according to some examples.
  • the pull implantation process may include inserting an implantation end of a body of the implantation device into an incision of a patient adjacent to a target bone portion, with a curved implantation end of the body arranged around the target bone portion.
  • the implantation device may include a shuttle coupled to an implantation cable.
  • a handle may be coupled to a handle end of the implantation wire. The handle may be pushed into the body, toward the bone, to extend the implantation cable out of an implantation end of the body.
  • the implantation cable may extend and form a loop around the target bone portion, thereby pushing the shuttle to travel around the target bone portion.
  • the shuttle may be coupled to the body.
  • the implantation device may include a cerclage wire that may be coupled to the shuttle when the implantation cable has traveled around the target bone portion and the shuttle is arranged at the body.
  • the implantation cable may be retracted back into the body, thereby causing the shuttle to travel back around the bone to the implantation end of the body.
  • the cerclage wire due to the attachment to the shuttle, is pulled around the bone.
  • the cerclage wire at least partially encircles the target bone portion.
  • the implantation device may be manipulated out of the body of the patient, leaving the cerclage wire encircling the target bone portion.
  • an insertion tool for wrapping an orthopedic cable around a bone may include a tool body having an insertion end portion and a slot; a push-pull means that is slidably assembled in the tool body; a memory loop having a proximal end portion and a distal end portion, the proximal end portion affixed to the push-pull means, the memory loop may include a shuttle at the distal end portion, the shuttle may be adapted to receive the orthopedic cable, wherein the memory loop is a memory-shaped, metal tape that curves to a pre-defined radius of curvature when unconstrained; and a locking mechanism connected to the memory loop, the locking mechanism having a knob that partially extends through the tool body slot; wherein the memory loop may be selectively manipulable by the push- pull means to extend from an insertion end of the tool body and wrap around the bone and to retract back into the tool body, and wherein the locking mechanism is selectively operable to temporarily constrain the memory loop in a fixed position.
  • a surgical method may include providing an insertion tool for wrapping an orthopedic cable around a bone; connecting the orthopedic cable to a memory loop located on the insertion tool; making an incision; inserting an insertion end portion of the insertion tool through the incision; advancing push-pull means to advance the memory loop with a portion of the cable around the bone; operating a locking mechanism to temporarily constrain the memory loop; withdrawing the push pull means; and securing the orthopedic cable to the bone.
  • an implantation device may reduce an amount of implantation device manipulation within the patient, compared to conventional devices, which may lead to a reduction in the surgical incision required for an implantation process. For instance, an implantation device according to some examples may require little to no manipulation to get the body of the implantation device (e.g., the hook of the implantation device) inserted within tissue and around the target bone area.
  • the body of the implantation device e.g., the hook of the implantation device
  • an implantation process using an implantation device may utilize minimally invasive surgical techniques to implant a cerclage wire around a target bone area.
  • an implantation device may lead to reduced damage to tissue surrounding the target bone area when achieving cerclage wire implantation.
  • an implantation device may provide for more reliable and accurate cerclage wire implantation.
  • an implantation device may allow for an implantation procedure that is less complex and error prone compared with conventional techniques, allowing surgeons to implant cerclage wires with reduced risk for error and without requiring extensive experience, in a manner that is safer for patients and that leads to improved patient outcomes.
  • a cerclage wire implantation device may include a body having an implantation end and a hollow portion; an implantation cable at least partially arranged within the hollow portion; a shuttle coupled to a shuttle end of the implantation cable, the shuttle end arranged at the implantation end of the body; a cerclage wire; and a handle coupled to a handle end of the implantation cable, the handle end arranged opposite the shuttle end.
  • the implantation end may be configured to be positioned within an incision of a patient and adjacent to a bone of the patient.
  • the implantation end may include a curved or hooked shape configured to be positioned around at least a portion of the bone.
  • the shuttle end of the implantation cable may be configured to form a loop having a predetermined radius.
  • the handle may be configured to be pushed toward the insertion end of the body to cause the implantation cable to extend out of an opening at the implantation end of the body and around the bone.
  • movement of the implantation cable may be configured to cause corresponding movement of the shuttle around the bone.
  • the shuttle may include a face shaped to cut through tissue to facilitate movement of the shuttle around the bone.
  • the cerclage wire may be coupled to the shuttle.
  • the shuttle may be configured to push the cerclage wire around the bone as the shuttle travels around the bone.
  • the implantation device may further include a locking mechanism configured to couple the shuttle to the body after the shuttle has encircled the bone and exited the incision.
  • the implantation cable may be configured to be released from the shuttle, when the shuttle is coupled to the body, and retracted within the body.
  • the cerclage wire may be coupled to the body.
  • the shuttle may be configured to be coupled to the cerclage wire after the shuttle has encircled the bone and exited the incision.
  • the implantation cable may be configured to be retracted within the body, pulling the shuttle and the cerclage wire coupled to the shuttle around the bone, wherein at least a portion of the cerclage wire encircles the bone when the implantation cable is fully retracted within the body.
  • the body may be configured to be removed from the patient via the incision, wherein the cerclage wire is retained around the bone.
  • the handle may be coupled to the cerclage wire via an extension structure.
  • the handle may be configured to be pulled in a retraction direction away from the extension end of the body to retract the implantation cable, at least partially, within the body, and pushed in an extension direction toward the implantation end of the body to extend, at least partially, the implantation cable outside of the body.
  • the implantation cable may be formed of a memory material.
  • the memory material may include at least one of a shape memory material (SMM), a shape memory alloy (SMA), nickel (Ni), titanium (Ti), copper (Cu), zinc (Zn), aluminum (Al), Ni-Ti materials, nitinol, Cu-Zn-Al materials, or Cu-Al-Ni materials.
  • SMM shape memory material
  • SMA shape memory alloy
  • Ni nickel
  • Ti titanium
  • Cu copper
  • Zn zinc
  • Al aluminum
  • Ni-Ti materials nitinol
  • Cu-Zn-Al materials or Cu-Al-Ni materials.
  • the implantation cable may have a flat or substantially flat shape.
  • the shuttle may be releasably coupled to the implantation cable.
  • the bone may include a shaft of a femur.
  • a push method of implanting a cerclage wire around a bone of a patient may include inserting an implantation end of a body of an implantation device into an incision in the patient and adjacent to the bone, the implantation device including: an implantation cable at least partially arranged within the body, a shuttle coupled to a shuttle end of the implantation cable, the shuttle end arranged at the implantation end of the body, a cerclage wire coupled to the shuttle, and a handle coupled to a handle end of the implantation cable, the handle end arranged opposite the shuttle end; and pushing the handle toward the implantation end to cause the implantation cable to extend out of an opening at the implantation end of the body and to move with the shuttle around the bone, the shuttle configured to push the cerclage wire around the bone as the shuttle travels around the bone.
  • the implantation end may have a curved or hooked shape configured to be positioned around at least a portion of the bone.
  • the shuttle end of the implantation cable may be configured to form a loop having a predetermined radius.
  • the shuttle may have a face shaped to cut through tissue to facilitate movement of the shuttle around the bone.
  • the method may further include coupling the shuttle to the body, via a locking mechanism, after the shuttle has encircled the bone and exited the incision.
  • the method may further include releasing the implantation cable from the shuttle, when the shuttle is coupled to the body, thereby retracting the implantation cable within the body.
  • the method may further include removing the body from the patient via the incision, wherein the cerclage wire is retained around the bone.
  • the handle may be coupled to the cerclage wire via an extension structure.
  • the handle may be configured to be pulled in a retraction direction away from the extension end of the body to retract the implantation cable, at least partially, within the body, and pushed in an extension direction toward the implantation end of the body to extend, at least partially, the implantation cable outside of the body.
  • the implantation cable may be formed of a memory material.
  • the memory material may include at least one of a shape memory material (SMM), a shape memory alloy (SMA), nickel (Ni), titanium (Ti), copper (Cu), zinc (Zn), aluminum (Al), Ni-Ti materials, nitinol, Cu-Zn-Al materials, or Cu-Al-Ni materials.
  • the implantation cable may have a flat or substantially flat shape.
  • the shuttle releasably may be coupled to the implantation cable.
  • the bone may include a shaft of a femur.
  • a pull method of implanting a cerclage wire around a bone of a patient may include inserting an implantation end of a body of an implantation device into an incision in the patient and adjacent to the bone, the implantation device including: an implantation cable at least partially arranged within the body, a shuttle coupled to a shuttle end of the implantation cable, the shuttle end arranged at the implantation end of the body, a cerclage wire coupled to the body, and a handle coupled to a handle end of the implantation cable, the handle end arranged opposite the shuttle end; pushing the handle toward the implantation end to cause the implantation cable to extend out of an opening at the implantation end of the body and to move with the shuttle around the bone, out of the incision, and to couple to the cerclage wire; and retracting the implantation cable within the body, pulling the shuttle and the cerclage wire coupled to the shuttle around the bone, wherein at least a portion of the cerclage wire encircles the bone when the implantation cable is fully retracted within
  • the shuttle end of the implantation cable may be configured to form a loop having a predetermined radius.
  • the shuttle may have a face shaped to cut through tissue to facilitate movement of the shuttle around the bone.
  • the method may further include removing the body from the patient via the incision, wherein the cerclage wire is retained around the bone.
  • the handle may be coupled to the cerclage wire via an extension structure.
  • the handle may be configured to be pulled in a retraction direction away from the extension end of the body to retract the implantation cable, at least partially, within the body, and pushed in an extension direction toward the implantation end of the body to extend, at least partially, the implantation cable outside of the body.
  • the implantation cable may be formed of a memory material.
  • the memory material may include at least one of a shape memory material (SMM), a shape memory alloy (SMA), nickel (Ni), titanium (Ti), copper (Cu), zinc (Zn), aluminum (Al), Ni-Ti materials, nitinol, Cu-Zn-Al materials, or Cu-Al-Ni materials.
  • SMM shape memory material
  • SMA shape memory alloy
  • Ni nickel
  • Ti titanium
  • Cu copper
  • Zn zinc
  • Al aluminum
  • Ni-Ti materials nitinol
  • Cu-Zn-Al materials or Cu-Al-Ni materials.
  • the implantation cable may have a flat or substantially flat shape.
  • the shuttle may be releasably coupled to the implantation cable.
  • the bone may include a shaft of a femur.
  • FIGS. 1A-1D depict an implantation process using a first illustrative example of an implantation device in accordance with the present disclosure
  • FIGS. 2A-2D depict an implantation process using a second illustrative example of an implantation device in accordance with the present disclosure
  • FIG. 3A depicts a side view of a third illustrative example of an implantation device in accordance with the present disclosure
  • FIG. 3B depicts a top-down view of the illustrative example of an implantation device shown in FIG. 3A in accordance with the present disclosure
  • FIG. 3C depicts a perspective view from a handle end of the illustrative example of an implantation device shown in FIG. 3A in accordance with the present disclosure
  • FIG. 3D depicts a perspective view from an implantation end of the illustrative example of an implantation device shown in FIG. 3A in accordance with the present disclosure
  • FIGS. 4A and 4B depict exploded views of the illustrative example of an implantation device shown in FIG. 3A in accordance with the present disclosure; and [0085] FIGS. 4C-4G depict views of components of the illustrative example of an implantation device shown in FIG. 3A in accordance with the present disclosure.
  • various implantation systems including one or more features arranged and configured to enable securement of a wire, a cable, an orthopedic cable, cerclage wire, or the like (terms used interchangeably herein without the intent to limit), for instance, via a cable clamp system where a cerclage wire is used in a stand-alone procedure or via a cable assembly where a cerclage cable is used in combination with an orthopedic implant such as, for example, a bone fastener and/or plate.
  • FIGS. 1A-1D depict an implantation process using a first illustrative example of an implantation device in accordance with the present disclosure. As shown in FIG.
  • a cerclage wire implantation device 100 may include a hollow or partially hollow body 110 having a first, proximal, or handle end 111 and a second, distal, or implantation end 113.
  • distal may refer to an end of implantation device 100 that is closer to a target bone 120 when implanted within a patient and the term “proximal” may refer to an end of implantation device 100 that is closer to an operator of implantation device 100 when implanted within a patient.
  • body 110 may be configured as a hooked or curved cannula or tube that may be inserted into a patient and arranged, at least partially, around a portion of a patient bone.
  • body 100 may have various dimensions, including a length, diameter, and/or the like. In various examples, the dimensions of body 100 may be dependent on one or more factors, including, without limitation, the size and/or length of a cerclage wire 102, implantation cable 104, and/or any accessory devices necessary for implantation which must pass through body 100. In some examples, body 100 may have a length of about at least 6 inches. In various examples, body 100 may have a length of about 4 inches, about 5 inches, about 6 inches, about 7 inches, about 8 inches, 10 inches, greater than about 10 inches, or any value or range between any two of these values (including endpoints). In various examples, body 100 may have a diameter of about 0.75 inches. In some examples, body 100 may have a diameter of less than about 0.5 inches, about 0.5 inches, about 0.75 inches, about 1.0 inches, about 2.0 inches, greater than about 2.0 inches, or any value or range between any two of these values (including endpoints).
  • an incision 124 may be made at or near a fracture site of bone 120 targeted for cerclage wire implantation.
  • bone 120 may include a femur, for instance, a shaft portion of a femur.
  • Implantation end 113 may be inserted through incision 124 and manipulated around bone 120.
  • FIGS. 1A-1D depict implantation device 100 after installation of implantation device 100 around bone.
  • body 110 may be curved or have a hook shape.
  • at least a portion of implantation end 113 may include a curved, hooked, or convex portion shaped to correspond to an outer diameter of bone 120.
  • implantation end 113 may be configured to partially encircle bone 120.
  • implantation end 113 may be configured to encircle about 0 mm (e.g., no portion of bone is encircled), less than about 3 mm, about 3 mm, about 5 mm, about 7 mm, about 10 mm, about 12 mm, about 15 mm, about 20 mm, about 40 mm, greater than about 40 mm, and any value or range between any two of these values (including endpoints) of the circumference of bone 120.
  • implantation end 113 may be configured to encircle about 10 percent, about 15 percent, about 20 percent, about 25 percent, about 33 percent, about 50 percent, about 75 percent, and any value or range between any two of these values (including endpoints) of the circumference of bone 120.
  • body 110 may not have a curved or hooked end.
  • body 110 may not encircle a portion of bone 120 (e.g., body 110 may be placed adjacent to bone 120 and implantation cable 104 and/or cerclage wire 102 may encircle bone 120 without having a portion of body 110 encircling bone).
  • Implantation device 100 may include a handle 114 coupled to a shaft 112. Handle 114 may be configured to push/pull shaft 112 in/out of body 110 through handle opening 115 in body 110.
  • Shaft 112 may be a rigid or substantially rigid structure coupled to a handle end 103 of an implantation cable, loop, ribbon, ligament, strip, band, elongated element, and/or the like (terms used interchangeably herein without the intent to limit) 104.
  • a shuttle end 105 of implantation cable 104 may be coupled to a shuttle 106.
  • implantation cable 104 may be releasably coupled to shuttle 106 (see, for example, FIG. ID).
  • pushing shaft 112 via handle 114 within body 110 toward bone 120 may cause implantation cable 104 to extend out of body 110 via opening 119.
  • the extension of implantation cable 104 may push shuttle 106 around bone 120.
  • the use of handle 114 and shaft 112 to push implantation cable 104 out of body 110 and around bone 120, as depicted in FIGS. 1A-1D, is for illustrative purposes. For instance, movement of implantation cable 104 may be facilitated or augmented by various other manual and/or automated techniques.
  • implantation cable 104 may be configured to form a loop around or otherwise encircle at least a portion of bone 120 when extended out of body 110 (and not constrained by the inner walls of body 110).
  • implantation cable 104 may be formed of a memory material configured to form a loop having a predetermined radius or radius range when extended outside of body 110. The radius or radius range may be configured to correspond to the outer diameter of bone 120.
  • Implantation cable 104 may be formed of various materials, including, without limitation a shape memory material (SMM), a shape memory alloy (SMA), future developed SMMs and SMAs, nickel (Ni), titanium (Ti), copper (Cu), zinc (Zn), aluminum (Al), Ni-Ti materials, nitinol, Cu-Zn-Al materials, Cu-Al-Ni materials, mixtures thereof, alloys thereof, and/or the like.
  • implantation cable 104 may be formed of nitinol or a material that contains nitinol.
  • implantation cable 104 may be a flat or substantially flat structure (see, for example, FIG. 3D). In various examples, implantation cable 104 may have a flat, ribbon- or band-like shape. In some examples, implantation cable 104 may have a width of about 0.5 mm, about 0.75 mm, about 1.0 mm, about 1.25 mm, about 1.5 mm, about 1.75 mm, about 2.0 mm, about 3.0 mm, about 5.0 mm, about 6 mm, greater than about 6 mm, and any value or range between any two of these values (including endpoints). In some examples, implantation cable 104 may have a width of about 3 mm to about 6 mm. In various examples, a width of implantation cable 104 may be based, at least in part, on patient anatomy dimensions, for example, smaller bone radii may allow for smaller implantation cable 104 widths.
  • Conventional loop-based passer devices typically include loops formed of tubular or cylindrical structures. Such loop structures are generally unreliable because that do not follow a direct path around a bone (for instance, they may veer off in unintended directions as the loop is being extended around the bone), leading to injury of tissue adjacent to the bone and/or erroneous implantation of cerclage wires that are not located at the correct target site. Accordingly, implantation cable 104 according to some examples may have a ribbon or ribbon-like shape, for instance, a flat and (relatively) wide shape, particularly compared to conventional loop-based passer devices. In addition, implantation cable 104 may be coupled to shuttle 106 that is configured to provide for reliable travel of implantation cable 104 (and cerclage wire 102) that reduces or even eliminates damage (or unintended damage) to tissue surrounding bone 120.
  • shuttle engagement structure 151 may include an opening in body 110 and shuttle 106 may extend at least partially through the opening.
  • shuttle engagement structure 151 may include an element, such as a flange, clip, protrusion, recess, cavity, and/or the like configured to engage a portion of shuttle 106.
  • shuttle engagement structure 151 may include a flange and shuttle 106 may include a corresponding protrusion configured to engage the flange to couple shuttle 106 to body 110 (i.e., maintaining implantation cable 104 in a loop around bone 120).
  • shuttle engagement structure 151 may include a magnet system configured to magnetically hold shuttle 106 to/within/on/etc. body 110.
  • body 110 may include a shuttle guiding structure 152 configured to guide shuttle 106 for at least a portion of the path around bone 120 to body 110.
  • shuttle guiding structure 152 may be or may include a magnet configured to attract shuttle 106 to body 110.
  • shuttle guiding structure 152 may be a part of or coupled to shuttle, for instance, a magnet configured to attract shuttle to body 110.
  • shuttle guiding structure 152 may only guide shuttle 106 as it nears body 110, for example, to ensure shuttle 106 couples properly to body 110.
  • implantation device 100 may include a locking mechanism.
  • locking mechanism 130 may be a button, toggle, and/or the like that may be actuated to cause a locking element 121 (e.g., a locking pin or other elongated structure) to engage a portion of shuttle 106 to hold shuttle 106 to or at a locking area of body 110 (i.e., maintaining implantation cable 104 in a loop around bone 120).
  • a locking element 121 e.g., a locking pin or other elongated structure
  • shaft 112 may be pushed into body 110 toward bone 120, causing implantation cable 104 to extend out of body 110 and to loop around bone 120.
  • a cerclage wire 102 may be arranged in or on a component of implantation device 100. Cerclage wire 102 may be formed of various materials, including metal materials, polymer materials, and/or the like. In some examples, cerclage wire 102 may be a flexible, monofilament structure.
  • Implantation device 100 may be configured to operate in a “push” or “pull” mode.
  • a push mode for example, see, FIGS. 1A-1D
  • implantation cable 104 may pull cerclage wire 102 around bone 120 as implantation cable 104 extends around bone 120 responsive to pushing shaft 112 within body 110.
  • a pull mode see, for example, FIGS.
  • implantation cable 104 may be extended around bone 120 responsive to pushing shaft 112 within body 110 toward bone 120 without cerclage wire 102 being attached to shuttle 106, then shuttle 106 may be attached to cerclage wire 102 and may pull cerclage wire 102 around bone 120 when implantation cable 104 is retracted back into body 110 via pulling shaft 112 out of body 110 in a direction away from bone 120.
  • implantation cable 104 may be releasably coupled to shuttle 106.
  • implantation cable 104 may be coupled to shuttle 106 via various techniques such that implantation cable 104 may be released from shuttle 106.
  • Non-limiting examples of releasable connections may include a magnetic connection, a trigger lock/release connection, a snap-fit connection, a gear-based connection, a release pin-or rod-based connection, and/or the like.
  • multiple types of releasable connections and/or components thereof may be used in combination. For instance, a release pin-or rod-based connection may be used with magnetic connection components.
  • a cable detachment actuator 131 may be actuated to release implantation cable 104 from shuttle 106.
  • locking element 121 (or other rod or pin) may operate to release implantation cable 104 from shuttle 106 via actuation of locking mechanism 130 (or other actuator).
  • locking mechanism 130 and detachment actuator 131 are depicted as separate elements in FIGS. 1A-1D, the associated functionality may be performed by a single element.
  • a shuttle end 141 of cerclage wire 102 may be attached to shuttle 106 prior to placement of body 110 through incision 124 and the arrangement of implantation end 113 around bone 120.
  • a free end 142 of cerclage wire 102 may remain outside of the patient.
  • cerclage wire 102 may be releasably attached to shuttle 106.
  • cerclage wire 102 may be permanently or non-releasably attached to shuttle 106 (e.g., requiring cutting or other manual removal by an operator).
  • cerclage wire 102 may be arranged on an outside of body 110. In various examples, at least a portion of cerclage wire 102 may be arranged within body 110.
  • a face 143 of shuttle 106 may have a shape and/or elements configured to facilitate movement of implantation end 113 within the patient and around bone 120.
  • face 143 may be or may have elements that are configured to pierce or cut through tissue (for instance, the linea aspera attached to the femur).
  • face 143 may be or may have elements that are rounded, beveled, square, angled, pointed, protruding, faceted, sharp, curved, straight, combinations thereof, and/or the like.
  • shuttle 106 may be a leading edge of implantation device 100 moving within the patient.
  • shuttle 106 may be integral in the function of positioning implantation device 110 around bone 120.
  • shuttle 106 and/or face 143 may be shaped to facilitate shuttle 106 taking a path around bone 120 during extension.
  • extension of implantation cable 104 outside of the body of the patient may cause implantation cable 104 (and therefore shuttle 106) to extend in a (non-looped) straight or substantially straight path.
  • shuttle 106 and/or face 143 may be shaped such that as implantation cable 104 is extended within the body of the patient, adjacent to bone 120, shuttle 106 and/or face 143 may cause shuttle 106 to follow a path around bone 120 to encircle bone (for instance, due to contact of shuttle 106 and/or face 143 with tissue surrounding bone 120 and/or due to memory material properties of implantation cable 104).
  • Shuttle 106 may be formed of various materials, including metals, polymers, magnets, and/or the like described according to some examples in the present disclosure.
  • shuttle 106 may have a length, width, and/or height of about 0.25 mm, about 0.5 mm, about 1 mm, about 1.5 mm, about 2.0 mm, about 3.0 mm, about 5.0 mm, and any value or range between any two of these values (including endpoints).
  • shuttle 106 may have a width the same or substantially the same as a width of implantation cable 104.
  • shuttle 106 may have a width of about 3 mm.
  • shuttle 106 may have a length of about 5 mm.
  • shuttle 106 may have a height of about 5 nun.
  • shuttle 106 may have one or more shapes, including, without limitation, a square or substantially square shape, a rectangular or substantially rectangular shape, a round or substantially round shape, a triangular or substantially triangular shape, a bullet or substantially bullet shape, combinations thereof, variations thereof, and/or the like.
  • FIGS. 1A-1D depict a pushing implantation process operating using shuttle 106 to push cerclage wire 102 around bone 120
  • examples are not so limited, as cerclage wire 102 may be implanted around bone 120 via direct attachment to implantation cable 104 without the use of shuttle 106. Accordingly, in some examples, a shuttle may not be used.
  • a cerclage wire may be directly coupled/de-coupled from an implantation cable the same or similar as described for a shuttle in the present disclosure.
  • FIGS. 2A-2D depict an implantation process using a second illustrative example of an implantation device in accordance with the present disclosure.
  • FIGS. 2A-2D depict an implantation device 200 that may be configured for a “pull” implantation process.
  • an implantation device 200 may include a body 210 having an implantation cable 204 arranged therein.
  • Implantation cable 204 may be coupled to a shuttle 206 on a first end and a shaft or handle 212 on an opposite end.
  • Implantation device 200 may be inserted within an incision 224 in a limb 222 of patient and arranged around a bone 220, such as a femur.
  • shuttle 206 may include a sharp or pointed leading edge 245 configured to facilitate movement of implantation device 200 and shuttle 206 through tissue surrounding bone 220.
  • implantation device 200 may include a cerclage wire 202.
  • at least a portion of cerclage wire 202 may be arranged within body 210.
  • cerclage wire 202 may be arranged outside of body 210.
  • Cerclage wire 202 may have a coupling element 235 arranged at a shuttle end 241.
  • coupling element 235 may be configured to couple cerclage wire 202 to shuttle 206.
  • shuttle 206 may have a coupling element 237 that corresponds to coupling element 235 of cerclage wire 202.
  • only cerclage wire 202 has a coupling element 235.
  • only shuttle 206 has a coupling element 237.
  • Non-limiting examples of coupling elements 235 and/or 237 may include magnets, flanges, protrusions, grooves, slots, tabs, hooks, and/or the like.
  • coupling element 235 and/or 237 may include a magnet that may be coupled to a corresponding coupling element (such as a magnet) and/or directly to shuttle 206 (for coupling element 235) or cerclage wire (for coupling element 237).
  • coupling element 235 (or shuttle end 241) may be configured to engage coupling element 237, such as a slot, groove, and/or the like, which receives coupling element 235 (or shuttle end 241) and holds cerclage wire 202 to shuttle 206.
  • cerclage wire 202 may be manufactured with an integrated coupling element 235 such that a user may cut integrated coupling element 235 off of cerclage wire 202 prior to final tensioning.
  • shaft 212 may be pushed into body 210 toward bone 220, causing implantation cable 204 to extend out of body 210.
  • Implantation cable 204 may be configured to loop around bone 220 when extended out of body 210.
  • implantation cable 204 may be formed of a memory material configured to form a loop of a predetermined radius to encircle bone 220.
  • implantation cable 204 may engage (and/or cut through) tissue surrounding bone 220 causing implantation cable 204 to follow a path to encircle bone 220. As implantation cable 204 extends out of body 210, implantation cable 204 pushes shuttle 206 around bone 220.
  • Shuttle 206 engages and is coupled to cerclage wire 202, for instance, via shuttle end 241 and/or coupling elements 235 and/or 237.
  • a locking mechanism 230 may be used to lock shuttle 206 at body 210.
  • implantation cable 204 is looped around bone 220 and locked in place at body 210 (for instance, via one or more shuttle engagement structures).
  • shuttle 206 may be coupled to cerclage wire 202.
  • implantation cable 204 has been retracted back into body 210.
  • handle 212 may be pulled out of body 210 in a direction away from bone 220, pulling implantation cable 204 into body 210.
  • shuttle 206 has traveled back around bone 220 to rest at an implantation or distal end 213 of body 210.
  • retraction of implantation cable 204 may pull cerclage wire 202 around bone 220 to distal end 213 of body 210, thereby causing cerclage wire 202 to encircle bone 220.
  • implantation device 200 may be manipulated around bone 220 and out of the patient through incision 224. In the step depicted in FIG. 2C, only cerclage wire 202 remains in the patient, looped around bone 220. In some examples, cerclage wire 202 may be removed from implantation device 200, for example, via cutting cerclage wire 202 or releasing cerclage wire 202 and/or shuttle 206 from implantation device 200 via a release mechanism (not shown).
  • FIGS. 2A-2D depict a pulling implantation process operating using shuttle 206 to pull cerclage wire 202 around bone 220
  • examples are not so limited, as cerclage wire 202 may be implanted around bone 220 via direct attachment to implantation cable 204 without the use of shuttle 206. Accordingly, in some examples, a shuttle may not be used.
  • a cerclage wire may be directly coupled/de-coupled from an implantation cable the same or similar as described for a shuttle in the present disclosure.
  • FIGS. 3A-3D depict various views of a third illustrative example of an implantation device 300 in accordance with the present disclosure. More specifically, FIG. 3A depicts a side view of implantation device 300, FIG. 3B depicts a top-down view of implantation device 300, FIG. 3C depicts a perspective view from a handle end of implantation device 300, and FIG. 3D depicts a perspective view from an implantation end of implantation device 300.
  • an implantation device 300 may include an at least partially hollow body 310 having a handle 312 configured to extend and retract an implantation cable 304 out of/into a body 310.
  • Implantation device 300 may include a cerclage wire (not shown) arranged on and/or within body 310 according to various examples. The cerclage wire may be coupled to a portion of implantation cable 304 or a shuttle 306 coupled to the implantation cable.
  • implantation device 300 may include a grip 316.
  • a first hand of an operator may hold onto grip 316, while a second hand of operator pulls/pushes on handle 312 to retract/extend implantation cable 304.
  • implantation cable 304 may be coupled to a shuttle 306. Referring to FIG. 3C, therein is depicted a close-up of region 340 of implantation device 300. As shown in the close-up of region 340, implantation cable 304 may be a flat, wide elongated member formed as, for example, a flexible band or ribbon of memory material.
  • FIG. 3A depicts implantation device 300 in an initial state, with the shuttle end of implantation cable 304 arranged outside of body 310 in a loop 335.
  • An operator may pull handle 312 in a proximal direction away from the implantation end of body 310, causing implantation cable 304 to unloop and to be pulled at least partially within body 310, placing implantation device 300 into an implantation state.
  • all or substantially all of implantation cable 304 may be pulled into body.
  • shuttle 306 may be partially or wholly pulled into body 310. In various examples, shuttle is not pulled into body 310.
  • the implantation end of body 310 is inserted into the patient incision and adjacent to the target bone (or around the target bone if body 310 is curved).
  • the handle 312 is pushed distally toward body 310 to cause implantation cable 304 to extend out of body, pushing shuttle 306 and the implantation end of the implantation cable 304 around the bone.
  • the cerclage wire (not shown) is coupled to the shuttle 306 (or the implantation end of implantation cable 304), the cerclage wire is also pushed around the bone along with the implantation cable.
  • the cerclage wire may be decoupled from the shuttle 306 (or implantation cable 304) according to various examples within the present disclosure.
  • FIGS. 4A and 4B depict exploded views of the illustrative example of an implantation device shown in FIG. 3A in accordance with the present disclosure. More specifically, FIG. 4A depicts a top perspective exploded view of implantation device 300 and FIG. 4B depicts a side perspective exploded view of implantation device 300.
  • implantation device 300 may include a pusher component 331 configured to slidably move within housing 310.
  • pusher component 331 may include a handle connection component 330 on a handle end 337 configured to connect pusher component 331 to handle 312.
  • Handle connection component 330 may include a flange, protrusion, or other element configured to be arranged within a corresponding cavity 332 of handle to couple handle connection component 330 to handle 312. In this manner, movement of handle in a push or pull motion may cause a corresponding movement of pusher component 330.
  • pusher component 330 may be connected to implantation cable 304 (for example, at a cable end 338 (see, FIG. 4D)).
  • bushings 340 may be arranged within housing 310.
  • implantation device 300 may include two bushings 340.
  • bushings 340 may be configured to secure, stabilize, facilitate operation of, etc. components of implantation device 300, such as securing implantation cable 304.
  • bushings 340 may be configured to reduce friction or “drag” on a portion of implantation cable 304.
  • bushings 340 may operate to reduce drag on loop 335 (or the portion of implantation cable 304 that forms loop 335) as the implantation cable 304 is being pushed or pulled through housing and/or to provide stability for loop 335 to reduce or even eliminate undesirable rotation or increased friction during implantation in the patient (which may lead an operator to perceive that they are catching soft tissue when they are actually not and/or premature extension away from the bone rather than around the bone as desired).
  • FIGS. 4C-4G depict views of components of the illustrative example of an implantation device shown in FIG. 3A in accordance with the present disclosure.
  • FIG. 4C depicts an illustrative example of housing 310.
  • housing 310 may include a cable opening 334 for allowing implantation cable 304 to move in and out of housing 310.
  • Housing 310 may include a pusher opening for allowing pusher component 330 to slide within housing 310.
  • FIG. 4D depicts an illustrative example of pusher component 330.
  • pusher component 330 may include handle end 337 configured to be coupled to handle 312 and a cable end 338 configured to be coupled to implantation cable 304.
  • FIGS. 4E-4G depict an illustrative example of implantation cable 304. More specifically, FIG. 4E depicts a side perspective view of implantation cable 304 and FIGS. 4F and 4G depict close-up perspective views of area 345 of FIG. 4E.
  • implantation cable may include a cable loop 335 and an insertion end 336. In some examples, at least a portion of insertion end 336 may have a width that is different than a width of the implantation cable 304. For instance, implantation cable 304 may have an insertion end tip that is less wide than the main implantation cable 304.
  • a shuttle 306 is arranged on or about insertion end 336.
  • Directional terms such as top, bottom, superior, inferior, medial, lateral, anterior, posterior, proximal, distal, upper, lower, upward, downward, left, right, longitudinal, front, back, above, below, vertical, horizontal, radial, axial, clockwise, and counterclockwise) and the like may have been used herein. Such directional references are only used for identification purposes to aid the reader’ s understanding of the present disclosure.
  • distal may refer to the end farthest away from the medical professional/operator when introducing a device into a patient
  • proximal may refer to the end closest to the medical professional when introducing a device into a patient.
  • an "example” may refer to an illustrative representation of an environment or article or component in which a disclosed concept or feature may be provided or embodied, or to the representation of a manner in which just the concept or feature may be provided or embodied.
  • illustrated examples are to be understood as examples (unless otherwise stated), and other manners of embodying the described concepts or features, such as may be understood by one of ordinary skill in the art upon learning the concepts or features from the present disclosure, are within the scope of the disclosure.
  • references to “one example” of the present disclosure are not intended to be interpreted as excluding the existence of additional examples that also incorporate the recited features.
  • Connection references e.g., engaged, attached, coupled, connected, and joined
  • connection references do not necessarily infer that two elements are directly connected and in fixed relation to each other.
  • Identification references e.g., primary, secondary, first, second, third, fourth, etc.
  • the drawings are for purposes of illustration only and the dimensions, positions, order and relative to sizes reflected in the drawings attached hereto may vary.

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  • 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)
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Abstract

Un dispositif d'implantation pour un fil de cerclage orthopédique est divulgué dans la présente invention. Le dispositif d'implantation peut comprendre un corps creux présentant une extrémité incurvée ou recourbée configurée pour être agencée autour d'une région osseuse cible, telle qu'une partie d'une tige d'un fémur. Un câble d'implantation configuré sous la forme d'un élément allongé de type ruban flexible plat peut être exploité pour être étendu hors du corps afin d'encercler la région osseuse cible. Le câble d'implantation peut être configuré pour former une boucle comprenant un rayon ou une plage de rayons prédéterminé(e) lorsqu'il est étendu à l'extérieur du corps. Une navette peut être couplée à une extrémité du câble d'implantation qui se déplace autour de l'os lorsqu'il est étendu. La navette peut être reliée à un fil de cerclage pour pousser ou tirer le fil de cerclage autour de l'os lorsque le câble d'implantation est étendu ou rétracté.
PCT/US2023/030845 2022-08-23 2023-08-22 Système d'implantation de fil orthopédique WO2024044201A1 (fr)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5601572A (en) * 1989-08-16 1997-02-11 Raychem Corporation Device or apparatus for manipulating matter having a elastic ring clip
US20080132753A1 (en) * 2006-10-03 2008-06-05 Boston Scientific Scimed, Inc. Coaxial device for delivering an implant to a patient's pelvic region
CN104586495A (zh) * 2015-02-04 2015-05-06 山东省立医院 一种股骨干骨折骨块固定用钢丝引导器
US20180116701A1 (en) * 2015-03-25 2018-05-03 Coracoid Solutions, Llc Joint repair system

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5601572A (en) * 1989-08-16 1997-02-11 Raychem Corporation Device or apparatus for manipulating matter having a elastic ring clip
US20080132753A1 (en) * 2006-10-03 2008-06-05 Boston Scientific Scimed, Inc. Coaxial device for delivering an implant to a patient's pelvic region
CN104586495A (zh) * 2015-02-04 2015-05-06 山东省立医院 一种股骨干骨折骨块固定用钢丝引导器
US20180116701A1 (en) * 2015-03-25 2018-05-03 Coracoid Solutions, Llc Joint repair system

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