Sternal closure cerclage, plate implant and instrumentation

• US 10,010,359 B2
• Filed: 08/22/2014
• Issued: 07/03/2018
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Zimmer Biomet CMF and Thoracic, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Biomet CMF and Thoracic, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Garcia, Saddy R., Luby, Ryan N., Wilcox, Bryan, Sidwell, Scott, Bruneau, Aurelien, Sink, Sam, Hale, Rachel, Witten, Benjamin
• Primary Examiner(s): Waggle, Jr., Larry E
• Application Number:
  US14/466,485
• Publication Number:
  US 20150038969A1
• Time in Patent Office: 1,411 Days
• CPC Class Codes: A61B 17/1728 for holes for bone plates or plate screws
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/8076 for the ribs or the sternum
• CPC Class Codes: A61B 17/82 for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 17/823 for the sternum
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 17/8861 Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 17/8869 Tensioning devices
• CPC Class Codes: F16L 33/08 in which a worm coacts with a part of the hose-encircling member that is toothed like a worm-wheel
• CPC Class Codes: Y10T 24/1412 with tighteners

Abstract

A closure system may secure a first bone portion to a second bone portion. The closure system may include a band, a locking terminal, and a tensioning device. The band may be adapted to be looped around the first and second bone portions. The locking terminal may fixedly engage a first portion of the band and selectively fixedly engage a second portion of the band. The tensioning device may include a body and a threaded rod. The threaded rod may be received in the body and may engage the band such that movement of the threaded rod relative to the body moves the second portion of the band relative to the first portion of the band.

Claims

1. A closure system for securing a first bone portion to a second bone portion, the closure system comprising:

a band adapted to be looped around the first and second bone portions;

a locking terminal fixedly engaging a first portion of the band and selectively fixedly engaging a second portion of the band; and

a tensioning device including a body and a threaded rod, the threaded rod received in the body and engaging the band such that that the threaded rod is configured to move axially relative to the body to move the second portion of the band relative to the first portion of the band.

2. The closure system of claim 1, wherein the tensioning device includes a sleeve that slidably receives the body.

3. The closure system of claim 2, wherein the tensioning device includes a resiliently flexible collar received in the sleeve and receiving a portion of the body.

4. The closure system of claim 3, wherein the collar includes a first axial end engaging an annular groove in the body and a second axial end that removably engages the locking terminal.

5. The closure system of claim 4, wherein the sleeve is axially movable relative to the body and the collar between a first position restricting radial flexing of the collar and a second position allowing the collar to flex radially outward relative to the body.

6. The closure system of claim 1, wherein the tensioning device includes an adjustment member partially received in the body and threadably engaging the threaded rod, the adjustment member is rotatable relative to the body and is axially fixed relative to the body such that rotation of the adjustment member relative to the body causes corresponding axial movement of the threaded rod relative to the body.

7. The closure system of claim 6, wherein the tensioning device includes an anti-rotation pin extending through the body and engaging the threaded rod to restrict relative rotation between the threaded rod and the body while allowing relative axial movement between the threaded rod and the body.

8. The closure system of claim 1, wherein the tensioning device includes a toggle lock mounted to the threaded rod and movable relative to the threaded rod between an unlocked position allowing the band to move through an aperture in the threaded rod and a locked position in which the toggle lock engages the band and restricts movement of the band relative to the threaded rod.

9. The closure system of claim 1, wherein the locking terminal includes a casing and a cam member, the casing engaging the first portion of the band, the cam member is rotatable relative to the casing and the first portion of the band between an unlocked position allowing the second portion of the band to move through the casing and a locked position in which the cam member engages the second portion of the band to restrict movement of the second portion relative to the casing and the first portion.

10. The closure system of claim 9, wherein the casing includes a first casing member and a second casing member, the first portion of the band and the cam member are disposed between the first and second casing members.

11. The closure system of claim 10, wherein the first and second casing members and the first portion of the band all include apertures that are aligned with each other to allow the second portion of the band to pass therethrough.

12. The closure system of claim 9, wherein the casing is a one-piece, unitary body.

13. The closure system of claim 9, wherein the cam member clamps the second portion of the band against the casing in the locked position.

14. The closure system of claim 9, wherein the first portion of the band includes a deflectable tab that allows movement of the cam member from the unlocked position to the locked position and restricts movement of the cam member from the locked position to the unlocked position.

15. The closure system of claim 9, wherein the cam member includes a deflectable tab that releasably engages the casing in the locked position to restrict the cam member from moving out of the locked position.

16. The closure system of claim 15, wherein the deflectable tab releasably engages a first aperture in the casing in the locked position to restrict movement of the cam member out of the locked position, and wherein the deflectable tab releasably engages a second aperture in the casing in the unlocked position to restrict movement of the cam member out of the unlocked position.

17. The closure system of claim 9, wherein the body includes a member fixed to an axial end of the body, the member including a rim defining a central recess receiving the locking terminal, the rim includes a keyway receiving a portion of the cam member such that relative rotation of the body relative to the locking terminal causes rotation of the cam member from the unlocked position to the locked position.

18. The closure system of claim 17, wherein the member includes a shearing aperture through which the second portion of the band extends, and wherein walls of the shearing aperture are configured to cut the second portion of the band in response to rotation of the body relative to the locking terminal.

19. The closure system of claim 18, wherein the shearing aperture is configured so that the walls of the shearing aperture will cut the second portion of the band only after at least ninety degrees of rotation of the body relative to the locking terminal.

20. The closure system of claim 18, wherein the shearing aperture is a bowtie-shaped aperture.

21. The closure system of claim 1, wherein a sleeve is molded around the band and through at least one aperture in the band.

22. A tensioning device for tightening a band around a first bone portion and a second bone portion, the tensioning device comprising:

an elongated body including a central aperture extending axially through the body;

a threaded rod received in the central aperture of the body and adapted to engage the band such that movement of the threaded rod relative to the body moves a second portion of the band relative to a first portion of the band;

a sleeve slidably receiving the body; and

a resiliently flexible locking arm extending from the body and configured to releasably secure the tensioning device relative to the band.

23. The tensioning device of claim 22, wherein the locking arm is a part of a collar received in the sleeve and receiving a portion of the body.

24. The tensioning device of claim 23, wherein the collar includes an axial end engaging an annular groove in the body.

25. The tensioning device of claim 22, wherein the sleeve is axially movable relative to the body and the locking arm between a first position restricting radial flexing of the locking arm and a second position allowing the locking arm to flex radially outward relative to the body.

26. The tensioning device of claim 22, further comprising an adjustment member partially received in the body and threadably engaging the threaded rod, the adjustment member is rotatable relative to the body and is axially fixed relative to the body such that rotation of the adjustment member relative to the body causes corresponding axial movement of the threaded rod relative to the body.

27. The tensioning device of claim 26, further comprising an anti-rotation pin extending through the body and engaging the threaded rod to restrict relative rotation between the threaded rod and the body while allowing relative axial movement between the threaded rod and the body.

28. The tensioning device of claim 22, further comprising a toggle lock mounted to the threaded rod and movable relative to the threaded rod between an unlocked position allowing the band to move through an aperture in the threaded rod and a locked position in which the toggle lock engaging the band and restricts movement of the band relative to the threaded rod.

29. The tensioning device of claim 22, wherein the body includes a shearing member fixed to an axial end of the body, the shearing member including a rim defining a central recess and a keyway extending through the rim.

30. The tensioning device of claim 29, wherein the shearing member includes a shearing aperture extending from the central recess of the shearing member to the central aperture of the body.

31. The tensioning device of claim 30, wherein the shearing aperture is a bowtie-shaped aperture.

32. A closure system including the tensioning device of claim 30, and further comprising a locking terminal having a casing and a cam member, the casing engaging the first portion of the band, the cam member is rotatable relative to the casing and the first portion of the band between an unlocked position allowing the second portion of the band to move through the casing and a locked position in which the cam member engages the second portion of the band to restrict movement of the second portion through the casing.

33. The closure system of claim 32, wherein the casing includes a first casing member and a second casing member, the first portion of the band and the cam member are disposed between the first and second casing members.

34. The closure system of claim 33, wherein the first and second casing members and the first portion of the band all include apertures that are aligned with each other to allow the second portion of the band to pass therethrough.

35. The closure system of claim 32, wherein the casing is a one-piece, unitary body.

36. The closure system of claim 32, wherein the cam member clamps the second portion of the band against the casing in the locked position.

37. The closure system of claim 36, wherein the first portion of the band includes a deflectable tab that allows movement of the cam member from the unlocked position to the locked position and restricts movement of the cam member from the locked position to the unlocked position.

38. The closure system of claim 36, wherein the cam member includes a deflectable tab that releasably engages the casing in the locked position to restrict the cam member from moving out of the locked position.

39. The closure system of claim 38, wherein the deflectable tab releasably engages a first aperture in the casing in the locked position to restrict movement of the cam member out of the locked position, and wherein the deflectable tab releasably engages a second aperture in the casing in the unlocked position to restrict movement of the cam member out of the unlocked position.

40. The closure system of claim 36, wherein the central recess of the shearing member receives the locking terminal, and wherein the keyway of the shearing member receives a portion of the cam member such that relative rotation of the body relative to the locking terminal causes rotation of the cam member from the unlocked position to the locked position.

41. The closure system of claim 40, wherein the second portion of the band extends through the shearing aperture, and wherein walls of the shearing aperture are configured to cut the second portion of the band in response to rotation of the body relative to the locking terminal.

42. The closure system of claim 41, wherein the shearing aperture is configured so that the walls of the shearing aperture will cut the second portion of the band only after at least ninety degrees of rotation of the body relative to the locking terminal.

43. The closure system of claim 32, wherein a sleeve is molded around the band and through at least one aperture in the band.