Fixation systems and methods

• US 10,076,377 B2
• Filed: 03/15/2013
• Issued: 09/18/2018
• Est. Priority Date: 01/05/2013
• Status: Active Grant

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M., Cremens, Matthew J.
• Primary Examiner(s): Templeton, Christopher L
• Assistant Examiner(s): Ulsh, George J
• Application Number:
  US13/831,826
• Publication Number:
  US 20140194907A1
• Time in Patent Office: 2,013 Days
• Field of Search: 606 86 R, 606232
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/12168 having a mesh structure A61B17/1214 takes precedence
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• 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 17/744 the longitudinal elements coupled to an intramedullary nail
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/8866 for gripping or pushing bones, e.g. approximators joint distractors A61B17/025
• CPC Class Codes: A61B 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61B 2017/00659 located only on one side of the opening
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0411 Instruments for removing suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0453 threaded elements, e.g. set screws
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61F 2/0805 Implements for inserting tendons or ligaments
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0835 : with deformation of anchor parts, e.g. expansion of dowel by set screw
• CPC Class Codes: A61F 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 : Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone

Abstract

Embodiments may include fixation devices and methods for securing first and second body tissue portions. Fixation devices may include a base component, an insert component, and a flexible member. The base component may include a passage. The insert component may be positionable within at least a portion of the passage. The elongate member may be configured to be positioned through the first and second body tissue portions. The elongate member may be tensioned and pinched between the base component and insert component to secure the first and second portions.

Claims

1. A fixation system for securing first and second body tissue portions of a fracture, the system comprising:

a base component having an aperture, a head portion, and a body portion, wherein the head portion extends at least partially beyond the body portion and is configured to be positioned on an outer surface of the first body tissue, and wherein the body portion has an entirely unthreaded exterior surface and is configured to be positioned in a passage extending through the first and second body tissue portions, and wherein the aperture through the base component has an at least partially tapered inner wall;

an insert component positionable within at least a portion of the aperture in the base component, and having an at least partially tapered outer surface;

an elongate member configured to be positioned through the passage extending through the first and second body tissue portions and the aperture of the base component, wherein the elongate member is at least one of a suture, wire, and cable; and

an anchor configured to couple to the elongate member, the anchor configured to be positioned through the passage extending through the first and second body tissue portions, and the anchor configured to be positioned on the distal outer surface of the second body tissue,

wherein the slidably positioned elongate member is substantially maintained against the insert component when the at least partially tapered portion of the insert component is pressed against the at least partially tapered inner wall of the aperture through the base component, deforming a portion of at least one of the base component, insert component, and elongate member to secure the first and second body tissue portions, and wherein the elongate member does not contact with at least one of an internal threaded surface of the body portion of the base component and an external threaded surface of the insert component.

2. The system of claim 1, wherein the base and insert components are pressed together to secure the elongate member.

3. The system of claim 1, wherein an interior bore of the base component and an exterior surface of the insert component are joined together by mating tapered surfaces.

4. The system of claim 1, wherein an interior taper of the base component is configured to match an exterior taper of the insert component to lock the elongate member.

5. The system of claim 1, wherein a taper is disposed between the base component and insert component to promote locking of the elongate member while it is tensioned through the passage and the insert component is pulled into the base component.

6. The system of claim 1, wherein the base component has a cylindrical portion dimensioned to a drilled hole in a proximal bone portion.

7. The system of claim 6, wherein the cylindrical portion provides additional contact length for locking the elongate member.

8. The system of claim 6, wherein the cylindrical portion is configured to minimize the height protruding above a surface of the bone portion.

9. The system of claim 6, wherein the cylindrical portion is configured to stabilize the base and insert components by maintaining a position relative to the hole in body tissue.

10. The system of claim 1, wherein the head portion of the base component includes at least one tab configured to conform to a proximal bone surface and resist the base component from being pulled into a drilled hole on the proximal bone surface.

11. The system of claim 10, wherein the head portion of the base component includes two, three, or more tabs.

12. The system of claim 10, wherein the tab surrounds the perimeter of the head portion of the base component.

13. The system of claim 1, wherein the base component includes a smooth and tapered interior surface.

14. The system of claim 1, wherein the base component includes a tapered distal portion and a threaded proximal interior portion configured to mate with the insert component.

15. The system of claim 1, wherein the insert component includes a passage configured to receive the elongate member and a distal portion configured to pinch the elongate member against the base component.

16. The system of claim 1, wherein the insert component includes threads on a proximal exterior portion for mating with threads in the base component.

17. The system of claim 1, wherein the insert component includes a square, star, or hex shaped recess for screwing the insert component into the base component.

18. The system of claim 1, wherein the insert component includes a recess configured to receive a removal tool for un-screwing the insert component from the base component.

19. The system of claim 1, wherein the insert component includes two or more finger members around a passage through the insert component that are configured to collapse and lock against the elongate member when the insert component is pressed into the base component.

20. The system of claim 1, wherein the insert component includes a tapered exterior configured to press and lock the elongate member between an exterior surface of the insert component and an interior surface of the base component.

21. The system of claim 1, wherein the insert component includes a drilled or tapped passage into a portion of a length of the insert component, the passage being configured to receive a threaded instrument.

22. The system of claim 1, wherein the insert component is configured to be removed from the base component by screwing a threaded tip tool into a passage in the insert component until the tool locks or bottoms in the insert component.

23. The system of claim 22, wherein the insert component is configured to be loosened by rotation of the tool and removed by pulling the tool.

24. The system of claim 1, further comprising a plate or rod.

25. The system of claim 24, wherein the plate or rod includes holes to receive a cannulated drill for making a passage through the fracture.

26. The system of claim 25, wherein the cannulated drill is configured to pass a fastener and elongate member through a cannulated portion of the cannulated drill.

27. The system of claim 24, wherein the plate or rod includes tapered holes configured to allow locking of the elongate member independent of the base component.

28. The system of claim 24, wherein the plate or rod includes holes or cavities.

29. The system of claim 1, wherein the base or insert component includes a metallic, polymer, or resorbable material.

30. The system of claim 29, wherein the metallic material includes stainless steel or titanium.

31. The system of claim 29, wherein the polymer material includes PEEK (polyetheretherketone).

32. The system of claim 1, wherein the base component and insert component are different materials.

33. The system of claim 1, wherein the elongate member includes a metallic material.

34. The system of claim 1, wherein the base component includes metal and the insert component includes PEEK.