Hard or soft tissue closure

• US 20030078585A1
• Filed: 11/25/2002
• Published: 04/24/2003
• Est. Priority Date: 06/22/2000
• Status: Abandoned Application

• Current Assignee: Greg A. Johnson, James A. Magovern, James F. Antaki, John Andrew Holmes, Matthew R. Frushell, Thomas David Will
• Original Assignee: Greg A. Johnson, James A. Magovern, James F. Antaki, John Andrew Holmes, Matthew R. Frushell, Thomas David Will
• Inventors: Frushell, Matthew R., Will, Thomas David, Johnson, Greg A., Antaki, James F., Magovern, James A., Holmes, John Andrew
• Application Number:
  US10/303,192
• Publication Number:
  US 20030078585A1
• Time in Patent Office: Days
• US Class Current: 606/72
• 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 17/0466 Suture bridges
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/686 Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
• CPC Class Codes: A61B 17/823 for the sternum
• CPC Class Codes: A61B 17/8861 Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0443 the shaft being resilient and having a coiled or helical shape in the released state
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2017/0649 Coils or spirals

Abstract

An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal. A suture. A grommet for a bone. A method for securing a suture through a bone.

Claims

1. An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising:

a first bendable hollow sleeve adapted for insertion into the first portion of the bone;

a second bendable hollow sleeve adapted for insertion into a second portion of the bone;

a suture which is threaded through the first and second sleeves; and

a pusher for pushing the first and second sleeves into the first and second portions of the bone, respectively, wherein when the suture is tightened, the first and second portions are pulled together and the first and second sleeves bend and protect the first and second portions from the suture.

2. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

inserting a first bendable hollow sleeve into the first portion of the bone;

inserting a second bendable hollow sleeve into the second portion of the bone;

threading a suture through the first and second sleeves; and

pulling the first portion and second portion together with the suture and causing the first and second sleeves to bend and protect the first and second portions from the suture contacting the first and second portions.

3. A method as described in claim 2 including after the pulling step, there is the step of closing the first and second ends of the suture together.

4. A method as described in claim 3 wherein the first sleeve inserting step includes the step of placing a pusher in the first sleeve, pushing the first sleeve through the first portion with the pusher, and removing the pusher from the first sleeve.

5. A method as described in claim 4 wherein the second sleeve inserting step includes the step of placing the pusher in the second sleeve, pushing the second sleeve through the second portion with the pusher, and removing the pusher from the second sleeve.

6. A method as described in claim 5 wherein before the inserting the first sleeve step, there is the step of forming a hole through the first portion.

7. A method as described in claim 6 wherein before the inserting the second sleeve step, there is the step of forming a hole through the second portion.

8. A method as described in claim 2 wherein after the first sleeve inserting step, there is the step of seating a cap of the first sleeve on the top surface of the first portion and after the second sleeve inserting step, there is the step of seating a cap of the second sleeve on a top surface of the second portion.

12. A method as described in claim 2 wherein the inserting the first sleeve step includes the step of inserting an implantor in which the first sleeve is disposed into the first portion and wherein the inserting the second sleeve step includes the step of inserting the implantor in which the second sleeve is disposed into the second portion.

13. A method as described in claim 12 wherein before the first sleeve inserting step, there is the step of placing the first sleeve with the implantor.

9. An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising:

a first bendable hollow sleeve adapted for insertion into the first portion of the bone, the first sleeve having a cap adapted to seat on a top surface of the first portion;

a second bendable hollow sleeve adapted for insertion into a second portion of the bone, the second sleeve having a cap adapted to seat on a top surface of the second portion; and

a suture which is threaded through the first and second sleeves.

11. An apparatus as described in claim 9 wherein the implantor has a housing of a cylindrical shape with a groove in which the first or second sleeve fits, and with a pointed end.

10. An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising:

a first bendable hollow sleeve adapted for insertion into the first portion of the bone;

a second bendable hollow sleeve adapted for insertion into a second portion of the bone;

a suture which is threaded through the first and second sleeves; and

an implantor which holds the first or second sleeve and inserts the first or second sleeve into the first or second portion, respectively.

14. An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising:

a hollow tube adapted to extend from the first and second portions;

a suture which is adapted to extend through the hollow tube when the hollow tube extends through the first and second portion;

a first bottom cap and second bottom cap disposed on the suture and adapted to fit in the bottom of the first and second portion, respectively; and

a first top cap and second top cap through which the suture is inserted when the tube is removed, said first and second cap adapted to fit in the top of the first and second portions, respectively.

15. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

inserting a first end of a hollow tube into the top surface of the first portion, through the first portion and out the bottom of the first portion;

inserting a second end of the hollow tube into the top surface of the second portion, through the second portion and out the bottom of the second portion;

inserting a first end of the suture having a first bottom cap and second bottom cap on the suture into the first end of the hollow tube until it extends past the top surface of the first portion;

inserting a second end of the suture having the first bottom cap and second bottom cap on the suture into the second end of the hollow tube until it extends past the top surface of the second portion;

removing the tube from the suture and the first and second portion;

sliding the first bottom cap along the suture to the bottom surface of the first portion;

placing the first bottom cap into the bottom surface of the first portion;

sliding the second bottom cap along the suture to the bottom surface of the second portion;

placing the second bottom cap into the bottom surface of the second portion;

placing a first top cap over the first end of the suture and into the top surface of the first portion;

placing a second top cap over the second end of the suture and into the top surface of the second portion;

moving the first portion and second portion together; and

closing the first end and second end of the suture together to hold the first portion and second portion together.

16. A suture comprising:

a wire adapted to extend through bone of a patient; and

an insulation portion disposed about the wire and adapted to protect the bone from the wire.

17. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

extending a suture comprising a wire and an insulation portion about the wire through the first portion and the second portion;

pulling the first portion and second portion together; and

securing the first and second portions together with the suture wherein the insulation of the suture protects the first portion and second portion from the wire.

18. A grommet for a bone comprising:

a top cap having a top flange that is adapted to seat on the top surface of the bone and a threaded portion which extends from the top flange and is adapted to be disposed in the bone, the top flange and threaded portion having a top channel extending through them; and

a bottom cap having a bottom flange that is adapted to seat on the bottom surface of the bone and a bottom strut which extends from the bottom portion and engages with the threaded portion to hold the top cap to the bottom cap and is adapted to be disposed in the bone, the bottom flange and a strut having a bottom channel extending through them, the top channel and bottom channel adapted for a suture to extend through the top channel and bottom channel.

19. A method for securing a suture through a bone comprising:

placing a bottom cap of a grommet into the bone wherein a bottom flange of the bottom cap seats on the bottom surface of the bone and a bottom strut of the bottom cap connecting to the bottom flange extends into the bone;

placing a top cap of a grommet into the bone wherein the top flange of the top cap seats on the top surface of the bone and a threaded portion of the top cap is connected to the top flange and extends into the bone and contacts the bottom strut;

screwing the threaded portion of the top cap into the bottom strut; and

passing a suture through the bone via a channel of the top cap and bottom cap.

20. An apparatus for holding together a first portion of a bone and a second portion of a bone for the bone to heal comprising:

a wire having a first end and a second end;

a first needle attached to the first end;

a second needle attached to the second end;

a first bottom cap with a flange adapted for placement into the bottom of the first portion with the wire through it;

a second bottom cap with a flange adapted for placement into the bottom of the second portion with the wire through it;

a first top cap with a flange adapted for placement into the top of the first portion with the wire through it; and

a second top cap with a flange adapted for placement into the top of the second portion with the wirethrough it.

21. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

passing a first needle attached to a first end of a suture through the first portion;

passing a second needle attached to a second end of a suture through the second portion;

guiding a first bottom cap through which the suture is disposed along the suture until it contacts the first portion;

inserting the first bottom cap into the bottom of the first portion;

guiding a second bottom cap through which the suture is disposed along the suture until it contacts the second portion;

inserting the second bottom cap into the bottom of the second portion;

separating the first needle from the first end;

separating the second needle from the second end;

passing the first end through a first top cap;

guiding the first top cap along the wire;

inserting the first top cap into the top surface of the first portion;

passing the second end through a second top cap;

guiding the second top cap along the wire;

inserting the second top cap into the top surface of the second portion; and

securing the suture in place about the first and second portion by connecting the first and second ends.

22. An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising:

a strap made of a memory metal having a central portion with a right side and a left side, a right portion that extends angularly downward from the central portion adjacent to the right portion, and a left portion that extends angularly downward from the central portion adjacent to the left side, said right and left portion is adapted to extend into and through the first and second portion of the bone, respectively, with the central portion disposed along the top surface of the first and second portions, the bottom of the right and left portions curling and hooking into the first and second portions, respectively, to grip the first and second portions.

23. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

inserting a right portion of a strap made of a memory metal into and through the first portion of the bone and a left portion of the strap into and through the second portion of the bone with a central portion of the strap connecting the right portion and the left portion and extending over and between the first and second portions; and

heating the right portion and left portion until they curl and the bottom of the right and left portions hook into the first and second portions, respectively.

24. An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising:

a plurality of grommets, each grommet having a channel, a flange adapted to seat on the surface of the bone, and a tube which extends from the flange and is adapted to be disposed in the bone;

a suture which extends through at least two of the plurality of grommets which oppose each other when they are disposed in the first and second portions of the bone, respectively;

a poker which removably fits in the channel of a grommet and has a pointed end adapted to pierce the bone and to install the grommet into the bone; and

a platform against which the tube of one of the grommets with the poker through it is pressed to cause the end of the tube to flare out and form a bottom flange that seats on the bottom surface of the bone.

25. An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising:

a plurality of grommets, each having a channel and a top portion and a bottom portion, each portion having a flange adapted to seat on the surface of the bone, and a tube which extends from the flange and is adapted to be disposed in the bone;

a poker which removably fits in the channel of the top and bottom portions and has a pointed end adapted to pierce the bone and to install the top portion into the bone and along which the bottom portion fits to be guided into the bottom of the bone.

26. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

placing a poker having a pointed end through a channel of a first grommet having a top flange and a tube which extends from the top flange;

inserting the poker, pointed end first, with the first grommet on it through the top surface of the first portion until it contacts a platform disposed adjacent the bottom surface of the first portion and the tube of the grommet is disposed in and extends through the first portion;

pressing the poker against the platform until the bottom of the tube flares out and forms a bottom flange; and

removing the poker from the first grommet leaving the first grommet in the first portion with the top flange and bottom flange adjacent to the top surface and bottom surface, respectively;

implanting a second grommet having a channel in the second portion;

extending a suture through the channels of the first and second grommets;

bringing the first and second portions together; and

securing the first and second portions together with the suture.

27. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

placing a poker having a pointed end through a channel of a top portion of a first grommet having a top flange and a tube which extends from the top flange;

inserting the poker, pointed end first, with the top portion of the first grommet on it through the top surface of the first wherein the flange seats on the top surface of the first portion and the tube is disposed in the first portion;

placing a tube of a bottom portion of the first grommet on the pointed end;

sliding the bottom portion along the poker until a flange of the bottom portion seats on the bottom surface of the first portion and the tube of the bottom portion is in the bottom of the first portion;

removing the poker from the first grommet leaving the first grommet in the first portion with the top flange and bottom flange seated on the top surface and bottom surface, respectively;

implanting a second grommet having a channel in the second portion;

extending a suture through the channels of the first and second grommets;

bringing the first and second portions together; and

securing the first and second portions together with the suture.

28. A grommet for a bone comprising:

a top cap having a top flange adapted for placement on the top surface of the bone and a top strut adapted for placement in the bone extending from the top flange, the top strut having slots disposed along its outer surface, the top cap having a channel for a suture to extend through, the top strut adapted for placement in the bone; and

a bottom cap having a bottom flange adapted for placement on the bottom surface of the bone and a bottom strut adapted for placement in the bone extending from the bottom flange, the bottom strut having a catch extending from its inner surface to engage a slot to secure the top cap and bottom cap together.

29. A method for holding a first portion of a bone and a second portion of a bone together for the bone when to heal comprising the steps of:

inserting a top strut of a top cap of a first grommet into a hole in the top surface of the first portion until a top flange of the top cap seats on the top surface of the bone;

inserting a bottom strut of a bottom cap of the first grommet into the hole in the bottom surface of the first portion until a catch extending from the inner surface of the bottom strut of engages a slot disposed along the outer surface of the top strut wherein the top cap and bottom cap are secured together;

inserting a second grommet having a channel into a second portion of the bone;

threading a suture through a channel of the first grommet and the channel of the second grommet;

pulling the first portion the second portion together; and

securing the suture wherein the first portion and second portion are secured together.

30. A grommet for insertion in a bone comprising:

a housing having a channel for a suture, the housing adapted for placement in the bone, said housing having at least one pre-crimp in its wall which expands outward and collapses when the housing is compressed in an axial direction.

31. A method for placing a suture through a bone comprising the steps of:

inserting a grommet into a bone;

compressing the grommet axially from its top and bottom causing a pre-crimp in the housing wall to extend outward and collapse to form an anchor in the bone; and

threading a suture through a channel in the grommet.

32. A grommet for implantation into a hole in hard or soft tissue of a patient comprising:

a spring having a head flange adapted to seat on the top portion of the tissue;

a tail flange adapted to seat on the top portion of the tissue; and

an elongate central portion connected to the head flange and the tail flange.

33. A grommet as described in claim 32 wherein the tail flange has a tail end which bends inwards.

34. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal comprising the steps of:

placing a pushing rod having a pushing end with a slot through a channel of a first grommet in a form of a spring having a head flange, tail flange and central portion which connects with the head flange and tail flange which extends from the top flange;

placing a tail end of the tail flange into the slot;

twisting the pushing rod so the tail flange and central portion narrow in diameter;

inserting the first grommet with the pushing rod into the first portion until the tail flange extends from the bottom surface of the first portion;

removing the pushing rod from the first grommet and the first portion so the tail flange and head flange seat on the bottom and top surfaces, respectively, of the first portion;

implanting a second grommet having a channel in the second portion;

extending a suture through the channels of the first and second grommets;

bringing the first and second portions together; and

securing the first and second portions together with the suture.