Internal cord fixation device
First Claim
1. An orthopedic fixation system for fixing a bone having an exterior cortical portion and a non-cortical interior portion to an element which is a bone fragment or a prosthesis, comprising a length of flexible, inelastic cord;
- a first fastener for attaching the cord to said element;
a second fastener for attaching the cord to the bone and enabling the cord to extend from said first fastener within the non-cortical interior of the bone to the second fastener, at least one of the fasteners having an opening through which the cord may pass from the interior of the bone to the exterior to enable said element to be securely mounted to the bone portion, and an axially rigid tubular support sized to permit the cord to extend through it.
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Accused Products
Abstract
Methods and apparatuses for fixing a bone fragment or a bone prosthesis onto a bone. To affix a bone fragment to the bone, an internal fastener is attached from within the interior of the bone to a bone fragment with a length of flexible, inelastic cord extending within the bone interior and attached to the fastener and passing outwardly through an opening in a second bone fragment. An axially rigid tubular support may be placed along the cord to reduce particulate shedding, to reduce ingrowth of bone into the cord, to provide compressive resistance to the cable, or to deliver antibiotics or other pharmaceuticals. The fastener and cord are so positioned as to draw respective fracture surfaces together to reduce the fracture when the cord is pulled outwardly of the opening in the second bone fragment. A second fastener desirably is attached to the bone opening, this fastener including an open bore to receive the cord and a lock to secure the cord to this fastener and maintain the cord under tension.
222 Citations
60 Claims
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1. An orthopedic fixation system for fixing a bone having an exterior cortical portion and a non-cortical interior portion to an element which is a bone fragment or a prosthesis, comprising a length of flexible, inelastic cord;
- a first fastener for attaching the cord to said element;
a second fastener for attaching the cord to the bone and enabling the cord to extend from said first fastener within the non-cortical interior of the bone to the second fastener, at least one of the fasteners having an opening through which the cord may pass from the interior of the bone to the exterior to enable said element to be securely mounted to the bone portion, and an axially rigid tubular support sized to permit the cord to extend through it. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
- a first fastener for attaching the cord to said element;
- 20. A bone fracture reduction system for reducing and promoting healing of a bone fracture of a bone normally having an exterior cortical portion and a non-cortical interior portion and having bone fragments with generally confronting fracture surfaces, comprising an internal fastener from within the non-cortical interior to a first bone fragment, a second fastener attachable to a second bone fragment, a length of flexible, inelastic cord having substantially no axial compressive strength and extendable within said bone interior and attached to said internal fastener and the second fastener, the internal fastener, the second fastener, and the cord being so positioned as to draw respective fracture surfaces together to reduce the fracture upon tensioning of the cord between the internal fastener and the second fastener, and an axially rigid tubular support sized to permit the cord to extend through it.
- 39. A Method for positioning fragments of a bone fracture with respect to each other to reduce the fracture and promote healing of a bone which normally has an exterior cortical portion and a non-cortical interior portion, the bone fragments having confronting fracture surfaces forming a fracture interface, the method comprising attaching from within the interior of the bone to a first bone fragment an internal fastener to which is attached a length of flexible, inelastic cord, advancing an axially rigid tubular support over the cord, and drawing the cord through a bore formed in a second bone fragment to draw the fragments together in a direction to relieve the fracture.
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55. A method for reducing a bone fracture in a bone having a cortical exterior portion and a non-cortical interior portion, the bone having at least three bone fragments in which first and second fragments have first mating fracture surfaces and second and third bone fragments have second, different mating fracture surfaces, the method comprising attaching one end of a length of flexible cord from within the bone interior to the first bone fragment, attaching an internal pulley bearing the cord to the second bone fragment, the other end of the cord passing outwardly of the bone through an opening in the third bone fragment, advancing a first axially rigid tubular support over the cord between the first and second bone fragments and advancing a second axially rigid tubular support over the cord between the second and third bone fragments tensioning the cord to draw together said mating fracture surfaces to relieve the fractures, and securing the tensioned cord to said third bone fragment.
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56. A method for reducing a bone fracture comprising at least two pairs of bone fragments, the first pair of bone fragments having first mating fracture surfaces and the second pair of bone fragments having second, different mating fracture surfaces, and wherein one bone fragment may be common to each of the first and second pairs, the bone having an exterior cortical portion and an interior non-cortical portion, the method comprising
a. attaching one end of a length of flexible cord from the interior of the bone to one fragment of the first pair, advancing a first axially rigid tubular support over the cord, and extending the cord through an opening in the other bone fragment of the first pair in a direction so that when the cord is placed in tension, the first mating fracture surfaces are drawn toward each other; -
b. attaching one end of a second length of flexible cord from the interior of the bone to one fragment of the second pair, advancing a second axially rigid tubular support over the cord, and extending the second length of cord extending through an opening in the other bone fragment of the second pair in a direction so that when the cord is placed in tension, the second mating fracture surfaces are drawn toward each other; and
C. appropriately adjusting tension in the cords with respect to each other to reduce the fracture surfaces. - View Dependent Claims (57)
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58. A method for reducing a bone fracture of a bone having a cortical exterior portion and a non-cortical interior portion, the fracture comprising at least three bone fragments each having fracture surfaces mating with fracture surfaces of the other fragments, the method comprising:
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a. attaching from the interior of the bone to each of two of the bone fragments a fastener having a pulley surface over which is trained a length of flexible cord;
b. advancing an axially rigid tubular support over the cord;
c. drawing the cord through an opening in a third bone fragment and tensioning the cord to draw the fracture surfaces together; and
d. securing the cord to the third bone fragment to reduce the fracture surfaces.
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59. Method for reducing a bone fracture of an elongated bone having a medullary canal and a generally transverse fracture dividing the bone into first and second bone fragments, comprising
a. attaching from the interior of the bone to one of said bone fragments an internal fastener from which extends at least two flexible, inelastic cord lengths; -
b. advancing an axially rigid tubular support over each of the cords;
c. drawing the cord lengths through openings formed in the second bone fragment at spaced positions along the interior of the medullary canal of that fragment so that the cord lengths are spaced from one another within the medullary canal at the fracture site; and
d. securing the cords to the second bone fragment to reduce the fracture surfaces, the spaced cords resisting bending moments at the fracture site.
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60. A bone fracture reduction system for use in reducing a fracture of a long bone producing first and second bone fragments, comprising an internal fastener adapted to be fastened to the interior of one bone fragment, a pair of flexible, inelastic cords attached to and extending from the internal fastener, a pair of axially rigid tubular supports each sized to receive one of the cords therethrough, and a pair of external fasteners attachable to the other of the bone fragments and having openings through which the cords may respectively pass on opposite sides of the medullary canal, whereby the cords may traverse the fracture site within the medullary canal on opposite sides thereof to resist bending moments at the fracture site.
Specification