Instrument for applying a tie to two items and method of making same

• US 20040267286A1
• Filed: 03/22/2004
• Published: 12/30/2004
• Est. Priority Date: 10/24/2002
• Status: Active Grant

• Current Assignee: Tecomet, Inc.
• Original Assignee: Technology Holding Company II (Teleflex Incorporated)
• Inventors: Rinner, James A, Gao, Hua
• Granted Patent: US 7,131,467 B2
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/128 for applying or removing clamps or clips

Abstract

An instrument for applying a tie (12) to two items (10, 11), and a method of making same. The instrument is arranged for pulling separated bones or other items together and securing them together by twisting a tie onto them. The instrument can be made of plastic and it need not include any threaded parts. It can have two handles (21, 22) with a tie gripper (24) and a tie guide (26) on respective ones of the handles which can be squeezed together for pulling on a tie to draw separated items together. The handles rotate together, and there can be a crank (27) for effecting the rotation and thereby twist the tie onto the items.

Claims

1. An instrument for applying a tie to two items to pull and secure the items together where the items have the tie connected thereto, comprising an assembly of all of the following parts:

a first handle and a second handle relatively movable along and rotatable about an axis,

a tie guide attached to said first handle for directing the tie in having the tie cross over upon itself at a location on said axis,

a tie gripper attached to said second handle for securing the tie to said gripper and thereby to said second handle,

said tie guide and said location and said gripper all being sequentially spaced from each other along said axis and to be sequentially disposed in a direction away from the separated items,

a releasable connector operatively connected between said handles for temporarily holding said gripper and said guide in a first spaced relationship along said axis, and

said connector being operatively releasable for movement between said gripper and said guide to a second spaced relationship along said axis and with the spacing of said second spaced relationship being greater than the spacing of said first spaced relationship to thereby pull on the tie to pull the items together when moving to said second spaced relationship.

2. The instrument for applying a tie, as claimed in claim 1, including:

a rotator connected to said handles for rotating said handles and said guide and said gripper all in unison and about said axis for twisting the tie onto itself for securing the application of the tie to the items.

3. The instrument for applying a tie, as claimed in claim 2, wherein:

said rotator is a crank connected to said handles for the rotating.

4. The instrument for applying a tie, as claimed in claim 3, including:

a third handle rotatably mounted on said first and said second handles for guiding the instrument while rotating.

5. The instrument for applying a tie, as claimed in claim 1, wherein:

said connector is self-operatively releasable in response to the movement between said gripper and said guide.

6. The instrument for applying a tie, as claimed in claim 1, wherein:

said handles have respective portions adjacent each other for being-squeezed together to move said handles relatively to each other along said axis and thereby pull on the tie.

7. The instrument for applying a tie, as claimed in claim 1, wherein:

said assembly is free of any threaded attachments and connections.

8. The instrument for applying a tie, as claimed in claim 7, wherein:

said assembly is entirely of plastic material and the attachments and connections includes detents for snapping together and thereby the instrument is made to be disposable after only one use in the medical application thereof.

9. The instrument for applying a tie, as claimed in claim 1, wherein:

said attachments and said connections of said assembly are interlocking latches for hooking together.

10. The instrument for applying a tie, as claimed in claim 1, including:

said gripper being attached to said second handle for rocking motion relative to said second handle to thereby automatically adjust to any tension in the tie attached to said gripper when said gripper is moving to said second spaced relationship, and

a restrictor operative on said gripper for detering the rocking motion when said gripper is in said first spaced relationship.

11. The instrument for applying a tie, as claimed in claim 1, including:

said guide having slots thereon spaced from said axis for stringing reception of the tie to thereby impose orbital motion to the tie upon rotation of said handles.

12. The instrument for applying a tie, as claimed in claim 1, wherein:

said guide is non-movably affixed relative to said first handle and is formed to have the tie nest therewith.

13. An instrument for applying a tie to two items for pulling and securing the items together where the items have the tie connected thereto, comprising an assembly of all of the following parts:

a first handle and a second handle telescoped together by having said first handle extend through and beyond said second handle in a terminal end and with said handles relatively movable along and rotatable about an axis,

a tie guide attached to said terminal end of said first handle for directing the tie in having the tie cross over upon itself at a location on said axis,

a tie gripper attached to said second handle for securing the tie to said gripper and thereby to said second handle,

said guide and said gripper both having tie receptors accessible from the exteriors thereof for stringing the tie thereon free of any need for releasing the tie during the stringing,

said tie guide and said location and said gripper all being sequentially spaced from each other along said axis and to be sequentially disposed in a direction away from the separated items,

said gripper being movable along said axis and relative to said guide and in response to and upon movement of said second handle along said axis for thereby pulling on said tie to pull the items together, and

said assembly being rotatable about said axis as a single unit and initially in a one-half turn in a direction of continuing the cross over so the tie is twisted upon itself and doing so while said gripper is still pulling on said tie.

14. The instrument for applying a tie, as claimed in claim 13, including:

a releasable connector operatively connected between said handles for temporarily holding said gripper and said guide in a first spaced relationship along said axis, and

said connector being operatively releasable for movement between said gripper and said guide to a second spaced relationship along said axis and with the spacing of said second spaced relationship being greater than the spacing of said first spaced relationship to thereby pull on the tie to pull the items together when moving to said second spaced relationship.

15. The instrument for applying a tie, as claimed in claim 14, wherein:

said connector is self-operatively releasable in response to the movement between said gripper and said guide.

16. The instrument for applying a tie, as claimed in claim 13, including:

a rotator connected to said handles for rotating said handles and said guide and said gripper all in unison and about said axis for twisting the tie onto itself for securing the application of the tie to the items.

17. The instrument for applying a tie, as claimed in claim 15, wherein:

said rotator is a crank connected to said handles for the rotating.

18. The instrument for applying a tie, as claimed in claim 17, including:

a third handle rotatably mounted on said first and said second handles for guiding the instrument while rotating.

19. The instrument for applying a tie, as claimed in claim 13, wherein:

said handles have respective portions adjacent each other for being squeezed together to move said handles relatively to each other along said axis and thereby pull on the tie.

20. The instrument for applying a tie, as claimed in claim 13, wherein:

said assembly has snap attachments and connections and is free of any threaded attachments and connections.

21. The instrument for applying a tie, as claimed in claim 20, wherein:

said assembly is entirely of plastic material and the attachments and connections includes detents for snapping together and thereby the instrument is made to be disposable after only one use in the medical application thereof.

22. The instrument for applying a tie, as claimed in claim 13, wherein:

said attachments and said connections of said assembly are interlocking latches for hooking together.

23. The instrument for applying a tie, as claimed in claim 13, including;

said gripper, being attached to said second handle for rocking motion relative to said second handle to thereby automatically adjust to any tension in the tie attached to said gripper when said gripper is moving to said second spaced relationship, and

a restrictor operative on said gripper for detering the rocking motion when said gripper is in said first spaced relationship.

24. The instrument for applying a tie, as claimed in claim 13, including:

said guide having slots thereon spaced from said axis for stringing reception of the tie to thereby impose orbital motion to the tie upon rotation of said handles.

25. The instrument for applying a tie, as claimed in claim 13, wherein:

said guide is non-movably affixed relative to said first handle and is formed to have the tie nest therewith.

26. An instrument for applying a tie to two items for pulling and securing the items together where the items have the tie connected thereto, comprising an assembly of all of the following parts:

a first handle and a second handle telescoped together by having said first handle extend through and beyond said second handle in a terminal end and with said handles being relatively movable along an axis and being rotatably connected together for unitary rotation about said axis,

a tie guide attached to said terminal end of said first handle for directing the tie in having the tie cross over upon itself at a location on said axis,

a tie gripper and said second handle having mutually engagable portions for securing said gripper to said second handle by hooking therebetween,

said guide and said gripper both having tie receptors accessible from the exteriors thereof for stringing the tie thereon while constantly holding the tie during the stringing,

said tie guide and said location and said gripper all to be sequentially spaced from each other along said axis and to be sequentially disposed in an axial direction away from the items,

said gripper being movable along said axis and relative to said guide and in response to and upon movement of said second handle along said axis for thereby pulling on said tie to pull the items together, and

said assembly being rotatable about said axis as a single unit and initially in a one-half turn in a direction for a continuation of the cross over orientation so the tie is twisted upon itself and to be able to do so while said gripper is still pulling on said tie.

27. The instrument for applying a tie, as claimed in claim 26, including:

rockably securing said gripper to said second handle for having said gripper self-adjust in response to the tension in the tie connected thereto.

28. A method of making an instrument for applying a tie to items to pull and secure the items together, comprising the steps of:

providing parts which include a first handle and a second handle and a tie guide and a tie gripper,

connecting said tie gripper to said second handle,

telescopically assembling said first handle and said second handle on an axis by penetrating said second handle with said first handle and have said first handle extend beyond said second handle and have said handles in rotation drive therebetween and about said axis,

connecting said tie guide to the extending end of said first handle and having said gripper and said guide movable relative to each other along said axis, and

releasably connecting said gripper and said guide relative to each other.

29. The method of making an instrument for applying a tie, as claimed in claim 28, including:

releasably connecting said gripper and said guide together to have said gripper and said guide self-activating for the releasability thereof and in response to the movement therebetween.

30. The method of making an instrument for applying a tie, as claimed in claim 28, including:

connecting said tie gripper to said second handle and connecting said tie guide to said first handle with detent connections to effect snap connections.

31. The method of making an instrument for applying a tie, as claimed in claim 28, including:

telescopically assembling said first handle and said second handle to be movable relative to each other and along said axis.

32. The method of making an instrument for applying a tie, as claimed in claim 28, including:

connecting said tie gripper to said second handle to have a rocking action of said tie gripper on said second handle for having said tie gripper rock to self-adjust to tension in the tie.

33. The method of making an instrument for applying a tie, as claimed in claim 28, including:

making all said parts and connections only with plastic material.

34. The method of making an instrument for applying a tie, as claimed in claim 28, including:

placing a third handle in telescoping and rotational relationship relative to said first handle and said second handle.

35. The method of making an instrument for applying a tie, as claimed in claim 28, including:

forming a crank on said first handle for inducing rotation about said axis.

36. A method of making an instrument for applying a tie to items to pull and secure the items together, comprising the steps of:

providing parts which include a first handle and a second handle and a tie guide and a tie gripper for assembly along an axis,

making said second handle to include two flexible legs extending in the direction of said axis and on opposite sides of and spaced apart from said axis,

placing a projection on each said leg and having said projections extend away from said axis,

sliding said tie gripper over said legs and said projections by flexing said legs toward each other and connect said gripper onto said projections,

arranging said second handle with a passageway along its entire axial extent and arranging said first handle to be snugly positioned in said passageway and to extend therebeyond and have said handles related to be rotatable together about said axis and relatively axially movable and to have said legs pressed apart for securing said projections connected with said gripper, and

connecting said tie guide onto the extending end of said first handle.

37. The method of raking an instrument for applying a tie, as claimed in claim 36, including:

releasably connecting said tie gripper to said tie guide for fixed spacing therebetween along said axis and for subsequent relative movement along said axis upon axial movement of said handles.

38. The method of making an instrument for applying a tie, as claimed in claim 36, including:

rockably connecting said tie gripper onto said projections for self-adjusting rocking action of said gripper on said projections in response to tension in said tie.

39. A bone closer instrument for applying a suture onto two parts of bone which has a break along a plane extending perpendicular to the bone and along the break and with the perpendicular plane having a front direction and a rear direction therealong, comprising:

said instrument being arranged to receive a flexible suture having a length with an intermediate portion disposable in clinching relationship with the bone two parts and with said length having two extending portions extending in opposite directions from said intermediate portion and crossing the perpendicular plane at a cross-over location which is adjacent the bone and with said suture two extending portions terminating in two terminal ends,

two instrument parts movable relative to each other and with a first one of said parts fixedly gripping said two terminal ends and a second one of said two parts having surfaces in contact with said intermediate portions and being positioned between the perpendicular plane and said intermediate portions and away from the bone in the direction beyond the cross-over location whereby holding said terminal ends and simultaneously moving said surfaces toward the bone causes said suture to draw the two parts of the bone together, and

a rotation handle on the instrument and connected with said surfaces for rotating said surfaces around the cross-over location for twisting said suture onto itself.

40. The bone closer instrument, as claimed in claim 39, wherein:

said suture intermediate portions and terminal ends are disposed on the exterior of said instrument parts and are free of extending through said instruments parts and are therefore available for the gripping and are exposed relative to said parts.

41. The bone closer instrument, as claimed in claim 39, wherein:

said two parts are handles disposed adjacent to each other within a spacing to be simultaneously gripped and squeezed by one hand of the operator to move said two handles relative to each other in the causing of said suture to draw the bone parts together.

42. The bone closer instrument, as claimed in claim 39, including:

said first one of said parts having suture grippers on the exterior to be available for placing of said terminal ends onto said grippers from the exterior of said first one of said parts.

43. The bone closer instrument, as claimed in claim 39, including:

said two parts being rotatably connected together for uniform rotation by said rotation handle in the twisting of said suture.

44. The bone closer instrument, as claimed in claim 39, including:

a stabilizing handle associated with said two parts and with said rotation handle for guiding said instrument during the twisting of said suture.

45. A bone closer instrument for controlling a suture extending around two fragments of bone and with the suture extending from the bone in two end extensions, comprising:

two T-shaped handles with each having a stem and a cross portion extending perpendicular to said stem,

said stems being slidably telescopically related to each other along a longitudinal axis and being connected together to rotate in unison about said axis,

a first one of said stems having a first set of two portions of said first stem for gripping the two ends of the suture in a spaced-apart relationship,

a second one of said stems having a second set of two portions of said second stem for abutting the suture in two spaced-apart locations on the suture for manipulating said two sets relative to each other and thereby tensioning the suture relative to the bone to draw the bone fragments together, and

a third handle connected to said two handles for rotation of said two handles in unison and thereby twist the suture onto itself to tie the suture to the bone.

46. The bone closer instrument, as claimed in claim 45, including:

a releasable connection between said two handles for alternately releasing and locking said two handles relative to each other and relative to the slidable telescopic relationship therebetween.

47. The bone closer instrument, as claimed in claim 45, wherein:

said first and said second two portions are respectively on the exterior of said two handles and are located thereon to be accessible from said exterior in the direction perpendicular to said axis for directly positioning the suture onto said two portions from the exterior of the instrument.

48. The bone closer instrument, as claimed in claim 45, wherein:

said two handles have a first end along said axis and said first and said second sets of said two portions are located adjacent said first end.

49. The bone closer instrument, as claimed in claim 45, including:

a fourth handle telescoped over said two stems and being rotatable thereon for stabilizing said instrument during the rotation of said two handles.

50. The bone closer instrument, as claimed in claim 49, wherein:

said first set of said two portions and said fourth handle have interengaging surfaces for stabilizing said first set of said two portions while manipulating said two sets relative to each other in drawing the bone fragments together.

51. The bone closer instrument, as claimed in claim 45, wherein:

said first set of said two portions is movably supported on said first stem to be movable relative to said first stem while twisting said suture during rotation of said two handles.

52. The bone closer instrument, as claimed in claim 45, wherein:

said cross portions of said two handles are disposed adjacent each other for simultaneous gripping by a user'"'"'s single hand and thereby allow single hand squeezing of said two cross portions toward each other in the tensioning of said suture.

53. The bone closer instrument, as claimed in claim 45, including:

the suture having an overall length from and between said two end extensions and having an intermediate portion along the length, and

two suture guides on said second one of said stems and located adjacent said second set of said two portions for engaging and guiding the suture intermediate length in the twisting of the suture.

54. The bone closer instrument, as claimed in claim 45, wherein:

the suture is provided and consists of stainless steel wire of a rigidity capable of twisting upon itself into a helical pattern and self-retain that pattern in several complete loops of twist.

55. An instrument for closing broken bone by applying a suture having a wire characteristic which is capable of being twisted upon itself and to self-retain its twist and thereby form a tie to hold the bone together, comprising:

said instrument having two parts movable relative to each other and with a first one of said parts having wire-guide surfaces thereon and a second one of said parts having wire grippers thereon and with said surfaces and said grippers being engageable with the wire when the wire is strung onto the bone and across the break therein,

a hand grip on each of said parts and disposed within the span of an user'"'"'s hand for simultaneous gripping and squeezing by the user to move said wire-guide surfaces and said wire grippers relative to each other for tightening the wire onto the bone and thereby force the bone together, and

a rotator on said parts for rotating said parts for twisting the wire onto itself to tie the wire to hold the bone together.

56. The instrument for closing broken bone, as claimed in claim 55, including:

a releasable latch operable between said two parts for selectively restraining said two parts against movement relative to each other and thereby temporarily establish spacing between said surfaces and said grippers for the stringing of the wire, and

said latch being arranged for automatic release in response to the relative movement between said two parts for the tightening of the wire onto the bone.

57. The instrument for closing broken bone, as claimed in claim 56, including:

a guide interengaged between said two parts for guiding said two parts during their relative movement and for resisting relative rotation between said two parts.

58. The instrument for closing broken bone, as claimed in claim 55, including:

a connector operative for movably mounting said grippers on said second one of said two parts for self-adjusting of said grippers in response to forces applied thereto by the wire.

59. The instrument for closing broken bone, as claimed in claim 58 including:

a member on said two parts and being connectable with said connector for selectively restraining said connector to thereby limit movement of said grippers.

60. A method of applying a suture to two parts of broken bone, comprising the steps of:

positioning said suture in contact with the bone and to cross over itself in two lengths of said suture at a location relative to the bone,

pulling and tensioning said suture against the bone to move the two parts toward each other,

moving said two lengths once around each other to have said two lengths directed back onto themselves to hook said lengths together at said location and to thereby hold said broken bone together, and

subsequently applying a cranking action to said suture to twist said lengths onto themselves and thereby tie said suture to the bone.

61. The method of applying a suture to two parts of broken bone, as claimed in claim 60, including:

said suture having two ends and applying spaced apart grippers to said ends for the pulling and tensioning of said suture against the bone, and

having said grippers self-adjust in position relative to said location and in response to the tension in said suture when said suture is being twisted, to thereby equalize the tension in said suture between said ends.

62. An instrument for closing two fragments of broken bone by applying a suture having a wire characteristic of being capable of being twisted upon itself and to self-retain the twist and thereby form a tie to hold the bone fragments together, comprising:

said instrument being arranged to receive a flexible suture having a length with an intermediate portion disposable in clinching relationship with the bone fragments and with said length having two extending portions extendable from said intermediate portion and being capable of crossing over each other at a cross-over location which can be adjacent the bone and with said suture two extending portions being capable of terminating in two terminal ends,

two instrument parts movable relative to each other,

two suture grippers on a first one of said parts and with each having a V-shape for securely gripping said two terminal ends to hold said ends away from the bone,

a second one of said two parts having surfaces contactable with said intermediate portions of said suture for guiding said intermediate portions for simultaneously moving said surfaces toward the bone to cause said suture to draw the two fragments of the bone together, and

a rotation handle on the instrument and connected with said surfaces for rotating said surfaces around the cross-over location for twisting said suture onto itself.