CERCLAGE SYSTEM FOR BONE

• US 20100094294A1
• Filed: 10/10/2008
• Published: 04/15/2010
• Est. Priority Date: 10/10/2008
• Status: Active Grant

• Current Assignee: Acumed Llc (Berkshire Hathaway Incorporated)
• Original Assignee: Acute Innovations LLC (Berkshire Hathaway Incorporated)
• Inventors: Knight, Mariah, Gillard, Joel
• Granted Patent: US 8,486,114 B2
• Time in Patent Office: Days
• US Class Current: 606/74
• CPC Class Codes: A61B 17/8076 for the ribs or the sternum
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 17/823 for the sternum
• CPC Class Codes: A61B 17/8869 Tensioning devices
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00831 Material properties
• CPC Class Codes: A61B 2017/0088 ceramic
• CPC Class Codes: A61B 2017/00933 bone or bone-like

Abstract

Cerclage system, including methods, devices, and kits, for stabilizing bone, such as a sternum. The cerclage system may include a wire or cable that encircles bone, and a bone plate to which segments of the wire or cable lock. The cerclage system also or alternatively may include a tensioner for applying tension to a wire or cable.

Claims

1. A cerclage device for stabilizing bone, comprising:

a bone plate including

(a) a plate body having opposing inner and outer surfaces and forming at least one spanning member, the spanning member having opposing end surfaces and defining a pair of channels, each channel extending to both opposing end surfaces and being configured to receive a segment of a wire or cable,

(b) a plurality of cleats projecting from the inner surface of the plate body, and

(c) a pair of locking studs projecting from the spanning member at nonoverlapping positions along the spanning member to permit serial actuation of the locking studs, each locking stud being operatively coupled to only one respective channel of the pair such that application of compressive force to the spanning member and locking stud actuates the locking stud to lock a wire or cable segment to the plate body in the only one respective channel.

2. The cerclage device of claim 1, wherein the locking studs project from respective opposing side surfaces of the spanning member.

3. The cerclage device of claim 1, wherein the plate body includes a pair of tabs extending laterally from the spanning member adjacent each of the opposing end surfaces of the spanning member.

4. The cerclage device of claim 3, wherein the cleats are prongs, wherein the plate body has opposing inner and outer surfaces, and wherein at least one prong projects from each tab.

5. The cerclage device of claim 3, wherein each tab is thinner than the spanning member.

6. The cerclage device of claim 1, wherein the plate body defines a long axis, wherein the at least one spanning member is a plurality of spanning members, wherein a pair of locking studs projects from each spanning member, and wherein the spanning members are arranged along the long axis with each spanning member extending transversely to the long axis.

7. The cerclage device of claim 6, wherein the plate body has opposing inner and outer surfaces, wherein the plate body defines a plurality of apertures extending to the inner and outer surfaces and arranged along the long axis, and wherein each pair of locking studs projects into an adjacent pair of the apertures.

8. A cerclage device for stabilizing bone, comprising:

a bone plate including

(a) a plate body forming at least one spanning member, the spanning member having opposing end surfaces and defining a pair of channels, each channel extending to both opposing end surfaces and being configured to receive a segment of a wire or cable, and

(b) a pair of locking studs projecting from the spanning member at nonoverlapping positions along the spanning member to permit serial actuation of the locking studs, each locking stud being operatively coupled to only one respective channel of the pair such that application of compressive force to the spanning member and locking stud actuates the locking stud to lock a wire or cable segment to the plate body in the only one respective channel.

9. A cerclage device for stabilizing bone, comprising:

a bone plate including a plate body having opposing inner and outer surfaces and a pair of side surfaces that opposingly flank the inner and outer surfaces, the plate body defining a plurality of openings each extending to the inner and outer surfaces to form a plurality of spanning members arranged along the plate body between adjacent pairs of the openings, each spanning member defining a pair of channels that extend along the spanning member to each side surface of the plate body, each channel being configured to receive a segment of a wire or cable.

10. The cerclage device of claim 9, further comprising a wire or cable, wherein a segment of the wire or cable is locked to the bone plate in each channel of at least one of the spanning members.

11. The cerclage device of claim 9, wherein the bone plate includes a plurality of cleats projecting from the inner surface of the plate body.

12. The cerclage device of claim 9, wherein the bone plate further includes a pair of locking studs projecting from each spanning member and configured to be actuated to lock segments of a wire or cable in the pair of channels defined by the spanning member.

13. The cerclage device of claim 12, wherein the pair of locking studs of a spanning member are disposed at nonoverlapping positions along the spanning member to permit serial actuation of the locking studs.

14. A method of fixing a sternum using a wire or cable and a bone plate, the bone plate including a plurality of cleats and also including at least one spanning member defining a pair of channels extending to both opposing end surfaces of the spanning member, the method comprising:

encircling at least a region of a sternum with a wire or cable assembled with the bone plate such that segments of the wire or cable are disposed in respective channels of the spanning member of the bone plate;

disposing the bone plate on the sternum with the spanning member spanning a discontinuity in the sternum and with one or more cleats of the bone plate in engagement with the sternum on each opposing side of the discontinuity; and

locking the wire or cable to the bone plate in each channel.

15. The method of claim 14, wherein the step of encircling includes a step of placing the wire through the sternum and only partway around a perimeter of the sternum such that only an anterior region of the sternum is encircled by the wire or cable assembled with the bone plate.

16. The method of claim 14, wherein the step of encircling forms a loop, and wherein the step of disposing the bone plate includes a step of urging the bone plate toward the sternum by pulling the wire or cable to make the loop smaller.

17. The method of claim 14, wherein the step of locking includes a step of locking a segment of the wire or cable to the bone plate in one channel of the pair before another segment of the wire is locked to the bone plate in the other channel of the pair.

18. The method of claim 17, further comprising a step of tensioning the wire with the wire locked to the bone plate in only the one channel.

19. The method of claim 14, wherein the bone plate defines a long axis and includes a plurality of spanning members arranged along the long axis and each extending transversely to the long axis, wherein each spanning member defines a pair of channels extending to both opposing ends of the spanning member, wherein the step of disposing includes a step of disposing the long axis of the bone plate along the sternum, and wherein the steps of encircling, disposing, and locking are performed using at least two of the spanning members.

20. The method of claim 14, wherein the bone plate includes a pair of locking studs projecting from at least one side surface of the spanning member and at nonoverlapping positions along the spanning member to permit serial actuation of the locking studs, and wherein the step of locking including a step of actuating the locking studs serially to lock respective segments of the wire or cable to the bone plate in each channel at a different time.

21. A method of fixing a bone using a wire or cable and a bone plate, the bone plate including a spanning member defining a pair of channels extending to both opposing end surfaces of the spanning member, the bone plate also including a pair of locking studs projecting from the spanning member, each locking stud being operatively coupled to a respective channel such that application of a compressive force to the spanning member and locking stud actuates the locking stud to lock a wire or cable segment to the bone plate in the respective channel, the method comprising:

encircling at least a region of a bone with a wire or cable assembled with the bone plate such that segments of the wire or cable are disposed in respective channels of the spanning member;

disposing the bone plate on the bone with the spanning member spanning a discontinuity in the bone; and

actuating the locking studs serially to lock segments of the wire or cable to the bone plate in the channels at different times.