STERNAL CLOSURE CERCLAGE, PLATE IMPLANT AND INSTRUMENTATION

• US 20190380756A1
• Filed: 05/24/2019
• Published: 12/19/2019
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Zimmer Biomet CMF and Thoracic, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Biomet CMF and Thoracic, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Garcia, Saddy, Wilcox, Bryan, Witten, Benjamin
• Granted Patent: US 10,939,927 B2
• Time in Patent Office: Days
• 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 17/0487 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 17/06004 Means for attaching suture to needle tipping A61B17/06195; connecting wire to other metallic objects B21F15/00
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/1606 of forceps type, i.e. having two jaw elements moving relative to each other
• CPC Class Codes: A61B 17/1611 the two jaw elements being integral with respective elongate shaft elements
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1728 for holes for bone plates or plate screws
• CPC Class Codes: A61B 17/1789 for the sternum
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• 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 17/7053 with parts attached to bones or to each other by flexible wires, straps, sutures or cables
• CPC Class Codes: A61B 17/8076 for the ribs or the sternum
• CPC Class Codes: A61B 17/808 Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
• CPC Class Codes: A61B 17/82 for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 17/823 for the sternum
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 17/8861 : Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 17/8869 : Tensioning devices
• CPC Class Codes: A61B 2017/00734 : battery operated
• CPC Class Codes: A61B 2017/0417 : T-fasteners
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06038 : soldered or brazed or welded for connecting prosthetic parts A61F2002/30451, A61F2220/0058
• CPC Class Codes: A61B 2017/06057 : Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61B 2017/06071 : with an abrupt angle formed between two adjacent sections
• CPC Class Codes: A61B 2017/0608 : J-shaped
• CPC Class Codes: A61B 2017/06104 : interconnected at their distal ends, e.g. two hollow needles forming a loop for passing a suture
• CPC Class Codes: A61B 2017/0619 : thermoplastic, e.g. for bonding, welding, fusing or cutting the suture by melting it suture cutters A61B17/0467; ultrasonic cutters A61B17/320068; electrically heated instruments A61B18/08

Abstract

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

Claims

1. A method, comprising:

positioning a bracket over first and second bone portions, the bracket comprising a plurality of bracket apertures;

aligning a guide unit with the bracket, the guide unit comprising a plurality of fastener guides; and

driving a plurality of fasteners through the guide unit and into bracket apertures and into at least one of the first bone portion and the second bone portion.

2. The method of claim 1, wherein aligning the guide unit with the bracket comprises aligning the plurality of fastener guides with the plurality of bracket apertures.

3. The method of claim 2, wherein positioning the bracket comprises positioning the bracket over at least a portion of a cerclage that is wrapped around at least a portion of the first and second bone portions.

4. The method of claim 1, further comprising:

coupling the guide unit to the bracket via a mounting feature.

5. The method of claim 1, further comprising:

separating the guide unit from the bracket while leaving the plurality of fasteners attached to the bracket.

6. The method of claim 1, further comprising:

preloading the guide unit with the plurality of fasteners prior to a surgical operation.

7. The method of claim 1, further comprising:

moving the first bone portion adjacent to the second bone portion;

wherein driving a plurality of fasteners comprises driving one of the plurality of fasteners into the first bone portion and then driving a second of the plurality of fasteners into the second bone portion.

8. The method of claim 1, wherein placing the bracket comprises placing the bracket such that it conforms to contours of at least one of the first and second pone portions.

9. The method of claim 1, further comprising:

wrapping a cerclage around at least a portion of the each of the first and second bone portions.

10. The method of claim 9, wherein placing the bracket comprises placing the bracket over the cerclage.

11. The method of claim 9, further comprising:

tensioning the cerclage to secure the first bone portion to the second bone portion.

12. The method of claim 1, wherein aligning the guide unit with the bracket comprises matching a shape of the guide unit with at least a portion of a shape of the bracket.

13. A method, comprising:

placing a bracket over first and second bone portions, the bracket comprising a plurality of bracket apertures;

coupling a guide unit to the bracket;

driving a plurality of fasteners through the guide unit and into the bracket to fix the bracket to at least one of the first and second bone portions; and

separating the guide unit from the bracket while the bracket remains fixed to at least one of the first and second bone portions.

14. The method of claim 13, further comprising:

preloading the guide unit with the plurality of fasteners prior to a surgical operation.

15. The method of claim 13, further comprising:

moving at least one of the first and second bone portions such that the first bone portion is adjacent to the second bone portion;

wherein driving a plurality of fasteners comprises driving one of the plurality of fasteners into the first bone portion and then driving a second of the plurality of fasteners into the second bone portion.

16. The method of claim 13, further comprising:

passing a cerclage around a portion of at least one of the first and second bone portions.

17. The method of claim 16, further comprising:

positioning the bracket over the cerclage.

18. A method, comprising:

positioning a bracket over a bone portion, the bracket comprising a plurality of bracket apertures;

aligning a guide unit over the bracket such that each of a plurality of fastener guides of the guide unit aligns with a respective bracket aperture of the plurality of bracket apertures;

engaging the bracket with a mounting feature of the guide unit to couple the guide unit to the bracket;

engaging a driver to at least one fastener positioned in a fastener guide of the plurality of fastener guides; and

driving the at least one fastener into a respective bracket aperture and into the bone portion.

19. The method of claim 18, further comprising:

preloading the guide unit with the plurality of fasteners prior to a surgical operation.

20. The method of claim 18, further comprising:

removing the guide unit from the bracket while the fastener remains extending through the bracket aperture into the bone portion.