Locking filament caps

• US 5,258,015 A
• Filed: 05/03/1991
• Issued: 11/02/1993
• Est. Priority Date: 05/03/1991
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: American Colloid Company (Minerals Technologies Incorporated)
• Inventors: Li, Lehmann K., O'Leary, James P.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Jackson, Gary
• Application Number:
  US07/695,536
• Time in Patent Office: 914 Days
• Field of Search: 606/232, 606/233, 606/220, 606/164, 606/165, 24/324, 24/453, 24/662, 24/4, 128/DIG. 26, 128/912, 128/785
• US Class Current: 606/232
• 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 17/0487 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/685 Elements to be fitted on the end of screws or wires, e.g. protective caps
• CPC Class Codes: A61B 17/8695 Washers surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: Y10S 128/26 Cannula supporters
• CPC Class Codes: Y10S 128/912 Connections and closures for tubes delivering fluids to or from the body
• CPC Class Codes: Y10T 24/42 Independent, headed, aperture pass-through fastener
• CPC Class Codes: Y10T 24/45775 having resiliently biased interlocking component or segment

Abstract

An improved locking cap for mounting on the smooth flexible filament of a surgical fastener wherein the locking cap is of a thin flat washer-like shape with gripping elements for engaging the filament and locking the cap in position relative to the filament.

Claims

1. A combination of a surgical fastener having a fastener end and a locking cap means for securing the fastener end against tissue, the combination comprising:

a surgical fastener having a fastener end,

a cap body having a through passage adapted to receive said fastener end and allowing for translational movement of the cap body with respect to the fastener end,

means associated with said cap body providing at least one locking member which is movable into a clamping position wherein said member temporarily deforms said fastener end to insure positive clamping but which if moved out of the clamping position allows the fastener end to return to its non-deformed condition,

and wherein said fastener end is of such material that when tensioned and released it will exert pressure to maintain the locking member in clamping position.

2. The locking cap means of claim 1 wherein the means associated with said cap body provides at least two locking flag elements connected to said cap body by means of a living hinge.

3. The locking cap means of claim 2 wherein said locking flap elements have end portions which are arranged to lie opposed to each other adjacent said through passage.

4. The locking cap means of claim 3 wherein said end portions are each provided with a plurality of teeth.

5. The locking cap means of either of claims 3 or 4 wherein said locking flap elements are each provided with a stabilizer element extending normal to the path of motion of said flap elements.

6. The locking cap means of claim 5 wherein said cap body has a recessed area within which said flap and stabilizer elements are accommodated.

7. The locking cap means of claim 2 wherein said cap body is provided with a series of upstanding post members spaced from one another to provide recessed areas to accommodate said locking flaps.

8. The locking cap means of claim 7 wherein said locking flap elements have end portions which are arranged to lie opposed to each other adjacent said through passage.

9. The locking cap means of claim 8 wherein said end portions are provided with recessed areas juxtaposed to one another at said through passage and of a generally V-shape to accommodate said filament.

10. The locking cap means of claim 9 wherein said recessed areas on said end portions are tapered so that openings are presented on the upper and lower surfaces of the flap elements which are of different depth.

11. The locking cap means of claim 3 wherein each of said flap elements have a second living hinge located intermediate said first living hinge and the end portion.

12. The locking cap means of claim 1 wherein the means associated with said cap body comprises a locking rod movable within said cap body into a clamping position wherein a portion of the rod bears against the fastener end to deform it and insure a positive clamping action.

13. The locking cap means of claim 12 wherein said cap body is provided with a slot dimensioned so as to receive said locking rod in a rolling fit, said slot being angled to said fastener end so as to direct said rod toward the fastener end.

14. The locking cap means of claim 13 wherein said slot is internal of the cap body whereby said rod is captured within said cap body.

15. The locking cap means of claim 13 wherein said slot passes through said cap body substantially chordal to said through passage, and said rod is of a length that exceeds the length of said slot whereby portions of said rod protrude from said cap body.

16. The locking cap means of claim 1 wherein the means associated with said cap body comprises a wedging sleeve providing a plurality of wedging flaps which are movable into a clamping position with said fastener end.

17. The locking cap means of claim 16 wherein said cap body is provided with a tapered hole into which said wedging sleeve is adapted to be placed, said wedging sleeve and tapered hole being so constructed and arranged that as said sleeve is moved further into said tapered hole greater pressure is applied to said wedging flaps to urge them into clamping position.

18. The locking cap means of claim 17 wherein each of said wedging flaps is provided with interlocking means on its outer surface so constructed and arranged that when said wedging sleeve is assembled to said cap body it is prevented from backing out of the cap body.

19. The locking cap means of any of claims 16, 17 or 18 wherein said wedging sleeve comprises an upper cylindrical body having a conical lower portion depending therefrom, said conical lower portion being furcated to form said wedging flaps.

20. The locking cap means of claim 1 wherein the means associated with said cap body comprises a locking flap and a recessed area in said cap body adapted to receive said flap when it is in clamping position with respect to said fastener end.

21. The locking cap means of claim 20 wherein said locking flap is assembled to said cap body by means of attaching arms.

22. The locking cap means of either of claims 20 or 21 wherein said locking flap has an inner end surface which is adapted to bear against said fastener end, said inner end surface having an area cut out in the form of a V-notch to receive the fastener end.

23. A method for securing tissue after a surgical procedure, wherein a surgical suture is employed having a smooth flexible filament end, comprising the steps of

passing said filament end through said tissue and extending it outwardly thereof;

mounting a locking cap means upon said filament, said locking cap means having a through hole permitting said locking cap to slide along said filament;

sliding said locking cap means along said filament until said means are in contact with the tissue;

applying pressure against said locking cap means to firmly seat it against the tissue;

thereafter applying tensioning force to said filament while maintaining the pressure upon said locking cap means; and

simultaneously actuating clamping elements associated with said locking cap means into filament engaging position, whereby said filament is deformed and said clamping elements are retained in clamping position.

24. The method of claim 23 including the step of severing the filament beyond said locking cap means away from said tissue following said actuating step, whereby said filament thereafter exerts forces to retain said clamping elements in filament engaging position.

25. A locking cap means for securing the fastener end of a surgical fastener against tissue, comprising:

a cap body having a through passage adapted to receive the fastener end and allowing for translational movement of the cap body with respect to the fastener end;

means associated with said cap body providing at least one locking member which is movable into a clamping position wherein said member temporarily deforms the fastener end to insure positive clamping but which if moved out the clamping position allows the fastener end to return to its non-deformed condition;

the cap body being in the form of a collet comprising a generally flat cylindrical portion having a locking extension protruding outwardly therefrom, the through passage being located to pass through both said cylindrical portion and locking extension; and

wherein the locking extension is furcated to form a plurality of locking flaps.

26. The locking cap means of claim 25 wherein the means associated with said cap body comprises a washer-like element having a hole centrally thereof.

27. The locking cap means of claim 26 wherein the locking extension has a tapered outer surface, and the hole in said washer-like element is tapered.

28. The locking cap means of claim 25 wherein the locking extension has a tapered outer surface, and the hole in said washer-like element is tapered, whereby when said washer-like element is assembled to said locking extension with the tapered hole in said element being oriented to conform with the tapered outer surface of said locking extension, movement of the washer-like element inward along said locking extension toward the flat cylindrical portion of said collet will force said locking flaps into engagement with said fastener end.

29. The locking cap means of claim 28 wherein said locking flaps each have a protrusion at the end thereof to prevent inadvertent disassembly of said washer-like element from said collet.

30. A locking cap means for securing the fastener end of a surgical fastener against tissue, comprising:

a cap body having a through passage adapted to receive the fastener end and allowing for translational movement of the cap body with respect to the fastener end;

the cap body being in the form of a collet comprising a generally flat cylindrical portion having a locking extension protruding outwardly therefrom, the through passage being located to pass through both said cylindrical portion and locking extension; and

the means associated with said cap body comprises a washer-like element having a hole centrally thereof.

31. The locking cap means of claim 30 wherein the locking extension has a tapered outer surface, and the hole in said washer-like element is tapered.

32. The locking cap means of claim 30 wherein the locking extension is furcated to form a plurality of locking flaps.

33. The locking cap means of claim 32 wherein the locking extension has a tapered outer surface, and the hole in said washer-like element is tapered, whereby when said washer-like element is assembled to said locking extension with the tapered hole in said element being oriented to conform with the tapered outer surface of said locking extension, movement of the washer-like element inward along said locking extension toward the flat cylindrical portion of said collet will force said locking flaps into engagement with said fastener end.

34. The locking cap means of claim 33 wherein said locking flaps each have a protrusion at the end thereof to prevent inadvertent disassembly of said washer-like element from said collet.

35. A combination of a surgical fastener having a smooth surface flexible filament and a locking cap means mounted on the smooth surface flexible filament for clamping against tissue, the combination comprising:

a surgical fastener having a smooth surface flexible filament;

a cap body having a hole therethrough for receiving said filament and dimensioned to permit translational movement of the cap body with respect to the filament;

means associated with said cap body providing at least one locking member which is movable into a clamping position wherein said member temporarily deforms said filament to insure positive clamping but which if moved out of the clamping position allows the filament to return to its non-deformed condition; and

said filament being of such material that when it is tensioned and released it will exert pressure to maintain the locking member in clamping position.

36. A combination of a surgical fastener having a fastener end and a locking cap means for securing the fastener end against tissue, the combination comprising:

a surgical fastener having a fastener end;

a cap body having a through passage adapted to receive said fastener end and dimensioned to permit translational movement of the cap body with respect to the fastener end;

means associated with said cap body providing at least one locking member which is movable into a clamping position wherein said member temporarily deforms said fastener end to insure positive clamping but which if moved out of the clamping position allows the fastener end to return to its non-deformed condition, said locking member being formed of a material denser than the material of said fastener end; and

said fastener end being of such material that when it is tensioned and released it will exert pressure to maintain the locking member in clamping position.

37. A combination of a surgical filament having a filament end and a locking cap for securing the filament end against tissue, the combination comprising:

a surgical filament having a filament end;

a locking cap having a first body and a second body, said first body having a first through passage adapted to receive the filament end to allow translational movement of said first body with respect to the filament end, said first body having at least two locking members mounted proximate said through passage and movable into a clamping position to engage the filament end; and

said second body having a second, larger-width through passage slideable over an outer portion of said locking member to force it into said clamping position.

38. The locking cap of claim 37 wherein one of an outer surface of said locking member and the second passage of said second body is tapered to drive said locking member into said clamping position.

39. The locking cap of claim 37 wherein said locking member includes tab means for engaging said second body to secure said second body relative to said first body.

40. A locking cap means for securing the fastener end of a surgical fastener against tissue, comprising:

a first body having a first through passage adapted to receive the fastener end to allow translational movement of said first body with respect to the fastener end, said first body having at least tow locking members spaced about a portion of said through passage and movable into a clamping position to engage the fastener end;

a second body having a second, larger-width through passage slideable over an outer portion of said locking members to force them into said clamping position;

at least one of an outer surface of said locking members and the second passage of said second body being tapered to drive all of said locking members into said clamping position; and

at least one of said clamping members including tab means for engaging said second body to secure said second body relative to said first body.