Internal cord fixation device

• US 6,368,326 B1
• Filed: 09/28/1998
• Issued: 04/09/2002
• Est. Priority Date: 09/28/1998
• Status: Expired due to Fees

• Current Assignee: Daos Limited
• Original Assignee: Daos Limited
• Inventors: Lippincott, Albert L. III, Dakin, Edward B.
• Primary Examiner(s): Reip, David O.
• Assistant Examiner(s): Woo, Julian W
• Application Number:
  US09/162,036
• Time in Patent Office: 1,289 Days
• Field of Search: 606/103, 606/139, 606/150, 606/232, 606/73, 606/71, 606/213, 606/74, 606/60, 411/340, 623/13.14, 623/13.19, 623/13.2
• US Class Current: 606/103
• 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 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 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 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: Y10S 606/916 Tool for installing or removing orthopedic fastener

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. 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.

Claims

1. An orthopedic fixation system for fixing a bone having an exterior cortical portion and a non-cortical interior to an element which is a prosthesis or a bone fragment, comprising a length of inelastic, flexible 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, and a third internal fastener fastenable to bone from the interior of the bone and having a surface over which said cord may be movably trained to change the direction of said cord between the first and second fasteners.

2. 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 and having bone fragments with generally confronting fracture surfaces, comprising an internal fastener attachable 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 second fastener, and a third fastener fastenable from the interior of said bone to a third bone fragment and having a pulley surface interior of said bone over which said cord is movably trained to enable the direction of said cord within the interior of said bone to be changed.

3. Method for reducing a bone fracture in a bone having a cortical exterior portion and a non-cortical interior, said fractured 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 said cord from within the bone interior to the second bone fragment, the other end of said cord passing outwardly of the bone through an opening in the third bone fragment, tensioning said cord to draw together said mating fracture surfaces to relieve the fractures, and securing said tensioned cord to said third bone fragment.

4. Method for reducing a bone fracture comprising at least two pairs of bone fragments, a first pair of bone fragments having first mating fracture surfaces and a 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 said first pair, said cord extending through an opening in the other bone fragment of said first pair in a direction so that when said 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 said second pair, said second length of cord extending through an opening in the other bone fragment of said second pair in a direction so that when said cord is placed in tension, the second mating fracture surfaces are drawn toward each other; and

c. appropriately adjusting tension in said cords with respect to each other to reduce the fracture surfaces.

5. The method of claim 4 including the step of securing the tensioned cords to said other bone fragments.

6. Method for reducing a bone fracture of a bone having a cortical exterior portion and a non-cortical interior, the fracture comprising at least three bone fragments each having fracture surfaces mating with fracture surfaces of the other fragments, the method comprising:

a. attaching from the interior of the bone to each of two of said bone fragments fastener having an interior pulley surface over which is trained a length of flexible cord;

b. drawing said cord through an opening in a third bone fragment and tensioning said cord to draw said fracture surfaces together; and

c. securing said cord to said third bone fragment to respect to each other to reduce the fracture surfaces.

7. 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. drawing said cord lengths through openings formed in said second bone fragment at spaced positions along the interior of the medullary canal of that fragment so that said cord lengths are spaced from one another within the medullary canal at the fracture site; and

c. securing said cords to said second bone fragment to reduce the fracture surfaces, said spaced cords resisting bending moments at the fracture site.

8. 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 having a threaded portion adapted to be screwed into one bone fragment, a pair of flexible, inelastic cords attached at laterally spaced points to and extending from said internal fastener, and a pair of spaced external fasteners attachable to the other of said bone fragments and having openings through which said cords may respectively pass on opposite sides of the medullary canal, whereby said cords may traverse the fracture site within the medullary canal on opposite sides thereof to resist bending moments at the fracture site.

9. An orthopedic fixation system for fixing a bone having an exterior cortical portion and a non-cortical interior to an element which is a prosthesis or a bone fragment, comprising a length of inelastic, flexible cord;

a first fastener for attaching the cord to said element, a second fastener for attaching the cord to the bone to enable the cord to extend from said first fastener within the non-cortical interior of the bone to the second fastener, at least one of said fasteners including an opening through which said cord may pass from the interior of the bone to the exterior, said at least one fastener including a lock for locking the cord to the fastener through which it passes, and at least one of said fasteners includes a threaded portion adapted to be screwed into bone.

10. An orthopedic fixation system for fixing a bone having an exterior cortical portion and a non-cortical interior to a bone fragment resulting from a fracture of said bone, comprising a length of inelastic, flexible cord;

a first fastener including a threaded portion adapted to be screwed into bone for attaching the cord to said bone fragment, a second fastener for attaching the cord to the bone to enable the cord to extend from said first fastener within the non-cortical interior of the bone to the second fastener, at least one of said fasteners including a bone plate adapted to engage a bone surface.

11. An orthopedic fixation system for fixing a bone having an exterior cortical portion and a non-cortical interior to a bone fragment resulting from a fracture of said bone, comprising a length of inelastic, flexible 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 said fasteners including an at least partially threaded bore through which said cord may pass from the interior of the bone to the exterior, said at least one fastener including a lock for locking the cord to the fastener through which it passes, said lock comprising a threaded member threadingly received in the bore and capable of engaging said cord to restrain cord movement.

12. 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 and having bone fragments with generally confronting fracture surfaces, an internal fastener including a threaded portion adapted to be screwed into bone and attachable from within said interior to a first bone fragment, a length of flexible, inelastic cord extendable within said bone interior and attached to said internal fastener and adapted to pass outwardly through an opening in a second bone fragment, said internal fastener and cord being positionable to draw respective fracture surfaces together to reduce said fracture upon tensioning of the cord, said second fastener including a plate adapted to engage the outer surface of the cortical portion.

13. 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 and having bone fragments with generally confronting fracture surfaces, an internal fastener attachable from within said interior to a first bone fragment, a length of flexible, inelastic cord extendable within said bone interior and attached to said internal fastener and adapted to pass outwardly through an opening in a second bone fragment, said internal fastener and cord being positionable to draw respective fracture surfaces together to reduce said fracture upon tensioning of the cord extendable outwardly through said opening, said system including a second fastener fastenable from the interior of said bone to a third bone fragment, each said fastener having a pulley surface over which said cord is trained to enable the direction of said cord to be changed within the interior of said bone.

14. 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, 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, drawing said cord through a bore formed in a second bone fragment to draw said fragments together in a direction to relieve the fracture, said internal fastener having a threaded end, the method including the step of screwing said threaded end from the interior of said bone into a cortical portion of said first bone segment.

15. 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, the bone fragments having confronting fracture surfaces forming a fracture interface, the method comprising attaching from within the interior of the bone a plurality of internal fasteners to different ones of a plurality of bone fragments, said internal fasteners having attached to them a length of flexible, inelastic cord, drawing said cord through a bore formed in a bone fragment and at least one of said internal fasteners including a threaded portion screwed into bone, said internal fasteners being so positioned with respect to each other that when said cord is tensioned, said fragments are drawn together in directions to reduce the fracture.

16. The method of claim 15 wherein at least one of said interior fasteners includes a pulley surface over which said cord is movably trained to change the direction of said cord within the interior of said bone, the method including the step of pulling said cord over said pulley surface.

17. The method of claim 15 wherein each of said interior fasteners includes a pulley surface over which said cord is movably trained to change the direction of said cord within the interior of said bone, the method including the step of pulling said cord over said pulley surfaces.