Instrument and method for pulling and twisting a tie onto two separated items

• US 6,752,810 B1
• Filed: 05/31/2002
• Issued: 06/22/2004
• Est. Priority Date: 05/31/2002
• Status: Expired due to Fees

• Current Assignee: Tecomet, Inc.
• Original Assignee: Pilling Weck Incorporated (Teleflex Incorporated)
• Inventors: Gao, Hua, Rinner, James A.
• Primary Examiner(s): Milano, Michael J.
• Assistant Examiner(s): Pantuck, Bradford C
• Application Number:
  US10/158,470
• Time in Patent Office: 753 Days
• Field of Search: 606/103, 606/74, 606/148, 140/93.R, 140/93.2, 140/117, 140/118, 140/119
• US Class Current: 606/103
• 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

Abstract

An instrument and method for applying a suture of stiff but bendable material, such as wire, to broken bone for closing and holding the break. Also, the instrument and method are for pulling and holding two items together with a tie. The instrument has two parts movable relative to each other for pulling the items or bone together and for twisting the suture onto the bone to hold it together. The suture is strung onto the instrument on the exterior thereof without having the suture extend through the instrument interior, so the surgeon can guide the suture and accurately string it. A crank is applied to twist the suture after the suture has been initially secured to the bone to hold the bone together.

Claims

1. 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 which has 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 crossover location which is adjacent the bone and with each of said suture two extending portions having a terminal end,

two instrument parts telescoped together and having a releasable lock therebetween and being constructed and related to be initially mechanically axially restrained in a first axially disposed telescopically collapsed fixed set relationship and being subsequently mechanically axially released of any mechanical restraint effective in either axial direction upon release of said lock to thereby be relatively axially movable for telescopically extending and be slideably movable relative to each other to a second relative axial position and with a first one of said two instrument parts fixedly gripping each said terminal end and a second one of said two instrument 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 crossover location whereby holding each said terminal end and simultaneously moving said surfaces toward the bone causes said suture to draw the two parts of the bone together,

a rotation handle on the instrument and connected with said two instrument parts and said surfaces for rotating said two instruments parts and said surfaces around the crossover location for twisting said suture onto itself, and

a stationary stabilizing handle telescoped over and being non-rotatable on said two instrument parts for guiding said instrument during the rotation of said two instrument parts and said surfaces.

2. The bone closer instrument, as claimed in claim 1, wherein:

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

3. The bone closer instrument, as claimed in claim 1, wherein:

said two instrument parts are two 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.

4. The bone closer instrument, as claimed in claim 1, including:

said first one of said two instrument parts having suture grippers on the exterior to be available for respectively placing of each said terminal end onto a respective one of said grippers from the exterior of said first one of said two instrument parts.

5. The bone closer instrument, as claimed in claim 1, including:

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

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

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

said stems being slideably telescopically related to each other along a longitudinal axis and being connected together to rotate in unison about said axis and having a releasable connection between said two stems for alternately releasing and locking said two stems relative to each other and relative to the slideable telescopic relationship therebetween for axially releasably restraining said stems in only one axially set relationship, which is a telescopically collapsed and set relationship, and said stems being free to move in either axial direction upon release of said releasable connection,

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

a second one of said stems having a second set of two portions on said second stem for abutting the suture in two spaced-apart locations on the suture,

said two sets being respectively connected to said stems for moving said two sets away from each other upon telescopically sliding said two stems relative to each other and thereby tension the suture relative to the bone to draw the bone fragments together after releasing said stop and moving said stems out of said collapsed and set relationship, 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.

7. The bone closer instrument, as claimed in claim 6, 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.

8. The bone closer instrument, as claimed in claim 6, 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.

9. The bone closer instrument, as claimed in claim 6, 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.

10. The bone closer instrument, as claimed in claim 6, 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.

11. The bone closer instrument, as claimed in claim 6, wherein:

said stems are slideably telescopically related by having a slot extending longitudinally axially along said first stem and having a pin on said second stem slideably received in said slot.

12. The bone closer instrument, as claimed in claim 6, wherein:

said stems are connected together to rotate in unison by having a pin and slot connection therebetween.

13. The bone closer instrument, as claimed in claim 6, 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.

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

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

said stems being slideably telescopically related to each other along a longitudinal axis and being connected together to rotate in unison about said axis and having a stop operative between said stems for axially releasably restraining said stems in only one axially set relationship, which is a telescopically collapsed and set relationship, and said stems being free to move in either axial direction upon release of said stop,

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

a second one of said stems having a second set of two portions on said second stem for abutting the suture in two spaced-apart locations on the suture,

said two sets being respectively connected to said stems for moving said two sets away from each other upon telescopically sliding said two stems relative to each other and thereby tension the suture relative to the bone to draw the bone fragments together after releasing said stop and upon moving said stems out of said collapsed and set relationship,

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, and

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

15. The bone closer instrument, as claimed in claim 14, 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.

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

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

said stems being slideably telescopically related to each other along a longitudinal axis and being connected together to rotate in unison about said axis and having a releasable connection between said two stems for alternately releasing and locking said two stems relative to each other and relative to the slideable telescopic relationship therebetween for axially releasably restraining said stems in only one axially set relationship, which is a telescopically collapsed and set relationship, and said stems being free to move in either axial direction upon release of said releasable connection,

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

a second one of said stems having a second set of two portions on said second stem for abutting the suture in two spaced-apart locations on the suture,

said two sets being respectively connected to said stems for moving said two sets away from each other upon telescopically sliding said two stems relative to each other and thereby tension the suture relative to the bone to draw the bone fragments together after releasing said stop and moving said stems out of said collapsed and set relationship,

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,

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.

17. 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 which has 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 having a longitudinal axis and being telescoped together and telescopically movable relative to each other and having a lock therebetween for providing a physically axially secured position for repeatedly establishing a set maximum telescopically collapsed relationship and with side lock being releasable and thereby having said two parts freely telescopically movable away from said secured position,

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,

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, and

a stationary stabilizing handle telescoped over said two instrument parts for guiding said instrument during the rotation of said instrument parts and said surfaces for the twisting of said suture.

18. The instrument for closing two fragments of broken bone by applying a suture, as claimed in claim 17, wherein:

said grippers are V-shaped in two views thereof which are taken at right angles to each other to thereby have each of the grippers with two V-shapes.

19. The instrument for closing two fragments of broken bone by applying a suture, as claimed in claim 18, wherein:

said two V-shapes have a common apex.

20. 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 which has 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 crossover 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 having a longitudinal axis and being telescoped together and telescopically movable relative to each other and having a lock therebetween for providing a physically axially secured position for repeatedly establishing a set maximum telescopically collapsed relationship and with said lock being releasable and thereby having said two parts freely telescopically movable away from said secured position,

two suture grippers rockably mounted on a first one of said parts for securely gripping said two terminal ends to hold said ends away from the bone and for adjusting tension along said suture and between said suture two terminal ends upon rocking of said grippers,

a restricting surface on said two parts for movement into and out of contact with said grippers for respectively precluding and freeing the rocking of said grippers,

a second one of said two parts having two abutment surfaces contactable with said intermediate portions of said suture for guiding said intermediate portions for simultaneously moving said abutment 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 abutment surfaces for rotating said abutment surfaces around the crossover location for twisting said suture onto itself.

21. The instrument for closing two fragments of broken bone, as claimed in claim 20, including:

a stabilizing handle telescoped over said two instrument parts for guiding said instrument during the rotation of said instrument parts and said abutment surfaces for the twisting of said suture, and

said stabilizing handle being axially movable relative to said two instrument parts and having said restricting surface thereon for the movement into and out of contact with said grippers.

22. The instrument for closing two fragments of broken bone by applying a suture, as claimed in claim 20, wherein:

said grippers are V-shaped in two views thereof which are taken at right angles to each other to thereby have each of the grippers with two V-shapes.