Sternal closure device and method

• US 7,361,179 B2
• Filed: 04/22/2004
• Issued: 04/22/2008
• Est. Priority Date: 04/22/2004
• Status: Active Grant

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Rousseau, Robert A., Weadock, Kevin S., Chatlynne, Etan S.
• Primary Examiner(s): Robert; Eduardo C.
• Assistant Examiner(s): Araj; Michael J.
• Application Number:
  US10/830,122
• Publication Number:
  US 20050240189A1
• Time in Patent Office: 1,461 Days
• Field of Search: 606 72- 76, 606/78
• US Class Current: 606/281
• 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 17/823 for the sternum

Abstract

A device and method for joining a severed sternum is disclosed. The device includes first and second bearing members, a sternum joining member having an axis and first and second ends, the first end connected to the first bearing member, the second bearing member adapted to engage the sternum joining member, and the sternum joining member is adapted to traverse the exposed cancellous surfaces of the sternal portions. The method includes moving the second bearing member along the axis of the sternum joining member toward the first bearing member, with the sternum joining member traversing the cancellous surfaces of both sternal portions, and securing the second bearing member on the axis of the sternum joining member so that the severed sternum is securely closed. A kit including sternal closure devices and other tools for closing a sternotomy is also disclosed.

Claims

1. A method for closing a severed sternum having first and second portions that are formed after a sternal incision has been made perpendicular to the plane of the anterior or posterior surface of the sternum, each portion having exposed cortical and cancellous surfaces at the sternal incision margin, comprising:

placing at least one first hole in the first sternal portion, such that the first and second holes form a pathway from the anterior surface to the posterior surface of the sternum, the pathway obliquely traversing the sternal incision margins when the first and second sternal portions are approximated;

at least partially approximating the first and second sternal portions, and performing one of the following steps (a)-(d);

(a) providing a device comprising a first bearing member having a collapsed and an expanded position, a second bearing member, and a sternum joining member having an axis and engaging the first and second bearing members;

inserting the first bearing member through the pathway with the first bearing member in a collapsed position, until the first bearing member extends past the posterior surface of the sternum and assumes the expanded position;

moving the second bearing member along the axis of the sternum joining member until the first and second sternal portions are approximated; and

securing the sternum joining member to the second bearing member;

or

(b) providing a device comprising a first bearing member having a collapsed and an expanded position, and a sternum joining member engaging the first bearing member and having an axis and a free end, inserting the first bearing member through the pathway with the first bearing member in a collapsed position, until the first bearing member extends past the posterior surface of the sternum and assumes the expended position;

engaging a second bearing member with the free end of the sternum joining member;

moving the second bearing member along the axis of the sternum joining member until the first and second sternal portions are approximated; and

securing the sternum joining member to the second bearing member;

or

(c) providing a device comprising a first bearing member, and a sternum joining member engaging the first bearing member and having an axis and a free end;

inserting the free end of the sternum joining member in the formed pathway from either the anterior or posterior surface of the sternum until the free end extends past the opposite surface of the sternum;

engaging a second bearing member with the free end of the sternum joining member;

moving the second bearing member along the axis of the sternum joining member until the first and second sternal portions are approximated; and

securing the sternum joining member to the second bearing member;

or

(d) inserting a sternal joining member having an axis and first and second ends, in the formed pathway until the ends extends past the anterior and posterior surfaces of the sternum;

engaging a first bearing member with the first end and a second bearing member with the second end of the sternum joining member;

moving the second bearing member along the axis the sternum joining member until the first and second sternal portions are approximated; and

securing the sternum joining member to the second bearing member.

2. A method for closing a severed sternum having first and second portions that are formed after a sternal incision has been made perpendicular to the plane of the anterior or posterior surface of the sternum, each portion having exposed cortical and cancellous surfaces at the sternal incision margin, comprising:

placing at least one first hole in the first sternal portion and at least one second hole in the second sternal portion, such that the first and second holes form a pathway from one intercostal space in the first sternal portion to an opposite intercostals space in the second sternal portion, the pathway perpendicularly traversing the sternal incision margins when the first and second sternal portions are approximated;

at least partially approximating the first and second sternal portions; and

performing one of the following steps (a) or (b);

(a) providing a device comprising a first bearing member, and a sternum joining member engaging the first bearing member and having an axis and a free end;

inserting the free end of the sternum joining member in the formed pathway from one intercostal space until the free end extends into the opposite intercostal space;

engaging a second bearing member with the free end of the sternum joining member;

moving the second bearing member along the axis of the sternum joining member until the first and second sternal portions are approximated; and

securing the sternum joining member to the second bearing member;

or

(b) inserting a sternal joining member having an axis and first and second ends, in the formed pathway from one intercostal space until the first and second ends extend into opposite intercostal spaces;

engaging a first bearing member with the first end and a second bearing member with the second end of the sternum joining member;

moving the second bearing member along the axis of the sternum joining member until the first and second sternal portions are approximated; and

securing the sternum joining member to the second bearing member.