Sternal reconstruction system

• US 9,295,507 B2
• Filed: 03/12/2013
• Issued: 03/29/2016
• Est. Priority Date: 04/21/2004
• Status: Expired due to Fees

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Inventors: Albertson, Thomas, Goheen, Christopher, Michels, Mark
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US13/796,209
• Publication Number:
  US 20130190826A1
• Time in Patent Office: 1,113 Days
• Field of Search: 606280-283, 606/286, 606/304, 606/323, 606/74
• US Class Current: 1/1
• CPC Class Codes: A61B 17/8076 for the ribs or the sternum
• CPC Class Codes: A61B 17/823 for the sternum
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8861 Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 17/8863 Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
• CPC Class Codes: A61B 17/8869 Tensioning devices
• CPC Class Codes: Y10S 606/905 Rib or sternum plate
• CPC Class Codes: Y10S 606/915 Toolkit for installing or removing cortical plate

Abstract

A flexible cable for sternal reconstruction, the cable including first and second ends, the first end of the cable including a crimp fitting member, and the crimp fitting member including a flattened disk-like head. Also provided are methods for sternal reconstruction including wrapping a flexible cable having first and second ends around the sternum, tensioning the flexible cable to a desired tension and securing the tensioned cable, wherein the first end of the cable includes a crimp fitting member, and the crimp fitting member includes a flattened disk-like head.

Claims

1. A method for sternal reconstruction, comprising the steps of:

positioning a reconstruction plate adjacent to the sternum such that a lower surface of the reconstruction plate faces the sternum and an upper surface of the reconstruction plate faces away from the sternum;

inserting a shaft of a fastener into a hole of the reconstruction plate and into the sternum until a head of the fastener seats against the reconstruction plate, thereby securing the reconstruction plate to the sternum;

wrapping a flexible cable around a first portion and a second portion of a sternum, the flexible cable having first and second ends;

inserting the second end of the flexible cable through a lumen of the fastener;

feeding the flexible cable through a hole of a ferrule;

tensioning the flexible cable to a desired tension so as to produce a tensioned cable; and

crimping the ferrule onto the tensioned cable so as to secure the tensioned cable to the ferrule, wherein the crimping step further comprises the step of bringing a sharp edge of the ferrule that is positioned within the hole into contact with the tensioned cable so as to cut the tensioned cable in the hole of the ferrule.

2. The method of claim 1, further comprising the steps of:

driving at least one cannulated screw into the sternum; and

feeding the second end of the flexible cable through a lumen of the at least one cannulated screw.

3. The method of claim 2, wherein the sternum includes a first sternal fragment that includes the first portion of the sternum, and the sternum includes a second sternal fragment that includes the second portion of the sternum, the second sternal fragment separated from the first sternal fragment by a fracture, and the driving step further comprises the steps of:

driving a first cannulated screw into the first sternal fragment; and

driving a second cannulated screw into the second sternal fragment.

4. The method of claim 3, wherein the step of feeding the second end of the flexible cable through a lumen of the at least one cannulated screw further comprises the steps of:

feeding the second end of the flexible cable through a lumen of the first cannulated screw after the step of driving the first cannulated screw into the first sternal fragment; and

feeding the second end of the flexible cable through a lumen of the second cannulated screw after the step of driving the second cannulated screw into the second sternal fragment.

5. The method of claim 1, wherein the inserting step further comprises inserting the head of the fastener in the hole of the reconstruction plate.

6. The method of claim 1, wherein the hole of the reconstruction plate is a first hole, the method further comprising the step of passing the second end of the flexible cable through a second hole of the reconstruction plate that is oriented perpendicular to the first hole.

7. The method of claim 1, wherein the sternum includes a first sternal fragment that includes the first portion of the sternum and a second sternal fragment that includes the second portion of the sternum, the second sternal fragment separated from the first sternal fragment by a fracture, the reconstruction plate is a first reconstruction plate, the hole of the reconstruction plate is a first hole, and the fastener is a first cannulated screw, further comprising the steps of:

positioning a second reconstruction plate adjacent to the sternum such that a lower surface of the second reconstruction plate faces the sternum and an upper surface of the second reconstruction plate faces away from the sternum, and

inserting a second shaft of a second cannulated screw through a second hole of the second reconstruction plate and into the sternum until a second head of the second screw seats against the second reconstruction plate, thereby securing the second reconstruction plate to the sternum.

8. The method of claim 7, wherein:

securing the first reconstruction plate to the sternum includes securing the first reconstruction plate to the first sternal fragment;

securing the second reconstruction plate includes securing the second reconstruction plate to the second sternal fragment; and

the wrapping step includes passing the second end of the flexible cable through both the lumen of the first cannulated screw when the first cannulated screw is inserted into the first hole and a lumen of the second cannulated screw when the second cannulated screw is inserted into the second hole.

9. The method of claim 1, wherein the feeding step is performed after the tensioning step.

10. The method of claim 1, further comprising the step of bracing the first end of the cable prior to the tensioning step, and the securing step comprises crimping the ferrule onto the flexible cable after the bracing step.

11. A method for sternal reconstruction comprising the steps of:

driving a first cannulated screw through a first reconstruction plate and into a first sternal fragment so as to attach the first reconstruction plate to the sternum;

feeding a flexible cable having first and second ends through a lumen of the first cannulated screw and through the first reconstruction plate;

tensioning the flexible cable to a desired tension; and

securing the tensioned cable by crimping a ferrule onto the flexible cable.

12. The method of claim 11, further comprising the steps of:

wrapping the flexible cable around a portion of the first sternal fragment; and

wrapping the flexible cable around a portion of a second sternal fragment that is separated from the first sternal fragment by a sternal fracture.

13. The method of claim 12, wherein the first reconstruction plate is elongate along a longitudinal axis, the first reconstruction plate includes an upper surface, a lower surface, and at least one hole passing through the upper and lower surfaces and such that the at least one hole is generally perpendicular to the longitudinal axis, the at least one hole is configured to receive a head of the first cannulated screw, the first reconstruction plate further including at least one bore disposed transverse to the generally perpendicularly disposed at least one hole, and the driving step includes driving the first cannulated screw through the one of the at least one holes.

14. The method of claim 13, further comprising the step of driving a second cannulated screw through a second reconstruction plate and into the second sternal fragment.

15. The method of claim 12, wherein the feeding step further comprises feeding the flexible cable through a hole in the first reconstruction plate.

16. The method of claim 15, wherein the hole is a first hole, and the feeding step further comprises feeding the flexible cable through a second hole in the first reconstruction plate, the second hole being perpendicular to the first hole.

17. The method of claim 15, wherein the hole of the first reconstruction plate is a first hole, and the first hole is perpendicular to a second hole of the first reconstruction plate, and wherein the driving step includes inserting the first cannulated screw into the second hole.

18. The method of claim 15, wherein the step of feeding the flexible cable through the lumen of the first cannulated screw causes the flexible cable to pass through a hole of the reconstruction plate that receives the first cannulated screw.

19. The method of claim 12, further comprising the step of feeding the flexible cable through a hole of the ferrule.

20. The method of claim 19, wherein the step of crimping the ferrule further comprises the step of cutting the flexible cable with a sharp edge positioned within the hole of the ferrule.

21. The method of claim 19, wherein the step of feeding the flexible cable through the hole of the ferrule is performed after the tensioning step.

22. The method of claim 12, further comprising the step of bracing the first end of the cable prior to the tensioning step, and the securing step comprises crimping the ferrule onto the flexible cable after the bracing step.

23. The method of claim 12, wherein the first reconstruction plate includes a first hole and a second hole, the first hole being substantially parallel to the second hole, and the driving step includes driving the first cannulated screw through the first hole and into the first sternal fragment, the method further comprising the steps of:

driving a second cannulated screw through the second hole and into the first sternal fragment;

driving a third cannulated screw through a first hole of a second reconstruction plate and into the second sternal fragment; and

driving a fourth cannulated screw through a second hole of the second reconstruction plate and into the second sternal fragment.

24. The method of claim 23, further comprising the steps of:

feeding the second end of the flexible cable through a lumen of the second cannulated screw;

feeding the second end of the flexible cable through a lumen of the third cannulated screw; and

feeding the second end of the flexible cable through a lumen of the fourth cannulated screw.

25. A method for sternal reconstruction, comprising the steps of:

positioning a reconstruction plate adjacent to the sternum such that a lower surface of the reconstruction plate faces the sternum and an upper surface of the reconstruction plate faces away from the sternum;

inserting a shaft of a fastener into a hole of the reconstruction plate and into the sternum until a head of the fastener seats against the reconstruction plate, thereby securing the reconstruction plate to the sternum;

wrapping a flexible cable around a first portion and a second portion of a sternum, the flexible cable having first and second ends;

inserting the second end of the flexible cable through a lumen of the fastener;

feeding the flexible cable through a hole of a ferrule;

tensioning the flexible cable to a desired tension so as to produce a tensioned cable;

crimping the ferrule onto the flexible cable thereby securing the tensioned cable; and

cutting the tensioned cable;

wherein the crimping step and the cutting step are performed simultaneously.

26. The method of claim 25, further comprising the step of placing the ferrule adjacent to the sternum.

27. The method of claim 25, further comprising the steps of:

driving at least one cannulated screw into the sternum; and

feeding the second end of the flexible cable through a lumen of the at least one cannulated screw.

28. The method of claim 25, wherein the crimping step causes the cutting step.

29. The method of claim 25, wherein the inserting step further comprises inserting the head of the fastener in the hole of the reconstruction plate.

30. The method of claim 25, wherein the hole of the reconstruction plate is a first hole, the method further comprising the step of passing the second end of the flexible cable through a second hole of the reconstruction plate that is oriented perpendicular to the first hole.

31. The method of claim 25, wherein the sternum includes a first sternal fragment and a second sternal fragment separated from the first sternal fragment by a fracture, the reconstruction plate is a first reconstruction plate, the hole of the reconstruction plate is a first hole, and the fastener is a first cannulated screw, further comprising the steps of:

positioning a second reconstruction plate adjacent to the sternum such that a lower surface of the second reconstruction plate faces the sternum and an upper surface of the second reconstruction plate faces away from the sternum, and

inserting a second shaft of a second cannulated screw through a second hole of the second reconstruction plate and into the sternum until a second head of the second screw seats against the second reconstruction plate, thereby securing the second reconstruction plate to the sternum.

32. The method of claim 31, wherein:

securing the first reconstruction plate to the sternum includes securing the first reconstruction plate to the first sternal fragment;

securing the second reconstruction plate includes securing the second reconstruction plate to the second sternal fragment; and

the wrapping step includes passing the second end of the flexible cable through both the lumen of the first cannulated screw when the first cannulated screw is inserted into the first hole and a lumen of the second cannulated screw when the second cannulated screw is inserted into the second hole.