Method and apparatus for fracture fixation

• US 9,538,998 B2
• Filed: 10/25/2011
• Issued: 01/10/2017
• Est. Priority Date: 02/03/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Stone, Kevin T., Berelsman, Brian K., Kaiser, Ryan A.
• Primary Examiner(s): Dornbusch, Dianne
• Application Number:
  US13/281,009
• Publication Number:
  US 20120041486A1
• Time in Patent Office: 1,904 Days
• US Class Current: 1/1
• 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 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1697 specially adapted for wire insertion
• 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 17/7291 for small bones, e.g. in the foot, ankle, hand or wrist
• CPC Class Codes: A61B 17/82 for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/848 Kirschner wires, i.e. thin, long nails
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06019 by means of a suture-receiving lateral eyelet machined in the needle lateral opening for attaching suture to suture anchor A61B2017/0414
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061

Abstract

A method for supporting a first bone portion relative to a second bone portion can include: (a) aligning the first bone portion relative to the second bone portion, (b) forming a bore extending through the first bone portion and the second bone portion through a void defined by opposing surfaces of the first and second bone portions after the aligning of the first bone portion with the second bone portion, (c) disposing a pin in the bore to span the void, wherein the pin includes a coupler, (d) drawing a self-locking, adjustable suture construct coupled to the coupler through the bore by withdrawing the pin from the bore, and (e) compressing the first bone portion and the second bone portion between a first anchor and a second anchor coupled to the suture construct by tensioning the suture construct.

Claims

1. A method for supporting a first bone portion relative to a second bone portion, comprising:

aligning the first bone portion relative to the second bone portion;

forming a bore extending through the first bone portion and the second bone portion through a void defined by opposing surfaces of the first and second bone portions after the aligning of the first bone portion with the second bone portion;

disposing a pin in the bore to span the void, wherein the pin includes a coupler;

drawing a self-locking, adjustable suture construct coupled to the coupler through the bore by withdrawing the pin from the bore; and

compressing the first bone portion and the second bone portion between a first anchor and a second anchor coupled to the suture construct by tensioning the suture construct,

wherein the coupling of the suture construct to the coupler includes collapsing the coupler by engaging the coupler with the bore.

2. The method of claim 1, further comprising coupling the suture construct to the coupler after the disposing of the pin in the bore.

3. The method of claim 2, wherein the coupling of the suture construct to the coupler includes:

passing an end of the first anchor through the coupler; and

engaging the end with the coupler.

4. The method of claim 1, wherein the forming of the bore is performed by inserting the pin through the first bone portion and the second bone portion.

5. The method of claim 1, wherein:

the disposing of the pin in the bore includes advancing the pin within the bore in a first direction; and

the drawing of the suture construct includes drawing the suture construct through the bore in a second direction opposite the first direction.

6. The method of claim 1, wherein the tensioning of the suture construct includes positioning a first anchor and a second anchor relative to one of the bore or an outer surface of one of the first and second bone portions.

7. The method of claim 1, wherein the tensioning of the suture construct includes:

positioning a first anchor relative to one of the bore or an outer surface of one of the first and second bone portions; and

engaging a second anchor with the bore.

8. The method of claim 1, wherein the aligning of the first bone portion relative to the second bone portion includes one of:

aligning a first bone fragment relative to a second bone fragment, or

aligning a first bone relative to a second bone.

9. The method of claim 1, further comprising:

enlarging the bore to form an enlarged bore by drilling into the first bone portion and the second bone portion using a cannulated drill guided by the pin; and

inserting a rigid tubular support rod in the enlarged bore about the pin to span between the first bone portion and the second bone portion, the support rod having a longitudinal passage through which the pin extends, wherein the drawing of the suture construct through the bore includes drawing the suture construct through the longitudinal passage of the support rod.

10. The method of claim 1, wherein the opposing surfaces are articulating surfaces of the first and second bone portions.

11. The method of claim 1, wherein the suture construct includes:

a braided body defining a passage portion, a first aperture, and a second aperture;

a first strand extending from the braided body and having a first end passing through the first aperture into the passage portion and out the second aperture to create a self-locking adjustable first loop; and

a second strand extending from the braided body and having a second end passing through the second aperture into the passage portion and out the first aperture to create a self-locking adjustable second loop.

12. The method of claim 1, wherein forming the bore and disposing the pin further includes forming the bore and disposing the pin substantially normal to the opposing surfaces of the first and second bone portions.

13. The method of claim 1, further comprising inserting a rigid tubular support rod into the bore to span between the first bone portion and the second bone portion.

14. The method of claim 13, further comprising positioning the rod such that an end of the rod is below a surface of the first bone portion.

15. A method for supporting a first bone portion and a second bone portion, comprising:

aligning the first bone portion relative to the second bone portion;

forming a first bore extending through the first bone portion and the second bone portion through a void defined by opposing surfaces of the first and second bone portions;

forming a second bore extending through the first bone portion and the second bone portion through the void at an angle relative to the first bore;

disposing a first pin in the first bore to span the void;

disposing a second pin in the second bore to span the void;

selecting a coupler of one of the first pin or the second pin to receive a self-locking, adjustable suture construct;

drawing the suture construct through the first bone portion and the second bone portion by withdrawing the selected one of the first pin and the second pin from the respective one of the first bore and the second bore; and

compressing the first bone portion and the second bone portion between a first anchor and a second anchor coupled to the suture construct by tensioning the suture construct,

wherein the selecting of the coupler includes selecting the coupler based on a location of the one of the first pin and the second pin relative to an articulation surface.

16. The method of claim 15, further comprising coupling the suture construct to the coupler after the disposing of the selected one of the first pin or the second pin.

17. A method for supporting a first bone fragment and a second bone fragment, comprising:

aligning the first bone fragment relative to the second bone fragment;

forming a first bore, a second bore, and a third bore through the first bone fragment and the second bone fragment through a void defined by opposing fracture surfaces of the first and second bone fragments, wherein the first bore extends through an articulating surface;

disposing a first pin, a second pin, and a third pin in the first bore, the second bore, and the third bore respectively, wherein each of the first, second, and third pins spans the void and together, the first, second, and third pins lock the first and second bone fragments in an aligned position;

drawing a self-locking, adjustable suture construct coupled to the first pin through the first bore by withdrawing the first pin from the first bore; and

compressing the first bone fragment and the second bone fragment between a first anchor and a second anchor coupled to the suture construct by tensioning the suture construct,

wherein in elevational view, each of the first, second, and third bores intersects a remaining two of the first, second, and third bores so that together, the first, second, and third bores define a triangular region that intersects the void.

18. The method of claim 17, wherein the tensioning of the suture construct includes:

engaging the first anchor with the first bore beneath the articulating surface; and

positioning the second anchor relative to one of the first bore or an outer surface of one of the first and second bone fragments.

19. The method of claim 17, wherein the first and second fragments are fragments of a radius.

20. A method for supporting a first bone portion relative to a second bone portion, comprising:

aligning the first bone portion relative to the second bone portion;

forming a bore extending through the first bone portion and the second bone portion through a void defined by opposing surfaces of the first and second bone portions after the aligning of the first bone portion with the second bone portion;

disposing a pin in the bore to span the void, wherein the pin includes a coupler;

drawing a self-locking, adjustable suture construct coupled to the coupler through the bore by withdrawing the pin from the bore; and

compressing the first bone portion and the second bone portion between a first anchor and a second anchor coupled to the suture construct by tensioning the suture construct,

wherein the suture construct includes;

a braided body defining a passage portion, a first aperture, and a second aperture;

a first strand extending from the braided body and having a first end passing through the first aperture into the passage portion and out the second aperture to create a self-locking adjustable first loop; and

a second strand extending from the braided body and having a second end passing through the second aperture into the passage portion and out the first aperture to create a self-locking adjustable second loop.

21. A method for supporting a first bone portion and a second bone portion, comprising:

aligning the first bone portion relative to the second bone portion;

forming a first bore extending through the first bone portion and the second bone portion through a void defined by opposing surfaces of the first and second bone portions;

forming a second bore extending through the first bone portion and the second bone portion through the void at an angle relative to the first bore;

disposing a first pin in the first bore to span the void;

disposing a second pin in the second bore to span the void;

selecting a coupler of one of the first pin or the second pin to receive a self-locking, adjustable suture construct;

drawing the suture construct through the first bone portion and the second bone portion by withdrawing the selected one of the first pin and the second pin from the respective one of the first bore and the second bore; and

compressing the first bone portion and the second bone portion between a first anchor and a second anchor coupled to the suture construct by tensioning the suture construct,

wherein the selecting of the coupler includes selecting the coupler based on an orientation of the one of the first pin and the second pin relative to the opposing surfaces of the first and second bone portions defining the void.