Abstract: A device for tensioning suture which includes two telescopically slidable cannulated tubes. An adjustment wheel is coupled to and turns a threaded post which is threadingly engaged with the proximal end of one of the slidable tubes. A suture end is passed through the cannulated tubes of the suture tensioning device and secured to the adjustment wheel. Rotating the adjustment wheel counterclockwise increases the overall length of the suture tensioning device and increases tension on the suture.

Abstract: A cutting and forming device includes an outer sleeve, an inner sleeve, and a housing. The outer sleeve has a longitudinal axis, a front end, a rear end, and a borehole having an borehole axis. The inner sleeve, can be rotated in the outer sleeve's borehole and includes a front end, a rear end, and a borehole having a borehole axis. The housing with a central axis has a front end, a rear end, and a cavity which accommodates the outer sleeve and passes through the housing parallel to the central axis. The front end of the inner sleeve has a circular cutting edge which is concentric with the borehole axis of the inner sleeve, and the borehole at the front end of the outer sleeve has a constriction whose longitudinal axis is parallel to the borehole axis of the outer sleeve.

Abstract: Systems, methods, and apparatuses for clamping and reclamping an orthopedic surgical cable used in conjunction with an orthopedic implant device, a bone, and/or bone implant or structure. Systems and methods provide a clamping body, a clamping mechanism, and a force application member that cooperate to allow tensioning and re-tensioning of a surgical cable.

Abstract: To avoid a maximum displacing force being exceeded in the case of a device for pushing together a thread loop which is formed by a slip knot at the distal free end of the thread which can be displaced along the thread, with a displacing element which can be displaced on the thread in the direction of the loop, it is proposed that the displacing element or the proximal portion of the thread disposed at the end of the displacing element remote from the loop has connected to it a gripping element which releases the connection between itself and the displacing element or the proximal portion of the thread when a specific holding force is exceeded.

Abstract: A line lock includes a body at least partially bounding a primary passageway, a secondary passageway, and a working passageway. In one embodiment at least a portion of the working passageway is disposed between the primary passageway and the secondary passageway such that a geometric line segment extending between the primary passageway and the secondary passageway intersects with working passageway. A line extends through the primary passageway, the secondary passageway and then through the working passageway such that a relative compression section of the line is formed between the primary passageway and the secondary passageway. The compression section of the line selectively biases against a portion of the line extending out of the working passageway so as to selectively lock the line to the body when the line is tensioned against the body.

Abstract: The present invention provides a torquer for maneuvering a medical guidewire during endovascular surgical procedures or the like, which can be easily positioned and re-positioned along the length of the wire. A clamp-like device is formed with a top arm and a bottom arm connected to one another by means of a flap hinge. A horizontal slit is defined within the flap hinge, and a vertical slit is defined on a clamping tongue positioned at the top distal end of the top arm, such that the torquer is placed onto the guidewire and snapped into place with the guidewire penetrating the vertical slit. A wire channel means is further defined between the two arms to hold the guidewire within the torquer.

Abstract: An instrument for tensioning a flexible elongate member in a surgical procedure includes a tensioning mechanism engageable to a portion of the flexible elongate member and operable to apply a tensioning force to the elongate member. The instrument includes a distal end portion at a distal end of the tensioning mechanism that is adapted to allow orientation of the elongate member in a first direction for implantation and to allow the instrument to extend transversely to the implantation orientation during application of a tensioning force. The distal end portion can also include a receptacle to receive a structure at the surgical site to facilitate positioning of the distal end portion at the desired location.

Abstract: Apparatus and methods for repairing damaged tendons or ligaments. Various repair apparatus include an elongate tensile member and a pair of anchor structures connected for movement along the tensile member on either side of a repair site, such as a tear or laceration. The anchor structures may take many forms, and may include barbed, helical, and crimp-type anchors. In the preferred embodiments, at least one anchor structure is movable along the elongate tensile member to assist with adjusting a tendon segment to an appropriate repair position and the anchor structure or structures are then lockable onto the elongate tensile member to assist with affixing the tendon at the repair position. The invention further provides tendon-to-bone repair apparatus and methods employing similar concepts. Tendon retrieval devices of the invention include helical members for rotating into a tendon end and subsequently moving the tendon to an appropriate operating position.

Abstract: A bone screw assembly comprising: a bone screw with an externally threaded shank having a head integrally formed at the proximal end and defining a cannula extending through the head and shank. An internal thread formed on the surface defining the inner cannula to receive an anchor bolt having a threaded portion, and a head defining plurality of throughgoing wire receiving holes.

Abstract: A filament retaining washer for mounting about the shank of a bone screw deployed in a bone whereby to retain the filament to the bone, the filament retaining washer comprising a structure having a screw hole extending therethrough for receiving therein the shank of the bone screw deployed in the bone, whereby to secure the structure to the bone, the screw hole defining a first axis, and the structure having a filament hole extending therethrough for receiving a filament therein so as to retain the filament to the structure, the filament hole defining a second axis extending substantially perpendicular to the first axis.

Abstract: An intraocular lens (IOL) insertion system for implanting IOLs into the eye. The insertion system includes an insertion cartridge that receives the IOL and cooperates with a handpiece. The cartridge includes a longitudinal lumen from a loading chamber to an open distal mouth that gradually narrows in dimension so as to fold the IOL into a tube for insertion through an incision in the eye. A distal tip member of a plunger rod in the handpiece enters the loading chamber of the cartridge and urges the IOL therethrough. The distal tip member has a portion that enters the folded IOL and is trapped therein for maximum control of IOL advancement. A soft tip, such as silicone, may cover a longitudinally extending portion of the distal tip to effect the IOL trapping. The distal tip member further has a portion that engages and pushes the IOL optic.

Abstract: An instrumentarium for implanting a tendon replacement in a channel within a bone comprises a suture retention device. Said suture retention device has a plate-shaped body and a cylindrical pin projecting from said plate-shaped body. At least two openings extend through that plate-shaped body and said cylindrical pin for threading fixation threads of a tendon replacement therethrough. Said plate-shaped body having edges adapted for applying a tool for rotating said suture retention device (FIG. 13).

Abstract: The invention concerns a method for determining the filling of a lung, wherein the movement of an anatomical structure which moves with breathing, or one or more points on the moving anatomical structure whose movement trajectory is highly correlated with lung filling, is detected with respect to the location of at least one anatomical structure which is not spatially affected by breathing, and wherein each distance between the structures is assigned a particular lung filling value.

Abstract: A surgical tool for tensioning a cable positioned around a split sternum, for crimping a ferrule around the cable, and for terminating the cable at the ferrule after crimping. The tool includes a tensioning actuator for gripping and tensioning the cable to a predetermined tension and a crimping actuator for crimping the ferrule onto the cable. The crimping actuator is operative to sever a free end of the cable concurrently with crimping of the ferrule. The actuator includes an indenter to retain the ferrule therein. A method of using the tool includes looping a cable comprising a cable end fitting attached to a first end of the cable around the split sternum and passing a second end of the cable through the cable end fitting, then using the tool to tension the cable, crimp a ferrule installed on the cable, and cut the cable flush with the ferrule.

Abstract: An instrument for tensioning a flexible elongate member in a surgical procedure includes a tensioning mechanism engageable to a portion of the flexible elongate member and operable to apply a tensioning force to the elongate member. The instrument includes a distal end portion at a distal end of the tensioning mechanism that is adapted to allow orientation of the elongate member in a first direction for implantation and to allow the instrument to extend transversely to the implantation orientation during application of a tensioning force. The distal end portion can also include a receptacle to receive a structure at the surgical site to facilitate positioning of the distal end portion at the desired location.

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. An axially rigid tubular support may be placed along the cord to reduce particulate shedding, to reduce ingrowth of bone into the cord, to provide compressive resistance to the cable, or to deliver antibiotics or other pharmaceuticals. 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.

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.

Abstract: A tensioning tool which holds the free ends of a tension band secured to a clip and clip screw and rotation of an adjusting knob causes tension to be applied to pull the band through the clip until the desired tension is achieved.

Abstract: A novel system and method for use for ensuring appropriate positioning of a cable about bone portions, particularly, vertebral bone, for stabilization of the spine during spinal reconstructive and fusion procedures is disclosed. The system includes cabling uniquely adapted for spinal reconstruction processes, ligature passers and hook passers of varying sizes to facilitate looping of the cable about the spinal/vertebral bone, and a tensioning apparatus which secures the cable at a predetermined tensioned value about the vertebral bone. A novel method for applying a cable about vertebral bone for spinal stabilization is also disclosed.

Abstract: A surgical cable system and method for securing surgical cable around a portion of a human element (e.g., bone) are described. The surgical cable system may include a connector and a tensioner. The connector may be adapted to hold a pin, positionable within the connector, such that the pin may secure the cable within the connector. The pin may be repositioned, after securing the cable, to allow the cable, to move freely through the connector. The cable may be oriented within the connector such that the ends of the cable are either perpendicular or parallel with respect to each other. In one embodiment, the tensioner is adapted to vary the tension of the cable. The cable may be passed through the connector, around a portion of a human bone, and back through the connector. The cable may be tensioned by use of the tensioner and secured into position within the connector. The connector may include a locking portion for engaging a protrusion formed on the pin.

Abstract: A cable passing apparatus useful in passing a cable around a bone. The cable is used to repair broken bone during an orthopaedic surgery. The cable passer comprises a cannulated internal assembly that is extendable at least partially around a bone. A cable suitable for surgical applications can be threaded through the apparatus and removed as desired.

Abstract: A clip for holding two ends of a flat surgical cable includes an outer portion with female threads and an inner male portion having mating male threads.

Abstract: An intraocular lens (IOL) insertion system for implanting IOLs into the eye. The insertion system includes an insertion cartridge that receives the IOL and cooperates with a handpiece. The cartridge includes a longitudinal lumen from a loading chamber to an open distal mouth that gradually narrows in dimension so as to fold the IOL into a tube for insertion through an incision in the eye. A distal tip member of a plunger rod in the handpiece enters the loading chamber of the cartridge and urges the IOL therethrough. The distal tip member has a portion that enters the folded IOL and is trapped therein for maximum control of IOL advancement. A soft tip, such as silicone, may cover a longitudinally extending portion of the distal tip to effect the IOL trapping. The distal tip member further has a portion that engages and pushes the IOL optic.

Abstract: A surgical tool for tensioning cranial-flap clamps is provided. The tool includes first and second handles pivotally attached to one another. A first jaw extends from the first handle and has an aperture configured to accept a stem of the clamp therethrough. A second jaw extends from the second handle and has an aperture configured to accept a stem of the clamp therethrough. A ratcheting mechanism is positioned within a cavity of the second jaw for selectively locking the stem in place within the second jaw aperture while the first jaw moves clamp closure members toward one another. The ratcheting mechanism includes a pawl pivotally attached to the jaw, and having teeth on an outer edge thereof, and a spring associated with the jaw and pawl to bias the pawl in a locking position when the first and second jaws are separated.

Abstract: The surgical instrument for tensioning a cable-like, a band-like or a cord-like tensioning element (5) comprises a manually actuatable lever system. Two levers (1, 2)—the first and the second actuation lever—are jointedly connected by a third lever (3). In a basic position of the system the tensioning element can be laid into a laying-in opening (15) of the first lever and into a clamping gap (32) at the second and at the third lever. One of the actuation levers (2) is formed in one section as a beam (20′, 21′) which is elastic in bending. The extent of a shape change of the beam can be measured. A relationship between this shape change and a tension in the tensioning element is known. The tension can be set as a result of this knowledge and of a measurement (209, 211; 8) of the shape change, or a means a tension monitor or sensor, serving for the same purpose is provided for determining a torque which acts at the corresponding actuation lever (2).

Abstract: A cable tensioning device comprises tubular shaft having an outer threaded portion, and a handle member surrounding a portion of the shaft, with the shaft and handle member being connected in screw-threaded relation. The shaft moves longitudinally relative to the handle as the handle rotates, driven by the screw threaded connection. A gripping member is carried on the shaft distal to the handle member for holding a replaceable bit, which, in turn, may carry a cable crimp. A cable lock is positioned typically proximal of the handle member to hold the ends of cables extending through the tubular shaft. Rotation of the handle member can cause the shaft to move longitudinally to lengthen the distance between the cable lock and a crimp held by a bit which, in turn, is held by the gripping member, to impose a tension on the cable. A meter is present for measuring the amount of tension applied to the cable.

Abstract: A porous metal intervertebral spacer having at least one angled through hole extending from the side of the implant to a surface which interfaces with a vertebral body end plate such that an interference screw may be driven through the implant and into the bone, thereby securing the implant from undesired motion. In particular, the through holes are tapered to receive a screw and coupling element therethrough such that once fully seated, the screw is locked to the implant by virtue of a coupling element-through hole mutually tapered nesting. The head of the screw is round, as is the interior of the coupling element, thereby allowing the screw to be inserted at various angles relative to the hole without interfering with the proper seating of the coupling element in the through hole.

Abstract: A tensioning tool which holds the free ends of a tension band secured to a clip and clip screw and rotation of an adjusting knob causes tension to be applied to pull the band through the clip until the desired tension is achieved.

Abstract: An apparatus for holding a first portion of a bone and a second portion of a bone together for the bone to heal. A method for holding a first portion of a bone and a second portion of a bone together for the bone to heal. A suture. A grommet for a bone. A method for securing a suture through a bone.

Abstract: The present invention relates to a brace installation instrument placement that is mounted to anchors secured in an animal subject. The installation instrument includes anchor extensions coupled to the anchors. The instrument is movable with respect to the anchors to position a brace in a position more proximate the anchors. The brace can be indexed for insertion at a predetermined orientation with respect to the installation instrument. Methods and techniques for using the installation instrument are also provided.

Abstract: A filament retaining washer for mounting about the shank of a bone screw deployed in a bone whereby to retain the filament to the bone, the filament retaining washer comprising a structure having a screw hole extending therethrough for receiving therein the shank of the bone screw deployed in the bone, whereby to secure the structure to the bone, the screw hole defining a first axis, and the structure having a filament hole extending therethrough for receiving a filament therein so as to retain the filament to the structure, the filament hole defining a second axis extending substantially perpendicular to the first axis.

Abstract: A plate probe and associated system and method for facilitating the orientation of an osteotomy and the implantation of an artificial joint component during arthroplastic surgery requiring an osteotomy. The probe comprises a coupler and a plate. The coupler is configured so that it can be connected to a position tracker, such that the position and orientation of the plate can be determined from the position of the tracker. The plate is configured so that it can be inserted into an opening of a bone-cutting mechanical guide, which is generally designed for receiving and guiding a surgical saw blade during a cutting operation.

Abstract: Devices, instrumentation, and surgical techniques are described for a more structured coupling of lamina to an alignment rod. A body having an aperture formed therethrough to receive the rod includes a mechanism to lock the body in place once a desired position and two or more holes to receive a cable wrapped around a lamina to be stabilized. A sleeve may also be provided over the cable where it wraps around the lamina to distribute the force of the cable against the bone to prevent damage. The mechanism to lock the body in place preferably includes a threaded fastener having an exposed proximal end for tightening and a distal end that bears against the rod. The body may be unitary, or provided in sections, one with the aperture and the other with the cable receiving holes, and with the two sections being rotatable relative to one another. At least one of the cable-receiving holes may also be flared or ring-shaped to facilitate a range of motion to avoid cable fatigue.

Abstract: A femoral guide for precisely positioning a guide wire on a femur bone surface. A lumen allows a guide wire extending through the lumen to contact the bone surface at a location spaced a predetermined distance from an edge of the bone surface. With the guide wire driven into the bone, a bone tunnel can be formed substantially concentrically along the guide. Methods of precisely forming bone tunnels include the steps of engaging a bone surface edge with a tongue of the femoral guide, insertion of a guide wile through a femoral guide lumen, driving the guide wire into the bone through the lumen and forming a bone tunnel along the guide wire where a bone tunnel longitudinal axis is disposed from the edge engaged by die tongue a distance substantially equal to the distance that the tongue is disposed from the longitudinal axis of the lumen.

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.

Abstract: A handpiece having a set of longitudinally vibrating piezoelectric elements and which may additionally have an electric motor to provide rotational or oscillatory movement to the ultrasound horn. The piezoelectric elements are surrounded by a high temperature plastic sleeve, and the sleeve is filled with high temperature potting material. The potting material seal the piezoelectric elements against moisture without affecting the performance of the piezoelectric elements.

Abstract: A fracture reduction clamp for the reduction of a fractured bone. The fracture reduction clamp is particularly suitable for surgical procedures wherein a bone having a fracture is to be fixated with a fixation apparatus after reduction of the bone with a strap. The fracture reduction clamp includes a bifurcated strap guiding head for contacting and firmly gripping the fractured bone, and a strap retainer disposed between the strap guiding head and a rotatable strap tensioner for retaining the ends of the strap being used to reduce the fractured bone. The strap guiding head can include a retractable spike for enhancing the grip of the fractured bone by the fracture reduction clamp. Rotation of the strap tensioner will tighten or loosen the strap about the fractured bone.

Abstract: A system and method for closing a first side of a severed bone with a second side of a severed bone of a patient. The system includes a first anchor mechanism which is adapted to enter into the first side of the bone and a second anchor mechanism which is adapted to anchor into the second side of the bone. The second anchor mechanism is separate and remote from the first anchor mechanism. The system also includes a lash that extends through the first and second anchor mechanisms and which binds the first side of the severed bone with the second side of the severed bone. Preferably, the lash comprises a wire made of stainless steel or suture material. A method for closing a first side of a severed bone with a second side of a severed bone.

Abstract: A tensioned cord (208) formed into a closed loop is secured to adjacent bone structures (201, 203), and a flexible patch (236) is secured to the cord in tension so that the combined, predetermined tension is applied between the adjacent bones structures (201, 203). The tensioned cord (203) and patch (236) may be used with or without a fusion implant device (206) in order to, in the former instance, contribute to compressive forces applied to the fusion device by the surrounding bone structures. The patch (236) may also be used as a delivery medium for a substance such as bone graft (241).

Abstract: A method for installing spine-stabilization components comprises directing a long plastic flexible tool through a sublaminar space of a human spine vertebrae inside the spinal canal. Such tool enters the sublaminar space of a particular one of the human spine vertebrae posteriorly from the intervertebral gap with an adjacent vertebrae. It exits the sublaminar space of the particular one of the human spine vertebrae posteriorly from the intervertebral gap with another opposite-side adjacent vertebrae. A suture is threaded through an eye of the tool. The suture is pulled back through the sublaminar space by withdrawing the long plastic flexible tool. The suture is detached from the long plastic flexible tool. A pulled-through part of the suture is attached to a spinal-fixation wire or cable. The suture is then usable as a pilot-line to draw the spinal-fixation wire or cable through the sublaminar space. The spinal-fixation wire or cable is used to anchor a spinal-fixation system.

Abstract: A tissue anchoring system includes a tissue anchor affixed to an end of a cable and supported for insertion on a delivery device, the manipulation of which permits placement of the anchor on a far side of the tissue. A tensioning, crimping and cutting tool designed for use along the cable's longitudinal axis, thus reducing the number of incisions required. A suture anchoring system is also described for introducing a loop of suture into a surgical site and anchoring it, for instance, across a tear in soft tissue.

Abstract: A system for closing together a first side of a sternum and a second side of the sternum of a patient. The system includes a first grommet to be disposed in the first side. The system includes a second grommet adapted to be disposed in the second side. The system includes a mechanism for placing a grommet into the sternum. The placing mechanism is adapted to hold the grommet for placement in the sternum. The system includes a first wire suture for insertion through the first and second grommets. The system includes a stop mechanism for allowing the placing mechanism to place a grommet into the sternum only in a desired location of the patient and any other portion of the patient is protected from damage by the placing mechanism during operation. A grommet. An approximator. A drill stop mechanism. A placement tool. A method of threading a wire suture through a hole in a sternum. A method of bringing together a first side of a sternum and a second side of the sternum.

Abstract: A novel system and method for use for ensuring appropriate positioning of a cable about bone portions, particularly, vertebral bone, for stabilization of the spine during spinal reconstructive and fusion procedures is disclosed. The system includes cabling uniquely adapted for spinal reconstruction processes, ligature passers and hook passers of varying sizes to facilitate looping of the cable about the spinal/vertebral bone, and a tensioning apparatus which secures the cable at a predetermined tensioned value about the vertebral bone. A novel method for applying a cable about vertebral bone for spinal stabilization is also disclosed.

Abstract: A cable sleeve system for bone fixation, comprising a cable, and a sleeve including a head for securing the cable and a piercing portion, wherein the piercing portion projects from a bottom face of the head substantially perpendicularly therefrom, and the head is provided with a bore extending in parallel with the bottom face for securing the cable therein, the head being adapted to be crimped to secure the cable therein. Because the sleeve can be made highly compact, it is possible to avoid undesirable side effects such as hemorrhage and inflammation due to irritations to the human body tissues which occurred frequently in the case of the cable securing method using the conventional cable grip.

Abstract: A cranial cruciate ligament stabilization system comprises of a surgical tensioning device that applies accurate and precise tension to the suture, a surgical implant crimp clamp when crimped secures the suture and a crimping device that accurately and precisely crimps the surgical crimp clamp. The tensioning device is placed over the suture once the crimp clamps are positioned. The surgeon than squeezes the handle that will in turn open the distal tips., therefore, applying tension to the suture. The tensioning device, having a ratcheting mechanism, allows for the surgeon to test for the appropriate tension through out the tensioning process. Once the desired tension is achieved the surgeon will crimp the primary or center crimp clamp, which is already in place, using the crimping device. The crimp clamp has physical and mechanical properties that ensures that it can be crimped simply and hold it's deformed state once it is crimped. The crimping device has specific geometry within each of its jaws.

Abstract: A surgical cable system and method for securing surgical cable around a portion of a human element (e.g., bone) is described. The surgical cable system may include a connector and a tensioner. The connector may be adapted to hold a pin, positionable within the connector, such that the pin may secure the cable within the connector. The pin may be repositioned, after securing the cable, to allow the cable to move freely through the connector. The cable may be oriented within the connector such that the ends of the cable are perpendicular or parallel with respect to each other. The tensioner is preferably adapted to vary the tension of the cable. The cable may be passed through the connector, around a portion of a human bone, and back through the connector. The cable may be tensioned by use of the tensioner and secured into position within the connector.

Abstract: A surgical cable crimp device including a cable with a fixed and a free end and a crimp member for securing the cable. The crimp member has a first leg having a blind hole for receiving the fixed end of the cable, and a second leg with a through bore extending through the second leg for receiving the free end of the cable, the first and second legs connected in the front by a front bridging portion and in the back by a rear bridging portion. The rear bridging portion is longer than the front bridging portion so that the crimp member has a wedge-shape and the second leg is crimpable so that the cable is crimped to the crimp member after the free end is inserted in the through bore.

Abstract: A cranial cruciate ligament stabilization system comprises of a surgical tensioning device that applies accurate and precise tension to the suture, a surgical implant crimp clamp when crimped secures the suture and a crimping device that accurately and precisely crimps the surgical crimp clamp. The tensioning device is placed over the suture once the crimp clamps are positioned. The surgeon than squeezes the handle that will in turn open the distal tips, therefore, applying tension to the suture. The tensioning device, having a ratcheting mechanism, allows for the surgeon to test for the appropriate tension through out the tensioning process. Once the desired tension is achieved the surgeon will crimp the primary or center crimp clamp, which is already in place, using the crimping device. The crimp clamp has physical and mechanical properties that ensures that it can be crimped simply and hold it's deformed state once it is crimped. The crimping device has specific geometry within each of its jaws.

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.

Abstract: A cable tensioning device comprises tubular shaft having an outer threaded portion, and a handle member surrounding a portion of the shaft, with the shaft and handle member being connected in screw-threaded relation. The shaft moves longitudinally relative to the handle as the handle rotates, driven by the screw threaded connection. A gripping member is carried on the shaft distal to the handle member for holding a replaceable bit, which, in turn, may carry a cable crimp. A cable lock is positioned typically proximal of the handle member to hold the ends of cables extending through the tubular shaft. Rotation of the handle member can cause the shaft to move longitudinally to lengthen the distance between the cable lock and a crimp held by a bit which, in turn, is held by the gripping member, to impose a tension on the cable. A meter is present for measuring the amount of tension applied to the cable.