Abstract: A bone-tying cable tightening device is disclosed which makes itself unusable after having been used a predetermined number of times.

Abstract: Systems, devices, and methods for longitudinal closure of a dissected sternum are provided. The system includes first and second reinforcing members, fasteners, and closure members. Each reinforcing member is configured to be placed on an outer surface of a respective sternum portion, such that each reinforcing member is longitudinally disposed on an opposite side of a sternum opening with respect to the other reinforcing member. Fasteners may be placed in holes defined in the reinforcing members to secure a respective reinforcing member to a corresponding sternum portion. The closure members, which may be sternal closing wires, may then be wrapped around the sternum portions and the reinforcing members transversely to close the sternum opening. The system provides for a low installed profile, enhancing patient comfort and facilitating healing, and also provides for quick and easy access to the thoracic cavity for re-do sternotomies, if needed.

Abstract: A medical apparatus including a bar with a first attachment loop, a second attachment and a plurality of hooks, wherein the medical apparatus is an arch bar.

Abstract: A dynamic tissue holding device for dynamically holding two tissue portions in contact with one another includes a resilient body having a spring and a band arranged for extending about the tissue portions to be held together. The band has a first end for attachment to a first attachment portion on the resilient body and a second end for attachment to a second attachment portion on the resilient body. Stops are disposed on portions of the resilient body for limiting both the compression and expansion of the spring. The compression of the spring is limited by engagement of two of the stops with one another and the expansion of the spring is limited by engagement of at least one of the stops with the spring.

Abstract: The invention provides systems and methods for sternum repair. A sternum repair device may include a central body, which may include a plurality of bands and buckles, such that a band extends from the central body and is received by a buckle component. The band may wrap around the sternum and the device may be tightened to keep the separate sternum pieces together.

Abstract: A method for reinforcing a sternum after a sternotomy or a sternal fracture. The method includes i) applying a plurality of elongated members along at least one longitudinal lateral edge of the sternum, wherein the elongated members are each provided with a first connection part and a second connection part; ii) slidably joining a first connection part of a first elongated member with a second connection part of an adjacent preceding elongated member along the longitudinal lateral edge of the sternum; iii) slidably joining a second connection part of the first elongated member with a first connection part of an adjacent following elongated member along the same longitudinal lateral edge of the sternum; iv) fitting a projecting portion of one or more of said elongated members in an intercostal space adjacent to the longitudinal lateral edge of the sternum; and v) fixing the elongated members to the sternum.

Abstract: A method for spinal rod insertion includes providing a U-shaped hook tool comprising first and second legs, and inserting the first leg into a first location of a first vertebra and then pushing the hook tool along an arc-shaped path until the first leg exits through a second location of an adjacent second vertebra. Next, providing a spinal stabilization rod and a folded flexible wire comprising first and second open ends at the front end and a closed loop end. The closed loop end is attached to a first end of the spinal stabilization rod and the first and second open ends of the folded flexible wire are inserted into an open end of the second leg of the hook, and the folded flexible wire is threaded through the U-shaped hook and the first and second open ends of the flexible wire exit through an open end of the first leg.

Abstract: A device for binding a cable about a fractured bone to stabilize a fracture comprises a slot including a distal opening sized to receive an enlarged end of a cable and a proximal opening sized to permit the cable to slide therethrough while preventing the enlarged end from passing therethough and a bore sized to slidably receive the cable, the bore extending to a proximal opening in combination with a locking element channel extending to a distal end opening into the bore and a locking element movable into a locking position in which a distal end of the locking element extends into the bore to engage a portion of the cable received therein and lock the cable in a desired position within the bore.

Abstract: A fracture fixation system serves in repairing a comminuted humeral head of a humeral bone. The fracture fixation system includes a plate having an upper surface, a lower surface opposite the upper surface, one of a screw and a post, and at least one aperture for receiving the one of the screw and the post therethrough. The plate is secured to a portion of a humeral shaft of the humeral bone, and the one of the screw and the post is inserted through the at least one aperture through the plate. The portion of the comminuted humeral head is attached to the one of the screw and the post using at least one suture. The one of the screw and the post is rotated to wind the at least one suture therearound to reposition the portion of the comminuted humeral head relative to the portion of the humeral shaft.

Abstract: A method and apparatus including at least one suture anchor configured to be implanted into bone and at least one suture assembly configured to extend from the suture anchor and about at least a portion of a fibula when the suture anchor is implanted in a tibia on either side of a fibular notch of the tibia. The suture assembly is selectively adjustable from a non-tensioned condition to a tensioned condition to stabilize and reduce the fibula relative to the tibia.

Abstract: A closure system may secure a first bone portion to a second bone portion. The closure system may include a bracket, a band and a tensioning device. The bracket may include a first portion adapted to engage the first bone portion and a second portion adapted to engage the second bone portion. The band may engage the bracket and may be adapted to be looped around the first and second bone portions. The tensioning device may include a body and a threaded member. The threaded member may be received in the body and may engage the band such that rotation of the threaded member relative to the body moves a first end of the band relative to a second end of the band.

Abstract: A closure system may secure a first bone portion to a second bone portion. The closure system may include a band, a locking terminal, and a tensioning device. The band may be adapted to be looped around the first and second bone portions. The locking terminal may fixedly engage a first portion of the band and selectively fixedly engage a second portion of the band. The tensioning device may include a body and a threaded rod. The threaded rod may be received in the body and may engage the band such that movement of the threaded rod relative to the body moves the second portion of the band relative to the first portion of the band.

Abstract: A sternal clamp having a first sliding body member and a second sliding body member telescopically mated, and a suture-receiving channel disposed on the exterior of the first sliding body member and the second sliding body member, wherein the first sliding body member and the second sliding body member are securable about a severed sternum by encircling and securing a suture about the first sliding body member and the second sliding body member, the suture being received and retained within the suture-receiving channel.

Abstract: A method and tool for creating a location for a fixation device to be secured to a bone. The method includes bringing a bone cutting tool extending along a longitudinal axis into engagement with an outer surface of the bone. The bone cutting tool is rotated about the longitudinal axis while driving it from the outer surface of the bone to a predetermined depth in the bone to form a bore. The bone cutting tool is then continuously rotated at the predetermined depth to establish an enlarged bone pocket at a distal end of the bore. The bone pocket defines a shoulder extending around a circumference between the bone pocket and bore. The bone cutting tool is removed from the bone pocket and bore. The fixation device is then inserted into the bone pocket through the bore, where it is seated against the bone pocket shoulder.

Abstract: A locking mechanism for securing ends of an implantable fabric including a plate member having an aperture therethrough. A cam member is rotatable relative to the aperture between a locked state and an unlocked state. The implantable fabric is movable relative to the plate member when the cam member is in the unlocked state and restricted from moving relative to the plate member when the cam member is in the locked state.

Abstract: A surgical tensioning device for holding separated tissues in contact with one another. The device comprises a frame having two opposing first and second sides and a lower surface and an upper surface, and a band for extending through and around said separated tissues to be held together in conjunction with said frame. The band has two ends releasably attached to the sides of the frame. When the ends are secured to the sides of the frame, the band holds separated tissues together and establishes a path of tension along its length that extends linearly between the two ends of the band.

Abstract: An orthopaedic fixation component attachable to a femur, said femur defining a femur shaft, a femur head and a femur neck extending therebetween, said femur further defining a greater trochanter limiting laterally said femur neck, said orthopaedic fixation component comprising: a shaft section fixation portion and an end section fixation portion extending substantially longitudinally therefrom, said shaft section and end section fixation portions being respectively securable to said femur shaft and said greater trochanter; said end section fixation portion including a pair of end arms, said end arms being configured, sized and positioned to delimit a trochanter receiving recess for substantially fittingly receiving a prominent portion of said greater trochanter.

Abstract: Methods and devices for treating spinal deformities are provided. In one exemplary embodiment, a low-profile spinal anchoring device is provided for receiving a spinal fixation element, such as a tether, therethrough. The device generally includes a staple body that is adapted to seat a spinal fixation element, a fastening element for fixing the staple body to bone, and a locking assembly for coupling a spinal fixation element to the staple body. In one embodiment, the locking assembly includes a washer that is adapted to couple to the staple body such that the spinal fixation is disposed therebetween, and a locking nut that is adapted to engage the staple body to mate the washer to the staple body.

Abstract: A fixing device to connect a bone to a linking member (18) is characterized in that it comprises; —a connecting part (12, 20, 22) to be connected to said linking member (18), having an outer face; —a conformable elongate ligature (14) cooperating with said bone suitable for securing said connecting part to said bone; said ligature applying a portion of the outer surface of the connecting part against a portion of said bone; and—adjustable locking means (46) fastened to said connecting part (12) to maintain said ligature in a state which allows a controlled relative mobility between said bone and said connecting part (12).

Abstract: A vertebral fixing system comprising a connecting part with two longitudinal elements coupled to each other at a first end and having mutually facing recesses for receiving a rod. A portion of a flexible ligature extends through orifices of the two longitudinal elements to define a loop opposite two free ends of the flexible ligature. The two longitudinal elements are engaged at a second end of the connecting part via a locking means. When the two longitudinal elements of the connecting part are locked at the second end of the connecting part, two strands of the flexible ligature are pinched between the rod and a wall of the mutually facing recesses of the two longitudinal elements of the connecting part, preventing the flexible ligature from moving in translation relative to the connecting part.

Abstract: A method of closing a tissue wound includes providing a wound closure device having a first anchor, a second anchor, and a flexible member movably attached to the second anchor, positioning the first anchor against tissue, passing the flexible member across the wound, positioning the second anchor against tissue, and pulling on a free end of the flexible member to shorten a length of the flexible member between the first and second anchors, thereby closing the wound. A wound closure device includes a first anchor, a second anchor; and a flexible member connecting the first anchor to the second anchor, the flexible member being movably attached to the second anchor, such that pulling on a free end of the flexible member shortens a length of the flexible member between the first and second anchors.

Abstract: The invention is an insertion tool for wrapping an orthopedic wire around a bone. The tool has a memory loop made of memory-shaped material which, when unconstrained, curves to a pre-determined diameter. A push-pull mechanism in the tool body is used to selectively move the memory loop in and out of the tool body. A cutter is provided at the insertion end of the tool body, to cut through tissue close to the bone. When pushed out of the tool body in a direction tangential to the perimeter of a bone, the memory loop automatically curves and wraps around the bone. Orthopedic wire is then attached to the memory loop, which is then pulled back into the tool body, pulling the orthopedic wire around the bone. A cable adapter facilitates coupling any conventional orthopedic wire to the insertion tool.

Abstract: A system, devices and methods are provided for facilitating stabilization of periarticular fractures. The system includes a compression plate and one or more of a cerclage cable for encircling the bone and securing the compression plate to the bone, a crimp lug for securing the cable in tension relative to the bone and/or a plate, and a supplemental plate coupled to the compression plate and adapted to receive bicortical or unicortical bone screws to further secure the compression plate relative to the bone. In addition, the system includes a cable tensioner for temporarily retaining the cable in tension and then applying a tension to the cable until a desired compression is effected between a plate and bone and while a cable retaining structure is secured to the cable to retain the applied tension on the cable. Also provided is a jig for use with plates for minimally invasive fracture stabilization.

Abstract: The present disclosure relates to bone plates that are configured for use with bones having periprosthetic fractures. For example, in the event that a proximal femur is fractured in an area that is adjacent to a prosthetic component, such as a femoral stem used in a hip replacement, the periprosthetic bone plates of the present invention may be used. In one exemplary embodiment, the periprosthetic bone plates include a periprosthetic zone having a plurality of central apertures and a plurality of outer apertures that are offset from the central apertures. The periprosthetic zone may further include a plurality of indentations, each indentation extending longitudinally between adjacent outer apertures to narrow a width of the bone plate.

Abstract: A device for treating bone fractures, comprises an actuating mechanism removably coupleable to a clamping mechanism including a clamp defining a cable receiving channel extending therethrough and a compression member coupled to the clamp for movement relative thereto, movement of the compression member relative to the clamp in a first direction moving the clamping mechanism into a clamping configuration in which at least a portion of the clamp is compressed into the channel to fix a cable received therein relative to the clamping mechanism. The actuating mechanism includes a first member and a second member removably engagable with a clamping mechanism so that, when engaged, relative movement between the first and second members causes relative movement between the clamp and the compression member to move the clamping member between the clamping configuration and a release configuration, the actuating mechanism further including a tensioning mechanism.

Abstract: A surgical tensioning device for dynamically holding two tissue portions in contact with one another comprises a resilient body having a plurality of spring elements, and a plurality of stop members for limiting travel of the spring elements in order to control energy stored or delivered by the spring elements. A length of suture is also provided, wherein a first end of the suture is connected to the resilient body at a first attachment point and a second end of the suture is connected to the resilient body at a second attachment point. In one embodiment, the stop members contact one another to limit compression of the spring elements. When the suture is placed in tension, the spring elements move to an extended configuration and the stop members move apart, creating gaps between ends of each of the stop members.

Abstract: A fixation device for the fixation of bone fragments, applicable to the mutual fastening of bone fragments temporarily separated during a surgical operation or as a result of a trauma. The device is also suitable for the fixation of a bone flap in the replacement thereof in a corresponding aperture made in the cranium or cranial bone mass. The device is made of biocompatible material and comprises a flexible strip and fastening means, the strip having a length allowing the formation of a fastening loop tightly fastening the bone fragments to be joined together. The fastening means are provided with at least one opening provided with interlocking means allowing the passage of a free end of the strip and preventing its extraction in the direction opposite to the insertion.

Abstract: Assemblies for securing fractured bone are provided. The assembly includes a first fixation element, a second fixation element, and an adjustable flexible member construct. The first fixation element having a male or a female sleeve is secured within a first portion of the fractured bone. The second fixation element having the other of the male or female sleeve telescopically received within the one of the male or female sleeve is secured within a second portion of the fractured bone. The adjustable flexible member construct extends between the first and second fixation elements and has at least one adjustable loop coupled to the first fixation element and the second fixation element and a pair of adjusting ends extending through an opening in the first fixation element. The pair of adjusting ends can be pulled to reduce a diameter of the adjustable loop and to compress fragments of the fractured bone.

Abstract: The present disclosure relates to an implant for refixation of the greater trochanter on which an osteotomy has been performed or which is fractured. The implant comprises a plate that can be fixed on the proximal femur, and a device that can hold the greater trochanter with a form fit or force fit on the femur. This holding device preferably has bendable prongs located at a distance from each other, the first end portion of these prongs being attached to the upper edge of the base plate. The holding device also has flexible, elongate members, each of which is attached at one end to the free end portion of the respective prong. The other, free end portions of the longitudinal members are secured laterally on the base plate after these longitudinal members have crossed the medial aspect of the greater trochanter. This results in a tensioning band construction with at least two restraints based on a plate fixed securely on the proximal lateral femur.

Abstract: The invention provides systems and methods for sternum repair. A sternum repair device may include a central body, which may include a plurality of male and female components, such that a suture extends from a male component and is received by the female component. The suture may wrap around the sternum and the device may be tightened to keep the separate sternum pieces together.

Abstract: The various implementations of the present invention provide an improved apparatus for bone reduction and fixation. A flat, substantially rectangular band comprises a wing portion and a plurality of apertures formed in the body of the band. The band provides a mechanism for fixing bones in a desired position by encircling a first bone and a second bone. A first set of apertures provides for real time adjustment of the length of the band to allow for a wide variety of bone reduction applications. By selecting the appropriate length for the band and inserting the wing portion in the appropriate slot, the band can be used for a wide range of applications. A second set of apertures formed in the band provide for bone and tissue contact, promoting healing of the body where the band is placed. A method for determining the proper positioning and placement of the wing portion during the bone reduction process is also disclosed.

Abstract: A bone fixing system useful for holding bone in position, and a method for installing the same are disclosed. The ends of a conformable ligature are passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop extending from a first portion of the blocking body. The ends of the conformable ligature are passed through the blocking body and extend out a second portion of the body. The ends may be attached to a tensioning tool and a selected tension may be applied. A closure member may engage an engagement portion of the blocking body to create a friction force to hold the conformable ligature in place without significant movement relative to the blocking body.

Abstract: The invention provides systems and methods for sternum repair. A sternum repair device may include a central body, which may include a plurality of bands and buckles, such that a band extends from the central body and is received by a buckle component. The band may wrap around the sternum and the device may be tightened to keep the separate sternum pieces together.

Abstract: A sternum fixation assembly is disclosed for fixing the sternum following a modified median sternotomy. The sternotomy divides a median into left and right median facing walls. A pair of left and right opposing excavations are made in the walls. The assembly comprises an implantable bio-absorbable transverse member configured for enclosure into the excavations of the left and right halves of the vertically divided sternum. An elongated coupleable adjustable compression member is dimensioned for receipt about the inter-rib spaces about the sternum and adapted to apply compression to the outer ridges of the sternum to help maintain the sternum enclosure.

Abstract: A bone fixing system useful for holding bone in position, and a method for installing the same are disclosed. The ends of a conformable ligature are passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop extending from a first portion of a body. The ends of the conformable ligature are passed through the body and extend out a second portion of the body. The ends may be attached to a tensioning tool and a selected tension may be applied. A closure member may engage an engagement portion of the body to create a friction force to hold the conformable ligature in place without significant movement relative to the body.

Abstract: Disclosed herein are cable plugs for securing surgical cable to a bone plate. The cable plugs each have a cable retaining member and a fastening member. The cable retaining members each have a receiving portion adapted to receive a portion of the surgical cable therein. The cable retaining members are first coupled to the fastening members prior to securing the cable plug to the bone plate. The cable retaining member may rotate with respect to the fastening member about 270° along a longitudinal axis of the cable plug when the cable retaining member is coupled to the fastening member. When securing the surgical cable to the bone plate, the cable retaining member is rotated about the longitudinal axis of the cable plug until an axis of the receiving portion is parallel to an axis of the surgical cable. The surgical cable is then placed within the receiving portion, tightened, and crimped to secure the bone plate to the bone.

Abstract: A fixation device for the fixation of bone fragments, applicable to the mutual fastening of bone fragments temporarily separated during a surgical operation or as a result of a trauma. The device is also suitable for the fixation of a bone flap in the replacement thereof in a corresponding aperture made in the cranium or cranial bone mass. The device is made of biocompatible material and comprises a flexible strip and fastening means, the strip having a length allowing the formation of a fastening loop tightly fastening the bone fragments to be joined together. The fastening means are provided with at least one opening provided with interlocking means allowing the passage of a free end of the strip and preventing its extraction in the direction opposite to the insertion.

Abstract: A fixation device for the fixation of bone fragments, applicable to the mutual fastening of bone fragments temporarily separated during a surgical operation or as a result of a trauma. The device is also suitable for the fixation of a bone flap in the replacement thereof in a corresponding aperture made in the cranium or cranial bone mass. The device is made of biocompatible material and comprises a flexible strip and fastening means, the strip having a length allowing the formation of a fastening loop tightly fastening the bone fragments to be joined together. The fastening means are provided with at least one opening provided with interlocking means allowing the passage of a free end of the strip and preventing its extraction in the direction opposite to the insertion.

Abstract: An apparatus for securing together first and second bone segments having peripheral surfaces comprising one or more bends. In some implementations the fixation device includes an elongate flexible strap having a proximal end and a distal end, the elongate flexible strap having a plurality of ratchet teeth disposed along an elongate distal portion thereof that function with a ratchet member within a locking head situated at the proximal end to permit the formation of a closed loop about the bone fragments. In some implementations the elongate flexible strap has a first elongate portion situated between the locking head and the elongate distal portion, the first elongate portion of the elongate flexible strap being more flexible than the elongate distal portion of the elongate flexible strap, the first elongate portion configured to extend across at least one of the one or more bends when the apparatus is in a secured state.

Abstract: A tissue fixation system is provided for dynamic and rigid fixation of tissue. A fastener connected with an elongate fastening member, such as a cable, wire, suture, rod, or tube, is moved through a passage between opposite sides of tissue. A medical device is used to secure the fastener to the elongate fastening member. The medical device includes a tensioning mechanism for tensioning the elongate fastening member. As crimping mechanism is used to secure the fastener to the elongated member, where a cutting mechanism cut the excess portion of the elongated member.

Abstract: A fixation device for the fixation of bone fragments, applicable to the mutual fastening of bone fragments temporarily separated during a surgical operation or as a result of a trauma. The device is also suitable for the fixation of a bone flap in the replacement thereof in a corresponding aperture made in the cranium or cranial bone mass. The device is made of biocompatible material and comprises a flexible strip and fastening means, the strip having a length allowing the formation of a fastening loop tightly fastening the bone fragments to be joined together. The fastening means are provided with at least one opening provided with interlocking means allowing the passage of a free end of the strip and preventing its extraction in the direction opposite to the insertion.

Abstract: A cerclage arrangement is for fixing a bone fracture and comprises a plate that is provided with at least one throughhole. A pin is equipped with a head with an opening that extends perpendicular to the direction of the pin and is used for guiding a cerclage band or wire therethrough. The cerclage pin encompasses a shaft which is provided with an end that extends through the plate so as to engage into the bone area that is to be fixed.

Abstract: The present application is directed to devices and methods for releasing tension on a surgical tether. In one embodiment, the release mechanism is constructed to be positioned between a locked position and a release position. In the locked position, the release mechanism is attached to the tether to prevent the tether from moving through the release mechanism. In the release position, the release mechanism allows the tether to move through the body. The release mechanism may be constructed to move between the release and locked positions after being implanted within a patient. In one embodiment, the release mechanism returns to the locked position after the tension on the tether has been reduced below a predetermined amount.

Abstract: System, including methods, apparatus, and kits, for tensioning a surgical wire with a tensioning device and/or fixing bone with a surgical wire tensioned with a tensioning device.

Abstract: A tensioning device comprises an elongate member, preferably a band, and a frame having first and second sides. The band has a first end that is attachable to the first side of the frame and a second end that is releasably securable to the second side of the frame. A movable clamping member on the frame secures the second end of the band to the second side of the frame by cinching the second end of the band between an engagement surface on the band and a mating engagement surface on the second side of the frame. A restraining member is provided for restraining the clamping member to a first position spaced from the mating locking surface on the second side of the frame, when the restraining member is in a restraining orientation. The restraining member is movable out of the restraining orientation after the band is tensioned to a predetermined level using the second end.

Abstract: A method for closing a sternum separated into at least a first sternum portion and a second sternum portion includes preparing at least one cut surface of at least one of the first or second sternum portions to have an adhesive applied thereon. The adhesive is applied to at least a portion of the at least one cut surface. The at least one cut surface is approximated to a second cut surface of the other of the first sternum portion or second sternum portion. As the adhesive cures, it bonds with the first cut surface and the second cut surface. Preparing the at least one cut surface may remove contaminants that could inhibit adhesion of the adhesive. The adhesive may be applied through adhesive injection holes formed along an incision separating the first and second sternum portions. Devices for preparing the cut surfaces and applying the adhesive are also provided.

Abstract: A constraining apparatus includes a constraining structure that captures a first and a second anatomical structure. A motion limiting member coupled with the constraining structure is adapted to provide a force resistant to relative movement of the first anatomical structure away from the second anatomical structure. A regulating member is detachably coupled with the motion limiting member or the constraining structure and is adapted to change the resistant force provided by the motion limiting member when the regulating member is in direct engagement with the motion limiting member or constraining structure.

Abstract: Orthopedic fracture repair implants, systems and methods are disclosed. Implants include one or more biocompatible sleeves and struts. The implants, systems and methods are applied to bone fractures, such as segmentation fractures.

Abstract: A dynamic tissue holding device for dynamically holding two tissue portions in contact with one another includes a resilient body having a spring and a band arranged for extending about the tissue portions to be held together. The band has a first end for attachment to a first attachment portion on the resilient body and a second end for attachment to a second attachment portion on the resilient body. Stops are disposed on portions of the resilient body for limiting both the compression and expansion of the spring. The compression of the spring is limited by engagement of two of the stops with one another and the expansion of the spring is limited by engagement of at least one of the stops with the spring.

Abstract: A tensioning device comprises an elongate member, preferably a band, and a frame having first and second sides. The band has a first end that is attachable to the first side of the frame and a second end that is releasably securable to the second side of the frame. A movable clamping member on the frame secures the second end of the band to the second side of the frame by cinching the second end of the band between an engagement surface on the band and a mating engagement surface on the second side of the frame. A restraining member is provided for restraining the clamping member to a first position spaced from the mating locking surface on the second side of the frame, when the restraining member is in a restraining orientation. The restraining member is movable out of the restraining orientation after the band is tensioned to a predetermined level using the second end.