Abstract: A cable tie system, including methods, apparatus, and kits, for stabilizing bone. The system may provide a tie device comprising a strap including a leading region and a trailing region, a needle connected to the leading region of the strap, and a buckle connected to the trailing region of the strap. The buckle may be configured to receive the leading region of the strap such that the buckle and the strap collectively form a loop and a ratchet mechanism. The tie device also may comprise a handle connected to the buckle, to allow a person to tension the loop around bone by pulling the strap and the handle in opposite directions. The handle may be detached from the tie device after use.

Abstract: A method of accessing target tissue adjacent to a spinal nerve of a patient includes the steps of accessing a spine location of the patient by entering the patient through the skin at an access location, inserting a flexible tissue modification device through the access location to the spine location, advancing a distal portion of the first flexible tissue modification device from the spine location to a first exit location, passing through the first exit location and out of the patient, advancing the first or a second flexible tissue modification device through the same access location to the spine location and to a second exit location, and passing through the second exit location and out of the patient.

Abstract: We describe fixator (10) comprising an articulated bracelet (12). The bracele comprises a plurality of elements (24,26) arranged in a plurality of rows. The elements have complementary linking means (48,62) to permit linking the rows of elements together in an articulated or fixed relationship. One or more of the plurality of elements comprises means (34) for receiving and engaging at least a portion of a connecting device (16) such that the position of the connecting device can be altered around the bracelet or the limb that it is mounted on. The fixator further comprises an articulated connecting device, a rod and a hinge device.

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: The present disclosure provides for an apparatus and method for supporting a maxillo-mandibular fixation by securing the maxillary teeth and mandibular teeth together in a faster and less harmful manner, includes a floss-wire component for circumdental wiring a tooth initially by flossing the interproximal space of a tooth therewith and thereafter causing circumdental wiring of a tooth when the floss-wire component is pulled, the floss-wire component having a distal portion composed of a floss-like material and a proximal portion composed of a wire-like material, a clip having an anchoring point and grasping point, the clip interacts with the floss-wire component, thereby causing the clip and the floss-wire to secure tightly to a tooth, and a bar positioned between the buccal surface of one or more teeth and one or more clips, the bar having a plurality of indices to increase the stabilization of one or more clips.

Abstract: A cerclage device includes a base member, a cerclage member, and a drive member. The base member has a length sufficient to allow for manual holding by a user, an interior space extending from a distal end toward a proximal end, and a slot extending from the distal end toward the proximal end and connecting the interior space to the exterior. The cerclage member has a long side with a proximal end and a distal end and a curvature in one direction about its long side at least at the distal end. The cerclage member has means for attaching a suture and fits within and is straightened by the base member within the interior space when in a retracted position. In an extended curved position the distal end of the sheet is extended out of the interior space at the distal end of the base member. The drive member is attached or attachable to the cerclage member and is slidable within the slot and has an engagement portion that is disposed at least partially through the slot.

Abstract: A bone-tying cable tightening device with improved easiness of handling of is disclosed. The device comprises a grip portion, a rod-like member extending forward, a knot supporter at the tip, a cable holder to grip and hold the tow arms together, and a sliding block mounted around the rod-like member and connected to a puller and an operation lever to drive the puller. The knot supporter supports two arms that can be hooked away from each other and laterally above the rod-like member, the cable holder is made up of a longitudinal through groove a locking recess which extends, at the end of the through groove, and a backward biased locking member which is provided movably back and forth behind the locking recess on the upper side of the sliding block made so that its forward movement is blocked when it fits in the locking recess.

Abstract: A suture anchor for securing soft tissue to bone may include a threaded body, a head extending along a longitudinal axis, and a plurality of eyelets that extend though the anchor head and that are each configured to receive a suture. The eyelets are offset from one another along an axis that is transverse to the longitudinal axis of the suture anchor. Each eyelet may have a desired shape and cross section. Surgical kits including one or more suture anchors and one or more surgical tools are also described.

Abstract: A method for placing a fixation member around a bone for internal fixation of the bone includes (a) inserting a first member of a cerclage tool through an incision and into a vicinity of the bone, the first member extending from a first proximal end comprising a first handle portion and along a first central portion to a first distal end comprising a first bent tube portion; (b) inserting a second member of the cerclage tool through the incision and into the vicinity of the bone, the second member extending from a second proximal end comprising a second handle portion and along a second central portion to a second distal end comprising a second bent tube portion; (c) joining the first and second members together to form a continuous tube with the first bent tube portion and the second bent tube portion that encircles the bone, wherein the first bent tube portion and the second bent tube portion cross over one another to form a non-zero angle at a location that is proximal of the bone when viewed from a direct

Abstract: A minimally invasive skeletal fixation device includes two curved tubes and two positioning members. The two curved tubes are attached to each other and are in communication with each other. The positioning members are coupled to the curved tubes. The device is applicable to surgical operations for treating bone factures and offers the advantages of small incision size, simple structure, easy operation, improved performance of surgical operation, and flexible adjustment of installation sites of Kirschner pins.

Abstract: The present invention relates to a vertebral fixing system adapted to be mounted on a vertebra of the spine to connect it to a rod. Said fixing system comprises: a connecting part adapted to face the rib and/or said transverse process and to be connected to said rod; an elongate flexible ligature adapted to connect together said connecting part and at least one rib and/or one transverse process; and adjustable locking means fastened to said connecting part and adapted to fix simultaneously in position said connecting part relative to said rod and at least one portion of said ligature relative to said connecting part, so as to prevent relative displacement of said rod and said vertebra in opposite directions.

Abstract: A cerclage tool for placement of a wire around a bone for internal fixation of the bone comprising a first member having a handle portion, a central portion and a first bent tube portion and a second member having a handle portion, a central portion and a second bent tube portion. The first member and the second member are configured and adapted to be inserted separately through an incision into soft tissue surrounding the bone and subsequently joined together after insertion such that the first bent tube portion and the second bent tube portion form a continuous tube that encircles the bone.

Abstract: A device for treating a bone comprises a cable block including a first lumen extending from a first proximal opening in a proximal face of the cable block to a first distal opening in a distal face thereof, the first lumen being configured to receive a cerclage cable including an enlarged end. The cable block further includes a second lumen extending from a second proximal opening in the proximal face to a second distal opening in the distal face and being configured to receive a portion of the cable extending from the enlarged end while preventing the enlarged end from passing therethrough. The cable block includes a slot connecting distal portions of the first and second lumens and being at least as large as the second lumen in combination with a crimpable locking member including a channel configured to receive the portion of the cable extending from the enlarged end.

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 method for promoting fusion of and/or stabilizing a facet joint between two adjacent vertebrae comprises clamping the two adjacent vertebrae across the facet joint to apply a compressive force across the joint. Apparatus for promoting fusion of and/or stabilizing a facet joint comprises at least one cinchable tether and at least one locking member coupled with the tether for locking the cinched tether to maintain compressive force across the facet joint. The tether is adapted to extend through at least one hole through each of two adjacent vertebrae, across the facet joint.

Abstract: Methods and apparatus provide for: coupling an elongate guide substantially at a first end to at least one vertebral body of a spinal column of a patient; and extending a second end of the guide to a structure of the patient spaced in an anterior direction away from the at least one vertebral body towards an entry incision.

Abstract: A surgical cable and crimp device is provided. The cable has an enlargement (bead) affixed to one of its ends. The crimp member includes two holes. One of the holes includes a slot and a cavity. The cavity is sized to accept the bead of the cable, and the slot is sized to receive the flexible cable but not allow the bead to pass through. The other hole is a simple through hole. The cable can be inserted to loop the bone isolated from the crimp member. After the beaded end of the surgical cable is fastened to the crimp, the cable is passed through the simple through hole. The cable is then tensioned by the application thereto of a tensioning tool with the tool applied to the cable and to an abutment face of the crimp member.

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: A sternal closure device for securing and retaining longitudinally divided halves of a sternum, the device having two sets of anterior and posterior longitudinally extended brace members with brace joining mechanisms extending through the sternal halves to join the anterior brace members to the posterior brace members, such that the sternal halves are compressed between the anterior and posterior brace members, and transverse bridging members that laterally connect the two sets of brace members, with securing mechanisms to retain the two sets of brace members in a contracted configuration with the sternal halves in abutting relation.

Abstract: A cable tensioning system includes a reaction frame which contains a sliding platform arranged to move linearly within the frame, and a clam-type cleat attached to the sliding platform. The cleat features one or more grooves, each of which comprises two arrays of opposing ridges that converge to form a V-shape groove adapted to receive a length of cable. The ridges of each groove are tilted relative to an axis perpendicular to the groove's longitudinal axis, such that the cable is progressively captured between the ridges of the opposing arrays as it settles into the crotch of the groove when moved in a first direction, and can be disengaged from the cleat by relaxing the axial force on the cable and moving it in the opposite direction. A linear actuator mechanism may be coupled to the sliding platform to move the platform with respect to the reaction frame.

Abstract: An apparatus for leading a cerclage member along a desired path through a portion of bone, comprises a guide strip extending from a proximal end to a sharpened distal end, at least a portion of the guide strip being biased to assume a shape corresponding to a portion of a desired path along which the cerclage member is to pass through a portion of bone and a delivery cannula including a lumen sized to slidably receive the guide strip therein, the cannula maintaining the guide strip in a substantially straight configuration until the guide strip is extended distally out of the lumen.

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 has a flexible strip and fastening mechanism, the strip having a length allowing the formation of a fastening loop tightly fastening the bone fragments to be joined together. The fastening mechanism is provided with at least one opening provided with an interlocking mechanism allowing the passage of a free end of the strip and preventing its extraction in the direction opposite to the insertion.

Abstract: A system for securing a bone fixation device to a bone comprises a flexible longitudinal element configured to wrap about and stabilize one of a target portion of bone and a bone stabilizing element. The longitudinal element includes a plurality of projections extending distally from a first surface thereof. Each projection includes a proximal abutting surface in combination with a bone fixation element including a channel extending therethrough sized and shaped to slidably receive therein a portion of the longitudinal element distal of the head. The bone fixation element includes a recess shaped to receive the head and prevent the head from being drawn distally through the channel. The bone fixation element or the longitudinal element includes a tab configured to engage one of the proximal abutting surfaces to prevent the projections of the longitudinal element from moving proximally relative to the tab.

Abstract: A surgical cable and crimp device is provided. The cable has an enlargement (bead) affixed to one of its ends. The crimp member includes two holes. One of the holes includes a slot and a cavity. The cavity is sized to accept the bead of the cable, and the slot is sized to receive the flexible cable but not allow the bead to pass through. The other hole is a simple through hole. The cable can be inserted to loop the bone isolated from the crimp member. After the beaded end of the surgical cable is fastened to the crimp, the cable is passed through the simple through hole. The cable is then tensioned by the application thereto of a tensioning tool with the tool applied to the cable and to an abutment face of the crimp member.

Abstract: An apparatus for securing a cerclage member about a bone comprises a crimp including a first lumen extending therethrough from a first lumen proximal opening to a first lumen distal opening and being configured to slidably receive a cerclage member therein, a proximal portion of the first lumen comprising a first recess configured to receive an enlarged proximal end of the cerclage member, the crimp further comprising a second lumen extending parallel to the first lumen from a second lumen proximal opening to a second lumen distal opening, a distal portion of the second lumen comprising a second recess configured to slidably receive a sleeve provided over a distal end of a cerclage member. A first wall of the crimp adjacent the second lumen distal opening is angled with respect to a second wall of the crimp adjacent the first lumen distal opening to permit pivoting of the sleeve thereagainst.

Abstract: A thoracic closure device. The device has a handle member, a base member, and a feed path, and is designed to accept and, with a ratcheting mechanism, tension a toothed closure tie. A guide member is also provided, and assists in the placement of a closure tie prior to tensioning. Methods of closing a median sternotomy using toothed closure ties are also disclosed.

Abstract: A device and method to provide a surgically inserted internal tether between the femur and tibia is provided which will prevent distraction of the healing anterior cruciate ligament in all degrees of flexion and extension, at all times. The anterior cruciate ligament tether preserves the four-bar cruciate linkage, critical for normal knee mechanics. In addition, placement of the tether provides bleeding into the knee in the region of the anterior cruciate ligament attachment sites and the consequent inflow of pluripotential cells and healing mediators.

Abstract: Strip fasteners and cranial plugs for use in reattaching a skull flap removed during brain surgery and methods of using the same. The strip fasteners are flexible and can be shaped to follow the perimeter contour of the skull flap. The cranial plugs can be used to reattach the skull flap or they can be installed after the skull flap is reattached using the strip fasteners. In some embodiments, the cranial plug(s) and strip fasteners can be installed at the same time. The strip fasteners and cranial plugs are designed to encourage bone growth and healing of the skull flap and they can be used to deliver medication and bone growth enhancement compositions to the surgical site.

Abstract: Strip fasteners and cranial plugs for use in reattaching a skull flap removed during brain surgery and methods of using the same. The strip fasteners are flexible and can be shaped to follow the perimeter contour of the skull flap. The cranial plugs can be used to reattach the skull flap or they can be installed after the skull flap is reattached using the strip fasteners. In some embodiments, the cranial plug(s) and strip fasteners can be installed at the same time. The strip fasteners and cranial plugs are designed to encourage bone growth and healing of the skull flap and they can be used to deliver medication and bone growth enhancement compositions to the surgical site.

Abstract: An interbody fusion implant with deployable bone anchors includes a support member, a monolithic body that accommodates the support member, and a longitudinal hole along a vertical length of the support member. The support member includes a first end and a second end. The second end includes two flanges. The flanges are configured to dig into an endplate of a vertebral body. The flanges of the support member provide a location fixation on an implantation of the interbody fusion implant into the vertebral body. The support member may also include at least one of a clip shaped support member and an I-shaped support member. The I-shaped support member may allow a rigidity and a support in flexion-extension through a living-hinge positioned in a middle of the I-shaped support member. The longitudinal hole sustains loads imported on the interbody fusion implant and allows the interbody fusion implant to flex freely.

Abstract: The present application is directed to implants for positioned between vertebral members. The implant may include a superior surface to contact against a first vertebral member, and an inferior surface to contact against a second vertebral member. The implant includes a fixation mechanism that is operable to extend a portion of the fixation mechanism into the vertebral members immediately above and below the implanted implant to affix the implant within the vertebral space between such vertebral members. The implant is substantially open in the superior and inferior directions to allow for the introduction of bone growth material within the interior of the implant to help promote fusion between the vertebral members.

Abstract: A method of conducting a surgical procedure including implanting an anchor into a bone, wherein the anchor comprises a receiving portion and a screw, the screw including a screw head contained within the receiving portion and pivotally engageable with a surface of the receiving portion, and wherein the receiving portion and the screw comprising a different material. The method further includes selecting a rod from a group of rod types and coupling the rod with the receiving portion to stabilize a position of a portion of the spine.

Abstract: A line lock includes a body at least partially bounding two passageways that cooperate to receive a locking portion of a line such as a suture in such a manner that the locking portion can only be drawn through the passageways along one direction. A second suture locking portion may also received by the passageways, or by one of the two passageways in combination with a third passageway. The body may have an elongated, compact shape that is easily implantable in the body.

Abstract: A sternal reconstruction system for securing parts of a sternum includes at least one flexible cable with crimp fitting, at least one cannulated screw and at least one reconstruction plate. Circumferential or parasternal fixation may be brought about by use of a sternal reconstruction system including a flexible cable and crimp fitting alone; a sternal reconstruction system including a flexible cable, crimp fitting and cannulated screws; or a system including a flexible cable, crimp fitting, cannulated screws and one or more reconstruction plates. The reconstruction plates are typically planar, having an upper and a lower surface, and containing generally perpendicular and transverse plate holes. The generally perpendicular plate holes are countersunk to better accommodate the heads of the cannulated bone screws. Also provided is a kit for sternal reconstruction.

Abstract: Cerclage system, including methods, devices, and kits, for stabilizing bone, such as a sternum. The cerclage system may include a wire or cable that encircles bone, and a bone plate to which segments of the wire or cable lock. The cerclage system also or alternatively may include a tensioner for applying tension to a wire or cable.

Abstract: An interlocking intervertebral disc prosthesis is provided. The prosthesis can include a left prosthetic body and a right prosthetic body that interlock with one another. A kit for replacing an intervertebral disc with an interlocking intervertebral disc prosthesis is also provided. A method for surgically implanting an interlocking intervertebral disc prosthesis is also provided.

Abstract: In order to provide an implant for fixing adjacent bone plates, in particular cranial bone plates, which has an inner abutment element by means of which a separation gap between the bone plates can be overlapped at a bone plate inner side and has an outer abutment element for overlapping the separation gap at a bone plate outer side lying opposite the bone plate inner side and which is easy for a surgeon to use and by means of which the bone plates may be securely fixed, it is proposed that at least one tension band is guided displaceably through the outer abutment element, by means of which, when a tensile stress is exerted, the inner abutment element and the outer abutment element are mutually braceable, and that the at least one tension band is fixable on the outer abutment element.

Abstract: A suture fixation apparatus having a first body portion having a bone engaging feature to fixedly engage a bony tissue and a second body portion defining an eyelet for receipt of a suture. The second body portion is rotatable with respect to the first body portion. Rotating the second body portion causes the suture to form a twist to frictionally secure the suture.

Abstract: A suture construction and method for forming a suture construction is disclosed. The construction utilizes a suture having an enlarged central body portion defining a longitudinal passage. First and second ends of the suture are passed through first and second apertures associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes constriction of the longitudinal passage, thus preventing relative motions of the captured portions of the suture.

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 bioabsorbable band system is provided. The system comprises a bioabsorbable elongated band and two locking member systems. This band system may be used to heal bone fractures or osteotomies.

Abstract: An innovative bone anchor and methods for securing soft tissue, such as tendons, to bone, which permit a suture attachment that lies entirely beneath the cortical bone surface. Advantageously, the suturing material between the soft tissue and the bone anchor is secured without the need for tying a knot. The suture attachment to the bone anchor involves the looping of a length of suture around a pulley within the bone anchor, tightening the suture and attached soft tissue, and clamping the suture within the bone anchor. The bone anchor may be a tubular body having a lumen containing a plurality of suture-locking elements that clamp the suture therein. The locking elements may be thin and C-shaped. One or more locking plugs attached to separable actuation rods displace axially within the lumen and act on the locking elements to displace them radially.

Abstract: A device for securing cable around a bone comprises first and second handles pivotally coupled to one another and a first distal member a proximal end of which is pivotally coupled to a distal end of the first handle, the first distal member including a first crimp engaging protrusion in combination with a second distal member a proximal end of which is pivotally coupled to a distal end of the second handle, the second distal member including a second crimp engaging protrusion, and a depth level including an abutting surface, the first and second distal members being pivotally coupled to one another so that, when the first and second handles are drawn toward one another, the proximal ends of the first and second distal members are moved apart from one another, drawing the first and second protrusions toward one another to compress a crimp located therebetween.

Abstract: An anchoring fastener is adapted for attaching an elastic cable to a substrate, and is suitable for use in stabilizing and fixating a bony fracture with an elastic cable having known diameter and elastic properties. The invention includes: a generally annular collar, a deformable centering ring seatable inside the annular collar, and an anchor post adapted to be passed through the annular collar and ring. A loop or bight of cable passed around a shoulder of the anchor post is retained under compression in a defined annular void defined between a shoulder of the post and a cylindrical bore in the annular collar.

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: A greater trochanter re-attachment device for use in transfemoral revision surgery which comprises a bracket adapted to be attached to a femoral prosthesis with which it is to be used. The bracket has adjustable clamping elements adapted to extend from the brackets and pass around the segment of bone containing the greater trochanter and which when secured in position holds the greater trochanter in position in relation to the femoral prosthesis.

Abstract: A line lock includes a body at least partially bounding a plurality of passageways such that a suture can only be drawn through the passageways along one direction. The suture is attached to the line lock prior to use in surgery, either by securing one end of the suture to the line lock, or by retaining a loop of the suture with one of the passageways. A needle may be pre-attached to a free end of the suture. The suture may be inserted through the passageways through the use of a cartridge designed to contain the line lock. A threader may pass through the line lock within the cartridge along the desired pathway for the suture. Thus, the suture may be coupled to the threader and drawn through the passageways along the desired pathway by pulling the threader from the cartridge.

Abstract: An olecranon fracture fixation system includes an intramedullary core that is dimensioned for insertion in an intramedullary canal of the bone, and a hollow shell that is dimensioned for insertion in the intramedullary canal. The shell includes fixation elements that extend outwardly away from a proximal end of the shell. A fastener is provided for attaching the shell to the core in the intramedullary canal. When the core and shell are inserted in the intramedullary canal, the fixation elements extend away from the fracture line of the bone, and when the core and shell are attached in the intramedullary canal, the fixation elements engage an end surface of the end section of the bone. In one example version of the invention, the system is an olecranon fracture fixation system wherein the fixation elements are dimensioned to engage the triceps tendon and an end surface of the olecranon when the core and shell are attached in the intramedullary canal of the proximal ulna.

Abstract: A linkage device that can be connected with other linkage devices and to itself, the linkage device comprising a strip having a first end and a second end, a closure hub attached to the first end of the strip and having an opening to receive a second end and a locking mechanism within the closure hub, a connecting surface protruding from the strip operable to secure the second end within a closure device, and a tampering detection device connected to the linkage device.