WO2002087415A2 - Method of applying an active compressive force continuously across a fracture - Google Patents
Method of applying an active compressive force continuously across a fracture Download PDFInfo
- Publication number
- WO2002087415A2 WO2002087415A2 PCT/US2002/012928 US0212928W WO02087415A2 WO 2002087415 A2 WO2002087415 A2 WO 2002087415A2 US 0212928 W US0212928 W US 0212928W WO 02087415 A2 WO02087415 A2 WO 02087415A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cable
- segments
- bone segments
- wrapping
- compressive force
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/842—Flexible wires, bands or straps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
Definitions
- the invention relates to surgical repair of fractured body tissues and bones; and, more particularly, to repairing fractures by holding bones or bone fragments together to permit healing.
- FIG. 1 is a perspective view of a fractured bone having 2 segments wrapped by a cable in accordance with the teachings of the invention
- FIG. 2 is a detailed perspective view of a portion of the cable of Fig. 1 ;
- FIG. 3 is a perspective view of the portion of the cable of Fig. 2 in final braided condition
- FIG. 4 is a perspective view of a modification of the cable of Fig. 3;
- Fig. 5 is an end view of another modification of the cable of Figs. 3 and 4;
- Fig. 6 is a graphical illustration showing force/displacement relationships of cables of different materials
- Figs. 7, 8 and 9 are graphical illustrations of how differences in performance can be achieved by varying the methods of applying different composition cables to a fracture;
- FIG. 10 is a perspective view of cable connecting means used with the cable of our invention.
- FIG. 11 is a side view of the connector of the connecting means of Fig. 10 illustrating a cable connected thereto;
- Fig. 12 is a sectional view taken along lines 12-12 of Fig. 11 ;
- Fig. 13 is a top plan view of one of the components of the connecting means of Fig. 10.
- FIG. 1 shows a loading-bearing energy-inducing surgical cable 10 connecting two small bone fragments 11 , 12 of a bone 13 together.
- cable 10 can be used in the repair of any bone fragments, body tissues, etc.
- cable 10 is formed of a polymer core 14 having a plurality of outer fibers 15 that are braided (see Fig. 3) to form a reinforcing jacket. If desired, as seen in Fig. 4, an outer coating 16 may be applied over braided fibers 15.
- Core 14 is of a polymeric material, such as nylon, polyester, polyethylene or fluorocarbon, that has been processed by several cycles of stretching and tempering using methods commonly applied today. Multi-core arrangements with different polymers, depending on the mechanical performance desired, may also be used.
- core 14 is the primary source and preferably has an elongation of about 50 to 150% of its original length and may have an axial stiffness of about 5 to 20 Newtons (N) per millimeter. Axial stiffness, of course, is dependent on the size of the cable that is selected by the user.
- Fibers 15 are fine fibers of a high strength non-stretch material that are braided over an elastic polymer core 14.
- the fiber size and braid density determine the stress-strain results of the final cable.
- Applicants' cables can be made to stretch 30-100%.
- one present cable of 1.5mm diameter has a axial stiffness of 10N/mm and a stretch-to — failure of 60% over original length.
- Another cable has a diameter of 0.5mm with an axial stiffness of 5N/mm and a stretch-to-failure of 60% over its original length.
- the stretch-to-failure and axial stiffness can be proportional, the mechanical properties can be modified to accommodate the surgical application and instrumentation.
- fibers 15 may be braided about the plurality of cores 17 (otherwise identical to core 14). In both cases, the stretch of the cores 14, 17 is limited creating the relationship of stress-to-strain desired.
- Coating 16 may be applied to either embodiment of Figs. 2 and 5 and is preferably of polyethylene, polyester, silicone or any material suitable to protect and/or enhance the performance of cable 10.
- Fig. 7 As seen in Fig. 6, the stress/strain relationship of three different cables is shown.
- Applicant's cable is referred to in Fig. 7 as Poly 4.
- Figs. 7, 8 and 9 show the energy imparted into the bone by stretching the cable to a given force and then setting it.
- the potential energy imparted by the cable is defined as the area under the force-displacement line (hatched pattern in Figs. 7 to 9).
- the metal cable (Fig. 8) has only a tiny displacement (stretch) so its ability to store energy is very small. Indeed, in the actual practice of pulling bone surfaces together it is very unlikely that it stretches at all, relying instead on forcefully compressing the bone fragments to obtain a tight joint.
- Fig. 9 shows the energy of a latex or rubber cable. This cable, although it can be stretched, does not have much strength and therefore cannot develop the forces required to hold the bone fragments in proper position.
- Fig. 6 shows the differences in performance that can be achieved by varying the above methods.
- Cable A and Cable B demonstrate different stress/strain performance depending on how the different core properties, fiber properties and braiding variations are put together.
- Cable A is made to have properties that require high strength yet be elastic enough to allow some movement, however limited, of the fixation construct. This capability is very important because once the metal cables in present use are set and there is any repositioning of the construct or bone resorption, the system becomes loose. This is because the metal cable, being rigid, cannot compensate for nor does it allow for any motion.
- FIG. 10 Although any suitable means may be used to hold the free ends of the cable together across a fracture or the like during the healing process, one such connecting means 100 is shown in Fig. 10.
- one of the free ends 101 of cable 102 is passed through a hole 103 in a connector block 104 (see also Fig. 11).
- the free cable ends (ends 101 , 105) are wrapped around the bone segments 106 and pass through block 104.
- block 104 has a trapezoidally- shaped inner chamber 106 so that ends 101 , 105 extend from the smaller end 107 to the wider end 108 of chamber 106.
- a wedge 109 is provided generally triangular in cross- section, thus having a wider end 110 tapering to a pointed end 111.
- a plurality of spaced grooves, such as grooves 112 through 114 are provided along wedge 109 on each side thereof.
- wedge 109 is pushed into chamber 106 of block 104 forcing cable ends 101, 105 against the inner wall of the chamber 106. This locks the cable 102 in block 104.
- wedge 109 floats between the cable ends 101 , 105 to compensate for one end of the cable being slightly lesser in diameter than the other.
- the grooves 112 through 114, and the triangular configuration of wedge 109 serve to put tension on cable ends 101 , 105 if pulling of the cable 102 out of block 104 takes place.
- Applicants' cables may be set at loads of 400 to 800 N, depending on the surgical application. These forces are necessary for the cable to be effective. However, the cable must also allow for some movement.
- Applicants' cable also has advantages over metal cable in its elastic properties, while its distinction over the latex and o-ring elastomers is its strength by many orders of magnitude.
- Applicants' cable is designed to deliver a force/displacement (energy) component into the fixation construct of the surgeon to meet the physiological needs of the body and the fixation needs of the surgeon. This is in opposition to the devices in the prior art patents that actually emphasize the stiffness or non-stretch properties and thus teach away from Applicants' invention.
- a cable having a diameter of about 1.5mm that may have an axial stiffness of 5-25 N/mm and which can be set at loads of about 400 to 800 N to provide a continuous active compressive force across a fracture or the like.
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2002303458A AU2002303458A1 (en) | 2001-04-26 | 2002-04-23 | Method of applying an active compressive force continuously across a fracture |
EP02731481A EP1389940B1 (en) | 2001-04-26 | 2002-04-23 | Surgical cable for applying an active compressive force continuously across a fracture |
ES02731481T ES2396329T3 (en) | 2001-04-26 | 2002-04-23 | Surgical cable to apply a continuously active compression force through a fracture |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/844,809 US6589246B1 (en) | 2001-04-26 | 2001-04-26 | Method of applying an active compressive force continuously across a fracture |
US09/844,809 | 2001-04-26 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2002087415A2 true WO2002087415A2 (en) | 2002-11-07 |
WO2002087415A3 WO2002087415A3 (en) | 2003-02-27 |
Family
ID=25293684
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2002/012928 WO2002087415A2 (en) | 2001-04-26 | 2002-04-23 | Method of applying an active compressive force continuously across a fracture |
Country Status (5)
Country | Link |
---|---|
US (1) | US6589246B1 (en) |
EP (1) | EP1389940B1 (en) |
AU (1) | AU2002303458A1 (en) |
ES (1) | ES2396329T3 (en) |
WO (1) | WO2002087415A2 (en) |
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- 2001-04-26 US US09/844,809 patent/US6589246B1/en not_active Expired - Lifetime
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2002
- 2002-04-23 EP EP02731481A patent/EP1389940B1/en not_active Expired - Lifetime
- 2002-04-23 ES ES02731481T patent/ES2396329T3/en not_active Expired - Lifetime
- 2002-04-23 AU AU2002303458A patent/AU2002303458A1/en not_active Abandoned
- 2002-04-23 WO PCT/US2002/012928 patent/WO2002087415A2/en not_active Application Discontinuation
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Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2008018412A1 (en) * | 2006-08-11 | 2008-02-14 | Alfresa Pharma Corporation | Bone fastening hollow cable |
EP2316363A1 (en) * | 2009-10-27 | 2011-05-04 | Zimmer Spine | Bone holding device |
WO2011147449A1 (en) * | 2010-05-26 | 2011-12-01 | Stoba Ag | Cable seal assembly |
ITMO20120217A1 (en) * | 2012-09-17 | 2014-03-18 | Ncs Lab S R L | DEVICE FOR FIXING MUSCLE TENDONS TO A BONE. |
CN107205758A (en) * | 2015-01-20 | 2017-09-26 | 因普拉耐特公司 | The fixing device of flat rubber belting is fixed on bone parts |
Also Published As
Publication number | Publication date |
---|---|
EP1389940B1 (en) | 2012-10-24 |
US6589246B1 (en) | 2003-07-08 |
EP1389940A4 (en) | 2008-08-06 |
ES2396329T3 (en) | 2013-02-20 |
AU2002303458A1 (en) | 2002-11-11 |
EP1389940A2 (en) | 2004-02-25 |
WO2002087415A3 (en) | 2003-02-27 |
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