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EP-3322367-B1 - CABLE FIXATION DEVICE AND INSTRUMENTS

EP3322367B1EP 3322367 B1EP3322367 B1EP 3322367B1EP-3322367-B1

Inventors

  • FRANCIS, Korhonen
  • HANNA, WESLEY LELAND
  • WAINIO, BRANDEN
  • SANSTROM, Jason
  • KINNEY, ROBERT
  • VLAHOS, Jeffrey
  • MOSTELLER, JEFFREY
  • SONGER, MATTHEW N.

Dates

Publication Date
20260506
Application Date
20160714

Claims (13)

  1. A surgical cable fixation kit comprising: an implantable cable (502); a clamp housing (200); a lock cap (400) for advancement into said clamp housing (200) for locking said implantable cable (502); a multipart collet (300) compressible about said cable (502), said multipart collet (300) comprising a plurality of collet sections (314); a cerclage inserter instrument (108); a torsion wrench (935); said cerclage inserter instrument (108) comprising a bevel gear (909, 910) pair for transferring forces from said torsion wrench (935); a lock driver (702), said lock driver (702) comprising an inner cannula (712) sized to pass said implantable cable (502) therethrough; and a pair of opposed deflectable frame legs (132) for clasping on said clamp housing (200), wherein the multipart collet (300) comprises first and second oblique angled lock walls (305A, 305B) extending from opposed ends of said collet (300) for compressing said collet (300) about said implantable cable (502) during locking; and further wherein said lock cap (400) (a) is configured to complement the first oblique angled lock wall (305A) of said multipart collet (300) to cause each collet section to move toward central axis C as lock cap (400) is advanced and/or (b) has a locking cap drive axis (Axis B) and the clamp housing (200) further comprises a pair of opposed control slots (230), wherein an elongate side of each control slot (230) is perpendicular to the locking cap drive axis (Axis B).
  2. The surgical cable fixation kit of claim 1 further comprising surfaces between said lock cap (400) and said collet (300) that slide relative to each other for minimizing twisting of said cable (502) when advancing said lock cap (400).
  3. A cable fixation device for securing bone segments comprising: a clamp housing (200); a surgical cable (502); said surgical cable (502) having a cable head (504); a head aperture (212) situated within said clamp housing (200) for securing said cable head (504) within said head aperture (212); a lock aperture (203) within said clamp housing (200); a multipart collet (300) housed within said lock aperture (203), said multipart collet (300) comprising a plurality of collet sections (314); a lock cap (400) housed within said lock aperture (203); said surgical cable (502) formed into a cable loop with a portion of said cable (502) residing within said multipart collet (300); wherein said head aperture (212) and said lock aperture (203) intersect and are contiguous and said multipart collet (300) comprises a first oblique angled lock wall (305A) and a second oblique angled lock wall (305B) each extending from opposed ends of said multipart collet (300) for compressing said multipart collet (300) about said surgical cable (502) during locking; and further wherein said lock cap (400) (a) is configured to complement the first oblique angled lock wall (305A) of said multipart collet (300) to cause each collet section to move toward central axis C as lock cap (400) is advanced and/or (b) has a locking cap drive axis (Axis B) and the clamp housing (200) further comprises a pair of opposed control slots (230), wherein the elongate side of each control slot (230) is perpendicular to the locking cap drive axis (Axis B).
  4. The cable fixation device of claim 3 further comprising said cable loop orientated in a single plane.
  5. The cable fixation device of claim 3 or 4 further comprising an enlarged cable head (504) of said cable (502) and a head stop surface (220, 1220) positioned within said head aperture (212) to prevent pull out of said enlarged cable head (504) from within said clamp housing (200).
  6. The cable fixation device of claim 5 wherein said enlarged cable head (504) is in the form of a cable drum (501).
  7. The cable fixation device of claims 3 to 6, wherein said clamp housing (200) further comprises a concave bottom surface (216) for seating adjacent to bone.
  8. The cable fixation device of claim 7 further comprising a plurality of teeth projecting from said concave bottom surface (216) for seating into bone.
  9. The cable fixation device of any one of claims 3 to 8 comprising the pair of opposed control slots (230) extending into each opposing side surface of said clamp housing (200) for receiving instrumentation.
  10. The cable fixation device of any one of claims 3 to 9, wherein each collet section comprises a curved body (311) comprising a central aperture (306) extending therethrough along an axis 'C' defining cable surface (301), a bottom face (307), a top face (303), a portion of the first oblique angled first lock wall (305A), a portion of the second oblique angled lock wall (305B), a head face (302) and one or more gap walls (310).
  11. The cable fixation device of any one of claims 3 to 10, wherein the lock cap (400) comprises a cylindrical body (410) with an axis aperture (401) sufficient in diameter to pass the surgical cable (502).
  12. The cable fixation device of any one of claims 3 to 11, wherein the clamp housing (200) comprises a friction wall (221) and said lock cap (400) comprises an interference boss (413), wherein said friction wall (221) and said interference boss (413) are configured for frictional interference with each other as lock cap (400) approaches full advancement to a locked configuration.
  13. The cable fixation device of any one of claims 3 to 12, wherein said lock cap (400) comprises a top surface (411), a drive pocket (408) and a plurality of sloped surfaces drafted downward from top surface (411) to a predetermined depth within said drive pocket (408) configured to function as a drive lead (412) for easing alignment and insertion of a head of a driver instrument into said drive pocket (408).

Description

BACKGROUND OF THE INVENTION Field of the Invention. The invention is defined in the claims and relates generally to surgical implants and instruments, and more particularly to surgical tensioning lines such as surgical cable, devices for fixation of surgical cable during surgery, and related instruments. Surgical cable is used by orthopedic surgeons in a variety of surgical applications but primarily for the stabilization of bone and bone segments. For example, in an open heart surgery procedure, the sternum is cut into two halves and each half is retracted to access the heart. Following the surgical repairs to the heart, the sternum is often rejoined using surgical cable looped around the two halves of the sternum, the loop is tensioned then fixated therein providing the stability required for the two halves of the bone to fuse. Surgical cable may also be used to secure individual vertebral body segments to an elongated spinous rod for stabilization after spinal fracture or in an effort to correct a spinal deformity. Surgical cable is also effective at stabilizing fractures in long bones of the extremities such as in the femur. In these cases the cable is looped, also known as cerclaged, around the bone through a bone plate or a crimp, tightened to a specified tension with a tensioner tool, and then locked with a cable crimp or screw biting down on a crimp to clamp the cable. Although effective in many cases, these methods can be improved. Commonly the cable tensioner and the screw that locks down on the crimp are separated by an angle thereby necessitating the operation of two spaced instruments at once in a small surgical space. Also, repairing a fracture may require sequentially tensioning several different cables at a provisional tension and then returning for a final tensioning. This method typically requires the use of a 'retensioner' instrument on each cable used at the front of a tensioning instrument to maintain tension in the cable while the tensioning instrument is moved to the cable to be tightened. This method, albeit cumbersome, eliminates the need to deform the crimp during a provisional step which may cause damage to the cable or crimp. Description of Related Art. Surgical wires and cable has a history of use for the repair of the skeletal system. Their usefulness has suffered due to various deficiencies in their function. For example, US 2015/127003 A1 discloses a cable fixation device for securing bone segments and comprising: a clamp housing; a surgical cable having a cable head; a head aperture situated within said clamp housing and configured for securing said cable head within said head aperture; a lock aperture within said clamp housing; a collet housed within said lock aperture; the collet having a central aperture receiving the surgical cable therethrough; a lock cap housed within said lock aperture and configured to push the collet such that the collet slides along the cable until the collet collapses down thereby locking cable in place; and a pair of opposed control slots extending into opposite side surfaces of the clamp housing. Kilpela et al. in U.S. patent 5,415,658 discloses a cable loop connector. When utilizing this connector, the instruments required to tension the cable and lock the cable are situated along two axis's more than 90 degrees apart. This excessively wide spread between instruments requires a larger incision and increases difficulty in handling. In addition, the locking portion of the connector utilizes an internal crimp making it unuseable for a plurality of locking and unlocking cycles when cable re-adjustments are needed. Mattchen et al. in patent U.S. patent 7,207,090 discloses another form of cable retaining device for retaining flexible cables under tension. The device includes a body with an internal tapered void. A wedge shaped plug with recessed edges for containment of a cable is slidable into the void therein locking the cable between the body and plug. During clamping the slidable plug creates friction against the cable member potentially damaging the cable. Due to this, this system is also unsuitable for a plurality of locking and unlocking cycles. Allen et al. discloses in U.S. patent 7,255,701 various forms of looped cable locking mechanisms. Most embodiments suffer from having each end of the cable loop spaced from each other along the long axis of the bone under repair. The cable within the loop fails to lay in the same plane therein causing a torsional force on the locking mechanism and improper seating on the bone. In addition, the disclosed embodiments have a tensioning axis that is not aligned with the locking axis causing difficulties using instrumentation within a small surgical access space. Justin el al. discloses in U.S. patent 8,241,288 a collet fixation system for a cable loop and a cable locking instrument. In this bone fixation element, a cable passes through a pair of passageways in which the cable is secured. These passageways