Patent Application
20070043377
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The present invention is directed to a cerclage tool, and in particular to an instrument used to position a cerclage wire around a bone for fixation of a fracture such that when the instrument is inserted into the patient, the disruption of surrounding muscle tissue is minimal.
The use of cerclage wires for internal fixation of bone fractures is a well-known technique. Cerclage wiring techniques are frequently used following reduction for provisional fixation of long bone fractures to stabilize the bone for placement of screws, nails or rods, after which the wires are removed. They may also be used for definitive bone fixation, either alone or in combination with other fixation devices.
Cerclage wires are passed around the bone, so as to lie as perpendicular to the long axis of the bone as possible, using a “wire passer”, or cerclage tool, which is an instrument having a shaft with a curved end and an eyelet or notch in the curved end for guiding the wire around the bone. These wire passers are available in different curvature diameters to be used with larger or smaller diameter bones.
Surgical procedures on and in the vicinity of a bone with closely neighboring nerves, arteries, muscle, ligaments, complicated anatomical structures, and delicate areas represent a difficult and time consuming task for the surgeon.
The difficulty is to perform such procedures accurately, minimizing stress, trauma, risk, and injury to a patient, and with little difficulty for a surgeon performing such procedures, in as rapid a time frame as possible.
The orthopedic procedure is as follows: the curved end of the instrument is positioned around the bone and the wire is inserted into the eyelet so that it can be pulled around the bone as the instrument is withdrawn. After the wire has encircled the bone, the ends are twisted using wire tighteners.
Different surgical tools have heretofore been known. However, none of the tools adequately satisfies these aforementioned needs. Different instruments have been devised to pass the wire around the bone. Most of the surgical tools heretofore known have a handle structure with either a “C” or “S” shaped portion. Some of these instruments include a hollow or grooved part for guiding the orthopedic wire therethrough after the instrument is accurately positioned around the bone, as that disclosed in U.S. Pat. No. 5,772,663. Other instruments include an eyelet opening at the free end of the curve through which the wire is threaded during the cerclage procedure, as those disclosed in U.S. Pat. Nos. 4,606,335 and 5,501,688
Most of the cerclage devices in the prior art are designed with a curvature to partially encircle the bone shaft, they are formed from rigid material and at certain points in their travel around the bone, they can create a lever action which causes pulling of the soft tissue away from the bone and/or significant spreading of the incision.
For example, U.S. Pat. No. 4,606,335, U.S. Pat. No. 5,772,663 and U.S. Pat. No. 5,501,688 have the problem of requiring significant spreading of the incision and muscle trauma in order to allow the tip of the device to completely travel around the bone so that the tip can be viewed for insertion of the wire into the eyelet.
The cerclage wire passer disclosed in the U.S. Pat. Nos. 5,810,832 and 5,851,209 provides a flexible, retractable tip that curves around and adapts to the bone circumference, apparently solving the problem of significant spreading of the incision and muscle trauma. However, these devices has proven itself to be not strong enough to go through the bone surrounding muscles
U.S. Pat. No. 4,312,337 shows a scissor-like apparatus pretending to minimize the amount of soft tissue which has to be separated from bone to insert a cerclage wire. However, this device does not position the wire around the bone, but trough the bone cortex. It does not perform the same function as that of the present invention and still requires too much tissue and muscle trauma
The effectiveness of the cerclage wire has proven itself, but the cerclage procedure itself has proved difficult in many cases. The heretofore instruments fail to provide an adequate technique and lengthen the overall procedure significantly.
For the foregoing deficiencies in the prior art, a new cerclage wire passer is needed which takes into consideration the fact that the wire must be passed around the bone in a simple and reliable manner, without spreading the incision or requiring a large incision to provide the range of movement necessary to guide a rigid trip around the bone without excessive intrusion, exposure or stripping of the bone surrounding musculature; and as rapidly as possible by a surgeon performing such procedures.
Accordingly, it is an object of the present invention to provide a simple and effective tool and method to pass the wire or cable around the bone without requiring a large incision to provide the range of movement necessary to guide the device to conform to the bone circumference?
Another object of the invention herein is to provide an instrument and method wherein the exposure or stripping of the musculature away from the bone is minimized.
The preferred embodiment of the present invention comprises two members. Each member having a handle, a central part and a J shaped tube. When the central part of both members is firmly coupled together both J shaped tubes conform a continuous tube through which a wire, cable, band or suture can be fed.
The present invention by being an easy and straightforward procedure for the surgeon makes the cerclage wiring technique simple and fast overcoming one of the most important subject of matter of actual surgery, time shortening.
By fulfilling the recently mentioned objects, the present invention is extremely helpful to the medical care area.
Other objects, advantages and novel features of the present invention will become apparent from the following detailed description of the invention when considered in conjunction with the accompanying drawings.
Preferred features of the present invention are disclosed in the accompanying drawings, wherein similar reference characters denote similar elements throughout the several views, and wherein:
Hereinafter, a method of cerclage wiring according to the preferred embodiment of the present invention will be explained with reference to
As it is clearly seen in
The surgical procedure is described hereinto with reference to
During surgical procedures each member 1,2 of the bone cerclage tool 16 is successively inserted close to the bone 12 trough a small skin incision 15, minimally disturbing skin 14 and muscle 13, as best shown in
The completed surgical procedure is clearly shown in
While I have illustrated and described a preferred embodiment of the invention, it will be understood that those skilled in the art will thereby be enabled to devise variations and modifications without departing from the spirit and scope of this invention, as defined in the appended claims.
