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Sternum closure device having locking memberRelated Patent Categories: Surgery, Instruments, Orthopedic Instrumentation, Internal Fixation Means, Cortical Plate, Multi-element Or Coated PlateSternum closure device having locking member description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20060195101, Sternum closure device having locking member. Brief Patent Description - Full Patent Description - Patent Application Claims
REFERENCE TO RELATED APPLICATIONS [0001] This application is a continuation-in-part of U.S. patent application Ser. No. 10/699,208 filed Oct. 31, 2003. TECHNICAL FIELD OF THE INVENTION [0002] This invention relates generally to surgical devices. More specifically, the present invention relates to improved sternum clamping devices and methods to reapproximate a patient's sternum following a partial median sternotomy. BACKGROUND OF THE INVENTION [0003] A partial or median sternotomy is a procedure by which a saw or other appropriate cutting instrument is used to make a midline, longitudinal incision along a portion or the entire axial length of the patient's sternum, allowing two opposing sternal halves to be separated laterally. A large opening into the thoracic cavity is thus created, through which a surgeon may directly visualize and operate upon the heart and other thoracic organs or tissues. Following such a procedure, the two severed sternal halves must be reapproximated. [0004] Traditionally, sternal halves have been reapproximated with stainless steel wires wrapped around or through the sternal halves so as to exert medial compression thereon and twisted together to approximate the sternum. Other methods of sternum repair include the use of band or strap assemblies which typically include a locking mechanism, which secures a strap in a closed looped configuration about the sternum positions. While utilization of steel wires and strap assemblies have been widely accepted for sternum repair, these devices present a number of disadvantages. Steel wires can and do break, and provide insufficient (non-uniform) clamping force resulting in sternal nonunion. Steel wires are difficult to maneuver and place around the sternum. The cut ends of the steel wires are also sharp and can pierce through the surgeon's gloves or fingers. In addition, the small diameter of the steel wires can cause the wires to migrate into or through the tissue surrounding the sternum region or into the sternal bone itself over time and result in sternal disintegration into small segments. This can lead to significant patient pain and discomfort in addition to slowing the postoperative recovery and increasing the risk of sternal infection. Moreover, the strap mechanisms of band assemblies are often relatively structurally complex and are difficult to precisely apply about the sternum. There are also healing problems associated with the use of steel wires and band assemblies due to improper forces exerted by these devices which can cause unwanted bone movements leading to raking and rubbing of surrounding tissue or bone. [0005] Several other techniques of sternal reapproximation have been proposed both for primary closure following a median sternotomy and for reclosure following post-operative emergency surgical procedures. One such sternal fixation device is described in U.S. Pat. No. 6,051,007 entitled External Closure Device and Instruments Therefor, the entire contents of which are incorporated herein by reference. [0006] The sternum closure device of U.S. Pat. No. 6,051,007 however is absent some of the advantages of the present invention. Most particularly foot portions (20, 40) of the '007 device are limited to two points of contact on the posterior section of a patient's sternum and consequently lack the stability and positioning enhancement features of various embodiments of the present invention. Quite distinguishable, from the '007 patent and other devices practiced in the contemporary art is the novel structure of various embodiments of the present invention which advances the art by allowing and encouraging divided sternal plates to be tilted upward to maximize healing surfaces in apposition to each other, thus avoiding downward plate deflection and substandard healing. Also distinguishable from devices of the contemporary art, embodiments of the present invention span the width of at least two interspaces, thus eliminating the need for more than one device for tight/secured closure over the same sternal area. The four securing leg and foot structures of various embodiments of the present invention improve pulmonary mechanics by assisting in the alignment of ribs across the sternotomy allowing for simultaneous right and left rib elevation symmetrically across the sternum and chest. The projection member structures of various embodiments of the present invention leverage the tight connections provided by fascia and muscle, strengthens pulmonary compliance and allows for distribution of energy and positioning strength to be spread evenly throughout the sternum. Various embodiments of the present invention enable fragmented segments of the sternum to be held in place for healing, as opposed to single plate structures of the contemporary art which concentrate (as opposed to distribute) energy occasionally to a crushing central point thereby allowing laterally displaced fragments to further displace. BRIEF SUMMARY OF THE INVENTION [0007] The present invention provides an improved device and method for re-approximating the sternal halves of a patient's sternum following a median or partial sternotomy, and facilitates ready access to the thoracic cavity during or after a medical procedure advanced the art by overcoming the sternal nonunion problems inherent in prior art devices. [0008] A sternum closure device in accordance with an embodiment of the present invention includes a sliding attachment structure including a plurality of projection members with angularly disposed teeth-like structures inwardly positioned on the innermost edges of each the plurality of projection members, and first and second leg portions, each of the first and second leg portions including a sliding attachment structure associated integrated foot portion and a sliding attachment structure associated sternum engagement portion. The sternum closure device includes a receiving attachment structure including a securing aperture, and third and forth leg portions, each of the third and fourth leg portions including a receiving attachment structure associated integrated foot portion and a receiving attachment structure associated sternum engagement portion. The sternum closure device still further includes and a generally bow-shaped locking member attached to the securing aperture of the receiving attachment structure and including a first distal end and a second distal end, each of the first distal end and the second distal end including angularly disposed teeth-like structures. The generally bow-shaped locking member is resiliently tensioned between the plurality of projection members such that the angularly disposed teeth-like structures of the generally bow-shaped locking member engage the angularly disposed teeth-like structures of the plurality of projection members. [0009] The following disclosure teaches the structure and practice of a method for a sternal closure device, which comprises impermanently joined, sliding and receiving attachment structures that are adapted for intercostal positioning between at least two correspondingly positioned rib pairs substantially surrounding a patient's sternum with each structure having a cross member, a plurality of integrated leg and foot portions, a plurality of sternum engagement surfaces, and an end portion. BRIEF DESCRIPTION OF THE DRAWINGS [0010] FIG. 1 illustrates a frontal view of one embodiment of the present invention as practiced in its joined or associated state; [0011] FIG. 2 illustrates a posterior view of one embodiment of the present invention as practiced in its joined or associated state; [0012] FIG. 3 illustrates a side view of one embodiment of the present invention as practiced in its joined or associated state; [0013] FIG. 4 illustrates a posterior view of one embodiment of the sliding attachment structure with the locking member positioned therein; [0014] FIG. 5 illustrates distinguishable elements of one embodiment of the present invention in a disassociated state; [0015] FIG. 6 illustrates a posterior view of the present invention intercostally positioned above and below at least two correspondingly positioned rib pairs and substantially surrounding a patient's sternum; [0016] FIG. 7 illustrates a frontal view of the present invention intercostally positioned above and below at least two correspondingly positioned rib pairs and substantially surrounding a patient's sternum; [0017] FIG. 8 illustrates a frontal view of another embodiment of a sliding attachment structure of a sternal closure device of the present invention; [0018] FIGS. 9A-9D illustrate the sliding attachment structure of FIG. 8 after forming; [0019] FIGS. 10A-10B illustrate another embodiment of a sternum closure device assembly in an open configuration; and Continue reading about Sternum closure device having locking member... 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