US20090264936A1 - Soft tissue attachment system and clip - Google Patents

Abstract

A suture attachment clip and method for assisting in the attachment or re-attachment of soft tissue to bone. The clip generally comprises a head having a shape suitable for allowing the passage of a suture during attachment of soft tissue to bone. One or more clips can be secured to a bone plate through a variety of means, including a snap configuration, a screw configuration, and a bendable prong configuration. The clip can also be continuous with an adjacent clip, thus forming a multi-clip assembly that can either be secured to a bone plate or secured directly to a bone without a bone plate.

Description

CROSS REFERENCES TO RELATED APPLICATIONS
• This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Application No. 61/045,860, filed on Apr. 17, 2008, the complete disclosure of which is incorporated herein by reference in its entirety.
FIELD OF THE INVENTION
• The present invention relates to orthopedic devices used in the reattachment of soft tissue to bone in acute injuries or reconstructive procedures.
BACKGROUND OF THE INVENTION
• The present device and method provides a significant improvement for soft tissue attachment or reattachment to bone in acute injury or in reconstructive procedures. The various embodiments of the present invention can be used in conjunction with bone plates or by itself.
• Musculoskeletal injuries constitute combinations of bone and soft tissue injury. As such, bone fractures frequently have associated tendon or ligament tears. Fractures around joints—know in the art as periarticular fractures—are classic examples of combined bone and tendon, or bone and ligament injuries. Existing plate systems utilized in orthopaedic surgical procedures, such as fracture fixation or reconstruction procedures, provide limited options for incorporating additional soft tissue anchoring into the plate. In most instances the plates designed for use in periarticular fracture procedures will have a few small orifices for the passage of a curved surgical needle. A torn or avulsed tendon can be reattached to the bone at the time of fracture fixation through the small orifices on the plates. Often, the small amount and small size of the orifices on the plate are not sufficient to repair significant soft tissue components. In addition, it is often very difficult to pass a needle, curved or straight, through these orifices once the plate has been screwed to the bone. Accordingly, existing bone plates provide limited options for soft tissue reattachment.
• While the clinical success of bone anchors for the reattachment of tendon or ligament in musculoskeletal reconstruction is well documented, most existing bone anchors fail where the bone is very soft—as, or example, in severe osteopenia—or where the bone is very fragmented—as, for example, in fractures with severe bone fragmentation or comminution. In these instances, traditional bone anchors are inadequate for the reattachment of tendons and ligaments to bone.
• It is therefore an object of the present invention to broaden the usefulness of bone plates by introducing additional features to plate design and fabrication that facilitate the reattachment of soft tissue, tendons, and ligaments to bone. The present invention has applications in fracture situations, and reconstructive procedures alike.
• It is a further object of the present invention to provide a means of soft tissue reattachment or attachment to bone that can be used by itself without a bone plate; specifically, when other traditional methods, such as bone anchors, will not provide sufficient strength for repair.
SUMMARY OF THE INVENTION
• The present invention generally comprises a suture attachment clip having various embodiments which provide multiple options for soft tissue repair to a bone structure.
• In one embodiment of the present invention, the suture attachment clip comprises a head suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. A plurality of individual clips can attach to a bone plate by snapping the respective clips into corresponding receiving orifices on the bone plate, preferably located on the side of the bone plate. The clips can be attached to the bone plate at the time of manufacture or at the time of surgery.
• In another embodiment of the present invention, the plurality of individual clips are attached to the bone plate by screwing each respective clip into a corresponding receiving orifice on the bone plate, preferably located on the side of the bone plate and preferably threaded internally. The clips can be screwed into the bone plate at the time of manufacture or at the time of surgery.
• In yet another embodiment of the present invention, the plurality of individual clips are attached to a bone plate by inserting a free end of each respective clip through a corresponding pair of receiving orifices in the bone plate, preferably located on the side of the bone plate. The free ends of the clip are then bent through a corresponding pair of exit orifices on the bone plate, wherein the clip is fixed in place. In this embodiment, a clip can be designed and manufactured specifically to fit an existing bone plate's orifices, or alternatively, the bone plate and clip can be simultaneously and compatibly designed and manufactured. Each clip has a head suitably shaped to allow the passage of a suture during the repair of soft tissue to bone. The clips can be attached to the bone plate at the time of manufacture or at the time of the actual surgery.
• In yet another embodiment of the present invention, the terminal end of one suture attachment clip is continuous with the terminal end of an adjacent suture attachment clip, thus forming a single multi-clip assembly. Each clip of the multi-clip assembly has a head suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. The multi-clip assembly attaches to the bone plate by snapping the multi-clip assembly to corresponding receiving channels on the bone plate. The receiving channels are preferably located on the undersurface of the bone plate. To further secure the multi-clip assembly to the bone plate, the multi-clip assembly could alternatively be fastened to the bone plate by locking screws or fasteners. Depending on the fastening method used, the multi-clip assembly can be attached to the bone plate at the time of manufacture or at the time of the actual surgery.
• The multi-clip assembly can also be used without attachment to a bone plate. In this embodiment of the present invention, the multi-clip assembly is fastened to the bone with standard bone screws or fasteners through a plurality of eyelets positioned at various points on the multi-clip assembly.
DESCRIPTION OF THE DRAWINGS
• FIG. 1 illustrates a top perspective view of an individual clip with a snap configuration.
• FIG. 2 illustrates a plurality of individual clips with snap configurations attached to a bone plate.
• FIG. 3 illustrates a top perspective view of an individual clip with a threaded screw configuration.
• FIG. 4 illustrates a plurality of individual clips with threaded screw configurations attached to a bone plate.
• FIG. 5 illustrates a top perspective view of an individual clip with a dual prong configuration.
• FIG. 6 illustrates a plurality of individual clips with bendable prong configurations attached to a bone plate.
• FIG. 7 illustrates a top perspective view of a multi-clip assembly.
• FIG. 8 illustrates a top perspective view of a bone plate with the multi-clip assembly attached to the underside of the bone plate.
• FIG. 9 illustrates a bottom view of a bone plate with a receiving channel for the multi-clip assembly.
• FIG. 10 illustrates a perspective view of the multi-clip assembly with eyelets and bone screws for attachment without a bone plate.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
• As shown inFIG. 1, in one embodiment of the present invention, thesuture attachment clip1 comprises ahead2 suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. In this embodiment, thehead2 preferably has a first andsecond lobe3 and4. In a preferred embodiment of the present invention, the first andsecond lobes3 and4 are symmetrical with respect to one another. In a preferred embodiment of the present invention, first andsecond lobes3 and4 are continuous with first andsecond prongs5 and6 whereinfirst prong5 has a first outwardly protrudingterminal end7 andsecond prong6 has a second outwardly protruding terminal end8. Preferably, thehead2,prongs5 and6, andterminal ends7 and8 form an inverse-omega shape whenclip1 is viewed from the top perspective depicted inFIG. 1.
• As shown inFIG. 2, a plurality ofindividual clips1 can attach to abone plate9 by snappingprongs5 and6 of eachrespective clip1 into a correspondingreceiving orifice10 on thebone plate9. Thereceiving orifice10 is preferably located on the edge of thebone plate9. In this snapping configuration, pressure is applied to theprongs5 and6 so that the prongs are squeezed toward one another until eachterminal end7 and8 can pass through thereceiving orifice10. When terminal ends7 and8 have sufficiently passed through thereceiving orifice10, pressure on theprongs5 and6 is released so that the prongs contact the edges of thereceiving orifice10, thereby securing theclip1 to thebone plate9. On ormore clips1 can be attached to the bone plate at the time of manufacture or at the time of surgery.
• As shown inFIG. 3, in another embodiment of the present invention, thesuture attachment clip1 comprises ahead2 suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. In this embodiment, thehead2 preferably has a first andsecond lobe3 and4 which fuse into asingle prong11. In a preferred embodiment of the present invention, the first andsecond lobes3 and4 are symmetrical with respect to one another. In a preferred embodiment of the present invention,single prong11 hasexternal threading12.
• As shown inFIG. 4, in the threaded screw configuration of the present invention, a plurality ofindividual clips1 are attached to abone plate9 by screwing thesingle prong11 of eachrespective clip1 into a corresponding receivingorifice13 on thebone plate9, thereby securing theclip1 to thebone plate9. The receivingorifice13 is preferably located on the edge of thebone plate9 and is preferably threaded internally. On ormore clips1 can be screwed into the bone plate at the time of manufacture or at the time of surgery.
• As shown inFIG. 5, in another embodiment of the present invention, thesuture attachment clip1 comprises ahead2 suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. In this embodiment, thehead2 preferably has a first andsecond lobe3 and4. In a preferred embodiment of the present invention, the first andsecond lobes3 and4 are symmetrical with respect to one another. In a preferred embodiment of the present invention, first andsecond lobes3 and4 are continuous with first and secondbendable prongs14 and15. In a preferred embodiment of the present invention, the firstbendable prong14 is parallel to the secondparallel prong15. In a preferred embodiment of the present invention, firstbendable prong14 is continuous with first terminatingend16, and secondbendable prongs15 is continuous with second terminatingend17.
• As shown inFIG. 6, in the bendable prong configuration of the present invention, a plurality ofindividual clips1 are attached to abone plate9 by insertingbendable prongs14 and15 of eachrespective clip1 through corresponding first and second receivingorifices18 and19 in the bone plate. Receivingorifices18 and19 are preferably located on the edge ofbone plate9. In this embodiment,bendable prongs14 and15 are bent through corresponding first andsecond exit orifices20 and21 on thebone plate9.Exit orifices20 and21 are preferably located on the edge ofbone plate9. As shown inFIG. 6, whenbendable prongs14 and15 are bent throughexit orifices20 and21, first and second terminating ends16 and17 face away from thebone plate9 and toward thehead2 of theclip1, thus securing theclip1 to thebone plate5. In this embodiment,clip1 can be designed and manufactured specifically to fit an existing bone plate's orifices, or alternatively, the bone plate and one or more clips can be simultaneously and compatibly designed and manufactured. One ormore clips1 can be attached to the bone plate at the time of manufacture or at the time of the actual surgery.
• As shown inFIG. 7, in yet another embodiment of the present invention, at least one terminal end of eachclip1, as depicted inFIG. 1, is continuous with the terminal end of an adjacent clip. The process can be repeated to form a plurality of linked clips, or amulti-clip assembly22. Eachclip1 has a head suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. As shown inFIGS. 8 and 9, themulti-clip assembly22 can preferably attach to thebone plate9 by snapping the multi-clip assembly to corresponding receivingchannels23 on thebone plate9. The receivingchannels23 are preferably located on the undersurface of thebone plate9. While any portion of the multi-clip assembly can interlock with the corresponding receivingchannels23, as shown inFIG. 8, in a preferred embodiment of the present invention, a portion of thehead2 of eachclip1 linked together in themulti-clip assembly22 should remain sufficiently exposed beyond the edge of thebone plate9 in order to allow for the passage of a suture.
• To further secure themulti-clip assembly22 to thebone plate9, the multi-clip assembly could alternatively be fastened to the bone plate by locking screws or fasteners. Depending on the fastening method used, the multi-clip assembly can be attached to the bone plate at the time of manufacture or at the time of the actual surgery.
• As shown inFIG. 10, themulti-clip assembly22 can also be used without a bone plate. In this embodiment of the present invention, themulti-clip assembly22 is fastened to the bone by inserting standard bone screws23 or fasteners through a plurality ofeyelets24 positioned at various points on themulti-clip assembly22, preferably at the juncture of the respective terminal ends of each linkedindividual clip1 within themulti-clip assembly22.

Claims (36)

1. A suture attachment clip comprising a head suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone; said head further comprising one or more lobes, said lobes enclosing a space for the passage of a suture.

2. The suture attachment clip ofclaim 1 wherein said head further comprises a first and second lobe, wherein an end of said first lobe extends to form a first prong so that said first prong is continuous with said first lobe, said first prong having a first outwardly protruding terminal end, and wherein an end of said second lobe extends to form a second prong so that said second prong is continuous with said second lobe, said a second prong having a second outwardly protruding terminal end.

3. The suture attachment clip ofclaim 2 wherein said clip is capable of attaching to a bone plate by snapping said first prong and said second prong into a corresponding receiving orifice on said bone plate.

4. The suture attachment clip ofclaim 2 wherein said second outwardly protruding terminal end is continuous with a first outwardly protruding terminal end of a second suture attachment clip.

5. The suture attachment clip ofclaim 4 wherein said clip attaches to a bone plate by snapping into a corresponding receiving channel on said bone plate.

6. The suture attachment clip ofclaim 4 further comprising an eyelet for inserting bone screws or fasteners therethrough.

7. The suture attachment clip ofclaim 1 wherein said head further comprises a first and second lobe, wherein said first and second lobes are continuous with a single prong.

8. The suture attachment clip ofclaim 7 wherein said clip is capable of attaching to a bone plate by inserting said single prong into a corresponding receiving orifice on said bone plate.

9. The suture attachment clip ofclaim 7 wherein said single prong is externally threaded.

10. The suture attachment clip ofclaim 1 wherein said head further comprises a first and second lobe, said first lobe being continuous with a first bendable prong and said second lobe being continuous with a second bendable prong.

11. The suture attachment clip ofclaim 10 wherein said first and second bendable prongs are parallel to one another.

12. The suture attachment clip ofclaim 10 wherein said clip is capable of attaching to a bone plate by inserting said first and second bendable prongs through first and second receiving orifices in said bone plate; bending said first and second parallel prongs through first and second exit orifices on said bone plate.

13. A method for attaching soft tissue to bone using a clip comprising a head suitably shaped to allow the passage of a suture, said head having one or more lobes, said lobes enclosing a space for the passage of a suture; said method comprising the step of passing a suture through said enclosed space during the attachment of soft tissue to bone.

14. The method ofclaim 13 further comprising the step of passing a suture through a first or second lobe on said head, wherein an end of said first lobe extends to form a first prong so that said first prong is continuous with said first lobe, said first prong having a first outwardly protruding terminal end; and wherein an end of said second lobe extends to form a second prong so that said second prong is continuous with said second lobe, said second prong having a second outwardly protruding terminal end.

15. The method ofclaim 14 further comprising the step of snapping said first prong and said second prong into a corresponding receiving orifice on a bone plate.

16. The method ofclaim 14 wherein said second outwardly protruding terminal end is continuous with a first outwardly protruding terminal end of a second said suture attachment clip.

17. The method ofclaim 16 further comprising the step of attaching said clip to a bone plate by snapping said clip into a corresponding receiving channel on said bone plate.

18. The method ofclaim 16 further comprising the step of inserting bone screws or fasteners through an eyelet on said clip.

19. The method ofclaim 13 further comprising the step of passing said suture through a first or second lobe on said head, said first and second lobes being continuous with a single prong.

20. The method ofclaim 19 further comprising the step of attaching said clip to a bone plate by inserting said single prong into a corresponding receiving orifice on said bone plate.

21. The method ofclaim 19 wherein said single prong is externally threaded.

22. The method ofclaim 13 further comprising the step of passing said suture through a first or second lobe on said head, said first lobe being continuous with a first bendable prong and said second lobe being continuous with a second bendable prong.

23. The method ofclaim 22 wherein said first and second bendable prongs are parallel to one another.

24. The method ofclaim 22 further comprising the step of attaching said clip to a bone plate by inserting said first and second bendable prongs through first and second receiving orifices in said bone plate; bending said first and second parallel prongs through first and second exit orifices on said bone plate.

25. A system for attaching soft tissue to bone comprising,

a bone plate having one or more orifices on the perimeter of said bone plate;

one or more suture attachment clips, said one or more suture attachment clips comprising compressible prongs that are selectively insertable into and selectively detachable from said one or more orifices of said bone plate;

said one or more suture attachment clips further comprising a head forming an enclosed space for passage of one or more sutures when said one or more suture attachment clips are secured to the perimeter of said bone plate.

26. The system ofclaim 25, said one or more suture attachment clips further comprising,

at least two outwardly protruding lobes, whereby said at least two outwardly protruding lobes are connected by at least one inwardly protruding segment;

said at least two adjacent outwardly protruding lobes and said at least one inwardly protruding segment being integrally connected to form a continuous filament, said filament enclosing a space for the passage of one or more sutures.

27. A method for attaching soft tissue to bone comprising the steps of,

providing a bone plate having one or more orifices on the perimeter of said bone plate;

providing one or more suture attachment clips, said one or more suture attachment clips comprising compressible prongs and a head forming an enclosed space for passage of one or more sutures when said one or more suture attachment clips are secured to the perimeter of said bone plate:

compressing said prongs of said one or more suture attachment clips and selectively inserting said one or more suture attachment clips into said one or more orifices on the perimeter of said bone plate;

passing one or more sutures through said head of said one or more suture attachment clips during the attachment of soft tissue to bone.

28. The method ofclaim 27 whereby after the suture has been attached to soft tissue and bone, said method further comprising the step of compressing said prongs of said one or more suture attachment clips and selectively detaching said one or more suture attachment clips from said one or more orifices on the perimeter of said bone plate.

29. A kit for attaching soft tissue to bone comprising,

a bone plate having one or more orifices on the perimeter of said bone plate;

one or more suture attachment clips, said one or more suture attachment clips comprising compressible prongs that are selectively insertable into and selectively detachable from said one or more orifices of said bone plate;

said one or more suture attachment clips further comprising a head forming an enclosed space for passage of one or more sutures when said one or more suture attachment clips are secured to the perimeter of said bone plate.

30. A bone plating system, comprising:

a bone plate having top, bottom and side walls;

said side wall having a plurality of orifices configured therein;

at least one suture attachment clip configured to be detachably received in selected ones of said sidewall orifices.

31. The bone plating system ofclaim 30, wherein said at least one suture attachment clip is configured to define an enclosed loop that extends from said side wall when received in the orifice.

32. The bone plating system ofclaim 30, wherein said suture attachment clip has a generally U-shaped configuration with two distal ends that define an open side of the U-shape, and said distal ends are configured to fit within selected ones of said plurality of orifices.

33. A bone plate, comprising:

a top wall, a bottom wall, and a side wall extending between said top wall and said bottom wall;

at least one suture attachment structure extending from said side wall of the bone plate.

34. The bone plate ofclaim 33, wherein said suture attachment structure defines a loop for receiving a suture.

35. The bone plate ofclaim 33, wherein said suture attachment structure extends at an acute angle relative to said top wall.

36. The bone plate ofclaim 33, wherein said suture attachment structure is substantially rigid and defines a fixed area through which a suture can extend.

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