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:
[0001]    The present application is a continuation of U.S. application Ser. No. 12/121,269, filed May 15, 2008; which claims the benefit of U.S. Provisional Application No. 61/045,860, filed on Apr. 17, 2008; all of which are incorporated by reference herein. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    1. Field of the Invention 
         [0003]    The present invention relates to orthopedic devices used in the reattachment of soft tissue to bone in acute injuries or reconstructive procedures. 
         [0004]    2. Description of the Prior Art 
         [0005]    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. 
         [0006]    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. 
         [0007]    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. 
         [0008]    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. 
         [0009]    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 
       [0010]    The present invention generally comprises a suture attachment clip having various embodiments which provide multiple options for soft tissue repair to a bone structure. 
         [0011]    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. 
         [0012]    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. 
         [0013]    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&#39;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. 
         [0014]    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. 
         [0015]    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. 
         [0016]    These and other objects of the present invention will be apparent from review of the following specification and the accompanying drawings. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0017]      FIG. 1  illustrates a top perspective view of an individual clip with a snap configuration. 
           [0018]      FIG. 2  illustrates a plurality of individual clips with snap configurations attached to a bone plate. 
           [0019]      FIG. 3  illustrates a top perspective view of an individual clip with a threaded screw configuration. 
           [0020]      FIG. 4  illustrates a plurality of individual clips with threaded screw configurations attached to a bone plate. 
           [0021]      FIG. 5  illustrates a top perspective view of an individual clip with a dual prong configuration. 
           [0022]      FIG. 6  illustrates a plurality of individual clips with bendable prong configurations attached to a bone plate. 
           [0023]      FIG. 7  illustrates a top perspective view of a multi-clip assembly. 
           [0024]      FIG. 8  illustrates a top perspective view of a bone plate with the multi-clip assembly attached to the underside of the bone plate. 
           [0025]      FIG. 9  illustrates a bottom view of a bone plate with a receiving channel for the multi-clip assembly. 
           [0026]      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 EMBODIMENT 
       [0027]    As shown in  FIG. 1 , in one embodiment of the present invention, the suture attachment clip  1  comprises a head  2  suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. In this embodiment, the head  2  preferably has a first and second lobe  3  and  4 . In a preferred embodiment of the present invention, the first and second lobes  3  and  4  are symmetrical with respect to one another. In a preferred embodiment of the present invention, first and second lobes  3  and  4  are continuous with first and second prongs  5  and  6  wherein first prong  5  has a first outwardly protruding terminal end  7  and second prong  6  has a second outwardly protruding terminal end  8 . Preferably, the head  2 , prongs  5  and  6 , and terminal ends  7  and  8  form an inverse-omega shape when clip  1  is viewed from the top perspective depicted in  FIG. 1 . 
         [0028]    As shown in  FIG. 2 , a plurality of individual clips  1  can attach to a bone plate  9  by snapping prongs  5  and  6  of each respective clip  1  into a corresponding receiving orifice  10  on the bone plate  9 . The receiving orifice  10  is preferably located on the edge of the bone plate  9 . In this snapping configuration, pressure is applied to the prongs  5  and  6  so that the prongs are squeezed toward one another until each terminal end  7  and  8  can pass through the receiving orifice  10 . When terminal ends  7  and  8  have sufficiently passed through the receiving orifice  10 , pressure on the prongs  5  and  6  is released so that the prongs contact the edges of the receiving orifice  10 , thereby securing the clip  1  to the bone plate  9 . On or more clips  1  can be attached to the bone plate at the time of manufacture or at the time of surgery. 
         [0029]    As shown in  FIG. 3 , in another embodiment of the present invention, the suture attachment clip  1  comprises a head  2  suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. In this embodiment, the head  2  preferably has a first and second lobe  3  and  4  which fuse into a single prong  11 . In a preferred embodiment of the present invention, the first and second lobes  3  and  4  are symmetrical with respect to one another. In a preferred embodiment of the present invention, single prong  11  has external threading  12 . 
         [0030]    As shown in  FIG. 4 , in the threaded screw configuration of the present invention, a plurality of individual clips  1  are attached to a bone plate  9  by screwing the single prong  11  of each respective clip  1  into a corresponding receiving orifice  13  on the bone plate  9 , thereby securing the clip  1  to the bone plate  9 . The receiving orifice  13  is preferably located on the edge of the bone plate  9  and is preferably threaded internally. On or more clips  1  can be screwed into the bone plate at the time of manufacture or at the time of surgery. 
         [0031]    As shown in  FIG. 5 , in another embodiment of the present invention, the suture attachment clip  1  comprises a head  2  suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. In this embodiment, the head  2  preferably has a first and second lobe  3  and  4 . In a preferred embodiment of the present invention, the first and second lobes  3  and  4  are symmetrical with respect to one another. In a preferred embodiment of the present invention, first and second lobes  3  and  4  are continuous with first and second bendable prongs  14  and  15 . In a preferred embodiment of the present invention, the first bendable prong  14  is parallel to the second parallel prong  15 . In a preferred embodiment of the present invention, first bendable prong  14  is continuous with first terminating end  16 , and second bendable prongs  15  is continuous with second terminating end  17 . 
         [0032]    As shown in  FIG. 6 , in the bendable prong configuration of the present invention, a plurality of individual clips  1  are attached to a bone plate  9  by inserting bendable prongs  14  and  15  of each respective clip  1  through corresponding first and second receiving orifices  18  and  19  in the bone plate. Receiving orifices  18  and  19  are preferably located on the edge of bone plate  9 . In this embodiment, bendable prongs  14  and  15  are bent through corresponding first and second exit orifices  20  and  21  on the bone plate  9 . Exit orifices  20  and  21  are preferably located on the edge of bone plate  9 . As shown in  FIG. 6 , when bendable prongs  14  and  15  are bent through exit orifices  20  and  21 , first and second terminating ends  16  and  17  face away from the bone plate  9  and toward the head  2  of the clip  1 , thus securing the clip  1  to the bone plate  5 . In this embodiment, clip  1  can be designed and manufactured specifically to fit an existing bone plate&#39;s orifices, or alternatively, the bone plate and one or more clips can be simultaneously and compatibly designed and manufactured. One or more clips  1  can be attached to the bone plate at the time of manufacture or at the time of the actual surgery. 
         [0033]    As shown in  FIG. 7 , in yet another embodiment of the present invention, at least one terminal end of each clip  1 , as depicted in  FIG. 1 , is continuous with the terminal end of an adjacent clip. The process can be repeated to form a plurality of linked clips, or a multi-clip assembly  22 . Each clip  1  has a head suitably shaped to allow the passage of a suture during the attachment of soft tissue to bone. As shown in  FIGS. 8 and 9 , the multi-clip assembly  22  can preferably attach to the bone plate  9  by snapping the multi-clip assembly to corresponding receiving channels  23  on the bone plate  9 . The receiving channels  23  are preferably located on the undersurface of the bone plate  9 . While any portion of the multi-clip assembly can interlock with the corresponding receiving channels  23 , as shown in  FIG. 8 , in a preferred embodiment of the present invention, a portion of the head  2  of each clip  1  linked together in the multi-clip assembly  22  should remain sufficiently exposed beyond the edge of the bone plate  9  in order to allow for the passage of a suture. 
         [0034]    To further secure the multi-clip assembly  22  to the bone plate  9 , 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. 
         [0035]    As shown in  FIG. 10 , the multi-clip assembly  22  can also be used without a bone plate. In this embodiment of the present invention, the multi-clip assembly  22  is fastened to the bone by inserting standard bone screws  23  or fasteners through a plurality of eyelets  24  positioned at various points on the multi-clip assembly  22 , preferably at the juncture of the respective terminal ends of each linked individual clip  1  within the multi-clip assembly  22 . 
         [0036]    Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.