Patent Publication Number: US-7582089-B2

Title: Multi-use linkage device

Description:
This application is a Divisional of application Ser. No. 10/635,889, filed on Aug. 6, 2003, now U.S. Pat. No. 7,164,360 which claims priority of Provisional Patent Application Ser. No. 60/403,722, filed on Aug. 14, 2002, which are incorporated herein by reference in their entirety. 

   BACKGROUND OF THE INVENTION 
   This invention relates to a tie, and more particular to a linkage or binding device with a plurality of uses where such uses include being able to obtain use specific information from the closure device and being able to determine whether the device has been tampered with or has failed and to transport information and/or material through it to another location. 
   Plastic ties are well known in the prior art and have been used for a variety of uses, such as security seals, and binding devices to hold objects together. In recent years, plastic ties are now used in place of metal handcuffs especially when a plurality of arrests is made at a given time where a police officer needs to handcuff more than one individual. 
   Security seals are used to insure that containers are not opened, or tampered with during shipping. Even though security seals were primarily constructed of metal, plastic seals later became popular since unlike metal straps, plastic seals did not rust or corrode. Additionally, plastic seals are cheaper to produce. Nevertheless, current plastic seals also have drawbacks. For example it is believed that heat or glue can be used to defeat a plastic seal. Specifically, plastic seals, or ties have ratchet serrations or protrusions, on a surface, which lock into a socket mechanism at one end of the tie. The socket mechanism has been known to be defeated by using a thin pin to release the ratchet serrations from the socket mechanism. The ratchet serrations are then later re-reconnected to the socket mechanism with glue. Thus a user may not know that the tie had been defeated or tampered with. Likewise, heating the plastic, such as in hot water, has also been known to defeat the locking features, where the segment of the strap held in place within the socket mechanism loses its rigidity and is able to be removed from the socket. Having a seal or fastener that is not as easy to defeat and where an inspector can readily determine whether the device has been tampered with is desirable. 
   To assist with the healing process after certain medical procedures, surgical wire is usually used, such as to hold a separated bone together. For example, during an operation where a surgeon needs access to a patient&#39;s heart, such as for a heart valve replacement or coronary artery bypass, a median sternotomy procedure is performed where the sternum is typically separated longitudinally down the center of the bone, from the manubrium to the xyphoid, and then spread apart so that a surgeon has an unobstructed access to the heart for surgical exposure. Once the operation is complete, surgical wire, typically monofilament stainless steel suture, is used to immobilize the separated bone of the sternum so that the bone may begin its healing process. 
   The surgical wire, which has limited flexibility, is placed around both halves of the divided sternum. It is then threaded between ribs in the corresponding intercostal spaces and through the intercostal muscles on either side of the sternum. Once placed around the back of the sternum, the ends of the wire are secured on the front side, where the ends are twisted to pull together the halves of the sternum. Excess wire is then cut away and the twisted end is folded down onto the sternum. 
   After the wire is in place, it is not removed, unless there is another operation. Depending on how much skin and fat covers the sternum, a patient may have ridges showing through his or her skin from the surgical wire. These ridges may be uncomfortable when touched and also look abnormal, while also remaining as a constant reminder of the surgery. Additionally, the wire may later erode through the skin, and cause a chronic draining sinus or osteomyelitis of the sternum. In some cases the sternum has to be completely removed due to infection. Due to the physical characteristics of the wire, twisting the wire may increase the cold work in the wire, which makes it more brittle thus increases the probability that it may break. In fact, a majority do eventually break. 
   Situations arise where a doctor may need to know information about a prior surgery or a patient&#39;s prior condition. If the patient does not readily have the information available, the doctor may have to request the information from another hospital and/or another doctor, possibly located in another state or country. An emergency room situation is one instance where obtaining such information immediately may be paramount. Thus having the information provided on the binding device would be beneficial not only to the doctor, but to the patient as well. 
   BRIEF DESCRIPTION OF THE INVENTION 
   This invention is directed to a linkage, or binding, device where information can be collected, received or transported through the binding device. Such examples of information includes, but is not limited to, who installed the device, whether the device has been tampered with, or whether the device has failed. The invention is further directed to a device that can be used in a plurality of applications ranging from medical uses to industrial uses. 
   In one preferred embodiment of the present invention a linkage device is disclosed. The linkage device is comprised of a strip, a hub, a connecting surface protruding from the strip to provide a connecting surface to the hub, and a tampering detection device connected to or imbedded in the binding device. An application distinct tag signifying a specific use for the linkage device can also be part of the linkage device. 
   In another preferred embodiment a linkage system is disclosed. The linkage system includes a linkage device and an insertion device for placing the linkage device around an object to bind, such as a bone. Another preferred embodiment is a linkage system having a linkage device and a detection device that can read information contained on an application distinct tag. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The invention itself, both as to organization and method of operation, may best be understood by reference to the following description in conjunction with the accompanying drawings in which like numbers represent like parts throughout the drawings and in which: 
       FIG. 1  is an illustration of an exemplary embodiment of the linkage device; 
       FIG. 2A  is an illustration of an exemplary embodiment of the linkage device before being expanded; 
       FIG. 2B  is an illustration of an exemplary embodiment of the linkage device after being expanded; 
       FIG. 3  is another illustration of an exemplary embodiment of a closure hub engaging a strip; 
       FIG. 4  is an illustration of an exemplary embodiment of the linkage device being placed around a bone, such as sternal segments; 
       FIG. 5  is an illustration of an exemplary embodiment of a cross sectional view of a strip (first end) of the linkage device; 
       FIG. 5A  is an illustration of an exemplary embodiment of a cross sectional view of a strip where a material is spooled within; 
       FIG. 6  is an illustration of an exemplary embodiment of the linkage device with an air channel and a reservoir; 
       FIG. 7  is an illustration of an exemplary embodiment of the linkage device where an illumination material has left the reservoir; 
       FIG. 8  is an illustration of an exemplary embodiment of the linkage device with a tamper and/or information detection device; 
       FIG. 9  is an illustration of an exemplary embodiment of a closure hub with a compartmentalized baffle; 
       FIG. 10  is an illustration of an exemplary embodiment of a closure hub with a removable top; 
       FIG. 11  is an illustration of an exemplary embodiment of the closure hub with the removable top opened; 
       FIG. 12  is an illustration of an exemplary embodiment of a closure hub comprising a combination lock system; 
       FIG. 13  is an illustration of an exemplary embodiment of a torque screw securing and releasing system; 
       FIG. 14  is an illustration of an exemplary embodiment of the linkage device connected to a dilator; 
       FIG. 15  is an illustration of an exemplary embodiment of another embodiment of the linkage device placed around two bone segments, such as two sternal segments; 
       FIG. 16A  is an illustration of an exemplary embodiment of a vascular clip with a soft closure mechanism; 
       FIG. 16B  is an illustration of another exemplary embodiment of a vascular clip with a soft closure mechanism; 
       FIG. 16C  is an illustration of another exemplary embodiment of a vascular clip, in a closed configuration; 
       FIG. 17  is an illustration of an exemplary embodiment of an insertion device for long bones and sternal closure allowing for use of a multiplicity of devices for insertion; 
       FIG. 18  is an illustration of an exemplary embodiment of an insertion device in use; 
       FIG. 19  is an illustration of an exemplary embodiment of a plurality of linkage devices around a long bone; 
       FIG. 20  is an illustration of an exemplary embodiment of the linkage device used to close a long fascial wound; 
       FIG. 21  is an illustration of an exemplary embodiment of an insertion end of another insertion device; 
       FIG. 22  is an exemplary embodiment of a side view of the insertion device disclosed in  FIG. 21 ; 
       FIG. 23  is an illustration of an exemplary embodiment of an insertion device with a stamper; 
       FIG. 24  is an illustration of an exemplary embodiment of a drill insertion device; 
       FIG. 25  is an illustration of an exemplary embodiment of a drill insertion device used with Stealth Technology™; 
       FIG. 26  is an illustration of an exemplary embodiment of an insertion device for a plurality of vascular clips; 
       FIG. 27  is an illustration of an exemplary embodiment of a plurality of the linkage devices daisy-chained together and illustrating a motorized closure hub; 
       FIG. 28  is an illustration of an exemplary embodiment of an electric socket adapter; 
       FIG. 29  is an illustration of an exemplary embodiment of the electric socket adapter engaged in a closure hub; 
       FIG. 30  is an illustration of an exemplary embodiment of a box kite windmill device used to generate power through a linkage device; 
       FIG. 31  is an illustration of an exemplary embodiment of a plurality of linkage devices used as a sign; 
       FIG. 32  is an illustration of an exemplary embodiment of a plurality of linkage devices daisy-chained together where the hubs are light sockets; 
       FIG. 33  is an illustration of an exemplary embodiment of a plurality of linkage devices connected and used for an endoscope for the small bowel; 
       FIG. 34  is an illustration of an exemplary embodiment of a funnel-like device connected to the binding device; 
       FIG. 35  is an illustration of an exemplary embodiment of a closure hub with a plurality of closure locations; 
       FIG. 36A  is an illustration of an exemplary embodiment of a binding device with strips used as handcuffs; 
       FIG. 36B  is an illustration of another exemplary embodiment of a binding device with strips used as handcuffs; 
       FIG. 37  is an illustration of an exemplary embodiment of a binding device with a two strips in use; 
       FIG. 38  is an illustration of an exemplary embodiment of a net, fence and/or antenna constructed with a plurality of binding devices; 
       FIG. 39  is an illustration of an exemplary embodiment of a corner tab; 
       FIG. 40  is an illustration of an exemplary embodiment of the linkage device tunneled within a knee, such as a posterior cruciate ligament repair; 
       FIG. 41  is an illustration of an exemplary embodiment of an external cortical anchor (in the bone) end of the linkage device; 
       FIG. 42  is an illustration of an exemplary embodiment of the linkage device secured to a tibia and femur to replace a medial collateral ligament MCL; 
       FIG. 43  is an illustration of an exemplary embodiment of a linkage device used as a replacement bicycle tire; 
       FIG. 44  is an illustration of an exemplary embodiment of a block diagram of a passive detection system for a linkage device; 
       FIG. 45  is an illustration of an exemplary embodiment of the linkage device used with a prosthesis, such as a hip replacement prosthesis; 
       FIG. 46  is an illustration of a plurality of linkage devices being used to pump oil from a submerged oil tanker; 
       FIG. 47  is an illustration of an exemplary embodiment of a drill bit being used to anchor a linkage device in a bone (internal trabecular bone anchor); and 
       FIG. 48  is an illustration of an exemplary embodiment a cross sectional view of linkage devices used as braces to correct teeth alignment. 
   

   DETAILED DESCRIPTION OF THE INVENTION 
   With reference to the figures, exemplary embodiments of the invention will now be described. The scope of the invention disclosed is applicable to a plurality of linking, bindings, fasteners, closures, ties, or other connecting devices used to hold an object or objects together or to transport material (or information, energy, photons, etc.) from one location to another. Thus, even though several embodiments are described specific to certain medical devices, this invention is also applicable to other variations of sutures, linkage, and binding devices. Additionally, even though certain embodiments of the invention are disclosed for use with a human, one skilled in the art will readily recognize that this invention is also applicable to animals. 
   Likewise, even though certain embodiments are also disclosed specific to security devices, this invention is applicable to other closure devices where a user would benefit from being able to make a visual inspection, either with or without an additional instrument, such as a microscope or a photon-detection device, to determine whether the closure device has failed. Such other uses may include but are not limited to, luggage ties to prevent unauthorized entry into luggage or to identify luggage to a traveler via the traveler&#39;s ticket, personalized ribbons for wrapped packages at holidays, containers to be cleared, or already cleared, through customs, or to identify cargo at traffic or security check points, such as border crossings. 
   Additionally, the scope of the present invention is not limited to a single linkage device. The present invention can be connected to other versions of the present invention or variations thereof for other uses where it is not used to bind objects but to transport material or as a structure to support the placement of other structures. The size of the present invention may also vary, since this invention can be sized for use in Micro-Electro-Mechanical Systems (MEMS) technology, or smaller (nano-technology), and up to heavy construction uses, or larger. 
   As will become clear to one skilled in the art, the elements of the present invention can be imbedded inside of the invention or connected to an outer surface of the invention. For clarification, when connected to or imbedded is used, these terms are meant to address both ways, and other conceivable ways, of putting the present invention together. 
     FIG. 1  is an exemplary embodiment of the present invention. The invention  10  is a strip  12  of material that is elongated in shape where a first end has a closure device or hub device  14 . The strip  12  may be pliable, rigid and/or expandable. The material that comprises the present invention may be biodegradable material or a material that will not deteriorate over time, or a variation where parts may deteriorate whereas other parts will not. With respect to being expandable, in a preferred embodiment the strip has segments which can expand, as illustrated in  FIGS. 2A and 2B . In other embodiments, such as those discussed below, the center of the strip may be hollow wherein other components are placed. The elongated shaped segment  12  of the linkage device  10 , or strip, can have a plurality of shapes and lengths. For example the cross section of the strip can be cylindrical, triangular, rectangular, and/or any other geometric or non-geometric, shape. The second end  15  of the invention fits within the hub  14 . The second end  15  of the invention has protrusions  17 , or ridges, extending from the invention so that when the second end  15  engages the closure device  14 , the protrusions  17  engage a closing mechanism in the closure device  14  that prevents the second end  15  from being pulled out of the closure hub  14 . The protrusions  17  can be located on any surface of the strip. The protrusions  17  may comprise a plurality of shapes such as, but not limited to, shark-tooth ridges, and recessed double ridge back configuration ridges. The protrusions may extend in a plurality of directions from the strip  12 . Though the term protrusion is used, the protrusions could be indentions or another form of missing area from a strip wherein the hub  14  will have protrusions to engage the indentions. 
   As is illustrated in  FIG. 3 , in one preferred embodiment the strip  12  comprises forward facing protrusions  117  and backward facing protrusions  17 . As discussed previously, when placed within the hub  14 , the backward facing protrusions  17  engage an inner receiving surface  133  of the hub  14 . The hub  14  has a plunger device  129 , or devices so that when the strip  12  has engaged the hub  14 , the plunger devices  129  are positioned in a locked position, engaging the forward facing protrusions  117 . To further prevent tampering, plunger locks  131  are provided to hold the plunger devices  129  in place. As further illustrated, rolling pins, or ball bearings,  134  are located within the hub  14  and in one embodiment are the inner receiving surface that assist with the strip  12  engaging the hub  14 . The rolling pins  134  assist the strip  12  in moving freely into the hub  14 . 
   “Viper-teeth”  19 , as illustrated in  FIG. 4 , located near the closure end  14  of the invention or linkage, or binding, device  10 , can also be included on the linkage device  10 . The viper teeth  19  are used to assist in holding the invention  10  in place. Once positioned around an object the viper teeth  19  help to anchor it, preventing the invention  10  from rotating or sliding around the object  30 . 
   As is further disclosed in  FIG. 1 , an application distinct tag  20  is also connected to the invention  10 . In a preferred embodiment the tag  20  is used to identify a specific use of the linkage device. The application distinct tag, or information data tag  20 , may contain information. For example, this information can be deposited in a multiplicity of fashions detectable by instruments or sensation (seeing, hearing, touching, smell, and/or taste) of sentient beings. This information can be visible by the naked eye, by photon activation of the information, and/or by electronic activation wherein the information tag  20  may be on the surface, or imbedded, as illustrated in  FIG. 2B , within the linkage device. The information can be encoded where it is accessible at a given frequency located anywhere over a photonic frequency range. As further illustrated in  FIG. 2B , the tag  20  may reside on and/or in the hub  14 . Examples of photon activation techniques include, but are not limited to, laser, visible light photons, radio frequency photons, X-ray photon, gamma-ray photon, ultraviolet photon, and infrared photons, as illustrated in  FIG. 8 . With respect to the use of the invention in a living organism, the infrared photons are generated from a patient&#39;s own body heat. In each example a receiver  92 , or reader, of each respective photon activated information is suited to the type of activation used. In certain situations, the receiver  92  is able to read the tag  20  through other material such as, but not limited to, reading a tag located within a truck, via a Computerized Tomography (CT) scan, or through a large amount of fatty tissue. The information may be tactile, have sound, or a smell as well. 
   For medical uses, the tag  20  may be made of, but is not limited to, titanium, gold, barium, or another non-Ferro magnetic material, which is X-ray visible, and where an identification code, or data, is placed. In a preferred embodiment, the tag  20  includes markings which can be visible by the naked eye and/or by photon activation of information on the plate, which is then read by a photon reader  92 , as illustrated in  FIG. 8 . The information contained on the tag  20  may be an alphanumeric code, bar code, imprinted letters, numbers, symbols, digital code, and/or a predefined frequency. The information is just that, to include any way of encoding data that can be retrieved at a later date or concurrent to the data recording, e.g., tactile bumps of Braille. With respect to using X-ray photons to decode information, the reader  92  can be a hand-held reader which can read the information as light photons emanating from an illuminated X-ray film or soft copy of a digital radiograph or CT scan. In another preferred embodiment (not shown) a software reader is built into a computer program to read the information based on a defined region of interest. 
   With respect to using laser light to decode information, the reader can be a hand held laser, which activates a solution containing a fluorescent material or reflective material inside of the identification plate or tag  20 . The symbolic data is then fluoresced, or reflected, back to a visible light photon receiver. When the invention is used for medical uses, such as sutures, such an approach is more useable with thin patients or children, those typically with less than a few centimeters, such as five, of skin and subcutaneous fat covering these sutures. 
   When using radio frequency to decode information, in a preferred embodiment the tag  20  is a self-regulated chip, which turns off when detecting imaging frequencies from a magnetic resonance imaging (MRI) system. In one embodiment (not shown), this chip is a small coil with a selected set of radio frequency coils that provides a unique signature, such as 28.3 hertz and 32.5 hertz receiver coils imbedded in the plate coil. One skilled in the art will readily recognize other configurations are available with using radio frequency technology and passive identification technology. In other words, the coil&#39;s reception frequency can be individualized as a unique signature for each tag  20  much like a radio station has its own frequency designation on the radio frequency spectrum of a radio dial. 
   As illustrated in  FIG. 45 , a linkage device  10  as discussed above is used as part of a prosthesis  111 , such as a hip prosthesis, wherein its unique code, or inductive frequency signature, can be read at a security check point where a metal detector is used, such as at an airport wherein the security guard can readily ascertain that a reason a user is activating the metal detector is because of the metal prosthesis  111 . In a preferred embodiment, the security guard would use a detection device  91  that transmits and receives a photonic and/or electronic signal from the linkage device. The use described is not limited to a hip prosthesis. The present invention can also be used with, but not limited to, a shoulder, arm, and/or knee prosthesis as well as with a metal plate fitted within a skull, pacemaker, infusion pump, etc. In a preferred embodiment, the linkage device is provided in the prosthesis wherein the linkage device is insulated and coupled to the prosthetic device and emits a “prosthetic specific” inductive signature. In another preferred embodiment, the linkage device is resistively coupled to the metal in the prosthesis which results in the prosthesis having a specific identity or signature. Though illustrated as being connected to the greater trochanter  47 , the linkage device  10  can be integrated into the prosthesis  111 . 
   In another preferred embodiment, such as is illustrated in  FIG. 2B , the tag  20  also has its own battery  106  and emits its own radio wave frequency that is used for information storage, access of information, and/or determining a location of the present invention. In another preferred embodiment, the tag  20  is GPS active and gives a signal which can be used to determine the location of the linkage device, such as if necessary to locate a kidnapped child or adult who has a linkage device in or on their possession. The signal may be delivered as a burst signal, wherein information is rapidly sent. For example, with respect to a patient, who may have the present invention on or in his or her body, when a reader is used to access information, the information specific to the patient is immediately accessible via a burst download using a capacitor/battery storage device  106  within the hub. 
   For decoding information using infrared photon techniques, in one exemplary embodiment, strips of different types of heat transmissible material are imbedded in the tag  20 . In one embodiment, one strip is a linear bubble of air, which is a poor heat transmitter, and the next is a thin plate of metal, which has higher heat conductivity. When used together as an off/on pattern, the tag  20  is encoded with any type of information needed. For simplicity, a bar code is a preferred embodiment to provide encoded information using this technique. 
   In another preferred embodiment (not shown), the respective reader is operable to access a national database containing information about a plurality of the present invention. The reader sends the information to the computer containing the national database and processes the information, reads and matches the identification with the specific invention. For example, if the present invention  10  is used on a patient, the information provided is specific to the patient. Likewise, information specific to a container which is secured by the present invention, such as in through a security check point, such as may be used by the United States Customs Department, is also assessable in the same manner. With respect to a patient, examples of information that can be stored in the database, but not limited to, include critical information about the patient as well as name, date of the surgery, and drug allergies. 
   The length and the width of the invention  10  can be a plurality of sizes, where the length and width are tailored and customized for a given or particular application, such as, with respect to medical uses, any patient ranging from an infant to an adult or even large mammals. For example, when using the present invention  10  as a suture, a smaller embodiment of the present invention could be used for a child when compared to an adult. Specifically, depending upon the thickness of a sternum, bone or fascial wound size, the length can be customized. The thickness of the linkage device  10  in the medical application can also vary from less than a millimeter to a width matching the distance between two adjacent ribs of a given patient, or animal. In the case of a long bone, thicker bands of the linkage device may be preferable. 
   In a preferred embodiment, when used for medical purposes, the invention  10  further includes an antibiotic and/or antifungal impregnation of the linkage device  10 . The present invention may also have a bacteriostatic and/or a bactericidal coating. The antibiotic and/or antifungal impregnation may help to reduce the incidence of postoperative wound infections, and osteomyelitis. The device may be biodegradeable in the body whereas it is designed to last as long as needed to serve its closure purpose. In another medical use (not shown), externally applied inductive power can be supplied to heat the linkage device to coagulate local tissues by heating the linkage device to a defined temperature, such as in tumors of the liver where the device has been deployed by a catheter into the tumor. The device may be designed to fail at a certain temperature, to prevent damaging, such as by boiling, the surrounding tissue. 
   As illustrated in  FIG. 5 , in another preferred embodiment, the present invention  10  has a multi-layered strip  12 , or an annular ring configuration. In one embodiment, the inner layer  62 , consisting of a casing and an inner canal, is an opening that can be placed under vacuum. The next outer layer  64  is a plurality of fiber optic strands. The next layer  66  is a plurality of metal threads, such as a spiral core that may be conductive. The outer layer  68  is a plastic composite. One layer can be a cavity to allow a fluid to be transported through. One skilled in the art will readily recognize that the order of layers are interchangeable and that the combination of layers may be changed to include more or fewer layers than discussed, such as will be discussed below. 
   In a preferred embodiment, as illustrated in  FIGS. 6 and 7 , the strip  12  has an air channel  70  disposed within an outer layer and that is vacuum-sealed. The tag  20  has a reservoir  72 , such as an inkwell, connected to it wherein ink in the reservoir  72  is under pressure and allows information, or markings, on the tag  20  to be visible. If the present invention is tampered with, the vacuum-seal is broken and the ink exits the reservoir  72 , entering into a second reservoir (not shown), or leaving the present invention and getting the ink on the container that it is used to bind, causing the image of information to become less visible, as shown in  FIG. 7 . Thus by looking at the tag  20 , a user can determine if the present invention  10  has been tampered with, or whether the present invention  10  has failed. Though ink is disclosed above, any flowable medium, such as a liquid, gas, and/or a scent in either a liquid, gas, or solid form, may be used in place of ink. 
   Similarly, though not shown, in another preferred embodiment, the strip  12  has fiber optic strands disposed within the strip where the strands illuminate the tag  20  or information contained on the tag  20 . A light source, such as an external source, is provided, as discussed below, to illuminate the strands. If the present invention  10  is tampered with, where one or more strands are broken, the image of information becomes less visible. Just as discussed previously, by looking at the tag  20 , a user can determine if the present invention has been tampered with or whether the present invention  10  has failed. 
   In another preferred embodiment using fiber optic strands, the strands are doped, such as with a metal, so that a unique frequency characteristic is established for each strand. When a plurality of strands is placed within a strip, a unique spectrum of frequency absorption can be read from the linkage strip  10 . If the device is tampered with wherein even one strand is broken, the resulting interrogated frequency spectrum will change. A reader device  90 , further illustrated in  FIG. 8 , as discussed below can be used to detect whether the linkage device has failed or has been tampered with. 
   As further illustrated in  FIG. 8 , the present invention  10 , either on the strip  12 , tag  20 , or hub  14 , also comprises a port  80  to measure a photon level and/or an electrical flux  82 , such as conductive reading or resistance reading, of the present invention  10 . In another preferred embodiment, an electric input port  84  and/or photon input port  86  are also provided. Thus in operation, when the present invention has the hub  14  connected to its second end  15 , a measurement of the photon flux and/or electrical flux is made and recorded. The same readings are then taken later to compare to determine if there has been a decrease or significant change (one beyond the expected statistical variation for a change that is expected due to environmental conditions). Such a change would then suggest that the present invention  10  had failed or had been tampered with. Similarly, an electric charge can be supplied through the electric port and a resistance measurement is read wherein a second charge, of the same value, and reading may be taken at a destination, or while in transport to determine whether the present invention  10  has failed or has been tampered with. As further illustrated in  FIG. 8 , a reader device  90  is illustrated which is used to take such readings (electrical or photonic), including a bar code reader  92  to read information on the tag  20  if the information is in bar code form. One skilled in the art will recognize that instead of a bar code reader  92 , other reader technology, such as disclosed with respect to  FIG. 45 , may be incorporated depending on the photonic technology used for the tag  20 , including computer software that can read the information from a soft copy of the information. 
   To further illustrate how energy travels through the linkage device, the reader  90  supplies energy, either photonic or electrical, which travels through the strip  12  into the first end  15 . As illustrated in  FIG. 29 , the energy flows through protrusions  122 . The energy then travels into the clam feet  125  that make contact with the protrusions  122 , therby gaining entrance into the hub  14 . Once in the hub  14 , the energy is transported by its respective carrier to either a photonic or electrical port. 
   In another preferred embodiment, illustrated in  FIG. 9 , the closure hub  14  has a collapsible baffle  94  disposed within the hub  14  where glue resides. The baffle comprises at least one chamber, but may comprise a plurality of chambers. Once the ends  14 ,  15  of the present invention  10  engage each other, a user would squeeze the closure hub  14 , which in turn causes the baffle  94  to collapse, thus releasing the glue monomers which permanently fixes the ends  14 ,  15  of the present invention  10  together after the polymeric reaction. In another embodiment, the baffle  94  has two chambers  95 ,  96  wherein two different reagents are stored and, once squeezed and the reagents combine and go into a slot  103  containing the first end to seal it permanently wherein a polymeric reaction results that seals the ends  14 ,  15  together. This baffle  94  also may contain material that is released externally to the hub when externally activated. The baffle may contain a medicinal agent. 
   In another preferred embodiment, the hub device is configured so that the present invention  10  is reusable. In one embodiment, illustrated in  FIGS. 10 and 11 , the closure hub  14  has a removable cover  98  where screws  101 , or another securing component, are removed to open the hub  14 . As previously disclosed, the locking mechanism  102  disposed under the removable cover  98  is operable to allow the strip  12  to enter the closure device  14  in one direction but not to exit in the same direction entered. With the cover  98  removed, a user can disengage the end  15  of the present invention engaging the closure hub  14 , as disclosed in  FIG. 11 . In one embodiment the teeth  102  are connected to the back side of the cover  98  so that removing the cover  98  disengages the teeth  102  from the strip, thereby freeing the strip  12  from the hub  14 . Though not shown, in another preferred embodiment a single button operates as a release mechanism, releasing the strip  12  from the hub  14   
   In another preferred embodiment, a control (not shown) within the closure hub  14  is accessible to allow the components  102  engaging the protrusions  17  to release the protrusions only after the cover  98  is removed. In another preferred embodiment, disclosed in  FIG. 12 , the closure hub  14  has a combination-locking device  104  built into the closure hub  14 . When a correct combination is entered, the closure hub  14  releases the protrusions  17  from the hub lock. In another preferred embodiment, the closure hub  14  releases the second end  15  when a passive tag is passed near the present invention, which in turn activates the closure hub to release the second end. 
   In another preferred embodiment (not shown) the present invention has an electronic chip that releases the closure hub  14  from the second end  15  when an electrical code is recognized by the chip. The electrical code can be generated by a device generating the electrical code and included in a plurality of objects, such as a key chain. In yet another embodiment, illustrated in  FIG. 44 , passive identification technology is used to release the strip  12  from the hub  14  wherein when a passive tag is passed near the linkage device  10 , the hub  14  will release the strip  12 . More specifically, the hub  14  has an electronic latch system  350  which releases the strip  12  when a proper signal is recognized. The hub  14  is electrically activated with a circuit  352  that moves the latch  350  between a first (closed) and second (open) position. A portable power supply  106  is also provided. A power signal transmitter  355  is connected to the power supply  106  for transmitting an inducing power signal at a predetermined electromagnetic flux. A passive identification tag  357  is attached to a device, such as a key chain, and is preprogrammed with an identification code that is pre-selected from a large number of available identification codes. The passive identification tag  357  is responsive to the power signal and provides a return signal on the power signal representative of the preprogrammed identification code so that the power signal acts as a carrier of the imposed code signal. A reader circuit  360  is connected to the power signal transmitter and to the electrical activation circuit. The reader circuit  360  is responsive to the return signal to activate the electrical activation circuit to provide power from the portable power supply to move the latch between the first position to the second position, when the reader circuit determines that the identification code represented in the return signal matches an authorization code stored in the reader circuit  360 . 
   In another preferred embodiment, illustrated in  FIG. 13 , an adjustable torque screw is disclosed as part of the hub  14 . One skilled in the art will readily recognize a plurality of ways that an adjustable torque screw can be mechanized as part of the hub  14 .  FIG. 13  illustrates one embodiment where the torque screw  200 , when rotated is used to either feed the strip  12  into the hub  14  or to remove the strip  12  from the hub  14 . In a preferred embodiment as illustrated, the torque screw  200  is connected to a flat ratchet wheel  202  that has an outer edge  203  that engage rollers  206 ,  215  where the second roller  215  is a reverse roller engaging a second vertical roller  205 , causes it to turn opposite the first vertical roller  206 . The bottom of the plate  204  has protrusions  207  that engage a horizontal roller  210 . The vertical and horizontal rollers  205 ,  210  engage the strip  12 . Beneath the strip  12  is a second horizontal roller  212 . A reverse roller  215  is provided between the right vertical roller  205  and the ratchet wheel  202  which allows the right vertical roller  205  to spin in the opposite direction of the left vertical roller  206 . Torque screw  200  turns the ratchet wheel  202  to the right (or left) which engages the vertical roller  206  and turns it in a counter direction left (or right). The reverse roller  215  on the other side engages the ratchet wheel  202  and also turns in a counter direction left. This reverse roller  215  engages the vertical roller  205  to turn it to the right (left). Thus both vertical rollers  205 ,  206  spin in opposite directions to pull/push the strip  12  into/out of the hub  14 , via their directional influence on the turning of the horizontal spikes  209  and due to the turning of the bottom ratchet wheel  217  by the vertical roller  205 , while the top ratchet wheel  202  is turned in an opposite direction by the torque screw  200 . 
   There are numerous medical and dental uses for a preferred embodiment of the present invention. One such use is as a sternum suture-closing device, as is illustrated in  FIG. 14 . Prior to placing the invention  10  around a sternum, a dilator  22 , made of plastic, metal, silk, or Teflon™, secures a needle  23 , typically a stainless steel needle, to the second end  15  of the present invention. The invention is made of an X-ray transparent material, and has a closure device hub or socket  14 , such as a closure clip at a second end. In a preferred embodiment, shark-tooth ridges  17 , or other shaped ridges such as in a recessed double ridge back configuration, begin at the first end  15  and extend for a specified length of the invention  10 . On a flat surface between the closure clip, or hub  14 , and the ridges  17 , an identification plate, tag, or chip  20  is attached, or imbedded. In another preferred embodiment the chip is the hub  14 . On that portion of the invention that contacts the anterior aspect of the sternum, an anti-slip surface  25 , such as, but not limited to, roughening the backside, or Gortex™, may be applied. This surface will help hold the invention  10  in place as it is wrapped around the sternum and the first end  15  is secured in the hub  14 . In another preferred embodiment, the backside may have a glue surface, which will hold the invention in place once stationary for a given period. As already discussed and illustrated in  FIG. 4 , viper-teeth  19  extend from or near the hub  14  towards the bone being repaired. Similarly, in another preferred embodiment (not shown), reverse viper-teeth  19  are positioned on the hub  14  and extend towards the cavity of the hub  14  receiving the second end  15 , thus also assisting in holding the second end  15  in place once inserted into the hub  14 . 
   In one preferred embodiment, as further illustrated in  FIG. 4 , once the needle  23  is inserted around the under surface of the sternum  30 , or another bone or object, the needle is threaded through the closure clip  14  until the second end  15  of the invention  10  engages the closure hub  14 . Then the second end  15  is pulled through until the invention  10  has pulled the sternum  30  together to effect the healing process.  FIG. 15  illustrates another configuration of the present invention  10 . Instead of being looped around the sternum  30  once, to provide external compression to assist the healing process and to reduce the number of sutures required to close the sternum, the present invention  10  is double-looped, in a “pretzel shape,” around the sternum  30 . Thus, in this configuration, a single suture closes two sternal segments. 
     FIGS. 16A ,  16 B, and  16 C are exemplary embodiments of the present invention used as vascular clips. The hub  14  has an opening  221  in a vertical direction wherein the second end of strip  12  bends upward and fits within the opening of the hub  14 . The strip  12  has a first part  225  and a second part  227  that are connected by a joint  230 . The first and second parts are convexly shaped to apply extra pressure to the vessel or pipe that is being clamped. The first part  225  and the bottom  227  are more rigid. The area where the first part  225  and the second part  227  meet to form the clamp section may have soft or hard teeth  232  and intervening gaps  233  which can be varied in configuration based on the use of the clip. As is further illustrated in  FIGS. 16A ,  16 B, and  16 C, in one preferred embodiment the first part has teeth and gaps and the bottom part has alternating gaps and teeth to receive the top half  225  seamlessly when the two parts  225 ,  227  are approximated at closure as shown in  FIG. 16C . These teeth are however soft, and will yield to the vessel, or pipe wall, but will occlude the vessel or pipe lumen. In other preferred embodiment, if needed, the teeth can be hard can act to cut or permeate the structure being clamped. 
   A plurality of tools may be used to insert the present invention  10  within a patient.  FIG. 17  illustrates a device, an insertion device  32 , to allow for a plurality of the present inventions to be placed around a bone or close a wound at one time. As illustrated, the insertion device  32  has a first and a second handle  34 ,  36 . Between the handles is a rod  38 , or bar, which has attachments  40  for the needles  23 . The needles are attached to each of the present inventions by way of dilators  22 , as shown in  FIG. 4 . In one embodiment, the needles  23  are placed through the rod  38  by separating the rod vertically into two pieces  35 ,  37  where once the needles  23  are positioned, closure devices  41 , such as screws, hold both parts  35 ,  37  of the rod  38  and the needles  23  in place. One skilled in the art will readily recognize that other embodiments are available to connect the needles to the rod. Since 3 to 6 suture wires are typically used to close a sternum  30 , the device can hold as many of the linkage devices as needed. In a preferred embodiment, the needle attachments  40  are adjustable in a right to left direction, or a lateral direction along the rod  38  when the insertion device  32  is parallel to a horizontal surface, so that a spacing of the needles  23  is specific to a given patient. This spacing can be pre-set based on measurements taken from a pre-operative X-ray of rib interspaces of the patient, or made at the time of wound closure, tailored to fit the size needed. 
   In operation, as illustrated in  FIG. 18 , a surgeon holds both handles  34 ,  36 , similar to holding a rolling pin, while standing on the patient&#39;s side, such as the left side, of a patient above the split sternum. The needles  23  are introduced into the intercostal spaces on the side of the sternum farthest away from the surgeon. The handles  34 ,  36  are physically rotated with a forward twist to insert the needles through the muscle layer. Once through the muscle layer, the device is pulled towards the surgeon advancing the needles behind the sternum  30 , until the needles  23  start to protrude through the intercostal interspaces on the other side of the split sternum  30  (i.e., the side closest to the surgeon). The apparatus is unclamped, and then each needle  23  is pulled through the intercostal space, such as with forceps. Each needle is then threaded through the hub  14  of the linkage device  10  to secure the invention around the wound, split sternum or any other defect requiring closure. For example, an osteoporotic femur  42 , as illustrated in  FIG. 19 , fractured in multiple places requiring an intra medullary rod  44  and multiple circumferential support bands  10  to hold the bone together. As is discussed in more detail below, in another preferred embodiment of the linkage device illustrated in  FIG. 19 , a single hub  145  has a plurality of strips  12  extending from the hub  145 . The hub  145  has a plurality of openings to accept the plurality of strips  12 . As further illustrated in  FIG. 19 , the linkage device having the plurality of strips can be used for certain areas of a body, such as for fixation of a fractured greater trochanter  47  located on the femur. 
   In another embodiment, the insertion device  32  is used for long fascial wound closures, such as closing an abdominal wound as disclosed in  FIG. 20 . In larger patients, steel sutures are currently used to close an abdominal wound because of the increased tensile strength of the wire versus routine silk and catgut dissolvable suture material. In a preferred embodiment, the insertion device  32  is expandable to close a long wound, such as a long abdominal to pelvis incision. For such an incision, the insertion device  32  is expanded up to, but not limited to, 40 to 50 cm. 
   In another preferred embodiment, a crimper/staple-like apparatus  46 , or gun, is used to secure the linkage device around a bone  30 . In a preferred embodiment, disclosed in  FIG. 21 , the gun has crimper jaws  48  that bend the ends backward, as disclosed in  FIGS. 21 and 22 , and then when activated, push the linkage device  10  around the bone causing the ends  14 ,  15  to connect and lock.  FIG. 22  further illustrates a plurality of closure devices  10  loaded internally within the insertion gun  46 . A spring-loaded handle  49  is pulled close to activate closure of the crimpers  48 . In another preferred embodiment, illustrated in  FIG. 23 , the stapler device has a stamper mechanism  50  and a guide device  52  that fits around the bone, or object, being mended, and comprises a push-arm mechanism and roller device  54  to assist in placing the linkage device  10  and smoothing it out to insure a secure fit around the bone and assists in locking the ends,  14 ,  15  together. The stamper mechanism also has the ability to imprint a date, time, or other information impression upon the linkage device where the imprinted information can be read (e.g., physically photonically, or electronically). 
   In another preferred embodiment, illustrated in  FIG. 24 , a drill bit apparatus  56  is used to insert the linkage device  10  into a hardened substance, such as a bone and/or concrete. The drill bit apparatus  56  could be used in a surgical procedure involving Stealth Technology™, such as with a reference frame used to repair a fractured knee or damaged ligament. As further illustrated in  FIG. 24 , the apparatus  56  has a main body  58  and a drill bit end  60 . A cavity  69  in which the linkage device  10  fits is located within the main body  58  of the apparatus. In one embodiment, a top end  62  of the main body is removable so that the linkage device  10  may be placed within the cavity  69 . The drill end  60  is detachable from the main body  58 , such as by way of detachable clamps  64 . Thus, in a second embodiment, the drill end  60  is removed from the linkage device  10  by a screw  67  attaching the two. The device is then placed into the cavity through a second end  66  of the main body  58 , which is an alternate loading method. 
   In operation, either the whole apparatus  56  is rotated to allow the bit  60  to burrow into the hardened substance or in a preferred embodiment, the main body  58  has a spring  59  which allows the apparatus to be spring activated and turned by pushing up and down by hand on the main body  58  where a compression wall  61  is provided around the spring. Those skilled in the art will recognize other ways in which to mechanize the apparatus  56  so as to effectuate a spring loaded drill press. 
   In another embodiment an electric motor or air powered driving device  71  within the apparatus  56  turns the bit end  60 . Though not illustrated, if the device is rotated, either a motor or an air powered rotation device is provided. In another preferred embodiment, the connection  67  between the drill end  60  and the main body  58  is configured to allow the drill end  60  to pivot up to a one hundred and eighty degrees about the connection point  67 . In another embodiment, such as when used with a Reference Frame  240 , this device and its insertion can be coordinated with the patient&#39;s own unique anatomy determined from either a prior CT or MRI study. Stealth Technology™ has used this type of information in spinal surgeries. As is further illustrated in  FIG. 25 , the tip can be robotically guided and/or includes technology to be auto-finding to locate where to insert the linkage device  10  within a body of material. Infrared or other locator diodes help to reference the apparatus  56  to the patient in the Stealth™ Reference Frame  240 . 
   With respect to the vascular clip multiple insertion device configurations, a preferred embodiment of an insertion device is illustrated in  FIG. 26 . The insertion device  245  holds a plurality of clips, or linkage devices  10  where when one is inserted, a spring  247  pushes another clip  10 , as illustrated in  FIGS. 16A and 16B , into place for insertion. As illustrated the insertion device  245  has an area  250  to close the clip  10  about to be inserted and an insertion hammer  252  that pushes the clip into the operative field and then together presses the end of the strip  12  into the hub  14 . A second arm  251  is provided on the insertion device with a hammer end  252  that pushes the clip  10  out of its resting place and into the surgical field. 
   In another preferred embodiment, the linkage device may be daisy-chained with other embodiments of the linkage device. Daisy-chaining the linkage devices may be needed to fit the linkage devices around an object larger than the embodiments of an individual linkage device  10  currently at hand. In another embodiment, the linkage devices may be daisy-chained to tether objects or to move objects  110  about a fixed point or object  112 , as disclosed in  FIG. 27 . In such cases, a need may arise to provide electrical power through the linkage device, by way of an electrical line imbedded within the strip  114 . In a preferred embodiment, illustrated in  FIGS. 28 and 29 , a power feeder  120 , or electric socket adapter, fits within a closure hub  14 . The power feeder  120  has electric contacts  122  that engage a connection  125  within the closure hub  14 , such as “clam foot” contacts  125  extending from the inner surface of the closure hub, to receive the electricity. In a preferred embodiment, a surface within the closure hub  126 , which may be spring loaded, is provided to insure that the power feeder  122  contacts make contact with the connection part, or “clam foot,”  125  of the closure hub  14 . A second end  130  of the power feeder  120  can be plugged into an electric outlet, or connected to some other power source, such as a battery, as further illustrated in  FIG. 28 . Except for the contacts  122  and connection surfaces  125 , the rest of the closure hub  14  and feeder  120  are insulated so that a user can handle these components without receiving an electrical shock. In another preferred embodiment (not shown) where fiber optic stands are used, as discussed above, instead of providing power through the feeder  120 , the feeder  120  is used to provide photons from a source to the fiber optic strands of the device  10 . 
   In another preferred embodiment further illustrated in  FIG. 27 , the hub  14  is motorized where once a strip engages the hub, a motor  140  can be activated, either manually, or self activation, allowing the motor in the hub  14  to pull the strip  12  into the hub&#39;s opening as far as needed. The motor  140  may be powered by any source such as, but not limited to, a solar cell that provides electricity to the motor, a fuel cell, such as a battery connected to the linkage device, or an electric hub adaptor as discussed above with respect to  FIGS. 28 and 29  where instead of having power feeder  120  fitting within a hub  14 , the hub is connected directly to the power feeder  120 . In one embodiment, the motor  140  can be reversed should the strip  12  need to be removed from the motorized hub  140  or if more length is needed for the strip.  FIG. 27  shows five hubs A, B, C, D and a power hub connection (not labled). 
   Power may be generated by or through the linkage device in a plurality of ways. A plurality of power sources  106  can be used. Such power sources include, but are not limited to, battery, photo electric/laser light, inductive power, atomic power, and/or glucose/mitochondrial fuel supply. An example of power being generated is illustrated in  FIG. 30 . As illustrated, a strip  12  is connected to a kite  255 , the sides of which are derived from unspooling, or uncoiling, the devices, as illustrated in  FIG. 5A  and  FIG. 38 . The hub  14  has a propeller and generator  257  within it. The turning of the propeller  257 , by wind or water, generates electric power which is fed back through the strip  12  to a hub  14 , which has a battery storage device  106 . The kite itself is composed of interlocking linkage devices where the kite sides are stored within the strip and are spooled out from within the linkage device  10 . 
   In another embodiment power is provided from a remote source  107  wherein the power is then stored in a battery or capacitor, as illustrated in  FIG. 2B . Another source of power is inductive power. This can be added to the linkage device wherein power is supplied by connecting the strip to the hub forming a conductive loop that can in turn have current induced within it from an external electromagnetic frequency flux  107 . 
   Other embodiments of where the linkage device can be used where it is daisy-chained together and/or stacked are illustrated in  FIGS. 31 through 33 . In  FIG. 31  the linkage devices are used to form a wall sign  270  where the hub  14  has strips, and/or nobs,  12  extending from more than one surface for connection to another hub. A surface  271  of the hub  14  may be used for the signage or display area.  FIG. 32  illustrates hubs  14  that have recessed lighting sockets  280 , where the identification labels  20  may also be illuminated. Power can be supplied by a plug  130  and wire  120  to the hubs connected in series.  FIG. 33  illustrates the linkage device  10  being used as a small bowel endoscope in a human, since the length of the small bowl, approximately twenty-two feet, limits current endoscopes. With the daisy chain ability of this device, as many as are needed can be threaded through the intestines. 
   In another embodiment illustrated in  FIG. 34 , a funnel-like device  119  is connected to the end of the hub  14  receiving the strip  12 . The funnel-like device  119  further assists the linkage device  10  in connecting both ends  14 ,  15  together and can assist in transport of a fluid, including, but not limited to liquid, gas, plasma, and semisolid.  FIG. 46  is an illustration of the several linkage devices daisy-chained together and being used to remove a movable medium, such as oil, from a submerged tanker leaking oil. In one preferred embodiment, suction is applied through the linkage devices to pull the fluid through the linkage devices. In another preferred embodiment, illustrated in  FIG. 46 , the fluid is assisted by paddle devices  93  which are driven by an internal motor powered from an external and/or internal power supply (not shown). 
   The linkage device  10  can also be configured where the closing hub, or multi-hub, can accept a plurality of strips within a plurality of openings in a closing hub  145 , as illustrated in  FIG. 35 , as discussed previously with respect to  FIG. 19 . The hub can have a plurality of different shapes such as, but not limited to, hexagonal, pentagonal, square, or etc., where each side could have an opening disposed therethrough. In one embodiment a single strip  12  is connected to the closure hub  145 , but in other embodiments a plurality of strips  12  are connected wherein the number of strips  12  can equal or exceed the number of openings in the closure hub  145 . As discussed above, one of the openings may be used to provide electrical power to the linkage device  10 , which in turn provides power through all strips connected to the closure hub. 
   Using a multi-hub, integrated structures can be created, such as a net, or another 3-dimensional structure, wherein a plurality of the linkage devices with the multi-hub  145  are connected to form the basic structure of the net, and a finer material  147  is used to cover the basic structure, as illustrated in  FIG. 38 . The material  147  is stored, spooled, within a first linkage device, as illustrated in  FIG. 5A , wherein the other linkage devices comprise grooves, or connecting surfaces (not shown), to hold the material  147  in place. The material  147  is able to be pulled out and is retractable just like a window shade or projector screen. The center spool  148  is spring-loaded to allow the material to be pulled back inside the outer shell of the strip  12 . 
   In other exemplary embodiments, such as illustrated in  FIGS. 36A and 36B , the linkage device can be used as handcuffs where a multi hub  145  is provided with two strips  12 . The strips may extend from the same side of a hub, as illustrated in  FIG. 36B  or extend in opposite directions as illustrated in  FIG. 36A . The disposable cuffs could include a tag with such information as, but not limited to, the time/date of the arrest, crime committed, arresting officer, etc, tying a face, and/or fingerprints to an identification band by software (not shown). In other embodiment, a chip for information storage or a capacitor to deliver a shock to a prisoner is provided (not shown). As further illustrated in  FIG. 37 , a pressure column device, or field dressing, is provided, where the multi hub  145  is used to apply pressure to a wound. As illustrated the linkage device is used around a leg, such as the right leg  285  while the second strip immobilizes a second, or left, leg  286 . 
   In another preferred embodiment, illustrated in  FIG. 48 , the linkage devices are used as braces to correct teeth. As illustrated, a multi-hub  145  is used where a strip  12  is wrapped around a tooth  97  and then is inserted through the hub  145 . The strip is then inserted to an adjoining hub  145  connected to an adjacent tooth. A torque screw  200  is connected to the hub  14  to secure the strips in place. In a preferred embodiment the torque screw  200  does not adjust its own strip, but instead adjusts tension on the strip attached to the adjacent tooth. In another embodiment, not shown, two torque screws are provided on a hub to adjust each strip. 
   In another preferred embodiment, when using the linkage device to secure packages, instead of using glue on the back of the invention to hold the invention in place, corner tabs  150  placed at the edges of the container and the linkage device  10  is fed through an opening in the corner tabs  150 , as illustrated in  FIG. 39 . The protrusions  17  on the linkage device will then engage protrusions  154  on the inner surface of the corner tabs  150 , preventing the presenting invention from slipping. In another preferred embodiment, the stopper ends  151 ,  153  of the corner tabs  150  are pressed in toward the container thus providing a further block to any slippage of the linkage device  10  by acting as a stiff restraint to the reverse motion of the device by engaging the protrusions  17 . 
   Referring again to medical uses, the linkage device can be used to replace a tendon in a knee, such as when an anterior and/or posterior cruciate ligament (ACL or PCL, respectively) injury occurs. In a preferred embodiment, as illustrated in  FIGS. 40 and 41 , a tunnel  160  is drilled into the femur  165  and tibia  166  so that the linkage device is positioned in the location that the ACL or PCL should be located. The tunnel  160  in the tibia  166  starts slightly wider and grows smaller so that the external cortical hub  14  will fit snuggly within the tibia  166 . Similarly, the end where the linkage device  10  exits the femur  165  has a hole  162  that is large enough to accommodate the fixed cortical hub  180  it inserts into, as illustrated in  FIG. 41 . In another preferred embodiment the linkage device  10  could be inserted into the disc, attached to a hub (not shown). Once the linkage device is pulled through, a hub  170  is pushed onto a fixed device in the cortical  180  which can accept the hub or strip of the device as needed. To show this anchor, as illustrated in  FIG. 41 , the anchor  180  is fitted within a hole  162  where the anchor  180  has a connection point which holds a linkage device in place by way of its hub  170 , or second end  15  (not shown). One skilled in the art will realize that the hub  170  can be placed in the tibia  166  and the second end  15  passes through the femur  165 . These holes can be smaller than the tunnels currently used for native ligament repairs. 
   As further illustrated in  FIG. 40 , cortical discs  218  are provided to anchor the strip  12  much as the anchor  180  are dclosed with respect to  FIG. 41  and  FIG. 42 . In another preferred embodiment, illustrated in  FIG. 47 , when the drill insertion device  62  is used, the drill bit  60  remains in the femur as the superior anchor with one end, the hub end, of the linkage device  10  connected to the bit and the other end  15  is secured by the external cortical bone anchor  218  outside of the tibia  166 , or an implanted anchor  162  (not shown). There can be a torque screw  200 , not shown, to tighten the artificial ligament as needed at the external end of the strip  12  as it exits the cortical disc  218 . 
   As is fully illustrated herein, a plurality of uses for the linkage device is available.  FIG. 42  is an illustration of an exemplary embodiment of the linkage device used to repair a ruptured medial collateral ligament. As illustrated a plate, anchor, or saucer,  305  is secured to the medial condyle of the femur.  301 . In a preferred embodiment screws  303  are used to secure the plates, or anchor,  305 ,  306  to the bone. A hub  304  is fixed to one plate  306  and a hub  314  with a strip is fixed to the second plate  305 . Once the plates  305 ,  306  are in place, the strip  12  is inserted into the second hub  304  until a predetermined tension is achieved. A tension screw  200  can modify this tension. 
   In another embodiment, illustrated in  FIG. 43 , the insertion hub is a replacement tire, or belt  320 , such as for a bike, and the strip  12  connects the hub until its two facing surfaces are flush or a minimum gap is left. In a preferred embodiment, an adjustable torque screw  200 , discussed above, is used to further secure the replacement tire  320  to a rim  325 . In another preferred embodiment, not shown, the linkage device is used as an emergency fan belt where the strip connects to the hub after being placed around its respective pulleys and then is tightened by the adjustable torque screw. 
   While the invention has been described in what is presently considered to be a preferred embodiment, many variations and modifications will become apparent to those skilled in the art. Accordingly, it is intended that the invention not be limited to the specific illustrative embodiment, but be interpreted within the full spirit and scope of the appended claims.