Helical orthopedic fixation and reduction device, insertion system, and associated methods

Abstract

An orthopedic system for fixation of a soft tissue tear includes a generally helical fixation element. A hollow, generally helical insertion element is dimensioned to admit at least a distal portion of the fixation element into a lumen thereof. The insertion element is insertable in a screwing motion along the soft tissue tear, and is removable in a reverse screwing motion, leaving the fixation element positioned helically in bridging relation along the tear. A pair of guide needles is provided, wherein one needle is insertable along each of opposed sides of the tear. The proximal ends of each needle are movable into a closely opposed relation, so that when the pair of needles are closely opposed, the insertion element is insertable along the tear in encompassing relation to the pair of needles.

What is claimed is:  
     
         1 . An orthopedic system for fixation of a soft tissue tear comprising: 
 a generally helical fixation element; and    a hollow, generally helical insertion element dimensioned to admit at least a distal portion of the fixation element into a lumen thereof, the insertion element insertable in a screwing motion along the soft tissue tear, the insertion element removable in a reverse screwing motion, leaving the fixation element positioned helically in bridging relation along the tear.    
     
     
         2 . The system recited in  claim 1 , further comprising means for limiting the fixation element to a predetermined maximum length without limiting compression to a smaller length.  
     
     
         3 . The system recited in  claim 2 , wherein the limiting means comprises a flexible limiting element having a first end positioned in restraining relation to a distal end of the fixation element and having means at a second end for preventing a proximal end of the fixation element from passing therebeyond.  
     
     
         4 . The system recited in  claim 1 , further comprising a pair of guide needles, one needle insertable along each of opposed sides of the tear, proximal ends of each needle movable into a closely opposed relation, wherein, when the pair of needles are closely opposed, the insertion element is insertable along the tear in encompassing relation to the pair of needles.  
     
     
         5 . The system recited in  claim 1 , wherein the fixation element has a first pitch and the insertion element has a second pitch greater than a pitch of the first pitch.  
     
     
         6 . The system recited in  claim 1 , wherein the fixation element comprises a bioresorbable material.  
     
     
         7 . The system recited in  claim 1 , further comprising a flexible restraining element having a first end affixed to a first end of the fixation element and a second end affixable to a second end of the fixation element, the first ends of the restraining element and the fixation element opposed to the second ends of the restraining element and the fixation element, respectively, for retaining the flexible element to a desired maximum length.  
     
     
         8 . The system recited in  claim 1 , wherein the insertion element has an arcuate curvature for repairing an arcuate tear in a generally wedge-shaped portion of soft tissue.  
     
     
         9 . The system recited in  claim 8 , wherein the fixation element has a first pitch and the insertion element has a second pitch greater than a pitch of the first pitch.  
     
     
         10 . An orthopedic system for fixation of a soft tissue tear comprising: 
 a flexible fixation element; and    a hollow, generally helical insertion element dimensioned to admit at least a distal portion of the fixation element into a lumen thereof, the insertion element insertable in a screwing motion along the soft tissue tear, the insertion element removable in a reverse screwing motion, leaving the fixation element positioned helically in bridging relation along the tear.    
     
     
         11 . The system recited in  claim 10 , wherein the fixation element comprises suture material.  
     
     
         12 . The system recited in  claim 10 , wherein the fixation element comprises a bioresorbable material.  
     
     
         13 . A method of fixating a soft tissue tear comprising the steps of: 
 inserting a generally helical insertion element along a soft tissue tear in a screwing motion;    inserting at least a distal portion of a generally helical, flexible fixation element into a lumen of the insertion element; and    withdrawing the insertion element in an unscrewing motion, leaving the fixation element in position along the tear, drawing two sides of the tear together.    
     
     
         14 . The method recited in  claim 13 , further comprising the step of limiting a length of the fixation element to a predetermined maximum length.  
     
     
         15 . The method recited in  claim 14 , wherein the limiting step comprises affixing a first end of a flexible limiting element in restraining relation to a distal end of the fixation element, a second end of the flexible limiting element affixed to a proximal end of the fixation element.  
     
     
         16 . The method recited in  claim 13 , further comprising the steps, prior to the insertion element inserting step, of inserting a pair of guide needles along each of opposed sides of the tear 
 moving proximal ends of each needle into a closely opposed relation; and    wherein the insertion element inserting step comprises inserting the insertion element along the tear in encompassing relation to the pair of needles.    
     
     
         17 . The method recited in  claim 13 , wherein the fixation element has a first pitch and the insertion element has a second pitch greater than a pitch of the first pitch.  
     
     
         18 . An orthopedic system for fixation of a soft tissue tear comprising: 
 a length of flexible material having a first end and a second end; and    a hollow, generally helical insertion element comprising a plurality of loops and dimensioned to admit the flexible material into a helical lumen thereof, a portion of the flexible material extending from a distal end thereof and passable through the lumen toward a proximal end of the insertion element, the insertion element insertable in a screwing motion along the soft tissue tear, at least some of the loops of the insertion element bridging the tear, and the insertion element removable from the soft tissue in a reverse screwing motion, leaving the flexible material positioned in stitching relation to the tear, the first and the second ends of the flexible material tightenable to bring two sides of the tear together.    
     
     
         19 . The system recited in  claim 18 , further comprising means for limiting the fixation element to a predetermined maximum length without limiting compression to a smaller length.  
     
     
         20 . The system recited in  claim 19 , wherein the limiting means comprises a flexible limiting element having a first end positioned in restraining relation to a distal end of the fixation element and having means at a second end for preventing a proximal end of the fixation element from passing therebeyond.  
     
     
         21 . The system recited in  claim 18 , further comprising a pair of guide needles, one needle insertable along each of opposed sides of the tear, proximal ends of each needle movable into a closely opposed relation, wherein, when the pair of needles are closely opposed, the insertion element is insertable along the tear in encompassing relation to the pair of needles.  
     
     
         22 . The system recited in  claim 18 , wherein the fixation element has a first pitch and the insertion element has a second pitch greater than a pitch of the first pitch.  
     
     
         23 . The system recited in  claim 18 , wherein the fixation element comprises a bioresorbable material.  
     
     
         24 . The system recited in  claim 18 , further comprising a flexible restraining element having a first end affixed to a first end of the fixation element and a second end affixable to a second end of the fixation element, the first ends of the restraining element and the fixation element opposed to the second ends of the restraining element and the fixation element, respectively, for retaining the flexible element to a desired maximum length.  
     
     
         25 . The system recited in  claim 18 , wherein the insertion element has an arcuate curvature for repairing an arcuate tear in a generally wedge-shaped portion of soft tissue.  
     
     
         26 . The system recited in  claim 25 , wherein the fixation element has a first pitch and the insertion element has a second pitch greater than a pitch of the first pitch.  
     
     
         27 . A method for repairing a tear in soft tissue comprising the steps of: 
 inserting a generally helical insertion element along a soft tissue tear in a screwing motion, the insertion element having a helical lumen and a first portion of flexible material inserted therethrough, a second portion of flexible material extending out of a distal end of the insertion element and passing through an axial lumen thereof;    removing the insertion element while leaving the flexible material in place in stitching relation to the soft tissue tear;    pulling ends of the flexible material sufficiently taut to bring two sides of the tear together; and    securing the flexible material ends to retain a desired level of tautness in the soft tissue.