Woven or braided tubular metal structures

Abstract

Multifilament micro cables replace traditional monofilament threads as structural elements of woven or braided belts. This enhances the functionality and manufacturability of such belts in various applications, such as orthopedic surgery applications, including sternal closure.

Description

[0001] This application is a divisional application of the Chinese invention patent application with the application date of January 20, 2017, application number 201780007543.8, international application number PCT / US2017 / 014355, and name “Woven or braided tubular metal structure”.

[0002] Cross-reference to related applications

[0003] This application claims the benefit of U.S. Provisional Patent Application No. 62 / 286,062, filed on January 22, 2016, and entitled WOVEN OR BRAIDED TUBULAR METALCONSTRUCT, the entire disclosure of which is expressly incorporated herein by reference. background 1. Technical Field

[0005] The present disclosure relates to woven or braided bands, and in particular to woven or braided metal bands configured for use in high strength surgical suturing applications such as sternotomy closure.

[0006] 2. Description of related technologies

[0007] Woven or braided hollow tubes made of, for example, metal or polymer materials are sometimes used in corrective surgical applications, such as sternal closures. Such closures present unique challenges due to the potential for large movements near the incision as the patient moves and the attendant large forces that may be applied to the sutures.

[0008] To prevent damage to the bone, these woven or braided structures are adapted to lay flat on the bone to distribute the pressure from axial tension. Other such closures can be made from flat strips of material that also reduce the forces on adjacent bone or other tissues, provided that the flat surface of the strip is the contact surface.

[0009] Improvements over the foregoing are needed. Overview

[0010] The present disclosure relates to multifilament micro cables that replace traditional monofilament threads as structural elements of woven or braided belts. This enhances the functionality and manufacturability of such belts in various applications, such as orthopedic surgery applications, including sternal closure.

[0011] In one form thereof, the present disclosure provides a multifilament tubular structure comprising: a plurality of structural elements woven or braided into a tubular structure, the tubular structure defining an inner diameter, an outer diameter, and an axial length in the absence of external forces, the structural elements each comprising a plurality of metal wires having respective longitudinal axes extending substantially parallel to one another.

[0012] In one aspect, the structural element is a stranded cable in which the longitudinal axes of the plurality of wires each define a helix extending substantially parallel to one another.

[0013] In another aspect, the plurality of wires of the structural element comprises 2-343 wires.

[0014] In another aspect, the inner diameter of the tubular structure is from 0.010 inches to 0.200 inches, and / or the outer diameter of the tubular structure is from 0.014 inches to 0.208 inches.

[0015] In another aspect, the plurality of structural elements comprises 8-128 structural elements.

[0016] In another aspect, the plurality of structural elements define a plurality of picks at each intersection between adjacent structural elements, the number of picks being 1-50 per inch of axial distance along the outer surface of the tubular structure.

[0017] In another aspect, the structure further comprises at least one friction fit fitting formed at an end of the tubular structure.In one embodiment, the friction fit fitting cannot be removed from the tubular structure by a separation force of less than 142 lbf.

[0018] In yet another aspect, at least one of the plurality of wires of the structural element is formed of an absorbable metal, such as at least one of magnesium, zinc, iron, and alloys thereof.

[0019] In yet another aspect, at least one of the plurality of wires of the structural element is formed of stainless steel and / or a superelastic alloy such as Nitinol, and / or a cobalt-based alloy, and / or a cobalt-chromium alloy. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] The above and other features and objects of the present invention and the manner in which they are achieved will become more apparent and the present invention itself will be better understood by referring to the following description of embodiments of the present invention and the accompanying drawings, in which:

[0021] Figure 1A is a front view of a braided tubular structure prepared according to the present disclosure;

[0022] Figure 1B is an enlarged elevational view of a portion of FIG. 1 illustrating the individual twisted cables that form the structural element of the braided tubular structure;

[0023] Figure 2 To explain Figure 1A A schematic diagram of an example braiding pattern used in a braided tubular structure;

[0024] Figure 3Ais a cross-sectional view of a strand wire according to the present disclosure having three individual filaments constituting a strand of the wire;

[0025] Figure 3B is a cross-sectional view of another twisted wire according to the present disclosure having seven individual filaments making up a strand of the wire;

[0026] Figure 3C is a cross-sectional view of yet another twisted wire according to the present disclosure having 19 individual filaments constituting a strand of the wire;

[0027] Figure 3D is a cross-sectional view of a stranded cable according to the present disclosure having 7 sets of 7 individual filaments for a total of 49 strands constituting the cable;

[0028] Figure 3E is a cross-sectional view of another twisted-pair cable according to the present disclosure having 7 sets of 19 individual filaments for a total of 133 strands constituting the cable;

[0029] Figure 3F is a cross-sectional view of yet another twisted-pair cable according to the present disclosure having 7 sets of 19 individual filaments for a total of 133 strands constituting the cable;

[0030] Figure 3G is a cross-sectional view of yet another twisted-pair cable according to the present disclosure having 7×7 sets of 7 individual wires for a total of 343 strands constituting the cable;

[0031] Figure 4 is a perspective view of a sternal closure plate including a braided tubular structure according to the present disclosure;

[0032] Figure 5A is a cross-sectional elevational view of the braided tubular structure of FIG. 1 taken along line 5A-5A of FIG. 1 , shown in a free state without any external force applied;

[0033] Figure 5B for Figure 5A Another cross-sectional elevation view of a braided tubular structure illustrating a "flattening" deformation of the structure when it is bent or compressed about a surface; and

[0034] Figure 6 is an elevation view of a braided structure prepared in accordance with the present disclosure illustrating specific structural geometry and parameters.

[0035] Corresponding reference characters indicate corresponding parts throughout the several views. Although the exemplification described herein illustrates embodiments of the invention, the embodiments disclosed below are not intended to be exhaustive or to limit the scope of the invention to the precise forms described. Details

[0036] introduction

[0037] The present disclosure provides a braided or woven tubular structure 10 as shown in FIG. 1 , wherein each structural element 12 is composed of a plurality of twisted strands 14 ( Figure 2 As described in further detail below, the use of the multi-strand component 12 in the structure 10 provides a smooth texture or "feel" that facilitates the use of the structure 10 in corrective surgery and other medical applications, provides a large surface area contact with adjacent bone or tissue when the structure 10 is laid flat, and allows for high-strength crimped connections at the ends of the structure 10.

[0038] In one exemplary embodiment, for example, a multi-strand braided band 10 is prepared from a plurality of multi-strand component cables 12 having a total outer diameter of 0.0075 inches. This design is compatible with existing tools and orthopedic devices designed for use with existing monofilament component braids having individual filaments having a diameter of 0.0051 inches, so that the band 10 can be used with an ecosystem of industry standard orthopedic devices and connectors. However, instead of using 48 monofilament wires for a completed woven structure, the band 10 can use 48 twisted cables 12, each having 7 filaments for a total of 224 individual integral strands 14. It was found that this increase in the number of filaments and the accompanying reduction in the diameter of each individual strand 14 provide significant performance advantages, as further described below.

[0039] the term

[0040] As used herein, "silk" or "silk product" includes continuous filaments and silk products that can be continuously produced and wound onto a bobbin for later distribution and use, such as filaments with a circular cross section and filaments with a non-circular cross section, including flat filaments or ribbons. "Silk" or "silk product" also includes other silk-based products, such as strands, cables, coils, and tubes, which can be produced in specific lengths depending on specific applications. In some example embodiments, the filament or silk product according to the present disclosure may have a diameter of up to 2.5 mm.

[0041] "Nitinol" is a trade name for a shape memory alloy containing about 50 atomic % nickel and the balance titanium, also known as NiTi, which is commonly used in the medical device industry for highly elastic implants. An exemplary NiTi material is described in U.S. Patent No. 8,840,735, filed on September 18, 2009 and entitled "Fatigue Damage Resistant Wire and Method of Production Thereof," the entire disclosure of which is expressly incorporated herein by reference.

[0042] "Impurities," "incidental impurities," and "trace impurities" are components of a material present in a material at less than 500 parts per million or 0.05% by weight.

[0043] is a registered trademark of Fort Wayne Metals Research Products Corp., Fort Wayne, IN, and refers to a bimetallic or multimetallic composite wire product comprising two or more concentric layers of metals or alloys, typically at least one outer layer disposed on a core wire, the outer layer being formed by drawing a tube or multiple tube layers over a solid metal wire core element. The structure and processing of DFT materials are described in U.S. Patent Application Publication No. 2011 / 0319978, filed on June 24, 2011, and entitled “Biodegradable Composite Wire for Medical Devices,” the entire disclosure of which is expressly incorporated herein by reference.

[0044] As used herein, "fatigue strength" refers to the load level at which a material meets or exceeds a given number of load cycles to failure. Here, the load levels are given as alternating strains, such as the standards for displacement or strain controlled fatigue testing, whereby the terminology is consistent with those given in ASTM E606, which is incorporated herein by reference in its entirety.

[0045] Braid structure and characteristics

[0046] Figure 1A The braided tubular structure 10 shown includes a plurality of structural elements 12 that cooperate to define an outer diameter D O and inner diameter D Iand a longitudinal axis A. In particular, the individual elements 12 are wound around a mandrel (not shown) during production to form a helix, and the individual structural elements 12 are woven or braided relative to one another so as to form a regular overlapping pattern of crisscrossing helices to produce the final tubular structure 10. In many applications, the structure 10 is an inherently flexible structure in both the axial direction (i.e., the axial length of the structure can be "stretched" or "compressed" by forces applied along the longitudinal axis A) and the radial direction (i.e., the longitudinal axis A can be "bent" into a circular or non-linear form). For purposes of the present disclosure, the diameter D of the structure 10 is measured when the structure 10 is in a "free state". O , diameter D I and axial length, wherein no external forces are applied and the overall shape and size of the structure 10 is determined by its braid or woven form, the material of its structural elements 12, and any processing such as heat treatment (described further below).

[0047] Figure 1B Each element 12 is described as comprising a plurality of individual filaments or strands 14 extending parallel to one another. For purposes of this disclosure, a "filament" is a single or integral fiber, while a "strand" may be an integral fiber or a bundle of such fibers. Except as otherwise described herein, a "strand" refers to an integral fiber (i.e., a filament).

[0048] For example, Figure 1B The strands 14 are illustrated as straight wires having longitudinal axes that are parallel to adjacent strands 14 of a given element 12. In another exemplary embodiment, the elements 12 are formed as a multi-strand (i.e., multifilament) cable that includes a plurality (i.e., at least 2) of strands 14 twisted around one another. In this twisted cable design, the strands 14 of each element 12 form a helix that extends substantially parallel to the helix of the adjacent strands, such that the longitudinal axes of the strands 14 in a given element 12 extend parallel to one another.

[0049] Each connection between two elements 12 is referred to herein as a bond point 16, so that the "tightness" of the braid pattern can be expressed as the number of bond points 16 per unit axial length. An exemplary embodiment of the braid pattern of the tubular structure 10 is described in Figure 2 In. As shown, each element 12 includes 2 straight parallel strands 14. For the entire extent of structure 10, each element 12 of the braiding pattern passes through two adjacent elements, and then repeats the pattern under two adjacent elements. The longitudinal axis A is illustrated at a 45 degree angle to the criss-cross longitudinal axis of the element 12 (and strand 14), and 7 binding points 16 are illustrated along the axial portion of the structure 10. Depending on the requirements or needs of a specific application, other braiding patterns may also be used. Examples of suitable braiding patterns include full, diamond and half patterns. In an exemplary embodiment, any machine-woven pattern may be used to produce a high throughput of the braided material used for structure 10.

[0050] The braided or woven structure can be changed according to the requirements or needs of the desired application. In an exemplary embodiment, at least 8 discrete structural elements 12 are used to produce the structure 10, although as few as 4 structural elements 12 can be used. Up to 64 or 128 structural elements 12 can be used, or any number of 4-128 as required. In general, a large number of elements 12 promote a "tighter" braid, i.e. a braid with relatively more binding points 16 per inch, compared to a "loose" or "sparse" braid with fewer elements 12. In an exemplary embodiment, the binding points 16 can be as few as 1 per inch and as many as 50 per inch. A relatively small density of binding points 16 contributes to a smooth feel or "feel", while a higher density of binding points 16 is slightly rougher.

[0051] Figures 3A-3G Various other cross-sectional structures of strands 14 used to form elements 12 of structure 10 are shown. For purposes of this disclosure, Figures 3A-3G The elements 12A-12G are drawn in normal proportion to one another so that the effective outer diameter D C are basically the same. Figures 3A-3G As described above, as the number of strands 14 used in the elements 12A-12G increases, the diameter of each strand 14 becomes smaller. Figures 3A-3G Several example configurations of the multi-stranded wire element 12 are described, and other configurations that are consistent with the principles of wire rope construction may be used depending on the requirements or needs of a particular application. C , a higher number of strands 14 imparts to the structure 10 increased flexibility and "softness" or feel.

[0052] In one exemplary embodiment, the structure 10 is sized and configured for use as a suture or other binding assembly in a surgical procedure. In one particular exemplary embodiment, the structure 10 can be used as a closure cable for a sternal closure system, such as with a sternal closure plate 20 ( Figure 4 ) together, as discussed further below.

[0053] For example, a structure 10 configured for use in such medical closure applications may have an inner diameter D of 0.010 inches to 0.200 inches as measured by the outer diameter of a mandrel about which the structure 10 is braided. I (Figure 1). Outer diameter D O The diameter D of the structural element 12 C Get, that is, D O =D I +2(D C ). For outer diameters D from 0.014 inches to 0.208 inches O Range, diameter D of element 12 CIt can be 0.002 inches to 0.004 inches.

[0054] Additionally, the overall dimensions of the final braid of structure 10 may also be affected by the specific materials used for strands 14 of elements 12. As discussed further below, a variety of metallic materials may be used within the scope of the present disclosure.

[0055] In orthopedic and other applications, the structure 10 offers a number of advantages over woven or braided structures using monofilament components. For example, a structural element 12 using multiple strands 14 has increased flexibility compared to comparable monofilaments, and the individual strands 14 can rearrange around each other to "self-adjust" and lay flat when stretched. This avoids or reduces friction or cutting in adjacent surfaces, such as the sternum or tissue, and provides better load distribution to promote blood flow within the bone.

[0056] The structure 10 including the multifilament structural elements 12 also exhibits a smoother overall finish and feel or "hand" as described above, compared to monofilament braids or woven fabrics. At the same time, the elements 12 can lay flat and substantially parallel to define a textured and consistent surface that can form a surface that is more suitable for swaged fittings and other friction fit fittings such as crimps 22 (used in cerclage applications). Figure 4 ), or for effective anchoring of end plugs in some suturing applications. Since the surface texture can be achieved without kinking or deforming the individual elements 12, the anchoring capability does not bring a loss in the overall axial strength of the device, as demonstrated in the following examples.

[0057] The hollow tubular structure of structure 10 is orientation independent, i.e., it can be expected to lay flat ( Figure 5B ) regardless of its rotational orientation. This orientation independence is in contrast to other forms such as ribbons or other flat structures which are orientation dependent (e.g., the "sharp edge" of the ribbon must not contact the bone).

[0058] The braided or woven structure of structure 10 can be configured to reduce in diameter when placed under axial tension. This reduction allows structure 10 to pass through standard crimping devices of the type that are already widely used with non-tubular braided materials (such as multifilament cable or "wire rope"), while also providing the advantages of the multifilament design of the present invention. In addition, the multifilament design of the present invention is compatible with commonly used surgical instruments, such as sternal closure instruments.

[0059] Braid and strand materials and processing

[0060] As described above, the structural element 12 is made of a metal strand 14. For medical devices, any biocompatible or implantable metal is a suitable candidate for the strand 14, including: stainless steels, such as 316LVM and 2205; cobalt-based and cobalt-chromium alloys, including MP35N, 35N LT, and L605; superelastic alloys, including Nitinol (NiTi), NiTi ternary and quaternary alloys, and titanium beta alloys; titanium alloys; and bioabsorbable metals, including magnesium, zinc, iron, and alloys thereof. Any of these metals may form integral or composite wire materials, such as DFT (described above) and coated wire materials.

[0061] In production, the strands 14 are first formed into individual multifilament structural elements 12 by conventional methods, such as twisting or wire rope forming methods as described above. The structural element 12 is then helically formed around a mandrel using conventional braiding techniques and equipment. At this point, a heat treatment may be applied to "set" or form the element 12 into the desired helical braid form so that the inner diameter D is maintained after the mandrel is removed. I This shaping process can impart any of more than 10 straight and / or curved structures to the final structure.

[0062] For example, a multi-diameter structure may have one or more axial positions with a larger outer diameter D at some axial positions than at other axial positions. I and D O In one embodiment, the structure 10 can be formed with a periodic cycle of the bulbous region in a sinusoidal outer profile, which can be used for enhanced tissue contact in some applications.

[0063] Further thermal stress relaxation may be applied as required or desired for a particular application.The final material of structure 10 may be fully annealed to be "soft", ductile and flexible, or may be heat treated to maintain a relatively stiff and less ductile spring toughness.

[0064] In one exemplary embodiment, the structure 10 is subjected to a heat treatment at a temperature of 300° C. to 2100° C. for 1-1000 seconds. The specific time / temperature combination depends on the materials and the desired results, and can be varied within the above ranges as needed to meet the requirements of the application. The processing atmosphere should also be suitable for processing the specific alloy, and may include air, hydrogen, argon, helium, or mixtures thereof.

[0065] application

[0066] As noted above and Figure 4, an exemplary application of the structure 10 is in conjunction with a sternal closure plate 20. In the described embodiment, the plate 20 can be secured to the patient's sternum by bone screws 24 on either side of the incision and further secured by wrapping the structure 10 around the plate 20 and adjacent portions of the sternum on either side of the incision to form a cerclage. As described, a crimp 22 can be used to secure the ends of the structure 10 to close the loop. Advantageously, in this context, the use of the structure 10 is facilitated by allowing the flattening and self-adjusting structural element 12 ( Figure 5B ) maximizes contact with adjacent bone or tissue surfaces while minimizing stress on adjacent bones.

[0067] Other applications of the structure 10 include musculoskeletal fixation, such as fixation of fractures in the hip or long bones. The structure 10 may also be used for ligament repair and suturing or other soft or hard tissue surgical fixation or closure devices.

[0068] Still other possible applications include pacing leads, which in some cases may need to be made into sharp bends and withstand anatomical structures. Renal denervation is another application, where the structure 10 can be selectively axially stretched to a smaller outer diameter D O and axially compressed to a larger diameter D O To allow delivery through the catheter and controlled expansion once in the renal artery.

[0069] In addition, structure 10 can be used as a stent structure designed for use in body cavities (vascular, gastrointestinal tract, kidney, respiratory organs or other). In particular, some stents are used in devices that require relatively low radial forces and high deformation tolerance, compliance and fatigue life are ideal. Structure 10 provides this combination of features and is therefore suitable for stent applications.

[0070] Another application includes a carrier structure for soft robotic components, such as McKibben muscles, where the structure 10 can be expanded from the inside by pneumatic or hydraulic pressure to achieve a larger outer diameter (e.g. Figure 1A The diameter Do in the structure 10 and the resulting axial contraction. In some embodiments, further adjustment of the output of the soft robotic application can be achieved by incorporating a thermally responsive shape memory alloy wire, such as Nitinol or beta titanium, within the band element 12 of the structure 10, thereby allowing the stiffness response of the material to be changed to change in temperature. In still other embodiments, such temperature sensitive elements 12 can be incorporated into a fluid pressure responsive structure to enable complex multi-axis motion through the combined effects of fluid pressure and temperature. In still other embodiments, the structure 10 can be constructed with integral polymer or metal fibers or with composite structures such as polymer insulated conductive elements to provide electrical functionality to power sensors or other electrical devices that are incorporated or connected to the structure 10 by means of separate conductive pathways.

[0071] Still other non-medical applications include use of structure 10 as a tensioning lace or binding element for sporting equipment, such as ski boots, orthoses, helmets, skates, and gloves, wherein flattening of the element provides uniform force distribution and reduced tendency to slip or become loose as tension is lost. The lace or binding may be constructed with structure 10, wherein strand element 12 is a shape memory alloy capable of energy dissipation, such as Nitinol. In this application, the lace or binding element is used to provide holding force while also dissipating energy from sudden force application, such as from impacts to boots, orthoses, helmets, and other structures held on the user by structure 10. In this way, structure 10 can be used to dissipate energy applied to the user of the device, thereby protecting against injury.

[0072] Example

[0073] The following non-limiting examples illustrate various features and characteristics of the present invention, which are not to be construed as limiting the features and characteristics of the present invention.

[0074] In these examples, exemplary braided hollow metal ribbons according to the present disclosure were produced, tested, and characterized, particularly with respect to surface structural properties, crimp attachment strength, and overall functionality in sternotomy suturing applications.

[0075] Example 1

[0076] The braided structure 10 using the multifilament structural element 12 according to the present disclosure is prepared from the component twisted cables as described herein. 316LVM stainless steel is used for all strands 14, such as Figure 3B As shown, each is a "1 x 7" configuration. For a total component diameter D of 0.0075 inches C , each strand 14 has a diameter of 0.0025 inches. A total of 32 elements 12 are used to prepare a 0.108 inch outer diameter D after braiding each integral wire in the form of a total of 224 strands 14. O woven structure.

[0077] The curls 22 were secured to the ends of the final structure 10 and the curled structure was subjected to a tension test. The "breaking load", i.e., the amount of tension required to remove one or both curls 22, was about 142 lbf to about 210 lbf. Table 1 sets forth the tension test results for this example.

[0078] Table 1. Tension test results of braided structure

[0079]

[0080] The properties of the silk material and the construction of the braided structure 10 used for the above test are shown in the following Table 2 and Figure 6 middle, Figure 6Included are graphical representations of some of the variables used in Table 2.

[0081] Table 2. Silk materials and construction of braided structures

[0082]

[0083] Example 2

[0084] A braided structure using monofilament structural elements was prepared as a control group. 316LVM stainless steel was again used for all monofilament elements. Each element had a diameter of 0.0051 inches. A total of 48 monofilament elements were used to prepare a braided structure having an outer diameter D of 0.0984 inches after braiding. O woven structure.

[0085] The curls 22 were secured to the ends of the final monofilament control structure and the curled structure was subjected to a tensile test. The "breaking load", i.e., the amount of tension required to remove one or both curls 22, was from about 25 lbf to about 52 lbf, which is weaker than the breaking load observed in Example 1. Table 3 sets forth the tensile test results for this example.

[0086] Table 3. Tension test results of braided structure

[0087]

[0088] As shown in the above examples, structures prepared according to the present disclosure substantially outperformed comparative monofilament designs in breaking load with end curls.

[0089] Although the present invention is described as having an exemplary design, the present invention may be further modified within the spirit and scope of the disclosure. Therefore, the present application is intended to cover any variation, use or adjustment of the present invention using its general principles. In addition, the present application is intended to cover such deviations from the present disclosure that are known or customary practices in the field to which the present invention relates and fall within the limits of the appended claims.

Claims

1. A multifilament tubular structure comprising: A plurality of structural elements woven or braided into a tubular cerclage cable defining an inner diameter, an outer diameter, and an axial length in the absence of external forces, each of the structural elements comprising a twisted cable comprising: a plurality of wires whose longitudinal axes each define a helix extending substantially parallel to one another, such that the tubular structure is a flexible structure in both the axial and radial directions, the plurality of wires being repositionable and self-adjusting about one another and laying flat on the bone when stretched, the multifilament tubular structure minimizing stress on the adjacent bone or tissue surface by maximizing the surface area of ​​contact between the flattened and self-adjusting wires and the adjacent bone or tissue; and At least one friction fit fitting is formed at at least one end of the tubular structure.

2. A multifilament tubular structure according to claim 1, wherein the plurality of metal wires of the structural element comprises 2 to 343 wires.

3. The multifilament tubular structure of claim 1, wherein the tubular structure has an inner diameter of 0.010 inches to 0.200 inches.

4. The multifilament tubular structure of claim 3, wherein the tubular structure has an outer diameter of 0.014 inches to 0.208 inches.

5. The multifilament tubular structure according to claim 1, wherein said plurality of structural elements comprises 8-128 structural elements.

6. The multifilament tubular structure of claim 1, wherein the plurality of structural elements define a plurality of bond points at each intersection between adjacent structural elements, the number of bond points being 1-50 per inch of axial distance along the outer surface of the tubular structure.

7. The multifilament tubular structure of claim 1, wherein the friction fit fitting cannot be removed from the tubular structure by a separation force of less than 142 lbf.

8. The multifilament tubular structure of claim 1, wherein at least one of the plurality of metal wires of the structural element is formed of a resorbable metal.

9. The multifilament tubular structure according to claim 8, wherein the absorbable metal comprises at least one of magnesium, zinc, iron and alloys thereof.

10. The multifilament tubular structure of claim 1, wherein at least one of the plurality of wires of the structural element is formed of stainless steel.

11. The multifilament tubular structure of claim 1, wherein at least one of the plurality of wires of the structural element is formed from a superelastic alloy.

12. The multifilament tubular structure according to claim 11, wherein the superelastic alloy comprises Nitinol.

13. The multifilament tubular structure of claim 1, wherein at least one of the plurality of metal wires of the structural element is formed from a cobalt-based or cobalt-chromium alloy.

14. The multifilament tubular structure of claim 1, wherein the tubular structure is configured to deform into a flattened shape when the tubular structure is bent or compressed about a surface, wherein the tubular cerclage cables are adapted to reduce friction or cutting in adjacent bone.

15. The multifilament tubular structure of claim 1, wherein the friction fit fitting is deformed to contact the plurality of wires, thereby securing the friction fit fitting to the tubular structure.

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