tensioning device
By introducing a check segment and a pulley segment into the tensioning device, and by using a self-locking check mechanism and a pulley ring to enhance tension transmission, the problem of tension being difficult to apply and maintain in the prior art is solved, achieving efficient and safe tension application and long-term maintenance, which is suitable for minimally invasive surgery.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2024-12-17
- Publication Date
- 2026-07-21
AI Technical Summary
Existing tensioning devices are difficult to apply and maintain tension efficiently on biological structures, especially in minimally invasive surgery where the operation is complex and it is difficult to avoid tension decreasing over time. Manually applying high tension also poses risks.
The tensioning device design includes a check segment and a pulley segment. The first wire crosses the check segment and the pulley segment to form a self-locking check mechanism. The pulley ring enhances the tension transmission, thereby amplifying the tension and reducing friction loss.
It enables efficient application and long-term maintenance of tension on biological structures, reduces the difficulty of manually applying tension, improves the ease of use and safety of the device, and is suitable for minimally invasive surgery.
Smart Images
Figure CN122438657A_ABST
Abstract
Description
Technical Field
[0001] The present invention relates to a tensioning device for applying and maintaining tension on at least one structure (such as a biological structure). Background Technology
[0002] Several medical procedures require the application of tension to one or more biological structures. Once applied, this tension must be maintained to prevent it from being lost over time. An example is the application of cerclage, a surgical procedure in which a ring is placed around a structure such as a blood vessel or bone to provide support by contracting the ring and then maintaining it in a contracted state under tension. Other examples include anterior cruciate ligament (ACL) reconstruction surgery or posterior cruciate ligament (PCL) reconstruction, among many other procedures that can be performed, for example, on soft or hard tissue. More broadly, many surgical procedures require bringing two biological structures, such as those at the two ends of a torn tendon or ligament, closer together. For example, a surgical procedure to repair a torn tendon or ligament may involve connecting the two ends to a tensioning device to reconnect them and restore tension. Typically, an implant is used to connect the two ends, and a separate instrument is used to apply tension to the two torn ends.
[0003] Existing tensioning devices suffer from many drawbacks. For example, most known tensioning devices are specifically designed to apply tension or maintain previously applied tension, but not both. In particular, many known devices for applying tension are not suitable for implantation in the body, partly because many have complex mechanical structures that, while suitable for applying tension with high precision, are essentially surgical instruments rather than biocompatible implants.
[0004] Another drawback is that many existing devices are unable to establish a secure and robust connection, and more importantly, to maintain tension over time. With regard to known tension devices, once applied, the tension typically decreases gradually over time. This severely limits their use, especially in implantation cases where tension must be maintained over a process spanning months and years (if not decades).
[0005] Another known drawback of tensioning devices is the manual difficulty of applying tension (especially high tension) to biological structures. For example, many known tensioning devices require significant force to apply high tension to biological structures. Applying high force to a tensioning device during operation can be challenging and carries the risk of unintentional damage, such as overload or unwanted or uncontrolled movement. In particular, many tensioning devices require the same tension to be applied by a surgeon (manually or with mechanical assistance) to apply a given tension to a biological structure.
[0006] Another drawback of many known tensioning devices is their difficulty in execution, especially during complex procedures such as minimally invasive surgery. Furthermore, it is difficult to apply tension in a controlled manner with existing tensioning devices. In particular, avoiding over- or under-tension is challenging. Finally, many known techniques are difficult and cumbersome for surgeons to execute, thus reducing efficiency.
[0007] Therefore, there is a need for improved tensioning devices. Summary of the Invention
[0008] Therefore, the purpose of this disclosure is to advance the state of the art regarding tensioning devices, particularly tensioning devices for applying and maintaining tension on at least one structure (such as a biological structure). For example, it may be desirable to apply and maintain tension on one structure, or on two or more structures (e.g., between two structures). In particular, another object is to provide tensioning devices that allow the tension applied to a structure to be maintained with minimal loss of tension over time. Ideally, the tension will remain substantially constant over a period of weeks, preferably months, and more preferably years. Another object is to provide tensioning devices that facilitate the application of tension to structures such as biological structures. In particular, at least a preferred variation aims to amplify the tension applied by the user (e.g., by a surgeon during surgery). Ideally, the tension applied by the user will be amplified by at least 50%, preferably by at least 2 times. Another object of at least some variations of the device is to improve operability and enhance the ease of use of the device. Ideally, the device can be implanted and installed in minimally invasive surgical settings.
[0009] According to this disclosure, these objectives are addressed by the features of the independent claims. Further advantageous embodiments are derived from the dependent claims and the description.
[0010] This disclosure relates, in its first aspect, to a tensioning device for applying and maintaining tension on at least one structure. The structure may be, for example, a structure in a medical environment. The structure may be, for example, a biological structure.
[0011] The tensioning device includes a strip extending in a longitudinal direction and comprising a check valve segment and a pulley segment. The check valve segment and the pulley segment are arranged rearwards of each other in the longitudinal direction and each includes at least one opening. In some variations, the check valve segment includes two or more openings, preferably arranged rearwards of each other in the longitudinal direction. Alternatively or in combination, the pulley segment may include two or more openings, preferably arranged rearwards of each other in the longitudinal direction.
[0012] The tensioning device further includes at least a first wire. The first wire passes through at least one opening in the check segment and crosses itself at least once within the check segment, thereby forming a self-locking check mechanism to prevent the tension applied to the first wire from being released. Typically, the first wire crosses itself at least once between the strip and the first wire within the check segment. In other words, when the first wire crosses itself, a segment of the first wire is held between another segment of the first wire and the strip.
[0013] The first wire further passes through at least one opening in the pulley segment, thereby forming at least one pulley ring. The pulley ring extends from the pulley segment away from the check segment in the installation position and is configured to at least partially surround the structure.
[0014] Because the first filament crosses itself to form a self-locking check mechanism, the loss of tension previously applied to the structure is minimized. As an example, when tension is initially applied, a first segment of the first filament is crossed and clamped by a second segment of the first filament, such that the first segment of the first filament is held between the second segment of the first filament and the strip. This clamping force can be used to prevent displacement of the first filament, which would result in loosening of the tension. Typically, the strip segment with higher tension acts as a locking element for the strip segment with lower tension. Additionally, at least one pulley ring allows for increased tension applied by the user, thereby facilitating the application of high tension to the structure.
[0015] In some variations, the tensioning device is configured such that the force applied to the structure is increased by at least twice the force applied to the first wire. For example, when a pulley ring extending away from the check segment in its installation position closes and contracts on its circumference during the application of tension, the tension can be increased by at least twice due to the mechanical principles of the pulley system. In particular, the tension transmission factor is 2 because the distance traveled in the case of a pulley ring having two opposing and adjacent sides is doubled. Depending on the number of pulley rings, the force applied to the structure can be increased by a factor greater than 2. Typically, the tensioning device is configured such that the force applied to the structure is increased by at least 2n times the force applied to the first wire, where n is an integer of 1 or greater, preferably from 1 to 20, more preferably from 1 to 12. It is understood that losses due to friction can occur, which can result in a slight deviation from exactly twice or exactly 2n. Preferably, any loss (e.g., due to friction or other factors) relative to the force applied to the first wire does not exceed 25%, preferably not more than 10%, more preferably not more than 5%.
[0016] Depending on the application, at least one pulley ring can be formed in different ways. For example, in some variations, a first wire passes through at least one opening in the pulley segment, thereby forming at least one pulley ring. At least one pulley ring may be adapted to at least partially surround the structure. At least one pulley ring may extend, for example, in a longitudinal direction.
[0017] In some variations, the first wire passes successively through at least two openings in pulley segments arranged longitudinally behind each other, thereby forming at least two pulley rings in a helical manner. For example, a first pulley ring may be formed, which is at least partially, preferably completely, surrounded by a second pulley ring. Optionally, for example, a third or more pulley rings may be present, wherein the third pulley ring may at least partially, preferably completely, surround the second pulley ring. Similarly, each subsequent pulley ring may at least partially, preferably completely, surround each preceding pulley ring. For example, the pulley rings may be arranged in a snail shell configuration. One advantage of these embodiments is that they allow for a high multiple of tension amplification while minimizing friction. However, other arrangements are also possible. For example, multiple pulley rings may also be arranged adjacent to each other, regardless of whether they surround each other.
[0018] Depending on the application, the tensioning device may include one or more pulley rings. For example, the device may include two or more pulley rings, such as from two to six pulley rings.
[0019] Depending on the application, the first wire may pass through all or only some of the openings in the pulley segment. Furthermore, the first wire may pass through each opening in the pulley segment once or more. In some variations, the first wire passes through at least one opening in the pulley segment once, i.e., only once. This can, for example, help to minimize friction. For instance, it is possible that the first wire passes through three of the four openings in the pulley segment, and that the first wire passes through each of the three openings only once.
[0020] Depending on the application, the first wire may cross itself in different ways within the check valve section. For example, in some variations, the first wire may form at least two crossing points, preferably from two to 30 crossing points. Preferably, at least one crossing point is arranged on a first lateral side of the strip, and at least one crossing point is arranged on a second lateral side of the strip. For example, half of the crossing points may be arranged on the first lateral side, and half of the crossing points may be arranged on the second lateral side. The number of crossing points can, for example, be used to control and fine-tune the effectiveness of the check valve mechanism.
[0021] In some variations, at least one segment of the first filament extends helically around the lateral outer surface of the strip within a check valve segment. These variations can be used, for example, to optimize and fine-tune the check valve effect. For example, by extending helically around the lateral outer surface of the strip within a check valve segment, the corresponding segment of the first filament can pass through check valves arranged on different lateral sides of the strip. In some variations, a segment of the first filament passes through at least one check valve arranged on a first lateral side and at least one check valve arranged on a second lateral side. For example, a segment of the first filament can alternately pass through check valves (e.g., clamping rings) arranged on the first and second lateral sides. Depending on the application, selected check valves may or may not be skipped. In some variations, segments of the first filament pass successively through openings arranged rearward of each other in the longitudinal direction.
[0022] In some variations, one or more check rings may be labeled as one or more clamping rings. It is also possible that only some of the check rings act as clamping rings.
[0023] In some variations, a first filament passes through at least one opening in a check loop segment to form at least two check loops, wherein the first filament further passes through at least one of the at least two check loops. The at least two check loops extend laterally in the mounting position. Depending on the application, the first filament may pass through all check loops, or only some of them. Two or more check loops may be present; for example, in some variations, at least four check loops are formed. Depending on the application, the at least two check loops may have different arrangements. For example, at least one check loop may be arranged on a first lateral side of the strip, and at least one check loop may be arranged on a second lateral side of the strip opposite to the first lateral side. In some variations, for each check loop, the filament segment forming the corresponding check loop exits from and enters the same or different openings. Alternatively or in combination, for each check loop, the filament segment forming the corresponding check loop may exit from and enter a corresponding opening on the same or opposite lateral side of the strip. In some variations, each check loop is formed between two different openings.
[0024] In some variations, the first wire meanders through at least two openings in check rings arranged longitudinally behind each other. These variations can, for example, facilitate the preparation of the tensioning device. Furthermore, the meandering arrangement can, for example, allow for a uniform distribution of the clamping force applied by the check rings.
[0025] In some variations, the first end of the first wire is fixedly connected to the strip. For example, the first end of the first wire may be tied to the strip. The first end of the first wire may be fixedly connected to the strip, for example, at a connection point on the strip. The connection point may be arranged, for example, in a pulley segment of the strip. For example, the connection point may be arranged in the pulley segment and away from the check segment facing in the longitudinal direction. As an example, the connection point may be arranged near or at the second end of the pulley segment, which is arranged opposite the first end of the pulley segment in the longitudinal direction, and the first end of the pulley segment faces the check segment facing.
[0026] The second end of the first filament may be, for example, loose or free. For example, the second end may be loose so that tension can be applied to the first filament, for example, by pulling the second end.
[0027] Depending on the application, the tensioning device may include more than one check segment. Alternatively or in combination, the tensioning device may include more than one pulley segment. Alternatively or in combination, the tensioning device may include a second wire. In these variations, the check segment and pulley segment described above and below may, for example, be designated as a first check segment and a first pulley segment, respectively. In other words, for a variation characterized by a "second check segment," a "check segment" that is not a "second check segment" may optionally be designated as a "first check segment" to more clearly distinguish it from the "second check segment." Similarly, for a variation characterized by a "second pulley segment," a "pulley segment" that is not a "second pulley segment" may optionally be designated as a "first pulley segment" to more clearly distinguish it from the "second pulley segment." The embodiments described herein in the context of a check segment are generally applicable to a first check segment, or they may be applicable to a first check segment and a second check segment. Similarly, the embodiments described herein in the context of a pulley segment are generally applicable to a first pulley segment, or they may be applicable to a first pulley segment and a second pulley segment.
[0028] In some variations, the first check segment, the first pulley segment, and the second check segment and / or the second pulley segment are arranged behind each other in the longitudinal direction, and each includes at least one opening.
[0029] In some variations, the tensioning device further includes a second wire that passes through at least one opening in the second check segment and crosses itself at least once between the strip and the second wire in the second check segment, thereby forming a second self-locking check mechanism to prevent the tension applied to the second wire from being released. The embodiments described herein in the context of a self-locking check mechanism are applicable to both a first self-locking check mechanism and a second self-locking check mechanism independent of both.
[0030] Alternatively or in combination, the second wire may further pass through at least one opening in the second pulley segment, thereby forming at least one pulley ring that extends from the second pulley segment away from the second check segment in the installed position. The at least one pulley ring is typically configured to at least partially surround the structure. For example, at least one pulley ring may be adapted to surround at least a circumferential segment of the structure.
[0031] Depending on the application, the pulley segment and the check segment can have different arrangements relative to each other. For example, both the check segment and the second check segment can be arranged longitudinally between the pulley segment and the second pulley segment.
[0032] Depending on the application, different strips may be used. In some variations, the strip is at least partially made of a woven material. Alternatively or in combination, the strip may be made of an absorbent material. Depending on the application, the strip may have a length, for example, up to 500 mm, preferably up to 200 mm, more preferably from 1 mm to 100 mm. For example, in some variations, the strip has a length from 5 mm to 80 mm. Depending on the application, the strip may have different shapes and geometries. For example, in some variations, the strip may be trapezoidal. The strip may be made of different materials, for example, it may be made of a flexible material. In some variations, the strip is compressible in the longitudinal direction. Alternatively or in combination, the strip may be compressible in the radial direction.
[0033] In some variations, the openings in the strip may be, for example, eyelets. Depending on the application, the openings may extend laterally relative to the longitudinal direction from a first lateral side of the strip to an opposite second lateral side. Depending on the application, the first and second lateral sides may be arranged parallel to each other. In some variations, the central axis of each opening in the strip is parallel to the central axis of each other opening in the strip.
[0034] In some variations, the strip is designed to compress in the longitudinal direction such that when tension is applied to the first filament, the distance between at least two openings in the longitudinal direction decreases.
[0035] The materials of the first filament and the strip can be chosen to achieve a suitable trade-off between sliding performance and friction. For example, in some variations, the first filament and / or the second filament and / or any additional filament are made of a material having a surface with a low coefficient of friction. In some variations, the first filament and the strip are configured to allow the first filament to slide smoothly through an opening in the strip.
[0036] Depending on the application, different filaments can be used. For example, the first filament could be a suture, such as a medical suture. Different materials are conceivable. Typically, the filament is made of a material having a surface with a low coefficient of friction. In some variations, the filament is made of a material having a surface coefficient of friction similar to that of at least one filament. Depending on the application, the filament can, for example, have a diameter of less than 100 mm.2 Preferably less than 25mm 2 The cross-section.
[0037] In some variations, the tensioning device includes at least one removable application aid that forms an open space in at least one check ring (e.g., in at least one check ring). A segment of the first wire passing through at least one check ring may, for example, pass through the application aid.
[0038] Depending on the application, tensioning devices can be used to apply and maintain tension on one or more structures (e.g., one or more biological structures). For example, a first structure may be interconnected with a first end of a strip, and a second structure may be interconnected with a second end of the strip, wherein the second end is arranged opposite to the first end of the strip in the longitudinal direction. In this example, the tensioning device can be used to bring the first and second biological structures into close proximity. In another example, the tensioning device can be used for cerclage applications. For example, in the installation position, the tensioning device may surround the biological structure. For this purpose, for example, at least one pulley ring may be interconnected in the installation position with an end of the strip arranged opposite to at least one pulley ring.
[0039] In some variations, the tensioning device further includes a first interface for interconnecting the strip to the structure and / or at least one pulley ring. Depending on the application, the first interface may interconnect the strip directly or indirectly to the structure and / or at least one pulley ring in the installation position. In some variations, the tensioning device further includes a third wire that interconnects at least one pulley ring and the first interface in the installation position.
[0040] Depending on the application, the first interface may be arranged in different sections or segments of the strip. For example, in some variations, the first interface is arranged in an interface segment, which may be designated, for example, a fixed segment. In some variations, the interface segment, check segment, and pulley segment are arranged longitudinally behind each other (particularly adjacent to each other). In some variations, the check segment is arranged longitudinally between the interface segment and the pulley segment. If two or more check segments are present, the first check segment may be arranged longitudinally between the interface segment and the pulley segment in some variations. Alternatively or in combination, if two or more pulley segments are present, the check segment may be arranged longitudinally between the interface segment and the first pulley segment in some variations.
[0041] Depending on the application, different embodiments may implement the first interface. For example, the first interface may include an opening in the strip. In this example, the third wire may be tied to the opening, for example. In some variations, the first interface includes a check segment, which may be the same check segment as previously described, or it may be a separate check segment. For example, the interface may include a third check segment, wherein the first check segment may be arranged longitudinally between the third check segment and the pulley segment. It is understood that the term "third" is used only to distinguish different check segments, but does not necessarily imply the presence of at least three check segments. In other words, in these variations, the tensioning device may or may not include a second check segment. The third check segment may, for example, be configured to receive and hold at least one pulley ring. Alternatively or in combination, the third check segment may, for example, be configured to receive and hold a third wire.
[0042] As an example, the third check segment may include at least one check ring that extends laterally from the strip in the installed state. The at least one check ring of the third check segment may be configured to receive and clamp a third ribbon in the installed position. Alternatively or in combination, the at least one check ring of the third check segment may be configured to receive and clamp at least one pulley ring in the installed position.
[0043] The first interface may be arranged, for example, at the end of the strip, which is arranged opposite to at least one pulley ring.
[0044] In some variations, the first interface includes a retaining element, and the third ribbon includes a protrusion configured to be received by the retaining element. As an example, the retaining element may be an eyelet having a maximum inner extension smaller than the maximum outer extension of the protrusion. For instance, when tension is applied, the protrusion may be blocked by the retaining element, allowing tension to be applied to the structure.
[0045] The tensioning devices described herein can be used in various applications, including those in the medical field. These applications include, but are not limited to: cerclage systems, trochanteric reduction and fixation, sternal closure, spinal applications (such as posterior fixation around the spinous process), ACL, PCL, AC joints, and ligament connections. Attached Figure Description
[0046] The invention described herein will be more fully understood from the detailed description and accompanying drawings given below, which should not be construed as limiting the invention described in the appended claims. The drawings show: Figure 1 An embodiment of the tensioning device is shown; Figure 2 Another embodiment of a tensioning device including a third wire is shown in the application of circumcision. Figure 3 This shows yet another embodiment of a tensioning device in another application of scleral buckling; Figure 4This shows yet another embodiment of a tensioning device in another cerclage procedure, including a second check segment; Figure 5 This shows yet another embodiment of a tensioning device in another cerclage procedure, including a second check segment and a second pulley segment; Figure 6 This illustrates an embodiment of a tensioning device used in applications to apply and maintain tension between two biological structures. Detailed Implementation
[0047] Reference will now be made in detail to certain embodiments, examples of which are illustrated in the accompanying drawings, which show some, but not all, of the features. In fact, the embodiments disclosed herein may be embodied in many different forms and should not be construed as limiting to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Wherever possible, similar reference numerals will be used to refer to similar components or parts.
[0048] Figure 1 An embodiment of the tensioning device 1 is shown. The tensioning device 1 includes a strip 3 extending along a longitudinal axis. The tensioning device 1 further includes a filament 41, such as a suture. A first end of the filament 41 is tied to an opening 74 in the strip 3. A second end of the filament 41 is loose and can be pulled by a user to apply tension.
[0049] The strip 3 includes a check segment 51 and a pulley segment 52, the pulley segment 52 being arranged longitudinally behind the check segment 51. The check segment 51 includes a plurality of openings 71, 72, which are also arranged longitudinally behind each other. As shown, in some variations, the openings 71, 72, 73, 74 of the strip may be arranged centrally with respect to the longitudinal direction. Starting from its first end of the knot, the wire 41 extends longitudinally away from the check segment 51 before returning toward the check segment 51 and entering the opening 73 of the pulley segment 61, thereby forming the first pulley ring 81. The pulley ring 81 can be described as extending laterally away from the check segment 51. Figure 1 As shown, the second pulley ring 82 is formed in a similar manner. In the illustrated embodiment, pulley rings 81 and 82 are arranged in a helical manner. However, different arrangements are also conceivable.
[0050] In the check segment 51, the first wire 41 passes continuously through the openings 71, 72 of the strip 3, thereby forming a plurality of check loops 91, 92 on either side of the strip 3. In the illustrated embodiment, each check loop 91, 92 is formed between two adjacent openings. After reaching the opening 71 of the check segment 51, which is arranged opposite to the pulley segment 61, the first wire 41 returns longitudinally toward the pulley segment 61. On the return, the first wire 41 passes through the laterally extending check loops 91, 92. As the check loops 91, 92 are alternately arranged on opposite lateral sides of the strip 3, the first wire 41 spirals around the lateral outer surface of the strip 3. Although in the illustrated embodiment, the first wire 41 passes through all the check loops 91, 92, it is also possible that the first wire 41 passes through only a portion of the check loops 91, 92. Preferably, the first wire 41 passes through at least two, more preferably, at least three check loops 91, 92.
[0051] Ultimately, as Figure 2 As further shown, the first filament 41 reaches its loose end, which can be pulled to apply tension.
[0052] Figure 2 This shows another embodiment of the tensioning device 1. Figure 2 The tensioning device 1 shown in the figure and Figure 1 The tensioning device 1 shown is similar, but additionally includes a third wire 43, and also shows a circumcision application, as shown by the biological structure 2.
[0053] The third filament 43 passes through the pulley rings 81 and 82 and, for example, is connected to the opening 71 of the strip 3 by a cow knot, wraps around the biological structure 2.
[0054] To tighten the ligature by applying tension, the two loose ends of the third wire 43 are initially connected to each other, for example, by a knot. Tension is then applied by pulling the loose end of the first wire 41. As the loose end of the first wire 41 is pulled, the pulley rings 81, 82 and the check rings 91, 92 contract further. This contraction of the pulley rings 81, 82 reduces the longitudinal extension of the respective pulley rings 81, 82, thereby causing the biological structure 2 to contract further. Because the tensioning device 1 includes two check rings 91, 92 (each of which comprises two opposing portions extending in the longitudinal direction), the overall force transmission coefficient is 4. In other words, the tension applied, for example, by the surgeon to the loose end of the first wire 41 is effectively increased to four times, making a significantly stronger tension applicable to the biological structure 2. It is understood that friction and other effects can cause slight deviations from the theoretical force transmission coefficient of 4.
[0055] Simultaneously, the check rings 91 and 92 gradually contract, thereby clamping the filament 41 between the corresponding check rings 91 and 92 and the strip 3. This clamping prevents displacement of the first filament 41, thereby effectively maintaining the applied tension.
[0056] In the illustrated embodiment, strip 3 is made of a woven material and includes multiple branched segments defining openings. Furthermore, in the illustrated embodiment, strip 3 has an elliptical cross-section. However, other materials and other cross-sections may also be used.
[0057] Figure 3 Another embodiment of the tensioning device 1 is shown, which is related to... Figure 2 The embodiment shown is similar, but features a further variation of the interface used to connect the third filament 43 to the strip 3. Specifically, in Figure 3 In the embodiment shown, the third filament 43 includes a protrusion 11, which may be formed, for example, by a knot. The diameter of the protrusion is chosen to be larger than the inner diameter of the receiving ring 10, which forms the first interface 10 of the strip 3. This receiving ring 10 is arranged opposite the pulley segment 61 in the longitudinal direction. Although Figure 3 Not shown, but the receiving ring 10 may be designed to be self-shrinking. Because in the installed state, the inner diameter of the receiving ring 10 is smaller than the diameter of the protrusion of the third filament 43, once the protrusion of the first filament 43 passes through the receiving ring 10, the protrusion is blocked by the receiving ring 10 when tension is applied to the loose end of the first filament 41, thereby allowing tension to be applied to the biological structure 2.
[0058] Figure 3 Further illustrating that an auxiliary stabilizing structure can be used to apply a reaction force to strip 3 during tension application. For example, as... Figure 3 As shown, the auxiliary stabilizing structure can pass through one of the openings in strip 3, for example, through the penultimate opening.
[0059] Figure 4A further variation of the first interface 10 is shown, involving the use of a second check segment 52 as the first interface 10 for receiving and securing the third filament 43. Specifically, the first check segment 51 is arranged longitudinally between the second check segment 52 and the pulley segment 61. The second check segment 52 includes six openings 75 arranged longitudinally behind each other. For example, by fastening to one of the openings, the first end of the third filament 43 is fixedly connected to the strip 3. Subsequently, the third filament 43 forms a plurality of check loops in the second check segment 52 before circumferentially passing around the biological structure 2 to be tensioned and subsequently through the pulley rings 81, 82 of the pulley segment 61. Subsequently, the third filament 43 again circumferentially passes around the biological structure 2 and returns to the second check segment 52, wherein the third filament 43 passes through at least some of the check loops of the second check segment 52. In the illustrated embodiment, the third filament 43 passes through three check loops of the second check segment 52, but other variations are possible.
[0060] exist Figure 4 In the embodiment shown, tension is applied by pulling the loose ends of both the first wire 41 and the third wire 43. This causes increased contraction of the pulley rings 81, 81 of the pulley segment 61, the check rings 91, 92 of the first check segment 51, and the check ring of the second check segment 52. The contraction of the check ring of the second check segment 52 causes the third wire 43 to be clamped between the check ring of the second check segment 52 and the strip 3, thereby preventing displacement of the third wire 43 and thus preventing the applied tension from loosening.
[0061] Figure 4 Further illustrating that the tensioning device 1 may include an application aid as part of the first interface 10. Specifically, the application aid may include a tube passing through the check rings, through which the third wire 43 passes, and the tube facilitates the passage of the third wire 43 through the check rings and holds the third wire 43 in place.
[0062] Figure 5 An embodiment of the tensioning device 1 is shown, which includes two check segments 51, 52 and two pulley segments 61, 62. The two check segments 51, 52 are arranged longitudinally between the two pulley segments 61, 62. For example, as described above... Figure 1 Described in the context of [the previous description], the first wire 41 passes through the openings 71, 72, 73, and 74 of the first check segment 51 and the first pulley segment 61. Similarly, the second wire 42 passes through the openings 75 and 76 of the second check segment 52 and the second pulley segment 62. The two sides may, but do not necessarily, be mirror symmetrical. The pulley ring 81 of the first pulley segment 61 is interconnected with the pulley ring 83 of the second pulley segment 62 via the third wire 43. Figure 5As shown, the two loose ends of the third filament 43 can, for example, be tied together. Applying tension to the biological structure involves pulling the loose ends of the first filament 41 and the second filament 42.
[0063] Figure 6 An embodiment of a tensioning device 1 is shown for use in applications to apply and maintain tension between two biological structures. The structure of the tensioning device 1 is similar to... Figure 1 The embodiment shown is similar, wherein the tensioning device 1 also includes a strip 3 having a pulley segment 61 and a check segment 51, and a first wire 41 forming pulley rings 81, 82 and check rings 91, 92.
[0064] Figure 6 The embodiment additionally includes a first interface 10. With Figure 3 The auxiliary stabilizing structure shown in the background is similar. Figure 6 The first interface 10 of the embodiment shown is interconnected to an auxiliary stabilizing structure, which can be used, for example, to apply a reaction force to the strip 3 during the application of tension. Figure 6 The pulley rings 81 and 82 are further shown interconnected to the first biological structure 2. Therefore, the pulley rings 81 and 82 can effectively serve as a second interface for interconnecting the tensioning device 1 to the first biological structure 2. The first biological structure 2 can be, for example, a graft to which tension will be applied.
[0065] use Figure 6 The embodiments shown are open to various applications. For example, tensioning device 1 can be used to apply tension to a first biological structure 2 (e.g., a graft). In this variation, an auxiliary stabilizing structure can be used essentially to apply a reaction force during the application of tension to the first biological structure 2. In use, as explained above, pulling on the loose end of the first filament 41 will cause increased contraction of the pulley rings 81, 82, which results in increased tension on the second biological structure 2 toward the first interface 10. In another variation, strips 3 can be additionally interconnected to the second biological structure. For example, instead of or in addition to the auxiliary stabilizing structure, the second biological structure can, for example, pass through an opening that serves as the first interface 10. Figure 6The longitudinal structure passing through the opening that serves as the first interface 10 can be understood in some variations as a second biological structure rather than as an auxiliary stabilizing structure. In this variation, the tensioning device 1 can be used to apply and maintain tension between the second biological structure and the first biological structure 2. In yet other variations, the auxiliary stabilizing structure may not be used to replace the second biological structure, but rather to supplement it. For example, using another interface, the second biological structure may be interconnected to the strip 3 in other ways. For example, the strip 3 may additionally include a second check segment (not shown) for interconnection to the second biological structure. The second check segment may be arranged, for example, along the longitudinal direction of the strip 3 adjacent to the first interface 10. As an example, the first interface 10 may be arranged along the longitudinal direction of the first check segment 51 ( Figure 6 (shown in the image) and the second check segment ( Figure 6 Between (not shown), the second check segment can be used to interconnect with the second biological structure. In these variations, the tensioning device 1 can be used to apply and maintain tension between the first biological structure 2 and the second biological structure.
[0066] List of labels 1. Tensioning device 2. Structure 3 strips 41 The First Silk 42 Second thread 43 The Third Silk 51 First cessation segment 52 Second apnea segment 61 First pulley segment 62 Second pulley segment The openings of strips 71, 72, 73, 74, 75, and 76. 81, 82, 83, 84 Pulley rings 91,92 Check loop 10 First Interface 11. Protrusion.
Claims
1. A tensioning device (1) for applying and maintaining tension on at least one structure (2), comprising: a. A strip (3) extending in the longitudinal direction and comprising a check segment (51) and a pulley segment (61) arranged in the longitudinal direction behind each other and each including at least one opening (71,72,73,74,75,76); b. At least a first filament (41) passes through the at least one opening (71, 72) of the check segment (51) and crosses itself at least once between the strip (3) and the first filament (41) in the check segment (51), thereby forming a self-locking check mechanism to prevent the tension applied to the first filament (41) from being released. c. Wherein the first wire (41) further passes through the at least one opening (73, 74) of the pulley segment (61), thereby forming at least one pulley ring (81, 82) which extends from the pulley segment away from the check segment (51) in the installation position and is configured to at least partially surround the structure (2).
2. The tensioning device (1) according to claim 1, wherein, The tensioning device (1) is configured such that the force applied to the structure (2) is increased by at least twice the force applied to the first wire (41).
3. The tensioning device (1) according to any one of the preceding claims, wherein, The first wire (41) passes through at least one opening (73, 74) of the pulley segment (61), thereby forming at least one pulley ring (81, 82) suitable for at least partially surrounding the structure (2).
4. The tensioning device (1) according to any one of the preceding claims, wherein, The first wire (41) passes through at least one opening (71, 72) of the check segment (51) to form at least two check rings (91, 92) extending laterally at the mounting position, wherein the first wire (41) further passes through at least one of the at least two check rings (91, 92).
5. The tensioning device (1) according to any one of the preceding claims, wherein, For each check loop (91, 92), the filament segments forming the corresponding check loop (91, 92) leave and enter the same or different openings on the same or opposite lateral sides of the strip (3).
6. The tensioning device (1) according to any one of the preceding claims, wherein, Each check loop (91, 92) is formed between two different openings (71, 72, 73, 74, 75, 76).
7. The tensioning device (1) according to any one of the preceding claims, wherein, The first filament (41) meanders through at least two openings (71, 72) of the check segments (51) arranged behind each other in the longitudinal direction.
8. The tensioning device (1) according to any one of the preceding claims, wherein, At least one segment of the first filament (41) extends spirally around the lateral outer surface of the strip (3) in the check segment (51).
9. The tensioning device (1) according to any one of the preceding claims, wherein, The first end of the first filament (41) is fixedly connected to the strip (3).
10. The tensioning device (1) according to any one of the preceding claims, wherein, The first wire (41) passes successively through at least two openings (73, 74) of the pulley segments (61) arranged behind each other along the longitudinal direction, thereby forming at least two pulley rings (81, 82) in a spiral manner.
11. The tensioning device (1) according to any one of the preceding claims, wherein the tensioning device (1) further comprises: a. A second check segment (52) and / or a second pulley segment (62), wherein the check segment (51), the pulley segment (61), and the second check segment (52) and / or the second pulley segment (62) are arranged behind each other along the longitudinal direction and each includes at least one opening (71,72,73,74,75,76); as well as b. The second filament (42), i. wherein the second wire (42) passes through at least one opening of the second check segment (52) and crosses itself at least once between the strip (3) and the second wire (42) in the second check segment (52), thereby forming a second self-locking check mechanism to prevent the tension applied to the second wire (42) from being released; ii. and / or wherein the second wire (42) further passes through the at least one opening of the second pulley segment, thereby forming at least one pulley ring (83, 84) which extends from the second pulley segment (62) away from the second check segment (52) in the installed position and is configured to at least partially surround the structure (2).
12. The tensioning device (1) according to claim 11, wherein, The check segment (51) and the second check segment (52) are arranged longitudinally between the pulley segment (61) and the second pulley segment (62).
13. The tensioning device (1) according to any one of the preceding claims, wherein, The strip (3) is designed to be compressible in the longitudinal direction such that when tension is applied to the first filament (41), the distance between the at least two openings (71,72,73,74,75,76) in the longitudinal direction is reduced.
14. The tensioning device (1) according to any one of the preceding claims, wherein, The first wire (41) passes through at least one opening (73, 74) of the pulley segment (61) once.
15. The tensioning device (1) according to any one of the preceding claims, wherein, The first filament and the strip (3) are configured to allow the first filament (41) to slide smoothly through the opening of the strip (3).
16. The tensioning device (1) according to any one of the preceding claims, wherein, The first filament (41) is made of a material having a surface with a low coefficient of friction.
17. The tensioning device (1) according to any one of the preceding claims, wherein, The strip (3) is at least partially made of woven material.
18. The tensioning device (1) according to any one of the preceding claims, wherein, The strip (3) is made of absorbable material.
19. The tensioning device (1) according to any one of the preceding claims, the tensioning device further comprising a first interface (10) for interconnecting the strip (3) to the structure (2) and / or the at least one pulley ring (81, 82).
20. The tensioning device (1) according to claim 19, wherein the tensioning device (1) further comprises a third wire (43) for interconnecting the at least one pulley ring (81, 82) and the first interface (10) in the installation position.