A plating system is described that uses various configurations of bone fixation implants that are configured to attach to one or more portions of a bone. An exemplary bone fixation implant includes a two-dimensional structure comprising a bone-engaging surface and a tissue-engaging surface. A plurality of openings is defined in the two-dimensional structure, and arranged across a length and a width of the bone fixation implant. At least some of openings are configured to receive an attachment member for securing the bone fixation implant to an underlying bone structure. The tissue-engaging surface is configured to engage an overlying tissue structure for encouraging incorporation of the tissue structure into the bone fixation implant to promote stabilization of the underlying bone structure during healing. In certain embodiments, at least 50% of the area defined by and/or between the length and the width of the two-dimensional structure is an opening.

A plating system is described that uses various configurations of bone fixation implants that are configured to be attached to one or more portions of bone. The bone fixation implant may include at least one structural portion (e.g., a wire, plate, mesh, etc.) that includes metal and a polymer body at least partially surrounding the at least one structural portion. The polymer body may define an engaging surface that is configured to engage an attachment member that is applied to the bone fixation implant to fix the bone fixation implant to the bone, such that direct contact between the metal of the structural portion and the attachment member is prevented. Overlying muscle and tissue may be secured to the bone fixation implant to encourage incorporation of the tissue structure into the implant and promote stabilization and healing.

A device for securing tissue or bone. The device includes a self-locking construct, which includes first and second adjustable loops. The first adjustable loop includes a loop passage portion through which a first portion of the self-locking construct extends. The second adjustable loop extends through a sleeve defined by the self-locking construct. The self-locking construct is configured such that moving the second adjustable loop away from the first loop closes the first adjustable loop, and pulling the first portion further through the loop passage portion closes the second adjustable loop.

A locking mechanism for securing ends of an implantable fabric including a plate member having an aperture therethrough. A cam member is rotatable relative to the aperture between a locked state and an unlocked state. The implantable fabric is movable relative to the plate member when the cam member is in the unlocked state and restricted from moving relative to the plate member when the cam member is in the locked state.

An instrument includes a bearing member, and an actuator spaced from the bearing member in a proximal direction. The instrument includes, or can be attached to, an elongate member that extends from a location of the actuator toward the bearing member. The elongate member can attach to or extend from a portion of an implant, wherein the location is spaced from the bearing member a distance in the proximal direction. The actuator includes a flexible portion that is spaced from the elongate member in a direction perpendicular to the proximal direction, such that, when a force is applied to the flexible portion of the actuator, the flexible portion of the actuator deforms so as to increase the distance between the location and the bearing member.

Disclosed herein are improved surgical techniques for repairing bone defects in a sternum during a sternotomy procedure and implants adapted for such techniques. In an exemplary embodiment, provided is a fusion strip made of an osteoconductive material and of a dimension that is especially adapted for improved repair of sternal bone defects.

A sternotomy closure technique is suitably carried out with a cerclage mechanism which is capable of maintaining proper bony compression (within a desired range) across the sternum cut, in spite of a range of external forces and significant lateral distraction due to these external forces. The sternum fragments are aligned in apposition disposed around a longitudinal seam and secured with a resilient element. The resilient element is tensioned to a desired tension to compress the sternum to a desired compression range. The resilient element is then elongated and contracted while accepting multiple cycles of physiological distracting forces across the sternum while maintaining contact pressure across the longitudinal seam within a desired range for a length of time sufficient for bony healing. The resilient element is preferably a polymer cable comprising an elongated elastic polymeric core coaxially surrounded by a sheath woven from ultra-high molecular weight polyethylene strands.

In some embodiments a method comprises disposing an implant into contact with a first bone portion and into contact with a second bone portion, the implant having (1) a first interface configured to receive a restraining member, and (2) a second interface. The method further comprises inserting a portion of the fastener member into the first interface. The method further comprises securing the fastener member such that the first bone portion and the second bone portion are fixed to each other, at least in part by a substance after the securing, at least a portion of the substance disposed through the second interface.

An apparatus and technique for infernally securing a plurality of bone segments together. The device incorporates a plate-like structure stabilizing the fracture and integrated fasteners to attach straps circumscribing the bone segments.

A closure system may secure a first bone portion to a second bone portion. The closure system may include a band, a locking terminal, and a tensioning device. The band may be adapted to be looped around the first and second bone portions. The locking terminal may fixedly engage a first portion of the band and selectively fixedly engage a second portion of the band. The tensioning device may include a body and a threaded rod. The threaded rod may be received in the body and may engage the band such that movement of the threaded rod relative to the body moves the second portion of the band relative to the first portion of the band.