A bone closure assembly that includes a buckle and a strap having a first end fixedly attached to the buckle. The strap is configured for looping around bone portions. The bone closure assembly also includes a locking cap removably connected to the buckle. The locking cap is configured for securing the strap within the buckle to secure the bone portions together.

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.

Disclosed is a surgical instrument for tightening a bone fixation member around bone. The instrument comprises a body with a gripping portion extending from the body and configured to be grasped by a hand, a clamp for clamping a bone fixation member and a clamp carrier connected to and movably guided relative to the body. The clamp is connected to and movably guided relative to the clamp carrier. The instrument further comprises an actuator connected to and movably guided relative to the body, and configured to be operated by a hand, wherein the actuator is configured to move the clamp carrier via the clamp.

A sheath is provided. The sheath includes a core channel, and the core channel is configured to receive a tensioning element. The tensioning element is configured to circumscribe a bone, and the sheath is configured to be placed around a bone when the tensioning element received in the core channel circumscribes the bone. The sheath is configured to prevent direct contact between the tensioning element and the bone as the tensioning element is tensioned.

Disclosed herein is an implant for bone fixation comprising an elongated member configured to be wound around bone parts that are to be fixed, an engagement member coupled to the elongated member and configured to engage a portion of the elongated member so as to secure the implant in a loop around the bone parts, and a fastening member arranged between and coupled to the elongated member and the engagement member. The fastening member comprises at least two separate pieces each comprising one opening for receiving a bone fastener, wherein the separate pieces are coupled to each other by a material having a lower material strength than a material from which the separate pieces are made.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

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 system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

A flail chest stabilization device is provided that includes a pair of lateral bridges, a pair of main stabilization bars, a screw and slider-element connector assembly, and a slider introducer tool, where the slider introducer tool positions the slider-element, where the main stabilization bars are connected by the screw and slider connector assembly to the lateral bridges, where the stabilization bars are in a parallel configuration or crossed configuration.

Disclosed herein is an implant for bone fixation comprising an elongated member configured to be wound around bone parts that are to be fixed, an engagement member coupled to the elongated member and configured to engage a portion of the elongated member so as to secure the implant in a loop around the bone parts, and a fastening member arranged between and coupled to the elongated member and the engagement member. The fastening member comprises at least two separate pieces each comprising one opening for receiving a bone fastener, wherein the separate pieces are coupled to each other by a material having a lower material strength than a material from which the separate pieces are made.