Bone fixation tensioning tool and method

Abstract

A tensioning tool and method for tensioning a conformable ligature of a bone fixing system are disclosed. The ends of a conformable ligature can be passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop. Another portion of the conformable ligature can be coupled to a tensioning tool. The tensioning tool can include a first portion and a second portion in threaded engagement with each other. Rotation of one portion relative to the other can cause tensioning of the conformable ligature through translation of a tensioning member.

1 - 14 . (canceled) 
     
     
         15 . A system for applying tension to a conformable ligature of a bone fixing system, the system comprising:
 a spinal rod;   a bone fixing system including:
 a ligature capturing element; and 
 a conformable ligature; 
   a tensioning tool including:
 an elongate tool body having a first end and a second end; 
 a drive shaft extending along at least a portion of the tool body; 
 a connection portion positioned at the second end of the elongate tool body shaped to engage the ligature capturing element of the bone fixing system; and 
 a carriage positionable between an engagement position and a disengagement position relative to the drive shaft, wherein the carriage in the engagement position is engaged with the drive shaft to effect movement along the elongate tool body of the drive shaft to selectively apply tension to the conformable ligature, and wherein the carriage in the disengagement position is not engaged with the drive shaft such that the carriage is freely movable along the tool body. 
   
     
     
         16 . The system of  claim 15 , wherein the carriage is pivotable between the engagement and disengagement positions about the axis generally perpendicular to the central rotational axis of the drive shaft. 
     
     
         17 . The system of  claim 16 , wherein the carriage is configured to be pivoted by applying force to an external surface of the carriage with a tool or hand. 
     
     
         18 . The system of  claim 15 , wherein the drive shaft is threaded. 
     
     
         19 . The system of  claim 18 , wherein the carriage includes a drive shaft passage sized such that it allows for the carriage to pivot in order to engage or disengage a thread engaging portion of the carriage with the threads on the drive shaft. 
     
     
         20 . The system of  claim 19 , wherein a first portion of a thread engaging portion is positioned on a first side of the carriage proximate a first end of the carriage, and a second portion of the thread engaging portion is positioned on a second side of the carriage opposite the first side and proximate a second end of the carriage opposite the first end. 
     
     
         21 . The system of  claim 18 , wherein the carriage naturally is situated in the engagement position to engage the threads on the drive shaft when in a resting position. 
     
     
         22 . The system of  claim 18 , wherein the carriage in the engagement position is engaged with the threads of the drive shaft to effect movement along the elongate tool body through rotation of the threaded drive shaft to selectively apply tension to the conformable ligature, and wherein the carriage in the disengagement position is not engaged with the threads of the drive shaft such that the carriage is freely movable along the tool body without rotation of the threaded drive shaft. 
     
     
         23 . The system of  claim 15 , further comprising:
 a detachable handle connected to the drive shaft proximate the first end of the elongate tool body via a quick connector, the detachable handle configured to permit a user to rotate the drive shaft to apply the tensioning force to the conformable ligature.   
     
     
         24 . The system of  claim 15 , wherein the tensioning tool further includes a tension control device configured to determine the amount of tensioning force applied to the conformable ligature. 
     
     
         25 . The system of  claim 15 , wherein the connection portion includes first and second tangs configured to receive the ligature capturing element therebetween. 
     
     
         26 . The system of  claim 25 , wherein each of the first and second tangs includes one or more legs extending therefrom, each of the legs having an arcuate surface configured to contact the spinal rod passing through the ligature capturing element. 
     
     
         27 . The system of  claim 25 , wherein the first and second tangs are spaced apart to permit the conformable ligature to pass therebetween. 
     
     
         28 . The system of  claim 15 , further comprising a tensioning member extending from the carriage configured to receive a loop of the conformable ligature therearound. 
     
     
         29 . The system of  claim 28 , wherein the tensioning member includes a post extending from the carriage. 
     
     
         30 . The system of  claim 28 , wherein the tensioning member is rigidly coupled to the carriage. 
     
     
         31 . The system of  claim 15 , wherein the drive shaft extends through at least a portion of the elongate tool body. 
     
     
         32 . The system of  claim 31 , wherein the elongate tool body includes an elongate slot along which the carriage travels. 
     
     
         33 . The system of  claim 15 , wherein a proximal portion of the drive shaft includes tension force indicators. 
     
     
         34 . The system of  claim 15 , further comprising:
 a drive shaft seat in which a first end of the drive shaft is seated;   a spring that compresses between the drive shaft seat and the tool body, wherein the first end is an end proximate the connection portion.   
     
     
         35 . A tensioning tool, comprising:
 a threaded drive shaft extending along at least a portion of an elongated tool body having a first end and a second end; and   a carriage positionable between an engagement position and a disengagement position relative to the threaded drive shaft, wherein the carriage in the engagement position is engaged with threads of the drive shaft to effect movement along the elongate tool body through rotation of the threaded drive shaft to selectively apply tension to a conformable ligature, and wherein the carriage in the disengagement position is not engaged with the threads of the drive shaft such that the carriage is freely movable along the tool body without rotation of the threaded drive shaft; and   a tensioning member extending from the carriage configured to receive a loop of the conformable ligature therearound, wherein the tensioning member is adapted to receive the conformable ligature for tensioning within a ligature capturing element of a bone fixing system during axial movement of the carriage.   
     
     
         36 . The tensioning tool of  claim 34 , further comprising a connection portion positioned at the second end of the elongate tool body shaped to engage the ligature capturing element of the bone fixing system.