Adjustable button cinch anchor orthopedic fastener

An orthopedic fastening system comprising:

• a first elongate shaft that is affixable at one end thereof down-hole a bore present within a first tissue, the elongate shaft having and presenting when so affixed an extension region that extends beyond the bore and a ramp surface in a region that extends within the bore;
• a split collet sliding along the shaft region that extends beyond the bore so as to force a second tissue that has been slipped over the shaft's extension region along this region and compressively into position against the first tissue;
• a sleeve forcibly sliding over the split collet in its position upon the shaft's extension region so as to contract the split collet against the shaft, thereafter locking the split collet into position holding tight the second tissue against the first tissue in compression at the position of the bore;
• and
• an apertured split collet having (i) a central aperture fitting snugly around the shaft in the region thereof that extends within the bore, and (ii) flukes, the split collet having and presenting a first diameter less than the diameter of the bore until the shaft is forcibly moved transversely in the aperture of the split collet so as to force the collet's flukes to splay outward in greater separation from the central shaft, causing the flukes to expand in diameter and to forcibly compress against the first tissue that surrounds the bore.

An orthopedic fastener for fastening a first tissue in which is present a bore to a second tissue in which is present a hole, the fastener comprising:

• a shaft having and defining from a first end to a second end (i) a first circumferential surface region, (ii) a second circumferential surface region, and (iii) a third circumferential surface region with engagement features;
• a first split collet initially encircling the shaft at its second circumferential surface region;
• a deployment sleeve temporarily fitting over the shaft to force the first split collet from the second to the first circumferential surface region of the shaft while the first end of the shaft remains inserted in the bore within the first tissue, the split collet expanding during sliding from the second to the first circumferential surface region so as to become affixed within the bore;
• a second split collet for sliding when split in distension along the shaft from the second end towards the first end that is affixed within the bore so that the second tissue that has its hole slipped over the shaft is forced along the shaft and compressively into position against the first tissue, the second split collet then being in the third circumferential surface region of the shaft;
• a sleeve forcibly sliding over the second split collet in its position upon the shaft in the shaft's third circumferential surface region so as to contract the second split collet to the shaft, locking the second split collet into position holding tight in compression the second tissue against the first tissue at the position of the bore;
• wherein the first split collet expands while the second split collet contracts in order that each performs a holding function.

An orthopedic fastener comprising:

• an elongate shaft having and defining circumferential engagement features, the shaft mountable at one end region thereof to a first tissue of the body so that a remaining portion of the shaft with its circumferential engagement features extends beyond this first tissue;
• a split collet having and defining (i) an interior bore of a larger diameter than is the shaft with its circumferential engagement features, by which bore the split collet may slip the extending portion of the shaft, (ii) a plurality of deformable flukes at a split end of the collet, (iii) engagement features, complimentary to the engagement features of the shaft, located internally circumferentially on the collet's plurality of flukes, and (iv) a ramp surface located externally circumferentially on the collet's plurality of flukes;
• and
• a sleeve in the shape of a hollow truncated frustaconical body, the sleeve having and defining an internal bore of larger diameter than is an external diameter of the split collet elsewhere from the collet's plurality of flukes, and also an internally circumferential ramp surface to the bore which ramp surface is complimentary in shape and in diameter to the ramp surface of the collet's plurality of flukes;
• wherein when the split collet is slid upon the extended portion of the elongate shaft, and the sleeve is then slid forcibly over the split collet until its interior ramp surface forcibly engages the exterior ramp surface of the collet's plurality of flukes, then the plurality of flukes are deformed until their internal circumferential engagement features engage the complimentary engagement features of the extended shaft portion, affixing the split collet to the shaft.

A method of variably selectively compressing in vivo a free end of a soft tissue comprising:

• engaging in vivo the free end of a first, soft, tissue (i) about a first-end extension region of an elongate fastener that is affixed at a second-end region down-hole a bore which is present and defined within another, second, tissue, and (ii) between, on the one hand, a sliding lock that both slides and screws in position along the fastener's second-end extension region extending beyond the bore and that also locks and unlocks so as to so slide and screw in position upon this extension region, and, on the other hand, the second tissue;
• first sliding in vivo the sliding lock in a first direction along the fastener's second-end extension region that extends beyond the bore so as to assume a selectable first position wherein the soft tissue, which soft tissue has been engaged about the fastener's extension region and between the sliding lock and the second tissue, is compressed;
• first screwing in vivo the sliding lock in selectable first position so as to compress the soft tissue engaged about the fastener's extension region and between the sliding lock and the second tissue to a variably predetermined first extent so as to selectively apply tension or compression to the soft tissue along the length of the first-end extension region of the elongate fastener;
• and
• locking the sliding lock means in its assumed first position, therein to compress the soft tissue against the second tissue to the variably predetermined first extent.

A method of variably selectively compressing and variably selectively re-compressing in vivo a free end of a soft tissue, the method comprising:

• affixing an elongate fastener at a first-end region thereof down-hole a bore which is present and defined within a first tissue, leaving extending outside the bore a second-end extension region;
• mounting a lock that slides in position along the fastener's second-end extension region extending beyond the bore to lock and to unlock upon this extension region;
• engaging in vivo a second, soft, tissue about the second-end extension region of the elongate fastener and between the sliding lock and the first tissue;
• first sliding the sliding lock in a first direction along the fastener's second-end extension region that extends beyond the bore so as to assume a selectable first position where the soft tissue, which soft tissue has been engaged in vivo around the fastener's second-end extension region and between the sliding lock and the first tissue, is compressed along a lengthwise direction of the elongate fastener to a variably predetermined first extent;
• locking the sliding lock means in its assumed first position, therein to compress the soft tissue against the second tissue along the lengthwise direction of the elongate fastener and to the variably predetermined first extent;
• and later
• unlocking in vivo, at a time after the locking, the locked sliding lock in its first position along the fastener's second-end extension region;
• second sliding in vivo the sliding lock along the fastener's second-end extension region that extends beyond the bore to a selectable second position so as to compress said soft tissue that has been engaged about the fastener's second-end extension region into position against the first tissue to a variably predetermined second extent that is different from the variably predetermined first extent;
• and
• re-locking the sliding lock at it's selectable second position, therein re-compressing the soft tissue against the second tissue along the lengthwise direction of the elongate fastener and to the variably predetermined second extent.

A method of variably selectively tensioning in vivo a soft tissue to another, second, tissue, the method comprising:

• engaging in vivo a soft tissue (i) about an elongate fastener that is affixed at one end thereof down-hole a bore present within another, second tissue, the elongate fastener having and presenting when so affixed a threaded extension region that extends beyond the bore, and (ii) between, on the one hand, a sliding lock that both slides and screws along the fastener region that extends beyond the bore and that locks and unlocks so as to both slide and screw in this its position upon the fastener's extension region, and, on the other hand, the second tissue;
• first sliding in vivo the sliding lock to a selectable first position along the fastener region that extends beyond the bore so as to compress said soft tissue, which soft tissue has been engaged about the fastener's extension region and between the sliding lock and the second tissue, into, and into position proximate to, the first tissue;
• first screwing in vivo the sliding lock in its selectable first position so as to compress the soft tissue engaged about the fastener's extension region and between the sliding lock and the second tissue to a variably predetermined first extent so as to selectively apply tension or compression to the soft tissue along the length of the threaded extension region of the elongate fastener;
• and
• locking the sliding lock in its selectable first position, therein fixing the extent of compression of the soft tissue towards the second tissue.

A method of variably selectively tensioning and later variably selectively re-tensioning in vivo a soft tissue, the method comprising:

• engaging in vivo a soft tissue (i) around an elongate fastener that is affixed at one end thereof down-hole a bore present within another, second tissue, the elongate fastener having and presenting when so affixed an extension region that extends beyond the bore, and (ii) between, on the one hand, a sliding lock that both slides along the fastener region that extends beyond the bore, and that locks and unlocks in its position upon the fastener's extension region, and, on the other hand, the second tissue;
• first sliding in vivo the sliding lock to a selectable first position along the fastener region that extends beyond the bore so as to compress to a variably selectable first extent said soft tissue, which soft tissue has been engaged about the fastener's extension region and between the sliding lock and the second tissue, into, and into position proximate to, the first tissue;
• locking the sliding lock in its selectable first position, therein fixing the extent of compression of the soft tissue towards the second tissue along the length of the elongate fastener;
• and later
• unlocking in vivo, at a time after the locking, the locked sliding lock in its first selectable position along the fastener region;
• second sliding in vivo the sliding lock along the fastener region that extends beyond the bore to a selectable new, second, position so as to compress the soft tissue that has been engaged about the fastener's extension region into position against the first tissue to a variably selectable second extent that is different from the variably selectable first extent;
• and
• re-locking the sliding lock means at it's selectable second position, therein re-fixing the extent of compression of the soft tissue towards the second tissue along the length of the elongate fastener.

An orthopedic fastening system for fastening one tissue to another tissue, the system comprising:

• a first elongate fastener having a first end region that is passable through a bore present within a first tissue and that is then affixable to a second tissue, the elongate fastener having and presenting when so passed and so affixed a threaded second end extension region that extends beyond the bore;
• a split collet distending at times to a larger interior diameter than is an exterior diameter of the fastener's second end extension region so as to slide along the fastener's second end extension region that extends beyond the bore, and contracting at other times so as to threadingly engage the fastener's threaded second end extension region;
• and
• a sleeve forcibly sliding over the split collet in its position upon the fastener's second end extension region so as to contract the split collet against the fastener at its second end extension region, locking the split collet into position where it may subsequently be screwed in fine positional adjustment.

An orthopedic fastener comprising:

• an elongate shaft having and defining a first end portion that is passable through a bore present within a first tissue and that is then affixable to a second tissue, while a remaining, second end, portion of the shaft having and defining threads extends beyond the first tissue's bore;
• a split collet having and defining (i) an interior bore of a larger diameter than is the shaft's second end portion with its threads, by which bore the split collet may slip the extending second end portion of the shaft, (ii) a plurality of deformable flukes at a split end of the collet, (iii) threads complimentary to the threads of the shaft's second end portion, located internally circumferentially on the collet's plurality of flukes, and (iv) a ramp surface located externally circumferentially on the collet's plurality of flukes;
• and
• a sleeve in the shape of a hollow truncated frustaconical body, the sleeve having and defining an internal bore of larger diameter than is an external diameter of the split collet in positions elsewhere from the collet's plurality of flukes, and also having and defining an internally circumferential ramp surface to the bore which ramp surface is complimentary in shape and in diameter to the ramp surface of the collet's plurality of flukes;
• wherein when the split collet is slid upon the extended portion of the elongate shaft, and the sleeve is then slid forcibly over the split collet until its interior ramp surface forcibly engages the exterior ramp surface of the collet's plurality of flukes, then the plurality of flukes are deformed until their internal threads engage the complimentary threads of the shaft's second end portion, affixing the split collet to the shaft so that it may thereafter screw upon the shaft.

An orthopedic fastening system for fastening one tissue to another tissue, the system comprising:

• a first elongate member that is affixable at one end thereof down-hole a bore present within a first tissue, the elongate member having and presenting when so affixed a threaded extension region that extends beyond the bore;
• a screwing slider means first (i) distending to greater internal diameter than is the external diameter of the elongate fastener's threaded extension region so as to slide along the extension region of the elongate member that extends beyond the bore to a variable extent so as to force a second tissue that has been slipped over the elongate member's extension region along this region along the extension region and compressively into position against the first tissue, and then (ii) screwing upon the same threaded extension regions so as to adjust the compression along an axis of the extension region to a variably selected degree;
• and
• a retention means for locking the screwing slider means in its position upon the elongate member's extension region to the elongate member, thereafter holding tight the second tissue against the first tissue at the position of the bore while permitting the screwing slider means to screw into the selected degree of compression.