Adjustable suture-button construct for ankle syndesmosis repair

Patent metadata

Field	Value
Publication number	US-9179950-B2
Application number	US-201113298863-A
Country	US
Kind code	B2
Filing date	Nov 17, 2011
Priority date	Nov 17, 2010
Publication date	Nov 10, 2015
Grant date	Nov 10, 2015

Abstract

An adjustable, knotless button/loop construct for fixation of ankle syndesmosis tibio-fibular diastasis and an associated method of ankle repair using the same. The knotless construct comprises a pair of buttons attached to a flexible, continuous, self-cinching, adjustable loop integrated with two splices that are interconnected. The knotless construct is passed through fibular and tibia tunnels and the buttons are secured on the cortical surfaces of tibia and fibula. One of the buttons (for example, an oblong button) is secured on the medial side of the tibia by passing the button and the flexible, adjustable loop though the fibular and tibia tunnels and then flipping and seating the button outside the tibia. The length of the flexible adjustable loop is adjusted so that the second button (for example, a round button) is appropriately secured on the lateral fibula.

First claim

What is claimed as new and desired to be protected by Letters Patent of the United States is:

1. A method of fixation of ankle syndesmosis tibio-fibular diastasis without knot tying, comprising the steps of:
providing an integrated construct comprising an adjustable knotless button/loop construct having two buttons and a flexible, adjustable loop connected to the two buttons, the flexible loop having an adjustable length, two ends and two adjustable splices that are interconnected, the flexible loop being connected to the two buttons so that the two adjustable splices are on an opposite ends of one of the two buttons, and the two ends of the flexible loop pass through different holes of the other of the two buttons, and so that the other of the two buttons is centered between the two adjustable splices;
inserting the integrated construct within a hole through fibula and within a hole through tibia, and out of medial skin; and
adjusting the length of the loop to secure one of the two buttons against the medial tibia and the other of the two buttons against the lateral fibula by pulling on the two ends of the flexible loop, and adjusting the length of the loop in one direction while preventing or locking the integrated construct from loosening in an opposite direction.

2. The method of claim 1 , further comprising the steps of:
advancing a first of the two buttons and the adjustable button/loop through the hole through fibula and the hole through tibia, so as the first button exits the tibia and pivots and engages a cortical surface of the tibia; and
adjusting the length of the loop to position the adjustable button/loop within the hole through fibula and the hole through tibia.

3. The method of claim 1 , wherein the integrated construct is formed by the steps of:
providing a flexible strand having two ends;
passing the flexible strand through first and second holes of a first button;
passing the flexible strand through eyelets of a second button;
passing the flexible strand through a third hole of the first button, to connect the first button to the second button;
passing the flexible strand from the third hole under a strand from first and second holes, and through a fourth hole of the first button, to form an adjustable, flexible loop;
forming a first splice by passing a needle attached to the flexible strand through the flexible strand and near a center of the loop formed between the two buttons; and
forming a second splice by passing the needle through the flexible strand and near the first splice.

4. The method of claim 1 , wherein the one of the two buttons has a configuration which is different from a configuration of the other one of the two buttons.

5. A method of ankle reconstruction without knot tying, comprising:
providing an integrated construct comprising a round button connected to an oblong button by a continuous loop of flexible material attached to the round and oblong buttons, the loop of flexible material having an adjustable length and being provided with two adjustable splices that are interconnected and with two ends, wherein the two adjustable splices are on opposite ends of the oblong button so that the oblong button is centered between the two adjustable splices, and the two ends of the loop of flexible material pass through different holes of the round button;
inserting the integrated construct within a fibula tunnel and a tibia tunnel by advancing the first fixation device through the fibula and tibia tunnels so as to exit tibia and to pivot and engage a cortical surface of the tibia; and
adjusting the length of the continuous loop by pulling on the free ends and adjusting the length of the continuous loop in one direction while preventing or locking the integrated construct from loosening in an opposite direction, to fixate the integrated construct within the fibula and tibia tunnels.

6. The method of claim 5 , wherein the round button has a circular body and circular apertures, and the oblong button has an oblong body and oblong apertures, and wherein the loop is passed through all the circular apertures and all the oblong apertures.

Assignees

• Zajac Eric S
• Albertorio Ricardo
• Roller Brandon L
• Arthrex Inc

Inventors

• Zajac Eric S
• Albertorio Ricardo
• Roller Brandon L

Classifications

• A61B17/80 Primary

  Cortical plates {, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates} · CPC title

• A61B2017/0404

  Buttons · CPC title

• A61B2017/0477

  with pre-tied sutures · CPC title

• A61B17/0401 Primary

  Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811) · CPC title

• A61B17/809

  with bone-penetrating elements, e.g. blades or prongs (bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233) · CPC title