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The present application relates to the technical field of medical devices, in particular to an adjustable flexible bone-to-bone fixation device and an implanting mechanism, the adjustable flexible bone-to-bone fixation device comprising a first suture and a flexible fixation assembly, the first suture having a first traction end, a second traction end, a first wire inlet hole and a second wire outlet hole, the flexible fixation assembly comprising a second suture and a titanium alloy button; in use, the fibula and the tibia are adjusted to a suitable position, a drill bit is used to drill through the fibula, a drill bit is used to create a bone channel on the tibia through the fibula bone channel created by the drill bit, the second suture is passed through the fibula bone channel and knocked into the tibia bone channel, the titanium alloy button is arranged on the surface of the lateral cortical bone of the fibula, the first traction end and the second traction end are pulled, and the second suture is contracted into a mass in the bone channel to extrude the bone channel and achieve flexible fixation, so that reliable fixation can be achieved with a smaller amount of bone removal.