Automatic release of near bone suture button from button inserter

Abstract

To provide a button inserter designed to quickly and easily deploy a near bone button.SOLUTION: A button inserter and a system are disclosed that can easily and effectively deploy a near bone suture button from the button inserter when implementing the suture button technique. To deploy the near bone button, with a far bone button deployed from the button inserter and against the far bone, the button inserter's handle may be translated away from the deployed far bone button. Translating the handle changes a position of a carriage body within a channel of the handle thereby compressing a spring. Protrusions on the carriage body may be forced through notches in the handle, which thereby alters orientations of the carriage and releases the compressed spring, which applies a force to the carriage body. The combination of forces induces the carriage to rotate, thereby releasing the near bone button from the carriage. A free end of suture also releases from the carriage.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] Claiming priority This application claims priority to and the benefit of U.S. Provisional Application No. 63 / 018,825, filed May 1, 2020, which is incorporated by reference in its entirety.

[0002] This application relates generally to a button insertion tool for performing suture button techniques. More specifically, a button insertion tool and system having a release mechanism for easily and effectively deploying a near bone button from the button insertion tool is disclosed. [Background technology]

[0003] There may be injuries suffered by a patient that may require the fixation of a first or nearby bone to a second or distant bone to aid the patient in recovery from the injury. Ankle joint injuries may be one such type of injury. The ankle joint is made up of two bones, the tibia and the fibula, held together by the distal tibiofibular ligament. In some cases, for example, after an ankle injury, the ligament may be ruptured, leaving a gap between the tibia and the fibula. Ligament injuries need to be repaired if found to be ruptured or unstable to prevent ankle instability and subsequently reduce the risk of osteoarthritis of the ankle.

[0004] One method of fixing the proximal bone to the far bone is the suture button technique. The suture button technique involves deploying a bone fixation construct that includes a first (e.g., proximal) button connected to a second (e.g., distal) button with a suture. The suture can be tensioned to fix the proximal bone to the far bone. For example, to repair a ligament injury, the suture button technique involves two buttons that hold the fibula (e.g., proximal) and tibia (e.g., distal) together and sutures that connect the two buttons through drilled bone holes in the fibula and tibia. The distal button may be inserted through the drilled bone holes to fix the tibia, while the proximal button fixes the fibula. The buttons are typically placed in place with a needle and pull-through suture or with a button insertion tool.

[0005] Typical button insertion instruments require manual removal of the proximal button (e.g., one that has not been inserted through the bone) from the insertion instrument. This can be a multi-step process of loosening or untangling the sutures and then lifting the proximal button from the handle, which can be tedious and time-consuming for the surgeon. Therefore, a button insertion instrument designed to quickly and easily deploy the proximal button is desirable. Summary of the Invention

[0006] The present application provides a new and innovative button insertion instrument and system having a mechanism for deploying and releasing a proximal button from the insertion instrument. After deploying the distal button from the insertion instrument, the surgeon can deploy the proximal suture button and associated sutures in the suture button structure from the button insertion instrument in a single motion by translating the button insertion instrument. Thus, the provided button insertion instrument deploys the proximal button more effectively and efficiently than typical button insertion instruments.

[0007] In light of the technical features described herein, in a first aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, but is not limited to, a system for suture button insertion includes a suture button structure and a suture button insertion instrument. The suture button structure includes a distal button joined to a proximal button by a suture. The suture button insertion instrument includes a handle, a tube, a carriage, and a spring. A portion of the handle defines a channel, a first notch, and a second notch. The tube extends from the handle. The carriage includes a body. A button post, a first suture post, and a second suture post each extend from the body. A first protrusion and a second protrusion each extend from the body. In a pre-deployment configuration of the suture button insertion instrument, a portion of the body including the first and second protrusions is positioned within a channel of the handle such that a portion of the body can translate within the channel. A first end of the spring contacts a portion of the handle and a second end of the spring contacts a body of the carriage. Translating the carriage toward the first end of the spring compresses the spring. At least a portion of the body within the channel can be removed from the channel when the first and second protrusions are aligned with the first and second notches of the handle. In a pre-deployed configuration of the suture button insertion instrument, the proximal button is positioned against the button post and the distal button is positioned at the end of the tube such that the suture is tensioned between the proximal button and the distal button.

[0008] In a second aspect of the present disclosure, which can be combined with any other aspect unless otherwise specified, the suture is wrapped around a first suture post and a second suture post in a pre-deployed configuration of the suture button insertion device.

[0009] In a third aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, the suture is wrapped such that a first loop of the suture is formed around the first suture post, a second loop of the suture is then formed around both the first and second suture posts, the suture is then wrapped around the outside of the second suture post, and a third loop of the suture is then formed around the first suture post.

[0010] In a fourth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, the suture is wrapped around the first and second suture posts such that the suture is released from the first and second suture posts in response to the proximal bone button being released from the carriage.

[0011] In a fifth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, with the distal button deployed from the suture button insertion instrument and maintained in a fixed position, translating the handle of the suture button insertion instrument away from the deployed distal button changes the position of the carriage relative to the channel. The change in position of the carriage allows the first and second protrusions to exit the channel through the first and second notches, thereby inducing a change in orientation of the carriage, thus releasing the proximal button from the carriage.

[0012] In a sixth aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, the change in orientation includes the carriage rotating about an axis perpendicular to the tube.

[0013] In a seventh aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, a change in orientation of the carriage positions the first and second suture posts above the button post.

[0014] In an eighth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, tension in the suture between the distal button and the proximal button maintains the position of the carriage during translation of the handle of the suture button insertion instrument away from the distal button.

[0015] In a ninth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, translating the handle of the suture button insertion instrument away from the distal button compresses a spring between a portion of the handle and the body of the carriage.

[0016] In a tenth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, when the first and second protrusions of the carriage exit the channel through the first and second notches, the compressed spring releases energy inducing a change in orientation of the carriage.

[0017] In an eleventh aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, a suture button insertion instrument includes a handle, a carriage, and a spring. A portion of the handle defines a channel, a first notch, and a second notch. The carriage includes a body. A button post, a first suture post, and a second suture post each extend from the body. A first protrusion and a second protrusion each extend from the body. In a pre-deployed configuration of the suture button insertion instrument, a portion of the body including the first and second protrusions is positioned within the channel of the handle such that a portion of the body can translate within the channel. A first end of the spring is in contact with a portion of the handle and a second end of the spring is in contact with the body of the carriage. Translating the carriage toward the first end of the spring compresses the spring. At least a portion of the portion of the body within the channel is removable from the channel when the first and second protrusions are aligned with the first and second notches in the handle.

[0018] In a twelfth aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, the button insertion tool further includes a tube extending from the handle, an inner rod within the tube, and an actuator for translating the inner rod.

[0019] In a thirteenth aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, the button post includes a lip at an upper end of the button post.

[0020] In a fourteenth aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, the second end of the spring is in contact with the first end of the carriage, and the first end of the carriage includes a button post.

[0021] In a fifteenth aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, the carriage includes two separate button posts extending from a body of the carriage.

[0022] In a sixteenth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, the second end of the spring is in contact with the first end of the carriage, the first end of the carriage is opposite the second end of the carriage, and the second end of the carriage includes first and second protrusions.

[0023] In a seventeenth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, the second end of the spring is in contact with the first end of the carriage, the first end of the carriage is opposite the second end of the carriage, and the second end of the carriage includes first and second suture posts.

[0024] In an eighteenth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, a suture button structure includes a distal button joined by a suture to a proximal button. A method for deploying the suture button structure from a button insertion instrument includes inserting the distal button through a bone hole via the button insertion instrument. The distal button can then be deployed from the button insertion instrument. The button insertion instrument can then be translated away from the deployed distal button, thereby deploying the proximal button from the button insertion instrument.

[0025] In a nineteenth aspect of the present disclosure, which may be combined with any other aspect unless otherwise specified, the free ends of the sutures are coupled to a button insertion instrument, and translating the suture button insertion instrument away from the deployed distal button further deploys the free ends of the sutures from the button insertion instrument.

[0026] In a twentieth aspect of the disclosure of the present application, which may be combined with any other aspect unless otherwise specified, the method further includes wrapping the free ends of the suture around two posts of the button insertion instrument prior to inserting the distal bone button through the bone hole.

[0027] Additional features and advantages of the disclosed method and apparatus will be described in and will be apparent from the following detailed description and figures. The features and advantages described herein are not all-inclusive, and in particular many additional features and advantages will be apparent to those skilled in the art in view of the figures and description. Furthermore, it should be noted that the language used herein has been chosen primarily for ease of reading and explanatory purposes, and not to limit the scope of the inventive subject matter. [Brief description of the drawings]

[0028] [Figure 1] FIG. 1 is an exploded perspective view of a suture button insertion tool system including a suture button insertion tool and a suture button structure according to one aspect of the present disclosure. [Diagram 2]2 is a side view of the suture button insertion tool of FIG. 1 loaded with the suture button structure of FIG. 1 in a pre-deployed configuration, according to one aspect of the present disclosure. [Diagram 3] 2 is a top view of the suture button insertion tool of FIG. 1 loaded with the suture button structure of FIG. 1 in a pre-deployed configuration, according to one aspect of the present disclosure. [Figure 4A] FIG. 4 is an enlarged view of the top view of FIG. 3 according to one embodiment of the present disclosure. [Figure 4B] FIG. 2 is a perspective view of a carriage of the suture button insertion instrument of FIG. 1 according to one embodiment of the present disclosure. [Figure 5A] 1A-1D illustrate an exemplary suture winding method according to one aspect of the present disclosure. [Figure 5B] 1A-1D illustrate an exemplary suture winding method according to one aspect of the present disclosure. [Figure 5C] 1A-1D illustrate an exemplary suture winding method according to one aspect of the present disclosure. [Figure 5D] 1A-1D illustrate an exemplary suture winding method according to one aspect of the present disclosure. [Figure 5E] 1A-1D illustrate an exemplary suture winding method according to one aspect of the present disclosure. [Figure 5F] 1A-1D illustrate an exemplary suture winding method according to one aspect of the present disclosure. [Figure 5G] 1A-1D illustrate an exemplary suture winding method according to one aspect of the present disclosure. [Figure 6] FIG. 4 is an enlarged top view of FIG. 3 showing a deployment mechanism of the suture button insertion tool, according to one embodiment of the present disclosure. [Figure 7] 2 is a perspective view of the suture button insertion instrument of FIG. 1 in a deployed configuration, according to one embodiment of the present disclosure. [Figure 8] FIG. 1 is a perspective view of an exemplary distal bone button according to one aspect of the present disclosure. [Figure 9] FIG. 1 is a perspective view of an exemplary proximal bone button according to one aspect of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0029] Disclosed are button insertion instruments, systems, and methods that allow a surgeon, or any other suitable health care provider, to easily and effectively deploy a proximal button from a button insertion instrument when performing a suture button technique, such as for repairing syndesmosis injuries of the ankle. The button insertion instrument provided includes a handle that defines a channel. The handle can also define a pair of notches at an opening of the channel. A tube can extend from the handle that is part of a distal suture button deployment mechanism of the button insertion instrument.

[0030] The button insertion instrument provided further includes a carriage. The carriage can include a body portion and a number of posts extending from the body portion. For example, the carriage may include one or more button posts and one or more suture posts. The one or more button posts secure the positioning of the proximal bone button to maintain tension in the suture prior to deployment, as described further below. The one or more suture posts secure the free end of the suture prior to deployment, as described further below. The carriage can include at least two protrusions extending from the body portion. A portion of the carriage including the protrusions may be positioned within a channel of the handle prior to deployment and may translate within the channel. The protrusions serve to prevent this carriage portion from exiting the channel until the protrusions are aligned with a notch in the handle, at which point the protrusions may be translated through the notch to allow the carriage to fully or partially exit the channel.

[0031] A spring, or other suitable resilient member, resides within a channel in the handle. One end of the spring is in contact with the handle and the other end of the spring is in contact with the carriage. In this manner, the position of the carriage within the channel may be changed relative to the handle to compress the spring, or conversely, the compressed spring may apply a force to the carriage when the compressed spring releases.

[0032] The suture button structure may be loaded into a provided button insertion instrument for deployment into a patient. The suture button structure includes a distal button joined by a suture to a proximal button. In a pre-deployment configuration, the distal button is positioned on an end of a tube of the button insertion instrument, the proximal button is positioned against a button post of the carriage, and the suture between the distal button and the proximal button is tensioned. The free end of the suture may be wrapped around the suture post to allow the wrapped suture to be automatically released from the suture post upon deployment of the proximal button. For example, the free end of the suture may be wrapped around the suture post according to a wrapping method described below. The provided wrapping method helps prevent knot formation in the suture as the suture unravels, thereby eliminating the need for the surgeon to manually unwrap the suture.

[0033] To deploy the suture button structure from a provided button insertion instrument, a surgeon can deliver a distal button through the bone hole via the button insertion instrument and actuate a mechanism to deploy the distal button. For example, the surgeon can pull a trigger that translates a rod within the tube of the button insertion instrument to release the distal button from the tube, thereby deploying the distal button. With the distal button deployed from the button insertion instrument against the distal bone, the surgeon can translate the handle of the button insertion instrument away from the deployed distal button (e.g., at least partially back through the bone hole). Tension in the suture between the distal and proximal buttons prevents the carriage from translating with the handle. Thus, translating the handle compresses the spring and increases tension in the suture, each exerting a counteracting force on the carriage. Translating the handle also changes the position of the carriage body within the channel of the handle.

[0034] When the protrusion on the carriage body is aligned with the notch on the handle, the combination of the tension in the suture and the force exerted by the spring on the carriage body induces a change in carriage orientation as the protrusion moves through the notch. For example, the carriage can be rotated 90 degrees from a horizontal to a vertical orientation. In some cases, the surgeon can help push the protrusion through the notch. For example, the surgeon can use his thumb to push the suture post (or the suture wrapped around the suture post) of the carriage upwards, pushing the protrusion through the notch. The change in carriage orientation releases the proximal button from the carriage. For example, the button post no longer constrains the proximal button against the tension in the suture with the carriage in the vertical position. Additionally, the vertically positioned carriage releases the suture tension on the proximal button, thereby releasing the proximal button from the carriage. The free end of the suture is also released from the suture post. In this manner, the surgeon can deploy the proximal suture button and associated sutures in the suture button structure from the button insertion instrument in a single motion by translating the button insertion instrument. The surgeon can then secure the deployed proximal button to the proximal bone by tensioning the deployed sutures and tying the sutures.

[0035] 1 illustrates an exemplary suture button insertion system 100 including a suture button structure 130 and a button insertion instrument 110. In at least some embodiments, the suture button structure 130 includes a distal button 132 (e.g., FIG. 8) joined to a proximal button 134 (e.g., FIG. 9) by a suture 136. In some cases, the free end of the suture 136 may include a knot 138.

[0036] The exemplary button insertion tool 110 includes a handle 112. In various embodiments, a tube 114 extends from the handle 112. A rod 302 (FIG. 3) can be positioned within the tube 114. The rod 302 can be operably coupled to a trigger 116 such that actuation of the trigger 116 translates the rod 302 within the tube 114. The handle 112 defines a channel 140 (best shown in FIG. 7). In various embodiments, the handle 112 further defines at least two notches 704A and 704B (FIG. 7) at an opening of the channel 140.

[0037] The exemplary button insertion instrument 110 further includes a carriage 118. FIG. 4B shows a perspective view of the exemplary carriage 118. The carriage 118 can include a body 410. In various embodiments, at least two protrusions 412A and 412B (FIG. 7) can extend from the body 410. A portion of the body 410 of the carriage 118 (e.g., the portion including the protrusions 412A and 412B) can be positioned within the channel 140 of the handle 112. The protrusions 412A, 412B can help prevent a portion of the body 410 of the carriage 118 from exiting the channel 140 in a pre-deployed configuration of the suture button insertion system 100. In various embodiments, the carriage 118 can include one or more button posts 122, 124 extending from the body 410 of the carriage 118. In some embodiments, the button posts 122, 124 can include lips 414A, 414B. Although button post 122 and button post 124 are shown in the illustrated example, in other examples, carriage 118 can include a single suitable button post or three or more button posts. In various embodiments, carriage 118 can include one or more suture posts 120, 126. Although suture post 120 and suture post 126 are shown in the illustrated example, in other examples, carriage 118 can include a single suitable suture post or three or more suture posts.

[0038] 2 illustrates a loaded or pre-deployed configuration of the suture button insertion system 100 with the suture button structure 130 loaded onto the button insertion instrument 110. In the pre-deployed configuration, the distal button 132 is positioned at the end of the tube 114. In one example, the wings 804 (FIG. 8) of the distal button 132 may be positioned within a slit formed in the end of the tube 114. The proximal button 134 is positioned relative to the button posts 122 and 124. In one example, the head 900 (FIG. 9) of the proximal button 134 is positioned relative to the button posts 122 and 124, and the peg 902 (FIG. 9) is positioned between the button posts 122 and 124. In embodiments in which the button posts 122, 124 have lips 414A, 414B, the lips 414A, 414B may help prevent the proximal button 134 from translating beyond the lips 414A, 414B prior to deployment. The suture 136 is taut or tensioned between the distal button 132 and the proximal button 134 in the pre-deployed configuration. In at least some embodiments, the free ends of the suture 136 may be wrapped around the button posts 122 and 124 as shown.

[0039] 3 illustrates a top view of the suture button insertion system 100 in a pre-deployed configuration. In FIG. 3, a spring 300 is shown positioned within the channel 140 of the handle 112. One end of the spring 300 may contact the handle 112 and an opposite end of the spring 300 may contact the body 410 of the carriage 118. In various embodiments, the spring 300 may surround a rod 302. Although a spring 300 is utilized in the illustrated exemplary button insertion tool 110, in other examples, another suitable resilient member may be used in place of the spring 300.

[0040] In some embodiments, the button insertion instrument 110 can include one or more indicators for determining the proper location of the carriage 118 in the pre-deployed configuration. For example, FIG. 4A shows an enlarged top view of the button insertion system 100 showing a registration window 400 of the handle 112. In such an example, the carriage 118 can include an indicator 402 that can be aligned within the registration window 400 to position the carriage 118 in the proper location. For example, the proper location of the carriage 118 can be when the indicator 402 is positioned in front of the registration window 400 as shown. In at least some embodiments, the surgeon can tension the suture 136 between the distal button 132 within the proximal button 134 to position the carriage 118 in the proper location, and then wrap the free end of the suture 136 around the suture posts 120, 126 to maintain the position of the carriage 118. In other examples, the button insertion instrument 110 can include another suitable indicator for determining the proper location of the carriage 118.

[0041] As mentioned above, the free end of the suture 136 may be wrapped around the suture posts 120, 126 to release the suture 136 from the suture posts 120, 126 without forming a knot and without the surgeon having to loosen or unwind the suture 136. FIGS. 5A-5G illustrate an exemplary suture wrapping method. Although only a single strand of suture 136 is shown in FIGS. 5A-5G to help more clearly and simply illustrate various snapshots of the exemplary suture wrapping method, it will be understood that the free end of the suture 136 may include two separate strands of suture 136 that are wrapped in unison. Stated differently, the suture 136 shown in FIGS. 5A-5G may be two separate strands wrapped as shown.

[0042] As shown in FIG. 5A, a portion of the free end of the suture 136 may first be positioned between the suture post 120 and the suture post 126, with the remaining portion of the free end of the suture 136 offset to the side. As shown in FIG. 5B, the suture 136 may be wrapped in the direction of arrow 500, thereby forming a loop of the suture 136 around the suture post 126. As shown in FIG. 5C, the suture 136 may be wrapped in the direction of arrow 502 around the outside of the suture post 120 and then in the direction of arrow 504 around the outside of the suture post 126, thereby forming a loop of the suture 136 around both the suture post 120 and the suture post 126, as shown in FIG. 5D. As shown in FIG. 5E, the suture 136 may then be wrapped in the direction of arrow 506 around the outside of the suture post 120. As shown in Figure 5F, the suture 136 may then be wrapped in the direction of arrow 508 such that the suture 136 coming from button 134 is positioned between suture post 120 and suture post 126 while the currently wrapped portion of suture 136 is wrapped around the outside of suture post 126, thereby forming a loop around suture post 126. Figure 5G shows the final configuration of the wrapped suture 136.

[0043] A release mechanism for deploying the proximal button 134 from the exemplary button insertion instrument 110 will now be described. The surgeon may first use the button insertion instrument 110 to convey the distal button 132 through the bone holes formed in the first and second bones. Once through the formed bone holes, the surgeon may deploy the distal button 132 from the button insertion instrument 110. For example, the surgeon may actuate the trigger 116 to deploy the distal button 132. The deployed distal button 132 positions itself against the distal bone by the tension of the suture 136 that holds the distal button 132 against the distal bone. With the distal button 132 deployed, the proximal button 134 may then be deployed.

[0044] 6 shows an enlarged top view of a portion of the suture button insertion system 100 after the distal bone button 132 has been deployed from the button insertion instrument 110. The surgeon can translate the handle 112 of the button insertion instrument 110 away from the deployed distal bone button 132 in the direction of arrow 600. As the handle 112 translates in the direction of arrow 600, tension in the suture 136 prevents the carriage 118 from translating with the handle 112. Stated another way, the carriage 118 remains at least relatively stationary as the handle 112 translates in the direction of arrow 600 such that the position of the carriage 118 changes relative to the channel 140 of the handle 112. Movement of the handle 112 in the direction of arrow 600 while the carriage 118 remains stationary thereby compresses the spring 300 between the handle 112 and the carriage 118.

[0045] As the handle 112 translates in the direction of arrow 600 and the position of the carriage 118 changes relative to the channel 140, a point is reached where the projections 412A, 412B of the carriage 118 are aligned with the notches 704A, 704B of the handle 112. At this point, a threshold amount of tension in the suture 136 forces the carriage 118 to turn as the projections 412A, 412B progress through the notches 704A, 704B. For example, the tension in the suture 136 exerts a force on the carriage 118 in the direction of arrow 602. The force from the tension in the suture 136 at the level of the button posts 122, 124 (e.g., eccentric relative to the body 410 of the carriage 118) induces a rotation of the carriage 118. At the same time, the initial change in orientation of carriage 118 induces the release of compressed spring 300, which exerts a force on carriage 118 in the direction of arrow 600. The reaction force from spring 300 (e.g., the direction of arrow 600 is opposite the direction of arrow 602) is in a different plane than the plane in which the force from the tension in suture 136 exists, thereby further inducing rotation of carriage 118.

[0046] In various embodiments, the combination of the reaction forces from the tension in the suture 136 and the spring 300 rotates the carriage 118 approximately 90 degrees. For example, the carriage 118 can rotate from a horizontal orientation shown in FIG. 2 to a vertical orientation shown in FIG. 7. The change in orientation of the carriage 118 releases the proximal button 134 from the carriage 118. For example, the button posts 122, 124 no longer constrain the proximal button 134 against the tension in the suture 136 with the carriage 118 in the vertical orientation. Furthermore, the vertical orientation of the carriage 118 releases the tension of the suture 136 on the proximal button 134, thereby releasing the proximal button 134 from the carriage 118. Stated another way, the change in orientation of the carriage 118 in combination with the loosening tension in the suture 136 allows the proximal button 134 to separate from the button posts 122, 124 and release from the carriage 118.

[0047] As described above, the carriage 118 can be positioned in a suitable location in the pre-deployed configuration such that a reaction force from the tension in the suture 136 and the spring 300 induces a change in orientation of the carriage 118 when the projections 702A, 702B align with the notches 704A, 704B. Stated another way, in the pre-deployed configuration, the carriage 118 is positioned such that when the handle 112 translates to deploy the proximal bone button 134, a threshold amount of tension is generated in the suture 136 when the projections 412A, 412B of the carriage 118 align with the notches 704A, 704B.

[0048] As the proximal button 134 deploys from the carriage 118 and the handle 112 is further translated away from the deployed distal button 132 (e.g., in the direction of arrow 600), the free ends of the sutures 136 are released or unwound from the suture posts 120, 126. The exemplary suture wrapping method illustrated in Figures 5A-5G allows the sutures 136 to freely unwind from the suture posts 120 and 126 without forming knots as the proximal button 134 deploys from the carriage 118 and the button insertion instrument 110 is moved away from the deployed proximal button 134. Figure 7 illustrates the button insertion instrument 110 with the carriage 118 in a vertical orientation after deployment of the suture button structure 130.

[0049] Thus, the surgeon can deploy the proximal suture button 134 and associated sutures 136 in the suture button structure 130 from the button insertion instrument 110 in a single motion by translating the button insertion instrument 110 away from the deployed distal button 132. In this manner, the suture button insertion system 100 helps eliminate the manual process of loosening or untangling the sutures 136 and removing the proximal button 134 required by a surgeon using a typical button insertion instrument. Thus, the button insertion instrument 110 deploys the proximal button 134 more effectively and efficiently than a typical button insertion instrument.

[0050] 8 illustrates a perspective view of an exemplary distal bone button 132. In this example, the distal bone button 132 can include a base 800 integral with or connected to wings 802 and wings 804 extending from the base 800. An opening 806 through which a suture is routed can be defined by the base 800 of the exemplary distal bone button 132. In other examples, the distal bone button 132 can have other suitable configurations.

[0051] 9 shows a perspective view of an exemplary proximal bone button 134. In this example, the proximal bone button 134 can include a head 900 integral with or attached to a peg 902. The peg 902 can define an opening 904 through which a suture can be routed. The head 900 includes an opening 906 through which a suture can be routed. In other examples, the proximal bone button 134 can have other suitable configurations.

[0052] Without further elaboration, it is believed that those skilled in the art can use the preceding description to make the most of the claimed invention. The examples and embodiments disclosed herein should be construed as merely illustrative and in no way limit the scope of the present disclosure. It will be apparent to those skilled in the art that changes can be made to the details of the above examples without departing from the basic principles described. In other words, various modifications and improvements of the examples specifically disclosed in the above description are within the scope of the appended claims. For example, any suitable combination of features of the various examples described is contemplated.

Claims

1. 1. A system for suture button insertion, comprising: a suture button structure including a distal button joined by sutures to a proximal button; A suture button insertion device comprising: a handle, a portion of the handle defining a channel, a first notch, and a second notch; a tube extending from the handle; a carriage including a body, a button post extending from the body, first and second suture posts each extending from the body, and first and second protrusions each extending from the body, wherein a portion of the body including the first and second protrusions is positioned within the channel of the handle in a pre-deployed configuration of the suture button insertion instrument, and wherein the portion of the body is translatable within the channel; a spring having a first end in contact with a portion of the handle and a second end in contact with the body of the carriage; Including, translating the carriage toward the first end of the spring compresses the spring; At least a portion of the portion of the body is removable from the channel of the handle when the first and second protrusions are aligned with the first and second notches of the handle. Suture button insertion tool and Equipped with In the pre-deployed configuration of the suture button insertion instrument, the proximal button is positioned against the button post and the distal button is positioned at the end of the tube, such that the suture is tensioned between the proximal button and the distal button. System for suture button insertion.

2. The system for suture button insertion of claim 1 , wherein the suture is wrapped around the first suture post and the second suture post in the pre-deployed configuration of the suture button insertion instrument.

3. 3. The system for suture button insertion of claim 2, wherein the suture is wrapped such that a first loop of the suture is formed around the first suture post, a second loop of the suture is then formed around both the first suture post and the second suture post, the suture is then wrapped around the outside of the second suture post, and a third loop of the suture is then formed around the first suture post.

4. 3. The system for suture button insertion of claim 2, wherein the suture is wrapped around the first and second suture posts such that the suture is released from the first and second suture posts in response to the proximal bone button being released from the carriage.

5. with the distal button deployed from the suture button insertion instrument and maintained in a fixed position, translating the handle of the suture button insertion instrument away from the deployed distal button changes the position of the carriage relative to the channel; the change in position of the carriage allows the first and second protrusions to exit the channel through the first and second notches, thereby inducing a change in orientation of the carriage, thus releasing the proximal bone button from the carriage.

2. The system for suture button insertion of claim 1.

6. The system for suture button insertion of claim 5 , wherein the change in orientation includes the carriage rotating about an axis perpendicular to the tube.

7. The system for suture button insertion of claim 5 , wherein said change in orientation of said carriage positions said first and second suture posts above said button post.

8. 6. The system for suture button insertion of claim 5, wherein tension in the suture between the distal button and the proximal button maintains the position of the carriage during translation of the handle of the suture button insertion instrument away from the distal button.

9. 6. The system for suture button insertion of claim 5, wherein translating the handle of the suture button insertion instrument away from the distal button compresses the spring between the portion of the handle and the body of the carriage.

10. 10. The system for suture button insertion of claim 9, wherein when the first and second protrusions of the carriage exit the channel through the first and second notches, the compressed spring releases energy inducing a change in the orientation of the carriage.

11. A suture button insertion device comprising: a handle, a portion of the handle defining a channel, a first notch, and a second notch; a carriage including a body, a button post extending from the body, first and second suture posts each extending from the body, and first and second protrusions each extending from the body, wherein a portion of the body including the first and second protrusions is positioned within the channel of the handle in a pre-deployed configuration of the suture button insertion instrument, and wherein the portion of the body is translatable within the channel; a spring having a first end in contact with a portion of the handle and a second end in contact with the body of the carriage; Equipped with translating the carriage toward the first end of the spring compresses the spring; at least a portion of the portion of the body is removable from the channel of the handle when the first and second protrusions are aligned with the first and second notches of the handle; Suture button insertion tool.

12. The suture button insertion instrument of claim 11 further comprising a tube extending from the handle, an inner rod within the tube, and an actuator for translating the inner rod.

13. The suture button insertion tool of claim 11 , wherein the button post includes a lip on an upper end of the button post.

14. The suture button insertion tool of claim 11 , wherein the second end of the spring contacts a first end of the carriage, the first end of the carriage including the button post.

15. The suture button insertion instrument of claim 11 , wherein the carriage includes two separate button posts extending from the body of the carriage.

16. 12. The suture button insertion instrument of claim 11, wherein the second end of the spring is in contact with a first end of the carriage, the first end of the carriage opposite a second end of the carriage, the second end of the carriage including the first and second protrusions.

17. 12. The suture button insertion instrument of claim 11, wherein the second end of the spring is in contact with a first end of the carriage, the first end of the carriage opposite a second end of the carriage, the second end of the carriage including the first and second suture posts.

18. 1. A method for deploying a suture button structure from a button insertion instrument, the suture button structure including a distal button joined by a suture to a proximal button, the method comprising: inserting the distal bone button through the bone hole via the button insertion instrument; deploying the distal bone button from the button insertion instrument; translating the button insertion instrument away from the deployed distal button, thereby deploying the proximal button from the button insertion instrument. A method comprising:

19. 20. The method of claim 18, wherein a free end of the suture is coupled to the button insertion instrument, and translating the suture button insertion instrument away from the deployed distal button further deploys the free end of the suture from the button insertion instrument.

20. 20. The method of claim 18, further comprising wrapping the free ends of the suture around two posts of the button insertion instrument prior to inserting the distal bone button through the bone hole.

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