Suture-Button Construct for Hallux Valgus Repair
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current bunion repair techniques require multiple holes and high technical difficulty, especially when using the deconstructed Mini TightRope method, which is challenging and time-consuming, and existing methods do not offer a simpler yet equally strong alternative for correcting large intermetatarsal angles resulting from hallux valgus.
Innovation Solution
A suture-button construct with a continuous, uninterrupted suture loop attached to a button, where the suture ends are swaged together and used to drill a single hole through both metatarsals, allowing for secure fixation with a second button to adjust and secure the metatarsal alignment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If the deconstructed Mini TightRope technique is used, then the repair strength is equivalent to the original technique, but the technical difficulty and time required increase significantly
Solution Approach 1:
The invention divides the original single-button construct into two separate buttons, each placed in different drill holes. This segmentation allows the sutures to be passed through separate holes rather than requiring one large hole, reducing technical difficulty while maintaining repair strength through distributed fixation points
Solution Approach 2:
The invention introduces a second button as an intermediary element to work in conjunction with the first button. This additional component enables the suture to be secured across two separate fixation points, achieving equivalent or superior strength to the deconstructed technique while simplifying the overall procedure
2Strength
If the deconstructed Mini TightRope technique is used, then the repair strength is maintained, but the operating time increases
Solution Approach 1:
The buttons are pre-loaded with sutures before insertion, allowing for quicker placement during surgery. The sutures are already threaded through the buttons and prepared for insertion, eliminating time-consuming intraoperative threading steps while maintaining the strength benefits of the deconstructed technique
Solution Approach 2:
The suture-passing instrument with integrated needle and suture allows the suture to be pulled through the bone holes automatically during insertion. The instrument performs the suturing action itself as it is being positioned, reducing the need for separate manual threading steps and decreasing overall operating time
3Ease of operation
If one large diameter hole is drilled through both metatarsals, then the button passage is simplified, but the structural integrity of the bone is compromised
Solution Approach 1:
The single large hole is divided into two separate smaller holes, one in each metatarsal. This segmentation allows each hole to be smaller in diameter, preserving more bone structural integrity while still enabling easy button passage through each individual hole
Solution Approach 2:
Instead of creating one large hole spanning both bones, the invention creates two separate holes at different locations (one in each metatarsal). This dimensional change from a single continuous hole to two discrete holes distributes the structural impact and preserves bone integrity while maintaining button accessibility
Data Source
AI summary
A technique and associated instrumentation for correcting large intermetatarsal angles that result from hallux valgus. The system includes a button and a suture loop attached to the button. A suture strand is threaded through holes in the button to attach the button to the suture. The suture ends are then brought together (by being swaged, spliced or cinched together, for example) to form the suture loop comprising a continuous, uninterrupted suture loop with a single strand of swaged-together ends. The swaged-together ends may be attached to a suture passing instrument such as a K-wire (Kirschner wire) that may be further used to drill a hole through the first and second metatarsals. The swaged-together ends of the suture are then passed through the drill holes in the first and second metatarsals; and the ends of the suture are pulled until the button abuts the second metatarsal. The swaged together portion of the suture loop is then cut, and the free suture ends are passed through holes in another (second) button. The suture ends are pulled to adjust the first metatarsal to a correct intermetatarsal angle, and the first metatarsal is secured in place by tying the ends of the suture together against the second button.