LISFRANC REPAIR USING SUTURE-BUTTON CONSTRUCT

• US 20080177302A1
• Filed: 01/17/2008
• Published: 07/24/2008
• Est. Priority Date: 01/17/2007
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Shurnas, Paul J.
• Granted Patent: US 7,901,431 B2
• Time in Patent Office: Days
• US Class Current: 606/228
• CPC Class Codes: A61B 17/0401 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 Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1682 for the foot or ankle
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 2017/0404 Buttons

Abstract

An apparatus and method for Lisfranc repair using a suture-button construct. The method includes the steps of drilling a hole in a medial cuneiform and through a second metatarsal base, passing a needle with a pull-through suture strand of a suture-button construct through the hole, pulling the pull-through suture strand and simultaneously applying a lateral tension on a first suture strand such that the first button lies sideways and advancing the first button through the hole until the first button exits the hole at the medial cuneiform, flipping the first button to engage the first button against the medial aspect of the medial cuneiform and applying a lateral tension on the first suture strand, pulling free ends of the first suture strand to advance a second button of the suture-button construct over the second metatarsal base and to engage the second button against the second metatarsal base, and securing the second button against the second metatarsal base by tying a Surgeon'"'"'s knot and two reverse half-hitches.

Claims

1. A suture-construct assembly, comprising:

a suture-button construct, the suture-button construct comprising;

a first suture strand and a second suture strand;

a first button, the first button having at least a pair of apertures and the apertures being designed to allow passage of the suture strands; and

a second button, the second button having at least four apertures and the apertures being designed to allow passage of the suture strands,

wherein the first suture strand is double looped through the apertures of the first and second buttons leaving both free ends of the first suture strand free for tying, and wherein the second suture strand is looped through one of the apertures of the first button and is operatively associated with a needle; and

a drill bit, the drill bit being used to drill hole and the drilled hole allowing the first button and the second suture strand to pass through therein.

2. The suture-construct assembly of claim 1, wherein the suture-button construct is used to repair a Lisfranc ligament or joint.

3. The suture-construct assembly of claim 1, wherein the first suture strand comprises a plurality of fibers of ultrahigh molecular weight polyethylene.

4. The suture-construct assembly of claim 1, wherein the second suture strand comprises a plurality of fibers of ultrahigh molecular weight polyethylene.

5. The suture-construct assembly of claim 1, wherein the first and second buttons are made of a material comprising one of titanium, stainless steel, PEEK, or PLLA.

6. The suture-construct assembly of claim 1, wherein the first button is substantially oblong-shaped with chamfered or rounded corners and edges.

7. The suture-construct assembly of claim 1, wherein the pair of apertures of the first button are substantially triangular-shaped.

8. The suture-construct assembly of claim 1, wherein the second button is substantially round-shaped.

9. The suture-construct assembly of claim 1, wherein the four apertures of the second button are substantially circular-shaped.

10. A method of Lisfranc repair comprising:

drilling a hole in a medial cuneiform and through a second metatarsal base;

passing a needle with a second suture strand of a suture-button construct through the hole, the needle entering the hole from the second metatarsal base and exiting the hole out of the medial cuneiform;

pulling the second suture strand and simultaneously applying a lateral tension on a first suture strand such that the first button lies sideways, and advancing the first button through the hole until the first button exits the hole at the medial cuneiform;

flipping the first button to engage the first button against the medial aspect of the medial cuneiform and applying a lateral tension on the first suture strand;

pulling free ends of the first suture strand of the suture-button construct to advance a second button of the suture-button construct over the second metatarsal base and to engage the second button against the second metatarsal base; and

securing the second button against the second metatarsal base.

11. The method of claim 10, wherein the first button is oblong-shaped having at least two apertures, the apertures being substantially triangular in shape.

12. The method of claim 10, wherein the second button is round-shaped having at least four apertures, the four apertures being substantially circular-shaped and centers of the four apertures being substantially equi-distant from a center of the second button.

13. The method of claim 10, wherein the first and second suture strands comprise a plurality of fibers of ultrahigh molecular weight polyethylene.

14. The method of claim 10, further comprising the initial step of making a dorsal longitudinal incision over medial border of foot overlying medial cuneiform.