SUTURE PASSING K-WIRE

• US 20100152752A1
• Filed: 12/16/2009
• Published: 06/17/2010
• Est. Priority Date: 12/16/2008
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: DiNucci, Kris A., Gallen, Karen L., DENOVE, PETER A.
• Granted Patent: US 8,425,554 B2
• Time in Patent Office: Days
• US Class Current: 606/148
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• 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 17/842 Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/848 Kirschner wires, i.e. thin, long nails
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/06019 by means of a suture-receiving lateral eyelet machined in the needle
• CPC Class Codes: A61B 2017/06042 located close to needle tip
• CPC Class Codes: A61B 2017/565 for surgical correction of axial deviation, e.g. hallux valgus or genu valgus

Abstract

A method and apparatus for bunion repair using a suture passing K-wire configured to easily pass through bone tunnels with suture trailing. The suture passing K-wire includes a tapered guide pin with a multi-diameter shaft (i.e., comprising at least two regions or sections that have different diameters) and a loop which is securely attached to an end of the guide pin (i.e., to the smaller diameter section of the guide pin). The reconstruction system may be formed of a pair of buttons connected by a flexible strand. The procedure offers indirect placement of buttons and a minimally invasive approach.

Claims

1. A suture passing K-wire, comprising:

a shaft having a first linear region with a first diameter coupled to a second linear region with a second diameter, the second diameter being smaller than the first diameter; and

an eyelet located at a proximal end of the second linear region of the shaft.

2. The suture passing K-wire of claim 1, wherein the first region terminates in a sharp end.

3. The suture passing K-wire of claim 1, wherein the shaft is substantially straight.

4. The suture passing K-wire of claim 1, wherein the eyelet is a Nitinol loop.

5. The suture passing K-wire of claim 1, wherein the eyelet is formed by crimping a flexible strand to the second linear region of the shaft.

6. The suture passing K-wire of claim 1, wherein the eyelet is formed integral with the second linear region of the shaft.

7. The suture passing K-wire of claim 1, wherein the eyelet is formed of a material different from the material of the shaft.

8. The suture passing K-wire of claim 1, wherein the eyelet is formed of a material similar to the material of the shaft.

9. The suture passing K-wire of claim 1, wherein the eyelet is designed to allow passage of a flexible strand, the flexible strand being connected to a fixation device.

10. The suture passing K-wire of claim 9, wherein the fixation device is a button having at least a pair of apertures.

11. The suture passing K-wire of claim 10, wherein the fixation device is a button with two or four apertures.

12. The suture passing K-wire of claim 9, wherein the fixation device is a circular button or an oblong button.

13. The suture passing K-wire of claim 9, wherein the flexible strand is suture.

14. The suture passing K-wire of claim 9, wherein the flexible strand is a high strength suture.

15. The suture passing K-wire of claim 1, wherein the suture passing K-wire is used to repair bunions.

16. A system for bunion repair, comprising:

a tapered guide pin comprising;

a first region having a first diameter and terminating in a sharp tip; and

a second region having a second diameter and terminating in a loop, wherein the second region is coupled to the first region through a connecting portion, the connecting portion having a tapered diameter between a maximum value corresponding to the first diameter and a minimum value corresponding to the second diameter; and

a suture passed through the loop, the suture being connected to a button having at least a pair of apertures.

17. The system of claim 16, wherein the first diameter is of about 1.1 mm and the second diameter is of about 0.75 mm.

18. The system of claim 16, wherein the loop is a Nitinol loop.

19. The system of claim 16, wherein the guide pin is formed of stainless steel.

20. The system of claim 16, wherein the button is an oblong or circular button.

21. The system of claim 16, wherein the suture is a high strength suture.

22. A kit for bunion repair, comprising:

at least one suture/button construct comprising a button having at least two apertures designed to allow passage of a flexible strand;

a flexible strand looped through the apertures of the button, leaving both free ends of the flexible strand free; and

a suture passing K-wire comprising a straight first region having a first diameter and terminating in a sharp end, and a second straight region having a second diameter and terminating in an eyelet, the second diameter being smaller than the first diameter, the eyelet being operatively connected with the free ends of the flexible strand.

23. The kit of claim 22, wherein the suture passing K-wire is disposable.

24. The kit of claim 22, further comprising four buttons, four K-wires and a strand of UHMWPE suture.

25. The kit of claim 22, wherein the flexible strand is fed, in use, through the apertures of the button and through the eyelet of the suture passing K-wire.

26. The kit of claim 22, wherein the button is formed of a metal or a metal alloy.

27. The kit of claim 22, wherein the button is formed of a material selected from the group consisting of metals, metal alloys, PEEK and PLLA.

28. The kit of claim 22, wherein the K-wire is formed is formed of a metal or a metal alloy.

29. The kit of claim 22, wherein the K-wire is formed of stainless steel.

30. A method of bone repair comprising:

providing a suture passing K-wire in the vicinity of a first surface of a bone, the suture passing K-wire comprising a tapered guide pin having a first region with a first diameter and terminating in a sharp tip, and a second region with a second diameter and terminating in an eyelet, the second diameter being smaller than the first diameter;

passing a flexible strand through the eyelet of the K-wire;

inserting the K-wire into the bone and advancing the K-wire from the first surface of the bone to a second surface of the bone; and

passing the flexible strand through the bone.

31. The method of claim 30, wherein the step of advancing the K-wire into the bone is conducted simultaneously with the step of passing the flexible strand through the bone.

32. A method of bunion repair comprising:

inserting a suture passing K-wire from a second metatarsal to a first metatarsal, the suture passing K-wire comprising a tapered guide pin having a first region with a first diameter and terminating in a sharp tip, and a second region with a second diameter and terminating in an eyelet, the second diameter being smaller than the first diameter, the K-wire being inserted so that the distal end of the second region is adjacent the medial cortex of the first metatarsal and the eyelet is adjacent the lateral cortex of the second metatarsal;

passing a flexible strand of a suture-button construct through the eyelet of the K-wire; and

pulling the K-wire with the flexible strand in a medial direction from the second metatarsal to the first metatarsal so that the K-wire exits the first metatarsal, the flexible strand extends between the first metatarsal and the second metatarsal, and the button is engaged against the second metatarsal.

33. The method of claim 32, further comprising:

forming two pilot holes through the first metatarsal and the second metatarsal;

passing the flexible strand through a first plurality of apertures of a first button of the suture-button construct so that both free ends of the flexible strand are free;

inserting each of the free ends of the flexible strand through corresponding eyelets of two tapered K-wires; and

pulling the two tapered K-wires medially, so that the free ends of the flexible strand are passed through the pilot holes.

34. The method of claim 33, wherein the two K-wires are pulled simultaneously.

35. The method of claim 33, further comprising:

rethreading one of the free ends of the flexible strand through a second plurality of apertures of a second button; and

securing the first button on the second metatarsal and securing the second button on the first metatarsal.

36. The method of claim 35, wherein the first button is oblong-shaped having at least two apertures, the apertures being substantially triangular in shape, and the second button is round-shaped having at least four apertures, the four apertures being substantially circular-shaped.

37. The method of claim 35, wherein the flexible strand is formed of a suture comprising a plurality of fibers of ultrahigh molecular weight polyethylene.

38. The method of claim 35, further comprising the initial step of making a longitudinal incision over a medial aspect of a first metatarsophalangeal joint to expose a medial eminence;

and

removing the medial eminence.

39. The method of claim 35, performed in an opposite manner, such that the second button is advanced in an opposite direction through the pilot holes and ends up against the lateral side of the second metatarsal and the first button ends up against first metatarsal.