Hallux valgus repairs using suture-button construct

Abstract

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.

1 . A fixation system, comprising a button/loop construct having a button with at least a pair of apertures designed to allow passage of a flexible strand, and a loop construct connected to the button, the loop construct comprising a continuous uninterrupted loop of a flexible strand, with both opposing ends of the flexible strand terminating in a single strand. 
     
     
         2 . The fixation system of  claim 1 , wherein the flexible strand is a suture strand. 
     
     
         3 . The fixation system of  claim 2 , wherein the suture strand comprises a plurality of fibers of ultrahigh molecular weight polyethylene. 
     
     
         4 . The fixation system of  claim 1 , wherein the loop has a fixed length. 
     
     
         5 . The fixation system of  claim 1 , wherein the loop and the single strand have a combined length greater than a sum of a width of a first metatarsal, a width of a second metatarsal, and a distance between the first and second metatarsals. 
     
     
         6 . The fixation system of  claim 1 , wherein both opposing ends are swaged or cinched together to form the single strand. 
     
     
         7 . The fixation system of  claim 1 , wherein the single strand is formed by splicing both opposing ends of the flexible strand. 
     
     
         8 . The fixation system of  claim 1 , wherein the button has two apertures and the loop passes through the two apertures. 
     
     
         9 . A suture-button construct, comprising:
 a suture strand; and   a button having a pair of apertures, the apertures being designed to allow passage of the suture strand; and   wherein the suture strand is looped through the apertures of the button, and wherein both free legs of the suture strand are brought together to form a combined leg.   
     
     
         10 . The suture-button construct of  claim 9 , wherein the suture strand comprises a plurality of fibers of ultrahigh molecular weight polyethylene. 
     
     
         11 . The suture-button construct of  claim 9 , wherein the button is made of a material comprising one of titanium, stainless steel, PEEK, or PLLA. 
     
     
         12 . The suture-button construct of  claim 9 , wherein the button is substantially oblong-shaped with chamfered or rounded corners and edges. 
     
     
         13 . The suture-button construct of  claim 9 , wherein the free legs of the suture strand are cinched or swaged together to form the combined leg. 
     
     
         14 - 19 . (canceled)