Methods and devices for syndesmosis tensioning

A method for approximation of two bones, the method comprising:

• delivering, via a first handle and a removeable driver of a delivery device, a first anchor into a first bone,
• wherein the first anchor engages with a distal end of a flexible segment;
• disengaging the removeable driver from the delivery device, thereby exposing the flexible segment;
• adjusting, via a second handle of the delivery device, tension of the flexible segment by pulling one or more proximal ends of the flexible segment in a proximal direction;
• delivering, via a third handle of the delivery device, a second anchor into a second bone;
• and
• attaching, via the third handle of the delivery device, the flexible segment to the second anchor.

A method of constructing a system for approximation of two bones, the method comprising:

• coupling a locking component to a third handle of a delivery device;
• feeding a flexible segment through a second anchor of an implant;
• configuring the delivery device such that rotation of the third handle couples the locking component to the flexible segment and the second anchor;
• coupling a proximal end of the flexible segment to a second handle of the delivery device such that a distal end of the flexible segment is coupled to a first anchor of the implant;
• configuring the delivery device such that rotation of the second handle adjusts tension in the flexible segment;
• engaging a distal end of a removable driver to a proximal end of the first anchor and engaging a proximal end of the removable driver to a first handle of the delivery device such that the flexible segment extends along the removable driver;
• configuring the delivery device such that rotation of the first handle rotates the removable driver and thereby the first anchor;
• and
• configuring the delivery device such that the removable driver is configured to be disengaged from the first handle and the first anchor while the flexible segment remains coupled to the second handle and the first anchor.