# US 2022/0031301 A1 · Internal fibula sling

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- Number: US 2022/0031301 A1
- Document ID: US20220031301A1
- Status: Published application
- Kind: A1
- Application number: 16/941,629
- Filed: 2020-07-29
- Published: 2022-02-03
- Earliest claimed: 2020-07-29
- Assignees: Globus Medical, Inc.
- Applicants: Globus Medical, Inc.
- Inventors: Bradford H. Rippe; Zachary Shiner; Keiichi Matsuda; James A. Gault
- Web page: https://patentgrep.com/patent/US20220031301A1

## CPC

- 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)}
- A61B 17/1728: {for holes for bone plates or plate screws}
- A61B 17/1775: {for the foot or ankle}
- A61B 17/683: {comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut}
- A61B 17/8061: {specially adapted for particular bones (A61B17/70 and A61B17/74 take precedence)}
- A61B 17/808: {Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms}
- A61B 17/82: for bone cerclage {(apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842)}
- A61B 17/842: {Flexible wires, bands or straps (A61B17/72, A61B17/82, A61B17/86 take precedence)}
- A61B 17/8861: {Apparatus for manipulating flexible wires or straps (devices for inserting Kirschner wires A61B17/1697)}
- A61B 17/8869: {Tensioning devices}
- A61B 17/0485: {Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet}
- A61B 17/8695: {Washers (surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028)}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening}
- A61B 2017/0433: {the anchor or the separate member comprising threads, e.g. a set screw or a worm gear for moving spreading members}
- A61B 2017/0453: {threaded elements, e.g. set screws}
- A61B 2017/0496: {for tensioning sutures}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Syndesmotic fixation devices, systems, instruments, and methods thereof. An implant for stabilizing an ankle joint between a tibia and a fibula may include first and second anchors secured to the tibia and a suture configured to wrap around the fibula. The suture may be tensioned to provide a circumferential force around the fibula to stabilize the joint.

## Claims

### Claim 1

An implant for stabilizing a joint between a tibia and a fibula, the implant comprising:
a first anchor configured to be inserted into a posterior aspect of the tibia;
a second anchor configured to be inserted into an anterior aspect of the tibia; and
a suture extending from a first end to a second end configured to wrap around the fibula, the first end of the suture securable by the first anchor and the second end of the suture securable by the second anchor, wherein the suture is configured to be tensioned to provide a circumferential force around the fibula, thereby stabilizing the joint.

### Claim 2 (depends on 1)

The implant of claim 1, wherein the first anchor is a static anchor.

### Claim 3 (depends on 1)

The implant of claim 1, wherein the second anchor is a tensioning anchor.

### Claim 4 (depends on 3)

The implant of claim 3, wherein the second anchor includes a cannulated body extending from a proximal end to a distal end, wherein the distal end includes a buckle configured to secure and tension the suture.

### Claim 5 (depends on 4)

The implant of claim 4, wherein the buckle is integrated with the body of the anchor and includes a cross-member positioned between opposing side members, wherein the buckle defines a first opening and a second opening on opposite sides of the cross-member.

### Claim 6 (depends on 3)

The implant of claim 3, wherein the second anchor includes a pair of deployable wings.

### Claim 7 (depends on 6)

The implant of claim 6, wherein the second anchor includes an actuator configured to deploy the wings and crimp down on the suture.

### Claim 8 (depends on 1)

The implant of claim 1, wherein the second anchor includes an assembly including a washer with an integrated buckle and a bone screw positionable through the washer.

### Claim 9

An implant for stabilizing a joint between a first bone and a second bone, the implant comprising:
a static anchor configured to engage the first bone;
a tensioning anchor configured to engage the first bone, wherein the tensioning anchor includes a body with a suture opening extending therethrough, a pair of deployable wings on opposite sides of the body, and an actuator configured to extend the deployable wings; and
a suture configured to wrap around the second bone, a first end of the suture secured by the static anchor and a second end of the suture secured by the tensioning anchor, wherein the suture is configured to be tensioned to stabilize the joint.

### Claim 10 (depends on 9)

The implant of claim 9, wherein the tensioning anchor includes a plurality of barbs along the body of the anchor.

### Claim 11 (depends on 10)

The implant of claim 10, wherein the body includes a suture path devoid of barbs such that the suture may rest alongside the body of the anchor.

### Claim 12 (depends on 9)

The implant of claim 9, wherein each of the deployable wings are pivotably connected to the body of the anchor with a pivot pin.

### Claim 13 (depends on 9)

The implant of claim 9, wherein the deployable wings have a collapsed position where the wings are positioned against the body, and an extended position where the wings are extended outwardly away from the body of the anchor.

### Claim 14 (depends on 13)

The implant of claim 13, wherein the actuator is configured to engage with a cam surface along an inner portion of each wing, wherein as the actuator translates forward, the actuator slides against the cam surfaces, thereby pivoting the wings into the extended position.

### Claim 15 (depends on 9)

The implant of claim 9, wherein after the suture is passed through the suture opening, and when the actuator is advanced forward, the actuator crimps down on the suture.

### Claim 16

A method for stabilizing a joint between a tibia and a fibula, the method comprising:
inserting a static anchor into a posterior aspect of the tibia, wherein a suture is permanently affixed to the static anchor;
positioning a free end of the suture through a tensioning anchor;
wrapping the suture around the fibula;
inserting the tensioning anchor into an anterior aspect of the tibia; and
applying a tension to the suture, thereby stabilizing the fibula and tibia.

### Claim 17 (depends on 16)

The method of claim 16, wherein the static and tensioning anchors are positioned sub-flush beneath cortical bone of the tibia.

### Claim 18 (depends on 16)

The method of claim 16, wherein the suture is positioned through the tensioning anchor with a suture passer having a loop of wire positionable through an opening in the tensioning anchor, and after the free end of suture is passed through the loop of wire, removing the passer from the anchor such that the loop of wire pulls the suture through the opening.

### Claim 19 (depends on 16)

The method of claim 16, wherein the tension is applied to the suture with an inserter having a tensioner assembly with a plate defining a plurality of slits and a rotatable handle for translating the plate, wherein the suture is wound around the plate between the slits and the handle is rotated to translate the plate proximally and away from the anchor, thereby applying tension to the suture.

### Claim 20 (depends on 16)

The method of claim 16 further comprising advancing an actuator in the tensioning anchor to deploy a pair of wings and crimp down on the suture.