# US 9,433,407 B2 · Method of implanting a bone fixation assembly > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,433,407 B2 - Document ID: US9433407B2 - Status: Granted - Kind: B2 - Application number: 14/989,414 - Filed: 2016-01-06 - Published: 2016-04-28 - Granted: 2016-09-06 - Earliest claimed: 2012-01-03 - Assignees: Biomet Manufacturing, LLC - Applicants: Biomet Manufacturing, LLC - Inventors: Daniel D. Fritzinger; Nathan A. Winslow; Robert Taylor; Kevin T. Stone - Web page: https://patentgrep.com/patent/US9433407B2 ## 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 17/683: {comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut} - A61B 17/8057: {the interlocking form comprising a thread} - A61B 17/8061: {specially adapted for particular bones (A61B17/70 and A61B17/74 take precedence)} - A61B 2017/0404: {Buttons} - A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening} - A61B 2017/0417: {T-fasteners} - A61B 2017/0437: {the barbs being resilient or spring-like} - A61B 2017/0496: {for tensioning sutures} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A bone fixation assembly can include a suture button, a bone plate, and a suture assembly. The suture button can include a body that has a first end surface, a second end surface, and a circumferential outer surface. A first pair of passages can be formed through the body from the first end surface to the second end surface. The circumferential outer surface can include at least one protrusion or retaining rib extending radially therefrom. The bone plate defines an aperture. The suture button is configured to be at least partially received into the aperture in an assembled position such that the retaining rib engages the bone plate and inhibits withdrawal of the suture button from the aperture in the assembled position. The suture assembly includes a suture engaging member and a suture configured to couple the suture engaging member in the suture button. ## Claims ### Claim 1 A method of implanting a bone fixation assembly, the method comprising: positioning a portion of a suture through an eyelet in a suture engaging member to form first and second suture strands extending from opposite sides of the eyelet, the suture engaging member being elongated along a longitudinal direction; advancing the suture engaging member in a longitudinal orientation through a bone plate aperture in a bone plate, through a clavicle hole in a clavicle, and through a coracoid process hole in a coracoid process, so that the first and second suture strands extend from the eyelet sequentially through the coracoid process hole, the clavicle hole, and the bone plate aperture; advancing a suture button over the first and second suture strands into the bone plate aperture; securing the suture button to the bone plate by engaging retaining ribs formed on a circumferential surface of the suture button with one or more threads formed in the bone plate at the bone plate aperture; pulling on the first and second suture strands to: pivot the suture engaging member away from the longitudinal orientation so that the suture engaging member has an outer profile unsuitable for entering the coracoid process hole, and produce tension between the suture engaging member and the bone plate; and tying the first and second suture strands together to maintain the tension. ### Claim 2 (depends on 1) The method of claim 1, wherein the first and second suture strands extend through respective first and second longitudinal passages in the suture button. ### Claim 3 (depends on 2) The method of claim 2, wherein the first and second passages are positioned on opposite sides of a longitudinal axis of the suture button. ### Claim 4 (depends on 3) The method of claim 3, wherein the first and second passages are radially accessible through a lateral edge of the suture button. ### Claim 5 (depends on 3) The method of claim 3, wherein the first and second passages are radially inaccessible through a lateral edge of the suture button. ### Claim 6 (depends on 1) The method of claim 1, wherein: the first and second suture strands extend through a single longitudinal passage in the suture button; and the first and second suture strands are tied together in a knot that is too large to fit in the single longitudinal passage. ### Claim 7 (depends on 1) The method of claim 1, wherein the retaining ribs are discontinuous around the circumference of the suture button. ### Claim 8 (depends on 1) The method of claim 1, wherein the retaining ribs are arranged in groups around the circumference of the suture button, the ribs in each group being longitudinally offset from one another. ### Claim 9 (depends on 1) The method of claim 1, further comprising positioning the bone plate proximate the clavicle. ### Claim 10 (depends on 1) The method of claim 1, further comprising: preparing the clavicle hole through the clavicle; and preparing the coracoid process hole through the coracoid process. ### Claim 11 A method of implanting a bone fixation assembly, the method comprising: locating a portion of a suture through a bone plate aperture in a bone plate, through a clavicle hole in a clavicle, and through a coracoid process hole in a coracoid process, until a retaining member slidably disposed on the portion of the suture locates against an outer surface of the coracoid process; passing a second portion of the suture through a suture button aperture defined in a suture button; positively locating the suture button into the bone plate aperture including engaging retaining ribs formed on a circumferential surface of the suture button with one or more threads formed in the bone plate at the bone plate aperture; drawing the second portion of the suture away from the outer surface of the coracoid process causing tension between the retaining member and the bone plate; and securing the second portion of the suture at a position that maintains the tension. ### Claim 12 (depends on 11) The method of claim 11, wherein drawing the second portion of the suture away from the outer surface of the coracoid process comprises: manipulating the retaining member from a first position that has an outer profile generally suitable to pass through the clavicle hole and the coracoid process hole to a second position that has an outer profile generally unsuitable to pass through the coracoid process hole. ### Claim 13 (depends on 11) The method of claim 11, wherein drawing the second portion of the suture away from the outer surface of the coracoid process comprises: manipulating the retaining member from a first position that has an outer profile generally suitable to pass through the clavicle hole and the coracoid process hole to a second position that has an outer profile generally unsuitable to pass through the clavicle hole and the coracoid process hole. ### Claim 14 (depends on 11) The method of claim 11, further comprising: positioning the bone plate proximate the clavicle; preparing the clavicle hole through the clavicle; and preparing the coracoid process hole through the coracoid process. ### Claim 15 (depends on 11) The method of claim 11, wherein the retaining ribs are discontinuous around the circumference of the suture button. ### Claim 16 (depends on 11) The method of claim 11, wherein the retaining ribs are arranged in groups around the circumference of the suture button, the ribs in each group being longitudinally offset from one another. ### Claim 17 A method of implanting a bone fixation assembly, the method comprising: preparing a clavicle hole through a clavicle; preparing a coracoid process hole through a coracoid process; positioning a bone plate having an aperture proximate the clavicle; locating a portion of a suture through the aperture, the clavicle hole, and the coracoid process hole, until a retaining member slidably disposed on the portion of the suture locates against an outer surface of the coracoid process; passing a second portion of the suture through an aperture defined in a suture button; positively locating the suture button into the bone plate aperture including engaging retaining ribs formed on a circumferential surface of the suture button with one or more threads formed in the bone plate at the aperture; drawing the second portion of the suture away from the outer surface of the coracoid process causing tension between the retaining member and the bone plate; and securing the second portion of the suture at a position that maintains the tension. ### Claim 18 (depends on 17) The method of claim 17, wherein drawing the second portion of the suture away from the outer surface of the coracoid process comprises: manipulating the retaining member from a first position that has an outer profile generally suitable to pass through the clavicle hole and the coracoid process hole to a second position that has an outer profile generally unsuitable to pass through the clavicle hole and the coracoid process hole. ### Claim 19 (depends on 17) The method of claim 17, wherein the retaining ribs are discontinuous around the circumference of the suture button. ### Claim 20 (depends on 17) The method of claim 17, wherein the retaining ribs are arranged in groups around the circumference of the suture button, the ribs in each group being longitudinally offset from one another.