Apparatus and method for syndesmosis fixation

Abstract

A method and apparatus including at least one suture anchor configured to be implanted into bone and at least one suture assembly configured to extend from the suture anchor and about at least a portion of a fibula when the suture anchor is implanted in a tibia on either side of a fibular notch of the tibia. The suture assembly is selectively adjustable from a non-tensioned condition to a tensioned condition to stabilize and reduce the fibula relative to the tibia.

What is claimed is: 
     
         1 . An apparatus, comprising:
 at least two suture anchors, each of the suture anchors configured to be implanted into bone; and   at least one suture assembly configured to extend from one of the suture anchors to the other suture anchor about at least a portion of a fibula when the at least two suture anchors are implanted in a tibia on either side of a fibular notch of the tibia,   wherein the suture assembly is selectively adjustable from a non-tensioned condition to a tensioned condition to stabilize and reduce the fibula relative to the tibia.   
     
     
         2 . The apparatus of  claim 1 , wherein the suture assembly includes at least two suture assemblies, and wherein the apparatus further comprises a suture coupling to which each of the suture assemblies is attached. 
     
     
         3 . The apparatus of  claim 2 , wherein the suture coupling is configured to define a thin, flat body, the body being conformable to the contour of a surface of a bone when the body is positioned against the surface of the bone. 
     
     
         4 . The apparatus of  claim 2 , wherein at least one of the suture assemblies is selectively adjustable from a non-tensioned condition to a tensioned condition to stabilize and reduce the fibula relative to the tibia. 
     
     
         5 . The apparatus of  claim 4 , wherein each of the suture assemblies has a first loop attached to one of the suture anchors and a second loop attached to the suture coupling. 
     
     
         6 . The apparatus of  claim 5 , wherein the second loop is connected to a suture fixation member which is threaded through the suture coupling in such a way as to attach the second loop to the suture coupling. 
     
     
         7 . The apparatus of  claim 5 , wherein the suture coupling further includes at least one button attached to the body and around which the second loop of the suture assembly is looped to attach the second loop to the suture coupling. 
     
     
         8 . The apparatus of  claim 2 , further comprising:
 a third suture anchor comprising a body and a suture capture element formed in the body for attaching at least one suture to the suture anchor; and   a third suture assembly configured to extend through the tibia from the third suture anchor to the suture coupling when the third suture coupling is attached to the tibia at a location between the first suture anchor and the second suture anchor along a midline of the tibia,   wherein the third suture assembly is selectively adjustable from a non-tensioned condition to a tensioned condition to stabilize and reduce the fibula relative to the tibia.   
     
     
         9 . The apparatus of  claim 2 , further comprising a bone screw, and wherein the suture coupling further includes an aperture for receiving the shaft of the screw and the suture coupling configured such that the suture coupling is compressed between the head of the screw and the bone when the screw is implanted into the fibula. 
     
     
         10 . The apparatus of  claim 9 , wherein the bone screw has a length such that the bone screw is extendible through the fibula and through at least a portion of the tibia. 
     
     
         11 . An apparatus, comprising:
 at least one suture anchor, the suture anchor configured to be implanted into bone; and   at least one suture assembly configured to connect to and extend from the suture anchor and to extend about at least a portion of a fibula when the suture anchor is implanted in a tibia on either side of a fibular notch of the tibia,   wherein the suture assembly is selectively adjustable from a non-tensioned condition to a tensioned condition to stabilize and reduce the fibula relative to the tibia when the suture assembly is secured to the suture anchor and to the fibula.   
     
     
         12 . The apparatus of  claim 11 , further comprising a suture coupling to which the suture assembly is attached. 
     
     
         13 . The apparatus of  claim 12 , wherein the suture coupling is configured to define a thin, flat body, the body being conformable to the contour of a surface of a bone when the body is positioned against the surface of the bone. 
     
     
         14 . The apparatus of  claim 13 , wherein the suture assembly has a first loop attached to suture anchor and a second loop attached to the suture coupling. 
     
     
         15 . The apparatus of  claim 14 , wherein the second loop is connected to a suture fixation member which is threaded through the suture coupling in such a way as to attach the second loop to the suture coupling. 
     
     
         16 . The apparatus of  claim 15 , wherein the suture coupling further includes at least one button attached to the body and around which the second loop of the suture assembly is looped to attach the second loop to the suture coupling. 
     
     
         17 . The apparatus of  claim 12 , further comprising a bone screw, and wherein the suture coupling further includes an aperture for receiving the shaft of the screw and the suture coupling configured such that the suture coupling is compressed between the head of the screw and the bone when the screw is implanted into the fibula. 
     
     
         18 . A method for syndesmosis fixation, comprising:
 attaching a first suture anchor to a first tubercle of a tibia;   attaching a second suture anchor to second tubercle of the tibia so that the first suture anchor and the second suture anchor are positioned on opposing sides of a fibular notch of the tibia;   extending a suture assembly around a fibula from the first suture anchor to the second suture anchor; and   tensioning the suture assembly to stabilize and reduce the fibula relative to the tibia.   
     
     
         19 . A method for syndesmosis fixation, comprising:
 attaching a first suture anchor to a first tubercle of a tibia;   attaching a second suture anchor to second tubercle of the tibia so that the first suture anchor and the second suture anchor are positioned on opposing sides of a fibular notch of the tibia;   extending a first suture assembly around a portion of a fibula from the first suture anchor to a suture coupling;   extending a second suture assembly around another portion of the fibula from the second suture anchor to the suture coupling; and   tensioning at least one of the first and second suture assemblies to stabilize and reduce the fibula relative to the tibia.   
     
     
         20 . A method for syndesmosis fixation, comprising:
 attaching a suture anchor to a tubercle of a tibia;   extending the suture assembly from the suture anchor and around at least a portion of a fibula;   securing the suture assembly to the fibula; and   tensioning the suture assembly to stabilize and reduce the fibula relative to the tibia.   
     
     
         21 . The method of  claim 20 , wherein the securing step comprises securing the suture assembly to a suture coupling and securing the suture coupling to the fibula. 
     
     
         22 . The apparatus of  claim 2 , wherein the suture coupling is a screw insertable into the fibula. 
     
     
         23 . The apparatus of  claim 22  wherein the screw has a length such that the screw is extendible through the fibula and into at least a portion of the tibia. 
     
     
         24 . The apparatus of  claim 12 , wherein the suture coupling is a screw insertable into the fibula. 
     
     
         25 . The apparatus of  claim 25  wherein the screw has a length such that the screw is extendible through the fibula and into at least a portion of the tibia.