Abstract:
An insertion tool for deploying a flip anchor cable, including: a mechanism having a safety button and a slider, wherein the mechanism is configured to apply a clamping force on a portion of the flip anchor cable when the mechanism is in a first position; an inner tube having a proximal end connected to the mechanism configured to house a second portion of the flip anchor cable; a handle including a safety button opening and a slider opening, wherein the handle is configured to enclose a portion of the mechanism; and an outer tube having a proximal end connected to the handle configured to receive the inner tube; wherein the mechanism is configured to decrease the clamping force on the flip anchor cable when the mechanism is in a second position and to deploy a flip anchor of the flip anchor cable in the second position.

Description:
TECHNICAL FIELD 
       [0001]    Various exemplary embodiments disclosed herein relate generally to an insertion tool for inserting a flip anchor cable. 
       BACKGROUND 
       [0002]    It is a common requirement in orthopedic surgical procedures to anchor two or more elements together, such as pieces of a bone, two or more bones, or a combination of soft tissue and bone. This has been accomplished by a number of devices, such as bone bolts that penetrate two pieces of bone and use a nut to draw the segments together, bone screws and interconnecting plates, wires circling at least two pieces of bone, or sutures into the tissue. 
         [0003]    Often such devices require a relatively large access opening through surrounding and/or covering tissue to implant the anchoring devices. The enlarged access site may increase patient pain and lengthen recovery time. Further, in some locations it is difficult and impractical to make large access points to reach the appropriate site because of surrounding joints and vessels. Even with devices that penetrate the tissue in a substantially linear manner, i.e., lag bolts, the fracture must often be reduced before drilling and insertion of the bolt. Further, some of these devices may be difficult to use since it may be hard to reduce a fracture between two bone segments and maintain that reduction while the device is inserted. This is particularly true with small bone fragments where the use of threaded implants may tend to rotate one bone segment with respect to another, thereby creating a misalignment between the fragments. 
         [0004]    Cerclage systems provide an alternative to implants that must penetrate the bone to achieve fixation. These systems rely on passing a cable around two segments of bone and then tensioning the cable to squeeze the bone segments together. A significant drawback of these systems is that they require access around the entire bone. 
         [0005]    A flip anchor cable system provides a convenient and effective system for securing two segments of tissue together. Such a system may be operable through a relatively small insertion opening or openings to securely hold two tissue segments. 
       SUMMARY 
       [0006]    A brief summary of various exemplary embodiments is presented below. Some simplifications and omissions may be made in the following summary, which is intended to highlight and introduce some aspects of the various exemplary embodiments, but not to limit the scope of the invention. Detailed descriptions of an exemplary embodiment adequate to allow those of ordinary skill in the art to make and use the inventive concepts will follow in later sections. 
         [0007]    Various embodiments relate to a insertion tool for deploying a flip anchor cable, including: a mechanism having a safety button and a slider, wherein the mechanism is configured to apply a clamping force on a portion of the flip anchor cable when the mechanism is in a first position; an inner tube having a proximal end connected to the mechanism configured to house a second portion of the flip anchor cable; a handle including a safety button opening and a slider opening, wherein the handle is configured to enclose a portion of the mechanism; and an outer tube having a proximal end connected to the handle configured to receive the inner tube; wherein the mechanism is configured to decrease the clamping force on the flip anchor cable when the mechanism is in a second position and to deploy a flip anchor of the flip anchor cable in the second position. 
         [0008]    Various embodiments are described wherein the mechanism further includes: a safety button protrusion; and a safety button retainer configured to engage the safety button protrusion when the safety button is depressed to fix the safety button in a depressed position. 
         [0009]    Various embodiments are described wherein the safety button in the depressed position allows the mechanism to be placed in the second position by the application of a sliding force on the slider. 
         [0010]    Various embodiments are described wherein the mechanism further includes; a cable retaining member; and a cable retaining protrusion connected to the cable retaining member, wherein the cable retaining protrusion is configured to apply the clamping force on the flip anchor cable in the first position. 
         [0011]    Various embodiments are described wherein the handle further includes a cable retaining stop configured to engage the cable retaining member to apply the clamping force on the flip anchor cable in the first position. 
         [0012]    Various embodiments are described wherein the cable retaining member is configured to engage the cable retaining stop in the second position to prevent the mechanism from returning to the first position. 
         [0013]    Various embodiments are described wherein: the mechanism further includes: a cable retaining member; and a locking member connected to the cable retaining member; and the handle further includes a single-use stop configured to engage the locking member in the second position to prevent the mechanism from returning to the first position. 
         [0014]    Various embodiments are described wherein the locking member is configured to produce a sound as it slides over the single-use stop when the mechanism slides from the first position to the second position when a sliding force is applied to the slider. 
         [0015]    Various embodiments are described wherein the handle includes an orientation indicator on the exterior of the handle. 
         [0016]    Various embodiments are described wherein the handle includes a plurality of cable stays configured to secure the flip anchor cable inside the handle. 
         [0017]    Various embodiments are described wherein the handle includes a plurality of cable guides configured to facilitate unfolding of the flip anchor cable inside the handle. 
         [0018]    Various embodiments are described wherein handle includes a cable rod support configured to secure the cable rod of the flip anchor cable inside the handle. 
         [0019]    Various embodiments are described wherein a distal end of the outer tube is configured to receive a proximal end of the flip anchor to secure the flip anchor. 
         [0020]    Various embodiments are described wherein the inner tube has a distal end configured to engage the proximal end of the flip anchor and configured to push the proximal end of the flip anchor out of the distal end of the outer tube when the mechanism slides from the first position to the second position when a sliding force is applied to the slider. 
         [0021]    Various embodiments are described wherein the mechanism further includes: button support member connected to the safety button and the slider; a central support member flexibly connected to the button support member; and cable retaining member flexibly connected to the central support member. 
         [0022]    Various embodiments are described wherein the mechanism further includes: a safety button protrusion; a safety button retainer connected to the central support member configured to engage the safety button protrusion when the safety button is depressed to fix the safety button in a depressed position; a cable retaining protrusion connected to the cable retaining member, wherein the cable retaining protrusion is configured to apply the clamping force on the flip anchor cable in the first position; and a locking member connected to the cable retaining member. 
         [0023]    Various embodiments are described wherein the housing is configured to enclose a third portion of the cable and a cable rod attached to the third portion of the cable. 
         [0024]    Further various embodiments relate to a insertion tool, including: a flip anchor cable including flip anchor, a cable rod, and a cable connected to the flip anchor at a distal end and connected to the cable rod at the proximal end; a mechanism having a safety button and a slider, wherein the mechanism is configured to apply a clamping force on a first portion of the flip anchor cable when the mechanism is in a first position; an inner tube having a proximal end connected to the mechanism configured to house a second portion of the flip anchor cable; a handle including a safety button opening and a slider opening, wherein the handle is configured to enclose a portion of the mechanism; and an outer tube having a proximal end connected to the handle configured to receive the inner tube; wherein the mechanism is configured to decrease the clamping force on the flip anchor cable when the mechanism is in a second position and to deploy a flip anchor of the flip anchor cable in the second position. 
         [0025]    Various embodiments are described wherein the flip anchor includes a proximal end that is inside a distal end of the outer tube to secure the flip anchor. 
         [0026]    Various embodiments are described wherein the flip anchor includes a shoulder adjacent the proximal end wherein the shoulder is configured to engage a distal end of the inner tube and wherein the distal end of the inner tube pushes the shoulder to move the flip anchor out of the distal end of the outer tube when the mechanism slides from the first position to the second position when a sliding force is applied to the slider. 
         [0027]    Various embodiments are described wherein the flip anchor deploys by the proximal end of the flip anchor rotating away from the cable when the distal end of the inner tube pushes the shoulder to move the flip anchor out of the distal end. 
         [0028]    Various embodiments are described wherein the housing is configured to enclose a third portion of the cable and the cable rod. 
         [0029]    Further various embodiments relate to a mechanism for an insertion tool for deploying a flip anchor cable, improving: a safety button; a slider; a button support member connected to the safety button and the slider; a central support member flexibly connected to the button support member; and a cable retaining member flexibly connected to the central support member, wherein the cable retaining member is configured to apply a clamping force on a portion of the flip anchor cable when the mechanism is in a first position, and decrease the clamping force on the flip anchor cable when the mechanism is in a second position. 
         [0030]    Various embodiments are described further including: a safety button protrusion; and a safety button retainer configured to engage the safety button protrusion when the safety button is depressed to fix the safety button in a depressed position. 
         [0031]    Various embodiments are described wherein the safety button in the depressed position allows the mechanism to be placed in the second position by the application of a sliding force on the slider. 
         [0032]    Various embodiments are described wherein the cable retaining member further includes a cable retaining protrusion connected to the cable retaining member, wherein the cable retaining protrusion is configured to apply the clamping force on the flip anchor cable in the first position. 
         [0033]    Various embodiments are described wherein the mechanism further includes a locking member connected to the cable retaining member configured to engage a single-use stop on a handle of the insertion tool, wherein the locking member is configured to engage the single-use stop in the second position to prevent the mechanism from returning to the first position. 
         [0034]    Is contemplated that various combinations of the embodiments described herein may be made resulting in additional embodiments that are within the scope of the invention described herein. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0035]    In order to better understand various exemplary embodiments, reference is made to the accompanying drawings, wherein: 
           [0036]      FIGS. 1A, 1B, and 1C  provide perspective, side, and top views of the insertion tool, respectively; 
           [0037]      FIG. 2  illustrates an expanded view of the insertion tool; 
           [0038]      FIG. 3  illustrates the assembled insertion tool with the second handle member removed to show the interior of the assembled insertion tool; 
           [0039]      FIGS. 4A-4C  show perspective, side, and top views of the mechanism, respectively; 
           [0040]      FIGS. 5A-5D  show side and perspective views of the first handle portion and the second handle portion, respectively; and 
           [0041]      FIG. 6  illustrates the flip anchor at the end of the flip anchor cable extending from the inner tube and the outer tube. 
       
    
    
       [0042]    To facilitate understanding, identical reference numerals have been used to designate elements having substantially the same or similar structure and/or substantially the same or similar function. 
       DETAILED DESCRIPTION 
       [0043]    The description and drawings illustrate the principles of the invention. It will thus be appreciated that those skilled in the art will be able to devise various arrangements that, although not explicitly described or shown herein, embody the principles of the invention and are included within its scope. Furthermore, all examples recited herein are principally intended expressly to be for pedagogical purposes to aid the reader in understanding the principles of the invention and the concepts contributed by the inventor(s) to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. Additionally, the term, “or,” as used herein, refers to a non-exclusive or (i.e., and/or), unless otherwise indicated (e.g., “or else” or “or in the alternative”). Also, the various embodiments described herein are not necessarily mutually exclusive, as some embodiments can be combined with one or more other embodiments to form new embodiment 
         [0044]    A flip anchor cable is described in U.S. Pat. No. 6,761,722 to Cole et al. (“Cole”), which is hereby incorporated by reference for all purposes as if fully set forth herein. The flip anchor cable may be used to anchor tissue, for example, bone, cartilage, ligaments, tendons, muscle, etc. For example, the flip anchor cable may be used to reduce and secure a bone fracture. A hole may be drilled through the bone and the cable inserted through the hole. The flip anchor cable has an anchor at the end of the cable that is aligned with the cable during insertion. Once the anchor passes through the bone, the anchor rotates so that as the cable is then pulled back through the insertion hole, and the anchor is affixed to the bone surrounding the insertion hole. As tension is applied to the cable, the fracture in the bone may be reduced and secured. The cable may then be fixed in place by placing a ferrule over the cable and crimping the ferrule in place to securely anchor the reduced fracture. Other methods of securing the cable are also discussed in Cole. 
         [0045]    Embodiments of an insertion tool that facilitate the insertion of the flip anchor cable are described below. This insertion tool provides the following features that facilitate the insertion of the flip anchor cable. 
         [0046]    The insertion tool provides faster insertion of the flip anchor cable resulting in a shorter insertion time. The insertion tool also provides easier handling of the flip anchor cable to reduce the attention that a user has to give to handling the insertion of the flip anchor cable. Further, the insertion tool facilitates one handed use which allows the user to use their other hand for other tasks. The insertion tool protects and covers the cable which allows the cable to remain sterile and also makes handling the flip anchor cable simpler. Also, the insertion tool may be a single use tool meaning that there is no reprocessing time and cost. Further, the insertion tool provides a ready to use insertion system that does not require any assembly. This allows the user to immediately insert the flip anchor cable after removal from the packaging. As the insertion tool is pre-assembled and pre-positioned, the user may directly insert the flip anchor cable system directly after boring a hole. 
         [0047]      FIGS. 1A, 1B, and 1C  provide perspective, side, and top views of the insertion tool, respectively. The insertion tool  100  include a handle  102  and an outer tube  300  connected to the handle  102 . A flip anchor  406  that is part of a flip anchor cable protrudes from the outer tube  300 . The cable that is part of the flip anchor cable extends through the outer tube  300  into the handle  102  where the cable is stored in the handle as will be shown below. 
         [0048]    The handle  102  also includes a slider  202  and a safety button  204 . As will be described further below, the safety button  204  may be pressed and then the slider  202  may be pushed forward towards the outer tube  300 . This pushes the flip anchor  406  forward and free from the outer tube  300  to allow for the flip anchor cable to be deployed. The handle  102  also includes an orientation indicator  230  that shows the orientation of the flip anchor  406  as it deploys. This will assist the user in orienting the insertion tool  100  so that the flip anchor  406  will deploy in a chosen orientation. The orientation indicator  230  also allows for proper orientation of the flip anchor  406  when the user is unable to see the end of the insertion tool. 
         [0049]      FIG. 2  illustrates an expanded view of the insertion tool  100 . The insertion tool  100  includes a first handle portion  104 , a second handle portion  106 , a mechanism  200 , an inner tube  206 , the outer tube  300 , and a flip anchor cable  400 . 
         [0050]      FIGS. 5A-5D  show side and perspective views of the first handle portion and the second handle portion, respectively. As shown in  FIGS. 2 and 5A-5D , the first handle portion  104  includes a cylindrical mount  120  at a distal end of the first handle portion  104 . The cylindrical mount  120  accepts a proximal end of the outer tube  300  so as to mount the outer tube  300  to the first handle portion  104 . The second handle portion  106  includes a mating opening  122  that mates with the cylindrical mount  120 . 
         [0051]    The first handle portion  104  and the second handle portion  106  also include a safety button opening  110 . The two safety button openings  110  combine to form a single opening in the handle  102  that corresponds to the safety button  204 . The shape of the safety button opening  110  and the safety button  204  complement one another so that the safety button  204  fits in the safety button opening and is exposed to the user. Also, when the safety button  204  is exposed to the user, it prevents the mechanism  200  from sliding as will be discussed in further detail below. 
         [0052]    The first handle portion  104  and the second handle portion  106  also include a slider opening  108 . The two slider openings  108  combine to form a single opening that corresponds to the slider  202 . This combined slider opening is generally slot shaped and may accommodate a slider support  232  (see  FIG. 2  and  FIG. 4B ) that fits in the combined slider opening to allow the slider to move along the combined slider opening. The slider opening  108  may take any shape that accommodated the sliding of the slider  202  and the slider support  232 . 
         [0053]    The first handle portion  104  may also include a cable rod support  112 . The cable rod support  112  may extend as shown between two sides of the first handle portion  104 . The cable rod support  112  may include a slot  126  that accepts and secures the cable rod  404  in the first handle portion  104 . 
         [0054]    The first handle portion  104  may include cable stays  124 . The cable stays accept and secure a portion of the cable  402  when the cable  402  is folded and stored inside the handle  102 . Further, the first handle portion  104  may include cable guides  114 . The cable guides are shown as having a wave shape that facilitates the unfolding of the cable  402  when the cable is deployed and pulled out of the insertion tool  100 . When the cable  402  is folded in the handle  102 , the cable  402  may cross the handle across the lower portions of the cable guides  114 . As the cable is pulled out it will move up the wave shape to allow for smoother deployment of the cable  402  from the insertion tool  100 . The cable guides also reduce the amount of force needed to pull the cable  402  out of the cable stays  124  and out of the insertion tool  100 . 
         [0055]    The second handle portion  106  may include a cable retaining stop  116 . The cable retaining stop  116  applies a force to a cable retaining member  212  of the mechanism  200 . While the cable retaining stop  116  is shown as being part of the second handle portion  106 , it may be instead a part of the first handle portion  104 . Further, the cable retaining stop  116  may also be a part of both the first handle portion  104  and the second handle portion  106  that combine to apply the force to the cable retaining member  212 . 
         [0056]    The second handle portion  106  may include a single-use stop  118 . The single-use stop  118  interacts with a locking member  214  of the mechanism  200 . As will be described in further detail below, the single-use stop  118  may prevent the mechanism  200  from sliding backwards after the slider  202  has been pushed forward by a user. While the single-use stop  118  is shown as being part of the second handle portion  106 , it may be instead a part of the first handle portion  104 . Further, the single-use stop  118  may also be a part of both the first handle portion  104  and the second handle portion  106  that combine to prevent the mechanism  200  from sliding backwards. 
         [0057]      FIGS. 4A-4C  show perspective, side, and top views of the mechanism, respectively. As shown in  FIGS. 2 and 4A-4C , an inner tube  206  is attached at a proximal end to the mechanism  200 . The flip anchor cable  400  is inserted into the inner tube  206  and passes through the inner tube  206  as the flip anchor cable  400  is deployed. Further, the inner tube  206  fits and slides within the outer tube  300 . The mechanism may include an end portion  222  having an end hole  224 . The end hole  224  accepts the proximal end of the inner tube  206  to attach the inner tube  206  to the mechanism  200 . Further, the end hole  224  extends through the end portion  222  so that the flip anchor cable  400  can pass through the end hole  224  to interact with other parts of the mechanism. 
         [0058]    The mechanism  200  may include a button support member  208 . The safety button  204  may be connected to the button support member  208 . Also, the slider  202  may be connected to the button support member  208  via a slider support  232 . In other embodiments of the mechanism, the slider may be directly connected to the button support member  208  without a slider support  232 . 
         [0059]    The safety button  204  may also include a safety button protrusion  220 . The safety button protrusion  220  may engage a safety button retainer  218  as will be described further below. In other embodiments, the safety button protrusion  220  may instead extend from the button support member  208 . 
         [0060]    The mechanism  200  also may include a central support member  210 . The central support member  210  may connect with the button support member  208  at one end and with the end portion  222  at the other end. The connection between the central support member  210  and the button support member  208  may be flexible to allow the central support member  210  and the button support member  208  to move relative to one another when forces are applied to the mechanism  200 . 
         [0061]    The safety button retainer  218  may also be attached to the central support member  210 . When the safety button  204  is depressed by the user, the button support member  208  flexes towards the central support member  210 , thus bringing the safety button protrusion  220  into engagement with the safety button retainer  218 . The engagement between the safety button protrusion  220  and the safety button retainer  218  fixes the safety button  204  in place, i.e., in a depressed position, to prevent the button support member  208  from springing back away from the central support member  210 . While shapes are shown for the safety button retainer  218  and the safety button protrusion  220 , other shapes may be used that facilitate locking the safety button  204  after it has been depressed. 
         [0062]    The mechanism  200  may also include a cable retaining member  212  that is flexibly connected to the end portion  222 . In other embodiments, the cable retaining member  212  may also be connected to the central support member  210 . The cable retaining member  212  may have a cable retaining protrusion  216  that extends towards the central support member  210 . The cable retaining protrusion  216  may be near where the cable  402  extends out from the end hole  224  so as to engage and clamp a portion of the cable  402 . The cable retaining member  212  may also be connected to a locking member  214 . The locking member  214  extends away from the cable retaining member  212  and may move relative to the cable retaining member  212  when a force is applied. The operation of the cable retaining member  212 , the cable retaining protrusion  216 , and the locking member  214  will be described further below. In various embodiments, the shapes and locations of the cable retaining member  212 , the cable retaining protrusion  216 , and the locking member  214  may vary as long as they provide the functionality that will be described further below. 
         [0063]    In  FIG. 4C , the safety button  204  is shown as having a numeral “1” on its surface. Likewise, the slider  202  is shown as having a number “2” on its surface. This is to help guide the user in the operation of the insertion tool where the safety button  204  is first depressed, and then the slider  202  may be slid forward to begin deployment of the flip anchor cable  400 . 
         [0064]      FIG. 2  also shows the flip anchor cable  400  outside of the insertion tool. The flip anchor cable  400  may include the flip anchor  406  attached to distal end of the cable  402 . The cable rod  404  be connected to proximal end of the cable  402 . The flip anchor  406  may be attached to the cable in a flexible manner, where the flip anchor may rotate relative to the cable. In one position, the flip anchor  406  may be aligned with the cable  402  and held in place for example by the outer tube  300 . The flip anchor  406  may be connected to the cable  402  so that it is naturally at an angle to the cable  402 , so that when the flip anchor  406  is free of the outer tube  300 , it will rotate away from the cable  402  so that it may be deployed. 
         [0065]    The mechanism  200  may be made as a single unit out of a single material. The material may have the needed strength and flexibility to accomplish the described functionality. The mechanism  200  may be made using low cost materials and manufacturing processes. This allows for a single use insertion tool  100 , while keeping the cost of the flip anchor cable system down. 
         [0066]      FIG. 3  illustrates the assembled insertion tool with the second handle member removed to show the interior of the assembled insertion tool. The mechanism  200  along with the inner tube  206  are installed so that the inner tube  206  is inside the outer tube  300  and the safety button  204  is in the opening  110  (not shown in  FIG. 3 .) The flip anchor cable  400  is also installed. The cable rod  404  rests in the cable rod support  112 . A portion of the cable  402  extends from the cable rod  404  and then enters the end hole  224  (not shown in  FIG. 3 ). This portion of the cable  402  is folded as shown and held in place by the cable stays  124 . This portion of the cable may be folded to cross a lower portion of the cable guides  114 . Another portion of the cable  402  then further extends through the inner tube  206  so that the flip anchor  406  is fixed in the end of the outer tube  300 . 
         [0067]    The cable retaining member  212  is biased upward by the cable retaining stop  116  so that the cable retaining protrusion  216  is in contact with the cable  402 , thereby clamping the cable  402  in place. This clamping fixes the cable  402  in place to keep the flip anchor  406  in place and to prevent the cable from being inadvertently pulled out of the insertion tool  100 . 
         [0068]      FIG. 6  illustrates the flip anchor at the end of the flip anchor cable extending from the inner tube and the outer tube. The flip anchor  406  may have a proximal end  408  and a distal end  412 . The flip anchor  406  may be fixed to the distal end of the cable  402 , and the flip anchor  406  may be able to rotate away from the cable  402 . The proximal end  408  of the flip anchor  406  may have a shape that is complementary to shape of the end of the inner tube  206 . For example, the inner tube  206  may have an inner tube end member  226  that extends from inner tube  206 . This inner tube end member  226  extends along a portion of the cable  402  opposite the proximal end  408  of the flip anchor  406 . Further, at the end of the inner tube  206  is an inner tube pushing surface  228  that complements the proximal end  408  of the flip anchor  406 . When a user pushes the slider  202  (not shown) forward, the inner tube pushing surface  228  pushes the flip anchor  406  forward and free of the outer tube  300  so that the flip anchor  406  may deploy. 
         [0069]    The flip anchor  406  may also include a shoulder  410  adjacent to the proximal end  408 . The proximal end  408  may have a similar diameter as the inner tube  206  so that the proximal end  408  may be locked inside the end of the outer tube  300 . The shoulder has a larger diameter than the proximal end  408  and as a result mates with the end of the outer tube  300 . 
         [0070]    The operation of the insertion tool  100  will now be described. After a user drills a hole in, for example, a bone, the end of the insertion tool  100  is placed in the hole until the distal end of the insertion tool passes completely through the hole in the bone. The insertion tool  100  may be rotated to a specific angular position about its long axis so that the flip anchor  406  has a desired position. The orientation marker  230  on the handle  102  helps guide this alignment. 
         [0071]    The safety button  204  resides in the safety button opening  110  and this prevents the mechanism  200  from moving forward. Next, the user depresses the safety button  204  causing the safety button protrusion  220  to engage the safety button retainer  218 . This fixes the safety button  204  in a depressed position, and the safety button  204  disengages the safety button opening. Now the user may apply a forward force on the slider  202  to slide the mechanism  200  forward. 
         [0072]    Sliding the mechanism  200  forward has a number of different effects. First, as the cable retaining member  212  moves forward, it disengages from the cable retaining stop  116 . This results in the cable retaining protrusion  216  decreasing its clamping force on the cable  402 , which allows the flip anchor cable  400  to be pulled out of the insertion tool  100 . 
         [0073]    Second, as the locking member  214  moves forward, it passes over the single-use stop  118  and flexes downward. This may cause a snapping sound that provides an indication that the flip anchor  406  has been deployed. Further once the locking member  214  moves downward and over the single-use stop  118 , the single-use stop  118  now blocks the locking member  214  from moving backward. This prevents the mechanism  200  from moving backward providing a single-use safety feature for the insertion tool  100 . 
         [0074]    In an alternative embodiment, the mechanism  200  may not have a locking member  214 , and once the cable retaining member  212  moves downward and disengages from the cable retaining stop  116 , the cable retaining stop  116  may now block the cable retaining member  212  from moving backward. This prevents the mechanism  200  from moving backward providing a single-use safety feature for the insertion tool  100 . 
         [0075]    Third, as the mechanism  200  moves forward the inner tube  206  moves forward pushing the proximal end  408  of the flip anchor  406  out of the end of the outer tube  300 . This unlocks the flip anchor  406 . The flip anchor  406  then rotates so that it may engage the bone around the hole. 
         [0076]    The user may then pull the insertion tool  100  backwards to pull the cable  402  and the cable rod  404  out of the insertion tool. The cables guide  114  facilitates the unfolding of the cable  402  as the cable  402  is pulled out of the insertion tool  100 . 
         [0077]    Once the flip anchor cable  400  is completely pulled out of the insertion tool  100 , the insertion tool  100  may be disposed of. Now the user may further manipulate and secure the cable as is known in the art. 
         [0078]    The mechanism  200  and the insertion tool  100  allows for one time pressing of the safety button  204 , which gives the user clear feedback on the status of the insertion tool  100 . The safety button  204  and the slider  202  are close together on the top of the insertion tool  100  allowing for ease-of-use for both left and right handed users. 
         [0079]    The mechanism  200  provides for safe operation of the insertion tool  100 . As long as the safety button  204  is not pressed, the cable  402  is held by the mechanism  200  with a high clamping force between the cable  402  and the cable retaining protrusion  216 . After pressing the safety button  204  and sliding the sliding button  202  in distal direction, the clamping force on the cable  402  decreases. Further, after the safety button  204  is pressed and the mechanism  200  is slid forward, the mechanism  200  has features that prevents the mechanism  200  from sliding backwards. 
         [0080]    The design of the insertion system  100  facilitates operation using one hand. Other systems require multiple hands to correctly operate. This may be problematic as users are often required to use multiple instruments at one time. The insertion tool described herein allows the user to successfully insert the flip anchor cable, unlock the mechanism, release the cable, and remove the insertion tool with one hand. 
         [0081]    As the insertion tool is preassembled and internally stores the cable, contamination or mishandling of the cable may be prevented. This means that the user has no direct contact with the cable until after it is inserted within the bone and the flip anchor is released. This minimizes risk, shortens the operating time, and decreases the potential for user error. 
         [0082]    It should be appreciated by those skilled in the art that any diagrams or schematic drawings herein represent conceptual views of illustrative structures embodying the principles of the invention. 
         [0083]    Although the various exemplary embodiments have been described in detail with particular reference to certain exemplary aspects thereof, it should be understood that the invention is capable of other embodiments and its details are capable of modifications in various obvious respects. As is readily apparent to those skilled in the art, variations and modifications can be effected while remaining within the spirit and scope of the invention. Further, various elements from the various embodiments may be combined to form other embodiments that are within the spirit and scope of the invention. Accordingly, the foregoing disclosure, description, and figures are for illustrative purposes only and do not in any way limit the invention, which is defined only by the claims.