Patent Description:
Many currently available instruments used in conjunction with implants for correcting bone deformities and fractures use various alignment mechanisms. The currently available instruments may experience problems with adequate surgical exposure, alignment variability, inaccurate targeting and instability. Thus, new instruments and methods of use are needed to ensure proper and reproducible orientation of corrective or stabilization devices to be implanted into the foot and ankle. The following reference may be useful in understanding the background to the present disclosure. <CIT> describes an alignment guide apparatus including a body, a fixation insert, a guide pin, and a screw. The body may include an arm with a first end and a second end, an attachment portion at the first end, and an alignment portion at the second end. The fixation insert may be configured to pass through the attachment portion and the guide pin may be configured to pass through the alignment portion. The screw may be configured to engage the guide pin. The alignment system may include a bone plate, an alignment guide, a screw, at least one first fastener, and at least one second fastener.

<CIT> discloses a further targeting guide assembly for correcting bone deformity in the foot.

The invention relates to a targeting guide assembly as defined in claim <NUM>.

Aspects of the present disclosure provide instruments, implants, plates, systems, as defined in the claims and methods for correcting bone deformities in the foot (Methods are described for the purpose of illustrating the use of the claimed subject matter but the methods per se are not claimed).

In one aspect, provided herein is a targeting guide. The targeting guide includes a guide arm, at least one target member, at least one implant holder and a guide pin.

In another aspect, provided herein is a method of using the targeting guide to secure two bones together. The method includes, inserting the guide pin in a bone. The method also includes securing the guide arm to the guide pin at the second end. In addition, the method includes inserting the protector member into the first end of the guide arm and then inserting the target pin through the at least two bones that the user wants to secure. Next, the method may including drilling a hole over the target pin and threading the target member into the drill hole to secure the two bones. The method may also include removing the guide pin, the target pin and the guide arm. Alternatively, the method may further include attaching an implant holder to the guide arm, securing the implant to the implant holder and positioning the implant over a target location that may be the two bones to be secured.

These, and other objects, features and advantages of this invention will become apparent from the following detailed description of the various aspects of the invention taken in conjunction with the accompanying drawings.

The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate embodiments of the invention and together with the detailed description herein, serve to explain the principles of the invention. The drawings are only for purposes of illustrating preferred embodiments and are not to be construed as limiting the invention. The foregoing and other objects, features and advantages of the invention are apparent from the following detailed description taken in conjunction with the accompanying drawings in which:.

Generally stated, disclosed herein are instruments, implants, plates, and systems for correcting bone deformities. Further, methods for correcting bone deformities using instruments, implants, plates, and systems are discussed.

In this detailed description and the following claims, the words proximal, distal, anterior or plantar, posterior or dorsal, medial, lateral, superior and inferior are defined by their standard usage for indicating a particular part or portion of a bone or implant according to the relative disposition of the natural bone or directional terms of reference. For example, "proximal" means the portion of a device or implant nearest the torso, while "distal" indicates the portion of the device or implant farthest from the torso. As for directional terms, "anterior" is a direction towards the front side of the body, "posterior" means a direction towards the back side of the body, "medial" means towards the midline of the body, "lateral" is a direction towards the sides or away from the midline of the body, "superior" means a direction above and "inferior" means a direction below another object or structure. Further, specifically in regards to the foot, the term "dorsal" refers to the top of the foot and the term "plantar" refers the bottom of the foot.

Similarly, positions or directions may be used herein with reference to anatomical structures or surfaces. For example, as the current instrumentation and methods are described herein with reference to use with the bones of the foot, the bones of the foot, ankle and lower leg may be used to describe the surfaces, positions, directions or orientations of the instrumentation and methods. Further, the instrumentation and methods, and the aspects, components, features and the like thereof, disclosed herein are described with respect to one side of the body for brevity purposes. However, as the human body is relatively symmetrical or mirrored about a line of symmetry (midline), it is hereby expressly contemplated that the instrumentation and methods, and the aspects, components, features and the like thereof, described and/or illustrated herein may be changed, varied, modified, reconfigured or otherwise altered for use or association with another side of the body for a same or similar purpose. For example, the instrumentation and methods, and the aspects, components, features and the like thereof, described herein with respect to the right foot may be mirrored so that they likewise function with the left foot. Further, the instrumentation and methods, and the aspects, components, features and the like thereof, disclosed herein are described with respect to the foot for brevity purposes, but it should be understood that the instrumentation and methods may be used with other bones of the body having similar structures.

As shown in <FIG>, the targeting guide assembly may include a guide arm <NUM>, a target member <NUM>, an implant holder <NUM> and a guide pin <NUM>. As seen <FIG>, the target member <NUM> extends through a through hole <NUM> positioned at a first end <NUM> of the guide arm <NUM> and runs generally parallel to an elongate body or body <NUM> of the guide arm <NUM>. The first end <NUM> of the guide arm <NUM> with the through hole <NUM> allows for ease of insertion and removal of the target member <NUM> to accommodate various clinical circumstances and/or anatomic positions within the foot.

As seen in <FIG> and <FIG>, the implant holder <NUM> is placed on the body <NUM> of the guide arm <NUM>. The implant holder <NUM> is configured to slide along a top surface of the body <NUM> to allow for location adjustability. Further, the guide arm <NUM> includes a second end <NUM> that is located at the end of an angled portion <NUM> of the body <NUM>.

The guide arm <NUM> is shown in <FIG>, and includes the first end <NUM> that is connected to a second end <NUM> by the elongate body <NUM>. The first end <NUM> may, for example, include a wider portion <NUM> that includes arcuate sides that may attach the wider portion <NUM> in a generally perpendicular direction relative to the body <NUM>. The wider portion <NUM> also includes the through hole <NUM> that is sized to receive the target member <NUM>. It would be understood by one skilled in the art that the hole <NUM> may be smaller and/or larger than as shown in <FIG> as the hole dimension will depend upon the size and configuration of the target member <NUM> that is used. The hole <NUM> is oriented in a direction to allow the target member <NUM> to extend parallel to the body <NUM> of the guide arm <NUM>.

The angled portion <NUM> extends in a downward angled direction from the body <NUM> to the second end <NUM>. Positioned at the second end <NUM> is a housing element <NUM> that is configured to receive the guide pin <NUM>. As seen in <FIG>, <FIG>, and <FIG>, the housing element <NUM> includes an inner surface that is configured or sized and shaped to allow the guide pin <NUM> to pivot, rotate or move in multiple planes. <FIG> also shows that housing element <NUM> has a top opening <NUM> that is sized to allow for the insertion of the guide pin <NUM>. The bottom opening <NUM> may be slightly smaller than the top opening <NUM> to capture and/or retain the guide pin <NUM> within the inner cavity of the housing element <NUM>.

<FIG> show an embodiment of the guide pin <NUM> that may be inserted in the housing element <NUM>. The guide pin <NUM> includes a shaft <NUM>, a sphere <NUM>, a tip <NUM> and a tapered portion <NUM>. The tip as shown in <FIG> is threaded, however, it is also contemplated that the tip may have a smooth outer surface to facilitate insertion. The sphere <NUM> is sized and shaped or configured to be inserted into the housing element <NUM>, as shown in <FIG>, to allow for a full range of pivoting motions, when in use. The tip <NUM> is configured or sized and shaped to allow for the user to insert the guide pin <NUM> into a target bone either directly or through the skin and then be secured therein to establish the target location for the elongated target member <NUM>.

With continued reference to <FIG>, the tapered portion <NUM> of the shaft <NUM> has a larger diameter proximate to the sphere <NUM> and then tapers down to a smaller diameter proximate to the tip <NUM>. The tapered portion <NUM> functions to prevent the guide pin <NUM> from plunging or being inserted too deep into the target bone. The tapered portion <NUM> also may operate to ensure accurate positioning of the guide pin <NUM> to accomplish precise targeting functionality of the targeting guide <NUM>.

Although not shown, the second end <NUM> may have an alternative configuration which may include, for example, a universal joint, hinged joint or other constrained mobile connection that could be utilized in place of the spherical guide pin <NUM>-housing element <NUM> assembly. The housing element <NUM> may include, for example, a movable joint construct through which a guide pin, Steinman pin, K-wire or other elongated member is connected and used to establish a target location in vivo.

Referring now to <FIG>, a target member <NUM> is shown. The target member <NUM> includes, for example, a three piece construct with a protector member <NUM>, a threaded member <NUM> and a target pin <NUM>. The protector member <NUM> has a knob <NUM> and a cylindrical portion <NUM> that are cannulated and can be coupled together. The protector member <NUM> functions to protect the surrounding soft tissue when the target pin <NUM> is inserted. As shown in <FIG>, the threaded member <NUM> may have one end that is tapered to facilitate insertion and placement in vivo. The opposite end of the tube-like structure of the threaded member <NUM> has cutting flutes to facilitate the insertion of the target member into bone. The threaded member <NUM> may be cannulated or alternatively, be solid with no longitudinal opening. The threaded member <NUM>, as seen in <FIG> and <FIG>, is threaded along its entire length, however, one skilled in the art would contemplate using partially or segmentally divided threads depending on the clinical application. The third piece of the target member <NUM> is an elongated pin like structure <NUM>. The elongated pin like structure <NUM> may be, for example, a target pin, guide wire, k-wire or the like. The target pin <NUM> as shown, may have, for example, a smooth outer surface with a one sharpened end. When in use, typically the target pin <NUM> is inserted first from a distal to proximal direction with the pin <NUM> passing through the cannulated passage of the protector member <NUM> and threaded member <NUM> when this construct is being threaded into a bone pathway to secure the targeting guide in the surgical site and allow for the establishment of a target location proximally. The fully assembled targeting guide <NUM> is shown in <FIG> with the target member <NUM> in place.

Further, <FIG> shows an exploded view of the targeting guide <NUM> and the disassembled target member <NUM>. It will be understood by one of ordinary skill in the art that the target member <NUM> shown is one embodiment and that other constructs are also contemplated, for example, a one piece rod like structure, with or without threads, or alternatively, a two piece structure that includes threaded and non-threaded elements.

Referring now to <FIG> and <FIG> the implant holder is shown. The implant holder may be detachably attached to the body <NUM> of the guide arm <NUM>. The implant holder <NUM> includes a locking member <NUM>, a housing <NUM>, an attachment arm <NUM> and an alignment post <NUM>. The locking member <NUM> is positioned in a hole that has an opening at the top surface of the housing <NUM> and exits through an opening on the bottom surface of the housing <NUM>. The locking member <NUM> includes a knob <NUM> that allows the user to turn the locking member <NUM>, a shaft <NUM> that is connected to the knob <NUM>, and a threaded portion <NUM> of the shaft <NUM> is positioned at the opposite end of the knob <NUM>. As seen in <FIG>, when assembled, the shaft <NUM> of the locking member <NUM> is wholly contained within the housing as it passes through a through hole in the housing <NUM>. The implant holder <NUM> also has an alignment post <NUM> that is adjacent to the threaded portion <NUM>. The implant holder <NUM> further has an attachment arm <NUM> that is generally configured as a hook like structure. The attachment arm <NUM> hooks over the top of the body <NUM> of the guide arm <NUM> to permit the sliding movement along the longitudinal axis of the body <NUM>, as shown in <FIG>. The threaded portion <NUM> of the implant holder <NUM> may be, for example, secured to a bone plate. The threaded portion <NUM> may be threaded into a corresponding hole in the plate and the alignment post <NUM> is positioned within a second hole in the surface of the plate to secure the plate to the implant holder <NUM> and allow the user to move the secured implant along the length of the body <NUM>.

A surgical method for correcting bone deformities using the targeting guide instrument of <FIG> is disclosed. The method includes, for example, performing an arthrodesis across a minimum of one joint. A minimum of two bones are positioned in their desired final position and can be fixed temporarily via various means. The guide pin <NUM> sets the trajectory for the target pin <NUM> and the threaded member <NUM>. The method includes further the placing of the guide pin <NUM> in a bone such that the trajectory of the target pin <NUM> will triangulate to the threaded portion <NUM> of the guide pin <NUM>. The configuration of the guide arm <NUM> may provide guidance as to the location along the threaded portion <NUM> of the guide pin <NUM> where the target pin <NUM> will aim. The guide arm <NUM> may be adjusted for bones where the user may want to place the guide pin <NUM> deeper to allow for better fixation, while aiming closer to the edge or cortical surface of the bone. Next, the method may include attaching the housing element <NUM> of the guide arm <NUM> to the sphere <NUM> of the guide pin <NUM>. Further, the method may include placing the protector member <NUM> in the hole <NUM>. A target pin <NUM> may be placed into the protector member <NUM> and inserted past at least two bones but may be inserted to or past the threaded portion <NUM> of the guide pin <NUM>. The method may include removing the protector member <NUM> by sliding it out of the guide arm <NUM>. The guide arm <NUM> is removed from the sphere <NUM> of the guide pin <NUM>. The guide pin <NUM> may also be removed at this time or can be removed at a later time. A cannulated drill may be used to drill over the target pin <NUM>. The threaded member <NUM> is then inserted over the target pin <NUM> to the desired depth. Alternatively, if the threaded member <NUM> is not cannulated, the target pin <NUM> can be removed and the threaded member <NUM> inserted through the drill hole.

In one embodiment, the method may also include using an implant holder <NUM>. The implant holder <NUM> is attached to an implant (not shown). The implant may be, for example, a bone plate. The implant holder <NUM> may be attached to the guide arm <NUM> prior to placement on the guide pin <NUM>, or can be placed after the guide arm <NUM> is placed on the guide pin <NUM>. Likewise, the implant may be attached to the implant holder <NUM> prior to placement on the guide arm <NUM> or may be pre-assembled and then the implant holder <NUM> is attached to the guide arm <NUM>. The implant position may be adjusted along the length of the guide arm <NUM> to allow for implant positioning along a first plane. For example, along the sagittal plane. Alternatively, the guide arm <NUM> can be rotated around the guide pin <NUM> to rotate the plate in a second plane, for example the frontal plane. Movement of the implant in these two planes allows for fixation devices to be inserted with a trajectory to avoid contacting the threaded member <NUM>. The implant may secured with locking or non-locking fixation devices prior to placement of the guide pin <NUM>. Alternatively, the implant may be secured after the placement of the guide pin <NUM>.

A method of assembling the targeting guide <NUM> includes obtaining a guide arm <NUM> and a guide pin <NUM>. Placing the guide pin <NUM> in a bone. The method may further include attaching the guide arm <NUM> to the guide pin <NUM> at the second end <NUM> and inserting the protection member <NUM> into the hole <NUM>. Further, the method may include inserting the target pin <NUM> through the protection member <NUM> and then removing the protection member <NUM> from the hole <NUM>.

Referring now to <FIG>, another targeting guide assembly <NUM> is shown. The targeting guide assembly <NUM> includes a guide arm <NUM>, a target member <NUM>, an implant holder <NUM>, and a guide pin <NUM>. The target member <NUM> is received within a first end of the guide arm <NUM>. The implant holder <NUM> moveably engages the guide arm <NUM> and may, for example, slide along a top surface of a body <NUM> of the guide arm <NUM> to allow for location adjustability of a bone plate <NUM>, as shown in <FIG> and <FIG>. The guide pin <NUM> rotatably couples to the second end of the guide arm <NUM>. The implant holder <NUM> couples to a bone plate <NUM>.

As shown in <FIG>, the guide arm <NUM> includes a body <NUM> connecting a first end <NUM> and a second end <NUM> of the guide arm <NUM>. The first end <NUM> may, for example, include a wider portion <NUM> that includes arcuate sides that may attach the wider portion <NUM> in a generally perpendicular direction relative to the body <NUM>. The wider portion <NUM> may also include a through hole <NUM> that is sized and shaped to receive the target member <NUM>. The through hole <NUM> may be, for example, larger or smaller than as shown in <FIG>. The through hole <NUM> may extend through the wider portion <NUM> parallel to the body <NUM> allowing the target member <NUM> to extend parallel to the body <NUM> of the guide arm <NUM>. The second end <NUM> may, for example, include an angled portion <NUM>. The angled portion <NUM> extends in a downward angled direction from the body <NUM> to the second end <NUM>. A housing element <NUM> may be positioned at the second end <NUM> and be configured or sized and shaped to receive the guide pin <NUM>. The housing element <NUM> may include a top opening <NUM> and a bottom opening <NUM> forming an inner surface or cavity extending between the top opening <NUM> and the bottom opening <NUM>. The housing element <NUM> may also include a channel extending from an exterior surface of the housing element <NUM> into the inner surface. The inner surface may be, for example, configured or sized and shaped to allow the guide pin <NUM> to pivot, rotate, or move in multiple planes. The top opening <NUM> may be sized to allow for insertion of a sphere <NUM> of the guide pin <NUM> into the housing element <NUM>. The bottom opening <NUM> may be, for example, slightly smaller than the top opening <NUM> to capture or retain the guide pin <NUM> within the inner cavity of the housing element <NUM>.

The target member <NUM> is shown in <FIG> and includes a target pin <NUM>, a protector member <NUM>, a drill guide <NUM>, and a threaded member or implant <NUM>. The target pin <NUM> may be, for example, a guide wire, k-wire, pin, or the like elongated pin like structure or member for insertion through a joint. In the depicted embodiment the target pin <NUM> has a smooth outer surface with a point or sharped portion at one end.

The target pin <NUM> may be, for example, inserted from a distal to proximal direction through the cannulated opening of the protector member <NUM> when inserted into a bone pathway to secure the targeting guide in the surgical site and allow for the establishment of a target location proximally. The protector member <NUM> may include a knob <NUM> at a first end of a cylindrical portion <NUM>. The protector member <NUM> may also include a through hole or cannulated opening extending through the protector member <NUM> along a longitudinal axis of the protector member <NUM>. The protector member <NUM> may, for example, protect the surrounding soft tissue when the target pin <NUM> is inserted through the protector member <NUM> and into a patient's bones. The drill guide <NUM> may include a cylindrical portion <NUM> and a knob <NUM> positioned at a first end of the cylindrical portion <NUM>. The cylindrical portion <NUM> of the drill guide <NUM> may have, for example, a larger diameter than the cylindrical portion <NUM> of the protector member <NUM>. The drill guide <NUM> may also include a through hole or cannulated opening <NUM> extending along a longitudinal axis of the drill guide <NUM>. The drill guide <NUM> may, for example, protect the surrounding soft tissue when a drill is inserted through the cannulated opening <NUM> to drill an opening for inserting the threaded member <NUM>. The threaded member or implant <NUM> may include a head portion <NUM> at a first end of the threaded member <NUM> and cutting flutes <NUM> at a second end of the threaded member <NUM>. The cutting flutes <NUM> may facilitate the insertion of the threaded member <NUM> into bones. In addition, the threaded member <NUM> may include a through hole or cannulated opening <NUM> extending through the threaded member <NUM> along a longitudinal axis. The through hole <NUM> may be configured or sized and shaped to receive the target pin <NUM>. Alternatively, the threaded member <NUM> may be, for example, solid without a longitudinal opening. As shown, the threaded member <NUM> is threaded along the entire length, however, it is also contemplated that the threaded member <NUM> may be threaded along only a portion, for example, having partially or segmentally divided threads along the length.

The implant holder <NUM> may include a housing <NUM>, a knob <NUM> and a locking member <NUM>. The housing <NUM> may include an attachment arm <NUM> extending from and parallel to the housing <NUM> to form, for example, a U-shaped or hook like structure. The attachment arm <NUM> hooks under the bottom of the body <NUM> of the guide arm <NUM> to permit the sliding movement along the longitudinal axis of the body <NUM>. A channel <NUM> is formed between the attachment arm <NUM> and the housing <NUM>. The attachment arm <NUM> may also include at least one hole <NUM> extending through the attachment arm <NUM> from an exterior surface into the channel <NUM>. The at least one hole <NUM> may be, for example, three holes. The implant holder <NUM> may also include an alignment post <NUM> extending away from a bottom surface of housing <NUM>. The implant holder <NUM> may further include a through hole <NUM> extending through the housing <NUM> from a top surface to a bottom surface adjacent to the alignment post <NUM>. The knob <NUM> may include an engagement protrusion <NUM> extending away from a back surface of the knob <NUM>. The engagement protrusion <NUM> may be, for example, threaded to engage the at least one hole <NUM> to secure the implant holder <NUM> to the body <NUM> of the guide arm <NUM> at the desired position. The locking member <NUM> may include a shaft <NUM> with a knob <NUM> at a first end and a threaded portion <NUM> at a second end. The shaft <NUM> may be inserted through the through hole <NUM> of the housing <NUM> until the knob <NUM> contacts a top surface of the housing <NUM> and the threaded portion <NUM> extends past the bottom surface of the housing <NUM>. The threaded portion <NUM> may engage a bone plate, such as bone plate <NUM>, as described in greater detail below. The knob <NUM> may be rotated to insert the threaded portion <NUM> into the bone plate <NUM> and to remove the threaded portion <NUM> from the bone plate <NUM>.

As shown in <FIG>, the guide pin <NUM> includes a shaft <NUM>, a sphere <NUM>, a tip <NUM>, and a cylindrical protrusion <NUM>. The sphere or spherical member <NUM> may be positioned between a first end and the tip <NUM>. The tip <NUM> is threaded, however, it is also contemplated that the tip <NUM> may also have a smooth outer surface to facilitate insertion. The tip <NUM> is configured or sized and shaped to allow for the user to insert the guide pin <NUM> into a target bone either directly or through the skin. Once inserted into the target bone, the guide pin <NUM> may be secured to establish the target location for the threaded member <NUM>. The sphere <NUM> is sized and shaped or configured to be inserted into the housing element <NUM> to allow for a full range of pivoting motions, as shown in <FIG> and <FIG>. The cylindrical protrusion <NUM> may be positioned adjacent to the sphere <NUM> between the sphere <NUM> and the tip <NUM>.

The targeting guide assembly <NUM> may be assembled by inserting the guide pin <NUM> into the housing element <NUM> of the guide arm <NUM>. The protector member <NUM> may be inserted into the through hole <NUM> of the guide arm <NUM> to receive the target pin <NUM>. In addition, the implant holder <NUM> may be aligned with the body <NUM> of the guide arm <NUM> and secured in the desired position by engaging the engagement protrusion <NUM> with the body <NUM>. The locking member <NUM> may be inserted into the opening <NUM> of the housing <NUM>. Then, the alignment post <NUM> may be aligned with a corresponding alignment opening (not shown) in the bone plate <NUM> and the threaded portion <NUM> of the locking member <NUM> may engage a corresponding threaded opening (not shown) in the bone plate <NUM>. In addition, the protector member <NUM> may be removed and the drill guide <NUM> may be inserted into the through hole <NUM> of the guide arm <NUM> over the target pin <NUM>.

Referring now to <FIG>, a method for using the targeting guide assembly <NUM> to correct bone deformities is shown. The method may include, for example, performing an arthrodesis across at least one joint. The at least two bones of the at least one joint may be positioned in a desired final position and may be temporarily fixed. As shown in <FIG>, the method may also include inserting a guide pin <NUM> into a first bone <NUM> to set the trajectory for the target pin <NUM> and the threaded member <NUM>. Next, the housing element <NUM> of the guide arm <NUM> may be coupled to the sphere <NUM> of the guide pin <NUM>. The guide arm <NUM> may be rotated about the sphere <NUM> to position the first end <NUM> of the guide arm <NUM> with respect to a second bone <NUM>. Next, the protector member <NUM> may be inserted into the through hole <NUM> and a target pin <NUM> may be inserted through the protector member <NUM> and into at least one bone <NUM>, <NUM>, <NUM>, <NUM>. The trajectory of the target pin <NUM> will overlap or engage the guide pin <NUM>. In one embodiment, the implant holder <NUM> may be coupled to the guide arm <NUM> before the guide arm <NUM> is coupled to the guide pin <NUM>. Alternatively, the implant holder <NUM> may be coupled to the guide arm <NUM> after the target pin <NUM> is inserted into the bones <NUM>, <NUM>, <NUM>, <NUM>. The bone plate <NUM> may then be coupled to the implant holder <NUM> and aligned on the bones <NUM>, <NUM>, <NUM>, <NUM>, as shown in <FIG>. It is also contemplated that the bone plate <NUM> may be coupled to the implant holder <NUM> prior to the guide arm <NUM> being coupled to the guide pin <NUM>. Once the bone plate <NUM> is coupled to the implant holder <NUM>, the position of the implant <NUM> may be adjusted along the length of the guide arm <NUM> to allow for implant positioning in a first plane, for example, the sagittal plane. The guide arm <NUM> may alternatively or in addition to adjustment along the length be rotated around the guide pin <NUM> to rotate the bone plate <NUM> in a second plane, for example, the frontal plane. Movement of the bone plate <NUM> in the two planes allows for fixation devices or bone screws <NUM> to be inserted with a trajectory to avoid contacting the target pin <NUM> and/or threaded member <NUM>. The bone plate <NUM> may be secured to the bones <NUM>, <NUM>, <NUM>, <NUM> with bone fasteners <NUM> inserted to avoid contacting the target pin <NUM> and the threaded member <NUM> when inserted. The bone fasteners or fixation devices <NUM> may be, for example, locking or non-locking fasteners. The method may then include removing the protector member <NUM> by sliding the protector member <NUM> out of the through hole <NUM> of the guide arm <NUM> over the target pin <NUM>. As shown in <FIG>, the drill guide <NUM> may then be inserted through the through hole <NUM> over the target pin <NUM> and positioned onto a bone <NUM>. A cannulated drill may be used to drill over the target pin <NUM>. The cannulated drill and drill guide <NUM> may then be removed from the guide arm <NUM> and the threaded member <NUM> may be inserted over the target pin <NUM> and into the bones <NUM>, <NUM>, <NUM>, <NUM>, as shown in <FIG>. Although not shown, it is also contemplated that the bone plate <NUM> may be coupled to the bones <NUM>, <NUM>, <NUM>, <NUM> after the threaded member <NUM> is inserted into the bones <NUM>, <NUM>, <NUM>, <NUM>. As also shown in <FIG>, the guide arm <NUM> and guide pin <NUM> may be removed from the bones <NUM>, <NUM>, <NUM>, <NUM>. Finally, as shown in <FIG>, the target pin <NUM> may be removed from the bones <NUM>, <NUM>, <NUM>, <NUM> and the threaded member <NUM>.

As may be recognized by those of ordinary skill in the art based on the teachings herein, numerous changes and modifications may be made to the above-described and other embodiments of the present disclosure without departing from the scope of the disclosure. The components of the instruments, guides, implants, plates, and/or systems as disclosed in the specification, including the accompanying abstract and drawings, may be replaced by alternative component(s) or feature(s), such as those disclosed in another embodiment, which serve the same, equivalent or similar purpose as known by those skilled in the art to achieve the same, equivalent or similar results by such alternative component(s) or feature(s) to provide a similar function for the intended purpose. In addition, the instruments, guides, implants, plates, and/or systems may include more or fewer components or features than the embodiments as described and illustrated herein. For example, the components and features of <FIG> and <FIG> may be used interchangeably and in alternative combinations as would be modified or altered by one of skill in the art. Further, the steps of the surgical methods associated with <FIG> and <FIG> may be used interchangeably and in alternative combinations as would be modified or altered by one of skill in the art. Accordingly, this detailed description of the currently-preferred embodiments is to be taken in an illustrative, as opposed to limiting of the disclosure.

It will be further understood that the terms "comprise" (and any form of comprise, such as "comprises" and "comprising"), "have" (and any form of have, such as "has", and "having"), "include" (and any form of include, such as "includes" and "including"), and "contain" (and any form of contain, such as "contains" and "containing") are open-ended linking verbs. As a result, a method or device that "comprises," "has," "includes," or "contains" one or more steps or elements possesses those one or more steps or elements, but is not limited to possessing only those one or more steps or elements. Likewise, a step of a method or an element of a device that "comprises," "has," "includes," or "contains" one or more features possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way, but may also be configured in ways that are not listed.

Claim 1:
A targeting guide assembly (<NUM>, <NUM>) for correcting bone deformities in the foot, comprising:
a guide arm (<NUM>,<NUM>), comprising:
a body (<NUM>, <NUM>) extending between a first end (<NUM>, <NUM>) and a second end (<NUM>, <NUM>) of the guide arm (<NUM>, <NUM>);
a wider portion (<NUM>, <NUM>) at the first end (<NUM>, <NUM>), wherein the wider portion (<NUM>, <NUM>) extends from the body (<NUM>, <NUM>) in a perpendicular direction; and
an angled portion (<NUM>, <NUM>) extending in a downward direction from the body (<NUM>, <NUM>) to the second end (<NUM>, <NUM>), the second end (<NUM>, <NUM>) comprising a housing element (<NUM>, <NUM>) positioned at an end of the angled portion (<NUM>, <NUM>) opposite the body (<NUM>, <NUM>), the housing element (<NUM>, <NUM>) comprising:
a top opening (<NUM>, <NUM>);
a bottom opening (<NUM>, <NUM>);
an inner cavity formed by the top opening (<NUM>, <NUM>) engaging the bottom opening (<NUM>, <NUM>); and
a channel extending into the inner cavity from an exterior surface of the housing element (<NUM>, <NUM>);
a target member (<NUM>, <NUM>) coupled to the guide arm (<NUM>, <NUM>); and a guide pin (<NUM>, <NUM>) configured to be movably engaged to the housing element (<NUM>, <NUM>) of the guide arm (<NUM>, <NUM>).