Patent ID: 12226107

Corresponding reference characters indicate corresponding parts throughout the several views. The exemplary embodiments set forth herein are not to be construed as limiting the scope of the invention in any manner.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The present invention will be discussed hereinafter in detail in terms of various exemplary embodiments according to the present invention with reference to the accompanying drawings. In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the present invention. It will be obvious, however, to those skilled in the art that the present invention may be practiced without these specific details. In other instances, well-known structures are not shown in detail in order to avoid unnecessary obscuring of the present invention.

Thus, all the implementations described below are exemplary implementations provided to enable persons skilled in the art to make or use the embodiments of the disclosure and are not intended to limit the scope of the disclosure, which is defined by the claims. As used herein, the word “exemplary” or “illustrative” means “serving as an example, instance, or illustration.” Any implementation described herein as “exemplary” or “illustrative” is not necessarily to be construed as preferred or advantageous over other implementations. Moreover, in the present description, the terms “upper”, “lower”, “left”, “rear”, “right”, “front”, “vertical”, “horizontal”, and derivatives thereof shall relate to the invention as oriented inFIG.1.

The following description references systems, methods, and apparatuses for cutting tools for orthopedic surgery involving a foot or lower extremities. However, those possessing an ordinary level of skill in the relevant art will appreciate that other extremities, joints, and parts of the musculoskeletal system are suitable for use with the foregoing systems, methods and apparatuses. Likewise, the various figures, steps, procedures and work-flows are presented only as an example and in no way limit the systems, methods or apparatuses described to performing their respective tasks or outcomes in different time-frames or orders. The teachings of the present invention may be applied to any orthopedic surgery, such as on the hand as well as other upper and lower extremities and may be implemented in other treatments sites that have similar anatomical considerations.

Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary or the following detailed description. It is also to be understood that the specific devices and processes illustrated in the attached drawings, and described in the following specification, are simply exemplary embodiments of the inventive concepts defined in the appended claims. Hence, specific dimensions and other physical characteristics relating to the embodiments disclosed herein are not to be considered as limiting, unless the claims expressly state otherwise.

As depicted inFIGS.1and4-11, a cut guide100is connected to a first metatarsal bone122and a medial cuneiform bone121by a plurality of landmark guide wires or k-wires130inserted through a plurality of holes or bores108extending through cut guide100. Cut guide positioning is depicted in relation to a second metatarsal bone123. Cut guide100has a first member or cut guide body104, a second member or metatarsal cutting fixture or mobile metatarsal cutting portion103, an arm109and a compress-distraction fixture105. Compression-distraction fixture105extends from second member103and engages with first member104along a linear track115, with linear track115connected to first member104. Linear track115has a threaded rack107on a lateral face and a track groove112. Compression-distraction fixture105has a power screw or metatarsal adjustment screw106. When power screw106is engaged and turned by screwdriver250, compression-distraction fixture105is translatable movable along threaded rack107and within track groove112.

Further referring toFIGS.1and4-11, first member104has a first cut slot or proximal cuneiform cutting slot101and second member103has a second cut slot or distal metatarsal cutting slot102. Proximal cuneiform cutting slot101is elongated in the medial-lateral direction and narrow in the anterior-posterior direction. Proximal cuneiform cutting slot101extends through first member104in the dorsal-plantar direction. Distal metatarsal cutting slot102is a “U” shaped slot, elongated in the medial-lateral direction and narrow in the anterior-posterior direction. Distal metatarsal cutting slot102extends through second member103in the dorsal-plantar direction. Proximal cuneiform cutting slot101and distal metatarsal cutting slot102are parallel.

With continued reference toFIGS.1and4-11, second member103and compression-distraction fixture105are connected and therefore both are translated, moving in an anterior-posterior direction relative to first member104, when power screw106is turned. Proximal cuneiform cutting slot101and distal metatarsal cutting slot102remain parallel under, and after, such translation.

With reference toFIGS.2-3, a wire guide200has a body203, a bore hole205, and an arm201. Wire guide200is depicted with arm201positioned within a joint space202of a joint204between medial cuneiform bone121and first metatarsal bone122(FIG.1).

With reference toFIGS.12-14, an angle of obliquity is depicted with first metatarsal bone122removed inFIG.13, for use of illustration. First metatarsal bone122and a medial cuneiform bone121are depicted with a first bone wedge150removed from first metatarsal bone122, and a second bone wedge151removed from medial cuneiform bone121inFIG.12. A cuneiform cut155and a metatarsal cut156may be approximately parallel as depicted, for example, inFIG.12. The resulting bone surfaces (FIG.14) after first bone wedge150and second bone wedge151have been removed may, for example, be planar surfaces or further machined to be planar surfaces. Bone wedge150is depicted as having a thicker end and a thinner end, with the thicker end being bone removed from a lateral side of first metatarsal bone122and the thinner section being bone removed from a medial side of first metatarsal bone122. In another embodiment, a bone material amount removed in second wedge151may be, for example, greater than a bone material amount removed in first bone wedge150.

With reference toFIGS.1-11wire guide200(FIGS.2-3) and cut guide100(FIGS.1and4-11) are depicted for use in correcting the angle of obliquity between metatarsal bones (e.g. first metatarsal bone122) and cuneiform bones (e.g., medial cuneiform bone121). In an example, arm201of wire guide200is placed within joint space202to capture features of the joint such as obliquity, peaks and valleys. Wire guide200contains bore205for placing a landmark guide wire or a k-wire131of k-wires130into a bone (e.g., medial cuneiform bone121) that can be used as a reference. Wire guide200establishes an initial k-wire position, and an inserted first k-wire (e.g., k-wire131) is used to establish a cut distance. At this point, if a cut angle is known, a blocking k-wire (not shown) may be inserted into the bone (e.g., first metatarsal122) to establish cut distance and angle. The blocking k-wire may be placed parallel to the first k-wire (e.g., outside guide200but parallel to a longitudinal dimension thereof) to stop rotation of guide200about the installed k-wire (e.g., k-wire131) in a direction toward the second k-wire (not shown). However, if cut angle is yet to be determined, only one k-wire (e.g., k-wire131) is used to allow rotation of guide200. Selection of reference points for positioning cut guide100may be selected to, for example, remove more bone material from cuneiform bone121rather than from metatarsal bone122.

With continued reference toFIGS.1-11, wire guide200(FIGS.2-3) is removed and cut guide100is placed on k-wire131, for example, such that wire131is received in a bore208of bores108. If a cut angle is known, cut guide100is placed onto two k-wires, such that the wires (e.g., wires130) are received in bores (e.g., bores108) of cut guide100. For example, a first k-wire (e.g., wire131) may control a longitudinal position along a longitudinal dimension of first metatarsal122and a second wire, such as a second k-wire132may be received through a second bore209of bores108to control a rotation of cut guide100. Additional wires may be used to inhibit undesired positional and rotational movement of cut guide100relative to the bones (e.g. medial cuneiform bone121and first metatarsal bone122), including upward drift.

Continuing to refer toFIGS.1, and4-11, if only one k-wire (e.g., k-wire131) is used to connect cut guide100to cut guide100may be used (e.g., rotated about k-wire131) to establish a cut angle, as desired by a surgeon. Cut guide100may be placed at a predetermined position with respect to the peaks and valleys of joint204such that first cut slot101which may guide removal of bone from medial cuneiform bone121removes a minimal amount. Positioning cut guide100may be made to, for example, remove a minimal amount of bone from first metatarsal bone122, as well. A second k-wire (e.g., k-wire132) may be connected to cut guide100(e.g., via second bore209) once a desired angle is established (e.g., as set by a surgeon).

Referring toFIGS.4-7, the position of one hole/bore (e.g., bore209) on cut guide100may be, for example, at an angle relative to a first bore (e.g., bore208). By inserting at least two k-wires (e.g., k-wire131and k-wire132) at angles to each other via bore208and bore209, upward drift of cut guide100may be inhibited or prevented during cutting. A third k-wire (e.g, a k-wire133) may be connected through cut guide100to, for example, a lateral edge of first metatarsal bone122. A final k-wire (e.g., a k-wire134) may be placed into, for example, a medial aspect of first metatarsal bone122, securing the k-wire to second member103.

Still referring toFIGS.7-10, mobile metatarsal cutting portion103may be actuated using, for example, power screw106. Other actuation means may be used to translate mobile metatarsal cutting portion103relative to cut guide body104. By actuating metatarsal adjustment screw106, the metatarsal cutting portion103(e.g., distal metatarsal cutting slot102thereof) of cut guide100is advanced distally. Distal advancement of the medial side of first metatarsal bone122while the lateral side is fixed places a moment on the metatarsal (e.g. first metatarsal bone122), causing an intermetatarsal angle140to decrease. As metatarsal cutting portion103advances distally, both proximal cuneiform cutting slot101, and distal metatarsal cutting slot102remain parallel.

Further referring toFIGS.11-14, once intermetatarsal angle140angle is reduced to a desired angle and first metatarsal bone122is in a desired position, parallel saw cuts can be made using proximal cuneiform cutting slot101and distal metatarsal cutting slot102. Both slots are parallel and are configured (e.g. shaped and dimensioned) to, for example, remove more bone material from the lateral side of cuneiform bone121and the lateral side of first metatarsal bone122. In another example, cut guide100positioning is selected to remove material from medial cuneiform bone121and first metatarsal bone122in parallel configurations with bone removal creating parallel surfaces for bone alignment (i.e. alignment of medial cuneiform bone121and first metatarsal bone122), where such removal is necessary to correct the angle of obliquity. With reference toFIGS.11-14, once the cuts have been made, cut guide100may be removed and the bones (i.e. medial cuneiform bone121and first metatarsal bone122) brought into apposition for placement of hardware. However, cut guide100may remain connected to assist with hardware placement. By removing the k-wire on the lateral edge of first metatarsal bone122, power screw106may, for example, be turned in the opposite direction, advancing mobile metatarsal cutting portion103towards cut guide body104until bones are in apposition and compression is applied.

Continuing to refer toFIGS.11-14, cut guide100establishes the angle of the cuts prior to performing a cut and provides for parallel cuts to the bones (e.g. medial cuneiform bone121and first metatarsal bone122), allowing medial cuneiform bone121and first metatarsal bone122to be set at the desired angle. By establishing the angle prior to performing the cut, joint correction is performed first. By doing so, intermetatarsal angle140is adjusted before the cut, and cut guide100provides for two parallel cuts (e.g. one to medial cuneiform bone121and one to first metatarsal bone122) removing a fixed amount of bone before first metatarsal bone122is fused/connected to medial cuneiform bone121at the adjusted intermetatarsal angle. The bone surfaces after the cut are parallel and may be, for example, approximately flush when fused. Since the bone was adjusted prior to the cut, fusion does not affect the adjusted intermetatarsal angle (e.g., intermetatarsal angle140) and first metatarsal bone122remains positioned at the adjusted intermetatarsal angle.

Although the slots (e.g., cuneiform cutting slot101and distal metatarsal cutting slot102) are described above as being parallel to achieve parallel saw cuts, such slots may be substantially or approximately parallel such that the bone surfaces of the bones (e.g., first metatarsal bone122and medial cuneiform bone121) to be fused are parallel enough after cutting via such slots to allow the fusion of the bones after the desired correction of the intermetatarsal angle (e.g., intermetatarsal angle140).

Cut guide100may be reversed so that the majority of medial bone is removed from the cuneiform bone rather than the metatarsal bone.

In other embodiments, the initial k-wire hole may be a slot to allow for customization of cut depth.

The process of correcting frontal plane rotation occurs prior to placement of distal k-wires.

While this invention has been described with respect to at least one embodiment, the present invention can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains and which fall within the limits of the appended claims.