Independent surgical screw placement system with aiming jig

1 . An independent, surgical screw placement system for a surgical procedure on a foot joint, the system comprising:

a surgical plate sized to extend over the foot joint, the plate having upper and lower surfaces and a plurality of screw holes extending therethrough at spaced locations on the plate;

a plurality of joint screws adapted to be received in the screw holes and secured to the foot joint at corresponding joint locations, the screws defining respective, nominal trajectories in the foot joint;

an aiming jig removably securable to the plate, the aiming jig adapted to be adjustable to a user-selectable trajectory for an independent screw that does not cross the nominal trajectories of the joint screws, wherein the aiming jig comprises an arm having a first end located at the plate, the arm extending from the plate to a second end, the second end terminating in a housing and the user-selectable trajectory of the independent screw is characterized by multiple, angular parameters relative to the plate; and

a connector disposed between the plate and the aiming jig, the connector keyed to fix an angular orientation of the aiming jig relative to the plate and comprising a pilot pin mateable with an opposing pilot hole and a threadable connection disposed at the first end of the arm operable to secure the aiming jig relative to the plate upon mating of the pilot pin and the pilot hole,

wherein the arm includes first and second telescoping portions, the telescoping portions located and extending between the first and second ends of the arm, the telescoping portions being selectively moveable and fixable to locate the housing at a user-selectable angle relative to the plate, the user-selectable angle constituting one of the parameters of the user-selectable trajectory of the independent screw,

wherein the first telescoping portion comprises a longitudinally extending rail with a longitudinally extending slot defined therein, the second telescoping portion defining a tongue slidably received in the slot;

wherein the rail has a plurality of longitudinally spaced detents defined adjacent the slot; and

wherein the tongue includes a user-actuatable button, the button having a first position engaging a selected one of the detents to fix the rail and tongue relative to each other, the button having a second position disengaged from the detents to telescope the telescoping portions relative to each other.

2 . The system of claim 1 , wherein the telescoping portions comprise arcuate portions extending medially from the connector.

3 . The system of claim 2 , wherein the rail and the slot are located on one of the arcuate portions, and wherein the tongue and the user-actuatable button are located on the other of the arcuate portions to telescope the second end of the arm through a range of angular positions relative to a reference plane of the plate;

wherein the slot extends sufficiently for the range of angular positions to extend from 60° to 120° relative to the reference plane associated with the plate.

4 . The system of claim 1 ,

wherein the housing comprises distal and proximal sides, the distal side located to be opposing and in operative proximity to a foot associated with the foot joint when undergoing the procedure, the proximal side located to be user-accessible during the procedure;

wherein the housing further comprises at least one housing aperture extending through the sides;

wherein the aiming jig further comprises a k-wire tube removably receivable through the housing aperture, the k-wire tube having a longitudinally extending k-wire bore sized to receive a k-wire therethrough.

5 . The system of claim 4 , wherein the k-wire tube is selectively slidable proximally and distally to a desired position relative to the housing, and wherein the aiming jig includes a locking mechanism to fix the k-wire tube at the desired position.

6 . The system of claim 5 ;

wherein the locking mechanism comprises a longitudinally extending cut-out defined in an outer surface of the k-wire tube, the locking mechanism further including a shoulder defined in the k-wire bore, and a handle disposed at a proximal end of the k-wire tube, the handle connected to the k-wire tube so that rotation of the handle causes rotation of the cut-out within the bore relative to the shoulder;

wherein sufficient rotation of the handle relative to the shoulder selectively locks and unlocks the k-wire tube at the desired position, the handle further having a portion indicating whether the corresponding k-wire tube is in the locked or unlocked position.

7 . The system of claim 4 , further comprising three of the housing apertures, each of the housing apertures having respective central axes, the axes angled relative to each other to define a convergence point spaced from the housing distally, the housing locatable relative to the foot of the foot joint so that the convergence point corresponds to the distal end of the independent screw after insertion into the foot joint during the procedure.

8 . The system of claim 1 ,

wherein the surgical plate comprises a dorsal plate adapted to be secured to and extend over a first tarsometatarsal joint in association with a Lisfranc injury repair procedure, the dorsal plate having a distal surface capable of being brought against the foot joint during the procedure and a proximal surface opposite the distal surface and adapted to face away from the foot joint when secured to the foot joint;

wherein the aiming jig is adapted to locate the housing on a medial side of the foot joint and the aiming jig is adapted to have the user-selectable trajectory originate from the medial side.

9 . The system of claim 8 , wherein the screw holes extend anteriorly, and wherein the aiming jig is removably securable to at least one location on the dorsal plate posterior to at least one of the screw holes.

10 . The system of claim 9 , wherein the arm of the aiming jig comprises an arm tube at the first end of the arm and a post shaft movably received within the arm tube;

wherein the arm tube and the post shaft have respective proximal and distal ends and are co-axial about a longitudinal, arm-tube axis;

wherein the threadable connection comprises a threaded shaft disposed at the distal end of the post shaft and extending longitudinally therefrom, the threadable connection further comprising a corresponding threaded bore formed in the dorsal plate at a location posterior to multiple ones of the screw holes;

wherein the pilot pin is disposed on the distal end of the arm tube and extends longitudinally and distally from the arm tube;

wherein the pilot hole is formed on the proximal surface of the dorsal plate adjacent to the threaded bore of the threadable connection;

wherein the pilot pin and the threaded shaft extend parallel to each other, whereby the arm tube extends orthogonally from the proximal surface of the dorsal plate when secured thereto;

wherein the telescoping portions of the arm extend radially and arcuately outwardly from the arm-tube longitudinal axis when connected to the plate;

wherein the relative location of the threaded bore in the dorsal plate and the pilot hole in the dorsal plate determines an angular orientation of the arm of the aiming jig relative to the plate.

11 . The system of claim 10 , further comprising a user-actuatable post handle connected to the proximal end of the post shaft to screw the threaded shaft of the post shaft into the threaded bore of the plate.