Small bone fixation systems and techniques with guide sleeve

1 . A method of fixating bones for fusion, the method comprising:

positioning an implant guide sleeve at a first bone and a second bone and across a separation between the first bone and the second bone;

using the implant guide sleeve to guide creation of a first implant hole in the first bone and to guide creation of a second implant hole in the second bone;

aligning an inserter, operatively connected to a portion of an implant comprising a bridge, with the implant guide sleeve; and

advancing the inserter, relative to the implant guide sleeve, to position the implant in contact with the first bone and the second bone with the implant bridging between the first bone and the second bone.

2 . The method of claim 1 , further comprising fixating the implant guide sleeve to each of the first bone and the second bone,

wherein the implant guide sleeve is fixated to each of the first bone and the second bone prior to advancing the inserter, relative to the implant guide sleeve, to position the implant,

wherein fixating the implant guide sleeve to the first bone comprises inserting a first pin through a first pin aperture at the implant guide sleeve and into the first bone, and

wherein fixating the implant guide sleeve to the second bone comprises inserting a second pin through a second pin aperture at the implant guide sleeve and into the second bone.

3 . The method of claim 1 ,

wherein the implant guide sleeve includes a first end portion bottom surface, a second end portion bottom surface that is spaced apart from the first end portion bottom surface, a first end portion top surface that is aligned with the first end portion bottom surface, and a second end portion top surface that is aligned with the second end portion bottom surface and spaced apart from the first end portion top surface,

wherein positioning the implant guide sleeve at the first bone and the second bone comprises contacting the first bone with the first end portion bottom surface of the implant guide sleeve and contacting the second bone with the second end portion bottom surface of the implant guide sleeve, and

wherein advancing the inserter, relative to the implant guide sleeve, comprises advancing the implant and the inserter between the first end portion top surface and the second end portion top surface and toward the first end portion bottom surface and the second end portion bottom surface such that the implant is adjacent the first end portion bottom surface and the second end portion bottom surface when the implant is in contact with the first bone and the second bone with the implant bridging between the first bone and the second bone.

4 . The method of claim 1 , wherein advancing the inserter, relative to the implant guide sleeve, to position the implant in contact with the first bone and the second bone with the implant bridging between the first bone and the second bone comprises advancing the inserter, relative to the implant guide sleeve, to position the implant in the first implant hole in the first bone, in the second implant hole in the second bone, and across the separation.

5 . The method of claim 1 ,

wherein using the implant guide sleeve to guide creation of the first implant hole in the first bone and to guide creation of the second implant hole in the second bone comprises inserting a drill guide relative to the implant guide sleeve and drilling the first implant hole in the first bone and the second implant hole in the second bone through the drill guide inserted into the implant guide sleeve, and

wherein the implant guide sleeve has at least one sidewall defining an interior area, and the drill guide defines an outer perimeter size and shape indexed to the interior area of the implant guide sleeve.

6 . The method of claim 1 , further comprising adjusting a size of the implant guide sleeve between a first size configuration and a second size configuration.

7 . The method of claim 6 , wherein the first size configuration of the implant guide sleeve defines a first interior cross-sectional area bound by the implant guide sleeve, and the second size configuration of the implant guide sleeve defines a second interior cross-sectional area bound by the implant guide sleeve, the second interior cross-sectional area being larger than the first interior cross-sectional area.

8 . The method of claim 7 , further comprising:

prior to positioning the implant guide sleeve at the first bone, the second bone, and across the separation, inserting the implant guide sleeve, in the first size configuration, through an incision that exposes at least a portion of each of the first bone, the second bone, and the separation; and

after inserting the implant guide sleeve, in the first size configuration, through the incision, adjusting the size of the implant guide sleeve from the first size configuration to the second size configuration,

wherein the implant guide sleeve is adjusted from the first size configuration to the second size configuration before advancing the inserter relative to the guide sleeve.

9 . The method of claim 8 , further comprising fixating the implant guide sleeve to each of the first bone and the second bone after adjusting the implant guide sleeve from first size configuration to the second size configuration and before advancing relative to the guide sleeve.

10 . The method of claim 6 , wherein the implant guide sleeve includes a first guide arm and a second guide arm, and adjusting the size of the implant guide sleeve between the first size configuration and the second size configuration comprises rotating the first guide arm and rotating the second guide arm.

11 . The method of claim 1 ,

wherein the implant is a staple comprising a first leg and a second leg separated from each other by the bridge, and

wherein advancing the inserter, relative to the implant guide sleeve, to position the implant in contact with the first bone and the second bone comprises positioning the first leg of the staple in the first implant hole in the first bone and positioning the second leg of the staple in the second implant hole in the second bone.

12 . The method of claim 1 , wherein:

the inserter comprises a first coupling shaft connected to a first side of the implant, a second coupling shaft connected to a second side of the implant, and a connector;

the first coupling shaft and the second coupling shaft are biased toward each other to apply a load force to the implant; and

the connector joins the first coupling shaft and the second coupling shaft.

13 . The method of claim 12 , further comprising, after advancing the inserter, relative to the implant guide sleeve, to position the implant in contact with the first bone and the second bone, removing the connector, thereby causing the first coupling shaft and the second coupling shaft to move away from each other.

14 . The method of claim 1 , wherein first bone is a metatarsal, the second bone is a cuneiform, and the separation is a tarsometatarsal joint space between the metatarsal and the cuneiform.

15 . The method of claim 1 , wherein first bone is a metatarsal, the second bone is a proximal phalanx, and the separation is a metatarsophalangeal joint space between the metatarsal and the proximal phalanx.