Bone positioning and preparing guide systems and methods
Methods for temporarily fixing an orientation of a bone or bones. Methods of correcting a bunion deformity. Bone positioning devices. Methods of using a bone positioning device. Bone preparation guides. Methods of using a bone preparation guide.
1. A method of performing a multi-planar realignment of a metatarsal, the method comprising:
making an incision on a foot to provide access to a tarsal-metatarsal joint;
performing a soft tissue release to mobilize the tarsal-metatarsal joint;
moving a first metatarsal relative to a medial cuneiform in at least two planes, including a frontal plane and a transverse plane, to establish a moved position of the first metatarsal;
after moving the first metatarsal relative to the medial cuneiform, preparing an end of the first metatarsal;
after moving the first metatarsal relative to the medial cuneiform, preparing an end of the medial cuneiform;
fixing the moved position of the first metatarsal relative to the medial cuneiform by inserting a fixation device across the tarsal-metatarsal joint.
2. The method of claim 1 , wherein moving the first metatarsal relative to the medial cuneiform in at least two planes comprises moving the first metatarsal relative to the medial cuneiform in three planes.
3. The method of claim 1 , further comprising, after preparing the end of the first metatarsal and after preparing the end of the medial cuneiform, compressing the first metatarsal together with the medial cuneiform.
4. The method of claim 1 , further comprising, after preparing the end of the first metatarsal and after preparing the end of the medial cuneiform but prior to fixing the moved position of the first metatarsal relative to the medial cuneiform, provisionally fixing the moved position by inserting a fixation wire in the first metatarsal and into a second metatarsal to hold the moved position.
5. The method of claim 1 , wherein the fixation device comprises an intramedullary implant.
6. The method of claim 5 , wherein inserting the fixation device across the tarsal-metatarsal joint comprises inserting the intramedullary implant through the end of the first metatarsal, through the end of the medial cuneiform, and across the tarsal-metatarsal joint.
7. The method of claim 1 , wherein the fixation device comprises a plate, and inserting the fixation device across the tarsal-metatarsal joint comprises screwing the plate to the first metatarsal and screwing the plate to the medial cuneiform.
8. The method of claim 1 , wherein:
preparing the end of the first metatarsal comprises cutting the end of the first metatarsal; and
preparing the end of the medial cuneiform comprises cutting the end of the medial cuneiform.
9. The method of claim 1 , further comprising attaching a bone positioning guide to the first metatarsal and the medial cuneiform.
10. The method of claim 9 , wherein the bone positioning guide comprises a generally C-shaped body.
11. The method of claim 9 , wherein moving the first metatarsal relative to the medial cuneiform comprises moving the first metatarsal relative to the medial cuneiform using the bone positioning guide.
12. The method of claim 1 , wherein moving the first metatarsal relative to the medial cuneiform comprises moving the first metatarsal in the transverse plane by at least reducing an angle between the first metatarsal and a second metatarsal to 10 degrees or less.
13. The method of claim 12 , wherein moving the first metatarsal in the transverse plane comprises reducing the angle between the first metatarsal and the second metatarsal to between about 1 degree and 5 degrees.
14. The method of claim 1 , wherein moving the first metatarsal relative to the medial cuneiform in the frontal plane further comprises rotating a tibial sesamoid bone and a fibular sesamoid bone within the frontal plane.
15. The method of claim 1 , wherein moving the first metatarsal relative to the medial cuneiform in the frontal plane comprises rotating the first metatarsal to a metatarsal rotation ranging from about 0 degrees to 2 degrees.
16. The method of claim 1 , wherein preparing the end of the first metatarsal comprises preparing the end of the first metatarsal after preparing the end of the medial cuneiform.
17. The method of claim 1 , wherein making the incision comprises making the incision on a dorsal side of the foot.
18. A method of performing a multi-planar realignment of a metatarsal, the method comprising:
making an incision on a foot to provide access to a tarsal-metatarsal joint;
performing a soft tissue release to mobilize the tarsal-metatarsal joint;
moving a first metatarsal relative to a medial cuneiform in multiple planes, including a frontal plane, a transverse plane, and a sagittal plane, to establish a moved position of the first metatarsal;
after moving the first metatarsal relative to the medial cuneiform, preparing an end of the first metatarsal;
after moving the first metatarsal relative to the medial cuneiform, preparing an end of the medial cuneiform;
after preparing the end of the first metatarsal and after preparing the end of the medial cuneiform, provisionally fixing the moved position of the first metatarsal relative to the medial cuneiform by inserting a fixation wire in the first metatarsal and into a second metatarsal to hold the moved position; and
after provisionally fixing the moved position, fixing the moved position of the first metatarsal relative to the medial cuneiform by inserting a fixation device across the tarsal-metatarsal joint.
19. The method of claim 18 , further comprising, after preparing the end of the first metatarsal and after preparing the end of the medial cuneiform, compressing the first metatarsal together with the medial cuneiform.
20. The method of claim 18 , wherein:
the fixation device comprises an intramedullary implant, and
inserting the fixation device across the tarsal-metatarsal joint comprises inserting the intramedullary implant through the end of the first metatarsal, through the end of the medial cuneiform, and across the tarsal-metatarsal joint.
21. The method of claim 18 , wherein the fixation device comprises a plate, and inserting the fixation device across the tarsal-metatarsal joint comprises screwing the plate to the first metatarsal and screwing the plate to the medial cuneiform.
22. The method of claim 18 , wherein:
preparing the end of the first metatarsal comprises cutting the end of the first metatarsal; and
preparing the end of the medial cuneiform comprises cutting the end of the medial cuneiform.
23. The method of claim 18 , further comprising attaching a bone positioning guide having a generally C-shaped body to the first metatarsal and the medial cuneiform, wherein moving the first metatarsal relative to the medial cuneiform comprises moving the first metatarsal relative to the medial cuneiform using the bone positioning guide.
24. The method of claim 18 , wherein:
moving the first metatarsal relative to the medial cuneiform comprises moving the first metatarsal in the transverse plane by at least reducing an angle between the first metatarsal and a second metatarsal to between about 1 degree and 5 degrees, and
moving the first metatarsal relative to the medial cuneiform in the frontal plane comprises rotating the first metatarsal to a metatarsal rotation ranging from about 0 degrees to 2 degrees.
25. The method of claim 18 , wherein making the incision comprises making the incision on a dorsal side of the foot.