Bone positioning guide
A bone positioning guide may include a main body member, a shaft, and a bone engagement member. The shaft can be movably connected to the main body member and have the bone engagement member rotatably coupled to its distal end. The bone engagement member can have a surface configured to engage a bone. The main body member can also include a tip opposite the bone engagement member for engaging a second bone. In use, the bone engagement member may be positioned in contact with a medial side of a first metatarsal while the tip is positioned in contact with a lateral side of a different metatarsal, such as a second metatarsal. The shaft can then be moved to advance the bone engagement member toward the tip, causing realignment of the first metatarsal.
1. A method of correcting a position of a first metatarsal, the method comprising:
providing a bone positioning guide comprising a bone engagement member on an end of a shaft and a tip opposite the bone engagement member, the bone engagement member being separated from the tip by a distance;
making an incision to access an intermetatarsal space between a second metatarsal and a third metatarsal;
positioning the bone engagement member on a medial side of the first metatarsal;
positioning the tip through the incision and into the intermetatarsal space between the second metatarsal and the third metatarsal;
engaging the bone positioning guide to reduce the distance between the bone engagement member and the tip, thereby causing the first metatarsal to move in at least a transverse plane to reduce an intermetatarsal angle between the first metatarsal and the second metatarsal; and
fixating a moved position of the first metatarsal using at least one bone fixation device.
2. The method of claim 1 , wherein moving the first metatarsal in the transverse plane comprises reducing the intermetatarsal angle between the first metatarsal and the second metatarsal to between about 1 to 5 degrees.
3. The method of claim 1 , wherein:
the bone positioning guide comprises a stop configured to limit a depth of insertion of the tip relative to the second metatarsal.
4. The method of claim 3 , wherein:
the tip defines a surface configured to contact a lateral side of the second metatarsal, and
the stop provides a dorsal contact surface configured to contact a dorsal portion of the second metatarsal.
5. The method of claim 1 , further comprising:
preparing an end of the first metatarsal; and
preparing an end of a medial cuneiform separated from the first metatarsal by a tarsometatarsal joint.
6. The method of claim 5 , wherein
preparing the end of the first metatarsal comprises preparing the end of the first metatarsal before moving the first metatarsal in the transverse plane, and
preparing the end of the medial cuneiform comprises preparing the end of the medial cuneiform after moving the first metatarsal in the transverse plane.
7. The method of claim 1 , further comprising, prior to fixating the moved position of the first metatarsal, moving the first metatarsal in a frontal plane to adjust a frontal plane position of the first metatarsal.
8. The method of claim 7 , wherein moving the first metatarsal in the frontal plane comprises inserting a pin into the first metatarsal and moving the pin to move the first metatarsal in the frontal plane.
9. The method of claim 1 , wherein the bone engagement member comprises a cannulation, and further comprising inserting a fixation wire through the cannulation of the bone engagement member and into the first metatarsal.
10. The method of claim 1 , wherein the shaft is threaded.
11. The method of claim 10 , wherein the bone positioning guide comprises a knob rotatable to turn the treaded shaft, and engaging the bone positioning guide to reduce the distance between the bone engagement member and the tip comprises rotating the knob.
12. The method of claim 1 , wherein the bone engagement member defines a concave surface facing the medial side of the first metatarsal.
13. The method of claim 12 , wherein the tip defines a curved shape facing a lateral side of the second metatarsal.
14. The method of claim 1 , wherein the bone positioning guide is fabricated from at least two components joined together.
15. The method of claim 1 , further comprising provisionally fixating the moved position of the first metatarsal.
16. The method of claim 15 , wherein provisionally fixating the moved position of the first metatarsal comprises inserting a pin through the first metatarsal and into a medial cuneiform.
17. The method of claim 1 , wherein the at least one bone fixation device comprises a least one of a pin, a screw, a plate, and a staple.
18. The method of claim 17 , wherein the at least one bone fixation device comprises a plate and a staple.
19. The method of claim 1 , further comprising, prior to fixating the moved position of the first metatarsal, compressing an end of the first metatarsal and an end of a medial cuneiform separated from the first metatarsal by a tarsometatarsal joint together.