Alignment guides, cut guides, systems and methods of use and assembly
Guides, systems, and methods for maintaining, correcting and/or fusing joint deformities are disclosed. The guide system including a cut guide, an alignment guide, and at least one directional wire. The cut guide including a base portion, an extension member extending away from a bottom surface of the base portion, and at least one arm extending away from an end of the base portion. The alignment guide, including a base portion, a first extension member extending away from a bottom surface of the base portion in a first direction, and a second extension member extending away from the bottom surface of the base portion in a second direction. Methods of using a guide system for maintaining, correcting and/or fusing joint deformities are also disclosed.
1. A guide system, comprising:
a cut guide;
an alignment guide coupled to the cut guide, wherein the alignment guide comprises:
a base portion;
a first extension member extending away from a bottom surface of the base portion in a first direction, wherein the first extension member comprises:
a first portion with a first end and a second end, wherein the first end is coupled to the base portion;
a second portion with a first end and a second end, wherein the first end of the second portion is coupled to the second end of the first portion; and
a first engagement member with a first end and a second end, wherein the first end of the first engagement member is coupled to the second end of the second portion, and wherein the first engagement member couples to at least one slot of the cut guide; and
a second extension member extending away from the bottom surface of the base portion in a second direction, wherein the second extension member comprises:
a third portion with a first end and a second end, wherein the first end of the third portion is coupled to the base portion;
a fourth portion with a first end and a second end, wherein the first end of the fourth portion is coupled to the second end of the third portion; and
a second engagement member with a first end and a second end, wherein the first end of the second engagement member is coupled to the second end of the fourth portion, and wherein the second engagement member couples to the at least one slot of the cut guide; and
wherein the first extension member and the second extension member form a triangular shape positioned below the base portion of the alignment guide; and
a directional wire engaging a portion of the alignment guide.
2. The guide system of claim 1 , further comprising:
at least one wire for insertion through the cut guide.
3. The guide system of claim 1 , wherein the cut guide comprises:
a base portion;
an extension member extending away from a bottom surface of the base portion; and
at least one arm extending away from an end of the base portion.
4. The guide system of claim 3 , wherein the at least one slot extends between a first side and a second side of the base portion.
5. The guide system of claim 4 , wherein the at least one slot is two slots.
6. The guide system of claim 4 , wherein the at least one slot is four slots.
7. The guide system of claim 4 , wherein the at least one slot is angled as it extends from the second side to the first side of the base portion.
8. The guide system of claim 4 , wherein the at least one slot is angled as it extends from a top surface through the bottom surface of the base portion.
9. The guide system of claim 4 , wherein the base portion further comprises:
a hole extending into the base portion from a top surface.
10. The guide system of claim 9 , wherein the hole extends into the extension member.
11. The guide system of claim 3 , wherein the at least one arm comprises:
a first arm extending away from a first end of the base portion; and
a second arm extending away from a second end of the base portion.
12. The guide system of claim 11 , wherein the first arm comprises:
a first tapered body with a first end coupled to the first end of the base portion and a second end;
a first opening positioned near the second end of the first tapered body; and
a second opening positioned near the second end of the first tapered body and spaced apart from the first opening.
13. The guide system of claim 12 , wherein the first opening extends through the first arm from a top surface through a bottom surface of the first arm and the first opening extends parallel to the extension member; and
wherein the second opening extends through the first arm from the top surface through the bottom surface and the second opening is angled relative to the extension member.
14. The guide system of claim 12 , wherein the second arm comprises:
a second tapered body with a first end coupled to the second end of the base portion and a second end;
a third opening positioned near the second end of the second tapered body; and
a fourth opening positioned near the second end of the second tapered body and spaced apart from the first opening.
15. The guide system of claim 14 , wherein the third opening extends through the second arm from a top surface through a bottom surface of the second arm and the second opening extends parallel to the extension member; and
wherein the fourth opening extends through the second arm from the top surface through the bottom surface and the fourth opening is angled relative to the extension member.
16. The guide system of claim 3 , wherein the base portion further comprises
a recessed region extending into the base portion from the bottom surface toward a top surface of the base portion.
17. The guide system of claim 1 , wherein the base portion of the alignment guide comprises:
at least one opening extending through the base portion from a first end to a second end.
18. The guide system of claim 17 , wherein the directional wire is inserted through an opening of the at least one opening of the alignment guide.
19. The guide system of claim 1 , further comprising:
a position rotation device.
20. A method for using a guide system, comprising:
obtaining a cut guide, wherein the cut guide comprises:
a base portion;
an extension member extending away from a bottom surface of the base portion; and
at least one arm extending away from an end of the base portion;
inserting the extension member into a joint space;
coupling an alignment guide to the cut guide;
inserting a directional wire into at least one opening in the alignment guide;
inserting a first wire into a hole in the cut guide and checking an orientation of the cut guide;
inserting at least two second wires through the at least one arm of the cut guide and into at least one bone;
removing the alignment guide and the first wire;
cutting at least one of a first bone and a second bone using at least one slot of the cut guide;
removing at least one of the at least two second wires from the at least one bone and the cut guide; and
moving the first and second bones to a desired correction.
21. The method of claim 20 , further comprising:
removing resected cartilage and bone from the joint space.
22. The method of claim 21 , wherein moving the first and second bones to the desired correction comprises:
sliding a rotation device over at least one second wire;
repositioning the rotation device to insert a third wire into a zero hole on the rotation device;
adding a fourth wire into an opening corresponding to an angle of correction;
removing a distal medial wire and the rotation device; and
rotating the bones to position the distal medial wire and a proximal medial wire parallel to each other.
23. The method of claim 22 , further comprising:
securing the first and second bones with a plate and at least two screws.
24. The method of claim 20 , wherein the first bone is a first metatarsal and the second bone is a cuneiform.
25. The method of claim 20 , wherein the at least one arm is a first arm with two openings and a second arm with two openings and wherein the at least two second wires is four wires for insertion through the two openings in the first arm and the two openings in the second arm.
26. The method of claim 20 , further comprising:
checking an angle of correction based on a position of the alignment guide and directional wire;
determining the cut guide is at least one of over-correcting or under-correcting;
removing the cut guide from the joint space;
selecting a second cut guide;
inserting an extension member of the second cut guide into the joint space; and
re-checking the angle of correction.
27. The method of claim 20 , further comprising:
inserting a second cut guide after the cut guide and at least one of the at least two second wires are removed from the bone, wherein the second cut guide is inserted over at least one of the at least two second wires remaining in at least one of the first bone and the second bone;
positioning the second cut guide on at least one of the first bone and the second bone, wherein an extension member of the second cut guide is positioned parallel to a cut bone surface; and
making an additional cut to remove additional bone or cartilage from at least one of the first bone and the second bone.
28. The method of claim 20 , wherein cutting at least one of a first bone and a second bone using at least one slot of the cut guide, comprises:
cutting the first bone using a first slot of the cut guide; and
cutting the second bone using a second slot of the cut guide.
29. The method of claim 20 , wherein cutting at least one of a first bone and a second bone using at least one slot of the cut guide, comprises:
cutting the first bone in a dorsal to plantar direction.
30. The method of claim 29 , further comprising:
obtaining a second cut guide, wherein the second cut guide comprises:
a second base portion;
a second extension member extending away from a bottom surface of the second base portion; and
at least one second arm extending away from an end of the second base portion;
inserting the second extension member into the joint space after the cut guide and at least one of the at least two second wires are removed from the first bone, wherein the second cut guide is inserted over at least one of the at least two second wires remaining in at least one of the first bone and the second bone;
inserting at least two third wires through the at least one second arm of the second cut guide and into at least one of the first and second bones;
cutting the second bone using at least one slot of the second cut guide;
removing at least one of the at least two third wires from the at least one of the first and second bones and the second cut guide.
31. The method of claim 20 , wherein inserting at least two second wires through the at least one arm of the cut guide and into at least one bone comprises:
inserting one second wire through a first opening in a first arm of the cut guide; and
inserting another second wire through a second opening in a second arm of the cut guide;
wherein the first opening is parallel to the second opening as the first and second openings extend through the first and second arms from a top surface to a bottom surface.
32. The method of claim 31 , wherein after removal of the cut guide from the first wire and at least one second wire, a second cut guide may be inserted over the first and at least one second wires and aligned on the first and second bones.
33. The method of claim 31 , wherein after removal of the cut guide from the first wire and the at least one second wire, a rotation device may be slid over at least one of the first and the at least one second wires.