Techniques for performing an osteotomy procedure on bone to correct a bone misalignment
Devices and techniques for adjusting an alignment for a first metatarsal may include making a plurality of cuts along the length of the first metatarsal. In different applications of the technique, a plurality of transverse cuts may or may not be made intersecting the longitudinal cuts. In either case, the cuts can separate the first metatarsal into two individual portions and release a removable wedge of bone. The different portions of the metatarsal can be moved relative to each other to adjust an anatomical alignment of one portion relative to another portion, for example in multiple planes. After suitably adjusting the alignment of the different bone portions, the portions can be fixed together.
1. A method comprising:
attaching a bone cutting guide having a body defining a longitudinal cutting slot to a bone;
making a first longitudinal cut through the bone between a proximal end of the bone and a distal end of the bone using the bone cutting guide;
making a second longitudinal cut between the proximal end of the bone and the distal end of the bone using the bone cutting guide, wherein the second longitudinal cut is radially offset from the first longitudinal cut and intersects the first longitudinal cut;
making a transverse cut adjacent the proximal end of the bone that intersects the first longitudinal cut and the second longitudinal cut;
making a transverse cut adjacent the distal end of the bone that intersects the first longitudinal cut and the second longitudinal cut;
removing a bone wedge from the bone; and
moving a distal portion of the bone relative to a proximal portion of the bone in at least two planes, thereby adjusting an anatomical alignment of the distal portion of the bone relative to the proximal portion of the bone.
2. The method of claim 1 , wherein the second longitudinal cut is radially offset from the first longitudinal cut from 10 degrees to 50 degrees.
3. The method of claim 1 , wherein making the first longitudinal cut and making the second longitudinal cut comprises making the second longitudinal cut prior to making the first longitudinal cut.
4. The method of claim 1 , wherein attaching the bone cutting guide to the bone comprises inserting a fixation member through at least one fixation aperture defined by the body.
5. The method of claim 1 , wherein
making the first longitudinal cut through the bone comprises making the first longitudinal cut from a medial side of the bone; and
making the second longitudinal cut through the bone comprises making the second longitudinal cut from the medial side of the bone.
6. The method of claim 1 , wherein moving the distal portion of the bone relative to the proximal portion of the bone comprises rotating the distal portion of the bone in a frontal plane.
7. The method of claim 6 , wherein the bone is a metatarsal, and rotating the distal portion of the bone in the frontal plane comprises rotating the distal portion until a tibial sesamoid bone and a fibular sesamoid bone are on opposite sides of a sagittal plane when viewed from the frontal plane.
8. The method of claim 1 , further comprising, subsequent to moving the distal portion relative to the proximal portion, fixing the distal portion with respect to the proximal portion.
9. The method of claim 8 , wherein fixing the distal portion with respect to the proximal portion comprises applying at least one of a bone plate, a pin, a screw, and a staple across a joint separating the distal portion from the proximal portion.
10. The method of claim 1 ,
wherein removing the bone wedge from the bone comprises opening a gap in the bone, and
moving the distal portion of the bone relative to the proximal portion of the bone in at least two planes comprises closing the gap and opening a second gap, and
further comprising inserting a bone member into the second gap.
11. The method of claim 10 , wherein the bone member is selected from the group consisting of the bone wedge removed from the bone, an allograft, a xenograft, and synthetic bone.
12. The method of claim 10 , wherein the second gap is on an opposite side of the bone from the gap.
13. A method comprising:
making a first longitudinal cut through a bone extending from a proximal end of the bone to a distal end of the bone using a bone cutting guide having a longitudinal slot;
making a second longitudinal cut extending from the proximal end of the bone to the distal end of the bone using the bone cutting guide, wherein the second longitudinal cut is radially offset from the first longitudinal cut and intersects the first longitudinal cut, thereby separating the bone into a first portion, a second portion, and a bone wedge;
removing the bone wedge from the bone; and
moving the first portion of the bone relative to the second portion of the bone, thereby adjusting an anatomical alignment of the first portion of the bone relative to the second portion of the bone.
14. The method of claim 13 , wherein the second longitudinal cut is radially offset from the first longitudinal cut from 10 degrees to 50 degrees.
15. The method of claim 13 , wherein the first portion comprises a dorsal portion of the bone and the second portion comprises a plantar portion of the bone.
16. The method of claim 13 , wherein moving the first portion of the bone relative to the second portion of the bone comprises rotating the first portion in a frontal plane.
17. The method of claim 13 , wherein moving the first portion of the bone relative to the second portion of the bone comprises moving the first portion relative to the second portion in at least two planes.
18. The method of claim 13 ,
wherein removing the bone wedge from the bone comprises opening a gap in the bone, and
moving the first portion of the bone relative to the second portion of the bone comprises closing the gap and opening a second gap, and
further comprising inserting a bone member into the second gap.
19. The method of claim 18 , wherein the bone member is selected from the group consisting of the bone wedge removed from the bone, an allograft, a xenograft, and synthetic bone.