Bone cutting guide systems and methods
A method of correcting an alignment between bones of a foot may involve positioning a first cutting slot of a bone cutting guide over a first metatarsal and inserting a first fixation pin through a first fixation aperture of the bone cutting guide and into the first metatarsal. The method may also involve inserting a cutting member through the first cutting slot to remove a portion of the first metatarsal and adjusting an alignment of the first metatarsal relative to a first cuneiform. In some examples, the method further includes positioning a second cutting slot of the bone cutting guide over the first cuneiform and inserting a second fixation pin through a second fixation aperture of bone cutting guide into the first cuneiform. The method can involve inserting a cutting member through the second cutting slot to remove a portion of the first cuneiform and causing the first metatarsal to fuse to the first cuneiform in the moved position.
1. A method comprising:
attaching a bone preparation guide to a metatarsal by inserting at least one metatarsal-side fixation pin through a metatarsal-side fixation pin aperture of the bone preparation guide and into the metatarsal;
attaching the bone preparation guide to a cuneiform opposite the metatarsal by inserting at least one cuneiform-side fixation pin through a cuneiform-side fixation pin aperture of the bone preparation guide and into the cuneiform, wherein inserting the at least one cuneiform-side fixation pin comprises inserting the at least one cuneiform-side fixation pin parallel to the at least one metatarsal-side fixation pin;
inserting a cutting member through a cutting slot of the bone preparation guide to cut at least one of an end portion of the metatarsal and an end portion of the cuneiform;
sliding the bone preparation guide off the at least one metatarsal-side fixation pin and off the at least one cuneiform-side fixation pin; and
applying a force to compress the metatarsal-side fixation pin and the cuneiform-side together, thereby compressing the metatarsal and the opposing cuneiform together.
2. The method of claim 1 , wherein inserting at least one metatarsal-side fixation pin through the metatarsal-side fixation pin aperture of the bone preparation guide comprises inserting a first metatarsal-side fixation pin through a first metatarsal-side fixation pin aperture and inserting a second metatarsal-side fixation pin through a second metatarsal-side fixation pin aperture.
3. The method of claim 2 , wherein the first metatarsal-side fixation pin aperture is positioned distally along a length of the metatarsal from the second metatarsal-side fixation pin aperture.
4. The method of claim 1 , wherein inserting at least one cuneiform-side fixation pin through the cuneiform-side fixation pin aperture comprises inserting a first cuneiform-side fixation pin through a first cuneiform-side fixation pin aperture and inserting a second cuneiform-side fixation pin through a second cuneiform-side fixation pin aperture.
5. The method of claim 4 , wherein the second cuneiform-side fixation pin aperture is positioned distally along the length of the cuneiform from the first cuneiform-side fixation pin aperture.
6. The method of claim 4 , wherein the first cuneiform-side fixation pin aperture and the second cuneiform-side fixation pin aperture are spaced in a medial-to-lateral direction from each other.
7. The method of claim 1 , wherein:
inserting the at least one metatarsal-side fixation pin comprises inserting the at least one metatarsal-side fixation pin parallel to an end face of the metatarsal to be cut; and
inserting the at least one cuneiform-side fixation pin comprises inserting the at least one cuneiform-side fixation pin parallel to an end face of the cuneiform to be cut.
8. The method of claim 1 , wherein:
inserting the at least one metatarsal-side fixation pin comprises inserting the at least one metatarsal-side fixation pin extending in a dorsal-to-plantar direction, and
inserting the at least one cuneiform-side fixation pin comprises inserting the at least one cuneiform-side fixation pin extending in the dorsal-to-plantar direction.
9. The method of claim 1 , further comprising, after sliding the bone preparation guide off the at least one metatarsal-side fixation pin and off the at least one cuneiform-side fixation pin, and prior to applying the force to compress the metatarsal-side fixation pin and the cuneiform-side together, removing cut bone from between the metatarsal and the cuneiform.
10. The method of claim 1 , further comprising, prior to applying the force to compress the metatarsal-side fixation pin and the cuneiform-side together, applying an autograft or other compound between the metatarsal and the cuneiform.
11. The method of claim 1 , further comprising, prior to attaching the bone preparation guide to the metatarsal and the cuneiform, positioning the bone preparation guide on a dorsal side of the metatarsal.
12. The method of claim 1 , further comprising sliding the bone preparation guide back over the at least one metatarsal-side fixation pin and back over the at least one cuneiform-side fixation pin, wherein applying the force to compress the metatarsal-side fixation pin and the cuneiform-side together comprises applying the force using the bone preparation guide.
13. The method of claim 1 , further comprising:
adjusting an alignment of the metatarsal relative to the cuneiform prior to compressing the metatarsal and the cuneiform together, and
after adjusting the alignment of the metatarsal relative to the cuneiform and after compressing the metatarsal and the cuneiform together, causing the metatarsal to fuse to the cuneiform in the moved position.
14. The method of claim 13 , wherein causing the metatarsal to fuse to the cuneiform comprises applying a bone plate across a joint separating the cuneiform from the metatarsal.
15. The method of claim 14 , wherein the bone plate comprises a first bone plate, and further comprising applying a second bone plate across the joint.
16. The method of claim 15 , wherein applying the first bone plate comprises applying the first bone plate on a dorsal side of the metatarsal and the cuneiform, and applying the second bone plate comprises applying the second bone plate on a medial side of the metatarsal and the cuneiform.
17. The method of claim 1 , wherein inserting the cutting member through the cutting slot of the bone preparation guide to cut at least one of the end portion of the metatarsal and the end portion of the cuneiform comprises inserting the cutting member through the cutting slot of the bone preparation guide to cut the end portion of the metatarsal.
18. The method of claim 17 , further comprising, after inserting the cutting member through the cutting slot of the bone preparation guide to cut the end portion of the metatarsal, repositioning the cutting slot over the cuneiform and inserting the cutting member through the cutting slot of the bone preparation guide to cut the end portion of the cuneiform.
19. The method of claim 18 , wherein inserting at least one cuneiform-side fixation pin through the cuneiform-side fixation pin aperture of the bone preparation guide comprises inserting at least one cuneiform-side fixation pin through the cuneiform-side fixation pin aperture of the bone preparation guide after repositioning the cutting slot over the cuneiform.
20. The method of claim 1 , wherein the cutting slot comprises a first cutting slot and a second cutting slot, wherein inserting the cutting member through the cutting slot of the bone preparation guide to cut at least one of the end portion of the metatarsal and the end portion of the opposing cuneiform comprises:
inserting the cutting member through the first cutting slot of the bone preparation guide to cut one of the end portion of metatarsal and the end portion of the cuneiform, and
inserting the cutting member through the second cutting slot of the bone preparation guide to cut an other of the end portion of the metatarsal and the end portion of the cuneiform.
21. The method of claim 1 , wherein the bone cutting guide comprises a first guide surface defining a first plane and a second guide surface defining a second plane, with the cutting slot being provided between the first plane and the second plane.
22. The method of claim 1 , wherein the metatarsal is a first metatarsal and the cuneiform is a first cuneiform.
23. The method of claim 1 , wherein:
inserting at least one metatarsal-side fixation pin through the metatarsal-side fixation pin aperture of the bone preparation guide comprises inserting a first metatarsal-side fixation pin through a first metatarsal-side fixation pin aperture and inserting a second metatarsal-side fixation pin through a second metatarsal-side fixation pin aperture, the first metatarsal-side fixation pin aperture being positioned distally along a length of the metatarsal from the second metatarsal-side fixation pin aperture; and
inserting at least one cuneiform-side fixation pin through the cuneiform-side fixation pin aperture comprises inserting a first cuneiform-side fixation pin through a first cuneiform-side fixation pin aperture and inserting a second cuneiform-side fixation pin through a second cuneiform-side fixation pin aperture, the second cuneiform-side fixation pin aperture being positioned distally along the length of the cuneiform from the first cuneiform-side fixation pin aperture.
24. The method of claim 23 , wherein:
inserting the cutting member through the cutting slot of the bone preparation guide to cut at least one of the end portion of the metatarsal and the end portion of the cuneiform comprises inserting the cutting member through the cutting slot of the bone preparation guide to cut the end portion of the metatarsal, and
after inserting the cutting member through the cutting slot of the bone preparation guide to cut the end portion of the metatarsal, repositioning the cutting slot over the cuneiform and inserting the cutting member through the cutting slot of the bone preparation guide to cut the end portion of the cuneiform.
25. The method of claim 24 , wherein inserting the first cuneiform-side fixation pin through the first cuneiform-side fixation pin aperture and inserting the second cuneiform-side fixation pin through the second cuneiform-side fixation pin aperture comprises inserting the first cuneiform-side fixation pin through the first cuneiform-side fixation pin aperture and inserting the second cuneiform-side fixation pin through the second cuneiform-side fixation pin aperture after repositioning the cutting slot over the cuneiform.