Granted Patent B2

US 11,304,735 · App. 17/178,109 · Granted Apr 19, 2022

Inventors: Daniel Sayger (Southaven, MS); Michael Chad Hollis (Collierville, TN); Craig Squires (Cordova, TN)

Assignee: CrossRoads Extremity Systems, LLC

A61B17/7291A61B17/7225A61B17/7283

Abstract

Claims (123)

1. A method of correcting a bunion, the method comprising:

inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;

excising the first TMT joint of the foot, the excising comprising:

cutting a base of the first metatarsal proximate the first TMT joint; and

cutting a base of a first cuneiform of the foot proximate the first TMT joint;

inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform; and

fixing the first TMT joint, wherein the first TMT joint is fixed using a bone plate and a plurality of bone screws, and wherein at least one of the plurality of bone screws is a cross screw extending at an angle of less than 90 degrees relative to the bone plate.

2. The method of claim 1 , wherein the cross screw extends through the bone plate, the first metatarsal, and at least a portion of a second metatarsal of the foot or a second cuneiform of the foot.

3. The method of claim 1 , further comprising placing a staple through the bone plate such that a first leg of the staple is seated within the first cuneiform and a second leg of the staple is seated within the first metatarsal.

4. The method of claim 3 , wherein the bone plate comprises a cross screw aperture shaped to guide placement of the cross screw such that the second leg of the staple does not impede placement of the cross screw.

5. The method of claim 1 , wherein the plurality of metatarsal pins are inserted prior to excising the first TMT joint.

6. The method of claim 1 , wherein the plurality of cuneiform pins are inserted prior to cutting the base of the first cuneiform.

7. The method of claim 1 , further comprising placing a reversible cut guide across a dorsal side of the first TMT joint prior to inserting the plurality of metatarsal pins and the plurality of cuneiform pins, the reversible cut guide comprising:

a body;

a plurality of first pin holes extending parallel through the body;

a plurality of second pin holes extending through the body parallel to the proximal pin holes;

a joint-seeking paddle extending downward from the body between the proximal pin holes and the distal pin holes such that, when the joint-seeking paddle is at least partially disposed within the first TMT joint, the first pin holes define the first predetermined spacing relative to the first TMT joint; and

a slot extending through the body parallel to a plane of the joint-seeking paddle such that the slot defines a cutting plane for cutting the base of the first metatarsal or the base of the first cuneiform.

8. The method of claim 7 , wherein the base of the first metatarsal and the base of the first cuneiform are cut through the slot, the method further comprising, after cutting the base of the first metatarsal and prior to cutting the base of the first cuneiform:

removing the reversible cut guide from the first TMT joint; and

placing the reversible cut guide across the dorsal side of the first TMT joint in a reversed orientation such that the slot defines a cutting plane for cutting the base of the first cuneiform.

9. The method of claim 1 , further comprising, prior to fixing the first TMT joint, re-cutting the base of the first metatarsal or the base of the first cuneiform to remove additional tissue.

10. The method of claim 1 , further comprising, prior to fixing the first TMT joint, performing a frontal plane realignment comprising additional rotation within the frontal plane of the first metatarsal.

11. A method of correcting a bunion, the method comprising:

inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;

excising the first TMT joint of the foot, the excising comprising:

cutting a base of the first metatarsal proximate the first TMT joint; and

cutting a base of a first cuneiform of the foot proximate the first TMT joint;

inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform; and

fixing the first TMT joint,

the method further comprising placing a cut guide across a dorsal side of the first TMT joint prior to inserting the plurality of metatarsal pins and the plurality of cuneiform pins, the cut guide comprising:

a body;

a plurality of proximal pin holes extending parallel through the body;

a plurality of distal pin holes extending through the body parallel to the proximal pin holes; and

a joint-seeking paddle extending downward from the body between the proximal pin holes and the distal pin holes such that, when the joint-seeking paddle is at least partially disposed within the first TMT joint, the distal pin holes define the first predetermined spacing relative to the first TMT joint and the proximal pin holes define the second predetermined spacing relative to the first TMT joint.

12. The method of claim 11 , wherein the cut guide further comprises a proximal slot extending through the body and a distal slot extending through the body on an opposite side of the joint-seeking paddle relative to the proximal slot, such that the distal slot defines a cutting plane for cutting the base of the first metatarsal and the proximal slot defines a cutting plane for cutting the base of the first cuneiform.

13. A method of correcting a bunion, the method comprising:

inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;

excising the first TMT joint of the foot, the excising comprising:

cutting a base of the first metatarsal proximate the first TMT joint; and

cutting a base of a first cuneiform of the foot proximate the first TMT joint;

inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform; and

fixing the first TMT joint,

the method further comprising, prior to compressing the first TMT joint:

adjusting an alignment of the first metatarsal within a frontal plane of the foot using a control handle coupled to the plurality of metatarsal pins; and

adjusting an alignment of the first metatarsal within a transverse plane of the foot using a linear reducer comprising a medial hook disposed on a medial side of the first metatarsal and a lateral hook disposed on a lateral side of a second metatarsal of the foot, the lateral hook having an adjustable spacing relative to the medial hook.

14. The method of claim 13 , further comprising inserting a medial hook pin through an aperture of the medial hook and into the first metatarsal to rotationally fix the first metatarsal relative to the medial hook prior to adjusting the alignment of the first metatarsal within the transverse plane.

15. The method of claim 13 , wherein at least one of the medial hook and the lateral hook comprises a radiolucent material.

16. The method of claim 13 , wherein the control handle comprises a handle portion and an engagement portion, the engagement portion comprising a plurality of pin apertures spaced apart at a same spacing as a distance between the metatarsal pins.

17. The method of claim 16 , wherein adjusting the alignment of the first metatarsal within the frontal plane comprises:

sliding the pin apertures over the metatarsal pins such that the engagement portion is proximate the first metatarsal; and

rotating the first metatarsal about a longitudinal axis of the first metatarsal by applying torque to the control handle.

18. The method of claim 13 , wherein adjusting the alignment of the first metatarsal within the transverse plane comprises reducing the adjustable spacing between the lateral hook and the medial hook to bring a distal end of the first metatarsal closer to the second metatarsal.

19. The method of claim 18 , wherein the transverse plane alignment of the first metatarsal is adjusted while the first metatarsal is rotationally fixed relative to the medial hook of the linear reducer.

20. The method of claim 13 , wherein the plurality of cuneiform pins are inserted subsequent to adjusting the alignment of the first metatarsal in the frontal plane and the transverse plane.

21. A method of correcting a bunion, the method comprising:

inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;

excising the first TMT joint of the foot, the excising comprising:

cutting a base of the first metatarsal proximate the first TMT joint; and

cutting a base of a first cuneiform of the foot proximate the first TMT joint;

inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform; and

fixing the first TMT joint,

wherein the compressor block comprises:

a body comprising a top surface and a bottom surface;

a plurality of proximal pin holes extending through the body from the top surface to the bottom surface at a first angle of less than 90 degrees relative to the top surface and the bottom surface; and

a plurality of distal pin holes extending through the body from the top surface to the bottom surface at the first angle relative to top surface and the bottom surface such that the proximal and distal pin holes are more closely spaced at the bottom surface relative to the top surface.

22. The method of claim 21 , wherein compressing the first TMT joint comprises:

inserting the cuneiform pins into the proximal pin holes at the bottom surface;

inserting the metatarsal pins into the distal pin holes at the bottom surface; and

sliding the compressor block along the cuneiform pins and the metatarsal pins toward the first TMT joint.

23. The method of claim 21 , wherein the compressor block further comprises at least one cross pin hole extending therethrough, each of the at least one cross pin holes defining a linear path passing diagonally through the first TMT joint when the compressor block is aligned proximate the first TMT joint on the cuneiform pins and the metatarsal pins.

24. The method of claim 23 , further comprising, after compressing the first TMT joint:

inserting a cross pin through the at least one cross pin hole to temporarily fix the first TMT joint;

removing the cuneiform pins and the metatarsal pins from the foot; and

removing the compressor block by sliding the compressor block away from the first TMT joint along the cross pin.

25. The method of claim 24 , further comprising removing the cross pin after at least partially fixing the first TMT joint.

26. A method of correcting a bunion, the method comprising:

inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;

excising the first TMT joint of the foot, the excising comprising:

cutting a base of the first metatarsal proximate the first TMT joint; and

cutting a base of a first cuneiform of the foot proximate the first TMT joint;

inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;

re-cutting the base of the first metatarsal or the base of the first cuneiform to remove additional tissue; and

fixing the first TMT joint subsequent to the re-cutting,

wherein the re-cutting is performed using a re-cut guide disposed on the metatarsal pins or the cuneiform pins, the re-cut guide defining a predetermined re-cut spacing smaller than a predetermined spacing defined by a cut guide used for the excising of the first TMT joint.

27. A method of correcting a bunion, the method comprising:

inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;

excising the first TMT joint of the foot, the excising comprising:

cutting a base of the first metatarsal proximate the first TMT joint; and

cutting a base of a first cuneiform of the foot proximate the first TMT joint;

inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;

performing a frontal plane realignment comprising additional rotation within the frontal plane of the metatarsal; and

fixing the first TMT joint subsequent the frontal plane realignment,

wherein the frontal plane realignment is performed simultaneously with the compressing of the first TMT joint, and wherein the compressor block is configured as a realignment guide comprising angularly displaced pin holes such that placing the compressor block compresses the first TMT joint and maintains the additional rotation.

28. A method of correcting a bunion, the method comprising:

inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;

excising the first TMT joint of the foot, the excising comprising:

cutting a base of the first metatarsal proximate the first TMT joint; and

cutting a base of a first cuneiform of the foot proximate the first TMT joint;

inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;

performing a frontal plane realignment comprising additional rotation within the frontal plane of the metatarsal; and

fixing the first TMT joint subsequent the frontal plane realignment,

wherein the frontal plane realignment is performed prior to the compressing of the first TMT joint, and wherein the frontal plane realignment comprises:

inserting, through a realignment guide, a plurality of replacement metatarsal pins at the first predetermined spacing relative to the first TMT joint, the replacement metatarsal pins being angularly displaced relative to the metatarsal pins; and

aligning the replacement metatarsal pins linearly with the cuneiform pins prior to compressing the first TMT joint.

29. A method of correcting a bunion, the method comprising:

placing a cut guide across a dorsal side of a first tarsometatarsal (TMT) joint of a foot such that a plurality of first pin holes of the cut guide are disposed proximate a first metatarsal of the foot, a plurality of second pin holes of the cut guide are disposed proximate a first cuneiform of the foot, and a joint-seeking paddle of the cut guide is at least partially disposed within the first TMT joint;

inserting a plurality of metatarsal pins into the first metatarsal through the first pin holes;

cutting a base of the first metatarsal proximate the first TMT joint through a slot extending through the cut guide between the first pin holes and the joint-seeking paddle;

removing the cut guide from the foot;

replacing the cut guide across the dorsal side of the first TMT joint in a reversed configuration in which the metatarsal pins extend through the second pin holes;

adjusting an alignment of the first metatarsal within at least one of a frontal plane and a transverse plane of the foot;

inserting a plurality of cuneiform pins into the first cuneiform through the first pin holes;

cutting a base of the first cuneiform proximate the first TMT joint through the slot;

compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform; and

fixing the first TMT joint.

Assignments (1)

Continuity (4)

Cited By (19)

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