Systems and methods for metatarsal phalangeal joint fusion
A system for metatarsal phalangeal joint fusion includes a hinged guide; a trajectory guide attachable to the hinged guide; and an anchoring wire to attach the hinged guide to a bone.
1 . A system for metatarsal phalangeal joint fusion comprising:
a hinged guide including a connecting body coupled to a hinge body by a hinge so that the hinge body articulates with respect to the connecting body;
a metatarsal guide attached to the hinge body; and
a phalanx guide attached to the connecting body via a dowel and a lead screw;
a trajectory guide attachable to the hinged guide; and
an anchoring wire to attach the hinged guide to a bone.
2 . The system of claim 1 , wherein the hinged guide further includes:
a first set screw to adjust articulation between the connecting body and the hinge body; and
a second set screw to adjust articulation between the hinge body and the metatarsal guide.
3 . The system of claim 1 , wherein the hinged guide includes radiopaque indicators.
4 . The system of claim 2 , wherein a distance between the connecting body and the phalanx guide is adjustable via the lead screw.
5 . The system of claim 1 , wherein the trajectory guide includes:
an upright portion that is insertable into the hinged guide; and
an indicator portion that extends from the upright portion.
6 . The system of claim 5 , wherein the indicator portion includes a radiopaque indicator that extends from the upright portion.
7 . The system of claim 1 , further comprising a single-chamfer wire sleeve configured to be inserted through a hole in the trajectory guide along a trajectory for a fixation fastener.
8 . The system of claim 1 , wherein the hinged guide includes:
a connecting body;
a metatarsal guide attached by a hinge to the connecting body; and
a phalanx guide attached to the connecting body via a dowel and a lead screw.
9 . The system of claim 8 , further comprising a first knob to lock articulation between the connecting body and the metatarsal guide.
10 . The system of claim 8 , further comprising:
two first converging anchoring wires insertable through the phalanx guide and into a phalanx; and
two second converging anchoring wires insertable through the metatarsal guide and into a metatarsal.
11 . The system of claim 8 , further comprising an outrigger to attach the trajectory guide to the phalanx guide.
12 . The system of claim 11 , further comprising a second knob to lock articulation between the connecting body and the outrigger.
13 . The system of claim 11 , further comprising an adjustment screw to adjust elevation between the connecting body and the outrigger.
14 . The system of claim 11 , further comprising an outer single-chamfer wire sleeve configured to be inserted through a hole in the outrigger and anchored into a bone via a spike protruding from one end of the outer single-chamfer wire sleeve.
15 . The system of claim 14 , further comprising an inner single-chamfer wire sleeve configured to be inserted through a bore of the outer single-chamfer wire sleeve and guide a fastener guide wire into a bone.
16 . The system of claim 14 , wherein a bore through the outer single-chamfer wire sleeve is offset from a center of the outer single-chamfer wire sleeve.
17 . A method of fusing a metatarsal phalangeal joint comprising:
aligning a hinged guide with a phalanx or a metatarsal;
anchoring the hinged guide to the phalanx or the metatarsal of the metatarsal phalangeal joint;
distracting the phalanx and the metatarsal;
preparing the metatarsal phalangeal joint;
adjusting dorsiflexion of the metatarsal phalangeal joint;
locking the hinged guide to set the dorsiflexion;
compressing the phalanx and the metatarsal;
selecting a trajectory of a fixation fastener; and
inserting the fixation fastener into one of the phalanx and the metatarsal along a selected trajectory.
18 . The method of claim 17 , wherein the aligning includes placing a guide wire into about a center of a metatarsal head and placing the hinged guide over the guide wire.
19 . The method of claim 17 , wherein the anchoring includes placing a first wire through the hinged guide and into the phalanx and a second wire through the hinged guide and into the metatarsal.
20 . The method of claim 17 , wherein aligning the hinged guide includes visualizing radiopaque indicators in the hinged guide.
21 . The method of claim 17 , wherein the selecting a trajectory of a fixation fastener includes adjusting a trajectory guide with respect to the metatarsal phalangeal joint.
22 . The method of claim 21 , wherein the selecting a trajectory of a fixation fastener includes selecting a diameter of the fixation fastener.