INTRAMEDULLARY NAIL FIXATION GUIDES, DEVICES, AND METHODS OF USE

1 . An intramedullary nail, comprising:

a body with a first end and a second end, the body comprising:

a fastening end at the first end of the body and with an insertion opening extending from the first end into the body along a longitudinal axis of the body;

a closed end at the second end of the body; and

at least two openings positioned oblique to the longitudinal axis of the body between the first end and the second end of the body; and

a cap removably engaging the fastening end.

2 . The intramedullary nail of claim 1 , wherein the fastening end, further comprises:

a first fastening segment extending away from the body a first distance;

a second fastening segment extending away from the body a second distance, wherein the first distance is greater than the second distance; and

an engagement opening extending from the first end through the body to an exterior surface and wherein a portion of the engagement opening overlaps with the insertion opening.

3 . The intramedullary nail of claim 1 , wherein the at least two openings comprise:

four openings extending through the body on independent planes and angularly spaced apart.

4 . The intramedullary nail of claim 3 , wherein the at least two openings comprise:

three first openings; and

a second elongated opening.

5 . The intramedullary nail of claim 1 , further comprising:

a plurality of fasteners, wherein two fasteners of the plurality of fasteners engage the at least two openings of the body; and

a cam member sized to engage the insertion opening and the second elongated opening to translate a fastener of the plurality of fasteners inserted through the second elongated opening along the second elongated opening,

wherein the insertion opening of the fastening end engages the second elongated opening.

6 . The intramedullary nail of claim 1 , wherein the cap comprises:

an opening extending into the cap from a first end; and

an exterior surface surrounding the opening.

7 . The intramedullary nail of claim 6 , wherein the opening is threaded.

8 . The intramedullary nail of claim 7 , wherein the fastening end further comprises:

a threaded portion positioned on an exterior surface of the body.

9 . The intramedullary nail of claim 8 , wherein the threaded portion surrounds the insertion opening.

10 . The intramedullary nail of claim 8 , wherein the threads of the opening of the cap engage the threaded portion of the fastening end.

11 . The intramedullary nail of claim 10 , wherein the cap is removably threaded onto the fastening end of the body and covers at least one end of the insertion opening.

12 . The intramedullary nail of claim 8 , wherein the threaded portion is positioned adjacent the insertion opening and the engagement opening.

13 . The intramedullary nail of claim 2 , wherein the fastening end further comprises:

a threaded portion positioned on an exterior surface of the body, wherein the threaded portion is disposed only on an exterior surface of the first fastening segment.

14 . The intramedullary nail of claim 2 , wherein the fastening end further comprises:

a threaded portion positioned on an exterior surface of the body, wherein the threaded portion is disposed only on an exterior surface of the second fastening segment.

15 . The intramedullary nail of claim 2 , wherein the fastening end further comprises:

a threaded portion positioned on an exterior surface of the body, wherein the threaded portion is disposed on at least a portion of an exterior surface of the first fastening segment and at least a portion of an exterior surface of the second fastening segment.

16 . The intramedullary nail of claim 1 , wherein the cap has an internal thread.

17 . A method of inserting an intramedullary nail into two bones for fixation of the two bones, comprising:

creating an incision near the two bones;

preparing the two bones for fixation;

securing an alignment guide to the two bones to position a guidewire across the two bones;

drilling over the guidewire to create a cavity for the intramedullary nail that passes through the two bones, wherein the intramedullary nail includes a securing screw hole at a first end of the intramedullary nail and at least two peg holes;

obtaining a fixation guide device, wherein the fixation guide device includes a frame with at least two drill holes and a compression device;

attaching the intramedullary nail to the compression device of the fixation guide device;

inserting the intramedullary nail into the cavity;

inserting a drill sleeve into a first drill hole at a second end of the fixation guide device and drilling a first opening that aligns with a first peg hole in the second end of the intramedullary nail;

inserting a first peg into the first opening and through the first peg hole;

using the first peg and compression device to compress the two bones;

inserting the drill sleeve into a second drill hole at a first end of the fixation guide device and drilling a second opening that mates with a second peg hole in the first end of the intramedullary nail;

inserting a second peg into the second opening and through the second peg hole to secure the two bones in compression;

detaching the intramedullary nail from the fixation guide and removing the fixation guide device;

inserting a cap onto an end of the intramedullary nail; and

closing the incision.

18 . The method of claim 17 , further comprising:

inserting the drill sleeve into a fourth drill hole at the first end of the fixation guide device and drilling a fourth opening that aligns with a fourth peg hole;

inserting a fourth peg into the fourth opening and through the fourth peg hole to secure the two bones in compression; and

verifying the stability and position using fluoroscopy.

19 . The method of claim 18 , wherein the two bones are a joint and the joint is a tarsal-metatarsal joint.

20 . The method of claim 18 , wherein the two bones are a joint and the joint is a metatarsal-phalangeal joint.