Method and apparatus for the stabilization of the trapeziometacarpal joint
A method and apparatus for the stabilization of the trapeziometacarpal joint following the removal or partial resection of the trapezium includes an assembly for securing a first metacarpal relative to a second metacarpal. The assembly includes a suture guide having a suture anchor plate that is frangibly connected to a guide stem.
1. A method for carpometacarpal fixation comprising
positioning a drill guide by advancing the drill guide from the ulnar side of the second metacarpal to the base of the first metacarpal,
advancing a cannulated drill over the drill guide,
removing the drill guide,
advancing a suture guide into the cannulated drill,
inserting a suture into the suture guide,
withdrawing the suture guide such that suture material is exposed on both the ulnar side of the second metacarpal and the radial side of the first metacarpal
separating a first anchor plate from the suture guide, and
fixing the suture to stabilize the relation between the first and second metacarpals.
2. The method of claim 1 , further comprising positioning a second anchor plate to seat against the second metacarpal.
3. The method of claim 1 , further comprising positioning the first anchor plate to seat against the first metacarpal.
4. The method of claim 3 , further comprising separating the first anchor plate from the suture guide by fracturing a frangible connection between the first anchor plate and the remainder of the suture guide.
5. The method of claim 4 , further comprising positioning a second anchor plate to seat against the second metacarpal.
6. The method of claim 5 , further comprising positioning the suture such that a first suture loop engages the second anchor plate and the free ends of the suture are accessible at the radial side of the first metacarpal.
7. The method of claim 6 , further comprising reducing the distance between the first metacarpal and the second metacarpal by reducing an operable length of the suture by pulling on first and second free ends of the suture.
8. The method of claim 7 , further comprising positioning the suture such that a second suture loop engages the first anchor plate.
9. The method of claim 8 , further comprising removing the cannulated drill.
10. The method of claim 1 , further comprising removing the cannulated drill.
11. A method for carpometacarpal fixation comprising
positioning a drill guide by advancing the drill guide from the ulnar side of the second metacarpal to the base of the first metacarpal,
advancing a cannulated drill over the drill guide,
removing the drill,
advancing a cannula over the drill guide through the first and second metacarpals,
removing the drill guide,
advancing a suture guide through the cannula radial to ulnar,
inserting a suture into the suture guide,
separating a first anchor plate from the suture guide, and
fixing the suture to stabilize the relation between the first and second metacarpals.
12. The method of claim 11 , further comprising positioning a second anchor plate to seat against the first metacarpal.
13. The method of claim 11 , further comprising positioning the second anchor plate to seat against the second metacarpal.
14. The method of claim 13 , further comprising separating the first anchor plate from the suture guide by fracturing a frangible connection between the first anchor plate and the remainder of the suture guide.
15. The method of claim 14 , further comprising positioning a second anchor plate to seat against the first metacarpal.
16. The method of claim 15 , further comprising positioning the suture such that a first suture loop engages the second anchor plate and the free ends of the suture are accessible at the ulnar side of the second metacarpal.
17. The method of claim 16 , further comprising reducing the distance between the first metacarpal and the second metacarpal by reducing an operable length of the suture by pulling on the first and second free ends of the suture.
18. The method of claim 17 , further comprising positioning the suture such that a second suture loop engages the first anchor plate.
19. The method of claim 18 , further comprising removing the cannula.
20. The method of claim 11 , further comprising removing the cannula.