Lapidus Complete Reduction Clamp

Abstract

The system includes a main orthodontic assembly having a fixed body configured to be secured to a first bone of a patient and a movable body configured to move relative to the fixed body. The movable body includes an anchor body configured to be secured to a second bone of the patient and a first portion configured to rotate the anchor body in a first rotational direction in a first plane relative to the fixed body. The main orthodontic assembly defines a rotation axis, and the anchor body is rotated in the first plane relative to the fixed body about the rotation axis by the first portion. The main orthodontic assembly is configured such that the rotation axis is substantially disposed in a joint adjacent to the second bone when the fixed body is secured to the first bone.

Description

[Technical Field]

[0001] Priority claim This application claims priority to U.S. Provisional Patent Application No. 63 / 442,663, filed February 1, 2023, and U.S. Provisional Patent Application No. 63 / 524,410, filed June 30, 2023, the entire contents of each of which are incorporated by reference herein and relied upon. [Background technology]

[0002] The Lapidus procedure refers to a surgical procedure for the treatment of hallux valgus deformity. Hallux valgus is a bony protrusion that forms on the side of the big toe joint, which can cause foot deformity. The Lapidus procedure involves correcting the foot structure by repositioning the poorly aligned first metatarsal bone to its proper position.

[0003] The Lapidus procedure traditionally requires full exposure of the first tarsometatarsal (TMT) joint, which means that an incision at least 3.5 cm long is traditionally required to complete the Lapidus procedure, which can leave a large scar, require more healing time, and carry the risk of infection. Summary of the Invention [Means for solving the problem]

[0004] The present disclosure provides new and innovative systems and methods for controlled realignment of bones (e.g., the first metatarsal) in multiple planes for rapidus surgery. In some examples, the system includes a main orthotic assembly having a fixed body configured to be secured to a first bone of a patient and a movable body configured to move relative to the fixed body. The movable body includes an anchor body configured to be secured to a second bone of the patient and a first portion having a first movement mechanism configured to move the anchor body relative to the fixed body in a first direction in a first plane.

[0005] In some examples, a method according to the present disclosure can include aligning a main correction assembly relative to first and second bones of a patient; fixing a fixation body to the first bone of the patient; fixing an anchor body to a second bone of the patient; moving the anchor body in a first direction in a first plane relative to the fixation body using a first movement mechanism to correct the position of the second bone in the first direction; and cutting the second bone with a bone cutting device.

[0006] Additional features and advantages of the disclosed systems and methods are described in, and will be apparent from, the following detailed description and figures. [Brief explanation of the drawings]

[0007] [Figure 1] FIG. 1 is a diagram of a perspective view of a system for controlled realignment of bone in multiple planes, according to an example of the present disclosure. [Figure 2] 2 is a diagram of a perspective view of an exemplary main straightening assembly of the system of FIG. 1. [Figure 3] FIG. 3 is a diagram of a right side view of the main orthodontic assembly of FIG. 2. [Figure 4] FIG. 3 is a diagram of a left side view of the main orthodontic assembly of FIG. 2. [Figure 5] FIG. 3 is a diagram of a rear view of the main orthodontic assembly of FIG. 2. [Figure 6] 3 is a diagram of a portion of an exemplary stationary body of the main straightening assembly of FIG. 2. [Figure 7] 2 is a diagram of a perspective view of an exemplary alignment guide of the system of FIG. 1. [Figure 8] 2 is a diagram of a perspective view of an exemplary cutting guide of the system of FIG. 1. [Figure 9] 1. FIG. 3 is a diagram of a perspective view of another exemplary cutting guide of the system of FIG. [Figure 10A] 1 is a diagram of a system for controlled realignment of bone in multiple planes, according to another example of the present disclosure. [Figure 10B] 1 is a diagram of a system for controlled realignment of bone in multiple planes, according to another example of the present disclosure. [Figure 11] 1 is a diagram illustrating a method for controlled realignment of bone in multiple planes. [Figure 12] 1 is a diagram illustrating a method for controlled realignment of bone in multiple planes. [Figure 13] 1 is a diagram illustrating a method for controlled realignment of bone in multiple planes. [Figure 14] 1 is a diagram illustrating a method for controlled realignment of bone in multiple planes. [Figure 15] 1 is a diagram illustrating a method for controlled realignment of bone in multiple planes. [Figure 16] 1 is a diagram illustrating a method for controlled realignment of bone in multiple planes. [Figure 17] 1 is a diagram of a top view of the foot anatomy of a patient with hallux valgus. [Figure 18]FIG. 10 is a diagram of a front right perspective view of a system for controlled realignment of bone in multiple planes according to another example of the present disclosure. [Figure 19] FIG. 19 is a diagram of a top view of the system of FIG. 18. [Figure 20] FIG. 19 is a diagram of a front-rear perspective view of the system of FIG. 18. [Figure 21] 19 is a diagram of the fixed body portion of the system of FIG. 18. [Figure 22A] 19A-19C are diagrams of various cross-sectional views of the fixation body portion of the system of FIG. 18. [Figure 22B] 19A-19C are diagrams of various cross-sectional views of the fixation body portion of the system of FIG. 18. [Figure 22C] 19A-19C are diagrams of various cross-sectional views of the fixation body portion of the system of FIG. 18. [Figure 23] 19 is a diagram of an enlarged view of the stationary body and first portion of the system of FIG. 18. [Figure 24] FIG. 10 is a diagram of a front right perspective view of a system for controlled realignment of bone in multiple planes according to another example of the present disclosure. [Figure 25] FIG. 25 is a diagram of a front right perspective view of an exemplary main correction assembly of the system of FIG. [Figure 26] 25 is a diagram of a front right perspective view of an exemplary cutting guide assembly of the system of FIG. 24. [Figure 27] 1 is a diagram of a perspective view of an exemplary cutting guide according to one example of the present disclosure. [Figure 28] 10 is a diagram of a perspective view of another exemplary cutting guide according to one example of the present disclosure. [Figure 29A] 28 illustrates an exemplary use of the cutting guide of FIG. 27 according to an example of the present disclosure. [Figure 29B] 29 illustrates an exemplary use of the cutting guide of FIG. 28 according to an example of the present disclosure. [Figure 30A] 10 is a diagram of a perspective view of another exemplary cutting guide according to one example of the present disclosure. [Figure 30B] 10 is a diagram of a perspective view of another exemplary cutting guide according to one example of the present disclosure. [Figure 31A] 30A and 30B, according to one example of the present disclosure. [Figure 31B] 30A and 30B, according to one example of the present disclosure. [Figure 32] FIG. 10 is a diagram of a front right perspective view of a system for controlled realignment of bone in multiple planes according to another example of the present disclosure. [Figure 33] FIG. 33 is a diagram of a side view of the system of FIG. 32. DETAILED DESCRIPTION OF THE INVENTION

[0008] The present disclosure is directed to systems and methods for controlled realignment of bones (e.g., the first metatarsal) in multiple planes, for example, for Lapidus surgery. As discussed above, conventional Lapidus procedures can require incisions having a length of at least 3.5 cm, which can have various problems, such as large scars, increased healing time, and infection risk. Moreover, conventional devices for Lapidus procedures can only allow for single (sagittal) plane correction, requiring the surgeon to manually perform corrections in other planes (e.g., the coronal and transverse planes), which requires larger incision sizes and can reduce the precision and reproducibility of the procedure.

[0009]

[0006] Aspects of the present disclosure can address the above-discussed problems with conventional Lapidus procedures. For example, aspects of the present disclosure can provide a (single) system / device with multiple movement mechanisms, which allows for multiplanar (sagittal, coronal, and transverse) correction of a bone (e.g., the first metatarsal) and compression / distraction of a joint adjacent to the bone to be corrected (e.g., the first tarsometatarsal joint). Moreover, because bones can be corrected in multiple planes using a system according to the present disclosure, the accuracy and repeatability of the Lapidus procedure can be improved.

[0010] Moreover, a system according to the present disclosure can enable the surgeon to make two (parallel) cuts near the joint between the two bones to be cut (e.g., the first tarsometatarsal joint), which may allow the Rapidus surgery to be performed through a smaller incision (e.g., approximately 3 mm to 3.5 mm) than the traditional approach (e.g., with an approximately 3.5 cm incision), which can reduce scar size, healing time, and risk of infection compared to traditional full exposure techniques.

[0011] FIG. 1 depicts an exemplary system 10 for controlled realignment of bone in multiple planes, according to one example of the present disclosure. As shown in FIG. 1, the system 10 can include a main correction assembly 100 and an alignment guide 300. With reference to FIGS. 1-5, the main correction assembly 100 can include a fixed body portion 110 and a movable body portion 200.

[0012] The fixation body 110 can be configured to be fixed to a first bone of the patient. In some examples, the first bone can be the middle cuneiform bone. In other examples, the first bone can be the lateral cuneiform bone, the cuboid bone, the navicular bone, or any other suitable and / or stable bone of the patient.

[0013] The movable body portion 200 can be configured to move relative to the fixed body portion 110. The movable body portion 200 can include an anchor body portion 210. The anchor body portion 210 can be configured to be secured to a second bone of the patient. In some examples, the second bone can be a first metatarsal. In other examples, the second bone can be any other bone that needs to be corrected (e.g., another metatarsal).

[0014] The movable body portion 200 can further include a first portion 220 having a first movement mechanism 222. The first movement mechanism 222 can be configured to move the anchor body portion 210 in a first (rotational) direction 225 relative to the fixed body portion 110. In some examples, the first direction 225 can be in a first plane. The first plane can be a transverse plane or substantially parallel to a transverse plane (e.g., when the main corrective assembly 100 is attached to a human body).

[0015] In some examples, the anchor body 110 can include an engagement feature 114 configured to engage with a first movement mechanism 222. For example, the first movement mechanism 222 can be rotatably coupled to the engagement feature 114 of the anchor body 110. In some examples, the engagement feature 114 and the first movement mechanism 222 can together form a gear arrangement. For example, the first movement mechanism 222 can be in the form of a worm / threaded rod / screw, and the engagement feature 114 can be in the form of a worm wheel (at least a partial worm wheel) or a toothed flange. In other examples, the engagement feature 114 and the first movement mechanism 222 can together form any other suitable positioning / adjustment mechanism through which the anchor body 210 can move / rotate in a first direction 225 in a first plane relative to the anchor body 110.

[0016] The first portion 220 can further include a graspable device 224 (e.g., a knob) connected to the first moving mechanism 222. A user (e.g., a surgeon) can use the graspable device 224 to rotate the first moving mechanism 222, for example, by rotating the graspable device 224. Rotation of the first moving mechanism 222 can rotate the anchor body 210 in a first direction 225 within a first plane relative to the fixation body 110. In some examples, rotation of the first moving mechanism 222 can further rotate all components disposed between the first moving mechanism 222 and the anchor body 210 in the first direction 225 within the first plane.

[0017] In some examples, the movable body portion 200 can include a second portion 230. The second portion 230 can have a second movement mechanism 232 configured to move and / or rotate the anchor body portion 210 in a second direction 235 within a second plane relative to the fixed body portion 110. The second movement mechanism 232 can include a second partial body portion 234. In some examples, the second movement mechanism 232 can further move all components disposed between the second movement mechanism 232 and the anchor body portion 210 in the second direction 235 within the second plane. In some examples, the second plane can be perpendicular to the first plane. The second plane can be a sagittal plane (dorsalis / plantar) or substantially parallel to the sagittal plane (e.g., when the main orthotic assembly 100 is attached to a human body).

[0018] In some examples, the second portion 230 can be coupled to the first portion 220 via a first connecting body 120. The first connecting body 120 can include a first plate 120a and a second plate 120b. Each of the first plate 120a and the second plate 120b can include an aperture configured to receive the rotation rod 124.

[0019] In some examples, at least a portion of the second partial body portion 234 can be disposed between the first plate 120a and the second plate 120b. In some examples, at least a portion of the second partial body portion 234 can extend outward from the first and second plates 120a, 120b. The second partial body portion 234 can include a hole configured to receive the rotation rod 124. The rotation rod 124 can define a longitudinal axis 125, and the second partial body portion 234 can rotate about the longitudinal axis 125 of the rotation rod 124, with the longitudinal axis 125 serving as a pivot axis. In some examples, the second partial body portion 234 of the second section 230 can be tower-shaped (e.g., rectangular). In other examples, the second partial body portion 234 can have any other suitable shape (e.g., as long as it can be rotated about the pivot axis 125).

[0020] In some examples, the second portion can include a locking mechanism 237. The second portion body 234 can include a hole configured to receive the locking mechanism 237. In some examples, the locking mechanism 237 can be rod-shaped. In other examples, the locking mechanism 237 can have any other suitable shape.

[0021] First and second plates 120a, 120b may include recesses 122 in which locking mechanisms 237 may be mounted. Locking mechanisms 237 may be movable within recesses 122. Recesses 122, together with locking mechanisms 237, may define a range of rotation 231 of second portion 230 (e.g., second portion body portion 234).

[0022] In some examples, the locking mechanism 237 and the second partial body portion 234 can have a threaded engagement. The locking mechanism 237 can include a compression portion 239, which can be disposed outside the first and second plates 120a, 120b and face the second plate 120b. The compression portion 239 can have a diameter larger than the diameter of the rest of the locking mechanism 237. When the locking mechanism 237 is rotated in one direction (e.g., counterclockwise), the compression portion 239 of the locking mechanism 237 can move toward the second plate 120b and compress the second plate 120b against the second partial body portion 234, thereby locking the movement of the second portion 230 (e.g., the second partial body portion 234). When locking mechanism 237 is rotated in another direction (e.g., clockwise), compression portion 239 of locking mechanism 237 can move away from second plate 120b and release second plate 120b from second partial body 234, thereby unlocking second portion 230 and allowing second partial body 234 to rotate about pivot axis 125. Locking mechanism 237 of second portion 230 can, for example, prevent anchor body 210 from being unintentionally rotated in a second (sagittal) plane after the second bone has been corrected in the second plane.

[0023] In some examples, the second portion 230 can further include a graspable device 236 (e.g., a knob) connected to the locking mechanism 237. A user (e.g., a surgeon) can use the graspable device 236 to rotate the first locking mechanism 237, for example, by rotating the graspable device 236.

[0024] In some examples, the movable body 200 can include a third portion 240. The third portion 240 can have a third movement mechanism 242. The third movement mechanism 242 can be configured to move the anchor body 210 in a third direction 245 relative to the stationary body 110. In some examples, the third movement mechanism 242 can further move all components disposed between the third movement mechanism 242 and the anchor body 210 in the third direction 245. In some examples, the third direction 245 can be disposed in the first plane and / or the second plane.

[0025] In some examples, the third portion 240 can be coupled to the second portion 230 via the second connection body 130. For example, the second connection body 130 can be connected to one end portion of the second portion body 234 (opposite the portion of the second portion body 234 disposed between the first plate 120a and the second plate 120b). The second connection body 130 can include a hole 132 configured to receive the third movement mechanism 242. The second connection body 130 and the third movement mechanism 242 can have a threaded engagement. For example, the third movement mechanism 242 can include a screw thread, and the hole 132 of the second connection body 130 can include an internal thread. Rotation of the third movement mechanism 242 can move the third movement mechanism 242 (and ultimately the third portion 240) in a third direction 245 relative to the second connection body 130.

[0026] In some examples, the third movement mechanism 242 can be in the shape of a rod (e.g., a threaded rod). In other examples, the third movement mechanism 242 can have any other suitable shape. In some examples, the third portion 240 can further include one or more support bodies 246 a and 246 b, which can extend parallel to the third movement mechanism 242. In this case, the second connection body 130 can further include one or more holes 134 a, 134 b configured to receive the one or more support bodies 246 a and 246 b.

[0027] Rotation of the third movement mechanism 242 can cause the anchor body 210 (and all other components between the third movement mechanism 242 and the anchor body 210) to move in a third direction 245. Movement of the anchor body 210 relative to the fixation body 110 in the third direction 245 can cause a joint adjacent to a second bone (e.g., the first tarsometatarsal joint) to be compressed or pulled apart. In other examples, the third movement mechanism 242 can be moved back and forth (in the third direction 245) in any other suitable manner (e.g., simply pushing or pulling the movement mechanism 242 back and forth).

[0028] In some examples, the third portion 240 may further include a graspable device 248 (e.g., a knob) connected to the third movement mechanism 242. A user may use the graspable device 248 to rotate the third movement mechanism 242, for example, by rotating the graspable device 248.

[0029] In some examples, the third portion 240 can include a base cap 247. The base cap 247 can cover one end portion (opposite the end portion adjacent the graspable device 248) of the third movement mechanism 242 and / or one or more of the support body portions 246 a, 246 b.

[0030] In some examples, the movable body portion 200 can further include a fourth portion 250. The fourth portion 250 can include a fourth movement mechanism 252. The fourth movement mechanism 252 can be configured to move and / or rotate the anchor body portion 210 in a fourth direction 255 within a third plane relative to the fixed body portion 110. In some examples, the fourth movement mechanism 252 can further move and / or rotate all components (if any) disposed between the fourth movement mechanism 252 and the anchor body portion 210 in the fourth direction 255 within the third plane. In some examples, the third plane can be perpendicular to the first plane and / or the second plane. The third plane can be the frontal plane or substantially parallel to the frontal plane (e.g., when the main corrective assembly 100 is attached to a human body).

[0031] In some examples, the fourth portion 250 can be coupled to the third portion 240 via the third connecting body 140. The third connecting body 140 can include a first portion 141 and a second portion 143. One end portion (opposite the portion covered by the base cap 247) of each of the third moving mechanism 242 and / or one or more support bodies 246a, 246b can be connected to the first portion 141 of the third connecting body 140. For example, the first portion 141 can include one or more holes 142a, 142b, 142c configured to receive the third moving mechanism 242 and / or one or more support bodies 246a, 246b.

[0032] The second portion 143 of the third connecting body 140 can include one or more apertures 144a, 144b configured to receive the fourth movement mechanism 252. The second portion 143 can include an interior space 147, and at least a portion of the fourth movement mechanism 252 can be disposed within the interior space 147.

[0033] In some examples, the fourth movement mechanism 252 can be rod-shaped (at least a portion of the rod is threaded), while in other examples, the fourth movement mechanism 252 can have any other suitable shape.

[0034] In some examples, the fourth portion 250 may further include a graspable device 256 (e.g., a knob) connected to the fourth movement mechanism 252. A user may use the graspable device 256 to rotate the fourth movement mechanism 252, for example, by rotating the graspable device 256.

[0035] In some examples, the anchor body 210 can include a (toothed) rotating arm 212. The rotating arm 212 can be rotatably coupled to a fourth translation mechanism 252. In some examples, the rotating arm 212 and the fourth translation mechanism 252 can together form a gear arrangement. For example, the fourth translation mechanism 252 can be in the form of a worm / threaded rod / screw, and the rotating arm 212 can be in the form of a worm wheel (at least a partial worm wheel) / toothed flange. In other examples, the rotating arm 212 and the fourth translation mechanism 252 can together form any other suitable positioning / adjustment mechanism through which the anchor body 210 can rotate in a fourth direction 255 in a third plane relative to the fixation body 110.

[0036] In some examples, the second portion 143 of the third connecting body portion 140 can include one or more recesses 145 a, 145 b configured to receive the rotating arm 212. In some examples, at least a portion of the rotating arm 212 can be disclosed within an interior space 147 of the second portion 143.

[0037] In some examples, the rotating arm 212 can include one or more side protrusions 213 a, 213 b. Each of the one or more recesses 145 a, 145 b can include a corresponding recess 146 a, 146 b configured to receive the one or more side protrusions 213 a, 213 b of the rotating arm 212.

[0038] In some examples, the anchor body portion 210 can include an anchor base 214. The anchor base 214 can be configured to be secured to a second bone of the patient. In some examples, the anchor base 214 can be secured to a distal portion of the second bone. In other examples, the anchor base 214 can be secured to any other suitable portion of the second bone (such as a middle portion or a proximal portion).

[0039] In some examples, the rotating arm 212 (at least the portion adjacent to and / or to be engaged with the fourth moving mechanism 252) can be curved or partially circular in shape. In some examples, as shown in FIG. 5 , the rotating arm 212 can be configured such that a center C of the curve or partially circular shape can be positioned within the second bone when the anchor body 210 is secured to / placed on the second bone. Rotation of the fourth moving mechanism 252 can rotate the rotating arm 212 (and ultimately the second bone) about center C, which can serve as an axis of rotation.

[0040] In some examples, the shortest distance between anchor base 214 and center C of the curve of rotating arm 212 can be in the range of about 0.3 cm to about 1.5 cm, such as in the range of about 0.3 cm to about 0.7 cm, about 0.7 cm to about 1.2 cm, or about 1.2 cm to about 1.5 cm. In other examples, the shortest distance between anchor base 214 and center C of the curve can have any other suitable value (e.g., less than 0.3 cm or greater than 1.5 cm).

[0041] In some examples, anchor base 214 can extend in a direction that is (substantially) parallel to third direction 245. In some examples, rotating arm 212 can extend in a direction that is (substantially) perpendicular to third direction 245. When anchor body 210 is fixed to a second bone, the longitudinal direction of the second bone can be (substantially) parallel to third direction 245.

[0042] In some examples, the anchor base 214 can include one or more channels 216a, 216b configured to receive a bone fastener. When multiple channels are present, the channels can be distributed in a third direction 245 along the anchor base 214. In some examples, the bone fastener can be a pin, screw, tack, or k-wire. In other examples, the bone fastener can be any other suitable fastening device capable of securing (temporarily or removably) a target component (e.g., anchor base, fixation body portion) to a patient's bone. In some examples, the bone fastener can include a hat that prevents the bone fastener from penetrating deeper into the bone than a predetermined length (preventing it from unintentionally penetrating into another bone or tissue). In some examples, the diameter of the bone fastener can be smaller than the diameter of the one or more channels 216a, 216b.

[0043] In other examples, the anchor base 214 can have any other suitable fixation mechanism, such as a clamp or any other suitable device that can secure (temporarily or removably) the anchor base 214 to a second bone of the patient.

[0044] In some examples, the fixation body portion 110 can include an inner body portion 118 and an outer body portion 119. The outer body portion 119 can include an engagement feature 114. FIG. 6 illustrates a portion (including the inner body portion 118) of an exemplary fixation body portion 110 of a main orthodontic assembly according to the present disclosure. In some examples, the fixation body portion 110 can include one or more channels configured to receive bone fasteners. With reference to FIG. 6, in some examples, the one or more channels of the fixation body portion 110 can include a first channel 116a having a first track 117a and a second channel 116b having a second track 117b. In some examples, the first and second tracks 117a, 117b can be parallel to one another. In this way, after the fixed body portion 110 is fixed to the first bone, the main corrective assembly 100 can still be moved along the first / second trajectory 117a / 117b (e.g., in the dorsal to plantar direction or the plantar to dorsal direction).

[0045] In some examples, the one or more channels of the fixation body portion 110 may include a third channel 116c having a third track 117c. The third track 117c may be non-parallel to the first and second tracks 117a, 117b. Thus, when a bone fastener is inserted into the third channel 116c and at least one of the first and second channels 116a, 116b, movement of the main orthotic assembly 100 along the first / second track 117a / 117b (e.g., in a dorsal-to-plantar or plantar-to-dorsal direction) may be prevented. The angle between the first / second track 117a / 117b and the third track 117c may range from approximately 5° to approximately 25°. In other examples, the angle between the first / second track 117a / 117b and the third track 117c can have any other suitable value (less than 5° or greater than 25°). In some examples, the diameter of the bone fastener can be smaller than the diameter of one or more of the channels 116a, 116b, 116c.

[0046] 6, the inner body portion 118 of the fixation body portion 110 can include one or more grooves 113a, 113b configured to receive a fastener (e.g., a screw) for securing the inner body portion 118 to the outer body portion 119. The fastener for securing the inner body portion 118 to the outer body portion 119 can be inserted through a through-hole 111 formed in the outer body portion 119 and received in the one or more grooves 113a, 113b of the inner body portion 118. In some examples, the fastener can be threadably engaged with the through-hole 111 and / or the one or more grooves 113a, 113b.

[0047] In some examples, the alignment guide 300 can be removably coupled to the stationary body 110. In other examples, the alignment guide 300 can be permanently coupled to the stationary body 110. Referring to FIGS. 1 and 7 , in some examples, the alignment guide 300 can include an alignment channel 302. The alignment channel 302 can be provided to receive a bone fastener. The alignment guide 300 and the main orthotic assembly 100 can be aligned with respect to a first bone and a second bone using the alignment channel 302 and the bone fastener. For example, a bone fastener can be inserted into a joint adjacent to the patient's second bone (e.g., the first tarsometatarsal joint), and the bone fastener can be inserted downward through the alignment channel 302. In other examples, the alignment channel can be provided on the main orthotic assembly 100. In some examples, the diameter of the bone fastener can be smaller than the diameter of the alignment channel 302.

[0048] In some examples, the alignment guide 300 may further include a first support 310, a second support 320, and / or a third support 330. The first support 310 may have a first end portion 312 and a second end portion 314. The second support 320 may have a first end portion 322 and a second end portion 324. The fixed body 110 may be interposed between the first support 310 and the second support 320 when the alignment guide 300 is coupled to the fixed body 110. The third support 330 may have a first end portion 332 connected to the second end portion 314 of the first support 310 and a second end portion 334 connected to the second end portion 324 of the second support 320.

[0049] In some examples, the alignment guide 300 may further include a fixation device 340 configured to fix the alignment guide 300 to the fixation body 110. The fixation device 340 may include a shaft 342 and a graspable device 346 (e.g., a knob). The fixation device 340 (e.g., shaft 342) may be connected to the first end portion 312 of the first support 310 and the first end portion 322 of the second support 320. When the shaft 342 of the fixation device 340 is rotated in one direction (e.g., counterclockwise), using, for example, the graspable device 346, the first end portion 322 of the second support 320 may move toward the first end portion 312 of the first support 310, thereby compressing the fixation body between the first support 310 and the second support 320, thereby fixing the fixation body 110 to the alignment guide 300. When the shaft 342 of the fixing device 340 is rotated in another direction (e.g., clockwise), the first end portion 322 of the second support 320 can move away from the first end portion 312 of the first support 310, thereby loosening the engagement between the fixing body portion 110 and the alignment guide 300.

[0050] In some examples, the alignment guide 300 can be coupled to the fixed body 110 to allow the alignment guide 300 to rotate and / or translate relative to the fixed body 110, for example, in a first (transverse) plane. For example, referring back to FIGS. 2 and 3 , in some examples, the fixed body 110 can include one or more grooves 113. The one or more grooves 113 can be configured to receive the second support 320. The one or more grooves 113 can be provided so that the alignment guide 300 can be easily attached to, removed from, and / or rotated about the fixed body 110. The one or more grooves 113 and the second support 320 are sized and shaped so that the second support 320 can be rotated over the one or more grooves 113.

[0051] In some examples, the alignment channel 302 can be disposed in the third support 330. In other examples, the alignment channel 302 can be disposed in any other suitable component of the alignment guide 300 (e.g., the first support 310, the second support 320).

[0052] In some examples, the alignment guide 300 can further include a receiver 350. The receiver 350 can be provided to receive a cutting guide 360. The cutting guide 360 ​​can be provided to guide a bone-cutting device. The receiver 350 can be disposed on the second end portion 334 of the third support 330. The receiver 350 can include a cutting guide-receiving hole 352 and a fastener-receiving hole 354.

[0053] 8 illustrates an exemplary cutting guide 360 ​​according to one example of the present disclosure. In some examples, the cutting guide 360 ​​can include a head portion 361 and a body portion 364. The head portion 361 can be sized and shaped to be received within the cutting guide-receiving hole 352 of the receiver 350. The head portion 361 can include a fastener-receiving hole 362. In some examples, a fastener 370 can be provided to secure the cutting guide 360 ​​to the receiver 350. For example, the fastener 370 can be inserted into the fastener-receiving hole 354 of the receiver 350 and the fastener-receiving hole 362 of the cutting guide 360.

[0054] The cutting guide 360 ​​can include one or more cutting slots 365 a, 365 b. A bone-cutting device can be inserted into the one or more cutting slots 365 a, 365 b to cut a second bone and / or a third bone. For example, a bone-cutting device can be inserted into the first cutting slot 365 a to cut the second bone and into the second cutting slot 365 b to cut the third bone. The third bone can be the medial cuneiform bone.

[0055] 9 illustrates another example of a cutting guide 360 ​​according to one example of the present disclosure. The cutting guide 360 ​​can include one or more guide surfaces 367 a, 367 b. A bone-cutting device can be abutted adjacent to the one or more guide surfaces 367 a, 367 b to cut the second bone and / or the third bone. For example, the bone-cutting device can be abutted adjacent to the first guide surface 367 a to cut the second bone and adjacent to the second guide surface 367 b to cut the third bone. Examples of bone-cutting devices can include a bur, a surgical saw (e.g., a sagittal saw), an osteotome, and a reciprocating saw.

[0056] In some examples, the cutting guide 360 ​​can serve as a joint alignment guide. In this case, the cutting guide 360 ​​can include one or more ridges configured to align with a joint adjacent to a second bone of the patient (e.g., the first tarsometatarsal joint). For example, the cutting guide 360 ​​can include one or more side edges 368 a, 368 b, which can serve as the ridges. Other configurations / features / attributes of the cutting guide 360 ​​of FIG. 9 can be similar and / or the same as those described above with respect to the cutting guide 360 ​​illustrated with respect to FIG. 8, and therefore, redundant description may be omitted.

[0057] 10A and 10B illustrate another example of a main orthodontic assembly 100 according to one example of the present disclosure. The second portion 230 can have a second movement mechanism 232. The second movement mechanism 232 can be configured to move and / or rotate the anchor body 210 in a second direction 235 within a second plane relative to the fixation body 110. In this example, the second movement mechanism 232 can include a second portion body 234, a mover 233, and a connector 238 disposed between the second portion body 234 and the mover 233. The connector 238 can include a first connector portion 238a connected to the second portion body 234 (through the second connecting body 130), a third connector portion 238c connected to the mover 233, and a second connector portion 238b disposed between the first connector portion 238a and the third connector portion 238c. The second connector portion 238b may be rotatably connected to the first connector portion 238a and the third connector portion 238c.

[0058] In some examples, mover 233 can be in the form of a threaded rod, and third connector portion 238c can include a threaded bore configured to receive mover 233. In some examples, when mover 233 is rotated in one direction (e.g., counterclockwise), using, for example, graspable device 236, third connector portion 238c can move upward (e.g., in a plantar-to-dorsal direction), which can move first connector portion 238a away from mover 233 / third connector portion 238c, thereby rotating second partial body portion 234 in a second direction 235 (e.g., in a dorsalis-to-plantar direction), for example, about longitudinal axis 125 of rotation rod 124.

[0059] When the second moving mechanism 232 is rotated in another direction (e.g., clockwise), the third connector portion 238c can move downward (e.g., in a dorsal-to-plantar direction), which can move the first connector portion 238a toward the mover 233 / third connector portion 238c, thereby rotating the second partial body portion 234 in the second direction 235 (e.g., in a plantar-to-dorsal direction). Other configurations / features / attributes of the main orthotic assembly 100 of Figures 10A and 10B can be similar and / or the same as those described above with respect to the main orthotic assembly 100 shown with respect to Figures 1-6, and therefore, repeated description may be omitted.

[0060] In some examples, methods are provided for controlled realignment of bones (e.g., the first metatarsal) in multiple planes for Lapidus surgery using the system 10 disclosed herein. The steps presented herein can be performed in any suitable order and combination, and can be modified by or combined with any of the other procedures and features disclosed elsewhere herein.

[0061] The method may include inserting a first bone fastener 405 into a joint adjacent to a second bone of the patient (e.g., the first tarsometatarsal joint) in a dorsal-to-plantar direction, as shown in FIG. 11 . After the first bone fastener 405 is inserted into the joint, the main orthotic assembly 100 may be aligned with respect to the first and second bones of the patient. For example, aligning the main orthotic assembly 100 may include attaching an alignment guide 300 to the main orthotic assembly 100 (e.g., the stationary body portion 110) and inserting the first bone fastener 405 down through the alignment channel 302, as shown in FIG. 12 . The position of the main orthotic assembly 100 may then be adjusted (e.g., rotated about the first bone fastener 405) so that the channels 116 a, 116 b, 116 c of the stationary body portion 110 may be positioned directly over the first bone. The fixation device 340 of the alignment guide 300 can be tightened to fix the position.

[0062] The fixation body 110 can then be secured to a first bone of the patient, as shown in Figure 13. For example, one or more bone fasteners 410, 415 can be passed through one or more channels 116a, 116b, 116c of the fixation body 110 and inserted (e.g., percutaneously) into the first bone.

[0063] In some examples, after the fixation body portion 110 is secured to the first bone, the first bone fastener 405 can be removed by withdrawing it from the joint and alignment channel 302. Additionally, the alignment guide 300 can be removed by detaching the alignment guide 300 from the main correction assembly 100. In some examples, after the fixation body portion 110 is secured to the first bone, the main correction assembly 100 can be adjusted so that the anchor base channels 216 a, 216 b can be positioned directly over the second bone (e.g., a distal portion of the diaphysis of the second bone).

[0064] Anchor body 210 can then be secured to a second bone of the patient, as shown in Figure 14. For example, one or more bone fasteners 420, 425 can be passed through one or more channels 216a, 216b of anchor body 210 and inserted (e.g., percutaneously) into the second bone.

[0065] The anchor body 210 can then be moved / rotated in the first, second, and / or third directions 225, 235, 245 to correct the position of the second bone in the first, second, and / or third plane. In some examples, the anchor body 210 can be moved / rotated in the fourth direction 255 in the third (coronal) plane relative to the fixation body 110 using the fourth movement mechanism 252 of the fourth part 250 to correct the position of the second bone in the third plane.

[0066] If the first metatarsal is not corrected in the frontal plane, a bone misalignment problem may exist. For example, there are two small bones (called sesamoid bones) below the first metatarsal, and if the metatarsal is corrected only in the transverse plane, these bones may become misaligned, which may cause significant imbalance in the soft tissues around the toes. This may also cause various other problems associated with hallux valgus. Aspects of the present disclosure can provide a way to correct frontal plane rotation, for example, using the fourth translation mechanism 252, which can ensure that the sesamoid bones are returned to their positions below the articulation with the phalanges.

[0067] The anchor body 210 can then be moved / rotated in a first direction 225 in a first (transverse) plane relative to the fixation body 110 using the first moving mechanism 222 to correct the position of the second bone in the first plane. After the first plane correction of the second bone, the anchor body 210 can be moved / rotated in a second direction 235 in a second (sagittal) plane relative to the fixation body 110 using the second moving mechanism 232 of the second part 230 to correct the position of the second bone in the second plane. Although the second bone is described above as being corrected in the order of third plane-first plane-second plane, the second bone can be corrected in any other suitable order (e.g., third plane-second plane-first plane).

[0068] In some instances, before, after, and / or while the second bone is corrected in the first, second, and / or third plane, the joint between the second bone and the third bone can be distracted, if necessary, to reposition the second bone to a desired location.

[0069] After the second bone has been corrected in the first, second, and / or third plane, alignment guide 300 can be reattached to stationary body 110, as shown in Figure 15. Also, cutting guide 360 ​​can be inserted into receiver 350 of alignment guide 300.

[0070] A second bone can then be cut with a bone-cutting device. The bone-cutting device can be inserted into the second bone along the cutting guide 360, for example, by inserting the bone-cutting device into the second bone through the first cutting slot 365a of the cutting guide 360. In some examples, a third bone can be cut by inserting the bone-cutting device into the third bone along the cutting guide 360. For example, the bone-cutting device can be inserted into the third bone through the second cutting slot 365b. In some examples, the cutting guide 360 ​​can include one or more guide surfaces 367a, 367b (see FIG. 9 ), in which case the bone-cutting device can be abutted adjacent to the guide surfaces 367a, 367b to cut the second / third bone.

[0071] 17 is a diagram of a top view of the anatomy of the foot of a patient suffering from hallux valgus. As shown in FIG. 17, a first incision 505 can be made, for example, on the side of the foot, near the joint between a second bone 520 (e.g., the first metatarsal) and a third bone 530 (e.g., the medial cuneiform). In some examples, a first cut can be made along line 532, for example, above the second bone 520 (e.g., the first metatarsal).

[0072] In some instances, a second cut can be made along line 534 to cut the third bone 530. In some instances, the first cut line 532 can be substantially parallel to the second cut line 534. In some instances, the first cut line 532 and the second cut line 534 can be substantially parallel to the joint line between the second bone 520 and the third bone 530. In some instances, the first cut line 532 and the second cut line 534 can be substantially perpendicular to the longitudinal axis of the second bone. In some instances, the first and second cuts can be intended to cut the upper surfaces of the second and third bones 520, 530 down to the bloody bone surface and prepare the second and third bones 520, 530 for fusion.

[0073] In some examples, the size of the first incision 505 can be in the range of about 3 mm to about 10 mm, such as about 3 mm to about 5 mm, about 5 mm to about 7 mm, about 7 mm to about 9 mm, and / or about 9 mm to about 10 mm. In other examples, the first incision 505 can have any other suitable size (smaller than 3 mm or larger than 10 mm). In some examples, a separate incision can be provided for each cut (e.g., one incision for the first cut and another incision for the second cut).

[0074] In some examples, one or more additional incisions are made. For example, a second incision 510 can be made on the dorsal / superior side of the foot. The surgeon can run irrigation fluid through the second incision 510 to remove debris and any removed material. The size of the second incision 510 can be the same or similar to the size of the first incision 505. The second incision 510 can also be made to protect soft tissue (e.g., blood vessels, tendons, muscles) that should not be cut / removed during the first / second cut. For example, a blocking device can be made through the second incision 510 to prevent a bone-cutting device (e.g., a burr) from cutting soft tissue that needs to be protected.

[0075] In some instances, before correcting the second bone in the first, second, and / or third plane, a soft tissue release can be performed through an incision 505 inside the joint between the second bone 520 and the third bone 530 to completely free the joint. The soft tissue to be released can include ligaments that may be holding the second and third bones together. Some of this soft tissue can be cut or removed, allowing the second bone 520 to move around to correct its angle / position. This soft tissue release can detach the second bone 520 from the third bone 530, completely freeing the space between them and preparing the two bones for fusion. The soft tissue release can be performed through a scalpel or any other suitable sharp device. After the soft tissue release, the connection between the second bone 520 and the third bone 530 can be loosened, but to some extent, it can still be held together through muscles and tendons. In some instances, a distraction device can be used to loosen a connection between a second bone and a third bone.

[0076] If the joint between the second and third bones is fully freed through soft tissue release prior to correction of the second bone in the first, second, and / or third planes, the first metatarsal and medial cuneiform may not be stable. A system according to the present disclosure may be able to reposition the first metatarsal relative to the middle cuneiform (or other stable bone), which can serve as the basis for measuring the intermetatarsal angle, which can avoid any instability or misalignment of the medial cuneiform, while also avoiding stressing and potentially destroying the second metatarsal (or other metatarsal).

[0077] In some examples, portions of the second bone 520 and the third bone 530 cut by the bone cutting device can be removed, for example, through the incision 505. In some examples, after the second and / or third bones are cut, the anchor body 210 can be moved in a third direction 245 relative to the fixation body 110 using the third movement mechanism 242 of the third portion 240. Movement of the anchor body 210 relative to the fixation body 110 in the third direction 245 can cause the joint adjacent to the second bone (e.g., the first tarsometatarsal joint) to be compressed or pulled apart.

[0078] In some examples, after cutting the second and third bones, the joint can be compressed using the third moving mechanism 242. In this way, the second bone can be pushed close to the third bone and fused together (e.g., the first metatarsal can be screwed or plated into the medial cuneiform bone), bringing the two bones together to form one new bone without a joint. The second and third bones can be fixed together by any suitable means (e.g., using plates, screws, etc.). The (human) body can then begin the healing process, which can cause the two bones to grow together.

[0079] In some instances, after cutting the second and third bones (and before compressing the joint), the joint between the second and third bones can be distracted and the bone surfaces prepared for fusion by fenestration or any other suitable means.

[0080] 16 , in some examples, aligning the main correction assembly can include attaching the alignment guide 300 to the stationary body 110, inserting a joint alignment guide (e.g., cutting guide 360, which may be shown in FIGS. 9 and 16 ) into the receiver 350 of the alignment guide 300, and aligning a ridge (e.g., side edge 368 a / 368 b) of the joint alignment guide 360 ​​with the joint adjacent to the second bone. In some examples, after the stationary body 110 is secured to the first bone, the alignment guide 300 and the joint alignment guide 360 ​​can be removed by detaching the alignment guide 300 from the main correction assembly 100.

[0081] Embodiments of the present disclosure can guide surgeons in performing osteotomies using bone-cutting devices through small incisions for minimally invasive surgery (MIS), particularly for multiplanar Rapidus procedures. The system 10 according to the present disclosure allows surgeons to make two (parallel) cuts near a joint (e.g., the first tarsometatarsal joint) through small incisions (e.g., approximately 3 mm to 3.5 mm) that are smaller than traditional approaches (e.g., with an incision of approximately 3.5 cm), thereby resulting in less scarring, shorter soft tissue healing time, and a lower risk of infection compared to traditional full-exposure techniques. In some examples, embodiments of the present disclosure can be applied to other midfoot fusions (metatarsal adduction) and carpometacarpal joint fusions of the hand.

[0082] 18-20 illustrate another example of a system for controlled realignment of bone in multiple planes according to another example of the present disclosure. The system can include a main correction assembly 100. In some examples, the main correction assembly 100 can include a stationary body portion 110 configured to be fixed to a first bone of a patient and a movable body portion 200 configured to move relative to the stationary body portion 110. The movable body portion 200 includes an anchor body portion 210 configured to be fixed to a second bone of the patient and a first portion 220 configured to rotate the anchor body portion 210 in a first rotational direction 225 in a first plane relative to the stationary body portion. In some examples, the first plane can be a transverse plane.

[0083] In some examples, the main correction assembly 100 can define a rotation axis 150 about which the movable body portion 200 (e.g., the anchor body portion 210 and / or the first portion 220) can be rotated in a first plane relative to the fixed body portion 110. In some examples, the main correction assembly 100 can be configured such that the rotation axis 150 is substantially disposed in a joint adjacent to a second bone when the fixed body portion is secured to a first bone. For example, the rotation axis 150, or at least a portion thereof, can be disposed in a joint adjacent to the second bone, or the shortest distance between the rotation axis 150 and the joint can be less than about 5 mm, preferably less than about 3 mm, and more preferably less than 1 mm.

[0084] In some examples, the first bone can be the medial cuneiform bone. In other examples, the first bone can be the lateral cuneiform bone, the cuboid bone, the navicular bone, or any other suitable and / or stable bone of the patient. In some examples, the second bone can be the first metatarsal bone. In other examples, the second bone can be any other bone that needs to be corrected (e.g., any one of the other metatarsals). In some examples, the joint adjacent to the second bone can be the first tarsometatarsal joint between the medial cuneiform bone and the first metatarsal bone. In other examples, the joint adjacent to the second bone can be any one of the other tarsometatarsal joints.

[0085] Figure 21 illustrates an exemplary stationary body 110 of the system of Figure 18. As shown in Figure 21, the stationary body 110 can include a main body 161 and a first curved arm 162. The first curved arm 162 can extend from the main body 161. For example, the first curved arm 162 can extend from an upper side portion of the main body 161. In some examples, the first portion 220 of the movable body 200 can be configured to rotate along the curved arm 162 of the stationary body 110.

[0086] In some examples, the fixed body portion 110 may further include a second curved arm 163. The second curved arm 163 may extend from the main body portion 161. For example, the second curved arm 163 may extend from a lower side portion of the main body portion 161. In some examples, the first portion 220 of the movable body portion 200 may be configured to rotate along both the first and second curved arms 162, 163 of the fixed body portion 110. In some examples, the first curved arm 162 and / or the second curved arm 163 may be partially circular in shape.

[0087] In some examples, the first curved arm 162 and / or the second curved arm 163 can be configured such that a center C2 of the curve or partial circle of the first curved arm 162 and / or the second curved arm 163 can be disposed substantially within a joint adjacent to a second bone when the fixation body 110 is fixed to a first bone. The center C2 of the curve or partial circle can be positioned within the axis of rotation 150. In some examples, the radius of curvature R1 of the first curved arm 162 can be in a range from about 2 cm to about 7 cm, and more preferably in a range from about 3 cm to about 5 cm.

[0088] If the axis of rotation 150 is not positioned substantially within the joint adjacent to the second bone, the proximal end of the first metatarsal may be forced into the second metatarsal while the mobile body portion 200 is rotated relative to the fixed body portion 110, thereby causing an impingement problem. Aspects of the present disclosure can address the impingement problem by configuring the main orthotic assembly 100 to have the axis of rotation 150 substantially within the joint adjacent to the second bone when the main orthotic assembly 100 is fixed to the patient's foot.

[0089] In some examples, the first curved arm 162 of the fixation body 110 can be engaged with the first moving mechanism 222 of the first portion 220. For example, the first moving mechanism 222 can be rotatably coupled to the first curved arm 162 of the fixation body 110. In some examples, the first curved arm 162 and the first moving mechanism 222 can together form a gear arrangement. For example, the first moving mechanism 222 can be in the form of a worm / threaded rod / screw, and the first curved arm 162 can include teeth 164. In other examples, the first curved arm 162 and the first moving mechanism 222 can together form any other suitable positioning / adjustment mechanism through which the anchor body 210 can rotate in a first direction 225 in a first plane relative to the fixation body 110.

[0090] The first curved arm 162 can have a free end portion 165. The first curved arm 162 can have a stopper 167 at the free end portion 165. The stopper 167 can protrude from the free end portion 165 of the first curved arm 162. The stopper 167 can be provided to prevent the first curved arm 162 (and ultimately the locking body 110) from being removed / disassembled from the first part 220. In some examples, the second curved arm 163 can have a stopper / protrusion at its free end portion to prevent the second curved arm 163 (and ultimately the locking body 110) from being removed / disassembled from the first part 220.

[0091] 21 , 22A-C, and 23 , in some examples, the fixation body portion 110 can include one or more channels configured to receive bone fasteners for (temporarily or removably) fixing the fixation body portion 110 to a first bone. The one or more channels of the fixation body portion 110 can include a first channel 171 having a first track 172 and a second channel 173 having a second track 174. In some examples, the first and second track 172, 174 can be parallel to each other. In this manner, after the fixation body portion 110 is fixed to the first bone, the main orthotic assembly 100 can still be moved along the first / second track 172 / 174 (e.g., in a dorsal-to-plantar or plantar-to-dorsal direction). In some examples, the first and second track 172, 174 can be substantially perpendicular to the first plane.

[0092] In some examples, the one or more channels of the fixation body portion 110 may include a third channel 175 having a third track 176. The third track 176 may be non-parallel to the first and second tracks 172, 174. Thus, when a bone fastener is inserted into the third channel 175 and at least one of the first and second channels 171, 173, movement of the main orthotic assembly 100 along the first / second track 172 / 174 (e.g., in a dorsal-to-plantar or plantar-to-dorsal direction) may be prevented. The angle between the first / second track 172 / 174 and the third track 176 may range from approximately 5° to approximately 25°. In other examples, the angle between the first / second track 172 / 174 and the third track 176 may have any other suitable value (less than 5° or greater than 25°).

[0093] In some examples, the one or more channels of the fixation body portion 110 may include a fourth channel 177 having a fourth track 178. The fourth track 178 may be non-parallel to the first and second tracks 172, 174. Thus, when a bone fastener is inserted into the fourth channel 177 and at least one of the first and second channels 171, 173, movement of the main orthotic assembly 100 along the first / second track 172 / 174 (e.g., in a dorsal-to-plantar or plantar-to-dorsal direction) may be prevented. The angle between the first / second track 172 / 174 and the fourth track 178 may range from approximately 5° to approximately 25°. In other examples, the angle between the first / second track 172 / 174 and the fourth track 178 may have any other suitable value (less than 5° or greater than 25°).

[0094] In some examples, the fourth track 178 can be non-parallel to the third track 176. In some examples, the third and fourth tracks 176, 178 are symmetrical to one another about an axis that is parallel to the first and second tracks. In some examples, the diameter of the bone fastener can be smaller than the diameter of the one or more channels.

[0095] In some examples, the stationary body portion 110 can include one or more visual markers 186, 188 that indicate the direction of the third and / or fourth tracks (e.g., the direction of the channel from the opening in a top view). For example, the stationary body portion 110 can include a first marker 186 that indicates the direction of the third track 176 and a second marker 188 that indicates the direction of the fourth track 178.

[0096] In some examples, the movable body 200 can include a second portion 230 movably connected to the first portion 220. The second portion 230 can have a second movement mechanism 232. The second movement mechanism 232 can be configured to move the anchor body 210 in a second direction 235 in a second plane relative to the fixed body 110.

[0097] In some examples, the second movement mechanism 232 can further move all components disposed between the second movement mechanism 232 and the anchor body portion 210 in a second direction 235 within a second plane. In some examples, the second plane can be perpendicular to the first plane. The second plane can be a sagittal (dorsalis / plantar) plane or substantially parallel to the sagittal plane (e.g., when the main orthotic assembly 100 is attached to a human body). In this example, the second direction 235 can be a dorsalis-to-plantar or plantar-to-dorsalis direction.

[0098] In some examples, first portion 220 can include a bore configured to receive second movement mechanism 232. First portion 220 and second movement mechanism 232 can have a threaded engagement. For example, second movement mechanism 232 can include a screw thread, and the bore of first portion 220 can include an internal thread. Rotation of second movement mechanism 232 can move second movement mechanism 232 (and ultimately second portion 230) in second direction 235 relative to first portion 220.

[0099] In some examples, second movement mechanism 232 can be in the shape of a rod (e.g., a threaded rod). In other examples, second movement mechanism 232 can have any other suitable shape. In some examples, second portion 230 can further include one or more support bodies 236 a and 236 b, which can extend parallel to second movement mechanism 232. In this case, first portion 220 can further include one or more holes configured to receive one or more support bodies 236 a and 236 b.

[0100] In other examples, the second moving mechanism 232 can be moved up and down (in the second direction 235) in any other suitable manner (e.g., simply pushing or pulling the moving mechanism 232 up and down).

[0101] Other configurations / features / attributes of the main straightening assembly 100 of FIG. 18 may be similar and / or the same as those described above with respect to the main straightening assembly 100 illustrated with respect to FIG. 1 and / or FIG. 10A, and therefore, duplicate descriptions may be omitted.

[0102] 24 illustrates a system for controlled realignment of bone in multiple planes according to another example of the present disclosure. The system can include a main correction assembly 100 and a cutting guide assembly (CGA) 600.

[0103] As shown in FIG. 25 , the main correction assembly 100 can include a fixed body portion 110 configured to be fixed to a first bone of a patient and a movable body portion 200 configured to move relative to the fixed body portion 110. Other configurations / features / attributes of the main correction assembly 100 of FIGS. 24-25 can be similar and / or the same as those described above with respect to the main correction assembly 100 illustrated with respect to FIGS. 1 , 10A, and / or 18, and therefore, redundant description may be omitted.

[0104] 26 , the cutting guide assembly 600 can include a first CGA portion 610 configured to be removably coupled to the fixed body portion 110 of the main correction assembly 100, a second CGA portion 620, and a cutting guide 630 configured to guide a bone-cutting device. The first CGA portion 610 can be movably coupled to the second CGA portion 620.

[0105] The first CGA portion 610 can include an opening 611. In some examples, an inner surface 612 of the first CGA portion 610 within the opening 611 is configured to be secured to an outer surface of the fixation body 110. In some examples, the first CGA portion 610 can be ring-shaped or hoop-shaped, as shown in FIG. 26 . In other examples, the first CGA portion 610 can have any other suitable shape (e.g., oval, rectangular, triangular, square, hexagonal, or any other suitable polygonal shape). In some examples, the first CGA portion 610 can be rotatable in a rotational direction 615 about a rotational axis 614 relative to the second CGA portion 620.

[0106] The second CGA portion 620 can be movably coupled to the cutting guide 630. In some examples, the second CGA portion 620 can be an (elongated) arm. The arm can include a slot 622. The slot 622 can be elongated. In some examples, the first CGA portion 610 can be movable along the slot 622 relative to the second CGA portion 620 (e.g., in the fifth direction 616).

[0107] In some examples, the second CGA portion 620 can be configured to move / rotate in a sixth direction 625 relative to the cutting guide 630. In some examples, the fifth direction 616 can be (substantially) perpendicular to the sixth direction 625.

[0108] The cutting guide 630 can include one or more cutting slots 631 a, 631 b configured to receive a bone-cutting device. In some examples, the one or more cutting slots can include a first cutting slot 631 a and a second cutting slot 631 b. The first cutting slot 631 a can be provided to guide the bone-cutting device to cut a third bone, and the second cutting slot 631 b can be provided to guide the bone-cutting device to cut a second bone. Although only two cutting slots are shown in FIG. 26 , more or less than two cutting slots (e.g., one, three, four, five, etc.) can be provided by the cutting guide 630.

[0109] In some examples, the first cutting slot 631 a can be parallel to the second cutting slot 631 b. In other examples, the first cutting slot 631 a can be non-parallel to the second cutting slot 631 b. In some examples, at least a portion of the cutting guide 630 and one or more cutting slots can be curved, as shown in FIG. 26. In other examples, the entire body of the cutting guide 630 can be flat.

[0110] In some examples, the cutting guide 630 can include one or more distal channels 633 configured to receive bone fasteners for securing the cutting guide 630 to a second bone. In some examples, the cutting guide 630 can include multiple distal channels 633, and at least two of the distal channels 633 can have different diameters for different sized bone fasteners.

[0111] In some examples, the cutting guide 630 can also include one or more central channels 634 configured to receive a bone fastener to be inserted into a joint adjacent a second bone and align the cutting guide 630 with the joint. In some examples, the one or more central channels 634 can be disposed between the first cutting slot 631 a and the second cutting slot 631 b. In some examples, the cutting guide 630 can include multiple central channels 634, with at least two of the central channels 634 having different diameters for different sized bone fasteners.

[0112] In some examples, the one or more central channels 634 can serve as alignment channels similar to the alignment channel 302 of the alignment guide 300. That is, the cutting guide assembly 600 and the main orthotic assembly 100 can be aligned relative to a first bone and a second bone using the one or more central channels 634 and bone fasteners inserted into the one or more central channels 634. For example, a bone fastener can be inserted into a joint adjacent to the second bone of the patient (e.g., the first tarsometatarsal joint), and the bone fastener can be inserted down through the one or more central channels 634 while the cutting guide assembly 600 is coupled to the main orthotic assembly 100.

[0113] In some examples, the cutting guide assembly 600 can further include an adjustable fastening mechanism 640. The adjustable fastening mechanism 640 can be configured to fasten and unfasten the first CGA portion 610 to the second CGA portion 620. Fastening the first CGA portion 610 to the second CGA portion 620 with the adjustable fastening mechanism 640 can prevent the first CGA portion 610 from moving and / or rotating relative to the second CGA portion 620. In some examples, the adjustable fastening mechanism 640 can be a cam lock lever. In other examples, the adjustable fastening mechanism 640 can be any other suitable fastening means.

[0114] In some examples, the cutting guide assembly 600 may further include a connector 650. The connector 650 may connect the second CGA portion 620 to the cutting guide 630. In some examples, the cutting guide 630 may be configured to move in a seventh direction 635 relative to the connector 650. In some examples, the seventh direction 635 may be (substantially) perpendicular to the sixth direction 625. In some examples, the plane in which the seventh direction 635 is disposed may be (substantially) perpendicular to the plane in which the sixth direction 625 is disposed. In some examples, the fifth direction 616 may be disposed within the plane in which the sixth direction 625 is disposed.

[0115] FIG. 27 illustrates an exemplary cutting guide 700 according to one example of the present disclosure. The cutting guide 700 can include one or more cutting slots configured to receive a bone-cutting device. In some examples, the one or more cutting slots can include a first cutting slot 710a and a second cutting slot 710b. The first cutting slot 710a can be provided to guide the bone-cutting device to cut a third bone, and the second cutting slot 710b can be provided to guide the bone-cutting device to cut a second bone. Although only two cutting slots are shown in FIG. 27 , more or fewer than two cutting slots (e.g., one, three, four, five, etc.) can be provided by the cutting guide 700. In some examples, the first cutting slot 710a can be parallel to the second cutting slot 710b. In other examples, the first cutting slot 710a can be non-parallel to the second cutting slot 710b. In some instances, the entire body of the cutting guide 700 can be flat.

[0116] In some examples, cutting guide 700 can include one or more fixation channels configured to receive bone fasteners to secure cutting guide 700 to a second bone and a third bone. For example, cutting guide 700 can include a proximal fixation channel 722 configured to receive a first bone fastener to secure cutting guide 700 to a third bone of the patient, and a distal fixation channel 724 configured to receive a second bone fastener to secure cutting guide 700 to the second bone of the patient.

[0117] In some examples, the proximal fixation channel 722 and the distal fixation channel 724 can be disposed on opposite sides of the cutter slots 710 a, 710 b. In some examples, the proximal fixation channel 722 and the distal fixation channel 724 can define a straight line extending from the proximal fixation channel 722 to the distal fixation channel 724, and the straight line can be substantially perpendicular to at least one of the cutter slots 710 a, 710 b.

[0118] In some examples, the cutting guide 700 can also include a central channel 732 configured to receive a bone fastener to be inserted into the joint adjacent the second bone and align the cutting guide 700 with the joint, the second bone, and / or a third bone. In some examples, the central channel 732 can be disposed between the first cutting slot 710a and the second cutting slot 710b. In some examples, the central channel 732 can be disposed on a line defined by the proximal fixation channel 722 and the distal fixation channel 724. Although only one proximal fixation channel 722, one distal fixation channel 724, and one central channel 732 are shown in FIG. 27 , each of these channels can have two or more channels (e.g., two, three, four, five, etc.).

[0119] In some examples, the diameters of proximal fixation channel 722 and distal fixation channel 724 can be larger than the diameter of central channel 732 such that proximal fixation channel 722 and distal fixation channel 724 can receive bone fasteners having larger diameters than central channel 732. In other examples, the diameters of proximal fixation channel 722 and distal fixation channel 724 can be the same as the diameter of central channel 732.

[0120] In some examples, the shortest distance between the proximal fixation channel 722 and the first cutting slot 710a can be in the range of about 2 mm to about 10 mm. Similarly, the shortest distance between the distal fixation channel 724 and the second cutting slot 710b can be in the range of about 2 mm to about 10 mm.

[0121] In some examples, the cutting guide 700 can be cross-shaped, as shown in FIG. 27 . For example, the cutting guide 700 can include an elongated main body portion 702, a proximal protrusion 704, and a distal protrusion 705, the cutting slots 710 a, 710 b can extend along and be elongated along the elongated main body portion 702, the proximal protrusion 704 extending from the elongated main body portion 702 and having a proximal locking channel 722, and the distal protrusion 705 extending from the elongated main body portion 702 and having a distal locking channel 724. The distal protrusion 705 can extend from the elongated main body portion 702 in a direction opposite the direction in which the proximal protrusion 704 extends from the elongated main body portion 702. In other examples, the cutting guide 700 can have any other suitable shape (e.g., circular, rectangular, or any other suitable polygonal shape).

[0122] FIG. 28 illustrates another exemplary cutting guide 800 according to one example of the present disclosure. The cutting guide 800 can include one or more cutting slots configured to receive a bone-cutting device. In some examples, the one or more cutting slots can include a first cutting slot 810a and a second cutting slot 810b. The first cutting slot 810a can be provided to guide the bone-cutting device to cut a third bone, and the second cutting slot 810b can be provided to guide the bone-cutting device to cut a second bone. Although only two cutting slots are shown in FIG. 28 , more or fewer than two cutting slots (e.g., one, three, four, five, etc.) can be provided by the cutting guide 800. In some examples, the first cutting slot 810a can be parallel to the second cutting slot 810b. In other examples, the first cutting slot 810a can be non-parallel to the second cutting slot 810b. In some examples, all or at least a portion of the cutting guide 800 and one or more cutting slots 810a, 810b can be curved.

[0123] In some examples, cutting guide 800 can include one or more fixation channels configured to receive bone fasteners to secure cutting guide 800 to a second bone and a third bone. For example, cutting guide 800 can include one or more proximal fixation channels 822a, 822b configured to receive bone fasteners to secure cutting guide 800 to a third bone of the patient, and one or more distal fixation channels 824a, 824b configured to receive bone fasteners to secure cutting guide 800 to the second bone of the patient.

[0124] In some examples, one or more proximal fixation channels and one or more distal fixation channels can be disposed on opposite sides of the cutting slots 810 a, 810 b. For example, a first proximal fixation channel 822 a and a first distal fixation channel 824 a can be disposed on opposite sides of the cutting slots 810 a, 810 b, and a second proximal fixation channel 822 b and a second distal fixation channel 824 b can be disposed on opposite sides of the cutting slots 810 a, 810 b.

[0125] In some examples, the first / second proximal fixation channel 822a / b and the first / second distal fixation channel 824a / b can define a straight line extending from the first / second proximal fixation channel 822a / b to the first / second distal fixation channel 824a / b, and the straight line can be substantially perpendicular to at least one of the cutting slots 810a, 810b.

[0126] In some examples, the cutting guide 800 can also include one or more central channels 832 a, 832 b, 832 c configured to receive a bone fastener to be inserted into a joint adjacent a second bone and align the cutting guide 800 with the joint, the second bone, and / or a third bone. In some examples, the one or more central channels 832 a, 832 b, 832 c can be disposed between the first cutting slot 810 a and the second cutting slot 810 b. In some examples, the one or more central channels 832 a, 832 b can be disposed on a line defined by the first / second proximal fixation channels 822 a / b and the first / second distal fixation channels 824 a / b.

[0127] In some examples, the diameters of the proximal and distal fixation channels can be larger than the diameter of the one or more central channels such that the proximal and distal fixation channels can receive bone fasteners having larger diameters than the central channel, while in other examples, the diameters of the proximal and distal fixation channels can be the same as the diameter of the central channel.

[0128] In some examples, the shortest distance between one or more proximal fixation channels 822a, 822b and the first cutting slot 810a can be in a range of about 2 mm to about 10 mm. Similarly, the shortest distance between one or more distal fixation channels 824a, 824b and the second cutting slot 810b can be in a range of about 2 mm to about 10 mm. In some examples, the shortest distance between the first proximal fixation channel 822a and the first cutting slot 810a can be shorter than the shortest distance between the second proximal fixation channel 822b and the first cutting slot 810a. Similarly, the shortest distance between the first distal fixation channel 824a and the second cutting slot 810b can be shorter than the shortest distance between the second distal fixation channel 824b and the second cutting slot 810b.

[0129] In some examples, the cutting guide 800 can include multiple proximal and distal projections, as shown in Figure 28. The cutting guide 800 can include an elongated main body portion 802, and the cutting slots 810a, 810b can extend along and be elongated along the elongated main body portion 802. The cutting guide 800 can further include a first proximal projection 804a and a first distal projection 805a, the first proximal projection 804a extending from the elongated main body portion 802 and having a first proximal fixation channel 822a, and the first distal projection 805a extending from the elongated main body portion 802 and having a first distal fixation channel 824a. The cutting guide 800 can also include a second proximal protrusion 804b and a second distal protrusion 805b, where the second proximal protrusion 804b extends from the elongate main body portion 802 and has a second proximal fixation channel 822b, and the second distal protrusion 805b extends from the elongate main body portion 802 and has a second distal fixation channel 824b. The first / second distal protrusions 805a / b can extend from the elongate main body portion 802 in a direction opposite to the direction in which the first / second proximal protrusions 804a / b extend from the elongate main body portion 802. In other examples, the cutting guide 800 can have any other suitable shape (e.g., circular, rectangular, or any other suitable polygonal shape).

[0130] 29A and 29B illustrate exemplary uses of the cutting guides 700, 800 of FIGS. 27 and 28, respectively, according to one example of the present disclosure. Referring to FIG. 29A, the cutting guide 700 can be disposed dorsally around a joint adjacent to a second bone, allowing a bone-cutting device to be approached dorsally. Referring to FIG. 29B, the cutting guide 800 can cover both the dorsal and medial sides of the joint adjacent to the second bone, allowing a bone-cutting device to be approached dorsally or dorsomedially. In this manner, the cutting guides 700 / 800 allow a bone-cutting device to be approached from the dorsal or dorsomedial direction, thereby preventing damage to soft tissue or another bone (e.g., the second metatarsal) that may occur when a bone-cutting device is approached from the medial side.

[0131] 30A and 30B illustrate another exemplary cutting guide 900 according to one example of the present disclosure. The exemplary cutting guide 900 can include one or more cutting slots configured to receive a bone-cutting device. In some examples, the one or more cutting slots can include a first cutting slot 910a and a second cutting slot 910b. The first cutting slot 910a can be provided to guide the bone-cutting device to cut a third bone, and the second cutting slot 910b can be provided to guide the bone-cutting device to cut a second bone. Although only two cutting slots are shown in FIG. 30A , more or fewer than two cutting slots (e.g., one, three, four, five, etc.) can be provided by the cutting guide 900. In some examples, the first cutting slot 910a can be parallel to the second cutting slot 910b. In other examples, the first cutting slot 910a can be non-parallel to the second cutting slot 910b. In some instances, the entire body of the cutting guide 900 and cutting slot, or at least a portion thereof, can be curved, while in other instances, the entire body of the cutting guide 900 can be flat.

[0132] In some examples, cutting guide 900 can include one or more fixation channels configured to receive bone fasteners to secure cutting guide 900 to a second bone and a third bone. For example, cutting guide 900 can include one or more proximal fixation channels 922 configured to receive bone fasteners to secure cutting guide 900 to a third bone of the patient, and one or more distal fixation channels 924 configured to receive bone fasteners to secure cutting guide 900 to the second bone of the patient.

[0133] In some examples, the one or more proximal fixation channels 922 and the one or more distal fixation channels 924 can be disposed on opposite sides of the cut slots 910 a, 910 b. In some examples, the one or more proximal fixation channels 922 and the one or more distal fixation channels 924 can define a straight line extending from the one or more proximal fixation channels 922 to the one or more distal fixation channels 924, and the straight line can be substantially perpendicular to at least one of the cut slots 910 a, 910 b.

[0134] 30A , the cutting guide 900 can be cross-shaped. For example, the cutting guide 900 can include an elongated main body portion 902, a proximal protrusion 904, and a distal protrusion 905, the cutting slots 910 a, 910 b can extend along and be elongated along the elongated main body portion 902, the proximal protrusion 904 extending from the elongated main body portion 902 and having one or more proximal fixation channels 922, and the distal protrusion 905 extending from the elongated main body portion 902 and having one or more distal fixation channels 924. The distal protrusion 905 can extend from the elongated main body portion 902 in a direction opposite to the direction in which the proximal protrusion 904 extends from the elongated main body portion 902. In other examples, the cutting guide 900 can have any other suitable shape (eg, circular, rectangular, or any other suitable polygonal shape).

[0135] In some examples, the cutting guide 900 may also include one or more central channels 932, 934 configured to receive a bone fastener to be inserted into a joint adjacent a second bone and align the cutting guide 900 with the joint, the second bone, and / or a third bone. In some examples, the first central channel 932 may be disposed between the first cutting slot 910a and the second cutting slot 910b. In some examples, the central channel 932 may be disposed on a line defined by the one or more proximal fixation channels 922 and the one or more distal fixation channels 924. The second central channel 934 may be disposed in a lower portion of the elongated main body portion 902. In some examples, the first central channel 932 and the second central channel 934 may define a line, which may be parallel to at least one of the cutting slots 910a, 910b.

[0136] In some examples, the diameter of one or more proximal fixation channels 922 and one or more distal fixation channels 924 can be larger than the diameter of the central channel 932, 934 such that the proximal and distal fixation channels 922, 924 can accept bone fasteners having larger diameters than the central channel 932, 934. In other examples, the diameter of the proximal and distal fixation channels 922, 924 can be the same as the diameter of the central channel 932, 934.

[0137] In some examples, the shortest distance between the innermost proximal fixation channel 922 and the first cutting slot 910a can be in the range of about 2 mm to about 10 mm. Similarly, the shortest distance between the innermost distal fixation channel 924 and the second cutting slot 910b can be in the range of about 2 mm to about 10 mm.

[0138] In some examples, the cutting guide 900 can include a top surface 942 and a bottom surface 944 opposite the top surface 942, and the cutting guide 900 can further include one or more fins protruding from the bottom surface 944. The one or more fins can include a first fin 950 a and a second fin 950 b. The one or more fins can be configured to interact with a joint adjacent the second bone and help ensure the cutting guide 900 is properly oriented and centered relative to the joint.

[0139] In some examples, one or more fins may protrude from the elongated main body portion 902. The central channel 932 may define a central channel axis 933, which may be disposed between the first fin 950 a and the second fin 950 b. In some examples, the length of the first fin 950 a may be greater than the length of the second fin 950 b.

[0140] 31A and 31B illustrate an exemplary use of the cutting guide 900 of FIGS. 30A and 30B according to one example of the present disclosure. In some examples, a first bone fastener 972 can be inserted into a joint adjacent to a second bone (e.g., the first tarsometatarsal joint). The first bone fastener 972 can be flush with the joint. The cutting guide 900 can then be slid down over the first bone fastener 972 by inserting the first bone fastener 972 down through the central channel 932. Then, in some examples, a second bone fastener 974 can be inserted into the central channel 934 and into the joint adjacent to the second bone. The second bone fastener 974 can be flush with the joint. The use of the second bone fastener 974 can help ensure alignment of the cutting guide 900 with respect to the joint and can further secure the cutting guide 900 during insertion of additional bone fasteners in subsequent steps.

[0141] After the first bone fastener 972 and / or the second bone fastener 974 are inserted into the joint, the third and fourth bone fasteners 976, 978 can be inserted into the proximal and distal fixation channels 922, 924. After the third and fourth bone fasteners 976, 978 are inserted, the first bone fastener 972 and / or the second bone fastener 974 can be removed to create space and / or allow clearance for the bone cutting device, as shown in FIG. 31B . The bone cutting device can then be inserted into the cutting slots 910a and 910b to cut the third and second bones, which prepares the joint between the third and second bones for fusion. After the cuts are made, the third and fourth bone fasteners 976, 978 can be removed, and the cutting guide 900 can be removed.

[0142] In some examples, the cutting guide assembly (CGA) 600 and cutting guides 700, 800, 900 can be made from metal (stainless steel or titanium alloy), while in other examples, the cutting guide assembly (CGA) 600 and cutting guides 700, 800, 900 can be made from any other suitable durable material.

[0143] 32 and 33 illustrate another exemplary system for controlled realignment of bone in multiple planes according to another example of the present disclosure. The system can include a main correction assembly 100. In some examples, the main correction assembly 100 can include a stationary body portion 110 configured to be secured to a first bone of a patient and a movable body portion 200 configured to move relative to the stationary body portion 110. The movable body portion 200 can include an anchor body portion 210 configured to be secured to a second bone of the patient and a first portion 220 configured to rotate the anchor body portion 210 in a first rotational direction 225 in a first plane relative to the stationary body portion. In some examples, the first plane can be a transverse plane.

[0144] In some examples, the main correction assembly 100 can define a rotation axis 150 about which the movable body portion 200 (e.g., the anchor body portion 210 and / or the first portion 220) can be rotated in a first plane relative to the fixed body portion 110. In some examples, the main correction assembly 100 can be configured such that the rotation axis 150 is substantially disposed in a joint adjacent to a second bone when the fixed body portion is secured to a first bone. For example, the rotation axis 150, or at least a portion thereof, can be disposed in a joint adjacent to the second bone, or the shortest distance between the rotation axis and the joint can be less than about 5 mm, preferably less than about 3 mm, and more preferably less than 1 mm.

[0145] In some examples, the movable body 200 can include a second portion 230. The second portion 230 can have a second movement mechanism 232 configured to rotate the anchor body 210 relative to the fixed body 110 in a second direction 235 within a second plane. The second portion 230 can include a second partial body 234. In some examples, the second movement mechanism 232 can further move all components disposed between the second movement mechanism 232 and the anchor body 210 in the second direction 235 within the second plane. In some examples, the second plane can be perpendicular to the first plane. The second plane can be a sagittal (dorsalis / plantar) plane or substantially parallel to the sagittal plane (e.g., when the main orthotic assembly 100 is attached to a human body).

[0146] In some examples, the second moving mechanism 232 can be a threaded rod, and the second portion body 234 can include internal threads configured to engage with the threaded rod. Rotation of the second moving mechanism 232 can rotate the anchor body 210 in a second direction 235 in a second plane relative to the fixation body 110. In some examples, rotation of the second moving mechanism 232 can further rotate all components disposed between the second moving mechanism 232 and the anchor body 210 in the second direction 235 in the second plane. For example, the connecting body 131 can be provided between the third portion 240 and the second portion 230. The connecting body 131 can be coupled to the second moving mechanism 232. The connecting body portion 131 (and ultimately the third portion 240) can be moved along the second partial body portion 234 by moving the second moving mechanism 232 along the second partial body portion 234.

[0147] 33, in some examples, second partial body portion 234 can be curved. Thus, second moving mechanism 232 can also rotate along the curve of second partial body portion 234. In some examples, the radius of curvature of second partial body portion 234 and / or direction 235 can be in the range of about 5 cm to about 20 cm.

[0148] Other configurations / features / attributes of the main straightening assembly 100 of Figures 32 and 33 may be similar and / or the same as those described above with respect to the main straightening assembly 100 illustrated with respect to Figure 18, and therefore, duplicate descriptions may be omitted.

[0149] Embodiment I Various aspects of the subject matter described herein are set forth in the following numbered embodiments.

[0150] Embodiment 1. A system, the system including a main correction assembly, the main correction assembly including a fixed body portion configured to be fixed to a first bone of a patient, and a movable body portion configured to move relative to the fixed body portion, the movable body portion including an anchor body portion configured to be fixed to a second bone of the patient, and a first portion having a first movement mechanism configured to move the anchor body portion in a first direction in a first plane relative to the fixed body portion.

[0151] Embodiment 2. The system of embodiment 1, wherein the first bone includes one of the middle cuneiform, the lateral cuneiform, the cuboid, and the navicular.

[0152] Embodiment 3. The system of any one of embodiments 1-2, wherein the second bone includes a first metatarsal.

[0153] Embodiment 4. A system described in any one of embodiments 1 to 3, wherein the anchor body includes a toothed flange, the first moving mechanism includes a first threaded rod rotatably coupled to the toothed flange of the anchor body, and rotation of the first threaded rod rotates the anchor body in a first plane relative to the anchor body.

[0154] Embodiment 5. A system according to any one of embodiments 1 to 4, wherein the first plane is a transverse plane.

[0155] Embodiment 6. A system described in any one of embodiments 1 to 5, wherein the movable body portion further includes a second portion having a second movement mechanism configured to move the anchor body portion in a second direction in a second plane relative to the fixed body portion.

[0156] Embodiment 7. The system of embodiment 6, wherein the second plane is perpendicular to the first plane.

[0157] Embodiment 8. A system described in any one of embodiments 6 to 7, wherein the second plane is a sagittal plane.

[0158] Embodiment 9. The system of any one of embodiments 6 to 8, wherein the second movement mechanism includes a second partial body portion and a mover.

[0159] Embodiment 10. A system described in any one of embodiments 1 to 9, wherein the movable body portion further includes a third portion having a third movement mechanism configured to move the anchor body portion in a third direction relative to the fixed body portion.

[0160] Embodiment 11. The system of embodiment 10, wherein the third direction is within the first plane.

[0161] Embodiment 12. A system described in any one of embodiments 10-11, wherein movement of the anchor body portion relative to the fixation body portion in a third direction causes the joint adjacent to the second bone to be compressed or pulled apart.

[0162] Embodiment 13. A system described in any one of embodiments 10 to 12, wherein the third moving mechanism includes a third threaded rod, and the third portion further includes a third threaded rod support extending parallel to the third threaded rod.

[0163] Embodiment 14. A system described in any one of embodiments 1 to 13, wherein the movable body portion further includes a fourth portion having a fourth movement mechanism configured to move the anchor body portion in a fourth direction within a third plane relative to the fixed body portion.

[0164] Embodiment 15. The system of embodiment 14, wherein the third plane is the coronal plane.

[0165] Embodiment 16. A system described in any one of embodiments 14 to 15, wherein the anchor body includes a rotating arm rotatably coupled to the fourth moving mechanism and an anchor base configured to be fixed to a second bone of the patient.

[0166] Embodiment 17. The system of embodiment 16, wherein the rotating arm is curved or partially circular in shape.

[0167] Embodiment 18. The system of embodiment 17, wherein the rotating arm is configured so that the center of the curve or partial circle is positioned within the second bone when the anchor body is fixed to the second bone.

[0168] Embodiment 19. A system described in any one of embodiments 16 to 18, wherein the anchor base extends in a third direction and the rotating arm extends in a direction perpendicular to the third direction.

[0169] Embodiment 20. A system described in any one of embodiments 16 to 19, wherein the anchor base includes one or more channels configured to receive a bone fastener.

[0170] Embodiment 21. A system described in any one of embodiments 16 to 20, wherein the fourth moving mechanism includes a fourth threaded rod rotatably coupled to the rotating arm, and rotation of the fourth threaded rod rotates the anchor body portion in a fourth direction relative to the fixation body portion.

[0171] Embodiment 22. A system described in any one of embodiments 1 to 21, wherein the fixation body portion includes one or more channels configured to receive a bone fastener.

[0172] Embodiment 23. The system described in embodiment 22, wherein the one or more channels of the fixed body portion include a first channel having a first track, a second channel having a second track, and a third channel having a third track, wherein the first and second tracks are parallel to each other and the third track is non-parallel to the first and second tracks.

[0173] Embodiment 24. A system described in any one of embodiments 1 to 23, wherein the system further includes an alignment guide configured to be removably coupled to the fixed body portion of the main orthodontic assembly.

[0174] Embodiment 25. The system of embodiment 24, wherein the alignment guide includes an alignment channel configured to receive a bone fastener, and the alignment guide and main orthodontic assembly are aligned relative to the first bone and the second bone using the alignment channel and the bone fastener.

[0175] Embodiment 26. The system of embodiment 25, wherein the bone fastener is configured to be inserted into a joint adjacent to a second bone of the patient.

[0176] Embodiment 27. A system described in any one of embodiments 25 to 26, wherein the alignment guide includes: a first support having a first end portion and a second end portion; a second support having a first end portion and a second end portion, wherein the fixed body portion is interposed between the first support and the second support when the alignment guide is coupled to the fixed body portion; a third support having a first end portion connected to the second end portion of the first support and a second end portion connected to the second end portion of the second support; and a fixation device configured to fix the alignment guide to the fixed body portion, wherein the fixation device is connected to the first end portion of the first support and the first end portion of the second support.

[0177] Embodiment 28. The system of embodiment 27, wherein the alignment channel is disposed in a third support.

[0178] Embodiment 29. A system described in any one of embodiments 27 to 28, wherein the alignment guide further includes a receiver configured to receive a cutting guide configured to guide a bone cutting device, and the receiver is disposed at a second end portion of the third support.

[0179] Embodiment 30. The system described in embodiment 29, wherein the cutting guide includes one or more cutting slots, and the bone cutting device is configured to be inserted into the one or more cutting slots.

[0180] Embodiment 31. A system described in any one of embodiments 29 to 30, wherein the cutting guide includes one or more guide surfaces and the bone cutting device is configured to be abutted adjacent to the one or more guide surfaces.

[0181] Embodiment 32. A system described in any one of embodiments 27 to 31, wherein the alignment guide further includes a receiver configured to receive the joint alignment guide, the receiver being disposed at the second end portion of the third support.

[0182] Embodiment 33. The system of embodiment 32, wherein the joint alignment guide includes one or more ridges, the one or more ridges configured to align with a joint adjacent to a second bone of the patient.

[0183] Embodiment 34. A method of using a system described in any one of embodiments 1 to 33, the method including the steps of aligning a main correction assembly relative to a first and second bone of a patient, fixing a fixation body portion to the first bone of the patient, fixing an anchor body portion to a second bone of the patient, using a first moving mechanism to move the anchor body portion in a first direction in a first plane relative to the fixation body portion to correct the position of the second bone in the first direction, and cutting the second bone with a bone cutting device.

[0184] Embodiment 35. The method of embodiment 34, wherein the method further includes inserting a first bone fastener into the joint adjacent to a second bone of the patient before the step of aligning the main correction assembly, and the step of aligning the main correction assembly includes attaching an alignment guide to the fixed body portion and inserting the first bone fastener down through the alignment channel of the alignment guide.

[0185] Embodiment 36. The method of embodiment 35, wherein the step of fixing the fixation body to the first bone includes inserting one or more bone fasteners into the first bone through one or more channels of the fixation body.

[0186] Embodiment 37. The method of any one of embodiments 35-36, wherein the method further comprises removing the first bone fastener by withdrawing the first bone fastener from the alignment channel of the joint and alignment guide.

[0187] Embodiment 38. The method of embodiment 37, wherein the method further comprises removing the alignment guide by detaching the alignment guide from the main orthodontic assembly.

[0188] Embodiment 39. The method of any one of embodiments 34 to 38, wherein the step of fixing the anchor body to the second bone includes inserting one or more bone fasteners into the second bone through one or more channels in the anchor body.

[0189] Embodiment 40. The method of any one of embodiments 34 to 39, further comprising using a second movement mechanism of the second portion of the movable body to move the anchor body in a second direction in a second plane relative to the fixed body, thereby correcting the position of the second bone in the second direction.

[0190] Embodiment 41. The method of embodiment 40, wherein the second plane is a sagittal plane.

[0191] Embodiment 42. The method of any one of embodiments 34 to 41, wherein the method further includes a step of using a third movement mechanism of a third portion of the movable body portion to move the anchor body portion in a third direction relative to the fixed body portion.

[0192] Embodiment 43. The method of embodiment 42, wherein movement of the anchor body relative to the fixation body in a third direction causes the joint adjacent to the second bone to be compressed or pulled apart.

[0193] Embodiment 44. The method of any one of embodiments 34 to 43, further comprising using a fourth movement mechanism of the fourth part of the movable body portion to move the anchor body portion in a fourth direction in a third plane relative to the fixed body portion, thereby correcting the position of the second bone in the fourth direction.

[0194] Embodiment 45. The method of embodiment 44, wherein the third plane is the coronal plane.

[0195] Embodiment 46. The method of any one of embodiments 34 to 45, wherein the step of cutting the second bone includes inserting a bone cutting device into the second bone along the cutting guide.

[0196] Embodiment 47. The method of embodiment 46, wherein the cutting guide includes one or more cutting slots, and the step of inserting the bone cutting device along the cutting guide into the second bone includes the step of inserting the bone cutting device into the second bone through one of the cutting slots.

[0197] Embodiment 48. The method of any one of embodiments 34 to 47, wherein the method further comprises the step of cutting a third bone by inserting a bone cutting device into the third bone along the cutting guide.

[0198] Embodiment 49. The method of embodiment 48, wherein the cutting guide includes one or more cutting slots, and the step of inserting the bone cutting device along the cutting guide into the third bone includes the step of inserting the bone cutting device into the third bone through one of the cutting slots.

[0199] Embodiment 50. A method according to any one of embodiments 48 to 49, wherein the cutting guide includes one or more guide surfaces, and the step of inserting the bone-cutting device along the cutting guide into the third bone includes abutting the bone-cutting device adjacent to one of the guide surfaces.

[0200] Embodiment 51. The method of any one of embodiments 34 to 50, wherein the step of aligning the main orthodontic assembly includes the steps of attaching an alignment guide to the fixed body portion, inserting a joint alignment guide into the alignment guide receiver, and aligning the ridge of the joint alignment guide with the joint adjacent to the second bone.

[0201] Embodiment 52. The method of embodiment 51, wherein the step of fixing the fixation body to the first bone includes inserting one or more bone fasteners into the first bone through one or more channels of the fixation body.

[0202] Embodiment 53. The method of embodiment 52, wherein the method further comprises removing the alignment guide and the joint alignment guide by detaching the alignment guide from the main orthodontic assembly.

[0203] Embodiment II Various additional aspects of the subject matter described herein are set forth in the following numbered embodiments.

[0204] Embodiment 1. A system including a main correction assembly, the main correction assembly including a fixed body configured to be fixed to a first bone of a patient and a movable body configured to move relative to the fixed body, the movable body including an anchor body configured to be fixed to a second bone of the patient and a first portion configured to rotate the anchor body in a first rotational direction in a first plane relative to the fixed body, the main correction assembly defining a rotation axis, the anchor body being rotated in the first plane relative to the fixed body by the first portion about the rotation axis, the main correction assembly configured such that the rotation axis is substantially disposed in a joint adjacent to the second bone when the fixation body is fixed to the first bone.

[0205] Embodiment 2. The system of embodiment 1, wherein the first bone includes one of the middle cuneiform, the lateral cuneiform, the cuboid, and the navicular.

[0206] Embodiment 3. The system of any one of embodiments 1 and 2, wherein the second bone includes a first metatarsal.

[0207] Embodiment 4. A system according to any one of embodiments 1 to 3, wherein the joint comprises the first tarsometatarsal joint between the medial cuneiform bone and the first metatarsal bone.

[0208] Embodiment 5. A system described in any one of embodiments 1 to 4, wherein the fixed body portion includes a curved arm and the first portion is configured to rotate along the curved arm of the fixed body portion.

[0209] Embodiment 6. The system of embodiment 5, wherein the curved arm includes teeth, and the first portion includes a first threaded rod rotatably coupled to the teeth of the curved arm of the anchor body, and rotation of the first threaded rod along the teeth of the curved arm rotates the anchor body in a first plane relative to the anchor body.

[0210] Embodiment 7. The system of any one of embodiments 1 to 6, wherein the first plane is a transverse plane.

[0211] Embodiment 8. A system described in any one of embodiments 1 to 7, wherein the fixation body portion includes one or more channels configured to receive a bone fastener so that the fixation body portion is fixed to the first bone.

[0212] Embodiment 9. The system described in embodiment 8, wherein the one or more channels of the fixed body portion include a first channel having a first track, a second channel having a second track, and a third channel having a third track, wherein the first and second tracks are parallel to each other and the third track is non-parallel to the first and second tracks.

[0213] Embodiment 10. The system of embodiment 9, wherein the one or more channels of the fixed body portion further include a fourth channel having a fourth trajectory, the fourth trajectory being non-parallel to the first, second, and third trajectories.

[0214] Embodiment 11. The system of embodiment 10, wherein the third and fourth trajectories are symmetrical to each other about an axis parallel to the first and second trajectories.

[0215] Embodiment 12. A system described in any one of embodiments 10 to 11, wherein the fixed body portion includes one or more visual markers indicating the direction of the third and / or fourth trajectories.

[0216] Embodiment 13. A system described in any one of embodiments 1 to 12, wherein the movable body portion further includes a second portion configured to move the anchor body portion in a second direction within a second plane relative to the fixed body portion.

[0217] Embodiment 14. The system of embodiment 13, wherein the second plane is perpendicular to the first plane.

[0218] Embodiment 15. A system described in any one of embodiments 13 to 14, wherein the second plane is a sagittal plane.

[0219] Embodiment 16. A system described in any one of embodiments 13 to 15, wherein the movable body portion further includes a third portion configured to move the anchor body portion in a third direction relative to the fixed body portion.

[0220] Embodiment 17. The system of embodiment 16, wherein the third direction is parallel to the first plane and / or the second plane.

[0221] Embodiment 18. A system described in any one of embodiments 16-17, wherein movement of the anchor body portion relative to the fixation body portion in a third direction causes the joint adjacent to the second bone to be compressed or pulled apart.

[0222] Embodiment 19. A system described in any one of embodiments 16 to 18, wherein the movable body portion further includes a fourth portion configured to move the anchor body portion in a fourth direction within a third plane relative to the fixed body portion.

[0223] Embodiment 20. The system of embodiment 19, wherein the third plane is the coronal plane.

[0224] Embodiment 21. A system described in any one of embodiments 1 to 20, wherein the system further includes a cutting guide configured to guide the bone cutting device, the cutting guide including one or more cutting slots configured to accept the bone cutting device.

[0225] Embodiment 22. The system of embodiment 21, wherein the cutting guide includes a first channel configured to receive a first bone fastener to secure the cutting guide to a third bone of the patient, and a second channel configured to receive a second bone fastener to secure the cutting guide to a second bone of the patient.

[0226] Embodiment 23. The system of embodiment 22, wherein the cutting guide further includes a third channel configured to receive a third bone fastener to be inserted into the joint and align the cutting guide with the joint, the second bone, and / or the third bone.

[0227] Embodiment 24. The system described in embodiment 23, wherein the one or more cutting slots include a first cutting slot and a second cutting slot, and the third channel is disposed between the first cutting slot and the second cutting slot.

[0228] Embodiment 25. The system of embodiment 24, wherein the first cutting slot is provided for guiding the bone cutting device to cut the third bone, and the second cutting slot is provided for guiding the bone cutting device to cut the second bone.

[0229] Embodiment 26. A system described in any one of embodiments 22 to 25, wherein the first channel includes at least two first channels and the second channel includes at least two second channels.

[0230] Embodiment 27. A system described in any one of embodiments 21 to 26, wherein at least a portion of the cutting guide and one or more cutting slots are curved.

[0231] Embodiment 28. A system described in any one of embodiments 21 to 27, wherein the cutting guide includes an upper surface and a bottom surface opposite the upper surface, and the cutting guide further includes one or more fins, the one or more fins protruding from the bottom surface and configured to interact with the joint so that the cutting guide is aligned with the joint.

[0232] Embodiment 29. A system, the system including: a main orthodontic assembly, the main orthodontic assembly including a fixed body portion configured to be fixed to a first bone of a patient; and a movable body portion configured to move relative to the fixed body portion, the movable body portion including an anchor body portion configured to be fixed to a second bone of the patient; a first portion configured to rotate the anchor body portion in a first direction in a first plane relative to the fixed body portion; and a cutting guide assembly (CGA), the cutting guide assembly (CGA) including: a first CGA portion configured to be removably coupled to the fixed body portion of the main orthodontic assembly; and a second CGA portion, the first CGA portion being movably coupled to the second CGA portion; and a cutting guide configured to guide a bone-cutting device, the cutting guide including one or more cutting slots configured to receive the bone-cutting device, the second CGA portion being movably coupled to the cutting guide.

[0233] Embodiment 30. The system of embodiment 29, wherein the first CGA portion includes an opening, and an inner surface of the first CGA portion within the opening is configured to be secured to an outer surface of the securing body portion.

[0234] Embodiment 31. The system of embodiment 30, wherein the first CGA portion is ring-shaped or hoop-shaped.

[0235] Embodiment 32. The system of any one of embodiments 30-31, wherein the first CGA portion is rotatable relative to the second CGA portion.

[0236] Embodiment 33. A system described in any one of embodiments 29 to 32, wherein the second CGA portion includes an arm with a slot, and the first CGA portion is movable relative to the second CGA portion along the slot.

[0237] Embodiment 34. A system described in any one of embodiments 29 to 33, wherein the cutting guide assembly further includes an adjustable fastening mechanism, the adjustable fastening mechanism configured to fasten and unclamp the first CGA portion to and from the second CGA portion.

[0238] Embodiment 35. The system of embodiment 34, wherein fastening the first CGA portion to the second CGA portion by an adjustable fastening mechanism prevents the first CGA portion from moving and rotating relative to the second CGA portion.

[0239] Embodiment 36. A system described in any one of embodiments 34-35, wherein the adjustable fastening mechanism includes a cam lock lever.

[0240] Embodiment 37. A system described in any one of embodiments 34 to 36, wherein the first CGA portion is configured to move in a fifth direction relative to the second CGA portion, and the second CGA portion is configured to move in a sixth direction relative to the cutting guide, and the fifth direction is perpendicular to the sixth direction.

[0241] Embodiment 38. The system described in embodiment 37, wherein the cutting guide assembly further includes a connector connecting the second CGA portion to the cutting guide, and the cutting guide is configured to move in a seventh direction relative to the connector, the seventh direction being perpendicular to the fifth direction and / or the sixth direction.

[0242] Embodiment 39. A system described in any one of embodiments 29 to 38, wherein the cutting guide includes a distal channel configured to receive a first bone fastener to secure the cutting guide to a second bone.

[0243] Embodiment 40. A system described in any one of embodiments 29 to 39, wherein the cutting guide further includes a central channel configured to receive a second bone fastener to be inserted into the joint adjacent to the second bone and align the cutting guide with the joint.

[0244] Embodiment 41. The system described in embodiment 40, wherein the one or more cutting slots include a first cutting slot and a second cutting slot, and the central channel is disposed between the first cutting slot and the second cutting slot.

[0245] Embodiment 42. The system of embodiment 41, wherein the first cutting slot is provided for guiding the bone cutting device to cut the third bone, and the second cutting slot is provided for guiding the bone cutting device to cut the second bone.

[0246] Embodiment 43. A system described in any one of embodiments 29 to 42, wherein at least a portion of the cutting guide and one or more cutting slots are curved.

[0247] As used herein, "about," "approximately," and "substantially" are understood to refer to numbers within a range of numerical values, e.g., within a range of -10% to +10% of the referenced number, preferably within a range of -5% to +5% of the referenced number, more preferably within a range of -1% to +1% of the referenced number, and most preferably within a range of -0.1% to +0.1% of the referenced number. Moreover, these numerical ranges should be interpreted as providing support for claims directed to any number or subset of numbers within that range. For example, a disclosure of 1 to 10 should be interpreted as supporting a range of 1 to 8, a range of 3 to 7, a range of 1 to 9, a range of 3.6 to 4.6, a range of 3.5 to 9.9, etc.

[0248] Throughout this specification, reference to "various aspects," "some aspects," "some examples," "other examples," "some cases," or "one aspect" means that a particular feature, structure, or characteristic described in connection with that aspect is included in at least one example. Thus, appearances of the phrases "various aspects," "some aspects," "particular embodiments," "some examples," "other examples," "particular other embodiments," "some cases," or "in one aspect" throughout this specification do not necessarily all refer to the same aspect. Moreover, a particular feature, structure, or characteristic illustrated or described in connection with one example can be combined, in whole or in part, with a feature, structure, or characteristic of one or more other aspects, without limitation.

[0249] When a positional relationship between two parts is described using terms such as "above," "upper," "below," "under," and "adjacent," one or more parts may be positioned between the two parts, unless the term is used in conjunction with the term "directly" or "directly." Similarly, as used herein, the terms "coupled," "attachable," "mounted," "connectable," "connected," or any similar term can include "directly or indirectly coupled," "directly or indirectly attachable," "directly or indirectly attached," "directly or indirectly connectable," and "directly or indirectly connected."

[0250] It should be understood that at least some of the figures and descriptions herein have been simplified to illustrate elements relevant for a clear understanding of the disclosure, while excluding other elements for purposes of clarity. However, one skilled in the art will recognize that these and other elements may be desirable. However, because such elements are well known in the art and because they do not facilitate a better understanding of the disclosure, a discussion of such elements is not provided herein.

[0251] The terminology used herein is intended to describe particular embodiments only and is not intended to limit the disclosure. As used herein, the singular forms "a," "an," and "the" are intended to include the plural as well, unless otherwise indicated. It will be further understood that the terms "comprises" and / or "comprising," as used herein, specify the presence of stated features, integers, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and / or groups thereof. As used herein, the terms "at least one of X or Y" or "at least one of X and Y" should be interpreted as X, Y, or X and Y.

[0252] Additionally, in describing components of the present disclosure, terms such as first, second, A, B, (a), and (b) may be used, which are merely for the purpose of differentiating one component from another and do not imply or suggest the substance, order, sequence, or number of the components.

[0253] It should be understood that various changes and modifications to the examples described herein will be apparent to those skilled in the art. Such changes and modifications can be made without departing from the spirit and scope of the present subject matter and without diminishing its intended advantages. It is therefore intended that such changes and modifications be covered by the appended claims. [Explanation of symbols]

[0254] 10 Systems 100 Main Orthodontic Assembly 110 Fixed body part 111 through hole portion 113a, 113b Groove 114 Engagement Features 116a First Channel 116b Second Channel 116c Third Channel 117a First Orbit 117b Second Orbit 117c Third Orbit 118 Internal body part 119 External body part 120 first connection body 120a First Plate 120b Second Plate 122 recess 124 Rotating Rod 125 Longitudinal axis 130 second connection body 131 Connection body 132 Hole 134a, 134b hole 140 third connection body 141 First Part 142a, 142b, 142c holes 143 Second Part 144a, 144b hole 145a, 145b recesses 146a, 146b recesses 147 interior space 150 rotation axis 161 Main body 162 First Curved Arm 163 Second Curved Arm 164 teeth 165 Free end section 167 Stopper 171 First Channel 172 First Orbit 173 Second Channel 174 Second Orbit 175 Third Channel 176 Third Orbit 177 Fourth Channel 178 Fourth Orbit 186 First Marker 188 Second Marker 200 Movable body part 210 Anchor body 212 Rotating Arm 213a, 213b side protrusions 214 Anchor Base Channels 216a and 216b 220 First Part 222 First Transfer Mechanism 224 Graspable Devices 225 First Direction 230 Second Part 231 rotation range 232 Secondary Movement Mechanism 233 Mover 234 Second Part Body 235 Second Direction 236 Graspable Devices 236a, 236b Support body part 237 Locking Mechanism 238 Connector 238a First connector part 238b Second connector part 238c Third connector part 239 Compressed Part 240 Third Part 242 The Third Mobility Mechanism 245 The Third Direction 246a, 246b Support body part 247 Base Cap 248 Graspable Devices 250 Fourth Part 252 The Fourth Movement Mechanism 255 The Fourth Direction 256 Graspable Devices 300 Alignment Guide 302 Alignment Channel 310 First Support 312 first end portion 314 Second end portion 320 Second Support 322 first end portion 324 Second end portion 330 Third Support 332 first end portion 334 Second end portion 340 Fixed Devices 342 Shaft 346 Graspable Devices 350 receiver 352 Cutting guide receiving hole 354 Fastener receiving hole 360 Cutting Guide 361 Head part 362 Fastener receiving hole 364 Main body part 365a First cutting slot 365b Second cutting slot 367a first guide surface 367b Second guide surface 368a, 368b side edges 370 Fasteners 405 First Bone Fastener 410 Bone fasteners 415 Bone fasteners 420 Bone fasteners 425 Bone fasteners 505 First incision 510 Second incision 520 Second Bone 530 Third Bone 532 First cutting line 534 Second Cutting Line 600 Cutting Guide Assembly (CGA) 610 First CGA Part 611 Opening 612 Inner surface 614 Rotation axis 615 Rotation direction 616 The Fifth Direction 620 Second CGA Part 622 Slots 625 The Sixth Direction 630 Cutting Guide 631a First cutting slot 631b Second cutting slot 633 Distal Channel 634 Central Channel 635 The Seventh Direction 640 Adjustable Fastening Mechanism 650 Connector 700 Cutting Guide 702 Long and slender main body 704 Proximal protrusion 705 Distal protrusion 710a First cutting slot 710b Second cutting slot 722 Proximal Fixation Channel 724 Distal Fixation Channel 732 Central Channel 800 Cutting Guide 802 Long and slender main body 804a first proximal protrusion 804b second proximal protrusion 805a first distal protrusion 805b second distal protrusion 810a First cutting slot 810b Second cutting slot 822a First Proximal Fixation Channel 822b Second Proximal Fixation Channel 824a First Distal Fixation Channel 824b Second Distal Fixation Channel 832a, 832b, 832c center channels 900 Cutting Guide 902 Long and slender main body 904 Proximal protrusion 905 Distal protrusion 910a First cutting slot 910b Second cutting slot 922 Proximal Fixation Channel 924 Distal Fixation Channel 932 First Central Channel 933 Channel center axis 934 Second Central Channel 942 Upper surface 944 Bottom surface 950a First Fin 950b Second Fin 972 First Bone Fastener 974 Secondary Bone Fastener 976 Third Bone Fastener 978 Fourth Bone Fastener C center C2 center R1 - Radius of curvature of first curved arm 162

Claims

1. 1. A system comprising: Includes main straightening assembly, The main straightening assembly includes: a fixation body configured to be fixed to a first bone of a patient; a movable body portion configured to move relative to the fixed body portion; Including, The movable main body portion is an anchor body configured to be secured to a second bone of the patient; a first portion having a first movement mechanism configured to move the anchor body in a first direction in a first plane relative to the fixation body; Including, system.

2. 2. The system of claim 1, wherein the first bone comprises one of a middle cuneiform, a lateral cuneiform, a cuboid, and a navicular bone, and the second bone comprises a first metatarsal.

3. 2. The system of claim 1, wherein the main correction assembly defines an axis of rotation, the anchor body is rotated by the first portion in the first plane relative to the fixation body about the axis of rotation, and the main correction assembly is configured such that the axis of rotation is disposed substantially in a joint adjacent to the second bone when the fixation body is fixed to the first bone.

4. The system of claim 1 , wherein the first plane is a transverse plane.

5. 10. The system of claim 1, wherein the movable body further includes a second portion having a second movement mechanism configured to move the anchor body in a second direction in a second plane relative to the fixed body.

6. The system of claim 5 , wherein the second plane is perpendicular to the first plane.

7. The system of claim 5 , wherein the second plane is a sagittal plane.

8. 6. The system of claim 5, wherein the movable body further includes a third portion having a third movement mechanism configured to move the anchor body in a third direction relative to the fixed body.

9. 10. The system of claim 8, wherein movement of the anchor body relative to the fixation body in the third direction causes a joint adjacent the second bone to be compressed or pulled apart.

10. 9. The system of claim 8, wherein the third movement mechanism includes a third threaded rod, and the third portion further includes a third threaded rod support extending parallel to the third threaded rod.

11. 10. The system of claim 8, wherein the movable body further includes a fourth portion having a fourth movement mechanism configured to move the anchor body in a fourth direction in a third plane relative to the fixed body.

12. The system of claim 11 , wherein the third plane is a coronal plane.

13. The anchor body portion is a rotating arm rotatably coupled to the fourth moving mechanism; an anchor base configured to be secured to the second bone of the patient; Including, The system of claim 11.

14. 14. The system of claim 13, wherein the rotating arm is curved or partially circular in shape.

15. 15. The system of claim 14, wherein the rotating arm is configured such that a center of the curve or partial circle is positioned within the second bone when the anchor body is secured to the second bone.

16. 14. The system of claim 13, wherein the anchor base extends in the third direction and the rotating arm extends in a direction perpendicular to the third direction.

17. 14. The system of claim 13, wherein the anchor base includes one or more channels configured to receive bone fasteners.

18. 14. The system of claim 13, wherein the fourth translation mechanism includes a fourth threaded rod rotatably coupled to the rotating arm, wherein rotation of the fourth threaded rod rotates the anchor body in the fourth direction relative to the fixation body.

19. 10. The system of claim 1, wherein the fixation body includes one or more channels configured to receive bone fasteners.

20. 20. The system of claim 19, wherein the one or more channels of the stationary body include a first channel having a first track, a second channel having a second track, and a third channel having a third track, the first and second tracks being parallel to one another and the third track being non-parallel to the first and second tracks.

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