Bone Repositioning Guide System and Procedure

Abstract

To provide a kit for correcting alignment between a first bone and a second bone by fusing a joint between the first bone and the second bone.SOLUTION: A first guide is configured such that inserting a first k-wire through a first cannula intersects a first bone and inserting a second k-wire through a second cannula intersects a second bone when the first and second bones are in a deformed configuration. The second guide is configured such that when the first k-wire is fixed within the first bone and the second k-wire is fixed within the second bone in the deformed configuration, sliding the second guide over first and second k-wires, with the first and second k-wires received within the respective first and second cannula of the second guide, re-aligns the first and second bones into a corrected configuration.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] The present invention relates generally to surgical systems and procedures for correcting alignment between two bones and a joint, and more particularly to surgical systems and procedures for correcting a bunion in a patient's foot. [Background technology]

[0002] Bone misalignment and / or deformity can be a cause of discomfort and reduced mobility in patients, particularly in their feet. One particularly common foot disorder is bunions. Bunions are progressive disorders that typically begin with a tilt of the big toe. The tilt of the big toe can gradually change the angle of the bone and create a characteristic protuberance on the medial side of the metatarsal near its joint with the proximal phalanx. Specifically, a bunion is a protrusion of bone and, in some cases, an inflammatory bursa. Hallux valgus is a condition in which the big toe deviates from its normal position toward the second toe. Therefore, the present invention is directed to surgical systems and procedures for the correction of bunions, i.e., hallux valgus, and more generally, for bone realignment. Summary of the Invention [Means for solving the problem]

[0003] The foregoing summary is illustrative only and is not intended to be limiting. Other aspects, features, and advantages of the systems, devices, and methods and / or other subject matter described herein will become apparent from the teachings set forth below. The summary is provided to introduce a set of some concepts of the disclosure. The summary is not intended to identify key or essential features of any subject matter described herein.

[0004] According to one aspect of the present disclosure, a method for correcting alignment between a first bone and a second bone by fusing a joint between the first bone and the second bone includes providing a first guide. The first guide includes a first end portion with a first cannula aligned along a first axis. The second end portion has a second cannula aligned along a second axis. The first axis is non-parallel to the second axis. When the first and second bones are in a deformed configuration, the first axis is configured to intersect the first bone and the second axis is configured to intersect the second bone. A first k-wire is inserted into the first bone through the first cannula. A second k-wire is inserted into the second bone through the second cannula. The first guide is removed from the first and second k-wires. The second guide includes a first end portion with the first cannula. The second end portion has a second cannula. The first cannula is parallel to the second cannula. The second guide slides over the first and second k-wires. The first k-wire is received within the first cannula of the second guide, and the second k-wire is received within the second cannula of the second guide. The second guide acts on the first and second k-wires to realign the first and second bones into a corrective configuration.

[0005] In another aspect, the method includes fixing the first and second bones in the corrected configuration and removing the second guide and the first and second k-wires from the first and second bones.

[0006] In another aspect, the method includes fixing the first and second bones in a corrective configuration, including inserting a first stabilization wire into the first and second bones.

[0007] In another aspect, the method includes attaching a first end of a bone plate to a first bone and a second end of the bone plate to a second bone such that the first and second bones are retained in a corrective configuration. The method includes the step of:

[0008] In another aspect, the method includes inserting bone plate clips into the first and second bones.

[0009] In another aspect, the method includes resecting a first end of a first bone.

[0010] In another aspect, the first end portion of the first guide includes a third cannula aligned parallel to the first axis.

[0011] In another aspect, the method includes inserting a third k-wire into the first bone through the third cannula, and resecting a first end of the first bone includes inserting a first resection guide over the first and third k-wires and aligning the first resection guide with the first end of the first bone.

[0012] In another aspect, the method includes resecting a first end of a second bone.

[0013] In another aspect, the second end of the first guide includes a fourth cannula aligned parallel to the second axis.

[0014] In another aspect, the method includes resecting a first end of a second bone.

[0015] In another aspect, the method includes inserting a second resection guide over the second k-wire and the fourth k-wire inserted into the second bone and aligning the second resection guide with a first end of the second bone.

[0016] In another aspect, the first bone is a metatarsal and the second bone is a medial cuneiform, the deformation configuration of the first and second bones includes a bunion, and the correction configuration of the first and second bones corrects the bunion.

[0017] In another aspect, the second guide adjusts the angle of the first bone in three orthogonal planes between the deformed configuration and the corrected configuration.

[0018] In another aspect, the second guide adjusts the position of the first bone in three orthogonal planes between the deformed configuration and the corrected configuration.

[0019] In another aspect, the method includes centering the first guide between the first bone and the second bone by inserting a centering k-wire through a centering cannula on the first guide.

[0020] In another aspect, the method includes removing the first guide from the first and second k-wires, including at least partially disassembling the first guide.

[0021] In another aspect, the method includes scanning a first bone and a second bone in a deformed configuration and rendering a 3D model thereof including the first virtual bone and the second virtual bone in a virtual deformed configuration; adjusting the first virtual bone and the second virtual bone in the 3D model to align the first virtual bone and the second virtual bone in a virtual correction configuration; fixing a first virtual axis relative to the first virtual bone and a second virtual axis relative to the second virtual bone in the virtual correction configuration, wherein the first virtual axis is parallel to the second virtual axis; and returning the first and second virtual bones to the virtual deformed configuration, wherein the first and second virtual axes are parallel to the virtual deformed configuration. and defining a correction factor therebetween during construction.

[0022] In another aspect, the method includes identifying a virtual resection plane where the first virtual bone and the second virtual bone overlap in a virtual correction configuration, and fixing the first virtual axis relative to the first virtual bone includes aligning the first virtual axis parallel to the virtual resection plane.

[0023] In another aspect, the method includes forming the first guide based on a correction factor.

[0024] In another aspect, the correction factor includes a first virtual vector passing through a first virtual point in the virtual coordinate plane and a second virtual vector passing through a second virtual point in the virtual coordinate plane.

[0025] In another aspect, forming the first guide includes correlating a virtual coordinate plane with the coordinate plane of the first guide such that a first axis corresponds to a first virtual vector and a first virtual point, and an aligned second axis corresponds to a second virtual vector and a second virtual point.

[0026] In another aspect, each correction factor includes a position vector and two direction vectors corresponding to first and second axes of an individual guide in the plurality of guides.

[0027] In another aspect, the first guide is selected from a plurality of guides, each of the plurality of guides having a different angle between the first axis and the second axis.

[0028] According to another aspect, a method of manufacturing a kit for correcting alignment between a first bone and a second bone includes receiving a correction coefficient, the correction coefficient including a first virtual vector passing through a first virtual point in a virtual coordinate plane and a second virtual vector passing through a second virtual point in the virtual coordinate plane.

[0029] A first guide is formed based on the correction coefficient, the first guide including a first end portion having a first cannula aligned along a first axis and a second end portion having a second cannula aligned along a second axis, the first axis corresponding to a first virtual vector and a first virtual point, the second axis corresponding to a second virtual vector and a second virtual point, the first and second axes being non-parallel, and the first guide is configured such that, in a deformed configuration, a first k-wire inserted through the first cannula crosses the first bone and a second k-wire inserted through the second cannula crosses the second bone.

[0030] In another aspect, the method includes receiving dimensions for a second guide, the second guide including a first end portion with a first cannula and a second end portion with a second cannula, the first cannula being parallel to the second cannula, and the first guide configured such that when the second guide is slid over the first and second k-wires, the first and second k-wires are received within the respective first and second cannulae of the second guide, and the second guide realigns the first and second bones into a corrective configuration.

[0031] In another aspect, the method includes receiving a scan of a first bone and a second bone in a deformed configuration and rendering a 3D model thereof, the 3D model including the first virtual bone and the second virtual bone in a virtual deformed configuration. The first virtual bone and the second virtual bone are adjusted in the 3D model to align the first virtual bone and the second virtual bone in a virtual correction configuration. In the virtual correction configuration, a first virtual axis is fixed relative to the first virtual bone and a second virtual axis is fixed relative to the second virtual bone. The first virtual axis is parallel to the second virtual axis. The first and second virtual bones are adjusted in the 3D model to align the first virtual bone and the second virtual bone in a virtual correction configuration. The imaginary bone is returned to a virtual deformed configuration along with first and second virtual axes defining first and second virtual vectors and first and second virtual points of the correction coefficient, respectively.

[0032] In another aspect, the method includes identifying a virtual resection plane where the first virtual bone and the second virtual bone overlap in a virtual correction configuration, and fixing the first virtual axis relative to the first virtual bone includes aligning the first virtual axis parallel to the virtual resection plane.

[0033] According to another aspect of the present disclosure, a kit for correcting alignment between a first bone and a second bone by fusing a joint between the first bone and the second bone includes a first guide. The first guide includes a first end portion with a first cannula aligned along a first axis and a second end portion with a second cannula aligned along a second axis. The first axis is non-parallel to the second axis. The first guide is configured such that, when the first and second bones are in a deformed configuration, inserting a first k-wire through the first cannula crosses the first bone and inserting a second k-wire through the second cannula crosses the second bone. The second guide includes a first end portion with a first cannula and a second end portion with a second cannula. The first cannula can be parallel to the second cannula. The second guide is configured such that in the deformed configuration, when the first k-wire is fixed in the first bone and the second k-wire is fixed in the second bone, the first and second k-wires are received in respective first and second cannulas of the second guide, and sliding the second guide over the first and second k-wires realigns the first and second bones to a corrected configuration.

[0034] In another aspect, a stabilization wire secures the first and second bones in a corrective configuration by insertion into the first and second bones.

[0035] In another aspect, a bone plate with a first end configured to be attached to a first bone and a second end configured to be attached to a second bone retains the first and second bones in a corrective configuration.

[0036] In another aspect, a bone plate clip is inserted into the first and second bones in the corrective configuration.

[0037] In another aspect, a first resection guide aligns a resection tool with a resection location on a first bone.

[0038] In another aspect, the first resection guide includes first and second cannulas configured to be advanced over the first k-wire and the third k-wire, the third k-wire being parallel to the first k-wire.

[0039] In another aspect, a second resection guide aligns the resection tool with a resection location on the second bone.

[0040] According to another aspect, a method for correcting alignment between a first bone and a second bone by fusing a joint between the first bone and the second bone includes aligning a first end portion of a first guide with the first bone. The first end portion has a first cannula and a second cannula aligned in a first direction. A first k-wire is inserted into the first bone through the first cannula, and a second k-wire is inserted into the first bone through the second cannula. A first end of the first bone is resected through a slot to form a first resection surface. The slot is aligned with the first end of the first bone by the first and second k-wires. A third k-wire and a fourth k-wire are inserted through the first guide. The first guide is inserted into the second bone. A first end of the second bone is resected to form a second resection surface. The second guide is slid over the first, second, third, and fourth k-wires to adjust the positioning of the first and second bones so that the first and second resection surfaces abut in the corrected configuration. The first and second bones are fixed in the corrected configuration.

[0041] In another aspect, the method includes fixing the first and second bones in a corrective configuration by inserting a stabilization wire into the first and second bones.

[0042] In another aspect, the method includes fixing the first and second bones in a corrective configuration by attaching a first end of a bone plate to the first bone and attaching a second end of the bone plate to the second bone such that the first and second bones are retained in the corrective configuration.

[0043] In another aspect, the method includes sliding a second guide over the first, second, third, and fourth k-wires to translate the first resection plane toward the second resection plane.

[0044] In another aspect, the method includes sliding a second guide over the first, second, third, and fourth k-wires to rotate the alignment between the first bone and the second bone.

[0045] In another aspect, a third k-wire and a fourth k-wire are inserted through a second end portion of the first guide, the second end portion including a third cannula and a fourth cannula, into a second bone, the third and fourth cannula being aligned in a second direction.

[0046] In another aspect, a first end of a second bone is resected through the slot, the slot being aligned with the first end of the second bone by third and fourth k-wires.

[0047] In another aspect, the slot is on the resection guide, which includes first and second openings configured to align with the first and second k-wires.

[0048] In another aspect, the first bone is a metatarsal and the second bone is a medial cuneiform, and the corrective configuration of the first and second bones corrects a bunion.

[0049] In another aspect, the second guide adjusts the angle of the first bone in three orthogonal planes between the deformed configuration and the corrected configuration.

[0050] In another aspect, the method includes removing the first guide from the first and second k-wires after resecting the first end of the second bone and forming a second resection surface.

[0051] In another aspect, the method includes removing the second guide and the first, second, third, and fourth k-wires from the first and second bones after fixing the first and second bones in the corrective configuration.

[0052] According to another aspect, a method for correcting alignment between a first bone and a second bone by fusing a joint between the first bone and the second bone includes positioning a cutting guide at a first position proximate a first end of the first bone, the cutting guide including a cutting slot and first and second cannulas extending therethrough. The cutting guide at the first position includes first and second k-wires positioned in the first bone through the first and second cannulas. The first end of the first bone is resected through the cutting slot to form a first resection surface. The cutting guide is removed from the first and second k-wires. The cutting guide is positioned at a second position proximate the first end of the second bone. The cutting guide in the second position includes third and fourth k-wires positioned in the second bone through the first and second cannulas. A first end of the second bone is resected through the cutting slot to form a second resection surface. The cutting guide is removed from the third and fourth k-wires. A second guide is slid over the first, second, third, and fourth k-wires. The second guide adjusts the positioning of the first and second bones so that the first and second resection surfaces abut in a corrective configuration. The first and second bones are fixed in the corrective configuration.

[0053] In another aspect, the method includes the steps of positioning a first end portion of a first guide with a first bone, the first end portion having a third cannula and a fourth cannula, the third and fourth cannula being aligned in a first direction, and inserting a first k-wire into the first bone through the third cannula and a second k-wire into the first bone through the fourth cannula.

[0054] In another aspect, the method includes positioning a second end portion of the first guide with a second bone, the second end portion having a fifth cannula and a sixth cannula, the fifth and sixth cannulas being aligned in a second direction, and inserting a third k-wire into the second bone through the fifth cannula and a fourth k-wire into the second bone through the sixth cannula.

[0055] In another aspect, fixing the first and second bones in the corrective configuration includes inserting stabilization wires into the first and second bones.

[0056] In another aspect, the step of fixing the first and second bones in the corrective configuration includes attaching a first end of a bone plate to the first bone and attaching a second end of the bone plate to the second bone such that the first and second bones are retained in the corrective configuration.

[0057] In another aspect, sliding the second guide over the first, second, third, and fourth k-wires translates the first resection plane toward the second resection plane.

[0058] In another aspect, sliding the second guide over the first, second, third, and fourth k-wires rotates the first bone relative to the second bone to adjust the alignment therebetween. [Brief explanation of the drawings]

[0059] Various embodiments are depicted in the accompanying drawings for illustrative purposes and should not be construed as limiting the scope of the embodiments in any way. Various features of different disclosed embodiments can be combined to form additional embodiments that are part of this disclosure.

[0060] [Figure 1] FIG. 1 shows a top view of a patient's foot in a deformed configuration.

[0061] [Figure 2A]FIG. 2A shows a front perspective view of the alignment guide.

[0062] [Figure 2B] FIG. 2B shows a rear perspective view of the alignment guide.

[0063] [Figure 3A] FIG. 3A shows a front view of the alignment guide.

[0064] [Figure 3B] FIG. 3B shows a cross-sectional view taken along line 15B-15B of FIG. 15A.

[0065] [Figure 4] FIG. 4 shows an exploded view of the alignment guide.

[0066] [Figure 5] FIG. 5 shows the angle between the cannulas of the alignment guide.

[0067] [Figure 6] FIG. 6 shows a second angle between the cannulas of the alignment guide.

[0068] [Figure 7] FIG. 7 illustrates a third angle between the cannulas of the alignment guide.

[0069] [Figure 8] FIG. 8 shows an alignment guide that is aligned with the medial cuneiform and metatarsal bones in the patient's foot.

[0070] [Figure 9] FIG. 9 shows the insertion of multiple k-wires through the alignment guide and into the medial cuneiform and metatarsal bones.

[0071] [Figure 10] FIG. 10 shows a partial exploded view of the alignment guide.

[0072] [Figure 11A]FIG. 11A shows a perspective view of the resection guide.

[0073] [Figure 11B] FIG. 11B shows a front view of the resection guide.

[0074] [Figure 12A] 12A-B show the alignment guide removed and placement of the first resection guide. [Figure 12B] 12A-B show the alignment guide removed and placement of the first resection guide.

[0075] [Figure 13] FIG. 13 shows placement of a second resection guide.

[0076] [Figure 14A] FIG. 14A shows a perspective view of a correction guide.

[0077] [Figure 14B] FIG. 14B shows a top view of the correction guide.

[0078] [Figure 15A] 15A-B show an orthotic guide assembled over multiple k-wires to align the medial cuneiform and metatarsal bones of a patient's foot in a corrective configuration. [Figure 15B] 15A-B show an orthotic guide assembled over multiple k-wires to align the medial cuneiform and metatarsal bones of a patient's foot in a corrective configuration.

[0079] [Figure 16] FIG. 16 shows the insertion of the first and second fixation k-wires into the medial cuneiform and metatarsal bones.

[0080] [Figure 17] FIG. 17 shows the patient's leg with multiple k-wires removed.

[0081] [Figure 18] FIG. 18 shows an exploded view of the bone plate assembly aligned with the medial cuneiform and metatarsal in the corrective configuration.

[0082] [Figure 19] FIG. 19 shows a top view of the bone plate.

[0083] [Figure 20] FIG. 20 shows a side view of the bone plate.

[0084] [Figure 21] FIG. 21 shows the bone plate assembly assembled with the medial cuneiform and metatarsal in the corrective configuration.

[0085] [Figure 22] FIG. 22 shows a side view of the patient's foot in the corrective configuration.

[0086] [Figure 23] FIG. 23 shows how the correction factor is calculated using a hypothetical model.

[0087] [Figure 24A] FIG. 24A shows the virtual model in a virtual deformed configuration.

[0088] [Figure 24B] FIG. 24B shows the virtual model adjusted to the virtual orthodontic configuration.

[0089] [Figure 24C] FIG. 24C shows the step of fixing two virtual axes in the first virtual bone and the second virtual bone, respectively, in the virtual correction configuration.

[0090] [Figure 24D] FIG. 24D shows the virtual model returned to the virtual deformed configuration, with the resulting orientation of the two virtual axes defining the correction factor for the virtual model.

[0091] [Figure 25] FIG. 25 illustrates a method for manufacturing an adjustment guide based on a correction factor.

[0092] [Figure 26A] FIG. 26A shows a side view of another implementation of an alignment guide.

[0093] [Figure 26B] FIG. 26B shows a top view of the alignment guide of FIG. 26A.

[0094] [Figure 27] FIG. 27 shows an exploded view of the alignment guide of FIG. 26A.

[0095] [Figure 28A] FIG. 28A shows a perspective view of another implementation of a resection guide.

[0096] [Figure 28B] FIG. 28B shows a front view of the resection guide of FIG. 28A.

[0097] [Figure 29] FIG. 29 shows the alignment of the alignment guide of FIG. 26A with the patient's foot.

[0098] [Figure 30] FIG. 30 shows the insertion of multiple k-wires through the alignment guide and into the medial cuneiform and metatarsal bones.

[0099] [Figure 31] FIG. 31 shows a partial exploded view of the alignment guide.

[0100] [Figure 32] FIG. 32 shows the alignment guide removed and placement of the resection guide of FIG. 28A.

[0101] [Figure 33]FIG. 33 shows the insertion of a correction guide assembled over multiple k-wires to align the medial cuneiform and metatarsal bones of the patient's foot in a corrective configuration, as well as fixation k-wires.

[0102] [Figure 34] FIG. 34 shows the bone plate assembly assembled with the medial cuneiform and metatarsal in the corrective configuration. DETAILED DESCRIPTION OF THE INVENTION

[0103] Detailed Description Overview Bunion correction or repair is a common surgical procedure, with over 100,000 surgeries performed annually in the United States. Many surgical procedures for bunion repair are invasive and painful, requiring multi-inch incisions and lengthy recovery periods of up to 10-12 weeks. Minimally Invasive Surgery Surgery has been performed in orthopedics for decades. One common procedure is known as a Lapidus bunionectomy. In a Lapidus bunionectomy, the bunion is corrected in the big toe by adjusting the alignment at the first tarsometatarsal joint. The metatarsal can also be stabilized using bone screws and / or plates to promote fusion between the metatarsal and medial cuneiform bone.

[0104] However, existing Lapidus bunionectomy procedures have various drawbacks and risks, including requiring more than minimally invasive surgery, using realignment devices that offer little control over the rotation and relative angle of the metatarsals, procedures that rely on intra-surgical trial and error to identify the best alignment of the patient's foot bones and intra-surgical judgment to identify locations for performing the resections, a lack of customization to account for the individual patient's foot condition, and / or a lack of available guides for performing pre-planned resections of the foot bones. Various aspects of the bone repositioning systems and procedures described herein overcome and improve upon these existing procedures, leading to better patient outcomes.

[0105] The various features and advantages of the systems, devices, and methods for bone repositioning described herein will become more fully apparent from the following description of the examples illustrated in the figures. These examples are intended to illustrate the principles of the present disclosure, and the present disclosure should not be limited to only the examples illustrated. Features of the illustrated examples can be modified, combined, removed, and / or substituted, as would be apparent to one skilled in the art, in response to consideration of the principles disclosed herein. Deformity correction procedures

[0106] FIG. 1 shows a skeletal diagram of a patient's foot 100 with one or more bones in a deformed configuration 102. The deformed configuration 102 may be a bunion, as shown. The deformed configuration 102 may be a misalignment between the metatarsal 108 of the patient's big toe and the phalanges 112. The metatarsal 108 may be at an angle relative to the phalanges at 112. A severe misalignment between the metatarsal 108 and the phalanges 112 can lead to severe pain and friction, as well as discomfort, and other problems in the patient's foot 100. Therefore, it may be beneficial to correct the alignment between the metatarsal 108 of the big toe and the phalanges 112.

[0107] The patient's foot 100 may further include a medial cuneiform bone 104. The medial cuneiform bone 104 may be connected (e.g., by one or more ligaments) to the proximal ends of the metatarsals 108. FIGS. 1-22 illustrate systems and methods for correcting alignment between the medial cuneiform bone 104 and the metatarsals 108. In turn, proper alignment between the medial cuneiform bone 104 and the metatarsals 108 can correct alignment between the metatarsals 108 and the phalanges 112. Thus, the deformed configuration 102 of the patient's foot 100 can be corrected. The present disclosure relates to systems and methods for correcting the deformed configuration 102. Furthermore, the systems and methods described herein may be used more generally to correct alignment between any two bones in a patient's body.

[0108] As shown in FIGS. 2A-4 , a system for correcting alignment in a patient's foot 100 can include an alignment guide 200. The alignment guide 200 can be formed from a rigid material. The alignment guide 200 can include a first end portion 204. The first end portion 204 can include one or more openings 210 a, 212 a. Although two openings are described and illustrated, more or fewer openings can be included on the first end portion 204. The openings 210 a, 212 a can include internal threads 221, 222, respectively. The openings 210 a, 212 a can be chamfered on one or both sides of the alignment guide 200. The openings 210 a, 212 a can extend entirely through the alignment guide 200. The openings 210 a, 212 a can be threaded onto individual axes 230, The axes 230, 232 may be aligned along 204 a. The axes 230, 232 may be parallel. Alternatively, the axes 230, 232 may converge. The axes 230, 232 may be spaced apart by a distance 204 a. The distance 204 a may be based on the length of the medial cuneiform bone 104.

[0109] As shown in FIG. 4 , the alignment guide 200 can include one or more removable tubes 240, 242. The removable tube 240 can include a first end 240a and a second end 240b. The first end 240a can be received within the opening 210a. The removable tube 240 can include a threaded portion 244. The threaded portion 244 can engage with the internal threads 221 of the opening 210a. The removable tube 242 can include a first end 242a and a second end 242b. The first end 242a can be received within the opening 212a. The removable tube 240 can include a threaded portion 246. The threaded portion 246 can engage with the internal threads 222 of the opening 212a.

[0110] The removable tube 240 can define a cannula 210. When disposed within the opening 210a, the cannula 210 can be aligned along the axis 230 of the opening 210a. The removable tube 242 can define a cannula 212. When disposed within the opening 212a, the cannula 212 can be aligned along the axis 232 of the opening 212a. The cannulae 210, 212 can define different diameters therethrough. The cannula 212 can have a larger diameter than the cannula 210 (or vice versa). In other implementations, the cannulae 210, 212 can define the same but different diameters therethrough. In other implementations, the cannulae 210, 212 can define various diameters therethrough.

[0111] Alignment guide 200 can include a second end portion 208. Second end portion 208 can include one or more cannulas 214, 216. The cannulas 214, 216 can be defined through the body of alignment guide 200 and / or through their respective extensions 219, 218. Although two cannulas are described and illustrated, more or fewer cannulas can be included on second end portion 208. Additionally, second end portion 208 can include removable inserts or portions (e.g., removable tubes) around cannulas 214, 216.

[0112] The cannulas 214, 216 can extend entirely through the alignment guide 200 (e.g., including the extensions 218, 219). The cannulas 214, 216 can define different diameters therethrough. The cannula 214 can have a larger diameter than the cannula 216 (or vice versa). In other implementations, the cannulas 214, 216 can define the same different diameters therethrough. In other implementations, the cannulas 214, 216 can define various diameters therethrough.

[0113] The cannulas 214, 216 can be aligned along respective parallel axes 234, 236. The axes 234, 236 can be spaced apart by a distance 208a. The distance 208a can be based on the length of the metatarsal 108.

[0114] 5-7 show the assembled alignment guide 200. The first end portion 204 can define the location and orientation of the first set of cannulas (e.g., cannulas 210, 212). The second end portion 208 can define the location and orientation of the second set of cannulas (e.g., cannulas 214, 216). The first set of cannulas and the second set of cannulas can be offset from each other, angled relative to each other and / or relative to each other.

[0115] FIG. 5 illustrates angle α between axis 230 of cannula 210 and axis 236 of cannula 216. Angle α defines the relative orientation angle between the first set of cannulas on first end 204 and the second set of cannulas on second end 208. Angle α may be defined in a zx plane within a Cartesian coordinate system (having x, y, and z axes). Cannula 210 may include point A. Alternatively, point A may be any fixed location along cannula 210. Point A may have x, y, and z coordinate locations within the Cartesian coordinate system (having x, y, and z axes). Cannula 216 may include point B. Alternatively, point B may be any fixed location along cannula 216. Point B may have x, y, and z coordinate locations within the Cartesian coordinate system. Points A and B may define the relative positions of axes 230, 236 in a Cartesian coordinate system.

[0116] Figure 6 illustrates angle β between axis 230 of cannula 210 and axis 236 of cannula 216. Angle β defines the relative orientation angle between the first set of cannulae on first end 204 and the second set of cannulae on second end 208 in the y-x plane. Figure 7 illustrates angle γ between axis 230 of cannula 210 and axis 236 of cannula 216. Angle γ defines the relative orientation angle between the first set of cannulae on first end 204 and the second set of cannulae on second end 208 in the y-z plane.

[0117] Together, the relative positions of points A and B, and at least two of the relative angles α, β, and γ can define the axis of a cannula on alignment guide 200. Using appropriate selection of the relative angles α, β, and / or γ, and / or the relative positions of points A, B, alignment guide 200 can be used to properly align bones in a patient's foot 100, as described further below.

[0118] As shown in FIG. 8 , the alignment guide 200 can be aligned with the patient's foot 100. The first end portion 204 can be generally aligned with the medial cuneiform 104. The second end portion 208 can be generally aligned with the metatarsal 108. As shown in FIG. 9 , multiple k-wires 300 can be extended through individual cannulas of the alignment guide 200. The k-wires can extend through the cannulas into the individual medial cuneiform 104 and metatarsal 108. A first k-wire 310 can be inserted into the medial cuneiform 104 through the cannula 210. The first k-wire 310 can be inserted at an insertion point 320 on the medial cuneiform 104. A second k-wire 312 can be inserted through the cannula 212. A second k-wire 312 can be inserted through the medial cuneiform bone 104 at an insertion point 322. A third k-wire 314 can be inserted through the cannula 214. The third k-wire 314 can cross over and be inserted into the metatarsal bone 108 at an insertion point 324. A fourth k-wire 316 can be inserted through the fourth cannula 216. The fourth k-wire 316 can be inserted into the metatarsal bone 108 at an insertion point 326.

[0119] The first and second k-wires 310, 312 can be parallel to each other based on the parallel cannulas 210, 212. The third and fourth k-wires 314, 316 can be parallel to each other based on the cannulas 214, 216. One or more of the insertion points 320, 322, 324, 326 (e.g., at least one on each bone 104, 108) can be at predetermined locations on the patient's foot. The length of the extensions 218, 219 and / or tubes 240, 242 can provide additional stability to the k-wire 300 received therein. The diameter of the k-wire 300 can be sized according to the diameter of the individual cannulas of the alignment guide 200 to ensure accurate insertion at an angle into the bones 104, 108. Furthermore, the k-wire 300 can be matched to the correct cannula based on different diameter sizes.

[0120] 10 illustrates the removal of the tubes 240, 242 from the first end 204 of the alignment guide 200. The first and second tubes 240, 242 are removed from the first end portion 204 to allow the alignment guide 200 to be removed from the multiple k-wires 300 inserted into the medial cuneiform and metatarsal 108. In some situations, without removable or otherwise disassemblable elements, it may be difficult for a user to remove the alignment guide 200 from the multiple k-wires 300 due to misalignment between the first and second ends 204, 208.

[0121] 11A-B, a system for correcting alignment in a patient's foot 100 can include a resection guide 404. The resection guide 404 can align a resection tool (not shown), such as a saw, broach, or the like, with the end of the medial cuneiform bone 104 and / or the end of the metatarsal bone 108, respectively.

[0122] Resection guide 404 can include a cannulated portion 411. Cannulated portion 411 can include one or more openings 415, 417. Resection guide 404 can include a planar portion 409. The planar portion can include a slot 407 for aligning a resection tool. Openings 415, 417 can interact with one or more k-wires (e.g., k-wires 300) or pins to align planar portion 409 with a desired target location for the resection tool.

[0123] Planar portion 409 (e.g., the plane defining slot 407) can be approximately perpendicular to cannulated portion 411 (e.g., the axis between openings 415, 417). In other implementations, planar portion 409 can be angled relative to cannulated portion 411.

[0124] Apertures 415, 417 can extend through cannulated portion 411. Apertures 415, 417 can be sized to align with k-wires or stents. Slot 407 can extend through planar portion 409. Slot 407 can have a height and thickness sized to accommodate the cutting portion of a resection tool. Slot 407 can have a depth sufficient to maintain alignment of the resection tool with the desired target location.

[0125] Depending on the planned corrective configuration of the first cuneiform 104 with the metatarsal 108, it may be necessary to remove material from the medial ends of one or both of the cuneiform 104 and metatarsal 108. The angle between the cuneiform 104 and metatarsal 108 can be adjusted during corrective configuration. The length of one or both of the cuneiform 104 and metatarsal 108 can also be adjusted during corrective configuration. Each of these adjustments can contribute to correcting a deformity in the patient's foot 100.

[0126] 12A-B thus illustrate the use of first resection guide 404 to align a resection tool with the first inner end of first wedge bone 104. Cannulated portion 411 can be received over first and second k-wires 310, 312 on openings 415, 417, respectively, which can align planar portions (e.g., slot 407) with the ends of first wedge bone 104. Resection surface 104a can be cut into first wedge bone 104 using a resection tool through slot 407. Resection surface 104a can be aligned with first and second k-wires 310, 312.

[0127] 13 illustrates the use of a second resection guide 408 to align a resection tool with a first medial end of the metatarsal 108. The second resection guide 408 can include the same components as the resection guide 404 (e.g., a flat portion 409 and a cannulated portion 411).

[0128] The cannulated portion 411 of the second resection guide 408 can be received over the third and fourth k-wires 314, 316 on the openings 415, 417, respectively. The third and fourth k-wires can align the planar portion 409 and slot 407 with the end of the metatarsal 108. A resection surface 108a can be cut into the metatarsal 108 using a resection tool through the slot 407. The resection surface 108a can be aligned with the third and fourth k-wires 314, 316. In some implementations, the resection guide 404 can be used to form the resection surface 108a instead of the cross-sectional resection guide 408.

[0129] As shown in FIGS. 14A-B, a system for correcting alignment in a patient's foot 100 can include a correction guide 500. The correction guide 500 can align bones in the patient's foot 100 to a corrective configuration 103, as shown in FIG. 15. The correction guide 500 can include a first end portion 504. The first end portion 504 can include one or more cannulas 510, 512. The cannulas 510, 512 can extend through the correction guide 500. The cannulas 510, 512 can correspond to first and second k-wires 310, 312, respectively, that are inserted into the medial cuneiform bone 104. The cannulas 510, 512 can be aligned along first and second axes 530, 532, respectively. The first and second axes 530, 532 can be parallel.

[0130] The correction guide 500 can include a second end portion 508. The second end portion 508 can include one or more cannulas 514, 516. The cannulas 514, 516 can extend through the correction guide 500. The cannulas 514, 516 can correspond to third and fourth k-wires 314, 362, respectively, that are inserted into the metatarsal 108. The cannulas 514, 516 can be aligned along third and fourth axes 534, 536, respectively. The third and fourth axes 534, 536 can be parallel.

[0131] The first and second axes 530, 532 can be parallel to the third and fourth axes 534, 536. The first and second axes 530, 532 can be aligned in the same plane as the third and fourth axes 534, 536. In other implementations, the first and second axes 530, 532 can be aligned out of plane with (e.g., offset from) the third and fourth axes 534, 536.

[0132] The first axis 530 may extend through point C. Point C may have a position (x, y, z) in the Cartesian coordinate plane. The fourth axis 536 may extend through point D. Point D may have a position (x, y, z) in the Cartesian coordinate plane. Points C and D may define the relative positions of the first and fourth axes 530, 536 in the Cartesian coordinate system.

[0133] 15 , the correction guide 500 can be received over the k-wires 300. First and second k-wires 310, 312 can be received within cannulae 510, 512, respectively, on the first end 504 of the correction guide 500. Third and fourth k-wires 314, 316 can be received within cannulae 514, 516, respectively, on the second end 508 of the correction guide 500.

[0134] Thus, the correction guide 500 can align the metatarsal 108 relative to the medial cuneiform 104 as it is advanced over the k-wire 300. The correction guide can orient the metatarsal 108 and proximal phalanx 112 in the corrective configuration 103. The reorientation of the metatarsal 108 relative to the medial cuneiform 104 can be achieved by adjusting the coordinate system of the metatarsal 108 within a Cartesian coordinate system (e.g., in three orthogonal planes). The degree of rotation and / or translation of the metatarsal 108 can be determined based on the angles α, β, and / or γ and / or any difference in the relative positions of the axes between the alignment guide 200 and the correction guide 500 (e.g., any difference in the relative positions defined by points A, B and points C, D).

[0135] The corrective configuration 103 can include one or more corrections to the alignment of the bones of the patient's foot 100. For example, the metatarsal 108 can be generally aligned with the proximal phalanx 112 of the big toe. The corrective configuration 103 can facilitate healing of bunions and / or hallux valgus deformities. The resected surface 104a of the medial cuneiform 104 can abut against the resected surface 108a of the metatarsal 108. True abutment can facilitate fusion or union of the metatarsal 108 with the medial cuneiform 104. Proper abutment may require translation of the metatarsal 108 relative to the medial cuneiform 104.

[0136] As shown in FIG. 16 , the medial cuneiform 104 can be temporarily or permanently fixed to the metatarsal 108 in the corrective configuration 103. A first fixation k-wire 610 can be inserted into the medial cuneiform 104 and the metatarsal 108. The first fixation wire 610 can extend through the resection surfaces 104 a, 108 a. A second fixation k-wire 612 can be inserted into the medial cuneiform 104 through the metatarsal 108. The second fixation k-wire 612 can extend through the resection surfaces 104 a, 108 a. In other implementations, any temporary or permanent fixation means can be used to connect the medial cuneiform 104 with the metatarsal 108 in the corrective configuration. For example, the medial cuneiform 104 and metatarsal 108 can be screwed together, reinforced together, glued together, or otherwise connected together, either temporarily or permanently.

[0137] 17 , with the medial cuneiform 104 and metatarsal 108 secured in the corrective configuration 103, the correction guide 500 can be removed from the plurality of k-wires 300. The plurality of k-wires 300 can be removed from the medial cuneiform 104 and / or metatarsal 108.

[0138] As shown in FIG. 18 , a system for correcting alignment in a patient's foot 100 can include a bone plate assembly 700. The bone plate assembly 700 attaches to the medial cuneiform bone 104 and the metatarsal bone 108, as shown in FIGS. 21-22 . The bone plate assembly 700 can include a bone plate 710. The bone plate 710 can include a first end 704 and a second end 708. The bone plate assembly 700 can include a bone clip 720. The bone clip 720 can be coupled between the medial cuneiform bone 104 and the metatarsal bone 108. The bone clip 720 can include first tines 724 and second tines 728 connected by a transverse member 726. The bone plate assembly 700 can include a plurality of fasteners 730, such as bone screws, pins, or other fasteners known within the field of orthopedic surgery.

[0139] 19-20 show further details of bone plate 710. Bone plate 710 can be contoured to fit against the medial cuneiform bone 104 and metatarsal bones 108. Bone plate 710 can be manufactured from titanium, aluminum, steel, or other suitable materials within the orthopedic field.

[0140] The first end 704 of the bone plate 710 can have a plurality of apertures 715, 716, 717. The apertures 716, 717 can be sized to receive the fastener 730. The aperture 715 can be sized to receive the tines 724 of the clip 720. The second end 708 of the bone plate 710 can have a plurality of apertures 711, 712, 713. The apertures 711, 712 can be sized to receive the fastener 730. The opening 713 can be sized to receive the tines 728 of the clip 720. The clip 720 can include a recess 719 for receiving, or at least partially receiving, the transverse member 726 of the clip 720. This can reduce the overall profile of the assembled bone plate assembly 700.

[0141] 21-22 show a bone plate assembly 710 assembled with a patient's foot 100. A first end 704 of the bone plate 710 can be attached to the medial cuneiform bone 104 with a fastener 730. The fastener 730 can extend into the medial cuneiform bone 104 through openings 716, 717. A second end 708 of the bone plate 710 can be attached to the metatarsal bone 108. The fastener 730 can extend into the metatarsal bone 108 through openings 711, 712. In some implementations, the fasteners 730 can be received within respective intersections 320, 322, 324, and / or 326 of the k-wires 300. Alternatively, the fasteners can form new holes in the bones of the patient's foot.

[0142] The clip 720 can span across the joint between the medial cuneiform 104 and the metatarsal 108. The first tine 724 can be received within the metatarsal 108 within the opening 715. The second tine 728 can be received within the medial cuneiform 104 through the opening 713. In some implementations, the tines 724, 728 can be received within the respective intersection points 322, 324. The tines 724, 728 can include multiple serrations for improved engagement features for attachment within bones in the patient's foot 100.

[0143] In some implementations, different alignment guides 200 can be used depending on the intended fixation means for the medial cuneiform 104 with the metatarsal 108. The different alignment guides 200 can include cannulae that align the k-wires 300 at different points within the bone and match openings for different fixation means. Virtual modeling of correction coefficients

[0144] FIG. 23 illustrates a process 800 for designing an alignment guide customized to a patient's unique anatomy. While described herein in the context of a patient's foot, process 800 can be used for other parts of a patient's body. Process 800 is further illustrated in FIGS. 24A-24D. In step 812, a virtual model 840 of the patient's foot is generated. Virtual model 840 can be based on a scan of the patient's foot, including deformities such as bunions and / or hallux valgus. The scan used to generate or render virtual model 840 can be based on a CT, PET, X-ray, ultrasound, MRI, or other type of medical image scan.

[0145] The virtual model 840 may include a virtual representation of the bones of the patient's foot. The virtual model 840 may include a virtual deformed configuration 802 of the patient's bones. The virtual model 840 may include a virtual first bone 804 and a virtual second bone 808. The virtual first bone 804 may correspond to the medial cuneiform bone in the patient's foot, and the virtual second bone 808 may correspond to a metatarsal bone.

[0146] The virtual model 840 can be displayed to the user through a graphical user interface (e.g., on a computer). The virtual model 840 can be manipulated by the user. In some implementations, the virtual model 840 can approximate the natural connections (e.g., ligaments, cartilage, and / or muscles) between the bones in the patient's foot. Thus, movement of one virtual bone can alter the location of connected virtual bones. In other implementations, the virtual bones of the model 840 can be freely moved and manipulated by the user. Thus, the possible repositioning of bones and the resulting movement of connected virtual bones can be controlled by the user. can be approximated based on the skill and knowledge of the

[0147] In step 814, the user adjusts the configuration of the first and second virtual bones 804, 808 into a virtual correction configuration 803. The virtual correction configuration 803 can include correction of one or more deformities of the patient's foot. The adjustments to the virtual correction configuration 803 can include changing the relative angle and position between the first and second virtual bones 804, 808. Additionally, the virtual correction configuration 803 can include one or more overlapping portions of the first and second virtual bones 804, 808. One or more virtual resection planes 804a, 808a can be identified by the user to remove or otherwise adjust the length and dimensions of the overlapping portions of the first and second virtual bones 804, 808.

[0148] In step 816, a first virtual axis 830 is added to intersect the first virtual bone 804. A second virtual axis 836 is added to intersect the second virtual bone 808. The first virtual axis 830 is fixed relative to the first virtual bone 804. The second virtual axis 836 is fixed relative to the second virtual bone 808. The first and second virtual axes 830, 836 can be aligned with the virtual model 840 in a location that is easily accessible during surgery on the patient's foot.

[0149] The first and second virtual axes 830, 836 are parallel to one another. Advantageously, the first and second virtual axes 830, 836 can be aligned with one or more of the virtual resection planes 804a, 808a. The first virtual axis 830 extends through a point G located in a virtual Cartesian coordinate system. The second virtual axis 836 extends through a point H located in the virtual Cartesian coordinate system.

[0150] In step 818, the first and second virtual bones 804, 808 are returned to the original deformed configuration 802 of the model 840. The first and second virtual axes 830, 836 are angled / rotated and / or translated relative to each other from the corrected configuration 803 to the deformed configuration 802. In the deformed configuration 802, the first and second virtual axes 830, 836 can be defined as vectors passing through respective points E, F in a virtual Cartesian coordinate system.

[0151] In step 820, the relative positions of the first and second virtual axes 830, 836 in the deformed configuration 802 can be used to define a correction factor for the alignment guide. The relative positions can include relative angles in two or more of the virtual Cartesian coordinate system planes (e.g., zx, zy, xy). The relative angles can correspond to the α, β, and / or γ angles in the alignment guide (e.g., alignment guide 200 or equivalent). The relative positions of the first and second virtual axes 830, 836 can be based on respective points E, F. Points E, F can correspond to respective points A, B in the alignment guide (e.g., alignment guide 200 or equivalent). Thus, the dimensions of the virtual model 840 can be used to form a correction factor of the alignment guide for use in a surgical procedure on a patient's foot.

[0152] Additionally, the relative positions of the first and second virtual axes 830, 836 in the corrective configuration 803 can be used to define the dimensions of the correction guide. Points G and H can correspond to respective points C and D in an alignment guide (e.g., alignment guide 500 or equivalent). The first and second virtual axes 830, 836 in the corrective configuration 803 can correspond to parallel axes of cannulas within the correction guide.

[0153] Additionally, the relative positions of the first and second virtual axes 830, 836 in the deformed configuration 802 can be used to define the dimensions of the resection guide. The resection guide can include an orientation of a slot (e.g., slot 407) that can be aligned parallel to one or more of the resection surfaces 804a, 808a. The resection guide can also include one or more openings that are aligned with the first and / or second imaginary axes 830, 836 in the deformed configuration 802.

[0154] As an alternative to generating model 803, a user (e.g., a surgeon) may describe the angles (α, β, and / or γ) and / or translations required to correct a deformity in the patient's foot 100. This description may be based on the user's knowledge and experience and / or in conjunction with visualizing a scan of the patient's foot 100. The user-provided information may indicate the alignment guides 200 required during the surgical procedure. For example, a user may be provided with a kit with multiple alignment guides and may select from among pre-determined sets of alignment guides 200, each correcting a different but commonly found deformity in a patient's foot. In some implementations, alignment guide 200 may include multiple sets of cannulas corresponding to different correction factors. Rapidus System Manufacturing

[0155] Process 900 is a method of manufacturing a system for correcting alignment in a patient's foot 100 based on a correction factor. In step 912, a manufacturer can receive the correction factor. The correction factor can define one or more dimensions of an alignment guide (e.g., alignment guide 200). The correction factor, in some implementations, can be a CAD model. The dimensions can include the orientation and positioning of one or more cannulas therethrough. For example, the correction factor can be based on process 800 described above and / or user-provided information. The correction factor can be customized to an individual patient's foot. Alternatively, the correction factor can be one of a standard set of commonly used correction factors.

[0156] In step 914, the manufacturer may form the alignment guide based on the correction factors. For example, the manufacturer may 3D print the alignment guide.

[0157] In step 916, the manufacturer can receive dimensions for creating the orthotic guide. The dimensions for the orthotic guide can be based on process 800 described above or otherwise customized to the individual patient's foot.

[0158] In step 918, the manufacturer can form the alignment guide based on the received dimensions. For example, the manufacturer can 3D print the alignment guide. Alternative component structure

[0159] 26A-26B illustrate another possible configuration for adjustment guide 1000. Adjustment guide 1000 can include the same features and functionality of adjustment guide 200 described above, with some of the differences noted below. Adjustment guide 1000 can include a first portion 1004 and a second portion 1008. First portion 1004 can be releasably connectable to second portion 1008. First portion 1004 can include a handle 1004a. Handle portion 1004a can include an opening therethrough. Handle portion 1004a can function to allow a user to easily hold adjustment guide 1000 in place during use. First portion 1004 of adjustment guide 1000 can include one or more cannulas 1010, 1012 extending therethrough. Cannulas 1010, 1012 can extend through first portion 1004. The cannulas 1010, 1012 can extend along parallel axes 1020, 1022.

[0160] The second portion 1008 can include one or more cannulas 1014, 1016. The cannulas 1014, 1016 can extend through the second portion 1008. The cannulas 1014, 1016 can extend along parallel axes 1024, 1026, respectively. The axes 1020, 1022 can be non-parallel to the axes 1024, 1026.

[0161] The first or second portion 1004, 1008 can include a centering cannula 1009. The centering cannula 1009 can be used to align the adjustment guide 1000 at the tarsometatarsal joint between the medial cuneiform 104 and the metatarsal 108.

[0162] As shown in FIG. 27 , the first portion 1004 can be connectable to the second portion 1008 by an attachment mechanism 1006. The attachment mechanism 1006 can be a thumbscrew. As a thumbscrew, the attachment mechanism 1006 can include a threaded end 1006a. The attachment mechanism 1006 can extend through an opening 1006b in the first portion 1004. The attachment mechanism 1006 can extend through an opening 1006c in the second portion 1008. At least one of the openings 1006b, 1006c can be internally threaded to mate with the threaded end 1006a. Thus, the first and second portions 1004, 1008 can be coupled together by the attachment mechanism 1006.

[0163] The second portion 1008 may include a recess 1008a. The first portion 1004 may include a protruding portion 1004b. The protruding portion 1004b may be received within the recessed portion 1008a. The recess / protrusion arrangement may improve the stability of the bond between the first portion 1004 and the second portion 1008.

[0164] 28A-28B show another implementation of a resection guide 1100. The resection guide 1100 can be structured similarly to the resection guide 404 described above, including some of the differences noted herein. The resection guide 1100 can include a first portion 1111. The first portion 1111 can include one or more openings 1115, 1117 extending therethrough. The first portion 1111 can be coupled to a planar portion 1109. The planar portion 1109 can include a slot 1107 therein. The slot 1107 can be sized to allow a resection tool to extend therethrough to resect a bone of the patient's body (e.g., the patient's foot 100). In some implementations, the planar portion 1109 can include a curved shape to allow the slot 1107 to be placed closer to and / or in contact with the patient's body. This can reduce errors associated with the bone resection process.

[0165] 29 illustrates one method of using an adjustment guide 1100 in a procedure for correcting alignment between two bones in a patient's body. The adjustment guide 1100 can be used to correct the alignment of the medial cuneiform 104 and metatarsal 108 in a patient's foot 100. The process illustrated in FIGS. 29-34 can be similar to and include any of the steps and details described above in the process illustrated in FIGS. 1-22.

[0166] The centering cannula 1009 can align the adjustment guide 1000 at the tarsometatarsal joint between the medial cuneiform 104 and the metatarsal 108. A k-wire (not shown) can extend through the centering cannula 1009 into the space between the medial cuneiform 104 and the metatarsal 108. The first end 1004 of the adjustment guide 1000 can be generally aligned with the medial cuneiform 104. The second end 1008 of the adjustment guide 1000 can be generally aligned with the metatarsal 108. As further shown in FIG. 30 Additionally, multiple k-wires 1300 can be inserted into the medial cuneiform 104 and metatarsal 108 through respective cannulas of the adjustment guide 1000. A first k-wire 1310 can be received within the cannula 1010 and cross the medial cuneiform 104. A second k-wire 1312 can be received through the cannula 1012. A third k-wire 1314 can be inserted into the metatarsal 108 through the cannula 1014. A fourth k-wire 1316 can extend into the metatarsal 108 through the cannula 1016. The k-wires 1300 can extend along respective axes of the cannulas of the adjustment guide 1000. Thus, the alignment guide can define the crossing angle of the k-wires 1300.

[0167] 31 , the first portion 1004 of the adjustment guide 1000 can be removed from the second portion 1008. The attachment mechanism 1006 can be removed from between the first portion 1004 and the second portion 1008. The first portion 1004 can be removed from the K-wire 1300. The second portion 1008 can be removed from the k-wire 1300.

[0168] 32 , the resection guide 1100 can be slid over the k-wires 1300. The planar portion 1109 can be aligned with one or both of the medial cuneiform 104 and / or metatarsal 108. A resection tool 1400 can be inserted through the slot 1107 to form resection surfaces 104a and / or 108a on the respective medial cuneiform 104 and metatarsal 108. As explained above, this can facilitate alignment of the medial cuneiform 104 and metatarsal 108 during the corrective configuration 103.

[0169] 33 , a correction guide 1500 can be slid over the k-wires 1300. The correction guide 1500 can be similar to the correction guide 500. The correction guide 1500 can include multiple cannulae extending along parallel axes. The k-wires 1300 can be received within the cannulae of the collection guide 1500. This can realign and adjust the position of the medial cuneiform 104, metatarsal 108, and / or proximal phalanx 112 to form a corrective configuration 103 of the patient's foot 100.

[0170] In the corrective configuration 103, fixation k-wires 1600 (or similar mechanisms) can be inserted to fix the position of the first metatarsal 108 and the medial cuneiform 104. As shown in FIG. 34 , a bone plate assembly 1700 similar to bone plate assembly 700 can be attached to the medial cuneiform 104 and metatarsal 108 to maintain the relative positions of the two bones in the corrective configuration 103. A term

[0171] Orientational terms used herein, such as "top," "bottom," "proximal," "distal," "longitudinal," "lateral," and "end," are used in connection with the illustrated examples. However, the present disclosure should not be limited to the orientations shown. Indeed, other orientations are possible and within the scope of the present disclosure. Circular terms, such as diameter or radius, as used herein should not be construed as requiring a perfectly circular structure, but rather should apply to any suitable structure with a cross-sectional area that can be measured side-to-side. In general, shape terms, such as "circular," "cylindrical," "semicircular," or "half-cylinder," or any related or similar term, are not required to strictly conform to the mathematical definition of a circle or cylinder or other structure, but can encompass structures that are a reasonably close approximation.

[0172] Conditional terms such as "can," "could," "might," or "may" are specifically stated otherwise. Unless otherwise stated or understood otherwise within the context as used, such conditional language is generally intended to convey that an embodiment includes or does not include certain features, elements, and / or steps. Thus, such conditional language is generally not intended to imply that features, elements, and / or steps are required for one or more embodiments in any way.

[0173] Conjunction language such as the phrase "at least one of X, Y, and Z," unless specifically stated otherwise, is understood differently in the context as commonly used to convey that an item, term, etc., can be either X, Y, or Z. Thus, such conjunctive language is not generally intended to imply that an embodiment requires the presence of at least one of X, at least one of Y, and at least one of Z.

[0174] The terms "approximately," "about," and "substantially," as used herein, refer to an amount close to the stated amount that still performs a desired function or achieves a desired result. For example, in some embodiments, as the context may dictate, the terms "approximately," "about," and "substantially" may refer to an amount that is less than or equal to 10% of the stated amount. The term "generally," as used herein, refers to a value, amount, or characteristic that primarily includes or tends toward a particular value, amount, or characteristic. By way of example, in some embodiments, as the context may dictate, the term "approximately parallel" may refer to something that deviates from exact parallelism by less than or equal to 20 degrees. All ranges include the endpoints. overview

[0175] Several illustrative embodiments of the Rapidus procedure system and method have been disclosed. While the present disclosure has been described in terms of certain illustrative embodiments and applications, other embodiments and applications, including embodiments and applications that do not provide all of the features and advantages described herein, are also within the scope of the present disclosure. Components, elements, features, acts, or steps may be arranged or implemented differently than described, and components, elements, features, acts, or steps may be combined, merged, added, or omitted in various embodiments. All possible combinations and subcombinations of the elements and components described herein are intended to be included within the present disclosure. No feature or group of features is necessary or essential.

[0176] Certain features described in this disclosure in the context of separate implementations can also be implemented in combination in a single implementation. Conversely, various features described in this disclosure in the context of a single implementation can also be implemented in multiple implementations, separately or in any suitable subcombination. Furthermore, while features may be described above as acting in a combination, one or more features from a claimed combination can, in some cases, be excluded from the combination, and the combination may be claimed as a subcombination or a variation of the subcombination.

[0177] Any portion of any of the steps, processes, structures, and / or devices disclosed or illustrated in one embodiment of the present disclosure can be combined or (alternatively) used in conjunction with any other portion of any of the steps, processes, structures, and / or devices disclosed or illustrated in a different embodiment or flowchart. The embodiments described herein are not intended to be discrete and separate from one another. Combinations, variations, and implementations of the disclosed features are within the scope of the present disclosure.

[0178] Although operations may be depicted in the figures or described herein in a particular order, such operations need not be performed in the particular order shown, or in sequential order, or even all operations need to be performed to achieve desirable results. Other operations not depicted or described may also be incorporated into the example methods and processes. For example, one or more additional operations may be performed before, after, simultaneously with, or between any of the described operations. Additionally, operations may be rearranged or reordered in some implementations. Also, the separation of various components in the implementations described above should not be understood as requiring such separation in all implementations, and it should be understood that the described components and systems may generally be integrated together in a single product or packaged in multiple products. Additionally, other implementations are within the scope of this disclosure.

[0179] Additionally, although illustrative embodiments have been described, any embodiments having equivalent elements, modifications, omissions, and / or combinations are also within the scope of the present disclosure. Furthermore, although certain aspects, advantages, and novel features have been described herein, not necessarily all such advantages may be achieved in accordance with any particular embodiment. For example, some embodiments within the scope of the present disclosure may achieve one advantage or group of advantages as taught herein without necessarily achieving other advantages taught or suggested herein. Furthermore, some embodiments may achieve advantages different from those taught or suggested herein.

[0180] Several embodiments have been described in connection with the accompanying drawings. While the figures are drawn and / or shown to scale, such scale should not be considered limiting, as dimensions and proportions other than those shown are contemplated and within the scope of the disclosed invention. Distances, angles, and the like are illustrative only and do not necessarily bear an exact relationship to the actual dimensions and layout of the devices shown. Components may be added, removed, and / or rearranged. Furthermore, the present disclosure herein of any particular features, aspects, methods, properties, characteristics, qualities, attributes, elements, or equivalents associated with various embodiments may be used in all other embodiments described herein. Additionally, any method described herein may be practiced using any device suitable for performing the recited steps.

[0181] For purposes of summarizing the disclosure, certain aspects, advantages, and features of the invention have been described herein. Not all or any such advantages will necessarily be achieved in accordance with any particular embodiment of the invention disclosed herein. No aspect of the present disclosure is required or essential. In many embodiments, devices, systems, and methods may be configured differently from that illustrated in the figures or descriptions herein. For example, various functionality provided by the illustrated modules may be combined, rearranged, added, or deleted. In some implementations, additional or different processors or modules may perform some or all of the functionality described in the figures and with reference to the illustrated embodiments. Many implementation variations are possible. Any of the features, structures, steps, or processes disclosed herein may be included in any embodiment.

[0182] In summary, various embodiments of the Rapidus Procedural System and related methods have been disclosed. The disclosure extends beyond the specifically disclosed embodiments to other alternative embodiments and / or other uses of the embodiments, as well as certain modifications and equivalents thereof. Moreover, the disclosure expressly contemplates that various features and aspects of the disclosed embodiments may be combined with or substituted for one another. Therefore, the scope of the disclosure should not be limited by the particular disclosed embodiments described above, but should also be determined solely by a fair reading of the claims.

Claims

1. 1. A kit for correcting alignment between a first bone and a second bone by fusing a joint between the first bone and the second bone, the kit comprising: A first guide, the first guide comprising: a first end portion having a first cannula aligned along a first axis; a second end portion having a second cannula aligned along a second axis, the first axis being non-parallel to the second axis; Equipped with the first guide is configured such that, when the first and second bones are in a deformed configuration, inserting a first k-wire through the first cannula crosses the first bone and inserting a second k-wire through the second cannula crosses the second bone; A second guide, the second guide comprising: a first end portion having a first cannula; a second end portion having a second cannula, the first cannula of the second guide being parallel to the second cannula of the second guide; a second guide comprising: Equipped with The second guide is configured such that, in the deformed configuration, when the first k-wire is fixed in the first bone and the second k-wire is fixed in the second bone, the first and second k-wires are received in the respective first and second cannulas of the second guide, and sliding the second guide over the first and second k-wires realigns the first and second bones to a corrected configuration.

2. The kit of claim 1 , further comprising a stabilization wire for fixing the first and second bones in the corrected configuration by inserting a stabilization wire into the first and second bones.

3. 2. The kit of claim 1, further comprising a bone plate, a first end configured to be attached to the first bone, and a second end of the bone plate configured to be attached to the second bone, such that the first and second bones are retained in the corrective configuration.

4. The kit of claim 3 , further comprising a bone plate clip configured for insertion into the first and second bones in the corrective configuration.

5. The kit of claim 1 , further comprising a first resection guide configured to align a resection tool with a resection location on the first bone.

6. 6. The kit of claim 5, wherein the first resection guide includes first and second cannulas configured to be advanced over the first k-wire and a third k-wire, the third k-wire being parallel to the first k-wire.

7. The kit of claim 6 , further comprising a second resection guide configured to align the resection tool with a resection location on the second bone.

8. 1. A method of manufacturing a kit for correcting alignment between a first bone and a second bone, comprising: receiving a correction factor, the correction factor including a first virtual vector passing through a first virtual point in a virtual coordinate plane and a second virtual vector passing through a second virtual point in the virtual coordinate plane; forming a first guide based on the correction factor, the first guide including a first end portion having a first cannula aligned along a first axis and a second end portion having a second cannula aligned along a second axis; Including, the first axis corresponds to the first virtual vector and the first virtual point, the second axis corresponds to the second virtual vector and the second virtual point, and the first and second axes are non-parallel; The method, wherein the first guide is configured such that, in a deformed configuration, a first k-wire inserted through the first cannula crosses the first bone and a second k-wire inserted through the second cannula crosses the second bone.

9. receiving a scan of the first bone and the second bone in the deformed configuration and rendering a 3D model including the first virtual bone and the second virtual bone in a virtually deformed configuration; adjusting the first virtual bone and the second virtual bone in the 3D model to align the first virtual bone and the second virtual bone in a virtual corrective configuration; In the virtual correction configuration, a first virtual axis is fixed relative to the first virtual bone and a second virtual axis is fixed relative to the second virtual bone, the first virtual axis being parallel to the second virtual axis; returning the first and second virtual bones to the virtual deformed configuration, the first and second virtual axes defining first and second virtual vectors and first and second virtual points of the correction factor, respectively; The method of claim 8 further comprising:

10. further comprising identifying a virtual resection plane where the first virtual bone and the second virtual bone overlap in the virtual correction configuration; Fixing the first virtual axis relative to the first virtual bone includes aligning the first virtual axis parallel to the virtual resection plane.

10. The method of claim 9.

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