Transdermal targeting device

Abstract

To provide a guide to assist with screw placement for minimally invasive foot surgery (e.g., bunion surgery, i.e., Chevron and / or Aiken osteotomy). The percutaneous targeting device includes a body that holds an extension. The body has a targeting guide that holds a targeting pin, which can be a K-wire. The extension has two guide sleeves that hold the guide wires. All wires are held in a common plane. The guide wires act as guides for cannulated fixation screws. The extension is movable relative to the body to adjust the angle between the targeting pin and the guide wires.

Description

Technical Field

[0005] ,

[0001] The present disclosure relates to a percutaneous targeting device that can be used in chevron osteotomy procedures.

Background Art

[0002] Hallux valgus deformity is a common foot disorder that can result in the formation of a sesamoid tumor in the patient's foot. A known technique for correcting hallux valgus deformity is the minimally invasive chevron osteotomy procedure. After performing chevron osteotomy, the bone fragments are repositioned and fixed with fixation screws. The screws can be inserted at an oblique angle into the bone by the surgeon in a minimally invasive manner. To correctly place the screws, multiple X-ray images are required, which can result in loss of time, high radiation dose, and cost.

Summary of the Invention

Means for Solving the Problems

[0003] <0**********16>[[ID=**********22]]As described herein, a guide for assisting screw placement for minimally invasive foot surgery (e.g., sesamoid tumor surgery, i.e., chevron and / or akin osteotomy) is disclosed. The device herein facilitates the placement of a guide wire (e.g., Kirschner wire, also known as a K-wire) for fixing a screw (e.g., a screw into which a cannula is inserted).

[0004] As described herein, according to various embodiments, a percutaneous targeting device, also described as a tool, enables easy and accurate targeting for placing a screw for fixing a small bone fragment. After a target pin is placed in the bone (which can be done by a drill or similar tool), the tool is placed on the reference pin, and the tool ensures that the screw is in the plane through the target pin. By markings and / or windows, the length of the target pin can be easily adjusted so that the target pin ends within the target window portion or intersection.

[0005] The position of the plane can be easily confirmed by the surgeon by considering the positions of the body and target pin. To clearly indicate the plane, the body can have a flat shape. The tool can be adjusted by moving the extension relative to the body so that the angle between the target pin and the guide pin can be adapted to specific needs. Regardless of this adjustment, the guide pin remains parallel. If one of the guide pins is fixed to the bone (which can be done with a drill or similar tool), the tool is fixed in that position relative to the bone. A second, or any further, guide pin is forced to be parallel to the first guide pin. Thus, angled screws and weakening of the bone material are prevented. The length of the guide pin is indicated by markings on the tool. The reverse is also true, but as mentioned above, if the target pin is adjusted relative to the tool, the length of the first guide pin in contact with the tip of the target pin is always the same. The indicated length allows for the calculation of the required screw length.

[0006] Methods for fixing bone fragments in minimally invasive foot surgery include the use of a percutaneous targeting device. A targeting device with a target guide may be positioned on the target pin so that the target pin is guided within the target guide. Positioning can be performed so that a visible mark on the target pin aligns with the body of the target guide or its markings. Alternatively, the sleeve of the target guide may be positioned on the target pin, and the targeting device body may be attached to the target guide later. After the osteotomy, the hook of the hook-sleeve assembly may be inserted intramedullarily into the proximal portion of the metatarsal bone. A first guidewire may be positioned in the distal portion of the metatarsal bone through the positioning screw and hook sleeve of the hook-sleeve assembly. The distal portion of the metatarsal bone may be shifted / positioned by rotating the positioning screw along the guidewire. The tip of the positioning screw may be in direct contact with the distal bone fragment or may be pressed against the fragment through the skin (via the plunger tip). In addition, the first guide sleeve can be inserted into the outermost mounting hole, and at least the other guide sleeves can be inserted into one of the other mounting holes. The tool can then be adjusted by moving the extension so that the guide sleeve or guide wire is at the desired angle relative to the target pin. Doing so allows for precise selection of the screw angle in the bone.

[0007] These methods ensure that multiple screws are precisely parallel. The length of the screws can be selected based on the lengths of the first and second guidewires extending into the bone. Therefore, screws that are too long may prevent drilling into the two surfaces of the bone. [Brief explanation of the drawing]

[0008] [Figure 1] This is a diagram showing a targeting device. [Figure 2] This figure shows the application of a targeting device to bone. [Figure 3] This figure shows the geometric shape and movement details of the targeting device. [Figure 4a] This figure shows a further embodiment of the targeting device. [Figure 4b] This figure shows a further embodiment of the targeting device. [Figure 4c] This figure shows a further embodiment of the targeting device. [Figure 5] This is a cross-sectional view of a targeting device. [Figure 6] This is a perspective view of a targeting device. [Figure 7] This is a perspective view of further targeting devices. [Figure 8] This is a diagram showing a hook sleeve. [Figure 9] This is a detailed diagram of a hook sleeve. [Modes for carrying out the invention]

[0009] Embodiments of the devices disclosed herein simplify the placement of fixation screws in distal extremity bone, which can be problematic during such surgical procedures. For example, after a minimally invasive chevron osteotomy, the fixation of metatarsal fragments is simplified using the devices described herein.

[0010] In the first embodiment, a percutaneous targeting device for minimally invasive foot surgery comprises a body that holds an extension. The body has mounting means for a target guide having a target sleeve for holding a target pin. Furthermore, or alternatively, a hook sleeve or hook sleeve assembly having a lateral hook can be used. The extension has a plurality of mounting holes for holding at least one guide wire and / or at least one guide sleeve. At least one guide sleeve can further hold a guide wire. The guide sleeve provides good guidance and high stability to the guide wire. The target sleeve is configured to hold a target pin which can be a K-wire. The target pin can extend axially through the target sleeve. The target sleeve may be configured to hold the target pin in a fixed position relative to the target sleeve. If necessary, the target pin can be released from its fixed position. The target pin may be movable within the target sleeve in a direction which can be along its longitudinal axis. This allows the target pin to be positioned and / or to be inserted / removed. The guide sleeve may be configured to hold a guide wire. A K-wire is a wire with a tip and configured to be inserted into a hole drilled in the bone. A guidewire may have a tip and may be configured to be inserted into a hole drilled in the bone. Any guidewire may be a K-wire. The target pin and guidewire may have diameters between 5 mm and 0.5 mm, or between 3 mm and 1 mm. The first mounting hole for holding the first guide sleeve or first guidewire is located on the outermost part of the extension and therefore furthest from the target sleeve. Further mounting holes for holding further guide sleeves or guides.

[0011] The wire can be parallel to the first mounting hole and close to the target sleeve. The extension is movable relative to the body and held slidably within the body to extend the distance and / or angle between the target sleeve and the guide sleeve. The target sleeve, as well as the guide sleeve and / or guide wire, can be located in a common plane and at a single point toward a common target area. Thus, the wires held by the target sleeve and guide sleeve can be in the same plane, and when properly inserted, their ends can terminate within the target area.

[0012] The target sleeve may have a tubular shape that forms a target sleeve channel. The first guide sleeve may have a tubular shape that forms a first guide sleeve channel. The second guide sleeve may have a tubular shape that forms a second guide sleeve channel. Other guide sleeves may have a tubular shape, and the guide sleeves form a guide sleeve channel. The channels may have an inner hole that fits the outer diameter of the wires they are used with. The target guide may be fitted to the body, and the guide sleeve may be fitted to the mounting hole. The guide sleeve may have a mark or ruler that can indicate the depth of the wire held by the guide sleeve. For this purpose, the wire may have a visible mark, such as a laser mark.

[0013] The main body and extension can be arc-shaped. The arc-shaped main body can define a first radial axis, and the arc-shaped extension can define a second radial axis. The first and second radial axes can intersect at an intersection within the target area. One of the target sleeve and guide sleeve can also point to an intersection within the target area, which can be the same intersection as described above. The target area can be defined as a circular area centered on the intersection. When the extension slides in and out of the main body, it moves in an arc, and the intersection may not move, but the angle between the target sleeve channel and the first guide sleeve channel or the first guide wire changes when the guide wire is held without a sleeve.

[0014] The target pin may have at least one visible mark that can be laser-marked at a predetermined distance from its tip. The target guide may have a window through which the target pin can be viewed, and thus the visible mark on the target pin can be aligned with the body. For this purpose, the body may have alignment marks. Alignment of the body with the visible mark on the target pin can ensure that the tip of the target pin is within the target area. In a further embodiment, the tip of the target pin may be at an intersection. The target guide may also have a target sleeve which may have a connecting section that is threaded and thereby movable to position metatarsal fragments. The target sleeve may have a gear rack which interacts with a rack wheel in the body, allowing the target sleeve to move along its longitudinal axis.

[0015] In further embodiments, the main body can be integrated with an extension, or at least fixed to it. Angle adjustment can be performed by selecting a mounting hole that provides the desired angle between the target pin and at least one guide wire.

[0016] In various embodiments, the percutaneous targeting device, also described herein as a tool, enables simple and precise targeting for positioning screws to fix small bone fragments. After the target pin is positioned in the bone (which can be done by drilling or a similar tool) and the tool is positioned on the reference pin, the tool ensures that the screw is in a plane through the target pin. The length of the target pin can be easily adjusted by markings and / or windows so that the target pin terminates within the target window or further at an intersection.

[0017] The position of the plane can be easily confirmed by the surgeon by considering the positions of the body and target pin. To clearly indicate the plane, the body can have a flat shape. The tool can be adjusted by moving the extension relative to the body so that the angle between the target pin and the guide pin can be adapted to specific needs. Regardless of this adjustment, the guide pin remains parallel. If one of the guide pins is fixed to the bone (which can be done with a drill or similar tool), the tool is fixed in that position relative to the bone. A second, or any further, guide pin can be forced to be parallel to the first guide pin. Thus, angled screws and weakening of the bone material are prevented. The length of the guide pin is indicated by a marking on the tool. The reverse is also true, but as mentioned above, if the target pin is adjusted relative to the tool, the length of the first guide pin in contact with the tip of the target pin is always the same. The indicated length allows for the calculation of the required screw length.

[0018] Finally, a screw (e.g., a fixation screw into which a cannula is inserted) can be inserted via a guide wire. The instrument can be easily removed by successively removing the wires.

[0019] A method of fixing bone fragments in minimally invasive foot surgery involves placing a target pin, which can be a K-wire, at the distal portion of the midfoot bone. An osteotomy can then be performed and the distal bone portion can be repositioned using the target pin. In the next step, a targeting device having a target guide can be placed over the target pin such that the target pin is guided within the target guide. Positioning can be done such that a visible mark on the target pin is aligned with the body of the target guide or its markings. Alternatively, a sleeve of the target guide is placed over the target pin and the targeting device body can be attached to the target guide later. In a further embodiment, after performing the osteotomy, a hook of a hook sleeve assembly can be inserted intramedullary into the proximal portion of the midfoot bone. A first target pin can be placed at the distal portion of the midfoot bone through the positioning screw and the hook sleeve of the hook sleeve assembly. The distal portion of the midfoot bone can be shifted / positioned by rotating the positioning screw along the target pin. The tip of the positioning screw can contact directly the distal bone fragment or push the fragment through the skin (e.g., via the plunger tip).

[0020] The first guide sleeve can be inserted into the outermost mounting hole and at least another guide sleeve can be inserted into one of the other mounting holes. This step can also be performed before positioning the tool over the reference guide. The guide sleeves can also be pre-assembled. The tool can be adjusted by moving an extension such that the guide sleeve or guide wire can be at a desired angle with respect to the target pin. Doing so enables an accurate selection of the angle of the screw in the bone.

[0021] Guide wires, for example, two guide wires, can be inserted into the bone through a guide sleeve. Alternatively, at least one guide wire can also be inserted directly through the mounting hole. In this embodiment, the step of inserting the guide sleeve can be excluded. The tip of the outermost guide wire in the first guide sleeve can contact the tip of the target pin within the target area, or can further contact at the intersection point. The tips of the other guide wires in the other guide sleeves can contact the target pin within the target area. The intersection between the target pin and the first guide wire, and / or the intersection between the target pin and the second guide wire can be outside the target sleeve. The target pin and the guide wires can all be in the same plane. The guide wires can be inserted in any order. The first guide wire can be inserted first, and then the second guide wire can be inserted. Alternatively, the first guide wire can follow the second guide wire. It is also possible to insert the guide wire first and then insert the target pin.

[0022] Any of the target pin, the first guide wire, and the second guide wire can define a central axis. Generally, the central axis of the target pin can intersect the central axis of the first guide wire, and / or the central axis of the target pin can intersect the central axis of the second guide wire. The central axis of the first guide wire can be parallel to the central axis of the second guide wire.

[0023] In an embodiment, the extension can be adjusted to move the guide sleeve to a new position relative to another guide wire after inserting the first guide wire.

[0024] The fixation screw inserted into the cannula can be screwed into the bone using a guidewire. The guidewire guides the screw through the cannula insertion. The tool can be removed before or after screwing the fixation screw into the bone. Finally, the tool, guidewire, and target pin can be removed.

[0025] These methods ensure that multiple screws are precisely parallel. The length of the screws can be selected based on the lengths of the first and second guidewires extending into the bone. Therefore, screws that are too long can prevent drilling through two surfaces of the bone.

[0026] Figure 1 shows a first embodiment. The transcutaneous targeting device 100 comprises a main body 110 and an extension 120. The extension may be movable relative to the main body for angle adjustment. The main body 110 has means for attaching to a target guide 200. In the embodiment, the target guide 200 has a tubular target sleeve 210 with a target sleeve channel 211 having a diameter adapted to hold a target pin 220. A hole or cylindrical bore may be present in the device body to hold the target guide 200. Locking means 112 may also be present in the device body to fix the target guide 200 in place. The target guide 200 may be movable within the main body and removable from the main body. The target guide 200 may also be fixed to the main body, or in part, to the main body. It may further have a window 214 through which a mark 222, such as a laser mark on the target pin 220, can be seen aligned with the body 110, or a mark on the body 110, or a mark on the target guide 200. The target guide 200 may also have a connecting section 212, such as a threaded section, so that it can be held by a handle for easy mounting. The target pin 220 may be a K-wire having a tip and configured to be drilled and inserted into bone.

[0027] The extension 120 may have a plurality of mounting holes for holding guide sleeves 310, 330. The guide sleeves 310, 330 may have tubular bodies forming channels 311, 331 for holding guide wires. A first mounting hole 121 may be located at the outermost position, furthest from the target guide 200. Further mounting holes 122, 123, 124 may be located further away from the first mounting hole but closer to the target guide 200. The mounting holes 121, 122, 123, 124 may include cylindrical holes, but any other suitable form may be used. The mounting holes 122, 123, 124 are so close to each other that there are no side walls between the holes. At least one guide sleeve 310 may be located at the outermost or first mounting hole 121. A second guide sleeve 330 may be located at one of the other mounting holes 122, 123, 124. The guide sleeves 310 and 330 may be movable within the extension 120, and they may be removable from the extension 120.

[0028] Depending on the desired distance from the first guide wire 320, held by the first guide sleeve 310, to the second guide wire 340, held by the second guide sleeve 330, appropriate mounting holes 121, 122, 123, and 124 can be selected. The guide wires 320 and 340 may have tips and may be configured to be drilled into bone. The first guide wire 320, the second guide wire 340, and the target pin 220 may all be in the same plane. When properly extended, the tip of the target pin 220 may contact the tip of the first guide wire 320. The tip of the second guide wire 330 may contact the target pin 220 away from its tip, but may still be in the same plane. In this specification, the term "same plane" may include deviations of, for example, up to 5 mm, 2 mm, or 1 mm.

[0029] Guide sleeves 310, 330 may have markings or depth scales 312, 332 to indicate the depth or length of the inserted guide wires 320, 340. For accurate length readings, guide wires 320, 340 may also have marks, for example, laser marks.

[0030] In this embodiment, the target sleeve channel 211, the first guide sleeve channel 311, and the second guide sleeve channel 331 may be configured such that the intersection between the target pin 220 and the first guide wire 320, and / or the intersection between the target pin 220 and the second guide wire 340, is on the outside of the target sleeve 210.

[0031] Figure 2 shows the application of the targeting device 100 in a bone. The big toe 500 comprises a metatarsal bone 530, a proximal phalanx 520, and a distal phalanx 510. The metatarsal bone 530 has been cut so that two fragments 531 and 532 are present. These two fragments need to be screwed together into a new position, as indicated by two bone screws. Here, the target pin 220 is inserted into the metatarsal fragment 531 and holds the guide tool. The first guide wire 320 and the second guide wire 340 have already been inserted. The first cannula-inserted screw 410 and the second cannula-inserted screw 420 have already been screwed into the bone, fixing fragments 531 and 532 together.

[0032] Figure 3 shows the geometric shape and motion details of the targeting device. The main body 110 can be arc-shaped and may have a hollow opening 115 to receive at least a portion of an extension 120, which may also be arc-shaped. The extension 120 may be configured to move within the device body 110. The extension 120 may be configured to move in a direction 172 relative to the main body 110 to make rotational adjustments. Doing so changes the rotation angle 176 between the central axis 161 of the target pin 220 and the central axis 162 of the first guide wire 320. The target pin 220 may be in a fixed angular relationship with the device body 110, and the guide wires 320, 340 may be in a fixed angular relationship with the device extension 120. The central axis 161 of the target pin 220 and the central axis 162 of the first guide wire 320 intersect at the intersection 163 within the target area 155, or independently of the relative position of the extension 120 with respect to the main body 110.

[0033] To adjust the dimensions, the position of the target pin 220 can be adjusted in direction 171 along its central axis 161. Depth adjustment can be performed by moving either guide wire 320 or 340 along the central axis 161 of the first guide wire 320, or in direction 174 parallel to it. The distance between guide wires 320 and 340 can be adjusted by parallel movement of the guide wires in direction 173.

[0034] The target pin 220 and the first guide wire 320 can contact each other within the target area 155, or further at the intersection 163. The target pin 220 and the second guide wire 340 can contact each other within the target area 155. The target area can be circular and may have a diameter of, for example, 10 mm, 5 mm, or 2 mm.

[0035] In this embodiment, the extension 120 can be configured to move relative to the main body 110 so that the point of intersection between the target pin 220 and the first guide wire 320 does not move.

[0036] Figures 4a, 4b, and 4c show further embodiments, where the first guide wire 320 and the second guide wire 340 can be held by sleeveless extensions 120, and the third guide wire 360 ​​can be held by a guide sleeve 350. The third guide wire 360 ​​can be parallel to and coplane with the first guide wire 320 and the second guide wire 340. The central axis of the guide sleeve and / or the central axis of the guide wires can be in the same plane.

[0037] In this embodiment, the target sleeve 210 may have a gear rack 216 on one side, which interacts with a rack wheel 217 shown in Figure 5. The rack wheel 217 may be driven by a handle 116. Rotation of the handle 116 can rotate the rack wheel 217, and thus move the gear rack 216 and the target sleeve 210 inward and outward.

[0038] An extension lock 119 may be provided to lock the device extension 120 in a fixed relationship with the device body 110. The extension lock 119 may be a button that, when pressed, releases the device extension 120 so that the device extension 120 can be moved relative to the device body 110.

[0039] The features of the embodiments described herein can be combined in any combination.

[0040] Before inserting either guidewire into the bone, the targeting device can be rotated around the target pin 220 in direction 175, which produces angle formation at angle 177.

[0041] Figure 4a shows a front view, Figure 4b shows a right side view, and Figure 4c shows a top view of the embodiment.

[0042] Figure 5 shows a cross-sectional view of the targeting device.

[0043] In this embodiment, any of the guide wires 320, 340, and 360 can be directly held by the device extension 120 without using the guide sleeves 310, 330, and 350. For this purpose, a retaining structure 126 may be present in the device extension 120. This retaining structure 126 may include holes, ribs, wedge-shaped elements, or other elements that form mounting holes, which can be adapted to hold the guide wires and / or sleeves.

[0044] Figure 6 shows a perspective view of the targeting device.

[0045] Figure 7 shows a perspective view of a further targeting device. This embodiment has a partially simplified body and a hook sleeve assembly comprising a positioning screw 610 and a hook sleeve 615 further comprising a hook. Here, at least some of the sleeves can be integrated into the body and / or extension.

[0046] Figure 8 shows the hook sleeve and positioning screw in detail. The positioning screw 610, having an inner sleeve 613, fits onto the target pin 220. The positioning screw 610 may have an outer thread 612 and a nut 611. The positioning screw 610 can be screwed into the hook sleeve 615. When screwed together, the sleeve assembly comprising the inner sleeve 613 and the positioning screw 610 can be securely held on the target pin 220, and it may be located near the tip of the target pin. The hook sleeve 615 may have a hook 616 with a radial extension relative to the target pin 220. The hook may further have an axial extension that provides an axial offset. The hook may have a diameter of less than 2 mm or less than 1 mm and may include a wire that may have a length of less than 15 mm or less than 10 mm. The hook sleeve can be used as an alternative to the target sleeve 210.

[0047] Figure 9 shows a detailed view of the hook sleeve assembly. Here, the hook sleeve 615 and the positioning screw 610 are disassembled. [Explanation of Symbols]

[0048] 100 Targeting Devices 110 Device Body 112 Locking mechanism 115 Hollow opening 116 Handle 119 Extension lock 120 Device extension 121 First mounting hole 122, 123, 124 Mounting holes 126 Retention structure 155 Target Area 161 Target pin central axis 162 Central axis of the first guidewire 163 Intersection 171 Direction of dimensional adjustment using target pins 172 Direction of rotation adjustment 173 Direction of distance adjustment 174 Direction of depth adjustment 175 Direction of angle formation adjustment 176 rotation angle 177 Angle forming angle 200 Target Guide 210 Target Sleeves 211 Target Sleeve Channel 212 Joined Sections 214 Window section 216 Gear Rack 217 Rack Wheel 220 target pins 222 Laser Mark 310 First guide sleeve 311 First guide sleeve channel 312 Depth Scale 320 First guide wire 330 Second guide sleeve 331 Second Channel 332 Depth Scale 340 Second guidewire 350 Third Guide Sleeve 360 Third guidewire 410 First screw 420 Second screw 500 Big toe 510 Distal phalanx 520 Proximal phalanx 530 Metatarsals 531, 532 Metatarsal fragments 610 Hook Sleeve Assembly 611 Nut 612 threads 613 Inner sleeve 615 Hook Sleeve 616 Hook

Claims

1. A transdermal targeting device, Arc-shaped device body; A device extension portion having an arc shape that is partially received so as to be retractable from one end of the device body along an arc extending the arc shape of the device body, the device extension portion having at least one mounting hole into which at least one guide sleeve is inserted, and the at least one mounting hole comprising a first mounting hole into which a first guide sleeve is inserted; A target guide, including a target sleeve, which can be fixed in close proximity to the other end of the device body; A target pin, which is inserted into the distal portion of the bone through the target sleeve, fixes the device body to the distal portion of the bone; A first guide wire received in the first guide sleeve; and A fixing screw into which a first cannula is inserted, which is screwed in from the proximal portion to the distal portion of the bone using the first guidewire; Equipped with, A transcutaneous targeting device characterized in that the target pin and the first guide wire are arranged toward the center of the arc shape on the same plane as the plane on which the arc shape is formed, and the device extension can be extended and retracted from one end of the device body, thereby allowing adjustment of the angle of the axis of the first guide wire with respect to the axis of the target pin.

2. The transcutaneous targeting device according to claim 1, characterized in that the bone is a metatarsal bone.

3. The transcutaneous targeting device according to claim 1, characterized in that the at least one mounting hole further comprises a second mounting hole for receiving a second guide sleeve for receiving a second guide wire.

4. The transcutaneous targeting device according to claim 3, wherein the at least one mounting hole further comprises a third mounting hole, and the second guide sleeve is housed in either the second mounting hole or the third mounting hole depending on a desired distance between the first guide wire and the second guide wire.

5. The percutaneous targeting device according to claim 3, comprising a fixing screw into which a second cannula is inserted and screwed into the bone using the second guidewire.

6. The transcutaneous targeting device according to claim 4, characterized in that no side wall is disposed between the second mounting hole and the third mounting hole.

7. The transdermal targeting device according to claim 3, characterized in that the first mounting hole is the mounting hole furthest from one end of the device body, and the second mounting hole is the mounting hole closest to one end of the device body.

8. The transcutaneous targeting device according to claim 1, characterized in that the target sleeve is configured to allow the movement of the target pin within the target guide.

9. The percutaneous targeting device according to claim 1, characterized in that the target guide comprises a hook-sleeve assembly comprising a hook inserted into the medullary tissue of the proximal portion of the bone and a hook sleeve.

10. The transcutaneous targeting device according to claim 9, characterized in that the hook sleeve assembly includes a positioning screw for holding the target pin in a fixed position relative to the target guide.

11. The transcutaneous targeting device according to claim 9, characterized in that the hook includes an extension that extends perpendicularly to the axis of the target pin.

12. The transcutaneous targeting device according to claim 1, characterized in that the target guide is configured to hold the target pin in a fixed position relative to the target guide.

13. The transcutaneous targeting device according to claim 1, characterized in that the target pin is a K-wire extending axially through the target guide.

14. The percutaneous targeting device according to claim 3, characterized in that the first guidewire and the second guidewire each have a tip and are configured to penetrate the bone.

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