Apparatus and method for an MIS bunion treatment guide

Abstract

An apparatus and methods are provided for an MIS bunion treatment guide for corrective procedures of the hallux. The guide includes a pusher for laterally shifting a metatarsal bone head. The pusher supports a K-wire extended into the metatarsal bone head to fixate its position. The bone head pusher includes a hook for inserting into a medullary canal of the metatarsal bone during shifting the metatarsal bone head. The bone head pusher supports a K-wire extended into the medullary canal to fixate the metatarsal bone. The guide includes a slidable arm for angling first and second K -wires toward the metatarsal bone. The slidable arm is configured to support an optional K-wire that may be extended into the 1st cuneiform bone of the foot. The guide includes a slidable arm extension for supporting the sleeves for directing the first and second K -wires.

Description

APPARATUS AND METHOD FOR AN MIS BUNION TREATMENT GUIDEPRIORITY

[0001] This application claims the benefit of and priority to U.S. Provisional Application, entitled “MIS Bunion Treatment Guide,” filed on January 17, 2024, and having application serial number 63 / 621,983, the entirety of said application being incorporated herein by reference.FIELD

[0002] Embodiments of the present disclosure generally relate to treating bones deformities. More specifically, embodiments of the disclosure relate to an apparatus and methods for a Minimally Invasive Surgery bunion treatment guide for corrective procedures of the hallux.BACKGROUND

[0003] Hallux valgus is a progressive foot deformity wherein the distal region of the big toe (i.e., the “hallux”) deviates in a lateral direction. Such a deformity can be caused by wearing pointed shoes with a narrow toe box. For example, when wearing high heel shoes, the foot is forced into the front of the shoe. The narrow front of the shoe forces the distal hallux in the lateral direction, toward the other toes, while a distal portion of the 1stmetatarsal head is forced in a medial direction. Forcing the distal metatarsal head in the medial direction pushes it outward and against an edge of the shoe. The irritation caused by pressing the metatarsal head against the shoe often causes an enlarged and thickened callus, or a bunion, to form.

[0004] A hallux valgus deformity may have significant ramifications for soft tissue problems in other areas, such as pain and functional deficit. For example, a hallux valgus deformity can give rise to an impaired gait characterized by lateral and posterior weight shift, late heel rise, decreased single-limb balance, pronation deformity, and the like. When the hallux is deviating away from its normal position, it does not have the mechanical ability to perform these tasks correctly. For example, if the hallux is not preventing overpronation, a number of other problems may develop, including plantar fasciitis, shin splints, or other ankle or knee pathologies.

[0005] Given that hallux valgus is relatively prevalent in the general population, there is an ongoing need for the development of foot treatment capabilities such as those related to, for example, treating hallux valgus deformities. Provided herein are embodiments and methods for aMinimally Invasive Surgery (MIS) bunion treatment guide for a lateral head shift osteotomy of a 1stmetatarsal bone for corrective procedures of the hallux.SUMMARY

[0006] An apparatus and methods are provided for an MIS bunion treatment guide for corrective procedures of the hallux. The guide includes a pusher for laterally shifting a metatarsal bone head. The pusher supports a K-wire extended into the metatarsal bone head to fixate its position. The bone head pusher includes a hook for inserting into a medullary canal of the metatarsal bone during shifting the metatarsal bone head. The bone head pusher supports a K- wire extended into the medullary canal to fixate the metatarsal bone. The guide includes a slidable arm for angling first and second K-wires toward the metatarsal bone. The slidable arm is configured to support an optional K-wire that may be extended into the 1stcuneiform bone of the foot. The guide includes a slidable arm extension for supporting the sleeves for directing the first and second K-wires.

[0007] In an exemplary embodiment, an apparatus for performing a lateral head shift osteotomy, comprises: a bone head pusher for laterally shifting a metatarsal bone head; a slidable arm for angling a first K-wire and a second K-wire toward the metatarsal bone; and a slidable arm extension for supporting the first K-wire and the second K-wire.

[0008] In an exemplary embodiment, wherein the bone head pusher is adapted for laterally shifting the metatarsal bone head. In an exemplary embodiment, wherein the bone head pusher is configured to support a K-wire that may be extended into an intramedullary canal of the metatarsal bone. In an exemplary embodiment, wherein the bone head pusher includes a hook that is adapted to be inserted into the intramedullary canal of the metatarsal bone. In an exemplary embodiment, wherein the hook comprises a pair of parallel prongs that are spaced apart to provide clearance for the second K-wire to extend through the metatarsal bone into the metatarsal bone head.

[0009] In an exemplary embodiment, wherein the slidable arm includes multiple radiopaque markers to facilitate visualization of the apparatus under fluoroscopy. In an exemplary embodiment, wherein the slidable arm is configured to support an optional K-wire that may be extended into the 1stcuneiform bone of the foot. In an exemplary embodiment, wherein theoptional K-wire guide is configured extended into the 1stcuneiform bone to stabilize the apparatus in a desired angulation with respect to a foot of the patient.

[0010] In an exemplary embodiment, wherein the slidable arm extension is configured to support a proximal K-wire sleeve and a distal K-wire sleeve. In an exemplary embodiment, wherein the proximal K-wire sleeve and the distal K-wire sleeve are configured to respectively support a proximal K-wire and a distal K-wire that fixate the metatarsal bone head with respect to the metatarsal bone.

[0011] In an exemplary embodiment, wherein a first locking wheel is configured to enable fixating the slidable arm within a rear jib portion comprising the pusher. In an exemplary embodiment, wherein a second locking wheel is configured to enable fixating the slidable arm extension with respect to the slidable arm. In an exemplary embodiment, wherein the slidable arm includes a narrow section adapted to receive the rear jig portion. In an exemplary embodiment, wherein the slidable arm includes a label that indicates an intended use on a right foot or a left foot of the patient.

[0012] In an exemplary embodiment, wherein the bone head pusher comprises a pusher that is configured to support a K-wire that may be extended into and fixate a position of the metatarsal bone head. In an exemplary embodiment, wherein the pusher comprises a graduated wheel that supports the bone head pusher and rides on a rear jig portion. In an exemplary embodiment, wherein the rear jig portion comprises a threaded portion that engages with the graduated wheel while a smooth portion of the rear jig portion extends through the graduated wheel to the front of the bone head pusher. In an exemplary embodiment, wherein the threaded portion moves a distal end of the smooth portion with respect to the metatarsal bone head when the graduated wheel is rotated on the threaded portion. In an exemplary embodiment, wherein an index line disposed on the smooth portion and a graduated index disposed on the graduated wheel are configured to enable ascertaining a distance the distal end moves. In an exemplary embodiment, wherein the distal end includes smooth surfaces that are configured to minimize trauma to the metatarsal bone head during treatment.

[0013] These and other features of the concepts provided herein may be better understood with reference to the drawings, description, and appended claims.BRIEF DESCRIPTION OF THE DRAWINGS

[0014] The drawings refer to embodiments of the present disclosure in which:

[0015] Figure 1 illustrates an exemplary-use environment wherein an exemplary embodiment of an MIS bunion treatment guide is engaged with a right foot undergoing a lateral head shift osteotomy of a 1stmetatarsal bone, according to the present disclosure;

[0016] Figure 2 illustrates an exemplary embodiment of a slidable arm comprising an MIS bunion treatment guide in accordance with the present disclosure;

[0017] Figure 3 illustrates an exploded view of the slidable arm of Fig. 2, according to the present disclosure;

[0018] Figure 4 illustrates an exemplary embodiment of a slidable arm that includes radiopaque markers in accordance with the present disclosure;

[0019] Figure 5 is a close-up view of an exemplary embodiment of a slidable arm and a slidable arm extension that share a 0-degree index;

[0020] Figure 6 illustrates a side view of an exemplary embodiment of a pusher comprising an MIS bunion treatment guide, according to the present disclosure;

[0021] Figure 7 illustrates an exploded view of the pusher shown in Fig. 6;

[0022] Figure 8 illustrates an exploded view of a locking wheel and the pusher of Fig. 6;

[0023] Figure 9 illustrates an exemplary embodiment of a bone head pusher comprising an MIS bunion treatment guide, according to the present disclosure;

[0024] Figure 10 illustrates an exemplary -use environment wherein an osteotomy cut is performed to separate the metatarsal bone and the metatarsal bone head;

[0025] Figure 11 illustrates an exemplary-use environment wherein the pusher is used as a lever to laterally shift the metatarsal bone head, according to the present disclosure;

[0026] Figure 12 illustrates an exemplary -use environment wherein K-wires are used to fixate the metatarsal bone head and the metatarsal bone in accordance with the present disclosure;

[0027] Figures 13-14 illustrate an exemplary-use environment wherein an exemplary embodiment of a slidable arm is coupled with an exemplary embodiment of a pusher, according to the present disclosure;

[0028] Figure 15 illustrates an exemplary-use environment wherein a proximal K-wire sleeve is coupled with an exemplary embodiment of a slidable arm extension, according to the present disclosure;

[0029] Figure 16 illustrates an exemplary embodiment of a slidable arm extension that includes a distal K-wire guide hole and three proximal K-wire guide holes in accordance with the present disclosure;

[0030] Figure 17 illustrates an exemplary -use environment wherein a slidable arm is moved to position a proximal K-wire sleeve to target a proximal-most entry point along the metatarsal bone, according to the present disclosure;

[0031] Figure 18 illustrates an exemplary-use environment wherein an optional cuneiform K- wire extends through an exemplary embodiment of a guide slot into the 1stcuneiform of the foot, according to the present disclosure;

[0032] Figure 19 illustrates an exemplary -use environment wherein an intramedullary K-wire is pulled from the medullar canal of the metatarsal bone and removed from the bone head pusher in accordance with the present disclosure;

[0033] Figure 20 illustrates an exemplary-use environment wherein proximal and distal K- wires are respectively passed through proximal and distal K-wire sleeves before being driven into the metatarsal bone and the metatarsal bone head, according to the present disclosure; and

[0034] Figures 21-22 illustrate an exemplary -use environment wherein an exemplary embodiment of an MIS bunion treatment guide is being removed from a foot in the course treating a hallux valgus deformity in accordance with the present disclosure.

[0035] While the present disclosure is subject to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. The present disclosure should be understood to not be limited to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure.DETAILED DESCRIPTION

[0036] In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present disclosure. It will be apparent, however, to one of ordinary skill in the art that the MIS bunion treatment guide and methods disclosed herein may be practiced without these specific details. In other instances, specific numeric references such as “first portion,” may be made. However, the specific numeric reference should not be interpreted as a literal sequential order but rather interpreted that the “first portion” is different than a “second portion.” Thus, the specific details set forth are merely exemplary. The specific details may be varied from and still be contemplated to be within the spirit and scope of the present disclosure. The term “coupled” is defined as meaning connected either directly to the component or indirectly to the component through another component. Further, as used herein, the terms “about,” “approximately,” or “substantially” for any numerical values or ranges indicate a suitable dimensional tolerance that allows the part or collection of components to function for its intended purpose as described herein.

[0037] A hallux valgus deformity can cause soft tissue problems, such as pain and functional deficit. For example, a hallux valgus deformity can give rise to an impaired gait characterized by lateral and posterior weight shift, late heel rise, decreased single-limb balance, pronation deformity, and the like. When the hallux is deviating away from its normal position, a number of other problems may develop, including plantar fasciitis, shin splints, or other ankle or knee pathologies. Given that hallux valgus is relatively prevalent in the general population, there is an ongoing need for the development of foot treatment capabilities such as that related to, for example, treating hallux valgus deformities. Provided herein are embodiments and methods for a Minimally Invasive Surgery (MIS) bunion treatment guide for a lateral head shift osteotomy of a 1stmetatarsal bone for corrective procedures of the hallux.

[0038] Figure 1 illustrates an exemplary-use environment wherein an exemplary embodiment of an MIS bunion treatment guide 100 (hereinafter, “treatment guide 100”) is engaged with a right foot 104 of a patient undergoing a lateral head shift osteotomy of a 1stmetatarsal bone 108, according to the present disclosure. The treatment guide 100 generally comprises a pusher 112 and a slidable arm 116 that are joined by way of a first locking wheel 122. The pusher 112 comprises a bone head pusher 120 that is adapted for laterally shifting a metatarsal bone head 124, as shown in Fig. 1. Further, the first locking wheel 122 fixates the slidable arm 116 within a rear jig portion 128 comprising the pusher 112. A second locking wheel 132 fixates a slidable arm extension 136 with respect to the slidable arm 116.

[0039] The treatment guide 100 is configured to stabilize the bones of the foot 104 during the lateral head shift osteotomy of the metatarsal bone 108. More specifically, the pusher 112 supports a metatarsal K-wire 140 that extends into and fixates the position of the metatarsal bone head 124. The bone head pusher 120 supports an intramedullary K-wire 144 that extends into the medullary canal of the metatarsal bone 108. In the illustrated embodiment, the slidable arm 116 supports an optional cuneiform K-wire 148 that extends into the 1stcuneiform bone 152 of the foot 104. The cuneiform K-wire 148 may be used to stabilize the treatment guide 100 in a desired angulation with respect to the foot 104. As further shown in Fig. 1, the slidable arm extension 136 supports a proximal K-wire sleeve 156 and a distal K-wire sleeve 160. As will be appreciated, the K-wire sleeves 156, 160 respectively support a proximal K-wire 164 and a distal K-wire 168 that fixate the metatarsal bone head 124 with respect to the metatarsal bone 108.

[0040] Figures 2-5 illustrate an exemplary embodiment of the slidable arm 116 comprising the treatment guide 100 in accordance with the present disclosure. As shown in Fig. 2, the slidable arm 116 includes a narrow section 172 and a label 176. The narrow section 172 is adapted to receive the rear jig portion 128 as shown in Fig. 1. The label 176 is configured to indicate whether the treatment guide 100 is intended for use on the right foot 104 or a left foot of the patient. As such, the label 176 can display an “R,” as shown in Fig. 2., or may display an “L” when the treatment guide 100 is configured for treating a left foot.

[0041] As best shown in Fig. 3, the second locking wheel 132 is configured to couple the slidable arm 116 and the slidable arm extension 136. The slidable arm extension 136 includes atang 180 that is configured to fixated within a slot 184 of the slidable arm 116 by way of the second locking wheel 132. As such, the second locking wheel 132 includes a threaded portion 188 that is configured to be inserted into a hole 192 disposed on the slidable arm 116 and engaged with a hole 196 disposed on the tang 180. In some embodiments, the hole 196 is an unthreaded through-hole that allows free passage of the threaded portion 188 such that the sidewalls of the slot 184 may be tightened onto the tang 180.

[0042] As shown in Fig. 5, a 0-degree index 200 may be disposed on both the slidable arm 116 and the slidable arm extension 136 so as to indicate alignment of the extension 136 with the slidable arm 116. Further, as shown in Figs. 2-3, the slidable arm extension 136 includes a distal K-wire guide hole 204 and a multiple proximal K-wire guide holes 208. It is contemplated, therefore, that the 0-degree index 200 can be used to indicate an alignment of the proximal and distal K-wires 164, 168 with respect to the treatment guide 100.

[0043] Figure 4 illustrates a partial ghost-view of an exemplary embodiment of a slidable arm 116 that includes multiple radiopaque markers 212 to facilitate visualization of the treatment guide 100 under fluoroscopy in accordance with the present disclosure. In the illustrated embodiment, the slidable arm 116 includes four radiopaque markers 212, but any desired number of radiopaque markers 212 may be incorporated into the slidable arm 116, without limitation. As further shown in Fig. 4, the slidable arm 116 includes a cuneiform K-wire guide slot 216. The cuneiform K-wire guide slot 216 may be used to support a cuneiform K-wire 148 to stabilize the treatment guide 100 in a desired angulation with respect to the foot 104.

[0044] Turning, now, to Figs. 6-9, the pusher 112 is a generally elongate assembly comprising a graduated wheel 220 that supports the bone head pusher 120 and rides on the rear jig portion 128. As best shown in Fig. 7, the rear jig portion 128 comprises a threaded portion 224 and a smooth portion 228. The threaded portion 224 engages with the graduated wheel 220 while the smooth portion 228 extends through the graduated wheel 220 to the front of the bone head pusher 120. As such, rotating the graduated wheel 220 clockwise on the threaded portion 224, as viewed from the rear jig portion 128, advances a distal end 230 of the smooth portion 228 toward the metatarsal bone head 124, as shown in Fig. 1. The distance the distal end 230 moves may beascertained by viewing a change in position of an index line 232 disposed on the smooth portion 228 with respect to a graduated index 236 disposed on the graduated wheel 220.

[0045] As best shown in Fig. 8, the rear jig portion 128 includes a recess 240 and opposing teeth 244 for retaining the slidable arm 116, as shown in Fig. 1. As will be appreciated, the opposing teeth 244 share a spacing that allows the narrow section 172 (see Figs 2-3) of the slidable arm 116 to enter the recess 240. Upon positioning the rear jig portion 128 on the slidable arm 116, as shown in Fig. 1, the opposing teeth 244 retain the slidable arm 116 in the recess 240. The first locking wheel 122 is configured to fixate the slidable arm 116 within the recess 240 of the rear jig portion 128. To this end, the first locking wheel 122 includes a threaded portion 248 that is received into a threaded hole 252 in the rear jig portion 128, such that tightening the first locking wheel 122 presses the threaded portion 248 against the slidable arm 116.

[0046] As best shown in Fig. 9, the bone head pusher 120 and the distal end 230 of the smooth portion 228 are adapted to interact with the metatarsal bone 108 and the metatarsal bone head 124. The bone head pusher 120 includes a hook 256 that is adapted to be inserted into the medullary canal of the metatarsal bone 108. As shown in Fig. 9, the hook 256 comprises a pair of parallel prongs 260 that are spaced apart to provide clearance for the distal K-wire 168 extending through the metatarsal bone 108 into the metatarsal bone head 124. Further, the distal end 230 of the smooth portion 228 includes smooth surfaces 264 configured to minimize trauma to the metatarsal bone head 124 during treatment.

[0047] Figures 10-20 illustrate an exemplary -use environment wherein the treatment guide 100 is engaged with a patient’s foot 104 in the course of performing a lateral head shift osteotomy of a 1stmetatarsal bone 108 for treating a hallux valgus deformity. As shown in Fig. 10, an osteotomy cut 268 is performed to separate the metatarsal bone 108 and the metatarsal bone head 124. The hook 256 is then inserted into the osteotomy cut 268 and moved in a lateral direction 272 toward the metatarsal bone 108. As shown in Fig. 11, once the hook 256 is inserted into the osteotomy cut 268, the pusher 112 may be used as a lever that is rotated through an angle 276 to insert the hook 256 into a medullar canal of the metatarsal bone 108. In some embodiments, the pusher 112 may be moved through the angle 276 such that the metatarsal bone head 124 is pushedoutside the skin of the patient. In some embodiments, however, the metatarsal bone head 124 is left inside the skin, without limitation.

[0048] As shown in Fig. 12, a metatarsal K-wire 140 can be inserted through the pusher 112 and pushed into the metatarsal bone head 124. In some embodiments, the metatarsal K-wire has a length of about 100 mm and a diameter of about 1.6 mm. Next, an intramedullary K-wire 144 can be inserted through the bone head pusher 120 into the intramedullary canal of the metatarsal bone 108. With the K-wires 140, 144 sufficiently placed, the graduated wheel 220 can be rotated in a clockwise direction 280 to advance the distal end 230 to displace the metatarsal bone head 124. The distance the distal end 230 moves can be determined by viewing the change in position of an index line 232 disposed on the smooth portion 228 with respect to a graduated index 236 disposed on the graduated wheel 220.

[0049] Figures 13 and 14 illustrate an exemplary-use environment wherein the slidable arm 116 is coupled with the pusher 112. As described in connection with Fig. 8, the rear jig portion 128 includes a recess 240 and opposing teeth 244 for retaining the slidable arm 116. The opposing teeth 244 share a spacing that allows the narrow section 172 of the slidable arm 116 to enter the recess 240. Upon moving the slidable arm 116 through a distance 284 to position the rear jig portion 128 on the slidable arm 116, the opposing teeth 244 retain the slidable arm 116 in the recess 240. The first locking wheel 122 can then be tightened to fixate the slidable arm 116 within the recess 240, as shown in Fig. 14.

[0050] Once the treatment guide 100 is assembled as described in connections with Figs. 13- 14, a proximal K-wire sleeve 156 may be coupled with the slidable arm extension 136 as shown in Fig. 15. As shown in Fig. 16, the slidable arm extension 136 includes a distal K-wire guide hole 204 and three proximal K-wire guide holes 208. The three proximal K-wire guide holes 208 are disposed progressively farther from the distal K-wire guide hole 204 to facilitate selecting a desired separation distance between a proximal K-wire 164 and a distal K-wire 168 that are used fixate the metatarsal bone head 124 with respect to the metatarsal bone 108. In the illustrated embodiment of Fig. 16, the distances between the distal K-wire guide hole 204 and the three proximal K-wire guide holes 208 are about 8 mm (0.315”), about 13 mm (0.512”), and about 18 mm (0.709”). It should be borne in mind that more or less than three proximal K-wire guide holes208 may be incorporated into the slidable arm extension 136 and the distances between the holes may vary from the above-mentioned distances, without limitation.

[0051] Once the proximal K-wire sleeve 156 is installed into the slidable arm extension 136, as described with respect to Figs. 15-16, the proximal K-wire sleeve 156 may be moved to an advantageous position near the metatarsal bone 108. As shown in Fig. 17, the first locking wheel 122 may be loosened to allow the slidable arm 116 to be moved within the rear jig portion 128. The slidable arm 116 may then be moved along direction 288 to position the proximal K-wire sleeve 156 to target a proximal -most entry point along the metatarsal bone 108 for the proximal K-wire 164. As will be appreciated, the first locking wheel 122 may be tightened to fixate the slidable arm 116 within the rear jig portion 128, and thus to maintain the targeting of the proximal K-wire sleeve 156 on the proximal -most entry point of the metatarsal bone 108.

[0052] Figure 18 illustrates an exemplary-use environment wherein an optional cuneiform K- wire 148 extends through a guide slot 216 into the 1stcuneiform 152 of the foot 104. The cuneiform K-wire 148 may be used to stabilize the treatment guide 100 in a desired angulation with respect to the foot 104. As shown in Fig. 18, before inserting the cuneiform K-wire 148, the treatment guide 100 may be rotated in a direction 292 for increased dorsal to plantar targeting or rotated in a direction 296 for increased plantar to dorsal targeting. Once the desired targeting is achieved, the cuneiform K-wire 148 may be used to fixate the disposition of the treatment guide 100. In some embodiments, the cuneiform K-wire 148 may have a length of about 200 mm and a diameter of about 2.0 mm, without limitation.

[0053] Once the proximal K-wire sleeve 156 is advantageously positioned the intramedullary K-wire 144 may be pulled from the medullar canal of the metatarsal bone 108 and removed from the bone head pusher 120, as shown in Fig. 19. It is contemplated that removing the intramedullary K-wire 144 provides clearance for insertion of the proximal and distal K-wires 164, 168 through the metatarsal bone 108. As shown in Fig. 20, the distal K-wire sleeve 160 can be mounted in the distal K-wire guide hole 204 (see Fig. 16) and then the proximal and distal K-wires 164, 168 can be respectively passed through the proximal and distal K-wire sleeves 156, 160 before being driven into the metatarsal bone 108 and the metatarsal bone head 124. As will be appreciated, the distance between the distal K-wire guide hole 204 and the selected proximal K-wire guide hole 208 controlsthe separation distance between the proximal and distal K-wires 164, 168. Further, in some embodiments, a dedicated depth gauge can be coupled with either or both of the proximal and distal K-wire sleeves 156, 160 to indicate the insertion depth of the proximal and distal K-wires 164, 168.

[0054] Figures 21 and 22 illustrate an exemplary -use environment wherein the treatment guide 100 is being removed from a patient’s foot 104 in the course of performing a lateral head shift osteotomy of a 1stmetatarsal bone 108 for treating a hallux valgus deformity. Once the proximal and distal K-wires 164, 168 are advantageously implanted into the metatarsal bone 108 and the metatarsal bone head 124, as shown in Fig. 21, the proximal and distal K-wire sleeves 156, 160 may be removed by sliding along their respective K-wires 164, 168. Next, the first locking wheel 122 may be loosened to allow the slidable arm 116 to move freely within the recess 240 (see Fig. 13) of the rear jig portion 128, and the second locking wheel 132 (see Fig. 3) may be removed from the slidable arm 116 to release the slidable arm extension 136. Upon moving the slidable arm 116 through a distance 300, the slidable arm extension 136 may be removed by sliding along the proximal and distal K-wires 164, 168. The first locking wheel 122 can then be tightened to fixate the slidable arm 116 within the recess 240, again, as shown in Fig. 21.

[0055] As shown in Fig. 22, the metatarsal K-wire 140 (see Fig. 21) has been pulled from the metatarsal bone head 124 and removed from the pusher 112 of the treatment guide 100. Next, the treatment guide 100 may be moved in direction 304 to remove the hook 156 from the medullary canal of the metatarsal bone 108. The treatment guide 100 can then be removed from the patient’s foot 104, leaving the metatarsal bone head 124 and the metatarsal bone 108 advantageously fixated solely by way of the proximal and distal K-wires 164, 168.

[0056] While the MIS bunion treatment guide and methods have been described in terms of particular variations and illustrative figures, those of ordinary skill in the art will recognize that the MIS bunion treatment guide is not limited to the variations or figures described. In addition, where methods and steps described above indicate certain events occurring in certain order, those of ordinary skill in the art will recognize that the ordering of certain steps may be modified and that such modifications are in accordance with the variations of the MIS bunion treatment guide. Additionally, certain of the steps may be performed concurrently in a parallel process, whenpossible, as well as performed sequentially as described above. To the extent there are variations of the MIS bunion treatment guide, which are within the spirit of the disclosure or equivalent to the MIS bunion treatment guide found in the claims, it is the intent that this patent will cover those variations as well. Therefore, the present disclosure is to be understood as not limited by the specific embodiments described herein, but only by scope of the appended claims.

Claims

CLAIMSWhat is claimed is:

1. An apparatus for performing a lateral head shift osteotomy, comprising: a bone head pusher for laterally shifting a metatarsal bone head; a slidable arm for angling a first K-wire and a second K-wire toward the metatarsal bone; and a slidable arm extension for supporting the first K-wire and the second K-wire.

2. The apparatus of claim 1, wherein the bone head pusher is adapted for laterally shifting the metatarsal bone head.

3. The apparatus of claim 1, wherein the bone head pusher is configured to support a K-wire that may be extended into an intramedullary canal of the metatarsal bone.

4. The apparatus of claim 3, wherein the bone head pusher includes a hook that is adapted to be inserted into the intramedullary canal of the metatarsal bone.

5. The apparatus of claim 4, wherein the hook comprises a pair of parallel prongs that are spaced apart to provide clearance for the second K-wire to extend through the metatarsal bone into the metatarsal bone head.

6. The apparatus of claim 1, wherein the slidable arm includes multiple radiopaque markers to facilitate visualization of the apparatus under fluoroscopy.

7. The apparatus of claim 1, wherein the slidable arm is configured to support an optional K-wire that may be extended into the 1stcuneiform bone of the foot.

8. The apparatus of claim 7, wherein the optional K-wire guide is configured extended into the 1stcuneiform bone to stabilize the apparatus in a desired angulation with respect to a foot of the patient.

9. The apparatus of claim 1, wherein the slidable arm extension is configured to support a proximal K-wire sleeve and a distal K-wire sleeve.

10. The apparatus of claim 9, wherein the proximal K-wire sleeve and the distal K-wire sleeve are configured to respectively support a proximal K-wire and a distal K-wire that fixate the metatarsal bone head with respect to the metatarsal bone.

11. The apparatus of claim 1, wherein a first locking wheel is configured to enable fixating the slidable arm within a rear jib portion comprising the pusher.

12. The apparatus of claim 11, wherein a second locking wheel is configured to enable fixating the slidable arm extension with respect to the slidable arm.

13. The apparatus of claim 11, wherein the slidable arm includes a narrow section adapted to receive the rear jig portion.

14. The apparatus of claim 11, wherein the slidable arm includes a label that indicates an intended use on a right foot or a left foot of the patient.

15. The apparatus of claim 1, wherein the bone head pusher comprises a pusher that is configured to support a K-wire that may be extended into and fixate a position of the metatarsal bone head.

16. The apparatus of claim 15, wherein the pusher comprises a graduated wheel that supports the bone head pusher and rides on a rear jig portion.

17. The apparatus of claim 16, wherein the rear jig portion comprises a threaded portion that engages with the graduated wheel while a smooth portion of the rear jig portion extends through the graduated wheel to the front of the bone head pusher.

18. The apparatus of claim 17, wherein the threaded portion moves a distal end of the smooth portion with respect to the metatarsal bone head when the graduated wheel is rotated on the threaded portion.

19. The apparatus of claim 18, wherein an index line disposed on the smooth portion and a graduated index disposed on the graduated wheel are configured to enable ascertaining a distance the distal end moves.

20. The apparatus of claim 19, wherein the distal end includes smooth surfaces that are configured to minimize trauma to the metatarsal bone head during treatment.

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