Medial malleolus resection guide system and methods for use in distal tibia osteotomies

Abstract

A subchondral medial malleolus resection guide system and methods are provided for performing medial malleolus osteotomies. The system includes a resection guide for attaching to a distal tibia by way of two proximal K -wires and a distal transvers K-wire, and a distal tibia wire guide for attaching to the distal tibia by way of one or more distal K -wires. The resection guide includes cutting slots that guide a cutting blade during performing a resection cut. Central ribs between cutting slots have a tapered cross-section to facilitate performing a complete resection cut without having to reposition the resection guide. The distal tibia wire guide includes a cylindrical grip portion that snaps onto a cylindrical housing of the resection guide and is free to rotate around the distal transverse K-wire. Rotating the distal tibia wire guide provides adjustability for distal K-wire placement trajectories into the most distal portion of the medial malleolus.

Description

MEDIAL MALLEOLUS RESECTION GUIDE SYSTEM AND METHODS FOR USE INDISTAL TIBIA OSTEOTOMIESPRIORITY

[0001] This application claims the benefit of and priority to U.S. Provisional Application, entitled “Medial Malleolus Resection Guide System And Methods For Use In Distal Tibia Osteotomies,” filed on January 17, 2024, and having application serial number 63 / 622,020, the entirety of said application being incorporated herein by reference.FIELD

[0002] Embodiments of the present disclosure generally relate to surgical implants. More specifically, embodiments of the disclosure relate to a medial malleolus resection guide system and methods for use in distal tibia osteotomies.BACKGROUND

[0003] A medial malleolar osteotomy is a surgical procedure that involves cutting through the medial malleolus, a bony bump on the inner side of the ankle. This procedure provides surgeons with better access to the talus, enabling surgeons to treat osteochondral lesions of the talus. In some instances, a medial malleolar osteotomy may be performed when a fracture in the talus cannot be properly aligned and stabilized without open access. A medial malleolar osteotomy may also be performed to treat complex talar fractures, such as fractures involving multiple fragments or extending into the joint surface.

[0004] Potential complications associated with medial malleolar osteotomy include risks generally associated with surgery such as anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. In some instances, injury to tendons, nerves, or blood vessels may be a possible complication of medial malleolar osteotomy. As such, there is a continuing desire to develop surgical instruments and implants that minimize or eliminate the complications associated with medial malleolar osteotomy procedures.SUMMARY

[0005] A subchondral medial malleolus resection guide system and methods are provided for performing medial malleolus osteotomies. The system includes a resection guide for attaching to a distal tibia by way of two proximal K-wires and a distal transvers K-wire, and a distal tibia wire guide for attaching to the distal tibia by way of one or more distal K-wires. The resection guide includes cutting slots that guide a cutting blade during performing a resection cut. Central ribs between cutting slots have a tapered cross-section to facilitate performing a complete resection cut without having to reposition the resection guide. The distal tibia wire guide includes a cylindrical grip portion that snaps onto a cylindrical housing of the resection guide and is free to rotate around the distal transverse K-wire. Rotating the distal tibia wire guide provides adjustability for distal K-wire placement trajectories into the most distal portion of the medial malleolus.

[0006] In an exemplary embodiment, a subchondral medial malleolus resection guide system comprises: a resection guide for attaching to a distal tibia by way of two proximal K-wires and a distal transvers K-wire; and a distal tibia wire guide for attaching to the distal tibia by way of one or more distal K-wires.

[0007] In another exemplary embodiment, the distal tibia wire guide includes multiple distal holes that are configured to receive the one or more distal K-wires. In another exemplary embodiment, the multiple distal holes comprises four distal holes. In another exemplary embodiment, the resection guide includes two proximal holes that are configured to receive the two proximal K-wires. In another exemplary embodiment, the two proximal holes are configured to receive the two proximal K-wires. In another exemplary embodiment, each of the two proximal K-wires has a diameter of about 0.062” and a length of about 6”.

[0008] In another exemplary embodiment, the resection guide includes a cylindrical housing having a distal transverse hole. In another exemplary embodiment, the distal transverse hole is configured to receive the distal transverse K-wire. In another exemplary embodiment, the distal tibia wire guide includes a cylindrical grip portion that is configured to attach onto the cylindrical housing. In another exemplary embodiment, the distal tibia wire guide snaps onto the cylindrical housing and is free to rotate around the distal transverse K-wire. In another exemplaryembodiment, rotating the distal tibia wire guide provides an advantageous degree of adjustability for distal K-wire placement trajectories into the most distal portion of the medial malleolus.

[0009] In another exemplary embodiment, the resection guide includes at least four cutting slots configured to guide a cutting blade during performing a resection cut. In another exemplary embodiment, pairs of cutting slots share an intervening central rib having a tapered cross-section configured to facilitate angling the cutting blade toward a centerline of the resection guide. In another exemplary embodiment, the tapered cross-section of the central ribs facilitates a practitioner angling the cutting blade to perform a complete osteotomy cut to the medial malleolus without having to remove or reposition the resection guide.

[0010] In an exemplary embodiment, a method for a subchondral medial malleolus resection guide system comprises: configuring a resection guide to be attached to a distal tibia by way of two proximal K-wires and a distal transvers K-wire; and configuring a distal tibia wire guide to be attached to the distal tibia by way of one or more distal K-wires.

[0011] In another exemplary embodiment, configuring the resection guide includes configuring two proximal holes to receive the two proximal K-wires. In another exemplary embodiment, configuring the distal tibia wire guide includes configuring multiple distal holes to receive the one or more distal K-wires.

[0012] In another exemplary embodiment, configuring the resection guide includes configuring at least four cutting slots to guide a cutting blade during performing a resection cut. In another exemplary embodiment, configuring the at least four cutting slots includes disposing an intervening central rib between pairs of cutting slots. In another exemplary embodiment, disposing the intervening central rib includes configuring a tapered cross-section of the central rib to facilitate angling the cutting blade toward a centerline of the resection guide.

[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 a subchondral medial malleolus resection guide system is being used to perform a medial malleolus osteotomy, according to the present disclosure;

[0016] Figure 2 illustrates an exemplary embodiment of a medial malleolus resection guide system in accordance with the present disclosure;

[0017] Figure 3 illustrates a top view of an exemplary embodiment of a medial malleolus resection guide, according to the present disclosure;

[0018] Figure 4 illustrates a cross-sectional view of an exemplary embodiment of a medial malleolus resection guide, showing a tapered central rib in accordance with the present disclosure;

[0019] Figure 5 illustrates an exemplary embodiment of a medial malleolus resection guide coupled with a distal tibia wire guide, according to the present disclosure;

[0020] Figure 6 illustrates a cutting blade being guided by a slot comprising an exemplary embodiment of a medial malleolus resection guide system, according to the present disclosure;

[0021] Figure 7 illustrates an exemplary embodiment of a medial malleolus resection guide coupled with a distal tibia wire guide that is supporting a distal K-wire, in accordance with the present disclosure;

[0022] Figure 8 illustrates an exemplary-use environment wherein an exemplary embodiment of a medial malleolus resection guide is being placed onto a distal tibia in accordance with the present disclosure;

[0023] Figure 9 is a fluoroscopic image showing an exemplary-use environment wherein an exemplary embodiment of a medial malleolus resection guide is being placed onto a distal tibia in accordance with the present disclosure;

[0024] Figure 10 illustrates an exemplary-use environment wherein an exemplary embodiment of a distal tibia wire guide is coupled with a medial malleolus resection guide, according to the present disclosure;

[0025] Figure 11 is a fluoroscopic image showing an exemplary-use environment wherein an exemplary embodiment of a distal tibia wire guide is coupled with a medial malleolus resection guide, according to the present disclosure;

[0026] Figure 12 illustrates an exemplary-use environment wherein an exemplary embodiment of a medial malleolus resection guide system is directing a resection cut in accordance with the present disclosure;

[0027] Figure 13 is a fluoroscopic image showing an exemplary-use environment wherein an exemplary embodiment of a medial malleolus resection guide system is directing a resection cut in accordance with the present disclosure;

[0028] Figure 14 illustrates an exemplary-use environment wherein an exemplary embodiment of a medial malleolus resection guide system is attached to a distal tibia after an osteotomy cut has been performed in accordance with the present disclosure; and

[0029] Figure 15 is a fluoroscopic image showing an exemplary-use environment wherein an osteotomy cut is fixated according to surgeon preference, accordance with the present disclosure.

[0030] 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

[0031] 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 medial malleolus resection guide system and methods disclosed herein may be practiced without these specific details. In other instances, specific numeric references such as“first screw,” may be made. However, the specific numeric reference should not be interpreted as a literal sequential order but rather interpreted that the “first screw” is different than a “second screw.” 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.

[0032] Potential complications associated with medial malleolar osteotomy include risks generally associated with surgery such as anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. In some instances, injury to tendons, nerves, or blood vessels may be a possible complication of medial malleolar osteotomy. As such, there is a continuing desire to develop surgical instruments and implants that minimize or eliminate the complications associated with medial malleolar osteotomy procedures. Embodiments presented herein provide a medial malleolus resection guide system and methods for use in distal tibia osteotomies.

[0033] Figure 1 illustrates an exemplary-use environment wherein an exemplary embodiment of a subchondral medial malleolus resection system 100 is being used to perform a medial malleolus osteotomy, according to the present disclosure. The subchondral medial malleolus resection system 100 comprises a resection guide 104 and a distal tibia wire guide 108 that are attached to a distal tibia 112. The resection guide 104 is attached to the distal tibia 112 by way of two proximal K- wires 116, 120 and a distal transvers K-wire 124. The distal tibia wire guide is attached to the distal tibia 112 by way of one or more distal K-wires 128. As shown in Fig. 1, the resection guide 100 includes multiple slots 132 for guiding a cutting blade 136 toward the distal tibia 112.

[0034] Figure 2 illustrates the resection guide 104 and the distal tibia wire guide 108 in accordance with the present disclosure. The resection guide 104 includes two proximal holes 140, 144 that are configured to respectively receive the proximal K-wires 116, 120, as shown in Fig. 1. The resection guide 104 further includes a cylindrical housing 148 having a distal transverse hole152. The distal transverse hole 1 2 is configured to receive the distal transverse K-wire 124 shown in Fig. 1. In one embodiment, the holes 140, 144, 152 are configured to receive K-wires 116, 120, 124 each having a diameter of about 0.062” and a length of about 6”, without limitation.

[0035] The resection guide 104 further includes at least four cutting slots 132. As shown in Figs. 2-3, the cutting slots 132 are generally flat spaces configured to receive the cutting blade 136 shown in Fig. 1. As best shown in Fig. 3, pairs of cutting slots 132 share an intervening central rib 156. The central ribs 156 each have a tapered cross-section that is configured to facilitate angling the cutting blade 136 toward a centerline of the resection guide 104. It is contemplated that the tapered cross-section of the central ribs 156 facilitates a practitioner angling the cutting blade 136 to perform a complete osteotomy cut to the medial malleolus without having to remove or reposition the resection guide 104.

[0036] As shown in Fig. 2, the distal tibia wire guide 108 includes multiple distal holes 160. The distal holes 160 are each configured to receive a distal K-wire, such as the distal K-wire 128 shown in Fig. 1. In some embodiments, the distal K-wires 128 have a diameter of about 0.062” and a length of about 6”, without limitation. In the illustrated embodiment, the distal tibia wire guide 108 includes four distal holes 160, although any number of distal holes 160 may be included, as desired.

[0037] As shown in Fig. 2, the distal tibia wire guide 108 includes a cylindrical grip portion 164 that is configured to attach onto the cylindrical housing 148 of the resection guide 104. As shown in Figs. 5-7, the distal tibia wire guide 108 snaps onto the cylindrical housing 148 and is free to rotate around the distal transverse K-wire 124. It is contemplated that rotating the distal tibia wire guide 108 provides an advantageous degree of adjustability for distal K-wire placement trajectories into the most distal portion of the medial malleolus.

[0038] Figure 6 illustrates the cutting blade 136 being guided by a cutting slot 132 comprising the resection guide 104. As shown in Fig. 6, the distal transverse K-wire 124 and the distal K-wire 128 may be retracted somewhat to provide clearance for the cutting blade 136 to the distal tibia 112. As shown in Fig. 7, once the osteotomy cut in complete and the cutting blade 136 is withdrawn from the resection guide 104, the distal transverse K-wire 124 and the distal K-wire 128 may be advanced across the osteotomy cut, as described herein.

[0039] Figures 8-9 illustrate an exemplary-use environment wherein the resection guide 104 is being placed onto a distal tibia in accordance with the present disclosure. After typical tissue resection at the distal tibia 112, the resection guide 104 can be placed onto the distal tibia 112 over the optimal osteotomy site. The proximal K-wires 116, 120 and the transverse K-wire 124 can be inserted through their respective wire holes 140, 144, 152 (see Fig. 2) of the resection guide 104 for provisional fixation onto the tibia 112. Next, the cutting blade 136 can be placed into the desired guide cutting slot 132. As shown in Fig. 9, fluoroscopy can be used to confirm an optimal cutting slot 132 and transverse K-wire 124 trajectory.

[0040] Figures 10-11 illustrate an exemplary-use environment wherein the distal tibia wire guide 108 is coupled with the resection guide 104, according to the present disclosure. The distal tibia wire guide 108 is snapped onto the cylindrical housing 148 (see Fig. 2) and then positioned as desired. Next, one or more distal K-wire 128 can be inserted through the distal holes 160 (see Fig. 2) and extended across the osteotomy site where appropriate. As shown in Fig. 11, fluoroscopy can be used to confirm an optimal trajectory of the distal K-wires 128.

[0041] Figures 12-13 illustrate an exemplary-use environment wherein the resection guide 104 is directing the cutting blade 136 toward the distal tibia 112. The distal transverse K-wire 124 and the distal K-wires 128 have been retracted from the site of the projected resection cut 168. With the cutting blade 136 extending through the desired cutting slot 132 of the resection guide 104, resection cut 168 is performed. As shown in Fig. 13, fluoroscopy can be used to confirm that the desired resection cut 168 is completed.

[0042] Figure 14 illustrates an exemplary-use environment wherein the resection guide 100 remains attached to the distal tibia 112 after the resection cut 168 has been performed in accordance with the present disclosure. Once the cutting blade 136 is removed from the cutting slot 132, the distal transverse K-wire 124 and the distal K-wires 128 can be advanced across resection cut 168 and then appropriate fixation can be used according to surgeon preference. As shown in Fig. 15, the resection cut 168 is fixated by way of at least two transverse fixators 172 and at least three distal fixators 176. It should be recognized that the specific type of fixators 172, 176, as well as the number of fixators 172, 176 used, will be determined by surgeon preference, and thus should not be construed as limiting the present disclosure in any way.

[0043] While the medial malleolus resection guide system and methods have been described in terms of particular variations and illustrative figures, those of ordinary skill in the art will recognize that the medial malleolus resection guide system 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 medial malleolus resection guide system. Additionally, certain of the steps may be performed concurrently in a parallel process, when possible, as well as performed sequentially as described above. To the extent there are variations of the medial malleolus resection guide system, which are within the spirit of the disclosure or equivalent to the medial malleolus resection guide system 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. A subchondral medial malleolus resection guide system, comprising: a resection guide for attaching to a distal tibia by way of two proximal K-wires and a distal transvers K-wire; and a distal tibia wire guide for attaching to the distal tibia by way of one or more distal K-wires.

2. The system of claim 1, wherein the distal tibia wire guide includes multiple distal holes that are configured to receive the one or more distal K-wires.

3. The system of claim 2, wherein the multiple distal holes comprises four distal holes.

4. The system of claim 1, wherein the resection guide includes two proximal holes that are configured to receive the two proximal K-wires.

5. The system of claim 4, wherein the two proximal holes are configured to receive the two proximal K-wires.

6. The system of claim 4, wherein each of the two proximal K-wires has a diameter of about 0.062” and a length of about 6”.

7. The system of claim 1, wherein the resection guide includes a cylindrical housing having a distal transverse hole.

8. The system of claim 7, wherein the distal transverse hole is configured to receive the distal transverse K-wire.

9. The system of claim 7, wherein the distal tibia wire guide includes a cylindrical grip portion that is configured to attach onto the cylindrical housing.

10. The system of claim 9, wherein the distal tibia wire guide snaps onto the cylindrical housing and is free to rotate around the distal transverse K-wire.

11. The system of claim 10, wherein rotating the distal tibia wire guide provides an advantageous degree of adjustability for distal K-wire placement trajectories into the most distal portion of the medial malleolus.

12. The system of claim 1, wherein the resection guide includes at least four cutting slots configured to guide a cutting blade during performing a resection cut.

13. The system of claim 12, wherein pairs of cutting slots share an intervening central rib having a tapered cross-section configured to facilitate angling the cutting blade toward a centerline of the resection guide.

14. The system of claim 13, wherein the tapered cross-section of the central ribs facilitates a practitioner angling the cutting blade to perform a complete osteotomy cut to the medial malleolus without having to remove or reposition the resection guide.

15. A method for a subchondral medial malleolus resection guide system, comprising: configuring a resection guide to be attached to a distal tibia by way of two proximal K- wires and a distal transvers K-wire; and configuring a distal tibia wire guide to be attached to the distal tibia by way of one or more distal K-wires.

16. The method of claim 15, wherein configuring the resection guide includes configuring two proximal holes to receive the two proximal K-wires.

17. The method of claim 15, wherein configuring the distal tibia wire guide includes configuring multiple distal holes to receive the one or more distal K-wires.

18. The method of claim 15, wherein configuring the resection guide includes configuring at least four cutting slots to guide a cutting blade during performing a resection cut.

19. The method of claim 18, wherein configuring the at least four cutting slots includes disposing an intervening central rib between pairs of cutting slots.

20. The method of claim 19, wherein disposing the intervening central rib includes configuring a tapered cross-section of the central rib to facilitate angling the cutting blade toward a centerline of the resection guide.

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