Devices and techniques for treating metatarsus adductus

Patent metadata

Field	Value
Publication number	US-12004789-B2
Application number	US-202117325167-A
Country	US
Kind code	B2
Filing date	May 19, 2021
Priority date	May 19, 2020
Publication date	Jun 11, 2024
Grant date	Jun 11, 2024

Abstract

A metatarsus adductus technique may involve cutting an end of one or both of a second metatarsal and an intermediate cuneiform to create a wedge-shaped opening between the end of the second metatarsal and the intermediate cuneiform. The method may further involve cutting an end of one or both of a third metatarsal and a lateral cuneiform to also create a wedge-shaped opening between the end of the third metatarsal and the lateral cuneiform. The second metatarsal and the third metatarsal can then be moved in a transverse plane to close a metatarsus adductus angle. Movement of the second and third metatarsal may close the wedge-shaped openings forming during bone cutting. With the second and third metatarsals appropriately realigned, the clinician can fixate the moved position of the second metatarsal and the third metatarsal.

First claim

The invention claimed is:

1. A method for treating metatarsus adductus comprising:
positioning a cutting guide defining a guide surface over a dorsal side of a second metatarsal and over a dorsal side of a third metatarsal;
cutting an end of the second metatarsal by at least advancing a cutting tool along the guide surface to remove a portion of an end of the second metatarsal to create an opening between the end of the second metatarsal and an intermediate cuneiform;
cutting an end of the third metatarsal by at least advancing the cutting tool along the guide surface to remove a portion of an end of the third metatarsal to create an opening between the end of the third metatarsal and a lateral cuneiform;
moving the second metatarsal and the third metatarsal in at least a transverse plane to close a metatarsus adductus angle; and
fixating a moved position of the second metatarsal and the third metatarsal.

2. The method of claim 1 , wherein moving the second metatarsal and the third metatarsal comprises moving the second metatarsal and the third metatarsal together as a joined bone group.

3. The method of claim 2 , wherein moving the second metatarsal and the third metatarsal together as a joined bone group comprises preserving ligamentous attachments between the second metatarsal and the third metatarsal.

4. The method of claim 2 , wherein moving the second metatarsal and the third metatarsal together as a joined bone group comprises moving the second metatarsal and the third metatarsal without significantly changing an intermetatarsal angle between the second metatarsal and the third metatarsal.

5. The method of claim 1 , wherein moving the second metatarsal and the third metatarsal in at least the transverse plane comprises pivoting the second metatarsal and the third metatarsal in the transverse plane about a medial aspect of the second metatarsal.

6. The method of claim 1 , further comprising:
preparing an end of the intermediate cuneiform; and
preparing an end of the lateral cuneiform.

7. The method of claim 6 , wherein preparing the end of the intermediate cuneiform comprises cutting the intermediate cuneiform, and preparing the end of the lateral cuneiform comprises cutting the end of the lateral cuneiform.

8. The method of claim 1 , wherein:
cutting the end of the second metatarsal to create the opening comprises cutting the end of the second metatarsal to create a wedge-shaped opening; and
cutting the end of the third metatarsal to create the opening comprises cutting the end of the third metatarsal to create a wedge-shaped opening.

9. The method of claim 8 , wherein:
cutting the end of the second metatarsal to create the wedge-shaped opening comprises making a cut angled in the transverse plane to create a wedge-shaped section of bone, and further comprising, prior to moving the second metatarsal, removing the wedge-shaped section of bone, and
cutting the end of the third metatarsal to create the wedge-shaped opening comprises making a cut angled in the transverse plane to create a wedge-shaped section of bone, and further comprising, prior to moving the third metatarsal, removing the wedge-shaped section of bone.

10. The method of claim 8 , wherein:
moving the second metatarsal in the transverse plane comprises closing the wedge-shaped opening between the end of the second metatarsal and the intermediate cuneiform; and
moving the third metatarsal in the transverse plane comprises closing the wedge-shaped opening between the end of the third metatarsal and the lateral cuneiform.

11. The method of claim 1 , further comprising, prior to fixating the moved position, compressing the end of the second metatarsal against the end of the intermediate cuneiform and compressing the end of the third metatarsal against the end of the lateral cuneiform.

12. The method of claim 1 , further comprising engaging a bone positioning guide with at least one of the second metatarsal and the third metatarsal and a bone other than the second metatarsal and the third metatarsal, wherein moving the second metatarsal and the third metatarsal in the transverse plane comprises engaging the bone positioning guide.

13. The method of claim 12 , wherein the bone positioning guide is a compressor, and engaging the bone positioning guide with at least one of the second metatarsal and the third metatarsal comprises attaching the compressor to at least one of:
the intermediate cuneiform and the second metatarsal, and
the lateral cuneiform and the third metatarsal.

14. The method of claim 12 , wherein the bone positioning guide is engaged with (a) at least one of a medial side of the second metatarsal and a medial side of the third metatarsal and (b) a bone other than the second metatarsal and the third metatarsal.

15. The method of claim 1 , wherein moving the second metatarsal and the third metatarsal in at least the transverse plane to close the metatarsus adductus angle further comprises moving a fourth metatarsal and a fifth metatarsal in at least the transverse plane.

16. The method of claim 1 , further comprising provisionally fixating a moved position of the second metatarsal and the third metatarsal.

17. The method of claim 16 , wherein provisionally fixating the moved position of the second metatarsal and the third metatarsal comprises inserting a pin through the third metatarsal and into the intermediate cuneiform.

18. The method of claim 1 , wherein fixating the moved position of the second metatarsal and the third metatarsal comprises:
applying at least one fixation device across a second tarsal-metatarsal joint between the second metatarsal and the intermediate cuneiform, and
applying at least one fixation device across a third tarsal-metatarsal joint between the third metatarsal and the lateral cuneiform.

19. The method of claim 18 , wherein:
applying at least one fixation device across the second tarsal-metatarsal joint comprises attaching a first plate or a first staple to the second metatarsal and to the intermediate cuneiform, and
applying at least one fixation device across the third tarsal-metatarsal joint comprises attaching a second plate or a second staple to the third metatarsal and to the lateral cuneiform.

20. The method of claim 1 , further comprising realigning a first metatarsal by at least:
preparing an end of the first metatarsal;
preparing an end of a medial cuneiform facing the first metatarsal;
moving the first metatarsal in at least the transverse plane to close an intermetatarsal angle between the first metatarsal and the second metatarsal; and
fixating a moved position of the first metatarsal.

21. The method of claim 20 , wherein moving the first metatarsal in at least the transverse plane further comprises rotating the first metatarsal in a frontal plane.

22. The method of claim 20 , wherein moving the first metatarsal comprises moving the first metatarsal after moving the second metatarsal and the third metatarsal.

23. The method of claim 1 , wherein the guide surface comprises a continuous guide surface extending from a medial-most side of the second metatarsal to a lateral-most side of the third metatarsal.

24. The method of claim 1 , wherein the guide surface defines a first guide surface, and further comprises a second guide surface parallel to the first guide surface to define a cutting slot between the first guide surface and the second guide surface, wherein advancing the cutting tool al

Assignees

• Treace Medical Concepts Inc

Inventors

• Mcaleer Jody
• Decarbo William
• Hatch Daniel
• Dayton Paul
• Santrock Robert
• Smith W Bret
• Kuyler Adriaan
• Scanlan Sean

Classifications

• A61B17/151

  for corrective osteotomy · CPC title

• A61B17/1728

  for holes for bone plates or plate screws · CPC title

• A61B2017/565

  for surgical correction of axial deviation, e.g. hallux valgus or genu valgus · CPC title

• A61B17/6425

  specially adapted to be fitted across a bone joint · CPC title

• A61B17/1682

  for the foot or ankle · CPC title