Systems and methods for Lapidus repair of bunions

A method of correcting a bunion, the method comprising:

• inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;
• excising the first TMT joint of the foot, the excising comprising:
• cutting a base of the first metatarsal proximate the first TMT joint;
• and
• cutting a base of a first cuneiform of the foot proximate the first TMT joint;
• inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;
• compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;
• and
• fixing the first TMT joint,
• the method further comprising placing a cut guide across a dorsal side of the first TMT joint prior to inserting the plurality of metatarsal pins and the plurality of cuneiform pins, the cut guide comprising:
• a body;
• a plurality of proximal pin holes extending parallel through the body;
• a plurality of distal pin holes extending through the body parallel to the proximal pin holes;
• and
• a joint-seeking paddle extending downward from the body between the proximal pin holes and the distal pin holes such that, when the joint-seeking paddle is at least partially disposed within the first TMT joint, the distal pin holes define the first predetermined spacing relative to the first TMT joint and the proximal pin holes define the second predetermined spacing relative to the first TMT joint.

A method of correcting a bunion, the method comprising:

• inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;
• excising the first TMT joint of the foot, the excising comprising:
• cutting a base of the first metatarsal proximate the first TMT joint;
• and
• cutting a base of a first cuneiform of the foot proximate the first TMT joint;
• inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;
• compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;
• and
• fixing the first TMT joint,
• the method further comprising, prior to compressing the first TMT joint:
• adjusting an alignment of the first metatarsal within a frontal plane of the foot using a control handle coupled to the plurality of metatarsal pins;
• and
• adjusting an alignment of the first metatarsal within a transverse plane of the foot using a linear reducer comprising a medial hook disposed on a medial side of the first metatarsal and a lateral hook disposed on a lateral side of a second metatarsal of the foot, the lateral hook having an adjustable spacing relative to the medial hook.

A method of correcting a bunion, the method comprising:

• inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;
• excising the first TMT joint of the foot, the excising comprising:
• cutting a base of the first metatarsal proximate the first TMT joint;
• and
• cutting a base of a first cuneiform of the foot proximate the first TMT joint;
• inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;
• compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;
• and
• fixing the first TMT joint,
• wherein the compressor block comprises:
• a body comprising a top surface and a bottom surface;
• a plurality of proximal pin holes extending through the body from the top surface to the bottom surface at a first angle of less than 90 degrees relative to the top surface and the bottom surface;
• and
• a plurality of distal pin holes extending through the body from the top surface to the bottom surface at the first angle relative to top surface and the bottom surface such that the proximal and distal pin holes are more closely spaced at the bottom surface relative to the top surface.

A method of correcting a bunion, the method comprising:

• inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;
• excising the first TMT joint of the foot, the excising comprising:
• cutting a base of the first metatarsal proximate the first TMT joint;
• and
• cutting a base of a first cuneiform of the foot proximate the first TMT joint;
• inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;
• compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;
• re-cutting the base of the first metatarsal or the base of the first cuneiform to remove additional tissue;
• and
• fixing the first TMT joint subsequent to the re-cutting,
• wherein the re-cutting is performed using a re-cut guide disposed on the metatarsal pins or the cuneiform pins, the re-cut guide defining a predetermined re-cut spacing smaller than a predetermined spacing defined by a cut guide used for the excising of the first TMT joint.

A method of correcting a bunion, the method comprising:

• inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;
• excising the first TMT joint of the foot, the excising comprising:
• cutting a base of the first metatarsal proximate the first TMT joint;
• and
• cutting a base of a first cuneiform of the foot proximate the first TMT joint;
• inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;
• compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;
• performing a frontal plane realignment comprising additional rotation within the frontal plane of the metatarsal;
• and
• fixing the first TMT joint subsequent the frontal plane realignment,
• wherein the frontal plane realignment is performed simultaneously with the compressing of the first TMT joint, and wherein the compressor block is configured as a realignment guide comprising angularly displaced pin holes such that placing the compressor block compresses the first TMT joint and maintains the additional rotation.

A method of correcting a bunion, the method comprising:

• inserting a plurality of metatarsal pins into a first metatarsal of a foot at a first predetermined spacing relative to a first tarsometatarsal (TMT) joint;
• excising the first TMT joint of the foot, the excising comprising:
• cutting a base of the first metatarsal proximate the first TMT joint;
• and
• cutting a base of a first cuneiform of the foot proximate the first TMT joint;
• inserting a plurality of cuneiform pins into the first cuneiform at a second predetermined spacing relative to the first TMT joint;
• compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;
• performing a frontal plane realignment comprising additional rotation within the frontal plane of the metatarsal;
• and
• fixing the first TMT joint subsequent the frontal plane realignment,
• wherein the frontal plane realignment is performed prior to the compressing of the first TMT joint, and wherein the frontal plane realignment comprises:
• inserting, through a realignment guide, a plurality of replacement metatarsal pins at the first predetermined spacing relative to the first TMT joint, the replacement metatarsal pins being angularly displaced relative to the metatarsal pins;
• and
• aligning the replacement metatarsal pins linearly with the cuneiform pins prior to compressing the first TMT joint.

A method of correcting a bunion, the method comprising:

• placing a cut guide across a dorsal side of a first tarsometatarsal (TMT) joint of a foot such that a plurality of first pin holes of the cut guide are disposed proximate a first metatarsal of the foot, a plurality of second pin holes of the cut guide are disposed proximate a first cuneiform of the foot, and a joint-seeking paddle of the cut guide is at least partially disposed within the first TMT joint;
• inserting a plurality of metatarsal pins into the first metatarsal through the first pin holes;
• cutting a base of the first metatarsal proximate the first TMT joint through a slot extending through the cut guide between the first pin holes and the joint-seeking paddle;
• removing the cut guide from the foot;
• replacing the cut guide across the dorsal side of the first TMT joint in a reversed configuration in which the metatarsal pins extend through the second pin holes;
• adjusting an alignment of the first metatarsal within at least one of a frontal plane and a transverse plane of the foot;
• inserting a plurality of cuneiform pins into the first cuneiform through the first pin holes;
• cutting a base of the first cuneiform proximate the first TMT joint through the slot;
• compressing the first TMT joint using a compressor block such that a cut face of the first metatarsal contacts a cut face of the first cuneiform;
• and
• fixing the first TMT joint.