# US 12,004,786 B2 · Bunion correction system and method

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- Number: US 12,004,786 B2
- Document ID: US12004786B2
- Status: Granted
- Kind: B2
- Application number: 16/859,531
- Filed: 2020-04-27
- Published: 2020-08-13
- Granted: 2024-06-11
- Earliest claimed: 2018-07-11
- Assignees: Crossroads Extremity Systems, LLC
- Applicants: Crossroads Extremity Systems, LLC
- Inventors: Bradley Lamm; Michael Chad Hollis; Daniel Sayger
- Web page: https://patentgrep.com/patent/US12004786B2

## CPC

- A61B 17/7291: {for small bones, e.g. in the foot, ankle, hand or wrist}
- A61B 17/151: {for corrective osteotomy}
- A61B 17/1682: {for the foot or ankle}
- A61B 17/1717: {for applying intramedullary nails or pins}
- A61B 17/1775: {for the foot or ankle}
- A61B 17/7233: {with special means of locking the nail to the bone}
- A61B 17/8061: {specially adapted for particular bones (A61B17/70 and A61B17/74 take precedence)}
- A61B 17/848: {Kirschner wires, i.e. thin, long nails}
- A61B 17/06166: {Sutures (suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M)}
- A61B 2017/565: {for surgical correction of axial deviation, e.g. hallux valgus or genu valgus}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A minimally invasive method of correcting a bunion includes performing an osteotomy to divide the metatarsal into first and second portions, implanting a nail in the first portion, securing a suture to the joint capsule, tensioning the suture to align the great toe with the metatarsal, attaching the suture to the nail, and fastening the nail to the second portion. A first guide block includes a plurality of coplanar passages to guide an instrument to create one or more holes in the metatarsal in advance of the osteotomy, and a second guide block includes a guide slot for another instrument to complete the osteotomy. The method can be performed through an incision of 0.5 inches or less. The nail includes an anchor portion for anchoring in the first portion, a head for attachment to a second portion, and can include a passage for attachment of the suture.

## Claims

### Claim 1

A method for correcting a bunion formed at a joint between a metatarsal and a great toe, the method comprising:
selecting a target location on the metatarsal;
creating an osteotomy in the metatarsal at the target location, the osteotomy resecting the metatarsal into a first metatarsal portion and a separate second metatarsal portion;
implanting an implant into the metatarsal, the implant comprising a monolithic body having a head and an anchor, wherein implanting the implant into the metatarsal comprises inserting the anchor into the intramedullary canal of the first metatarsal portion;
securing a length of suture to the great toe;
tensioning the suture to re-align the great toe relative to the first metatarsal portion; and
attaching the length of suture to the implant head.

### Claim 2 (depends on 1)

The method of claim 1, further comprising inserting at least one k-wire into the metatarsal adjacent to the target location.

### Claim 3 (depends on 2)

The method of claim 2, further comprising mounting a guide block onto the k-wire, wherein the guide block defines a cutting slot.

### Claim 4 (depends on 3)

The method of claim 3, further comprising actuating a cutting tool through the cutting slot to create the osteotomy in the metatarsal.

### Claim 5 (depends on 4)

The method of claim 4, wherein the cutting tool is selected from the group consisting of a broach, a saw, a blade, a chisel, an osteotome, a curette, a pick, and a rasp.

### Claim 6 (depends on 1)

The method of claim 1, further comprising attaching the implant head to the second metatarsal portion.

### Claim 7 (depends on 1)

The method of claim 1, wherein the incision is 0.5 inch or less in length.

### Claim 8

A method for correcting a bunion formed at a joint between a metatarsal and a great toe, the method comprising:
selecting a target location on the metatarsal;
positioning a guide block at the target location;
guiding a cutting instrument with the guide block to create an osteotomy in the metatarsal at the target location, the osteotomy dividing the metatarsal into a first metatarsal portion and a separate second metatarsal portion;
implanting an implant into the metatarsal, the implant comprising a monolithic body having a head and an anchor, wherein implanting the implant into the metatarsal comprises inserting the anchor into the intramedullary canal of the first metatarsal portion;
securing a length of suture to the great toe;
tensioning the suture to re-align the great toe relative to the first metatarsal portion; and
attaching the length of suture to the implant head.

### Claim 9 (depends on 8)

The method of claim 8, further comprising inserting at least one k-wire into the metatarsal adjacent to the target location;
mounting the guide block onto the k-wire, wherein the guide block defines a cutting slot; and
actuating the cutting instrument through the cutting slot to create the osteotomy in the metatarsal.

### Claim 10 (depends on 8)

The method of claim 8, wherein the cutting instrument is selected from the group consisting of a broach, a saw, a blade, a chisel, an osteotome, a curette, a pick, and a rasp.

### Claim 11 (depends on 8)

The method of claim 8, wherein a joint capsule surrounds the joint, wherein securing the length of suture to the great toe comprises securing the length of suture to the joint capsule.

### Claim 12 (depends on 8)

The method of claim 8, further comprising attaching the implant head to the second metatarsal portion.

### Claim 13 (depends on 8)

The method of claim 8, wherein the incision is 0.5 inch or less in length.

### Claim 14

A method for correcting a bunion formed at a joint between a metatarsal and a great toe, the method comprising:
selecting a target location on the metatarsal;
creating an osteotomy in the metatarsal at the target location, the osteotomy dividing the metatarsal into a first metatarsal portion and a separate second metatarsal portion;
implanting an implant into the metatarsal, the implant comprising a monolithic body having a head and an anchor, wherein implanting the implant into the metatarsal comprises implanting the anchor into the first metatarsal portion;
securing a length of suture to a joint capsule surrounding the joint;
tensioning the length of suture to re-align the great toe relative to the first metatarsal portion;
attaching the length of suture to the implant head; and
fastening the implant head to the second metatarsal portion.

### Claim 15 (depends on 14)

The method of claim 14, wherein the first metatarsal portion is proximal to the second metatarsal portion.

### Claim 16 (depends on 15)

The method of claim 15, further comprising:
translating the second metatarsal portion to expose a distal-facing surface of the first metatarsal portion; and
inserting the implant anchor through the distal-facing surface into the intramedullary canal of the first metatarsal portion.

### Claim 17 (depends on 16)

The method of claim 16, further comprising abutting the implant head against the distal-facing surface on the first metatarsal portion.

### Claim 18 (depends on 14)

The method of claim 14, wherein the implant head further comprises a transverse bore, wherein attaching the length of suture to the implant head comprises passing the suture through the transverse bore.

### Claim 19 (depends on 14)

The method of claim 14, comprising:
making an incision along a side of the metatarsal before selecting the target location, creating the osteotomy, implanting the implant, securing the length of suture to the joint capsule, tensioning the length of suture, attaching the length of suture to the implant head, and fastening the implant head to the second metatarsal portion; and
closing the incision after selecting the target location, creating the osteotomy, implanting the implant, securing the length of suture to the joint capsule, tensioning the length of suture, attaching the length of suture to the implant head, and fastening the implant head to the second metatarsal portion, wherein the suture is a non-resorbable suture, and wherein the length of suture remains secured to the joint capsule and attached to the implant after closing the incision.