Instruments and surgical methods for bunion procedures

An alignment system, comprising:

• an alignment instrument, comprising:
• a lateral portion comprising an upper portion and lower portion slidably adjustable and releasably couplable with one another;
• a medial portion adjustable and releasably couplable with the lateral portion and comprising a distal portion and a proximal portion;
• wherein the distal portion and the proximal portion are couplable with first and second bones of a patient and actuatable to apply a compression therebetween the first and second bones;
• and
• a retention element releasably couplable with the upper portion of the lateral portion of the alignment instrument and configured to engage with a third bone of the patient;
• and
• a positioning instrument.

A surgical method, comprising:

• coupling a retention member with a first bone of a patient;
• coupling a lateral portion of an alignment instrument with the retention member;
• coupling a medial portion of the alignment instrument with the lateral portion of the alignment instrument;
• coupling a distal aspect of the medial portion of the alignment instrument with a second bone of the patient;
• coupling a proximal aspect of the medial portion of the alignment instrument with a third bone of the patient;
• actuating the alignment instrument to apply compression between the second and third bones;
• and
• applying fixation across the second and third bones.