# US 2025/0375232 A1 · Minimally invasive surgery osteotomy fragment shifter, stabilizer, and targeter

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- Number: US 2025/0375232 A1
- Document ID: US20250375232A1
- Status: Published application
- Kind: A1
- Application number: 19/311,484
- Filed: 2025-08-27
- Published: 2025-12-11
- Earliest claimed: 2021-06-17
- Assignees: Wright Medical Technology, Inc.
- Applicants: Wright Medical Technology, Inc.
- Inventors: Zachary KORMAN; Shannon D. CUMMINGS
- Web page: https://patentgrep.com/patent/US20250375232A1

## CPC

- A61B 17/8866: {for gripping or pushing bones, e.g. approximators (joint distractors A61B17/025)}
- A61B 17/1775: {for the foot or ankle}
- A61B 17/66: {Alignment}, compression or distraction mechanisms
- A61B 17/8897: {Guide wires or guide pins}
- 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 system, includes a first screw mechanism including: a first block; a first screw threaded through the first block and including a first skin-interfacing portion; and an intramedullary (IM) member extending from and attached to the first block and including an end portion configured to be inserted into an intramedullary canal of a first bone fragment, wherein a first lateral force is generated between the first skin-interfacing portion against a second bone fragment, adjacent to the first bone fragment, and a holding force provided by the end portion when the first screw is rotated and the end portion is located in the intramedullary canal.

## Claims

### Claim 1

An osteotomy fragment shifter comprising:
a first block defining a threaded bore and an opening formed through a wall of the block;
a cannulated first screw threadingly received in the threaded bore;
a skin-interfacing wedge coupled to a distal end of the first screw so as to rotate with the first screw relative to the first block; and
an intramedullary (IM) member fixed to the first block and projecting distally therefrom, the IM member including a proximal shank that passes through the opening and a distal end sized and configured to be received within an intramedullary canal of a bone fragment,
wherein rotation of the first screw drives the wedge at least one of toward and away from the IM member to generate a lateral force between the wedge and the bone fragment while the distal end of the IM member resists translational movement.

### Claim 2 (depends on 1)

The shifter of claim 1, wherein the IM member is generally J-shaped with a long-length portion extending substantially perpendicular to a first longitudinal axis of the first screw and a curved distal end configured to engage cancellous bone.

### Claim 3 (depends on 1)

The shifter of claim 1, wherein a cross-section of the IM member is rectangular along the long-length portion and transitions to a tapered circular cross-section adjacent the distal end.

### Claim 4 (depends on 1)

The shifter of claim 1, wherein the opening in the first block forms a window that communicates with the proximal shank of the IM member so as to permit confirmation of an intramedullary seating depth.

### Claim 5 (depends on 1)

The shifter of claim 1, wherein the IM member is connected to the first block by a hinge that enables selective pivoting of the IM member about an axis parallel to a first longitudinal axis of the first screw.

### Claim 6 (depends on 1)

The shifter of claim 1, wherein the bore of the cannulated shaft of the first screw is sized to receive an anchor pin for securing the wedge to a large fragment.

### Claim 7 (depends on 1)

The shifter of claim 1, wherein the skin-interfacing wedge is generally U-shaped and is attached to the first screw by a bearing configured to allow the wedge to remain stationary with respect to skin of the patient while the screw is rotated.

### Claim 8 (depends on 1)

The shifter of claim 1, wherein the first block further comprises at least one transverse anchor hole sized to receive a fixation pin for anchoring the first block to cortical bone adjacent the intramedullary canal.

### Claim 9 (depends on 1)

A system for shifting, stabilizing, and targeting osteotomy fragments, the system comprising:
the osteotomy fragment shifter of claim 1;
a second block attachable to the first block and a second screw coupled to a second skin-interfacing wedge, the second screw being oriented and configured for advancing rotation so as to apply an opposing lateral force to a proximal bone fragment; and
a targeting arm releasably couplable to at least one of the skin-interfacing wedges and having a guide defining one or more channels aligned so as to define a trajectory toward a predetermined target location on a large bone fragment.

### Claim 10 (depends on 9)

The system of claim 9, wherein the second block includes a dovetailed projection that is receivable within a complementary groove formed in the first block to couple the first and second blocks together.

### Claim 11 (depends on 9)

The system of claim 9, wherein the first screw and the second screw are arranged in substantially parallel relationship to one another when the first and second blocks are joined.

### Claim 12 (depends on 9)

The system of claim 9, wherein the targeting arm defines a plurality of parallel channels that are spaced laterally from the skin-interfacing wedge so as to provide selectable guide trajectories.

### Claim 13 (depends on 12)

The system of claim 12, further comprising a plurality of removable wire sleeves, each sized to be received in a respective channel to guide a guide wire toward the large fragment.

### Claim 14 (depends on 9)

The system of claim 9, wherein the cannulated shaft of at least one of the first screw and the second screw is configured to receive an anchor pin that locks the corresponding skin-interfacing wedge against medial skin adjacent to a metatarsal bone.

### Claim 15 (depends on 9)

The system of claim 9, further comprising at least one wire sleeve insertable through a channel of the targeting arm and configured to direct a K-wire through a proximal bone fragment and into the large bone fragment along the defined trajectory.

### Claim 16 (depends on 9)

The system of claim 9, wherein the targeting arm further defines a through-hole located proximally of the channels, the through-hole being sized to accept an olive anchor pin for clamping the targeting arm to cortical bone.

### Claim 17 (depends on 9)

The system of claim 9, wherein the targeting arm is generally U-shaped and includes opposed tabs arranged so as to snap into corresponding recesses defined in the skin-interfacing wedge such that the targeting arm can pivot about an axis extending through the tabs.

### Claim 18 (depends on 9)

The system of claim 9, wherein the guide is dimensioned so that the defined trajectory intersects the large fragment at a position between 5 mm and 15 mm lateral to a pushing surface of the skin-interfacing wedge.

### Claim 19

A targeting arm assembly for use in minimally invasive metatarsal osteotomy procedures, the assembly comprising:
a resilient body having two legs extending from a base;
at least one attachment feature formed on each leg and configured to detachably engage complementary recesses in a skin-interfacing wedge of a screw mechanism; and
a guiding mechanism integrally formed with the base and defining a plurality of guide channels extending along respective longitudinal axes, each guide channel being configured to receive a guide sleeve for directing a guide wire toward a target region of bone.

### Claim 20 (depends on 19)

The targeting arm assembly of claim 19, wherein the resilient body is symmetrically U-shaped and the attachment features are inwardly directed detents formed on inner surfaces of the legs.

### Claim 21 (depends on 19)

The targeting arm assembly of claim 19, wherein the resilient body is L-shaped and the attachment feature comprises a single detent positioned at a distal end of one leg.

### Claim 22 (depends on 19)

The targeting arm assembly of claim 19, wherein the guiding mechanism comprises a block protruding from the base and includes at least one through-hole sized to receive an anchor pin for stabilizing the assembly against a patient's foot.

### Claim 23 (depends on 19)

The targeting arm assembly of claim 19, wherein at least two of the guide channels are oriented at different, non-parallel angles relative to the base to provide selectable converging trajectories.

### Claim 24 (depends on 19)

The targeting arm assembly of claim 19, wherein the resilient body and guiding mechanism are formed from a radiolucent polymer.

### Claim 25 (depends on 1, 9, 19)

A surgical kit for minimally invasive correction of hallux valgus, the kit comprising:
the osteotomy fragment shifter of claim 1;
the second screw mechanism of claim 9;
the targeting arm assembly of claim 19;
at least one anchor pin sized to pass through the cannulated shaft of the first screw;
at least one additional anchor pin configured to secure the targeting arm assembly to bone; and
at least one wire sleeve and at least one guide wire sized to be received in a guide channel of the targeting arm assembly,
all provided in sterile packaging.

### Claim 26 (depends on 25)

The kit of claim 25, wherein the anchor pin configured to secure the targeting arm assembly includes an olive-shaped head dimensioned to clamp the targeting arm assembly against cortical bone.

### Claim 27 (depends on 25)

The kit of claim 25, further comprising a plurality of wire sleeves of different lengths to accommodate varying soft-tissue thicknesses.

### Claim 28 (depends on 25)

The kit of claim 25, wherein the guide wire is a K-wire having a trocar tip for self-drilling insertion through cortical bone.

### Claim 29 (depends on 25)

The kit of claim 25, wherein the sterile packaging includes discrete compartments segregating the IM member, screws, targeting arm assembly, and wire sleeves to maintain component integrity prior to use.

### Claim 30 (depends on 25)

The kit of claim 25, wherein the first screw mechanism and the second screw mechanism are color-coded to facilitate rapid identification of proximal and distal components during surgery.