Methods and apparatus are disclosed for excising a joint between first and second bones to define a resected joint, approximating the first and second bones to reduce the resected joint, and fixing the first and second bones relative to each other. The excising step can be performed using a cut guide that is movable from a first orientation to cut the first bone to a second orientation to cut the second bone. A compressor block can be driven over temporary fixation members that extends into the first and second bones to reduce the resected joint. A staple, along or in combination with other fixation elements, can then permanently fix the first bone to the second bone.

A bone cutting and joint realignment instrument may include an integrated spacer body, bone preparation guide, and fulcrum body. The spacer body is configured to be inserted into a joint space between a metatarsal and an opposed cuneiform of a foot. The bone preparation guide body is affixed to the spacer body with the spacer body extending downwardly from the bone preparation guide body. The bone preparation guide body can define at least one guide surface configured to be positioned over at least one of the metatarsal and the opposed cuneiform. The fulcrum body may be rotatably coupled to the spacer body within a bounded range of rotation, such as a bounded range of less than 45 degree. The fulcrum body can be configured to be inserted in an intermetatarsal space between the metatarsal and an adjacent metatarsal.

A method of ankle replacement includes forming an anterior cut in a bone and forming a stem hole in a distal end of the bone. The stem hole is formed using a plurality of broaches positioned against the distal end of the bone through the anterior cut. A first portion and a second portion of a stem implant are inserted into the stem hole through the anterior cut in the bone. The first portion is coupled to the second portion using a coupling device inserted through the anterior cut in the bone. The stem implant is impacted into the stem hole using an offset impactor.

A bone cut guide includes a first portion having a first cut slot and having an aperture for receiving a wire to connect the first portion to a first bone. A second portion has a second cut slot and a second aperture for receiving a second wire to connect the second portion to a second bone. The first portion and the second portion are movably connected to each other to allow the first bone and the second bone to move relative to each other.

A system includes a base and a targeting guide coupled to the base. The base includes a first member and a second member. The first member defines a first hole for receiving a first fixation element for coupling the first member to a bone. The second member is pivotably coupled to the first member. The second member defines a second hole and a third hole. The second hole is for receiving a second fixation element for coupling the second member to a bone, and the third hole is for receiving an adjustment member for adjusting an angle between the first member and the second member. The targeting guide extends from a first end to a second end and defines a fourth hole adjacent to the second end of the targeting guide. The fourth hole is sized and configured to receive a fixation device therein.

A system includes a first tool. The first tool includes a first component, a second component, and at least one fastener for coupling the first component to the second component. The first component is coupled to the second component such that a distance between the first component and the second component in a first direction is adjustable. The first tool is configured to provide a controlled adjustment of a first bone relative to a second bone in a second direction that is different from the first direction.

Apparatus and methods are described for use in securing a first bone relative to a second bone using a pair of surgical staples or, alternatively, a surgical staple and a bone screw. When a pair of staples are used, one of the legs of one of the staples may pass between the legs of the another of the staples. When a staple and a bone screw are used, the bone screw may pass between the legs of the staple. A guide tool can be used during the drilling of the holes for the legs of the staples or the legs of the staple and a bone screw. The guide tool provides guides for drilling guide holes for the staples or for the screw and staple. The guides can be fixed relative to each other during drilling of the guide holes.

A system includes a first tool having a first portion and a second portion supported by the first portion. The first portion extends from a first end to a second end, which includes a sleeve defining a first hole defining a first axis. The second portion defines a second hole having a second axis that is disposed at an angle relative to the first axis. The first and second holes are sized and configured to receive fixation elements for coupling the first tool to at least one bone. The first portion is configured to rotate about the first hole when a first fixation element is received within the first hole, and the sleeve defines a third hole that intersects a bottom surface of the sleeve. The third hole defines a third axis that is disposed at an angle relative to the first axis and the second axis.

A surgical drill alignment guide is disclosed that can provide an accurate trajectory for placement of a bone screw along a longitudinal axis of a bone.

A capital fragment guide is configured to be temporarily secured to a capital fragment of a metatarsal that has been surgically separated from a proximal portion of the metatarsal. The capital fragment guide can be manipulated to correspondingly manipulate the capital fragment, thereby correcting a bunion. An implant can permanently secure the proximal portion to the capital fragment.