Device and Surgical Technique for Foot Surgery

Abstract

A correction clamp assembly that permits a physician to surgically correct a bunion or similar deformity is provided. The assembly includes an elongate bridge, as well as first and second blocks slidably or rotatably connected to the elongate bridge. More specifically, first block is configured to slide along a slot formed in the elongate bridge, as well as rotate relative thereto. Additionally, the second block is configured to rotate relative to the elongate bridge. First and second pins may be configured to extend through the first and second block, and then into various pieces of bone. Once a cut is made in a portion of joint or bone, the pins can thereafter be moved towards and away from one another to position the respective pieces of bone in a desired location. Locking screws may also be provided to releasably secure the blocks relative to the bridge.

Claims

1. A correction clamp assembly for manipulating first and second pieces of bone relative to one another comprising: an elongate bridge comprising: a body; a first opening formed in the body; and a slot extending along and through a portion of the body; a first block slidably connected to the elongate bridge; a second block rotatably connected to the elongate bridge; and a plurality of pins associated with one of the first block, the second block, and the elongate bridge.

2. The correction clamp assembly of claim 1, further comprising: a first pin associated with the first block; and a second pin associated with the second block.

3. The correction clamp assembly of claim 2, wherein the first block slides and rotates relative to the slot; and wherein the second block rotates relative to the first opening.

4. The correction clamp assembly of claim 3, further comprising: at least one first block locking screw configured to releasably secure the first block relative to the elongate bridge in a lateral translational direction; at least one second block locking screw configured to releasably secure the second block relative to the elongate bridge in a rotational direction.

5. The correction clamp assembly of claim 4, wherein the first block further comprises at least one guide rail configured to guide movement of the first block relative to the elongate bridge.

6. The correction clamp assembly of claim 4, wherein the second pin is configured to be secure to a first metatarsal; and wherein the first pin is configured to be secured to a second metatarsal.

7. The correction clamp assembly of claim 6, wherein the second pin is configured to be manipulated to move the first metatarsal towards the second metatarsal.

7. The correction clamp assembly of claim 1, wherein the first block further comprises: a main body; a tube with a first opening extending therethrough along a first axis; a second opening extending through the body along a second axis; and wherein the second block further comprises: a main body; a tube with a first opening extending therethrough along a first axis; a second opening extending through the body along a second axis.

8. The correction clamp assembly of claim 1, wherein the first block further comprises at least one guide rail configured to guide movement of the first block relative to the elongate bridge.

9. The correction clamp assembly of claim 1, wherein the first block further comprises a gripping section and an identifier; wherein the second block further comprises a gripping section and an identifier; wherein the elongate bridge includes first and second identifiers; wherein the first block identifier is aligned with the first identifier of the elongate bridge; and wherein the second block identifier is aligned with the second identifier of the elongate bridge.

10. A method of performing a medical procedure comprising the steps of: inserting a first pin through a second metatarsal; inserting the first pin through a first block associated with a correction clamp; inserting a second pin through a first metatarsal; inserting the second pin through a second block associated with the correction clamp; creating a corrective cut in one or more of a bone and a joint; manipulating the second pin to move the second block and the first metatarsal relative to the second metatarsal; reaching a desired location of the first metatarsal; and securing the first metatarsal in place.

11. The method of performing a medical procedure of claim 10, further comprising the steps of: sliding the first block relative to a bridge associated with the correction clamp; and rotating the second block relative to the bridge.

12. The method of performing a medical procedure of claim 11, further comprising the steps of: sliding the first block relative to a slot formed in the bridge; and rotating the second block about a bridge hole formed in the bridge.

13. The method of performing a medical procedure of claim 11, further comprising the step of sliding at least one guide rail associated with the first block to enable movement of the first block relative to the bridge.

14. The method of performing a medical procedure of claim 11, further comprising the steps of: securing the first block in place relative to the bridge using a first locking screw; and securing the second block in place relative to the bridge using a second locking screw.

15. The method of performing a medical procedure of claim 10, further comprising the steps of: inserting the first pin through an opening in a tube that extends through the first block; and inserting the second pin through an opening in a tube that extends through the second block.

16. The method of performing a medical procedure of claim 10, further comprising the steps of: pressing the second pin towards the first pin; and moving the first metatarsal to the desired location.

17. The method of performing a medical procedure of claim 16, further comprising the steps of: releasably securing first block into place relative to a bridge associated with the corrective clamp once the first metatarsal is in the desired location; and releasably securing the second block into place relative to the bridge associated with the corrective clamp once the first metatarsal is in the desired location.

18. A kit for an osteotomy or joint fusion medical procedure comprising: a bridge comprising a body, a first opening formed in the body, and an elongate slot formed in the body; a first block configured to be secured to the bridge along the slot; a second block configured to be secured to the bridge about the first opening; and a plurality of pins.

19. The kit of claim 18, further comprising a plurality of locking screws configured to releasably secure the first block and the second block in place relative to the bridge.

20. The kit of claim 18, further comprising a cutting saw for creating a corrective cut or preparing a joint in one or more of bone and a joint; and a screw configured to secure a portion of bone in place.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0015] A clear conception of the advantages and features constituting the present invention, and of the construction and operation of typical mechanisms provided with the present invention, will become more readily apparent by referring to the exemplary, and therefore non-limiting, embodiments illustrated in the drawings accompanying and forming a part of this specification, wherein like reference numerals designate the same elements in the several views, and in which:

[0016] FIG. 1 is a top plan view of the bones of a foot with a bunion deformity;

[0017] FIG. 2 is a top plan view of the bones of a foot with normal anatomy;

[0018] FIG. 3 is an isometric view of an inventive correction clamp device with pins extending therethrough;

[0019] FIG. 4 is an isometric view of the correction clamp with pins of FIG. 3;

[0020] FIG. 5 is a left side elevation view of the correction clamp with pins of FIGS. 3 and 4;

[0021] FIG. 6 is a right side elevation view of the correction clamp with pins of FIGS. 3-5;

[0022] FIG. 7 is a top plan view of the correction clamp with pins of FIGS. 3-6;

[0023] FIG. 8 is a bottom plan view of the correction clamp with pins of FIGS. 3-7;

[0024] FIG. 9 is a front end elevation view of the correction clamp with pins of FIGS. 3-8;

[0025] FIG. 10 is a rear end elevation view of the correction clamp with pins of FIGS. 3-9;

[0026] FIG. 11 is an isometric view of a bridge of the correction clamp of FIGS. 3-10;

[0027] FIG. 12 is an isometric view of a first block of the correction clamp of FIGS. 3-10;

[0028] FIG. 13 is an isometric view of a second block of the correction clamp of FIGS. 3-10;

[0029] FIG. 14 is a perspective view of a first embodiment of the correction clamp positioned over a first and second metatarsal;

[0030] FIG. 15 is a left side elevation view of a foot with a bunion deformity, with the first embodiment of the correction clamp positioned over first and second metatarsal;

[0031] FIG. 16 is a right side elevation view of a foot with a bunion deformity, with the first embodiment of the correction clamp positioned over first and second metatarsal;

[0032] FIG. 17 is a perspective view of the first embodiment of the correction clamp positioned over a foot;

[0033] FIG. 18 is an isometric end view of the first embodiment of the correction clamp positioned over the first metatarsal and foot;

[0034] FIG. 19 is an isometric view of a foot with a bunion deformity, with the correction clamp and pins in position, before correction of the deformity;

[0035] FIG. 20 is an isometric view of a foot with the first metatarsal being manipulated with the correction clamp to begin the correction of the bunion deformity;

[0036] FIG. 21 is an isometric view of a foot with the first metatarsal being shifted towards the second metatarsal using the correction clamp to correct the bunion deformity; and

[0037] FIG. 22 is an isometric view of a foot with the correction clamp in place and the first pin being rotated towards the second pin such that the bunion deformity is fully corrected.

[0038] In describing the preferred embodiment of the invention which is illustrated in the drawings, specific terminology will be resorted to for the sake of clarity. However, it is not intended that the invention be limited to the specific terms so selected and it is to be understood that each specific term includes all technical equivalents which operate in a similar manner to accomplish a similar purpose. For example, the word connected, attached, or terms similar thereto are often used. They are not limited to direct connection but include connection through other elements where such connection is recognized as being equivalent by those skilled in the art.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

[0039] The present invention and the various features and advantageous details thereof are explained more fully with reference to the non-limiting embodiments described in detail in the following description. Initially, a variety of tools will be described, after which use of the tools together will be described to perform the desired medical procedure. Preferably, the described system can be used to streamline and simplify minimally invasive surgical procedures. Additionally, the described system preferably results in better cosmetic results, such as less scarring, decreased trauma to the soft tissues, less damage to blood supply, faster healing, less time in the operating room for the patient and physicians, less post-operative pain, swelling, and complications, and/or quicker recovery time and earlier return to activities. While the description below will primarily be in relation to surgical procedures designed to correct issues relating to hallux valgus/bunions, the present invention could similarly be used to correct other issues in a patient's feet, ankles, and elsewhere on the body.

[0040] Turning initially to FIG. 1, a foot 20 with a bunion deformity that requires surgical correction is illustrated, whereas FIG. 2 shows a normal foot with no deformity. The feet 20 in both FIGS. 1 and 2 show a second metatarsal 28 that has no or minimal deformity. As seen in FIG. 1, the first metatarsal 22 is deformed in multiple planes. Additionally, the medial cuneiform 24 and the proximal phalanx 26 are also deformed due to their attachment to the first metatarsal 22. When the present invention is used to surgically correct the foot shown in FIG. 1, the first metatarsal 22 will be substantially repositioned as it is shown in FIG. 2 into a normal anatomic position. As a result, the medial cuneiform 24 and the proximal phalanx 26 are also in the proper anatomic position.

[0041] Moving generally to FIGS. 3-13, the inventive correction clamp 30 and associated components such as a first installed pin 32 and a second installed pin 34, are illustrated. This inventive correction clamp 30 is used to remedy the bunion deformity shown in FIG. 1, after which the foot will be surgically corrected to look substantially more anatomic as it does in FIG. 2 as will further be described.

[0042] The correction clamp 30 consists of three main pieces: a first block 36, a second block 38, and a bridge 40. Each of these are shown assembled in FIGS. 3-10, and in isolation in FIGS. 11-13. Advantageously, each of the first block 36, the second block 38, and the bridge 40 are relatively simple parts have few components that can be installed and manipulated relative to one another, and can also be affordably manufactured. While exemplary embodiments of these components are shown in the figures, these components could take virtually any shape or size while functioning as described here. Further, while features of these components are described below, each of these components could include additional or fewer components depending on any number of different factors.

[0043] Turning to FIG. 12, the first block 36 includes a body 42 that has a tube 44 with a pin hole opening 46 formed therein that extends through the length of the tube 44. The tube 44 and the pin hole opening 46 extend along a first axis, which will be described herein as a substantially vertical axis based on how it is shown in FIG. 12, but of course the first block 36, as well as the clamp 30, could be oriented in any direction when in use. A screw hole opening 48 also extends through the body 42 of the first block 36, with the screw hole opening 48 extending along a second axis that is substantially perpendicular relative to the first axis. As shown, the second axis is substantially horizontal, such that the screw hole opening 48 extends in the horizontal direction.

[0044] The tube 44 is configured to receive the first pin 32 through the pin hole opening 46. The first pin 32 can move freely through the tube 44, otherwise, it can be locked into place, for instance using a locking screw 50 that can be inserted into the screw hole opening 48, after which it can be twisted to either release the first pin 32 or hold it in place.

[0045] Additionally, top and bottom guide rails 52, 54 are provided that extend from the body 42 of the first block 36. Again, use of the words “top” and “bottom” are used relative to what is shown in FIG. 12, although the components could be used in other orientations. These guide rails 52, 54 are configured to secure the first block 36 to the bridge 40 and enable movement of the first block 36 relative to the bridge 40 as will further be described below.

[0046] Further still, the first block 36 may include a grip section 56, which can be engaged by a user's fingers. The grip section 56 includes a tab 58, as well as a textured portion 60 that can be easily gripped by and manipulated by a user during a medical procedure. Further still, the first block 36 may include an identifier 62, here the number “3”, which helps users identifying the relevant parts and assembly and/or use of the correction clamp 30. The first block 36 may not include an identifier in other embodiments.

[0047] Next, the second block 38 will be described. The second block 38 includes a body 64 that has a tube 66 with a pin hole opening 68 formed therein that extends through the length of the tube 66. The tube 66 and the pin hole opening 68 extend along a first axis, which will be described herein as a substantially vertical axis based on how it is shown in FIG. 13, but of course the second block 38, as well as the clamp 30, could be oriented in any direction when in use. A screw hole opening 70 also extends through the body 64 of the second block 38, with the screw hole opening 70 extending along a second axis that is substantially perpendicular relative to the first axis. As shown, the second axis is substantially horizontal, such that the screw hole opening 70 extends in the horizontal direction.

[0048] The tube 66 is configured to receive the second pin 34 through the pin hole opening 68. The second pin 34 can move freely through the tube 66, otherwise, it can be locked into place, for instance using a locking screw 72 that can be inserted into the screw hole opening 70, after which it can be twisted to either release the second pin 34 or hold it in place.

[0049] Additionally, the second block 38 may include a grip section 74 including a textured portion 76, which can be engaged by a user's forgers. Further still, the second block 38 may include an identifier 78, here the number “4”, which helps users in terms of identifying the relevant parts and assembly and/or use of the correction clamp 30. The second block 38 may not include an identifier in other embodiments.

[0050] Next, the bridge 40 will be described. The bridge 40 includes an elongate body 78. Within the elongate body 78, a slot 80 is shown that extends along a majority of the elongate body 78 from a first end 82 toward a second end 84. The slot 80 allows the first block 36 to be translated towards and away relative to the second block 38 as will be further described below. Additionally, a bridge hole 86 is formed in the second end 84, with a portion of the elongate body 78 separating the bridge hole 86 from the slot 80. Both the slot 80 and the bridge hole 86 are sized to receive additional locking screws 88, 90, as again will further be described below. Further still, the bridge 40 may include a grip section 92 that can be used in conjunction with the grip section 74 of the second block 38 in order to manipulate the various pieces relative to one another as will further be described below. Further still, the bridge 40 may include one or more identifiers 94, 96, here the numbers “1” and “2”, which helps users in terms of identifying the relevant parts and assembly and/or use of the correction clamp 30. In other embodiments, the identifiers may be inverted, with identifier 94 being directed to “2” and identifier 96 being “1”. In other embodiments the bridge 90 may not include identifiers at all. Further, the bridge 40 may include an upper lip 98 and a lower lip 100 extending from a front face 102 of the bridge 40. Additionally, channel 104 may be located in the bottom of the bridge 40, which in turn forms the lower lip 100. The upper lip 98 and lower lip 100 are dimensioned such that the top guide rail 52 and the bottom guide rail 54 are configured to engage with, and slide along, these lips 98, 100.

[0051] As described above, the correction clamp 30 includes a plurality of locking screws, as seen, four locking screws 50, 72, 88, 90. Each of these locking screws 50, 72, 88, 90 are illustrated to be substantially the same, although of course screws having different diameters or operating characteristics could be similarly used. Furthermore, other fasteners configured to releasably attach the various components to one another could similarly be employed.

[0052] Whether the illustrated locking screws 50, 72, 88, 90 are used, or other fasteners are, these components allow the first block 36 to be locked and released from translating and/or rotating relative to the bridge 40, and allow the second block 38 to be locked and released from rotating relative to the bridge 40. More specifically, a user of the correction clamp 30 can push or pull on the first block 36 and the second block 38 to translate the first block 36. Once the blocks 36, 38 and associated pins 32, 34 reach a desired location, the locking screws 50, 72, 88, 90 may be tightened in order to hold the first block 36 in place. Thereafter, the locking screws 50, 72, 88, 90 can be loosened to release the first block 36 and allow it to translate. Additionally, the first block 36 and second block 38 are able to rotate relative to the bridge 40. More specifically, locking screws 50, 72, 88, 90 may be tightened or loosed to prevent or enable rotation of the first block 36 or the second block 38.

[0053] Additionally, the first block 36 and the second block 38 are both slidably attached to the bridge 40. The bridge 40 may be ratcheted, ridged, or have other features to allow sliding and then locking in place of the first block 36 and the second block 38. The bridge 40 can extend past the first block 36 and the second block 20 if desired or needed. A release button (not shown) or other quick release feature may be used to release the bridge 30 so that it moves freely into the first block 36 or the second block 38, for example if the bridge 40 is ratcheted.

[0054] Turning next to FIGS. 3-10, various views are provided of the correction clamp 30, with the first pin 32 and the second pin installed 34 installed. As will be appreciated by one having ordinary skill in the art, the first block 36 can be translated in the slot 80 of the bridge 40. In these figures, the first pin 32 is shown rotated at an angle of approximately 30-degrees relative to the second pin 34. The design of first block 36 and the second block 38 is such that the first pin 32 and the second pin 34 can each be rotated to any desired position.

[0055] Next, FIGS. 14-22 show how the correction clamp 30 would be used in surgery on a right foot. The correction clamp 30 could also be made to be suitable for both feet, or with separate right-foot and left-foot versions. These figures show a foot 20 with a first metatarsal 22 and a second metatarsal 28. The correction clamp 30 is shown positioned in place in different views. In the illustrated embodiment, the second block 38 is positioned over the second metatarsal 28, and the second pin 34 is oriented approximately perpendicular to the foot 20 and passes through the second block 38 into the second metatarsal 28. Additionally, the first block 36 is positioned over the first metatarsal 100, and the first pin 32 is angled at approximately 30 degrees relative to the vertical. The first pin 32 passes through the first block 36 and into the first metatarsal 22. In this way, the first pin 32 is configured to allow for rotation of the first metatarsal 22 in the frontal plane. Alternatively, the second block 38 can attach to other undeformed bones of the foot, such as the lesser toe metatarsals or another location, depending on designer and physician preference. Of course, the bridge 40 could be longer than what is shown in the figures when the correction clamp 30 is used with other bones of the foot.

[0056] The correction clamp 30 is configured to have the first block 36 attach to an undeformed portion of the foot such as the second metatarsal 28, while second block 38 attaches to a deformed portion of the foot such as the first metatarsal 22, and then allow the first metatarsal 22 to be manipulated by the physician into its proper anatomic location while the correction clamp 30 moves to accommodate this repositioning. The locking screws 50, 72, 88, 90 can be tightened and loosened as needed to allow for appropriate degrees of freedom.

[0057] FIGS. 19-22 provide an isometric view of the successive steps of the surgical procedure. First, in FIG. 19, the corrective clamp 30 is positioned on the foot 20, with the second pin 34 in the first metatarsal 22 and the first pin 32 in the second metatarsal 28. The surgeon then prepares the first metatarso-cuneiform joint, after which the first metatarsal 22 can be positioned and rotated freely relative to the second metatarsal 28.

[0058] Next, FIG. 20 shows the first metatarsal 22 now being straightened to eliminate part of a deformity. The corrective clamp 30 allows second block 38 to be translated away from the first block 36, after the locking screws 72, 90 have been loosened to enable movement.

[0059] In FIG. 21, the first metatarsal 22 can now be moved into proper anatomical location by pressing the second block 38 towards the first block 36. The first block 36 moves along the bridge 40 in the slot 80. When the first block 36 has moved the desired distance, the locking screws 50 can be tightened to hold the first block 36 in place, and thus hold the first metatarsal 22 in its new position.

[0060] FIG. 22 shows that one of the locking screw 90 has now been loosened, with the other locking screw 88 remaining tight. Loosening the locking screw 90 allows the second pin 34 to be rotated relative to first pin 32. Since the second pin 34 passes into the first metatarsal 22, in this way the first metatarsal 22 is also rotated relative to the second metatarsal 24. The locking screw 90 can be tightened when the desired correction is achieved.

[0061] The steps described above and shown in FIGS. 19-22 can be iterated any number of times, to properly position the two metatarsals. The locking screws 50, 72, 88, 90 can be loosened and tightened as needed, to allow for relative motion of the two metatarsals. The corrective clamp 30 is capable of correcting the abnormal metatarsal/foot deformity and holding the two metatarsals in the corrected position until the surgeon places permanent fixation.

[0062] The correction clamp 30 and associated components can be packaged together with a first pin 32 and a second pin 34, as well as other instruments in a surgical kit. The kit can be presented in the operating room as a pre-sterilized kit, or non-sterile. The kit can include common fixation mechanisms such as nitinol staple, orthopedic screws, or a plate with screws.

[0063] Although the best mode contemplated by the inventors of carrying out the present invention is disclosed above, practice of the present invention is not limited thereto. It will be manifest that various additions, modifications and rearrangements of the features of the present invention may be made without deviating from the spirit and scope of the underlying inventive concept. For example, any of the specific aspects of any of the described embodiments could similarly be used with any of the other embodiments. Furthermore, while specific materials have been described, it should be known that any materials could used to create any of the described drapes. For instance, materials may be chosen based on any number of criteria, including costs, availability, and various sterility properties. Moreover, as described above, the individual components need not be formed in the disclosed shapes, or assembled in the disclosed configuration, but could be provided in virtually any shape, and assembled in virtually any configuration. Further, any of the components can be manufactured with one another or be separately manufactured and later assembled. Furthermore, all the disclosed features of each disclosed embodiment can be combined with, or substituted for, the disclosed features of every other disclosed embodiment except where such features are mutually exclusive. Figures are not to scale, and some features are exaggerated to show details of particular features or method steps. Further still, some of the tools described above may be reusable, while others may be disposable.

[0064] It is intended that the appended claims cover all such additions, modifications and rearrangements. Expedient embodiments of the present invention are differentiated by the appended claims.