Abstract: Systems, techniques, and devices are described that may be used in a minimally invasive bone realignment procedure. In some examples, a method of performing a minimally invasive metatarsal correction procedure involves using a bone preparation guide having a guide surface with a length less than a diameter of a bone to be cut using the guide surface. The clinician can guide a bone preparation instrument along the guide surface and angle the bone preparation instrument beyond one or both ends of the guide surface to cut the end of the underlying bone beyond one or both of the ends.

Abstract: A bone plate can be used to fixate one or more bones. In some examples, a bone plate has first, second, third, and fourth fixation holes. The first and second fixation holes may be located in a distal body region of the bone plate and co-linear with a bridge central longitudinal axis. The third and fourth fixation holes may be located in a proximal body region of the bone plate, with the third fixation hole co-linear with the bridge central longitudinal axis and the fourth fixation hole offset from the bridge central longitudinal axis in a first plane by a first angle and in a second plane by a second angle.

Abstract: A variety of surgical procedures may be performed on the bones of the foot, such as on one or more lesser metatarsals of the foot positioned laterally of the first metatarsal. For example, a surgical procedure may involve cutting an end of one or both of a second metatarsal and an intermediate cuneiform and/or cutting an end of one or both of a third metatarsal and a lateral cuneiform. The tarsometatarsal joints defined be one or both sets of bones may be cut to treat an arthritic joint, metatarsus adductus, and/or other clinical condition. In any case, various surgical instruments can be utilized during a procedure to help increase the accuracy and repeatability of the procedure patient-to-patient, improving overall patient outcomes. For example, one or more cut guides, compressor-distractor devices, and/or other instruments designed to accommodate the specific anatomical conditions of the procedure being performed may be utilized during procedure.

Abstract: An orthopedic cutting instrument can be used to cut and release soft tissue to mobilize a bone for subsequent realignment of the bone. In some examples, the cutting instrument is configured with a handle and a cutting head. The cutting head has multiple cutting surfaces, such as a lead cutting surface and side cutting surfaces extending angularly away from the lead cutting surface. A mirror set of cutting surfaces may be provided on the opposite side of the cutting head. The cutting surfaces may be arranged to allow controlling cutting of soft tissue while limiting inadvertent deep penetration of the cutting instrument. In addition, the cutting surfaces may be arranged to allow back-and-forth cutting movement of the cutting head, which can be useful when working in a tight joint space.

Abstract: Instruments and techniques can be used to release a first metatarsal for realignment. In some implementations, a techniques involves surgically accessing a sesamoidal ligament in a foot of a patient and advancing a guiding projection of a cutting instrument under the sesamoidal ligament. This can capture the sesamoidal ligament between the guiding projection of the cutting instrument and a cutting surface of the cutting instrument that is recessed relative to a distal end of the guiding projection. The techniques further involves cutting the sesamoidal ligament with the cutting surface of the cutting instrument.

Abstract: A technique for correcting a bone deformity, such as a bunion, may be performed using an instrument that defines a spacer body connected to a fulcrum. The spacer body portion of the instrument can be inserted into a joint space between opposed bone ends. The fulcrum body can be inserted between adjacent metatarsals. An angle set between the spacer body and fulcrum body can help properly position both features within different joint spaces for ensuring that subsequent steps of the surgical procedure are properly performed and instrumentation is appropriately aligned.

Abstract: A method of preparing a metatarsophalangeal joint for fusion may involve surgically accessing the metatarsophalangeal joint and separating the metatarsal from the opposed proximal phalanx at the joint. The technique may involve preparing an end of the metatarsal and preparing an end of the opposed proximal phalanx for fusion. With or without the aid of a bone positioner, the metatarsal may be moved in one or more planes, such as the frontal and transverse planes. The proximal phalanx may also be moved in one or more planes, for example relative to the moved metatarsal. Subsequently, a bone fixation device can be applied across or through the metatarsophalangeal joint separating the metatarsal from the opposed proximal phalanx.

Abstract: A technique for correcting a bone deformity, such as a bunion, may be performed using an instrument that defines a spacer body connected to a fulcrum. The spacer body portion of the instrument can be inserted into a joint space between opposed bone ends. The fulcrum body can be inserted between adjacent metatarsals. An angle set between the spacer body and fulcrum body can help properly position both features within different joint spaces for ensuring that subsequent steps of the surgical procedure are properly performed and instrumentation is appropriately aligned.

Abstract: A method of preparing a metatarsophalangeal joint for fusion may involve surgically accessing the metatarsophalangeal joint and separating the metatarsal from the opposed proximal phalanx at the joint. The technique may involve preparing an end of the metatarsal and preparing an end of the opposed proximal phalanx for fusion. With or without the aid of a bone positioner, the metatarsal may be moved in one or more planes, such as the frontal and transverse planes. The proximal phalanx may also be moved in one or more planes, for example relative to the moved metatarsal. Subsequently, a bone fixation device can be applied across or through the metatarsophalangeal joint separating the metatarsal from the opposed proximal phalanx.

Abstract: A surgical technique can be performed utilizing a detachable driver-implant system and comparatively small surgical incision. The clinician can make an incision through the skin of the patient and retract the skin along the incision to expose a first bone region. The clinician can insert an implant into one or more bone portions using a detachable driver-implant system and then detach the driver, leaving the implant in the one or more bone portions. The clinician can reposition the skin of the patient at least partially over the end of the implant to expose a second bone region not exposed while the first bone region was exposed. After optionally performing one or more surgical steps on second bone region, the clinician can reposition the skin to again expose the first bone region. The clinician can then reattach the driver to the implant and remove the implant from the bone portions.

Abstract: A metatarsus adductus technique may involve cutting an end of one or both of a second metatarsal and an intermediate cuneiform to create a wedge-shaped opening between the end of the second metatarsal and the intermediate cuneiform. The method may further involve cutting an end of one or both of a third metatarsal and a lateral cuneiform to also create a wedge-shaped opening between the end of the third metatarsal and the lateral cuneiform. The second metatarsal and the third metatarsal can then be moved in a transverse plane to close a metatarsus adductus angle. Movement of the second and third metatarsal may close the wedge-shaped openings forming during bone cutting. With the second and third metatarsals appropriately realigned, the clinician can fixate the moved position of the second metatarsal and the third metatarsal.

Abstract: 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.

Abstract: A technique for correcting a bone deformity, such as a bunion, may be performed using an instrument that defines a spacer body connected to a fulcrum. The spacer body portion of the instrument can be inserted into a joint space between opposed bone ends. The fulcrum body can be inserted between adjacent metatarsals. An angle set between the spacer body and fulcrum body can help properly position both features within different joint spaces for ensuring that subsequent steps of the surgical procedure are properly performed and instrumentation is appropriately aligned.

Abstract: A metatarsal correction procedure may be performed so as to minimize the length of the surgical incision created during the procedure. A variety of different instruments and/or techniques and facilitate the minimal incision procedure. In some examples, a technique involves making a comparatively small surgical incision to access a tarsometatarsal joint. A metatarsal and a cuneiform separated by the tarsometatarsal joint can be prepared. In addition, the metatarsal can be moved relative to the cuneiform using a bone positioning device having a metatarsal engagement member positioned in contact with the skin of the patient on a medial side of the metatarsal. After moving the metatarsal, a fixation device can be installed across the tarsometatarsal joint to cause fusion. In some examples, a plate holder is attached to a U-shaped bone plate to facilitate plating across the joint through the comparatively small incision.

Abstract: A metatarsus adductus technique may involve cutting an end of one or both of a second metatarsal and an intermediate cuneiform to create a wedge-shaped opening between the end of the second metatarsal and the intermediate cuneiform. The method may further involve cutting an end of one or both of a third metatarsal and a lateral cuneiform to also create a wedge-shaped opening between the end of the third metatarsal and the lateral cuneiform. The second metatarsal and the third metatarsal can then be moved in a transverse plane to close a metatarsus adductus angle. Movement of the second and third metatarsal may close the wedge-shaped openings forming during bone cutting. With the second and third metatarsals appropriately realigned, the clinician can fixate the moved position of the second metatarsal and the third metatarsal.

Abstract: A method of preparing a metatarsophalangeal joint for fusion may involve surgically accessing the metatarsophalangeal joint and separating the metatarsal from the opposed proximal phalanx at the joint. The technique may involve preparing an end of the metatarsal and preparing an end of the opposed proximal phalanx for fusion. With or without the aid of a bone positioner, the metatarsal may be moved in one or more planes, such as the frontal and transverse planes. The proximal phalanx may also be moved in one or more planes, for example relative to the moved metatarsal. Subsequently, a bone fixation device can be applied across or through the metatarsophalangeal joint separating the metatarsal from the opposed proximal phalanx.

Abstract: A technique for correcting a bone deformity, such as a bunion, may be performed using an instrument that defines a spacer body connected to a fulcrum. The spacer body portion of the instrument can be inserted into a joint space between opposed bone ends. The fulcrum body can be inserted between adjacent metatarsals. An angle set between the spacer body and fulcrum body can help properly position both features within different joint spaces for ensuring that subsequent steps of the surgical procedure are properly performed and instrumentation is appropriately aligned.