Minimally invasive bunionectomy procedure using chevron osteotomy guide

摘要

A chevron osteotomy guide for use in a minimally invasive bunionectomy procedure comprises an oblong base plate having a modified rectangular shape with two parallel longitudinal sides, and having a semi-circular proximal end and a chevron shaped distal end. The chevron shape is isosceles triangular in which a dorsal edge and a plantar edge intersect to form an apex angle that is less than 90 degrees and greater than 60 degrees. In the bunionectomy procedure, the chevron osteotomy guide is attached to the first metatarsal bone using two K wires or pins through proximal and distal apertures in the guide. The proximal aperture is surrounded by two concentric tubular projections which are orthogonal to the plane of the base plate. These projections consist of an inner tubular core, having a circumference that coincides with that of the proximal aperture, and an outer tubular haft, which serves as a handle by which the surgeon adjusts the position of the guide on the first metatarsal bone. Once the osteotomy guide is stabilized on the medial side of the first metatarsal bone, the surgeon uses a sagittal saw sequentially guided along the dorsal edge and then along the plantar edge of the chevron guide, so as complete osteotomies through the dorsal and plantar cortices of the first metatarsal bone. These osteotomies allow the metatarsal head to be translated and pivoted into a position that corrects the patient's bunion condition.