Abstract: A fixator for adjustably securing a first skeletal element on a superior side of an ankle joint relative to a skeletal element on the inferior side of the ankle joint. The fixator includes a bone screw clamping assembly that preferably secures a pair of screws to the bones of the foot. The bone screw clamping assembly is attached to a central body of the fixator and is operative for articulating the pair of bone screws about an axis substantially co-axial with the anatomical pivot axis of the ankle joint. The bone screw clamping assembly further defines a radiographic window for permitting lateral radiographic examination of the anatomical pivot axis of the ankle joint.

Abstract: The present invention relates to an implantable element for fixation of one or more fractured bone fragments (9) to a stable bone fragment (10). The element comprises a pin plate (1), which is fixed to the stable bone fragment (10) by one or more screws (7) or the like. To fixate the loose bone fragments (9) one or more pins (8) are passed through holes (3) in the pin plate (1), through the loose bone fragments and further into the stable bone fragment (10). The end of the pin is locked to the pin plate (1) in any suitable way. The form of the pin plate (1) is adapted to the intended site of use.

Abstract: A cable used in spinal surgery has one crimp of a two crimp assembly crimped to one end of it. The second crimp has a ball held in a socket of the first crimp. The other end of the cable is passed around the bone or bones and any necessary orthopedic spinal device and it is then passed through an aperture in the second crimp. The cable is then tensioned by application thereto of a tensioning tool with the tool applied to the cable and to an abutment face of the second crimp, whereupon the cable is tensioned, with the ball and socket arrangement enabling swiveling of the crimps with respect to each other, thus minimizing sharp bends in the cable. Then the second crimp portion receiving the cable portion in the aperture adjacent the tensioning tool is crimped onto that cable portion to complete the attachment. Then the tensioning tool is removed, and the free end of the cable is cut off at the abutment surface.

Abstract: Apparatus for forming a centered bore within an intramedullary canal of a femur in preparation for the implantation of a prosthetic device is disclosed. The apparatus comprises an elongated rigid rod having a handle adjacent its proximal end. The rod includes outwardly projecting fins at its distal end adapted to engage the interior wall of the cortex of the femur, thus centering the bore. Additionally, the rod has a hollow interior which permit suction to be applied to rod's proximal end.

Abstract: A spinal fixation system utilizing grapple hooks comprising a lower hook attached to the lamina on the caudal-side of a vertebra and an upper hook attached to the lamina on the cranial-side of a vertebra. The hooks clamp the vertebra lamina in the center. Thus, the hooks clamp the lamina at the spinous process which is the strongest part of the lamina. Bolts are provided for attaching the lower hook to the upper hook to thereby attach the lower and upper hooks to the vertebra and clamps for attaching the lower and upper hooks to spine rods. A spinal fixation kit is provided with a plurality of uniquely configured fixation systems to assure satisfactory fit to any vertebra of any patient, and specially designed tools are preferably provided to aide in a method of implanting the systems thereby reducing the time required for implantation.

Abstract: A method and apparatus for introducing and compacting bone graft material in an enlarged femoral cavity including a dispenser having a barrel containing bone graft material and a cannulated ejector/compactor positionable over a multi-section guide wire for both ejecting bone graft material from the barrel and compacting the bone graft material while being guided on the guide wire. The ejector/compactor has a modular head which may be removed and replaced by other heads of varying size.

Abstract: The invention provides surgical resection instruments, and methods of use, for facilitating accurately cut surfaces for the placement of femoral prosthesis components. The posterior condyles and anterior femoral cortex provide reference points for measurement and cuts of the femur with these instruments. One embodiment of the femoral resection instrument provides for precise anterior cuts of the femur appropriate for one of several sizes of prosthesis components without the need for separate cutting guides. Another embodiment provides for shifting the cutting location of both the posterior and anterior cuts by a portion of the distance between sizes of the prosthesis components while maintaining the reference position relative to the posterior part of the condyles and corresponding intercondylar notch. A third embodiment has an adjustable paddle so that the femoral resection instrument can be adjusted to the correct orientation when the femoral condyles are worn unequally.

Abstract: A self-drilling, self-tapping screw for use in repairing broken bones. The screw is made of a high strength material selected from the group consisting of titanium alloys, chrome cobalt, and high strength resinous polymer. The screw has threw segments: a tip region, a body region and a head region. The tip and body regions have a retention thread formed over substantially their entire lengths. The tip has an included angle .alpha. in the range between 45.degree. and 50.degree.. The head region is specifically designed to maximize the torque it can withstand and minimize the amount of material removed in formation of the recess. The head has a generally frusto-conical shape with an included angle of between 90.degree. and 120.degree. to prevent pull through while minimizing the head's profile. The retention threads on the tip region and the body region have similar shapes and pitches with the pitch on the tip region being slightly smaller than the pitch on the body region.

Abstract: The invention disclosed is a method and instrument set for repairing focal arthritic defects in a mammalian joint, especially in a human knee. The articular cartilage transplantation instrument set includes a coring device and first and second obturators. The coring device includes a cylindrical tube extending a distance along a coring axis between distal and proximal ends. A set of cutting elements or teeth are disposed at the distal end, and a gripper is at the proximal end. The outer diameters of the obturators are slightly less than the inner diameter of the tube of the coring device so that each of the obturators may be slidingly within the tube of the device with each of the respective obturator axes being substantially coaxial with the axis of the of the coring device tube. The length of the first obturator is selected so that when its rod is positioned all the way into the tube of the device, the distal end of the obturator is displaced by a distance X1 from the distal end of the device.

Abstract: An orthopaedic implant, namely a locking device for anchoring to cortical bone for the fixation of fractures of bone and/or dislocations of joints. The locking device includes a cable, a locking member slidable over the cable, and a spreader member attached to a distal end of the cable. The locking member has an expandable portion that may be expanded when the locking member engages the spreader member. A capturing assembly has a raised portion and a contractible passage therethrough for securably receiving a proximal portion of the cable, and preferably includes a cooperating sleeve and annular-shaped member adapted to contract the contractible passage. The cable and locking device are introduced through a hole in a bone, the locking member is expanded, thereby engaging the distal or far surface of the bone. The capturing assembly is introduced over the cable until the raised portion engages the proximal or near surface of the bone.

Abstract: A bone-modification device includes a plurality of cutting guides, wherein at least one of the guides is used to resect or otherwise modify a bone to receive a prosthetic element of a particular size, and one or more additional guides to modify or resect the bone in conjunction with a prosthetic element of a different size. In one disclosed example, the guides are configured to resect a distal femur so as to receive a femoral prosthesis in conjunction with knee-replacement surgery, wherein a plurality of guide sets are provided for anterior, posterior, and associated chamfer cuts for a plurality of differently sized femoral prosthesis. In this instance, the guide preferably features one or more sets of spaced-apart saw-receiving slots, including a first slot to resect the bone to receive a femoral prosthesis of a first size, and a second slot to resect the bone to receive a femoral prosthesis of a second size, different from the first.

Abstract: An apparatus and method for tibial alignment which allows the independent establishment of two separate geometric planes to be used as a reference for the cutting of the tibial plateau during total knee arthroplasty. Two separate frame assemblies with telescoping rods are attached to the tibia with a fixed relative angle between them, thereby allowing alignment with the mechanical axis of the bone. A cutting block is mounted on one of the assembly frames and is positioned against the tibia. Stabilizing pins are then placed in the cutting block, allowing the proper tibial plateau resection plane to be created.

Abstract: A surgical tensioning apparatus has a base, first and second bone tissue engaging elements mounted on the base and being displaceable toward and away from each other. One of the tissue engaging elements being adapted to be oriented by the tissue engaged thereby. A guide element is provided which is adjustable in relation to the base and one of the tissue engaging elements for positioning first location element to locate a cutting guide provided with cooperating second location element onto the bone to be resectioned.

Abstract: An instrument for performing a correctional osteotomy of a lower extremity of a patient has a securing frame (1), fixation elements (7, 8) for attaching the frame to the skeleton of the lower extremity of the patient, and securing components (6, 9) adjustably holding the fixation elements on the frame. A saw guide (25) is mounted on said frame so as to be angularly adjustable relative to the frame. An angle-indicating scale plate (10) is adjustably attached to one of the securing components. A rotation axis pin (12) penetrates the scale plate and points toward a location on the skeleton for intersection of bone cuts to be made. An angle determining component (23) is pivotable about the rotation axis pin and carries the saw guide and two pointers (26, 27) aligned with each other and alignable with a projection of a mechanical loading axis of the extremity of the patient, whereby adjustment of the pointers directly causes adjustment of the saw guide.

Abstract: A surgical hand drill for inserting orthopedic screws and for drilling holes in the fixing of fractures and bone grafts employing a pair of bushings at opposite ends of a double-helix spiral drive shaft to maintain concentricity of rotation when transferring a squeeze hand motion to a pistol grip handle to a rotating drive motion for the screw and for the twist drill, with a compression-type return spring to return the drive shaft to its quiescent position, while providing a tactile feel to the surgeon as to the success in setting the screw into the bone, or drilling a hole, and which includes a quick disconnect adapter for accepting orthopedic screw driver tips of square, hexagonal and/or cross-fit end shank or other configurations, or twist drills.

Abstract: An introduction apparatus for approximating a longitudinal member and an implant to permit fixation therebetween. The introduction apparatus having a gripping nose for securely engaging an implant, a lateral approximation mechanism for laterally aligning an implant and an offset longitudinal member, and a reduction mechanism for reducing the vertical distance between the implant and the longitudinal member. The introduction apparatus is provide with a gripping nose actuated by axial movement of a clamping shaft in an outer sleeve. The clamping shaft further includes an axial cannula for passage of a fastener to the implant.

Abstract: Instruments for use in endoscopic carpal tunnel surgery include a cannula having a diameter suitable for passage in the carpal tunnel, a diametrically narrowing open tip to facilitate entry into the carpal tunnel and a matted interior surface to maximize visual clarity of the carpal tunnel display, an obturator having a diameter suitable for passage in the cannula end, a plow shaped tip which laterally shifts tendons and nerves from its path as the tip is passed in the carpal tunnel and a sway-back portion proximate the tip which maximizes the efficiency of the tip as it plows through the carpal tunnel tendons and nerves and a rasp having a rod of diameter suitable for passage in the cannula, a roughened face on an upwardly tapering trapezoidal cross-section tip for guiding penetration of the tip through the longitudinal slot in the cannula but limiting penetration of the tip therethrough, and a bend in the rod so that the roughened face of the tip is in substantially flush alignment with the ligaments when t

Abstract: An osteosynthetic implant for setting a broken bone. The implant comprises a nail having a plurality of helically twisted blades that share a common helical axis. At least two of the blades define an angle of less than 180.degree. in a plane perpendicular to the helical axis. In a preferred embodiment, one pair of the blades of the nail is tapered towards its proximal portion and another pair has a uniform thickness. The blades are twisted by at least about 30.degree.. A cannulation runs through the center of the nail to receive a guide wire. The nail is slidably engageable to a member that is securable to an elongated portion of the bone, such as a side plate or an intramedullary nail. In a preferred implantation orientation, the proximate portion of the tapered blades is parallel to the elongated portion of the bone, and a proximate portion of the uniform blades is perpendicular thereto.

Abstract: A tibial milling guide which incorporates a combination of instruments for producing a planar surface on a portion of the tibia using a milling device. The system includes: an extramedullary alignment guide with a detachable reference guide, an adjustable milling base assembly, a detachable milling template, a sizing gauge, and a milling depth gauge. The reference guide is used to position the alignment guide to the tibia. The reference guide has a T-shaped member which provides a planar reference and a centering reference to the tibial head. The reference guide also allows the surgeon to set the rotational alignment before the alignment guide is secured in place. The adjustable milling base assembly is also detachably connected to the alignment guide. The milling base assembly includes a slide and a shiftable base that allows for lateral adjustments of the template with respect to the articular surface after the alignment guide has been properly secured to the tibia.

Abstract: A fusion cage for vertebral body fusion is conically-shaped. A thread is formed as part of the external conical surface of the fusion cage. Apertures are defined through the fusion cage in order to provide for contact between the engaged vertebral bone structures and bone growth inducing substances packed within the fusion cage. The fusion cage is introduced and maintains or increases the lordosis between adjacent vertebral bone structures.