Abstract: A fracture fixation plate system for use on a long bone having a metaphysis and a diaphysis, includes at least one end plate having a head portion for the metaphysis, and at least one diaphyseal plate having a first end and a second end with a plurality of screw holes therebetween. The end plate includes mating structure adapted to mate with and securely couple to at least one end of the at least one diaphyseal plate. The system preferably includes several end plates and diaphyseal plates to accommodate anatomy of various sizes. A method for coupling the plates to the bone is also provided.

Abstract: A flexible endoscopic clip applier includes a flexible coil with a manual actuator coupled to one end and a jaw assembly coupled to the other end. A store of clips is arranged adjacent to the jaw assembly and a clip pusher is arranged adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and the lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a distal portion. The threaded portion engages a threaded member near the pusher and is coupled to the pusher such that rotation of the threaded control member by the crank causes the pusher to be moved distally.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A pair of plate benders are provided for bending a bone plate. Each bender includes a lever arm having a first end and a second end. The first end includes a fulcrum for placement on the upper surface of the plate, and a foot insertable through the oblong screw hole to contact the lower surface of the plate. The second end includes a cut-out with a central divider. The cut-out has a length dimensioned to extend widthwise about the plate at the location of the oblong screw hole with the divider extending into the oblong screw hole for stability. The second end may also be provided with a deep slot that accommodates the thickness of the plate. In use, plate benders with such structure can be used in pairs to longitudinal bend the plate; bend the plate in plane; or twist the plate along its axis.

Abstract: A bone plate includes at least one torsional modification feature (TMF). Each TMF is structured to decrease the torsional rigidity of the plate relative to longitudinally opposite portions, but may be modified to increase the torsional rigidity thereat. Each TMF is defined by beams contiguous with the lateral sides of the plate, and an opening extending laterally therebetween. In a preferred embodiment, opposed projections extend into the opening to define threaded discontinuous wall portions for receiving an insert, such as a set screw. In one embodiment, bioabsorbable and/or bioactive inserts may be used to temporarily increase the torsional rigidity of the plate during initial fixation and thereafter have reduced torsional rigidity to mimic normal callus. The plate is preferably used with fixed angle fasteners that may be subject to high torsional loads post-operatively.

Abstract: A flexible endoscopic clip applier includes a flexible coil with a manual actuator coupled to one end and a jaw assembly coupled to the other end. A store of clips is arranged adjacent to the jaw assembly and a clip pusher is arranged adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and the lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a distal portion. The threaded portion engages a threaded member near the pusher and is coupled to the pusher such that rotation of the threaded control member by the crank causes the pusher to be moved distally.

Abstract: A surgical retractor includes a “swivel” having a string extending from one end and a string extending from the midpoint between the two ends. The swivel is delivered by pushing it out of a tube which is inserted through a small incision between the ribs of the patient. After the swivel is deployed, the tube is removed and the string which is attached to the center of the swivel is pulled to lift the pericardium. When the procedure is complete, the swivel is removed from the patient by pulling the string attached to the end of the swivel. According to one embodiment, the swivel is a cylinder with a blunt conical end. According to another embodiment, the swivel has a sharp end which is covered by a spring loaded collar.

Abstract: A fracture fixation plate system for use on a long bone having a metaphysis and a diaphysis, includes at least one end plate having a head portion for the metaphysis, and at least one diaphyseal plate having a first end and a second end with a plurality of screw holes therebetween. The end plate includes mating structure adapted to mate with and securely couple to at least one end of the at least one diaphyseal plate. The system preferably includes several end plates and diaphyseal plates to accommodate anatomy of various sizes.

Abstract: A surgical clip has a base portion and two generally parallel, spaced arms extending from the base portion and defining an opening therebetween. The arms terminate distally in fingers which are of reduced width and thickness relative to the arms and which are adapted to be bent towards and past each other. A transition section from each arm to the finger provides curved structures which extending away from each other and providing a wider mouth for the opening between the arms. The arms also have a proximal section with an undercut which helps in flexure of the arms. The base is an extended structure having a rounded proximal end with outwardly extending shoulders which are arranged to be engaged by the curved structures of the mouth of another clip.

Abstract: A low profile bone screw system includes a retainable washer and a low profile bone screw having a smooth conical head for insertion into the washer. The washer has an axial bore with a conical portion for fully seating the screw head and a smooth outer surface shaped like the head of a conventional compression bone screw head. Washer dispensing units are also provided.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A polyaxial locking screw system includes a bone plate defining a plate hole with an inner spherical surface and a relatively harder split polyaxial bushing with a outer spherical surface provided within the plate hole for receiving a bone screw. In one embodiment, the plate is formed from titanium alloy, while the bushing is formed from a cobalt chrome alloy. The outer surface of the polyaxial bushing includes a plurality of spikes. When the screw is inserted into the bushing, since the bushing material is considerably harder than the plate material, the forceful expansion of the bushing during screw insertion causes the spikes to penetrate into the inner spherical surface of the hole, thereby increasing the frictional engagement of the bushing to the plate to lock the screw at a desired angle.

Abstract: An improved surgical port device includes a port body with a tubular section having a distal end. A flexible flange is disposed at the distal end. A retention member is slidably mated along the tubular section such that a distance between the retention member and the flexible flange can be adjusted. In this manner, the position of the retention member with respect to the flexible flange is adjustably fixed to clamp portions of a body wall disposed therebetween, thus effectively clamping the port body in place. The flexible flange has an adaptable diameter that is reduced when the port body passes through a narrow opening in the body wall. Preferably, the flexible flange has a conically-shape that butts up against the inner surface of the body wall during use to thereby provide a seal between the body wall and the frusto-conical flange.

Abstract: A surgical retractor includes a “swivel” having a string extending from one end and a string extending from the midpoint between the two ends. The swivel is delivered by pushing it out of a tube which is inserted through a small incision between the ribs of the patient. After the swivel is deployed, the tube is removed and the string which is attached to the center of the swivel is pulled to lift the pericardium. When the procedure is complete, the swivel is removed from the patient by pulling the string attached to the end of the swivel. According to one embodiment, the swivel is a cylinder with a blunt conical end. According to another embodiment, the swivel has a sharp end which is covered by a spring loaded collar.

Abstract: A flexible endoscopic dip applier includes a flexible coil with a manual actuator coupled to one end and a jaw assembly coupled to the other end. A store of clips is arranged adjacent to the jaw assembly and a clip pusher is arranged adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and the lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a distal portion. The threaded portion engages a threaded member near the pusher and is coupled to the pusher such that rotation of the threaded control member by the crank causes the pusher to be moved distally.

Abstract: A surgical retractor includes a “swivel” having a string extending from one end and a string extending from the midpoint between the two ends. The swivel is delivered by pushing it out of a tube which is inserted through a small incision between the ribs of the patient. After the swivel is deployed, the tube is removed and the string which is attached to the center of the swivel is pulled to lift the pericardium. When the procedure is complete, the swivel is removed from the patient by pulling the string attached to the end of the swivel. According to one embodiment, the swivel is a cylinder with a blunt conical end. According to another embodiment, the swivel has a sharp end which is covered by a spring loaded collar.

Abstract: An endoscopic retractor includes a tube having a proximal end and a distal end with a push rod extending therethrough. The proximal ends of the push rod is provided with a threaded portion. A rotatable handle is coupled to the proximal end of the tube and threadably engages the threaded portion of the push rod such that rotation of the handle causes a translation of the push rod. The distal end of the tube is provided with a clevis through which the distal end of the push rod extends. A multi-segment canopy is coupled to the clevis and the push rod via an articulate linkage. Translation of the push rod in the distal direction causes the canopy to be moved from a starting substantially cylindrical configuration with its axis nearly collinear with the axis of the tube to an opened quasi-planar configuration. Further translation of the push rod in the distal direction causes the quasi-planar canopy to be rotated in the clevis to an angle of approximately ninety degrees relative to the axis of the tube.

Abstract: A bone plate clamp includes a C-shaped frame with opposing arms spaced apart about a bridge portion. One arm includes a threaded bore into which an adjustable clamping screw having a clamping end is inserted. The clamping screw defines a longitudinal drill guide. The opposite arm has a V-shaped surface oriented to support the bone at two points on the opposite side of the bone from the clamping end of the screw such that the bone clamp securely holds the bone and the bone plate together at three points. The bridge portion is structured to flex when the clamp applies a compressive force between the first and second arms. Flexing of the bridge applies a preload to the clamp which allows the clamp to function as a spring and maintain compression over a range of bone-plate dimensions. The bone plate clamp also includes a removable handle.