Abstract: A surgical system and procedure are provided for correcting a deformity between first and second bones using an alignment guide based on a correction factor. The alignment guide is used to insert one or more k-wires into each of the first and second bones in a deformed configuration. A correction guide is passed along the k-wires to rotate and/or translate the first bone relative to the second bone into the corrected configuration. An auxiliary correction guide can be passed along the k-wires to further rotate and/or translate the first bone relative to the second bone from the corrected configuration to an adjusted configuration.

Abstract: A bone plate system may include a bone plate having a bone-facing side, an obverse side displaced from the bone-facing side by a thickness of the bone plate, a first end, and second end displaced from the first end along a longitudinal length of the bone plate. The bone plate may have a first fastener hole extending through the bone plate between the bone-facing side and the obverse side, a second fastener hole extending through the bone plate between the bone-facing side and the obverse side, and a plug extending outwardly from the bone-facing side. The plug may have a cross-sectional shape, perpendicular to the thickness, that is elongated along the longitudinal length.

Abstract: A system for providing fixation of first and second bones includes a drill guide that receives a drill bit to create first and second holes in the first and second bones, respectively. Guide pins can be driven into the first and second holes. The guide pins are received by a surgical saw to guide the surgical saw toward a joint between the first and second bones, thereby creating a third hole in each of the bones across the joint. The guide pins are then removed, and an implant can be inserted into the bones, such that a first leg of the implant is disposed in the first hole, a second leg of the implant is disposed in the second hole, and a keel of the implant is disposed in the third hole.

Abstract: An improved surgical system and procedure for correcting a deformity between first and second bones using an alignment guide based on a correction factor. The correction factor can be based on a virtual model of the first and second bones in a deformed configuration and a corrected configuration. In the virtual corrected configuration, first and second virtual axes can be fixed in the respective first and second bones. When reverted to the virtual deformed configuration, the orientation of the first and second axes can be used to determine the correction factor. The alignment guide is used to insert one or more k-wires into each of the first and second bones in a deformed configuration. A correction guide is passed along the k-wires to rotate and/or translate the first bone relative to the second bone into the corrected configuration.

Abstract: Apparatus and methods are disclosed for correcting deformities in a patient's foot. In one example, a metatarsus adductus is addressed using a pin placement guide that is angulated to be placed in alignment with a cuneiform and a metatarsal, such that the TMT joint can be subsequently cut, and the metatarsal moved into proper alignment. Th pin placement guide can be a variable angle guide, or a kit of fixed-angle pin placement guides can be provided.

Abstract: A surgical tool and related methods are provided for removal of a bone sliver from a resected joint. The tool can include a housing including an upper end, a lower end, and a channel extending from the upper end to the lower end. A paddle member extends from the lower end of the housing. The paddle member includes a paddle shaft and a paddle head. The surgical tool further includes an insertion member that has a handle end, an extension that extends from the handle end, and a cutting tip. The extension is translatable within the channel such that the handle end and the cutting tip can move relative to the housing between a retracted position and an advanced position.

Abstract: An improved surgical system and procedure for correcting a deformity between first and second bones using an alignment guide based on a correction factor. The correction factor can be based on a virtual model of the first and second bones in a deformed configuration and a corrected configuration. In the virtual corrected configuration, first and second virtual axes can be fixed in the respective first and second bones. When reverted to the virtual deformed configuration, the orientation of the first and second axes can be used to determine the correction factor. The alignment guide is used to insert one or more k-wires into each of the first and second bones in a deformed configuration. A correction guide is passed along the k-wires to rotate and/or translate the first bone relative to the second bone into the corrected configuration.

Abstract: A minimally invasive method of correcting a bunion includes performing an osteotomy to divide the metatarsal into first and second portions, creating a pocket in the first portion implanting a nail in the pocket, securing a suture to the joint capsule, tensioning the suture to align the great toe with the metatarsal, attaching the suture to the nail, and fastening the nail to the second portion. The nail includes an anchor portion for anchoring in the first portion, a head for attachment to a second portion, a passage for attachment of the suture, a first aperture for a fastener to attach the head with the first portion, and a second aperture for a fastener to attach the head with the second portion.

Abstract: A knotless suture anchor system is disclosed for improved anchoring in tissue. The knotless suture anchor system includes an anchor body having an exterior surface, a proximal end, a distal end, a longitudinal axis extending between the proximal and distal ends, an interior longitudinal passageway extending at least partway from the proximal end toward the distal end, a proximal opening communicating with the longitudinal passageway nearer the proximal end, and a distal opening communicating with the longitudinal passageway nearer the distal end. The knotless suture anchor system also includes an interference member insertable distally into the longitudinal passageway to secure a portion of a suture within the longitudinal passageway by compressing the portion of the suture between the interference member and the anchor body, and a frangible connection that joins a proximal member to the anchor body.

Abstract: The disclosure provides apparatus and methods of use pertaining to syndesmosis reinforcement. Embodiments include a clamp having two jaws that extend toward each other to clamp two bone portions therebetween. The clamp may include an angle gauge and an adjustment mechanism having a force gauge that combine to enable the compression of the two bone portions in an optimal direction or angle and at an optimal, measurable compression force. Embodiments also include a tension instrument configured to knotlessly lock a flexible strand construct between two anchors at the same optimal direction and tension applied by the clamp. Further embodiments include an exemplary syndesmosis reinforcement procedure that employs the clamp and the tension instrument to construct a ligament reinforcement construct that achieves optimal anatomic positioning in both directional alignment and the reduction force applied by the construct. Other embodiments are disclosed.

Abstract: The disclosure provides devices and methods of use pertaining to extra joint stabilization. Embodiments include a number of suture returning and locking anchors that feature both a suture return element and a suture locking feature that employs an interference fit between a flexible synthetic strand, a receiver of the anchor, and a set screw, where the receiver and the set screw each have a number of gradual, opposing tapers to facilitate gradual proximal-to-distal gripping and releasing of the flexible strand to achieve an optimal locking force while preventing severing of the flexible strand. Embodiments also include a counter-torque anchor driver configured to resist torsional forces generated during and translated to the anchor during set-screw insertion. Further embodiments include extra joint reinforcement, stabilization, and attachment constructs formed using the disclosed devices. Other embodiments are disclosed.

Abstract: A bone fixation system can be used to stabilize two bone portions intended to be fused together. The system include a bone staple or clip that includes a cross bar and two legs. The system can include a plurality of screws or other additional implant(s) configured to be implanted at an angle to the legs of the bone staple on opposite sides of the interface between two bone portions. The system can improve fixation strength and/or stability of the two bone portions. The fixation system can be used, for example, in small bones such as bones in the foot or hand.

Abstract: A bone plate assembly may include a bone plate with an obverse side, a reverse side, a fastener hole formed through the bone plate from the obverse side to the reverse side, a first draw hole formed through the bone plate from the obverse side to the reverse side, with a wire engagement surface, a fastener insertable through the fastener hole and into tissue, and a first wire insertable into the first draw hole, with a distal end anchorable in the tissue and a proximal end with a retention portion that is retainable in the first draw hole. The wire engagement surface may be oriented obliquely relative to a pilot hole formed in the tissue to receive the wire such that motion of the first wire through the first draw hole exerts a compressive force against the tissue.

Abstract: The disclosure provides apparatus and methods of use pertaining to a multiple suture threader. Embodiments of the multiple suture threader include a handle that is coupled with a first collapsible loop and a second collapsible loop that is axially offset from the first collapsible loop. In use, one or more sutures are doubled over each of the first and the second collapsible loops such that when the axially spaced loops are passed through a narrow axial passage of a surgical implant, a surgical instrument, or a bodily passage such as a bone tunnel, a twenty-five to fifty percent reduction in suture traffic, or in the maximum number of suture thicknesses that simultaneously pass through the narrow passage, is achieved. Other embodiments are disclosed.

Abstract: A modular bone fixation implant includes a center post having exterior bone engaging features and configured to be implanted within a bone. The center post includes an aperture at an outer end of the center post. One or more interchangeable modular components may be placed within the bone and anchored to the aperture of the center post. Interchangeable modular components may include staples, bone plates, and spacers, each having at least a first end including a post engaging arm sized and shaped to seat within an interlocking feature of the aperture. A locking screw is provided to anchor all components to the center post when the interchangeable modular components have been placed.

Abstract: A minimally invasive method of correcting a bunion includes performing an osteotomy to divide the metatarsal into first and second portions, implanting a nail in the first portion, securing a suture to the joint capsule, tensioning the suture to align the great toe with the metatarsal, attaching the suture to the nail, and fastening the nail to the second portion. A first guide block includes a plurality of coplanar passages to guide an instrument to create one or more holes in the metatarsal in advance of the osteotomy, and a second guide block includes a guide slot for another instrument to complete the osteotomy. The method can be performed through an incision of 0.5 inches or less. The nail includes an anchor portion for anchoring in the first portion, a head for attachment to a second portion, and can include a passage for attachment of the suture.

Abstract: An assembly used in osteosynthesis comprising a delivery instrument in combination with an implant wherein the delivery instrument releasably holds the implant in a first configuration prior to attachment of the implant to bone. The delivery instrument allows the implant to be affixed to bone before the implant is released from the instrument. And the instrument may comprise guide means for drills, depth gauges, screws, pins, pegs, blades and or drivers which are used or implanted when the implant is releasably attached to the instrument. After the implant is affixed to bone and released from the delivery instrument, the implant assumes at least a second configuration which provides compression and or distraction and or control of spatial orientation.

Abstract: Methods and devices for performing an osteotomy on a bone are presented. In one example of the invention, a method of performing an osteotomy on a bone includes removing a portion of bone from a first side of the bone to create a gap on the first side of the bone; making a cut on a second side of the bone, opposite the first side; and rotating the bone from a first position to a second position to close the gap on the first side of the bone and open the cut on the second side of the bone to create a gap on the second side of the bone.