Abstract: A surgical implant for total wrist replacement (TWR) includes a carpal portion and a radial portion to fully encompass both sides of the articulated joint defining wrist movement. The carpal portion is defined by a unitary structure that defines a fused form of the scaphoid, lunate and triquetrum, and bears against the radial portion for permitting articulated motion. The radial portion replaces a distal portion of the natural radius adjacent the wrist, and has the form of a “T” to combine a bearing surface with a stem adapted for implantation in the natural radius. The stem engages a receptacle or bore formed in a truncated end of the natural radius. Both the radial portion and the carpal portion patient-specific members are formed from image scans of the patient's own skeletal structures, and incorporate inverted, contralateral images of healthy structure based on an assessment of deformation in the replaced joint.

Abstract: A prosthetic implant surface cap adapted for securement to an interface region of the prosthetic defined by articulating prosthetic implants. 3D printing or additive manufacturing is employed to form the surface cap adapted for securement to an identified interface region, in which the interface region is defined by engaging contact with adjacent skeletal structures in response to patient movement. The surface cap is disposed on the implant surface to contact the adjacent skeletal structures during articulated movement, and is adhered to the interface region of the prosthetic implant for absorbing and distributing the contact and frictional forces of the articulating skeletal members.

Abstract: A surgical implant for a proximal carpal row replacement surgery employs a scanned image of each of the scaphoid, lunate and triquetrum bones for generating a unitary, homogeneous model defining a fused shape for implantation as the proximal carpal row. The implant utilizes a contralateral image of healthy bones of the patient for generating the replacement model, and employs shrink-wrap and smoothing processing to generate the unitary replacement. The resulting implant replaces the intercalary bone structures of the scaphoid, lunate and triquetrum with a single appliance, and is slideably engaged with the distal carpal row via a surgical tunnel and tethered by a resectioned tendon, ligament, or other connective member. The implant facilitates wrist function since the unitary implant replaces skeletal structures that are encapsulated by adjacent bones and frequently move as a unit, while eliminating gaps, voids and ligaments between the intercalary structure.

Abstract: A guide tool having a through bore and at least one distal locating feature is provided. The distal locating feature of the guide tool is placed into a predetermined relationship with the plate. A fastener is engaged with a distal end of a driver shaft of a fastener driver. The fastener driver has a driver orientation means associated with the driver shaft. The fastener is inserted into the through bore of the guide tool with the fastener driver. The driver orientation means is mated with a guide orientation means located in the through bore of the guide tool. At least a portion of the fastener is inserted through the fastener hole. The fastener is secured into the bone through actuation of the fastener driver. The fastener driver is withdrawn from the guide tool, which is withdrawn from the plate.

Abstract: A body tissue fixation apparatus includes a plate having oppositely disposed outer and tissue-contacting surfaces, and at least one fixation hole extending between the outer and tissue-contacting surfaces along a longitudinal axis. The fixation hole is defined in part by an inner hole surface having at least one serration. At least one fixation device of the body tissue fixation apparatus has a shank and a head portion, the shank being insertable through the fixation hole in the plate to affix the plate to the body tissue member upon rotation of the head portion. At least one deformable member is connected to the head portion, the deformable member extending laterally in a direction substantially perpendicular to the longitudinal axis and being adapted to deflect to engage with at least one serration formed on the inner hole surface. A method for using the body tissue fixation apparatus is also described.