Abstract: A safety penetrating instrument for establishing a portal in the wall of an anatomical cavity includes a housing, a distally-biased portal sleeve movable proximally during penetration from an extended rest position to a retracted position, a penetrating member disposed within the portal sleeve and movable relative thereto between an extended position where a distal end of the penetrating member protrudes from the portal sleeve distal end and a retracted position where the penetrating member distal end is proximally spaced from the portal sleeve distal end, a retracting mechanism for moving the penetrating member from the penetrating member extended position to the penetrating member retracted position, a locking mechanism for locking the penetrating member in the penetrating member extended position while permitting a predetermined amount of proximal movement of the penetrating member during penetration of the anatomical cavity wall, a penetrating member bias member for biasing the penetrating member distally

Abstract: The apparatus of the present invention includes a number of components including a guide body component, an extension block component, a rotating arm component, an extension rod component, and a tibial referencing component. The guide body component contacts the distal-most surface of the femur. Its location is based off of the posterior femoral condyles and the surface of the distal-most femoral resection or the unresected distal-most femoral surface. The rotating arm component is interconnected with the guide body and may rotate with respect thereto, thus allowing for the direct or indirect adjustment of the rotating alignment of cutting guides for resecting the distal femur. The rotating arm component carries arms with drill screw apertures which direct placement of drill holes in the femur which are used to attach a cutting guide to the femur.

Abstract: A bone clamp for insertion into a surgical incision perpendicular to a bone fracture has a ratchet mechanism. The bone clamp includes a scissor portion and a clamping portion. The scissor portion includes a pair of scissor arms, pivotally connected to one another, each having a finger loop at one end. Cooperating components of the ratchet mechanism are carried on each scissor arm, permitting a stepwise reduction in distance between the loops and between terminal ends of the scissor arms through the pivotal connection while preventing separation of the loops. The clamping portion includes a first elongated member pivotally connected at one of its ends to the terminal end of one of the scissor arms with a gripping point at another end. A second elongated member is pivotally connected to the terminal end of the other scissor arm. The first and second elongated members are slidably mounted to one another along their longitudinal axes.

Abstract: A safety penetrating instrument for penetrating an anatomical cavity wall to gain access to an anatomical cavity includes a penetrating member having a distal end for penetrating the anatomical cavity wall, a distally-biased safety member having a distal end movable between an extended position where the safety member distal end protrudes distally from the penetrating member distal end to protect the distal end of the penetrating member and a retracted position where the safety member distal end is disposed proximally of the penetrating member distal end to expose the penetrating member distal end, an extending mechanism for moving the safety member to the extended position and for permitting the safety member to move proximally toward the retracted position, a mechanism for manually moving the safety member proximally to the retracted position and a locking mechanism for locking the safety member in the retracted position to prevent movement of the safety member to the extended position during penetration of

Abstract: A system for spinal osteosynthesis is provided comprising a pedicle screw having a pedicle thread for introduction into the pedicle of a vertebra and a saddle thread adapted to receive a saddle member, a rod, at least one saddle member with a hole of a diameter substantially corresponding to the diameter of the saddle thread and a throat portion the axis of which is substantially perpendicular to the axis of the head and which includes a passage for the rod. A device secures the saddle member on the screw adapted to render the pedicle screw integral with the saddle member at the head thereof prior to application of mechanical effort for effecting spinal reduction. A part of the saddle thread is thereby left free. The rod is secured in the throat portion and is integral with the throat portion of the saddle member after application of mechanical effort for effecting spinal reduction.

Abstract: A surgical instrument for installing an implant in a living tissue. The instrument includes a frame including an installation channel that is adapted for receiving the implant and is adapted to be placed in connection with the tissue. The implant is inserted in the tissue when it exits the installation channel. The frame includes an installation end. Apparatus produces a reciprocating movement that is transmitted to the implant to produce a periodic movement in the implant. An installation member conveys an external installation force to the implant for installing the implant. The installation member is insertable in the installation channel.

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 tile tensioning tool is removed, and the free end of the cable is cut off at the abutment surface.

Abstract: A fastener, driving device, and method are provided for repairing a tear in soft tissue of a patient, a particular exemplary embodiment comprising a meniscal tear in a knee. The fastener has a variable-pitch helical protrusion along a central portion that decreases from the distal end to the proximal end, which can serve to bring two sides of the tear into apposition as the fastener is advanced across the two sides of the tear in a screwing motion. The fastener material preferably is a biodegradable, biocompatible, nontoxic plastic that is specifically designed to be biodegradable generally within the time span of the healing process. A delivery device for introducing the fastener is also provided that includes an elongated needle rotationally coupled with the fastener, the turning of which turns the fastener, advancing the fastener into the tissue.

Abstract: A method and apparatus useful in the reduction of a bone fracture is disclosed and relates to a guide rod inserted into a medullary canal of a bone. The guide rod includes a retention mechanism that holds the guide rod in place during the bone reduction procedure. The retention mechanism may include a finger member that contacts material within the bone to hold the guide rod in place.

Abstract: An awl suitable for both opening up a bone canal and for sizing that bone canal so as to obviate the use of a Charnley awl and the use of 4 to 5 distal reamers comprises (a) a tapered distal cutting head having a pointed first end, and a second end; and (b) a shaft attached to the second end, such that the shaft has a multiplicity of grooves calibrated so as to indicate the diameter of the isthmus of the bone canal. Also provided is a method of opening up a bone canal and of measuring the diameter of the isthmus of the bone canal with a single instrument.

Abstract: A femoral intramedullary rod has a thin or reduced proximal segment so as to provide room for the use of femoral hip screws. Use of the rod for femoral shaft fixation permits subsequent independent treatment of an ipsilateral femoral hip fracture as an isolated injury, regardless of whether initially detected. Different rod embodiments are formed by the omission of different proximal portions of the rod. It is in such portions that the femoral screws may be placed to set hip fractures. The rod is cannulated for installation over a guide wire. Internal rod threads, below the thin proximal segment in some embodiments, are used for initial installation of the rod with a driving member screwed into such threads. Without driving forces on the thin proximal segment, such segment can be made even thinner. Once the rod is seated, hip screws may be installed if there is a detected hip fracture. Subsequent to healing, the femoral screws and interlocking screws (if any) may be removed.

Abstract: A disposable external fixator includes a rod and pins insertable therethrough and insertable into a fractured bone for fixation. The rod includes equidistantly spaced and aligned bores and ends provided with threads. The diameter of the bores is larger than the diameter of the pins. The fixator also includes two stretching tubes of relatively soft material slidably mountable onto the ends of the rod and having bores corresponding to the bores of the rod. Internally threaded closing pieces are screwable onto the threaded ends of the rod to axially displace the stretching tubes relative to the rod.

Abstract: A polyaxial orthopedic device for use with rod implant apparatus includes a screw having a curvate head and a generally hollow coupling element. The coupling element includes an interior axial passage having an interior surface which is inwardly curvate at the lower portion thereof such that it comprises a socket for polyaxially retaining the curvate head of the screw. The coupling element further includes a pair of vertically oriented opposing channels extending down from the top of the coupling element, which define therebetween a rod receiving locus. The channel further divides the walls of the upper portion into a pair of upwardly extending members, each including an exterior threading disposed on the upper most portion for receiving a locking nut. During implantation of the assembly, the locking nut seats against the top of the rod, which in turn seats on the top of the screw head.

Abstract: An intercondylar notch cutter using a plunge milling bit and bit guide which engages parallel tracks in a trial prosthesis. The intercondylar notch cutter comprises a cutting bit and a guide sleeve. The cutting bit can be thrust into the femur and then translated through the femur cutting a notch without removing the trial prosthesis. The bit is supported by a guide or housing with a guide platform which extends medially and laterally from the guide. Two condyle articulating surfaces on the platform slidingly engage a condyle surface on a trial prosthesis. Along the condyle surfaces on the trial prosthesis are two parallel grooves. Posts on the notch cutter are slidingly received within the grooves. A surgeon first places the trial implant on the femur without cutting an intercondylar notch. The surgeon can proceed immediately to cut an intercondyle notch without removing the femoral trial prosthesis.

Abstract: A modular surgical drill in the form of a rigid drill shaft and a drill bit which are connected together at the rear end of the drill bit and the forward end of the drill shaft by a tongue-and-groove arrangement. Each of the shaft and drill bit are provided with through bores extending centrally through their entire length. These bores become aligned upon assembly of the drill bit and shaft. The modular drill is intended to be employed with a guidewire for drilling holes into bone. The assembled drill bit and shaft are placed on the guidewire and moved down such guidewire into contact with the bone, whereupon a tunnel may be formed into the bone by rotating and advancing the drill bit along the guidewire. The dimensions of the bore and guidewire are so selected as to prevent the drill bit and drill shaft from moving relative to one another once they are assembled and mounted upon the guidewire.

Abstract: An apparatus and method for tightening and crimping a surgical wire used for orthopedic purposes. The apparatus of this invention includes a pair of operating handles which are biased apart and which operate a pair of opposed jaws to which they are connected. Disposed on opposite sides of the operating handles are a pair of capstans. The jaws are adapted to hold a crimp member therein without deforming it while opposite ends of a length of wire are passed through the crimping member in opposite directions. Each end of the wire is wrapped about an associated capstan. A ratchet handle simultaneously rotates both capstans to wrap the opposite ends of the wire. Once the desired traction force has been achieved, the jaws are further activated to crimp the crimp member. A ring-shaped crimp member is also disclosed which has a central opening extending along the axis thereof and two parallel channels, one channel being disposed on either side of the central opening.

Abstract: An occipital clamp assembly. The occipital clamp assembly comprises a lower occipital plate for attachment to the skull of a patient, wherein the lower occipital plate includes grooves in its upper surface. An occipital plate stud mounted in the lower occipital plate and upper occipital plates, having a groove in each of their lower surfaces, mounted on the occipital plate stud wherein the grooves of the lower occipital plate mate with the grooves of the upper occipital plates to thereby form rod receiving apertures. Also provided is means for securing the upper occipital plate to the occipital plate stud and means for securing the lower occipital plate to the skull.

Abstract: The hook (32) comprises a body (33) and a laminar portion (37) which is suitably profiled and adapted to penetrate a foramen opening at the base of the occiput against which it bears. The body is arranged to receive an osteosynthesis rod or plate and has a plane of symmetry (P). The laminar portion (37) has a curvature adapted to the thickness of the occipito-cervical shell and is inclined relative to one side or the other of the plane of symmetry (P) so as to be adaptable to the anatomy of the edge of the occiput in the region of the foramen. This inclination may be for example substantially 45.degree.. This asymmetry of the laminar portion (37) relative to the body (33) of the hook (32) enables the surgeon to avoid having to previously remove a piece of the edge of the occiput of the patient and consequently damage the occiput.

Abstract: An apparatus for lengthening bones is disclosed including a plurality of frame elements (12) spaced apart from one another. The frame elements are U-shaped for at least partially enclosing the bone, and two elements may be connected to fully enclose the bone. Fixation elements (14) that transfix the bone approximately perpendicular to its long direction are secured to the frame elements. Telescopically extendable tensioning elements (16) connect the frame elements together and fix them in position relative to one another. The frame elements (12) include a plurality of rows (18, 18') of longitudinal slots (20, 20', 20"). The tensioning elements (16) are clamped to the frame elements at aligned slots and the fixation elements (14) are similarly clamped to the appropriate slots in the corresponding frame elements. The tensioning elements include three threaded sections with a first section including a spindle and sleeve with a second and third threaded section threaded into the first section.

Abstract: A replicator is provided for precisely resecting bone into a desired shape of a pattern. A pattern holder and a bone holder are spaced apart from each other, and rotatably mounted to a cylindrical shaft for indexing through corresponding predetermined angular increments about two parallel axes, which are perpendicular to an axis of the cylindrical shaft. A linkage means connects a probe and cutting tool to a frame for allowing free movement of the probe and cutting tool with respect to the frame, in three dimensions, while maintaining end tips of the probe and cutting tool parallel to the axis of the shaft. The probe and cutting tool are moved to trace the tip of the probe over an exterior surface of the pattern while operating the cutting tool to cut contours of the pattern into the bone. The pattern and bone holders may be rotated with the cylindrical shaft about the axis of the cylindrical shaft.