Abstract: A modular bone fixation implant can include a bone plate, a post insert, a staple, and a bone screw. The bone plate includes a post aperture extending through a first end, a screw aperture extending through a second end, and a staple aperture at an intermediate location. Expandable arms disposed radially about the post axis include outward-facing bone engaging features which are forced outward to anchor the bone plate within a bone when the post insert is inserted through the post aperture. The post insert can comprise a polymer penetrable by screws such that the interior body of the post insert can serve as an anchor point for bone screws inserted laterally from a variety of angles, forming a modularly customizable implant for the midfoot or other bones.

Abstract: Methods and apparatus are disclosed for excising a joint between first and second bones to define a resected joint, approximating the first and second bones to reduce the resected joint, and fixing the first and second bones relative to each other. The excising step can be performed using a cut guide that is movable from a first orientation to cut the first bone to a second orientation to cut the second bone. A compressor block can be driven over temporary fixation members that extends into the first and second bones to reduce the resected joint. A staple, along or in combination with other fixation elements, can then permanently fix the first bone to the second bone.

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 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: Bone plate and instrument systems include interconnections and locking mechanisms to fix the bone plates to the instruments, and guide features that aim k-wires, drills, and/or fasteners to pass through holes in the bone plates when the bone plates are fixed to the instruments. The locking mechanisms include elongated flexible elements that connect to the bons plates.

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 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: Bone plate and instrument systems include interconnections and locking mechanisms to fix the bone plates to the instruments, and guide features that aim k-wires, drills, and/or fasteners to pass through holes in the bone plates when the bone plates are fixed to the instruments. The locking mechanisms include elongated flexible elements that connect to the bone plates.

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: 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 system is provided for the approximation of two bones. The system may include an implant having a first anchor, a flexible segment, and a second anchor. The first anchor may be configured for insertion into a first bone. The second anchor may be configured to engage with a second bone. The flexible segment may extend between the first and second anchors. The system may include a delivery device which may include a removable driver configured to facilitate insertion of the first anchor into the first bone, and a first handle configured to engage the removeable driver. The delivery device may include a second handle configured to increase tension on the flexible segment. The delivery device may include a third handle configured to engage the second anchor with the second bone and to attach the flexible segment to the second anchor.

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 system is provided for the approximation of two bones. The system may include an implant having a first anchor, a flexible segment, and a second anchor. The first anchor may be configured for insertion into a first bone. The second anchor may be configured to engage with a second bone. The flexible segment may extend between the first and second anchors. The system may include a delivery device which may include a removable driver configured to facilitate insertion of the first anchor into the first bone, and a first handle configured to engage the removeable driver. The delivery device may include a second handle configured to increase tension on the flexible segment. The delivery device may include a third handle configured to engage the second anchor with the second bone and to attach the flexible segment to the second anchor.

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: A system is provided for the approximation of two bones. The system may include an implant having a first anchor, a flexible segment, and a second anchor. The first anchor may be configured for insertion into a first bone. The second anchor may be configured to engage with a second bone. The flexible segment may extend between the first and second anchors. The system may include a delivery device which may include a removable driver configured to facilitate insertion of the first anchor into the first bone, and a first handle configured to engage the removeable driver. The delivery device may include a second handle configured to increase tension on the flexible segment. The delivery device may include a third handle configured to engage the second anchor with the second bone and to attach the flexible segment to the second anchor.