Abstract: The present invention, in one embodiment, includes a method of assembling a filamentary fixation device including obtaining a filamentary sleeve having a pathway therethrough, and a loading member and retriever member each positioned through at least a portion of the pathway, engaging a working suture with the retriever member, positioning at least a portion of the working suture in the pathway using the retriever member, and engaging the working suture with the loading member.

Abstract: Novel stay suture devices and stay suture combinations with meshes are disclosed. The stay suture devices have a clip and a suture. The clip has leg members that are mounted to a hernia mesh implant such that the leg members are locked in a closed configuration. Also disclosed are novel methods of mounting stay sutures to a surgical mesh implant and repairing a body wall defect such as a hernia defect.

Abstract: The disclosure provides examples of an open architecture anchor for securing soft tissue to bone, for example, to repair a torn rotor cuff. The anchor includes at least one open helical coil defining a polygonal internal volume and at least one rib disposed within the polygonal internal volume and connected to at least two turns of the at least one open helical coil. The at least one rib is sized to engage a driver and a combination of the at least one rib and the polygonal internal volume is sized to provide an anchor drive torque required to drive the anchor into bone.

Abstract: A device for reducing the volume of a hollow body organ includes a tissue port and a plurality of fasteners. The fasteners may be coupled to a flexible filament, such as a suture, which is tensioned to constrict the hollow body organ to achieve volume reduction.

Abstract: A needle cartridge is adapted to be attached to a receiver on a surgical suturing device. The cartridge comprises an arced needle having a leading end, a trailing end, and a length of suture. A body has a track receiving the needle and defining a circular path. A needle driver is operable to rotate the needle along the circular path. A cover captures the needle in the track. A cage engages and retains the needle cover against the body. The cage may slide relative the body to disengage with a portion of the cover allowing the cover to deflect and release the needle from the track.

Abstract: A suture cinch, cinch applicator, and cinch loader for loading the cinch into the cinch applicator are provided and permit re-use of the applicator with multiple cinches during an endoscopic procedure. The applicator can be loaded with a first cinch, apply the first cinch onto a portion of suture to fix the portion of suture relative to anatomical tissue, reloaded with a second cinch optionally using the loader, and subsequently used to apply the second cinch to fix another portion of suture to fix the other portion of suture relative to anatomical tissue. The cinch is a tubular member through which the suture can be advanced when the cinch is loaded within the applicator. The cinch defines multiple ribs and cutter defined in a wall thereof. Operation of the applicator deforms the ribs inward to retain the cinch on the suture, and displaces the cutter to sever the suture.

Abstract: Barbed medical devices include a crown interconnecting a pair of legs and at least one barb extending from each of the legs. The at least one barb may define an inner surface with a first portion disposed at a first orientation relative to a longitudinal axis of the leg, a second portion disposed at a second orientation relative to the longitudinal axis, and optionally, a third portion disposed at a third orientation relative to the longitudinal axis of the leg.

Abstract: An absorbable screw fastener and a method of firing with an applicator capable of applying a surgical fastener to tissue in order to form tissue connection to secure objects to tissue, the fastener including a body portion having a helical thread, a head portion disposed at the proximal end of the body portion. The head portion includes a driver receiving configuration on its outer surface. The screw fastener further includes a cannulated center lumen with an opening extending from the head portion through the longitudinal length of the body portion.

Abstract: An anvil-attachable layer and a retainer for aligning and attaching the layer to an anvil of a surgical stapler. Embodiments of the anvil-attachable layer can include one or more attachment features extending from the layer. A retainer can push the attachment features into a knife slot in the anvil so that the fit between the attachment features and the slot hold the anvil-attachable layer in place. Other embodiments of the anvil-attachable layer can include deployable attachment features formed in the layer. The deployable attachment features can be deployed from an undeployed position substantially in a plane defined by the layer to a deployed position extending out of the plane. In the deployed position, the deployable attachment features can extend into a slot in an anvil. A retainer can include features to push the deployable attachment features into the deployed position.

Abstract: Devices and methods are provided for stabilizing fasteners post-deployment. Devices and methods are also provided for facilitating ejection of surgical fasteners from a cartridge. Devices and methods are also provided for guiding surgical fasteners. Devices and methods are also provided for facilitating closing and clamping of an end effector of a surgical device. Devices and methods are also provided for securing fasteners and adjunct materials to tissue. Devices and methods are also provided for removably coupling a cartridge to an end effector of a surgical device. Devices and methods are also provided for locking a surgical device based on loading of a fastener cartridge in the surgical device. Devices and methods are provided for adjusting a tissue gap of an end effector of a surgical device. Devices and methods are also provided for manually retracting a drive shaft, drive beam, and associated components.

Abstract: A surgical instrument includes an end effector with a first jaw and a second jaw. The instrument also includes a first drive assembly, a first motor coupled to the first drive assembly, a second drive assembly, a second motor coupled to the second drive assembly, a control module, and a closure trigger. The first motor is operable to motivate the first drive assembly, and the second motor is operable to motivate the second drive assembly. The control module is operably couplable to the first motor and the second motor. The closure trigger is movable during a closure stroke to transition the end effector to the approximated configuration, and to transition the control module from operable engagement with the first motor to operable engagement with the second motor.

Abstract: In some aspects, a surgical procedure for the removal of a prostate gland is provided. The procedure comprises: (a) positioning an implant material within the urethra, (b) removing the prostate, thereby cresting a urethral stump and a bladder neck, wherein the implant material occupies the urethral stump, the bladder neck, or both, and (c) securing the bladder neck to the urethral stump in an anastomosis procedure to establish a path of urine flow from the bladder to an external urethral opening (e.g., the meatus). Subsequently, the implant material is removed from the urethra, for example, by natural urine voiding or by flowing a removal fluid through and/or around the implant material in the urethra. In other aspects, a medical kit is provided.

Abstract: Systems and methods for fastening tissue include a hollow element and an elongate insertion element. The insertion element has a delivery device including a cone, suture, and needle at a delivery end, and an anchor at an opposite end. The hollow element includes an engagement structure in its interior surface that permits movement of the insertion element through the hollow element in a first direction, and prevents movement of the insertion element through the hollow element in a second direction opposite the first direction. The engagement structure may include a braid or mesh that operates on a finger-trap principle. The hollow element may include an elongate element with a cone, suture, and needle at a delivery end, and an anchor at an opposite end. Alternatively, the hollow element may include a button that incorporates the braid or mesh.

Abstract: An occluding device apparatus includes an embolization coil with a distal end and a proximal end with an opening and an attacher that is threaded through the opening at the proximal end of the embolization coil. The apparatus further comprises a delivery kit for delivery of the embolization coil in a body cavity. The kit comprises a guide catheter for percutaneous introduction of the embolization coil and an inner catheter slidably disposed within the guide catheter during insertion. The inner catheter comprises a proximal end and a distal end. The inner catheter further includes a hub disposed adjacent the proximal end. The kit further comprises a guide wire slidably disposed within the inner catheter. The guide wire provides a path during insertion thereof within a body cavity. The kit further comprises a pushwire to advance the embolization coil through the inner catheter.

Abstract: An intracorporeal space filling device and a delivery system and method for using the device is disclosed. The space filling device is preferably configured for percutaneous delivery from a peripheral conduit of a patient. The space filling device has an elongated tubular or interconnected bead structure which may have a transmutable material disposed within it. The transmutable material can be altered from a non-rigid state to a rigid state by the application of various types of energy or by other suitable means. The space filling device can be positioned by a delivery system and detached from the delivery system after desired positioning is achieved.

Abstract: An implantable medical device includes a support structure which is twistable in a longitudinal direction of the device. A sleeve of filter or occluding material is attached to the ends of the structure. The structure in practice twists on itself in the longitudinal direction, causing the sleeve to twist on itself and as a result to close the lumen through the sleeve. The device provides reliable closure and as a result occlusion of a vessel. It is also able to be delivered over a guide wire. In another embodiment, the support structure includes a wire which coils around the sleeve to constrict the sleeve and as a result to close a lumen of the sleeve.

Abstract: A clip for leaflet tissue includes a substantially cylindrical hollow body having a proximal end and a distal end. In an initial configuration of the clip, the distal end has a diameter that is smaller than the diameter of the hollow body. The distal end is held in an expanded condition for delivery into a patient. When deployed, the distal end collapses to its initial configuration to grasp onto captured leaflet tissue.

Abstract: A bone access instrument comprising a shaft having a first shaft portion and a second shaft portion. The first shaft portion has a first diameter, a proximal end, a tapered distal end including at least three straight cutting edges being equally spaced circumferentially about the tapered distal end, and at least three flutes extending from the tapered distal end toward the proximal end in a parallel relationship to one another. The second shaft portion has a second diameter and a tapered distal end. The second diameter is less than the first diameter, and the second shaft portion extends axially from the distal end of the first shaft portion.

Abstract: A system and method for attaching tissue to bone are provided. In one embodiment, a system for attaching tissue to bone includes a suture, suture anchor, inserter tool, drill, and drill guide having an outer guide and an inner guide. A method for attaching tissue to bone includes attaching a suture to tissue, nesting the suture in a notch on the distal end of the outer guide, passing the suture through a lumen formed in the outer guide, and inserting an inner guide in a lumen formed in the outer guide. The drill guide protects the suture from rotational movement of the drill and allows a user to maintain alignment between the drill guide and the drilled hole. As a result, a suture anchor can be more easily positioned within the drilled hole.

Abstract: Disclosed herein are unicompartmental femoral and tibial arthroplasty jigs for respectively assisting in the performance of unicompartmental femoral and tibial arthroplasty procedures on femoral and tibial arthroplasty target regions. The femoral and tibial unicompartmental arthroplasty jigs each include a first side, a second side and a mating surface. Each second side is generally opposite its respective first side. For the femoral jig, the mating surface is in the first side of the femoral jig and configured to matingly receive and contact a generally planar area of an anterior side of a femoral shaft generally proximal of the patellar facet border and generally distal an articularis genu. The first side of the femoral jig is configured to be oriented towards the femoral arthroplasty target region surface when the mating surface of the femoral jig matingly receives and contacts the planar area.

Abstract: Disclosed herein are unicompartmental femoral and tibial arthroplasty jigs for respectively assisting in the performance of unicompartmental femoral and tibial arthroplasty procedures on femoral and tibial arthroplasty target regions. The jigs each include a mating surface. The mating surface of the femoral jig is configured to matingly receive and contact a generally planar area of an anterior side of a femoral shaft generally proximal of the patellar facet border and generally distal an articularis genu. The mating surface of the tibial jig is configured to matingly receive and contact a generally planar area of an anterior side of a tibial shaft distal of the tibial plateau edge and generally proximal of the tibial tuberosity.

Abstract: A medical manipulator includes a trigger lever operated by hands, a shaft that extends from a body in which the trigger lever is provided, and a tip operating unit that is provided at a tip of the shaft. The tip operating unit includes an end effector to which the operation of the trigger lever is mechanically transmitted and in which the operation is performed, and a detection mechanism that detects an operation state of the first input unit.

Abstract: A laparoscopic forceps comprising a handpiece including a distal end portion; a tubular member protruding from the distal end portion of the handpiece, the tubular member having a distal end, a pair of jaws having legs that are disposed within the tubular member and partially protruding from the distal end of the tubular member, the pair of jaws and the tubular member being movable relative to each other in a direction parallel to a longitudinal axis of the tubular member; wherein each of the pair of jaws has an arcuate section, and the pair of jaws are closable by advancing the tubular member over the arcuate section of the jaws; and an operable mechanism for creating relative motion between the pair of jaws and the tubular member along a direction parallel to the axis of the tubular member, wherein at the distal end portion of the tubular member there is a profile shape that is non-circular.

Abstract: Disclosed herein are tissue-removal devices and methods for treating spinal diseases using such devices. The tissue-removal devices may comprise a cable and/or extendable elements with a retracted and a deployed configuration. The cable and/or extendable elements may be distally supported and restrained by a support element such that the support element may be pushed transversely away when the extendable element is distally extended into its deployed configuration. An annular cutting element may be provided about the distal end of the extendable element or the support element. Various configurations of the extendable and support elements are described herein, as well as methods of using tissue-removal devices with extendable and support elements coupled by an annular cutting element for treating spinal diseases.

Abstract: An aspiration control device may include a conduit having a distal end and a proximal end and defining a conduit lumen, wherein the conduit defines a vent that is open to the conduit lumen, a coupling configured to couple the proximal end of the conduit with a vacuum source and an inner cannula such that a vacuum is supplied to each of the conduit lumen and the inner cannula, a sleeve movably disposed about the conduit and configured to move relative to the vent to achieve a desired level of vacuum delivered to the inner cannula.

Abstract: An apparatus comprises an end effector, a body assembly, a power source, and a control module. The end effector is operable for use in a surgical procedure and can deliver energy to a surgical site. The end effector comprises at least one sensor. The sensor is able to measure at least one physical characteristic associated with the surgical site. The body assembly is in communication with the end effector. The power source is in communication with the body assembly and is operable to deliver power to the end effector. The control module is in communication with the sensor and is operable to change delivery of power to the end effector based on data from the sensor indicating a change in tissue density.

Abstract: An ultrasonic surgical tool comprises a substantially planar blade body having a pair of opposed lateral surfaces and a cutting edge. A shank integral on a distal side with the blade body is provided at a proximal side with a connector for operatively linking the blade to a source of ultrasonic mechanical vibrations. The blade body is provided in at least one of the lateral surfaces with a shallow recess which is nearly coextensive with that lateral surface. The blade body has a raised rim surrounding and defining the recess, the rim being narrow on the three sides between the recess and the cutting edge.

Abstract: This document describes rotational atherectomy devices and systems for removing or reducing stenotic lesions in blood vessels by rotating an abrasive element within the vessel to partially or completely remove the stenotic lesion material.

Abstract: A method of removing material from a blood flow lumen includes providing a device having a cutting element and an opening, the cutting element being movable relative to the opening. The method then includes advancing the device through a patient's vascular system to the blood flow lumen. Finally, the method involves moving the cutting element and the opening relative to the blood flow lumen so that a continuous piece of material is severed by the cutting element and directed into the opening as the cutting element and opening move through the blood flow lumen, the continuous piece of severed material being directed into the device for removal from the patient. The method may include providing a device having a rotatable cutter that, in some embodiments, is not parallel to the longitudinal axis of the device, is movable, has retracted and deployed positions, or any combination thereof.

Abstract: Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

Abstract: An access system is provided for establishing an access path to a surgical site within a patient. The access system comprises an access portal defining a working channel with a central axis, and an adaptor with a mating section mountable to the access portal. The adaptor is selectively rotatable about the central axis. The access portal includes a plurality of openings and the adaptor includes a plurality of projections, each of the projections and openings being arranged so that, in a first orientation, the openings and projections align to allow mounting of the adaptor to the access portal and, in a second orientation, the openings and projections do not align to prevent disassociation between the adaptor and the access portal. The adaptor also includes a holder for a viewing device, the viewing device being movable with the adaptor about the access portal and vertically translatable relative to the access portal.

Abstract: A surgical system comprising a cannula assembly and an obturator assembly for penetrating tissue is disclosed. A cover of the cannula assembly is mounted to a cannula housing and has a cover aperture therethrough. The cover has a trailing end face defining a predetermined geometrical configuration, at least a portion of the trailing end face is obliquely arranged relative to a longitudinal axis and terminates in, and leads toward the cover aperture to facilitate guiding of the surgical object through the cover aperture. The obturator assembly includes an obturator housing and an obturator member. The obturator housing has a housing base defining a leading end face, which defines a predetermined geometrical configuration corresponding to the predetermined geometrical configuration of the trailing end face of the cover to mate therewith upon assembly of the obturator assembly with the cannula assembly.

Abstract: Apparatus and methods are described, including apparatus for puncturing a fossa ovalis of a heart. The apparatus includes a catheter shaped to define a catheter lumen. A puncturing element is slidably disposed within the catheter lumen, and is deployed from a distal portion of the catheter and to puncture the fossa ovalis. A probing element is deployed from the distal portion of the catheter. Upon being deployed, the probing element probes tissue near the fossa ovalis, the probing element having a first configuration thereof upon probing the tissue near the fossa ovalis. Upon probing tissue of the fossa ovalis, the probing element facilitates positioning of the puncturing element, by automatically adopting a second configuration thereof that is different from the first configuration. Other applications are also described.

Abstract: A method of adjusting a uterine manipulator includes moving a colpotomizer cup of the uterine manipulator along a curved shaft of the uterine manipulator in a manner such that a distal face of the colpotomizer cup remains centered on an arch centerline of the curved shaft and an axial centerline of the colpotomizer cup remains offset from the arch centerline of the curved shaft at an opening of the colpotomizer cup that is spaced proximally from the distal face of the colpotomizer cup.

Abstract: A pedicure assembly includes a housing that has a handle portion and a motor portion. A buffing unit is attached to the housing and the buffing unit abrasively removes calluses. The buffing unit comprises a drive and a head. An abrasive pad is attached to the head and the abrasive pad may be positioned to abut the callus thereby facilitating the abrasive pad to abrade and eliminate the callus.

Abstract: The present application discloses embodiments related to an external bone fixation device configured to correct bone deformities or repair bone injuries. The device can include a plurality of bases configured to be attached to portions of a bone and a plurality of struts configured to be adjustable in length to change the position and orientation of the plurality of bases and the attached bone portions.

Abstract: Sacral fixation implants can include first and second implant segments. One of the first and second implant segments is received in the other of the first and second implant segments, and the first and segments can be fixed with respect to movement toward and away from each other, thereby stabilizing a sacral fracture.

Abstract: The present invention relates to stable fixation of spine segments, allowing for fusion in, e.g., skeletally mature patients. More particularly, the invention relates to a bone fixation device that can be affixed to vertebrae of a spine to provide reduction (or enlargement) capabilities and allow for fixation in the treatment of various conditions, including, e.g., spondyloslisthesis, degenerative disc disease, fracture, dislocation, spinal tumor, failed previous fusion, and the like, in the spine. The invention also relates to a method for delivering and implanting the bone fixation device.

Abstract: Spinal fixation systems including a member, a first attachment portion, a second attachment portion, and an intermediate portion. The first attachment portion is attached at a superior end of the member and includes a first opening. The second attachment portion is attached at an inferior end of the member and includes a second opening. The intermediate portion connects the first and second attachment portions. The spinal fixation systems may also include a relief in at least one of the first opening and the second opening. The systems may also include a third attachment portion with a third opening and an intermediate portion with a first and a second elastic mechanism. The first elastic mechanism connects the first and third attachment portions and the second elastic mechanism connects the third and second attachment portions. Surgical methods for inserting the spinal fixation systems in a patient are also disclosed.

Abstract: A bone anchoring device includes a shank to be anchored in a bone or vertebra, a head, and a receiving part receiving the head for connecting the shank to a rod. The shank and the head are separate parts. The head has a bore with a cylindrical inner surface, a ring-shaped groove provided on the inner surface, and at least one slit extending from the inner surface to the outer surface of the head. The shank has a first portion for anchoring in the bone or vertebra and a second portion with a cylindrical outer surface adjoining a free end. A projection is provided on the cylindrical outer surface which engages with the ring-shaped groove of the head, when the cylindrical second portion of the shank is inserted in the bore of the head.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an upper portion, a receiver member or head, a retaining and articulating structure, and a pressure insert disposed between the shank upper portion and a rod. The receiver has a U-shaped cradle defining a channel for receiving a spinal fixation rod and a receiver cavity. The retaining and articulating structure attaches to the shank and rotates with the shank in the cavity during positioning. The pressure insert presses upon the shank upper portion and not the retaining and articulating structure.

Abstract: A method for treating vertebrae comprises the steps of: connecting at least one fastener with portions of vertebrae; providing a fastener comprising a first portion including a receiver defining an implant cavity and a member disposable with the implant cavity and movable relative to the receiver, and a second portion defining a longitudinal axis and being configured to penetrate vertebral tissue, wherein the receiver is non-pivotable relative to the longitudinal axis and connecting the fastener to the vertebrae; providing a longitudinal element; connecting a first portion of the longitudinal element with the at least one fastener; derotating the vertebrae to a selected orientation; and connecting a second portion of the longitudinal element with the fastener to substantially maintain the vertebrae in the selected orientation. Systems are disclosed.

Abstract: A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver.

Abstract: A spinal fixation element rotation instrument with two lever arms is provided. The lever arms are connected to each other at distal ends thereof. The second lever arm rotates relative to the first lever arm. The distal ends of the first and second lever arms are adapted to couple to a spinal fixation element. The distal ends of the lever arms may have a dual ratchet feature that prevents rotation in a set direction. When one arm rotates back and forth, the other arm is held stationary. As a result, the spinal fixation element rotates in a predetermined direction and is prevented from rotating back toward its initial position. The direction of the rotation of the spinal fixation element may be set using knobs or switches provided at a proximal end of one or both of the lever arms.

Abstract: Apparatus and methods for bone fracture repair. The apparatus may include a structural support for positioning a first bone segment relative to a second bone segment. The apparatus may include an anchoring substrate. The anchoring substrate may be configured to compress the first bone segment to the second bone segment. The anchoring substrate may transmit tension from a distal bone segment anchor in the first bone segment to a proximal bone segment anchor in the second bone segment. The apparatus may be configured to be deployed percutaneously in an inner cavity of a bone. The apparatus may be installed in an open fracture. The apparatus may be expanded, self-expanding or configured for mechanically actuation. Some embodiments of the apparatus may include a central axis member that may be used in conjunction with expansion of one or both of the structural support and the anchoring substrate to configure the apparatus.

Abstract: A device, method, and system for treatment or fixation of a fractured, damaged, or deteriorating bone or bones in a mid-foot region. The device comprising an implant with both proximal and distal fastener holes, along with fastener slots in a central elongated body, for securing the implant to the appropriate osseous cortical structures of the foot. The method for treatment or fixation of fractured, damaged, or deteriorating bones in the medial column of the foot with use of a device such as an intramedullary nail that attaches to either the talus or first metatarsal bones to secure the medial cuneiform and navicular bones in place.

Abstract: A device for treating fractures, comprises a plate receiving structure including on a bone facing side thereof a recess sized and shaped to receive a fixation plate anchored in a desired position on a bone and a mating structure sized and located to engage a corresponding structure of the fixation plate to prevent relative movement between the fixation plate and the device in combination with at least one leg projecting laterally away from the recess, a first one of the at least one legs including a first fixation element receiving hole extending therethrough, the first leg being positioned and oriented so that, when the device is received on a fixation plate anchored to the bone in the desired position, the first fixation element receiving hole is aligned to pass a fixation element inserted therethrough into the bone without passing through a longitudinal axis of the medullary canal.

Abstract: Embodiments provide methods, apparatuses, and systems for fixation of a fractured bone with a bone plate. In various embodiments, the systems and plates provide elastic suspension of the receiving holes relative to an osteosynthesis plate. This elastic suspension can promote load distribution between the screws that connect a bone segment to the plate, thereby reducing stress risers and load shielding effect. In addition, stress at the screw holes, and within the construct as a whole, is reduced by incorporation of these elastic elements in the plate. Additionally, in some embodiments where fracture healing by callus formation is desired, elastic suspension of the receiving holes relative to the osteosynthesis plate can enable small, controlled amounts of relative motion between bone fragments connected by the plate. This relative motion can promote fracture healing by callus formation.

Abstract: A bone plate system is for osteosynthesis with a bone plate, a bone screw, the screw head of which has, at least in sections, a surface structure, a further bone screw, the screw head of which has, at least in sections, a surface structure, a through-hole, which is configured to hold the bone screw polyaxially, a further through-hole, which is associated with the through-hole and configured to hold the further bone screw, a perforation which connects the through-hole and the further throughhole, and a bulge, which is formed opposite to the perforation on the through-hole, extending the latter, hi the screwed-in state, the bone screw and the further bone screw are affixed at a fixed angle in many dimensions by virtue of the screw heads of the bone screw and the further bone screw being secured against a relative notion in relation to one another and in relation to the bone plate by a tensioned multi-point mount, in which attachments of the bone screw are formed in the through-hole at both transition regions be

Abstract: An apparatus for securing a cerclage member about a bone within a living body comprises a crimp including a first space extending longitudinally therethrough from a first space proximal opening to a first space distal opening, the first space sized and shaped to slidably receive a cerclage member therein and a second space extending parallel to the first space from a second space proximal opening to a second space distal opening, the second space including a proximal portion to receive the cerclage member and a distal portion decreasing in cross-sectional area and an insert that, when inserted into the second space distal opening adjacent to a cerclage member, a decreasing cross-sectional area of the second space distal portion forces the insert laterally relative to a longitudinal axis of the second space, pinching and locking the cerclage member against movement relative to the crimp.