Abstract: A surgical stapling device includes an adaptor assembly and a reload assembly supported on a distal end portion of the adaptor assembly. The reload assembly includes a shell housing, a staple cartridge supporting staples, a staple pusher, a staple actuator, a knife carrier, and a locking member. The staple pusher is movable from a retracted position to an advanced position to eject the staples from the staple cartridge. The staple actuator is movable from a retracted position to an advanced position to move the staple pusher from its retracted position to its advanced position. The knife carrier is movable between a retracted position and an advanced position. The locking member is supported on the knife carrier. The locking member is configured to engage the staple actuator in its advanced position while engaging the knife carrier in its retracted position such that the locking member inhibits re-advancement of the knife carrier.

Abstract: A surgical stapling device includes a reload assembly that includes a locking member to retain a knife carrier of the reload assembly in a retracted position after the stapling device is fired. The locking member may be supported on an inner housing portion of the shell housing or on a staple pusher assembly of the reload assembly.

Abstract: According to one aspect, a fastening device may include a coupling body having (1) a portion configured to couple to a distal end of a medical device, (2) a cartridge holder, and (3) an anvil pivotably coupled to the cartridge holder. The cartridge holder and the anvil may extend distally from the portion and may be configured to extend distally of a distalmost face of the medical device when the portion is coupled to the distal end of the medical device. A flexible member may be configured to extend through a channel of the medical device. A fastener cartridge may be coupled to a distal end of the flexible member, including at least one fastener, and may be configured for releasable coupling to the cartridge holder.

Abstract: A suturing kit includes a suture and a suture holder for holding the suture. The suture has a first end and a second, opposite, end. The suture holder includes an elongated wall defining a suture receiving passage that is elongated along a longitudinal axis and terminates at a suture exit opening. The suture receiving passage has a width at least twice the diameter of the suture and receives the suture such that the suture is folded over forming a half loop section spaced from the suture exit opening. A first second of the suture extends from the half loop section toward the first end and a second section of the suture extends from the half loop section towards the second end. The first section and the second section of the suture within the suture receiving passage are aligned parallel to the longitudinal axis.

Abstract: There is provided a product comprising a suture thread which, prior to being used to form a surgical suture, is in a stressed state which gives the suture thread a tendency to undergo lengthwise viscoelastic contraction. The suture thread undergoes viscoelastic contraction when in use as a surgical suture and this may promote wound healing to a greater extent than a conventional suture thread which does not undergo viscoelastic contraction.

Abstract: Locking assemblies for surgical clamping and cutting instruments include a locking member and a switch. A drive member may be configured to releasably engage a knife and/or a shuttle of the surgical instrument for translating the knife and/or shuttle in a distal direction through a firing stroke. The locking member is movable from a first position permitting distal translation of the drive member through the firing stroke, and a second position inhibiting distal translation of the drive member through the firing stroke. A switch, when proximally positioned, releasably engages the locking member to maintain the locking member in the first position. The switch disengages from the locking member when the switch is moved to a distal position.

Abstract: A surgical device comprising a surgical end effector, an actuation assembly having a part operable to move between a first position and a second position, an electrically-powered motor, a transmission mechanically connecting the motor to the part and being operable to selectively displace the part between the first and second positions when the motor is operated, and a manual release mechanically coupled to the transmission to selectively interrupt the transmission and, during interruption, displace the part towards the first position independent of operation of the motor.

Abstract: Surgical systems configured to determine whether a surgical cartridge is present and unfired. A surgical system includes a surgical instrument, a drive source, a sensor and a controller. The surgical instrument is configured to receive and support a surgical cartridge. The drive source is drivingly coupled with an actuation output. The sensor is configured to generate a sensor output indicative of movement of the actuation output. The controller controls the drive source to attempt to actuate the actuation output opposite to the firing direction by a predetermined amount. The controller determines that the surgical cartridge is present and unfired when the resulting actuation amount of the actuation output is less than a threshold actuation amount.

Abstract: Described herein are devices and methods for guide elements configured with variable stiffness, with one or more flexible portions and one or more stiff portions. The flexible portion is be used as a tensioning element of a cinchable implant to tighten or compress tissues while the stiff portion is used to facilitate the insertion or withdrawal of portions of the implant or instruments acting on the implant. The guide element is further configured to be separated or severed between the flexible and stiff portions so that a flexible portion is left within the body as part of the implant, while the stiff portion is withdrawn from the body after implantation is completed.

Abstract: The present disclosure pertains to medical devices. More particularly, the present disclosure pertains to devices, systems, and methods for closing a wound, such as a tissue defect resulting from an endoscopic mucosal resection or endoscopic submucosal dissection procedure. In one example, a device for closing a wound may include a closure element having a delivery configuration and a deployed configuration, the closure element configured to be disposed about an endcap of an endoscope in a delivery configuration. A release filament may have a distal end releasably coupled to the closure element and a proximal end extendable within the endcap. The closure element may be configured to substantially close about the wound in the deployed configuration.

Abstract: An instrument assembly can comprise a shaft comprising a first drive portion of a drive system, an end effector comprising a second drive portion of the drive system, and an articulation joint rotatably connecting the end effector to the shaft. The end effector is rotatable between a first position and a second position about the articulation joint, wherein the first drive portion is not operably engaged with the second drive portion when the end effector is in the first position, and operably engaged with the second drive portion when the end effector is in the second position. The end effector can comprise a first jaw and a second jaw, wherein the first jaw is movable relative to the second jaw between an open position and a closed position within a closure plane, and wherein the end effector is rotatable within an articulation plane which is co-planar with the closure plane.

Abstract: A clipping device includes a clip including a capsule and a pair of clip arms, proximal ends of which are slidably received within the channel to move the clip arms between an open configuration and a closed configuration. Each of the pair of clip arms includes an elongated opening extending through the proximal ends thereof. A connector includes a central portion received between the proximal ends of the clip arms and a pin extending from the central portion receivable within the opening of each of the clip arms, the connector movable from an unlocked configuration, in which the pin is received within a distal portion of the elongated opening, to a locked configuration, in which the pin is received within a proximal portion of the elongated opening, when a predetermined force is applied thereto.

Abstract: A crosslinked embolic hydrogel is disclosed, the crosslinked embolic hydrogel comprising a hydrophilic polymer functionalized with first reactive groups and a crosslinking agent functionalized with second reactive groups; wherein the first and second reacting groups comprise a biorthogonally reactive pair that react to form the crosslinked embolic hydrogel. Methods and systems are also disclosed.

Abstract: A device for treating tissue includes a clip including clip arms and a coupler. Each of the clip arms extends from a proximal end to a distal end. Proximal ends of the clip arms are slidably received within a channel of a capsule. A proximal end of the capsule includes openings extending through a wall. The coupler is mounted over the proximal end of the capsule via deployment arms including engaging features extending laterally inward from an interior surface thereof to engage the openings of the capsule. The coupler includes retention arms configured to engage a corresponding portion of an applicator. When a pre-determined compressive force is applied to the coupler, the deployment arms are proximally slidable along the corresponding portion of the applicator to deflect the deployment arms out of engagement with the capsule so that the coupler is separable from the capsule.

Abstract: A clipping system for treating tissue a clip with clip arms and an applicator having a flexible member and a control member. Proximal ends of the arms are received within a channel of a capsule. The capsule includes a slot extending from a proximal end of the capsule through a wall thereof The control member includes a distal end connectable to the arms to move them between the open and closed configurations. A distal end of the flexible member includes a bushing having a distal portion receivable within a proximal end of the capsule. The distal portion includes an engaging tab extending laterally outward therefrom receivable within an engaging portion of the slot, a spring extending along the distal portion and disposed proximally of the engaging tab so that, when the engaging tab is received within the engaging portion, the spring is compressed against a portion of the capsule.

Abstract: A device for treating hemorrhoids includes a housing sized and shaped for insertion to a target site within a rectum. The device also includes an inner member received within the housing such that the member may move longitudinally relative to the housing. In addition, the device includes a ligating mechanism at a distal end of the member which includes grasping arms movable between a receiving configuration in which distal ends of the arms are separated from one another and a grasping configuration in which the distal ends are drawn together to grasp tissue. The mechanism includes a ligating band received around the arms that is movable distally off of the arms to constrict around tissue grasped by the arms.

Abstract: A tissue clipping apparatus, comprises a flexible, elongate member, a proximal end of which remains external to the body accessible to a user while a distal end of the flexible member is inserted into the body to a location adjacent to target tissue to be clipped and a control wire extending through the flexible member in combination with a capsule releasably coupled to a distal end of the flexible member and a clip a proximal portion of which is received within the capsule. A joint releasably coupling the clip to the control wire, includes a yoke extending around a proximal end of the clip and a frangible link which fails when subject to a predetermined force to separate the clip from the control wire.

Abstract: An embolic implantation system configured to deliver an embolic implant intravascularly to a treatment site includes an elongated delivery tube to which the embolic implant is detachably attached by a flexible loop extending through a retaining ring or opening on the embolic implant and an elongated detachment member or pull wire extending through the delivery tube and flexible loop. The pull wire has a bump near its distal end that inhibits the pull wire from moving further distally when the bump presses distally against the flexible loop and/or retaining ring. The flexible loop and retaining ring thereby serve as a distal obstruction obstructing distal movement of the bump and thereby distal movement of the pull wire into the implant.

Abstract: A tourniquet assembly is provided comprising an external band and an internal band with a first and second semi-permanent adhesive members. The external band has a first connecting member affixed thereto and a second connecting member removably connected thereto. The internal band is designed to form a loop having a circumference around a limb for constricting blood flow in the limb when the external band forms a loop when the first connecting member is attached to the second connecting member. The tourniquet assembly further comprises a tensioning member connected to the internal band and configured to apply direct tension to the internal band without applying direct tension to the external band. Herein, the circumference formed by the internal band is reduced when the tensioning member is actuated, thereby compressing the limb when the tourniquet assembly is placed around the limb, and thereby reducing blood flow to the limb.

Abstract: Described herein is an anti-skid surgical instrument for use in preparing holes in bone tissue. The disclosed surgical instrument provides the ability to prepare a precise hole in bone tissue during surgery (e.g., spinal surgeries and pedicle screw placement, intramedullary screw placement). The disclosed surgical instrument accomplishes precise hole placement regardless of whether the angle between the drill axis and surface of the bone tissue is perpendicular. The disclosed technology includes a flat drilling surface which is perpendicular to the surface of the body of the surgical instrument. This reduces the likelihood of the surgical instrument skidding on the surface of the bone tissue and thereby increases the precision of the hole.

Abstract: A cleaning module for cleaning bone stock used in surgical procedures. The cleaning module includes a shell. The shell defines a void space to receive the bone stock. A cutter is rotating mounted in the void space. A shaving tube, also able to rotate, is coaxially disposed about the cutter. The cutter and shaving tube have complementary edges. A drive assembly rotates the cutter and shaving tube at different speeds, at different times or in different directions relative to the cutter. As a result of the rotation of the cutter and shaving tube soft tissue adhering to the bone stock is cut away from the bone stock by the relative rotating of the cutting edges of the cutter and shaving tube.

Abstract: A system, method and/or reamer driver device provides a fully closed tube which prevents the invasion of debris and minimizes abrasion of soft tissue during use. The reamer device includes a minimum number of component assemblies, so as to permit easy replacement and minimize wear.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: Various exemplary methods, systems, and devices for instability repair are provided. In general, a surgical device can be configured to drill a hole in bone and to deliver a suture anchor into the hole. In this way, a single surgical device can drill the hole and deliver the anchor into the hole for securing soft tissue to the bone. The anchor can be configured to allow the soft tissue to be secured to the bone using a suture coupled to a suture anchor without the need to knot or otherwise tie the suture to secure the soft tissue in place relative to the bone.

Abstract: Instruments and methods for surgical transosseous attachment to a bone include a guide able to guide the formation of intersecting bone tunnels and a passer able to pass a member through the bone tunnels.

Abstract: A method of using a suction device to remove an object from a subject's body includes extending a suction device into the body through a lumen of a medical device and expanding the suction head from a contracted configuration to an expanded configuration within the body. The suction head may be provided at a distal end of an elongate conduit. The method may also include applying suction to move the object into the expanded suction head, and removing the suction device with the object from the body.

Abstract: A method for removing a stone from a patient comprising the steps of: providing a suction evacuation assembly which includes a sheath and one or more side arms; inserting and positioning a distal end of the sheath into a lumen or cavity of a patient's body containing a stones; connecting a tube to one of the side arms and to a collection bottle; connecting another tube to the collection bottle and a negative pressure system; visualizing the stone or foreign body using a scope inserted through the assembly; activating the negative pressure system in order to remove the stone from the cavity if the diameter of the stone is narrower than an inside diameter of the sheath and the side arm, or performing a lithotripsy on the stone to create fragments with a decreased diameter which allow the passage through the assembly; and collecting the stone in the collection bottle.

Abstract: An endovascular apparatus includes a first cannula, a second cannula, and an operator handle. The first cannula has a proximal end, a distal end, and a first lumen. The second cannula is slidably coupled to the first cannula. The second cannula has a proximal end portion, a distal end portion, and a second lumen. The distal end portion is extendable in a distal direction beyond the distal end of the first cannula. The operator handle is operably coupled to the second cannula. The operator handle may be configured to articulate the distal end portion of the second cannula relative to the first cannula. The second cannula may include an articulation joint. Optionally, the operator handle may be configured to extend, retract, and rotate the second cannula relative to the first cannula. Also, optionally, the endovascular apparatus may include a magnetic coupler.

Abstract: A method for removing a stone from a patient comprising the steps of: providing a suction evacuation assembly which includes a sheath and one or more side arms; inserting and positioning a distal end of the sheath into a lumen or cavity of a patient's body containing a stones; connecting a tube to one of the side arms and to a collection bottle; connecting another tube to the collection bottle and a negative pressure system; visualizing the stone or foreign body using a scope inserted through the assembly; activating the negative pressure system in order to remove the stone from the cavity if the diameter of the stone is narrower than an inside diameter of the sheath and the side arm, or performing a lithotripsy on the stone to create fragments with a decreased diameter which allow the passage through the assembly; and collecting the stone in the collection bottle.

Abstract: An instrument drive assembly for use with a surgical instrument includes a housing assembly supporting a drive assembly therein, a coupling tube supported at a distal end of the housing assembly and extending distally therefrom, a coupling assembly, and a retention mechanism. The coupling assembly is supported in the housing assembly and is configured to releasably couple to an instrument drive shaft of the surgical instrument, and the retention mechanism is configured to releasably couple to an instrument sleeve of the surgical instrument.

Abstract: A catheter for use in treating pleural diseases, such as pleural effusions and pneumothorax, includes a tip portion that is configured to irritate the pleura when the catheter is inserted in the pleural cavity, thereby initiating mechanical pleurodesis. The tip portion has a substantially rough configuration and may include one or more protrusions that contact the pleura when the catheter is in use, thereby irritating the layers. This irritation causes the creation of fibrous adhesions between the parietal and visceral layers that close off the pleural cavity and prevent further fluid and/or air accumulations that occur as a result of pleural diseases.

Abstract: The present disclosure relates to an arthroscopic resection device. The device includes an outer member including a hub, an inner member including a hub, the inner member housed within the outer member, a tube coupled to the outer member, and means for allowing longitudinal movement of the outer member relative to the inner member, the means coupled to the tube. A method of tissue repair and other arthroscopic resection devices are also disclosed.

Abstract: An ultrasonic horn for use with an ultrasonic surgical handpiece including a resonator comprises a linear cutting blade at the distal end of a horn body. The linear cutting blade includes adjacent side-by-side rows of teeth each of which includes a land through which ultrasonic waves are propagated outwardly from the distal end. The lands of the rows of teeth are angled so that the propagated ultrasonic waves of one plurality of lands intersects the propagated ultrasonic waves from the other row of lands. Shear stress fields are developed at the intersections of the ultrasonic waves that will perform the cutting function on target tissue. An irrigation arrangement is also disclosed.

Abstract: A medical device is disclosed for cutting substances inside a body lumen, the medical device including a rotatable tubular drive shaft; a treatment member arranged on a distal side of the drive shaft; and a device handle configured to retract the drive shaft, the device handle comprising: a fixed guide cover disposed to cover the drive shaft and an outer sheath disposed to cover the guide cover; and an annular gap between the outer sheath and the guide cover on a proximal side of a fluid connection configured to supply a physiological salt solution into the outer sheath.

Abstract: An endovascular treatment mesh device for closing outpouchings by affixing at least one amorphous hydrogel layer expandable in vivo to any or all surfaces of an expandable body comprising at least one material adapted to close said outpouching in the body. The treatment mesh further includes a telescoping center-support bar disposed therein, the center-support bar having at least two telescoping elements that act as reinforcing extension elements to minimize the risk of collapse. Hydrogel is affixed to the surface of the telescoping elements to inhibit retraction. An embodiment wherein the treatment mesh device is a stent.

Abstract: A thrombectomy device for removing thrombus from a body lumen comprises an elongated catheter member (2) having a distal part and a proximal part, a thrombus blocking body (5) disposed on the distal part of the catheter member and radially expansible between a contracted orientation and an expanded, thrombus-blocking, orientation, a thrombus capture body (3) disposed on the distal part of the catheter member in an axially spaced-apart relationship to the thrombus blocking body, and radially expansible between a contracted orientation and an expanded, thrombus-capture, orientation, deployment means actuable to deploy and retract the thrombus capture body and thrombus blocking body; and an elongated control arm operably connected to the thrombus capture body. The thrombus capture body is a cage having an inwardly tapering leading end, the elongated control arm is operably connected to the leading end of the cage, and a thrombus extractor or macerator mechanism is disposed within the cage.

Abstract: A surgical device includes an outer member, an inner member, and at least one locking element. The inner member is at least partially supported within the outer member. The at least one locking element is configured in a first arrangement of the surgical device to lock the inner member in a first position and configured in a second arrangement of the surgical device to unlock the inner member from the first position. The at least one locking element is configured to change from the first arrangement to the second arrangement upon coupling the inner member in an operational arrangement to a hand piece.

Abstract: A surgical access port comprises an instrument guide. The instrument guide comprises a proximal end, a distal end, a plurality of instrument guide channels between the proximal and distal ends, and an outside surface that fits closely to an inner wall surface of a cannula into which the instrument guide is inserted. The instrument guide also comprises a first guide channel opening defined along a length of a first guide channel of the plurality of instrument guide channels. The instrument guide also comprises a second guide channel opening defined along a length of a second guide channel of the plurality of instrument guide channels. The instrument guide also comprises an insufflation channel defined between the first and second guide channel openings. The insufflation channel extends from a position between the proximal and distal ends of the instrument guide to the distal end of the instrument guide.

Abstract: Selectively lockable holding arrangements for a surgical access assembly are disclosed. One holding arrangement includes a proximal body portion, a distal body portion, a retaining member, and a rotation brake. The distal body portion is adjacent the proximal body portion and configured to be selectively rotated relative to the proximal body portion. The retaining member is at a distal end of the distal body portion. The rotation brake extends from the proximal body portion to the distal body portion and is selectively operable to lock the distal body portion against rotation with respect to the proximal body portion.

Abstract: The invention relates to a Multipurpose Vaginal Occlusion and Distension Device with Distension Controller, which helps patients with Female Stress Urinary Incontinence and for Fecal Incontinence. It comprises of double layered cylindrical body (101) making inflatable annular space and with closed anterior (103) and posterior (104) wall provided with inflatable tubular silicon ribs (103a, 104a), but the posterior end is provided with gas flow tube (106) connectable to the “Distension control and release mechanism” by which the cylindrical cavity (107), annular space, tubular ribs at both the end can be inflated. But the same device can be used, if the anterior end (301) is opened for collecting menstrual blood during Menstrual Cycle as an alternative to menstrual cups and pads.

Abstract: A bone fastener system can comprise a fastener and a first sizing component. The fastener can comprise a shaft that provides an anchoring footprint. The first sizing component can be configured to be connected to the shaft and can include a first anchoring feature, or circumferential bone engaging feature, to increase a size of the anchoring footprint. The first anchoring feature can comprise a sleeve that radially expands a diameter of the threaded shaft. The first anchoring feature can comprise axially extending teeth. The system can further comprise a second sizing component including a second anchoring feature to increase the size of the anchoring footprint, the second anchoring feature being different from the first anchoring feature. The second anchoring feature can expand the diameter of the threaded shaft a greater amount than the first anchoring feature. The second anchoring feature can have a length greater than the first anchoring feature.

Abstract: A bone anchor system can comprise a fastener, a rod housing and a first directional component configured for connection to the fastener. The fastener can comprise a shaft having a shaft diameter, an anchoring projection on the shaft, and a head at an end of the shaft. The rod housing can be connected to the head of the fastener. The first directional component can comprise a first body portion having a first outer diameter larger than the shaft diameter, a first bore extending through the first body portion, the first bore sized to receive the shaft diameter, and a first locking component extending from the first body portion configured to engage the rod housing to limit movement of the housing.

Abstract: The invention provides antibodies that specifically bind to PD-L1 and fusion molecules comprising PD-L1 binding proteins constructed with an IL 15 receptor-binding domain, nucleic acid molecules encoding the same, and therapeutic compositions thereof. The agents inhibit PD-L1-mediated immunosuppression and enhance cell and cytokine mediated immunity for the treatment of neoplastic and infectious diseases.

Abstract: A coupling assembly for coupling a rod to a bone anchoring element, including a receiving part having first and second ends, a recess at the first end for the rod, and an accommodation space for a head of the bone anchoring element, the accommodation space having an opening at the second end to permit insertion of the head into the receiving part, a retainer element configured to be arranged at least partially in the accommodation space and to hold at least part of the head, and a spring element configured to be arranged at least partially in the accommodation space and to be compressed in an axial direction. The retainer element and the spring element are separate parts. When the retainer element and the spring element are in the accommodation space of the receiving part in a first position, the spring element extends into the recess of the receiving part.

Abstract: A cervical polyaxial bone anchor includes a shank having an integral spherical head and a receiver having an upper channel for receiving a rod and a lower seat near a lower opening for receiving a closed retainer that includes a compressible upper portion engaged with the receiver seat and an expandable lower portion capturing the shank head. An outer sleeve slidable with the receiver prohibits expansion of the retainer lower portion during operation. A compression insert engages the retainer upper portion and is in friction fit with the shank head prior to fixing of an angle of the shank with respect to the receiver.

Abstract: A medical implant assembly includes a polyaxial bone anchor having a shank, a receiver, a lower compression insert with surfaces for closely receiving an elongate connecting member and a dual closure structure that may include a single flange or helical flange. The dual closure structure independently engages the connecting member and the lower compression insert. A threaded capture connection of the bone anchor includes a shank upper surface exclusively engaging the lower compression insert and a retainer threadably attached to the shank and spaced from the upper surface, the retainer configured for polyaxial motion with respect to the receiver prior to locking.

Abstract: A folding anterior cervical locking plate system for stabilizing the cervical spine in a spinal fusion procedure. The plate system has at least two plate sections hinged together by a hinge structure at adjacent ends for pivoting movement of the plate sections relative to one another through at least 90° in each of two directions. A first hole in each plate section enables visualization of the underlying graft. A locking plate spans adjacent ends of the plate sections and holes in the locking plate are aligned with holes in adjacent plate sections so pedicle screws inserted through the holes in the locking plates extend through the holes in the plate sections to secure the system to the vertebral bodies and stabilizes the cervical spine. In one embodiment the locking plate slides in guide channels on opposite side edges of the plate sections.

Abstract: A ratcheted spinal device including a variable-length member including a ratchet mechanism that has an operative configuration that allows a change in length of the variable-length member in one direction and prevents a change in length of the variable-length member in an opposite direction, wherein the variable-length member includes polyaxial-joint attachment members for attachment to bone, which permit pivoting movement of the attachment members about more than one pivoting axis.

Abstract: A surgical instrument includes a body member having a proximal portion and a distal portion. The distal portion includes a first surface defining a first implant cavity and a second surface defining a second implant cavity. The second surface is engageable with an implant and includes a pivot. In some embodiments, spinal constructs, implants, systems and methods are disclosed.

Abstract: Intramedullary rods, targeting devices, intramedullary rod systems, intramedullary rod kits, and methods of placing an intramedullary rod in a bone are described. An intramedullary rod comprises a head member having a first end, a second end, and a body extending between the first end of the head member and the second end of the head member. The head member is formed of a first material and defines a circumferential flange and a circumferential shoulder. The circumferential flange extends radially outwardly from the head member and the circumferential shoulder is disposed between the first end of the head member and the circumferential flange. A shaft member extends from the head member and a head extension is partially disposed over the head, member. The head extension is formed of a second material that is different than the first material and has an end contacting the circumferential shoulder of the head member.