Abstract: A cerclage tool for placement of a wire around a bone for internal fixation of the bone comprising a first member having a handle portion, a central portion and a first bent tube portion and a second member having a handle portion, a central portion and a second bent tube portion. The first member and the second member are configured and adapted to be inserted separately through an incision into soft tissue surrounding the bone and subsequently joined together after insertion such that the first bent tube portion and the second bent tube portion form a continuous tube that encircles the bone.

Abstract: An implant for fracture fixation in which a wire element has one end installed in bone and an opposite end fixed externally to the bone to apply compression across the fracture wherein a guide system is provided for guiding a tip of the one end of the wire element into a pilot hole in the bone prior to producing compression across the fracture.

Abstract: System, including methods, apparatus, and kits, for tensioning a surgical wire with a tensioning device and/or fixing bone with a surgical wire tensioned with a tensioning device.

Abstract: Fusion of cervical spinal vertebrae with one or more fixation devices can be accomplished with the described tools and methods. For example, a guidewire introducer can include a tubular introducer cannula and a handle. The handle can be angularly offset from the introducer cannula such that positioning of the introducer on the cervical spine does not interfere with a patient's head. A sheath assembly can include inner and outer sheath bodies and a handle. The handle is angularly offset from the sheath bodies such that the sheath assembly can be applied to the cervical spine without interference to the patient's head. The sheath body can be curved or straight. Various tools such as drills, tapping devices, compression tools, and pin release tools can be applied to the cervical spine through the sheath body to apply the fixation device. The tools can include elongate flexible shafts.

Abstract: A method of operating a rod reducer includes connecting a cam coupling rod reducer to a screw head of a pedicle screw assembly, wherein spaces in between prongs at a second end of an inner tube of the rod reducer are positioned parallel to a rod of the pedicle screw assembly, and wherein the connection of the cam coupling rod reducer to the screw head indicates a first position of operation; rotating a lever cam of the cam coupling rod reducer until an indication line marked on an outer body of the cam coupling rod reducer moves to a second position of operation; and rotating the lever cam to a third position of operation, wherein the third position of operation indicates that the rod is optimally seated in the pedicle screw assembly, and that the pedicle screw assembly is ready to accept a blocker screw.

Abstract: Disclosed is an intra-medullary rod, including: a cylindrical body made of an X-ray transmitting material; a plurality of wires, which are made of a material that does not transmit X-ray and are deposited at regular intervals along a surface of the cylindrical body in the circumferential direction, being extended in an axial direction in a spiral shape, wherein each of the wires is made in a way that a starting end and a terminating end of the cylindrical body are connected by the shortest distance along the outer surface thereof. In a fluoroscopic image of the cylindrical body, a distance from a reference position to an intersection location of a pair of the wires corresponds to an amount of rotational angle of the intra-medullary rod. By digitizing the intersection location, the rotational angle of the intra-medullary rod is measured.

Abstract: The invention facilitates the fixation of bone fractures. In a particular embodiment, a method for fixing bone fractures comprises the steps of: inserting a head component coupled to a wire through a first bone portion and anchoring the head component in a second bone portion, inserting a cap over the wire toward the head component until the cap contacts the second bone portion, and applying pressure to the wire using a tensioner to reduce the distance between the first bone portion and the second bone portion. The excess wire beyond the cap can then be removed.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.

Abstract: A tensioner for a tightening a surgical knot has a squeeze handle and a pair of jaw arms that pivot from a common point behind the handle. The jaw arms have a jaw clamp at the distal tip to clamp onto the suture material, and a release handle at the proximal or butt end. A spreader or distractor mechanism may be a pantographic arrangement of struts joined to anchor points on the jaw arms. This converts axial motion of an actuator rod into a lateral distractive force. A tension gauge in the handle indicates the amount of tension being applied to the suture material.

Abstract: A rod inserter and method of inserting a rod into a vertebral body, wherein the rod inserter holds a rod in a vertical or semi-vertical position from one end and allows the rod to be inserted and then rotated into its final horizontal position inside a wound. The device comprises a longitudinal member comprising holes located at distal ends of the longitudinal member; and a holder comprising a tip end comprising a first and second portion any of which comprise a prong tip. The holder also includes a handle end located distally away from the tip end, wherein the handle end comprises a first gripping arm and a second gripping arm; and an engaging member comprising tooth-like features connecting the first gripping arm to the second gripping arm, wherein the tooth-like features engage the second gripping arm, and wherein the prong tip fits into a hole of the longitudinal member.

Abstract: Various exemplary methods and devices are provided for tensioning suture. The methods and devices are particularly useful in surgical suturing applications in which it is desirable to maintain tension on suture being delivered, yet to allow the tension to be released as desired without retracting the suture. Thus, when tension is released, a length of suture extended from the device can remain extended without any tension being applied thereto. Tension is only applied to any additional length of suture that is extended from the device. The tension applied to the suture is proportional to the length of the suture extended from the device until the tension is released and reset.

Abstract: An apparatus for securing a cerclage member about a bone comprises a crimp including a first lumen extending therethrough from a first lumen proximal opening to a first lumen distal opening and being configured to slidably receive a cerclage member therein, a proximal portion of the first lumen comprising a first recess configured to receive an enlarged proximal end of the cerclage member, the crimp further comprising a second lumen extending parallel to the first lumen from a second lumen proximal opening to a second lumen distal opening, a distal portion of the second lumen comprising a second recess configured to slidably receive a sleeve provided over a distal end of a cerclage member. A first wall of the crimp adjacent the second lumen distal opening is angled with respect to a second wall of the crimp adjacent the first lumen distal opening to permit pivoting of the sleeve thereagainst.

Abstract: A system comprised of custom radiographically designed tibial and talar cutting guides, a tibial reaming guide and bit, and instrumentalities for use in total ankle replacement surgery and a computer-based system and method for making the custom radiographically designed tibial and talar cutting guides.

Abstract: A thoracic closure device. The device has a handle member, a base member, and a feed path, and is designed to accept and, with a ratcheting mechanism, tension a toothed closure tie. A guide member is also provided, and assists in the placement of a closure tie prior to tensioning. Methods of closing a median sternotomy using toothed closure ties are also disclosed.

Abstract: A Kirschner wire clamp is used to reliably and simply fix bone plates to a bone surface. The wire clamp consists of a tubular guide member for receiving a Kirschner wire. The guide member has a bore surrounded by a wall and a base for engaging a hole in a bone plate such as a bone screw hole. A spring clamp is mounted adjacent an open end of the tubular guide bore opposite the base which clamps the Kirschner wire to the guide member after the wire has been fixed in bone. The Kirschner wire clamp can be aligned simply and reliably by the guide member, and by the clamping mechanism, can be reliably fixed to the Kirschner wire.

Abstract: The present invention provides a jig for use in relation to the surgical treatment of a bone having a bone fracture, the jig being formed to receive at least part of the bone about the bone fracture; said jig (10) having first (24,24?) and second (32) sets of apertures; said first set of apertures being located distal to the bone fracture; and said second set of apertures being located proximal to the bone fracture. The jig facilitates the positioning of intramedullary wires in the fixation of fractures to the bone, such as, but not limited to, fractures of the olecranon, for example, a Type II fracture of the olecranon.

Abstract: An electronically guided spinal rod system for the placement of a spinal rod into the heads of pedicle screws and other types of bone fixation systems includes a bone screw inserter having rod access slots extending longitudinally for a length along the screw inserter, a rod detection system coupled to the rod access slots and a rod pusher for inserting a spinal rod through the rod access slots. The electronically guided spinal rod system insures that the spinal rod will be accurately positioned while allowing the operator complete freedom to choose its specific path into the screw inserter rod access slots.

Abstract: A line lock includes a body at least partially bounding two passageways that cooperate to receive a locking portion of a line such as a suture in such a manner that the locking portion can only be drawn through the passageways along one direction. A second suture locking portion may also received by the passageways, or by one of the two passageways in combination with a third passageway. The body may have an elongated, compact shape that is easily implantable in the body.

Abstract: The present invention includes a surgically implantable compression staple, system, and method of use thereof for the internal fixation of bone fractures, fusions, and osteotomies. The staple has a grooved construction along the outside edge of each of its legs and cannulated tabs are aligned above the grooves. The grooves and cannulated tabs of the staple are sized to fit and align with guide wires. Once holes are drilled over the guide wires with a specialized cannulated drill, the appropriately sized staple can be inserted over the guide wires and the guide wires are subsequently removed. The compression feature of the staple is activated and the staple provides stability across the desired fractured site. The system and method allows for easy alignment and precise placement of surgically implantable staples.

Abstract: A suture fixation apparatus having a first body portion having a bone engaging feature to fixedly engage a bony tissue and a second body portion defining an eyelet for receipt of a suture. The second body portion is rotatable with respect to the first body portion. Rotating the second body portion causes the suture to form a twist to frictionally secure the suture.

Abstract: The invention relates to a method for tying together objects, in particular for fixing hone parts by a surgical cable (10), comprising the steps of laying the surgical cable, having two end parts, around at least part of the objects to be tied together, in particular the bone parts (40) to be fixed, bringing the two end parts together and tying them with a connection, which is slipping when a relatively high force is applied, exerting this relatively high force on the end parts which allows the connection to slip, thereby bringing the cable under a tension required for tying together the objects, in particular for fixing the bone parts. The invention also relates to a tensioning device (1) for exerting the force on the surgical cable.

Abstract: A cable tensioning apparatus and method are provided for positioning and tensioning a surgical cable to skeletal tissue or to implants. The invention is most applicable for securing surgical cable and/or orthopedic implants to bone in orthopedic surgery. A linearly translated drive rod attached to cable is driven by a friction drive to create tension on the surgical cable.

Abstract: A suture construction and method for forming a suture construction is disclosed. The construction utilizes a suture having an enlarged central body portion defining a longitudinal passage. First and second ends of the suture are passed through first and second apertures associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes constriction of the longitudinal passage, thus preventing relative motions of the captured portions of the suture.

Abstract: A method and device for cutting orthopedic cable including tensioning and crimping the cable in a desired position within a surgical cavity. A free end of the cable is inserted a device with two coaxial members having coordinating shearing faces. The shearing faces are moved along the cable to a position proximate a portion of the cable to be cut. Cutting is achieved is by rotating the coaxial members with respect to one another.

Abstract: An aiming device for insertion of a Kirschner-wire to treat a target bone, comprises an aiming block permitting placement of a Kirschner-wire against the target bone and a forceps connected to the aiming block, the forceps being configured to clamp to the target bone.

Abstract: Wire torque apparatus and methods for engaging a wire torque apparatus are disclosed. Wire insertion devices and methods for inserting a wire into a catheter are disclosed. An improved aneurysm clip utilizes non-metallic material. An improvement to an aneurysm clip applicator tool includes a power supply to power an electromagnet, an adjustable counter element that is attracted to the electromagnet when the electromagnet is magnetized, and a switch to disengage the electromagnet. When the electromagnet is magnetized and comes within a certain proximity to the counter element, the electromagnet and the counter element attract and cling to one another. They are released by activating a switch.

Abstract: A method includes inserting a bone fixation device into a patient's body. The bone fixation device includes a first member and a second member movably coupled to the first member. A passageway is defined within a bone tissue after the bone fixation device is inserted and while the bone fixation device is disposed within the patient's body. At least a portion of the first member of the bone fixation device is disposed within the bone tissue along the passageway. The second member of the bone fixation device is moved relative to the first member of the bone fixation device.

Abstract: A cam coupling rod reducer and method of operation comprises an inner tube comprising a first end having a hole and a second end having a plurality of prongs extending therefrom. The rod reducer further includes a lever cam connected to the first end, wherein the lever cam comprises a base and a pair of semicircular arms extending from the base, wherein each of the arms comprise a hole configured to align with the hole of the first end of the inner tube. The rod reducer also includes an outer extension tube connected to the inner tube, wherein the outer extension tube comprises positional markings on the body of the outer extension tube; a top end having a concave opening; and a bottom end comprising an opening configured to permit the prongs of the inner tube to extend therethrough; and a pair of pegs extending from the bottom end.

Abstract: A system and associated method for delivering to an internal body site a selected one of a plurality of instruments including fluid-dispensing instruments. An instrument storage chamber is providing having passages for separately accommodating the plurality of instruments. An outlet guide tube couples from the instrument storage chamber and receives a selected one of these instruments for delivery to an internal operative site. An indexing mechanism is provided associated with the chamber for causing relative displacement between the instruments and the outlet guide tube. An instrument driver displaces the registered instrument from the chamber into the outlet guide tube for delivery to the internal operative site.

Abstract: The present disclosure generally provides systems and methods of anchoring surgical wires, catheters, leads, and other medical objects in an effective, efficient, and cost-sensitive manner. In one embodiment, the present disclosure could include a system to secure a medical object. The system could include a body having a first inner arm, a second inner arm, and a first outer arm. The first inner arm and the first outer arm could include a pronged structure. The system could also include a crossbar having a bore to receive a screw. The crossbar could be disposed between opposing surfaces of the first inner arm and the second inner arm and could be coupled to sliding grooves disposed along the opposing surfaces. When the screw is in an engaged position relative to the crossbar, the pronged structure could be configured to secure the medical object.

Abstract: A line lock includes a body at least partially bounding a plurality of passageways such that a suture can only be drawn through the passageways along one direction. The suture is attached to the line lock prior to use in surgery, either by securing one end of the suture to the line lock, or by retaining a loop of the suture with one of the passageways. A needle may be pre-attached to a free end of the suture. The suture may be inserted through the passageways through the use of a cartridge designed to contain the line lock. A threader may pass through the line lock within the cartridge along the desired pathway for the suture. Thus, the suture may be coupled to the threader and drawn through the passageways along the desired pathway by pulling the threader from the cartridge.

Abstract: The invention facilitates the fixation of bone fractures. In a particular embodiment, the head component includes a tip, cutting threads and mating threads which are inserted into the far cortex of the bone. A wire extends from the head component and exits from the near cortex. A cap device having a sawtooth inner surface is threaded over the wire having an inverse sawtooth outer surface such that the cap is restricted from backwards movement. Tension is then applied to the wire while the cap is tightened against or within the bone surface to thereby apply an appropriate amount of pressure between the surfaces of the fracture. The excess wire beyond the cap can then be removed.

Abstract: A Kirschner wire clamp is used to reliably and simply fix bone plates to a bone surface. The wire clamp consists of a tubular guide member for receiving a Kirschner wire. The guide member has a bore surrounded by a wall and a base for engaging a hole in a bone plate such as a bone screw hole. A spring clamp is mounted adjacent an open end of the tubular guide bore opposite the base which clamps the Kirschner wire to the guide member after the wire has been fixed in bone. The Kirschner wire clamp can be aligned simply and reliably by the guide member, and by the clamping mechanism, can be reliably fixed to the Kirschner wire.

Abstract: A guide for positioning a guide wire on a femur to allow a tunnel to be formed in the femur along the guide wire is provided. The guide includes an elongated body having proximal and distal ends, and a distal tip formed on the distal end of the elongated body, the distal tip having a diameter substantially similar in size to the diameter of the desired resultant femoral tunnel, wherein the elongated body and the distal tip are cannulated to receive the guide wire.

Abstract: A line lock includes a body at least partially bounding a primary passageway, a secondary passageway, and a working passageway. The passageways may be sized to receive two locking portions of a suture such that each of the locking portions can only be moved through the line lock along one direction. The passageways may be symmetrically arranged to receive the two locking portions in symmetrical fashion. The passageways may also be arranged such that two ends of the suture can be drawn in substantially opposite directions to advance the body along the suture. The body may have one or more grooves into which corresponding portions of the suture can be pressed via tension in the suture to enhance locking. The body may have a generally circular profile that facilitates advancement of the body along the suture to tighten the suture against, for example, internal bodily tissue.

Abstract: An apparatus for use in tracking movement of a patella through a range of motion during a surgical navigation procedure, comprising a frame fixed in relation to the patella, a patella trial component associated with the frame for fixing the frame relative to the patella, and a reference array configured to attach to the frame, the reference array having first, second and third markers, the first, second and third markers being detectable by a surgical navigation system when exposed to a measurement field of the surgical navigation system.

Abstract: An instrument for tensioning a flexible elongate member in a surgical procedure includes a tensioning mechanism engageable to a portion of the flexible elongate member and operable to apply a tensioning force to the elongate member. The instrument includes a distal end portion at a distal end of the tensioning mechanism that is adapted to allow orientation of the elongate member in a first direction for implantation and to allow the instrument to extend transversely to the implantation orientation during application of a tensioning force. The distal end portion can also include a receptacle to receive a structure at the surgical site to facilitate positioning of the distal end portion at the desired location.

Abstract: A capless multiaxial screw fixation assembly, including: a screw having a threaded portion and a screw head portion positioned at one end thereof; and, a retainer having a first end, a second end opposite the first end, and a bore for receiving the screw threaded portion so that the screw head portion is seated therein. At least one of the screw and the retainer is configured such that the retainer is able to pivot about the screw head portion in a non-symmetrical manner.

Abstract: An orthopedic damper system and method to control the degree of flexion and/or extension motion of the mobile vertebral segment while providing additional stability to the spine. The damper system includes an anchor having a spring hitch, a spring coupled to the spring hitch, and a cap coupled to the spring. The anchor is adapted to connect to a spinous process. The spring includes an inner hollow area adapted to accommodate the spring hitch. The cap includes an opening connected to an inner cavity that is adapted to accommodate the spring and the spring hitch.

Abstract: The disclosure relates to systems and methods of spinal stabilization. Embodiments include methods of delivering a rod having a non-circular cross-sectional profile using a wire having an accommodating non-circular cross-sectional profile to inhibit movement of a rod relative to the wire. A surgical system can comprise a first sleeve advanced via a first incision to a vertebra, a second sleeve advanced via a second incision to another vertebra, a wire having a non-circular cross-sectional profile advanced via a third incision to the vertebrae and passed through the collars of bone fastener assemblies to extend from a fourth incision. A rod or a segment of a rod having a corresponding non-circular cross-sectional profile may be aligned with the wire and advanced and coupled with the vertebrae to stabilize the spine. After the rod is securely seated in the collars, the wire may be withdrawn from the body.

Abstract: An implant for fracture fixation in which a wire element has one end installed in bone and an opposite end fixed externally to the bone to apply compression across the fracture wherein a guide system is provided for guiding a tip of the one end of the wire element into a pilot hole in the bone prior to producing compression across the fracture.

Abstract: A facet support assembly including at least one rod including an upper portion rigidly fixed to a spinal fastener, and a lower portion configured to support an inferior articular process, wherein when the spinal fastener is secured to a pedicle of a lumbar vertebra, the lower portion of the at least one rod abuts against and supports the inferior articular process of the same lumbar vertebra.

Abstract: The present invention relates to flexible members for stabilizing a spinal column and methods for making the flexible members. In one embodiment, a flexible member comprises an inner elastomeric member and an outer fabric layer situated securely around the inner elastomeric member. The inner elastomeric member has a first elasticity to provide the flexible member with a desired flexibility. In another embodiment, the flexible member includes an outer covering that defines an outer elastomeric member. The outer elastomeric member may be situated securely around the outer fabric layer with the inner elastomeric member, the outer fabric layer, and the outer elastomeric member having the common lengthwise axis and defining the body including the opposing first and second ends. The outer elastomeric member may have a second elasticity that is less than the first elasticity.

Abstract: Provided is a novel mono-axial taper lock screw for connecting a connecting rod to bone. The screw is capable of being secured to the underlying bone while the screw head adapted to securely hold a connecting rod is rotated about the longitudinal axis of the screw to facilitate a stable connection to the connecting rod. The screw head can be partially locked to hold the device in place while permitting manipulation of the spine. The screw head can then be fully locked securing the connecting rod into a selected position. The screw is configured for easy insertion and connection as well as easy removal and disconnection from the connecting rod. Also provided is a bone fragments. A method of fixing bones or bone fragments is also provided.

Abstract: A tensioning tool and method for tensioning a conformable ligature of a bone fixing system are disclosed. The ends of a conformable ligature can be passed around bones, bone grafts, tendons, plates, rods, fasteners, or other anatomical or implanted structures, and the like to form a loop. Another portion of the conformable ligature can be coupled to a tensioning tool. The tensioning tool can include a first portion and a second portion in threaded engagement with each other. Rotation of one portion relative to the other can cause tensioning of the conformable ligature through translation of a tensioning member.

Abstract: A screw and rod fixation assembly includes a body member including a screw seat for seating a screw head therein and a rod seat for seating a rod therein. An adjustable locking ring applies a locking force against the screw head seated in the screw seat and a locking cap adjustably applies a locking force against a rod seated in the rod seat. The adjustable screw locking ring and locking cap function independent of each other. A method of fixing the rod to the screw includes the steps of inserting a screw head into a screw seat in one end of a body member and inserting a rod into a rod seat in a second end of a body member and selectively and independently adjusting a locking force on both the screw head and the rod within the screw seat and rod seat, respectively.

Abstract: A bone plate mounted on a bone. The bone plate has at least one opening for receiving a flush mounted cam. A through-bore passes from a side surface to opposing side surface of the bone plate. The through-bore has a diameter sized to allow insertion of a cable. A portion of the through-bore intersects with a peripheral portion of the opening. A second opening also passes from the side surface to opposing side surface. A cable may be inserted in the second opening, wrapped around the bone and its free end inserted in the through-bore. The cable may be tightened around the bone. The flush mounted cam can be rotated in place. Rotation of the cam results in the cam surface squeezing the cable between concave cam surface and walls of the opening, thereby locking the cable in the tightened state.

Abstract: The present invention relates to spinal support devices and, more specifically, to a flexible member having variable flexibility attributable to a specified configuration for use with a dynamic stabilization system or implant to provide dynamic stability to a person's spine. The flexible member generally includes a body having a lengthwise axis, an outer surface, and opposing first and second ends with an intermediate portion extending therebetween. The outer surface has one or more grooves providing the flexible member with a variable flexibility. The one or more grooves may be situated generally perpendicular to the lengthwise axis of the body and extending around less than the outer surface of the body, and/or situated generally perpendicular to the lengthwise axis of the body and extending around the outer surface of the body substantially directly in-between the ends.

Abstract: Embodiments of the disclosure provide an anisotropic spinal stabilization rod useful for connecting a set of bone fasteners that can anchor a spinal stabilization system onto vertebral bodies. The anisotropic spinal stabilization rod comprises a linear body made of a composite material with fibers selectively oriented in one or more directions to approximate a range of motion of a healthy spine.

Abstract: A spinal stabilization system includes a stabilization member with opposite end portions lying along a longitudinal axis and an adjustment mechanism between the end portions that allows the end portions to be moved toward and away from one another along the longitudinal axis.