Abstract: A compression device made of a superelastic material having a peripheral portion with an upper surface, a lower surface, and a central opening extending therethrough is provided. Tips of one or more resilient structures of the compression device project inward of the peripheral portion and form an opening. The one or more resilient structures are configured to exert a biasing force in a direction when deformed in an opposite direction. Also provided is a bone plate assembly comprising a captively retained compression device and a bone plate comprising one or more integrally formed resilient structures.

Abstract: Fixation device cartridges. At least one example embodiment is a cartridge including: a first tube; a second tube parallel to first tube; a first spacer coupled to the first tube and the second tube such that slots of the first and second tubes face each other; a second spacer coupled to the first tube and the second tube, the first and second spacers defining a suture volume between the slots of the first and second tubes, and the slot of the first tube and the slot of the second tube open into the suture volume; a first bone anchor disposed within the first tube, a first suture line associated with the first bone anchor and extending through the slot; and a second bone anchor disposed within the second tube and coupled to the first suture line.

Abstract: A polyaxial bone anchoring device is provided including a bone anchoring element (1) comprising a head (3) and a shank (2); a receiving part (4, 4?) for receiving a rod (100) for coupling the rod to the bone anchoring element, the receiving part comprising a first end (4a), an opposite second end (4b) and a central axis (C) extending through the first end and the second end, and a channel (9) for receiving the rod and an accommodation space (11) for receiving the head; a pressure element (6, 6?) arranged in the receiving part and configured to exert pressure onto the head; wherein the pressure element (6) comprises flexible sections (66a, 66b) facing away from the head (3), characterized in that the flexible sections (66a, 66b) comprise a free end portion (69a, 69b) with respect to the central axis (C) that cooperates with an inclined surface portion (15a, 15b) of the receiving part (4) such as to hold the pressure element (6) in a position in which it exerts a pre-load onto the head before the head is lo

Abstract: A bone positioning guide may include a main body member, a shaft, and a bone engagement member. The shaft can be movably connected to the main body member and have the bone engagement member rotatably coupled to its distal end. The bone engagement member can have a surface configured to engage a bone. The main body member can also include a tip opposite the bone engagement member for engaging a second bone. In use, the bone engagement member may be positioned in contact with a medial side of a first metatarsal while the tip is positioned in contact with a lateral side of a different metatarsal, such as a second metatarsal. The shaft can then be moved to advance the bone engagement member toward the tip, causing realignment of the first metatarsal.

Abstract: Embodiments are generally directed to an apparatus for reducing a rod into an orthopedic fixation device. An embodiment provides a rod-reducing apparatus. The rod-reducing apparatus may comprise a housing comprising a threaded through bore. The rod-reducing apparatus further may comprise a reduction shaft comprising a shaft portion and a through bore in the shaft portion, wherein the shaft portion may be configured to be received within the threaded through bore of the housing. The locking cap driver may comprise a locking cap driver comprising a shaft portion that may be configured to be received within the through bore of the reduction shaft, wherein a distal end of the shaft portion may be configured for attachment to a locking cap assembly.

Abstract: Methods for temporarily fixing an orientation of a bone or bones. Methods of correcting a bunion deformity. Bone positioning devices. Methods of using a bone positioning device. Bone preparation guides. Methods of using a bone preparation guide.

Abstract: This disclosure presents a MITLIF procedure. The procedure uses a single incision on one side and pedicle screws are placed on that side and through the same incision a facet screw is placed on the opposite side using a series of jigs, and, for example, the hole cutter, drill, guide shaft and screw driver described herein.

Abstract: A cervical plate assembly is disclosed. The cervical plate assembly includes a base plate including: (1) at least two bone screw seats, each bone screw seat including a borehole dimensioned to receive a bone screw, and (2) a first blocking seat positioned between the at least two bone screw seats. The cervical plate assembly includes a blocking mechanism retained within the first blocking seat of the base plate. The blocking mechanism is selectively positionable between a closed position in which the blocking mechanism obstructs at least one bone screw seat to retain a bone screw with the base plate, and an open position in which the bone screw seats are unobstructed.

Abstract: A syndesmotic reconstruction guide assembly is disclosed. The syndesmotic reconstruction guide assembly includes a medial arm, a medial foot, and a lateral arm. The medial foot is rotatably connected to the medial arm with at least one degree of freedom. The lateral arm is slidably connected to the medial arm at an end opposite the medial foot. The lateral arm includes a lateral foot. The medial foot and the lateral foot are adapted to clamp bones of a syndesmotic joint therebetween.

Abstract: A variable length headless compression screw insertion system includes a compression screw and a driver assembly for driving the compression screw into a bone. The compression screw has a bone screw and a compression sleeve coupled to the bone screw. The bone screw includes a proximal end having an external threading threadably received in the compression sleeve, and the compression sleeve includes a proximal end having a predefined drive feature and an external threading. The driver assembly includes a sleeve coupler adapted to threadably receive the external threading of the compression sleeve. A ram driver is coupled to the sleeve coupler and has a predetermined length such that its distal end is shaped to contact the proximal end of the bone screw to prevent translation of the bone screw relative to the compression sleeve.

Abstract: A kit for performing a spine stabilization procedure is provided. The kit can include a balloon-tipped cannula having an expandable balloon enclosed by an expandable metal mesh. The balloon-tipped cannula can be configured to pass through a working sleeve and to expand the expandable balloon and expandable metal mesh within a surgical site. The kit can also include a pedicle screw having at least one fenestration or cannulation. The pedicle screw can be configured to be inserted into the surgical site. Related apparatus, systems, kits, techniques and articles are also described.

Abstract: A guide provides for placing a suture anchor into an outer rim of a glenoid cavity of a patient adjacent an edge of a glenoid labrum. The guide comprises an elongated guide tube having an axial lumen with a distal opening a rim engagement member pivotally attached to the elongated tube adjacent the distal opening. The rim engagement member has a first contact surface and a second contact surface each of which are distal of the guide tube and are separated from each other and disposed on opposite lateral sides of the guide tube whereby to allow placement of the contact member over the glenoid rim, with subsequent angular positioning of the guide tube and passage of an instrument down the lumen to the labrum.

Abstract: A bone anchor insertion device for delivering one or more bone anchor components into bone is provided. The insertion device improves surgical control in bone anchor location, placement and insertion into target bone. The bone anchor insertion device also improves efficiency in placing the bone anchor. The surgical instrument provides improved control of stylet location and orientation, including directional control for precise bone anchor component insertion. Methods to use the bone anchor insertion device in surgical procedures are also provided.

Abstract: A stylet screw driver assembly having a screw driver/ratcheting handle assembly which houses a stylet, pre-assembled to a set length based on the screw length in use, fixed in place by a spring loaded button mechanism located on the proximal end of the ratcheting handle. The spring loaded button mates with the stylet assembly, providing various stylet protrusion lengths.

Abstract: The present application is directed to various spinal stabilization systems. The systems can include one or more guiding elements attached to screw members to assist in guiding rod implants and tools to desired locations within a patient. The guiding elements can include a plurality of wires, blades, or tabs. The guiding elements can be capable of criss-crossing or intersecting at or near an incision, such that only a single incision may be needed to perform a surgery. The guiding elements can also include telescoping features that allow the height of the guiding elements to be adjusted in use, thereby allowing multiple telescoping guiding elements to be used with the same incision.

Abstract: An external fixation strut and corresponding systems and methods of use with a bone alignment device are disclosed. The external fixation strut may provide an enhanced range of adjustable lengths and may be connected to a bone alignment device, thereby enabling the bone alignment device to be used over a larger workable range. As a result, comfort of a patient may be improved as the need to switch out the external fixation strut may be prevented. The external fixation strut may also include a single measurement scale that may be easily viewed and used to adjust the length of the external fixation strut, thereby ensuring more accurate length adjustments.

Abstract: This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. Extension guides are provided that attach to bone anchors implanted within the spine. The extension guides have a guide channel that align with a rod channel in the anchor to help direct the rod to the anchor. Instruments are provided to aid in insertion and positioning or the rod.

Abstract: The present invention discloses a prosthetic device for reconstruction of sternum, ribs, and clavicles, comprising a manubrium plate attached to a sternum plate by means of a joining plate. The manubrium plate has spherical ends coupled to the clavicle plate by screwing into a cup lock. The manubrium plate has extensions with holes, on which rib plates are seated. Similarly, the sternum plate has extensions with holes, on which rib plates are seated.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing, a firing system moveable along a first axis, a handle extending upwardly from the housing along a second axis that defines an acute angle with the first axis, the handle having an upper free end that defines a top of the applicator instrument, a trigger coupled with the housing for activating the firing system, and an elongated shaft extending from the distal end of the housing, the elongated shaft having a proximal shaft section extending along the first axis and a distal shaft section that is oriented at an angle relative to the proximal shaft section for extending upwardly toward the top of the applicator instrument. The trigger is squeezed for dispensing surgical fasteners from the distal end of the elongated shaft. The applicator instrument has at least one visual indicator for indicating a proper orientation for the applicator instrument in which the upper free end of the handle is positioned above the housing.

Abstract: A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

Abstract: Illustrative embodiments of orthopedic implants and methods for surgically repairing hammertoe are disclosed. According to at least one illustrative embodiment, an orthopedic implant includes a proximal segment comprising a number of spring arms forming an anchored barb at a first end of the implant, a distal segment extending between the proximal segment and a second end of the implant, and a central segment disposed between the proximal and distal segment.

Abstract: A surgical instrument having a first member engageable with a first end of a fastener having a second end configured to penetrate tissue. A second member includes an expandable member configured for engaging the first end. Systems and methods are disclosed.

Abstract: Guiding devices and methods are disclosed that comprise a detachable guide pin. The guiding devices may be driven into a bone to place the detachable guide pin within the bone. Once placed in the bone, the guide pin can be used to guide a surgical device into the bone.

Abstract: Alignment guide systems, fixation guide devices, and methods for positioning and inserting an intramedullary nail are disclosed. The alignment guide system includes a targeting guide with a first end and a second end, an alignment wire rotatably engaging a second end of the targeting guide, and a guide sleeve insert engaging an opening in the first end of the targeting guide. The fixation guide device including a frame including a first end and a second end, a compression device slidingly coupled to the first end of the frame, and the intramedullary nail secured to a nail attachment apparatus of the frame. A method of inserting an intramedullary nail into two bones for fixation of the two bones is also disclosed.

Abstract: Surgical instruments and methods for delivering bone anchor assemblies into bone are disclosed herein. Use of these anchors or instruments can eliminate one or more of the steps in a conventional bone anchor installation procedure, improving surgical efficiency and safety. In general, a surgical instrument can include a handle assembly having an elongate shaft extending distally therefrom. The handle assembly can be configured to axially translate a stylet extending therethrough relative to a bone anchor assembly coupled to the elongate shaft, and it can be configured to move the stylet proximally in response to distal advancement of a bone anchor assembly into bone. The surgical instruments can include various mechanisms for adjusting the position of the stylet.

Abstract: A fixator of a cranial flap to a skull, the fixator comprising a rigid rod, a lower disk placed at a distal extremity of said rigid rod, an upper disk mounted so as to be mobile along said rigid rod and a grip connected to the proximal extremity of said rigid rod enabling said upper disk to be made to slide towards said lower disk, said distal extremity of said rigid rod being provided with a ball-joint element and said lower disk comprising a recess for receiving said ball-joint element; said lower disk and said upper disk have convex shapes and are made out of a material enabling them to get deformed and adapt to shapes of the skull and the cranial flap, the lower and upper disks are placed flat against and secured to the internal and external surfaces of the skull and of the cranial flap.

Abstract: Systems, instruments, and methods for performing a medical procedure. The methods comprise: obtaining a surgical instrument that combines a head positioner and a driver into a single integrated part (the driver being at least partially inserted through an elongate aperture formed in the head positioner so as to extend from a proximal end of the head positioner to a distal end of the head positioner); using an actuable structure of the head positioner to limit an amount that the driver can linearly travel in a first direction within the elongate aperture formed in the head positioner; causing a screw to threadingly engage an object via rotation of the driver in at least a first direction around a central axis of the surgical instrument; and changing an orientation of a receiver via rotation of the head positioner about a portion of the driver.

Abstract: A system comprising surgical instruments of different types. Each surgical instrument includes a body member and a leg having a first end integrated with and a leg portion extending from the body member. The instrument includes a head cavity formed in a free end of the leg. The cavity holds a head. A channel is formed along a portion of a longitudinal length of the leg. The instrument includes an elongated rocker assembly pivotally coupled within the channel, with a spring actuation tab in proximity to the body member. The instrument includes a collar slidably coupled around the body member and having a first position located between the body member and the actuation tab such that a portion of the collar is under the actuation tab to limit pivotal motion of the rocker assembly and a second position of the collar has a clearance from under the actuation tab.

Abstract: A method comprises the steps of: fixing a distal end of a first member of a surgical instrument with tissue, the surgical instrument including a second member having a longitudinal passageway configured for disposal of the first member and being connected with a navigation component such that the distal end is disposable with the passageway at a selected distance from the navigation component, the navigation component being positioned relative to a sensor to communicate a signal representative of an orientation of the first member; removing the second member from the first member; and connecting a third member with the first member along the orientation such that a distal end of the third member is fixed with the tissue. Systems, spinal implants, constructs and instruments are disclosed.

Abstract: A battery pack assembly or enclosure comprises one or more batteries having an electrochemical cell and an enclosure having at least an outer wall configured to create a sealed volume of space substantially around the batteries. An atmosphere of the volume of space comprises gas having a thermal conductivity less than 0.018 watts per meter per degree Celsius. This atmosphere of gas provides an insulative layer between the outer wall of the enclosure and the batteries. With this insulative layer, the battery pack assembly can be subjected to autoclaving without damaging the batteries. The battery pack assembly can be used to power surgical tools or other devices that are subjected to autoclaving.

Abstract: Instruments and methods for selectively coupling to an object are provided, for example surgical instruments that can form a rigid connection with an object and also be disassembled for cleaning, sterilization, etc. One embodiment includes an elongate shaft with a longitudinal groove, a first partial circumferential groove that intersects with a distal end of the longitudinal groove, and a second at least partial circumferential groove formed distal to the first partial circumferential groove. The instrument also includes a sleeve disposed over the elongate shaft that includes a protrusion extending from an internal wall that is received within the longitudinal groove to constrain movement of the sleeve relative to the elongate shaft. The sleeve further includes a lock that interfaces with the second at least partial circumferential groove when the protrusion is disposed in the first partial circumferential groove to further selectively constrain axial and rotational movement of the sleeve.

Abstract: A method of tissue repair using a surgical assembly that includes the steps of assembling an implant and a driver, capturing tissue with the implant, installing the implant with the captured tissue in a socket or tunnel, advancing a tapered section of a set screw in the implant, thereby expanding the implant and fixing the implant with the captured tissue in the socket or tunnel, and releasing the driver from engagement with the set screw as the distal end of the set screw reaches the implant's closed end. A surgical assembly that includes an expandable implant having a hole with an entrance at a rear end of the implant and a closed end; a set screw, an implant insertion section, a driver engagement section, and a tapered section, where the implant insertion section is received in the hole of the implant, and a driver that is engaged with the set screw.

Abstract: A bone anchor system may include a bone anchor assembly and a driver tool. The bone anchor assembly may generally include a bone screw, a collar member, and a tulip member. The collar member may include first and second retaining arms configured to receive a retaining feature of the driver tool. The driver tool may be removably couplable to the bone anchor assembly by inserting the retention feature between the first and second retaining arms of the collar member, such that the retention feature is retained by the first and second retaining arms of the collar member.

Abstract: An implant for the stabilization and/or fusion of the sacroiliac joint has an elongated, spiraled exterior shape. The implant has a conically tapered inner core with a passage opening which extends in the axial direction along a central longitudinal axis over the entire axial length of the implant and ribs which run outward in a radial manner at least sectionally and which are arranged on the inner core and extend helically in the axial direction around at least one section of the inner core.

Abstract: A surgical repositioning instrument for lowering and fixing a fixing rod in the tulip head of a bone screw has a coupling sleeve with two distal latching arms. A locking sleeve is longitudinally displaceable on the coupling sleeve between a release and locking position. A rod presser contacts and lowers the fixing rod, which is arranged displaceably within the coupling sleeve. Arranged in a through bore in the handle part is the locking sleeve, coupling sleeve and rod presser. On a grip part, an actuating lever is pivotally mounted to advance the rod presser relative to the coupling sleeve. The actuating lever has a laterally projecting force arm and a load arm which is coupled to the rod presser. The locking sleeve protrudes in its release position and is independently slid into its locking position by the rod presser acting on its proximal end with an axially directed force.

Abstract: A hand-held electromechanical surgical device configured to selectively connect with a surgical accessory, is provided and includes a handle assembly having a power pack with a core assembly. The core assembly includes a plurality of motors, with each motor having a rotatable drive shaft extending therefrom, wherein each drive shaft is parallel to one another; a processor connected to and configured to control each motor; and a battery electrically connected to the processor and each motor. The power pack includes an inner housing encasing at least the plurality of motors, the processor, and the battery. The handle assembly includes an outer shell housing configured to selectively encase substantially the entire power pack therein, wherein a rotation from each rotatable drive shaft of each motor is transmitted through the inner housing and the outer shell housing.

Abstract: Fixation device cartridges. At least one example embodiment is a cartridge including: a first tube; a second tube parallel to first tube; a first spacer coupled to the first tube and the second tube such that slots of the first and second tubes face each other; a second spacer coupled to the first tube and the second tube, the first and second spacers defining a suture volume between the slots of the first and second tubes, and the slot of the first tube and the slot of the second tube open into the suture volume; a first bone anchor disposed within the first tube, a first suture line associated with the first bone anchor and extending through the slot; and a second bone anchor disposed within the second tube and coupled to the first suture line.

Abstract: Methods and systems are provided for securing tissue to bone. A surgical system can include a driver device, an elongate shaft receivable within the driver device and having a dilator feature at its distal end, and a capture suture extending through the shaft such that the capture suture's terminal end portions extend to a more proximal position on the driver and the capture suture forms a loop that extends through an opening formed through a side of the shaft. The loop is configured to receive at least one retention suture therethrough and can be tightened by pulling the capture suture's terminal ends, thereby coupling the retention suture with the suture anchor. Once the shaft is inserted into bone and the loop with the retention suture is closed, the suture anchor is driven distally towards the dilator features and into the bone to secure the retaining suture in the bone.

Abstract: A universal surgical instrument includes an elongated member having a first end and a second end, the second end having flexible prongs with a head cavity to hold therebetween a polyaxial head. The universal surgical instrument includes a cuff member at the first end to interface with interchangeable surgical instruments. The universal surgical instrument includes an I-shaped clamp coupled to the elongated member and being configured to unlock and separate the flexible prongs to expand the head cavity for placement of the polyaxial head therein and to lock the head cavity in response to application of a force to slide the I-shaped claim along the elongated member to a locked position. A system of surgical instruments include the universal instrument and interchangeable surgical instruments that can be interchanged in the cuff member of the universal instrument.

Abstract: Devices, systems, and methods are provided for managing suture filament during a tissue repair procedure. One exemplary embodiment of an anchor insertion tool includes a handle, an elongate shaft extending distally from the handle, and a ring disposed around the elongate shaft. The ring can be configured to slide along a length of the shaft, and can be configured to engage a filament extending from an anchor removably coupled to the shaft's distal end during a suture anchor insertion procedure. In some embodiments, the ring can include one or more slots for receiving a filament and maintaining a tension applied to the filament. The ring can also include features that prevent it from rotating with respect to the shaft, such as a boss formed on a ring's central opening that engages a slot formed in the shaft. Other devices, systems, and methods for suture anchor insertion are also provided.

Abstract: Disclosed is a system for assisting in guiding and performing a procedure on a subject. The subject may be any appropriate subject such as inanimate object and/or an animate object. The guide and system may include various manipulable or movable members and may be registered to selected coordinate systems.

Abstract: A surgical instrument comprises a member being engageable to a spinal implant configured for connection to a bone fastener shaft. An actuator is connected to the member. A latch is connected to the actuator and the connection is configured to change between at least one non-locked orientation such that the actuator is movable relative to the member and a locked orientation such that the actuator is fixed relative to the member. Systems, spinal constructs, implants and methods are disclosed.

Abstract: A method for suspension of the CMC joint that minimizes patient irritation/discomfort and damage to the surrounding tissue. Specifically, the method is a method for suspending a first metacarpal in relative position to a second metacarpal. The method includes the steps of: (i) drilling a hole through the first metacarpal; (ii) inserting a drill guide through the hole in the first metacarpal; (iii) advancing the drill guide to a surface of the second metacarpal, and drilling a hole in the second metacarpal; (iv) inserting an anchor into the hole formed in the second metacarpal, wherein the anchor is attached to suture; (v) deploying the anchor within the second metacarpal; (vi) tensioning the suture attached to the anchor; and (vii) fixing the position of the first metacarpal relative to the second metacarpal using the suture.

Abstract: This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. Extension guides are provided that attach to bone anchors implanted within the spine. The extension guides have a guide channel that align with a rod channel in the anchor to help direct the rod to the anchor. Instruments are provided to aid in insertion and positioning or the rod.

Abstract: A retractor system includes one or more blades, a handle, and a frame. The handle includes first and second arms with jaw portions and recesses configured to removably retain a blade. Both arms include rotatable connections and handles, where the rotatable connections are between jaw portions and handles. The rotatable connections are connected together such that the arms are rotatable with respect to one another. In one embodiment, the recesses are partial disc shapes opposed to one another, such that when the jaw portions are in a closed position, a disc-shaped space is present between the jaw portions in the closed position. The blade includes a corresponding disc-shape protrusion that may be retained in the recesses, and in some embodiments may include one or more notches to mate with a protrusion in a recess that prevents blade rotation while in the handle.

Abstract: A bone fastener includes a proximal portion including an inner surface defining an implant cavity. A first member is configured for disposal with the proximal portion and includes a wall defining a cavity. A second member is configured for disposal with the cavity. A distal portion includes a first end disposed within the members and a second end configured to penetrate tissue. The proximal portion overlaps the second member to limit movement of the first end of the distal portion. Systems and methods are disclosed.

Abstract: Multi-function driver instruments and related methods are disclosed herein, e.g., for applying a fastener to a bone anchor. In some embodiments, a single instrument can include features for driving multiple different types of fasteners, independently driving multiple different components of a single fastener assembly, and so forth, with the instrument being switchable between multiple operating modes to select the feature needed for a particular function. The instrument can include features for retaining a fastener to the instrument, e.g., during initial insertion of the fastener.

Abstract: Spinal correction surgical techniques and methodologies for correction of scoliosis using non fusion anterior scoliosis correction, including soft tissue releases, unique correction techniques such as de-rotation, and unique single and dual anchor screw/cord applications.

Abstract: Various devices, systems, and methods for anchoring sutures are provided In general, a suture anchor can include a groove formed in an exterior surface thereof and configured to seat a suture at least partially therein. The suture can be configured to automatically become seated in the groove during the advancement of the anchor into bone, such as by being rotated therein using a driver tool. The suture and the groove can have cooperating sizes such that the suture seated in the groove extends radially outward therefrom to be partially located outside of the anchor. This external portion of the suture can be press fit between the anchor and the bone, thereby securing both the anchor and the suture to the bone. This securing can occur as part of driving the anchor into bone.

Abstract: A percutaneous method for removing an outer portion of the proximal end of a lag screw protruding from a fractured femur when embedded in the femur to stabilize an intramedullary nail implanted in the intramedullary canal using a multi-part cannulated driver wherein the lag screw comprises a distal section, an intermediate section including a channel formed in the proximal portion thereof with a driver recess formed at the distal end thereof, and a proximal section having a notch, groove or score mark formed on the exterior surface of the lag screw separating or between the intermediate section and the proximal section and the multi-part cannulated driver comprises a cannulated shaft including a first driver member formed thereon configured to engage the driver recess to prevent the distal section and intermediate section of the lag screw from rotating in the femoral head when torque is applied to the proximal section by a second driver member engaging the proximal section of the lag screw to separate the pro