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

Abstract: An apparatus, system, and method are disclosed for positional fixation of a fastener, including but not limited to the extraction of an orthopedic screw. According to one embodiment, an instrument is provided which accepts a collet designed to conform to a proximal end of a variety of types and sizes of fasteners. The collet is installed through a chuck body, which is seated in a distal end of a handle. A closing mechanism within the handle causes the collet to tightly grip and lock onto the proximal end of the fastener. A compressible distal end of the collet may have longitudinal slits that define jaws for improving gripping flexibility.

Abstract: An implant has a bone plate with a bone contacting surface and an opposite outwardly facing surface. The plate includes a split-ring receiving recess open to the outwardly facing surface located intermediate first and second bone screw receiving openings in the plate. The first and second bone screw receiving openings each having a slot spaced from the outwardly facing surface towards the bone contacting surface. The slot is formed in a wall of the first and second bone screw receiving openings. The slot is open to the split ring receiving recess. A resilient split-ring has a thickness less than a height of the slots in the first and second bone screw openings when measured along the bone screw receiving opening axis.

Abstract: A wire or pin fixation and tensioning device has a wire post having a head portion with an opening having a predetermined longitudinal axis for reception of a wire or pin. The wire post has a neck portion for engaging an opening of the medical device. A locking element is adapted to be introduced into opening having an opening with inclined sections inclined to the longitudinal axis. A clamping cone abuts an abutment element and has a clamping opening to accommodate a wire and has outer surfaces inclined to the longitudinal axis and encompassed within the conical section of the locking element. Upon an axial displacement of the locking element relative to the cone a radial force is exerted onto the cone leading to a reduction of the diameter of the clamping opening to apply a radial force onto a wire or pin therein.

Abstract: A cannulated fastener system is provided for orthopedic applications that include attaching bone plates to bone. The bone fastener has a cannulation with an inner shape. One or more screwdrivers is provided with a shaft having a shape that matches the cannulation of the fastener to rotationally fix the fastener to the screwdriver. In addition, the screwdrivers have a cutting blade that begins the drilling of a hole for the bone fastener. The screwdrivers may either be for use with a single fastener or have multiple fasteners loaded within a retaining sleeve for automatic or controlled dispensing.

Abstract: A tool and a method are provided for driving a bone pin into a fractured bone to stabilize the fractured bone by maintaining the fractured bone in a reduced state. The tool may be a handheld device including a cartridge having at least one passageway that receives the bone pin. The tool may also include a pneumatically-powered piston having a needle that is sized for receipt within the passageway of the cartridge, the needle applying sufficient force to the bone pin to drive the bone pin out of the cartridge and into the fractured bone.

Abstract: An interlock driving instrument is configured to be releasably lockable to a fastener, such as a bone anchor. A bone anchor can be locked to the interlock driving instrument by inserting an expandable distal end of the shaft of the interlock driving instrument into the driving opening of the bone anchor and expanding the distal end within the driving opening by translating an expansion member into the expandable distal end. Alternatively, the bone anchor can be locked to the interlock driving instrument by inserting the distal end of the shaft of the interlock driving instrument into the driving opening of the bone anchor and translating a sliding member along a sloped surface defined in a channel extending into the shaft.

Abstract: A method of determining the pedicle base circumference and the pedicle isthmus to facilitate screw placement in a pedicle of a vertebral body during spinal surgery, comprising providing a series of first lines tangential to the outer cortical surface of the vertebral body in and near the pedicle on a transverse section from a three-dimensional image of the vertebral body, providing a series of second lines extending through the vertebral body in and near the pedicle thereof in perpendicular relation to the series of first lines, identifying the pedicle base circumference as the areas of the outer cortical surface where adjacent second lines are at the greatest angle with respect to one another, and identifying the pedicle isthmus as the areas of the outer cortical surface where the second lines that are opposed to each other are closest to being parallel to one another.

Abstract: Provided are fixation members useful in fixing an implant to a bone. The fixation members include an awl tip so as to enable their secure installation by use of an awling motion, which in turn speeds the installation of the fixation members.

Abstract: Disclosed are several embodiments directed to a flexible fixation device and method to provide adequate purchase into bone at angles that are awkward for properly engaging inflexible and rigid screws. In one instance, the fixation device is comprised of a head to effect engagement of the device and to acts as an insertion-stop for the device, as well as a helical portion of a suitable cross-sectional geometry to allow for adequate purchase into bone. The helical portion provides fixation as the helical form engages the bone over a relatively large surface area relative to the size of the entry point. The helical portion may be variously configured to resemble, for example, a cork screw, a coiled spring, and so forth. Most variations offer both flexibility (to make angled insertion achievable) while still retaining enough helical-directional rigidity to achieve the desired implantation and fixation.

Abstract: A method of placing screws into bone or tissue structure during a medical procedure uses a power driven screw driver, a fastener carrier with a series of fasteners temporarily attached thereto and an elongated band structure carried by the fastener carrier system for positioning and advancing the individual fasteners of the series of medical fasteners in a controlled manner to a position to receive a driving tip on the powered screw driver.

Abstract: A surgical tool includes a proximal end, a distal end and a longitudinal axis extending from the proximal end to the distal end. The surgical tool has a fastener engagement tip having a spring extension extending substantially parallel to the longitudinal axis of the surgical tool. The spring extension is resiliently flexible and deflectable between a first arrangement, in which the spring extension is in a relaxed state, and a second arrangement, in which the spring extension is deflected to facilitate insertion of the fastener engagement tip into a fastener slot.

Abstract: An instrument system is provided for positioning an internal fixation prosthesis and guiding a cannulated bone drill during a surgical, radioscopic procedure for the repair of a fractured bone of a patient. The instrument system includes a target wire, a handle formed from a radio translucent material having a target hole for guided passage of the target wire along a target axis. The target axis coincides with the intersection of a first plane and a second plane orthogonal to the first plane. The instrument system also includes a nose component attached to an end of the handle and removably connectable to the prosthesis. The nose component includes an alignment sight formed from a radio-opaque material.

Abstract: A spinal fixation system that utilizes a composite rod to which polyaxial pedicle screw/tulip assemblies are secured, a screwdriver that permits independent threading of a guide member to the tulip and independent threading of the pedicle screw, together with interengaging conical surfaces that true the screwdriver with the pedicle screw. In preferred embodiments, the screwdriver includes an elongated drive shaft having a handle end for imparting rotation and a pedicle screw engaging end, a cylindrical guide member rotatably mounted about said drive shaft, a knob at one end of said guide member for rotating same and a threaded tulip engaging end at the other end thereof. A grip is preferably sleeved around the cylindrical drive member and is longitudinally movable between proximal and distal positions wherein its distal end uncovers and covers, respectively, the screw engaging unit.

Abstract: A one step entry pedicular preparation device works well with Minimal Invasive Spine Surgery (MISS) to facilitating such approach. A related intervertebral disc access system and pedicle screw compatible with the systems is also illustrated. The systems include a manipulator having a bar handle and main body with main barrel bore a pedicle dart having a proximal tip end and a second distal open end selectably attachable to the manipulator using a variety of interconnect configurations, both of which work in conjunction with a guide pin. The pedicle darts can be made of any material, disposable or re-usable and can be utilized for a variety of purposes, including bone structure formation for faster conventional pedicle screw insertion with precision and vertebra fixation.

Abstract: A system comprising a screw element having a generally cylindrical body having a bore or lumen therethrough and a plurality of fenestrations or windows through which biological material may be provided. The system comprises a tool for inserting the biological material into the screw element so that the biological material may extrude through the plurality of fenestrations or windows and through an aperture in the tip of the screw element thereby enabling providing a fusion mass across two adjacent facet bones or a facet joint wherein the screw itself provides both a fixation component and a screw component.

Abstract: A bone anchor having a bone engaging portion adapted for anchoring to bone, and an elongate post portion extending from the bone engaging portion and arranged along a longitudinal axis. The elongate post portion includes a proximal end region connected to the bone engaging portion, a break-off region extending axially from the proximal end region, and a guide region extending axially from the break-off region and configured for sliding engagement with an implant, and with the break-off region including a pre-defined fracture initiator zone to facilitate initiation of a fracture therealong upon application of a sufficient torsional force onto the break-off region and removal of a length of the elongate post portion distal of the fracture.

Abstract: An instrument set for screwing an implant into an intervertebral disc space comprises a guide sleeve and a screwing-in instrument. The latter has a shank having a distal end at which the implant can be fixed in a rotationally rigid manner. At the proximal end a rotary handle is fastened in a rotationally rigid manner. The screwing-in instrument further has a residual-advance indicator, which is configured to quantitatively indicate to the surgeon, during the screwing-in procedure, how far the implant is distant in the axial direction from an axial specified position that is fixed relative to the location at which the guide sleeve is supported on the vertebrae.

Abstract: A polyaxial screwdriver for inserting a bone screw in a vertebra. A polyaxial bone screw assembly includes a coupling element. When a screw engaging end of the polyaxial screwdriver is lowered on the head of the bone screw, the complimentary surfaces of the screw engaging end of the screwdriver and the head of the screw self-align. A ratchet mechanism formed in the screwdriver provides progressive and automatic locking of the polyaxial screwdriver to the coupling element and prevents the accidental unthreading from the coupling element. In another embodiment of the polyaxial screwdriver, a collet slides over the outside surface of the upper end of the coupling element and locks on to the coupling element. In yet another embodiment of a polyaxial screwdriver, the outer sleeve of the polyaxial screwdriver has a split end that securely engages the coupling element.

Abstract: A surgical instrument for securing an anchor in a target area of the skull of a patient, wherein the anchor has a shaped surface, a top and a base. In one embodiment, the surgical instrument includes a driver having a first end, an opposite, second end, and a body portion defined therebetween forming a bore therein along a longitudinal axis, where the bore is configured to allow the anchor to be received therein, a first inner surface formed inside the bore proximate to the first end, wherein the first inner surface is formed with a shape that is complimentary to the shaped surface of the anchor, and a second inner surface formed inside the bore and between the first inner surface and the second end, wherein the second inner surface is formed with a shape that is different from that of the first inner surface.

Abstract: Apparatus and methods for facet fusion include an insertion tool and a guide tool coupled to one another. The insertion tool has a proximal end portion and an opposite distal end portion. The distal end portion of the insertion tool is configured to retain an interbody implant, such as, for example, an inter-facet implant configured for placement between a superior facet and inferior facet of a facet joint. The proximal end portion of the insertion tool includes a handle. The guide tool includes an elongated body with a passage extending between and opening at its distal and proximal ends. A linking member extends between and adjustably connects the guide tool to the insertion tool so that the passage of the guide tool is alignable with the interbody implant retained on the insertion tool while the insertion tool and guide tool are in substantially orthogonal relation to one another.

Abstract: A snap-off surgical screw configured for threading into a bone of a patient using a driver member, comprising a shaft extension joined to a screw portion via a frangible connection. The frangible connection comprises at least one defect formed through an outer surface of the frangible connection. The defect is configured to promote selective separation of the shaft extension from the screw portion at the defect. A proximal end of the screw portion is preferably provided with a recess, and the frangible connection is preferably positioned in the recess to thereby configure the shaft extension to snap-off from the screw portion below the proximal end of the screw portion.

Abstract: A tool and a method are provided for driving a bone pin into a fractured bone to stabilize the fractured bone by maintaining the fractured bone in a reduced state. The tool may be a handheld device including a cartridge having at least one passageway that receives the bone pin. The tool may also include a pneumatically-powered piston having a needle that is sized for receipt within the passageway of the cartridge, the needle applying sufficient force to the bone pin to drive the bone pin out of the cartridge and into the fractured bone.

Abstract: A sacro-iliac implant delivery instrument includes a first arm connected to a first cannula. The first cannula is rotatable relative to the first arm and is configured for support of a fastening element. A second arm is connected to the first arm. The second arm is rotatable relative to the first arm and is configured for detachable connection to a sacro-iliac implant. The second arm and the first cannula are configured for rotation relative to the first arm to a preset orientation such that the second arm is disposed along a first predetermined trajectory for delivering the sacro-iliac implant and the first cannula is disposed along a second predetermined trajectory for delivering the fastening element in alignment with the sacro-iliac implant for transarticular fixation. Methods of use are disclosed.

Abstract: A surgical plate system, components and methods of using are described. A surgical plate system includes a plate having an anterior surface, a posterior surface, a longitudinal axis, a transverse axis and a through hole passing through the anterior and posterior surfaces. A variable fastener is configured and dimensioned to connect to the plate, the variable fastener having a head and a shaft extending distally from the head. The head is configured to assume different proximal end diameters. The head, in a first configuration allows inward flexing to reduce a diameter of the head to allow the head to pass through an entrance opening of the through hole. In a second configuration, the head is prevented from flexing inwardly thereby preventing the head from backing out of the entrance opening, while allowing articulation of the head, within the through hole, relative to the plate.

Abstract: The present disclosure relates to a delivery device and screw combination. The combination includes a delivery device comprising a handle and a shaft coupled to the handle, the shaft including a proximal end, a distal end, a non-circular cannulation, and markings along a length of the shaft; an interference screw coupled to the delivery device comprising a proximal end and a distal end, the screw including threads extending in an open helical form from the proximal end to the distal end, a suture bridge located at a distal end of the screw and housed within a slot of the delivery device shaft, and a plurality of runners extending longitudinally along an interior of the screw, the runners housed within grooves of the delivery device shaft; and a suture disposed around the suture bridge, ends of the suture extending through the cannulation of the delivery device shaft.

Abstract: An instrument for manipulating a spinal fixation element relative to a bone anchor includes a bone anchor grasping mechanism, a first adjustment mechanism, and a second adjustment mechanism. The bone anchor grasping mechanism includes a first arm having a distal end configured to engage an opening provided in the bone anchor. The first adjustment mechanism includes a second arm pivotally connected to the first arm. The second arm has a distal end configured to engage an opening provided in the bone anchor and is operable to adjust a spinal fixation element in a first direction upon pivoting relative to the first arm. The second adjustment mechanism is removably and replaceably coupled to the bone anchor grasping mechanism and is movable relative to the bone anchor grasping mechanism to adjust the spinal fixation element in a second direction, perpendicular to the first direction, relative to the bone anchor.

Abstract: A bone screw is provided having first and second threaded portions of different diameter separated by a middle portion that is unthreaded so that the bone screw may be inserted into a pair of adjacent bone fragments and used to compress the fragments together by driving the screw into a hole drilled in the fragments. An installation tool is also disclosed for threadably engaging one end of the bone screw and is used to initially drive the screw into the bone hole. Thereafter, a screwdriver may be inserted through the tool and into engagement with a recess in the bone screw and may be used to drive the screw fully into the bone and to separate the bone screw from the installation tool. A method of installation is further provided.

Abstract: A blade assembly has a blade body and a blade body surround. A retractor attachment structure is attached to the blade body at the first end portion thereof extending from an exterior surface thereof. The retractor attachment structure is configured for having one of the blade body mounting structures of the retractor engaged therewith in a manner whereby the blade body is independently pivotable about and translatable along the blade body mounting structure. An alignment member protrudes from an interior surface of the blade body adjacent its first end portion. A slot extends through the blade body at its first end portion. The blade body surround and the blade body jointly form a generally cylindrical-shaped structure when the blade body is in a seated position within the slot. The cylindrical structure defines a central passage extending between the first and second end portions of blade body surround.

Abstract: The various embodiments disclosed herein relate to implantable devices for the treatment of syndesmosis injuries. More specifically, the various embodiments include systems, devices, and methods for implantation of an implantable device having at least one bone anchor for treating such injuries.

Abstract: A system for delivering a surgical tack in tissue includes a driver, comprising: a shaft having a slot and a channel; and a handle slidably connected to said shaft and having a driving mechanism, said driving mechanism having a driving pin for providing a downward force through said shaft; and a tack cartridge having a plurality of tacks and adapted to be received in said slot and further adapted to feed said tacks between said driving mechanism and said channel.

Abstract: A minimally invasive tool to facilitate implanting a pedicle screw and housing is provided. The minimally invasive tool includes a first sleeve having flexible tabs that couple to a housing and a second sleeve slidably engaged in the first sleeve. The second sleeve provides reinforcing such that the first and second sleeve provide counter torque for driving the pedicle screw.

Abstract: A percutaneous facet fixation system minimally invasive, reproducible, efficient, and effective. Capable of immediate stabilization of a facet joint complex, the instrumentation and methods may be used with C-arm and/or endoscopic visualization.

Abstract: A locking spring screw, comprising: a cylindrical screw body; a flexible spring member; and, a screw head attached to the cylindrical screw body, wherein the screw head comprises a tool slot adapted for receipt of the spring member, at least one outlet adjacent to the tool slot adapted for passage therethrough of a tongue of the spring member, and, a ridge located opposite the at least one outlet from the cylindrical screw body and at least partially around the circumference of the screw head.

Abstract: A spinal implant inserter having a) an outer sleeve having a bore, and b) a forked inner shaft having a proximal rod and a pair of distal tynes extending therefrom, each distal tyne comprising an engagement feature having a laterally-extending dovetail feature. An assembly comprising the implant inserter and an implant having a pair of mating dovetail features.

Abstract: An assembly includes a holder having a first arm and a second arm, the holder being movable between a first configuration and a second configuration. The assembly further includes an actuator movable in relation to the holder between a first position and a second position. Movement of the actuator from the first position to the second position causes movement of the holder from the first configuration to the second configuration. The first arm has a first bone plate contact portion, and the second arm has a second bone plate contact portion. The first bone plate contact portion and the second bone plate contact portion are separated by a first distance when the holder is in the first configuration. The first bone plate contact portion and the second bone plate contact portion are separated by a second distance when the holder is in the second configuration. The first distance is greater than the second distance.

Abstract: A bone anchoring device has an anchoring element, a receiving portion, and a pressure element. The anchoring element includes a shank to be anchored in a bone or a vertebra and a head, the head having an exterior surface with a spherical segment-shaped portion. The shank and the head are separate parts. The receiving portion includes a first end, a second end, a longitudinal axis passing through the two ends, a bore coaxial with the longitudinal axis, and a first region adjacent to the second end for receiving a spherical segment-shaped section of the head. The pressure element exerts pressure on the head to lock the head in the receiving portion. The head has a hollow inner portion to receive a free end portion of the shank and wherein the head and the end portion are formed such that the end portion can be elastically clamped by the head.

Abstract: A surgical fastening system for attaching one piece of tissue to another piece of tissue. The system comprises a surgical fastener, an installation tool for deploying the surgical fastener in tissue, and a method for using the same.

Abstract: A trajectory structure is configured for contact with a surface to dictate an insertion trajectory of a pin relative to the surface. A location structure is configured to allow longitudinal passage of at least a portion of the pin therethrough to dictate an insertion location of the pin relative to the surface. An elongate handling rod is connected to the trajectory structure and the location structure. The handling rod supports the trajectory structure and the location structure for manipulation by a user. The handling rod spaces the trajectory structure and the location structure longitudinally apart. The trajectory structure is connected to the handling rod for trajectory adjustment in at least two degrees of freedom relative to the handling rod. The insertion trajectory of the pin insertion is substantially dependent upon the trajectory adjustment. A method for inserting an elongate guide pin into a bone surface is also provided.

Abstract: Bone screws have heads which are provided with a hex socket as well as a threaded portion. A screw driver system includes a hex driver and a threaded driver. The screw driver system permits driving the screw through a plate system into a bone until desired compression is obtained. Then the screw is locked to the plate while maintaining the imparted compression.

Abstract: An insertion handle for medical implants includes a handle with an elongate shaft extending therefrom and connection means for the implant disposed at the end of the shaft opposite the handle. The connection means includes a pivotable attachment for the implant that is controlled remotely from the handle. Both angle of the implant with respect to the handle and shaft as well as the attachment may be separately controlled and adjusted. Remote angular adjustment facilitates insertion of implants in to small surgical sites because the orientation of the implant may be repeatedly, remotely adjusted as the implant is inserted. Connectors may also be provided at the engagement surface between the handle and implant in order to provide communication with the implant or surgical site. The connectors also may serve as torque bearing members to avoid the need for separate torque bearing means such as keyways and the like.

Abstract: The instant invention is directed to a universal bone screw screwdriver and in particular to a universal screwdriver that permits the removal of screws from bone plates that are manufactured by different manufacturers having distinct characteristics. The universal bone screw screwdriver is adapted to replaceably receive tool bits corresponding to the screw heads of different manufacturers and comprises a torque limiting spring to secure the tool bit to the driver shaft and inhibit over-tightening of the bone screw into the bone or bone plate as the case may be.

Abstract: A system for guiding an implant to an optimal placement within a patient includes a trajectory guide for guiding instruments along a selected trajectory and a trajectory fixation device for fixing the trajectory guide in a selected position. The trajectory guide defines a path configured to align with the selected trajectory. A movable support mounts the trajectory guide and selectively moves the trajectory guide to align the trajectory guide with the selected trajectory prior to fixing the trajectory guide in the selected position. After fixing the trajectory guide, instruments can be inserted along the trajectory through the path defined by the trajectory guide.

Abstract: A tool for holding or driving an implant member having a recess is provided including an elongate tool shaft having a distal head portion for being received in the recess and a securing mechanism that keeps the head portion in the drive recess and which is disposed proximally up along the tool shaft from the distal head portion. In one form, the securing mechanism includes a plurality of resilient leg member having distal end locking portions. In another form, a drive system includes a drive tool and a driven member. The drive tool has a generally annular flange portion that is radially larger than the drive head portion. The driven member has a generally annular securing portion for receiving the flange portion in releasably locked engagement so that the circumferential extent of the locking engagement is maximized relative to the smaller radial size of the drive head portion.

Abstract: The present invention generally relates to devices for deploying intraocular shunts without the use of an optical apparatus that contacts an eye, such as a goniolens. In certain embodiments, devices of the invention include a housing including a proximal portion and a distal portion, in which the distal portion is movable within the proximal portion, a deployment mechanism at least partially disposed within the housing, and a hollow shaft coupled to the deployment mechanism, in which the shaft is configured to hold an intraocular shunt.

Abstract: A retractor system and method for locating and placing a polyaxial screw while substantially simultaneously retracting tissue is shown and described. The retractor has a channel that facilitates introducing a rod into the polyaxial screw. Various embodiments are shown, including one which utilized a reducer for moving the rod in the retractor.

Abstract: Disclosed is a surgical screwdriver providing a secure fit for a fastener for use in inserting the fastener into a patient. The device creates negative pressure within the tip of the surgical screwdriver for holding the fastener in place. Negative pressure is created by drawing air through a nozzle at the tip of the device. Air is pulled through the device and out the proximal end of the device's handle via suction tubing connected to the suction attachment of the proximal end of the handle.

Abstract: An apparatus for providing medical treatment includes a tool portion configured to operate relative to bone tissue, a handle portion to operate the tool portion, and a nerve monitoring system to detect neural elements. The tool portion includes an insulated shaft comprised of an electrically conductive member and a non-insulated tip. The shaft carries an electrical signal to the non-insulated tip. The handle portion, which is removably and operably connected to the tool portion, incorporates an operating system to rotationally operate the tool portion. Additionally, the nerve monitoring system is linked to the tip and is operable to detect a neural element as a function of a characteristic of the electrical signal on the tip. Upon detection of a neural element, the nerve monitoring system provides a signal to the operating system of the handle portion directing the operating system stop rotation of the tool portion.

Abstract: A surgical instrument for applying a rotational force to a structural element during a surgical procedure. The instrument may be designed for increasing an input force to produce an enlarged output force adequate for fracturing an excess section of the elongated element from a remainder of the structural element. The instrument may include an input mechanism that receives an external rotational input force, a planetary gear system that multiples the input force, and an output mechanism that attaches to and delivers the multiplied rotational output force to the excess section of the structural element. The output mechanism may also be configured to capture the separated excess section. The instrument may include a housing and a handle for grasping and manipulating during the surgical procedure.

Abstract: An introducer is provided for inserting a connecting rod into tissue of a spine that comprises an outer sleeve with an actuatable rod attachment portion at a distal end thereof to releasably pivotally attach to a connecting rod, and an elongate inner shaft movable translationally within the outer sleeve. The proximal end of the shaft is coupled to an actuation mechanism for selectively translating the inner shaft. The distal end of the shaft includes a rod engagement surface that is movable y the actuation mechanism to a first position to engage a cooperative engagement surface on the rod to hold the rod in a selected locked orientation, to a second position to space the rod engagement surface from the cooperative engagement surface of the rod to allow pivoting of the rod, and to a third position to release the rod from the outer sleeve.