Abstract: Methods and apparatus for immobilizing a synovial joint, such as a sacroiliac (SI) joint are disclosed. In one form, a multipiece fixation device, such as a dowel, includes multiple expandable fasteners that are configured to fix adjacent bones of a synovial joint with respect to one another. The expandable fasteners include expansion portions that are expanded radially via insertion of another expandable fastener or an expansion device to fix the expandable fasteners to the bone. The fixation device may be configured to provide for compression or distraction of the bones of the synovial joint while at the same time stabilizing the joint.

Abstract: Various methods and devices are provided for bone screw fixation. In one exemplary embodiment, the methods and devices provide a bone fixation device that includes a receiving head having a recess adapted to seat a spinal rod therein and a shank extending distally from the receiving head. An anti-rotation mechanism can be located distal of a distal end of the receiving head and around a proximal portion of the shank, and it can be configured to interact with bone to prevent rotation of at least a portion of the bone fixation device relative to the bone.

Abstract: A graft fixation system for fixing graft material in a bone tunnel includes an expandable fixation member having a graft receiving eyelet disposed proximate its distal end, opposed bone engaging elements disposed about its periphery, and an expansion plug receiving opening defined in its proximal end. The system also includes an expansion plug having a diameter greater than the diameter of the expansion plug receiving opening so that forceble insertion of the expansion plug into the expansion plug receiving opening causes an expansion of the expandable fixation member driving the opposed bone engaging elements apart so as to fix the bone engaging elements, as well as the graft material, in a bone tunnel.

Abstract: A bone anchoring element includes a shaft for anchoring in a bone, the shaft having a tubular body. The shaft comprises a plurality of barb elements, wherein each barb element is formed as continuous one-piece part with the tubular body. Each barb element is moveable between a first position adjacent to the tubular body and a second position further from the tubular body than the first position. The barb elements are arranged along at least one helical line around an axis of the shaft.

Abstract: A system and method are for bone fixation. A radially expandable sleeve is inserted over an elongated shaft of a bone screw. The bone screw and radially expandable sleeve are inserted into a transverse opening extending through a bone fixation device positioned in a bone until the radially expandable sleeve is fully housed within the transverse opening. The bone screw is further screwed into the bone relative to the radially expandable sleeve to cause expansion of the radially expandable sleeve within the bone fixation device, thereby locking the sleeve to the bone fixation device.

Abstract: An insert for receiving a bone screw includes an elongate sleeve having opposed proximal and distal ends and a wall defined by an outer peripheral surface configured for engaging bone and an inner peripheral surface configured for receiving a bone screw extended therethrough. At least one elongate slot is formed in the wall of the sleeve for promoting flexure of the insert. A tool for affixing an orthopedic screw insert within bone tissue includes a socket portion configured and adapted to engage a proximal section of an outer peripheral surface of an orthopedic screw insert. A driver extends distally from the socket portion. The driver is configured and adapted to engage a section of an inner peripheral surface of the orthopedic screw insert distal from the socket portion.

Abstract: A fixation device comprises a biodegradable inner core extending along a longitudinal axis from a distal tip to a proximal end in combination with a sleeve surrounding the core along a portion of a length thereof and comprising a thermoplastic polymer formed of a material which softens and expands into surrounding bone tissue when activated by an energy source.

Abstract: A biocompatible surgical fastener, comprising a sleeve and a screw or a pin, which expands when it is implanted in a patient. The sleeve is first implanted in a pre-drilled hole in the operating area of a patient, usually in a bone, cartilage or a bone and cartilage. When a screw or a pin is installed in the sleeve, the sleeve is caused to expand thereby stabilizing the fastener in the operating area. In many embodiments the screw or pin can be removed and reinserted without disturbing the tissue in the operating area. The surgical fastener can be used to repair tissue or to secure other implant devices in a patient.

Abstract: A system for communicating fluid to or from a bone includes an insert. The insert includes a shaft extending between proximal and distal ends of the insert, a fenestration, and an expandable portion coupled to the shaft. The shaft is cannulated along at least a portion of the shaft between the proximal and distal ends. The fenestration is disposed along the cannulated portion of the shaft. Outer surfaces of the expandable portion are configured to expand laterally outward to increase the cross-sectional area of the expandable portion orthogonal to the shaft.

Abstract: The invention facilitates the fixation of bone fractures. In particular, the invention relates to a cap that has an inside surface comprising an interface component that is operable to engage a flexible wire. The flexible wire is connected to a head component that engages a first bone fragment. The outside surface of the cap may include cutting threads to facilitate attachment to a second bone fragment. A tensioner may be used to exert tension on the wire, the cap and the head component, thereby drawing the first bone fragment to the second bone fragment. In various embodiments, the cap is a planar disk that has a central hole that restricts backward translation and expands when the cap is translating down a wire.

Abstract: An implant includes an elongate body having at least two radially expandable portions in the vicinity of the distal end thereof. An expander is disposed at least partially within the axial bore of the body, the expander including a longitudinal shaft and a tip at the distal end of the shaft. The expander is longitudinally movable between a distal position wherein the tip is positioned distal to the distal end of the body and a proximal position wherein the expandable portions of the body are moved to a radially outward expanded configuration by a camming action of the tip.

Abstract: A bone anchoring device includes a shaft for anchoring in a bone and a head, the shaft including a first section having a plurality of barb elements, the barb elements being elastically deformable relative to the body of the shaft, and a second section including a bone thread for engagement with the bone. The first section is located near the tip of the shaft and allows insertion by pushing whereas the second section provides enhanced resistance against pull-out.

Abstract: An apparatus is designed to attach an implant to bone in a manner that permits rotational adjustment of the implant about multiple axes prior to securement via the apparatus. The apparatus includes separate rotational and translational fasteners that can be individually locked to independently restrict rotation and translation of the implant relative to the bone. The rotational fastener includes an interpositional member, an expandable engagement member, and a rotational locking member that urges the expandable engagement member to advance along the interpositional member. The resulting expansion of the engagement member causes it to engage the implant. The rotational fastener is slidable along a fixation member implanted in the bone until the translational fastener is applied to restrict relative translation between the rotational fastener and the bone.

Abstract: A method and apparatus for reattaching soft tissue to a selected boney structure using a rivet. Generally, a rivet having first portion and a second portion is provided to fully secure a soft tissue in the boney structure. The first portion of the rivet retains the soft tissue via a suture which is threaded through the first portion. The second portion of the rivet has at least one expanding member which engages the boney structure upon contact with the first portion of the rivet. Thus, the soft tissue is fully secured to the boney structure, ensuring proper healing.

Abstract: A bone screw includes a head portion and shank portion. The shank portion includes a regularly outwardly expanding threaded portion.

Abstract: A surgical system comprising: an object to be secured to bone, the object comprising an opening extending therethrough; and a sleeve/expander construction for securing the object to bone, the sleeve/expander construction comprising: a sleeve adapted for positioning through the opening in the object and into the bone, the sleeve comprising: a shank having a distal end and a proximal end and an opening extending from the distal end to the proximal end, wherein the opening narrows toward the distal end of the shank, and further wherein the distal end of the shank is slit so as to form a plurality of radially-expandable segments; and an enlarged head formed at the proximal end of the shank, the enlarged head being formed so as to be radially-expandable; and an expander adapted for positioning through the opening in the sleeve, the expander being sized so as to (i) radially expand the distal end of the sleeve so that the sleeve is secured to the bone, and (ii) radially expand the enlarged head of the sleeve

Abstract: A reamer for reaming a portion of a long bone cavity for use in implanting a joint prosthesis. The reamer is used in cooperation with a portion of an orthopaedic implant component and includes an expandable body that is adapted to adjust between a plurality of diameters. A plurality of cutting edges are also included and extend outwardly from the body, the edges adapted for cooperation with bone, and the cutting edges expanding as the expandable body expands.

Abstract: A bone screw includes a head portion and shank portion. The shank portion includes a regularly outwardly expanding threaded portion.

Abstract: A graft fixation system for fixing graft material in a bone tunnel includes an expandable fixation member having a graft receiving eyelet disposed proximate its distal end, opposed bone engaging elements disposed about its periphery, and an expansion plug receiving opening defined in its proximal end. The system also includes an expansion plug having a diameter greater than the diameter of the expansion plug receiving opening so that forceable insertion of the expansion plug into the expansion plug receiving opening causes an expansion of the expandable fixation member driving the opposed bone engaging elements apart so as to fix the bone engaging elements, as well as the graft material, in a bone tunnel.

Abstract: A bone anchoring element is provided which has a shaft for anchoring in a bone. The shaft includes a tubular body having two open ends. At least one barb element is connected to the shaft. The barb element is cut into the tubular body. The barb element includes a free end and a base connecting the barb element to the shaft. The barb element has a first portion adjacent to the base and a second portion adjacent to the free end. The second portion is inclined relative to the first portion in a direction off said shaft.

Abstract: Apparatuses for attaching tissue to bone are provided. In one exemplary embodiment, the apparatus includes an expandable body defining a bore, an expander pin having a shaft sized to be received in the bore of the expandable body, and an insertion shaft slidingly disposed in the bore of the expandable body and in a bore of the expander pin. The body is configured to expand laterally into and attach to bone when the expander pin is driven into the expandable body. The body includes a proximal main member having a distally extending threaded projection and a harder, distal tip member having a threaded recess in a proximal surface thereof such that the projection is threadedly interengageable with the recess. The expansion of the body by way of the expander pin can occur when the proximal main member and distal tip member are threadedly engaged. The insertion shaft is releasably secured to the expandable body and extends distally beyond the expandable body.

Abstract: The present invention is directed a poly-axial bone securing system including a bone securing member and a coupling element. The coupling element includes an opening to permit the bone securing member to pass therethrough and a seat for contacting a head portion of the bone securing member. The opening including a discrete number of contact surfaces or points for engaging the head portion of the bone securing member so that discrete frictional or gripping forces may be generated at interface points of each contact surface or point.

Abstract: A bone anchor for use in conjunction with orthopedic spinal fixation comprising a pedicle screw having a threaded proximal tip for threaded insertion into a hole prepared into a vertebral body through the pedicle of the vertebra from the posterior approach. The shank of the anchor is of smaller diameter than the proximal tip so as to receive a sleeve after insertion into the bone. The tubular sleeve is provided with a plurality of longitudinal slots evenly arranged about the longitudinal axis of the sleeve to forming a plurality of longitudinal. A tubular compression collar for insertion over said shank portion is provided on the shank and driven toward the proximal tip compression the sleeve and causing the ribs to expand radially into a star pattern securing the anchor in the bone. A tubular collar of natural or synthetic bone growth promoting material may be inserted to promote bone growth, close the hole and further stabilize the anchor.

Abstract: Apparatuses, systems and methods for bone fixation are disclosed herein. A fixation apparatus is disclosed having a head portion having outer wall sections at least partially surrounding a central hollow area, and the head portion also having an inner bottom surface. A shank portion can extend from the head portion. An expander hub is provided for positioning at least partially within the central hollow area of the head portion and can be seated at least partially on the inner bottom surface of the head portion. The expander hub is rotatable to force the outer wall sections of the head portion outwardly for engaging and locking the fixation apparatus in place when the fixation apparatus is positioned within a hole of a plate. The fixation apparatus can advantageously be used with a plate whereby the fixation apparatus and plate can compress bone separately from locking the fixation apparatus in a desired position.

Abstract: An expandable osteosynthesis implant has branches each connected at one end to a seat which is pierced by an orifice, suitable for being slid from a posterior direction between the facing faces of two consecutive vertebrae in order to hold them a given distance apart and restore stability of the spinal column. The branches and the seat define a hollow cage which, in a “rest” position, has an outside general shape that is a cylinder of circular section, and a portion at least of the inside volume of the cage towards the distal ends of the branches is in the form of a circular truncated cone whose large base is towards the seat, which implant has at least three branches and, inside the inside volume at least one spacer suitable for passing through the orifice and the large base of the truncated cone.

Abstract: Disclosed is a fastener that can be mounted to a bone of a patient and can foreshorten and swell of a desired period of time. The fastener can include a head portion and a body portion extending from the head portion. At least one of the head portion and the body portion has a first width that changes to a second width greater than the first width and collectively the head portion and the body portion have a first length that changes to a second length shorter than the first length upon the head portion and the body portion being exposed to a temperature below a glass transition temperature of a polymeric material forming the head portion and the body portion.

Abstract: A fastening element, particularly a peg, for fastening bone fragments or the like, is divided into at least two partial elements (10, 12) in the longitudinal direction. The partial elements encompass an expansion element (14). The partial elements and the expansion element being designed and arranged relative to each other such that the expansion element is located between the partial elements. A displacement of the expansion element in the longitudinal direction of the fastening element effecting a displacement of the partial elements in the lateral direction such that the partial elements are forced apart in the lateral direction and the fastening elements are brought from a closed position into an expanded position. The first partial element (10) having a protrusion (110) at the proximal longitudinal end of the inwardly directed sliding surface (42).

Abstract: An attachment device with a radially expandable section is disclosed. The attachment device can have helical threads, for example, to facilitate screwing the attachment device into a bone. Methods of using the same are also disclosed. The attachment device can be positioned to radially expand the expandable section in cancellous bone substantially surrounded by cortical bone.

Abstract: The invention provides a bolt apparatus for fixation of bones, the bolt apparatus comprising an expandable section having respective ends, the expandable section being operable between a contracted position and an expanded position; and expanding means in operable association with the expandable section, to displace the expandable section between the contracted position and the expanded position by simultaneously applying force to the respective ends of the expandable section, such that each of the respective ends of the expandable section are advanced toward the opposing respective end. The invention also provides a method for fixation of bones. The method comprises the steps of reducing the fracture; providing a channel across the fracture; inserting a bolt apparatus of the invention; and fixing the bolt apparatus in the channel. Preferably, the method also comprises providing a plate in operative association with the bolt.

Abstract: A precision kinematic adjustment screw for optical mounts controls the position of the stage plate relative to the base plate so that the position is stable, consistent and reproducible. Use of a spring-loaded spherical member that is free to rotate independent of the screw minimizes friction between the proximal end of the screw and the contact surface of the stage plate and reduces the potential for deformation and/or abrasion of the contact surface.

Abstract: A hypobaric wound space is provided for prophylactic and diagnostic purposes in surgical wounds of the abdomen deliberately left open. The hypobaric wound space provided is established by a combination of an impermeable folio sheet or thin flexible membrane, tissue fluid absorbing gauze or sponge, a drain tube, and a suction device to create hypobaric conditions and prevent wound contamination and infection, and to collect wound fluid to diagnose protein, fluid and other substrate losses on a quantity and quality basis.

Abstract: A polyaxial bone screw having a bone implantable shank, a head and a retaining ring. The retaining ring includes an outer partial hemispherical surface and an inner bore with radially extending channels and partial capture recesses. The shank includes a bone implantable body with an external helical wound thread and an upwardly extending capture structure. The capture structure includes at least one spline which extends radially outward and has a wedged surface that faces radially outward therefrom. The capture structure operably passes through a central bore of the retaining ring while the spline passes through a suitably shaped channel so that the spline becomes positioned above the head at which time the shank is rotated appropriately and the shank is drawn back downwardly so that the spline engages and seats in the capture recess.

Abstract: An attachment device with a radially expandable section is disclosed. The attachment device can have helical threads, for example, to facilitate screwing the attachment device into a bone. Methods of using the same are also disclosed. The attachment device can be positioned to radially expand the expandable section in cancellous bone substantially surrounded by cortical bone.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined computed tomography (CT) imagable fiducial locator head, an integral bone screw, and an integral divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example includes a fluid/gel-absorbing coating or cover into which a magnetic resonance (MR) imagable fluid is introduced, thereby permitting both CT and MR imaging. Protective caps and collars may be used to protect the fiducial marker from mechanical impact and/or to guide the fiducial marker during affixation. A bull's-eye or other template is used to select a center of a substantially spherical fiducial marker head on an image, such as for use during patient registration.

Abstract: An attachment device with a radially expandable section is disclosed. The attachment device can have helical threads, for example, to facilitate screwing the attachment device into a bone. Methods of using the same are also disclosed. The attachment device can be positioned to radially expand the expandable section in cancellous bone substantially surrounded by cortical bone.

Abstract: The invention disclosed a multi-axial expandable pedicle screw and an expansion method by using the same. Structure of the screw comprising a hollow screw being spherical shaped end connecting with an adapting piece, which is universal joint structure; an inner wall of the adapting piece connecting a lock bolt through screw threads; the hollow screw with sharp shaped on another end having a bore inside formed hollow structure in its entirety; the bore having taper shaped tip; expansion gaps uniformly setting up two, or three or four or more anterior fins on the hollow screw along its axial direction upward, prolonging from its tip to the bore; the inner needle is disposed in the bore. The invention can reduce the pedicle screw loose and even occurrence ratio of pull-out and increase the stability and reliability and reduce the failure rate of spinal surgeries at the same time. It is also easy to operate, and degree of expansion is of controllable level.

Abstract: Disclosed is an expanding fastener. The expanding fastener includes two walls configured to be inserted in a bore in a bone, said two walls include: one first wall having at least one first flat planar wall portion, and one second wall. The expanding fastener further including a shaft having one flat planar shaft portion configured to slide along said one first flat planar wall portion, said shaft further having a shape configured to cause radial outward movement of at least one of said two walls during said sliding.

Abstract: The invention relates to a device for the distraction of bones or bone segments. The device comprises an anchoring screw having a longitudinal axis, a screw tip, a screw end for rotatably driving the anchoring screw, a threaded shank which adjoins the screw tip and has a screw thread, and a screw shank adjoining the screw end; and a distraction sleeve axially displaceable on the screw shank including a rear end, a front end, a through-bore extending coaxially therebetween, an external thread adjoining the front end, and a coupler portion formed in the rear end for receiving a driving tool. The anchoring screw comprises a collar positioned between the threaded shank and the screw shank that radially projects at least from the screw shank and which serves as an axial stop for the front end of the distraction sleeve when the distraction sleeve is positioned over the screw shank.

Abstract: A reversibly expandable vertebral fixation screw and minimally invasive techniques for inserting the screw are provided. The screw incorporates a divided tip and an expansion device that allows for the divided components of the tip of the screw to expanded outward to engage the internal surfaces of the vertebral body.