Abstract: A universal targeting apparatus includes a generally U-shaped body having one end configured to be coupled to the proximal end of the intramedullary implant and a mounting portion at an opposite end of said body. An arm is rotatably mounted to the mounting portion of the U-shaped body and includes bores defined at its opposite ends. Each bore is arranged at a different angle to correspond to the angle of a transverse aperture in the intramedullary implant. The arm can be rotated so an appropriate one of the angled bores is aligned with the transverse aperture to serve as a guide for creating targeting holes in the bone.

Abstract: Methods for drilling enlarged osteal tunnels using osteal guides capable of drilling an angled osteal tunnel, namely, an osteal tunnel having an angle or turn within the bone and for drawing a muscle, tendon or ligament in need of repair into the enlarged osteal tunnel such that the bone can mend about, around, over and/or within the muscle, tendon or ligament. A reamer and guide wire can be used to create the enlarged osteal tunnel to accommodate a portion of the muscle, tendon or ligament in need of repair. The device allows for the blind intraosseous preparation of osteal tunnels and the blind intraosseous retrieval of sutures from such osteal tunnels.

Abstract: A device for preparing multiple channels in a bone comprises a handle, a single guiding sleeve mounted removable at said handle and an arm projected from said handle. Said single guiding sleeve comprises a central first guiding channel for receiving a first aiming wire, a second guiding channel for receiving a further aiming wire, said channels have parallel axes. At least one cannulation is provided, a central longitudinal axis thereof runs at a distance and parallel to the guiding channels. Said at least one cannulation being arranged offset in a circumferential direction to said second channel. An aiming wire introduced in said second channel can be replaced into a cannulation by pulling off the guiding sleeve turning it about the first aiming wire and reinserting the turned guiding sleeve into said handle.

Abstract: A method of providing a replacement anterior cruciate ligament (ACL) provides a tibial tunnel and at least one femoral tunnel for receiving the replacement ligament, the femoral and tibial tunnels not being colinear but rather in an orientation that more closely mimics the natural ACL. The femoral tunnel is formed through the anterior medial portal. A cross pinning guide having a femoral rod for insertion into the femoral tunnel, a spaced apart arc shaped track and a guide block having one or more bores aligned with the femoral rod whereby an instrument inserted through one of the bores creates a pilot hole for the cross pin which intersects the femoral tunnel and an appropriate angle thereof which avoids ligaments and other sensitive tissue can be selected by adjusting the guide block along the track.

Abstract: A drill guide assembly having an elongated body is configured with a first and second arm members extending from the elongated body. The second arm member is configured and adapted to be longitudinally movable along the elongated body towards and away from the first arm member for reducing fractured bones for repair. A guide housing provided on the second arm member is fitted with a removable sleeve. The removable sleeve is provided with a longitudinal bore for guiding a guide wire or a drill bit for drilling into the bones.

Abstract: The device with an adjustable bi-rotatable base assembly, aligns the central longitudinal axis of a drilling device with the axis of an x-ray beam that is coaxial with the axis of a line that extends through the distal openings of an intramedullary nail that has been inserted into the cavity of a tubular bone.

Abstract: A universal targeting apparatus includes a generally U-shaped body having one end configured to be coupled to the proximal end of the intramedullary implant and a mounting portion at an opposite end of said body. An arm is rotatably mounted to the mounting portion of the U-shaped body and includes bores defined at its opposite ends. Each bore is arranged at a different angle to correspond to the angle of a transverse aperture in the intramedullary implant. The arm can be rotated so an appropriate one of the angled bores is aligned with the transverse aperture to serve as a guide for creating targeting holes in the bone.

Abstract: A system for installation of a graft ligament support block is provided. The system includes an installation tool having a holder including a shaft having a handle at a proximal end and a distal end configured for selectively engaging the graft ligament support block. The installation tool further includes a drill guide including an outrigger having a bore formed on its distal end for selectively receiving a drill sleeve and a proximal end configured to selectively engage the holder. Also provided is a kit for use in reconstructing a ligament. The kit includes an installation tool including a holder and a drill guide, a drill sleeve, a guidewire, one or more drills, one or more graft ligament support blocks and one or more transverse fixation pins.

Abstract: Method for positioning a viewing axis in relation to a distal fixation hole (2) for an intramedullary nail (1). A rigid support (3) is fixed to the proximal end of the nail (1). An adjustable viewing device (9) is mounted on the rigid support (3). A coarse adjustment is done of the length of the rigid support according to the length of the nail (1). A coarse adjustment is done in order to move the viewing device (9) closer to the nail, taking account of the patient's build. A precise adjustment is done of the position of the viewing device in relation to the nail, involving the translational and/or rotational movement of the viewing device in a plane perpendicular to the longitudinal axis of the viewing device (Z).

Abstract: The present invention relates to an intramedullary nail distal targeting device (20) adapted to be installed to an external jig system (A) having a proximal attachment (B) to support an intramedullary nail (C) thereon and an extension arm (D) secured to the proximal attachment (B), the nail distal targeting device including a drill guide (21) being defined by an abbreviated cylindrical body (23) having at least a pair of guide slots (24, 24?) each of the guide slots (24, 24?) having a scalloped inner surface (25), an attaching mechanism (22) being provided at the upper portion of the drill guide (21), the attaching mechanism (22) secured in a rotating and sliding manner to a distal end of the extension arm (D) and at least a pair of guide sleeves (10, 10?) being telescopically fitted correspondingly into the slots (24, 24?) of the drill guide (21), each of the guide sleeves (10, 10?) having a scalloped outer surface to correspondingly fit into the guide slots (24, 24?), each of the guide sleeves (10, 10?) bei

Abstract: An alignment device for an intramedullary locking nail insertable in an intramedullary canal of a long bone. The alignment device includes a locating member having a handle portion connected to an elongated insertion member, and a targeting member movably coupled to the locating member. The insertion member can be inserted in a proximal portion of the intramedullary canal. The targeting member includes a plurality of guiding portions. Each guiding portion is configured to receive one of a plurality of blocking fasteners along an implantation trajectory and into the bone and around the intramedullary canal when the insertion member is inserted into the intramedullary canal. The implantation trajectory of each blocking fastener does not intersect the insertion member.

Abstract: A novel coplanar X-ray guided method and aiming arm device for insertion of distal locking screws in intramedullary bone nails. Radiopaque target markers in the aiming arm enable the easy positioning of an X-ray source such that an X-ray beam is coplanar with the aiming arm transverse holes. After the X-ray source is accurately oriented, a single X-ray snapshot is enough to assess the exact distortion of the implanted intramedullary nail. The X-ray beam need not be coaxial with the nail holes. The aiming arm includes a mobile portion and a fixed portion fastened to the nail, and the aiming arm can be adjusted, displacing the mobile portion over the fixed portion, to compensate for the distortion of the intramedullary nail caused by implantation in bone.

Abstract: An adjustable angle targeting device for an intramedullary nail includes a frame, a drill guide, and a holding member with both the drill guide and the holding member supported by the frame. The holding member includes a spherical upper surface, a lower surface, a first rotational alignment member for aligning the intramedullary nail with the holding member, and a bore extending through the holding member. The bore includes a circular lower portion opening to the lower surface and a slot shaped upper portion opening to the upper surface and having a length greater than the diameter of the circular lower portion. The targeting device further includes a holding bolt for insertion through the bore. The holding bolt includes a coupling portion for coupling with the intramedullary nail and axially aligning the intramedullary nail and a head with a bottom surface shaped complementary to the upper surface of the holding member.

Abstract: The present invention relates to a drill guide for positioning a bone tunnel in which the drill guide comprises a depth stop. The drill guide comprises an aimer arm and a drill sleeve, and includes a sleeve channel. The drill sleeve is moveable towards and away from the distal end of the aimer arm within the sleeve channel, and the depth stop is adjustable to provide a fixed drilling path length, irrespective of the distance between drill sleeve and distal end of the aimer arm.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: An aiming guide aligns a surgical tool with a hole in a bone plate. The aiming guide includes an arm portion having a longitudinal axis, top and bottom surfaces, and first and second ends. The aiming guide further includes a handle portion having upper and lower ends. The handle portion is, at its lower end, connected to the bone plate. The handle portion is, at its upper end, connected to the arm portion. Bores extend from the top surface to the lower surface of the arm portion. Each bore is configured and dimensioned to receive a tool guide in at least two different preset positions which locates the channel in at least two different hole positions. The bore includes two diametrically opposed slots extending along at least a portion of a length of the bore, the slots configured and dimensioned to mate with diametrically opposed knobs extending radially outward from a tool guide. The tool guide has a head and a sleeve portion, which has a centered channel.

Abstract: A method and devices for facilitating fixating and joining of bone fractures utilizing expandable devices that are positioned within the bone and across the fracture site. The stress from the expanded may enhance and expedite bone healing.

Abstract: A system for securing a graft within a bone includes a tubular cross pin having an interior surface bounding a passageway extending between a proximal end and an opposing distal end, the distal end terminating at a distal end face. A guide pin has an exterior surface extending between a proximal end and an opposing distal end, the exterior surface including an outwardly projecting shoulder. The guide pin is removably received within the passageway of the cross pin such that the distal end face of the cross pin biases against the shoulder and a proximal portion of the guide pin freely projects beyond the proximal end of the cross pin.

Abstract: Apparatus and methods for accessing an inferior vertebra, a superior vertebra, and a disc space therebetween via a transpedicular approach in the inferior vertebra that may include creating a channel normal to the pedicle and using an offset guide to create a second transpedicular channel at an angle to the first, normal pedicle channel where the second transpedicular channel passes into the inferior vertebra, superior vertebra, or the disc space therebetween.

Abstract: A novel fixation system for fixing a graft ligament in a bone tunnel. The fixation system comprises an interference screw comprising a body having a distal end and a proximal end, screw threads extending longitudinally along the body, and a transversely-extending region formed in the body for receiving a transverse pin therein, whereby to securely lock the interference screw, and hence the graft ligament, to the bone. In accordance with a further feature of the present invention, there is provided a method for attaching a graft ligament to a bone, the method comprising the steps of: (i) drilling a tunnel in the bone; (ii) positioning the graft ligament in the bone tunnel; (iii) placing an interference screw in the bone tunnel so as to force the graft ligament laterally against the opposite side of the bone tunnel; and (iv) advancing a transverse pin transversely through the bone and through the interference screw so as to securely lock the interference screw, and hence the graft ligament, to the bone.

Abstract: A surgical apparatus may include a guide apparatus to be used in an arthroscopic procedure and to interact with a passageway through a body portion formed by intersecting first and second holes that may lead into the body portion from different positions, e.g., from two different locations on a bone. The guide apparatus may include first and second guide members having first and second passages, respectively, that communicate with the first and second holes. The surgical apparatus may also include a suture retriever arranged to retrieve, from the second passage, a suture fed into the first passage. A method may include forming a passageway including first and second intersecting holes. First and second guide tubes may be positioned relative to the first and second holes, a suture or suture-like material may be provided into the first guide tube, and the suture or suture-like material may be retrieved from the second guide tube.

Abstract: An system and method for performing a surgery, such as an anterior-cruciate-ligament replacement surgery, where a flexible strand insertion rod can co-operate with a U-Guide apparatus to insert a flexible strand into a tunnel formed in a bone portion. A soft tissue replacement can be affixed to one end of the flexible strand and pulled over a retaining member with the other end of the flexible strand.

Abstract: The invention relates to a system for the minimally invasive treatment of a bone fracture, especially of a proximal humeral or femoral fracture. The inventive system has an osteosynthesis plate having a supporting section in the cortical substance and an additional fastening section on the bone. A second linking section of the guide element and the shaft of the fixing element are configured as an axially displaceable anti-tilt slide bearing. The system has at least one anti-twist screw in the supporting section for preventing the detached bone fragment from rotation.

Abstract: A humeral fracture fixation system is provided and includes a nail-plate fixation device having a plate-like head portion, an intramedullary nail portion, and a bent neck portion therebetween which creates an angle between the plate and nail portions. The upper surface of the nail portion is substantially straight for contact with the endosteum and the nail portion includes threaded holes for machine screws. The head portion includes locking holes for receiving fixed-angle bone support elements, and K-wire alignment holes. The front of the head portion includes suture holes while presenting a smooth profile. A specific implantation jigs and a screw guide cannula are also provided.

Abstract: An intramedullary nail and a targeting and/or nailing instrument includes a connector end which has an axially parallel projection which cooperates with an axially parallel recess on the hollow connection end of the nail. The engagement of the projection and recess fastens the nail under axial engagement on the connection end of the instrument in predefined rotational position on the instrument. A quick-fastener element engages in the connection end of the nail and has a first coupling element and the connection end of the nail has a second coupling element. The coupling elements are configured so that in a first rotational position relative to the axially parallel projection the instrument can be introduced into the connection end of the nail and in a second rotational position the coupling elements cooperate so that the nail is held axially fixedly on the instrument.

Abstract: A novel coplanar X-ray guided method and device for insertion of distal locking screws in intramedullary bone nails. The device has coplanar holes, which allow insertion of protective sleeves. A drill and bone screws can be inserted through the protective sleeves. Radiopaque target markers in the aiming arm enable the easy positioning of an X-ray source such that an X-ray beam is coplanar with the aiming arm transverse holes. After the X-ray source is accurately oriented, a single X-ray snapshot is enough to assess the exact distortion of the implanted intramedullary nail. The X-ray beam need not be coaxial with the intramedullary nail holes. The aiming arm has a mobile portion and a fixed portion fastened to the nail, wherein said aiming arm can be adjusted, displacing the mobile portion over the fixed portion, to compensate for the distortion of the intramedullary nail after implantation.

Abstract: An apparatus for use with a passageway in a surgical procedure includes a reference structure, and first and second guide members. The first and second guide members may be arranged in a first and second positions relative to the reference structure so that passages in the guide members are adjacent, e.g., the distal ends of the guide members may be adjacent each other. This arrangement may allow for the first and second guide members to be used in forming a passageway in a body part, such as a portion of bone, and/or may provide a passageway for passing a suture or suture-like material from the first guide member to the second guide member.

Abstract: Systems and methods are provided for navigated placement of bone engaging elements, such as support pins used to support a cutting block on a bone for resection. In one embodiment, a guide apparatus is configured to be mounted to a bone and provides multi-degree of freedom gross and fine adjustments of a pin guide. The pin guide carries a position tracking element so that its real-time spatial position relative to a location on the bone can be evaluated.

Abstract: A system that enables targeting of an instrument placed within a drill bushing aligns the axis of a drill bushing with the axis of a transverse hole in an intramedullary nail. The system includes a probe having an elongated member with a distal end, a magnet that is polarized along its longitudinal axis that is mounted perpendicularly to the distal end of the elongated member; and a processor executing programmed instructions to determine a position and orientation of the magnetic sensor array with respect to the targeting magnet.

Abstract: A surgical apparatus may include a guide apparatus to be used in an arthroscopic procedure and to interact with a passageway through a body portion formed by intersecting first and second holes that may lead into the body portion from different positions, e.g., from two different locations on a bone. The guide apparatus may include first and second guide members having first and second passages, respectively, that communicate with the first and second holes. The surgical apparatus may also include a suture retriever arranged to retrieve, from the second passage, a suture fed into the first passage. A method may include forming a passageway including first and second intersecting holes. First and second guide tubes may be positioned relative to the first and second holes, a suture or suture-like material may be provided into the first guide tube, and the suture or suture-like material may be retrieved from the second guide tube.

Abstract: A method for forming a tunnel in a bone. The method includes forming a first tunnel in the bone, the tunnel having a longitudinal axis, inserting a first drill guide into the first tunnel, supporting a first tunnel-forming device along an axis defining a first offset relative the longitudinal axis of the first tunnel with the first drill guide, and forming a second tunnel alongside the first tunnel with the first tunnel-forming device, the second tunnel communicating with the first tunnel and defining a single elongated opening.

Abstract: A device, system and method for securing a plate to a bone. An anchor device has a screw (with a head portion) and a locking disc. The head portion includes a slotted wall defining a plurality of petals disposed around a central opening. The screw further includes an internal bore. The locking disc is rotatably disposed within the central opening, such that in a first rotational position the petals may flex inwardly, and in a second rotational position the petals are substantially prevented from flexing inwardly. A tool for manipulating the anchor device has a shaft with its end configured to mate with the internal bore of the screw to permit selective rotation of the screw, and a sleeve member rotatably and slideably mounted on the shaft having an end that mates with the locking disc to permit selective rotation of the disc.

Abstract: A bone fixation system including a bone plate and surgical drill guide is provided. The drill guide assembly includes one or more alignment drill tubes that are remotely aligned with corresponding fastener holes in the bone plate, and a plate holder to engage a hole in the bone plate. The surgical drill guide is releasably lockable to the plate holder.

Abstract: A device, method and system adapted to determine a targeting position on a surgically implantable nail adapted to be used in internal fixation of a bone, the nail comprising a distal end and a proximal end, the device including an extension rod comprising a longitudinal axis and adapted to be detachably coupled to the proximal end of the nail, a bridge member adjustably secured to the extension rod and extending radially from the longitudinal axis of the extension rod, a position of the bridge member on the extension rod being rotationally and longitudinally adjustable with respect to the longitudinal axis of the extension rod, and a targeting arm adjustably coupled to the bridge member and extending from the bridge member toward the distal end of the locking nail, the targeting arm comprising a drill guide.

Abstract: An alignment jig that creates a plurality of parallelograms may be used to align an external alignment line with an internal target path. The internal target path is within the patient's body and may be defined by two guide pin tips. The alignment jig may be created so that it creates the external alignment line to be co-linear with the internal target path or the external alignment line may be parallel to the internal target path by offset a distance from being co-linear. The external alignment line may be used in the provision of therapy such as the delivery of a screw to a precise location in the provision of therapy to a portion of the spine.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: A universal targeting apparatus includes a generally U-shaped body having one end configured to be coupled to the proximal end of the intramedullary implant and a mounting portion at an opposite end of said body. An arm is rotatably mounted to the mounting portion of the U-shaped body and includes bores defined at its opposite ends. Each bore is arranged at a different angle to correspond to the angle of a transverse aperture in the intramedullary implant. The arm can be rotated so an appropriate one of the angled bores is aligned with the transverse aperture to serve as a guide for creating targeting holes in the bone.

Abstract: A method and apparatus for fixing a ligament in a bone tunnel by cross-pinning the ligament in the bone tunnel.

Abstract: A guide assembly for forming a tunnel through a proximal end of a tibia includes a brace having a first end and an opposing second end. A template is mounted on the first end of the brace. The template is adapted to rest on a lateral or medial facet at a proximal end of the tibia. A tubular guide sleeve has a proximal end and an opposing distal end. The tubular guide sleeve is adjustably mounted on the second end of the brace such that when the template is disposed on the lateral or medial facet of the tibia, the distal end of the tubular guide sleeve can be selectively biased against a lateral, medial, or anterior side of a proximal end of the tibia.

Abstract: The present invention relates to an intramedullary nail distal targeting device (20) adapted to be installed to an external jig system (A) having a proximal attachment (B) to support an intramedullary nail (C) thereon and an extension arm (D) secured to the proximal attachment (B), the nail distal targeting device including a drill guide (21) being defined by an abbreviated cylindrical body (23) having at least a pair of guide slots (24, 24?) each of the guide slots (24, 24?) having a scalloped inner surface (25), an attaching mechanism (22) being provided at the upper portion of the drill guide (21), the attaching mechanism (22) secured in a rotating and sliding manner to a distal end of the extension arm (D) and at least a pair of guide sleeves (10, 10?) being telescopically fitted correspondingly into the slots (24, 24?) of the drill guide (21), each of the guide sleeves (10, 10?) having a scalloped outer surface to correspondingly fit into the guide slots (24, 24?), each of the guide sleeves (10, 10?) bei

Abstract: A compact hand held device is provided that can be safely used by those suffering from acne, blemished skin or fine wrinkles. The hand held device includes an on/off switch and a button that pulses the device when it is placed on the target site. A battery within the device powers a circuit board and drives a short pulse of current through a heating element, which heats up to approximately 300° C. in less than 0.1 sec. Thermal conduction transfers the heat to the skin and causes a biological response that accelerates acne clearing, treats blemished skin or fine wrinkles. The total heat transferred is low enough to prevent burns.

Abstract: A method of determining the size and/or placement of a prosthetic disc in a disc space between adjacent endplates of two vertebrae in a selected spinal area, comprising: using a computer to identify the disc space parameters of height, width, depth and lordosis between the adjacent vertebral endplates; using a computer to create an artificial volume corresponding to an actual prosthetic disc that can be positioned in the disc space in accordance with a manufacturer's size and lordosis specifications for prosthesis; using a computer to determine the center of the disc space and the center of rotation of the prosthetic disc volume; using a computer to position the prosthetic disc volume in the disc space such that the center of rotation of the prosthetic disc volume is positioned posterior to the center of the disc space; and using a computer to determine the prosthetic disc volume that fits within the disc space in accordance with a surgeon's or manufacturer's specification for prosthesis.

Abstract: An adjustable drill guide is provided that can be used to deliver a cross pin at a distance near the entrance to the femoral bone tunnel during ligament surgery. The cross pin positioned at the joint line, or tunnel opening, compresses and secures the graft within the bone tunnel, thereby preventing the graft from swaying back and forth post surgery when the joint is in motion. The adjustable drill guide assembly comprises a guide frame that includes an arm portion and a base portion that extends transversely to the arm portion. A rod member connects to the base portion for extending into the hone tunnel of the bone. Also included is a guide member configured for connection to the arm portion. The guide member is configured to be in moveable and lockable disposition along a length of the arm portion.

Abstract: A novel coplanar X-ray guided method and aiming arm device for insertion of distal locking screws in intramedullary bone nails. Radiopaque target markers in the aiming arm enable the easy positioning of an X-ray source such that an X-ray beam is coplanar with the aiming arm transverse holes. After the X-ray source is accurately oriented, a single X-ray snapshot is enough to assess the exact distortion of the implanted intramedullary nail. The X-ray beam need not be coaxial with the nail holes. The aiming arm includes a mobile portion and a fixed portion fastened to the nail, and the aiming arm can be adjusted, displacing the mobile portion over the fixed portion, to compensate for the distortion of the intramedullary nail caused by implantation in bone.

Abstract: A two piece graft fixation arrangement includes a graft block engageable with a graft and a transverse member engageable with the graft block to fix the graft block in a bone tunnel. Instruments and methods are presented for installing a graft in a bone tunnel and anchoring the graft with a transverse member placed through a transverse bore intersecting the bone tunnel.

Abstract: The present invention relates to apparatus for use in neurosurgery, and to a method of positioning neurosurgical apparatus. The stereoguide comprises first and second guide elements through which instruments are passed along an axis of insertion towards a target and a first clamp (25) having a clamping position on the axis between the guide elements and the target.