A retractor includes retractor blades and one or more shims coupled to one or more of the retractor blades. The shims can include features configured to fasten the shim to vertebral anatomy. Such features can facilitate the use a K-wire or barbed features. Example disclosed shim designs include those featuring a K-wire feature, a barbed feature, and a K-wire with barb design.

System, including apparatus and methods, for ankle fusion using a device for separating a first bone and a second bone of an ankle region. In some embodiments, the device may comprise an expandable spacer including first and second bone-contacting surface regions facing away from one another and configured to be abutted with the first and second bones, respectively. A distance between the first and second bone-contacting surface regions may be adjustable to change the separation of the first and second bones. The first bone-contacting surface region may correspond to a portion of a sphere and may be configured to be disposed at least partially in a concavity formed surgically in the first bone. The expandable spacer offers improved control over the length of the lower limb and the orientation of the foot during ankle fusion surgery.

A surgical retractor assembly is provided that can assume both open and closed positions, and is easily convertible from one position to the other. The retractor assembly involves an arcuate frame member that can be engaged to an arcuate connector, which together form a generally circular or elliptical retractor frame assembly. The frame member has a groove for the insertion of one or more mobile carriages that hold retractor blade posts and allow the posts to move in multiple directions. The carriages may be locked to prevent movement in one or more directions, as well.

A knee gap tensioning apparatus includes: a tensioner-balancer, including: a baseplate; a top plate; and a linkage operable to move the top plate relative to the bottom plate between retracted and extended positions in response to application of an actuating force, the linkage including: a first toggle linkage, including: a lower link having a first end pivotally connected to the baseplate; an upper link having a first end pivotally connected to the top plate, wherein second ends of the first and second links are pivotally connected to each other; a second toggle linkage, including: a lower link having a first end pivotally connected to the baseplate; an upper link having a first end pivotally connected to the top plate, wherein second ends of the first and second links are pivotally connected to each other; and a connector linkage interconnecting the first and second toggle linkages.

A method of evaluating soft tissue of a human joint which includes two or more bones and ligaments, wherein the ligaments are under anatomical tension to connect the bones together, creating a load-bearing articulating joint, the method includes: inserting into the joint a tensioner-balancer that includes a means of controlling a distraction force; providing an electronic receiving device; moving the joint through at least a portion of its range of motion; while moving the joint, controlling the distraction force, and collecting displacement and distraction load data of the bones; processing the collected data to produce a digital geometric model of the joint, wherein the model includes: ligament displacement data along a range of flexion angles and ligament load data along a range of flexion angles; and storing the digital geometric model for further use.

A method of preparing a tarsometatarsal joint can include imaging a tarsometatarsal joint of a patient between a metatarsal and a cuneiform to determine a size and/or angle of a wedge-shaped bone portion to be cut at the tarsometatarsal joint. The method can include obtaining a bone preparation guide that includes a first guide surface positionable over the metatarsal and a second guide surface positionable over the cuneiform, where an angle of the first guide surface relative to the second guide surface is selected corresponding to the size and/or angle of the wedge-shaped bone portion to be cut as determined via imaging of the tarsometatarsal joint. The method can include positioning the guide surfaces over the metatarsal and cuneiform and guiding a tissue removing instrument with the guide surfaces to cut an end of the metatarsal and to cut an end of the cuneiform.

A multi-stage dilator and cannula assembly for use in surgical procedures, including minimally invasive surgical procedures, to provide tissue dilation and opening of a portal to enable the surgeon to access and provide treatment to anatomical feature of interest.

An orthopedic system to monitor a parameter related to the muscular-skeletal system is disclosed. The orthopedic system includes electronic circuitry, at least one sensor, and a computer to receive measurement data in real-time. The orthopedic system comprises a first plurality of shims of a first type, a second plurality of a second type, a measurement module, and the computer. The measurement module houses the electronic circuitry and at least one sensor. The measurement module is adapted to be used with the first plurality of shims and the second plurality of shims. The measurement module has a medial surface that differs from a lateral surface by shape, size, or contour.

A surgical elevator device that can be used in the reduction of bone fractures, particularly facial bone fractures, and even more particularly zygomatic arch fractures. The elevator device enables accurate measurement of the depth of insertion of the device into tissue space and provides tactile control of fracture location and reduction. In one embodiment, the elevator device comprises a groove on an elevator element for receiving a bone structure. The groove can be formed by a pair of parallel ridges. A projection extending from the elevator provides a pivot point for applying a controlled force to the bone to reduce the fracture. A preferred embodiment further comprises a method of reducing a bone fracture, such as a zygomatic arch fracture.

A surgical retractor assembly is provided that can assume both open and closed positions, and is easily convertible from one position to the other. The retractor assembly involves an arcuate frame member that can be engaged to an arcuate connector, which together form a generally circular or elliptical retractor frame assembly. The frame member has a groove for the insertion of one or more mobile carriages that hold retractor blade posts and allow the posts to move in multiple directions. The carriages may be locked to prevent movement in one or more directions, as well.