Various articulating tools for endoscopic placement of fasteners are disclosed. The tool can comprise a multi-angle articulating screwdriver. The tool can have an elongate shaft with an articulating driver head at a distal end. The tool can rotate the articulating driver head to drive fasteners, such as screws, to a surgical site. The articulating driver head can articulate with respect to a longitudinal axis of the elongate shaft to enable the fastener to be driven at various angle. The tool can be coupled to a powered handpiece power and can transmit torque from the handpiece to the driver head.

Various articulating tools for endoscopic placement of fasteners are disclosed. The tool can comprise a multi-angle articulating screwdriver. The tool can have an elongate shaft with an articulating driver head at a distal end. The tool can rotate the articulating driver head to drive fasteners, such as screws, to a surgical site. The articulating driver head can articulate with respect to a longitudinal axis of the elongate shaft to enable the fastener to be driven at various angle. The tool can be coupled to a powered handpiece power and can transmit torque from the handpiece to the driver head.

A fixation assembly for securing parts of a sternum has a first section having a first attachment structure for securing the first section to a first sternum part. The fixation assembly includes a second section having a second attachment structure for securing the second section to a second sternum part. A mating arrangement is provided defining a mating direction and a predetermined relative position between the first and second sections in a plane perpendicular to the mating direction. At least one holding member is provided for detachably holding the first and second sections in an abutting relationship in the predetermined relative position. This may be achieved in one variant by simultaneous engagement of the first and second sections substantially along the mating direction.

Devices for carrying out subperiosteal minimally invasive jaw bone augmentation and reconstruction procedures, to develop a passageway and surgical site in a concealed area of patient tissue, where the surgical site is not exposed. The devices have shanks with specially configured tips to facilitate maneuvering the device through mammalian tissue to develop a tunnel in the tissue and a remote surgical site within the tissue. The device tips have one or more peripheral cutting surfaces that direct the positioning of the tunnel formation when the instrument handle is manipulated, e.g., by rotation, angular, forward or rearward motion. Embodiments of the devices are configured with tips that have a wide spread for cutting and elevating tissue, and with tips that may be maneuvered to condense bone graft material being implanted at a surgical site concealed within the tissue.

An apparatus for securing a cerclage member about a bone within a living body comprises a crimp including a first space extending longitudinally therethrough from a first space proximal opening to a first space distal opening, the first space sized and shaped to slidably receive a cerclage member therein and a second space extending parallel to the first space from a second space proximal opening to a second space distal opening, the second space including a proximal portion to receive the cerclage member and a distal portion decreasing in cross-sectional area and an insert that, when inserted into the second space distal opening adjacent to a cerclage member, a decreasing cross-sectional area of the second space distal portion forces the insert laterally relative to a longitudinal axis of the second space, pinching and locking the cerclage member against movement relative to the crimp.

Apparatus and methods for bone fracture repair. The apparatus may include a structural support for positioning a first bone segment relative to a second bone segment. The apparatus may include an anchoring substrate. The anchoring substrate may be configured to compress the first bone segment to the second bone segment. The anchoring substrate may transmit tension from a distal bone segment anchor in the first bone segment to a proximal bone segment anchor in the second bone segment. The apparatus may be configured to be deployed percutaneously in an inner cavity of a bone. The apparatus may be installed in an open fracture. The apparatus may be expanded, self-expanding or configured for mechanically actuation. Some embodiments of the apparatus may include a central axis member that may be used in conjunction with expansion of one or both of the structural support and the anchoring substrate to configure the apparatus.

A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver. Further alternative bone screws are hinged, polyaxial or fixed and include lordosing or kyphosing lateral surfaces.

A device is provided including a distal nail portion and a proximal nail portion that can be connected to each other to attain a rigid configuration. The device is to be placed internally within the medullary cavities of bones. The device is placed intramedullarily in order to minimize incision size, excessive bone resection and post-operative tendon damage and tenderness. Additionally, one particular method for using the device is provided that includes placing and affixing the distal nail in bone, placing the proximal nail in bone, connecting the distal nail to the proximal nail, doing the desired geometrical adjustments, affixing the proximal nail to the distal nail by tightening the connection and affixing the proximal nail to attain a rigid configuration.

A system for repairing separated body tissues includes a tensioning device comprising two proximal handles for grasping, a pair of movable distal tensioning tips, a pivot between the proximal handle and distal tensioning tips, and suture holding clamps proximal to the tensioning tips. The tensioning device is used in conjunction with a buckle with lock bars and a tensioning tab for securing and tensioning suture. The tensioning tab is provided to secure the lock bar in its first position until tension on the suture exceeds a predetermined level.

A tibiotalar fusion system includes that includes a curved fusion nail and interlocking fasteners, along with delivery instrumentation. The curved ankle fusion nail is delivered with the fasteners in such a manner that the curved ankle fusion nail does not pass through the subtalar (talocalcaneal) joint. The curved fusion nail thus preserves the subtalar (talocalcaneal) joint and the natural motion of the hindfoot within a mammal such as, for example, a human. Additionally, drill guided delivery instrumentation and surgical methods of delivering and fixing the curved tibiotalar nail within a desired anatomical location such as the ankle.