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.

Variable angle holes in bone plates structured to facilitate the formation of axial compression or tension of a bone, or which can assist in bone distraction. The variable angle hole can extend about a central axis and includes an inwardly extending wedge wall. The variable angle hole can be sized to receive insertion of a fixation element at a location at which a central longitudinal axis of the fixation element is axially offset from the central axis of the variable angle hole by an offset distance at least when the fixation element is initially driven into bone at least in a transverse direction. The wedge wall can be configured to be engaged by a portion of the fixation element in a manner that axially displaces at least one of the bone plate, the fixation element, and/or bone(s) in a direction that can generally reduce or increase the offset distance.

A medical device for approximating and securing tissue without requiring knots includes a lock-head, a strap section, distal protuberance, and a leader section. The device also includes a transition section between the leader and the strap section and a stiffening section proximal to the protuberance. The leader section is used to draw the strap section into the body through small apertures in tissue and the transition section provides a gradual transition in stiffness and size between the leader and the strap section.

A surgical instrument includes a member including a body engageable with a longitudinal element to fix the longitudinal element with the body. The member further includes a distal portion having a guide including an arcuate surface being engageable with the longitudinal element. An actuator is connected with the member to incrementally tension the longitudinal element. Surgical systems, implants, spinal constructs and methods are disclosed.

A bone fixation assembly may include an elongate fixation member and a flexible tensioning element. The elongate fixation member may include a central longitudinal axis, a distal portion couplable to a first bone fragment of a bone, and a proximal portion couplable to a second bone fragment of the bone to provide fixation of the second bone fragment relative to the first bone fragment. The flexible tensioning element may be couplable to the proximal and distal portions of the elongate fixation member to secure the elongate fixation member to the bone. The flexible tensioning element may be configured to span a bone fracture intermediate the first bone fragment and the second bone fragment to preload the bone fracture in compression to resist tensile force imparted across the bone fracture, thereby maintaining fixation of the first bone fragment relative to the second bone fragment.

A kit including (1) a plate configured to be secured to a scapular spine with a first end of the plate near a trigonum and a second end of the plate near an acromion; (2) a first hook including a mount, a first hook portion extending from the mount in a first direction, a spacer extending from the first hook portion in a transverse direction, and a second hook portion extending from an opposite end of the spacer in the first direction, the first hook adapted to extend around a lateral end of the acromion when fixed to the second end of the plate; and (3) a second hook including a mount, a curved portion curving away from the mount, and a hook portion at an opposite end of the curved portion, the second hook adapted to extend around the trigonum when fixed to the first end of the plate.

In order to promote bone growth without damage of a growth plate to improve the stability of a procedure, provided is an implant device for promoting bone growth, the device including: a first implant bar implanted to penetrate a metaphysis corresponding to the inside of a growth plate of a long bone to be treated; a second implant bar implanted to penetrate an epiphysis of the outside of the growth plate; and a stimulation elongation means disposed close to the external surface of the long bone to be treated and installed under skin tissues surrounding the long bone to be treated, and being elongated between end portions of the implant bars to increase a gap between the implant bars to cause the growth plate to be extended.

Bone plates for engaging bone members are described herein. The bone plates can receive one or more screws to secure the bone plates to an underlying bone member. The one or more screws can be inserted into bone plate holes that can be considered locking or non-locking. The bone plates described herein can have particular combinations of locking and/or non-locking holes. The bone plates can include features that accommodate the underlying anatomy of different types of bone, such as the condylar region of a femur.

A radially compressive implant, which includes a central vertical axis, is configured to transition between a natural shape and an insertion shape. A transition of the implant from the natural shape to the insertion shape facilitates the implant storing energy deliverable radially relative to the central vertical axis. A transition of the implant from the insertion shape toward the natural shape facilitates the implant delivering the energy stored therein radially relative to the central vertical axis. An implant delivery device in an implant engagement position is configured to engage the implant and constrain the implant in the insertion shape. The implant delivery device in an implant release position is configured to release the implant.

An improved fracture cabling system has one or more spacers. Each spacer has a longitudinal length extending along a body of the spacer. The body has an upper portion with an aperture configured to receive a wire or cable and a lower portion having one or more pairs of feet spaced by a longitudinal gap or groove. Each of the one or more pairs of feet is located on a lateral side of the spacer body and configured to contact a bone with a fracture. The gap is configured to be positioned over the fracture with each foot positioned on a side of the bone spaced from the fracture. The longitudinal length of the one or more spacers is preferably curved or arcuate. Each body of the one or more spacers has a leading end and a trailing end.