A locking element is configured to be used with a polyaxial bone anchor. The locking element including a central axis, a bottom side, a top side opposite to the bottom side, and a peripheral surface portion that extending completely around the locking element that has an external thread. The bottom side defines a first recess facing toward the bottom side for accommodating and applying a force in a direction toward the bottom side to at least the portion of the head of the polyaxial bone anchor. The top side defines a second recess having a non-circular cross-section in a plane perpendicular to the central axis for torqueable engagement with a driver.

A fixation system (900) for the fixation of a first bone fragment (932) relative to a second bone fragment (934); the fixation system (900) comprising at least one first bone engagement element engagable with the first bone fragment (932), wherein the first bone engagement element has an elongate body portion, a proximal end, a distal end, and a passageway extending through the body portion from the proximal end to the distal end, at least one further bone engagement element engageable with the second bone fragment (934) and having a tensile element (920) securement portion for affixing a tensile element (920) to the further bone engagement element; wherein the tensile element (920) passing the first bone engagement element when engaged with the first bone fragment (932) is fixed relative to the further bone engagement element when engaged with the second bone fragment (934) by the tensile element (920) securement portion; such that the first bone fragment (932) is affixed relative to the second bone fragment (934) from tensile stress in the tensile element (920).

An orthopaedic driving instrument including a first end portion, a second end portion opposite the first end portion, and a central portion, intermediate the first and second end portions, comprising a central section having an outer diameter representing a maximum outer diameter of the driving instrument. The first end comprises a first driving interface sized and shaped to, in operation of the instrument, engage a screw interface of a screw for applying torque to the screw. The second end comprises a second driving interface sized and shaped as the size and shape of the first driving interface.

Disclosed are aspects of exemplars of torque-limiting devices, methods and mechanisms. Exemplary methods may include placing an actuator in a tool containment interface of a handle, the interface being fluidly connected to an adjustment interface and adjustable via a fixation fastener; movably mounting a tool portion with an actuation catch and a work piece engaging region (WER) in the interface; applying sufficient force to the movable mounting to the handle may be via pins, guides and slots. Said catch may be one of a body catch and a lever catch; and, the actuator terminates on one of a ball shaped end that forms an interface with the body catch and a force lever that forms an interface with the lever catch.

Implants include fixation features which slidingly receive fixation elements. The fixation features may be negative or positive features, such as undercut channels or posts. Examples include unicompartmental tibial trays having a ridge protruding from the bone-facing side, an undercut channel formed within the ridge. Instruments are disclosed for preparing a ridge-receiving feature in bone. Implants and fixation elements are configured for implantation without penetrating a cortical wall of a bone. Instruments and surgical methods are disclosed.

A system for inserting an anchor member into bone includes a receiving member and an anchor member receivable within the receiving member. The receiving member is elongate along a longitudinal axis and has a proximal end and a distal end spaced from the proximal end along the longitudinal axis. The receiving member has an internal surface that defines a transmission element. The anchor member includes an engagement element configured to rotatably engage the transmission element such that the transmission element is configured to drive the anchor member in a distal direction relative to the transmission element so as to rotatably decouple the engagement element from the transmission element. The distal direction extends from the proximal end to the distal end of the receiving member and is parallel with the longitudinal axis.

Disclosed is a universal pedicle screw removal tool comprising a tapered shaft having an “L” shaped tip on one end and a generally square head on an opposite end. A lower section leads to a tapered section which is connected to a handle. The handle may include a set of serrations to provide increased grip. The handle is connected to the head. The tip is sized to engage the channel of a tuliped pedicle screw while the head is sized to engage a ratchet or other torque producing tool. In an alternate embodiment, the tip is “T” shaped. In another alternate embodiment, the handle section includes opposing members extending from the shaft to form a “T” shaped handle. In use, the tip is inserted into the channel of a tuliped pedicle screw while the shaft is rotated to unscrew the pedicle screw from a patient's bone.

An assembly includes a first portion including an anchor pivotally attached to a first end of the first portion, the anchor to be inserted into an intramedullary canal of a first bone fragment; a second portion pivotally attached to a second end of the first portion and including a first skin-interfacing portion; a second skin-interfacing portion to interface with and secure the assembly to skin adjacent to the first bone fragment; and an actuation mechanism attached between the first portion and the second portion that actuates pivoting of the second portion to the first portion; wherein a lateral force is generated between the first skin-interfacing portion against a second bone fragment, adjacent to the first bone fragment, and a holding force is provided by the anchor when the actuation mechanism is actuated, so the first portion pivots with respect to second portion, while the anchor is in the intramedullary canal.

An apparatus includes a body extending from a first end to a second end. The first end is a leading end, and the second end includes a first coupling element configured to couple the body to a first other component. The body includes an external fixation element extending along a length of the first component. The external fixation element is configured to engage bone. Systems and methods are also disclosed.

The invention provides a dual-purpose handle, comprising a body, wherein mounting holes are provided in the body and are used for connecting to functional members; the mounting holes are provided in the body in both an axial direction and a radial direction; axial and radial mounting holes provided in the body can enable the handle and the functional members to easily and quickly switch between two connection forms, i.e. straight and T-shaped; and torsional torques that are different in magnitude can be output by means of different connection manners under the action of the same operation force. Clamping devices fitted with the functional members are arranged in the mounting holes; and when the functional members are connected to the handle, the clamping devices can fix the functional members and prevent same from rotating in a cavity of the body of the handle. The axial and radial holes of the handle are configured to be through holes, so that the handle can be adapted to guide needles of different sizes passing through same and is suitable for minimally invasive surgery, thereby further expanding the range of use of the handle.