Intramedullary nails, systems, and methods. The intramedullary nail may include a generally elongate body extending from a first, distal end to a second, proximal end. The distal end may include one or more openings configured to receive one or more bone anchors that extend transversely through the distal end intramedullary nail, and thereby configured to secure the distal end of the nail. The proximal end may also include one or more openings configured to receive one or more bone anchors that extend transversely through the proximal end of the intramedullary nail, and thereby configured to secure the proximal end of the nail. In some embodiments, the proximal end may further include a cross-locking feature, which includes a second bone anchor that interlocks with a first bone anchor, for example, for enhanced bone purchase and bony fixation.

A method of using an orthopedic surgical instrument assembly that includes an instrument handle configured to clamp a broach and femoral stem trial assembly. A depth stop is configured to removably couple to the instrument handle. When the broach and femoral stem trial are advanced into a medullary canal of a patient's femur, a substantially planar proximal surface of the depth stop is configured to engage the distal surface of the femur, determining the depth of the broach in the medullary canal. The proximal surface of the depth stop is parallel to the joint line, defining an oblique angle to the anatomical axis of the femur. The depth stop may be attached to the instrument handle at a number of positions to control the depth of the broach. The assembly may include a spacer plate removably coupled to the depth stop that distalizes the broach in the medullary canal.

An aspect of the disclosure relates to an intramedullary device configured for ankle fusion. The intramedullary device for ankle fusion includes: a housing configured to be coupled to a calcaneus bone; and a rod configured to be coupled to a tibia bone, wherein a distal end of the housing includes an external thread. The rod is configured for telescopic movement relative to the housing, and to retract relative to the housing to cause ankle fusion. After fusion is achieved, the rod can be distracted to correct a limb length discrepancy.

An apparatus for extracting a medical implant from bone includes: a housing; a coupler carried by the housing and configured to be mechanically connected to a medical implant; and a forcing mechanism carried by the housing and operable to apply a cyclic excitation force with a specified amplitude, frequency, and vector to the coupler. Methods are described for using the apparatus to remove and/or implant medical implants.

An arthrodesis anchor as a monolithic piece has prongs supporting barbs extending radially therefrom. A neck between the ends may be angled to accommodate final alignment of resected surfaces of joints to be bonded. The neck may receive a tool for buttressing a first inserted end against further penetration into a joint while the second inserted end is inserted into the other adjacent joint. The proximal and intermediate phalangeal joints may be trimmed and pilot drilled, and may be broached with or without a K-wire guide. A first end may be inserted by a tool, typically into the proximal joint, but the order may be reversed. The second end may then be inserted into a pilot in the base of the intermediate joint.

An inserter includes a first end, a second end, and a body extending between the first end and the second end. A first impacting surface is disposed at the first end, and a second impacting surface is disposed adjacent to the second end. An interface disposed at the second end and is configured to engage an implant. The first impacting surface is configured to direct a first impacting force along the body of the inserter in a first direction, and the second impacting surface is configured to direct a second impacting force along the body in a second direction that is different from the first direction. Methods of use also are disclosed.

Disclosed herein are linear electric surgical hammer impact tools and methods of use thereof. The linear electric surgical hammer impact tools can include a housing, a slider, a shuttle, and a motor. The housing can define a cavity extending along a longitudinal axis of the housing. The slider can be located inside the cavity and arranged along the longitudinal axis of the housing. The shuttle can be located inside the cavity and arranged along the longitudinal axis of the housing. The shuttle can include a first set of collars and a second set of collars. The motor can be configured to drive the slider along the longitudinal axis in a first direction and a second direction. Motion of the slider in the first and second directions can cause the slider to contact the first and second sets of collars.

In one example, a system has an insertion handle that can be coupled to an intramedullary nail and includes a first coupler that defines one of a recess and a projection, and one of a latch and an abutment surface. The system has an aiming guide that includes a guide body that defines at least one alignment aperture therethrough. The aiming guide includes a second coupler that can couple the guide body to the first coupler such that the at least one alignment aperture is positioned to guide an instrument towards at least one bone-anchor fixation hole of the intramedullary nail. The second coupler defines another of the recess and the projection, and another of the latch and the abutment surface. The first and second couplers can couple to one another by receiving the projection in the recess and by engaging the latch with the abutment surface.

The present invention provides a technique for percutaneous intramedullary fixation. A protective outer sheath is provided for internal fixation of the proximal tibia. Additionally, a unique intramedullary plate is provided that is adapted for percutaneous insertion into the intramedullary canal of a long bone. A plate holder is also provided that may be utilized through the outer sheath to drive and position a fixation plate within the intramedullary canal.

In one embodiment, a router includes one or more processors and one or more computer-readable non-transitory storage media coupled to the one or more processors. The one or more computer-readable non-transitory storage media include instructions that, when executed by the one or more processors, cause the router to perform operations including receiving software-defined networking in a wide area network (SD-WAN) policies from a component of an SD-WAN network. The operations also include establishing a session with a mobile device and receiving information associated with the mobile device in response to establishing the session with the mobile device. The operations further include filtering the SD-WAN policies based on the information associated with the mobile device to generate SD-WAN device-specific policies and communicating the SD-WAN device-specific policies to the mobile device.