The invention relates to a bone anchor for triangular iliosacral osteosynthesis. The bone anchor includes an ilium screw having a first longitudinal direction and an iliosacral screw having a second longitudinal direction. The ilium screw, in a thread-free portion, has a preferably elongated-hole-like through-opening transversely to the first longitudinal direction, and the iliosacral screw has such a smaller outer diameter in relation to the ilium screw that the iliosacral screw can be guided through the through-opening and can be screwed proceeding from the ilium into the sacrum, through the ilium screw.

A bone fastener includes a shaft. The shaft includes a wall that defines a longitudinal cavity and a plurality of openings in communication therewith. The openings are disposed in axial alignment along the shaft and the wall is closed exclusive of the openings. In some embodiments, systems, spinal constructs, surgical instruments and methods are disclosed.

A bone screw for sacroiliac joint fusion is characterized by a longitudinal bone screw and a cylindrical sleeve received on a proximal end of the bone screw. The sleeve has axially extending fins or flutes on its outer surface that extend generally from one end of the sleeve to the other end of the sleeve. This feature allows the sleeve to resist reverse rotation which, in turn, aids in preventing back-out of the bone screw once installed. The bone screw has a self-tapping tip that allows the bone screw to be installed without need for a pilot hole, and self-harvesting geometry that gathers and retains bone shavings in and along the bone screw that are produced by bone screw installation for use as graft for bone fusion.

An intramedullary (IM) nail insertion assembly includes an IM nail extending longitudinally from a proximal end to a distal end. A proximal portion of the IM nail has an internal threading. The IM nail insertion assembly also includes a connecting screw extending longitudinally from a proximal end to a distal end. A distal portion of the connecting screw has an external threading for engaging the internal threading of the TM nail. One of the proximal portion of the IM nail and the distal portion of the connecting screw has a feature to resist a disengagement of the proximal portion from the distal portion.

A surgical fastener includes a cannulated collapsible fastening body having a trailing end and a leading end and defining a passage extending from the trailing end to the leading end, and a pin having a non-threaded shaft at least partially disposed within the passage and an enlarged tip. A method of using the surgical fastener includes engaging an end of a driver with a recess in a head of the surgical fastener, including inserting an extension at the end of the driver into the passage, and inserting the fastener into a bore in a bone during which the extension of the driver abuts a trailing end of the shaft of the pin to prevent the pin from moving in a direction from the leading end to the trailing end relative to the fastening body.

A graft or prosthetic element suitable, e.g., for replacing a tendon or ligament is fastened in a bone tunnel or blind opening with the aid of a fastener. In a first step, the graft or prosthetic element is press-fitted in the tunnel or opening by forcing the fastener into the opening or by positioning the fastener in the opening and then expanding it, wherein the fastener is in contact with the graft or prosthetic element and with the bone wall of the tunnel or blind opening. In a second step, the fastener is anchored in the bone wall of the tunnel or blind opening with the aid of a liquefiable material which is liquefied in the vicinity of the bone wall where it is in contact with the fastener and by making the liquefied material penetrate into the bone wall.

A modular spinal fixation system for securing an elongate rod to a bone of a patient includes a plurality of bone anchors, each having a universal shank head and an anchor portion opposite the universal shank head configured for fixation to the bone. The system further includes a plurality of pivoting and non-pivoting receiver sub-assemblies, with each receiver sub-assembly including a receiver having an upper portion defining a channel configured to receive the elongate rod and a base defining a lower portion of a central bore communicating with a bottom surface of the receiver through a bottom opening, and one of a shank head-engaging retainer or a rod-engaging insert positioned within the central bore. Each of the universal shank heads is configured for uploading into both the pivoting and non-pivoting receiver sub-assemblies through the bottom opening of the receiver and for axial rotation about a longitudinal axis of the shank relative to the receiver prior to locking the receiver sub-assembly to the head of the shank with the elongate rod and a closure.

A threaded implant can be provided with an elongated main body having external threads configured to thread into bone, and an internal support structure located within the external threads. The internal support structure has a helical arrangement that extends in an opposite direction to the external threads. Other threaded implants and methods are also disclosed.

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).

A bone insert is provided that includes a cap having a convex top surface made from a plurality of cap micro struts, an elongated stem made from a plurality of stem micro struts, and a barrier between the cap and the stem. The stem of the bone insert is inserted into a hole formed in a host bone until the barrier is pressed against the exposed bone. The bone implant can be placed against a small focus contact point on the cap. Liquid cement can be injected into a large center hole in the cap and the cement can flow through the fenestrations between all of the cap micro struts as well as the space between the bone implant and the bone. The cement can cure to create a high strength structure that provides a strong bond between the bone implant and the host bone.