The disclosure provides apparatus and methods of use pertaining to syndesmosis reinforcement. Embodiments include a clamp having two jaws that extend toward each other to clamp two bone portions therebetween. The clamp may include an angle gauge and an adjustment mechanism having a force gauge that combine to enable the compression of the two bone portions in an optimal direction or angle and at an optimal, measurable compression force. Embodiments also include a tension instrument configured to knotlessly lock a flexible strand construct between two anchors at the same optimal direction and tension applied by the clamp. Further embodiments include an exemplary syndesmosis reinforcement procedure that employs the clamp and the tension instrument to construct a ligament reinforcement construct that achieves optimal anatomic positioning in both directional alignment and the reduction force applied by the construct. Other embodiments are disclosed.

A tool for cleaning a vertebral disc includes an elongated hollow shaft including a proximal end and a distal end; a first drum rotatably disposed in a housing secured to the proximal end of the shaft, the first drum having a first axis; a second drum rotatably disposed proximate the distal end of the shaft, the second drum having a second axis parallel to the first axis; and a belt extending through the hollow shaft and operatively coupled to the first drum and the second drum, the belt comprising a plurality of teeth configured to cut anatomical tissue, each tooth of the plurality of teeth remaining flush with an outer surface of the belt when a section of the belt comprising the tooth is substantially straight, and projecting beyond the outer surface when the section of the belt bends around the first drum or the second drum.

Apparatus for securing an object to bone, the apparatus including an anchor assembly comprising an anchor and an actuation element extending from the anchor, wherein applying a force to the actuation element when the anchor is disposed in a hole formed in a bone secures the anchor to the bone; and an inserter for deploying the anchor assembly in a hole formed in a bone, the inserter including a shaft for releasably engaging the anchor; and a force delivery mechanism mounted to the shaft and connected to the actuation element, the force delivery mechanism being constructed so as to receive an input force from an external source and to selectively apply an output force to the actuation element, with the force delivery mechanism being constructed so that the magnitude of the output force is limited regardless of the magnitude of the input force.

Devices and methods for placing an implant between two bone portions are disclosed. In some embodiments, a method comprises disposing a portion of a flexible member through a first bone portion, through an aperture in a trial implant, and through a second bone portion. The trial implant can be withdrawn to enable an implant to be coupled to the flexible member. The method includes applying tension to the flexible member to urge the implant into the space between two bone portions. In some embodiments, the two bone portions are facets.

A handheld surgical instrument comprising an energy storage element, wherein the energy storage element is a spring coupled to the impacting mechanism, an impacting mechanism has a tip configured to impact a bone, wherein the tip includes a tapered point, a power transmission mechanism is configured to transmit energy from the energy storage element to the impacting mechanism, wherein the power transmission mechanism includes a semi-flexible metal wire guided by a hollow shaft, wherein the hollow shaft includes a distal end, the semi-flexible metal wire is includes a bend toward the distal end, a trigger mechanism is configured to release energy from the energy storage element, wherein the bend includes an angle between 14 degrees and 46 degrees, wherein the trigger mechanism includes a manual lever which, when actuated, simultaneously retracts the tip and charges the energy storage element.

Methods and systems are disclosed for accessing and treating the interior of the facet joint for vertebral distraction and immobilization. The systems include a number of tools that facilitate access to the facet joint, distraction of the articulating decortication of the articulating surfaces, and delivery of implants and agents into the facet joint for fusion.

A handle for a surgical tool including a shaft having a proximal end and a distal end with a gripping handle affixed to the proximal end of the shaft. A bushing is attached to the distal end of the shaft, the bushing including a plurality of flexible members circumferentially spaced apart. The handle further includes a sleeve circumscribing the shaft and the bushing. The sleeve is moveable between a first position substantially covering an entirety of the bushing and a second position spaced from a most distal end of the bushing.

A medical instrument, for example an impact instrument, and a method for producing a medical instrument. The medical instrument includes a proximal end and a distal end. A handle and a striking face facing in a proximal direction are arranged or formed on the proximal end. A tool instrument is arranged or formed on the distal end. An instrument shaft of the instrument extends from the proximal end to the tool element. The handle is configured in the form of a hollow handle.

A system for penetrating the lateral cortex of a long bone includes a tubular cortex penetrator having an inner surface and an outer surface, a proximal end, and a distal end comprising a beveled cutting edge configured to penetrate the lateral cortex. A guide wire is configured to pass over the tubular cortex penetrator, and a guide sleeve is configured to surround the outer surface of the tubular cortex penetrator. A hollow extraction screw with an axial bore, a proximal end, a distal end, and a threaded cutting edge is configured to pass through the axial bore of the hollow extraction screw; and the hollow extraction screw is configured to retract into a distal end of a bore through the tubular cortex penetrator.

In one aspect, an implant configured to attach a first bone section to a second bone section comprises an intramedullary portion and an extramedullary portion. The intramedullary portion is configured for insertion into the first bone section. The ex-tramedullary portion is configured to abut a surface of the second bone section and includes a first fastener aperture configured to eceive a bone fastener inserted in the second bone section. The intramedullary portion and the extramedullary portion are coupled such that the extramedullary portion is rotatable with respect to the intramedullary portion.