Implant positioning devices for use with and assisting in positioning orthopaedic fixation devices (such as bone plates, etc.). An implant positioning device may include a body that has a fastener guide with slits in a first end of the fastener guide that form a retaining arm proximal to the first end of the fastener guide. The implant positioning device may also be coupled to a bone plate by a retaining beam positioned within the implant positioning device to facilitate ease of alignment and insertion of the fastener into a fastener apertures of the bone plate.

An anchor assembly, for securing a first portion and a second portion of a separated sternum, can include a lock, an anchor, and a cerclage. The anchor can include a body locatable between the first portion and the second portion of the sternum, where the body can define an end portion. The anchor can include a collar connected to the body and extending outward from the end portion of the body. The collar can engage an outer surface of the sternum to limit movement of the body beyond the outer surface of the sternum. The cerclage can be connected to and can extend from the anchor. The cerclage can be configured to at least partially surround the first portion and the second portion of the separated sternum.

An intraosseous access device for accessing an intraosseous space of a patient includes a manual driver and a sternal locator. The handle is connected to an inner penetrator hub, and an inner penetrator extends from the inner penetrator hub. An outer penetrator hub is releasably engaged to the inner penetrator hub. A protective cover is slidably coupled to the handle. The protective cover is operable to move from an extended position where the inner penetrator is covered, to a retracted position where the inner penetrator is exposed. The sternal locator includes a base; a collar extending from a first surface of the base for securing the intraosseous access device to restrict longitudinal separation of the intraosseous access device from the locator. The locator may be removed from the patient while the outer penetrator remains inserted in an intraosseous space of the patient.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

A sternotomy closure technique is suitably carried out with a cerclage mechanism, which is capable of maintaining proper bony compression (within a desired range) across the sternum cut, in spite of a range of external forces and significant lateral distraction due to these external forces. The sternum fragments are aligned in apposition disposed around a longitudinal seam and secured with a resilient element. The resilient element is tensioned to a desired tension to compress the sternum to a desired compression range. The resilient element is then elongated and contracted while accepting multiple cycles of physiological distracting forces across the sternum while maintaining contact pressure across the longitudinal seam within a desired range for a length of time sufficient for bony healing. The resilient element is preferably a polymer cable comprising an elongated elastic polymeric core coaxially surrounded by a sheath woven from ultra-high molecular weight polyethylene strands.

A sternotomy closure technique is suitably carried out with a cerclage mechanism which is capable of maintaining proper bony compression (within a desired range) across the sternum cut, in spite of a range of external forces and significant lateral distraction due to these external forces. The sternum fragments are aligned in apposition disposed around a longitudinal seam and secured with a resilient element. The resilient element is tensioned to a desired tension to compress the sternum to a desired compression range. The resilient element is then elongated and contracted while accepting multiple cycles of physiological distracting forces across the sternum while maintaining contact pressure across the longitudinal seam within a desired range for a length of time sufficient for bony healing. The resilient element is preferably a polymer cable comprising an elongated elastic polymeric core coaxially surrounded by a sheath woven from ultra-high molecular weight polyethylene strands.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

Implant positioning devices for use with and assisting in positioning orthopaedic fixation devices (such as bone plates, etc.). An implant positioning device may include a body that has a fastener guide with slits in a first end of the fastener guide that form a retaining arm proximal to the first end of the fastener guide. The implant positioning device may also be coupled to a bone plate by a retaining beam positioned within the implant positioning device to facilitate ease of alignment and insertion of the fastener into a fastener apertures of the bone plate.

An apparatus and method for introducing portals into bone is described herein. An example apparatus for introducing portals into bone includes a handle, a base, and a driving member. The driving member can be made to project past the base by operating the handle. The base is detachable from the handle. The apparatus also includes a guide coupled at a first end to the handle and at a second end to the base. The base is detachably coupled to the guide. A base coupling detachably coupling the base to the guide includes an actuating member movable between a coupled configuration wherein the base is coupled to the guide and an uncoupled configuration wherein the base is released from the guide. The actuating member is arranged so that motion of the handle toward the base moves the actuating member from the coupled configuration to the uncoupled configuration.