Implants, Instruments, and Methods of Use

Abstract

The present disclosure relates to an implant having a proximal portion, a distal portion, and a central portion located between the proximal portion and the distal portion. The implant further includes a longitudinal axis, and the proximal portion, the distal portion, and the central portion are disposed along the longitudinal axis. Further disclosed is an implant system including an implant having a proximal portion including an opening, a distal portion including a thread, a tip, and a tip tapping feature, and a central portion having at least one flat on an outer surface. The central portion is disposed between the proximal portion and the distal portion. The implant system also includes an insertion instrument configured to releasably couple with the implant.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) The disclosures of U.S. Provisional Patent Application No. 63 / 269934, filed March 25, 2022, entitled "Implants, Instruments, And Methods Of Use," and U.S. Provisional Patent Application No. 63 / 480416, filed January 18, 2023, entitled "Implants, Instruments, And Methods Of Use," are hereby incorporated by reference in their entireties.

[0002] The present disclosure relates to surgical implants, instruments, systems, and methods of use performed in surgical procedures. The present disclosure relates to podiatric and orthopedic surgical implants, instruments, systems, and methodologies performed in various procedures of the foot and / or ankle, including various intramedullary procedures. More specifically, but not limited to, the present disclosure relates to surgical implants, instruments, systems, and methods performed in performing intramedullary procedures of the metatarsal and phalanges. [Background technology]

[0003] Many currently available surgical implants, instruments, systems, and methodologies do not fully address the needs of patients. Additionally, many currently available surgical implants, instruments, systems, and methodologies do not take into account the anatomical characteristics of the joint, which may result in less than favorable outcomes for the patient. Summary of the Invention

[0004] The present disclosure is directed to surgical implants in combination with instruments and methods for bone repair, arthrodesis, and other similar procedures.

[0005] A first aspect of the present disclosure is an implant having a proximal portion, a distal portion, and a central portion located between the proximal portion and the distal portion, the implant further including a longitudinal axis, the proximal portion, the distal portion, and the central portion being centrally disposed along the longitudinal axis.

[0006] A second aspect of the present disclosure is an implant system. The implant system includes an implant having a proximal portion including an opening, a distal portion including a thread, a tip, and a tip tapping feature, and a central portion having at least one flat on an outer surface, the central portion being disposed between the proximal portion and the distal portion. The implant system also includes an insertion instrument configured to releasably couple with the implant.

[0007] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the present invention and, together with the detailed description, serve to explain the principles of the present invention. It is emphasized that, in accordance with standard industry practice, various features may or may not be drawn to scale. In fact, dimensions of various features may be arbitrarily increased or decreased for clarity of discussion. The drawings are intended to illustrate embodiments of the present disclosure and are not to be construed as limiting the invention. [Brief description of the drawings]

[0008] [Figure 1] FIG. 1 is a perspective view of an exemplary implant according to the present disclosure. [Diagram 2] FIG. 2 is a side view of the exemplary implant of FIG. 1 in accordance with the present disclosure; [Diagram 3] FIG. 2 is a front perspective view of the exemplary implant of FIG. 1 in accordance with the present disclosure; [Figure 4] FIG. 2 is a rear perspective view of the exemplary implant of FIG. 1 in accordance with the present disclosure; [Diagram 5] FIG. 2 is a rear view of the exemplary implant of FIG. 1 in accordance with the present disclosure; [Figure 6] FIG. 1 is a side view of an exemplary implant according to the present disclosure. [Figure 7] FIG. 7 is a side perspective view of the exemplary implant of FIG. 6 in accordance with the present disclosure. [Figure 8] FIG. 7 is a front perspective view of the exemplary implant of FIG. 6 in accordance with the present disclosure. [Figure 9] FIG. 7 is a rear perspective view of the exemplary implant of FIG. 6 in accordance with the present disclosure. [Figure 10] FIG. 7 is an alternative rear perspective view of the exemplary implant of FIG. 6 in accordance with the present disclosure. [Figure 11] FIG. 7 is a rear view of the exemplary implant of FIG. 6 in accordance with the present disclosure. [Figure 12] FIG. 1 is a side perspective view of an exemplary implant according to the present disclosure. [Figure 13] FIG. 13 is a side view of the exemplary implant of FIG. 12 in accordance with the present disclosure. [Figure 14] FIG. 13 is a front perspective view of the exemplary implant of FIG. 12 in accordance with the present disclosure. [Figure 15] FIG. 13 is a rear perspective view of the exemplary implant of FIG. 12 in accordance with the present disclosure. [Figure 16] FIG. 13 is an alternative rear perspective view of the exemplary implant of FIG. 12 in accordance with the present disclosure. [Figure 17] FIG. 13 is a rear view of the exemplary implant of FIG. 12 in accordance with the present disclosure. [Figure 18] FIG. 1 is a side perspective view of an exemplary implant system according to the present disclosure. [Figure 19] FIG. 19 is an alternative side perspective view of the exemplary implant system of FIG. 18 in accordance with the present disclosure. [Figure 20] FIG. 19 is a top perspective view of the exemplary implant system of FIG. 18 in accordance with the present disclosure. [Figure 21] FIG. 19 is a bottom perspective view of the exemplary implant system of FIG. 18 in accordance with the present disclosure. [Figure 22] FIG. 20 is a side perspective view of an exemplary implant as shown in the exemplary system of FIG. 18 in accordance with the present disclosure. [Diagram 23] FIG. 20 is a side view of an exemplary implant as shown in the exemplary system of FIG. 18 in accordance with the present disclosure. [Figure 24]FIG. 20 is a rear perspective view of an exemplary implant as shown in the exemplary system of FIG. 18 in accordance with the present disclosure. [Diagram 25] FIG. 1 is a side perspective view of an exemplary implant according to the present disclosure. [Figure 26] FIG. 26 is an alternative side view of the exemplary implant of FIG. 25 in accordance with the present disclosure. [Figure 27] FIG. 26 is a rear perspective view of the exemplary implant of FIG. 25 in accordance with the present disclosure. [Figure 28] FIG. 1 is a side view of an exemplary implant according to the present disclosure. [Figure 29] FIG. 30 is an alternative side view of the exemplary implant of FIG. 28 in accordance with the present disclosure. [Diagram 30] FIG. 29 is a front perspective view of the exemplary implant of FIG. 28 in accordance with the present disclosure. [Diagram 31] 29 is a rear view of the exemplary implant of FIG. 28 in accordance with the present disclosure; [Diagram 32] FIG. 13 is a side perspective view of an exemplary device that can be implemented with the implant of FIGS. 1, 6, and / or 12 in accordance with the present disclosure. [Diagram 33] FIG. 33 is a front perspective view of the exemplary device of FIG. 32 that can be implemented with the implant of FIGS. 1, 6, and / or 12 or other implants according to the present disclosure. [Diagram 34] FIG. 23 is a top view of an exemplary instrument that may be implemented with the implant system of FIG. 18, the implants of FIGS. 22, 25, and / or 28, or other implants according to the present disclosure. [Diagram 35] FIG. 35 is a rear perspective view of the exemplary instrument of FIG. 34 that may be implemented with the implant system of FIG. 18, the implants of FIGS. 22, 25, and / or 28, or other implants according to the present disclosure. [Diagram 36] FIG. 33 is a side perspective view of an implant system according to the present disclosure that can be implemented with the implant of FIGS. 1, 6, and / or 12, or that can be implemented with the instrument of FIG. [Figure 37]FIG. 35 is a front perspective view of an implant system according to the present disclosure that can be implemented using the implant system of FIG. 18, the implants of FIGS. 22, 25, and / or 28, or that can be implemented using the instrument of FIG. 34. [Figure 38] FIG. 23 is a side view of an exemplary implant that can be implemented using the implant system of FIG. 18, the implants of FIG. 22, FIG. 25, and / or FIG. 28 in accordance with the present disclosure. [Figure 39] FIG. 38 is a perspective view of an exemplary implant of FIG. 38 that can be implemented with the implant system of FIG. 18, the implants of FIGS. 22, 25, and / or 28 in accordance with the present disclosure. [Diagram 40] FIG. 38 is a top view of an exemplary implant of FIG. 38 that can be implemented with the implant system of FIG. 18, the implants of FIGS. 22, 25, and / or 28 in accordance with the present disclosure. [Diagram 41] FIG. 1 is a perspective view of an exemplary device that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure. [Diagram 42] FIG. 42 is a top view of the exemplary device of FIG. 41 that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure. [Diagram 43] FIG. 1 is a top perspective view of an exemplary device that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure. [Diagram 44] FIG. 44 is a bottom perspective view of the exemplary device of FIG. 43 that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure. [Diagram 45] FIG. 1 is a perspective view of an exemplary device that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure. [Figure 46] FIG. 1 is an alternative perspective view of an exemplary device according to the present disclosure that may be implemented in combination with one or more of the implants, systems, and / or devices shown and described above. [Figure 47]FIG. 1 is a perspective view of an exemplary device that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure; [Figure 48] FIG. 1 is a perspective view of an exemplary device that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure; [Figure 49] FIG. 49 is a perspective view of the exemplary device of FIG. 48 that may be implemented in conjunction with one or more of the implants, systems, and / or devices shown and described above in accordance with the present disclosure. [Figure 50] FIG. 1 is a perspective view of an exemplary implant system according to the present disclosure. [Figure 51] FIG. 51 is a top view of a portion of the implant system of FIG. 50 positioned within a bone in accordance with the present disclosure. [Figure 52] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Diagram 53] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Figure 54] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Figure 55] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Figure 56] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Figure 57] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Figure 58] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Figure 59] FIG. 1 is a top view of an exemplary implant according to the present disclosure. [Figure 60] FIG. 51 is a perspective view of an exemplary instrument that may be implemented with the implant system of FIG. 50 in accordance with the present disclosure. [Figure 61] FIG. 51 is a perspective view of an exemplary instrument that may be implemented with the implant system of FIG. 50 in accordance with the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] In this detailed description and in the claims that follow, the terms proximal, distal, anterior or plantar, posterior or dorsal, medial, lateral, superior, and inferior are defined according to standard usage to designate particular portions or regions of a bone or implant, following reference terms that indicate the relative location or orientation of natural bone. For example, "proximal" refers to the portion of the device or implant closest to the torso, and "distal" refers to the portion of the device or implant furthest from the torso. As terms relating to directions, "anterior" means toward the front of the body, "posterior" means toward the back of the body, "medial" means toward the midline of the body, "lateral" means toward the side of the body or away from the midline of the body, "superior" means above another object or structure, and "inferior" means below another object or structure. Additionally, with respect to the foot specifically, the term "dorsal" refers to the top of the foot and the term "plantar" refers to the bottom of the foot.

[0010] Similarly, positions or orientations may be used herein with reference to anatomical structures or surfaces. For example, as current implants, devices, instrumentation, and methods are described herein with reference to use with the bones of the foot, the bones of the foot, ankle, and lower leg may be used to describe the surfaces, positions, directions, or orientations of the implants, devices, instrumentation, and methods. Additionally, the implants, devices, instrumentation, and methods disclosed herein, as well as aspects, components, features, etc. thereof, are described with respect to one side of the body for brevity. However, because the human body is relatively symmetrical or mirrored about a line of symmetry (the midline), it is expressly contemplated herein that the implants, devices, instrumentation, and methods described and / or illustrated herein, as well as their aspects, components, features, etc., may be changed, varied, modified, reconfigured, or otherwise altered for use with or in association with another side of the body for the same or similar purposes without departing from the spirit and scope of the present invention. For example, implants, devices, instrumentation, and methods described herein with respect to the right foot, as well as their aspects, components, features, etc., may be mirrored to function similarly on the left foot. Additionally, while the implants, devices, instrumentation, and methods disclosed herein, as well as their aspects, components, features, etc., are described with respect to the foot for purposes of brevity, it should be understood that the implants, devices, instrumentation, and methods may also be used with other bones of the body having similar structures.

[0011] 1-5, an exemplary implant 100 is shown. As shown and described later herein, it should be understood that implant 100 may be desirable in a variety of sizes / shapes and / or other configurations to address a variety of chronic and acute conditions in the limb (e.g., foot as illustratively shown herein) and other parts of the anatomy. In some embodiments, implant 100 may have a larger or smaller longitudinal dimension and / or cross-sectional dimension / shape. For example, portions of implant 100 may be longer, shorter, or have larger or smaller cross-sectional dimensions than the dimensions of implant 100 as shown in FIGS. 1-5. Similarly, implant 100 may omit features shown and described herein and / or include additional features.

[0012] The implant 100 is shown to include a proximal portion 110, a distal portion 130, and a central portion 120 disposed between the proximal portion 110 and the distal portion 130. As shown in FIGS. 1-5, the designations of the proximal portion 110 and the distal portion 130, respectively, are arbitrary. However, when implanted in various portions of the human anatomy, either the proximal portion 110 or the distal portion 130 can be disposed proximally (and the other portion disposed distally) relative to the anatomical structure. As shown, the proximal portion 110, the central portion 120, and the distal portion 130 are disposed substantially about a common longitudinal axis. In some embodiments, one or more of the proximal portion 110, the central portion 120, and the distal portion 130 may include the same and / or similar geometric shapes and / or cross-sections, e.g., substantially cylindrical cross-sections. As shown, each of the proximal portion 110, the central portion 120, and the distal portion 130 are integral with one another. However, in some embodiments, one or more of the proximal portion 110, the central portion 120, and the distal portion 130 may be releasably coupleable to one another and / or to other components of the implant system.

[0013] The proximal portion 110 of the implant 100 is shown extending from the central portion 120 in a substantially opposite direction to the distal portion 130. The proximal portion 110 is shown including a plurality of prongs 112 (e.g., prongs, tines, etc.) extending from the central portion 120, each of the plurality of prongs 112 extending along an axis that is substantially parallel to adjacent prongs in addition to being substantially parallel to the longitudinal axis of the implant 100. As shown in FIGS. 1-5, the plurality of prongs 112 includes four prongs, although alternative embodiments may include fewer or greater numbers of prongs 112. As shown, each of the plurality of prongs 112 has substantially the same shape as the other prongs of the implant 100. However, in some aspects, one or more of the plurality of prongs 112 may have a different size, length, or other geometric difference than the remaining prongs of the implant 100.

[0014] As shown, each of the projections 112 occupies about 90 degrees or less of a cylinder about the longitudinal axis of the implant 100. That is, each projection 112 is disposed in a separate quadrant of such cylinder or its circular cross section. However, as previously mentioned, a different number of projections 112 may result in other geometric configurations (e.g., two projections each occupying an angle of about 180 degrees or less). The projections 112 are spaced apart from one another by cavities 118 that occupy a space of the longitudinal axis of the implant 100 extending through the proximal portion 110 as shown. The cavities 188 may include a substantially cross (e.g., a plus sign) shape, with each projection of the cross extending outward from the longitudinal axis of the implant 100 and between two projections of the projections. Thus, the cavities 118 may have other shapes if the implant 100 includes a different number of projections.

[0015] Each of the plurality of protrusions 112 is shown to include a first portion 114 (e.g., a straight portion) and a second portion 116 (e.g., a rounded portion). As shown, each of the plurality of protrusions 112 includes substantially the same shape, and for brevity, a single protrusion of the plurality of protrusions 112 will be described in detail below. The straight portion 114 is shown to be integral with the central portion 120 of the implant 100 and to extend substantially opposite the distal portion 130 from the central portion 120 as described above, and to extend substantially parallel to the longitudinal axis of the implant 100. The straight portion 114 is shown to include three main surfaces, two of which form substantially perpendicular angles with each other adjacent the longitudinal axis of the implant 100. The third surface is shown to be a substantially rounded convex surface (which may correspond to a radius of the central portion 120 or other portions of the implant 100) extending between the edges of the two perpendicular surfaces. In some embodiments, each straight portion may have the same and / or similar shape as a quadrant of a cylinder and may include a corresponding cross-sectional shape.

[0016] The rounded portions 116 of each of the plurality of protrusions are also described with reference to a single protrusion for simplicity. The rounded portions 116 are shown to have a substantially larger lateral dimension (e.g., extending further radially from the longitudinal axis of the implant 100) than the straight portions 114. The outer surface of the rounded portions has a shape similar to a fraction of the outer surface of the bulbous or elliptical (or ellipsoidal) shape. With respect to the four rounded portions 116 as a whole, each includes a substantially equal surface area on the rounded portions 116, which collectively make up the majority of the outer surface of the bulbous / elliptical shape (with portions of the cavity 118 taking up the void). The illustrated rounded portions 116 are substantially symmetrical with respect to a line of symmetry constructed perpendicular to the longitudinal axis of the implant, the line of symmetry corresponding to the point where the circumference / radius of the bulbous / elliptical shape is at its maximum (and the circumference / radius decreases moving in either direction along the longitudinal axis of the implant 100 from the line of symmetry).

[0017] The plurality of projections 112 are configured such that one or more projections are depressed inward (e.g., toward the longitudinal axis of the implant) to reduce a lateral dimension of the proximal portion 110 of the implant 100. For example, a pilot hole can be formed in a portion of a bone (e.g., an intramedullary canal) with a lateral dimension that is smaller than the lateral dimension of the proximal portion 110 at its maximum point (round portion 116) when in an undepressed state. Thus, the implant 100 can be implanted into an opening / pilot hole or the like by depressing one or more of the plurality of projections 112 (specifically, round portion 116) to reduce the lateral dimension of the proximal portion 110, thereby allowing the proximal portion 110 to be easily implanted inside the opening / pilot hole. Once within the opening / pilot hole, the plurality of projections 112 may exhibit elastic properties and return to the same lateral dimension as prior to depression. In some embodiments, the multiple protrusions 112 can return to a semi-depressed state after implantation to facilitate implantation and retention within the opening / pilot hole of the proximal portion 110 of the implant 100 by a force directed radially outward from the longitudinal axis of the implant 100 (thus preventing pull-out and increasing pull-out resistance / strength).

[0018] The central portion 120 of the implant 100 is shown to have a substantially cylindrical shape extending from the end of the straight portion 114 of the proximal portion 110 to the proximal-most portion of the distal portion 130 of the implant 100. As shown, the central portion 120 has a smaller longitudinal dimension than the proximal portion 110 and the distal portion 130. However, in alternative embodiments, the central portion 120 may include a greater longitudinal dimension than is shown in FIGS. 1-5. Conversely, in some embodiments, the central portion 120 may include a smaller longitudinal dimension than is shown, or may be absent from the implant 100 in some aspects (e.g., the proximal portion 110 and the distal portion 130 are integral with one another). The central portion 120 is shown to include markings 122 disposed on its outer surface. As shown, the markings 122 span the circumference of the central portion 120 and can act as depth indicators to aid in the insertion of the implant 100. In some embodiments, the markings 122 can include multiple markings, for example, multiple rings that indicate various insertion depths when the implant 100 is implanted.

[0019] The distal portion 130 is shown to include a substantially cylindrical shape adjacent the central portion 120, which tapers toward the end of the distal portion 130 opposite the central portion 120. The distal portion is further shown to include threading 132 that extends circumferentially (e.g., in a spiral configuration) from adjacent the central portion 120 to a tip 134 at the end of the distal portion 130. In some embodiments, the threading 132 may be configured to be oversized relative to the circumference / taper of the tapered cylindrical shape of the distal portion 130. The tip 134 may include a tap 136 (e.g., a self-tapping portion, a cutting flute, a flute, etc.) configured to facilitate implantation within the intramedullary canal of a bone (e.g., to eliminate the need for a pilot hole or to facilitate implantation of the distal portion 130 of the implant after punching rather than drilling an opening in the intramedullary canal).

[0020] 6-11, an exemplary implant 200 is shown. As shown and described later herein, it should be understood that implant 200 may be desirable in various sizes / shapes and / or other configurations to address various chronic and acute conditions of the limb (e.g., foot as illustratively shown herein) and other parts of the anatomy. In some embodiments, implant 200 may have a larger or smaller longitudinal dimension and / or cross-sectional dimension / shape. For example, portions of implant 200 may be longer, shorter, or have larger or smaller cross-sectional dimensions than the dimensions of implant 200 as shown in FIGS. 6-11. Similarly, implant 200 may omit features shown and described herein and / or include additional features.

[0021] Implant 200 is shown to include a proximal portion 210, a distal portion 230, and a central portion 220 disposed between proximal portion 210 and distal portion 230. As shown in FIGS. 1-5, the designations of proximal portion 210 and distal portion 230, respectively, are arbitrary. However, when implanted in various portions of the human anatomy, either proximal portion 210 or distal portion 230 may be disposed proximally (and the other portion disposed distally) relative to the anatomical structure. As shown, proximal portion 210, central portion 220, and distal portion 230 are disposed substantially about a common longitudinal axis. In some embodiments, one or more of proximal portion 210, central portion 220, and distal portion 230 may include the same and / or similar geometric shape and / or cross-section, e.g., a substantially cylindrical cross-section. As shown, each of proximal portion 210, central portion 220, and distal portion 230 are integral with one another. However, in some embodiments, one or more of the proximal portion 210, the central portion 220, and the distal portion 230 may be releasably coupleable to one another and / or to other components of the implant system.

[0022] The proximal portion 210 of the implant 200 is shown extending from the central portion 220 in a substantially opposite direction to the distal portion 230. The proximal portion 210 is shown including a plurality of protrusions 212 (e.g., tines, teeth, etc.) extending from the central portion 220, each of the plurality of protrusions 212 extending along an axis that is substantially parallel to adjacent protrusions in addition to being substantially parallel to the longitudinal axis of the implant 200. As shown in FIGS. 6-11, the plurality of protrusions 212 includes four protrusions, although alternative embodiments may include fewer or greater numbers of protrusions 212. As shown, each of the plurality of protrusions 212 has substantially the same shape as the other protrusions of the implant 200. However, in some aspects, one or more of the plurality of protrusions 212 may have a different size, length, or other geometric difference than the remaining protrusions of the implant 200.

[0023] As shown, each of the projections 212 occupies about 90 degrees or less of a cylinder about the longitudinal axis of the implant 200. That is, each projection 212 is disposed in a separate quadrant of such cylinder or its circular cross section. However, as previously mentioned, a different number of projections 212 may result in other geometric configurations (e.g., two projections each occupying an angle of about 180 degrees or less). The projections 212 are spaced apart from one another by cavities 218 that occupy a space of the longitudinal axis of the implant 200 extending through the proximal portion 210 as shown. The cavities 188 may include a substantially cross (e.g., plus sign) shape, with each projection of the cross extending outward from the longitudinal axis of the implant 200 and between two projections of the projections. Thus, the cavities 218 may have other shapes if the implant 200 includes a different number of projections. Implant 200 is further shown to include a cannulation 224 that extends along the longitudinal axis of implant 200 over the length of the implant (e.g., in fluid communication with cavity 218 and establishing fluid communication along and / or about the longitudinal axis between opposing ends of proximal portion 210 and distal portion 230, respectively). In some embodiments, cannulation 224 may be configured to accommodate (e.g., releasably couple to, etc.) a portion of an instrument to facilitate implantation of implant 200.

[0024] Each of the plurality of projections 212 is shown to include a first portion 214 (e.g., a straight portion) and a second portion 216 (e.g., a rounded portion). As shown, each of the plurality of projections 212 includes substantially the same shape, and for brevity, a single projection of the plurality of projections 212 will be described in detail below. The straight portion 214 is shown to be integral with the central portion 220 of the implant 200 and to extend substantially opposite the distal portion 230 from the central portion 220 and substantially parallel to the longitudinal axis of the implant 200, as previously described. As shown, the straight portion 214 is substantially shorter in the longitudinal direction than the straight portion 114 of the implant 100. However, both the straight portion 114 and the straight portion 214 may include a variety of lengths. The straight portion 214 is shown to include three major surfaces, two of which form substantially perpendicular angles with each other adjacent the longitudinal axis of the implant 100. The third surface is shown to be a substantially rounded convex surface (which may correspond to the radius of the central portion 220 or other portion of the implant 200) extending between the edges of the two orthogonal surfaces. In some embodiments, each straight portion may have the same and / or similar shape as, and may include a corresponding cross-sectional shape to, a quadrant cross-section of a cylinder.

[0025] The rounded portions 216 of each of the plurality of protrusions are also described with reference to a single protrusion for simplicity. The rounded portions 216 are shown to have a substantially larger lateral dimension (e.g., extending further radially from the longitudinal axis of the implant 200) than the straight portions 214. The outer surfaces of the rounded portions have a shape similar to a portion of the outer surface of a bulbous or elliptical (or ellipsoidal) shape. With respect to the four rounded portions 216 as a whole, each includes a substantially equal surface area on the rounded portions 216, which collectively make up the majority of the outer surface of the bulbous / elliptical shape (with portions of the cavity 218 occupying the void). The illustrated rounded portions 216 are substantially symmetrical with respect to a line of symmetry constructed perpendicular to the longitudinal axis of the implant, the line of symmetry corresponding to the point where the circumference / radius of the bulbous / ellipsoidal shape is at its maximum (and the circumference / radius decreases moving in either direction along the longitudinal axis of the implant 200 from the line of symmetry).

[0026] The plurality of protrusions 212 are configured such that one or more of the protrusions are depressed inward (e.g., toward the longitudinal axis of the implant) to reduce a lateral dimension of the proximal portion 210 of the implant 200. For example, a pilot hole can be formed in a portion of a bone (e.g., an intramedullary canal) with a lateral dimension smaller than the lateral dimension of the proximal portion 210 at its maximum point (round portion 216) when in an undepressed state. Thus, the implant 200 can be implanted into an opening / pilot hole or the like by depressing one or more of the plurality of protrusions 212 (specifically, the round portion 216) to reduce the lateral dimension of the proximal portion 210, thereby allowing the proximal portion 210 to be easily implanted inside the opening / pilot hole. Once inside the opening / pilot hole, the plurality of protrusions 212 may exhibit elastic properties and return to the same lateral dimension as before being depressed. In some embodiments, the multiple protrusions 212 can return to a semi-depressed state after implantation to facilitate implantation and retention within the opening / pilot hole of the proximal portion 210 of the implant 200 by a force directed radially outward from the longitudinal axis of the implant (thus preventing pull-out and increasing pull-out resistance / strength).

[0027] The central portion 220 of the implant 200 is shown to have a substantially cylindrical shape extending from the end of the straight portion 214 of the proximal portion 210 to the proximal-most portion of the distal portion 230 of the implant 200. As shown, the central portion 220 has a longitudinal dimension approximately equal to the proximal portion 210 and the distal portion 230. However, in alternative embodiments, the central portion 220 may include a longitudinal dimension greater or less than that shown in FIGS. 6-11. Conversely, in some embodiments, the central portion 220 may include a longitudinal dimension less than that shown, or in some embodiments may be absent from the implant 200 (e.g., the proximal portion 210 and the distal portion 230 are integral with one another). In some embodiments, the implant 200 may include markings in the central portion 220 that are the same and / or similar to the implant 100, the markings being located on an outer surface thereof. The markings may span the circumference of the central portion 220 and act as depth indicators to aid in the insertion of the implant 200. In some embodiments, the markings may include multiple markings, for example multiple rings that indicate various insertion depths when the implant 200 is implanted.

[0028] Distal portion 230 is shown to include a substantially cylindrical shape having the same or similar lateral dimensions as central portion 220. In some embodiments, the distal portion may include a substantially tapered shape that tapers toward the end of distal portion 230 opposite central portion 220. The distal portion is further shown to include threads 232 that extend circumferentially (e.g., in a spiral configuration) from adjacent central portion 220 to a tip 234 at the terminus of distal portion 230. In some embodiments, threads 232 may be configured to be oversized relative to the circumference / taper of the tapered cylindrical shape of distal portion 230. The tip 234 may include a tap 236 (e.g., a self-tapping portion, a cutting flute, or a flute) configured to facilitate implantation within the intramedullary canal of the bone (e.g., to eliminate the need for a pilot hole or to facilitate implantation of the distal portion 230 of the implant after punching rather than drilling an opening in the intramedullary canal).

[0029] 12-17, an exemplary implant 300 is shown. As shown and described later herein, it should be understood that implant 300 may be desirable in various sizes / shapes and / or other configurations to address various chronic and acute conditions of the limb (e.g., foot as illustratively shown herein) and other parts of the anatomy. In some embodiments, implant 300 may have a larger or smaller longitudinal dimension and / or cross-sectional dimension / shape. For example, portions of implant 300 may be longer, shorter, or have larger or smaller cross-sectional dimensions than the dimensions of implant 300 as shown in FIGS. 12-17. Similarly, implant 300 may omit features shown and described herein and / or include additional features.

[0030] Implant 300 is shown to include a proximal portion 310, a distal portion 330, and a central portion 320 disposed between proximal portion 310 and distal portion 330. As shown in FIGS. 12-17, the designations of proximal portion 310 and distal portion 330, respectively, are arbitrary. However, when implanted in various portions of the human anatomy, either proximal portion 310 or distal portion 330 may be disposed proximally (and the other portion disposed distally) relative to the anatomical structure. As shown, proximal portion 310, central portion 320, and distal portion 330 are disposed substantially about a common longitudinal axis. In some embodiments, one or more of proximal portion 310, central portion 320, and distal portion 330 may include the same and / or similar geometric shape and / or cross-section, e.g., a substantially cylindrical cross-section. As shown, each of proximal portion 310, central portion 320, and distal portion 330 are integral with one another. However, in some embodiments, one or more of the proximal portion 310, the central portion 320, and the distal portion 330 may be releasably coupleable to one another and / or to other components of the implant system.

[0031] The proximal portion 310 of the implant 300 is shown extending from the central portion 320 in a substantially opposite direction to the distal portion 330. The proximal portion 310 is shown including a plurality of protrusions 312 (e.g., tines, teeth, etc.) extending from the central portion 320, each of the plurality of protrusions 312 extending along an axis that is substantially parallel to adjacent protrusions in addition to being substantially parallel to the longitudinal axis of the implant 300. As shown in FIGS. 1-5, the plurality of protrusions 312 includes four protrusions, although alternative embodiments may include fewer or greater numbers of protrusions 312. As shown, each of the plurality of protrusions 312 has substantially the same shape as the other protrusions of the implant 300. However, in some aspects, one or more of the plurality of protrusions 312 may have a different size, length, or other geometric difference than the remaining protrusions of the implant 300.

[0032] As shown, each of the projections 312 occupies about 90 degrees or less of a cylinder about the longitudinal axis of the implant 300. That is, each projection 312 is disposed in a separate quadrant of such cylinder or its circular cross section. However, as previously mentioned, a different number of projections 312 may result in other geometric configurations (e.g., two projections each occupying an angle of about 180 degrees or less). The projections 312 are spaced apart from one another by cavities 318 that occupy a space of the longitudinal axis of the implant 300 extending through the proximal portion 310 as shown. The cavities 188 may include a substantially cross (e.g., plus sign) shape, with each projection of the cross extending outward from the longitudinal axis of the implant 300 and between two projections of the projections. Thus, the cavities 318 may have other shapes when the implant 300 includes a different number of projections.

[0033] Each of the plurality of projections 312 is shown to include a first portion 314 (e.g., a straight portion) and a second portion 316 (e.g., a rounded portion). As shown, each of the plurality of projections 312 includes substantially the same shape, and for brevity, a single projection of the plurality of projections 312 will be described in detail below. The straight portion 314 is shown to be integral with the central portion 320 of the implant 300 and to extend substantially opposite the distal portion 330 from the central portion 320 as described above, and to extend substantially parallel to the longitudinal axis of the implant 300. The straight portion 314 is shown to include three major surfaces, two of which form substantially perpendicular angles with each other adjacent the longitudinal axis of the implant 300. The third surface is shown to be a substantially rounded convex surface (which may correspond to the radius of the central portion 320 or other portions of the implant 300) extending between the edges of the two perpendicular surfaces. In some embodiments, each straight portion may have the same and / or similar shape as a quadrant of a cylinder and may include a corresponding cross-sectional shape.

[0034] The rounded portions 316 of each of the plurality of protrusions are also described with reference to a single protrusion for simplicity. The rounded portions 316 are shown to have a substantially larger lateral dimension (e.g., extending further radially from the longitudinal axis of the implant 300) than the straight portions 314. The outer surfaces of the rounded portions have a shape similar to a portion of the outer surface of a bulbous or elliptical (or ellipsoidal) shape. With respect to the four rounded portions 316 as a whole, each includes a substantially equal surface area on the rounded portions 316, which collectively make up the majority of the outer surface of the bulbous / elliptical shape (with portions of the cavity 318 occupying the void). The illustrated rounded portions 316 are substantially symmetrical with respect to a line of symmetry constructed perpendicular to the longitudinal axis of the implant, the line of symmetry corresponding to the point where the circumference / radius of the bulbous / ellipsoidal shape is at its maximum (and the circumference / radius decreases moving in either direction along the longitudinal axis of the implant 300 from the line of symmetry).

[0035] The plurality of protrusions 312 are configured such that one or more of the protrusions are depressed inward (e.g., toward the longitudinal axis of the implant) to reduce a lateral dimension of the proximal portion 310 of the implant 300. For example, a pilot hole can be formed in a portion of a bone (e.g., an intramedullary canal) with a lateral dimension smaller than the lateral dimension of the proximal portion 310 at its maximum point (round portion 316) when in an undepressed state. Thus, the implant 300 can be implanted into an opening / pilot hole or the like by depressing one or more of the plurality of protrusions 312 (specifically, round portion 316) to reduce the lateral dimension of the proximal portion 310, thereby facilitating implantation of the proximal portion 310 inside the opening / pilot hole. Once within the opening / pilot hole, the plurality of protrusions 312 can exhibit elastic properties and return to the same lateral dimension as before being depressed. In some embodiments, the multiple protrusions 312 can return to a semi-depressed state after implantation to facilitate implantation and retention within the opening / pilot hole of the proximal portion 310 of the implant 300 by a force directed radially outward from the longitudinal axis of the implant (thus preventing pull-out and increasing pull-out resistance / strength).

[0036] The central portion 320 of the implant 300 is shown to have a substantially cylindrical shape extending from the end of the straight portion 314 of the proximal portion 310 to the proximal-most portion of the distal portion 330 of the implant 300. As shown, the central portion 320 has a smaller longitudinal dimension than the proximal portion 310 and the distal portion 330. However, in alternative embodiments, the central portion 320 may include a greater longitudinal dimension than is shown in FIGS. 12-17. Conversely, in some embodiments, the central portion 320 may include a smaller longitudinal dimension than is shown, or may be absent from the implant 300 in some aspects (e.g., the proximal portion 310 and the distal portion 330 are integral with one another). The central portion 320 is shown to include markings 322 disposed on its outer surface. As shown, the markings 322 span the circumference of the central portion 320 and may function as a depth indicator to aid in the insertion of the implant 300. In some embodiments, the markings 322 may include multiple markings, for example multiple rings that indicate various insertion depths when the implant 300 is implanted.

[0037] The distal portion 330 is shown to include a substantially cylindrical shape adjacent the central portion 320, which shape tapers toward an end of the distal portion 330 opposite the central portion 320. The distal portion is further shown to include threads 332 that extend circumferentially (e.g., in a spiral configuration) from adjacent the central portion 320 to a tip 334 at the end of the distal portion 330. In some embodiments, the threads 332 may be configured to be oversized relative to the circumference / taper of the tapered cylindrical shape of the distal portion 330. The tip 334 may include a tap 336 (e.g., a self-tapping portion, cutting flutes, or flutes, etc.) configured to facilitate implantation within the intramedullary canal of the bone (e.g., to eliminate the need for a pilot hole or to facilitate implantation of the distal portion 330 of the implant after punching rather than drilling an opening in the intramedullary canal).

[0038] It should be understood that implant 300 may include one or more features that are the same and / or similar to the features of implant 100 shown and described herein above. Similarly, implant 300 may include the same and / or similar features as implant 300, but one or more of those features have a different size, shape, or other spatial characteristic. For example, central portion 320 of implant 300 may be larger or smaller in diameter than central portion 120 of implant 100. Additionally, central portion 320 may be larger or smaller in longitudinal dimension than central portion 120. In some embodiments, implant 300 and implant 100 may be the same implant, but as previously described, its components differ in size (e.g., length, width, cross-sectional area, etc.) relative to corresponding components of implant 100. Thus, implant 300 may be substantially smaller in size (e.g., all components proportionally smaller than implant 100) due to structures that accommodate smaller portions of anatomy (similarly, implant 100 and its components may be proportionally larger to accommodate larger portions of anatomy).

[0039] 18-24, an implant system 400 according to an exemplary embodiment is shown. The implant system 400 is shown to include an implant 500 and a screw 540. As shown, the screw 540 includes a head 542 and a thread 544 extending along the length of the screw and terminating in a tip 546, the tip 546 being disposed substantially opposite the head 542 to the thread 544. As shown in FIGS. 18-21, at least a portion of the screw 540 (e.g., a portion of the screw 540 having the thread 544 and the thread 540 disposed on its outer surface) is configured to releasably couple the implant 500 with the screw 540. Additionally, the screw 540 may be configured to couple with the implant 500 through one or more bones of a portion of a patient's bone to compress the two bone components toward one another. For example, a first portion of implant 500 may be coupled to a first bone portion and a second portion of implant 500 may be coupled to a second bone portion via screw 540 so as to provide compression between the first and second bone portions via implant 500 and screw 540 (thus, screw 540 is coupled to both the implant and the second bone portion).

[0040] The implant 500 is shown to include a proximal portion 510, a distal portion 530, and a central portion 520 disposed between the proximal portion 510 and the distal portion 530. As shown in FIGS. 18-24, the designations of the proximal portion 510 and the distal portion 530, respectively, are arbitrary. However, when implanted in various portions of the human anatomy, either the proximal portion 510 or the distal portion 530 can be disposed proximally (and the other portion disposed distally) relative to the anatomical structure. As shown, the proximal portion 510, the central portion 520, and the distal portion 530 are disposed substantially about a common longitudinal axis. In some embodiments, one or more of the proximal portion 510, the central portion 520, and the distal portion 530 may include the same and / or similar geometric shapes and / or cross-sections, e.g., substantially cylindrical cross-sections. As shown, each of the proximal portion 510, the central portion 520, and the distal portion 530 are integral with one another. However, in some embodiments, one or more of the proximal portion 510, the central portion 520, and the distal portion 530 may be releasably coupleable to one another and / or to other components of the implant system.

[0041] The proximal portion 510 of the implant 500 is shown extending from the central portion 520 in a substantially opposite direction to the distal portion 530. As shown, the proximal portion 510 includes a lateral dimension that is substantially greater in at least one direction than the lateral dimension of the central portion 520 (e.g., as shown as being wider in at least the medial, lateral, anterior and / or posterior directions, or "wider" in the left-right / horizontal direction, and / or "higher" in the superior / inferior direction, where directions are arbitrarily assigned). The proximal portion is shown including an opening 512, shown as a through hole, centrally disposed therein and extending through the proximal portion 510 from one surface (e.g., the top surface) to a second opposing surface (e.g., the bottom surface). As shown, the opening 512 is positioned such that the longitudinal axis of the opening 512 (e.g., the axis about which the opening 512 is concentrically centered, which is shown as a circular / cylindrical opening but may include other shapes in alternative embodiments) lies substantially perpendicular (e.g., in a vertical plane) to the longitudinal axis of the implant 500. In some embodiments, the longitudinal axis of the opening 512 may intersect with the longitudinal axis of the implant 500. The opening 512 is configured to receive at least a portion of a fastener, such as a screw 540, therein, at least a portion of the screw 540 abutting a portion of the proximal portion 510 that defines the lateral dimension of the opening 512 (e.g., contacting a thread / shaft portion of the screw 540 as shown).

[0042] The proximal portion 510 is further shown to include a tapered edge 514 configured adjacent the opening 512. As shown, the entrance of the opening 512 to a top or bottom surface of the proximal portion 510 (e.g., a surface in a plane perpendicular to the longitudinal axis of the opening 512) is shown to have a tapered edge 514 (e.g., a graduated, rounded, or otherwise non-perpendicular interface) between the top / bottom surface of the proximal portion 512 and a surface of the proximal portion 510 that laterally defines the opening 512. The proximal portion 510 is also shown to include a tip 516 disposed at an end of the proximal portion 510 opposite its interface with the central portion 520. The tip 516 is shown to have a tapered shape such that the lateral dimension of the proximal portion 510 at the tip 516 is smaller than the lateral dimension of the interface with the proximal portion or central portion 520 immediately adjacent the opening 512.

[0043] The central portion 520 of the implant 500 is shown to have a substantially regtanguloid shape extending from the end of the proximal portion 510 to the proximal-most portion of the distal portion 530 of the implant 500. As shown, the central portion 520 has a longitudinal dimension that is smaller than the longitudinal dimension of the proximal portion 510. However, in alternative embodiments, the central portion 520 may include a longitudinal dimension that is greater than that shown in FIGS. 18-24. Conversely, in some embodiments, the central portion 520 may include a longitudinal dimension that is smaller than that shown, or may be missing from the implant 500 in some aspects (e.g., the proximal portion 510 and the distal portion 530 are integral with one another). The central portion 520 is shown to include a number of flats 522 (shown as four flats) disposed about the periphery (e.g., the outer surface of the rectangular prism) of the central portion 520. In some aspects, flats 522 may be configured to interface with or facilitate a releasable coupling to one or more instruments incorporated in conjunction with system 400. Additionally, in some embodiments, central portion 520 may include alternative geometries to the illustrated rectangular solid, in which case central portion 520 may include fewer or more flats 522 than illustrated (or such embodiments may even include the four flats illustrated).

[0044] The central portion 520 is further shown to include a cylindrical portion 524 disposed between the plurality of flats 522 and the distal portion 530. In some embodiments, the plurality of flats 522 may include a tapered transition to the cylindrical portion 524. The central portion 520 may also include markings disposed on its outer surface. Such markings may span the outer dimension of the central portion 520 and may function as depth indicators to aid in the insertion of the implant 500. In some embodiments, such markings may include multiple markings, for example, multiple rings that indicate various insertion depths when the implant 500 is implanted.

[0045] The distal portion 530 is shown to include a substantially cylindrical shape adjacent the central portion 520, which shape tapers toward an end of the distal portion 530 opposite the central portion 520. The distal portion is further shown to include threads 532 that extend circumferentially (e.g., in a spiral configuration) from adjacent the central portion 520 to a tip 534 at the end of the distal portion 530. In some embodiments, the threads 532 may be configured to be oversized relative to the circumference / taper of the tapered cylindrical shape of the distal portion 530. The tip 534 may include a tap 536 (e.g., a self-tapping portion, cutting flutes, or flutes, etc.) configured to facilitate implantation within the intramedullary canal of a bone (e.g., to eliminate the need for a pilot hole or to facilitate implantation of the distal portion 530 of the implant after punching rather than drilling an opening in the intramedullary canal).

[0046] The system 400 is configured such that the distal portion 530 may be rotatably coupled (via threads 532) to a first bone fragment, such as a distal portion of a metatarsal bone (e.g., an intramedullary canal that may be manipulated or "punched" to receive the distal portion 530 and form a volume sufficient to couple with the distal portion 530). The proximal portion 510 is similarly configured to couple with a second bone fragment (e.g., an intramedullary canal that may be manipulated or "punched" to receive the proximal portion 510 and form a volume sufficient to couple with the proximal portion 510), with the proximal portion positioned such that the longitudinal axis of the opening 512 extends substantially perpendicular to the longitudinal axis of the anatomical opening (e.g., the intramedullary canal). The proximal portion 510 may be placed in such an anatomical opening, and a screw 542 may be inserted along the longitudinal axis of the opening 512 (e.g., in a plane perpendicular to the longitudinal axis of the implant 500) such that a portion of the threads 544 of the screw 540 contacts a proximal-most end of a portion of the proximal portion 510 that defines the proximal-most portion of the opening 512. Such placement of the screw 540 thus biases the implant 500 proximally (relative to the implant 500) and compresses the first and second bone fragments.

[0047] 25-27, an implant 600 is shown according to an exemplary embodiment. The implant 600 may include one or more features the same and / or similar to the implant 500, and may further be compatible with the screw 540 (or other fastener) shown with reference to FIGS. 18-21 and described earlier herein. The implant 600 is shown to include a proximal portion 610, a distal portion 630, and a central portion 620 disposed between the proximal portion 610 and the distal portion 630. As shown in FIGS. 25-27, the designations of the proximal portion 610 and the distal portion 630, respectively, are arbitrary. However, when implanted in various portions of the human anatomy, either the proximal portion 610 or the distal portion 630 may be disposed proximally (and the other portion disposed distally) relative to the anatomical structure. As shown, the proximal portion 610, the central portion 620, and the distal portion 630 are disposed substantially about a common longitudinal axis. In some embodiments, one or more of the proximal portion 610, the central portion 620, and the distal portion 630 may include the same and / or similar geometric shapes and / or cross-sections, e.g., substantially cylindrical cross-sections. As shown, each of the proximal portion 610, the central portion 620, and the distal portion 630 are integral with one another. However, in some embodiments, one or more of the proximal portion 610, the central portion 620, and the distal portion 630 may be releasably coupleable with one another and / or with other components of the implant system.

[0048] The proximal portion 610 of the implant 600 is shown extending from the central portion 620 in a substantially opposite direction to the distal portion 630. As shown, the proximal portion 610 includes a lateral dimension that is substantially greater in at least one direction than the lateral dimension of the central portion 620 (e.g., as shown as being wider in at least the medial, lateral, anterior and / or posterior directions, or "wider" in the left-right / horizontal direction, and / or "higher" in the superior / inferior direction, where the directions are arbitrarily assigned). The proximal portion is shown including an opening 612, shown as a through hole, centrally disposed therein and extending through the proximal portion 610 from one surface (e.g., a top surface) to a second opposing surface (e.g., a bottom surface). As shown, the opening 612 is positioned such that the longitudinal axis of the opening 612 (e.g., the axis about which the opening 612 is concentrically centered, which is shown as a circular / cylindrical opening but may include other shapes in alternative embodiments) lies substantially perpendicular (e.g., in a vertical plane) to the longitudinal axis of the implant 600. In some embodiments, the longitudinal axis of the opening 612 may intersect with the longitudinal axis of the implant 600. The opening 612 is configured to receive at least a portion of a fastener, such as a screw 540, therein, where at least a portion of the screw 540 abuts a portion of the proximal portion 610 that defines the lateral dimension of the opening 612 (e.g., contacting a thread / shaft portion of the screw 540 as shown).

[0049] The proximal portion 610 is further shown to include a tapered end 614 configured adjacent the opening 612. As shown, the entrance of the opening 612 to a top or bottom surface of the proximal portion 610 (e.g., a surface in a plane perpendicular to the longitudinal axis of the opening 612) is shown to have a tapered end 614 (e.g., a stepped, rounded, or otherwise non-perpendicular interface) between the top / bottom surface of the proximal portion 612 and a surface of the proximal portion 610 that laterally defines the opening 612. The proximal portion 610 is also shown to include a tip 616 disposed at an end of the proximal portion 610 opposite the interface with the central portion 620. The tip 616 is shown to have a tapered shape such that the lateral dimension of the proximal portion 610 at the tip 616 is smaller than the lateral dimension of the interface with the proximal portion or central portion 620 immediately adjacent the opening 612.

[0050] The central portion 620 of the implant 600 is shown to have a substantially cylindrical shape extending from the end of the proximal portion 610 to the proximal-most portion of the distal portion 630 of the implant 600. As shown, the central portion 620 has a longitudinal dimension that is less than the longitudinal dimension of the proximal portion 610. However, in alternative embodiments, the central portion 620 may include a longitudinal dimension that is greater than that shown in FIGS. 25-27. Conversely, in some embodiments, the central portion 620 may include a longitudinal dimension that is less than that shown, or in some aspects may be missing from the implant 600 (e.g., the proximal portion 610 and the distal portion 630 are integral with one another). The central portion 620 is shown to include a plurality of flats 622 (shown as four flats spaced circumferentially at angles of approximately 90 degrees from the midpoint of each flat) disposed about (e.g., around) the central portion 620. 25-27, each flat of the plurality of flats 622 is cut into the cylindrical shape of the central portion 620. In some aspects, the flats 622 may be configured to interface with or facilitate a releasable coupling with, for example, one or more instruments that are incorporated in conjunction with the system 400. Additionally, in some embodiments, the central portion 620 may include alternative geometries to the depicted cylindrical shape, in which case the central portion 620 may include fewer or more flats 622 than depicted (or such embodiments may even include the four flats depicted).

[0051] The central portion 620 is further shown to include a cylindrical portion 624 disposed between the plurality of flats 622 and the distal portion 630. In some embodiments, the plurality of flats 622 may include a tapered transition to the cylindrical portion 624. The central portion 620 may also include markings disposed on its outer surface. Such markings may span the outer dimension of the central portion 620 and may function as depth indicators to aid in the insertion of the implant 600. In some embodiments, such markings may include multiple markings, for example, multiple rings that indicate various insertion depths when the implant 600 is implanted.

[0052] The distal portion 630 is shown to include a substantially cylindrical shape adjacent the central portion 620, which shape tapers toward an end of the distal portion 630 opposite the central portion 620. The distal portion is further shown to include threads 632 that extend circumferentially (e.g., in a spiral configuration) from adjacent the central portion 620 to a tip 634 at the end of the distal portion 630. In some embodiments, the threads 632 may be configured to be oversized relative to the circumference / taper of the tapered cylindrical shape of the distal portion 630. The tip 634 may include a tap 636 (e.g., a self-tapping portion, cutting flutes, or flutes, etc.) configured to facilitate implantation within the intramedullary canal of a bone (e.g., to eliminate the need for a pilot hole or to facilitate implantation of the distal portion 630 of the implant after punching rather than drilling an opening in the intramedullary canal).

[0053] Implant 600, which may be implemented similarly to implant 500 illustrated with reference to system 400, is configured such that distal portion 630 may be rotatably coupled (via threads 532) to a first bone fragment, such as a distal portion of a metatarsal bone (e.g., an intramedullary canal that may be manipulated or "punched" to receive and form a volume sufficient to couple with distal portion 630). Proximal portion 610 is similarly configured to couple with a second bone fragment (e.g., an intramedullary canal that may be manipulated or "punched" to receive and form a volume sufficient to couple with proximal portion 610), with the proximal portion positioned such that the longitudinal axis of opening 612 extends substantially perpendicular to the longitudinal axis of the anatomical opening (e.g., intramedullary canal). The proximal portion 610 may be placed in the anatomical opening, and the screw 542 may be inserted along the longitudinal axis of the opening 612 (e.g., in a plane perpendicular to the longitudinal axis of the implant 600) such that a portion of the threads 544 of the screw 540 contacts a proximal-most edge of a portion of the proximal portion 610 that defines the proximal-most portion of the opening 612. Such placement of the screw 540 thus biases the implant 600 proximally (relative to the implant 600) and compresses the first and second bone fragments.

[0054] 28-31, an implant 700 according to an exemplary embodiment is shown. The implant 700 may include one or more features the same and / or similar to the implant 500, and may further be compatible with the screw 540 (or other fastener) shown with reference to FIGS. 18-21 and described earlier herein. The implant 700 is shown to include a proximal portion 710, a distal portion 730, and a central portion 720 disposed between the proximal portion 710 and the distal portion 730. As shown in FIGS. 28-31, the designations of the proximal portion 710 and the distal portion 730, respectively, are arbitrary. However, when implanted in various portions of the human anatomy, either the proximal portion 710 or the distal portion 730 may be disposed proximally (and the other portion disposed distally) relative to the anatomical structure. As shown, the proximal portion 710, the central portion 720, and the distal portion 730 are disposed substantially about a common longitudinal axis. In some embodiments, one or more of the proximal portion 710, the central portion 720, and the distal portion 730 may include the same and / or similar geometric shapes and / or cross-sections, e.g., substantially cylindrical cross-sections. As shown, each of the proximal portion 710, the central portion 720, and the distal portion 730 are integral with one another. However, in some embodiments, one or more of the proximal portion 710, the central portion 720, and the distal portion 730 may be releasably coupleable with one another and / or with other components of the implant system.

[0055] The proximal portion 710 of the implant 700 is shown extending from the central portion 720 in a substantially opposite direction to the distal portion 730. As shown, the proximal portion 710 includes a lateral dimension that is substantially greater in at least one direction than the lateral dimension of the central portion 720 (e.g., as shown as being wider in at least the medial, lateral, anterior and / or posterior directions, or "wider" in the left-right / horizontal direction, and / or "higher" in the superior / inferior direction, where the directions are arbitrarily assigned). The proximal portion is shown including an opening 712, shown as a through hole centrally disposed therein and extending through the proximal portion 710 from one surface (e.g., a top surface) to a second opposing surface (e.g., a bottom surface). As shown, the opening 712 is positioned such that the longitudinal axis of the opening 712 (e.g., the axis about which the opening 712 is concentrically centered, which is shown as a circular / cylindrical opening but may include other shapes in alternative embodiments) lies substantially perpendicular (e.g., in a vertical plane) to the longitudinal axis of the implant 700. In some embodiments, the longitudinal axis of the opening 712 may intersect with the longitudinal axis of the implant 700. The opening 712 is configured to receive at least a portion of a fastener, such as a screw 540, therein, where at least a portion of the screw 540 abuts a portion of the proximal portion 710 that defines the lateral dimension of the opening 712 (e.g., contacting a thread / shaft portion of the screw 540 as shown).

[0056] The proximal portion 710 is further shown to include a tapered end 714 configured adjacent the opening 712. As shown, the entrance of the opening 712 to a top or bottom surface of the proximal portion 710 (e.g., a surface in a plane perpendicular to the longitudinal axis of the opening 712) is shown to have a tapered end 714 (e.g., a stepped, rounded, or otherwise non-perpendicular interface) between the top / bottom surface of the proximal portion 712 and a surface of the proximal portion 710 that laterally defines the opening 712. The proximal portion 710 is also shown to include a tip 716 disposed at an end of the proximal portion 710 opposite the interface with the central portion 720. The tip 716 is shown to have a tapered shape such that the lateral dimension of the proximal portion 710 at the tip 716 is smaller than the lateral dimension of the interface with the proximal portion or central portion 720 immediately adjacent the opening 712. The tip 716 is shown to include a cannulation 718 that extends along the longitudinal axis of the implant 700 from a terminal portion of the proximal portion 710, through the central portion 720, to a terminal portion of the distal portion 730, such that the opening 712 and the cannulation are in fluid communication with one another. In some embodiments, the cannulation 718 may be configured to receive a portion of an instrument, stabilization wire, or other component to facilitate implantation of the implant 700.

[0057] The central portion 720 of the implant 700 is shown to have a substantially rectangular parallelepiped shape extending from the end of the proximal portion 710 to the proximal-most portion of the distal portion 730 of the implant 700. As shown, the central portion 720 has a longitudinal dimension that is substantially equal to or slightly less than the longitudinal dimension of the proximal portion 710. Similarly, the central portion 720 is shown to have a cross-sectional shape that is substantially similar to the cross-sectional shape of the proximal portion 710. However, in alternative embodiments, the central portion 720 may include a longitudinal dimension greater than that shown in FIGS. 25-27 and / or alternative cross-sectional dimensions. Conversely, in some embodiments, the central portion 720 may include a longitudinal dimension less than that shown, or may be missing from the implant 700 in some aspects (e.g., the proximal portion 710 and the distal portion 730 are integral with one another). Central portion 720 is shown to include a number of flats 722 (shown as four flats spaced at approximately 90 degree angles from one another) disposed about the periphery (e.g., outer surface) of central portion 720. In some aspects, flats 722 may be configured to interface with or facilitate a releasable coupling with, for example, one or more instruments that are incorporated in conjunction with system 400. Additionally, in some embodiments, central portion 720 may include alternative geometries to the illustrated cylindrical shape, in which case central portion 720 may include fewer or more flats 722 than shown (or such embodiments may even include the four flats shown).

[0058] The central portion 720 is further shown to include a cylindrical portion 724 disposed between the plurality of flats 722 and the distal portion 730. In some embodiments, the plurality of flats 722 may include a tapered transition to the cylindrical portion 724. The central portion 720 may also include markings disposed on its outer surface. Such markings may span the outer dimension of the central portion 720 and may function as depth indicators to aid in the insertion of the implant 700. In some embodiments, such markings may include multiple markings, for example, multiple rings that indicate various insertion depths when the implant 700 is implanted.

[0059] The distal portion 730 is shown to include a substantially cylindrical shape adjacent the central portion 720, which shape tapers toward an end of the distal portion 730 opposite the central portion 720. The distal portion is further shown to include threads 732 that extend circumferentially (e.g., in a spiral configuration) from adjacent the central portion 720 to a tip 734 at the end of the distal portion 730. In some embodiments, the threads 732 may be configured to be oversized relative to the circumference / taper of the tapered cylindrical shape of the distal portion 730. The tip 734 may include a tap 736 (e.g., a self-tapping portion, cutting flutes, or flutes, etc.) configured to facilitate implantation within the intramedullary canal of the bone (e.g., to eliminate the need for a pilot hole or to facilitate implantation of the distal portion 730 of the implant after punching rather than drilling an opening in the intramedullary canal).

[0060] Implant 700, which may be implemented similarly to implant 500 shown with reference to system 400, is configured such that distal portion 730 may rotatably couple (via threads 532) with a first bone fragment, such as a distal portion of a metatarsal bone (e.g., an intramedullary canal that may be manipulated or "punched" to receive and form a volume sufficient to couple with distal portion 730). Proximal portion 710 is similarly configured to couple with a second bone fragment (e.g., an intramedullary canal that may be manipulated or "punched" to receive and form a volume sufficient to couple with proximal portion 710), with the proximal portion positioned such that the longitudinal axis of opening 712 extends substantially perpendicular to the longitudinal axis of the anatomical opening (e.g., intramedullary canal). The proximal portion 710 may be positioned in the anatomical opening, and the screw 542 may be inserted along the longitudinal axis of the opening 712 (e.g., in a plane perpendicular to the longitudinal axis of the implant 700) such that a portion of the threads 544 of the screw 540 contacts a proximal-most edge of a portion of the proximal portion 710 that defines the proximal-most portion of the opening 712. Such positioning of the screw 540 thus biases the implant 700 proximally (relative to the implant 700) and compresses the first and second bone fragments.

[0061] 32-33, an instrument 750 (e.g., an inserter) is shown according to an exemplary embodiment. The instrument 750 is shown to include a first portion 752 and a second portion 756, both of which are disposed about a longitudinal axis of the instrument 750. The first portion 752 is shown to include a flat 754 configured to facilitate releasable coupling with a handle and / or portion of another instrument, as shown and described later herein. In some aspects, the first portion 752 may include a substantially cylindrical shape, or the flat 754 may be cut into the cylindrical shape to provide a hemispherical shape. In some aspects, the flat 754 may include two or more flats. The second portion 756 is shown to include an engagement feature 758 including a plurality of fins (four as shown). In some embodiments, the engagement mechanism 758 may be the same as and / or similar to a standard engagement mechanism (e.g., a hexalobe, Torxx, or, as shown, a Phillips head). The engagement mechanism 758 is configured to interface with (e.g., releasably couple to) an implant, such as, but not limited to, implants 100, 200, and 300 as shown and described herein. When releasably coupling with the implant 100, for example, the multiple fins of the engagement mechanism 758 are configured to be received within the cavity 118 and adjacent the protrusion 112. Thus, the implant 100 can be manipulated in a fixed position (e.g., such that the threads 132 are releasably coupled to the bone fragment).

[0062] 34-35, an instrument 800 is shown according to an exemplary embodiment. The instrument 800 is shown to include a first portion 802 and a second portion 806, both of which are disposed about a longitudinal axis of the instrument 800. The first portion 802 is shown to include a flat 804 configured to facilitate releasable coupling with a handle and / or portion of another instrument, as shown and described later herein. In some aspects, the first portion 802 may include a substantially cylindrical shape, or the flat 804 may be cut into the cylindrical shape to provide a hemispherical shape. In some aspects, the flat 804 may include two or more flats. The second portion 806 is shown to include a lateral dimension that is greater than the lateral dimension of the first portion 802. Additionally, the second portion 806 is shown to include a through hole 808 and a recess 810. The through hole 808 is shown extending diametrically through the second portion 806 (e.g., substantially perpendicular to the longitudinal axis of the instrument 800). As shown, the recess 810 extends into the second portion 806 from a terminus of the second portion 806 of the instrument 800. As shown, the recess 810 includes a substantially oblong or rounded rectangular cross-sectional shape and may receive at least a portion of the implant 500 (or other implants, including but not limited to those shown and described herein). When received within the recess 810, the longitudinal axis of the opening 512 of the implant 500 may be aligned with the longitudinal axis of the through hole 808, and a rigid member (e.g., a screw 540 or similar) may be inserted through the through hole 808 and the opening 512 to hold the implant 100 with at least a portion of the proximal portion 510 of the implant disposed within the recess 810. Thus, the implant 500 can be manipulated in a fixed position (eg, such that the threads 532 are releasably engaged with the bone fragments).

[0063] 36, a system 770 according to an exemplary embodiment is shown. The system 770 is shown to include a handle 760, which may include a ratcheting mechanism or other features common to surgical handles configured to facilitate rotational movement of other components. The instrument 750 is shown to be releasably coupled to the handle 760 via a first portion 752 (more specifically, a flat portion 754), at least a portion of the first portion 752 being received and releasably retained within a portion of the handle 760. The instrument 750 is shown to be releasably coupled to the implant 100 via an engagement mechanism 758 (and its fins) that releasably couples with a protrusion 112 / cavity 118 of a proximal portion of the implant 100. Thus, the distal portion 130 of the implant 100 may be releasably coupled to a portion of bone (e.g., screwed in using the handle 760), after which the implant is released from releasable coupling with the engagement mechanism 758 of the instrument 750.

[0064] 37, a system 780 is shown according to an exemplary embodiment. The system 780 is shown to include a handle 760, which may include a ratchet mechanism or other features common to surgical handles configured to facilitate rotational movement of other components, as previously described. The instrument 800 is shown to be releasably coupled to the handle 760 via a first portion 802 (more specifically, a flat portion 804), at least a portion of the first portion 802 being received and releasably retained within a portion of the handle 760. The instrument 800 is shown to be releasably coupled to the implant 500 via a recess 810 that receives at least a portion of the proximal portion 510 of the implant 500. Thus, the distal portion 530 of the implant 500 may be releasably coupled to a portion of bone (e.g., screwed using the handle 760), after which the implant is released from releasable coupling with the engagement mechanism 808 of the instrument 800.

[0065] 38-40, an instrument 850 (e.g., drill guide, positioning guide, etc.) is shown in accordance with an exemplary embodiment. The instrument 850 may be configured to be implemented with various systems and / or implants shown and described herein, but for brevity will be described in connection with the implant 500. The instrument 850 includes a guide portion 852 and a handle 854 having a substantially square / rectangular shape. The instrument 850 can be grasped and manipulated by a physician via the handle 854 to position the guide portion 852 in a desired location. The guide portion 852 extending from the handle 854 may be configured to accept a stabilization wire (e.g., a stabilization wire such as the stabilization wire 960 shown in FIG. 46), a drill bit, or other similar component. The instrument 850 is also shown to include an engagement mechanism 856 extending from the handle 854. As shown, the engagement feature 856 includes a pair of protrusions defining recesses that can be configured to releasably mate with the plurality of flats 522 of the implant 500. Thus, when coupled to the implant 500, the instrument 850 can be positioned with the handle 854 and a stabilization wire (or drill bit) can be driven through the guide portion 852 into the bone fragment with the guide portion in a desired position relative to the bone member. In some embodiments, the engagement feature 856 can be spaced longitudinally from the guide portion such that when the engagement feature 856 is releasably coupled to the implant 500, the longitudinal axis of the opening 512 of the implant 500 is aligned with the longitudinal axis of the guide portion 852 (e.g., a stabilization wire or other component driven into the guide portion and penetrating the bone also passes through the opening 512). Thus, the instrument 850 may be configured to manipulate the proximal portion 510 of the implant 500 within an opening in the bone fragment (e.g., the intramedullary canal), and a stabilizing wire may be driven into the guide portion 852 and the opening 512 to hold the implant 500 in a desired position within the opening in the bone fragment.

[0066] 41-42, an instrument 900 (e.g., a cut guide) is shown in accordance with an exemplary embodiment. The instrument 900 may be implemented in combination with one or more of the systems, implants, instruments, and / or methods shown and described herein, or in combination with other components not shown or described herein. The instrument 900 is shown to include a handle portion 902 having a textured portion 904 disposed on at least a portion thereof, which may be configured to assist a physician in gripping and / or manipulating the instrument 900. The instrument 900 is also shown to include a base 906 integral with or coupled to a portion of the shaft 902 opposite the textured portion 904. The base 906 is shown to include at least one through hole 908 extending through the base 906, and a stabilizing wire may be placed within the at least one through hole 908 and in a bone disposed below the base 906 to releasably couple the base 906 (and the instrument 900) to a portion of the bone. The base 906 is also shown to include at least one slot 910 (e.g., a side-opening slot) extending into the base 906 from an end thereof. In some embodiments, the at least one slot 910 may be configured to receive a saw blade or other cutting instrument therein to guide one or more cuts into the bone to which the instrument 900 is coupled. In some embodiments, the base 906 may also include various markings on its surface to indicate, for example, a size or part number, an identification of the at least one slot 910, or other information.

[0067] 43-44, an instrument 920 is shown according to an exemplary embodiment. As with other instruments shown and described herein, the instrument 920 may be implemented in combination with one or more of the systems, implants, instruments, and / or methods also shown and described herein, or in combination with other components not shown or described herein. The instrument 920 is shown as including a shaft portion 922 having a substantially rectangular shape with a texture 924 disposed on at least a portion of the shaft portion 922. The shaft portion 922 is also shown as including at least one window 926 disposed substantially adjacent to the texture 924. In some aspects, the shaft portion 922 includes a contour 928 disposed on an opposite side of the shaft portion 922 from the texture 924. Collectively, the texture 924 and the contour 928 can aid the physician in grasping and / or manipulating the instrument 920. In some aspects, the shaft portion 922 may include one or more markings 930 disposed thereon indicating size, product information, or other information. The instrument 920 also includes a base portion 932 extending at a substantially oblique angle from the shaft portion 922 adjacent the texture 924. The base portion 932 is shown to have a smaller lateral dimension than the shaft portion 922. The base portion 932, as shown, is shown to have a substantially tapered cylindrical shape and includes a protrusion 934 disposed such that a longitudinal axis of the protrusion 934 extends in a plane substantially perpendicular to a plane in which a surface of the base portion 932 is disposed. Additionally, the protrusion 934 is shown to extend substantially in the direction of the shaft portion 922. The protrusion 934 may be configured to punch an opening (e.g., open or expand a volume within a bone, such as an intramedullary canal) that will later be occupied by a portion of the implant, as shown and described herein.

[0068] 45-46, an instrument 940 is shown according to an exemplary embodiment. As with other instruments shown and described herein, the instrument 940 may be implemented in combination with one or more of the systems, implants, instruments, and / or methods also shown and described herein, or in combination with other components not shown or described herein. The instrument 940 is shown as including a shaft portion 942 having a substantially rectangular shape with a texture 944 disposed on at least a portion of the shaft portion 942. In some embodiments, the shaft portion 942 includes a contour disposed on an opposite side of the shaft portion 922 from the texture 944. Collectively, the texture 944 and the contour can aid the physician in grasping and / or manipulating the instrument 940. The instrument 940 also includes a base portion 952 extending at a substantially oblique angle from the shaft portion 942 adjacent the texture 944. The base portion 952 is shown to have a smaller lateral dimension than the shaft portion 942. The base portion 952, as shown, is shown to have a substantially tapered cylindrical shape and includes a protrusion 954 disposed such that a longitudinal axis of the protrusion 954 extends in a plane substantially perpendicular to a plane in which a surface of the base portion 952 is disposed. Additionally, the protrusion 954 is shown to extend substantially in the direction of the shaft portion 952. The protrusion 954 may be configured to punch an opening (e.g., open or expand a volume within the bone, such as an intramedullary canal) that will later be occupied by a portion of the implant, as shown and described herein. In some embodiments, the protrusion 954 may be substantially larger in height and / or lateral dimensions than the protrusion 934 of the instrument 920. Additionally, in some embodiments, the system may include the instruments 920 and 940, as well as other instruments, with various components of each being of various sizes.

[0069] 48-49, an instrument 970 is shown according to an exemplary embodiment. As with other instruments shown and described herein, the instrument 970 may be implemented in combination with one or more of the systems, implants, instruments, and / or methods also shown and described herein, or in combination with other components not shown or described herein. The instrument 970 is shown to include a shaft portion 972 and a base portion 974, the shaft portion 972 and the base portion 974 being integral with one another. The shaft portion 972 is shown to include a concavity 976 on its upper surface, the concavity 976 having a substantially U- or V-shaped volume extending along a majority of the length of the shaft portion 972. The shaft portion 972 may also include a similar shape (e.g., a U- or V-shape), which may include one or more contours that, in combination with the concavity 976, may be configured to assist the physician in manipulating the instrument 970. The instrument 970 is further shown to include a recess 980 disposed at an end of the base portion 974. In some embodiments, the recess 980 may be open-ended and may extend in volume from an outer edge of the base portion 974 into the base portion 974. As such, the recess 980 may be configured to accommodate at least a portion of an implant, including but not limited to those shown and described herein, and to facilitate manipulation of the implant during the implantation process / procedure.

[0070] 50-61, an implant system 1400 according to an exemplary embodiment and its components that may be implemented therewith are shown. The implant system 1400 is shown to include an implant 1500 and a screw (e.g., fastener, etc.) 1540. As shown, the screw 1540 includes a head 1542 and threads 1544 that extend along the length of the screw shaft and terminate at a tip 1546, the tip 1546 being disposed substantially opposite the threads 1544 from the head 1542. As shown in FIG. 50, at least a portion of the screw 1540 (e.g., a portion of the screw 1540 on whose outer surface the threads 1544 and the screw 1540 are disposed) is configured to releasably couple the implant 1500 and the screw 1540. Additionally, the screw 1540 may be configured to couple with the implant 1500 through one or more bones of a portion of a patient's bone to compress the two bone components or segments toward one another. For example, a first portion of the implant 1500 may be coupled to a first bone portion and a second portion of the implant 1500 may be coupled to a second bone portion via the screw 1540 so as to provide compression between the first bone portion and the second bone portion via the implant 1500 and the screw 1540 (thus the screw 1540 is coupled to both the implant and the second bone portion).

[0071] The implant 1500 is shown to include a proximal portion 1510, a distal portion 1530, and a central portion 1520 disposed between the proximal portion 1510 and the distal portion 1530. As shown in FIGS. 50-51, the designations of the proximal portion 1510 and the distal portion 1530, respectively, are arbitrary (similar to those shown in FIGS. 18-24). However, when implanted in various portions of the human anatomy, either the proximal portion 1510 or the distal portion 1530 can be disposed proximally (and the other portion disposed distally) relative to the anatomical structure. As shown, the proximal portion 1510, the central portion 1520, and the distal portion 1530 are disposed substantially about a common longitudinal axis. In some embodiments, one or more of the proximal portion 1510, the central portion 1520, and the distal portion 1530 may include the same and / or similar geometric shapes and / or cross-sections, for example, substantially cylindrical cross-sections. As shown, each of the proximal portion 1510, the central portion 1520, and the distal portion 1530 are integral with one another, however, in some embodiments, one or more of the proximal portion 1510, the central portion 1520, and the distal portion 1530 may be releasably coupleable with one another and / or with other components of the implant system.

[0072] The proximal portion 1510 of the implant 1500 is shown extending in a substantially opposite direction from the central portion 1520 to the distal portion 1530. As shown, the proximal portion 1510 includes a lateral dimension that is substantially greater in at least one direction than the lateral dimension of the central portion 1520 (e.g., as shown as being wider in at least the medial, lateral, anterior and / or posterior directions, or "wider" in the left-right / horizontal direction, and / or "higher" in the superior / inferior direction, where directions are arbitrarily assigned). The proximal portion is shown including an opening 1512, shown as a through hole, centrally disposed therein and extending through the proximal portion 1510 from one surface (e.g., a top surface) to a second opposing surface (e.g., a bottom surface). As shown, the opening 1512 is positioned such that the longitudinal axis of the opening 1512 (e.g., the axis about which the opening 1512 is concentrically centered, which is shown as a circular / cylindrical opening but may include other shapes in alternative embodiments) lies substantially perpendicular (e.g., in a vertical plane) to the longitudinal axis of the implant 1500. In some embodiments, the longitudinal axis of the opening 1512 may intersect with the longitudinal axis of the implant 1500. The opening 1512 is configured to receive at least a portion of a fastener, such as a screw 1540, therein, which at least a portion of the screw 1540 abuts a portion of the proximal portion 1510 that defines the lateral dimension of the opening 1512 (e.g., contacting a thread / shaft portion of the screw 540 as shown).

[0073] The proximal portion 1510 is further shown to include a tapered end 1514 configured adjacent the opening 1512. As shown, the entrance of the opening 1512 to a top or bottom surface of the proximal portion 1510 (e.g., a surface in a plane perpendicular to the longitudinal axis of the opening 1512) is shown to have a tapered end 1514 (e.g., a stepped, rounded, or otherwise non-perpendicular interface) between the top / bottom surface of the proximal portion 1512 and a surface of the proximal portion 1510 that laterally defines the opening 1512. The proximal portion 1510 is also shown to include a tip 1516 disposed at an end of the proximal portion 1510 opposite its interface with the central portion 1520. The tip 1516 is shown to have a tapered shape such that the lateral dimension of the proximal portion 1510 at the tip 1516 is smaller than the lateral dimension of the interface with the proximal portion or central portion 1520 immediately adjacent the opening 1512.

[0074] The central portion 1520 of the implant 1500 is shown to have a substantially rectangular parallelepiped shape extending from the end of the proximal portion 1510 to the proximal-most portion of the distal portion 1530 of the implant 1500. As shown, the central portion 1520 has a longitudinal dimension that is less than the longitudinal dimension of the proximal portion 1510. However, in alternative embodiments, the central portion 1520 may include a longitudinal dimension that is greater than that shown in FIGS. 50-59. Conversely, in some embodiments, the central portion 1520 may include a longitudinal dimension that is less than that shown, or may be missing from the implant 1500 in some aspects (e.g., the proximal portion 1510 and the distal portion 1530 are integral with one another). The central portion 1520 is shown to include a number of flats 1522 (shown as four flats) disposed about the periphery of the central portion 1520 (e.g., the outer surface of the rectangular parallelepiped). In some aspects, the flats 1522 may be configured to interface with or facilitate a releasable coupling to one or more instruments incorporated in conjunction with the system 1400. Additionally, in some embodiments, the central portion 1520 may include alternative geometries to the illustrated rectangular solid, in which case the central portion 1520 may include fewer or more flats 1522 than illustrated (or such an embodiment may even include the four flats illustrated).

[0075] The central portion 1520 is further shown to include a cylindrical portion 1524 disposed between the plurality of flats 1522 and the distal portion 1530. In some embodiments, the plurality of flats 1522 may include a tapered transition to the cylindrical portion 1524. The central portion 1520 may also include markings disposed on its outer surface. Such markings may span the outer dimension of the central portion 1520 and may function as depth indicators to aid in the insertion of the implant 1500. In some embodiments, such markings may include multiple markings, for example, multiple rings that indicate various insertion depths when the implant 1500 is implanted.

[0076] The distal portion 1530 is shown to include a substantially cylindrical shape adjacent the central portion 1520, tapering toward an end of the distal portion 1530 opposite the central portion 1520. The distal portion is further shown to include threads 1532 that extend circumferentially (e.g., in a spiral configuration) from adjacent the central portion 1520 to a tip 1534 at the end of the distal portion 1530. In some embodiments, the threads 1532 may be configured to be oversized relative to the circumference / taper of the tapered cylindrical shape of the distal portion 1530. The tip 1534 may include a tap 1536 (e.g., a self-tapping portion, cutting flutes, flutes, etc.) configured to facilitate implantation within the intramedullary canal of a bone (e.g., to eliminate the need for a pilot hole or to facilitate implantation of the distal portion 1530 of the implant 1500 after punching rather than drilling an opening in the intramedullary canal).

[0077] The system 1400 is configured such that the distal portion 1530 may be rotatably coupled (via threads 1532) to a first bone fragment, such as a distal portion of a metatarsal bone (e.g., an intramedullary canal that may be manipulated or "punched" to receive the distal portion 1530 and form a volume sufficient to couple with the distal portion 1530). The proximal portion 1510 is similarly configured to couple with a second bone fragment (e.g., an intramedullary canal that may be manipulated or "punched" to receive the proximal portion 1510 and form a volume sufficient to couple with the proximal portion), with the proximal portion positioned such that the longitudinal axis of the opening 1512 extends substantially perpendicular to the longitudinal axis of the anatomical opening (e.g., the intramedullary canal). The proximal portion 1510 may be placed in such an anatomical opening, and the screw 1540 may be inserted along the longitudinal axis of the opening 1512 (e.g., in a plane perpendicular to the longitudinal axis of the implant 1500) such that a portion of the threads 1544 of the screw 1540 contacts a proximal-most end of a portion of the proximal portion 1510 that defines the proximal-most portion of the opening 1512. Such placement of the screw 1540 thus biases the implant 1500 proximally (relative to the implant 1500) and compresses the first and second bone fragments.

[0078] Implants 1500 as shown in Figures 50-59 may have various dimensions of the proximal portion 1510. For example, the implant 1500 of Figure 52 has a smaller lateral dimension of the proximal portion 1510 than the implant 1500 of Figures 53-59, and the implant 1500 of Figure 59 has the largest lateral dimension of the proximal portion 1510. In some embodiments, the lateral dimension (in at least one plane) of the proximal portion 1510 of the implant 1500 may be smaller (e.g., Figure 52), substantially equal (e.g., Figure 53), or larger (e.g., Figure 59) than the lateral dimension of the outermost portion of the threads 1532.

[0079] 60, an instrument 1970 is shown according to an exemplary embodiment. As with other instruments shown and described herein, the instrument 1970 may be implemented in combination with one or more of the systems, implants, instruments, and / or methods also shown and described herein, or in combination with other components not shown or described herein. The instrument 1970 is shown to include a shaft portion 1972 and a base portion 1974, the shaft portion 1972 and the base portion 1974 being integral with one another. The base portion 1974 is configured at an oblique angle (e.g., between approximately 20 degrees and 70 degrees) relative to the longitudinal axis of the shaft portion 1972. The shaft portion 1972 is shown to include an ergonomic feature 1976 (e.g., texture, surface coating, ridges, etc.) on its upper surface and extending along most of the length of the shaft portion 1972. Shaft portion 1972 may also include alternative shapes (e.g., U-shape or V-shape) that may include one or more contours that may be configured to aid the physician in manipulating instrument 1970 in combination with ergonomic features 1976. Instrument 1970 is further shown to include a recess 1980 disposed at an end of base portion 1974. In some embodiments, recess 1980 may be open ended and may extend in length and depth from an outer edge of base portion 1974 into base portion 1974. Thus, recess 1980 may be configured to accommodate at least a portion of an implant, including but not limited to those shown and described herein (e.g., 1500 and 1540), and facilitate manipulation of the implant during the implantation process / procedure.

[0080] 61, an apparatus 2000 is shown according to an exemplary embodiment. The instrument 2000 may be implemented in combination with one or more of the implants, implant systems, and / or instruments previously shown and described herein. The instrument 2000 includes an upper portion 2010, which is integral with a lower portion 2016, both of which are substantially linear and, as shown, are disposed off-axis relative to one another (e.g., the two portions do not share a common longitudinal axis). The upper portion 2010 includes a protrusion 2012 extending laterally therefrom and having a substantially rectangular (e.g., square) shape. As shown, the protrusion 2012 includes a depression configured to facilitate a physician's gripping of the instrument 2000 by the protrusion 2012 during surgery. Lower portion 2016 is shown extending downwardly from a side of projection 2012 (e.g., the side 90 degrees from the side abutting upper portion 2010) and including a connecting portion 2018 at its distal-most portion. Connecting portion 2018 is shown extending at an oblique angle from lower portion 2016 and is configured to at least partially receive therein at least a portion of an instrument, fastener, or other component. In some embodiments, one or more fasteners (e.g., screws) and / or instruments previously shown and described herein may be implemented with instrument 2000 depending on the performance of the surgical procedure. Instrument 2000 also includes depth markings 2014 to facilitate intraoperative depth measurement and fastener selection.

[0081] In an exemplary surgical method, one or more of the implants / implant systems and instruments shown and described herein, as well as other instruments common to orthopedic surgery, may be implemented. For example, the implant 1500 may be used (e.g., implanted) in response to a physician performing a procedure (e.g., a metatarsal shortening procedure) on a patient's metatarsal. In such a procedure, the physician may perform an osteotomy on the metatarsal (which may be guided by the same and / or similar cutting guides as those previously shown and described herein) in a plane substantially perpendicular to the longitudinal axis (e.g., long axis) of the metatarsal to separate the metatarsal into two bone fragments (hereinafter, a proximal bone fragment and a distal bone fragment). One or more implant trials may then be placed into the intramedullary canal of the proximal bone fragment, starting with the smallest trial (e.g., smallest diameter) provided in the set and progressing to larger size trials until the trial fits snugly into the intramedullary canal and the next larger size does not fit snugly. In some patients, the smallest trial will not fit into the intramedullary canal and a reamer may be used to increase the diameter of the canal to accommodate the smallest implant trial.

[0082] The instrument 1970 can then be used to manipulate the distal bone fragment so that the surface formed by the osteotomy is exposed. A pilot hole can then be drilled into the distal bone fragment perpendicular to the osteotomy surface using an instrument with a mechanical depth stop (e.g., an olive wire, etc.). An implant corresponding to a predetermined appropriate trial size, e.g., implant 1500, can then be coupled with an insertion instrument (e.g., instrument 780 as shown in FIG. 37, which can be adapted to accommodate implant 1500 or other implants) to facilitate insertion of the distal portion 1530 and threads 1532 into the distal bone fragment of the metatarsal bone by manipulating the insertion instrument in a clockwise direction until the most distal portion of the insertion instrument contacts the distal bone fragment of the metatarsal bone. At least a portion of the proximal portion 1510 of the implant 1500 can then be inserted into the intramedullary canal of the proximal bone fragment of the first metatarsal bone.

[0083] The instrument 850 can then be releasably coupled to the portion of the implant 1500 engaged with the engagement feature 856, with the guide portion 852 (and the bore extending therethrough) positioned superiorly relative to the proximal bone fragment. The proximal and distal bone fragments are then compressed with the instrument 850 positioned at least partially between the bone fragments. A K-wire or other similar instrument can then be placed through the bore of the guide portion 852 into the first metatarsal bone and then removed, with the instrument 2000 being used to measure the depth of the K-wire and to assist the physician in selecting a fastener having a length corresponding to the depth indicated by the instrument 2000. The instrument 850 is then disconnected from the implant 1500, and the proximal and distal bone fragments are compressed such that the osteotomy sites abut one another. Such compression biases the opening 1512 of the implant 1500 into a coaxial position with the bore formed by the K-wire. The selected fastener / screw is then placed through the metatarsal bore such that at least a portion of the fastener / screw is received through the opening 1512 (and may contact the proximal side of the opening) to hold the implant within the proximal bone fragment and provide compression between the two bone fragments.

[0084] The terms used herein are for the purpose of describing particular embodiments only and are not intended to be limiting of the invention. As used herein, the singular forms "a," "an," and "the" are intended to include the plural unless the context clearly indicates otherwise. Additionally, the terms "comprise" (and any form of comprise, such as "comprises" or "comprising"), "have" (and any form of have, such as "has" or "having"), "include" (and any form of include, such as "icludes" or "including"), and "contain" (and any form of contain, such as "contains" or "containing") will be understood to be open-ended linking verbs. As a result, a method or apparatus that "comprises," "has," "includes," or "contains" one or more steps or elements has one or more of those steps or elements, but is not limited to having only one or more of those steps or elements. Similarly, a method step or apparatus element that "comprises," "has," "includes," or "contains" one or more features means that it has those one or more features, but is not limited to having only those one or more features. Furthermore, an apparatus or structure that is configured in a certain way may be configured in ways not listed, although it is configured in at least that way.

[0085] The present invention has been described with reference to preferred embodiments. It will be understood that the architectural and operational embodiments described herein are illustrative of a number of possible arrangements for providing the same general features, characteristics, and general system operation. Modifications and changes may occur to others upon reading and understanding the foregoing detailed description. It is intended that the present invention be construed to include all such modifications and changes.

Claims

1. It is an implant, The proximal part and, The distal part, A central portion positioned between the proximal portion and the distal portion, Equipped with, The aforementioned implant further includes a vertical axis, The proximal portion, the distal portion, and the central portion are arranged in the center along the vertical axis. Dental implants.

2. The proximal portion, distal portion, and central portion are integral to each other. The implant according to claim 1.

3. The proximal portion, distal portion, and central portion are three distinct parts that can be joined together. The implant according to claim 1.

4. The aforementioned proximal portion comprises an upper surface and a bottom surface, The upper surface and the lower surface are planes parallel to each other. The implant according to claim 1.

5. The proximal portion further includes an opening extending from the upper surface to the bottom surface, The aforementioned opening is sized to accept a bone fastener. The implant according to claim 4.

6. The opening has a central axis, The central axis is perpendicular to the longitudinal axis of the implant. The implant according to claim 5.

7. The opening further comprises at least one of the following surfaces extending from the upper surface to the inner wall of the opening: a tapered surface, a rounded surface, or a stepped surface. The opening further comprises at least one of a tapered surface, a rounded surface, or a stepped surface extending from the bottom surface to the inner wall of the opening. At least one of the tapered surface, rounded surface, or stepped surface facilitates polyaxial movement of the bone retainer when inserted into the opening of the implant. The implant according to claim 5.

8. The aforementioned proximal portion further comprises a lateral dimension and a vertical dimension, The aforementioned horizontal dimension is larger than the aforementioned vertical dimension. The implant according to claim 1.

9. The aforementioned proximal portion further comprises a lateral dimension and a vertical dimension, The aforementioned horizontal dimension is smaller than the aforementioned vertical dimension. The implant according to claim 1.

10. The aforementioned proximal portion further comprises a lateral dimension and a vertical dimension, The aforementioned horizontal dimension is equal to the aforementioned vertical dimension. The implant according to claim 1.

11. The aforementioned proximal portion further comprises a tip section, The aforementioned tip portion has a flat surface adjacent to two tapered surfaces, The length of the plane is smaller than the lateral dimension of the proximal portion adjacent to the opening. The implant according to claim 1.

12. The aforementioned central portion has vertical dimensions, The vertical dimension of the central portion is smaller than the vertical dimension of the proximal portion. The implant according to claim 1.

13. The aforementioned central portion has vertical dimensions, The vertical dimension of the central portion is greater than the vertical dimension of the proximal portion. The implant according to claim 1.

14. The aforementioned central portion comprises a substantially rectangular parallelepiped portion and a cylindrical portion. The implant according to claim 1.

15. The substantially rectangular portion extends from the distal end of the proximal portion to the proximal end of the distal portion, The implant according to claim 14.

16. The substantially rectangular parallelepiped portion has a circular outer surface, The outer circumferential surface comprises at least one flat surface disposed thereon, The implant according to claim 14.

17. The at least one flat surface is configured to facilitate the connection of the insertion device. The implant according to claim 16.

18. The at least one flat surface extends over the longitudinal dimension of the substantially rectangular portion. The implant according to claim 16.

19. The cylindrical portion of the central part extends from the substantially rectangular portion and is tapered toward the proximal end of the distal portion of the implant. The implant according to claim 14.

20. The circumferential outer surface further comprises at least one marking thereon, The at least one marking indicates the depth of insertion of the implant into the bone. The implant according to claim 16.

21. The distal portion comprises a thread extending along at least a part of the distal portion and a tip located at the distal end of the distal portion. The implant according to claim 1.

22. The lateral dimension of the proximal portion is greater than the outermost dimension of the thread, equal to the outermost dimension of the thread, or less than the outermost dimension of the thread, at least one of these. The implant according to claim 21.

23. The distal portion is tapered from the proximal end to the distal end. The implant according to claim 1.

24. The tip portion comprises at least one of a self-tapping mechanism or at least one cutting flute. The implant according to claim 21.

25. The aforementioned screw threads are spiral threads arranged in the circumferential direction. The implant according to claim 21.

26. An implant for insertion into the first bone, A proximal portion comprising an opening that extends through the proximal portion of the implant, A distal portion comprising a thread extending along at least a portion of the distal portion, a tip located at the end of the distal portion opposite to the proximal portion, and a tapping feature located at the tip of the distal portion, A central portion is located between the proximal portion and the distal portion and has at least one flat portion on its outer surface, An implant equipped with, Fasteners and Equipped with, The fastener is sized to be inserted into the opening and pass through the opening to be inserted into the second bone. Implant system.

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