Surgical device for applying compression within or across an articular joint

Abstract

A surgical device for performing orthopedic surgical procedures is provided that can generate and apply compression within or across a joint. The surgical device can include a slider assembly including at least one slider configured to move within an outer body. A ring can be disposed around the slider to reduce contact between the slider and the outer body, thereby improving the wear characteristics of the surgical device.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims the benefit of U.S. Patent Application No. 18 / 082,671, filed December 16, 2022, which is incorporated herein by reference in its entirety.

[0002] FIELD OF THE DISCLOSURE The present disclosure relates to the field of orthopedic surgery, and more particularly to a surgical device for creating and applying compression within or across a joint. [Background technology]

[0003] Arthrodesis is common in orthopedic surgery to repair arthritic and / or deteriorated bones. The success of these surgical procedures often depends on successful approximation of the bones and the amount of compression achieved between the bones.

[0004] Intramedullary devices can be used during arthrodesis. These devices are designed to reduce and create compressive loads between bones. Summary of the Invention [Problem to be solved by the invention]

[0005] The present disclosure relates to surgical devices, such as arthrodesis devices including intramedullary nails, for performing surgical procedures within the human or animal body. The surgical devices described herein are capable of approximating bones or bone fragments, creating a compressive load, and maintaining the compressive load for an extended period of time while healing occurs. [Means for solving the problem]

[0006] An exemplary surgical device may include, among other things, a nail body extending along a longitudinal axis between a proximal portion and a distal portion, a slider assembly including a proximal slider located within the proximal portion, a distal slider located within the distal portion, and a Nitinol rod connected to both the proximal and distal sliders. A first ring is received within the first concave section of the proximal slider, and a second ring is received within the second concave section of the distal slider. The proximal and distal sliders are made of a metallic material, and the first and second rings are made of a thermoplastic material.

[0007] Another exemplary surgical apparatus may include, among other things, an outer body, a first slider received within the outer body, and a first ring disposed around the first slider and configured to reduce contact between the first slider and the outer body. [Brief explanation of the drawings]

[0008] [Figure 1] FIG. 1 shows a surgical device including a slider assembly. [Figure 2] FIG. 2 is a cross-sectional view through section 2-2 of the surgical apparatus of FIG. [Figure 3] FIG. 3 illustrates a proximal slider of the slider assembly of the surgical apparatus of FIGS. [Figure 4] FIG. 4 shows the proximal slider of FIG. 3 with the ring removed to show the concave section of the proximal slider. [Figure 5] FIG. 5 illustrates a distal slider of the slider assembly of the surgical apparatus of FIGS. [Figure 6] FIG. 6 shows the proximal slider of FIG. 5 with the ring removed to show the concave section of the proximal slider. [Figure 7] FIG. 7 illustrates an exemplary surgical use of the surgical apparatus of FIGS. [Figure 8] FIG. 8 shows a targeting guide for use with the surgical apparatus of FIGS. 1-2. [Figure 9]FIG. 9 shows the mounting arm and rotation stop of the targeting guide of FIG. DETAILED DESCRIPTION OF THE INVENTION

[0009] The present disclosure describes exemplary surgical devices, such as arthrodesis devices including intramedullary nails, for performing surgical procedures (e.g., arthrodesis or fusion procedures) within the human or animal body. The surgical devices described herein can approximate bones or bone fragments, generate a compressive load, and maintain the compressive load for extended periods of time while healing occurs. The surgical devices can further reduce certain wear characteristics associated with movable subcomponents of the surgical devices.

[0010] The surgical device may include, among other things, a nail body extending along a longitudinal axis between a proximal portion and a distal portion, a slider assembly including a proximal slider located within the proximal portion, a distal slider located within the distal portion, and a Nitinol rod connected to both the proximal and distal sliders. A first ring is received within the first concave section of the proximal slider, and a second ring is received within the second concave section of the distal slider. The proximal and distal sliders are made of a metallic material, and the first and second rings are made of a thermoplastic material.

[0011] In a further embodiment, the metallic material comprises titanium and the thermoplastic material comprises polyetheretherketone (PEEK).

[0012] In a further embodiment, a first ring surrounds the cylindrical surface of the first concave section and a second ring surrounds the cylindrical surface of the second concave section.

[0013] In a further embodiment, the outer diameter of the first ring is larger than the outer diameter of the proximal slider adjacent to the first concave section, and the outer diameter of the second ring is larger than the outer diameter of the distal slider adjacent to the second concave section.

[0014] In a further embodiment, at least a portion of the proximal and distal sliders include a wear-reducing coating.

[0015] Another surgical apparatus may include, among other things, an outer body, a first slider received within the outer body, and a first ring disposed around the first slider and configured to reduce contact between the first slider and the outer body.

[0016] In a further embodiment, the first slider comprises a first material and the first ring comprises a second material different from the first material.

[0017] In a further embodiment, the first material is a metallic material and the second material is a thermoplastic material.

[0018] In a further embodiment, the metallic material comprises titanium and the thermoplastic material comprises polyetheretherketone (PEEK).

[0019] In a further embodiment, the shape memory material connecting member is connected to the first slider.

[0020] In a further embodiment, the shape memory material connecting member is a Nitinol (NiTi) rod.

[0021] In a further embodiment, a second slider is received within the outer body and a shape memory material connecting member is connected to the second slider.

[0022] In a further embodiment, a second ring is disposed about the second slider and configured to reduce contact between the second slider and the outer body.

[0023] In a further embodiment, the first ring is received around the concave section of the slider.

[0024] In a further embodiment, the first ring surrounds the cylindrical surface of the concave section.

[0025] In a further embodiment, the first ring includes an outer diameter that is greater than an outer diameter of the first slider.

[0026] In a further embodiment, the tension adjuster is connected to the first slider.

[0027] In a further embodiment, the tension adjuster is a cable received through a transverse passage in the first slider.

[0028] In a further embodiment, the outer body is connectable to a targeting guide that includes a targeting arm having a hub.

[0029] In a further embodiment, the targeting guide includes a rotation stop having a retention button, and the spring-loaded wedge is configured to selectively engage the retention button.

[0030] 1 and 2 illustrate an exemplary surgical device 10 capable of applying compression within or across a joint, such as a joint of the human musculoskeletal system. In one embodiment, the surgical device 10 is an arthrodesis device, such as an intramedullary nail. However, other surgical devices, including trauma repair devices, are contemplated within the scope of this disclosure.

[0031] The surgical apparatus 10 may include an outer body 12 extending along a longitudinal axis A between a proximal portion 14 and a distal portion 16. In some implementations, the outer body 12 may be referred to as a nail body.

[0032] Outer body 12 may be configured as a sleeve to house various sub-components of surgical apparatus 10. In one embodiment, outer body 12 is made of a titanium alloy, such as, for example, Ti-6Al-4V. However, other implementations are also contemplated within the scope of this disclosure.

[0033] The outer body 12 may include a plurality of openings for receiving fixation devices, such as screws, pegs, etc., for securing the surgical apparatus 10 to one or more bones of a joint. For example, the proximal portion 14 of the outer body 12 may include a first proximal opening 18 and a second proximal opening 20 that is slightly distal to the first proximal opening 18 (e.g., displaced in a direction toward the distal portion 16). Each of the first proximal opening 18 and the second proximal opening 20 may receive a screw (not shown) or other fastener for securing the surgical apparatus 10 to one or more bones.

[0034] In one embodiment, the first proximal opening 18 and the second proximal opening 20 are both elongated openings, however, in another embodiment, one or both of the first proximal opening 18 and the second proximal opening 20 may be round openings.

[0035] In certain embodiments, the first proximal opening 18 and the second proximal opening 20 extend through diametrically opposed surfaces 22 of the proximal portion 14 of the outer body 12. Thus, the first proximal opening 18 and the second proximal opening 20 may each extend along an axis that is approximately perpendicular to the longitudinal axis A. In this disclosure, the terms "about" and "approximately" mean that the expressed quantity or range need not be exact but may be approximate and / or larger or smaller, reflecting tolerances, conversion factors, measurement errors, etc.

[0036] The distal portion 16 of the outer body 12 may include a first distal opening 24, a second distal opening 26, and a third distal opening 28. The second distal opening 26 may be immediately proximal to the first distal opening 24 (e.g., displaced in a direction toward the proximal portion 14), and the third distal opening 28 may be immediately proximal to the second distal opening 26. The first, second, and third distal openings 24, 26, 28 may each receive a screw (not shown) or other fastener for securing the surgical apparatus 10 to one or more bones.

[0037] In one embodiment, first distal opening 24 is a round opening and second distal opening 26 and third distal opening 28 are elongated openings, however, other configurations are possible within the scope of the present disclosure.

[0038] The first and second distal openings 24, 26 may extend through diametrically opposed surfaces 30 of the distal portion 16 of the outer body 12 and may extend along an axis generally perpendicular to the longitudinal axis A. The third distal opening 28 may extend through diametrically opposed surfaces 31 of the distal portion 16 of the outer body 12 and may extend along an axis generally perpendicular to the longitudinal axis A.

[0039] In the illustrated embodiment, the first proximal opening 18, the second proximal opening 20, and the third distal opening 28 extend through the outer body 12 along axes that are parallel to one another. Additionally, the first distal opening 24 and the second distal opening 26 may extend along an axis that is approximately perpendicular to the first proximal opening 18, the second proximal opening 20, and the third distal opening 28. However, one of ordinary skill in the art having the benefit of this disclosure will understand that the locations of the various fastener-receiving openings in the outer body 12 may be modified to achieve any desired design intent.

[0040] As best shown by the cross-sectional view of FIG. 2 , the outer body 12 of the surgical apparatus 10 may house a slider assembly 32. The slider assembly 32 may be housed within an internal bore 40 of the outer body 12. The slider assembly 32 may include a proximal slider 34, a distal slider 36, and a shape memory material connecting member 38. While two sliders are shown as part of the exemplary slider assembly 32, one of ordinary skill in the art having the benefit of this disclosure will understand that single slider implementations are also possible within the scope of this disclosure.

[0041] The proximal slider 34 may be movably received within the proximal section 42 of the internal bore 40 and may be at least partially exposed within the second proximal opening 20, the distal slider 36 may be movably received within the distal section 44 of the internal bore 40 and may be at least partially exposed within the second and third distal openings 26, 28, and the shape memory material connecting member 38 may be housed within the intermediate section 46 of the internal bore 40.

[0042] The intermediate section 46 may extend from the proximal section 42 to the distal section 44 of the inner bore 40. The intermediate section 46 may include a first diameter D1 that is smaller than the second diameter D2 of the proximal section 42 and the distal section 44.

[0043] In certain embodiments, the shape memory material connecting member 38 includes a first threaded portion 48, a second threaded portion 50, and a shaft 52 extending between the first threaded portion 48 and the second threaded portion 50. In certain embodiments, the first threaded portion 48 and the second threaded portion 50 include a diameter D3 that is greater than a diameter D4 of the shaft 52. The first threaded portion 48 may engage a threaded opening 54 of the proximal slider 34, and the second threaded portion 50 may engage a threaded opening 56 of the distal slider 36, connecting the shape memory material connecting member 38 to each of the proximal slider 34 and the distal slider 36.

[0044] The shape memory material connecting member 38 may be configured as a rod, for example, a rod made of nitinol (NiTi). However, the shape memory material connecting member 38 may have other shapes and configurations, and other superelastic materials (e.g., materials capable of exhibiting superelasticity and / or temperature-induced shape change) may be used to construct the shape memory material connecting member 38. Throughout this specification, the shape memory material of the shape memory material connecting member 38 may be a metal alloy (e.g., nitinol) or an elastic polymer (e.g., appropriately processed PEEK).

[0045] The surgical apparatus 10 may additionally include a cable 60, which may be used as a tensioning device. The cable 60 may be attached to the distal slider 36 and extend to a location outside the outer body 12. In one embodiment, the cable 60 is made of stainless steel, such as 304V stainless steel. The cable 60 may be received through a transverse passage 58 in the distal slider 36.

[0046] In use, the cable 60 may be tensioned to move the distal slider 36 within the distal section 44 of the bore 40, thereby extending the shaft 52 of the shape memory material connecting member 38 to an extended position. Once extended, the superelasticity of the shape memory material connecting member 38 biases the shaft 52 back toward its unextended position. Thus, once secured therein, the surgical apparatus 10 can apply a constant compressive force across the bones of a joint.

[0047] Additional details associated with the proximal slider 34 are shown in Figures 2, 3, and 4. The proximal slider 34 may include a threaded opening 54 extending along a first axis A1 and a non-threaded opening 64 extending along a second axis A2. In some embodiments, the second axis A2 is perpendicular to the first axis A1. The threaded opening 62 may receive a portion of the shape memory material connecting member 38 (see Figure 2), and the non-threaded opening 64 may receive a screw (not shown) for securing the surgical apparatus 10 to one or more bones.

[0048] The second threaded opening 66 may extend along a third axis A3 parallel to the second axis A2 and may receive a set screw 70 to maintain the positioning of the first threaded portion 48 of the shape memory material connecting member 38 relative to the proximal slider 34.

[0049] The second non-threaded opening 68 may extend along a fourth axis A4 that is perpendicular to the first axis A1 and the second axis A2. The second non-threaded opening 68 may receive a pin, such as a PLLA pin, that may be press-fit into place to prevent movement before the proximal slider 34 applies tension to the cable 60.

[0050] The proximal slider 34 may include one or more recessed sections 72 (best shown in FIG. 4). Each recessed section 72 may, for example, be machined into the proximal slider 34. The recessed sections 72 establish an area of ​​reduced diameter within the proximal slider 34.

[0051] Each recessed section 72 may establish a cylindrical surface 84 for receiving a ring 76. One ring 76 may be secured to the proximal slider 34 at each recessed section 72. In one embodiment, each ring 76 is secured around the proximal slider 34 via an interference fit. Once secured, the ring 76 surrounds the cylindrical surface 84 of the recessed section 72 such that the outer diameter 80 of the ring 76 is slightly larger than the outer diameter 82 of the proximal slider 34 adjacent the recessed section 72. Thus, when the ring 76 is received within one of the recessed sections 72, it protrudes slightly from the outer diameter 82 of the proximal slider 34.

[0052] In one embodiment, the proximal slider 34 is made of a metallic material such as a titanium alloy (e.g., Ti-6Al-4V), and each ring 76 is made of a thermoplastic material such as polyetheretherketone (PEEK). However, other materials may also be utilized. Each ring 76 establishes an interface between the proximal slider 34 and an inner wall 78 (see FIG. 2 ) of the proximal portion 14 of the outer body 12. Thus, the rings 76 may function to substantially minimize or even prevent metal-to-metal contact between the proximal slider 34 and the outer body 12, thereby reducing wear particle formation during cycling and extending the operational life of the surgical apparatus 10.

[0053] In the illustrated embodiment, the proximal slider 34 includes two recessed sections 72 and two rings 76. However, a greater or lesser number of recessed sections 72 and rings 76 may be provided on the proximal slider 34 within the scope of the present disclosure. Furthermore, the specific location of each recessed section 72 and each ring 76 may vary and generally may be in any location that does not interfere with components that interact with the proximal slider 34.

[0054] All or a portion of the outer surface of the proximal slider 34 may be coated with a wear-reducing coating 75. The wear-reducing coating 75 may include titanium niobium nitride (TiNbN). However, other coatings may also be suitable.

[0055] Additional details associated with the distal slider 36 are shown in Figures 2, 5, and 6. The distal slider 36 may include a threaded opening 56 extending along a first axis A1, a first non-threaded opening 88 extending along a second axis A2, a second non-threaded opening 90 extending along a third axis A3, and a transverse passage 58 extending along a fourth axis A4. In one embodiment, the second axis A2, the third axis A3, and the fourth axis A4 are each perpendicular to the first axis A1. In another embodiment, the second and fourth axes A2, A4 are parallel to each other but perpendicular to the third axis A3.

[0056] The threaded opening 56 may receive the second threaded portion 50 of the shape memory material connecting member 38, the first non-threaded opening 88 may receive a screw (not shown) extending through the third distal opening 28 of the outer body 12, the second non-threaded opening 90 may receive a screw (not shown) extending through the second distal opening 26 of the outer body 12, and the transverse passage 58 may receive a cable 60 of the surgical device 10.

[0057] Similar to the proximal slider 34, the distal slider 36 may include one or more recessed sections 92 (best shown in FIG. 6). Each recessed section 92 may be machined, for example, into the distal slider 36. The recessed sections 92 establish a region of reduced diameter within the distal slider 36.

[0058] Each recessed section 92 may define a cylindrical surface 94 for receiving a ring 96. One ring 96 may be secured to the distal slider 36 at each recessed section 92. In one embodiment, each ring 96 is secured to the distal slider 36 via an interference fit. Once secured, the ring 96 surrounds the cylindrical surface 94 of the recessed section 92 such that the outer diameter 98 of the ring 96 is slightly larger than the outer diameter 99 of the distal slider 36 adjacent the recessed section 92. Thus, when the ring 96 is received within one of the recessed sections 92, it protrudes slightly from the outer diameter 99 of the distal slider 36.

[0059] In one embodiment, the distal slider 36 is made of a metallic material such as a titanium alloy (e.g., Ti-6Al-4V), and each ring 96 is made of a thermoplastic material such as polyetheretherketone (PEEK). However, other materials may also be utilized. Each ring 96 establishes an interface between the distal slider 36 and the inner wall 86 (see FIG. 2 ) of the distal portion 16 of the outer body 12. Thus, each ring 96 may function to substantially minimize or even prevent metal-to-metal contact between the distal slider 36 and the outer body 12, thereby reducing wear particle formation during cycling and extending the operational life of the surgical apparatus 10.

[0060] In the illustrated embodiment, the distal slider 36 includes two recessed sections 92 and two rings 96. However, a greater or lesser number of recessed sections 92 and rings 96 may be provided on the distal slider 36 within the scope of the present disclosure. Furthermore, the specific location of each recessed section 92 and each ring 96 may vary and generally may be in any location that does not interfere with components that interact with the distal slider 36.

[0061] All or a portion of the outer surface of the distal slider 36 may be coated with a wear-reducing coating 75. The wear-reducing coating 75 may include titanium niobium nitride (TiNbN), although other coatings may also be suitable.

[0062] An exemplary use of the surgical device 10 as a tibio-talo-calcaneal (TTC) nail for use in the tibio-talo-calcaneal (TTC) joint 100 of the ankle is shown schematically in FIG. 7 (with continued reference to FIGS. 1-6). The TTC joint 100 includes a calcaneus 102, a talus 104, and a tibia 106. The TTC joint 100 can become unstable due to cartilage loss and / or diseased bone at the articular surfaces 108 of the calcaneus 102, talus 104, and / or tibia 106. Over time, patients suffering from this instability can develop arthritis, thus resulting in significant pain. Thus, the surgical apparatus 10 may be used to fuse the bones of the TTC joint 100 together, causing the calcaneus 102, talus 104, and tibia 106 to act as a single bone, substantially eliminating motion and reducing pain caused by arthritic joints. Although TTC joint fusion of the ankle is described herein as one exemplary surgical technique in which the surgical apparatus 10 may be used, the present disclosure is not intended to be limited solely to TTC joint fusion.

[0063] During a surgical procedure, the surgical device 10 may be inserted into a reamed passage formed through portions of the calcaneus 102, the talus 104, and the tibia 106. Once received within the reamed passage, the proximal portion 14 of the outer body 12 extends into the tibia 106, and the distal portion 16 of the outer body 12 extends into both the calcaneus 102 and the tibia 106.

[0064] A calcaneal screw (not shown) may be inserted through the first distal opening 24 of the outer body 12 to secure the surgical apparatus 10 in place. Thereafter, a tibial screw (not shown) may be inserted through the second proximal opening 20 of the outer body 12 and through the non-threaded opening 64 of the proximal slider 34. Insertion of the tibial screw substantially locks the proximal slider 34 from further movement relative to the outer body 12.

[0065] The cable 60 may then be tensioned, such as with a suitable tension adjustment device. Tensioning the cable 60 causes the distal slider 36 to move (e.g., slide) distally within the third distal opening 28. Because the proximal slider 34 is secured from movement, distal movement of the distal slider 36 stretches the shape memory material connecting member 38 to generate a compressive load. While tension is held on the cable 60, a talar screw is inserted through the third distal opening 28 of the outer body and through the first non-threaded opening 88 of the distal slider 36. An additional calcaneal screw may then be inserted through the second distal opening 26 of the outer body 12 and through the second non-threaded opening 90 of the distal slider 36.

[0066] The tension can then be released from the cable 60, and the cable can be removed. Releasing the tension on the cable 60 causes the shape memory material connecting member 38 to attempt to recover the strain caused by stretching the shape memory material connecting member 38 to the extended position, thus causing a compressive force to be generated and maintained across the bones of the TTC joint 100. If desired, additional tibial screws can be inserted through the first proximal opening 18 of the outer body 12 to enhance fixation.

[0067] Throughout the procedure, the rings 76, 96 may contact the inner walls 78, 86 of the outer body 12, thereby limiting metal-to-metal contact between the proximal and distal sliders 34, 36 and the outer body 12. Thus, wear particles and resulting corrosion are substantially reduced.

[0068] Additional embodiments of the present disclosure include the provision and use of surgical devices configured as compression intramedullary (IM) nails, which may be manufactured from titanium, stainless steel, etc. These IM nails may include a shape memory material (e.g., a material capable of exhibiting superelasticity and / or temperature-induced shape change) that pulls or pushes the locking screws together, thereby effectively pulling or pushing the bone fragments together.

[0069] 8 and 9 show selected portions of the targeting guide 110 that may be used to precisely align the surgical apparatus 10 with respect to the target implantation site. Precise alignment of the surgical apparatus 10 may be required, for example, to insert various screws or other fasteners through various openings in the surgical apparatus 10.

[0070] Targeting guide 110 may include a targeting arm 112 having a hub 114. An attachment arm 116 may be received through hub 114. Attachment arm 116 may include an extension 118 configured to engage distal portion 16 of outer body 12 of surgical apparatus 10, such as to guide surgical apparatus 10 into a reamed passage in one or more bones.

[0071] To maintain surgical apparatus 10 in the proper position to receive screws and / or other fixation devices, rotation of mounting arm 116 relative to hub 114 should be limited. Accordingly, targeting guide 110 may include a rotation stop 120. Rotation stop 120 may include a retention button 122 accessible on the outside of hub 114. Retention button 122 may be connected to a shaft 124 (see FIG. 9 ) that may be at least partially housed within a bore in targeting arm 112. A peg 126 of rotation stop 120 may selectively engage a hole 128 formed in a cylinder 130 of mounting arm 116 to prevent rotation of mounting arm 116 relative to hub 114.

[0072] Targeting guide 110 may further include a spring-loaded wedge 132 configured to selectively engage retention button 122. Spring-loaded wedge 132 may slide along a track 134 formed on the outer surface of hub 114. For example, spring-loaded wedge 132 may be moved into engagement with retention button 122 by sliding spring-loaded wedge 132 along track 134. In an embodiment, spring-loaded wedge 132 is biased away from retention button 122.

[0073] As spring wedge 132 moves further into engagement with retention button 122, retention button 122 is forced to move in a radially outward direction 136 relative to hub 114. Moving radially outward 136 moves peg 126 into a tighter engagement within hole 128, thereby reducing tolerances and improving rotational stability and accuracy of targeting guide 110.

[0074] The present disclosure provides a novel surgical device that can approximate bones or bone fragments, generate a compressive load, and maintain the compressive load for an extended period of time while healing occurs. The inclusion of a thermoplastic ring around a portion of the slider of the slider assembly limits or even prevents metal-to-metal contact, thereby improving the functionality and operational lifespan of the surgical device.

[0075] Although different non-limiting embodiments are illustrated as having particular components or steps, embodiments of the present disclosure are not limited to those particular combinations, and some of the components or features from any of the non-limiting embodiments may be used in combination with features or components from any of the other non-limiting embodiments.

[0076] It should be understood that like reference numerals identify corresponding or similar elements throughout the several views. It should be further understood that while particular component arrangements are disclosed and illustrated in these exemplary embodiments, other arrangements may also benefit from the teachings of the present disclosure.

[0077] The foregoing description should be interpreted as illustrative and not in any limiting sense. Those skilled in the art will appreciate that certain modifications may fall within the scope of the present disclosure. For these reasons, the following claims should be studied to determine the true scope and content of the present disclosure. [Explanation of symbols]

[0078] 10 Surgical equipment 12 Outer body 14 Proximal part 16 Distal portion 18 First proximal opening 20 Second proximal opening 22 Surface 24 First distal opening 26 Second distal opening 28 Third distal opening 30 surface 31 Surface 32 Slider assembly 34 Proximal Slider 36 Distal Slider 38 Shape memory material connecting member 40 Internal hole 42 Proximal Section 44 Distal Section 46 Mid Section 48 First threaded portion 50 Second threaded section 52 Shaft 54 threaded opening 56 threaded opening 58 Crossing Passage 60 Cable 62 threaded opening 64 Non-threaded opening 66 Second threaded opening 68 Second non-threaded opening 70 Set screw 72 concave section 75 Wear-reducing coating 76 Ring 78 Inner wall 80 outer diameter 82 outer diameter 84 Cylindrical Surfaces 86 Inner wall 88 First non-threaded opening 90 Second non-threaded opening 92 concave section 94 Cylindrical Surfaces 96 Ring 98 outer diameter 99 Outer diameter 100 Tibia-talo-calcaneal (TTC) joint 102 Calcaneus 104 Talus 106 Tibia 108 Articular Surface 110 Targeting Guide 112 Targeting Arm 114 Hub 116 Mounting arm 118 Extension 120 Rotation stopper 122 Hold button 124 shaft 126 Peg 128 holes 130 cylinders 132 Spring wedge 134 tracks 136 radially outward

Claims

1. 1. A surgical device comprising: a nail body extending along a longitudinal axis between a proximal portion and a distal portion; a slider assembly including a proximal slider located within the proximal portion, a distal slider located within the distal portion, and a nitinol rod connected to both the proximal slider and the distal slider; a first ring received within a first concave section of the proximal slider; a second ring received within the second concave section of the distal slider; The surgical device, wherein the proximal slider and the distal slider are made of a metallic material, and the first ring and the second ring are made of a thermoplastic material.

2. The surgical apparatus of claim 1 , wherein the metallic material comprises titanium and the thermoplastic material comprises polyetheretherketone (PEEK).

3. The surgical apparatus of claim 1 or 2, wherein the first ring surrounds a cylindrical surface of the first concave section and the second ring surrounds a cylindrical surface of the second concave section.

4. The surgical apparatus of any one of claims 1 to 3, wherein the outer diameter of the first ring is larger than the outer diameter of the proximal slider at a position adjacent to the first concave section, and the outer diameter of the second ring is larger than the outer diameter of the distal slider at a position adjacent to the second concave section.

5. The surgical apparatus of any preceding claim, wherein at least a portion of the proximal slider and the distal slider include a wear-reducing coating.

6. 1. A surgical device comprising: an outer body; a first slider received within the outer body; a first ring disposed around the first slider and configured to reduce contact between the first slider and the outer body.

7. The surgical apparatus of claim 6 , wherein the first slider is made of a first material and the first ring is made of a second material different from the first material.

8. The surgical apparatus of claim 7, wherein the first material is a metallic material and the second material is a thermoplastic material, optionally wherein the metallic material comprises titanium and the thermoplastic material comprises polyetheretherketone (PEEK).

9. The surgical apparatus of any of claims 6 to 8, further comprising a shape memory material connecting member connected to the first slider, optionally the shape memory material connecting member being a Nitinol (NiTi) rod.

10. 10. The surgical apparatus of claim 9, comprising a second slider received within the outer body, the shape memory material connecting member connected to the second slider and optionally comprising a second ring disposed around the second slider and configured to reduce contact between the second slider and the outer body.

11. The surgical apparatus of any of claims 6 to 10, wherein the first ring is received around a concave section of the slider, and optionally the first ring surrounds a cylindrical surface of the concave section.

12. The surgical apparatus of any of claims 6 to 11, wherein the first ring includes an outer diameter that is greater than an outer diameter of the first slider.

13. The surgical apparatus of any one of claims 6 to 12, further comprising a tension adjustment device connected to the first slider.

14. The surgical apparatus of claim 13 , wherein the tension adjustment device is a cable received through a transverse passage in the first slider.

15. 15. The surgical apparatus of claim 6, wherein the outer body is connectable to a targeting guide including a targeting arm having a hub, and optionally the targeting guide includes a rotation stop having a retention button, and a spring-loaded wedge configured to selectively engage the retention button.

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