Intramedullary nail driving instrument

Abstract

In one embodiment, a driving instrument that couples to an insertion handle of an intramedullary nail includes a shaft extending along a shaft axis and an abutment extending outward relative to the shaft. The abutment is rotatably secured to the shaft such that the shaft rotates the abutment between a first rotational orientation in which the abutment can be removed or inserted into the insertion handle and a second rotational orientation in which the abutment forms an interference with the insertion handle that prevents the abutment from being removed from the handle. The driving instrument includes a driving surface that can transmit an engagement force to the insertion handle and a lock that engages with the insertion handle to prevent the abutment from rotating from the second orientation back to the first orientation after the abutment is rotated within the insertion handle from the first orientation to the second orientation.

Description

[Technical Field]

[0001] SUMMARY The present disclosure relates to systems, assemblies, and methods for inserting and securing a nail into the medullary canal of a bone. [Background technology]

[0002] Intramedullary nails have been used for many years to treat fractures in the body's long bones, such as those in the femur, tibia, and humerus. To treat such fractures, the intramedullary nail is inserted into the medullary canal of the long bone so that the nail extends from one or more fracture sites in the long bone to the fragments of the long bone separated by the one or more fracture sites. Bone anchors are then inserted through the bone into the intramedullary nail on either side of the fracture site, thereby securing the intramedullary nail to the bone. The intramedullary nail may remain in the medullary canal at least until the fracture sites have healed. Summary of the Invention [Means for solving the problem]

[0003] In an exemplary embodiment, a driving instrument is configured to be coupled to an insertion handle of an intramedullary nail. The driving instrument includes a proximal end and a distal end opposite the proximal end along a distal direction. The driving instrument includes a shaft extending between the proximal and distal ends along a shaft axis. The driving instrument includes an abutment extending outward relative to the shaft along a first direction to define a length in the first direction that is greater than a cross-sectional dimension of the shaft in the first direction. The abutment is rotatably secured to the shaft such that the shaft is configured to rotate the abutment between a first rotational orientation in which the abutment can be removed or inserted into the insertion handle and a second rotational orientation in which the abutment is configured to form an interference with the insertion handle that prevents the abutment from being removed from the insertion handle. The driving instrument is translatably secured to the shaft and includes a driving surface configured to receive an impaction force from the impaction tool when the driving instrument is coupled to the insertion handle to transfer the impaction force from the driving instrument to the insertion handle. The driving instrument includes a lock configured such that when the abutment is received within the insertion handle and rotated relative to the insertion handle from a first rotational orientation to a second rotational orientation, the lock engages with the insertion handle to prevent the abutment from rotating from the second rotational orientation to the first rotational orientation.

[0004] In another exemplary embodiment, an intramedullary nail insertion system includes a method for coupling a driving tool to an insertion handle of an intramedullary nail. The method includes orienting an abutment of the driving tool in a first rotational orientation to align the abutment with a locking hole in the insertion handle. The method includes moving the driving tool along a distal direction to insert the abutment into the locking hole. The method includes rotating the abutment from the first rotational orientation to a second rotational orientation to engage the abutment with an inner surface of the locking hole, thereby preventing the driving tool from being removed from the insertion handle along a proximal direction opposite the distal direction. The method includes locking the driving tool in the second rotational orientation relative to the insertion handle. [Brief explanation of the drawings]

[0005] The following description of illustrative embodiments will be better understood when read in conjunction with the accompanying drawings, in which: It is to be understood that the possible embodiments of the disclosed systems and methods are not limited to those shown. [Figure 1] 1 illustrates an exploded perspective view of a system according to one embodiment having an insertion handle and a driving tool, with the driving tool spaced apart from the insertion handle. [Figure 2] 2 shows an assembled perspective view of the system of FIG. 1, with the driving tool coupled to the insertion handle. [Figure 3] 3 illustrates a side view of the driving instrument of FIGS. 1 and 2 according to one embodiment. [Figure 4] 4 shows a front view of the driving tool of FIG. 3. [Figure 5] 5 shows an exploded perspective view of the driving tool of FIG. 4. [Figure 6] 3 illustrates a top view of the insertion handle of FIGS. 1 and 2, according to one embodiment. FIG. [Figure 7] 3 shows a cross-sectional view of the system of FIGS. 1 and 2 taken along line AA, with the driving instrument in a second rotational orientation. [Figure 8] 3 shows a cross-sectional view of the system of FIGS. 1 and 2 taken along line AA, with the driving instrument in a first rotational orientation. [Figure 9] 10 illustrates an exploded perspective view of a system according to another embodiment having an insertion handle and a driving instrument, the driving instrument being spaced apart from the insertion handle. [Figure 10] 10 illustrates an assembled perspective view of the system of FIG. 9, with the driving tool coupled to the insertion handle. [Figure 11] 11 shows a top view of the insertion handle of FIGS. 9 and 10, according to one embodiment. FIG. [Figure 12] 11 shows a front view of the driving instrument of FIGS. 9 and 10, according to one embodiment. FIG. [Figure 13] 13 shows a side view of the driving tool of FIG. 12. [Figure 14] 13 shows an exploded perspective view of the driving instrument of FIG. 12. FIG. [Figure 15] 11 shows a cross-sectional view of the system of FIGS. 9 and 10 taken along line BB, with the driving instrument in a second rotational orientation. [Figure 16] 11 shows a cross-sectional view of the system of FIGS. 9 and 10 taken along line BB, with the driving instrument in a first rotational orientation. [Figure 17] 10 illustrates an exploded perspective view of a system according to yet another embodiment having an insertion handle and a driving instrument, the driving instrument being spaced apart from the insertion handle. [Figure 18] 18 shows an assembled perspective view of the system and impaction tool of FIG. 17, with the driving instrument coupled to the insertion handle. [Figure 19] 19 illustrates an exploded perspective view of the driving instrument of FIGS. 17 and 18, according to one embodiment. [Figure 20] 10 illustrates an exploded perspective view of a system according to yet another embodiment having an insertion handle and a driving instrument, the driving instrument being spaced apart from the insertion handle. [Figure 21] 21 shows an assembled perspective view of the system of FIG. 20, with the driving tool coupled to the insertion handle. [Figure 22] 22 shows a front view of the driving instrument of FIGS. 20 and 21 according to one embodiment. FIG. [Figure 23] 23 shows a side view of the driving tool of FIG. 22. [Figure 24] 23 shows an exploded perspective view of the driving instrument of FIG. 22. FIG. [Figure 25] 22 shows a cross-sectional view of the system of FIGS. 20 and 21 taken along line CC, with the driving instrument in a first rotational orientation. [Figure 26] 22 shows a cross-sectional view of the system of FIGS. 20 and 21 taken along line CC, with the driving instrument in a second rotational orientation. [Figure 27] 22 shows a top view of the insertion handle of FIGS. 20 and 21, according to one embodiment. FIG. [Figure 28] 1 illustrates an exploded perspective view of a system according to one embodiment having an intramedullary nail, an insertion handle, and a driving tool, with the driving tool spaced apart from the insertion handle. DETAILED DESCRIPTION OF THE INVENTION

[0006] During insertion of an intramedullary nail, an insertion handle is typically secured to the intramedullary nail and grasped by a medical professional to guide the intramedullary nail into the medullary canal of the bone. To drive the intramedullary nail into the medullary canal, a driving tool may be attached to the insertion handle, and the medical professional may impact the driving tool with an impacting tool, such as a hammer or mallet. The driving tool transfers an impaction force from the impacting tool to the insertion handle, which in turn transfers the impaction force to the intramedullary nail to drive the intramedullary nail into the medullary canal. Typically, the driving tool is attached to the insertion handle by a threaded connection. However, the impaction force from the impacting tool can loosen and, in some cases, damage the threaded connection between the driving tool and the insertion handle. The following discussion pertains to a driving tool and a system including the driving tool that is attached to the insertion handle using a connection other than a threaded connection. The connection may remain secure during impact and may be less susceptible to damage from impaction forces than a threaded connection.

[0007] Referring generally to Figures 1-32 and with particular attention to Figures 1, 9, 17, and 20, according to various embodiments, intramedullary nail insertion systems (10, 20, 30, 40) are configured to assist in the insertion of an intramedullary nail 100 (shown in Figure 28) into the medullary canal of a long bone. The intramedullary nail insertion systems (10, 20, 30, and 40) include insertion handles (200, 400, 600, 800) and driving instruments (300, 500, 700, 900). The insertion handles (200, 400, 600, 800) are configured to removably couple to the intramedullary nail 100 and to be grasped by a medical professional to guide the intramedullary nail 100 into the medullary canal of the long bone. The driving instrument (300, 500, 700, 900) removably couples to the insertion handle (200, 400, 600, 800). In some embodiments, the intramedullary nail insertion system 10 may include the intramedullary nail 100, although it will be understood that the intramedullary nail 100 may be spaced apart from the insertion handle (200, 400, 600, 800) and the driving instrument (300, 500, 700, 900), and the insertion handle (200, 400, 600, 800) and the driving instrument (300, 500, 700, 900) may be spaced apart from one another.

[0008] Generally, the driving instrument (300, 500, 700, 900) is configured to quickly couple to and quickly detach from the insertion handle (200, 400, 600, 800). The driving instrument (300, 500, 700, 900) has a proximal end (302, 502) and a distal end (304, 504) that is opposite the proximal end (302, 502) along a distal direction D. As used herein, the term "proximal end" refers to an end that is closer to a medical professional than the distal end during a medical procedure, and the term "distal end" refers to an end that is farther from a medical professional than the distal end during a medical procedure. Furthermore, the term "proximal direction" refers to a direction extending toward a medical professional during a medical procedure, and the term "distal direction" refers to a direction extending away from a medical professional during a medical procedure. In some embodiments, the proximal and distal directions referred to herein may correspond to the anatomical proximal and distal directions, respectively, of a patient's limb, such as in an antegrade approach where the nail is inserted into the anatomical proximal end of the limb. However, embodiments of the present disclosure are not so limited. Thus, in other embodiments, the proximal and distal directions referred to herein may correspond to the anatomical distal and proximal directions, respectively, such as in a retrograde approach where the nail is inserted into the anatomical distal end of the limb.

[0009] The driving instrument (300, 500, 700, 900) includes a shaft (306, 506) and an abutment (308, 508). The shaft (306, 506) has a shaft axis A extending along a distal direction D. S The abutment portion (308, 508) may extend between the proximal end (302, 502) and the distal end (304, 504) along a first direction D1. The abutment portion (308, 508) extends outward relative to the shaft (306, 506) along a first direction D1, such as radially outward from the shaft (306, 506). The driving instrument (300, 500, 700, 900) may be configured to have a shaft axis A SRotation of the shafts (306, 506) around is configured to cause corresponding rotation of the abutting portions (308, 508). In some examples, the abutting portions (308, 508) may be disposed adjacent to the distal ends (304, 504) of the driving instruments (300, 500, 700, 900). The abutting portions (308, 508) may define a length l and a width w in a plane perpendicular to the shaft axis A S and may extend along a first direction D1. The width may extend along a second direction D2 that is perpendicular to the first direction D1. The length l may be greater than the cross-sectional dimension of the shafts (306, 506) in the first direction D1. In at least some embodiments, the length l may be greater than the width w. The abutting portions (308, 508) may not have threads configured to engage the insertion handles (200, 400, 600, 800).

[0010] The shaft (306, 506) can be configured to rotate the abutment (308, 508) between a first rotational orientation relative to the insertion handle (200, 400, 600, 800) (e.g., as shown in FIGS. 1, 9, 17, and 20) and a second rotational orientation relative to the insertion handle (200, 400, 600, 800) (e.g., as shown in FIGS. 2, 10, 18, and 21). The abutment (308, 508) can have a keyed relationship with the locking hole (216, 416, 616) of the insertion handle (200, 400, 600, 800). Thus, the abutment portion (308, 508) is configured to be received within the locking hole (216, 416, 616) and rotated relative to the locking hole (216, 416, 616) to lock the abutment portion (308, 508) within the locking hole (216, 416, 616). The abutment portion (308, 508) is shaped such that when the abutment portion (308, 508) is oriented in a first rotational orientation relative to the insertion handle (200, 400, 600, 800), the abutment portion (308, 508) can be inserted into and removed from the locking hole (216, 416, 616) in the insertion handle (200, 400, 600, 800). Furthermore, the abutment portion (308, 508) is shaped such that when the abutment portion (308, 508) is received within the locking hole (216, 416, 616) of the insertion handle (200, 400, 600, 800) and rotated to a second rotational orientation relative to the insertion handle (200, 400, 600, 800), the abutment portion (308, 508) engages with the inner surface (218, 418, 618) of the insertion handle (200, 400, 600, 800) to define an interference with the inner surface (218, 418, 618) of the insertion handle (200, 400, 600, 800). The interference prevents the driving instrument (300, 500, 700, 900) from being removed from the insertion handle (200, 400, 600, 800) along a proximal direction P, which is opposite the distal direction D. In at least some embodiments, the driving instrument (300, 500, 700, 900) can be rotated between the first and second rotational orientations by rotating the shaft (306, 506), and thus the abutment portion (308, 508), 360 degrees or less, such as 270 degrees or less, such as 180 degrees or less, such as 135 degrees or less, such as 100 degrees or less.In a preferred embodiment, the driving instrument (300, 500, 700, 900) can be rotated between the first and second rotational orientations by rotating the shaft (306, 506), and thus the abutment (308, 508), approximately 90 degrees.

[0011] The driving instrument (300, 500, 700, 900) includes a lock (310, 510, 710, 910) configured to engage with the insertion handle (200, 400, 600, 800) when the abutment portion (308, 508) is received through the lock hole (216, 416, 616) in the insertion handle (200, 400, 600, 800) and rotated to the second rotational orientation to prevent the abutment portion (3008, 508) from rotating from the second rotational orientation to the first rotational orientation. For example, the lock (310, 510, 710, 910) may include at least one of a protrusion (324, 724) and a recess (925) configured to engage the other of the recess (220, 620) and the protrusion (425) of the handle (200, 400, 600, 800). The lock (310, 510, 710, 910) engages the insertion handle (200, 400, 600, 800) to prevent the shaft (306, 506), and therefore the abutment (308, 508), from rotating from the second rotational orientation to the first rotational orientation. Thus, the lock (310, 510, 710, 910) prevents the abutment (308, 508) from rotating into the first rotational orientation, thereby preventing the driving instrument (300, 500, 700, 900) from being removed from the insertion handle (200, 400, 600, 800) along the proximal direction P. The lock (310, 510, 710, 910) may be a releasable lock in that the lock (310, 510, 710, 910) may be released from engagement with the insertion handle (200, 400, 600, 800) to permit the abutment portion (308, 508) to rotate to a first rotational orientation, thereby allowing the driving instrument (300, 500, 700, 900) to be removed from the insertion handle (200, 400, 600, 800) along the proximal direction P. Thus, the lock (310, 510, 710, 910) may be configured to move between a locked position in which the lock (310, 510, 710, 910) prevents the abutment (308, 508) from rotating into the first rotational orientation, and an unlocked position in which the abutment (308, 508) is permitted to rotate into the first rotational orientation.

[0012] The driving instrument (300, 500, 700, 900) is configured to be impacted by an impaction tool (e.g., 1000 in FIG. 18 ), such as a hammer or mallet. In one example, the impaction tool can be configured to be guided along a shaft (306, 506) as shown in FIG. 18 . The driving instrument (300, 500, 700, 900) is configured to transfer an impaction force from the impaction tool to the insertion handle (200, 400, 600, 800), which is configured to transfer the impaction force from the driving instrument (300, 500, 700, 900) to the intramedullary nail 100 to drive the intramedullary nail 100 into the medullary canal. The driving instrument (300, 500, 700, 900) includes a driving surface (312, 512, 513, 912) fixed to the shaft (306, 506). The driving surface (312, 512, 513, 912) may be translatably fixed such that movement of the driving surface (312, 512, 513, 912) along the distal direction D causes corresponding translation of the shaft (306, 506) along the distal direction D. Thus, when the driving surface (312, 512, 513, 912) is impacted by a tool along the distal direction D, movement of the driving surface (312, 512, 513, 912) along the distal direction D causes corresponding translation of the shaft (306, 506) along the distal direction D.

[0013] Referring now more specifically to the details of the embodiment of FIGS. 1-8, and with specific reference to FIGS. 3-5, the driving instrument 300 includes an abutment portion 308, which may include opposed first and second abutment ends 308a, 308b. The abutment portion 308 may have opposed first and second abutment sides 308c, 308d. The first and second abutment sides 308c, 308d may extend between the first and second abutment ends 308a, 308b. The first and second abutment ends 308a, 308b may extend between the first and second abutment sides 308c, 308d. The abutment portion 308 may extend outward relative to the shaft 306 in a direction opposite the first and second abutment ends 308a, 308b. The abutment portion 308 may have a length l along a first direction D1 extending from the first abutment end 308a to the second abutment end 308b and a width w along a direction D2 extending from the first abutment side 308c to the second abutment side 308d. The length l may be greater than the width w. Thus, the abutment portion 308 may be elongated from the first abutment end 308a to the second abutment end 308b. The length l may be greater than a cross-sectional dimension of the shaft 306 extending from the first abutment end 308a to the second abutment end 308b along the first direction D1.

[0014] The abutment portion 308 may include at least one engagement surface 314 configured to engage the inner surface 218 (shown in FIG. 8 ) of the handle 200 to define an interference therewith when the abutment portion is in the second rotational orientation. For example, the abutment portion 308 may include a first engagement surface 314 extending from the shaft 306 to the first abutment end 308 a and a second engagement surface 314 extending from the shaft 306 to the second abutment end 308 b. Each engagement surface 314 may face in the proximal direction P.

[0015] 1 to 8, the abutment portion 308 is S17 illustrates an embodiment including at least one protrusion extending outward from shaft 306 in a direction away from shaft 306. For example, the at least one protrusion may include a first protrusion 316a and a second protrusion 316b extending in opposite directions away from opposite sides of shaft 306. First protrusion 316a may extend from shaft 306 to first side 308a, and second protrusion 316b may extend from shaft 306 to second side 308b. First side 308a and second side 308b, and thus first protrusion 316a and second protrusion 316b, may be aligned along first direction D1. It will be understood that the abutment may have other shapes, for example, as discussed in further detail below in connection with FIGS. 9-17.

[0016] The driving instrument 300 may include a force transfer surface 320 that is translatably fixed relative to the shaft 306 such that translation of the shaft 306 along the distal direction D causes corresponding translation of the force transfer surface 320. The force transfer surface 320 is configured to engage the insertion handle 200 to transmit an impaction force from the driving instrument 300 to the handle 200. The force transfer surface 320 may face in the distal direction D. In at least some examples, the force transfer surface 320 may face the at least one engagement surface 314 of the abutment portion 308. For example, the force transfer surface 320 may face the at least one engagement surface 314 of the abutment portion 308. The force transfer surface 320 may define a shoulder on the shaft 306. The shoulder may adjoin a first, or proximal, portion 306a of the shaft 306 to a second, or distal, portion 306b of the shaft 306, the first portion 306a having a cross-sectional dimension that is larger than the cross-sectional dimension of the second portion 306a to define the shoulder. In other examples, the force transfer surface 320 may define a distal-most surface of the driving instrument 300, such as a distal-most surface of the shaft 306.

[0017] The driving surface 312 may be disposed on the proximal end 302 of the driving instrument 300. In one example, the driving instrument 300 may include a knob 318 that defines the driving surface 312. The knob 318 may be disposed on the proximal end 302 of the driving instrument 300. The knob 318 may be rotatably fixed to the shaft 306. Thus, the driving instrument 300 may be configured such that rotation of the knob 318 causes a corresponding rotation of the shaft 306. The driving surface 312 may define a proximal-most surface of the driving instrument 300. The knob 318 may be configured to rotate in a selected lateral direction T s a cross-sectional dimension of the shaft 306 along the selected transverse direction T s The cross-sectional dimension along the selected transverse direction T s may be perpendicular to the distal direction D. The knob 318 may define a grip configured to be grasped by a medical professional to rotate the shaft 306 between the first and second rotational orientations.

[0018] The proximal end 302 of the driving instrument 300 may include a fastener 322 configured to attach to a back-out instrument (not shown). In one example, the fastener 322 may be a threaded hole. Once attached to the fastener 322, the back-out instrument may be struck along the proximal direction P to at least partially back the intramedullary nail 100 out of the medullary canal. The back-out instrument may be used, for example, when the intramedullary nail 100 is inadvertently pushed too far into the medullary canal.

[0019] The lock 310 includes at least one protrusion 324 configured to engage at least one recess 220 of the handle 200 to prevent the shaft 306, and therefore the abutment 308, from rotating from the second rotational orientation to the first rotational orientation when the abutment 308 is received in the lock hole 216 of the handle 200. The at least one protrusion 324 may include a pair of protrusions 324 that are offset from one another. In one example, the protrusion 324 is offset from the shaft axis A. SIt will be appreciated that in alternative embodiments, lock 310 may additionally or alternatively define at least one recess configured to engage at least one protrusion of handle 200 (e.g., as discussed below in connection with FIGS. 9-16).

[0020] The lock 310 may include a lock body 326 including at least one protrusion 324. In one example, as shown, the lock body 326 may be a sleeve, although it will be understood that the lock body 326 may have any other suitable shape. The lock body 326 may have a proximal end 326a and a distal end 326b. The lock body 326 may define a channel 327 therethrough extending from the proximal end 326a to the distal end 326b. The channel 327 may be configured to receive the shaft 306 therethrough such that the shaft 306 extends out from the proximal end 326a and the distal end 326b. The at least one protrusion 324 may extend from the distal end 326b along the distal direction D.

[0021] The lock body 326 may be rotatably fixed to the shaft 306 such that rotation of the shaft 306 causes corresponding rotation of the lock body 326. The lock body 326 may be configured to translate relative to the shaft 306 along the proximal direction P and the distal direction D so that the lock 310 may be transitioned between a locked position and an unlocked position, with the protrusion 324 protruding further along the distal direction D in the locked position than in the unlocked position. In the locked position, the protrusion may be received within the recess 220 of the handle 200, and in the unlocked position, the protrusion 324 may be removed from the recess 220 of the handle 200. It will be understood that the lock body 326 may have another suitable shape, other than a sleeve, configured to move along the proximal direction P and the distal direction D relative to the shaft 306 and to carry the protrusion 324 between the locked and unlocked positions.

[0022] The lock 310 may include a fastener coupling the lock body 326 to the shaft 306 such that the lock body 326 is rotatably fixed to the shaft 306 and translatable relative to the shaft 306 along the proximal direction P and the distal direction D. In one example, the fastener may include a pin 330 extending radially from and fixedly positioned on one of the shaft 306 and the lock body 326. The pin 330 may be received within a slot 328 in the other one of the shaft 306 and the lock body 326. The slot 328 may be elongated along the proximal direction P and the distal direction D. The pin 330 may be configured to translate within the slot 328 along the proximal direction P and the distal direction D to enable the lock body 326 to translate along the proximal direction P and the distal direction D.

[0023] In the embodiment of FIGS. 1-8 , lock body 326 defines slot 328, and pin 330 extends radially outward from shaft 306 and is fixedly positioned on shaft 306. Pin 330 and slot 328 are configured such that, when pin 330 is disposed within slot 328, pin 330 can translate within slot 328 along proximal direction P and distal direction D, thereby allowing lock body 326 to translate along proximal direction P and distal direction D relative to shaft 306. Pin 330 and slot 328 can be configured such that, when pin 330 is disposed within slot 328, pin 330 limits or completely prevents rotation of lock body 326 relative to shaft 306. Slot 328 can have a proximal end 328 a configured to engage pin 330 to limit movement of lock body 326 along distal direction D. Slot 328 can have a distal end 328b configured to engage pin 330 to limit movement of lock body 326 along proximal direction P. Thus, proximal end 328a and distal end 328b can act as stops to limit movement of lock body 326 along proximal direction P and distal direction D.

[0024] Lock 310 may include a flange 332 configured to be engaged by the finger or hand of a user, such as a medical professional, to move lock 310 from a locked position to an unlocked position along the proximal direction P. Flange 332 may extend outward from lock body 326. In one example, flange 332 may extend from proximal end 326a of lock body 326, although in alternative embodiments, flange 332 may extend anywhere between proximal end 326a and distal end 326b of lock body 326. Lock body 326 is configured to be axially aligned with shaft axis A. s , and flange 332 may have a cross-sectional dimension along a selected lateral direction that is perpendicular to flange 332, and flange 332 may have a flange cross-sectional dimension along the selected lateral direction that is larger than the cross-sectional dimension of lock body 326. A distal, or lower, end of flange 332 may be configured to receive a finger of a user, such as a medical professional. Thus, by pressing a finger against the distal, or lower, end and moving it along the proximal direction P, flange 332, and therefore lock body 326, may be moved along the proximal direction P from a locked position to an unlocked position.

[0025] The lock body 326 may be biased in the distal direction D toward the locked position. In other words, a biasing force may be applied to the lock body 326 to bias the lock body 326 in the distal direction D. For example, the lock 310 may include a spring 334 that biases the lock body 326 toward the locked position. The spring 334 may be a coil spring, such as a compression spring, an elastomeric material, or any other suitable spring that may bias the lock body 326 along the distal direction D. The spring 334 may be disposed between the lock body 326 and the knob 318. The spring 334 may engage the knob 318 and the lock body 326, such as the proximal end 326a of the lock body 326, to bias the lock body 326 along the distal direction D. The spring 334 may define a channel therethrough that receives the shaft 306 such that the spring 334 is disposed between the lock body 326 and the knob 318 .

[0026] 1, 2, and 6-8, the handle 200 has a first end 202 and a second end 204 that are offset from one another along a selected transverse direction T. The handle 200 has an upper end 210 and a lower end 203 that is offset from the upper end 210 along a distal direction D. The selected transverse direction T may be a radial direction that extends radially from the intramedullary nail 100 when the handle 200 is coupled to the intramedullary nail 100. The handle 200 has an outer surface 206 between the first end 202 and the second end 204 that defines a grip 214 configured to be grasped by a medical professional during insertion of the intramedullary nail 100. In one example, the grip 214 may have a generally cylindrical shape that extends along the selected transverse direction T.

[0027] The first end 202 may include a coupler 208 configured to couple the handle 200 to the intramedullary nail 100. In at least some embodiments, the coupler 208 may be configured to couple the handle 200 to the intramedullary nail 100 such that the handle 200 and the intramedullary nail 100 are rotatably fixed relative to one another. The first end 202 may define a cannulation 210 extending therethrough along the distal direction D. The cannulation 210 may be configured (e.g., sized and shaped) to receive a rod, such as a reaming rod, therein as the handle 200 guides the intramedullary nail 100 along the rod and into the medullary canal of the bone. The cannulation 210 may be configured to align with the cannulation of the intramedullary nail 100 when the handle 200 is coupled to the intramedullary nail 100. The cannulation 210 may extend through the coupler 208.

[0028] The handle 200 has a receptacle 212 configured to receive at least a portion of the driving tool 300 to couple the driving tool 300 to the handle 200. In one example, the receptacle 212 may be disposed at the first end 202 of the handle 200. For example, the receptacle 212 may be disposed between the coupler 208 and the grip 214 with respect to the selected lateral direction T, although alternative locations are contemplated. The receptacle 212 is oriented along a receptacle axis A. RThe upper end 201 may define a locking hole 216 extending into the upper end 201 toward the lower end 203 along a distal direction D. The locking hole 216 may be configured to receive a portion of the driving instrument, such as the abutment portion 308 and at least a portion of the shaft 306 of the driving instrument 300.

[0029] The locking hole 216 may include a proximal portion 216a and a distal portion 216b that is offset from the proximal portion 216a along a distal direction D. The proximal portion 216a is aligned with the receptacle axis A. R a length l1 along a first transverse direction T1, which is transverse to the receptacle axis A R and a width w1 along a second transverse direction T2 that is perpendicular to the first transverse direction T1. The length l1 of the proximal portion 216a may be greater than the width w1 of the proximal portion 216b. Thus, the proximal portion 216a may be elongated along the first transverse direction T1. The distal portion 216b may have a width w2 along the second transverse direction T2 that is greater than the width w1 of the proximal portion 216a. The locking hole 216 may have an inner surface 218 that defines a shoulder of the locking hole 216 that adjoins the proximal portion 216a to the distal portion 216b. The inner surface 218 may face the distal direction D.

[0030] The locking hole 216 may be sized and shaped to receive the abutment 308 through the proximal portion 216a and into the distal portion 216b of the locking hole 216 when the abutment 308 is in a first rotational orientation relative to the insertion handle 200 (as shown in FIG. 8 ). For example, the length l1 and width w1 of the proximal portion 216a of the locking hole 216 may be greater than the length l and width w of the abutment 308, respectively. The locking hole 216 may be sized and shaped to lock the abutment 308 within the distal portion 216b when the abutment 308 is in a second rotational orientation relative to the insertion handle 200 (as shown in FIG. 7 ) to secure the driving instrument 300 to the insertion handle 200 against translation along the proximal direction P and the distal direction D. For example, the width w1 of the proximal portion 216a of the locking hole 216 can be less than the length l of the abutment portion 308, and the width w2 of the distal portion 216b of the locking hole 216 can be greater than the length l of the abutment portion 308. When the abutment portion 308 is in a second rotational orientation relative to the insertion handle 200 (as shown in FIG. 7 ), the abutment portion 308 can abut against the inner surface 218 of the insertion handle 200 to prevent the abutment portion 308, and therefore the driving instrument 300, from moving relative to the insertion handle 200 along the proximal direction P.

[0031] The receptacle 212 may define at least one recess 220 extending into the top surface of the insertion handle 200. In some embodiments, the at least one recess 220 may comprise first and second recesses 220. The first and second recesses 220 may be disposed on opposite sides of the locking hole 216. The at least one recess 220 is configured to receive at least one protrusion 324 of the lock 310 when the driving instrument 300 is in a second rotational orientation relative to the insertion handle 200 to rotatably secure the driving instrument 300 to the insertion handle 200. When the at least one recess 220 receives the at least one protrusion 324, the inner wall of the insertion handle 200 defining the at least one recess 220 rotates the lock 310, and therefore the driving instrument 300, relative to the insertion handle 200 along the shaft axis A. S 324 to prevent rotation about the

[0032] The insertion handle 200 may include at least one angled surface 222 adjacent to the at least one recess 220. The at least one angled surface 222 may be angled toward the proximal direction P as it extends toward the at least one recess 220. The at least one angled surface 222 may extend around a portion of the lock hole 216 toward the at least one recess along one of a clockwise direction and a counterclockwise direction. The at least one angled surface 222 may be configured to guide the at least one protrusion 324 of the lock 310 up the angled surface 222 when the driving instrument 300 is rotated from a first direction to a second direction, thereby retracting the lock 310 along the proximal direction P. Retraction of the lock 310 in the proximal direction P may compress the spring 334. When the at least one protrusion 324 is aligned with the at least one recess 220, the biasing force of the lock 310 urges the at least one protrusion 324 in the distal direction D into the at least one recess 220, thereby rotatably securing the driving instrument 300 to the insertion handle 200.

[0033] 1 , 2 , 7 , and 8 , the method may include orienting the abutment portion 308 of the driving instrument 300 in a first rotational orientation to align the abutment portion 308 with the locking hole 216 of the insertion handle 200. The method may include moving the driving instrument 300 along a distal direction D to insert the abutment portion 308 through a proximal portion 216 a of the locking hole 216 and into a distal portion 216 b of the locking hole 216. The method may include rotating the driving instrument 300 from the first direction to a second rotational orientation. The rotating step may include rotating the shaft 306 to rotate the abutment portion 308 such that the abutment portion 308 engages the inner surface 218 of the locking hole 216, thereby preventing the driving instrument 300 from being removed from the insertion handle 200 along the proximal direction P. The method may include locking the driving instrument 300 in a second rotational orientation relative to the insertion handle 200. The locking step may include rotating the lock 310 to engage at least one protrusion 324 of the lock 310 with at least one recess 220 of the insertion handle 200 such that a wall of the at least one recess 220 interferes with the at least one protrusion 324, thereby preventing the lock 310 from rotating relative to the insertion handle 200. The rotating the lock 310 may occur simultaneously with the rotating the abutment 308. The method may include impacting the driving surface 312 of the driving instrument 300 with a tool to drive the intramedullary nail 100 into the medullary canal.

[0034] To remove the driving instrument 300, the method may include translating the lock body 326 of the lock 310 along the proximal direction P to disengage the at least one protrusion 324 of the lock 310 from the at least one recess 220 of the insertion handle 200. In performing the translating step, the medical professional may manually engage the lock body 326 (e.g., by placing a finger under the flange 332 of the lock body 326) and move the lock body 326 along the proximal direction P. The method may include rotating the driving instrument 310 from the second rotational orientation to the first rotational orientation such that interference between the abutment portion 308 and the inner surface 218 of the insertion handle 200 is removed. The method may include translating the driving instrument 300 along the proximal direction P to remove the abutment portion 308 from the lock hole 216 of the insertion handle 200.

[0035] 9-16, shaft 506 has a shaft axis A that is greater than the length of shaft 506 in the embodiment of FIGS. 1-8. s1-8, the abutment portion 508 may include opposed first and second abutment ends 508a, 508b. The abutment portion 508 may have opposed first and second abutment sides 508c, 508d. The first and second abutment sides 508c, 508d may extend between the first and second abutment ends 508a, 508b. The first and second abutment ends 508a, 508b may extend between the first and second abutment sides 508c, 508d. The abutment portion 508 may extend outward relative to the shaft 506 in a direction opposite the first abutment end 508a and the second abutment end 508b. The abutment portion 508 may have a length 1 along a direction extending from the first abutment end 508a to the second abutment end 508b and a width w along a direction extending from the first abutment side 508c to the second abutment side 508d. The length 1 may be greater than the width w. Thus, the abutment portion 508 may be elongated from the first abutment end 508a to the second abutment end 508b. The length 1 may be greater than the cross-sectional dimension of the shaft 506 extending along that direction from the first abutment end 508a to the second abutment end 508b.

[0036] The abutment portion 508 may include at least one engagement surface 514 configured to engage the inner surface 418 (shown in FIG. 16 ) of the handle 400 to define an interference therewith when the abutment portion is in the second rotational orientation. For example, the abutment portion 508 may include a first engagement surface 514 extending from the shaft 506 to the first abutment end 508 a and a second engagement surface 514 extending from the shaft 506 to the second abutment end 508 b. Each engagement surface 514 may face in the proximal direction P.

[0037] 9-16 illustrate an embodiment in which the abutment 508 is a single protrusion extending from the distal end of the shaft 506 along the distal direction D and along a transverse direction perpendicular to the distal direction D. The protrusion includes a first abutment end 508a and a second abutment end 508b. The first abutment end 508a and the second abutment end 508b may be aligned along the first direction D1. It will be understood that the abutment 508 may have other shapes suitable for locking the abutment 508 within a locking hole in the insertion handle.

[0038] The driving instrument 500 may include a force transfer surface 520 translatably fixed relative to the shaft 506 such that translation of the shaft 506 along the distal direction D causes corresponding translation of the force transfer surface 520 (shown in FIG. 13 ). The force transfer surface 520 is configured to engage the handle 400 to transmit an impaction force from the driving instrument 500 to the handle 400. The force transfer surface 520 may face the distal direction D. In at least some examples, the force transfer surface 520 may face the at least one engagement surface 514 of the abutment portion 508. The force transfer surface 520 may define a shoulder on the shaft 506. The shoulder may adjoin a proximal portion 506a (shown in FIG. 14 ) of the shaft 506 to a second portion 506b (shown in FIG. 14 ) of the shaft 506, the proximal portion 506a having a cross-sectional dimension greater than a cross-sectional dimension of the distal portion 506a to define the shoulder. In other examples, the force transfer surface 520 can define the distal-most surface of the driving instrument 500 , such as the distal-most surface of the abutment portion 508 .

[0039] The driving surface 512 may be disposed on the proximal end 502 of the driving instrument 500. The driving instrument 500 may include a knob 518 that defines the driving surface 512. The knob 518 may be disposed on the proximal end 502 of the driving instrument 500. The knob 518 may be rotatably fixed to the shaft 506. Thus, the driving instrument 500 may be configured such that rotation of the knob 518 causes a corresponding rotation of the shaft 506. The driving surface 512 may define a proximal-most surface of the driving instrument 500. The knob 518 may be configured to rotate in a selected lateral direction T s a cross-sectional dimension of the shaft 506 along a selected transverse direction T sThe cross-sectional dimension along the selected transverse direction T s may be perpendicular to distal direction D. Knob 518 may define a grip configured to be grasped by a medical professional to rotate shaft 506 between the first and second rotational orientations.

[0040] The driving tool 500 may additionally or alternatively include a driving surface 513 disposed between the proximal end 502 and the distal end 504 of the driving tool 500. For example, the driving surface 513 may be oriented in a direction perpendicular to the shaft axis A. s The driving surface 513 may be disposed between the abutment portion 508 and the middle portion of the shaft 506 along the shaft axis A. s 18 , the driving surface 513 may extend outward from the shaft 506 along a direction that is transverse to the driving surface 513. The driving surface 513 may be translatably fixed such that movement of the driving surface 513 along the distal direction D causes corresponding translation of the shaft 506 along the distal direction. Thus, when the driving surface 513 is impacted by a tool along the distal direction D, movement of the driving surface 513 along the distal direction D causes corresponding movement of the shaft 506 along the distal direction D. The shaft 506 may act as a guide to guide the tool 1000 to impact the driving surface 513, as shown in FIG. 18 .

[0041] 9 , the proximal end 502 of the driving instrument 500 can include a fastener 522 configured to attach to a back-out instrument (not shown). In one example, the fastener 522 can be a threaded hole. Once attached to the fastener 522, the back-out instrument can be struck along the proximal direction P to at least partially back the intramedullary nail 100 out of the medullary canal. The back-out instrument can be used, for example, when the intramedullary nail 100 has been inadvertently pushed too far into the medullary canal.

[0042] 12-14, the lock 510 includes at least one recess 525 configured to engage with at least one protrusion 425 of the handle 400 to prevent the shaft 506, and therefore the abutment portion 508, from rotating from the second rotational orientation to the first rotational orientation when the abutment portion 508 is received in the lock hole 416 of the handle 400. The at least one recess 525 may include a pair of recesses 525 that are offset from one another. In one example, the recess 525 is offset from the shaft axis A. S may be opposite each other on opposite sides of the

[0043] The lock 510 may include a lock body 526 defining at least one recess 525. In one example, as shown, the lock body 526 may be a sleeve, although it will be understood that the lock body 526 may have any other suitable shape. The lock body 526 may have a proximal end 526a and a distal end 526b. The lock body 526 may define a channel 529 therethrough extending from the proximal end 526a to the distal end 526b. The channel 529 may be configured to receive the shaft 506 therethrough such that the shaft 506 extends out from the proximal end 526a and the distal end 526b. The at least one recess 525 may extend into the distal end 526b of the lock body 526 along the proximal direction P toward the proximal end 526a.

[0044] The lock body 526 may be rotatably fixed to the shaft 506 such that rotation of the shaft 506 causes a corresponding rotation of the lock body 526. The lock body 526 is translatable relative to the shaft 506 along the proximal direction P and the distal direction D so that the lock 510 may be transitioned between a locked position and an unlocked position, with the recesses 525 protruding further along the distal direction D in the locked position than in the unlocked position. In the locked position, the at least one recess 525 receives the protrusion 425 of the handle 400, and in the unlocked position, the at least one recess 525 is disengaged from the protrusion 425 of the handle 400. It will be understood that the lock body 326 may have another suitable shape, other than a sleeve, configured to move along the proximal direction P and the distal direction D relative to the shaft 306 and to carry the protrusion 324 between the locked and unlocked positions.

[0045] The lock 510 may include a fastener coupling the lock body 526 to the shaft 506 such that the lock body 526 is rotatably fixed to the shaft 506 and translatable relative to the shaft 506 along the proximal direction P and the distal direction D. In one example, the fastener may include a pin 530 extending radially from and fixedly positioned on one of the shaft 506 and the lock body 526. The pin 530 may be received within a slot 528 in the other one of the shaft 506 and the lock body 526. The pin 530 may be configured to translate within the slot 528 along the proximal direction P and the distal direction D to allow the lock body 526 to translate along the proximal direction P and the distal direction D.

[0046] In the embodiment of FIGS. 9-16 , shaft 506 defines an elongated slot 528 along proximal direction P and distal direction D, and a pin 530 extending radially outward from shaft 506 and fixedly positioned in lock body 526. Pin 530 and slot 528 are configured such that, when pin 530 is disposed within slot 528, pin 530 can translate within slot 528 along proximal direction P and distal direction D, thereby allowing lock body 526 to translate along proximal direction P and distal direction D relative to shaft 506. Pin 530 and slot 528 can be configured such that, when pin 530 is disposed within slot 528, pin 530 can limit or completely prevent rotation of lock body 526 relative to shaft 506. Slot 528 can have a proximal end 528 a configured to engage pin 530 to limit movement of lock body 526 along distal direction D. Slot 528 can have a distal end 528b configured to engage pin 530 to limit movement of lock body 526 along proximal direction P. Thus, proximal end 528a and distal end 528b can act as stops to limit movement of lock body 526 along proximal direction P and distal direction D.

[0047] 12-14, lock 510 includes an actuator 536 configured to move lock body 526 from a locked position to an unlocked position. Actuator 536 may include a handle 538 and an actuator shaft 540 coupling handle 338 to lock body 326. Actuator 336 may be configured such that movement of handle 338 along proximal direction P moves actuator shaft 540 along proximal direction P, which in turn moves lock body 526 along proximal direction P from the locked position to the unlocked position.

[0048] In one example, as shown, the handle 538 may include a sleeve 542 and a flange 532 extending outwardly from the sleeve 542, although it will be understood that the handle 538 may have any other suitable shape. The handle 538 may define a channel 544 therethrough such that the shaft 506 extends outwardly from an opposite end of the handle 538, the channel 544 being configured to receive the shaft 506 therethrough. The flange 532 may be configured to be engaged by the finger or hand of a user, such as a medical professional, to move the lock 510 from the locked position to the unlocked position along the proximal direction P. In one example, the flange 532 may extend from the proximal end of the sleeve 542, although in alternative embodiments, the flange 532 may extend anywhere between the proximal and distal ends of the sleeve 542. The sleeve 542 may be configured to be oriented along the shaft axis A. s 5B, and flange 532 may have a cross-sectional dimension along a selected lateral direction that is perpendicular to flange 532, and flange 532 may have a cross-sectional dimension along the selected lateral direction that is larger than the cross-sectional dimension of sleeve 542. A distal, or lower, end of flange 532 may be configured to receive a finger of a user, such as a medical professional. Thus, by pressing a finger against the distal, or lower, end and moving it along the proximal direction P, flange 532, and therefore handle 538, may be moved along the proximal direction P.

[0049] The handle 538 may be translatable relative to the shaft 506 along a proximal direction P and a distal direction D. The actuator 536 may include a fastener coupling the handle 538 to the shaft 506 such that the handle 538 is translatable relative to the shaft 506 along the proximal direction P and the distal direction D, and in some examples, is rotatably fixed to the shaft 506.

[0050] The fastener may include a pin 550 extending radially from and fixedly positioned to one of the shaft 506 and the handle 538. The pin 550 may be received within a slot 552 in the other one of the shaft 506 and the handle 538. The slot 552 may be elongated along the proximal direction P and the distal direction D. The pin 550 may be configured to translate within the slot 552 along the proximal direction P and the distal direction D to allow the handle 538 to translate along the proximal direction P and the distal direction D.

[0051] In the embodiment of FIGS. 9-16 , the shaft 506 defines a slot 552, and the pin 550 extends radially outward from the handle 538 and is fixedly positioned within the handle 538. The pin 550 and slot 552 are configured such that, when the pin 550 is disposed within the slot 552, the pin 550 can translate within the slot 552 along the proximal direction P and the distal direction D, thereby allowing the handle 538 to translate along the proximal direction P and the distal direction D relative to the shaft 506. The pin 550 and slot 552 can be configured such that, when the pin 550 is disposed within the slot 552, the pin 550 limits or completely prevents rotation of the handle 538 relative to the shaft 506. The slot 552 can have a proximal end 552 a configured to engage the pin 550 to limit movement of the handle 538 along the distal direction D. Slot 552 can have a distal end 552b configured to engage pin 550 to limit movement of handle 538 along proximal direction P. Proximal end 552a and distal end 552b can therefore act as stops to limit movement of handle 538 along proximal direction P and distal direction D.

[0052] The actuator shaft 540 has a shaft axis A S In one example, the shaft 506 may have a proximal portion 540a and a distal portion 540b that are offset from one another along a shaft axis A. S15) extending from the proximal end 502 of the shaft 506 toward the distal end 304 thereof. The actuator shaft 540 may be received within the cannulation 507.

[0053] The proximal portion 540a of the actuator shaft 540 can be configured to couple the actuator shaft 540 to the handle 538 such that the handle 538 is translatably secured to the actuator shaft 540 relative to the proximal direction P and the distal direction D. For example, the proximal portion 540a can define a fastener 546 configured to couple to a pin 550. The fastener 546 can define an opening configured to receive the pin 550. The pin 550 secures the actuator shaft 540 to the handle 538 for translation along the proximal direction P and the distal direction D, and couples both the actuator shaft 540 and the handle 538 to the shaft 506 such that both are translatable relative to the shaft 506 along the proximal directions P and D.

[0054] Similarly, distal portion 540b can be configured to couple actuator shaft 540 to lock body 526 such that lock body 526 is translatably secured to actuator shaft 540 relative to proximal direction P and distal direction D. For example, distal portion 540b can define a fastener 548 configured to couple to pin 530. Fastener 548 can define an opening configured to receive pin 530. Pin 530 fixes actuator shaft 540 to lock body 536 for translation along proximal direction P and distal direction D, and couples both actuator shaft 540 and lock body 536 to shaft 506 such that both are translatable relative to shaft 506 along proximal directions P and D. Thus, movement of the handle 538 along the proximal direction P relative to the shaft 506 causes corresponding movement of the actuator shaft 540 along the proximal direction P relative to the shaft 506, which in turn causes corresponding movement of the lock body 536 along the proximal direction P relative to the shaft 506.

[0055] The lock body 526 may be biased in the distal direction D toward the locked position. In other words, a biasing force may be applied to the lock body 526 to bias the lock body 526 in the distal direction D. For example, the lock 510 may include a spring 554 that biases the lock body 526 toward the locked position. The spring 554 may be a coil spring, such as a compression spring, an elastomeric material, or any other suitable spring that may bias the lock body 526 along the distal direction D. The spring 554 may be disposed between the handle 538 and the knob 518. The spring 554 may engage the knob 518 and the handle 538, such as a proximal end of the handle 538, to bias the handle 538 along the distal direction D, thereby biasing the actuator shaft 540 and the lock body 526 along the distal direction D. The spring 554 may define a channel therethrough that receives the shaft 506 such that the spring 554 is disposed between the handle 538 and the knob 518 .

[0056] Additionally or alternatively, lock 510 may include a spring 534 (shown in FIG. 14 ) that biases lock body 526 toward the locked position. Spring 534 may be a coil spring, such as a compression spring, an elastomeric material, or any other suitable spring that can bias lock body 526 along distal direction D. Spring 534 may be configured to engage lock body 526 to bias lock body 526 along distal direction D. In one example, spring 534 may be disposed between striking surface 513 and lock body 526, such as at proximal end 526 a of lock body 526, to bias lock body 526 along distal direction D. Spring 534 may define a channel therethrough that receives shaft 506 such that spring 534 is disposed between striking surface 513 and lock body 526.

[0057] 9, 10, 11, and 15-16, the handle 400 may be implemented in a manner similar to the handle 400 of FIGS. 1-8, except that the handle 400 includes at least one protrusion 425 instead of the at least one recess 420. The handle 400 has a first end 402 and a second end 404 that are offset from one another along a selected lateral direction T. The handle 400 has an upper end 410 and a lower end 403 that is offset from the upper end 410 along a distal direction D. The selected lateral direction T may be a radial direction that extends radially from the intramedullary nail 100 when the handle 400 is coupled to the intramedullary nail 100. The handle 400 has an outer surface 406 between the first end 402 and the second end 404 that defines a grip 414 configured to be grasped by a medical professional during insertion of the intramedullary nail 100. In one example, the grip 414 may have a generally cylindrical shape extending along a selected lateral direction T.

[0058] The first end 402 may include a coupler 408 configured to couple the handle 400 to the intramedullary nail 100. In at least some embodiments, the coupler 408 may be configured to couple the handle 400 to the intramedullary nail 100 such that the handle 400 and the intramedullary nail 100 are rotatably fixed relative to one another. The first end 402 may define a cannulation 410 extending therethrough along the distal direction D. The cannulation 410 may be configured (e.g., sized and shaped) to receive a rod, such as a reaming rod, therein as the handle 400 guides the intramedullary nail 100 along the rod into the medullary canal of the bone. The cannulation 410 may be configured to align with the cannulation of the intramedullary nail 100 when the handle 400 is coupled to the intramedullary nail 100. The cannulation 410 may extend through the coupler 408.

[0059] The handle 400 has a receptacle 412 configured to receive at least a portion of the driving tool 500 to couple the driving tool 500 to the handle 400. In one example, the receptacle 412 may be disposed at the first end 402 of the handle 400. For example, the receptacle 412 may be disposed between the coupler 408 and the grip 414 with respect to the selected lateral direction T, although alternative locations are contemplated. The receptacle 412 is oriented along a receptacle axis A. R The upper end 401 may define a locking hole 416 extending into the upper end 401 toward the lower end 403 along a distal direction D. The locking hole 416 may be configured to receive a portion of the driving instrument, such as the abutment portion 508 and at least a portion of the shaft 506 of the driving instrument 500.

[0060] The locking hole 416 may include a proximal portion 416a and a distal portion 416b that is offset from the proximal portion 416a along a distal direction D. The proximal portion 416a is aligned with the receptacle axis A. RThe proximal portion 416a may have a length l1 along a first transverse direction T1, which is transverse to the first transverse direction T1, and a width w1 along a second transverse direction T2, which is perpendicular to the first transverse direction T1. The length l1 of the proximal portion 416a may be greater than the width w1 of the proximal portion 416b. Thus, the proximal portion 416a may be elongated along the first transverse direction T1. The distal portion 416b may have a width w2 along the second transverse direction T2 that is greater than the width w1 of the proximal portion 416a. The locking hole 416 may have an inner surface 418 that defines a shoulder of the locking hole 416, adjacent the proximal portion 416a to the distal portion 416b. The inner surface 418 may face the distal direction D.

[0061] The locking hole 416 can be sized and shaped to receive the abutment portion 508 through the proximal portion 416a and into the distal portion 416b of the locking hole 416 when the abutment portion 508 is in a first rotational orientation relative to the insertion handle 400 (as shown in FIG. 14 ). For example, the length l1 and width w1 of the proximal portion 416a of the locking hole 416 can be greater than the length l and width w of the abutment portion 508, respectively. The locking hole 416 can be sized and shaped to lock the abutment portion 508 within the distal portion 416b when the abutment portion 508 is in a second rotational orientation relative to the insertion handle 400 (as shown in FIG. 15 ) to secure the driving instrument 500 to the insertion handle 400 with respect to translation along the proximal direction P and the distal direction D. For example, the width w1 of the proximal portion 416a of the locking hole 416 can be less than the length l of the abutment portion 508, and the width w2 of the distal portion 416b of the locking hole 416 can be greater than the length l of the abutment portion 508. When the abutment portion 508 is in a second rotational orientation relative to the insertion handle 400 (as shown in FIG. 15 ), the abutment portion 508 can abut against the inner surface 418 of the insertion handle 400 to prevent the abutment portion 508, and therefore the driving instrument 500, from moving relative to the insertion handle 400 along the proximal direction P.

[0062] The receptacle 412 may define at least one protrusion 425 configured to be received by at least one recess 525 of the driving instrument 500. In one example, the at least one protrusion 425 protrudes into the locking hole 410 of the insertion handle 400. In some embodiments, the at least one protrusion 425 may include first and second protrusions 425. The first and second protrusions 425 are aligned along the receptacle axis A. R The at least one protrusion 425 may be disposed on opposite sides of the lock 510. For example, the first and second protrusions 425 may extend toward each other. It will be appreciated that the at least one protrusion may be positioned on the insertion handle in different manners. The at least one protrusion 425 is configured to be received by the at least one recess 525 of the lock 510 when the driving instrument 500 is in a second rotational orientation relative to the insertion handle 400 to rotatably secure the driving instrument 500 to the insertion handle 400. When the at least one recess 525 receives the at least one protrusion 425, the inner wall of the lock 510 that defines the at least one recess 525 rotates the lock 510, and therefore the driving instrument 3500, relative to the insertion handle 400 along the shaft axis A. S 425 so as to prevent it from rotating about the axis of rotation.

[0063] The lock body 526 may include at least one angled surface 527 (see FIG. 13 ) adjacent the at least one recess 525. The at least one angled surface 527 may be angled toward the distal direction D as it extends toward the at least one recess 525. The at least one angled surface 527 may extend around a portion of the sleeve 526 toward the at least one recess 525 along one of a clockwise direction and a counterclockwise direction. The at least one angled surface 527 may be configured to move with the at least one protrusion 425 of the insertion handle 400 when the driving instrument 500 is rotated from a first direction to a second direction, thereby retracting the lock 510 along the proximal direction P. Retraction of the lock 510 in the proximal direction P may compress at least one of the springs 554 and 534. When the at least one protrusion 425 is aligned with the at least one recess 525, the biasing force of the lock 510 biases the lock body 526, and therefore the at least one recess 525, distally to receive the at least one protrusion 425, thereby rotatably securing the driving instrument 500 to the insertion handle 200.

[0064] 17-19, an embodiment similar to the embodiment of FIGS. 9-16 is shown, except that (i) the lock 710 implements at least one protrusion 724 and (ii) the insertion handle 600 implements at least one recess 620. Note that features in FIGS. 17-19 similar to features in FIGS. 9-16 are labeled with like reference numerals. The at least one protrusion 724 may be implemented in a manner similar to the at least one protrusion 324 of FIGS. 1-8. The lock 710 may include at least one protrusion 724 configured to engage with the at least one recess 620 of the handle 600 to prevent the shaft 506, and therefore the abutment 508, from rotating from the second rotational orientation to the first rotational orientation when the abutment 508 is received in the locking hole 616 of the handle 600. At least one protrusion 724 may include a pair of protrusions 724 that are offset from one another. In one example, the protrusions 724 are offset from the shaft axis A. SThey may be opposite each other on opposite sides of the

[0065] The lock 710 may include a lock body 726 including at least one protrusion 724. In one example, as shown, the lock body 726 may be a sleeve, although it will be understood that the lock body 726 may have any other suitable shape. The lock body 726 may have a proximal end 726a and a distal end 726b. The lock body 726 may define a channel 729 therethrough extending from the proximal end 726a to the distal end 726b. The channel 729 may be configured to receive the shaft 506 therethrough such that the shaft 506 extends out from the proximal end 726a and the distal end 726b. The at least one protrusion 724 may extend from the distal end 726b along the distal direction D.

[0066] 17 and 18 , the at least one recess 620 may be implemented in a manner similar to the at least one recess 220 of FIGS. 1-8 . The receptacle 612 may define the at least one recess 620 such that the at least one recess 620 extends into a top surface of the insertion handle 600. In some embodiments, the at least one recess 620 may comprise first and second recesses 620. The first and second recesses 620 may be disposed on opposite sides of the locking hole 616. The at least one recess 620 is configured to receive the at least one protrusion 724 of the lock 710 when the driving instrument 700 is in a second rotational orientation relative to the insertion handle 600 to rotatably secure the driving instrument 700 to the insertion handle 600. When the at least one recess 620 receives the at least one protrusion 724, the inner wall of the insertion handle 600 that defines the at least one recess 620 rotates the lock 710, and therefore the driving instrument 700, relative to the insertion handle 600 along the shaft axis A. S 724 to prevent rotation about the

[0067] The insertion handle 600 may include at least one angled surface 622 adjacent to the at least one recess 620. The at least one angled surface 622 may be angled toward the proximal direction P as it extends toward the at least one recess 620. The at least one angled surface 622 may extend around a portion of the lock hole 616 toward the at least one recess along one of a clockwise direction and a counterclockwise direction. The at least one angled surface 622 may be configured to guide the at least one protrusion 724 of the lock 710 up the angled surface 622 when the driving instrument 700 is rotated from a first direction to a second direction, thereby retracting the lock 710 along the proximal direction P. Retraction of the lock 710 in the proximal direction P may compress the spring 534. When the at least one protrusion 724 is aligned with the at least one recess 620, the biasing force of the lock 710 urges the at least one protrusion 724 in the distal direction D into the at least one recess 620, thereby rotatably securing the driving instrument 700 to the insertion handle 600.

[0068] During operation, the method may include orienting the abutment portion 508 of the driving instrument (500, 700) in a first rotational orientation to align the abutment portion 508 with the locking hole 416 of the insertion handle (400, 600). The method may include moving the driving instrument (500, 700) along a distal direction D to insert the abutment portion 508 through a proximal portion 416a of the locking hole 416 and into a distal portion 416b of the locking hole 416. The method may include rotating the driving instrument (500, 700) from the first direction to a second rotational orientation. The rotating step may include rotating the shaft 506 to rotate the abutment portion 508 such that the abutment portion 508 engages the inner surface 418 of the locking hole 416, thereby preventing the driving instrument (500, 700) from being removed from the insertion handle (400, 600) along the proximal direction P. The method may include locking the driving instrument (500, 700) in a second rotational orientation relative to the insertion handle (400, 600). The locking step may include rotating the lock (510, 710) to engage at least one of the recess 525 and the protrusion 724 of the lock (510, 710) with the other of the at least one of the protrusion 425 and the recess 620 of the insertion handle (400, 600), thereby preventing the lock (510, 710) from rotating relative to the insertion handle (400, 600). The rotating the lock (510, 710) may occur simultaneously with the rotating the abutment 508. Thus, rotating the shaft 506 may result in rotation of the abutment 508 and the lock (510, 710). The method may include impacting the driving surfaces 512 and / or 513 of the driving instrument with a tool to drive the intramedullary nail 100 into the medullary canal.

[0069] To remove the driving instrument (500, 700), the method may include translating the lock body 526 of the lock (510, 710) along the proximal direction P to disengage at least one recess 525 and protrusion 724 of the lock (510, 710) from at least one of the protrusion 425 and recess 620 of the insertion handle (400, 600). Translating the lock body 526 may include translating the handle 538 of the actuator 536 of the driving instrument (500, 700) along the proximal direction P to translate the actuator shaft 540, and therefore the lock body 536, from a locked position to an unlocked position along the proximal direction. The method may include rotating the driving instrument (500, 700) from the second rotational orientation to the first rotational orientation such that interference between the abutment 508 and the inner surface 418 of the insertion handle (400, 600) is removed. The method can include translating the driving instrument (500, 700) along a proximal direction P to remove the abutment 508 from the locking hole 416 of the insertion handle (400, 600).

[0070] 20-24, an embodiment is shown in which the lock 910 may be implemented in a manner similar to that of FIGS. 9-16, except that the lock 910 has an actuator 936 implemented in an alternative manner. The driving instrument 900 includes the shaft 506, abutment 508, lock body 526, spring 534, driving surface 513, and actuator shaft 540 implemented as described above in connection with FIGS. 9-16. However, the actuator 936 is configured to rotate about the shaft 506 to move the lock body 526 between the locked and unlocked positions. The actuator 936 may include a handle 938 and an actuator shaft 540 connecting the handle 938 to the lock body 526. The actuator 936 rotates about a shaft axis A about a first rotational orientation. SThe actuator 936 may be configured to rotate about the shaft axis A along a second rotational orientation opposite the first rotational orientation. S Rotation of the handle 938 about may be configured to translate the actuator shaft 540 along the distal direction D, which in turn moves the lock body 526 along the distal direction D from the unlocked position to the locked position.

[0071] The handle 938 may include a tubular body 942, although it will be understood that the handle 938 may have any other suitable shape. The handle 938 may define a cannulation 944 configured to receive the shaft 506. In at least some embodiments, the shaft 506 may extend through the handle 938 to extend out from an opposing end of the handle 938. The actuator 936 may include a fastener coupling the handle 938 to the shaft 506 such that the handle 938 is rotatable about the shaft 506.

[0072] The fastener may include a pin 950 extending radially from and fixedly positioned to one of the shaft 506 and the handle 938. The pin 950 may pass through the fastener 546 of the actuator shaft 540 and be received within a slot 552 of the other one of the shaft 506 and the handle 938. The slot 552 may be elongated along the proximal direction P and the distal direction D. The pin 950 may be configured to translate within the slot 552 along the proximal direction P and the distal direction D. In the embodiment of FIGS. 20-24 , the shaft 506 defines the slot 552, and the pin 950 extends radially outward from the shaft 506 and is coupled to the handle 938. The pin 950 and the slot 552 are configured such that, when the pin 950 is disposed within the slot 552, the pin 950 can translate within the slot 552 along the proximal direction P and the distal direction D. The actuator 936 is configured such that the handle 938 is axially aligned with the shaft axis A. S9 in a first rotational orientation, the pin 950 translates along the proximal direction P, thereby causing the actuator shaft 540, and thus the lock body 526, to translate along the proximal direction P. Conversely, when the handle 938 is rotated about the shaft axis A, S to a second rotational orientation, pin 950 translates along distal direction D, thereby causing actuator shaft 540, and therefore lock body 526, to translate along distal direction P.

[0073] The actuator 936 receives the pin 950 and has an angled slot 960 aligned with the shaft axis A. S , may define an angled slot 960 configured to translate the pin 950 along the proximal direction P and the distal direction D. The angled slot 960 may be oriented along the shaft axis A. S The angled slot 960 may have a first end 960a and a second end 960b that are circumferentially offset from one another about the handle 938. The angled slot 960 may be elongated from the first end 960a to the second end 960b. The second end 960b may be offset from the first end 960a with respect to the proximal direction P. Thus, the angled slot 960 may be angled toward the proximal direction P as it extends from the first end 960a to the second end 960b. The actuator 936 may be configured such that when the handle 938 is rotated to a first rotational orientation, the pin 950 moves with the angled slot 960 to translate in the proximal direction P. The actuator 936 may be configured such that when the handle 938 is rotated to a second rotational orientation, the pin 950 moves with the angled slot 960 to translate in the distal direction P. The angled slot 960 may be defined in an interior surface of the handle 938. Alternatively, the driving instrument 900 can include a collar 962 that defines the angled slot 960. The collar 962 can be rotatably fixed to the handle 938. For example, the driving instrument 900 can include at least one fastener 964, such as at least one pin, that fixedly connects the collar 962 to the handle 938. The collar 962 can be received in the cannulated portion 944 of the handle 938. The shaft 506 can be received in the cannulated portion of the collar 962.

[0074] The lock body 526 can be biased in the distal direction D toward the locked position. In other words, a biasing force can be applied to the lock body 526 to bias the lock body 526 in the distal direction D. For example, the lock 910 can include a spring 534 that biases the lock body 526 toward the locked position, as described above. Additionally or alternatively, the actuator 936 can include a spring 954 that biases the actuator 936 to rotate toward the locked position. The spring 954 can be a coil spring, such as a compression spring, an elastomeric material, or any other suitable spring that can bias the handle 938 to rotate toward the locked position. In one example, one end of the spring 954 can engage the knob 918, and the other end of the spring 954 can engage the handle 938.

[0075] The driving surface 912 may be disposed on the proximal end 502 of the driving instrument 900. In one example, the driving instrument 900 may include a knob 918 that defines the driving surface 912. The knob 918 may be disposed on the proximal end 502 of the driving instrument 900. The knob 918 may be rotatably fixed to the shaft 506. Thus, the driving instrument 900 may be configured such that rotation of the knob 918 causes a corresponding rotation of the shaft 506. The driving surface 912 may define a proximal-most surface of the driving instrument 900. The knob 918 may be configured to rotate in a selected lateral direction T s a cross-sectional dimension of the shaft 506 along a selected transverse direction T s The cross-sectional dimension along the selected transverse direction T s may be perpendicular to distal direction D. Knob 918 may define a grip configured to be grasped by a medical professional to rotate shaft 506 between the first and second rotational orientations.

[0076] 20 , 21 , 25 , and 26 , in operation, the method may include orienting the abutment portion 508 of the driving instrument 900 in a first rotational orientation to align the abutment portion 508 with the locking hole 416 of the insertion handle 800. The method may include moving the driving instrument 900 along a distal direction D to insert the abutment portion 508 through a proximal portion 416 a of the locking hole 416 into a distal portion 416 b of the locking hole 416. The method may include rotating the driving instrument 900 from the first direction to a second rotational orientation. The rotating step may include rotating the shaft 506 to rotate the abutment portion 508 such that the abutment portion 508 engages the inner surface 418 of the locking hole 416, thereby preventing the driving instrument 900 from being removed from the insertion handle 800 along the proximal direction P. The method may include locking the driving instrument 900 in a second rotational orientation relative to the insertion handle 800. The locking step may include rotating the lock 910 to engage at least one of the recess 525 and the protrusion 724 of the lock 910 with the other of the at least one of the protrusion 425 and the recess 620 of the insertion handle 800, thereby preventing the lock 910 from rotating relative to the insertion handle 800. The rotating the lock 910 may occur simultaneously with rotating the abutment 508. Thus, rotating the shaft 506 may result in rotating the abutment 508 and the lock 910. The method may include impacting the driving surfaces 912 and / or 913 of the driving instrument with a tool to drive the intramedullary nail 100 into the medullary canal.

[0077] To remove the driving instrument 900, the method may include translating the lock body 526 of the lock 910 along the proximal direction P to disengage at least one recess 525 and protrusion 724 of the lock 910 from at least one of the protrusion 425 and recess 620 of the insertion handle 800. Translating the lock body 526 may involve aligning the handle 938 of the actuator 936 of the driving instrument 900 with the shaft axis A to translate the actuator shaft 540, and therefore the lock body 526, from the locked position to the unlocked position along the proximal direction. S The method may include rotating the driving instrument 900 from the second rotational orientation to the first rotational orientation such that interference between the abutment 508 and the inner surface 418 of the insertion handle 800 is removed. The method may include translating the driving instrument 900 along the proximal direction P to remove the abutment 508 from the locking hole 416 of the insertion handle 800.

[0078] Referring briefly to FIG. 28 , a system is shown having an intramedullary nail 100, an insertion handle 1100, and a driving tool 1200. The insertion handle 1100 may be implemented in a manner similar to any of the insertion handles described above. Similarly, the driving tool 1200 may be implemented in a manner similar to any of the driving tools described above. The intramedullary nail 100 has a distal end 104 and a proximal end 106 that are offset from one another. The distal end 104 may be considered the insertion end, or leading end, and may define a first terminal end, or first outermost end, of the intramedullary nail 100. The proximal end 106 may be considered the trailing end, and may define a second terminal end, or second outermost end, of the intramedullary nail 100. The proximal end 106 of the intramedullary nail 100 may include a coupler 107 configured to couple the intramedullary nail 100 to a handle 200. In at least some examples, the coupler 107 couples the nail shank A. N The handle 200 and the nail 100 may be rotatably fixed relative to one another for rotation about a coupler 107. The coupler 107 may be configured to couple to a corresponding coupler (e.g., 208 in FIG. 1, 408 in FIG. 9, 18, and 21) of the insertion handle 1100.

[0079] The intramedullary nail 100 is elongated from the proximal end 106 to the distal end 104. For example, the intramedullary nail 100 is substantially elongated along a central passageway that extends from the proximal end 106 to the distal end 104. In at least some embodiments, the central passageway is defined by a central axis A of the intramedullary nail 100 that extends from the proximal end 106 to the distal end 104. N It should be understood that the central pathway or central axis A of the intramedullary nail 100 N The central axis A of the nail 100 may be straight or curved. N The nail 100 may be straight or curved as it extends from the proximal end 106 to the distal end 104 along a central path, or axis A. N The catheter may be inserted into the medullary canal of a long bone so that it lies along the length of the canal.

[0080] The intramedullary nail 100 has tips, i.e., a distal body portion 108 and a proximal body portion 110, that are offset from one another. The intramedullary nail 100 also has an intermediate body portion 112 between the distal body portion 108 and the proximal body portion 110. The distal body portion 108 may extend from the distal end 104 toward the proximal end 106 of the intramedullary nail 100 along a proximal direction P (which may also be referred to as a posterior direction). Furthermore, the proximal body portion 110 may extend from the proximal end 106 toward the distal end 104 along a distal direction D (which may also be referred to as an insertion direction). For example, the distal body portion 108 may extend from the distal end 104 to the intermediate body portion 112, and the proximal body portion 110 may extend from the proximal end 106 to the intermediate body portion 112. It will be understood that distal direction D extends from proximal end 106 toward distal end 104, and proximal direction P extends in the opposite direction to distal direction D (i.e., from distal end 104 toward proximal end 106).

[0081] The intramedullary nail 100 has an outer surface 114 that extends from the distal body portion 108 to the proximal body portion 110. For example, the outer surface 114 may extend from the proximal end 106 to the distal end 104. The outer surface 114 may define the outermost periphery of the intramedullary nail 100. Furthermore, the outer surface 114 may have any suitable cross-sectional shape as desired. For example, the cross-section of the outer surface 114 may extend along a central path, or central axis A. N , may be substantially circular along a plane that is substantially perpendicular to the outer surface 114. In some embodiments, the intramedullary nail 100 may have an inner surface opposite the outer surface 114. Thus, the intramedullary nail 100 includes a tubular wall between the inner surface and the outer surface 114. The inner surface may define a cannulation that extends in the distal direction D into the proximal end 106. The cannulation may extend to the distal body portion 108. For example, the cannulation may extend through the distal end 104. Alternatively, the cannulation may terminate before the distal end 104, such as at the distal body portion 108 or the intermediate body portion 112. In at least some embodiments, the cannulation may be configured (e.g., sized and shaped) to receive a rod, such as a reaming rod, therein as the intramedullary nail 100 is guided along the rod into the medullary canal of the bone. The cannulation may be aligned with the central passage, or central axis A, of the intramedullary nail 100. N It may extend along.

[0082] The intramedullary nail 100 defines a plurality of bone anchor fixation holes 124. Each bone anchor fixation hole 124 is configured to receive a bone anchor for attaching the intramedullary nail 100 to bone. The bone anchor fixation holes 124 may include at least one proximal bone anchor fixation hole 126 and at least one distal bone anchor fixation hole 128. Each of the at least one proximal bone anchor fixation hole 126 extends into the proximal body portion 110 of the intramedullary nail 100. Similarly, each of the at least one distal bone anchor fixation hole 128 extends into the distal body portion 108 of the intramedullary nail 100.

[0083] Each bone anchor fixation hole 124 is configured to receive a bone anchor extending therethrough to attach the intramedullary nail 100 to a bone. Specifically, each bone anchor fixation hole 124 may enter the outer surface 114 and extend at least partially, e.g., completely, through the intramedullary nail 100. For example, each bone anchor fixation hole 124 may enter the outer surface 114 on a first side of the intramedullary nail 100 and extend out the outer surface 114 on a second side of the intramedullary nail 100 opposite the first side. Thus, each bone anchor fixation hole 124 may be considered a through-hole, although embodiments of the present disclosure are not limited to through-holes. Each bone anchor fixation hole 124 may be unthreaded or may include female threads to receive male threads of a bone anchor.

[0084] While specific embodiments of the present disclosure have been shown and described, it will be readily apparent to those skilled in the art that modifications may be made without departing from the scope of the appended claims. The embodiments described with respect to the exemplary embodiments are presented by way of example, and the present invention is therefore not intended to be limited to the disclosed embodiments. Moreover, the structure and features of each of the above-described embodiments may be applied to other embodiments described herein. Therefore, it will be understood by those skilled in the art that the present invention is intended to encompass all modifications and alternative arrangements falling within the spirit and scope of the present invention as defined by the appended claims.

[0085] It should be noted that the illustrations and descriptions of the examples and embodiments shown in the figures are merely exemplary and should not be construed as limiting the present disclosure. Those skilled in the art will understand that the present disclosure contemplates a variety of embodiments. Additionally, it should be understood that the concepts described above with the above examples and embodiments may be used alone or in combination with any of the other examples and embodiments described above. It should be further understood that, unless otherwise stated, the various alternative examples and embodiments described above with respect to one illustrated embodiment may be applied to all examples and embodiments described herein.

[0086] Unless otherwise stated, each numerical value and range should be construed as an approximation as if the word "about," "approximately," or "substantially" precedes the value or range. Unless otherwise stated, the terms "about," "approximately," and "substantially" can be understood to describe a range within 15 percent of the stated value.

[0087] As used herein, hypothetical language, such as "can," "could," "might," "may," "eg," and the like, among others, is intended to generally convey that certain embodiments include certain features, elements, and / or steps, and other embodiments do not, unless specifically specified otherwise or understood otherwise within the context in which it is used. Thus, such hypothetical language is not generally intended to imply that features, elements, and / or steps are required in any manner for one or more embodiments, or that one or more embodiments necessarily include logic, with or without author input or prompting, for determining whether those features, elements, and / or steps are necessarily included or performed in any particular embodiment. Terms such as "comprising," "including," and "having" are synonymous and used inclusively in a non-limiting manner and do not exclude additional elements, features, acts, operations, etc. Also, when the term "or" is used, for example, to connect a list of elements, the term "or" is used in its inclusive sense (and not its exclusive sense) to mean one, some, or all of the listed elements.

[0088] While certain exemplary embodiments have been described, these embodiments are presented by way of example only and are not intended to limit the scope of the invention(s) disclosed herein. Accordingly, nothing in the foregoing description is intended to imply that any particular feature, characteristic, step, module, or block is essential or essential. Indeed, the novel methods and systems described herein may be embodied in a wide variety of other forms. Furthermore, various omissions, substitutions, and changes can be made in the form of the methods and systems described herein without departing from the spirit of the invention(s) disclosed herein. The accompanying claims and their equivalents are intended to cover such forms or modifications as fall within the specific scope and spirit of the invention(s) disclosed herein.

[0089] It should be understood that the steps of the exemplary methods described herein do not necessarily have to be performed in the order described, and that the ordering of steps in such methods is merely exemplary. Similarly, additional steps may be included in such methods, and certain steps may be omitted or combined in methods consistent with various embodiments of the present invention.

[0090] In the method claims that follow, where elements with corresponding labeling may be recited in a particular order, it is not necessarily intended that the elements be limited to being performed in that particular order, unless the claim recitation implies a particular order for performing some or all of the elements.

[0091] [Embodiment] (1) A driving tool configured to couple to an insertion handle of an intramedullary nail, the driving tool comprising: a proximal end and a distal end distally opposite the proximal end; a shaft extending along a shaft axis between the proximal end and the distal end; an abutment extending outwardly relative to the shaft along a first direction such that the abutment defines a length in the first direction that is greater than a cross-sectional dimension of the shaft in the first direction, the abutment being rotatably fixed to the shaft such that the shaft is configured to rotate the abutment between a first rotational orientation in which the abutment can be removed or inserted into the insertion handle, and a second rotational orientation in which the abutment is configured to form an interference with the insertion handle that prevents the abutment from being removed from the insertion handle; a driving surface translatably secured to the shaft and configured to receive an impaction force from an impaction tool to transfer the impaction force from the driving instrument to the insertion handle when the driving instrument is coupled to the insertion handle; a lock configured to engage the insertion handle when the abutment is received within the insertion handle and rotated relative to the insertion handle from the first rotational orientation to the second rotational orientation to prevent the abutment from rotating from the second rotational orientation to the first rotational orientation. (2) The driving instrument of embodiment 1, wherein the lock includes at least one of a protrusion and a recess, and the at least one of the protrusion and the recess is configured to engage with the other of the recess and the protrusion of the insertion handle to prevent the abutment from rotating from the second rotational orientation to the first rotational orientation. (3) The driving instrument of embodiment 1, wherein the lock is a releasable lock configured to be released from engagement with the insertion handle to permit the abutment portion to rotate from the second rotational orientation to the first rotational orientation, thereby allowing the driving instrument to be removed from the insertion handle along a proximal direction opposite the distal direction. (4) The driving instrument of embodiment 1, wherein the length is defined in a plane perpendicular to the shaft axis, and the abutment portion has a width in the plane that is smaller than the length. (5) The driving instrument of embodiment 1, wherein the abutment portion includes at least one engagement surface configured to engage an inner surface of the insertion handle to define the interference with the inner surface of the insertion handle when the abutment portion is received within the insertion handle and rotated to the second rotational orientation.

[0092] (6) The driving instrument of embodiment 1, wherein the driving instrument includes a force transmission surface that is translatably fixed to the shaft and configured to engage the insertion handle to transmit the impaction force to the insertion handle. (7) The driving instrument of embodiment 2, wherein the lock includes a lock body including at least one of the protrusions and recesses of the lock, the lock body being configured to translate relative to the shaft along the shaft axis between a locked position and an unlocked position, and the at least one of the protrusions and recesses of the lock protruding further along the distal direction in the locked position than in the unlocked position. (8) The driving instrument of embodiment 7, wherein the lock body is rotatably secured to the shaft such that rotation of the shaft causes corresponding rotation of the lock body. (9) The driving instrument of embodiment 7, wherein the lock includes a flange extending outward from the lock body, the flange configured to be engaged by a medical professional and moved along a proximal direction opposite the distal direction to disengage at least one of the protrusion and recess of the lock from the other of the recess and protrusion of the insertion handle. (10) The driving instrument of embodiment 7, wherein the lock includes an actuator configured to be actuated to move the lock body between the locked position and the unlocked position.

[0093] (11) The driving instrument of claim 10, wherein the actuator comprises an actuator handle and an actuator shaft, the actuator shaft being coupled to the actuator handle and the lock body such that movement of the actuator handle causes the actuator shaft to move the lock body between the locked position and the unlocked position. (12) A system comprising: a driving instrument according to claim 1; the insertion handle. (13) The system of claim 12, wherein the insertion handle defines a locking hole configured to receive the abutment, and the abutment and the locking hole have a keyed relationship to one another. (14) The system of claim 12, wherein the driving instrument is configured to be rotated between the first rotational orientation and the second rotational orientation by rotating the abutment portion by 180 degrees or less. (15) The locking hole includes a proximal portion and a distal portion offset from the proximal portion along the distal direction, The system of embodiment 12, wherein the locking hole is configured to receive the abutment portion through the proximal portion and into the distal portion when the abutment portion is in the first rotational orientation, and the locking hole is configured to lock the abutment portion within the distal portion when the abutment portion is in the second rotational orientation to prevent the abutment portion from being removed from the locking hole along the proximal direction.

[0094] (16) A method of connecting a driving tool to an insertion handle of an intramedullary nail, comprising: orienting the abutment portion of the driving instrument in a first rotational orientation to align the abutment portion with the locking aperture of the insertion handle; moving the driving tool in a distal direction to insert the abutment portion into the locking hole; rotating the abutment from the first rotational orientation to a second rotational orientation to engage the abutment with an inner surface of the locking hole, thereby preventing the driving instrument from being removed from the insertion handle in a proximal direction opposite the distal direction; and locking the driving instrument in the second rotational orientation relative to the insertion handle. (17) The moving step includes moving the abutment through a proximal portion of the locking hole to a distal portion of the locking hole, the distal portion having a width greater than a width of the proximal portion to define the inner surface extending between the proximal portion and the distal portion; the abutment extends outwardly relative to the shaft of the driving tool to define an engagement surface; 17. The method of claim 16, wherein the rotating step includes rotating the abutment within the distal portion of the locking hole so that the engagement surface of the abutment interferes with the inner surface. (18) The method of embodiment 16, wherein the locking step includes rotating the lock to engage at least one of a protrusion and a recess of a lock on the driving instrument with the other of a recess and a protrusion of the insertion handle, thereby preventing rotation of the driving instrument relative to the insertion handle. (19) The method of claim 18, wherein the method includes performing the rotating step and the locking step simultaneously. (20) translating a locking body of the driving tool in a proximal direction to unlock the driving tool; rotating the abutment portion from the second rotational orientation to the first rotational orientation; moving the driving instrument along the proximal direction to remove the driving instrument from the insertion handle.

Claims

1. 1. A driving tool configured to couple to an insertion handle of an intramedullary nail, the driving tool comprising: a proximal end and a distal end distally opposite the proximal end; a shaft extending along a shaft axis between the proximal end and the distal end; an abutment extending outwardly relative to the shaft along a first direction such that the abutment defines a length in the first direction that is greater than a cross-sectional dimension of the shaft in the first direction, the abutment secured to the shaft such that the shaft is configured to rotate the abutment between a first rotational orientation in which the abutment can be removed or inserted into the insertion handle, and a second rotational orientation in which the abutment is configured to form an interference with the insertion handle that prevents the abutment from being removed from the insertion handle; a driving surface fixed to the shaft such that translation of the driving surface causes corresponding translation of the shaft, the driving surface configured to receive an impaction force from an impaction tool to transfer the impaction force from the driving instrument to the insertion handle when the driving instrument is coupled to the insertion handle; a lock configured to engage the insertion handle when the abutment is received within the insertion handle and rotated relative to the insertion handle from the first rotational orientation to the second rotational orientation to prevent the abutment from rotating from the second rotational orientation to the first rotational orientation.

2. 2. The driving instrument of claim 1, wherein the lock includes at least one of a protrusion and a recess, and when the lock includes the protrusion, the protrusion of the lock is configured to engage with the recess of the insertion handle to prevent the abutment from rotating from the second rotational orientation to the first rotational orientation, and when the lock includes the recess, the recess of the lock is configured to engage with the protrusion of the insertion handle to prevent the abutment from rotating from the second rotational orientation to the first rotational orientation.

3. 2. The driving instrument of claim 1, wherein the lock is a releasable lock configured to be released from engagement with the insertion handle to permit the abutment to rotate from the second rotational orientation to the first rotational orientation, thereby allowing the driving instrument to be removed from the insertion handle along a proximal direction opposite the distal direction.

4. The driving instrument of claim 1 , wherein the length is defined in a plane perpendicular to the shaft axis, and the abutment portion has a width in the plane that is less than the length.

5. 2. The driving instrument of claim 1, wherein the abutment includes at least one engagement surface configured to engage an inner surface of the insertion handle to define the interference with the inner surface of the insertion handle when the abutment is received within the insertion handle and rotated to the second rotational orientation.

6. 10. The driving instrument of claim 1, wherein the driving instrument includes a force transfer surface secured to the shaft such that translation of the shaft causes corresponding translation of the force transfer surface, the force transfer surface configured to engage the insertion handle to transfer the impaction force to the insertion handle.

7. 3. The driving instrument of claim 2, wherein the lock includes a lock body including the at least one of the protrusion and the recess of the lock, the lock body configured to translate relative to the shaft along the shaft axis between a locked position and an unlocked position, and the at least one of the protrusion and the recess of the lock protruding further along the distal direction in the locked position than in the unlocked position.

8. The driving instrument of claim 7 , wherein the locking body is secured to the shaft such that rotation of the shaft causes corresponding rotation of the locking body.

9. 8. The driving instrument of claim 7, wherein the lock includes a flange extending outward from the lock body, the flange configured to be engaged by a medical professional and moved along a proximal direction opposite the distal direction to remove the protrusion of the lock from the recess of the insertion handle, if the lock includes the protrusion, and the recess of the lock from the protrusion of the insertion handle, if the lock includes the recess.

10. The driving instrument of claim 7 , wherein the lock includes an actuator configured to be actuated to move the lock body between the locked position and the unlocked position.

11. 11. The driving instrument of claim 10, wherein the actuator comprises an actuator handle and an actuator shaft coupled to the actuator handle and the lock body such that movement of the actuator handle causes the actuator shaft to move the lock body between the locked position and the unlocked position.

12. 1. A system comprising: The driving tool of claim 1 ; the insertion handle.

13. The system of claim 12 , wherein the insertion handle defines a locking hole configured to receive the abutment, the abutment and the locking hole having a keyed relationship to one another.

14. 13. The system of claim 12, wherein the driving instrument is configured to be rotated between the first rotational orientation and the second rotational orientation by rotating the abutment no more than 180 degrees.

15. the locking aperture includes a proximal portion and a distal portion offset from the proximal portion along the distal direction; 14. The system of claim 13, wherein the locking hole is configured to receive the abutment portion through the proximal portion and into the distal portion when the abutment portion is in the first rotational orientation, and the locking hole is configured to lock the abutment portion within the distal portion when the abutment portion is in the second rotational orientation to prevent the abutment portion from being removed from the locking hole in a proximal direction.

16. 10. A method of connecting the driving instrument of claim 1 to the insertion handle of the intramedullary nail, comprising: the insertion handle defines a locking hole configured to receive the abutment, the abutment and the locking hole having a keyed relationship to one another; orienting the abutment portion of the driving instrument in the first rotational orientation to align the abutment portion with the locking aperture of the insertion handle; moving the driving tool along the distal direction to insert the abutment portion into the locking hole; rotating the abutment from the first rotational orientation to the second rotational orientation to engage the abutment with an inner surface of the locking hole, thereby preventing the driving instrument from being removed from the insertion handle in a proximal direction opposite the distal direction; and locking the driving instrument in the second rotational orientation relative to the insertion handle.

17. the moving step includes moving the abutment through a proximal portion of the locking aperture to a distal portion of the locking aperture, the distal portion having a width greater than a width of the proximal portion to define the inner surface extending between the proximal portion and the distal portion; the abutment extends outwardly relative to the shaft of the driving instrument to define an engagement surface; 17. The method of claim 16, wherein the rotating step includes rotating the abutment within the distal portion of the locking aperture such that the engagement surface of the abutment interferes with the interior surface.

18. The lock of the driving tool includes at least one of a protrusion and a recess, 17. The method of claim 16, wherein the locking step includes rotating the lock of the driving instrument to engage the protrusion of the lock with a recess of the insertion handle if the lock of the driving instrument includes the protrusion, and to engage the recess of the lock with the protrusion of the insertion handle if the lock of the driving instrument includes the recess, thereby preventing rotation of the driving instrument relative to the insertion handle.

19. The method of claim 18 , wherein the method includes performing the rotating and locking steps simultaneously.

20. translating a locking body of the driving instrument along the proximal direction to unlock the driving instrument; rotating the abutment portion from the second rotational orientation to the first rotational orientation; and moving the driving instrument along the proximal direction to remove the driving instrument from the insertion handle.

Images