Surgical techniques, instruments and systems for bone fusions and repairs (for example, phalangeal fusion) which allow alignment of small bones (for example, phalanges) without the use of guidewire and cannulated
instrumentation such as, for example, drills and drivers, and cannulated screws. A
drill / driver
hybrid instrument (a combined
drill / driver device) may be used in fusion of two small bones (for example, in interphalangeal fusion). One end of the
hybrid instrument is provided with a plurality of flutes so that the instrument can be used as a
drill to remove bone. The other end is shaped to mate with a device to be inserted intraarticularly (for example, interphalangeally), acting as a driver for that device.