BR112018016282B1 - EXTERNAL BONE FIXATION SYSTEM AND SUPPORT ASSEMBLY - Google Patents

Abstract

The present application provides external bone fixation systems. The systems include one or more pairs of bone fixation platforms in the form of rings or partial rings. The platforms can be attached to the corresponding bone segments. The pair of platforms are configured to accept a plurality of struts extending therebetween. The struts are configured to attach to the platforms via joints that provide three degrees of rotation. The rods are also configured so that their longitudinal length, which extends between the joints/platforms, can be incrementally adjusted whilst attached to the platforms. The struts are further configured such that their full length adjustment range can be increased by coupling at least one additional component to the struts in situ. The lengths of each of the plurality of struts can be adjusted to arrange the platforms, and therefore the bone segment attached thereto, in particular relative positions and orientations.

Description

FIELD OF THE INVENTION

[1] The present description is generally directed to external bone fixation systems and related methods. More particularly, the present disclosure is directed to external bone fixation systems and related methods that include a plurality of length-adjustable supports rotatably coupled between a pair of platforms configured to attach to bone segments.

BACKGROUND OF THE INVENTION

[2] External fixation devices have been used to treat bone and tissue conditions by positioning bone or tissue segments in desired relative positions based on particular clinical needs. One form of external fixation device is a hexapod fixation device. Hexapod devices, or more formally called Stewart platforms, include parallel manipulators or stands with six degrees of freedom (6DOF). In general, these devices have the ability to manipulate an article of interest relative to a base in all three orthogonal translation axes (X, Y, Z positions) and all rotations around these three orthogonal axes (yaw position, tilt and rotation).

[3] When configured as bone and tissue fixation systems, hexapod systems typically include a pair of rings that act as bone fixation platforms. The platforms are typically connected with six struts that extend between the platforms. The supports and platforms are commonly connected via spherical or cardan joints, which allow three rotations around three orthogonal axes. While some of the three brackets allow for length adjustment, their minimum and/or maximum lengths may not meet the needs of a particular clinical situation. For example, minimizing the distance between platforms to less than that provided by a particular strut requires the use of shorter struts - which naturally limits the adjustable range (ie, the maximum length) of the struts.

[4] As a result, current hexapod bone fixation systems utilize a collection of struts of different lengths (or different length ranges), which provide "short" struts for use when platforms need to be closer together and "long" struts for use when platforms need to be closer together. ” for use when platforms need to be even further apart. In many cases, these abutments must be progressively or regressively replaced to the next length abutment during a bone or tissue correction process, which is both a time-consuming and costly process, as the abutment being replaced cannot be reused. Further complicating such systems is the fact that some situations require a variety of different support lengths. For example, a variety of different support lengths are commonly required when extreme starting angulations or rotations are present. The process of selecting the correct combination of different brace lengths in such situations is a time consuming process that is typically done by trial and error in an operating room. Such systems and situations, therefore, also require an excessive amount of inventory, which is also costly and often confusing to use properly.

[5] Physically variable supports, in addition to being a nuisance, also limit the available dynamic range of the system when trying to reduce the deformity acutely. In this situation, braces are usually not added until such acute corrections are achieved, leaving the reduction to be performed by a team in an operating room while additional members of the operating room team pick and choose which braces will fit the platforms at the location. prescribed. This process is time consuming and requires a large inventory.

[6] Current hexapod fastening systems also typically utilize connections between platforms and supports that require the use of one or more fasteners that need to be secured at the time of application. Thus, connecting six supports and both ends to the platforms (ie twelve connections), sometimes in a trial-and-error manner, is a difficult and time-consuming task. A complicating matter is the fact that many current hexapod fixation systems utilize loose fasteners, which can be applied using instruments. These fixators and instruments add to the collection of parts and materials which must be tracked in an operating room setting while the fixation system is employed, such as while a reduction is being maintained.

[7] Accordingly, hexapod attachment systems and related methods that provide increased length adjustment ranges while remaining attached to platforms, decrease the amount of associated inventory, can be installed relatively quickly, and that reduce cost are desirable.

SUMMARY OF THE INVENTION

[8] In one aspect, the present disclosure provides an external bone fixation system, comprising a first platform, a second platform and at least six sets of adjustable length supports. The first platform defines an opening and is configured to be coupled with a first bone segment. The second platform defines an opening and is configured to be coupled with a second bone segment. Each of the support assemblies includes an externally threaded rod portion translatable through a support body portion. The rod portion of each support assembly is coupled to one of the first and second platforms via a respective pivot and the support body portion of each support assembly is coupled to the other of the first and second platforms via a linkage. respective articulation. The support assemblies are attached to the first and second platforms in pairs of support assemblies spaced around the first and second platforms. The pairs of support assemblies each include a first support assembly coupled to the respective platform by pivoting the threaded rod portion thereof and a second support assembly coupled to the respective platform by pivoting the support body portion. of the same.

[9] In another aspect, the present disclosure provides an external bone fixation system including a first platform, a second platform and a plurality of support assemblies of adjustable length. The first platform is configured to be coupled to a first bone segment and defining an opening. The second platform is configured to be coupled to a second bone segment and defining an opening. The support assemblies extend between the first and second platforms within an operable range of angulation or orientation relative to the platforms. At least one of the rod portion and the body portion of each support assembly is configured to attach to one of the first platform and the second platform by engaging the respective platform at an inoperable angle or orientation relative thereto and rotation. of the support assembly within the operable range of angulation or orientation.

[10] In another aspect, the present disclosure provides a support assembly for an external bone fixation system. The support assembly includes a support body, a first externally threaded rod portion and an externally threaded accessory rod portion. The support body portion includes a cavity extending therethrough and internal threads. The support body also includes a first hinge at an end portion thereof, configured to be coupled to an attachment platform. The first rod portion is translatable through the support body portion. The first rod portion includes a second hinge at an end portion thereof, configured to be coupled to an attachment platform. The externally threaded accessory rod portion is configured to attach to the first rod portion to extend the length thereof. The length between the first and second joints is adjustable. The accessory rod portion is attachable to the first rod portion when the first and second linkages are each coupled to the platform.

[11] These and other objects, elements, and advantages of this description will become apparent from the following detailed description of the various aspects of the description, taken in conjunction with the accompanying figures.

BRIEF DESCRIPTION OF THE FIGURES

[12] For purposes of illustration of the external bone fixation systems and related methods described herein, illustrative embodiments are shown. These illustrative embodiments are in no way limiting in terms of the precise arrangement and operation of the described external fixation systems, and other similar embodiments are envisioned.

[13] FIG. 1 is a perspective view of an external bone fixation system in a first configuration corresponding to the most compact configuration, including a plurality of platforms and a plurality of interconnected support assemblies.

[14] FIG. 2 is a perspective view of the external bone fixation system of FIG. 1 in a second configuration that corresponds to an extended configuration or state.

[15] FIG. 3 is a perspective view of a support assembly of the external bone fixation system of FIG. 1 shown in a more compact state.

[16] FIG. 4 is a side view of a support assembly of the external bone fixation system of FIG. 1 shown in a configuration or extended state.

[17] FIG. 5 is a front view of the support assembly of FIG. 4.

[18] FIG. 6 is a cross-sectional side view of the support assembly of FIG. 4 as indicated in FIG. 5.

[19] FIG. 7 is a cross-sectional front view of the support assembly of FIG. 4 as indicated in FIG. 4.

[20] FIG. 8 is a cross-sectional view of the support assembly of FIG. 4 as indicated in FIG. 4.

[21] FIG. 9 is a cross-sectional view of the support assembly of FIG. 4 as indicated in FIG. 4.

[22] FIG. 10 is a cross-sectional view of the support assembly of FIG. 4 as indicated in FIG. 5.

[23] FIG. 11 is an exploded view of a support body release mechanism of a support assembly of the external bone fixation system of FIG. 1.

[24] FIG. 12 is an exploded view of a pre-installed rod portion, a connecting element and an accessory rod portion.

[25] FIGS. 13 - 17 illustrate the connecting element progressively coupled to the preinstalled stem portion and the accessory stem portion of FIG. 12.

[26] FIG. 18 is a detailed view of the timing geometry for the preinstalled rod portion and the accessory rod portion of FIG. 12.

[27] FIG. 19 is an exploded view of the pivot mechanism of a support body of a support assembly of the external bone fixation system of FIG. 1.

[28] FIG. 20 illustrates a perspective view of a platform of a support assembly of the external bone fixation system of FIG. 1.

[29] FIG. 21 is a perspective view of a support assembly aligned with a beam of a platform in a non-operable orientation.

[30] FIG. 22 is a perspective view of the support assembly engaged with the platform support in the non-operable orientation of FIG. 21.

[31] FIG. 23 is a perspective view of the support assembly coupled to the platform support of FIG. 21 per rotation of the bracket to an operable orientation.

[32] FIG. 24 is an exploded view of a pivot mechanism for a threaded rod portion of a support assembly of the external bone fixation system of FIG. 1.

[33] FIG. 25 is a perspective view of examples of interconnected support assemblies of other examples of external bone fixation system in a first configuration in accordance with the present disclosure.

[34] FIG. 26 is a side view of the interconnected support assemblies of FIG. 25.

[35] FIG. 27 is a top view of the interconnected support assemblies of FIG. 25.

[36] FIG. 28 is a perspective view of the interconnected support assemblies of FIG. 25 in a second configuration.

[37] FIG. 29 is a top view of the interconnected support assemblies of FIG. 25 in the second configuration.

[38] FIG. 30 is a side view of the interconnected support assemblies of FIG. 25 in the second configuration.

[39] FIG. 31 is a perspective view of the interconnected support assemblies of FIG. 25 in a third collapsed configuration and coupled to the platforms of the external bone fixation system.

[40] FIG. 32 is a top view of the external bone fixation system of FIG. 31.

[41] FIG. 33 is a side view of the external bone fixation system of FIG. 31.

[42] FIG. 34 is a bottom perspective view of the external bone fixation system of FIG. 31 in an extended configuration of interconnected support assemblies.

[43] FIG. 35 is an elevated perspective view of the external bone fixation system of FIG. 33.

[44] FIG. 36 is a side view of the external bone fixation system of FIG. 33.

[45] FIG. 37 is a perspective view of the interconnected support assemblies of FIG. 25 in a third configuration and the platforms of the external bone fixation system.

[46] FIG. 38 is a perspective view of the interconnected support assemblies of FIG. 25 in the extended configuration and the platforms of the external bone fixation system.

[47] FIG. 39 is a perspective view of the interconnected support assemblies of FIG. 25 in the extended configuration and connected to the platforms of the external bone fixation system.

[48] FIG. 40 illustrates a bottom perspective and side view of the interconnected support assemblies of FIG. 25 in the third configuration collapsed and connected to the platforms of the external bone fixation system.

[49] FIG. 41 illustrates a bottom perspective and side view of the interconnected support assemblies of FIG. 25 in the third collapsed configuration with accessory bars installed and connected to the platforms of the external bone fixation system.

[50] FIG. 42 is a top perspective view of a support-platform connection mechanism coupled to a pair of support assemblies of the external bone fixation system of FIG. 25.

[51] FIG. 43 is a bottom perspective view of the support-platform connection mechanism of FIG. 42.

[52] FIG. 44 is a top perspective view of the support-platform connection mechanism of FIG. 42 by coupling the pair of support assemblies to a platform.

[53] FIG. 45 is a bottom perspective view of the support-platform connection mechanism of FIG. 42 by coupling the pair of support assemblies to a platform.

[54] FIG. 46 is a top view of a platform of the external bone fixation system of FIG. 25.

[55] FIG. 47 is an exploded perspective view of supporting assembly examples of the external bone fixation system of FIG. 25.

[56] FIG. 48 is an exploded perspective view of examples of the length adjustment mechanism of a support assembly of the external bone fixation system of FIG. 25.

[57] FIG. 49 is an exploded perspective view of examples of the length adjustment mechanism of a support assembly of the external bone fixation system of FIG. 25.

[58] FIG. 50 is a perspective view of partially threaded nut examples of the length adjustment mechanism of FIG. 48.

[59] FIG. 51 is a side view of the partially threaded nut of FIG. 50.

[60] FIG. 52 is a cross-sectional view of the partially threaded nut of FIG. 50.

[61] FIG. 53 is a perspective view of examples of the length adjustment mechanism of FIG. 48.

[62] FIG. 54 is a cross-sectional side view of examples of the length adjustment mechanism of FIG. 48 in an activated state.

[63] FIG. 55 is a cross-sectional side view of examples of the length adjustment mechanism of FIG. 48 in a disabled state.

[64] FIG. 56 is a cross-sectional perspective view of examples of the length adjustment mechanism of FIG. 48 in an activated state.

[65] FIG. 57 is a cross-sectional perspective view of examples of the length adjustment mechanism of FIG. 48 in a disabled state.

[66] FIG. 58 is an exploded perspective view of examples of the length adjustment mechanism of FIG. 48.

[67] FIG. 59 is a perspective view of examples of interconnected support assemblies from other examples of external bone fixation systems in accordance with the present disclosure.

[68] FIG. 60 is a top view of the interconnected support assemblies of FIG. 59.

[69] FIG. 61 is an elevated perspective view of the interconnected support assemblies of FIG. 59.

[70] FIG. 62 is a bottom perspective view of the interconnected support assemblies of FIG. 59.

[71] FIG. 63 is an elevated perspective view of the interconnected support assemblies of FIG. 59.

[72] FIG. 64 is a side view of the external bone fixation system of FIG. 59 with interconnected support assemblies coupled to a plurality of platforms.

[73] FIG. 65 is an elevated perspective view of the external bone fixation system of FIG. 59 as illustrated bone segments.

[74] FIG. 66 is an elevated perspective view of the external bone fixation system of FIG. 59 illustrating a connection mechanism coupling a pair of support assemblies to a platform.

[75] FIG. 67 is a bottom perspective view of the external bone fixation system of FIG. 59 illustrating a connection mechanism coupling a pair of support assemblies to a platform.

[76] FIG. 68 is an elevated perspective view of the external bone fixation system of FIG. 59 illustrating a connection mechanism coupling a pair of support assemblies to a pair of platforms.

[77] FIG. 69 is a perspective view of the external bone fixation system of FIG. 59 illustrating support-platform connection mechanisms.

[78] FIG. 70 is a side view of the external bone fixation system of FIG. 59 illustrating support-platform connection mechanisms.

[79] FIG. 71 is a perspective view of examples of the length adjustment mechanism for support assemblies of the external bone fixation system of FIG. 59.

[80] FIG. 72 is a side view of the length adjustment mechanism of FIG. 71.

[81] FIG. 73 is a cross-sectional view of the length adjustment mechanism of FIG. 71.

[82] FIG. 74 is another cross-sectional view of the length adjustment mechanism of FIG. 71.

[83] FIG. 75 is another cross-sectional view of the length adjustment mechanism of FIG. 71.

[84] FIG. 76 is another cross-sectional view of the length adjustment mechanism of FIG. 71.

[85] FIG. 77 is an exploded perspective view of the length adjustment mechanism of FIG. 71.

[86] FIG. 78 is another exploded perspective view of the length adjustment mechanism of FIG. 71.

[87] FIG. 79 is an exploded side view of the length adjustment mechanism of FIG. 71.

[88] FIG. 80 is another side exploded view of the length adjustment mechanism of FIG. 71.

[89] FIG. 81 is another cross-sectional view of the length adjustment mechanism of FIG. 71.

[90] FIG. 82 is a perspective view of other examples of the external bone fixation system in accordance with the present disclosure.

[91] FIG. 83 is an exterior elevation view of a support-platform connection mechanism of the external bone fixation system of FIG. 82 by attaching a pair of support assemblies to a platform.

[92] FIG. 84 is an exterior bottom perspective view of the support-platform connection mechanism of FIG. 83.

[93] FIG. 85 is an interior elevational view of the support-platform connection mechanism of FIG. 83.

[94] FIG. 86 is a top view of a platform of the external bone fixation system of FIG. 82.

[95] FIG. 87 is an elevated perspective view of the platform of FIG. 86.

[96] FIG. 88 is an enlarged elevational perspective view of the platform of FIG. 86.

[97] FIG. 89 is a side perspective view of the platform of FIG. 86.

[98] FIG. 90 is an exterior bottom perspective view of the support-platform connection mechanism of FIG. 83 be attached to the platform of FIG. 86.

[99] FIG. 91 is a top view of the support-platform connection mechanism of FIG. 90.

[100] FIG. 92 is a side view of the support-platform connection mechanism of FIG. 90.

[101] FIG. 93 is a cross-sectional view of the support-platform connection mechanism of FIG. 90.

[102] FIG. 94 is a perspective view of the support-platform connection mechanism of FIG. 83.

[103] FIG. 95 is a side view of the support-platform connection mechanism of FIG. 94.

[104] FIG. 96 is a top view of the support-platform connection mechanism of FIG. 94.

[105] FIG. 97 is a cross-sectional view of the support-platform connection mechanism of FIG. 94.

[106] FIG. 98 is another cross-sectional view of the support-platform connection mechanism of FIG. 94.

[107] FIG. 99 is a perspective view of a connection mechanism assembly of the support-platform connection mechanism of FIG. 83.

[108] FIG. 100 is a front view of the connection mechanism assembly of FIG. 99.

[109] FIG. 101 is a side view of the connection mechanism assembly of FIG. 99.

[110] FIG. 102 is a cross-sectional view of the connection mechanism assembly of FIG. 99.

[111] FIG. 103 is a top view of the connection mechanism assembly of FIG. 99.

[112] FIG. 104 is another cross-sectional view of the connection mechanism assembly of FIG. 99.

[113] FIG. 105 is another cross-sectional view of the connection mechanism assembly of FIG. 99.

DETAILED DESCRIPTION

[114] When elements of different embodiments of the present invention are introduced, the articles “a”, “an”, “the / the” and “referred / referred” are intended to mean that there are one or more of the elements. The terms "comprising", "including" and "featuring" are intended to be inclusive and mean that there may be additional elements in addition to those listed. Any parameter examples are not exclusive of other parameters of the described embodiments. Components, aspects, elements, configurations, arrangements, uses and the like described, illustrated or otherwise disclosed herein in connection with any particular embodiment may similarly be applied to any other embodiment described herein.

[115] The present disclosure provides bone and tissue fixation systems with six degrees of freedom (6DOF) and related fixation methods 100 as shown in FIGS. 1-18, which include the desired stability and mobility characteristics of a hexapod system without support choices - time-consuming length and difficulty of assembly. The fastening systems 100, as shown in FIGS. 1 - 18, also include sets of brackets 110 with relatively wide dynamic ranges, so that acute reductions in the operating room are not limited by the system 100 per se and the need for selection and replacement of one or more of the brackets 110 during surgery. reduction process. In some embodiments, the fastening systems and related fastening methods of the present disclosure 100 as shown in FIGS. 1 - 18 are particularly advantageous for the repair of fractures or deformities, such as fractures or deformities in relatively long bones.

[116] In one embodiment, the fastening systems or devices 100 include support assemblies each formed by a set of threaded bars 25 coupled, in a threadable manner, within a support body 5. As further explained below , the set of threaded bars 25 may include a first support screw or bar 12 and, potentially, a second accessory support screw or bar 13. The set of threaded bars 25 may include external threads, as shown in FIGS. 1 - 7, 10, 12 and 13. As also shown in FIGS. 1-3, the set of threaded bars 25 may include or define a longitudinal axis X-X, and may be elongated along the X-X axis. In some embodiments, the set of threaded bars 25 may be cylindrical. The set of threaded rods 25 can define a length L1 along the longitudinal axis X - X which includes the external threads, as shown in FIG. 3.

[117] As shown in FIGS. 1 - 7 and 11, the set of threaded rods 25 can be translatably received within the support body 5. The support body 5 can thus include a smooth, unthreaded cavity and potentially substantially configured to accept the support body 5 in it / through it, such as along the longitudinal axis X - X. The support body 5, and potentially the cavity thereof, can define a length L2 along the longitudinal axis X - X that is less than the length L1 of the set of threaded rods 25, as shown in FIG. 3. Support body 5 can be configured such that support body 5 is free to extend and/or translate across support body 5, as shown in FIGS. 1, 3 - 7, 16 and 17. As further explained below, one end portion of the support body 5 can be coupled to a first platform 120, and an opposite end portion of the set of threaded rods 25 can be coupled to a second platform 130. In this sense, the support body 5 and the set of threaded rods 25 can translate and relate to each other along the X - X axis to provide a relatively wide range of length adjustable form the support set 110 and , accordingly, the distance and/or orientation between the first and second platforms 120, 130 as shown in FIGS. 1 and 2.

[118] As further explained below, the first and second platforms 120, 130 can be rings or partial rings such that they can extend, at least partially, around an opening and/or an axis X2 - X2 (and, potentially at least partially around a bone and/or tissue in situ). The support assembly 110 can be coupled to the first and second platforms 120, 130 around axis X2 - X2. For example, as shown in FIGS. 1 and 2, the support assembly 110 can be positioned and circumferentially coupled to the first and second platforms 120, 130, and each support assembly 110 can be attached to the first and second platforms 120, 130 at different positions around the axis X2 - X2. As such, the support assembly 110 can be angled with respect to the X2 - X2 axis.

[119] As shown in FIGS. 1 and 2, the support assembly 110 can be arranged and coupled to the first and second platforms 120, 130 in such a configuration as to provide space for the extension of the threaded bar assembly 25 of the support body 5 (or vice versa). For example, support assembly 110 can be attached to first and second platforms 120, 130 on pairs of adjacent and relatively closely spaced pivots, and such pairs of support assemblies 110 can be spaced a greater distance relatively closely around the first and second platforms 120, 130 (and thus around axis X2 - X2). Each pair of support assemblies 110 may include a hinge coupling the set of threaded rods 25 of one support assembly 110 to the first or second platform 120, 130 and a hinge coupling the support body 5 of the other support assembly 110 to the first or second platform 110. second platform 120, 130. Support assembly 110 is thereby connected to first and second platforms 120, 130 in an alternate pattern or orientation.

[120] The support assembly 110 of each pair coupled to the first and second platforms 120, 130 can extend to the other platform 120, 130 in opposite angular directions around the axis X2 - X2 - a support assembly 110 can extend and be coupled to another platform 120, 130 in a different clockwise position and the other support assembly 110 can be extended and be coupled to another platform 120, 130 in a different counterclockwise position.

[121] As discussed above, the support assembly 110 can be configured such that the threaded bar assembly 25 is capable of extending completely through the support body 5, as shown in the offset arrangement shown in FIGS. 1 and 3. As each pair of support assemblies 110 includes a hinge coupling the set of threaded rods 25 of a first support assembly 110 to the respective first or second platform 120, 130 and a hinge coupling the support body 5 of a second support assembly 110 to the respective first or second platform 120, 130, the set of threaded bars 25 of the second support assembly 110 is able to extend outside the support body 5 (coupled to the respective first or second platform 120, 130) without interference from the first support assembly 110, as shown in FIG. 1. The alternative orientation of the support assembly 110 of the pairs of support assemblies 110 coupled to the first and second platforms 120, 130 thereby allows the set of threaded rods 25 to define a relatively long length L1. In this regard, the system 100 is capable of providing an acute reduction in the distance between the first and second platforms 120, 130 (and the bone or tissue segments coupled thereto) as shown in FIG. 1, while still providing a fit over a relatively large distance (i.e., relatively large offset) as shown in FIG. 2. This relatively large dynamic involves adjustment of the first and second platforms 120, 130 and is thus provided without the need for replacement or addition to the support assembly 110, which may advantageously free the surgeon to concentrate on orthopedic condition and reduction of the fracture or deformity.

[122] As shown in FIGS. 3 - 7 and described above, the set of threaded bars 25 (i.e. the first support screw or bar 12 and potentially the second accessory support screw or bar 13) can be provided within an open cavity of the support body 5 and engages, in a thread-capable manner, with corresponding internal threads of the support body 5. The support assembly 110 thus forms part of a prismatic hinge (by means of the set of threaded rods 25 and the support body 5) . In some embodiments, the support body 5 of the support assembly 110 can be threadably engaged with the set of threaded rods 25 by means of at least one screwdriver 8, as shown in FIGS. 6, 7, 10 and 11. The at least one key 8 can include or form an internal thread that corresponds to the external thread of the set of threaded rods 25. The support assembly 110 can be configured so that the at least one key 8 (such as two opposing keys 8, 8) is capable of being manually moved inwards and radially (e.g. relative to the X-X axis) to engage and disengage the set of threaded rods 25.

[123] As shown in FIG. 11, actuation of at least one screwdriver 8 can be achieved by means of rotation (eg manual rotation, potentially around the X - X axis) of an outer bearing 6. The at least one screwdriver 8 can be provided within at least one corresponding opening in the support body 5, and the outer bearing 6 can be provided around at least one threaded key 8, the support body 5 and the set of threaded rods 25 by means of an eccentric hole. The eccentric hole may include a shoulder surface so that when the bearing 6 is rotated (e.g. around the X - X axis) the shoulder surface allows the at least one threaded key 8 to move out of the engagement with the set of threaded bars 25 by means of a corresponding resilience member 10 or which forces the at least one threaded wrench 8 into engagement with the assembly of threaded bars 25 (i.e., the first support screw 12 and/or the second accessory support screw 13). As also shown in FIG. 11, the support assembly 110 can further include at least one radial pin 2 provided with a corresponding slot and the bearing 6 which, in this way, controls the positioning of the bearing 6 relative to the support body 5. The at least one slot may include at least one axially extending indentation corresponding to the position of at least one pin 2 (and thus the bearing 6 itself) in which the at least one screwdriver 8 is forced into engagement with the assembly of threaded rods 25 through the bearing 6 and/or the position of the at least one pin 2 (and thus the bearing 6 itself) on which the at least one screwdriver 8 is forced out of engagement with the set of threaded rods 25 by means of the at least one spring 8. As shown in FIG. 11, the support assembly 110 may include a resilient member 9 configured to axially bias the bearing 6 such that the at least one pin 2 is biased within the at least one axially extending indentation in the at least one slot.

[124] The rotation of the set of threaded bars 25 with respect to the support body 5, or rotation of the support body 5 with respect to the set of threaded bars 25, while the at least one threaded wrench 8 in engagement with the set of bars threaded bars 25 results, in this way, in a forced translation of the support body 5 in relation to the set of threaded bars 25 (or vice versa), therefore, increasing or decreasing the support set 110. While the at least one threaded wrench 8 is disengaged from the set of threaded bars 25, the set of threaded bars 25 is free to move (axially along the X - X axis and rotationally around the X - X axis) inside the support body 5, so that the length of the support assembly 110 can be freely and quickly adjusted.

[125] While the at least one threaded key 8 and external bearing 6 of the support body 5 allows selective adjustment of the length of the supports 110 (that is, the axial length X - X between the joint of the set of threaded bars 25 and the articulation of the support body 5, and thus the distance and orientation between the first and second platforms 120, 130), the system 100 can further provide for adjusting the length (for example, along the X - X axis) of the assemblies of threaded rods 25 (and/or the support bodies 5) and thus the total adjustment range of the system 100. In some embodiments, the system 100 can provide adjustment of the total potential length of the supports 110 (and/or or the support bodies 5) without disengaging / disconnecting the supports 110 from the platforms 120, 130, or otherwise interfering with the operation of the supports 110 in situ.

[126] As shown in FIGS. 12 and 13, in some embodiments, the system 100 can provide for selectively raising sets of threaded bars 25 without disengaging/disconnecting the supports 110 from the platforms 120, 130 or otherwise interfering with the operation of the supports 110 in situ. For example, the first support bolt 12 of the sets of threaded rods 25 shown in FIGS. 1 - 11, which have been augmented by the second accessory support screw or bar 13, as shown in FIG. 11. The threaded bar assemblies 25 can be augmented through the use of at least one accessory threaded bar 13 that includes external threads substantially the same as the external threads of the pre-existing component(s) of the threaded bar assemblies 25 (the first support screw 12), and may be otherwise substantially similar to pre-existing threaded rod assemblies component(s) 25. For example, the at least one accessory threaded rod 13 may include the same thread pitch as the external threads of the first support bolt 12 of the threaded bar assemblies 25. The at least one accessory threaded bar 13 (and/or the pre-existing component of the threaded bar assemblies 25 forming a free end thereof - such as the first support bolt 12) may include an end configuration that ensures synchronization of the respective thread pitches so that the pitch of the composite remains continuous along the joint bars.

[127] The sets of threaded rods 25 can be augmented by means of the accessory threaded rod 13 through various methodologies. In one example (not shown), the threaded bars of the threaded bar assemblies 25 may include a threaded cap concentrically disposed and positioned within a central channel of the accessory threaded bar 13. The accessory threaded bar 13 may be configured so that the cap thread extends out from the end of the accessory threaded bar 13, however the head of the threaded cap is held or captured within the cavity. The existing first threaded bar 12 may include a concentric tapped hole for threadably engaging the exposed portion of the threaded cap. To accept an additional accessory threaded bar 13 to further augment the threaded bar assemblies 25, the pre-installed accessory threaded bar 13 can be configured to accept a threaded insert beside the threaded cap captured within the cavity. The threaded insert may include the concentric tapped hole to accept the threaded cap from the following accessory threaded bar 13. In a certain manner, any number of accessory threaded rods 13 can be added to the set of threaded rods 25 in situ.

[128] As another example (not shown), a threaded turnbuckle can be used as a connection element between the threaded bar in situ or pre-installed (for example, the first threaded bar 12 of an accessory threaded bar 13 previously installed) and a accessory threaded rod 13. The threaded turnbuckle is configured to engage, in a thread capable manner, with the internal threads of center channels of the preinstalled threaded rod, such as the first threaded rod 12, and the accessory threaded rod 13. include a first portion with external right-hand threads and a second portion with external left-hand threads. The tensioner may further include a plug or other suitable driving device incorporated into one end configured to provide a means of transmitting torque to the tensioner. In such an embodiment, the internal threads of the in-situ or pre-installed threaded bar may include a thread pitch whose direction was the same as that at the opposite end of the tensioner driving feature, with the accessory threaded bar 13 having the same thread direction as the turnbuckle end featuring driving feature. A drive element can be inserted into the center channel on the accessory threaded bar 13 and engaged with the turnbuckle drive feature. The accessory threaded bar 13, while on the axis of the driving element and the tensioner driving feature engaged with the driving element, can be positioned coaxial with the in situ or pre-installed threaded bar and the tensioner tightened to thread inside both bars. threaded in situ or pre-installed and the accessory threaded bar 13 at the same time. Thread synchronization of the external threads of the in-situ or pre-installed threaded bar and the accessory threaded bar 13 can be achieved by the interdigitating feature at the ends and cross the in-situ or pre-installed threaded bar and the accessory threaded bar 13.

[129] As another example, the system 100 may include a tensioner connecting element 22 that provides or enables some means of the pre-assembly, so that the accessory threaded bar 13 and the connecting element 22 need not be separately handled during installation. installation, as shown in FIGS. 11 and 12. Similar to the tensioner described above, the connecting element 22 can be configured to engage, in a thread-capable manner, with the internal threads 58 of the center channels of the pre-installed threaded bar, such as the first threaded bar 12, and the accessory threaded bar 13. The connecting element 22 may include a first portion 60 with external threads of a first pitch and a second portion 61 with external threads of a second pitch that is different from the first pitch. For example, the first pitch can be a fine thread and the second pitch can be a coarse thread (or vice versa). While the pitch of external threads of the first and second portions 60, 61 can be different, the direction of the threads can be the same. As such, the internal threads 58 of the pre-installed threaded rod 12 may include the first pitch or the second pitch (and the corresponding thread direction) at at least a first end thereof, and the internal threads 58 of the accessory threaded rod 13 may include the other of the first pitch or the second pitch (and the corresponding thread direction) to at least a first end thereof.

[130] The internal threads of the second end of the accessory threaded bar 13 opposite the first end thereof may include the same thread pitch as the first end of the other first pass or the second pass. The second end of the accessory threaded bar 13 can thus allow an additional accessory threaded bar 13 to be installed to further extend the threaded bar assemblies 25 and thereby further increase the range of the threaded bar assemblies 25 in situ.

[131] In some embodiments, the internal threads 58 of the preinstalled threaded bar 12 may include a coarse thread pitch, and the internal threads 58 of the accessory threaded rod 13 may include a fine thread pitch (or vice versa). In such embodiments, if the connecting element 22 is tightened in a first rotational direction and engaged, threadably mating, to the internal threads 58 of the pre-installed threaded bar 12 and the accessory threaded bar 13, the connecting element 22 would advance out of the accessory bar 13 at a given rate as it is rotated, while advancing into the pre-installed threaded bar 12 at a relatively faster rate - thereby differentially bringing the threaded accessory bar 13 into contact with the pre-installed threaded bar 12. The connecting element 22 may include a plug or other suitable driving feature 62 incorporated in one end configured to provide such transmission of torque to the connecting element 22 (through the channel of the pre-installed threaded bar 12, for example).

[132] In this sense, the connection element 22 can be used to couple the accessory threaded bar 13 to the pre-installed threaded bar 12 without disconnecting or otherwise interfering with the pre-installed threaded bar 12 (that is, it can be installed in situ). In some embodiments, the connecting member 22 may be threaded to fit with the accessory threaded bar 13, and the accessory threaded bar 13 may include finer internal thread pitches than the pre-installed threaded bar 12 (or vice versa). As shown in FIG. 12, the connecting element 22 can include an unthreaded region 63 between the first and second portions 60, 61. The unthreaded region 63 can allow a thinner threaded portion pitch 60 or 61 of the connecting element 22 to be initially , partially over-threaded whenever accessory threaded bar 13 and pre-installed threaded bar 12 include the finest internal thread pitches.

[133] For example, FIGS. 13 - 17 being used to join and couple the first preinstalled threaded rod 12 and the second accessory threaded rod 13. As noted above, although two threaded rods from an external bone fixation system are being used to illustrate examples of element use connecting element 22, the connecting element 22 can be used to unite (or distance) and couple any two members or portions (even if they are part of an external bone fixation system or part of another orthopedic or non-orthopedic mechanism or system) . Furthermore, although the connecting element 22 is shown and described as having external threads 60, 61 and the first and second bar 12, 13 as having combined internal threads, the connecting element 22 can have internal threads and the members can have internal threads. external.

[134] As shown in FIGS. 13 and 14, initially the second bar or member 13 and the connecting element 22 may be engaged, in a thread-capable manner, by means of relatively fine thread pitches and rotated or tightened together (e.g., by means of a tool ) to threadably engage the first bar or member 12 by means of relatively coarse thread pitches. In such an embodiment, the unthreaded portion 63 of the connecting element 22 may extend between the first and second bars or members 12, 13. As shown in FIG. 14, the second bar or member 13 and the connecting member 22 can be rotated together as a unit until the first and second bar or member 12 meet at a given relative rotation between the first and second bar or member 12, 13 is avoided. As shown in FIGS. 15 and 16, the connecting element 22 can be further rotated therefrom, so that the connecting element 22 passes axially through the first and second bars or members 12, 13. However, due to the finer pitch of the threaded connection between the connecting element 22 and the second bar or member 13 with respect to the threaded connection between the connecting element 22 and the first bar or member 12, the connecting element 22 can traverse, slowly or over a longer distance shorter, as it is rotated through the second bar or member 13, than the first bar or member 12, as shown in FIGS. 16 and 17. In this sense, the connecting element 22 can receive the first and second bars or members 12, 13 together, so that an arrangement in which the external threads of the first and second bars or members 12, 13 are aligned or are continuous. It is noted that the combination of the relatively fine thread pitches and the relatively fine thread pitches of the connecting element 22 and the second bar member 12 and the first bar or member 12, respectively, provide an extremely high accuracy or axial fit between the first and second bars or members 12, 13 which may not be able to be reached by means of a single thread pitch due to physical constraints (i.e. one thread pitch equals the difference in thread pitch between the fine and thick may not realistically be physically achievable).

[135] The connecting element 22 may be supplied or otherwise pre-installed with the accessory threaded bar 13 by first being coupled to the pre-installed threaded bar 12. To make the most efficient use of the threads engaged in the connecting element 22 within of the accessory threaded bar 13, the accessory threaded bar 13 and/or the connecting element 22 can be configured such that the accessory threaded bar 13 and the connecting element 22 are rotated together as the connecting element 22 is threaded into the bar pre-installed threaded 12.

[136] As shown in FIG. 18, at least the free end of the pre-installed threaded bar 12 and the ends of the accessory threaded bar 13 may include a keying element 53 which ensures correct synchronization between the external threads of the pre-installed threaded bar 12 and the ends of the accessory threaded bar 13. In use, the first portion 60 of the connecting element 22 can be pre-installed within the channel of the accessory threaded bar 13, and the second portion 61 of the connecting element 22 can thus extend from the accessory threaded bar 13. The accessory threaded bar 13 and the connecting element 22 can be tightened (e.g., rotated together as a unit) so that the second portion 61 of the connecting element 22 threadably engages the internal threads from the cavity 28 of the pre-installed threaded bar 12, and thus pass axially into the pre-installed threaded bar 12 and receive the accessory threaded bar 13 and the pre-installed threaded bar 12 together. The keying element 53 of the accessory threaded bar 13 and the pre-installed threaded bar 12 can be configured so that, when their faces are matched within an optimal distance of each other, the mating faces of the keying elements 53 come into contact. contact with each other and prevent relative rotation between the accessory threaded bar 13 and the pre-installed threaded bar 12, as shown in FIG. 18.

[137] As also shown in FIG. 18, in such an embodiment, the keying elements 53 of the accessory threaded bar 13 and the preinstalled threaded bar 12 may include recesses 54 corresponding to the combined faces that allow relative axial translation between the accessory threaded bar 13 and the preinstalled threaded bar 12. In such a state, the driving feature 62 of the connecting element 22 can be fitted through the channel of the accessory threaded bar 13 and rotated so that the connecting element 22 translates, in a threadable manner, through cavities of the accessory threaded bar 13 and the pre-installed threaded bar 12 in different ranges to thereby axially translate the accessory threaded bar 13 and the pre-installed threaded bar 12 towards each other. Connector 22 can be tightened until matching end faces 56 of accessory threaded bar 13 and preinstalled threaded bar 12 come into contact with each other, as shown in FIG. 18. The accessory threaded bar 13 and the pre-installed threaded bar 12 can be configured so that when the combined end faces 56 of the keying elements 53 of the accessory threaded bar 13 and the pre-installed threaded bar 12 are engaged, the bar accessory thread 13 and the pre-installed threaded bar 12 are securely or rigidly coupled and the pitch of the external threads thereof is suitably locked, as shown in FIG. 18.

[138] The free end of the pre-installed threaded bar 12 or the free end of the accessory threaded bar 13, if fitted, may include a guide bushing 14 configured to intersect with the keying elements 53, the matched end faces 56 and/or recesses thereof, as shown in FIGS. 12 - 17. The guide bushing 14 can act to provide a relatively smooth surface for contact with the interior of the cavity of the support body 5 and, in this way, protect the external threads thereof. As also shown in FIG. 12, a threaded cap 3 can be used to ensure that the guide bushing 14 is installed on the pre-installed threaded bar 12 or on the free end of the accessory threaded bar 13.

[139] Although the connecting elements 22 are described and used above in relation to a first preinstalled threaded bar 12 and a second accessory threaded bar 13 of a support assembly, it is specifically and particularly contemplated herein that the connecting elements 22 are used with any other first and second members. In some embodiments, the first and second members coupled and joined by means of a connecting element 22 may not be associated with the support assembly, not a bone or tissue fixation system 6 DOF. Differently indicated, the first and second members coupled and joined via a connecting element 22 can be any first and second members configured to couple via the connecting element 22. For example, the connecting element 22, with the first and second thread portions of different pitch separated by an unthreaded portion, may be internally threaded or externally threaded for mating with first and second correspondingly threaded members. It is also noted that the double-threaded nature of the connecting element 22, the different pitches, provide a relatively high level of accuracy of axial movement between the first and second members (e.g., by means of the combination of thread pitches), produce a improved mechanical advantage over other mechanisms for fitting and joining the first and second members, produce a relatively high amount of torque, the first and second members remain closely coupled, and the construction remains substantially unaffected by vibration.

[140] As shown in FIGS. 3 - 7 and 19, the pre-installed threaded rod 12 of the threaded rod assemblies 25 of the supports 110 can include a transverse pin 18 adjacent to the support body 5 which can be manually engaged and used to apply a torque to the threaded rod assemblies 25 In this sense, considering that the support body 5 is engaged, in a threadable way, with the external threads of the sets of threaded rods 25, the transverse pin 18 can be used in situ to adjust the length of the supports 110 and, thereby, the distance and orientation between the first and second platforms 120, 130 (and, thereby, the bone or tissue segments coupled to the first and second platforms 120, 130).

[141] As noted above, support bodies 5 of support assemblies 110 may include a pivot to first or second platforms 120, 130 to provide rotation of support bodies 5. As shown in FIGS. 14 - 18, the support bodies 5 may include a spherical projection 15 formed or coupled to an end or end portion thereof. As shown in FIG. 19, the spherical projection 15 may include one or more slots 26. The hinges of the support bodies 5 of the support assemblies 110 may include a first barrier hinge 7 that includes a spherical internal cavity that is configured to accept and intersect the projection. sphere 15 of the support bodies 5, as shown in FIG. 19. Barrier hinge 7 may include one or more slots 28 extending therethrough. The hinges of the support bodies 5 may further include at least one pin 24 that is configured to extend through a corresponding slot 28 of the barrier hinge 7 and a corresponding slot 26 of the spherical projection 15. In this sense, the at least a pin 24 can limit the rotation of the spherical projection 15 of the support body 5 inside the barrier joint 7 around axis X3 - X3, as shown in FIG. 19 - thus forming a cardan joint.

[142] As shown in FIGS. 14-18, the barrier hinge 7 may also be configured to be removable and rotatably matched or engaged with the first and second platforms 120, 130. As shown in FIGS. 15-18, the first and second platforms 120, 130 may include beams 50 extending therefrom that define free ends. The beams 50 may be arranged in closely spaced pairs provided around the circumference of the first and second platforms 120, 130. In some embodiments, the beams 50 may extend radially, such as perpendicular to the axis X2 - X2 and/or along from a plane defined by respective platform 120, 130. As shown in FIG. 15, the beams 50 may be substantially cylindrical but include a flattened portion 52. The flattened portion 52 may be a flat chord joining two portions of the cylindrical outer surface of the beams 50. Each of the beams 50 may further include a recess or groove 52 extending at least substantially circumferentially around the outer surface between the free ends thereof and the respective first or second platform 120, 130. The circumferential groove 52 can thereby form an upper portion of the beams 50 with a substantially cylindrical outer surface and the flattened portion 52.

[143] As shown in FIGS. 16-18, the barrier hinge 7 may include an opening or cavity shaped and sized to receive a first or second platform beam 50 therein. As also shown in FIGS. 16 - 18, the barrier hinge 7 may include a guide pin or other element 1 that crosses a portion of the aperture or cavity of the barrier hinge 7. The barrier hinge opening or cavity 7 and the guide pin 1 may form the same shape and configuration as the beams 50, such as the cylindrical outer surface and flattened portion 52 of the beams 50 described above.

[144] In this regard, a support 110 can be oriented so that the barrier hinge 7 and pin 1 can be aligned with and slid over the cylindrical outer surface and flattened portion 52 of the beam 50, respectively, as shown in FIGS. 16 and 17. As shown in FIG. 17, pin 1 can be aligned with slot 52 of beam 50, and then support 110 can be rotated so that pin 1 is no longer aligned with flattened portion 52, and is then trapped in slot 52 along the side of the upper portion of the beam 50. The rotation of the support 110 can be such that the articulation of the sets of threaded rods 25 is aligned with, or at least positioned next to, a beam 50 corresponding to another of the first and second platforms 120, 130 The hinge thus allows for at least a few degrees of relative rotation between the support 110 and the respective platforms 120, 130. In this sense, the hinge provides two mutually perpendicular revolving axes of rotation between the support 110 and the respective platform 120, 130.

[145] In this sense, the articulations of the support bodies 5 can be a revolute articulation made of elements native to the platforms 120, 130 and others native to the support assembly 110. The articulation still does not provide a complete 360 degree rotation, however, the flattened portion 52 of the beams 50 may be oriented such that the relative range of rotation between the beam 50 and the support 110 is provided, such as the amount or range of relative rotation required or covered during the normal course of action of the system 100 The linkage, therefore, utilizes super rotation of the support assemblies 110 beyond the normal or expected operable range for mounting the links. Since the support assemblies 110 must be fitted at both ends, one end to the first platform 120 and the other end to the second platform 130, this hinge configuration is sufficient for the first connection to one of the first or second platforms 120, since the remaining support assembly 100 is free to rotate out of the operable range during the fitting process.

[146] As shown in FIG. 19, as the beams 50 are substantially identical to one another, the articulation of the threaded bar assemblies 25 can mimic the "out of operable rotational range" element of the support body articulation 5 (or be an operationally equivalent articulation). The preinstalled threaded rod end portion 12 of the threaded rod assemblies 25 may include or form a support bolt 12 with a ball joint 11 attached thereto. The end portion of the support bolt 12 can be threaded, and a detent ring 16 and wave spring 23 can be secured between the end cap 17 threaded on the external threads and the ball joint 11. The end cap 17 and the end cap 17 detent 16 can be rotationally coupled or fixed to each other. The ball joint 11 can include a series of detents adjacent the detent ring 16 and the wave spring 23 can bias the detents of the detent ring 16. The ball joint 11 can further include at least one slot for accepting the at least a pin 24 through it. The at least one pin 24 can rotationally secure the ball joint 11 with a screw joint cavity 15, as shown in FIG. 19. As further explained below, the screw joint 15 can be coupled to a beam 50 of one of the first and second platforms 120, 130. As such, rotation of the set of threaded bars 25 (e.g., by means of the cross pin 18) can thereby rotate the detent ring 16 relative to the screw joint 15 to provide a visual and/or tactical indication of the movement and/or rotational position of the threaded bar assemblies 25.

[147] The screw joint 15 of the joints of the threaded bar assemblies 25 of the support assemblies 110 may include a spherical internal cavity that is configured to accept and intersect with the ball joint 11 of the threaded bar assemblies 25, as shown in FIG. . 19. As noted above, the at least one pin 24 can extend into the screw joint 15 and the screw joint 15, which can limit rotation of the ball joint 11 of the threaded bar assemblies 25 within the screw joint 15 around an axis X4 - X4, as shown in FIG. 19 -thus forming a cardan joint.

[148] As also shown in FIG. 19, the screw pivot 15 of the threaded bar assemblies pivots 25 of the support assemblies 110 may include an opening or cavity shaped and sized to receive a beam 50 of the first or second platform 120, 130 therein. As also shown in FIG. 19, the screw joint 15 may include a pin or other element 19. The pin 19 may be provided within a slot or slot that allows the pin 19 to move between a position such that the pin 19 extends through a portion of the opening or cavity of the screw joint 15 and a position so that the pin 19 does not extend through the opening portion or cavity of the screw joint 15.

[149] The hinges of the threaded bar assemblies 25 of the support assemblies 110 further include a knob 20, a push pin 21 and a ball 4, as shown in FIG. 19. The knob 20 may include an internal surface that forms a cam effective to translate the thrust pin 21 into and through the screw joint 15 and into the pin 19. In this regard, a support 110 that is connected to one of the first and second platforms 120, 130 through the pivot of the support body 5 can be oriented so that the screw pivot 15 of the pivot of the threaded bar assembly 25 is aligned with and slides over the cylindrical outer surface and flattened portion 52 of the beam 50 Pin 19 can be aligned with slot 52 in beam 50 and then knob 20 can be rotated so that cam of knob 20 pushes thrust pin 21 into pin 19 so that pin 19 is engaged. extend through a portion of the opening or cavity of the screw joint 15 and into the slot 52 on the side of the upper portion of the beam 50. The ball 4 can be positioned adjacent to the thrust pin 21 and still prevent rotation of the knob 20 from said “locked” position. In this sense, the joints of the sets of threaded bars 25 can be revolved joints made from elements native to the platforms 120, 130 and others native to the support assembly 110.

[150] FIGS. 20 - 59 are illustrative of other bone or tissue fixation systems 6 DOF and related fixation methods 200 that include desired stability and mobility characteristics of a hexapod system without support choices - time consuming length and difficulty of assembly. The bone or tissue fixation systems DOF 6 and related fixation methods 200 of FIGS. 20 - 59 are similar to the bone or tissue fixation systems DOF 6 and related fixation methods 100 of FIGS. 1 - 19, and as such, similar reference numbers preceded by “2” are used to indicate similar features or functions, and the above description directed to features or functions thereof (and alternative embodiments thereof) applies equally to systems and methods 200. As shown in FIGS. 20 44B, system 200 differs from system 100 in that individual support assemblies 210 (six support assemblies 210) are coupled together as a single unit 315 both before (see FIGS. 20 - 31) and after engagement in the first and second platforms 220, 230 (see FIGS. 32 - 448). As further explained below, the ends of the support assemblies 210 include movable hinges or couplings that allow some relative movement between the pairs of support assemblies 210, but prevent the support assemblies 210 from becoming disconnected from one another. In this regard, the six support assemblies 210 form a single construction, unit or "out of the box" structure 215 as shown in FIGS. 20 - 449) The single construction 215 of the six individual but movably coupled support assemblies 210, as shown in FIGS. 20 - 31, allow for quick and easy manipulation and attachment to the first and second platforms 220, 230 as shown in FIGS. 32 - 44B. For example, instead of sourcing, assembling and/or fitting the six support assemblies 201 individually and then attaching them individually to each other and then to the first and second platforms 220, 230, the single construction 215 of the six assemblies movably coupled bracket 210 can be obtained and fitted as a single unit, as shown in FIGS. 20 - 31, and quickly and easily coupled to the first and second platforms 220, 230 as shown in FIGS. 32 - 44B.

[151] As shown in FIGS. 45-48, 50, 58 and 59, the single construction 215 of the six support assemblies 210 may be formed by movable hinges or coupling mechanisms that couple opposite ends of adjacent support assemblies 210. Such movable joints can be any joint that permits movement relative to the first or second platforms 220, 230 to which it is fitted and relative movement of adjacent joined support assemblies 210 to allow or provide movement and/or angulation between the first or second platforms 220, 230, as shown in FIGS. 41 - 44B. Examples of movable hinges shown in FIGS. 45 - 48, 50, 58 and 59 include a base pivot 201 rigidly attached to the support rail 205 by means of a pivot pivot column 204. The pivot pivot column 204 can be accommodated within a corresponding slot in the base pivot 201 and extends into an indentation in the strut 205. In this regard, the pivot pivot 204 can be rotationally coupled to the base pivot 201 about an axis that extends perpendicular to the strut 205. As also shown in the FIGS. 45 - 48, 50, 58 and 59, the first support bolt or primary support bolt 212 is pivotally coupled to a pivot yoke 230A via a spring pin 213. The first support bolt 212, pivot yoke 230A and spring 213 are configured so that the first support bolt 212 and pivot yoke 230A are pivotally engaged about an axis (the spring pin 213) that extends perpendicular to bolt 212.

[152] As shown in FIGS. 45 - 48, 50, 58 and 59, the pivot yoke 230A and the pivot pivot 204 can be rotationally coupled to each other via a pan head screw 202 that extends through slots in the edges of the pivot pivot 204 that are substantially aligned and spaced along the long axis of the strut 205. The pivot yoke 230A may be positioned between the edges of the pivot pivot 204 so that it is secured therebetween along the long axis of the strut 205, and the pan head screw 202 can still pass through a slot in the pivot yoke 230A. In this regard, the cylindrical head screw 202 can extend through one of the edges of the pivot pivot 204, then the pivot yoke 230A, and then finally through the barrier of the pivot pivot 204. The pivot pivot 204 and the pivot yoke 230A can thus be rotationally coupled to each other about an axis defined by the socket head screw 202. The socket screw 202 can be prevented from slipping out of the slots in the edges of the pivot pivot 204 and the slot of the pivot yoke 230A by a pin (not shown) that extends through the pivot yoke 230A and intersects at least a portion of the socket head screw 202 within a groove or the like of the socket head screw 202.

[153] As shown in FIGS. 45-49, for example, the ends attached or movably coupled to adjacent support pairs or assemblies 210 (as discussed above) can be quickly and easily attached or coupled to the first and second platforms 220, 230. only 215 of the six support assemblies can be quickly and easily attached or attached to the first and second platforms 220, 230. Referring to FIGS. 45 - 49, for example, the socket head screw 202 may include a threaded portion 275 that extends beyond the far edge of the pivot pivot 204. In this regard, in an unsecured state, the threaded portion 275 of the socket head screw 202 can form free ends. The threaded portion 275 of the pan head screws 202 may thus be aligned with a slot or attachment point 270 matched in the first or second platforms 220, 230 and screwed thereto to engage the movable pivot between pairs of support assemblies 210 of the first or second platforms 220, 230, as shown in FIGS. 47 and 48, for example.

[154] As shown in FIGS. 51 - 59, for example, the length adjustment mechanism of support assemblies 210 differs from the length adjustment mechanism of support assemblies 110. Referring to FIGS. 51-59, a washer 208 can be positioned within the base of the cavity or enclosure of the support barrier 205. As shown in FIGS. 51, 53, 56, 58 and 59, a nut 206 can still be positioned within the cavity or housing of the support barrier 205 and over the washer 208. The nut 206 can be sized smaller than the cavity of the support barrier 205 so that that nut 206 is capable of movement radially with respect to the long axis of support assembly 210 or support barrier 205 (e.g., concentric or eccentric with the cavity and/or long axis). As shown in FIGS. 51, 53 and 56A - 57B, the nut 206 may include an eccentric hole 288 and an internal concentric threaded portion 287 (or vice versa).

[155] With reference to FIGS. 51, 53, 58 and 59, for example, the nut 206 may include radially or laterally extending grooves 280b formed in an upper or upper surface thereof. Nut 206 may further include a first hole or bushing slot 283 that partially extends through nut 206 along the long axis of support assembly 210 or support rail 205. Nut 206 may further include a second hole or bushing slot 284 extending at least partially through nut 206 along the long axis of support assembly 210 or support fence 205. A spring 218c and bushing or pin 217 may be positioned within the second bushing slot 284 of so that the bushing 217 is angled out of the second slot of the bushing 284 and above an upper surface of the nut 206. However, the spring 218c can include enough traverse so that the bushing 217 can still be forced into the second slot bushing 284 when compared to its natural or neutral position.

[156] With further reference to FIGS. 51, 53, 58 and 59, for example, an adjustment knob 207 may be positioned partially within the cavity or housing of the support barrier 205 over the nut 206. The adjustment knob 207 may be rotationally coupled to the support barrier 205 by means of a plurality of pins 216 extending radially through the support rail 205 and into a concentric groove within the portion of the adjustment knob 207 positioned within the support rail 205. In a certain manner, for example, the adjustment knob adjustment 207 may be manually rotatable about the long axis of support assembly 210 or support barrier 205. To control and/or provide an indication of the orientation of the relative angular position of adjustment knob 207 relative to support barrier 205, a The plurality of balls 215 can be biased by springs 218a extending into corresponding slots 281 within the support barrier 205. The balls 215 can be biased by springs 218a into corresponding slots or indentations 286 formed in the lower surface of the adjustment knob 207 (see FIG. 52).

[157] As shown in FIG. 52, a lower surface of the adjustment knob 207 may further include radially or laterally extending grooves 280b that correspond to radially or laterally extending grooves 280b in an upper surface of the nut 206. As shown in FIGS. 51, 52 and 59, compression springs 218b may be positioned between and partially within corresponding radially or laterally extending grooves 280b, 280b of nut 206 and adjustment knob 207. Compression springs 218b and extending grooves radially or laterally 280b, 280b of nut 206 and adjustment knob 207 can be configured so that nut 206 is naturally or neutrally inclined eccentric to the long axis of support assembly 210 or support barrier 205 within the cavity of the support barrier 205. The nut 206 may be naturally or neutrally angled so that the eccentric hole 288 of the nut is aligned (i.e., concentric) with the long axis of the support assembly 210 or support rail 205 and the first or second support bolt 212 , 213 extending through nut 206, as shown in FIGS. 56B and 57B. In this regard, the concentric threaded portion 287 of the nut 206 may be naturally angled outward or spaced from the first or second support bolts 212, 213 that extend through the nut 206, as shown in FIGS. 56B and 57B.

[158] To allow lateral or radial repositioning of the nut 206 out of its natural position so that the concentric threaded portion 287 of the nut 206 is concentric with and engages with the first or second support bolts 212, 213, as shown in FIGS. . 56A and 57A, bushings 217, 217 can be fitted into lateral or radial slots 285 on the underside of adjustment knob 207 as shown in FIGS. 52 and 56A - 57B. When the threaded portion 287 of the nut 206 is concentric with and engages with the first or second support bolt 212, 213 as shown in FIGS. 56A and 57A, rotation of adjustment knob 207 can rotate nut 206 such that the threaded portion 287 of nut 206 rotates with respect to first or second support bolts 212, 213 to translate support rail 205 (and components of the length adjustment mechanism) with respect thereto and lengthening or shortening the support assembly 210.

[159] As shown in FIGS. 54 and 56A-57B, the radial groove 285 of the adjusting knob 207 corresponding to the bushing 217 that is axially biased by the spring 218c may include a slot or indentation 292 that accepts the corresponding bushing 217 therefrom. The mechanisms can be configured so that when the threaded portion 287 of the nut 206 is concentric with and engages with the first or second support bolt 212, 213, the slot or indentation 292 and the corresponding bushing 217 are aligned and the spring 218c naturally tilts or positions the corresponding bushing 217 within the slot or indentation 292. As shown in FIGS. 54, 55 and 56A - 57B, the adjustment knob 207 may include an access slot that allows access to the slot or indentation 292 and thereby the corresponding bushing 217 for manually removing the corresponding bushing 217 from the slot or indentation 292 and thereby allowing the nut 206 to be naturally biased by the compression springs 218b eccentric with the first or second support bolt 212, 213 with the concentric threaded portion 288 spaced from the first or second support bolt 212, 213 (i.e., undocked).

[160] The length adjustment mechanism can initially be provided in the natural state of the nut 206 so that it is biased by the compression springs 218b eccentric with the first or second support bolt 212, 213 so that the concentric threaded portion 288 is spaced apart from the first or second support bolt 212, 213 (i.e., disengaged) (and the eccentric hole 287 is concentric with the first or second support bolt 212, 213), as shown in FIGS. 56B and 57B. Support rail 205 may include an access slot 299 extending radially therethrough to the outer surface of nut 206, as shown in FIGS. 55 - 57B and 59. The access slot 299 can therefore allow a member (not shown) to be inserted through the access slot 299 and radially or laterally translate or move the nut 206 into the cavity of the support barrier 205 and with respect to adjustment knob 207. It is noted that the radial or lateral grooves 285 on the underside of adjustment knob 207 will allow nut 206 and bushings 217 to translate or move radially or laterally relative to adjustment knob 207. Nut 206 may be translated radially or laterally (through access slot 299) until bushing 217 which is biased by spring 218c is aligned with slot or indentation 292 in corresponding groove 285 of adjustment knob 207, and then inclined on it, as shown in FIG. 56A and 56B. In this regard, the eccentric threaded portion 288 of the nut 206 can be translated laterally or radially out of the socket with the first or second support bolt 212, 213 (as shown in FIGS. 56B and 57B) and into the socket with the first or second support bolt 212, 213 (as shown in FIGS. 56A and 57A) and releasably secured in such an arrangement. Rotation of adjustment knob 207 can thus rotate nut 206 so that threaded portion 287 of nut 206 rotates relative to first or second support bolts 212, 213 to translate support barrier 205 (and components of the length adjustment mechanism) with respect thereto to lengthen or shorten the support assembly 210.

[161] FIGS. 60 - 87 are illustrative of other bone or tissue fixation systems 6 DOF and related fixation methods 300 which include the desired stability and mobility characteristics of a hexapod system without support choices - time consuming length and difficulty of assembly. The bone or tissue fixation systems 6 DOF and related fixation methods 300 of FIGS. 20 - 59 are similar to the bone or tissue fixation systems DOF 6 and related fixation methods 100 of FIGS. 1 - 19 and the bone or tissue fixation systems DOF 6 and related fixation methods 200 of FIGS. 20 — 59, and accordingly, similar reference numbers preceded by “3” are used to indicate similar features or functions, and the above description directed to features or functions thereof (and alternative embodiments thereof) applies equally to systems and 300 methods.

[162] As shown in FIGS. 60 - 68, system 300 differs from system 100 and system 200 in the inclusion of fiducial markers or identifiers 307 as points of reference and/or measurement. Fiducial markers 307 can be configured to assist in identifying and/or manipulating the orientation of each support-platform hinge and the length of each support. For example, a first platform 320 of the system 300 can be coupled to the first bone segment and a second platform 330 of the system 300 can be coupled to a second bone segment, and then the system 300 can be manipulated, i.e. moved such that the first bone segment and a second bone segment are aligned in a desired position. This alignment can be modified over time to complete the deformity correction process. One of the bone segments can be a reference segment. The other segment, the moving segment, can be moved to align with the reference segment. Fiducial markers 307 of system 300 can provide identification (e.g., via clinical assessment and/or imaging) of the position and/or orientation of support assemblies 310 as shown in FIGS. 60 - 68, to facilitate a method or process of configuring a support to achieve a necessary or desired orientation of bone segments. In some embodiments, fiducial markers 307 of system 300 may provide identification of the position and/or orientation of coupling mechanisms that are provided to an end portion of pairs of supports 310 for coupling the supports 310 to a respective platform 320, 330 as shown in FIGS. 60 - 68 and, accordingly, the supports 310, by themselves, through extrapolation, facilitate a method or process of configuring a support to achieve a necessary or desired orientation of bone segments. In this regard, markers 307 can facilitate a method or process of configuring supports 307 of system 300 to achieve a necessary or desired orientation of bone segments, such as a method or process described in U.S. Patent No. 8,419,732, to which is expressly incorporated herein in its entirety. In some embodiments, the method or method may use markers 307 to determine a "current" position and/or orientation of the supports 307 and a "corrected" position and/or orientation of the supports. In some embodiments, the method or process may determine how markers 307 (and thus corresponding supports 310 are to be positioned and/or oriented in situ.

[163] As shown in FIGS. 60 - 71 and 75 - 78, the markers 307 can be spherical knobs or cylindrical head screw heads 302 that couple a socket base 303 that couple a pair of support assemblies 310 adjacent to a respective platform 320, 330. , the markers 307 can be used to tighten the pan head screw 302 to releasably and threadably engage the socket base 303 (and thus the bracket assemblies 310 attached thereto) to a respective platform 320, 330, as further explained below. Markers 307 may be positioned outside system 300, such as beyond an outside edge of respective platform 320, 330. Markers 307 may be configured to visually appear when imaged, such as in X-rays. Markers 307 may include, at least one marker that is visually different from some of the other markers 307. For example, as shown in FIGS. 60 - 71 and 75 - 78, the markers 307 include a single relatively smaller spherical marker at one end of the system 300 at a location or position on the respective platform 320, 330. The single marker 307 can be used as a reference marker 307 for determine the orientation and position of system 300 and support assemblies 310, as per the method described above. Furthermore, such single marker 307 can be used as a reference to effect the positions and/or orientations determined by the aforementioned method.

[164] As shown in FIGS. 60 - 71 and 75 - 78, the markers 307 may be spherical knobs or cylindrical head screw heads 302 that releasably secure a docking base 303 to which an adjacent pair of bracket assemblies 310 are integrally coupled. movable, to a respective platform 320, 330. The markers 307 can thus be positioned on the outside of the construction 315 and clearly visible in profile. Furthermore, the markers 307 are manually engageable to manually screw the pan head screws 302 into their respective platform 320, 330.

[165] The markers 307 may further initially be used to unpack or prepare the system 300 by removing the pan head screws 302 to separate the construction 315 from the end plates 371 and a connecting bar 373 extending therebetween , as shown in FIGS. 60 - 64. Each endplate 371 may be attached to three baseplates 303 at one end of the building 315 with each baseplate 303 attached to a pair of support assemblies 310. As shown in FIGS. 60 - 64, the socket head screw 302 can each engage, in a thread capable manner, through the respective slot or groove in an end plate 371 and into a respective base plate 303 to secure the end plate 371 between a collar or flange 377 and/or the marker 307 of the pan head screws 302 and the respective base plate 303. The connecting bar 373 may be threadably attached to, and extends between, the baseplates 371. Endplate 371 and connecting bar 373 can thereby secure baseplate 303 and support assemblies 310 together to prevent support assemblies 310 from extending and retract.

[166] As shown in FIGS. 66-81, opposite ends of the pair of adjacent support assemblies 310 can be movably coupled to substantially opposite side faces of the corresponding baseplate 303. Each support assembly 310 is rotatably coupled to one side of the corresponding baseplate 303 such that support assembly 310 is rotatable about at least two axes, as shown in FIGS. 66 - 81. The baseplate 303 may be triangular in shape, with curved outer side surfaces. Baseplate 303 may include an outer longitudinal mating surface 391 and an inner longitudinal mating surface 393, as shown in FIGS. 66 - 81. The outer longitudinal engagement surface 391 and/or an inner longitudinal engagement surface 393 may be flat and/or configured to intersect with corresponding beam surfaces 50 projecting radially from the platform 320, 330, as shown in FIGS. 67 - 76. The beams 50 can further be mating outer and inner surfaces to the mating surfaces 391, 393 of the baseplates 303 so that the baseplates 303 can be mated to and abut against either the mating inner or outer surfaces of the beams 50 , as shown in FIGS. 67 - 76 . Furthermore, as shown in FIGS. 67, 68 and 76, baseplates 303 may be positioned between and coupled a pair of platforms 320, 330 so that both the inner and outer mating surfaces 391, 393 of the baseplates 303 engage a portion of the beams 50 corresponding to the pair of platforms 320, 330.

[167] As also shown in FIGS. 66 - 81, the baseplates 303 may further include a projection 395 extending from the inner and/or outer mating surfaces 391, 393. The projection 395 may be positioned on a portion of the mating surface laterally and/or radially outward 391, 393. Projections 395 may be configured to cross within a corresponding slot, slot, recess, or the like in beams 50 of platforms 320, 330, as shown in FIGS. 67 - 76. Slit platforms 320, 330 can be opened at the outer lateral and/or radial end of beams 350 to allow projection 395 to be translated or slid therein. In addition to the slot corresponding to the projections 395 of the baseplates 303, the beams 350 of the platforms 320, 330 may further include the slot or portion extending from (or separate from) the slot configured to allow a cylindrical head 302 for threadably engaging and extending therethrough, as shown in FIGS. 66 - 81. The baseplates 303 may further include the slot configured to threadably engage the pan head screw 302. In this regard, a projection 395 may be positioned within a corresponding slot of the beam 350, a mating surface 391, 393 of the corresponding baseplate 303 may engage or abut a surface of the corresponding beam 350, and pan head screw 302 may engage, threadably, and extend into the beam 350 and baseplate 303 for rigidly and removablely engaging baseplate 303 (and support assemblies 310 coupled therewith) and corresponding platform(s) 320, 330, as shown in FIGS. 67 - 76. In some embodiments, the slot or slot in the beams 350 of the platforms 320, 330 that allow the pan head screws 302 to pass therethrough may include a bevel or countersink that extends along it into the surfaces. internal and/or external fitting 391, 393 to accept a matching collar or edge 377 of the cylindrical head screws 302 thereof, as shown in FIGS. 67 - 76. The reamer and the corresponding collar 377 can assist in the fixed or rigid coupling of the base plates 303 (and the support assemblies 310 coupled thereto) and the platform(s) 320, 330 correspondents.

[168] As shown in FIGS. 82 - 92, system 300 also differs from system 100 and system 200 in the configuration of length adjustment mechanisms of support assemblies 310 which are configured to selectively vary the arrangement of support barrier 305 and first or second threaded bar 312, 313. As shown in FIGS. 82-92, the strut 305 includes an upper portion at the free end thereof that includes external threads 313 and a cavity 309. The head of the strut portions 305 also includes a plurality of slots extending from the external threads 313 for cavity 309. In some embodiments, at least three slots are provided and may be radially extending and equally spaced circumferentially. As also shown in FIGS. 82 - 92, a ball bearing or other member may be formed, inserted or otherwise positioned at least partially within the slots of the upper portion of the support barrier 305. In this regard, the ball bearing or other member may be capable of move at least partially into, or at least partially out of, cavity 309 to varying degrees.

[169] The length adjustment mechanisms of the support assemblies 310 may further include an adjustment nut 306 with a hole that includes a threaded portion 387 and an unthreaded portion 387', as shown in FIGS. 88, 89 and 92. The adjusting nut 306 and a cavity 309 can be configured so that the adjusting nut 306 can be positioned or inserted into the cavity 309 with additional space or a portion of the cavity 309, as shown in FIGS. 92. Indicated differently, cavity 309 may be larger than adjusting nut 306 so that adjusting nut 306 may be able to translate within cavity 309, as shown in FIGS. 92. The length adjustment mechanisms of the support assemblies 310 may further include a release nut 398 that is engaged, in a thread capable manner, with the external threads 313 of the upper portion of the support barrier 305. The release nut 398 may include an internal threaded surface with a groove or recess therein, as shown in FIGS. 89 and 92.

[170] The groove and threaded portion of the inner surface of the release nut 398 can thereby move ball bearings or other members in and out of the cavity 309 of the upper portion of the support barrier 305, as shown in FIG. . 92. In this regard, the release nut 398 can be adjusted to either push the ball bearing or other members at least partially into the cavity 309 by means of the threaded portions as shown in FIG. 92, or into a position such that the internal groove is aligned with the ball bearings or other members to allow ball bearings or other members to move therefrom and at least partially out of the cavity 309. adjuster 306 positioned within cavity 309 can thus be biased by ball bearings or other members into a concentric position with threaded bar 312, 313 extending through support barrier 305, or allow adjuster nut 306 to moves to an eccentric position with the threaded rod 312, 313. In the concentric arrangement of the adjusting nut 306 and the threaded rod 312, 313, the threaded portion 387 of the adjusting nut 306 can be engaged with the threads of the threaded rod 312, 313, and in the eccentric position of the adjusting nut 306, the threaded portion 387 of the adjusting nut 306 can be disengaged with the threads of the threaded rod 312, 313 and the unthreaded portion 387' can be engaged with the threads of the threaded rod 312 , 313. It is noted that, when the release nut 398 is positioned to allow the adjusting nut 306 to move laterally within the cavity 309, the force between the threads of the threaded portion 387 and the threaded rod 312, 313 can act to move release nut 398 into eccentric position. In such a state, the unthreaded portion 387' can engage with the threads of the threaded rod 312, 313 (if any portion of the adjusting nut 306 engages therewith) to allow the threaded rod 312, 313 to translate freely and axially or longitudinally through of the support barrier 305.

[171] As shown in FIGS. 82-92, the length adjustment mechanisms of the support assemblies 310 may further include an adjustment knob 307 with a lower neck region that is configured to be positioned within the cavity 309 above the adjustment nut 306. The neck region bottom of adjustment knob 307 and an upper portion of cavity 309 may include slots, slots or channels to capture a plurality of ball bearings or any other rotationally moving members therebetween, as shown in FIGS. 88 - 92. The adjustment knob 307 may further include a longitudinal thread extending from the slot 391 that extends from the top or upper rim of the upper portion of the strut 305. As shown in FIGS. 88-92, the top or upper rim of the upper portion of the support rail 305 may include circumferentially spaced indentations and a spring plunger 399 or other member engaged, in a threadable manner, within the slot 391 so that the plunger 399 snaps into the indentations when aligned with them. Plunger 399 and indentations can therefore provide a tactile indication of the rotational position of adjustment knob 307 relative to support rail 305.

[172] The lower end or portion of the adjustment knob 307 may further include at least one slot 331 (or projection) that extends at least partially through the cavity 309, as shown in FIG. 90. Similarly, the upper end or portion of adjustment nut 306 may include at least one projection 333 (or slot) extending at least partially through cavity 309 and configured to intersect with slot 331 of adjustment knob 307 , as shown in FIG. 90. The slot 331 of the adjustment knob 307 and the projection 333 of the adjustment nut 306 can thus match so that rotation of the adjustment knob 307 effects rotation of the adjustment nut 306. In this regard, a user can rotating the adjustment knob 307 to rotate the adjusting nut 306 within the cavity 309 of the upper portion of the support barrier 305. As discussed above, the user may also rotate the release nut 398 to adjust its position longitudinally or axially to translate the ball bearings with respect to cavity 309 to force the nut to be concentric with the threaded bar 312, 313 to engage the threaded portion 287 therewith. In such an arrangement, adjustment knob 307 can be rotated to rotate nut 398 and force threaded rod 312, 313 through support barrier 305 to raise or lower support assembly 310, depending on the direction of rotation. Adjustment knob 307 can therefore be used for fine length adjustment of support assembly 310. For coarse adjustment of the length of a support assembly 310, the user may rotate release nut 398 to adjust its position. longitudinally or axially to align the groove with the ball bearings to allow the ball bearing to move out of the cavity 309 and thereby allow the adjusting nut 306 to move eccentrically with the threaded bar 312, 313. noted above, in the eccentric position of the adjusting nut 306, the threaded portion is not in engagement with the threaded rod 312, 313 to allow the threaded rod 312, 313 to freely translate axially or longitudinally through the support rail 305.

[173] FIGS. 82 - 105 are illustrative of bone or tissue fixation systems 6 DOF and related fixation methods 400 which include the desired stability and mobility characteristics of a hexapod system without support choices - time consuming length and difficulty of assembly. External bone or tissue fixation systems and related fixation methods 400 of FIGS. 82 - 105 are similar to the external fixation systems and related fixation methods 100 of FIGS. 1 - 19, the external fixation systems and related fixation methods 200 of FIGS. 20 - 59 and the related external fixation systems and methods of fixation 300 of FIGS. 20 - 59 and, accordingly, similar reference numbers preceded by “4” are used to indicate similar features or functions, and the above description directed to features or functions thereof (and alternative embodiments thereof) applies equally to systems and 400 methods.

[174] As shown in FIGS. 82-105, examples of system 400 differ from system 100, system 200, and system 300 in the coupling or rotatable connection mechanism between support assemblies 410 (e.g., pairs of support assemblies 410 oppositely oriented or facing each other). extend) and platforms or rings 420, 430. As shown in FIGS. 82-85, system 400 utilizes support assemblies 441 that securely and releasably attach or attach to corresponding projections 443 of platforms 420, 430, as shown in FIGS. 84 and 86 - 89. Assemblies 441 may be configured to be coupled to platforms 420, 430 by attachment to projections 443 by means of a threaded post portion 402 that threadably fits within a threaded slot 447 positioned adjacent to projections 443. In some embodiments, only the slots 447 of platforms 420, 430 that are positioned adjacent or immediately adjacent to projections 443 may be threaded (i.e., and other similar slots of platforms 420, 430 may not be threaded ).

[175] Threaded post 402 may extend through threaded slot 447 of platforms 420, 430 such that a portion of post 402 extends out beyond platforms 420, 430 on an opposite side thereof, compared to assembly 441, as shown in FIGS. 84 and 85. In some embodiments, this portion of the extended threaded post 402 can be used to attach other mechanisms to platforms 420, 430. 420, 430 through fiducial markers 407 positioned at, or extending from, one end of the column portion 402. For example, the fiducial markers 407 can be manually engaged by a surgeon or other user and used to rotate the columns threads 402 so that threaded posts 402 threadably engage and fit into threaded slots 447. Similarly, fiducial markers 407 can be used to rotate threaded posts 402 out of threaded slots 447. In some embodiments, the fiducial markers 407 may include a slot or indentation configured to allow a tool to apply a torque to the fiducial markers 407 to effect rotation of the threaded posts 402 relative to the threaded slots 447.

[176] As shown in FIG. 82, assembly 441 may be configured so that fiducial markers 407 are positioned within platforms 420, 430 so that stilts 402 extend through threaded slots 447 from an inner side thereof to an outer side of the even at least generally along the longitudinal axis of the support assemblies 410. In this regard, the fiducial markers 407 may be spaced from the ends of the support assemblies 410 and do not interfere with the extended nature of the threaded rod portion 412, 413 of the support assemblies. support 410 that extend outside the support barriers 405. The outer portions of the platforms 420, 430, particularly adjacent the projections 443, may thus be open and devoid of any structure that might interfere with the threaded rod portion 412 , 413 of support assemblies 410 that extend outside support barriers 405 beyond platforms 420, 430.

[177] As shown in FIGS. 86-89, each of the platforms 420, 430 may include at least three projections 443 (to be coupled to a pair of support assemblies 410, such as three pairs of support assemblies 410 in a hexapod configuration) extending radially to off platforms 420, 430. Each projection 443 may include a substantially flattened or radially flat outermost face, as shown in FIGS. 86 - 89. As also shown in FIGS. 86 - 89, each projection 443 can include an angled support surface 449 extending from the flat outer face and inner and outer surfaces 451 of platforms 420, 430. The flat outer faces of projections 443 can thus be thinner than major portions of platforms 420, 430 as measured between inner and outer surfaces 451. The flat outer face of projections 443 may be oriented substantially perpendicular to inner and outer surfaces 451 of platforms 420, 430. Angled edges 449 of projections 443 may thus meet or be radially angled outwards and both outwards and inwards (e.g., support surface 449 extending between outer face of projection 443 and outer surface 451 of platforms 420, 430 may abut radially outwardly and upwardly, and support surfaces 449 extending between the outer face of projection 443 and the inner surface 451 of platforms 420, 430 may abut radially outward. and inside). As the mounts 441 can be positioned on the inside face surfaces 451 of the platforms 420, 430, as shown in FIG. 82, the mounts 441 can engage the inward facing support surfaces 449 of the projection 443 and the inward facing surfaces 451 of the platforms 420, 430 to securely attach to the platforms 420, 430, as further explained below.

[178] As shown in FIGS. 90 - 83, assemblies 441 can attach to or be coupled to platforms 420, 430 (e.g., by means of projections 443 and threaded slots 447) so that a rear portion of assemblies 441 extends radially outward beyond the face outside of projections 443 and the outward surface of platforms 420, 430. This rear portion of assemblies 441 may include a pair of trunnions 453 rotatably coupled within slots or a channel of assemblies 441, as shown in FIGS. 90 - 98. Trunnions 453 can extend outwardly from respective mounting 441 to allow an end portion of the first threaded rod 412 or a support barrier 405 to be rotatably coupled thereto, as shown in FIGS. 82 - 85. For example, a first threaded bar 412 and a support rail 405 can be rotatably coupled to the exposed portions of the pair of trunnions 453 of the assembly 441, such as via a connecting pin. The connection between the trunnions 453 and the pair of support assemblies 410 of each assembly 441 can provide for relative rotation of the support assemblies 110 about an orthogonal axis.

[179] Trunnions 453, by themselves, can also provide relative rotation of support assemblies 110 about an orthogonal axis. For example, trunnions 453 may be capable of rotation within the slot(s) or channel(s) of assembly 441. In some embodiments, assembly 441 may be configured to provide a limited amount of rotation of trunnions 453 in relative to mount 441 (eg, such as about 300 degrees or 270 degrees). In some embodiments, trunnions 453 may be cylindrical members contained within a cylindrical hole or slot of mounting 441, as shown in FIGS. 90 - 98, 101 and 105. As shown in FIGS. 97 and 98, the trunnion portion 453 positioned within the assembly 441 may include a groove that partially encompasses or extends around the outer surface thereof. As shown in FIGS. 90, 91, 93, 94 and 96-98, assembly 441 may include trunnion pins or other mechanism, such as spring pins, that extend through respective slots such as pins that mate with trunnion slots 453 ( see Figures 97 and 98). Trunnion pins, therefore, prevent trunnions 453 from disengaging from assemblies 441 and allow limited rotation of trunnions 453 within assembly 441. In some other embodiments, the slots may encompass trunnions 453 so that they are capable of, fully or completely rotate within assemblies 441. To allow smooth, free rotation of trunnions 453 within assembly 441, assembly 441 may include an O-ring, washer, or other similar member 457 positioned between pair of trunnions 453 , as shown in FIG. 98.

[180] The threaded post 402 may be movably retained or captured within a keyhole slot 477 of the assembly 441 by means of a post pin or other member 457, such as a spring pin, as shown in FIGS. 90, 93 - 103. As shown in FIGS. 93, 97, 98 and 103, assembly 441 may include a keyhole or other irregularly shaped slot 477 extending therethrough between an outer surface and a mating surface 467. Mating surface 467 of assembly 441 may engaging the inner surface of platforms 420, 430 during use, as shown in FIG. 93. As shown in FIGS. 93 and 97, the post 402 may include a threaded portion 465, a chamfered or tapered flange 459, and an unthreaded portion 463 extending between the threaded portion 465 and the chamfered flange 459. The unthreaded portion 463 of the post 402 may defining a diameter or width smaller than a threaded portion 465 and the chamfered flange 459. The irregularly shaped slot 477 may include a first portion that is sized to allow the threaded portion 465 to pass therethrough, and a second portion that is dimensioned to prevent the threaded portion 465 from passing therethrough but allow the unthreaded portion 463 to pass through or be positioned therein, as shown in FIG. 98. To capture the post 402 within the irregularly shaped slot 477 and movably couple the post 402 to the mount 441, the post pin 457 can pass at least partially through the first portion of the irregularly shaped slot 477 with unthreaded portion 463 positioned therein to at least partially lock the first portion. As the second portion of the irregularly shaped slot 477 is too small for the threaded portion 465 and the chamfered flange 459 passes through, the post 402 is effectively captured within the irregularly shaped slot 477. The assembly 441 can therefore include a slot or channel configured to position the post pin 457 at least partially through the first portion of the irregularly shaped slot 477. In use, the assemblies 443 can be pre-assembled with the pegs 402 captured within the assemblies 443 by means of the column pin. columns 457.

[181] The outer surface of the assembly 441 that is opposite the mating surface 467 may include a bevel or reamer around the portion of the irregularly shaped slot 477 corresponding to the chamfered or tapered flange 459, as shown in FIGS. 93, 97, 99, 102 and 103. The irregularly shaped slot reamer 477 may be positioned at least partially within or around the second minor portion of the irregularly shaped slot 477. In this regard, when the threaded portion 465 of the post 402 is tightened down into the threaded slot 447 of the platform 420, 430, the mating surface 467 abuts and engages with the inner surface 451 of the platform 420, 430 and the chamfered flange 459 self-positions or centers in the reamer of the slot portion irregular shape 477, as shown in FIGS. 90, 92 - 95, 97 and 98.

[182] The irregularly shaped slot reamer 477 may also be configured to push or translate the assembly 441 radially inwardly so that the edge or arm portion 445 of the assembly 441 engages the angled inner support surface 449 of the projection 443 of the platform 420, 430, as shown in FIGS. 84, 93 and 97. As shown in FIGS. 84, 93, 94, 95, 97, 99, 101 and 105, the edge or arm portion 445 of assemblies 443 may extend axially inwardly of mating surface 467 and radially inwardly toward the interior or center of platform 420 430. The edge portion 445 of the assemblies 443 may thus extend along or around the planar outer face of the projection 443 and the inwardly angled support face 449, as shown in FIGS. 84 and 93. Further, assembly 441 and projection 443 can be configured so that when threaded portion 465 of post 402 is tightened down and into threaded slot 447 of platform 420, 430, and mating surface 467 abuts and engages the inner surface 451 of the platform 420, 430 and the chamfered flange 459 self-positions within the irregularly shaped slot portion 477 of the reamer, thereby translating the assembly 441 radially inward, the lip portion 445 engages the Angled inner support surface 449 of projection 443 of platform 420, 430. In this regard, assembly 441 can be attached to inner surface 451 and angled inner support surface 449 of platform 420, 430 to be securely coupled thereto. It is noted that other portions of the edge portion 445 may be slightly spaced from the flat outer surface and the angled supporting outer surface 449 of the projections 443 when the assembly 441 is attached to the platforms 420, 430, as shown in FIG. 93.

[183] In use, the threaded portion 465 of the column 402 can be threaded into the threaded slot 447 associated with one of the projections 443 of one of the platforms 420, 430. The unthreaded portion 463 of the column 402 can be positioned within the second widest portion of the irregularly shaped slot 477 to allow the edge portion 445 to extend past the outer surface and angled support surfaces 449 of the projection 443. As the post is tightened and fitted into the threaded slot 447, the portion of the chamfered flange 459 can engage the countersink of the irregularly shaped slot 477 and self-position therein by translating the assembly 441 radially inwardly (and the unthreaded portion 463 translated toward or partially into the first minor portion of the shaped slot irregular 477). The engagement surface 467 of the assembly 441 can thereby be forced against and engage and abut the inward support or engagement surface 451 of the platform 420, 430. Such radially inward movement or translation of the assembly 441 can thereby placing the edge portion 445 of the assembly 441 against and within the socket or post with the angled internal support surface 449 of the projection 443. attached to the angled support surface 449 of the projection 443, the inward support or mating surface 451 of the platform 420, 430 and the threaded slot 447 of the platform 420, 430.

[184] It should be understood that the above description is intended to be illustrative, not restrictive. Various changes and modifications can be made here by a person skilled in the art, without departing from the scope of the invention as defined by the following claims and their equivalents. For example, the above-described embodiments (and/or aspects thereof) may be used in combination with one another. In addition, many modifications can be made to adapt a particular situation or material to the teachings of the various modalities without going beyond their scope. While the dimensions and types of materials described here are intended to define the parameters of the various embodiments of the invention, they are by no means limiting and are mere examples. Many other embodiments will be apparent to one skilled in the art after reviewing the above description. The scope of various embodiments must therefore be determined with reference to the appended claims, together with the full scope of equivalents to which these claims are assigned. In the appended claims, the terms "including" and "in which" are used as plain English equivalents of the respective terms "comprising" and "in which". Furthermore, in the claims that follow, the terms "first", "second" and "third" etc. are used merely as classifications, and are not intended to impose numeric requirements on your objects. Further, the term "operably connected" is used herein to refer to both connections that result from distinct and separate components being directly or indirectly coupled and components being integrally formed (i.e., monolithic). Further, the limitations of the claims that follow are not written in "means and function" format and are not intended to be construed in accordance with 35 U.S.C. § 112, paragraph six, unless and until such limitations of the claims expressly use the phrase “means to” followed by a function declaration devoid of additional structure. It should be understood that not necessarily all of the aforementioned objects or advantages described above can be achieved according to any particular modality. Soon, for example, a person skilled in the art will recognize that the systems and techniques described here can be covered or performed in a way that achieves or optimizes an advantage or a group of advantages, as taught here, without necessarily achieving other objects or advantages. how they can be taught or suggested here.

[185] While the invention has been described in detail with respect to only a limited number of embodiments, it should be readily understood that the invention is not limited to said described embodiments. Indeed, the invention may be modified to incorporate any number of variations, alterations, substitutions or equivalent provisions not described hereinabove, but which are commensurate with the scope of the invention. Additionally, while several embodiments of the invention have been described, it should be understood that aspects of the description may include only some of the described embodiments. Accordingly, the invention should not be viewed as limiting the foregoing description, but is only limited by the scope of the appended claims.

[186] This written description uses examples to describe the invention, including the best embodiment, and to also enable any person skilled in the art to practice the invention, including making and using any devices or systems and practicing any methods incorporated therein. The patentable scope of the invention is defined by the claims, and may include other examples that occur to a person skilled in the art. Such other examples are intended to be within the scope of the claims if they present structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal language of the claims.

Claims (15)

1. External bone fixation system (100, 200, 300, 400) comprising: a first platform (120, 220, 320, 420) defining an opening and configured to be coupled to a first bone segment; a second platform (130, 230, 330, 430) defining an opening and configured to be coupled with a second bone segment; at least six adjustable length support assemblies (110, 210, 310, 410) each including an externally threaded rod portion (12, 112, 312, 412) translatable through an internally threaded support body portion (5, 205, 305, 405), the rod portion (12, 212, 312, 412) of each support assembly (110, 210, 310, 410) being coupled to one of the first and second platforms (120, 220, 320, 420, 130, 230, 330, 430) by means of a respective hinge and the support body portion (5, 205, 305, 405) of each support assembly (110, 210, 310, 410) being coupled to another of the first and second platforms (120, 220, 320, 420, 130, 230, 330, 430) by means of a respective joint, and CHARACTERIZED by the fact that at least one externally threaded accessory rod portion (13, 213, 313 , 413) attachable to one of the externally threaded rod portions (12, 212, 312, 412) when the support assembly (110, 210, 310, 410) is coupled to the first or second platform (120, 220, 320, 420 , 130, 230, 330, 430), wherein the support assemblies (110, 210, 310, 410) are coupled to first and second platforms (120, 220, 320, 420, 130, 230, 330, 430) at pairs of support assemblies (110, 210, 310, 410) spaced around the first and second platforms (120, 220, 320, 420, 130, 230, 330, 430), and wherein the pairs of support assemblies ( 110, 210, 310, 410) each include a first support assembly (110, 210, 310, 410) coupled to the respective platform (120, 220, 320, 420, 130, 230, 330, 430) via the articulation of the threaded rod portion (12, 212, 312, 412) thereof and a second support assembly (110, 210, 310, 410) coupled to the respective platform (120, 220, 320, 420, 130, 230, 330 , 430) by pivoting the support body portion (5, 205, 305, 405) thereof. 2. System (100, 200, 300, 400), according to claim 1, characterized by the fact that at least six adjustable length support sets (110, 210, 310, 410) are coupled to each other and form a single construction (215, 315) prior to coupling to the first and second platforms (120, 220, 320, 420, 130, 230, 330, 430). 3. System (100, 200, 300, 400), according to claim 1, characterized by the fact that the length of the support assemblies (110, 210, 310, 410) can be adjusted by rotating a nut (306) threadably engaged in the threaded rod portion (12, 212, 312, 412) and axially secured in the support body portion (5, 205, 305, 405) within a cavity (309) thereof . 4. System (100, 200, 300, 400), according to claim 3, characterized by the fact that the nut (306) is partially threaded, and in which the threaded portion (387) of the nut (306) is inclined towards into engagement with the threaded rod portion (12, 212, 312, 412) by means of a threaded release nut (398) engaged with the external threads (313) of the support body portion (5, 205, 305, 405). 5. System (100, 200, 300, 400), according to claim 4, characterized by the fact that the translation of the release nut (398) along the support body portion (5, 205, 305, 405) in a first direction urging the members into the cavity (309) to urge the nut (306) concentric with the threaded rod portion (387) and into the threaded fitting thereof. 6. System (100, 200, 300, 400), according to claim 5, characterized by the fact that the translation of the release nut (398) along the support body portion (5, 205, 305, 405) in a second direction allow the members to bypass the cavity (309) to allow the release nut (398) to eccentrically translate to the threaded rod portion (387) and disengage therefrom. 7. System (100, 200, 300, 400), according to claim 1, CHARACTERIZED by the fact that the pair of support assemblies (110, 210, 310, 410) are coupled to the first and second platforms (120 , 220, 320, 420, 130, 230, 330, 430) by means of respective mounts (441), and in which the mounts (441) are attached to the first and second platforms (120, 220, 320, 420, 130, 230, 330, 430) through projections (443) and threaded slots (447) of the first and second platforms (120, 220, 320, 420, 130, 230, 330, 430). 8. System (100, 200, 300, 400), according to claim 7, characterized by the fact that each assembly (441) includes a threaded column (402) that fits, in a way capable of being threaded, a threaded slot ( 447) of a respective first or second platform (120, 220, 320, 420, 130, 230, 330, 430). 9. System (100, 200, 300, 400), according to claim 8, FEATURED by the fact that a fiducial marker (307, 407) is positioned at one end of each threaded column (275, 302, 402) , and wherein one of the fiducial markers (307, 407) is unique from the other fiducial markers (307, 407). 10. System (100, 200, 300, 400), according to claim 8, characterized in that each projection (443) includes an angled support surface (449) and inner support surface (451), and in which each assembly (441) includes a mating surface (467) that engages the inner support surface (451) and an edge portion (445) that engages the angled support surface (449) to secure the assembly (441) to a respective first or second platform (120, 220, 320, 420, 130, 230, 330, 430). 11. System (100, 200, 300, 400), according to claim 10, FEATURED by the fact that each threaded column (275, 302, 402) passes through an irregular slot (477) through the respective assembly ( 441), and wherein a portion of the irregular slot (477) includes a countersink. 12. System (100, 200, 300, 400), according to claim 11, FEATURED by the fact that each threaded column (275, 302, 402) includes a chamfered flange (459) configured to cross with the reamer of the associated irregular slot (477), and in which the chamfered flange (459) acts to translate the assembly (441) with respect to the respective first or second platform (120, 220, 320, 420, 130, 230, 330, 430) of such that the edge portion (445) engages the angled support surface (449). 13. System (100, 200, 300, 400), according to claim 1, characterized by the fact that the externally threaded accessory rod portion (13, 213, 313, 413) is attachable to one of the externally threaded rod portions (12, 212, 312, 412) via a connecting member (22) that includes a first externally threaded portion (60) of a first step, an unthreaded portion (63), and a second externally threaded portion (61 ) of a second step that is larger than a first step. 14. System (100, 200, 300, 400), according to claim 13, characterized by the fact that the externally threaded accessory rod portion (13, 213, 313, 413) includes internal threads (58) of the first step of thread, and the externally threaded shank portions (12, 212, 312, 412) include internal threads (58) of the second thread pitch. 15. Support assembly (110, 210, 310, 410) for an external bone fixation system (100, 200, 300, 400) as defined in claim 1, comprising: a support body portion (5, 205, 305, 405) including a cavity (309) extending therealong and internal threads, the support body including a first hinge at an end portion thereof configured to be coupled to a first attachment platform; a first externally threaded rod portion (12, 112, 312, 412) translatable, in a thread capable manner, through the support body portion (5, 205, 305, 405), the first rod portion including a second hinge at an end portion thereof configured to be coupled to a second attachment platform; CHARACTERIZED in that an externally threaded accessory rod portion configured to attach to a free end of the first rod portion to extend the length thereof, wherein the length between the first and second joints is adjustable, and wherein the portion accessory rod is attachable to the first rod portion when the first and second linkages are each coupled to the platform.