WO2007009123A2

WO2007009123A2 - Implant systems and methods for use

Info

Publication number: WO2007009123A2
Application number: PCT/US2006/027803
Authority: WO
Inventors: Scott E. Greenhalgh; John Paul Romano
Original assignee: Stout Medical Group, L.P.
Priority date: 2005-07-14
Filing date: 2006-07-14
Publication date: 2007-01-18
Also published as: WO2007009123A3

Abstract

An articulable, locking support nail used to treat indications within the body, and methods for using the same, are disclosed. The articulating nail can be a locking rod for use to treat medical indications in which both flexibility during the insertion phase and rigidity in the treatment phase are necessary in the same structure. Applications can include scoliosis patients and internal long bone repairs. The nail can be inserted into a repair site while in a flexible state, and then once in place, locked into a desired configuration through the application of a compression force. Insertion and compression tools are also disclosed, as well as methods for using the articulating nail.

Description

TITLE OF THE INVENTION IMPLANT SYSTEMS AND METHODS FOR USE

E. Skott Greenhalgh John Paul Romano

CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims the benefit of U.S. Provisional Application No. 60/699,749, filed 14 July 2005, which is herein incorporated by reference in its entirety.

FIELD OF THE INVENTION [0002] The present invention relates to apparatus and methods for biological tissue repair and treatment. More particularly, a variation of the present invention relates implantation systems having flexible, lockable, elongate support apparatus for stabilizing and supporting orthopedic and other bodily structures, and methods for using the same. An additional variation of the invention includes support rods and shafts used to reinforce fractured bones and/or other damage connective tissue.

BACKGROUND OF THE INVENTION [0003] The use of repair rods for the repair of bone or other tissue injuries, for example in long medullary bones or other orthopedic applications, is well known. Such repair rods typically comprise a rigid linear rod, having a straight or contoured profile depending on the particular application. In cases where the bone repair site or channel (into which the rod will be inserted) does not follow a straight line or profile may present difficulties, especially when attempting to insert a rigid rod into place. One problem may arise as the repair rod may be set into its final profile prior to insertion into the desired repair site. Difficulties may arise as inserting such a repair rod into the repair site may futher disturb the repair site. [0004] The same problem can be encountered in treating patients with scoliosis. It may be difficult to introduce a properly configured stabilization device into the treatment site, due to the contour of the repair stabilization device. [0005] Therefore there is a need for a tissue repair/support device that can be inserted into a repair site while in a flexible state, and then once in place, locked into a desired configuration.

BRIEF SUMMARY OF THE INVENTION [0006] The present invention includes a variation for implantation systems having flexible, lockable, elongate support apparatus for stabilizing and supporting orthopedic and other bodily structures. Additionally, variation of the invention includes support rods and shafts used to reinforce fractured bones and/or other damage connective tissue. [0007] hi one variation, a flexible, locking support rod used to treat indications within the body, and methods for using the same, are provided. Applications may include scoliosis patients and internal long bone repairs. [0008] One variation of the implantation system includes an articulating nail assembly comprised of a number of interlocking segments each having a channel extending therethrough, where each end of each intermediate segment is configured to mate with a corresponding end of an adjacent segment. The surface of the ends can be configured, for example with a texture or coupling structure, to fix firmly against the adjacent segments in response to a compression force, thereby preventing relative movement therebetween. The variation can also have a locking member extending through the channels of the nested locking segments, where the locking member applies a compressive force among and between the locking segments, thereby causing adjacent segment couples to lock together. Segments may be added or removed to vary the length of the articulating nail. [0009] Another variation of the device includes an articulating nail having segments with ends whose surface can have texture or coupling structure that limits the modes in which adjacent segments can move with respect to each other. One example of such a structure includes a ratchet-type configuration. Another variation of the articulating nail can have a tissue-securing structure for securing the articulating nail to tissue. [0010] One variation of a method for using the articulating nail includes joining a plurality of nail segments together, where the nail segments are configured to couple together and form a locked assembly, then shaping the nail segments in a shape to accommodate the tissue to be repaired, and then applying a compressive force across the nail segments to lock them into the shape. [0011] In addition, variations of devices and methods of the invention enable placement of an implant/implants within tissue or bone that may be placed while minimizing trauma to the surrounding tissue and/or bone. The terms hard and soft tissue are meant to include muscle, bone, cartilage, bone marrow, parenchymal, and other types of tissue encountered when creating a path within the body. Variations of the invention allow placement in a channel or bore in tissue where the channel or bore may have both linear and non-linear paths (within a single plane or multiple planes). [0012] It should be noted, that wherever possible, combination of aspects of variations described below, or combinations of the variations themselves, are within the scope of this disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS [0013] Figure 1 illustrates a side view of a variation of the articulating nail in a deployed configuration. [0014] Figure 2 A illustrates a side view of a variation of the articulating nail. [0015] Figure 2B and 2C illustrate cutaway side views of variations of the articulating nail. [0016] Figures 3 and 4 illustrate side views of two variations of the articulating nail. [0017] Figures 5 A and 5B illustrate cutaway side views of a variation of the articulating nail. [0018] Figure 5C illustrates a cutaway side detail view of a variation of the articulating nail. [0019] Figures 6 and 7 illustrate cutaway side views of two variations of the articulating nail. [0020] Figure 8 A illustrates a rear perspective view of a variation of an element of the articulating nail. [0021] Figure 8B illustrates a front perspective view of a variation of an element of the articulating nail. [0022] Figure 9 A illustrates a rear view of a variation of an element of the articulating nail. [0023] Figure 9B illustrates a side view of a variation of the element of 9 A. [0024] Figure 9C illustrates a top view of the element of Figure 9 A. [0025] Figure 9D illustrates a top perspective view of the element of 9 A. [0026] Figure 10 illustrates a top view of a variation of the articulating nail. [0027] Figure 1 IA illustrates a side view of a variation of the articulating nail. [0028] Figure 1 IB illustrates a side view of the variation of Figure 1 IA in a deployed configuration. [0029] Figure 12 illustrates a side view of a variation of the articulating nail. [0030] Figure 13 A illustrates a side view of a variation of the articulating nail. [0031] Figure 13B illustrates a side view of the variation of Figure 13A, in a deployed configuration. [0032] Figure 14, 15, and 16A illustrate side views of variations of the articulating nail. [0033] Figure 16 B illustrates a side view of the variation of Figure 16 A, in a deployed configuration. [0034] Figure 17 A illustrates a side view of a variation of the articulating nail. [0035] Figure 17B illustrates a side view of the variation of Figure 17 A, in a deployed configuration. [0036] Figures 18 and 19A illustrate side views of two variations of the articulating nail. [0037] Figure 19B illustrates a side view of the variation of Figure 19 A, in a deployed configuration. [0038] Figure 20 illustrates a side view of a variation of the articulating nail. [0039] Figures 21A and 21B illustrate side views of a variation of the articulating nail and a variation of a deployment tool. [0040] Figure 22 illustrates a side view of a variation of a deployment tool for use with the articulating nail. [0041] Figure 23 illustrates a side cutaway view of a variation of the articulating nail together with the deployment tool of Figure 22. [0042] Figures 24 A through 24E illustrate side views of a variation of a method for using a variation of the articulating nail. [0043] Figure 25 illustrates a variation of an implant system of the present invention as implanted within a femur. [0044] Figure 26 illustrates a variation of a rod and support shafts of the present implant system. [0045] Figure 27 illustrates a variation of the support shaft showing a first mating surface which is used to guide a rod when coupled to the shaft. [0046] Figure 28 illustrates a rod and shaft when assembled together. [0047] Figure 29 illustrates the implant system after a rod is advanced over the shaft. [0048] Figure 30 illustrates an example of segmented components which form a rod or support shaft for use with the present invention.

DETAILED DESCRIPTION OF THE INVENTION [0049] Figure 1 illustrates a representation of an implant system as described herein. hi this variation, the profile of an articulating nail 2 is non-linear along its length. Such a profile or contour assists in securing the nail 2 inside a body cavity 3 to meet the contour of the body cavity 3. Bending in one or more locations permits the articulating nail 2 to contact the inside of a body cavity 3 in more than one location. [0050] Figure 2A illustrates one example of an articulating nail 2. Articulating nails as described herein may or may not have sharpened distal ends to allow for penetration of hard or soft tissue. As shown, the nail 2 can comprise individual articulation segments, for example segments 4a and 4b. The segments can be removably connected to one another. The articulating nail can comprise any number of segments, for example from about two to about 1000 segments, more narrowly from about five to about 50 segments, for example about 10 segments. The segments can be made from biocompatible material, for example, plastics, titanium, Nitinol, any known medical device implant material, other materials listed herein or a combination thereof. Variations of the implant include a nail 2 having individual segments in the made from different materials. [0051] The segments can have mutually-engaging irregular surfaces or interfaces. Figure 2A illustrates engagement surfaces 6a and 6b in Figure 2A that can be configured to interface with adjacent surfaces on a bottom surface of the segment. The engagement interfaces can comprise any number of interlocking structures, for example facets, knurling, ridges, splines, teeth, ball and socket joint, tongue and groove joint, or a combination thereof. Figure 2 A illustrates that engagement interfaces 6a and 6b can have protrusions or teeth. The engagement interfaces can allow an articulating nail to be configured into various contours, for example, an arc, curve, compound curve, or angular bend. Upon achieving the desired profile, a compressive force may be applied to the segments to lock the nail in shape. An angular bend can include an angle between two adjacent segments from about 0° to about 180°, more narrowly from about 90° to about 179°, for example about 45°. The engagement interfaces allow for multiple degrees of freedom, for example about two or about three degrees of freedom. The engagement interfaces can be locking, for example to lock multiple segments in a desired configuration, for example after insertion. The engagement interfaces can lock in response to a force, such as a compressive force, for example applied longitudinally along the length and between the segments of an articulating nail. [0052] Variations of the system can include segments that can be hollow, solid, or combinations thereof. Figure 2B illustrates that segments can have hollow channels, such as internal channels 8a and 8b. In additional variations, a channel can extend on a surface of the segment such that it is outside of the segment. The internal channels can be in communication with each other, for example, when the articulating nail is in a bent configuration. As shown in Figure 2B, a first surface or top face of the segment can have a first irregular surface while the bottom face of the segment has a second irregular surface 6B where the first and second irregular surface mirror each other so to form a nesting relationship upon application of a compressive force across the segments. [0053] In certain variations of the device, the engagement interfaces at the bottom of the segments can have locking or coupling means for joining segments. [0054] Figure 2C illustrates that a locking element or locking means, such as flexible locking rod 10, can be threaded or passed through hollow segments, such as segments 4a, 4b, and 4c, connecting them together by going through their internal channels 8. A flexible locking rod 10 can fixably attach to an articulating nail. For example, the rod may be fixably attached at one end of the articulating nail and/or with a connection element. For example, flexible locking rod 10 can connect to articulating nail 2 at one end by means of tension rod element catch 12. A flexible tension rod can apply a force, such as a compression force F, among and between the segments of an articulating nail, thereby locking the articulating nail in a desired configuration by locking the engagement interfaces on adjacent segments together. The compression force can be maintained by use of a rod locking element, for example tension lock 13. Alternatively or in combination, a compression rod locking element can be fixed to the rod to maintain compression. For example, such a rod may include a threaded portion that mates with one or more segments or may have a clip or other structure to affix the rod. [0055] Segments can be configured to connect the device to external stabilization elements, for example, bone screws or pins. The segments can have holes or other engagement structure for engaging external stabilization elements. An articulating nail, for example articulating nail 2 in Figure 3, can have segments that are perforated with holes or apertures, illustrated by perforated wall 5. [0056] As illustrated by Figure 3, an articulating nail can have a length, for example length L, and a diameter, for example diameter D. A length L can be between 1 cm (0.4 in.) and 100 cm (40 in.), more narrowly between 10 cm (4 in.) and 50 cm (20 in.), for example 12 cm (3.6 in.). A diameter D can be between 1 mm (0.04 in.) and 10 cm (4 in.), more narrowly between 1 cm (0.4 in.) and 5 cm (2 in.), for example 3 cm (1.2 in.). Figure 4 illustrates that an articulating nail 2 can have a radius R when in a bent configuration. Radius R can be between 10% and 100% of length L, more narrowly between 50% and 100% of length L, for example 75% of length L. [0057] Figure 5A illustrates that an articulating nail, for example articulating nail 2, can have one or more segments, for example segments 4a, 4b, that have a completely hollow centers, for example as illustrated by internal channel 8, and another segment, for example, segment 4c, that has a hollow center with a closed end 7. An articulating nail 2 can also have a connection element, for example a tension rod notch 14, to enable the connection of a tool to the articulating nail. [0058] Articulating nail 2 can have an engagement interface 6 having a structure that limits movement between adjacent segments. For example, the structure may limit movement to one degree of freedom, or one movement sense, such as one-way ratcheting teeth. An engagement interface with one-way ratcheting teeth can control articulation between adjacent segments, for example, to only allow articulation in one direction. Figure 5B illustrates an articulating nail 2 having an engagement interface 6 with one-way ratcheting teeth. An articulating nail 2 can have engagement interfaces with one-way ratcheting teeth that are oriented in opposite directions at each adjacent engagement interface. As illustrated by articulating nail 2, this interface can control articulation, for example to cause the nail to have a shorter effective length L' in the longitudinal direction, while simultaneously having a greater effective diameter D'. [0059] Figure 5C illustrates a close-up cross-sectional view of two segments, 4a and 4b, having ratcheting teeth 16a and 16b. The ratcheting teeth 16a and 16b can be configured to only allow articulation between segments 4a and 4b in one direction. [0060] Figure 6 illustrates a cross sectional view of another variation of a nail. The segments of the articulating nail 2, for example segment 4, can be connected together by a common carrier, for example segment carrier 20. The segments can be connected to a segment carrier 20 by a slidable, pivoting element, for example segment pivots 18a and 18b. This can allow, for example, for adequate clearance in between individual segments to facilitate articulation. [0061] Figure 7 illustrates a variation of an articulating nail 2 having a segment carrier 20 that can have a locking mechanism. The locking mechanism can be a locking nut such as segment carrier nut 24. The articulating nail 2 can have a locking mechanism, such as segment carrier washer 26 that engages with an engagement interface 6c of the articulating nail. The segment carrier 20 can have segment carrier threads 22 to receive a locking nut. [0062] Figure 8A illustrates a segment 4 having engagement interfaces 6a and 6b. Figure 8B illustrates that an internal channel 8 can pass through an engagement interface 6. [0063] Figure 9A illustrates a rear view of a segment 4 having an engagement interface 6 incorporating a tongue and groove type-system, for example having an engagement interface groove 30. Figure 9B illustrates a side view of a segment 4 having an engagement interface 6 with a tongue and groove system incorporating an engagement interface tongue 28, and an engagement interface groove 30. [0064] Figures 9C and 9D illustrate a segment 4 having an engagement interface 6 with a tongue and groove mechanism. An internal channel 8 can pass through the engagement interface 6 by passing through part of an engagement interface tongue 28, for example, separating the engagement interface tongue into about two sections, for example engagement interface tongues 28a and 28b. [0065] Figure 10 illustrates a variation of an articulating nail 2 having 12 segments 4 bent into a smooth, compound curve. A cover can be placed over the segments 4. [0066] The segments can expand in diameter, for example by means of an expansion mechanism. The expansion mechanism can be for example, a wedge, a screw, a balloon, or a combination thereof. The segments can expand by being forced against adjacent segments, for example, by a compression force. The segments can be configured to facilitate expansion in a particular direction, for example, by perforating, or slotting, or a combination thereof. The segments can be configured to expand, for example, in order to engage the surrounding tissue into which they are deployed. [0067] Figure 1 IA illustrates that the articulating nail 2 can have a segment configured to expand in diameter, such as expansion segment 36. The articulating nail 2 can have an expansion segment 36 having a penetrating tip, such as chisel tip 34. An expansion segment 36 can have a segment perforation 32 therethrough to facilitate expansion. An articulating nail 2 having an expansion segment 36 can have a locking element, such as flexible locking rod 10₅ located within an articulating nail 2 and configured to apply a compression force along an axis of an articulating nail 2. [0068] Figure 1 IB illustrates that an articulating nail 2 can have an expansion element 36 that can expand in diameter, as indicated by the opposing arrows. The expansion of the expansion element 36 can occur, for example, in response to a compression force F applied through a flexible locking rod 10. The flexible locking rod 10 can force the expansion segment 36 against an adjacent segment 4, thereby resulting in the expansion of an expansion segment 36. [0069] Figure 12 illustrates that an articulating nail 2 can have two or more expansion segments 36a and 36b. An expansion segment 36a can expand when forced against another, adjacent expansion segment 36b. Multiple expansion segments can be used in one articulating nail. Expansion segments can be placed adjacent to each other or separated by normal segments. Two expandable segments can be separated by a non- expandable segment. [0070] Figure 13 A illustrates that an articulating nail 2 can have a camming segment 38, for example connected to a locking element such as flexible locking rod 10. The articulating nail 2 can have a camming segment on a terminal end, on both terminal ends, and in an intermediate position in the articulating nail. [0071] Figure 13B illustrates that the articulating nail 2 can have a camming segment 38 that twists around, as illustrated by the curved arrow, in response to a force, for example a longitudinal compression forces, such as a force F applied through a locking element such as flexible locking rod 10. The camming segment 38 can twist by being compressed against an adjacent segment 4 in response to a force F. [0072] Figure 14 illustrates that an articulating nail 2 can have multiple camming segments, for example 2, such as camming segments 38a and 38b. Multiple camming segments can twist around, as illustrated by the curved arrows, in response to an applied force such as compression force F. A force can be applied to camming segments through a locking element, for example flexible locking rod 10. An articulating nail 2 can have multiple camming segments on either or both terminal end of the articulating nail, and also in intermediate positions within the articulating nail. Camming segments can be compressed against each other, for example as illustrated by a camming segment 38b against camming segment 38a. Camming segments can also be compressed against another, normal, segments, for example segment 4. [0073] Figure 15 illustrates a variation of an articulating nail 2 having a penetrating segment, for example a threaded segment 40, that can rotate about the longitudinal axis of an articulating nail 2, as indicated by the curved arrow. A rotating, penetrating segment, such as screw segment 40, can be located at either or both terminal ends of an articulating nail, and also in any intermediate position in the articulating nail, or a combination thereof. [0074] Figure 16A illustrates that an articulating nail 2 can have an expansion segment 36 that has segment hinges 42a and 42b, for example to facilitate expansion of the expansion segment. The distal tip of an expansion segment 36 can be connected to the end of a locking element, such as flexible locking rod 10. [0075] Figure 16B illustrates that an articulating nail 2 can have an expansion element 36 that expands in diameter, as indicated by the opposing arrows, when acted on by a force, such as a compression force F, applied by a locking element, such as flexible locking rod 10. An expansion segment 36 can be compressed by a flexible locking rod 10 against an adjacent normal segment 4, or compressed against other expansion segments. Multiple expansion segments can be used in consecutive series. Expansion segments can be located in terminal or intermediate positions in an articulating nail, or both. The expansion segment 36 can be configured to expand by folding at predetermined points such as segment hinges 42a and 42b, for example by a thinning or perforation of the segment body at the predetermined points. [0076] Figures 17A and 17B illustrate that an articulating nail 2 can have an expansion segment 36 configured to expand when compressed by a wedge type member or expander 44. The articulating nail 2 can have an expansion segment 36 that is configured to expand along a segment perforation 32. An expander 44 can be connected to a' locking element, such as flexible locking rod 10, in order to transmit force against the expansion segment 36. [0077] Figure 18 illustrates that an articulating nail 2 can have an expansion segment 36 with a crowned tip 46. Both expansion segments and normal segments can have closed or open tips with penetrating designs, such as cutting elements or sharpened teeth. The segments can be self-penetrating. Expansion segments and normal segments may have surface elements configured to secure the segment to the surrounding tissue, such as barbs or hooks, or texturing, splining, knurling, ribbing, spikes, or combinations thereof. Surface elements configured to secure the segment to the surrounding tissue may be non-movable or deployable with respect to the body of the segment on which they are used. [0078] Figure 19A illustrates that an articulating nail 2 can have an expansion to segment 36 having a balloon expander 48. A balloon expander 48 can be connected to an expansion fluid, such as a liquid or gas, for example saline or air, via an inflation tube 58. Figure 19B illustrates that an expansion segment 36 can expand in diameter, as indicated by the opposing arrows, when acted upon by an inflating balloon expander 48. For example, a fluid, such as air, can be pumped into the balloon expander 48 through an inflation tube 58 in fluid communication with the balloon expander 48. Figure 20 illustrates that a balloon expander 48 can be used to expand an expansion segment 36 having a crowned tip 46. [0079] Figures 21 A and 21 B illustrate that an articulating nail 2 can be used with an insertion rod 50. An insertion rod 50 can be received by and inserted into an internal channel of an articulating nail 2. An insertion rod can be rigid, semi rigid, or flexible. And insertion rod can be connected to the articulating nail, for example, at the leading end. And insertion rod can be configured to fit within or without the articulating nail. [0080] Figure 22 illustrates that a tension rod and an insertion rod can be combined into one insertion/tension rod combination 52. An insertion/tension rod combination 52 can have a connection element such as a tension rod catch 12, to enable it to engage securely with an articulating nail. An insertion/tension rod combination 52 can have a compression mechanism, such as tension rod threads 11, configured to engage a tension rod nut 15, in order to apply a compression force to an articulating nail, for example to lock it in a fixed configuration, expand expansion elements, or both. [0081] Figure 23 illustrates that an insertion/tension rod combination 52 can be received by and inserted into an internal channel 8 in an articulating nail 2, so that a connection element such as tension rod notches 14a and 14b can be engaged by tension rod catches 12 to securely connect the articulating nail 2 to the insertion/tension rod combination 52. [0082] A force can be applied along the articulating nail, for example by means of a tension or locking element, for example, a cable, cord, rod, or a combination thereof, for example to lock the articulating nail into a desired configuration or to expand expansion elements, or to force the articulating nail into a treatment site, or a combination thereof. [0083] As noted herein, the segment bodies of any variation can have holes or perforations therethrough, or can be solid depending upon their intended application. Segments can have two faces, for example, a leading face and a trailing face. One or both faces can be configured to facilitate penetration, for example, with a point, chisel, or a cutting tip. [0084] When not locked together, for example due to an applied force among and between segments, segments can be rotated or manipulated with respect to one another. [0085] Unlocked segments can be secured together by means of a connecting element, such as a cord, strip, wire, cable, or string, or combination thereof. The connection element can be flexible, semi-flexible, or rigid. The segments can be connected to one another by their engagement interfaces, for example, by an interference fit or by snapping together. The segments can be rotatable or non- rotatable with respect to one another. [0086] The segments can have a smooth or textured surface. For example, the segments can have barbs, splines, threading, knurling, teeth, or combinations thereof, upon their surface. The segments can be coated, for example, with a medicinal coating, such as, bone growth agents, antibiotics, other materials disclosed herein or a combination thereof. Segments can incorporate radiopaque markings, such as those disclosed herein. Individual segments in the same articulating nail can have the same or different coatings or surface configurations. [0087] The segments can be produced by casting, stamping, extrusion, sintering, forging or a combination thereof. The segments can be laser cut. Individual segments can be added or removed to an articulating nail by hand or with the use of tools. [0088] Figure 1 illustrates that the articulating nail can be used to stabilize a body cavity 3 having a greater diameter D than the articulating nail diameter d. The articulating nail 2 can be contoured to contact the inner surface of the body cavity 3 in which the articulating nail 2 is deployed at various locations along the length of the body cavity 3, for example, bracing the body containing the body cavity 3 by supporting the body at different locations along the body's length. The articulating nail 2 can be wedged in place, for example, fixing the articulating nail 2 to the surrounding tissue by contouring the articulating nail 2 to touch the inner wall of the body cavity 3 into which the articulating nail 2 is placed at various locations and then locking the articulating nail into position. [0089] The articulating nail can be inserted into a treatment site in an unlocked configuration. The articulating nail can be used to treat conditions in biological tissue, for example, bone, cartilage, or soft tissue. For example, the articulating nail can be used to provide support to a treatment site, for example to facilitate healing. An articulating nail can be used to provide therapeutic orthopedic support, for example as a brace, for example for a scoliosis patient. An articulating nail can be used both within and outside of a patient's body. An articulating nail can be used as a prosthetic. [0090] The articulating nail can be introduced into the desired treatment site by threading, for example, around obstacles or areas of tissue that must not be disturbed. [0091] An insertion rod can be used to insert an articulating nail, for example, by pushing the articulating nail into position, such as by applying translation force. [0092] Once an articulating nail has been inserted into the desired treatment site, it can be fixably secured in place. For example, one of the segments, such as the leading end segment, can be expanded to engage the surrounding tissue. More than one segment can be expanded to engage surrounding tissue. Once inserted into the desired treatment site, the articulating nail can be locked in its configuration. This locking can be accomplished, for example, by applying a compressive force to the articulating nail device. This can be accomplished, for example, by tightening an internal locking element, causing the engagement interfaces of adjacent segments to engage one another and lock into position. After the device is locked into position another one or more segments can be expanded to further secure the device into place by causing an engagement with the surrounding tissue. [0093] Figure 24A illustrates that an articulating nail 2 can be locked onto an insertion/locking rod combination 52 in preparation for using the articulating nail 2 to repair a damage site 56 in a bone 53 having a bone medullary canal 55. The bone 53 can have previously been provided with a bone access port 54 in preparation for the operation. A bone access port 54 can be created in a bone using conventional methods as are known in the art, including drilling, boring, and other methods. The articulating nail 2 can be translated toward the bone access port 54 using an insertion tool, such as an insertion/tension rod combination 52. [0094] Figure 24B illustrates insertion of the articulating nail 2 through the bone access port 54 into the bone medullary canal 55. The flexible qualities of the articulating nail 2 can enable it to bend around the corner between the bone access port 54 and the medullary canal 55. [0095] Figure 24C illustrates translation of the articulating nail 2 through the medullary canal 55 in the bone 53 in order to bridge the damage site 56. The insertion/tension rod combination 52 can be flexible to enable it to be used to insert the articulating nail 2 into the damage site 56 around the corner between the bone access port 54 and the bone medullary canal 55. [0096] Figure 24D illustrates that a compression mechanism can be deployed, such as by sliding a tension rod nut 15 down the insertion/tension rod combination 52 to the tension rod threads 11 , whereafter it can be screwed along the tension rod threads 11 to come into contact with the articulating nail 2. A tension rod nut can be screwed against a proximal segment 4, thereby compressing an articulating nail 2 against itself. The articulating nail 2 can then compress and flex on itself by articulation between the individual segments, causing a tight fit within the medullary canal 55, thereby locking the articulating nail in place. [0097] Figure 24E illustrates that after deployment of the articulating nail into the repair site, the main portion of an insertion tool, such as an insertion/tension rod combination 52, can be severed from the portion that is inside the articulating nail 2, and the main part of the insertion/tension rod combination 52 can be removed from the bone access port 54 leaving only the firmly locked articulating nail 2 in place to affect the repair by supporting the damage site 56. [0098] Figure 25 illustrates another variation of an implantation systems as placed within a femur 60. It is noted that the present invention can be used within a number of locations within the body. Figure 25 illustrates that the implant system 80 can be implanted within the femur 60. [0099] Figure 25 illustrates the implant system 80 that can include a support shaft 82 that can be coupled to a support rod 84. The majority of the support shaft 82 can reside within the head of the femur 62. The majority of the rod 84 can be placed between the femur head 62 and/or the remainder of the femur 60. The support shaft 82 can be a femoral head support shaft. The rod 84 can be referred to as an intramedullary rod. [0100] Figure 265 illustrates potential fracture lines on the femur 60 and the load redistribution resulting from the implant system 80. The fracture lines 66 and 68, represent potential areas in which the femur 60 can fail. [0101] A compressive force, shown by arrow 72, can act upon the head of the femur 62 when the implant recipient attempts to bear weight on the respective leg. A compressive force, shown by arrows 72, can be applied by the rod 84 upon the interior of the femur 60. [0102] Prior to placement of the implant system 80 within the bone, the surgeon can create channels within the bone for insertion of the support shaft 82 and support rod 84. A number of drilling tools and/or reamers can be used to create the channel, for example, a straight and/or curved drill can be used. A drill having adjustable profiles can be used. For example, see Secant Provisional Application Attorney Docket No. SCNT-P-ZOl 0.00 filed herewith, the entirety of which is hereby incorporated by reference. [0103] The implant system 80 when inserted can provide support for the femur 60 while minimizing the need for additional trauma to the surrounding soft tissue and femoral body. The femoral head support shaft 82 can be inserted through the access hole 64. The intramedullary rod 84 can then be slidably coupled to the support shaft 82 prior to insertion and/or during insertion of the support shaft 82 into the access hole 64. The shaft 82 can be slidably attached to the rod 84. The shaft 82 can have a surface that can be configured to mate to the surface of the rod 84. A portion of the mating surfaces on the shaft 82 and the rod 84 can limit advancement of one or both of the shaft 82 and the rod 84 and/or lock the shaft 82 and the rod 84 together upon reaching the desired implantation position. The system 80 can include various additional screws, adhesives, etc., for securing the shaft 82 and the rod 84 together. [0104] The shaft 82 and/or rod 84 can individually comprise locking components. The shaft 82 and/or rod 84 can be flexible and adjustable to any number of profiles until the shaft 82 and/or rod 84 are locked together to remain in a single profile. This variation is conducive to inserting the shaft 82 and/or rod 84 to greater depths within the bone space and then locking the shaft 82 and/or rod 84 to a profile when appropriate. These characteristics eliminate the need for multiple and/or larger diameter incisions and/or channel in the bone. [0105] Any or all elements of the system 80 and/or articulating nail 2 and/or other devices or apparatuses described herein can be made from, for example, a single or multiple stainless steel alloys, nickel titanium alloys (e.g., Nitinol), cobalt-chrome alloys (e.g., ELGILOY® from Elgin Specialty Metals, Elgin, IL; CONICHROME® from Carpenter Metals Corp., Wyomissing, PA), nickel-cobalt alloys (e.g., MP35N® from Magellan Industrial Trading Company, Inc., Westport, CT), molybdenum alloys (e.g., molybdenum TZM alloy, for example as disclosed in International Pub. No. WO 03/082363 A2, published 9 October 2003 , which is herein incorporated by reference in its entirety), tungsten-rhenium alloys, for example, as disclosed in International Pub. No. WO 03/082363, polymers such as polyethylene teraphathalate (PET), polyester (e.g., DACRON® from E. I. Du Pont de Nemours and Company, Wilmington, DE), polypropylene, aromatic polyesters, such as liquid crystal polymers (e.g., Vectran, from Kuraray Co., Ltd., Tokyo, Japan), ultra high molecular weight polyethylene (i.e., extended chain, high-modulus or high-performance polyethylene) fiber and/or yarn (e.g., SPECTRA® Fiber and SPECTRA® Guard, from Honeywell International, Inc., Morris Township, NJ, or DYNEEMA® from Royal DSM N.V., Heerlen, the Netherlands), polytetrafluoroethylene (PTFE), expanded PTFE (ePTFE), polyether ketone (PEK), polyether ether ketone (PEEK), poly ether ketone ketone (PEKK) (also poly aryl ether ketone ketone), nylon, polyether-block co-polyamide polymers (e.g., PEBAX® from ATOFINA, Paris, France), aliphatic polyether polyurethanes (e.g., TECOFLEX® from Thermedics Polymer Products, Wilmington, MA), polyvinyl chloride (PVC), polyurethane, thermoplastic, fluorinated ethylene propylene (FEP), absorbable or resorbable polymers such as polyglycolic acid (PGA), poly-L-glycolic acid (PLGA), polylactic acid (PLA), poly-L-lactic acid (PLLA), polycaprolactone (PCL), polyethyl acrylate (PEA), polydioxanone (PDS), and pseudo-polyamino tyrosine-based acids, extruded collagen, silicone, zinc, echogenic, radioactive, radiopaque materials, a biomaterial (e.g., cadaver tissue, collagen, allograft, autograft, xenograft, bone cement, morselized bone, osteogenic powder, beads of bone) any of the other materials listed herein or combinations thereof. Examples of radiopaque materials are barium sulfate, zinc oxide, titanium, stainless steel, nickel-titanium alloys, tantalum and gold. [0106] Any or all elements of the system 80 and/or articulating nail 2 and/or other devices or apparatuses described herein, can be, have, and/or be completely or partially coated with agents and/or a matrix a matrix for cell ingrowth or used with a fabric, for example a covering (not shown) that acts as a matrix for cell ingrowth. The matrix and/or fabric can be, for example, polyester (e.g., DACRON® from E. I. Du Pont de Nemours and Company, Wilmington, DE), polypropylene, PTFE, ePTFE, nylon, extruded collagen, silicone or combinations thereof. [0107] The system 80 and/or articulating nail 2 and/or elements of the system 80 and/or articulating nail 2 and/or other devices or apparatuses described herein and/or the fabric can be filled, coated, layered and/or otherwise made with and/or from cements, fillers, glues, and/or an agent delivery matrix known to one having ordinary skill in the art and/or a therapeutic and/or diagnostic agent. Any of these cements and/or fillers and/or glues can be osteogenic and osteoinductive growth factors. [0108] Examples of such cements and/or fillers includes bone chips, demineralized bone matrix (DBM), calcium sulfate, coralline hydroxyapatite, biocoral, tricalcium phosphate, calcium phosphate, polymethyl methacrylate (PMMA), biodegradable ceramics, bioactive glasses, hyaluronic acid, lactoferrin, bone morphogenic proteins (BMPs) such as recombinant human bone morphogenetic proteins (rhBMPs), other materials described herein, or combinations thereof. [0109] The agents within these matrices can include any agent disclosed herein or combinations thereof, including radioactive materials; radiopaque materials; cytogenic agents; cytotoxic agents; cytostatic agents; thrombogenic agents, for example polyurethane, cellulose acetate polymer mixed with bismuth trioxide, and ethylene vinyl alcohol; lubricious, hydrophilic materials; phosphor cholene; anti- inflammatory agents, for example non-steroidal antiinflammatories (NSAIDs) such as cyclooxygenase-1 (COX-I) inhibitors (e.g., acetylsalicylic acid, for example ASPIRIN® from Bayer AG, Leverkusen, Germany; ibuprofen, for example ADVIL® from Wyeth, Collegeville, PA; indomethacin; mefenamic acid), COX-2 inhibitors (e.g., VIOXX® from Merck & Co., Inc., Whitehouse Station, NJ; CELEBREX® from Pharmacia Corp., Peapack, NJ; COX-I inhibitors); immunosuppressive agents, for example Sirolimus (RAPAMUNE®, from Wyeth, Collegeville, PA), or matrix metalloproteinase (MMP) inhibitors (e.g., tetracycline and tetracycline derivatives) that act early within the pathways of an inflammatory response. Examples of other agents are provided in Walton et al, Inhibition of Prostaglandin E₂ Synthesis in Abdominal Aortic Aneurysms, Circulation, July 6, 1999, 48-54; Tambiah et al, Provocation of Experimental Aortic Inflammation Mediators and Chlamydia Pneumoniae, Brit. J. Surgery 88 (7), 935-940; Franklin et al, Uptake of Tetracycline by Aortic Aneurysm Wall and Its Effect on Inflammation and Proteolysis, Brit. J. Surgery 86 (6), 771-775; Xu et al, SpI Increases Expression of Cyclooxygenase-2 in Hypoxic Vascular Endothelium, J. Biological Chemistry 275 (32) 24583-24589; and Pyo et al, Targeted Gene Disruption of Matrix Metalloproteinase-9 (Gelatinase B) Suppresses Development of Experimental Abdominal Aortic Aneurysms, J. Clinical Investigation 105 (11), 1641-1649 which are all incorporated by reference in their entireties. [0110] The agents within these matrices can include any agent disclosed herein or combinations thereof, including radioactive materials; radiopaque materials; cytogenic agents; cytotoxic agents; cytostatic agents; thrombogenic agents, for example polyurethane, cellulose acetate polymer mixed with bismuth trioxide, and ethylene vinyl alcohol; lubricious, hydrophilic materials; phosphor cholene; anti- inflammatory agents, for example non-steroidal antiinflammatories (NSAIDs) such as cyclooxygenase-1 (COX-I) inhibitors (e.g., acetylsalicylic acid, for example ASPIRIN® from Bayer AG, Leverkusen, Germany; ibuprofen, for example ADVIL® from Wyeth, Collegeville, PA; indomethacin; mefenamic acid), COX-2 inhibitors (e.g., VIOXX® from Merck & Co., Inc., Whitehouse Station, NJ; CELEBREX® from Pharmacia Corp., Peapack, NJ; COX-I inhibitors); immunosuppressive agents, for example Sirolimus (RAPAMUNE®, from Wyeth, Collegeville, PA), or matrix metalloproteinase (MMP) inhibitors (e.g., tetracycline and tetracycline derivatives) that act early within the pathways of an inflammatory response. Examples of other agents are provided in Walton et al, Inhibition of Prostaglandin E₂ Synthesis in Abdominal Aortic Aneurysms, Circulation, July 6, 1999, 48-54; Tambiah et al, Provocation of Experimental Aortic Inflammation Mediators and Chlamydia Pneumoniae, Brit. J. Surgery 88 (7), 935-940; Franklin et al, Uptake of Tetracycline by Aortic Aneurysm Wall and Its Effect on Inflammation and Proteolysis, Brit. J. Surgery 86 (6), 771-775; Xu et al, SpI Increases Expression of Cyclooxygenase-2 in Hypoxic Vascular Endothelium, J. Biological Chemistry 275 (32) 24583-24589; and Pyo et al, Targeted Gene Disruption of Matrix Metalloproteinase-9 (Gelatinase B) Suppresses Development of Experimental Abdominal Aortic Aneurysms, J. Clinical Investigation 105 (11), 1641-1649 which are all incorporated by reference in their entireties. [0111] Figure 26 illustrates a side view of the support shaft 82 and rod 84. The invention can include a support shaft 82 that is configured to flex in a single direction. The shaft 82 can have a plurality of slits or openings 86 in one side of the shaft 82. The openings 86 can be configured to enable the shaft 82 to bend uni-directionally before, and/or during, and/or after implantation. The openings 86 can be configured to limit the internal angle of bending within the shaft 82. [0112] Figure 27 illustrates a variation of the support shaft 82 having one end that can have a first mating surface 88. The first mating service 88 can be used to guide the rod 84 when coupled to the shaft 82. The mating surface 88 can have a guide slot or similar protrusion and can be located on a single or both sides of the shaft 82. Alternatively, or in combination, the mating surfaces described herein can be a channel or groove or a combination protrusion/groove. The rod 84 can be readied to be advanced over the shaft 82 and mating surface 88. The rod 84 can have a passageway as well as a second mating surface (not shown) configured to be slidably engaged with the shaft 82. [0113] Figure 28 illustrates the rod 84 and shaft 82 when the assembly is in the final configuration (i.e., when either the rod or slot are advanced relative to one another to sufficiently such that the mating surfaces prevent further advancement). The passageway 92 of the rod 84 can include one or more second mating surfaces 90 for engagement with the first mating surface 88 of the shaft 82. [0114] Figure 29 illustrates the implant system 80 after the rod 84 can be advanced over the shaft 82. As shown, the second mating surface 90 can be guided by the first mating surface 88. As noted above, the mating surface can be any surfaces that enable aligned interaction of the shaft 82 and rod 84. Therefore, the first and second mating surfaces can be a track and groove configuration, a bearing/groove configuration, or any other configuration in which two surfaces join together. [0115] The passageway 92 can reduce in size at the end of the rod 84 thereby preventing further movement of the rod 84 on the shaft 82. hi the variation shown, the end of the shaft 82 comprises a taper and the passageway 92 of the rod 84 includes a wedge shape which mates with the taper on the shaft 82. [0116] The shaft 84 can have one or more passageways 94. The passageways 92 can be configured to allow for the delivery of fluids, gels, and/or solids, such as cement, drugs, contrast agents, saline, morselized bone, agents described herein, combinations thereof, or other fluid or substances as desired. Additionally, the devices herein can also comprise any number of openings to assist in securing the system to the body. Tissue securing means as described herein may include any such openings or other currently know structure that is used to affix the device to tissue. [0117] Figure 30 illustrates that the shaft 82 and/or rod 84 (shown as shaft 82 for illustrative purposes only) can comprise segmented components 96. The shaft 82 and/or rod 84 can individually comprise locking components. The segmented components 96 can be flexible and adjustable when connected together to form any number of profiles until the components 96 are locked together to remain in a single profile. The locking can be accomplished by applying a compressive force to the components 96. As noted above, this variation is conducive to inserting the rod or shaft to greater depths within the bone space and then locking the device to a profile when appropriate. Accordingly, these characteristics eliminate the need for multiple and/or larger diameter incisions and/or channel in the bone. For example, a rod, in the flexible state, can be inserted in to the access site. The rod can then take the shape of a curved channel created within the bone or can adapt to the intramedullary portion of the bone. [0118] The invention further includes methods of treating fractures of a bone or multiple bones. The method can comprise creating a single access hole in a bone, (such as but not limited to the femoral body), inserting a flexible support shaft in the access hole, inserting a flexible intramedullary rod in the access hole, and coupling the intramedullary rod to the support shaft. The method can further include drilling a curved path within a femoral head using a curved drill and or drilling a curved path within a femur using a curved drill. [0119] The devices can then be locked into a first profile by applying a compressive force across the support devices as described above. As noted herein, the devices (support rod and/or shaft) can comprise a plurality of segments where the length of the devices may and further comprising adjusting a length of the devices by adding or removing one or more rod segments. [0120] The devices of the present invention can have openings for insertion of a screw or nail for additional securing within the body. [0121] Although various illustrative variations are described above, it will be evident to one skilled in the art that various changes and modifications are within the scope of the articulating nail. Moreover, such changes, modifications, and combinations of various features from different variations, as practicable, are intended to be included within the scope of this disclosure. It is further intended in the appended claims to cover all such changes, modifications, and combinations that fall within the true spirit and scope of the articulating nail.

Claims

What Is Claimed Is: 1. An orthopedic component for a fixation assembly, the orthopedic component comprising: a segment having a top face and a bottom face; a channel extending through the segment; the top face having a first irregular surface, and the bottom face having a second irregular surface, where the first irregular surface and second irregular surface each have a shape to permit nesting therebetween, such that a number of orthopedic components are configured to articulably nest within each other to form an elongate fixation assembly having a length directly related to the number of component, and where application of a compressive force to the plurality of components fixes the components relative to one-another.

2. The orthopedic component of claim 1 , where at least one of the irregular surfaces are configured to remain fixed to the opposite irregular surface together upon removal of the compressive force.

3. The orthopedic component of claim 2, where at least the first or second irregular surface plastically deforms upon the application of the compressive force.

4. The orthopedic component of claim 1 , where the first irregular surface comprises at least one protrusion, and where the second irregular surface comprises at least one recess.

5. The orthopedic component of claim 1 , where the first irregular surface and second irregular surface have the same shape.

6. The orthopedic component of claim 1 , where the first irregular surface mirrors the second irregular surface.

7. The orthopedic component of claim 1 , where the top face has a profile selected from a flat profile, a knurled profile, a convex profile, a concave profile, a spherical profile, a cruciform profile, and an arcuate profile.

8. The orthopedic component of claim 1, where the bottom face has a profile selected from a flat profile, a knurled profile, a convex profile, a concave profile, a spherical profile, a cruciform profile, and an arcuate profile.

9. The orthopedic component of claim 1, where the channel extends through the segment.

10. The orthopedic component of claim 1 , where the channel extends along a surface of the segment.

11. The orthopedic component of claim 1 , where at least the first or second irregular surface is threaded.

12. The orthopedic component of claim 1 , where the segment expands upon the application of the compressive force to form a wedge.

13. The orthopedic component of claim 1 , where the segment comprises an opening to accommodate an orthopedic screw or nail.

14. The orthopedic component of claim 1, where the segment comprises a material selected from a steel material, a titanium material, Nitinol, a polymeric material, or a combination thereof.

15. The orthopedic component of claim 1 , where at least the first or second irregular surface permits movement in only one plane.

16. The orthopedic component of claim 1 , where the segment is porous.

17. An orthopedic fixation assembly comprising: a plurality of segments each having a top face and a bottom face; a channel extending through each segment; each segment having a first and second coupling means for joining adjacent segments, the first coupling means disposed on the top face and the second coupling means disposed on the bottom face, where the first and second coupling means may be nested within each other to join the plurality of segments so that the fixation assembly comprises a length directly related to the number of joined segments; a locking means for locking the plurality of joined segments together, the locking means, extending in the channel; a tissue securing means for securing the fixation assembly to tissue.

18. The orthopedic fixation assembly of claim 17, where one of the coupling means plastically deforms upon the application of the locking means.

19. The orthopedic fixation assembly of claim 17, where the first coupling means comprises at least one protrusion, and where the second coupling means comprises at least one recess.

20. The orthopedic fixation assembly of claim 17, where the coupling means and second coupling means have the same shape.

21. The orthopedic fixation assembly of claim 17, where the top face has a profile selected from a flat profile, a knurled profile, a convex profile, a concave profile, a spherical profile, a cruciform profile, and an arcuate profile.

22. The orthopedic fixation assembly of claim 17, where the bottom face has a profile selected from a flat profile, a knurled profile, a convex profile, a concave profile, a spherical profile, a cruciform profile, and an arcuate profile.

23. The orthopedic fixation assembly of claim 17, where the channel extends through the segment to form an extended channel through the fixation assembly.

1 24. The orthopedic fixation assembly of claim 17, where the channel

2 extends along a surface of the segment to form an extended channel on a surface of

3 the fixation assembly. 4

5 25. The orthopedic fixation assembly of claim 17, where at least the first

6 or second coupling means is threaded. 7

8 26. The orthopedic fixation assembly of claim 17, where at least one

9 segment expands upon the application of the locking means. 10

11 27. The orthopedic fixation assembly of claim 17, where the tissue

12 securing means comprises an opening to accommodate an orthopedic screw or nail. 13

14 28. The orthopedic fixation assembly of claim 17, where the segment

15 comprises a material selected from a steel material, a titanium material, Nitinol, a 1.6 polymeric material, or a combination thereof.

17

18 29. The orthopedic fixation assembly of claim 17, where at least the first

19 or second irregular surface permits movement in only one plane. 20

21 30. The orthopedic fixation assembly of claim 17, where the locking

22 means further includes a locking end located at an end of the fixation assembly, the

23 locking end and locking means configured to apply a compressive force against the

24 segments.

25

26 31. The orthopedic fixation assembly of claim 30, where the locking end

27 expands over an adjacent segment upon the application of the compressive force.

28

29 32. The orthopedic fixation assembly of claim 30, where the locking end

30 rotates onto an adjacent segment to upon the application of the compressive force. 31

32 33. The orthopedic fixation assembly of claim 30, where the locking end

33 screws onto an adjacent segment to apply the compressive force.

34

34. The orthopedic fixation assembly of claim 30, where the locking end plastically expands upon the application of the compressive force.

35. The orthopedic fixation assembly of claim 30, where the locking end further includes an expandable member within the locking end, where expansion of the expandable member causes the locking end to expand.

36. The orthopedic fixation assembly of claim 17, where at least one segment is porous.

37. A orthopedic fixation assembly, the fixation assembly comprising: a plurality of locking segments each having a top face and a bottom face and a channel extending between the top and bottom face, where the top face of a first locking segment may be nested with bottom face of a second locking segment, a locking member extending in the channels of the nested locking segments, where the locking member is configured to apply a compressive force against the locking segments, where the top face of at least one locking segment couples to the bottom face of at least one adjacent locking segment to secure the locking segments together.

38. The orthopedic fixation assembly of claim 37, where at least one of the faces of the locking segment plastically deforms upon the application of the locking means.

39. The orthopedic fixation assembly of claim 37, where the top face comprises at least one protrusion, and where the bottom face comprises at least one recess.

40. The orthopedic fixation assembly of claim 37, where the top face and bottom face have the same shape.

41. The orthopedic fixation assembly of claim 37, where the top face has a profile selected from a flat profile, a knurled profile, a convex profile, a concave profile, a spherical profile, a cruciform profile, and an arcuate profile.

42. The orthopedic fixation assembly of claim 37, where the bottom face has a profile selected from a flat profile, a knurled profile, a convex profile, a concave profile, a spherical profile, a cruciform profile, and an arcuate profile.

43. The orthopedic fixation assembly of claim 37, where the channel extends through each of the segments to form an extended channel through the fixation assembly.

44. The orthopedic fixation assembly of claim 37, where the channel extends along a surface of the segment to form an extended channel on a surface of the fixation assembly.

45. The orthopedic fixation assembly of claim 37, where at least top or bottom face is threaded.

46. The orthopedic fixation assembly of claim 37, where at least one segment expands upon being forced into an adjacent segment.

47. The orthopedic fixation assembly of claim 37, further comprising at least one opening in at least one segment to accommodate an orthopedic screw or nail.

48. The orthopedic fixation assembly of claim 37, where the segment comprises a material selected from a steel material, a titanium material, Nitinol, a polymeric material, or a combination thereof.

49. The orthopedic fixation assembly of claim 37, where at least the top or bottom face surface permits movement in only one plane.

50. The orthopedic fixation assembly of claim 37, further comprising a locking end located at an end of the fixation assembly, the locking end configured to apply a compressive force on the segments.

51. The orthopedic fixation assembly of claim 49, where the locking end expands over an adjacent segment upon the application of the compressive force.

52. The orthopedic fixation assembly of claim 49, where the locking end rotates onto an adjacent segment to upon the application of the compressive force.

53. The orthopedic fixation assembly of claim 49, where the locking end screws onto an adjacent segment to apply the compressive force.

54. The orthopedic fixation assembly of claim 49, where the locking end plastically expands upon the application of the compressive force.

55. The orthopedic fixation assembly of claim 49, where the locking end further includes an expandable member within the locking end, where expansion of the expandable member causes the locking end to expand.

56. The orthopedic fixation assembly of claim 37, where at least one segment is porous.

57. A method of securing a bone or plurality of bones, the method comprising: joining a plurality of segments together, where the segments are configured to couple together and form a locked assembly, shaping the plurality of segments in a shape to accommodate the bone or bones; applying a compressive force across the plurality of segments to lock the plurality of segments into the shape.

58. The method of claim 57, further comprising securing a locking segment on at least one end of the plurality of segments to maintain the compressive force.

59. The method of claim 57, where securing the locking segment may occur via a mode selected from rotating, expanding, twisting, deforming, crushing, or a combination thereof.

60. The method of claim 57, where the shape comprises a shape selected from a simple curve, compound curve, acute angular bend, and obtuse angular bend.

61. The method of claim 57, where the shape is contained in a single plane.

62. The method of claim 57, further comprises placing the plurality of segments into a groove located in tissue, and shaping plurality of segments comprises forming the plurality of segments into a curved or jagged shape.

63. A hip reinforcement implant assembly comprising: a femoral head support shaft, the support shaft being flexible such that the shaft support comprises a first profile; an intramedullary rod comprising a first and second ends, and a passage extending therethrough, the intramedullary rod being flexible such that a portion of the rod between the first and second ends may form a second profile; wherein the first end of the intramedullary rod comprises an opening such that the intramedullary rod is configured to advance over at least a portion of the support shaft, and wherein the second end of the intramedullary comprises a stop configured to limit advancement of the support shaft.

64. The hip reinforcement implant assembly of claim 63, where the support shaft is configured to flex in a single direction.

65. The hip reinforcement implant assembly of claim 63, where the support shaft comprises a plurality of slots in a first side such that the shaft is limited to flexing in a single direction.

66. The hip reinforcement implant assembly of claim 63, where the first profile may vary from linear to non-linear.

67. The hip reinforcement implant assembly of claim 63, where the second profile may vary from linear to non-linear.

68. The hip reinforcement implant assembly of claim 63, where the support shaft comprises a plurality of support shaft segments each shaft segment interconnecting to an adjacent shaft segment.

69. The hip reinforcement implant assembly of claim 68, where the plurality of support shaft segments lock together to retain the first profile upon the application of a compressive force.

70. The hip reinforcement implant assembly of claim 68, where the length of the support shaft is adjusted by adding or removing one or more support shaft segments.

71. The hip reinforcement implant assembly of claim 63 , where the support shaft includes a first mating surface and the intramedullary rod includes a second mating surface, where the first mating surface and second mating surface are slidably coupled such that intramedullary rod advances over a portion of the support shaft, the first and second mating surfaces serve as a guide member.

72. The hip reinforcement implant assembly of claim 63, where the support shaft further includes at least one opening capable of receiving a screw or nail.

73. The hip reinforcement implant assembly of claim 63 , where the intramedullary rod further includes at least one opening capable of receiving a screw or nail.

74. The hip reinforcement implant assembly of claim 63, where the intramedullary rod comprises a plurality of rod segments each rod segment interconnecting to an adjacent rod segment.

75. The hip reinforcement implant assembly of claim 63, where the plurality of rod segments lock together to retain the second profile upon the application of a compressive force.

76. The hip reinforcement implant assembly of claim 63, where the length of the intramedullary rod may be adjusted by adding or removing one or more rod segments.

77. The hip reinforcement implant assembly of claim 63, where the support shaft comprises a passageway extending between a first and second end thereof.

78. A method of treating a fracture comprising: creating a single access hole in a femoral body; inserting a flexible support shaft in the access hole; inserting a flexible intramedullary rod in the access hole; and coupling the intramedullary rod to the support shaft.

79. The method of claim 78, further comprising drilling a curved path within a femoral head using a curved drill.

80. The method of claim 78, further comprising drilling a curved path within a femur using a curved drill.

81. The method of claim 78, further comprising locking the support shaft into a first profile by applying a compressive force across the support shaft.

82. The method of claim 78, further comprising locking the intramedullary rod into a second profile by applying a compressive force across the intramedullary rod.

83. The method of claim 78, where coupling the intramedullary rod to the support shaft occurs when at least a portion of the support shaft is within the femoral body.

84. The method of claim 77, where coupling the intramedullary rod to the support shaft occurs when at least a portion of the intramedullary rod is within the femoral body.

85. The method of claim 77, where the intramedullary rod and the support shaft have a first and second mating surfaces respectively, and where coupling the intramedullary rod to the support shaft comprises engaging the first and second mating surfaces.

86. The method of claim 77, where the intramedullary rod comprises a plurality of rod segments, and further comprising adjusting a length of the intramedullary rod by adding or removing one or more rod segments.

87. The method of claim 77, where the support shaft comprises a plurality of shaft segments, and further comprising adjusting a length of the support shaft by adding or removing one or more shaft segments.

88. The method of claim 77, further comprising inserting a screw or nail into the support shaft

89. The method of claim 77, further comprising inserting a screw or nail into the intramedullary rod.

90. The method of claim 77, further comprising inserting a screw or nail into the intramedullary rod.

91. The method of claim 77, where the support shaft further comprises a passage, the method further comprising injecting a fluid into the passage.

92. The method of claim 77, where the intramedullary rod further comprises a passage, the method further comprising injecting a fluid into the passage.