Abstract:
Apparatus and methods for preparing a fractured bone for repair. Preparing the bone may include fracture reduction. Preparing the bone may include holding a fracture in reduction. Preparing the bone may include identifying locations for obtaining access to an interior region of the bone. The apparatus may include structures outside the bone that interact with fragments of the bone. The structures may participate in the reduction. The structures may participate in holding the reduction. The structures may participate in identifying the locations.

Description:
CROSS-REFERENCE TO OTHER APPLICATIONS 
       [0001]    This application is a nonprovisional of U.S. Application No. 61/450,112, which was filed on Mar. 7, 2011, and is hereby incorporated by reference herein in its entirety. 
     
    
     FIELD OF TECHNOLOGY 
       [0002]    Aspects of the disclosure relate to providing apparatus and methods for repairing bone fractures. In particular, the disclosure relates to apparatus and methods for preparing a fractured bone for receiving a therapeutic implant. 
       BACKGROUND 
       [0003]    Bone fracture fixation may involve the anchoring of bone fragments to a rigid support that is outside or inside the bone. Typical supports include (a) a plate that is screwed to the outside of the bone; and (b) an implant that is inserted inside the bone. 
         [0004]    Therapeutic use of a support depends reducing the fracture and holding the reduction during administration of the support. Typically, a clinician inserts pins in the bone fragments and reduces the fracture by moving anatomy adjacent the bone fractures directly with hands. Another clinician then braces the pins, in a procedure known as external fixation, using wholly external pins that run between the inserted pins. The wholly external and internal pins are joined at junction members that are secured by set screws. 
         [0005]    The use of direct manual reduction and bracing pins with junctions offers limited control over bone fragment positioning and may involve numerous manual tasks that may be difficult to coordinate in such a manner that a reduction is efficiently achieved and properly held. 
         [0006]    It would be desirable, therefore, to provide apparatus and methods for preparing a fractured bone for repair. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0007]    The objects and advantages of the invention will be apparent upon consideration of the following detailed description, taken in conjunction with the accompanying drawings, in which like reference characters refer to like parts throughout, and in which: 
           [0008]      FIG. 1  shows anatomy in connection with which the invention may be practiced. 
           [0009]      FIG. 2A  shows a portion of the anatomy shown in  FIG. 1 . 
           [0010]      FIG. 2B  shows the anatomy shown in  FIG. 2A  along with descriptive information. 
           [0011]      FIG. 3A  shows a partial cross-sectional view of the anatomy shown in  FIG. 2A . 
           [0012]      FIG. 3B  shows apparatus in connection with which the invention may be practiced. 
           [0013]      FIG. 4  shows a procedure in connection with which the invention may be practiced. 
           [0014]      FIG. 5  shows another procedure, in connection with which the invention may be practiced, involving the anatomy shown in  FIG. 2A  and other anatomy. 
           [0015]      FIG. 6  shows anatomy similar to the anatomy shown in  FIG. 2A , in a different condition from that shown in  FIG. 2A , along with apparatus. 
           [0016]      FIG. 7  shows schematic anatomy in connection with which the invention may be practiced. 
           [0017]      FIG. 8  shows a portion of the anatomy shown in  FIG. 1  in a different state from that shown in  FIG. 1 . 
           [0018]      FIG. 9  shows the anatomy shown in  FIG. 8  in a state that is different from that shown in  FIG. 8 . 
           [0019]      FIG. 10  shows illustrative apparatus in accordance with principles of the invention. 
           [0020]      FIG. 11  shows other illustrative apparatus in accordance with principles of the invention. 
           [0021]      FIG. 12A  shows the apparatus shown in  FIG. 10  along with the anatomy shown in  FIG. 8 . 
           [0022]      FIG. 12B  shows a portion of the apparatus shown in  FIG. 10 . 
           [0023]      FIG. 12C  shows a cross-sectional view, taken along lines  12 C- 12 C (shown in  FIG. 10 ) of the apparatus shown in  FIG. 10 . 
           [0024]      FIG. 13  shows still other apparatus in accordance with the principles of the invention. 
           [0025]      FIG. 14  shows a portion of the apparatus shown in  FIG. 13 . 
           [0026]      FIG. 15  shows a portion of the apparatus shown in  FIG. 14 . 
           [0027]      FIG. 16  shows a portion of the apparatus shown in  FIG. 15 . 
           [0028]      FIG. 17  shows a portion of the apparatus shown in  FIG. 14 . 
           [0029]      FIG. 18  shows a cross-sectional view, taken along lines  18 - 18  (shown in  FIG. 17 ) of the apparatus shown in  FIG. 17 . 
           [0030]      FIG. 19  shows another portion of the apparatus shown in  FIG. 13 . 
           [0031]      FIG. 20  shows a cross-sectional view, taken along lines  20 - 20  (shown in  FIG. 13 ) of the apparatus shown in  FIG. 13 . 
           [0032]      FIG. 21  shows yet other apparatus in accordance with the principles of the invention. 
           [0033]      FIG. 22  shows a portion of the apparatus shown in  FIG. 21 . 
           [0034]      FIG. 23  shows a cross-sectional view, taken along lines  23 - 23  (shown in  FIG. 21 ) of the apparatus shown in  FIG. 21 . 
           [0035]      FIG. 24  shows a portion of the apparatus shown in  FIG. 21 . 
           [0036]      FIG. 25  shows a transparent view of a portion of the apparatus shown in  FIG. 21 . 
           [0037]      FIG. 26  shows the apparatus of  FIG. 13  along with anatomy shown in  FIG. 6 . 
           [0038]      FIG. 27  shows yet other apparatus in accordance with the principles of the invention along with a portion of the anatomy shown in  FIG. 8 . 
           [0039]      FIG. 28  shows yet other apparatus in accordance with the principles of the invention. 
           [0040]      FIG. 29  shows the apparatus of  FIG. 28 , along with other apparatus and a portion of the anatomy shown in  FIG. 8 . 
           [0041]      FIG. 30  shows yet other apparatus in accordance with the principles of the invention along with apparatus shown in  FIG. 27 . 
           [0042]      FIG. 31  shows information in accordance with the principles of the invention. 
           [0043]      FIG. 32  shows yet other apparatus in accordance with the principles of the invention. 
           [0044]      FIG. 33  shows yet other apparatus in accordance with the principles of the invention. 
           [0045]      FIG. 34  shows the apparatus of  FIGS. 32 and 33 . 
           [0046]      FIG. 35  shows information in accordance with the principles of the invention. 
           [0047]      FIG. 36  shows yet other apparatus in accordance with the principles of the invention along with a portion of the anatomy shown in  FIG. 8 . 
           [0048]      FIG. 37  shows yet other apparatus in accordance with the principles of the invention. 
           [0049]      FIG. 38  shows yet other apparatus in accordance with the principles of the invention. 
           [0050]      FIG. 39  shows yet other apparatus in accordance with the principles of the invention, along with anatomy. 
           [0051]      FIG. 40  shows the apparatus and anatomy of  FIG. 39 , along with other apparatus in accordance with the principles of the invention. 
           [0052]      FIG. 41  shows yet other apparatus in accordance with the principles of the invention. 
           [0053]      FIG. 42  shows a portion of the apparatus shown in  FIG. 41 . 
           [0054]      FIG. 43  shows a portion of the apparatus shown in  FIG. 42 . 
           [0055]      FIG. 44  shows a cross-sectional view, taken along lines  44 - 44  (shown in  FIG. 42 ) of the apparatus shown in  FIG. 42 . 
           [0056]      FIG. 45  shows the apparatus shown in  FIG. 42  along with other apparatus in accordance with the principles of the invention. 
           [0057]      FIG. 46  shows yet other apparatus in accordance with the principles of the invention. 
           [0058]      FIG. 47  shows yet other apparatus in accordance with the principles of the invention. 
           [0059]      FIG. 48A  shows yet other apparatus in accordance with the principles of the invention, along with anatomy. 
           [0060]      FIG. 48B  shows yet other apparatus in accordance with the principles of the invention, along with anatomy. 
           [0061]      FIG. 49  shows the apparatus of  FIG. 48A  in a configuration that is different from that shown in  FIG. 48A . 
           [0062]      FIG. 50  shows a portion of the apparatus shown in  FIG. 48A . 
           [0063]      FIG. 51  shows yet other apparatus in accordance with the principles of the invention. 
           [0064]      FIG. 52  shows yet other apparatus in accordance with the principles of the invention. 
           [0065]      FIG. 53  shows a portion of the apparatus shown in  FIG. 52 , along with anatomy. 
           [0066]      FIG. 54  shows a portion of the apparatus shown in  FIG. 52 , along with anatomy. 
           [0067]      FIG. 55  shows a portion of the apparatus shown in  FIG. 52 , along with anatomy. 
       
    
    
     DETAILED DESCRIPTION 
       [0068]    Apparatus and methods for preparing a fractured bone for therapy are provided. 
         [0069]    The bone may have one, two, three or more fragments. (A one-fragment fractured bone may have a fracture that did not completely separate the bone into two or more fragments.) The bone may be repaired using an implant and one or more anchors to fasten the fragments to the implant. 
         [0070]    Preparation of the bone for repair may include reduction of the fracture, holding the fracture in a reduced configuration, selecting a site for the implant in the bone interior, selecting a site for an access hole in the bone through which to deliver the implant to the bone interior, opening the hole, clearing a cavity in the interior and any other suitable steps. Apparatus and methods shown and described in commonly owned U.S. Patent Application Publications Nos.: US20090182336, US20110178520, US20110190832, US20110218626 and US20110218585, all of which are hereby incorporated by reference herein in their entireties show apparatus and methods that may be used in connection with some of the aforementioned steps. 
         [0071]    Fracture reduction may involve translation and rotation of a bone fragment along and about orthogonal axes having an origin in the fragment. For example, a clinician may translate or rotate (or translate and rotate) a bone fragment relative to the axes to maneuver the bone fragment into a position in which the fragment can be anchored to the implant. When the fragment is so positioned, the position may be fixed to prepare the fragment for anchoring to the implant. 
         [0072]    The clinician may position the bone fragment without piercing the skin by manipulating anatomy. 
         [0073]    The clinician may position the bone fragment using a bone penetrating member. Some of the apparatus and methods may be used to do so. The bone penetrating member may be elongated and have a first end that penetrates the bone fragment and forms an interference fit therewith. The bone penetrating member may have a second end that may be manipulated away from the bone. The bone penetrating member may pierce the skin. The bone penetrating member may penetrate bone from which skin has been displaced. 
         [0074]    The clinician may fix a reduced position of a first bone fragment relative to a second bone fragment by securing the bone penetrating member to the second bone fragment. The second bone fragment may be naturally engaged with anatomy, such as skeletal anatomy, such that the second bone fragment is relatively stable. The second bone fragment may be used as a “reference” fragment for evaluating positioning, for example of the first bone fragment, in connection with fracture reduction. 
         [0075]    The first and second bone fragments may be manipulated, perhaps with corresponding first and second bone penetrating members. The first and second bone penetrating members may be manipulated free of assistance from an exterior device. The first and second bone penetrating members may be manipulated in concert with external device. The external device may secure positions of the first and second bone penetrating members, relative to each other. The first and second bone penetrating members, when placed to transect one or more fractures, may fix the reduced positions of the first and second fragments without mutual securement of the first and second bone penetrating members. 
         [0076]    The external device may support one or more other external devices for selecting a site for the implant in the bone interior, selecting a site for an access hole in the bone through which to deliver the implant to the bone interior, opening the hole, clearing a cavity in the interior, deploying the implant and any other suitable steps or procedures. Surgical tools that may be used in connection with these steps may include saws, drills, wires, broaches and any other suitable surgical tools. 
         [0077]    The apparatus may include, and the methods may involve, the external device. 
         [0078]    The apparatus may include exclusively radiolucent materials. The apparatus may include exclusively radiopaque materials. The apparatus may include both radiolucent and radiopaque materials. 
         [0079]    In some embodiments, the apparatus may include, and the methods may involve, apparatus for reducing a fracture of a bone. The apparatus may include a first bone penetrating element. The apparatus may include a second bone penetrating element. The apparatus may include a bridging element. The bridging element may be deployed external to the bone. The bridging element may be configured to receive the first bone penetrating element and the second bone penetrating element. The apparatus may include a retention mechanism that is configured to retain a first position, relative to the bridging element, of the first bone penetrating element and a second position, relative to the bridging element, of the second bone penetrating element. 
         [0080]    The retention mechanism may include an elongated pressure distribution member that is configured to apply pressure to the first bone penetrating element and the second bone penetrating element. The pressure distribution member may retain the first bone penetrating element in the first position and the second bone penetrating element in the second position. 
         [0081]    The apparatus may include a fixation mechanism that is configured to deliver pressure to a portion of the pressure distribution member such that the pressure distribution member retains the first bone penetrating element in the first position and the second bone penetrating element in the second position. 
         [0082]    The fixation mechanism may include a set screw. 
         [0083]    The apparatus may include a third bone penetrating member and a base. The third bone penetrating member may be configured to engage the base with a reference bone fragment. The first bone penetrating member may be configured to position a first bone fragment relative to the reference bone fragment. 
         [0084]    The base may include a collar that is configured to receive the third bone penetrating member. 
         [0085]    The apparatus may include an elevation lock for fixing an elevation of the base relative to the bone. 
         [0086]    The apparatus may include a length lock for fixing a length between the bridging member and the collar. 
         [0087]    The second bone penetrating member may be configured to position a second bone fragment relative to the reference bone fragment. 
         [0088]    The apparatus may include a support that is configured to rigidly join the base to the bridging element. The support may define a recess for electromagnetic imaging of the bone and attendant apparatus. A portion of the recess may substantially coincide with a longitudinal axis of the bone. 
         [0089]    The apparatus may include a hinge that joins the support to the bridging element. The apparatus may include a hinge lock that is configured to fix the bridging member at an oblique angle to the support. 
         [0090]    The apparatus may include a unitary frame. The frame may include a first receptacle for receiving a first bone penetrating element; a second receptacle for receiving a second bone penetrating element; and a third receptacle for receiving a third bone penetrating element. 
         [0091]    The first and second bone penetrating elements may be configured to move first and second bone fragments, respectively, relative to a third bone fragment that corresponds to the third bone penetrating element. The first receptacle and the second receptacle may define a first ray that originates at the first receptacle. The first receptacle and the third receptacle may define a second ray that originates at the first receptacle; and the first and second rays define an acute angle. 
         [0092]    The angle may range from about 40° to about 89°. The angle may range from about 45° to about 80°. The angle may range from about 55° to about 75°. 
         [0093]    The first receptacle and the second receptacle may correspond to first and second anatomical half-spaces of the bone, the first anatomical half-space being separated by a plane that substantially bisects the bone. The first anatomical half-space may be an anterior half-space and the second anatomical half-space may be a posterior half-space. The first anatomical half-space may be a volar half-space; and the second anatomical half-space may be a dorsal half-space. The first anatomical half-space may be a medial half-space; and the second anatomical half-space may be a lateral half-space. 
         [0094]    Anatomical planes, or view planes, such as anterior-posterior and medial-lateral, may be instructive for illustrating the apparatus and methods. It will be understood that the anterior-posterior plane is a plane that is normal to an axis running from anterior to posterior in an anatomical feature. It will be understood that the medial-lateral plane is a plane that is normal to an axis running from medial to lateral in an anatomical feature. 
         [0095]    The third receptacle may correspond to a plane that substantially bisects the bone and defines first and second anatomical half-spaces of the bone. The first anatomical half-space may be an anterior half-space; and the second anatomical half-space may be a posterior half-space. 
         [0096]    The first anatomical half-space may be a volar half-space; and the second anatomical half-space may be a dorsal half-space. The first anatomical half-space may be a medial half-space; and the second anatomical half-space may be a lateral half-space. 
         [0097]    The methods may include a method for reducing a fracture. The method may include inserting a first bone penetrating member in a first bone fragment; inserting a second bone penetrating member in a second bone fragment; and distributing a locking force from an actuator to the first bone penetrating member and the second bone penetrating member to lock the first bone penetrating member and the second bone penetrating member to a bridging member that spans from the first bone penetrating member to the second bone penetrating member. 
         [0098]    The method may include rotating the bridging member to an oblique angle relative to a longitudinal axis of a reference bone fragment. The angle may be a radial inclination. 
         [0099]    The method may include fixing the bridging member at the oblique angle by pinning a base to the reference fragment. The base may be rigidly joined to the bridging member. 
         [0100]    The method may include adjusting an elevation, relative to a reference bone fragment, of a base to rotate the first and second bone fragments to an angle relative to the reference bone fragment. The angle may be a volar tilt. The method may include fixing the elevation to fix the angle. 
         [0101]    The method may include adjusting a position, relative to a base, of a third bone penetrating member that is engaged with a reference bone fragment, to adjust a distance between (a) the first and second bone fragments; and (b) the reference bone fragment. 
         [0102]    The distance may correspond to a radial height. 
         [0103]    The method may include fixing a position of a collar relative to the base to fix the distance. 
         [0104]    The method may include fixing the bridging member relative to a reference bone using a rigid radiopaque support having a recess; and imaging an interior of the bone via the recess. 
         [0105]    The apparatus may include a base that is configured to be secured to a first bone fragment; and a bone fragment manipulator. The bone fragment manipulator may be in mechanical communication with the base. The bone fragment manipulator may be configured to: be rigidly engaged with a second bone fragment; displace the second bone fragment along three orthogonal axes; and rotate the bone second bone fragment along each of the three orthogonal axes. 
         [0106]    The apparatus may include a pressure source that is configured to fix the manipulator to substantially prevent: displacement of the second bone fragment along the three orthogonal axes; and rotation of the second bone fragment about the three orthogonal axes. 
         [0107]    The bone fragment manipulator may include an elongated bone penetrating member; and a collar configured to receive the elongated bone penetrating member. The bone fragment manipulator may include a pressure source that is configured to lock the bone penetrating member relative to the collar. The bone fragment manipulator may include a collar support that is configured to translate in: a first direction; and a second direction that is orthogonal to the first direction. The bone fragment manipulator may include a pressure source that is configured to lock the collar relative to the collar support. 
         [0108]    The bone fragment manipulator may include a pressure source that is configured to lock the collar support relative to the base. 
         [0109]    The pressure source may be configured to lock the collar relative to the collar support. The pressure source may be configured to lock the collar support relative to the base. 
         [0110]    The pressure source may be a first pressure source. The apparatus may include a second pressure source that is configured to lock the collar support relative to the base. 
         [0111]    The collar may include a collet. The collet may include an articulating surface that articulates relative to the collar support. The pressure source may include a thread of the collet. The articulating surface may include a substantially spherical curvature. 
         [0112]    The collet may include a cannulated body for receiving the elongated bone penetrating member. The cannulated body may include outer threads. The cannulated body may include retention fingers. The retention fingers may be configured to retain the elongated bone penetrating member. The cannulated body may include a tapered form for receiving the cannulated body and compressing the retention fingers against the elongated bone penetrating member. The cannulated body may include a female threaded member for engaging the outer threads and directing the cannulated body into the tapered form. 
         [0113]    The female threaded member may include a first curved articulating surface for articulating against the collar support. The tapered form may include a second curved articulating surface for articulating against the collar support. The tapered form may include expansion members that are configured to engage the collar support in response to engagement of the elongated bone penetrating member by the retention fingers. 
         [0114]    The apparatus may include a detent that limits rotational displacement, relative to the collar support, of the tapered form. The detent may include a pin that extends from the tapered form and is configured to interfere with the collar support. 
         [0115]    The female threaded member and the tapered form may be configured to be displaced from each other by force of the retention fingers against the form. 
         [0116]    The collar support may include an upper plate and a lower plate. Displacement of the female threaded member from the tapered form may displace the upper plate from the lower plate. 
         [0117]    The base may include a frame that is configured to limit displacement of the upper plate from the lower plate. 
         [0118]    The collet may lock the elongated bone penetrating member by applying pressure: (a) through the female threaded member and the tapered form to the collar support; and (b) through the collar support to the frame. 
         [0119]    The bone fragment manipulator may be a first bone-fragment-manipulator and the three orthogonal axes may correspond to the second bone fragment. The apparatus may include a second bone fragment manipulator that is in mechanical communication with the base. The second bone fragment manipulator may be configured to: be rigidly engaged with a third bone fragment; displace the third bone fragment along three orthogonal axes that correspond to the third bone fragment; and rotate the third bone fragment along each of the three orthogonal axes. 
         [0120]    The apparatus may include a malleable frame; a first collar that is fixed to the frame and configured to receive a first elongated bone penetrating member; and a second collar that is fixed to the frame and configured to receive a second elongated bone penetrating member. The malleable frame may be configured to retain a position of the second elongated bone penetrating member relative to the first elongated bone penetrating member. 
         [0121]    The apparatus may include a first control handle that is rigidly coupled to the first collar; and a second control handle that is rigidly coupled to the second collar. The second control handle may be configured to move the second collar from a first position relative to the first collar to a second position relative to the first collar. 
         [0122]    The first control handle, in use, may be coupled to the first collar and may be, after use, removable from the first collar. The second control handle, in use, may be coupled to the second collar and may be, after use, removable from the second collar. 
         [0123]    The first collar may include a first pressure source that is configured to lock the first elongated bone penetrating member relative to the first collar; and the second collar may include a second pressure source that is configured to lock the second elongated bone penetrating member relative to the second collar. 
         [0124]    The apparatus may include: a first support configured to support first soft tissue that corresponds to a first bone fragment; a second support configured to support second soft tissue that corresponds to a second bone fragment, the second support articulating with respect to the first support via a joint; and a lock that is configured to fix the joint to set an angle between the first support and the second support. 
         [0125]    The apparatus may include a first bracing element that braces the first soft tissue to the first support; and a second bracing element that braces the second soft tissue to the second support. 
         [0126]    The second bracing element may be configured to apply tension to the second soft tissue to displace the second bone fragment away from the first bone fragment. 
         [0127]    The second bracing element may include a soft tissue grasper. The soft tissue grasper may be configured to apply increasing traction to the soft tissue as a displacement of the second bone fragment away from the first bone fragment increases. 
         [0128]    In some embodiments, the apparatus may include, and the methods may involve, apparatus for positioning a surgical tool relative to a site interior to a fractured bone. 
         [0129]    The apparatus may include a pin configured to penetrate a fragment of the bone; and a support that is configured to articulate relative to the pin and indicate an access point that corresponds to the site. 
         [0130]    The support may include a concave surface for articulating against the pin. The support may include an indicator for indicating the access point. The support may include a cannulated fixture that is configured to receive the pin, the cannulated fixture including a concave surface. 
         [0131]    The support may include a curvature that is configured to span from a first anatomical aspect of the bone to a second anatomical aspect of the bone. The first and second anatomical aspects may be normal to each other. 
         [0132]    The first anatomical aspect may be an anterior aspect and the second anatomical aspect may be a medial aspect. The first anatomical aspect may be an anterior aspect and the second anatomical aspect may be a lateral aspect. 
         [0133]    The first anatomical aspect may be a posterior aspect and the second anatomical aspect may be a medial aspect. The first anatomical aspect may be a posterior aspect and the second anatomical aspect may be a lateral aspect. 
         [0134]    The first anatomical aspect may be a dorsal aspect and the second anatomical aspect may be a medial aspect. The first anatomical aspect may be a dorsal aspect and the second anatomical aspect may be a lateral aspect. 
         [0135]    The first anatomical aspect may be a volar aspect and the second anatomical aspect may be a medial aspect. 
         [0136]    The first anatomical aspect may be a volar aspect and the second anatomical aspect may be a lateral aspect. 
         [0137]    The bone fragment may be a first bone fragment. The pin may be fixed to a jig that retains the first bone fragment in a reduced orientation relative to a second bone fragment. The pin and the support, when mutually engaged, may define a spherical surface. The pin may lie along a radius of the spherical surface. The pin may include a tip that substantially coincides with the geometric center of the spherical surface. The support may be configured such that the access point is located at an intersection of the spherical surface and soft tissue adjacent the bone. 
         [0138]    The pin may include a detent that defines a maximum penetration depth of the pin into the bone fragment. The pin may include a detent that defines a minimum elevation, relative to the bone fragment, of the support when the support and the pin are engaged. The detents, together, may function like a vertical spacer. 
         [0139]    The support may include a fixture that is configured to engage the pin; and an extension that is configured to extend, away from the fixture, along a spherical trajectory, until it contacts soft tissue adjacent the bone. 
         [0140]    The extension may include an indicator that indicates the access point when the indicator is proximate the bone. The indicator may extend away from the extension in a direction that is orthogonal to the spherical trajectory. 
         [0141]    The apparatus may include an elongated guide that has an end and a guide surface. The guide may be in mechanical coordination with the support such that the guide end corresponds to the access point and the guide surface is oriented to align a surgical tool with the site. 
         [0142]    The surgical tool may be a drill, a saw, a rotary drill, a rotary saw, a k-wire, or any other suitable surgical tool. The tool may be used to initiate a hole adjacent the guide surface at the access point. The tool may be inserted into or through a cortical layer of bone. After the hole is initiated, the tool may be rotated away from its primary axis of rotation to orient the hole along a direction that leads to a site for deployment of an implant. 
         [0143]    The pin may include a penetrating end that is configured to be placed in the bone fragment. The support may be configured to orient the guide such that the guide surface is oriented to align the surgical tool with the penetrating end. 
         [0144]    The apparatus may include a first radiopaque target on a first target arm. The apparatus may include a second radiopaque target on a second target arm. The site and the access point may define a guide axis. The first target arm may be in mechanical communication with the pin. The second target arm may be in mechanical communication with the pin. The first target arm may be configured to support the first target at a first distance along a first direction away from the guide axis. The second target arm may be configured to support the second target at a second distance along a second direction away from the guide axis. The second direction may be substantially perpendicular to the first direction. 
         [0145]    The first direction and the second direction may define a plane that intersects the site. 
         [0146]    In some embodiments, the apparatus may include, and the methods may involve, apparatus for provisionally reducing and holding reduced a bone fracture comprising. The apparatus may include a mechanism to hold bone fragments stable relative to a stable part of the bone. The stable part of the bone may be a bone fragment. The stable part of the bone may be naturally engaged with the skeleton. The stable part of the bone may be naturally engaged with the skeleton at a joint. 
         [0147]    The apparatus may include alignment features to position an implant for the inside of the bone. The implant may be an intramedullary implant. The apparatus may include a tissue protector. The apparatus may include a guide sleeve to direct access to the bone. The apparatus may include a guide sleeve to direct positioning of the implant on the inside of the bone. 
         [0148]    The apparatus may include a non joint spanning attachment mechanism. The apparatus may include a joint spanning attachment mechanism. 
         [0149]    The apparatus may include a positioning system that is configured to template an implant. The template may be aligned with a site for the implant. The positioning system may be registered to the template to position surgical apparatus for accessing the site. 
         [0150]    The positioning system may be registered to a positioned K-wire. 
         [0151]    The positioning system may be configured to place bone fragment screws or anchors in the bone fragment and into the intramedullary implant. 
         [0152]    The apparatus may include a mechanism that allows the fragments to be manipulated in position relative to the stable bone in a controlled manner and locked into desired position. 
         [0153]    The apparatus may include a mechanism that allows the fragments to be manipulated in position relative to the stable bone and relative to other bone fragments in a controlled manner and locked into a desired position. 
         [0154]    The apparatus may be configured to allow, while holding the reduction, an implant to be placed into the bone without obstructing an access path or a position of the implant. 
         [0155]    In some embodiments, the apparatus may include, and the methods may involve, apparatus for positioning an access hole in a bone. The access hole may be used for delivery of an implant to a site in an interior cavity of the bone. The apparatus may include a first member that is configured to be registered to the site in a first anatomical viewing plane; and a second member that is attached to the first member. When the second member is brought into contact with tissue in a second anatomical viewing plane that is substantially orthogonal to the first anatomical viewing plane, the second member identifies a point on the tissue and a direction that leads from that point to the site. The tissue may include hard tissue, such as bone. The tissue may include soft tissue, such as skin and connective tissue or muscle. 
         [0156]    The first member may include a radiopaque target for registering the first member to the site. 
         [0157]    The first member may include a pivot end that rotatably supports a frame. The frame may include a receptacle for receiving a bone penetrating member. The bone penetrating member may be configured to affix the frame to a bone fragment of the bone. The first member may include a pressure source that is configured to fix the first member relative to the frame. 
         [0158]    The apparatus may include a strut that spans from the first anatomical view to the second anatomical view. The first member and the second member may be elongated. The first member may, away from the pivot end, support the strut. The strut may support the second member. The strut may rotatably support the second member. The strut may lockably support the second member. 
         [0159]    When the first member and the second member are parallel, the second member may be shorter than the first member by a length that corresponds to: (a) a length of the implant; and (b) a distance between an end of the second member and an end of the site. 
         [0160]    The second member may include a guide tube. The guide tube may be used to guide the surgical tool to a location in the interior of the bone. 
         [0161]    The second member may have a base adjacent a distal opening of the guide tube. The base may be configured to contact an outer surface of the bone. 
         [0162]    The base may include a contact that is configured to grip the surface to prevent translation of the base relative to the surface. 
         [0163]    The contact may be a first contact. The apparatus may include a second contact that is configured to grip the surface to prevent, in concert with the first contact, rotation of the base relative to the surface. 
         [0164]    The base may include a first alignment member extending from a first side of the base and a second alignment member extending from a second side of the base opposite the first side. The alignment members may be configured to tangentially engage opposing surfaces of the bone to align the guide tube with a longitudinal axis of the bone. 
         [0165]    The base may include a first lateral cleat extending from a first side of the base and a second lateral cleat extending from a second side of the base opposite the first side. The lateral cleats may be configured to grip opposing surfaces of the bone to prevent the base from rotating circumferentially about a longitudinal axis of the bone. 
         [0166]    The base may include a receptacle for a bone penetrating member such that the bone penetrating member engages the base with the bone. The receptacle may be a first receptacle and the bone penetrating member may be a second bone penetrating member. The base may include a second receptacle for a second bone penetrating member such that the second bone penetrating member engages the base with the bone. The first and second receptacles may be skewed to cause the first and second bone penetrating members to fix the base to the bone by a toenail arrangement. 
         [0167]    The apparatus may include a first radiopaque target for registering the pivot end of the first member to the site. The apparatus may include a second radiopaque target for registering the base to the site. The second radiopaque target may extend from the base. The second radiopaque target may lie substantially in the second anatomical view plane. 
         [0168]    The apparatus may include a bone penetrating member guide. The bone penetrating member guide may be supported by the base. The bone penetrating member guide may be aligned with the guide tube. The frame may be configured to fix a first bone fragment to a second bone fragment. The base may be configured to contact the first bone fragment. The bone penetrating member guide may be configured to direct a bone penetrating member through the second bone fragment into the implant to anchor the second bone fragment to the implant. 
         [0169]    In some embodiments, the apparatus may include, and the methods may involve, apparatus that includes a pointer that corresponds to first sites on a bone that are spaced a substantially uniform distance from an internal point in the bone. The internal point may correspond to a location for a bone implant. The apparatus may include an engagement element that extends away from the pointer. The engagement element may be configured to rotate about a pin that is fixed relative to the bone and oriented at an angle to the bone. A change in the angle may cause the pointer to correspond to second sites on the bone. The second sites may be different from the first sites and may be spaced apart from the internal point by the substantially uniform distance. 
         [0170]    The substantially uniform distance may correspond to a length of the implant. 
         [0171]    The apparatus may include a pointer that corresponds to sites on a bone that are spaced a substantially uniform distance from an internal point in the bone. The internal point may correspond to a location for a bone implant. The apparatus may include an engagement element that extends away from the pointer. The engagement element may be configured to rotate about a pin that is fixed relative to the bone. The substantially uniform distance may be independent of the angle at which the pin is fixed to the bone. 
         [0172]    In some embodiments, the apparatus may include, and the methods may involve, apparatus for positioning orthopedic tools outside a bone near a site inside the bone. The apparatus may include a tool bracket defining three orthogonal axes. The tool bracket may be translatable along one or more of the axes. The tool bracket may be rotatable about one or more of the axes. The apparatus may include a support assembly. The support assembly may include a platform that is configured to be positioned away from the bone and engaged with a fragment of the bone. The apparatus may include an adjustment boom that connects the platform to the tool bracket. 
         [0173]    The support assembly may be configured to support the tool bracket outside the bone, near the site. The support assembly may provide to the tool bracket translation along, and rotational about, one or more of the three axes. 
         [0174]    The adjustment boom may include a housing. The adjustment boom may include a first rod that extends from the housing to a first ball joint in the tool bracket. The adjustment boom may include a second rod that extends from a second ball joint in the housing to a bore in the platform. 
         [0175]    The housing may be translatable and rotatable, relative to the platform, via the second rod. 
         [0176]    The apparatus may include a radiopaque target that is configured to attach to the tool bracket for registering the tool bracket to the site using medical imaging. 
         [0177]    The apparatus may include a guide tube. The guide tube may include a fixture that is configured to be attached to the tool bracket in an orientation. The guide tube may include a cannula. The cannula may be aligned with an axis of the site, based on the orientation. The guide tube may be configured to guide a rotary surgical tool to the site. 
         [0178]    The apparatus may include a bone penetrating member guide. The bone penetrating member guide may include a fixture that is configured to be attached to the tool bracket in an orientation. The bone penetrating member guide may include a guide passageway that is aligned with an axis of the site based on the orientation. When the bone fragment is a first bone fragment, the guide passageway may be configured to direct a bone penetrating member through a second bone fragment into the implant to anchor the second bone fragment to the implant. 
         [0179]    In some embodiments, the apparatus and methods may be used in conjunction with a bone penetrating member that includes a vertical spacer. The vertical spacer may be used set a height from a bone to apparatus shown and described herein. For example, using two or more such spacers, a jig or frame could be supported at a desired uniform or nonuniform height above the bone. 
         [0180]    The vertical spacer may provide structural stability to the bone penetrating member without increasing the overall diameter of the bone penetrating member. 
         [0181]    In some embodiments, the apparatus and methods may be used in conjunction with a bone penetrating member that includes a penetration limiter. The penetration limiter may be used to prevent penetration of bone or other tissue that for which penetration is not desired. 
         [0182]    In some embodiments, a distal end of a bone penetrating member may include a tissue engagement feature such as threads, one or more ridges, one or more ribs or one or more barbs to increase the strength of engagement between the bone penetrating member and the bone. This may increase the amount of force that can be imparted by the bone penetrating member to the bone. 
         [0183]    Apparatus and methods in accordance with the invention will now be described in connection with the FIGS. The features are illustrated in the context of selected embodiments. It will be understood that features shown in connection with one of the embodiments may be practiced in accordance with the principles of the invention along with features shown in connection with others of the embodiments. 
         [0184]    Apparatus and methods described herein are illustrative. Apparatus and methods of the invention may involve some or all of the features of the illustrative apparatus and/or some or all of the steps of the illustrative methods. The steps of the methods may be performed in an order other than the order shown and described herein. Some embodiments may omit steps shown and described in connection with the illustrative methods. Some embodiments may include steps that are not shown and described in connection with the illustrative methods. 
         [0185]    The apparatus and methods of the invention will be described in connection with embodiments and features of an illustrative bone repair devices and associated hardware and instrumentation. The device and associated hardware and instruments will be described now with reference to the FIGS. It is to be understood that other embodiments may be utilized and structural, functional and procedural modifications may be made without departing from the scope and spirit of the present invention. 
         [0186]      FIG. 1  shows illustrative skeleton S. Skeleton S includes illustrative bones Si in which apparatus and methods in accordance with the principles of the invention may be used. Table 1 includes a partial list of bones Si. 
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 1 
               
             
             
               
                   
               
               
                 Bones S i . 
               
             
          
           
               
                   
                   
                 Reference numeral 
               
               
                   
                 Bone 
                 in FIG. 1 
               
               
                   
                   
               
               
                   
                 Distal Radius 
                 S 0   
               
               
                   
                 Humerus 
                 S 1   
               
               
                   
                 Proximal Radius and Ulna (Elbow) 
                 S 2   
               
               
                   
                 Metacarpals 
                 S 3   
               
               
                   
                 Clavicle 
                 S 4   
               
               
                   
                 Ribs 
                 S 5   
               
               
                   
                 Vertebrae 
                 S 6   
               
               
                   
                 Ulna 
                 S 7   
               
               
                   
                 Hip 
                 S 8   
               
               
                   
                 Femur 
                 S 9   
               
               
                   
                 Tibia 
                 S 10   
               
               
                   
                 Fibula 
                 S 11   
               
               
                   
                 Metatarsals 
                 S 12   
               
               
                   
                   
               
             
          
         
       
     
         [0187]      FIG. 2A  schematically shows anatomy of bone B that may be a bone Si. Anatomical features of bone B are listed in Table 2. Apparatus and methods in accordance with the principles of the invention may involve one or more of the anatomical features shown in Table 3. Features of bone B may be described in reference to bone axis LB (in which B indicates bone) and radius RB (in which B indicates bone). 
         [0000]    
       
         
               
             
               
               
               
             
           
               
                 TABLE 2 
               
             
             
               
                   
               
               
                 Anatomical features of some of the bone types that 
               
               
                 may be treated by the apparatus and methods. 
               
             
          
           
               
                   
                   
                 Reference numeral 
               
               
                   
                 Anatomical feature 
                 in FIG. 2A 
               
               
                   
                   
               
               
                   
                 Articular surface 
                 B 0   
               
               
                   
                 Cancellous, spongy or trabecular bone 
                 B 1   
               
               
                   
                 Medullary cavity 
                 B 2   
               
               
                   
                 Cortical or dense bone 
                 B 3   
               
               
                   
                 Periosteum 
                 B 4   
               
               
                   
                 Proximal articular surface 
                 B 5   
               
               
                   
                 Diaphysis or midshaft 
                 B 6   
               
               
                   
                 Metaphysis or end region 
                 B 7   
               
               
                   
                 Epiphysis 
                 B 8   
               
               
                   
                 Articular surface 
                 B 9   
               
               
                   
                   
               
             
          
         
       
     
         [0188]    The terms “end-bone” and “end-bone fracture” may be used to refer to fractures that occur in the epiphyseal or metaphyseal region of long bones. Such fractures include peri-articular and intra-articular fractures. 
         [0189]      FIG. 2B  illustrates anatomical features of bone B. Bone B may be substantially bisected by plane  200 . Plane  200  may include half-spaces  205  and  207 . Bone B may be substantially bisected by plane  202 . Plane  202  may include half-spaces  203  and  209 . Half-spaces  203 ,  205 ,  207  or  209  may correspond to a dorsal, anterior, posterior, volar, medial or lateral half space. A designation of half-spaces  203 ,  205 ,  207  or  209  may be based on an orientation of bone B in skeleton S (shown in  FIG. 1 ). 
         [0190]      FIG. 3A  illustrates anatomical features of a fractured bone B. Reference frame  300  shows that the view of bone B is substantially in anterior/posterior plane  302 . Anterior/posterior plane  302  includes a medial half-space MED and a lateral half-space LAT. Medial/lateral plane  304  includes volar half-space VOL and dorsal half-space DOR. 
         [0191]    Bone B is illustrated as a radius that is fractured at fractures Fh and Fa. Bone B includes bone segments Pb, Ph and Pa in distal end D. Bone segment Pb is the largest portion of bone B. Bone segment Ph is a head portion of bone B. Bone segments Ph and Pa include articular surface AS. Bone segment Pa includes a portion of articular surface AS. Bone portions Pb, Ph and Pa are separated or partially separated along fractures Fa and Fh. Fracture Fa transects articular surface AS. Fracture Fh transects the head portion of bone B. 
         [0192]    Bone B, shown in a cross section that includes approximate longitudinal axis LB, includes cortical bone BCO and cancellous bone BCA. Deployment of an implant into distal end D of bone B may require an access hole at site H′. Although H′ is illustrated as being located on a radial aspect of bone B, H′ may be located on other aspects of bone B, such as a volar, dorsal, lateral, medial or posterior aspect of bone B. Deployment of the implant may require displacement of cancellous bone BCA. Illustrative contours C 1 , C 2  and C 3  in cancellous bone BCA are different contours within which cancellous bone BCA may be displaced. Contour C 4 , which is a projection of contour C 3  onto articular surface AS, shows that contour C 4 , for example, may be asymmetric. Contour C 4  may have major axis A 1  and minor axis A 2  (shown in half). The other contours may also be asymmetric. 
         [0193]    Apparatus and methods provided herein may indicate and provide an access hole H at site H′. An apparatus inserted at site H′ through access hole H, may travel a distance XH through intramedullary space IS to reach the head portion of bone B. An apparatus inserted at site I′ through access hole I may travel a distance XI through intramedullary space IS to reach a head portion of bone B. An apparatus inserted at H′ may require a “bend” to travel through intramedullary space IS to reach a head portion of bone B. An apparatus inserted at I′ may not require a “bend” to reach a head portion of bone B. Apparatus and methods provided herein may displace cancellous bone BCA within a contour such as C 1 , C 2  or C 3 . 
         [0194]      FIG. 3B  shows illustrative implant  300 . Implant  300  may be implanted in bone B. Implant  300  may be configured to maintain a reduction of fractures Fa and Fh. 
         [0195]    Implant  300  may be positioned at a site interior to bone B. Implant  300  may be positioned within intramedullary space IS (shown in  FIG. 3A ). Implant  300  may be inserted through access hole I. Implant  300  may be inserted through access hole H. 
         [0196]    Implant  300  may be implanted in a bone (not shown). Implant  300  is elongated along its longitudinal axis LI (in which I indicates implant). Implant  300  may include an outer expandable web  306 . Implant  300  may include an inner expandable web  308 . Expandable web  306  may be expanded to a radial distance from LI. Expandable web  308  may be expanded to a radial distance from LI. 
         [0197]    Expandable web  306  may extend from proximal base  330  to distal hub  310 . (“Distal,” relative to “proximal,” generally means the leading end of an apparatus that is inserted, or is to be inserted, in the body.) Expandable web  308  may extend from a proximal base (not shown) to distal hub  320 . 
         [0198]    Expandable web  306  may include an arrangement of cells  322 . Expandable web  308  may include an arrangement of cells  324 . An arrangement of cells  322  and/or cells  324  may be any suitable arrangement and may include an arrangement that provides different zones of flexibility. 
         [0199]    Cell  322  may be configured to expand. Cell  324  may be configured to expand. Cell  322  may be expanded by expansion of expandable web  306 . Cell  324  may be expanded by expansion of expandable web  308 . 
         [0200]    Cell  322  may be configured to receive any suitable anchor, such as anchor  326  or anchor  329 . Cell  324  may be configured to receive any suitable anchor such as anchor  326  or anchor  329 . Anchors  326  and  329  may be configured to penetrate expandable web  306  and/or expandable web  308 . Anchors  326  and  329  may penetrate expandable web  306  and/or expandable web  308  at two or more locations. 
         [0201]    Anchors  326  or  329  that may be configured to secure a bone segment to the expandable web when the expandable web is inside the bone. 
         [0202]    Implant  300  may include component  328 . Component  328  may extend longitudinally along axis LI. Component  328  may extend between distal hub  310  and proximal hub  330 . 
         [0203]      FIG. 4  shows illustrative therapeutic scenario  400 . In scenario  400 , manual traction techniques are applied to reestablish anatomic reduction in fracture Fp in bone B. 
         [0204]    Provisional or temporary reduction is often undertaken in fracture repair to restore bone segments to their normal positions before they are anchored. 
         [0205]    When the number of bone segments is small and/or the dislocation of the bone segments is modest, closed reduction techniques may be employed. Closed reduction does not include incisions and utilizes traction. The traction may utilize different tension, compression, and bending motions for reestablishing normal bone segment positioning. 
         [0206]    For more displaced fracture patterns, a limited open reduction can be utilized. External probes, special clamps or bone penetrating members, such as wires, can be employed for the provisional reduction. Small incisions can be made allowing the probes and clamps to aid in repositioning the fracture segments. An open reduction may be performed in a surgical environment. 
         [0207]    The wires may include metal, polymer, fiber or any other suitable material. The wires may be k-wires. The k-wires may range in diameter from about 1 mm to about 2 mm in diameter. The k-wires may have pointed faceted tips to facilitate insertion in a bone using a surgical drill. The k-wires may be driven across a fracture from bone fragment to bone fragment to retain the fragments in position relative to each other. The k-wires may be positioned and then removed strategically to facilitate the reduction procedure in a manner that reduces interference with bone cavity preparation or implant deployment. 
         [0208]    A k-wire may be inserted into a bone segment without surgically opening the skin. A k-wire may be drilled directly through the skin and into the bone segment. A clinician may manipulate the bone segment via the k-wire. Once the bone segments are in position, k-wires may further be utilized to maintain the reduction. 
         [0209]      FIG. 5  shows portion  500  of an illustrative surgical environment in which a fracture in bone B may be diagnosed and treated utilizing a therapeutic technique. Patient P may be sedated appropriately. A limb nerve block may be administered. A pressure cuff (not shown) may be used to maintain limb Q in a relatively blood-free state. Limb Q may be supported by procedure table  502  and any other appropriate supports to manage the position of bone B during surgery. Environment  500  may include imaging system  504 . Imaging system  504  may be an electromagnetic imaging system. Apparatus and methods provided herein may allow obstruction-free imaging of the fracture in bone B. Imaging system  504  may show a position of one or more of a bone fragment, a jig, a target, a marker or any suitable radiopaque device. 
         [0210]      FIG. 6  shows illustrative therapeutic scenario  600 . In scenario  600 , a limited open reduction technique is utilized to reestablish anatomic reduction in fractures Fh and Fa in bone B. K-wire  601  may be drilled across fracture Fh. K-Wire  601  may maintain bone fragment Pa is a position relative to bone segment Pb. K-wire  603  may be drilled across fracture Fa. K-wire  603  may maintain bone segment Ph in a position relative to bone segment Pb. K-wire  603  may be drilled at an angle that substantially follows a subchrondral surface of bone B or any other suitable anatomical characteristic of bone B. 
         [0211]    K-wires  601  and  603  may be drilled across fracture Fh and fracture Fa. K-wires  603  and  601  may maintain bone segments Pa and Ph in positions relative to bone segment Pb. Bone segment Pb may be a reference bone segment. Bone segment Pb may be a diaphysis or midshaft region of bone B. K-wires  601  and  603  may provisionally position bone segments Pa and Ph relative to bone segment Pb. K-wires may be manipulated to position bone segments Pb and Pa in a variety of therapeutic positions relative to bone segment Pb. 
         [0212]      FIG. 7  shows illustrative bone segments  700  of bone B. Bone segment Pb may be the largest bone segment. A fracture, such as fracture Fh or fracture Fa (shown in  FIG. 3A ), may allow bone segments Pa or Ph to shift out of anatomic alignment with respect to bone segment Pb. Bone segment Pb may serve as a reference bone segment, such that, for therapeutic treatment, one or more bone segments such as Pa and Ph may be positioned relative to the reference bone segment. 
         [0213]    The fracture may allow bone segment Ph to be displaced along one or more of orthogonal axes x 1 , y 1  and z 1 , centered at O 1 . The fracture may allow bone segment Ph to rotate about one or more of the axes centered at O 1 . The fracture may allow bone segment Pa to be displaced along one or more of orthogonal axes x 2 , y 2 , and z 2 , centered at O 2 . The fracture may allow bone segment Pa to rotate about one or more of the axes centered at O 2 . 
         [0214]    A bone-penetrating member may be inserted into bone segment Ph at a site such as  709 . The bone penetrating member may allow a clinician to move Ph along or about one or more of axes x 1 , y 1 , and z 1 . A bone penetrating member may be drilled into bone segment Pa at a site such as  711 . The bone penetrating member may allow a clinician to move Pa along or about one or more of axes x 2 , y 2 , and z 2 . 
         [0215]    Bone penetrating members may be inserted in Pb at one or more sites such as  713  and  715 . The bone penetrating members may anchor a device to bone segment Pb. The device may hold a position of one or both of Pa and Ph relative to segment Pb. The device may move one or both of Pa and Ph relative to segment Pb. 
         [0216]      FIG. 8  shows illustrative anatomy  800 . Anatomy  800  includes a dorsal view of radius R and ulna U. Soft tissue S may be present around radius R and ulna U. Radius R and ulna U are shown in substantially volar/dorsal plane  304  (shown in  FIG. 3A ). Radius R includes fracture Fh. Fracture Fh may separate segment Bs from radius R. Radius R may include facture Fa (shown in  FIG. 3A ). Fracture Fa may separate segment Bs into segments Pa and Ph (shown in  FIG. 3A ). Displacement of Bs may include movement of Bs to an abnormal position relative to radius R or ulna U. 
         [0217]    Segment Bs may normally be positioned at radial height Rh. Radial height Rh may be measured based on a distance between illustrative lines L 3  and L 4 . Line L 3  is drawn from a radial styloid and perpendicular to a longitudinal axis of radius R. Line L 4  is drawn from an articular surface of radius R and perpendicular to a longitudinal axis of radius R. A normal radial height may range between 10-13 mm. Radial height Rh may be measured relative to an anatomical characteristic of ulna U. Bone segment Bs may be positioned at an abnormal radial height. 
         [0218]    Radial inclination α may be an inclination, substantially in plane  302  (shown in  FIG. 3A ), between articular surface As and transverse plane Pt. Transverse plane Pt is normal to projection L 2  of the longitudinal axis of radius R. α in a typical, unbroken bone may range from about 7° to about 37°. The apparatus and methods may be used to change a for one or more bone segments such as bone segments Pa and Ph (shown in  FIG. 3A ). 
         [0219]      FIG. 9  shows anatomy  900 . Anatomy  900  shows a lateral view of radius R and ulna U. Radius R and ulna U are shown in substantially medial/lateral plane  302  (shown in  FIG. 3A ). Volar tilt λ may be an inclination, substantially in plane  304  (shown in  FIG. 3A ), between articular surface As and transverse plane Pt (shown in a position that is different from the position shown in  FIG. 8 ). (Volar tilt may be given by the complement of λ, represented in the FIG. by δ, the angle between articular surface As and the longitudinal axis of the radius, LR.) The apparatus and methods may be used to change λ for one or more bone segments such as bone segments Pa and Ph (shown in  FIG. 3A ). 
         [0220]      FIG. 10  shows illustrative jig  1000 . Bone penetrating element  1001  may be drilled into bone B (shown in  FIG. 2A ). Bone penetrating element  1001  may be a k-wire. Bone penetrating element  1001  may be positioned in bone B relative to an anatomical landmark. Bone penetrating element  1001  may be inserted in a dorsal surface of bone B. 
         [0221]    Jig  1000  may include bridging element  1005 . Bridging element  1005  may include receptacles  1003 . Receptacles  1003  may be configured to receive bone penetrating element  1001 . Receptacles  1003  may be configured to receive bone penetrating element  1007 . Bridging member  1005  may position bone penetrating element  1001  relative to bone penetrating element  1007 . 
         [0222]    Bone penetrating element  1001  may be inserted into a bone segment such as bone segment Ph (shown in  FIG. 3A ). Bone penetrating element  1003  may be inserted into a bone segment such as bone segment Pa (shown in  FIG. 7 ). Bridging element  1005  may be moved to position bone segments Ph and Pa. For example, bridging element  1005  may be moved to change radial inclination α (shown in  FIG. 8 ). A clinician may manipulate bone penetrating element  1001  to move bone segment Ph about origin O 1  (shown in  FIG. 7 ) whether or not site  709  (shown in  FIG. 7 ) is coincident with origin O 1 . A clinician may manipulate bone penetrating element  1007  to move bone segment Pa about origin O 2  (shown in  FIG. 7 ) whether or not site  711  (shown in  FIG. 7 ) is coincident with origin O 2 . 
         [0223]    Bridging member  1005  may include pressure distribution member  1013 . Pressure distribution member  1013  may slide in channel  1015 . In a first position, pressure distribution member  1013  may allow a bone penetrating element positioned by bridging member  1005  to move within receptacle  1003 . In the first position, bone penetrating element  1001  may move along axis L 1001  and rotate about axis L 1001 . In the first position, bone penetrating element  1007  may move along axis L 1007  and rotate about axis L 1007 . Movement of bone penetrating elements  1001  and  1007  may cause movement of bone segments Ph and Pa about axes O 1  and O 2 , respectively. 
         [0224]    In a second position, pressure distribution member  1013  may exert pressure on a bone penetrating element and substantially prevent movement of the bone penetrating element. 
         [0225]    The pressure may be exerted on a bone penetrating element by narrowing, at least a portion, of receptacles  1003 . In the second position, pressure distribution member  1013  may be configured to narrow a portion of receptacles  1003  that traverse pressure distribution member  1013 . 
         [0226]    In the second position, pressure distribution member  1013  may prevent movement, relative to bridging member  1005 , of any bone penetrating element received by receptacles  1003  and of corresponding movements of bone segments Ph and Pa relative to origins O 1  and O 2 , respectively. 
         [0227]    Pressure distribution member  1013  may be set in the first position or the second position using set screw  1017 . Rotation of set screw  1017  may slide pressure distribution member  1013  in channel  1015 . 
         [0228]    Jig  1000  may include base  1019 . Movement of base  1019  may position bone penetrating element  1001  relative to bone penetrating element  1007 . Movement of base  1019  may pivot bridging element  1005  about axis L 1001 . Movement of base  1019  may pivot bridging element  1005  about axis L 1007 . Movement of base  1019  may rotate bridging element  1005  a substantially posterior/anterior plane. Movement of base  1019  may change radial inclination α (shown in  FIG. 8 ). 
         [0229]    Base  1019  may include collar  1021 . Collar  1021  may include receptacle  1025 . Receptacle  1025  may be configured to receive bone penetrating element  1023 . Bone penetrating element  1023  may be inserted in bone segment Pb (shown in  FIG. 7 ). 
         [0230]    Bone penetrating element  1023  may move within collar  1021 . Bone penetrating element  1023  may translate along axis L 1023 . Bone penetrating element  1023  may rotate about axis L 1023 . Bone penetration element  1023  may be secured to collar  1021  using set screw  1027 . In a first position set screw  1027  may allow bone penetrating element  1023  to move freely within collar  1021 . In a second position, set screw  1027  may restrict movement of bone penetrating element  1023  within collar  1021 . In the second position, set screw  1027  may distribute pressure to bone penetrating element  1023 . The pressure may be distributed relative to collar  1021 . Rotation of set screw  1027  may relieve or apply pressure to bone penetrating element  1023 . 
         [0231]    With appropriate use of set screw  1027 , base  1019  may be moved up or down along bone penetrating member  1023 , and locked in place, to rotate bridging member  1005  and thus adjust, and lock, volar tilt λ (shown in  FIG. 9 ). 
         [0232]    Collar  1021  may translate along axis L 1019 . Base  1019  may include channels  1033  and  1035  to allow movement of collar  1021 . Rotation of set screw  1029  may translate collar  1021  along axis L 1019 . Set screw  1029  may restrict translation of collar  1021  along axis L 1019 . Set screw  1029  may include receptacles  1031 . Receptacles  1031  may be configured to receive a bone penetrating element. The bone penetrating element received by receptacle  1031  may set a position of collar  1021  along axis L 1019 . A position of collar  1021  relative to bridging member  1005  may correspond to a radial height Rh (shown in  FIG. 8 ). 
         [0233]    Support  1009  may join base  1019  to bridging member  1005 . Movement of base  1019  may position bone penetrating element  1023  relative to bone penetrating elements  1001  and  1007 . Movement of base  1019  may move bone segments Ph or Pa (shown in  FIG. 7 ) about origins O 1  and O 2  (shown in  FIG. 7 ), respectively. Movement of base  1019  may position bone segments Ph and Pa relative to bone segment Pb (shown in  FIG. 7 ). 
         [0234]    Support  1009  may include receptacles  1011 . Receptacles  1011  may receive a bone penetrating element. Receptacles  1011  may be configured to receive a bone penetrating element drilled into anatomy proximate to bone B (shown in  FIG. 2A ). For example, if bone B is a radius R (shown in  FIG. 8 ), receptacles  1011  may receive a bone penetrating element drilled into ulna U (shown in  FIG. 8 ). 
         [0235]      FIG. 11  shows unitary frame  1100 . Frame  1100  may have may have one or more features in common with jig  1000  (shown in  FIG. 10 ). Frame  1100  may include bridging member  1005 . Illustrative projection  1107  may be used to align bridging member  1005  with an anatomical landmark. Frame  1100  may include base  1019 . Frame  1100  may include receptacles  1101  and  1102 . Receptacles  1101  and  1102  may be configured to a receive bone penetrating elements  1001  and  1007  (shown in  FIG. 10 ). Bone penetrating elements  1001  and  1007  may be inserted into bone segments Ph and Pa (shown in  FIG. 3A ). 
         [0236]    Receptacles  1101  and  1102  may define Ray 1 . Receptacles  1101  and  1102  may be separated by a plane that includes axis LB (shown in  FIG. 3A .) The plane may be plane  200  (shown in  FIG. 2B ). The plane may be plane  202  (shown in  FIG. 2B ). Receptacles  1101  and  1102  may receive a bone penetrating element that penetrates a half-space of bone B (shown in  FIG. 2A ). The half-space may be half-space  203 ,  205 ,  207  or  209  (shown in  FIG. 2B ). 
         [0237]    A bone penetrating element received by receptacle  1101  may be inserted into a segment of bone B (shown in  FIG. 2A ). The bone segment may reside in the half-space including receptacle  1101 . A bone penetrating element received by receptacle  1102  may be inserted into a segment of bone B. The bone segment may reside in the half-space including receptacle  1102 . 
         [0238]    Receptacle  1103  may be configured to receive bone penetrating element  1023  (shown in  FIG. 10 ). Receptacle  1103  may be configured to direct bone penetrating element  1023  into bone B (shown in  FIG. 2A ). Bone penetrating element  1023  may be drilled into bone segment Pb (shown in  FIG. 3A ). Receptacle  1103  may direct bone penetrating element  1023  substantially into plane  200  (shown in  FIG. 2B ). Plane  200  may bisect bone B. Plane  200  may define half-spaces  207  and  205  (shown in  FIG. 2B ). Receptacle  1103  may direct bone penetrating element substantially along plane  202  (shown in  FIG. 2B ). Plane  202  may bisect bone B. Plane  202  may define half-spaces  203  and  209  (shown in  FIG. 2B ). 
         [0239]    Receptacle  1103  and receptacle  1101  may define Ray 2 . Ray 1  and Ray 2  may form angle ρ. Angle ρ may be adjusted by rotating set screw  1029 . Rotation of set screw  1029  may correspond to movement of receptacle  1103  along a projection of LB. Rotation of set screw  1029  may apply pressure to bone penetrating elements  1001 ,  1007  and  1023  (shown in  FIG. 10 ). The pressure may move bone segments Ph and Pa relative to bone segment Pb (shown in  FIG. 3A ). 
         [0240]    Angle ρ may be set by drilling a bone penetrating element though receptacle  1031 . Angle ρ may correspond to a radial height Rh (shown in  FIG. 8 ). Ray 1  and Ray 2  may be selected based on an anatomical characteristic of a bone. 
         [0241]    Angle θ may be formed between Ray 1  and a projection of axis LB. Angle θ may be selected to correspond to radial inclination α (shown in  FIG. 8 ). Angle θ may be selected to correspond to volar tilt λ (shown in  FIG. 9 ). Angle θ may be adjusted by rotating bridging member  1005 . Angle θ may be set by drilling bone penetrating element  1023  through receptacle  1103  and a bone segment such as bone segment Pb (shown in  FIG. 7 ). 
         [0242]    Bridging member  1005 , support  1009  and base  1019  may define recess  1105 . Recess  1105  may provide unobstructed access to bone B (shown in  FIG. 2A ). Recess  1105  may facilitate imaging of bone segments Pb, Ph and Pa (shown in  FIG. 3A ) using imaging system  504  (shown in  FIG. 5 ). 
         [0243]      FIG. 12A  shows illustrative therapeutic scenario  1200 . Bone segment Bs is separated from radius R. The separation may be due to a fracture such as fracture Fh or fracture Fa (shown in  FIG. 3A ). A device such as jig  1000  (shown in  FIG. 10 ) or unitary frame  1100  (shown in  FIG. 11 ) may be used to position bone segment Bs relative to radius R. Radius R may have a longitudinal axis LR. A clinician may therapeutically position bone segment Bs relative to radius R. For example, the clinician may adjust volar tilt λ (shown in  FIG. 9 ). 
         [0244]    Bone penetrating element  1001  may be secured to bridging member  1005  by set screw  1017  and pressure distribution member  1013 . Bone penetrating member  1001  may be drilled into bone segment Bs. Bone penetrating member  1001  may be used to manipulate a position of bone segment Bs about a center of bone segment Bs. 
         [0245]    Bridging member  1005  may be secured to base  1019  via support  1009 . Bone penetrating member  1023  may pass through base  1019  and collar  1021  via receptacle  1025  (shown in  FIG. 10 ). Bone penetrating member  1023  may pass into radius R. Bridging member  1005  may be rotated by translating base  1019  along axis L 1023 . Base  1019  may be prevented from substantially translating along axis L 1019  by collar  1021  and set screw  1029 . 
         [0246]    Translating base  1019  along axis L 1023  and rotating bridging member  1005  may rotate bone segment Bs. Rotation of bone segment Bs may adjust angle γ. Angle γ may be adjusted to correspond to volar tilt lambda. Angle γ may be set using set screw  1027 . Set screw  1027  may substantial prevent movement of base  1019  along axis L 1023 . 
         [0247]      FIG. 12B  shows pressure distribution member  1013 . Pressure distribution member  1013  may include one or more vias such as  1252 . Each of the vias may correspond to one of receptacles  1003  (shown in  FIGS. 10 and 11 ). Via  1252  is a pass-through for bone penetrating members such as  1001  and  1007  (shown in  FIG. 10 ). Via  1252  may include wide end  1254  and narrow end  1256 . Via  1252  may have length l, which may be greater than the diameter of the corresponding receptacle. Pressure distribution member  1013  may, guided by channels  1258  and  1260 , slide longitudinally. Detent surfaces  1262  and  1264  may limit the longitudinal motion by interference with detents (not shown) from bridging member  1005  that are positioned in the guide channels. 
         [0248]    When a bone penetrating member is inserted or adjusted within a receptacle  1003 , wide end  1254  is aligned with the receptacle. When the bone penetrating member is locked, pressure distribution member  1013  is shifted so that narrow end  1256  is aligned with the receptacle. Narrow end  1256  may be sufficiently narrow to apply pressure to the bone penetrating member to hold the bone penetrating member relative to bridging member  1005 . 
         [0249]      FIG. 12C  shows pressure distribution member  1013  within bridging member  1005 . Bone penetrating members  1001  and  1007  pass through vias in pressure distribution member  1013 . Via  1252  is not occupied by a pressure distribution member. Detent surface  1264  abuts detent  2180 . Detent surface  1262  is displaced from detent  2182 . Pressure distribution member  1013  is therefore in an unlocked configuration. Set screw  1017  is affixed to pressure distribution member  1013  (out of the plane of the FIG.) such that set screw  1017  can displace pressure distribution member  1013  and generate pressure that is transmitted by pressure distribution member  1013  substantially simultaneously to any bone engaging members that may be present in bridging member  1005 . 
         [0250]    Illustrative projection  1107  may be used to align bridging member  1005  with an anatomical landmark. 
         [0251]      FIG. 12B  shows pressure distribution member  1013  within bridging member  1005 . Bone penetrating members  1001  and  1007  pass through vias in pressure distribution member  1013 . Via  1252  is not occupied by a pressure distribution member. Detent surface  1264  abuts detent  2180 . Detent surface  1262  is displaced from detent  2182 . Pressure distribution member  1013  is therefore in an unlocked configuration. Set screw  1017  is affixed to pressure distribution member  1013  (out of the plane of the FIG.) such that set screw  1017  can displace pressure distribution member  1013  and generate pressure that is transmitted by pressure distribution member  1013  substantially simultaneously to any bone engaging members that may be present in bridging member  1005 . 
         [0252]      FIG. 13  shows illustrative jig  1300 . Jig  1300  may include a first bone fragment manipulator  1312 . First bone fragment manipulator  1312  may include bone penetrating member  1315 . Bone penetrating member  1315  may be secured to a bone segment such as bone segment Pa or bone segment Ph (shown in  FIG. 3A ). First bone fragment manipulator  1312  may include tube  1317 . Tube  1317  may include receptacle  1326 . Receptacle  1326  may receive bone penetrating member  1315 . 
         [0253]    Bone penetrating member  1315 , when secured to a bone, may displace the bone segment along axes X, Y and Z. Bone penetrating member  1315 , when secured to the bone segment may rotate the bone segment about axes X, Y and Z. Displacement or rotation of the bone segment may correspond to displacement or rotation of bone segment about an origin of the bone segment. Displacement or rotation of the bone segment may position the bone segment at an appropriate therapeutic position relative to a reference bone segment such as Pb (shown in  FIG. 3A ). 
         [0254]    The first bone fragment manipulator  1312  may include collar support  1325 . Collar support  1325  may be configured to translate in plane X-Y. Tube  1317  may include articulating surface  1319 . Articulating surface  1319  may permit displacement and rotation of bone penetrating member  1315  about axes X, Y and Z. Articulating surface  1319  may articulate relative to collar support  1325 . 
         [0255]    Tube  1317  may rotate about axis Z. Tube  1317  may include outer threads  1327 . Tube  1317  may threadedly engage female threaded member  1318 . Female threaded member  1318  may include articulating surface  1319 . Threaded engagement of tube  1317  and may displace tube  1317  relative to female threaded member  1318 . Threaded engagement of tube  1317  and female threaded member  1318  may apply or relieve pressure on bone penetrating member  1315 . Threaded engagement of tube  1317  and female threaded member  1318  may apply or relieve pressure on articulating surface  1319 . Threaded engagement of tube  1317  and female threaded member  1318  may apply or relieve pressure on collar support  1325 . Threaded engagement of tube  1317  and female threaded member  1318  may apply or relieve pressure on frame  1323 . Frame  1323  may include frame cover  1324 . 
         [0256]    Pressure applied to bone penetrating member  1315 , articulating surface  1319 , collar support  1325  and frame  1323  may substantially fix a position of the bone segment secured to bone penetrating member  1315 . 
         [0257]    Jig  1300  may include second bone fragment manipulator  1314 . Second bone fragment manipulator  1314  may have one or more features in common with first bone fragment manipulator  1312 . For example, the second bone fragment manipulator may include bone penetrating member  1313 , tube  1329 , threads  1335 , articulating surface  1333 , collar support  1331  and female threaded member  1332 . 
         [0258]    Second bone fragment manipulator  1314  may displace or rotate a second bone segment such as bone segment Pa or Ph. Second bone fragment manipulator  1314  may substantially fix a position of the bone segment secured to bone penetrating member  1313 . Second bone fragment manipulator  1314  may position the second bone segment relative to the first bone segment. 
         [0259]    Jig  1300  may include base  1301 . Base  1301  may include slider  1305 . Slider  1305  may slide along axis L 1301  in channel  1303 . Set screw  1307  may set a position of slider  1305  along axis L 1301 . Slider  1305  may include receptacles  1321 . Receptacles  1321  may receive bone penetrating member  1311 . Bone penetrating member may have may have one or more features in common with bone penetrating members  1001 ,  1007  or  1023  (shown in  FIG. 10 ). 
         [0260]    Bone penetrating member  1311  may be secured to a reference bone segment such as segment Pb (shown in  FIG. 3A ). Slider  1305  and base  1301  may rotate about axis L 1311 . Rotation about axis L 1311  may position the first and second bone segments relative to the reference bone segment. A position about axis L 1311  may be substantially fixed by rotating set screw  1309 . Rotation of set screw  1309  may apply or relieve pressure on bone penetrating member  1311 . 
         [0261]    Slider  1305  and base  1301  may translate along axis L 1311 . Translation along axis L 1311  may position the first and second bone segments relative to the reference bone segment. For example, translation along axis L 1311  may position the first and second bone segments at a volar tilt (shown in  FIG. 9 ) or at a radial inclination (shown in  FIG. 8 ). A position of slider  1305  relative to base  1301  along axis L 1311  may be set by rotating set screw  1309 . Rotation of set screw  1309  may apply or relieve pressure to base  1301 . 
         [0262]    Base  1301  may translate along axis L 1301 . Translation along axis L 1301  may position the first and second bone segments relative to the reference bone segment. For example, translation along axis L 1301  may position the first and second bone segments at a radial height (shown in  FIG. 8 ). A position of base  1301  along axis L 1301  may be set by rotating set screw  1307 . Rotation of set screw  1307  may apply or relieve pressure on base  1301 . A position of slider  1305  relative to base  1301  may be set by securing a bone penetrating member (not shown) to the reference bone via receptacle  1321 . 
         [0263]      FIG. 14  shows illustrative bone fragment manipulator  1400 . Bone fragment manipulator  1312  or bone fragment manipulator  1314  may have one or more features in common with bone fragment manipulator  1400 . Bone fragment manipulator includes collar  1401  and bone penetrating member  1315 . Collar  1401  includes tube  1317 . Tube  1317  may include a cannula for receiving bone penetrating member  1403 . The cannula may have one or more features in common with receptacle  1326  (shown in  FIG. 13 ). Tube  1317  includes outer threads  1327 . Threads  1327  may engage female threaded member  1318 . Female threaded member  1318  may include articulating surface  1319 . Articulating surface  1319  may include a substantially spherically shaped portion. 
         [0264]    Collar  1401  may include tapered form  1405 . Tapered form  1405  may include articulating surface  1411 . Articulating surface  1411  may include a substantially spherically shaped portion. Engagement of tube  1317  and tapered form  1405  may apply or relieve pressure on retention fingers  1413 , for example, like a collet. Pressure applied to retention fingers  1413  may substantially fix a position of bone penetrating member  1315 . Pressure applied to retention fingers  1413  may substantially fix a position of bone penetrating member  1315  along or about axis Z. 
         [0265]    Articulating surfaces  1411  and  1319  may provide a freedom of movement to collar  1401  relative to collar support  1325 . Articulating surfaces  1411  and  1319  may allow collar  1401  to freedom to translate and rotate about axes X, Y and Z. Articulating surfaces  1411  and  1319  may facilitate movement of a bone segment secured to bone fragment manipulator  1400  along and about three orthogonal axes. 
         [0266]      FIG. 15  shows illustrative component  1500 . Component  1500  may include tube  1317  threadedly engaged with female threaded member  1318 . Component  1500  may include retention fingers  1413 . Threaded engagement of tube  1317  and female threaded member  1318  may direct retention fingers  1413  into tapered form  1405  (shown in  FIG. 14 ). Threaded engagement of tube  1317  and female threaded member  1318  may displace female threaded member  1318  relative to tapered form  1411 . 
         [0267]      FIG. 16  shows tube  1600 . Tube  1600  may include one or more of the features of tube  1317 . Tube  1600  may include cannula  1601 . Cannula  1601  may be configured to receive bone penetrating member  1315 . 
         [0268]    Tube  1600  may include retention fingers  1413 . Retention fingers  1413  may be associated with a first radius r 1 . Radius r 1  may be measured with respect to a longitudinal axis L 1601  that passes through a center of cannula  1601 . Retention fingers  1413  may be associated with a second radius r 2 . Radius r 2  may be measured with respect to a center of cannula  1601 . 
         [0269]    Radii r 1  and r 2  may define a taper associated with retention fingers  1413 . Tapered form  1405  (shown in  FIG. 14 ) may be configured to apply pressure to retention fingers  1413 . The pressure may compress retention fingers  1413  against a bone penetration member inserted into cannula  1601 . 
         [0270]      FIG. 17  shows illustrative component  1700 . Component  1700  may include tube  1317  and tapered form  1405 . Tapered form  1405  may be configured to receive retention fingers  1413 . Tapered form  1405  may include surface  1701 . 
         [0271]      FIG. 18  is view of tapered form  1405  along lines  18 - 18  (shown in  FIG. 17 ). Tapered form  1405  may include a cannula  1801 . Cannula  1801  and cannula  1601  (shown in  FIG. 16 ) may be concentric. Cannula  1801  may include a radius r 3 . Radius r 3  may have a magnitude less than a magnitude of radius r 2  (shown in  FIG. 16 ). Radius r 3  may form detent  1803 . Detent  1803  may be configured to compress retention fingers  1413 . 
         [0272]    Radii r 3  and r 4  may define a taper. The taper defined by radii r 3  and r 4  may correspond to the taper defined by radii r 1  and r 2 . The taper defined by radii r 3  and r 4  may be configured to compress retention fingers  1413 . 
         [0273]      FIG. 19  shows illustrative components  1900 . Components  1900  may illustrate features of jig  1300  encapsulated by frame  1323 . 
         [0274]    Collar support  1325  may include upper plate  1905  and lower plate  1901 . Articulating surface  1319  may be configured to articulate against upper plate  1905 . Articulating surface  1411  (shown in  FIG. 14 ) may be configured to articulate against lower plate  1901 . Articulation against upper plate  1905  and lower plate  1901  may allow movement of bone fragment manipulator  1312  about and along axes X, Y and Z. 
         [0275]    Upper plate  1905  may be displaced from lower plate  1901 . Displacement of upper plate  1905  from lower plate  1901  may be constrained by frame  1323  (shown in  FIG. 13 ). Displacement of upper plate  1905  from lower plate  1901  against frame  1323  may apply pressure to frame  1323 . 
         [0276]    Collar support  1331  may include upper plate  1907  and lower plate  1903 . Upper plate  1907  and lower plate  1903  may have one or more features in common with upper plate  1905  and lower plate  1901 , respectively. Bone fragment manipulator  1314  may have one or more features in common with bone fragment manipulator  1312 . 
         [0277]      FIG. 20  shows illustrative cross-section  2000  taken along lines  20 - 20  (shown in  FIG. 13 ). Outer threads  1327  may engage female threaded member  1318 . Threaded engagement of tube  1317  and female threaded member  1318  may displace female threaded member  1318  from tapered form  1405 . Threaded engagement of tube  1317  and female threaded member  1318  may displace tube  1317  relative to female threaded member  1318 . Threaded engagement of tube  1317  and female threaded member  1318  may direct retention fingers  1413  into tapered form  1405 . 
         [0278]    In tapered form  1405 , detent  1803  and cannula  1801  (shown in  FIG. 18 ) may compress retention fingers  1413  against bone penetrating member  1315 . Compression of retention fingers  1413  against bone penetrating member  1315  may substantially prevent movement of bone penetrating member  1315  within tube  1317 . 
         [0279]    Compression of retention fingers  1413  may be limited by bone penetrating member  1315 . Expansion of retention fingers  1413  may be limited by detent  1803  and cannula  1801 . Limits imposed by bone penetrating member  1315 , detent  1803  and cannula  1801  may displace female threaded member  1318  from tapered form  1405 . Displacement of female threaded member  1318  from tapered form  1405  may displace upper plate  1905  from lower plate  1901 . Displacement of upper plate  1905  from lower plate  1901  may be limited by frame  1323 . 
         [0280]    Displacement of female threaded member  1318  from tapered form  1405  and displacement of upper plate  1905  from lower plate  1901  may generate pressure within frame  1323 . Pressure within frame  1323  may fix a position of tube  1317  relative to collar support  1325 . Pressure within frame  1323  may fix a position of collar support  1325  relative to frame  1323  (shown in  FIG. 13 ). Pressure within frame  1323  may substantially prevent movement of bone manipulator  1312 . Pressure within frame  1323  may fix a position of bone manipulator  1312 . Pressure within frame  1323  may fix a position of a bone segment secured to bone manipulator  1312 . 
         [0281]      FIG. 21  shows illustrative component  2100 . Component  2100  may include collar  2101 . Collar  2101  may include tube  2102 . Tube  2102  may include outer threads  2103 . Collar  2101  may include female threaded member  2107 . Collar  2101  may include receptacle  2105 . Receptacle  2105  may be configured to receive a bone penetrating member such as bone penetrating member  1315  (shown in  FIG. 13 ). The bone penetrating member may translate along axis Z. The bone penetrating member may rotate about axis Z. The bone penetrating member may be secured to a bone segment such as bone segments Pa or Ph (shown in  FIG. 3A ). 
         [0282]    Collar  2101  may include tapered form  2114 . Tapered form  2114  may include expansion members  2115 . Expansion members may be configured to engage collar support  2109 . Engagement of expansion members  2115  and collar support  2109  may fix a position of collar  2101  relative to collar support  2109 . Engagement of expansion members  2115  and collar support  2109  may fix a position of a bone penetrating member relative to collar support  2109 . Engagement of expansion members  2115  and collar support  2109  may fix a position of a bone segment relative to collar support  2109 . 
         [0283]    Expansion members  2115  may define a substantially spherically shape. Collar  2101  may be configured to translate along axes X, Y or Z. Collar  2101  may be configured to rotate about axes X, Y or Z. 
         [0284]    Collar support  2109  may be configured to translate along axis Y. Collar support  2109  may be configured to translate along axis X. A set screw, such as set screw  1307  (shown in  FIG. 13 ) may be inserted into channel  2113 . Collar support  2109  may be configured to pivot about the set screw. The set screw may threadedly engage a base (not shown). The base may be secured to a reference bone segment, such as bone segment Pb (shown in  FIG. 3A ). The Threaded engagement of the set screw and the base may fix a position of collar support  2109  in plane X-Y. 
         [0285]    Positioning collar support  2109  in plane X-Y may position a bone segment secured to collar support  2109  relative to the base. Positioning collar support  2109  in plane X-Y may position a bone segment secured to collar support  2109  relative to the reference bone segment secured to the base. Fixing a position of collar support  2109  relative to the base may reduce a fracture Fa or Fh (shown in  FIG. 3A ) in bone B. 
         [0286]      FIG. 22  shows illustrative tube  2200 . Tube  2200  may include outer threads  2103 . Tube  2200  may include retention finger  2201 . Retention finger  2101  may include radius r 7 . Radius r 7  may be measured with respect to a longitudinal axis L 2203  that passes through a center of cannula  2203 . Retention finger  2201  may include radius r 6 . Radius r 6  may be measured with respect to a center of cannula  2203 . Radii r 6  and r 7  may define a taper associated with retention finger  2201 . 
         [0287]    Tube  2200  may include kerf cut  2205 . Kerf cut  2205  may allow compression of expansion finger  2201  about axis L 2203 . Tapered form  2114  (shown in  FIG. 21 ) may be configured to apply pressure to retention finger  2101  along the taper defined by r 6  and r 7 . The pressure may compress retention finger  2101 . The pressure may compress retention finger  2101  against a bone penetration member inserted into cannula  2203 . 
         [0288]      FIG. 23  shows a cross-section of component  2100  along lines  23 - 23  (shown in  FIG. 21 ). Threaded engagement of outer threads  2103  and female threaded member  2107  may direct retention finger  2201  into tapered form  2114 . Tapered form  2114  may include expansion members  2115 . Tapered form may include radius r 8 . Tapered form may include radius r 9 . Radii r 8  and r 9  define a taper. The taper defined by radii r 8  and r 9  may be configured to compress retention finger  2201  about axis L 2203  in response to threaded engagement of outer threads  2103  and female threaded member  2107 . 
         [0289]    Compression of retention finger  2201  about axis L 2203  may apply pressure to a bone penetrating member inserted into cannula  2203 . Compression of retention finger  2201  may be limited by the bone penetrating member. 
         [0290]    Pressure applied by retention finger  2201  on the bone penetrating member and pressure applied by retention finger  2201  on taper form  2114  may expand expansion members  2115  against collar support  2109 . Expansion of expansion members  2115  may be limited by collar support  2109 . Pressure on the bone penetrating member and collar support  2109  may substantially fix a position of collar  2101 . Pressure on the bone penetrating member and collar support  2101  may substantially fix a position of the bone penetrating member. Pressure on the bone penetrating member and collar support  2101  may substantially fix a position of a bone segment secured to the bone penetrating member. 
         [0291]      FIG. 24  shows illustrative collar  2400 . Collar  2400  may include one or more of the features of collar  2101  (shown in  FIG. 21 ). Collar  2400  may include detent  2401 . Detent  2401  may be affixed to expansion member  2115 . Detent  2401  may be configured to resist movement of tapered form  2114 . 
         [0292]      FIG. 25  shows illustrative component  2500 . Component  2500  may include female threaded member  2107 , tapered form  2114 , expansion member  2115  and collar support  2109 . Expansion member  2115  may include detent  2401 . Collar support  2109  may include enclosure  2501 . Enclosure  2501  may be configured to limit movement of tapered form  2114  relative to collar support  2109 . 
         [0293]    Limited movement of tapered form  2114  may facilitate release of pressure within collar support  2109  in response to threaded engagement of tube  2102  and female threaded member  2107 . Limited movement of tapered form  2114  may facilitate application of pressure within collar support  2109  in response to threaded engagement of tube  2102  and female threaded member  2107 . 
         [0294]      FIG. 26  shows illustrative therapeutic scenario  2600 . Bone fragment manipulator  1312  may be secured to bone segment Ph. Bone fragment manipulator may position bone segment Ph along three orthogonal axes. Bone fragment manipulator  1312  may position bone segment Ph by rotating bone segment Ph about three orthogonal axes. The three orthogonal axes may originate originating at an origin (shown in  FIG. 7 ) of bone segment Ph. Bone segment Ph may be positioned relative to bone segment Pa. Bone segment Ph may be positioned relative to reference bone segment Pb. Bone fragment manipulator  1312  may lock a position of bone segment Ph relative to another bone segment. 
         [0295]    Bone fragment manipulator  1314  may be secured to bone segment Pa. Bone fragment manipulator may position bone segment Pa along three orthogonal axes. Bone fragment manipulator  1314  may rotate bone segment Pa about three orthogonal axes. The three orthogonal axes may originate originating at an origin (shown in  FIG. 7 ) of bone segment Pa. Bone segment Pa may be positioned relative to bone segment Ph. Bone segment may be positioned relative to reference bone segment Pb. Bone fragment manipulator  1314  may lock a position of bone segment Pa relative to another bone segment. 
         [0296]    Slider  1305  may position bone segments Pa and Ph relative to reference bone segment Pb. Bone penetrating member  2601  may be inserted into receptacle  1321  (shown in  FIG. 13 ) and secured to Pb. A position of slider  1305  along bone penetrating members  1311  and  2601  may be locked by rotating set screws  1309  and  1307 . 
         [0297]    Set screw  1307  may apply pressure to base  1301 . Set screw  1307  may apply pressure by pressing slider  1305  and slider bottom  2603  against base  1301 . The pressure may substantially fix a position of sider  1305  and slider bottom  2603 . The pressure may substantially fix a position of base  1301  relative to Pb. The pressure may substantially fix a position of bone segments Pa and Ph relative to Pb. 
         [0298]    Bone segments Pa, Ph and Pb may be locked at a therapeutic distances from each other. Locking a position of bone segments Ph, Pa and Pb may reduce fractures Fh and Fa. 
         [0299]      FIG. 27  shows illustrative clinical step  2700 . Clinical step  2700  may include drilling bone penetrating member  2701  into bone segment Bs. Bone segment Bs may be separated from reference bone segment Pb by fracture F. Bone penetrating member  2701  may be drilled into a location on bone segment Bs. The location may be identified based on an anatomical feature of bone segment Bs. The location may be identified based on a target site interior to bone B. The target site may correspond to a target location of an implant inserted into bone B to repair fracture F. The location may be identified based on sites H′ or I′ on bone B. 
         [0300]      FIG. 28  shows illustrative apparatus  2800 . Apparatus  2800  may include pin  2815 . Pin  2815  may have one or more features in common with bone penetrating member  2701 . Apparatus  2800  may include support  2801 . Support  2801  may include extension  2805 , extension  2817  and extension  2807 . A configuration of extension  2817  relative to extensions  2805  and  2807  may be adjusted using set screw  2819  and receptacles  2811  and  2813 . 
         [0301]    Support  2801  may be configured to articulate relative to pin  2815 . Support  2801  may include concave surface  2809 . Support  2801  may include concave surface  2821 . Concave surface  2809  may be configured to articulate against pin  2815 . Concave surface  2821  may be configured to articulate against pin  2815 . 
         [0302]    Bone B (shown in  FIG. 27 ) may be a radius. When bone B is a radius on a right side of skeleton S (shown in  FIG. 1 ), concave surface  2809  may be configured to articulate against pin  2815 . When bone B is a radius on a left side of skeleton S, concave surface  2821  may be configured to articulate against pin  2815 . 
         [0303]    Support  2801  may include indicator  2803 . Support  2801  may span from a first anatomical aspect of bone B to a second anatomical aspect of bone B. The first anatomical aspect may correspond to a location of pin  2815  on bone B (see  FIG. 27 ). Concave surface  2809  or  2821  may be positioned at the first anatomical aspect. Indicator  2803  may be positioned at the second anatomical aspect. When bone B is a radius, support  2801  may span from a dorsal aspect of bone B (shown in  FIG. 3A ) to a medial aspect of bone B (shown in  FIG. 3A ). 
         [0304]    Articulation of concave surface  2809  or  2821  against pin  2815  may position indicator  2803  proximate to an anatomical aspect of bone B. In a position proximate to the anatomical aspect of bone B, indicator  2803  may point to an access point on bone B. 
         [0305]    The access point may correspond to site H′ or site I′ (shown in  FIG. 3A ). The access point may be based on a target site interior to bone B. The target site may correspond to target location of an implant configured to repair fracture F. 
         [0306]      FIG. 29  shows illustrative therapeutic scenario  2900 . In scenario  2900  support  2801  is mutually engaged with pin  2815 . Support  2801  and pin  2815  when mutually engaged may define spherical surface  2907 . Spherical surface  2907  may be centered at pin  2815  and include radius r 10 . Indicator  2803  may be configured to identify access point  2903 . Access point  2903  may be positioned at an intersection of spherical surface  2907  and soft tissue (not shown) adjacent to bone B. 
         [0307]    Support  2801  may be configured to identify an access point corresponding to an implant having a first length. Support  2801  may be configured to indicate an access point for an implant having a second length. The implant may be configured to repair fracture F in bone B. 
         [0308]    For an implant having the first length, support  2801  may be configured to define a spherical surface characterized by radius r 10 . When support  2801  is configured to define a spherical surface characterized by radius r 10 , extension  2817  may be positioned a distance  2905  from detent  2909 . 
         [0309]    For an implant having the second length, support  2801  may be configured to define a spherical surface characterized by radius smaller in magnitude than radius r 10 . When support  2801  is configured to indicate an access point for an implant having the second length, extension  2817  may be positioned substantially adjacent to detent  2909 . 
         [0310]    Extension  2817  may be positioned relative to detent  2909  using set screw  2819 . Set screw  2819  may be secured using receptacle  2811  (shown in  FIG. 28 ) for an implant having the first length. Set screw  2819  may be secured using receptacle  2813  (shown in  FIG. 28 ) for an implant having the second length. 
         [0311]    Drill  2901  may be positioned adjacent to indicator  2803 . Drill  2901  may penetrate bone B at access point  2903 . 
         [0312]      FIG. 30  shows illustrative apparatus  3000 . Apparatus  3000  may include one or more of the features of apparatus  2800 . Apparatus  3000  may include support  3011 . Support  3011  may include extensions  3001 ,  3009 ,  3003  and  3007 . 
         [0313]    Apparatus  3000  may include bushing  3005 . Bushing  3005  may include cannula  3013 . Cannula  3013  may receive pin  2701 . Cannula  3013  may define a concave surface of bushing  3005 . Pin  2701  may articulate against the concave surface of bushing  3005 . Support  3011  may articulate relative to pin  2701 . A support that includes bushing  3005  for receiving pin  2701  may limit movement of support relative to pin  2701 . Limited movement of support relative to pin  2701  may reduce measurement error in determining an access point of a target site interior to bone B. 
         [0314]      FIG. 31  shows schematic model  3150 . Model  3150  illustrates principles that may embodied in apparatus  3000  (shown in  FIG. 30 ). Model  3150  shows points  3120 ,  3122  and  3124 . Points  3120 ,  3122  and  3124  may be interior to bone B. Each of points  3120 ,  3122  and  3124  may correspond to a location for a bone implant such as implant  300  (shown in  FIG. 3B ). 
         [0315]    Each of points  3120 ,  3122  and  3124  may lie on line  3127 . Line  3127  may correspond to a pin, such as pin  2701  (shown in  FIG. 27 ), fixed at an angle w relative to bone B. 
         [0316]    Line  3117  may represent a uniform distance. Line  3117  may represent a length of a bone implant, such as implant  300 . Line  3117  may be fixed at an orientation orthogonal to line  3127 . Line  3117  may represent a pointer fixed orthogonally to line  3127 . Line  3117 , when fixed orthogonally to line  3127  identifies points spaced apart from line  3127  by uniform distance  3117 . 
         [0317]    Line  3119  may be fixed orthogonally to line  3117 . Rotation of line  3119  about line  3127  at a distance  3117  from line  3127  may identify sites on bone B spaced apart from line  3127  by distance  3117 . Line  3119  may represent an engagement element that identifies points, such as points  3121 ,  3123  and  3125  on a convex surface of bone B a distance  3117  from line  3127 . A point of intersection of line  3119  and bone B may represent an access point, such as H′ or I′ (shown in  FIG. 3A ) on bone B. 
         [0318]    A change in angle w may cause line  3119  to identify points different from points  3121 ,  3123  or  3125 , but the points will remain at distance  3117  from line  3119 . 
         [0319]      FIG. 32  shows illustrative pin  3200 . Pin  3200  may include one or more of the features of pin  2701 . Pin  3200  may include collar  3215 . Collar  3215  may include detent  3211 . Collar  3215  may include detent  3213 . 
         [0320]    Detent  3211  may define a maximum penetration of end  3205  into bone segment Bs (shown in  FIG. 27 ). The maximum penetration may correspond to distance  3209 . Detent  3213  may define a minimum elevation of support  3011  or support  2801  above bone segment Bs. The minimum elevation may correspond to distance  3207 . 
         [0321]      FIG. 33  shows illustrative apparatus  3300 . Apparatus  3300  may include support  3302 . Support  3302  may include fixture  3301 . Fixture  3301  may include receptacle  3309 . Receptacle  3309  may be configured to receive pin  3203  (shown in  FIG. 32 ). Receptacle  3309  may be configured to receive pin  2701  (shown in  FIG. 27 ). Support  3300  may articulate against the pin received by receptacle  3309 . Support  3300  may pivot about the pin received by receptacle  3309 . Support  3300  pivot about the pin and sweep out spherical surface  3311 . 
         [0322]    Support  3300  may include extension  3303 . Extension  3302  may be configured to extend along spherical trajectory  3313 . Extension  3303  may extend along rail  3307 . 
         [0323]    Extension  3303  may include indicator  3305 . Indicator  3305  may be configured to indicate an access point. The access point may correspond to an intersection of spherical surface  3311  and soft tissue adjacent to bone B. 
         [0324]    Indicator  3305  may extend away from extension  3303  along spherical trajectory  3315 . Trajectory  3315  may be orthogonal to trajectory  3313 . Extension  3303  may extend along trajectory  3313  until extension  3303  contacts soft tissue adjacent to bone B. Extension  3303  may extend along trajectory  3313  until indicator  3305  contacts soft tissue adjacent to bone B. Indicator  3305  may indicate an access point for inserting an implant into bone B at a target site. 
         [0325]      FIG. 34  shows illustrative apparatus  3400 . Apparatus  3400  may have one or more features in common with apparatus  3300 . Pin  3203  may be secured to a bone segment such as bone segment Pa, Ph, Pb (shown in  FIG. 3A ) or Bs (shown in  FIG. 27 ). Detent  3211  may define a minimum elevation of fixture  3301  relative to the bone segment. Detent  3213  may define a maximum elevation  3207  of fixture  3301  above the bone segment. 
         [0326]    Pin  3203  and support  3302  may be configured such that indicator  3305  points to an access point along spherical trajectory  3315  (shown in  FIG. 33 ). Pin  3203  and support  3302  may be configured such that a target site for an implant may correspond to end  3205  of pin  3203 . The access point along spherical trajectory  3315  may be substantially a first distance from end  3205 . The distance may substantially correspond to a magnitude of radius r 11 . Spherical trajectory  3313  of extension  3303  may be a second distance from end  3205 . The second distance may substantially correspond to a magnitude of radius r 12 . 
         [0327]    The magnitude of radius r 11  may substantially correspond to the magnitude of radius r 12 . Trajectory  3313  may be orthogonal to trajectory  3315 . Radius r 11  may be orthogonal to radius r 12 . The first distance may equal the second distance. 
         [0328]    End  3205  may be a center of spherical trajectory  3313 . End  3205  may be a center of spherical trajectory  3315  (shown in  FIG. 33 ). End  3205  may correspond to a target site interior to bone B. Indicator  3305  may be associated with a known distance (r 11 ) from the target site. Indicator  3305  may identify an access point on bone B a known distance from the target site. Indicator  3305  may identify the access point on bone B at a known distance from the target site independent of anatomical discrepancies associated with bone B. Indicator  3305  may consistently identify an access point on bone B a known distance from the target site. 
         [0329]      FIG. 35  shows illustrative schematic model  3550 . Model  3550  illustrates principles that may be embodied in apparatus such as  3400  (shown in  FIG. 34 ). Model  3550  shows point  3552 . Point  3552  may be interior to a bone B. Point  3552  may correspond to a location for an end of a bone implant such as implant  300  (shown in  FIG. 3B ). The bone implant may have a length commensurate with line  3117 . 
         [0330]    Point  3552  may lie on line  3557 . Line  3557  may correspond to a pin, such as pin  2701  (shown in  FIG. 27 ), fixed at angle W relative to bone B. Point  3552  may be a center of spherical surface  3563  (shown in cross-section). 
         [0331]    Each of lines  3552 ,  3554  and  3556  are radii of spherical surface  3563  and have corresponding endpoints  3551 ,  3553  and  3555  on a convex portion of the surface of bone B. Each of endpoints  3551 ,  3553  and  3555  is thus spaced apart a distance  3117  from point  3553  and is a suitable candidate for placing an access hole for the deployment of an implant having length  3117 . 
         [0332]      FIG. 36  shows illustrative apparatus  3600 . Apparatus  3600  may include support  3611 . Support  3611  may include receptacle  3619 . Receptacle  3619  may guide pin  2701  into bone segment Bs. Support  3611  may include marker  3609 . Marker  3609  may be visible under fluoroscopic imaging. Marker  3609  may position support  3611  relative to bone B. Marker  3609  may position support  3611  along a center-line Lb of bone B (shown in  FIG. 3A ). Marker  3609  may be aligned based on a target site for an implant inserted into bone B. 
         [0333]    Support  3611  may be positioned, such that pin  2701 , when inserted through receptacle  3619  follows a subchondral surface  3603  of bone B. Support  3611  may pivot about axis Ps. Support  3611  may pivot about axis Ps to reduce a displacement indicated by arrows  3617 . Displacement  3617  may correspond to a distance of guide  3601  from bone B. 
         [0334]    Apparatus  3600  may include guide  3601 . Guide  3601  may be positioned on bone B. Alignment member  3613  may align guide  3601  on bone B. Guide  3601  may include guide surface  3615 . Guide surface  3615  may be positioned to direct a surgical tool, such as drill  2901  (shown in  FIG. 29 ) to an access point on bone B. Guide  3601  may be positioned on a lateral side of bone B. Guide  3601  may be positioned on a medial side of bone B. 
         [0335]    Apparatus  3600  may include bone penetrating members  3607  and  3605 . Bone penetrating members  3607  and  3605  may be inserted into cortical bone BCO (shown in  FIG. 3A ) of bone B. Bone penetrating member  3605  may be inserted into bone B through receptacle  3621 . Receptacle  3621  may be configured to direct bone penetrating member  3605  into bone B in a “toe-nail” position. Bone penetrating member  3607  may be inserted into radius R through a receptacle (not shown). Bone penetrating members  3607  and  3605  may stabilize guide  3601  on bone B. 
         [0336]      FIG. 37  shows illustrative apparatus  3700 . Apparatus  3700  may include jig  3702 . Jig  3702  may include one or more of the features of jig  1000  (shown in  FIG. 10 ). 
         [0337]    Apparatus  3700  may include bridging member  3715 . Bridging member  3715  may include receptacles  3723  and  3724 . Receptacle  3723  may be configured to receive a first bone penetrating member such as bone penetrating member  1007  (shown in  FIG. 10 ). The first bone penetrating member may be secured to a first bone segment such as bone segments Pa or Ph (shown in  FIG. 3A ). 
         [0338]    Receptacle  3724  may be configured to receive a second bone penetrating member such as bone penetrating member  1001  (shown in  FIG. 10 ). The second bone penetrating member may be secured to a second bone segment such as bone segments Pa or Ph (shown in  FIG. 3A ). The first and second bone penetrating members may position the first bone segment relative to the second bone segment. The first and second bone penetrating members may be secured to a dorsal side (shown in  FIG. 3A ) of bone B. 
         [0339]    Apparatus  3700  may include support  3717 . Support  3717  may be joined to base  3719 . Base  3719  may include receptacle  3721 . Receptacle  3721  may be configured to receive a third bone penetrating member secured to a reference bone segment. The third bone penetrating member may position the first and the second bone segments relative to the reference bone segment. 
         [0340]    Bridging member  3715  may fix a position of the first bone segment relative to the second bone segment. Bridging member  3715  and base  3719  may fix a position of the first and second bone segments relative to the reference bone segment. Apparatus  3700  may reduce fractures Fa and Fh (shown in  FIG. 3A ). 
         [0341]    Receptacle  3731  may be configured to receive pin  2701 . Support  3727  may articulate against pin  2701 . A position of support  3727  relative to channel  3729  may be fixed by set screw  3725 . 
         [0342]    Apparatus  3700  may include guide  3709 . Guide  3709  may be in mechanical coordination with support  3727 . Support  3727  may position guide  3709  on a lateral side of bone B. Support  3727  may position guide  3709  relative to a site interior to a fractured bone. Guide  3709  may include guide surface  3711 . Guide surface  3711  may align a surgical tool with the site. 
         [0343]    Apparatus  3700  may include guide surface extender  3713 . Guide surface extender  3713  may position a guide surface extension (not shown) relative to the reference bone segment. Rotation of guide surface extender  3713  may fix a position of the guide surface extension relative to the reference bone segment. 
         [0344]    Apparatus  3700  may include channels  3703  and  3707 . Bone penetrating members  3705  and  3707  may be inserted through channels  3707  and  3703 , respectively, through cortical bone BCO (shown in  FIG. 3A ). Bone penetrating members  3705  and  3707  may stabilize guide  3709  on bone B. Bone penetrating members  3705  and  3707  may be K-wires. Bone penetrating members  3705  and  3707  may be inserted into bone B using a wire drill. 
         [0345]    Apparatus  3700  may include alignment members  3733  and  3701 . Alignment members  3733  and  3701  align guide  3709  along the reference bone. Alignment members  3733  and  3701  may align guide  3709  along a center-line LB of bone B (shown in  FIG. 3A ). 
         [0346]      FIG. 38  shows illustrative apparatus  3800 . Apparatus  3800  may include jig  3801 . Jig  3801  may include one or more of the features of jig  1000  (shown in  FIG. 10 ). 
         [0347]    Apparatus  3800  may include bridging member  3837 . Bridging member  3837  may include receptacles  3823  and  3825 . Receptacles  3823  and  3825  may be configured to receive bone penetrating elements such as bone penetrating members  1312  and  1314  (shown in  FIG. 13 ). Bone penetrating members  1312  and  1314  may each be secured to a bone segments such as Ph or Pa (shown in  FIG. 3A ). Set screws  3827  and  3829  may fix a position of bone penetrating elements  1312  and  1314  relative to bridging member  3837 . 
         [0348]    Bridging member  3837  may be configured to pivot about axis Z. Axis Z may be positioned relative to a site interior to bone B. Apparatus  3800  may include a marker (not shown) positioned about axis Z. The marker may include one or more of the features of marker  3609  (shown in  FIG. 36 ). The marker may aid positioning of apparatus  3800  relative to the site interior to bone B. Rotation of bridging member  3837  about axis Z may position the bone segments secured to bone penetrating members  1312  and  1314 . A position of bridging member  3837  about axis Z may be fixed by set screw  3831 . 
         [0349]    Apparatus  3800  may include base  3803 . Apparatus  3800  may include collar  3805 . Collar  3805  may include receptacles  3833  and  3835 . Bone penetrating members such as  1311  and  2601  (shown in  FIG. 26 ) may be received by receptacles  3833  and  3835 . Bone penetrating members such as  1311  and  2601  may secure base  3803  to a reference bone segment such as bone segment Pb (shown in  FIG. 3A ). Set screw  3839  may position collar  3805  relative to base  3803 . 
         [0350]    Apparatus  3800  may be configured to position bone segment Pa relative to bone segment Ph. Apparatus  3800  may be configured to position bone segments Pa and Ph relative to bone segment Pb. Apparatus  3800  may be configured to lock a relative position of bone segments Pb, Pa and Ph. 
         [0351]    Apparatus  3800  may include support  3811 . Support  3811  may pivot about axis Z. Support  3811  may include extension  3813 . Extension  3813  may translate relative to band  3815 . Set screw  3841  may fix a position of extension  3813  relative to band  3815 . Support  3811  and extension  3813  may be configured to position guide  3807  relative to bone B. Alignment members  3817  and  3819  may position guide  3807  relative to a center-line Lb (shown in  FIG. 3A ) of bone B. Guide end  3849  may indicate an access point on bone B. Guide surface  3847  may be oriented to align a surgical tool at the indicated access point. 
         [0352]    Guide  3807  may include channels  3843  and  3845 . Bone penetrating members  3805  and  3807  may be inserted through channels  3707  and  3703  into cortical bone BCO (shown in  FIG. 3A ) to stabilize guide  3807  on bone B. Extension  3813  may include receptacle  3821 . A bone penetrating member may be inserted through receptacle  3821  into cortical bone BCO (shown in  FIG. 3A ) to stabilize apparatus  3800  on bone B. A bone penetrating member may be inserted through receptacle  3821  into cortical bone BCO to create a pilot hole in bone B. 
         [0353]      FIG. 39  shows illustrative apparatus  3900 . Apparatus  3900  may have one or more features in common with jig  1000  (shown in  FIG. 10 ) or jig  1300  (shown in  FIG. 13 ). 
         [0354]    Apparatus  3900  may include bridging member  3905 . Bridging member  3905  may include receptacles  3907  and  3909 . Receptacles  3907  may be configured to receive bone penetrating members  3921  and  3919 , respectively. Bone penetrating member  3921  may be secured to bone segment Pa. A position of bone penetrating member  3921  may be fixed relative to bridging member  3905  using a set screw (not shown) inserted into receptacle  3931 . 
         [0355]    Bone penetrating member  3919  may be secured to bone segment Ph. A position of bone penetrating member  3919  may be fixed relative to bridging member  3905  using a set screw (not shown) inserted into receptacle  3929 . Apparatus  3900  may be configured to position bone segment Ph relative to bone segment Pa. 
         [0356]    Apparatus  3900  may include base extensions  3911  and  3913 . Base extension  3913  may include receptacle  3915 . Receptacle  3915  may be configured to receive bone penetrating member  3925 . Base extension  3913  may include a receptacle (not shown) configured to receive bone penetrating member  3923 . Bone penetrating members  3925  and  3923  may be secured to bone segment Pb. Bone penetrating members  3925  and  3923  may be fixed relative to base extension  3913  by one or more set screws (not shown). Base extension  3911  may have one or more features in common with base extension  3913 . 
         [0357]    Apparatus  3900  may be configured to position bone segment Pa relative to a center of bone segment Pa. Apparatus  3900  may be configured to position bone segment Ph relative to a center of bone segment Ph. Apparatus  3900  may be configured to fix a position of bone segments Ph and Pa relative to bone segment Pb. Apparatus  3900  may be configured to reduce fractures Fh and Fa. 
         [0358]    Apparatus  3900  may include guide support  3903 . Guide support  3903  may be configured to rotate about axis P 1 . A position of guide support  3903  about axis P 1  may be fixed by tightening set screw  3917 . Guide support  3903  may be positioned about axis P 1  relative to bone segment Pb. Guide support  3903  may include knobbed detent  3927 . Guide support  3903  may include articulating surface  3931 . Guide support  3903  may be affixed to a dorsal side of bone B. 
         [0359]      FIG. 40  shows illustrative apparatus  4000 . Apparatus  4000  may have one or more features in common with the apparatus  3900 . Apparatus  4000  may be positioned relative to a site interior to bone B. Marker  4019  may be visible under fluoroscopic imaging. Marker  4019  may be positioned relative to the site interior to bone B. 
         [0360]    Apparatus  4000  may include guide extension  4023 . Guide extensions  3903  and  4023  may be configured to position guide  4021  relative to bone B. Guide extension  3903  may pivot about axis P 1 . Articulating surface  3931  (shown in  FIG. 39 ) may be positioned at a distance from bone B. A position of articulating surface  3931  may be fixed using set screw  3917  (shown in  FIG. 39 ). 
         [0361]    Guide extension  3903  may be configured to articulate against articulating surface  3931 . Guide extension  4023  may pivot about axis P 2 . Guide extension  4023  may be configured to align guide  4021  and guide collar  4015  with bone B. 
         [0362]    Guide  4021  and guide collar  4015  may be detached from guide support  3903 . Guide  4021  and guide collar  4015  may be detached from guide support  3903  during reduction of fractures Fa and Fh (shown in  FIG. 39 ). Detachment of guide  4021  and guide collar  4015  from bone B may provide a substantially unobstructed view of bone B during the reduction procedure. 
         [0363]    Guide extension  4023  may include enclosure  4025 . Guide extension  4023  may be fixed at a position about axis P 2  by knobbed detent  3927 . Knobbed detent  3927  may be maintained in a default position by a spring (not shown). Knobbed detent  3927  may include tip  4027 . Tip  4027  may be configured to extend into enclosure  4025 . Translating knobbed detent along axis P 2  may release guide  4021  and guide collar  4015  from guide support  3903 . Translating knobbed detent along axis P 2  may release tip  4027  from enclosure  4025 . 
         [0364]    Guide collar  4015  may be configured to position guide  4021  on bone B. Guide collar  4015  may include alignment members  4009  and  4011 . Alignment members  4009  and  4011  may position guide  4021  along a center-line LB (shown in  FIG. 3A ) of bone B. Receptacle  4013  may be configured to receive bone penetrating member  4005 . A receptacle (not shown) may be configured to receive bone penetrating member  4007 . The receptacle may have one or more features in common with receptacle  4013 . Bone penetrating members  4005  and  4007  may be secured to bone B. Bone penetrating members  4005  and  4007  may be secured to bone B in a “toe-nail” configuration. Bone penetrating members  4005  and  4007  may fix a position of guide collar  4015  relative to bone B. 
         [0365]    Insert  4029  may be configured to be position inside guide collar  4015 . Insert  4029  may include indicator  4017 . Indicator  4017  may indicate a site interior to bone B. The site may correspond to a target site of an implant configured to maintain a reduction of fractures Fa and Fh. Insert  4017  may be positioned or removed from guide collar  4015  using handle  4001 . Inserted  4017  may be removed from guide collar  4015  after guide collar  4015  is secured to bone B. 
         [0366]    Handle  4001  may include bushing  4003 . Bushing  4003  may be configured to receive a bone penetrating member. The bone penetrating member may be secured to bone B. Bushing  4003  may be configured to indicate an access point (shown in  FIG. 29 ). The access point may correspond to the site interior to bone B. Bushing  4003  may position a surgical tool such as drill  2901  (shown in  FIG. 29 ) at the access point. 
         [0367]      FIG. 41  shows illustrative apparatus  4100 . Apparatus  4100  may include collar  4143 . Collar  4143  may include offset member  4139 . Offset member  4139  may include receptacle  4119 . Receptacle  4119  may be configured to receive bone a penetrating member. The bone penetrating member may be secured to a bone segment, such as bone segment Pa or bone segment Ph (shown in  FIG. 3A ). 
         [0368]    A position of the bone penetrating member may be fixed relative to offset member  4139 . Offset member  4139  may include receptacle  4121 . Receptacle  4121  may be configured to receive a set screw (not shown). The set screw may fix a position of the bone penetrating member relative to offset member  4139 . 
         [0369]    Collar  4143  may be configured to displace the bone segment secured to the bone penetrating member. Collar  4143  may be configured to displace the bone segment relative to a center of the bone segment. The center of the bone segment may correspond to origin O 1  or O 2  (shown in  FIG. 7 ). Collar  4143  may be configured to displace the bone segment along three orthogonal axes. Collar  4143  may be configured to rotate the bone segment about three orthogonal axes. 
         [0370]    Collar  4143  may be configured to rotate about axis P 4143 . Collar  4143  may be configured to rotate the bone segment about axis  4143 . Offset member  4139  may include receptacle  4147 . Receptacle  4147  may be configured to receive a set screw (not shown). The set screw may fix a position of offset member  4139  about axis P 4143 . 
         [0371]    Collar  4143  may be configured to displace the bone segment along axes X, Y and Z. Collar  4143  may be configured to rotate the bone segment about axes X, Y and Z. 
         [0372]    Apparatus  4100  may include collar support  4145 . Collar support  4145  may include hemisphere  4125  and hemisphere  4127 . Hemisphere  4125  may include receptacle  4123 . Hemisphere  4127  may include female threaded member  4129 . Receptacle  4123  may be configured to receive a set screw (not shown). The set screw may include outer threads configured to engage female threaded member  4129 . Engagement of the set screw and female threaded member  4129  may fix a position of collar  4143  along axes X, Y and Z. Engagement of the set screw and female threaded member  4129  may fix a position of collar  4143  about axes X, Y and Z. 
         [0373]    Apparatus  4100  may include central member  4101 . Central member  4101  may include receptacles  4107  and  4109 . Receptacles  4107  and  4109  may each be configured to receive a bone penetrating member. The bone penetrating member may be secured to a bone segment such as bone segment Pb (shown in  FIG. 3A ). Central member  4101  may be configured to secure apparatus  4100  to a reference bone segment. Central member  4101  may be positioned relative to a bone segment. 
         [0374]    Central member  4101  may include receptacles  4105  and  4103 . Receptacles  4105  and  4103  may each be configured to receive a set screw (not shown). The set screw may fix a position of the bone penetrating member received by receptacle  4107  or  4109 . The set screw may fix a position of central member  4101  relative to the bone penetrating member. The set screw may fix a position of central member  4101  relative to the bone segment secured to the bone penetrating member. 
         [0375]    Apparatus  4100  may include rail  4102  and base  4111 . Rail  4102  may be rigidly secured to central member  4101 . Rail  4102  may include receptacle  4115 . Receptacle  4115  may be configured to receive a set screw (not shown). The set screw may secure base  4111  to rail  4102 . Base  4111  may be configured to translate relative to rail  4102  along axis L 4111 . The set screw may fix a position of base  4111  relative to rail  4102 . 
         [0376]    Base  4111  may include bracket  4141 . Bracket  4141  may be rigidly secured to base  4111 . Bracket  4141  may include a receptacle (not shown). The receptacle may be configured to receive hemisphere  4125 . Bracket  4141  may be secured to hemisphere  4125 . 
         [0377]    Apparatus  4100  may be configured to position bone segment Pa relative to bone segment Ph. Apparatus  4100  may be configured to fix a position bone segment Pa relative to bone segment Ph. 
         [0378]    Apparatus  4100  may be configured to manipulate two or more bone segments relative to a reference bone segment. Apparatus  4100  may include collar  4142 , collar support  4144 , bracket  4140  and base  4110 . Collar  4138  may have one or more features in common with collar  4143 . Collar support  4144  may have one or more features in common with collar support  4145 . Bracket  4140  may have one or more features in common with bracket  4141 . Base  4110  may have one or more features in common with base  4111 . 
         [0379]    Apparatus  4100  may be configured to position bone segment Pa and bone segment Ph relative to bone segment Pb (shown in  FIG. 3A ). Apparatus  4100  may be configured to reduce fractures Fa or Fh (shown in  FIG. 3A ). 
         [0380]    Apparatus  4100  may include slider  4131 . Slider  4131  may be configured to translate relative to rail  4102 . Apparatus  4100  may include targeting member  4133 . Targeting member  4133  may be configured to translate relative to slider  4131 . Targeting member  4133  may include nose  4149 . Nose  4149  may include marker  4137 . Marker  4137  may position apparatus  4100  relative to a sit interior to bone B. Maker  4137  may be visible during fluoroscopic imaging. 
         [0381]      FIG. 42  shows illustrative components  4200 . Components  4200  may include collar  4143 . Collar  4143  may include articulating surface  4205 . Articulating surface  4205  may include a spherical curvature. Articulating surface  4205  may be configured to translate along axes X, Y or Z. Articulating surface  4205  may be configured to rotate about axes X, Y or Z. 
         [0382]    Components  4200  may include collar support  4145 . Collar support  4145  may include hemisphere  4145  and hemisphere  4127 . Articulating surface  4205  may be configured to articulate against hemisphere  4125 . Articulating surface  4205  may be configured to articulate against hemisphere  4127 . 
         [0383]    Hemisphere  4127  may include female threaded member  4129 . Set screw  4201  may be configured to threadedly engage female threaded member  4129 . Hemisphere  4125  may include receptacle  4123 . Receptacle  4123  may be configured to receive set screw  4201 . Threaded engagement of set screw  4201  and female threaded member  4129  may compress hemisphere  4125  and hemisphere  4127  against articulating surface  4205 . 
         [0384]    Compression of hemisphere  4125  and hemisphere  4127  against articulating surface  4205  may fix a position of collar  4143  along axes X, Y and Z. Compression of hemisphere  4125  and hemisphere  4127  against articulating surface  4205  may fix a position of collar  4143  about axes X, Y and Z. Compression of hemisphere  4125  and hemisphere  4127  against articulating surface  4205  may fix a position of a bone segment secured to collar  4143 . The position of the bone segment may be fixed relative to center of the bone segment. The center may correspond to origin O 1  or O 2  (shown in  FIG. 7 ). The position of the bone segment may be fixed relative to a reference bone segment. 
         [0385]    Hemisphere  4125  may include edge  4211 . Hemisphere  4209  may include edge  4209 . Collar  4143  may include female threaded member  4207 . Female threaded member  4207  may be configured to articulate against a portion of edge  4211 . Female threaded member  4207  may be configured to articulate against a portion of edge  4209 . 
         [0386]    Female threaded member  4207  may be configured to threadedly engage set screw  4203 . Threaded engagement of set screw  4203  and female threaded member  4207  may fix a position of offset arm  4139  about axis P 4143 . Threaded engagement of set screw  4203  and female threaded member  4207  may fix a position of a bone segment secured to collar  4143 . The position of the bone segment may be fixed relative to axis P 4143 . The position of the bone segment may be fixed relative to a center of the bone segment. The center of the bone segment may correspond to origin O 1  or O 2 . 
         [0387]      FIG. 43  shows illustrative components  4300 . Components  4300  may include articulating surface  4205 . Articulating surface  4205  may include receptacle  4301 . Receptacle  4301  may be configured to receive set screw  4201  (shown in  FIG. 42 ). 
         [0388]      FIG. 44  shows cross-section  4400  along lines  44 - 44  (shown in  FIG. 42 ). Cross-section  4200  shows set screw  4201  (shown in  FIG. 42 ) passing through receptacle  4301  (shown in  FIG. 43 ). Cross-section  4200  shows set screw  4201  threadedly engaged with female threaded member  4129  (shown in  FIG. 41 ). 
         [0389]    Cross-section  4400  shows set screw  4203  passing through receptacle  4147  (shown in  FIG. 41 ). Cross-section  4400  shows set screw  4203  threadedly engaged with female threaded member  4207 . 
         [0390]      FIG. 45  shows illustrative apparatus  4500 . Apparatus may have one or more features in common with apparatus  4100 . Apparatus  4500  may include slider  4131  (shown in  FIG. 41 ). Slider  4131  may be configured to translate along axis L 4131 . Slider  4131  may be configured to translate relative to rails  4501  and  4102 . 
         [0391]    Apparatus  4500  may include central member  4101 . Central member  4101  may be secured to a bone segment. Slider  4131  may be configured to translate relative to the bone segment. 
         [0392]    Apparatus  4500  may include targeting member  4133 . Targeting member  4133  may include nose  4149  and marker  4137 . Marker  4137  may include template  4505 . Template  4505  may be visible during fluoroscopic imaging. Targeting member  4133  may be configured to translate along axis H 4149 . 
         [0393]    Translation of slider  4131  may position marker along axis L 4131 . Translation along axis L 4131  may position marker  4137  relative to a site interior to bone B. Translation of targeting member  4133  may position marker  4137  along axis H 4133 . Translation along axis H 4133  may position marker  4137  relative to a site interior to bone B. 
         [0394]    Slider  4131  may include receptacle  4511 . Threaded engagement of a set screw (not shown) and receptacle  4511  may fix a position of slider  4131  relative to rails  4501  and  4102 . Targeting member  4133  may include receptacle  4513 . Threaded engagement of a set screw (not shown) and receptacle  4513  may fix a position of targeting member  4133  relative to slider  4131 . 
         [0395]    Apparatus  4500  may include support  4503 . Support  4503  may include clasp  4509 . Clasp  4509  may be configured to articulate against cylindrical surface  4135 . Support  4503  may be configured to articulate relative to targeting member  4133 . 
         [0396]    Support  4503  may include indicator  4507 . Indicator  4507  may be configured to identify an access point on bone B. Support  4503  may be configured to identify the access point at an intersection of indicator  4507  and soft tissue adjacent bone B. Indicator  4507  may be configured to cooperate with a guide (not shown). The access point may correspond to a site interior to bone B. The access point may correspond to the site identified by marker  4137 . 
         [0397]      FIG. 46  shows illustrative apparatus  4600 . Apparatus  4600  may include base  4601 . Base  4601  may include channel  4643 . Apparatus  4600  may include slider  4603 . Slider may include receptacles  4647  and  4645 . Receptacle  4643  may be configured to receive bone penetrating member  4637 . Receptacle  4645  may be configured to receive bone penetrating member  4635 . Bone penetrating members  4637  and  4635  may be secured to bone segment Pb. Bone penetrating members  4637  and  4635  may secured slider  4603  to bone segment Pb. Set screws  4639  and  4641  may fix an elevation of slider  4603  relative to bone segment Pb. 
         [0398]    Within channel  4643 , slider  4603  may be configured to translate relative to base  4601 . Set screw  4605  may fix a position of slider  4603  relative to base  4601 . 
         [0399]    Apparatus  4600  may include collar  4607 . Collar  4607  may include articulating surface  4615 . Articulating surface  4615  may include a substantially spherically curvature. Collar  4607  may include planar surface  4614 . Planar surface  4614  may include receptacles  4651 . Receptacles  4651  may be configured to receive bone penetrating member  4631 . Bone penetrating member  4633  may be secured to bone segment Pa. 
         [0400]    Apparatus  4600  may be configured to position bone segment Pa along axes X, Y and Z. Apparatus  4600  may be configured to rotate bone segment Pa about axes X, Y and Z. Axis Z may be off-set from bone penetrating member  4631 . 
         [0401]    Apparatus  4600  may be configured to position bone segment Pa relative to a center of bone segment Pa. The center of bone segment Pa may correspond to origin O 2  (shown in  FIG. 7 ). Apparatus  4600  may be configured to position bone segment Pa relative to bone segment Pb. Apparatus  4600  may be configured to position bone segment Pa relative to bone segment Ph. 
         [0402]    Apparatus  4600  may include collar support  4614 . Articulating surface  4615  may articulate against collar support  4614 . Collar support  4614  may include extensions  4653  and  4655 . Set screw  4617  may be configured to compress extensions  4653  and  4655  about plane Z-Y. Compression of extensions  4653  and  4655  may apply pressure to articulating surface  4615 . The pressure may fix a position of collar  4607  relative to collar support  4614 . The pressure may fix a position of bone penetrating member  4631 . The pressure may fix a position of bone segment Pa relative to origin O 2 . 
         [0403]    Apparatus  4600  may include collar  4620 . Collar  4620  may include articulating surface  4619 . Articulating surface  4619  may have one or more features in common with articulating surface  4615 . Collar  4620  may include extension  4609 . Extension  4609  may have one or more features in common with collar support  4614 . Extension  4609  may have one or more features in common with collar  4607 . Extension  4609  may be configured to receive bone penetrating member  4629 . Bone penetrating  4629  may be secured to bones segments Pa and Ph. Bone penetrating member  4629  may bridge fracture Fa. 
         [0404]    Collar  4620  may be configured to fix a position of bone segments Pa and Ph relative to bone segment Pb. Set screw  4621  may fix a position of articulating surface  4619  relative to collar support  4618 . Set screw  4627  may fix a position of articulating surface  4625  relative to extension  4609 . Set screws  4621  and  4627  may fix a position of bone segments Pa and Ph relative to bone segment Pb. 
         [0405]    Apparatus  4600  may include collar  4611 . Collar  4611  may be configured to receive bone penetrating member  4633 . Bone penetrating member  4633  may be secured to bone segment Ph. Collar  4611  may have one or more features in common with collar  4607 . Collar  4611  may be configured to position bone segment Ph about origin O 1  (shown in  FIG. 7 ). Apparatus  4600  may include collar support  4657 . Collar support  4657  may have one or more features in common with collar support  4614 . 
         [0406]    Set screw  4613  may be configured to fix a position of collar  4611  relative to collar support  4657 . Set screw  4613  may be configured to fix a position of bone segment Ph relative to origin O 1 . 
         [0407]      FIG. 47  shows illustrative apparatus  4700 . Apparatus  4700  may include bridging member  4707 . Bridging member  4707  may include receptacles  4701 . Receptacles  4701  may be configured to receive a bone penetrating member. Receptacles  4701  may provide multiple positions for one or more bone penetrating members. Apparatus  4700  may include a pressure distribution member (see item  1013 ,  FIG. 10 ). The pressure distribution member may be configured to fix a position of one or more bone penetrating members received by receptacles  4701 . 
         [0408]    Apparatus  4700  may include bridging member  4705 . Bridging member  4705  may include receptacles  4703 . Bridging member  4705  may have one or more features in common with bridging member  4707 . 
         [0409]    Support  4709  may join bridging member  4707  and bridging member  4705 . Support  4709  may rigidly join bridging member  4707  and bridging member  4705 . Support  4709  may include a hinge (not shown). 
         [0410]      FIG. 48A  shows illustrative apparatus  4800 . Apparatus  4800  may include support  4803 . Support  4803  may be configured to support soft tissue  4808 . Soft tissue  4808  may correspond to a first bone fragment (not shown). 
         [0411]    Apparatus  4800  may include bracing element  4807 . Bracing element  4807  may substantially fix a position of soft tissue  4808  relative to support  4803 . Bracing element  4807  may substantially fix a position of the first bone segment relative to support  4803 . 
         [0412]    Apparatus  4800  may include support  4801 . Support  4801  may be configured to support soft tissue  4809 . Soft tissue  4809  may correspond to a second bone fragment (not shown). 
         [0413]    Apparatus  4800  may include bracing element  4811 . Bracing element  4811  may include soft tissue grasper  4823 . Bracing element  4811  may include tensioning knob  4815 . Bracing element  4811  may include spring  4819 . Bracing element  4811  may include tensioner  4817 . 
         [0414]    Bracing element  4811  may be configured to apply tension to soft tissue  4809 . The tension may displace the second bone fragment from the first bone fragment. Soft tissue grasper  4823  may be configured to apply increasing tension as displacement of the second bone fragment from the first bone fragment increases. 
         [0415]    Bracing element  4811  may be configured to substantially fix a position of soft tissue  4809  relative to support  4801 . Bracing element  48011  may substantially fix a position of the first bone segment relative to support  4803 . 
         [0416]    Apparatus  4800  may include bracing element  4813 . Bracing element  4813  may have one or more features in common with bracing element  4811 . 
         [0417]    Apparatus  4800  may include support  4825 . Support  4825  may include receptacle  4821 . Receptacle  4821  may be configured to threadedly engage tensioning knob  4815 . Threaded engagement of tensioning knob  4815  and receptacle  4821  may increase tension in spring  4819 . Tension in spring  4821  may increase tension on tensioner  4817  and soft tissue grasper  4823 . Increased tension on soft tissue grasper  4823  may increase traction to soft tissue  4809 . 
         [0418]    Apparatus  4800  may include set screw  4805 . Set screw  4805  may be configured to fix a position of support  4803  relative to support  4801 . Set screw  4805  may be configured to fix a position of the first bone fragment relative to the second bone fragment. Apparatus  4800  may be configured to reduce fractures Fa and Fh in bone B (shown in  FIG. 3A ). 
         [0419]    Apparatus  4800  may reduce a fracture in bone B through application of forces applied in tension, translation, angle, and any suitable manipulation of bone segments of bone B relative to each other. Apparatus  4800  may be “self-contained” in that it may be secured directly only to the patient&#39;s body and to no other structure or support. Because apparatus  4800  may be self-contained, the clinician may freely manipulate apparatus  4800  to accommodate personal, clinical or therapeutic positioning requirements and preferences while maintaining reduction. 
         [0420]      FIG. 48B  shows illustrative apparatus  4850 . Elements of apparatus  4850  may have features in common with corresponding features of apparatus  4800  (shown in  FIG. 48 ). For example, support  4857  may correspond to support  4801 . Support  4859  may correspond to support  4803 . 
         [0421]    Apparatus  4850  may include brace  4855 . Brace  4855  may secure soft tissue  4808  (shown in  FIG. 48 ) against sliding relative to support  4857 . Brace  4855  may secure soft tissue  4808  against sliding, for example, by providing resistance against an anterior region of the humerus. 
         [0422]    Articulating lock  4853  may fix a position and orientation of support  4859  relative to support  4857 . When lock  4853  is unlocked, gap  4851 , between support  4857  and support  4859  may be lengthened or shortened. 
         [0423]    For example, during a reduction procedure, supports  4857  and  4859  may be arranged in substantially the same plane. Gap  4851  may be lengthened to apply traction. Support  4859  may then be translated downward, while maintaining the attitude of support  4859 . Support  4859  may then be tilted or rotated relative to support  4857 . Lock  4853  may then be actuated to fix the position and orientation of support  4859  relative to support  4857 . 
         [0424]      FIG. 49  shows illustrative apparatus  4900 . Apparatus  4900  may have one or more features in common with apparatus  4800 . Apparatus  4900  may include supports  4803  and  4801  (shown in  FIG. 48 ). Apparatus  4900  may include ball joint  4901 . Ball joint  4901  may be fixed to support  4801 . Support  4805  may include a socket  4903 . Socket  4903  may be configured to receive ball joint  4901 . Ball joint  4901  may articulate against a portion of socket  4903 . 
         [0425]    Supports  4801  and  4803  may be configured to translate along axes X, Y and Z. Support  4801  and  4803  may be configured to rotate about axes X, Y and Z. Supports  4801  and  4803  may be positioned at an angle sigma. Angle sigma may correspond to a relative elevation of support  4801  relative to support  4803 . Supports  4801  and  4803  may be positioned at an angle phi. Angle phi may correspond to a planar orientation, in plane X-Y, of support  4801  relative to support  4803 . 
         [0426]    Set screws  4805   4905  may threadedly engage base  4803 . Set screws  4805   4905  may be configured to engage ball joint  4901 . Set screws  4805   4905  may apply pressure to ball joint  4901 . The pressure may fix a position of support  4801  relative to support  4803 . 
         [0427]      FIG. 50  shows a close-up view  5000  of a portion of apparatus  4800 . View  5000  shows bracing element  4813 . Bracing element  4813  may include web  5001 . Web may include strands  5015  and  5017 . Strands  5015  and  5017  may form angle mu. 
         [0428]    Tensioning knob  5003  may be threadedly engagement with support  4825 . Threaded engagement of tensioning knob  5003  and support  4825  may compress spring  5005  against tensioner  5007 . The compression may induce tension in bracing element along axis T 1 . The tension and traction of soft tissue  5013  against web  5001  may decrease magnitude of angle mu. 
         [0429]    Decreasing the magnitude of angle mu may increase a length of web  5001  along axis T 1 . Decreasing the magnitude of angle mu may compress web  5001  about lines T 2 -T 2 . Decreasing the magnitude of angle mu may increase traction of web  5001  against soft tissue  5013 . Increased traction against soft tissue  5001  may fix a position of soft tissue  5013  relative to base  4801 . 
         [0430]    Tensioner  5007  may include receptacle  5011 . Set screw  5009  may be configured to threadedly engage receptacle  5011 . Set screw  5009  may fix a position of bracing element  4813  relative to tensioner  5007 . 
         [0431]      FIG. 51  shows illustrative apparatus  5100 . Apparatus  5100  may include malleable frame  5101 . Collars  5115 ,  5117  and  5119  may be fixed to malleable frame  5101 . 
         [0432]    Collar  5115  may include receptacles  5109  and  5123 . Receptacle  5109  may be configured to receive a bone penetrating member. Receptacle  5123  may be configured to receive a set screw (not shown). Engagement of the set screw and receptacle may apply pressure to a bone penetrating member received by receptacle  5109 . The pressure may fix a position of the bone penetrating member with respect to collar  5115 . 
         [0433]    Collar  5115  may include receptacle  5127 . Receptacle  5127  may have one or more features in common with receptacle  5109 . Collar  5115  may include receptacle  5129 . Receptacle  5129  may have one or more features in common with receptacle  5123 . Collar  5115  may be configured to be secured to one or more bone segments, such as bone segments Pa, Ph or Pb (shown in  FIG. 3A ). 
         [0434]    Handle  5103  may position a bone segment secured to collar  5115  about a center of the bone segment. The center of the bone segment may correspond to origin O 1  or O 2  (shown in  FIG. 7 ). Handle  5103  may position collar  5115  relative to collar  5117 . 
         [0435]    Apparatus  5100  may include release mechanism  5121 . Release mechanism  5121  may be configured to release handle  5103  from collar  5115 . Handle  5103  may be removable from collar  5115 . 
         [0436]    Collar  5117  may have one or more features in common with collar  5115 . Collar  5117  may include receptacle  5111 . Receptacle  5111  may be configured to receive a bone penetrating member. A bone penetrating member received by receptacle  5111  may be secured to a bone segment. A position of collar  5117  relative to the bone penetrating member may be fixed. Collar  5117  may be secured to a bone segment such as bone segments Pa, Ph or Pb (shown in  FIG. 3A ). 
         [0437]    Handle  5101  may include one or more of the features of handle  5103 . Handle  5101  may include a release mechanism. Handle  5105  may position a bone segment secured to collar  5117  about a center of the bone segment. The center of the bone segment may correspond to origin O 1  or O 2  (shown in  FIG. 7 ). Handle  5105  may position collar  5117  relative to collar  5115 . Handle  5101  may be removable from collar  5117 . 
         [0438]    Collar  5119  may include one or more of the features of collar  5115 . Collar  5119  may include receptacle  5113 . Receptacle  5113  may be configured to receive a bone penetrating member (not shown). A bone penetrating member received by receptacle  5113  may be secured to a bone segment. A position of collar  5119  relative to the bone penetrating member may be fixed. Collar  5119  may be secured to a bone segment such as bone segments Pa, Ph or Pb (shown in  FIG. 3A ). 
         [0439]    Handle  5101  may include one or more of the features of handle  5103 . Handle  5101  may include a release mechanism. Handle  5105  may position a bone segment secured to collar  5117  about a center of the bone segment. The center of the bone segment may correspond to origin O 1  or O 2  (shown in  FIG. 7 ). Handle  5105  may position collar  5117  relative to collar  5115 . Handle  5101  may be removable from collar  5117 . 
         [0440]    Malleable frame  5101  may be configured to retain a position of bone segments Pa and Ph relative to bone segment Pb. Apparatus  5100  may be configured to reduce a fracture in bone B. Apparatus  5100  may be configured to reduce fractures Fh and Fa in bone B (shown in  FIG. 3A ). 
         [0441]      FIG. 52  shows illustrative apparatus  5200 . Apparatus  5200  may include tool bracket  5201 . Axes X, Y and Z may be three orthogonal axes. 
         [0442]    Apparatus  5200  may include platform  5203 . Platform  5203  may be positioned proximal to fractures Fa and Fh. Bone penetrating members  5223  and  5221  may be secured to bone B. 
         [0443]    Bone penetrating member  5223  may pass alongside indent  5241  and washer  5231 . Set screw  5225  may threadedly engage platform  5203 . Threaded engagement of set screw  5225  and platform  5203  may press washer  5231  against platform  5203 . Threaded engagement of set screw  5225  and platform  5203  may fix a position of platform  5203  relative to bone penetrating member  5223 . Threaded engagement of set screw  5225  and platform  5203  may fix a position of platform  5203  relative to bone B. 
         [0444]    Bone penetrating member  5221  may pass alongside indent  5243  and washer  5229 . Set screw  5227  may threadedly engage platform  5203 . Threaded engagement of set screw  5227  and platform  5203  may press washer  5229  against platform  5203 . Threaded engagement of set screw  5227  and platform  5203  may fix a position of platform  5203  relative to bone penetrating member  5221 . Threaded engagement of set screw  5227  and platform  5203  may fix a position of platform  5203  relative to bone B. 
         [0445]    Threaded engagement of set screws  5227  and  5225  with platform  5203  may secure platform  5203  to bone B. Threaded engagement of set screws  5227  and  5225  with platform  4203  may fix distance D. Distance D may correspond to a position of platform  5203  relative to bone B. 
         [0446]    Apparatus  5200  may include housing  5215 . Rod  5205  may extend from housing  5215  to ball joint  5209 . Ball joint  5209  may be configured to articulate against socket  5219  of tool bracket  5201 . Articulation of ball joint  5209  against socket  5219  may provide tool bracket  5201  freedom to translate along and rotate about three orthogonal axes, such as axes X, Y and Z. 
         [0447]    Knob  5237  may threadedly engage tool bracket  5201 . Threaded engagement of knob  5237  and tool bracket  5201  may apply pressure to ball joint  5209 . The pressure may fix a position of tool bracket  5201  along or about three orthogonal axes. The pressure may limit displacement of tool bracket  5201  relative to bone B. 
         [0448]    Rod  5217  may extend from ball joint  5211  through bore  5245  in platform  5203 . Ball joint  5211  may be configured to articulate against socket  5213  of housing  5215 . Articulation of ball joint  5211  against socket  5213  may provide housing  5201  freedom to translate along and rotate about three orthogonal axes. Articulation of ball joint  5211  against socket  5213  may provide tool bracket  5201  freedom to translate along and rotate about three orthogonal axes, such as axes X, Y and Z. 
         [0449]    Knob  5235  may threadedly engage housing  5215 . Threaded engagement of knob  5235  and housing  5215  may apply pressure to ball joint  5211 . The pressure may fix a position of housing  5215  along or about three orthogonal axes. The pressure may limit displacement of tool bracket  5201  relative to bone B. 
         [0450]    Housing  5215  may be translatable, relative to platform  5203 , along axis L 5203 . Housing  5215  may be translatable, relative to bone B, along axis L 5203 . Knob  5233  may be configured to threadedly engage platform  5203 . Threaded engagement of knob  5233  and platform  5203  may apply pressure to rod  5217 . The pressure may fix a position of housing  5215  along axis L 5203 . The pressure may limit displacement of tool bracket  5201  relative to bone B. 
         [0451]    Pressure applied by knobs  5237 ,  5235  and  5233  may fix a position of tool bracket  5201  relative to bone B. Tool bracket  5201  may be fixed outside bone B relative to site  5261  interior to bone B. Tool bracket  5201  may include cannula  5239 . Center axis L 5201  of cannula  5239  may be aligned to correspond to an axis of site  5261 . A position of tool bracket  5201  may be fixed such that axis L 5201  corresponds to an axis of site  5261 . 
         [0452]      FIG. 53  shows illustrative apparatus  5300 . Apparatus  5300  may have one or more features in common with apparatus  5200 . Apparatus  5300  may include radiopaque target  5302 . Radiopaque target  5302  may be configured to attach to tool bracket  5201 . Seat  5311  may be configured to attach radiopaque target  5302  to tool bracket  5201 . 
         [0453]    Radiopaque target  5302  may be configured to be removable from tool bracket  5201 . 
         [0454]    Radiopaque target  5302  may include extension  5305 . Extension  5305  may include targets  5301 . Targets  5301  may include spokes  5303 . Targets  5301  may be separated by distance  5315 . Spokes  5303  and distance  5315  may be configured to reduce parallax error when targeting a site, such as site  5261  (shown in  FIG. 52 ), interior to bone B. 
         [0455]    Radiopaque target  5302  may include extension  5307 . Extension  5307  may include targets  5301 . Extension  5305  may be positioned substantially parallel to a first anatomical viewing plane, such as plane  200  or  202  (shown in  FIG. 2B ). Extension  5307  may be positioned substantially parallel to a second anatomical viewing plane, such as plane  200  or  202  (shown in  FIG. 2B ). Extensions  5307  and be positioned in substantially orthogonal planes. Extension  5305  may be adjusted relative to extension  5307 . 
         [0456]    Displacement of tool bracket  5201  along and about axes X, Y and Z (shown in  FIG. 52 ) may position targets  5301  relative to bone B. Medical imaging may be used to position targets  5301  relative to site  5261  interior to bone B. Seat  5311  may be configured such that positioning of targets  5301  relative to site  5261  positions tool bracket  5201  relative to site  5261 . Seat  5311  may be configured such that positioning of targets  5301  relative to site  5261  positions tool bracket  5201  relative to center-line Lb (shown in  FIG. 3A ) of bone B. 
         [0457]    Positioning targets  5301  relative to site  5261  may position tool bracket  5201  relative to site  5261  (shown in  FIG. 52 ). Site  5261  may be interior to bone B. Positioning targets  5301  relative to site  5261  may register tool bracket  5201  to site  5261 . Registering tool bracket  5201  to site  5261  may include aligning axis L 5201  with an axis of the site. After registering tool bracket  5201  to site  5261 , knobs  5237 ,  5235  and  5233  may be configured to lock a position of tool bracket  5201  relative to site  5261 . 
         [0458]      FIG. 54  shows illustrative apparatus  5400 . Apparatus  5400  may have one or more features in common with apparatus  5200 . 
         [0459]    Apparatus  5400  may include guide tube  5401 . Guide tube  5401  may be configured to attach to tool bracket  5201 . Guide tube  5401  may be configured to be removed from tool bracket  5201 . Guide tube  5401  may be inserted into cannula  5239 . 
         [0460]    Radiopaque target  5302  may be configured to position tool bracket  5201  such that guide tube  5401 , when inserted into cannula  5239 , is configured to guide a surgical tool to site  5261 . The surgical tool may be a rotary surgical tool (not shown). Cannula  5403  may guide the surgical tool. Cannula  5403  may be configured to guide the surgical tool along axis L 5201 . 
         [0461]      FIG. 55  shows illustrative apparatus  5500 . Apparatus  5500  may have one or more features in common with apparatus  5200 . 
         [0462]    Apparatus  5500  may include fixture  5501  fixture  5501  may be attached to tool bracket  5201 . Fixture  5501  may include guide passageway  5503 . Guide passageway  5503  may be configured receive wire support  5505 . Wire support  5505  may be configured to receive a bone penetrating element such as anchors  329  or  326  (shown in  FIG. 3B ). The bone penetrating element may be secured to a bone segment, such as bone segments Pa or Ph. 
         [0463]    Radiopaque target  5302  may be configured to position tool bracket  5201  such that guide passageway, when attached to tool bracket  5201 , is oriented relative to site  5261 . Radiopaque target  5302  may be configured to position tool bracket  5201  such that guide passageway  5503 , when attached to tool bracket  5201 , is oriented relative to center-line LB (shown in  FIG. 3A ) of bone B. 
         [0464]    When attached to tool bracket  5201 , guide passageway  5503  may be aligned with an axis of site  5261  (shown in  FIG. 52 ). When attached to tool bracket  5201 , guide passageway  5503  may direct a bone penetrating member received by wire support  5505  into bone segment Pa. The bone penetrating member received by wire support  5505  may be secured to implant  300  (shown in  FIG. 3B ). Implant  300  may be deployed at site  5261  (shown in  FIG. 52 ). The bone penetrating member received by wire support  5505  may secure bone segment Pa to implant  300 . 
         [0465]    Table 3 lists illustrative steps that may be taken for therapeutic use of the apparatus. 
         [0000]    
       
         
               
             
               
               
             
           
               
                 TABLE 3 
               
             
             
               
                   
               
               
                 Illustrative steps that may be taken 
               
               
                 for therapeutic use of the apparatus 
               
             
          
           
               
                 Illustra- 
                   
               
               
                 tive FIG. 
                 Illustrative Steps and Illustrative Reference Numerals 
               
               
                   
               
               
                 10, 11, 
                 1. Reduce and stabilize bone (employing one or both of 
               
               
                 12A, 12B, 
                 subchondral and transfracture k-wires, as appropriate). 
               
               
                 12C 
                 2. Place k-wire 1001 in distal end of dorsal ulnar 
               
               
                   
                 radius. 
               
               
                   
                 3. Place jig on k-wire and center base along radius. 
               
               
                   
                 4. Insert styloid k-wire 1007. 
               
               
                   
                 5. Center jig on radius (restore radial inclination). 
               
               
                   
                 6. Insert radius k-wire 1023. 
               
               
                   
                 7. Lock k-wires. 
               
               
                   
                 8. Restore radial height. 
               
               
                   
                 9. Restore volar tilt. 
               
               
                 13, 26 
                 1. Place bone penetrating members into fracture 
               
               
                   
                 fragments, 1314 and 1315. 
               
               
                   
                 2. Place 1311 in radius or unfractured bone section. 
               
               
                   
                 3. Manipulate 1314 and 1315 so that bone fragments are 
               
               
                   
                 positioned into desired locations. 
               
               
                   
                 4. Lock position using feature 1329 
               
               
                   
                 5. Adjust relative position of fragments using 
               
               
                   
                 adjustment of member 1307, 1305. 
               
               
                 29, 28, 
                 1. Position k-wire into desired location of distal tip 
               
               
                 30 
                 of the implant. Usually centered under the lunate facet. 
               
               
                   
                 2. Apply jig onto k-wire engagement feature 2815. 
               
               
                   
                 3. Swing down jig until it comes into contact with the 
               
               
                   
                 bone. 
               
               
                   
                 4. Drill into bone at location identified in step 3. 
               
               
                 32, 33 
                 1. Position k-wire into desired location of distal tip 
               
               
                   
                 of the implant. Usually centered under the lunate facet. 
               
               
                   
                 Drill into bone until shoulder of wire rests on surface 
               
               
                   
                 of bone. 
               
               
                   
                 2. Apply jig onto k-wire engagement feature 3309. Bring 
               
               
                   
                 jig down onto shoulder of k-wire. 
               
               
                   
                 3. Swing down jig until it comes into contact with the 
               
               
                   
                 bone, extend length of arc as necessary to contact bone 
               
               
                   
                 in desired location. 
               
               
                   
                 4. Drill into bone at location identified in step 3. 
               
               
                 36 
                 1. Place wire under subchondral surface entering at the 
               
               
                   
                 radial Styloid centered in the dorsal palmer aspect. 
               
               
                   
                 2. Place jig over wire. 
               
               
                   
                 3. Swing jig down onto bone. 
               
               
                   
                 4. Place toe nail wires securing the jig onto the bone. 
               
               
                   
                 5. Use drill guide tube to direct access into bone 
               
               
                   
                 cavity. 
               
               
                 37 
                 1. Position k-wire into desired location of distal tip 
               
               
                   
                 of the implant. Usually centered under the lunate facet. 
               
               
                   
                 2. Apply jig onto k-wire engagement feature 3724. 
               
               
                   
                 3. Swing down jig until it comes into contact with the 
               
               
                   
                 bone. 
               
               
                   
                 4. Slide up and down wire as necessary to contact bone 
               
               
                   
                 in desired location. 
               
               
                   
                 5. Place toe nail wires securing the jig onto the bone. 
               
               
                   
                 6. Use drill guide tube to direct access into bone 
               
               
                   
                 cavity. 
               
               
                 38, 39, 40 
                 1. Apply k-wires through distal hole locations into the 
               
               
                   
                 bone fracture segments. Position these wires such that 
               
               
                   
                 the member 3809 is centered on the bone in the position 
               
               
                   
                 of the center of the implant. 
               
               
                   
                 2. Apply k-wires on proximal aspect of jig 3833 and 3835 
               
               
                   
                 into the long bone section of the radius. 
               
               
                   
                 3. Adjust height of the height of the broken segments 
               
               
                   
                 with member 3839. 
               
               
                   
                 4. Adjust volar tilt of fragments using member 3837. 
               
               
                   
                 5. Adjust radial inclination using member 3831. 
               
               
                   
                 6. When bone is in desired position mount arm 3811 onto 
               
               
                   
                 base jig and swing down onto bone in desired position. 
               
               
                   
                 7. Secure jig to bone using 3843 k-wire toe nail 
               
               
                   
                 features. 
               
               
                   
                 8. Adjust drill tube angle to be parallel with bone axis 
               
               
                   
                 using feature 3821 and 3817. 
               
               
                   
                 9. Access bone cavity through guide tube 3847. 
               
               
                 37, 38 
                 1. Position radiopaque targets into desired implant 
               
               
                   
                 location. 
               
               
                   
                 2. Apply jig until it comes into contact with the bone. 
               
               
                   
                 3. Place toe nail wires securing the jig onto the bone. 
               
               
                   
                 4. Use drill guide tube to direct access into bone 
               
               
                   
                 cavity. 
               
               
                 41 
                 1. Place bone penetrating members into fracture 
               
               
                   
                 fragments, through 4211. 
               
               
                   
                 2. Place k-wires through 4107, 4109 in reference bone 
               
               
                   
                 fragment. 
               
               
                   
                 3. Manipulate 4139 and 4110 so that bone fragments are 
               
               
                   
                 positioned into desired locations. 
               
               
                   
                 4. Lock position using feature 4213, 4115, 4121. 
               
               
                   
                 5. Adjust relative position of fragments using 
               
               
                   
                 adjustment of member 4102. 
               
               
                   
                 6. Position 4149 in to desired location of implant. 
               
               
                   
                 7. Attach swing arm onto 4149 and follow similar steps 
               
               
                   
                 as above. 
               
               
                 46 
                 1. Place bone penetrating members into fracture 
               
               
                   
                 fragments, through 4613, 4614, 4625. 
               
               
                   
                 2. Place k-wires through 4645, 4647 in radius or 
               
               
                   
                 unfractured bone section. 
               
               
                   
                 3. Manipulate 4633, 4631 so that bone fragments are 
               
               
                   
                 positioned into desired locations. 
               
               
                   
                 4. Lock position using feature 4613, 4627, 4617. 
               
               
                   
                 5. Adjust relative position of fragments using 
               
               
                   
                 adjustment of member 4605. 
               
               
                 48 
                 1. Place broken wrist over member 4805 on jig. 
               
               
                   
                 2. Place fingers into traps. 
               
               
                   
                 3. Attach forearm to jig 4803 with some member 4807 such 
               
               
                   
                 as coban or ace bandage. 
               
               
                   
                 4. Apply tension to fingers using 4817. 
               
               
                   
                 5. Position angle of jig using 4805 such that the wrist 
               
               
                   
                 is put into extension and flexion. 
               
               
                 51 
                 1. Place bone penetrating members into fracture 
               
               
                   
                 fragments, through 5113 5111 
               
               
                   
                 2. Place k-wires through 5129 in radius or unfractured 
               
               
                   
                 bone section. 
               
               
                   
                 3. Manipulate 5107, 5125 so that bone fragments are 
               
               
                   
                 positioned into desired locations. 
               
               
                   
               
             
          
         
       
     
         [0466]    There are numerous other steps that may be included. Different embodiments of the apparatus shown and described herein may be used in conjunction with different steps of methods of the invention, whether or not listed in Table 4. 
         [0467]    Thus, apparatus and methods for preparing a fractured bone for repair. Persons skilled in the art will appreciate that the present invention can be practiced by other than the described embodiments, which are presented for purposes of illustration rather than of limitation. 
         [0468]    The present invention is limited only by the claims that follow.