Abstract:
Embodiments of the invention are directed to a distal interphalangeal (“DIP”) fusion device for connecting a first bone of a patient to a second, adjacent bone of the patient. The device may include an anchor assembly and a compressor assembly. In another embodiment, a separate compressor base assembly is included. In yet another embodiment an access port assembly is included. The anchor assembly is rotationally coupled to one end of the compressor assembly, such that the compressor assembly may rotate about the anchor assembly within a semi-spherical zone (three degrees of rotational freedom) and translate axially (one degree of translational freedom). In an operative position, the anchor assembly is anchored in an intermediate phalanx of a digit of a patient, the compressor assembly is contained in a distal phalanx of the digit, and the distal phalanx is flexed relative to the intermediate phalanx to create a joint angle. The joint angle is then fixated for fusion by compressing the phalanges together in the flexed position by counter-rotation of the compressor assembly. An advantage of an embodiment of the invention is the screw threads may be matching which eliminates the need to pre-drill two different diameter pilot holes.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application claims priority from U.S. Provisional Application Ser. No. 61/238,098, filed Aug. 28, 2009. 
    
    
     FIELD 
     Implementations generally relate to a medical device and medical procedure using that device, and more particularly, to a joint fusion assembly for arthroplastic convergence of opposing ends of bones. 
     BACKGROUND 
     Patients that suffer from joint disorders often undergo arthrodesis to compress adjacent bones against one another to fixate them for fusion. Joint disorders, such as arthritis in the joints of digits, can be extremely painful. A common procedure to alleviate pain in such patients is to fixate the joint for fusion by arthrodesis. There are a number of arthrodesis techniques that promote fusion of adjacent bones of a digit (e.g., finger or toe). Historically, these techniques utilize a bone screw that draws the adjacent bones together in at a 180 degree angle. The digit then fuses at the joint in a fully-extended orientation. 
     This fully-extended orientation of the digit in conventional arthrodesis techniques weakens grip strength and is often not esthetically pleasing to the patient. For example, the grip strength of the hand increases when the fingers can oppose each other as the hand grasps an object. If a finger is extended, it cannot properly oppose the other fingers to grasp the object, stabilize the object in the hand, or exert as much force on the object. Moreover, the digits of a human hand rest in a flexed position; therefore, a digit that is fused in an extended position looks abnormal and is not esthetically pleasing. 
     Accordingly, it would be an advantage to provide a joint assembly that overcomes the disadvantages of previous technology. 
     SUMMARY 
     In one implementation, a distal interphalangeal (“DIP”) fusion device connects a first bone of a patient to a second, adjacent bone of the patient. The joint assembly includes an anchor assembly and a compressor assembly. The anchor assembly is rotationally coupled to one end of the compressor assembly, such that the compressor assembly may rotate about the anchor assembly within a semi-spherical zone (three degrees of rotational freedom) and translate axially (one degree of translational freedom). In an operative position, the anchor assembly is anchored in an intermediate phalanx of a digit of a patient, the compressor assembly is contained in a distal phalanx of the digit, and the distal phalanx is flexed relative to the intermediate phalanx to create a joint angle. The joint angle is then fixated for fusion by compressing the phalanges together in the flexed position. 
     In another implementation, the joint assembly includes an anchor element, a compressor base element, and a compressor sleeve element. The anchor element is coupled to the medial end of the compressor base element, allowing planar rotation of the anchor element relative to the compressor base element (a single degree of rotational freedom). The compressor sleeve element is threadably coupled to a distal end of the compressor base element allowing axial rotation of the compressor sleeve element relative to the anchor base element (a single degree of translational freedom). In an operative position, the anchor element is anchored in an intermediate phalanx of a digit of a patient, the compressor element is contained in a distal phalanx of the digit, and the distal phalanx is flexed relative to the intermediate phalanx to create a joint angle. The joint angle is then fixated for fusion by threadably compressing the phalanges together in the flexed position. 
     In yet another implementation, a method provides for insertion of a joint assembly device into a digit of a patient. A percutaneous probe, such as a K-wire, is used to create a bore through a distal phalanx and the intermediate phalanx of a digit of a patient. A delivery tool is removeably inserted into Applicants&#39; distal interphalangeal (“DIP”) fusion device that includes an anchor assembly and a compressor assembly that are coupled together via an articulating linkage. The delivery tool extends through the compressor assembly and at least a portion of the anchor assembly. The delivery tool is then used to insert the joint assembly device into the digit by applying a first rotational (e.g., clockwise rotation) pressure to the joint assembly device at the bore. In this manner, the anchor assembly is inserted into the intermediate phalanx and the compressor assembly is inserted into the distal phalanx. 
     The delivery tool is removed from the joint assembly device and the distal phalanx is bent relative to the intermediate phalanx. Applicants&#39; compressor tool is inserted into the inserted DIP fusion device, and caused to compress the distal phalanx against the intermediate phalanx by applying a second rotational (e.g., counterclockwise rotation) pressure to the compressor assembly such that the compressor assembly moves away from the anchor assembly and the joint is fixated for fusion. 
     Another embodiment of the invention is directed to a bone fusion device comprising an anchor assembly, the anchor assembly having a tubular cylindrical body at least a portion of which is covered by external threads adapted to engage hard tissue, the anchor assembly having a first end adapted to engage hard tissue and a second end adapted to rotationally couple with a compressor assembly; and a compressor assembly, the compressor assembly having a tubular cylindrical body at least a portion of which is covered by external threads adapted to engage hard tissue, the compressor assembly having a first end adapted to rotationally couple with the anchor assembly and a second end having a lumen adapted to admit a tool, the external threads on both the anchor assembly and the compressor assembly having substantially the same pitch and diameter. 
     Another embodiment of the invention is directed to a bone fusion device comprising an anchor assembly, the anchor assembly having a tubular cylindrical body at least a portion of which is covered by external threads adapted to engage hard tissue, the anchor assembly having a first end adapted to engage hard tissue and a second end adapted to rotationally couple with a compressor base assembly through a single plane of rotation; a compressor base assembly having a first end for rotatably coupling to the anchor assembly through a single plane of rotation, the compressor base assembly also having a second end for rotatably coupling to the compressor assembly through an axial plane of rotation, a compressor sleeve assembly, the compressor sleeve assembly having a tubular cylindrical body at least a portion of which is covered by external threads adapted to engage hard tissue, the compressor sleeve assembly having a first end adapted to rotationally couple with the anchor assembly through an axial plane of rotation and a second end having a lumen adapted to admit a tool, the external threads on both the anchor assembly and the compressor sleeve assembly having substantially the same pitch and diameter. 
     Another embodiment of the invention is directed to a bone fusion device comprising an anchor assembly, the anchor assembly having a tubular cylindrical body at least a portion of which is covered by external threads adapted to engage hard tissue, the anchor assembly having a first end adapted to engage hard tissue and a second end having a portion of a shared articulating linkage; and a compressor assembly, the compressor assembly having a tubular cylindrical body at least a portion of which is covered by external threads adapted to engage hard tissue, the compressor assembly having a first end adapted to rotationally couple with the anchor assembly through the shared articulating linkage and a second end having a lumen adapted to admit a tool, the external threads on both the anchor assembly and the compressor assembly having substantially the same pitch and diameter. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Implementations will become more apparent from the detailed description set forth below when taken in conjunction with the drawings, in which like elements bear like reference numerals. 
         FIG. 1.1  is a first perspective view of Applicants&#39; distal interphalangeal (“DIP”) fusion device comprising a ball and socket articulating interconnection; 
         FIG. 1.2  is a second perspective view of the DIP fusion device of  FIG. 1.1 ; 
         FIG. 1.3  is a first side view of the DIP fusion device of  FIG. 1.1 ; 
         FIG. 1.4  is a second side view of the DIP fusion device of  FIG. 1.1 ; 
         FIG. 1.5  is a front view of the device of  FIG. 1.1 ; 
         FIG. 1.6  illustrates the individual components of the device of  FIG. 1.1   
         FIG. 1.7  illustrates a lumen formed within the device of  FIG. 1.1 ; 
         FIG. 1.8  depicts an enlarged view of a ball and socket interconnection between an anchor assembly and a compressor assembly; 
         FIG. 1.9  illustrates a socket portion of Applicants&#39; compressor assembly; 
         FIG. 1.10  illustrates a portion of Applicants&#39; anchor assembly rotated upwardly from Applicants&#39; compressor assembly; 
         FIG. 1.11  illustrates a portion of Applicants&#39; anchor assembly rotated downwardly from Applicants&#39; compressor assembly FIG. 
         FIG. 2.1  depicts a perspective front elevational view of a delivery tool for the DIP fusion device of  FIG. 1.1  loaded with the DIP fusion device of  FIG. 1.1 ; 
         FIG. 2.2  is a sectional side view of the loaded delivery tool seen in  FIG. 2.1  where a portion of the delivery tool and the DIP fusion device have been cut away to expose the internal structures therein; 
         FIG. 2.3  is a front view of Applicants&#39; delivery tool for the DIP fusion device of  FIG. 1.1 ; 
         FIG. 3.1  is a perspective front view of Applicants&#39; compressor tool for the DIP fusion device of  FIG. 1.1  loaded with the DIP fusion device of  FIG. 1.1 ; 
         FIG. 3.2  depicts a sectional side view of the loaded compressor tool seen in  FIG. 3.1  where a portion of the compressor tool and the DIP fusion device of  FIG. 1.1  have been cut away to expose the internal structures therein; 
         FIG. 3.3  is a front view of Applicants&#39; compressor tool for the DIP fusion device of  FIG. 1.1 ; 
         FIG. 4.1A  is a perspective view of one implementation of a second embodiment of Applicants&#39; DIP fusion device; 
         FIG. 4.1B  is a perspective view of a second implementation of the second embodiment of Applicants&#39; DIP fusion device; 
         FIG. 4.2A  illustrates the individual assemblies in the implementation of  FIG. 4.1A  used to form the DIP fusion device of  FIG. 4.1 ; 
         FIG. 4.2B  illustrates the individual assemblies used to form the DIP fusion device of  FIG. 4.1B ; 
         FIG. 4.3A  is a first side view illustrating certain elements of the DIP fusion device of  FIG. 4.1A ; 
         FIG. 4.3B  is a first side view illustrating certain elements of the DIP fusion device of  FIG. 4.1B ; 
         FIG. 4.4A  is a second side view illustrating certain elements of the DIP fusion device of  FIG. 4.1A ; 
         FIG. 4.4B  is a second side view illustrating certain elements of the DIP fusion device of  FIG. 4.1B ; 
         FIG. 4.5A  is a cross-sectional view showing certain internal elements of the DIP fusion device of  FIG. 4.1A ; 
         FIG. 4.5B  is a second side view illustrating certain elements of the DIP fusion device of  FIG. 4.1B ; 
         FIG. 4.6  is an internal view showing a plurality of lumens formed in the various assemblies comprising the DIP fusion devices of  FIGS. 4.1A  and  4 . 1 B; 
         FIG. 4.7  is a first perspective view illustrating attachment portions disposed on Applicants&#39; anchor assembly and on Applicants&#39; compressor base assembly; 
         FIG. 4.8  is a second perspective view illustrating attachment portions disposed on Applicants&#39; anchor assembly and on Applicants&#39; compressor base assembly; 
         FIG. 4.9A  is a block diagram illustrating the attachment portions of  FIGS. 4.7  and  4 . 8 ; 
         FIG. 4.9B  illustrates Applicants&#39; attachment portions interconnected in an unlocked configuration; 
         FIG. 4.9C  illustrates Applicants&#39; attachment portions interconnected in a locked configuration; 
         FIG. 4.10  is a perspective view showing the articulating joint of  FIG. 4.9  in a first configuration; 
         FIG. 4.11  is a perspective view showing the articulating joint of  FIG. 4.9  in a second configuration; 
         FIG. 5.1  depicts a perspective front elevational view of a delivery tool for the DIP fusion device of  FIG. 4.1 ; 
         FIG. 5.2  is a side view of the loaded delivery tool seen in  FIG. 5.1  where a portion of the delivery tool and the DIP fusion device have been cut away to expose the internal structures therein; 
         FIG. 5.3  is a front view of Applicants&#39; delivery tool for the DIP fusion device of  FIG. 5.1 ; 
         FIG. 6.1  is a perspective front view of Applicants&#39; compressor tool for the DIP fusion device of  FIG. 5.1 ; 
         FIG. 6.2  depicts a side view of the loaded compressor tool seen in  FIG. 6.1  where a portion of the compressor tool and the DIP fusion device of  FIG. 5.1  have been cut away to expose the internal structures therein; 
         FIG. 6.3  is a front view of Applicants&#39; compressor tool for the DIP fusion device of  FIG. 5.1 ; 
         FIG. 7  illustrates Applicants&#39; DIP fusion device loaded on Applicants&#39; delivery tool in preparation for insertion into a distal phalanx and a medial phalanx; 
         FIG. 8  illustrates Applicants&#39; DIP fusion device inserted into a distal phalanx and a medial phalanx; 
         FIG. 9  illustrates the distal phalanx disposed in a flexed configuration with respect to the medial phalanx; 
         FIG. 10  illustrates Applicants&#39; compressor tool being used to bring Applicants&#39; inserted DIP fusion device into tension, and the distal phalanx and medial phalanx being brought into compression; 
         FIG. 11  illustrates Applicants&#39; compressor tool being used to bring Applicants&#39; inserted DIP fusion device out of tension, and the distal phalanx and medial phalanx being brought out of compression; and 
         FIG. 12  shows Applicants&#39; inserted DIP fusion device remaining in tension, and the distal phalanx and medial phalanx remaining in compression, after removal of an access port assembly portion of Applicants&#39; DIP fusion device. 
     
    
    
     DETAILED DESCRIPTION 
     This invention is described in preferred embodiments in the following description with reference to the FIG.s, in which like numbers represent the same or similar elements. Reference throughout this specification to “one embodiment,” “an embodiment,” or similar language means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, appearances of the phrases “in one embodiment,” “in an embodiment,” and similar language throughout this specification may, but do not necessarily, all refer to the same embodiment. 
     The described features, structures, or characteristics of the invention may be combined in any suitable manner in one or more embodiments. In the following description, numerous specific details are recited to provide a thorough understanding of embodiments of the invention. One skilled in the relevant art will recognize, however, that the invention may be practiced without one or more of the specific details, or with other methods, components, materials, and so forth. In other instances, well-known structures, materials, or operations are not shown or described in detail to avoid obscuring aspects of the invention. 
     Several implementations disclose Applicants&#39; distal interphalangeal (“DIP”) fusion device, comprising a threaded anchor assembly that is coupled with at least one threaded compressor assembly via one or more articulating linkages. The joint assembly is inserted into two, adjacent bones of a digit of a patient (e.g. adjacent bones of a finger, thumb, or toe of a patient) such that the anchor assembly is in an intermediate phalanx while the compressor assembly is in a distal phalanx of the digit. The articulating linkage is then flexed and fixated for fusion of the two bones. 
     In DIP fusion device  100 , the articulating linkage of the joint assembly comprises a ball and socket design. Referring to  FIGS. 1.1  to  1 . 6 , DIP fusion device  100  includes an anchor assembly  110 , a compressor assembly  120 , and an access port assembly  130 , interlinked such that end  118  of anchor assembly  110  is rotatably coupled to end  126  of compressor assembly  120 , and such that end  128  of compressor assembly  120  is threadably coupled to end  132  of access port assembly  130 . In certain embodiments, distal end  134  of access port assembly  130  comprises a knurled feature  234  to facilitate rotation. 
     Anchor assembly  110  comprises a tubular cylindrical body  115 . In certain embodiments, anchor assembly  110  is formed from titanium. In certain embodiments, anchor assembly  110  is formed from stainless steel. 
     Anchor assembly further comprises a longitudinal axis  113  extending from first end  116  to second end  118 . In certain embodiments, anchor assembly  110 , comprises a cannular form wherein a bore, lumen or cavity  111 A extends from first end  116  to second end  118 . 
     In certain embodiments, anchor assembly  110  comprises a length along longitudinal axis  113  from about 10 mm and about 40 mm. In certain embodiments, anchor assembly  110  comprises a diameter from about 2 mm to about 5 mm. 
     Compressor assembly  120  comprises a tubular cylindrical body  125 . In certain embodiments, compressor assembly  120  is formed from titanium. In certain embodiments, compressor assembly  120  is formed from stainless steel. 
     Compressor assembly  120  further comprises a longitudinal axis  123  extending from first end  126  to second end  128 . In certain embodiments, compressor assembly  120  comprises a cannular form wherein a bore, lumen or cavity  121 A extends from first end  126  to second end  128 . 
     In certain embodiments, compressor assembly  120  comprises a length along longitudinal axis  123  from about 10 mm and about 40 mm. In certain embodiments, compressor assembly  120  comprises a diameter from about 2 mm to about 5 mm. 
     Access port assembly  130  comprises a tubular cylindrical body  135 . In certain embodiments, access port assembly  130  is formed from titanium. In certain embodiments, access port assembly  130  is formed from stainless steel. 
     Access port assembly  130  further comprises a longitudinal axis  133  extending from first end  132  to second end  134 . In certain embodiments, access port assembly  130  comprises a cannular form wherein a bore, lumen or cavity  131 A extends from first end  132  to second end  134 . 
     In certain embodiments, access port assembly  130  comprises a length along longitudinal axis  133  from about 10 mm and about 40 mm. In certain embodiments, access port assembly  130  comprises a diameter from about 2 mm to about 5 mm. 
     As shown in  FIGS. 1.1  to  1 . 4 , in a straight configuration, DIP fusion device  100  comprises a composite longitudinal axis  105  created by aligning longitudinal axis  113  of anchor assembly  110 , longitudinal axis  123  of compressor assembly  120 , and longitudinal axis  133  of access port assembly  130 . In this straight configuration, cavities  111 A,  121 A, and  131 A, are also aligned to form a continuous lumen extending from a first open end  107  formed in end  134  of access port assembly  130  to second open end  108  formed in end  116  of anchor assembly  110 . 
     In certain embodiments, anchor assembly  110 , compressor assembly  120 , and the access port assembly  130  comprise one or more external features that facilitate advancement or retraction of DIP fusion device  100 , or elements thereof, into or out of hard and/or soft tissues. In the illustrated embodiments, first end  116  of anchor assembly  110  comprises a bit or blade shape. In certain embodiments, each of the anchor assembly  110  and the compressor assembly  120  comprise external threading  112 , and  122 , respectively, that facilitates advancing DIP fusion device  100  into hard tissue. In certain embodiments, the respective external threadings are formed to include grooves  104  that facilitate cutting of hard tissue, and removal of the debris formed thereby. 
     In certain embodiments, anchor assembly  110 , and/or compressor assembly  120 , and/or access port assembly  130 , comprise internal features that facilitate collective or independent manipulation, i.e. rotation, of each. In certain embodiments, ridges disposed in one or more lumens formed within Applicants&#39; DIP fusion device releaseably mate with grooved portions formed in Applicants&#39; delivery tool and/or compressor tool. 
     In certain embodiments, a diameter of a lumen formed in anchor assembly  110 , differs from a diameter of a lumen formed in compressor assembly  120 , and further differs from a diameter of a lumen formed in access port assembly  130 . For example, in certain embodiments the diameter of an anchor assembly lumen is less than the diameter of a compressor assembly lumen. In certain embodiments, the delivery tool and/or the compressor tool is formed to comprise complementary diameter elements such that different portions of the delivery tool and/or the compressor tool can only be inserted into, and releaseably mesh with, the anchor assembly  110 , or with the compressor assembly  120 , or with access port assembly  130 . For example, in certain embodiments different portions of a delivery tool and/or a compressor tool can mesh with different asymmetrical groupings of ridges formed in an anchor assembly lumen, or in the compressor assembly lumen, or in an access port assembly lumen, to collectively or independently manipulate, i.e. rotate, one or more of those elements. 
     Referring now to  FIGS. 1.4  and  1 . 7 , lumen  111 A formed in anchor assembly  110  comprises a diameter  106 . In certain embodiments, diameter  106  is between about 1 mm and about 4 mm. Lumen  111 A is defined by wall  111 B. In the illustrated embodiment of  FIG. 1.7 , an asymmetrical grouping of rounded ridges  119  is disposed longitudinally on wall  111 B. Further in the illustrated embodiment of  FIG. 1.7 , seven rounded ridges  119  comprise an octagonal arrangement with a missing eighth ridge. The missing eighth rounded ridge in the otherwise octagonal pattern creates an asymmetry. 
     Referring now to  FIGS. 1.4  and  1 . 7 , lumen  121 A formed in compressor assembly  120  comprises a diameter  107 . Lumen  121 A is defined by wall  121 B. In the illustrated embodiment of  FIG. 1.7 , an asymmetrical grouping of rounded ridges  129  is disposed longitudinally on wall  121 B. Further in the illustrated embodiment of  FIG. 1.7 , seven rounded ridges  129  comprises an octagonal arrangement with a missing eighth ridge. The missing eighth rounded ridge in the otherwise octagonal pattern creates an asymmetry. 
     Referring now to  FIGS. 1.4  and  1 . 7 , lumen  131  formed in access port assembly  130  comprises a diameter  109 . In certain embodiments, diameter  109  is between about 1.5 mm and about 4.5 mm. 
     In the illustrated embodiment of  FIG. 1.7 , second open end  108  of lumen  111 A comprises a diameter  103 . In certain embodiments, diameter  103  is between about 0.5 mm and about 2 mm. 
       FIG. 1.6  illustrates the individual assemblies comprising a first embodiment of Applicants&#39; DIP fusion device  100 . Referring now to  FIG. 1.6 , anchor assembly  110  comprises a semi-spherical element  210 , also referred to herein as ball  210 , formed on end  118 . Referring now to  FIGS. 1.6  and  1 . 9 , compressor assembly  120  is formed to include a semi-spherical cavity  220 , i.e. socket  220 , in end  126 . Arcuate wall  230  defines socket  220 . In device  100 , the diameters of ball  210  and socket  220  are dimensioned such that semi-spherical element  210  is rotatably disposed in semi-spherical socket  220 . 
       FIGS. 1.10  and  1 . 11  show a cross-section view of ball  210  rotatably disposed in socket  220 . In the illustrated embodiment of  FIG. 1.10 , anchor assembly  110  has been moved upwardly such that longitudinal axis  113  of anchor assembly  110  and longitudinal axis  123  of compressor assembly  120  define an angle +Φ.  FIG. 1.11  shows a cross-section of a semi-spherical element  210  rotatably disposed in socket  220 . In the illustrated embodiment of  FIG. 1.10 , anchor assembly  110  has been moved downwardly such that longitudinal axis  113  of anchor assembly  110  and longitudinal axis  123  of compressor assembly  120  define an angle −Φ. 
     In certain embodiments, angle Φ can be adjusted to a value between 0 degrees and 30 degrees. In certain embodiments, anchor assembly  110  can be moved with respect to compressor assembly  120  such that the angle Φ comprises a value of 0 to +/−30° off-axis rotation around a 360° conical zone. 
     As would be appreciated by those of ordinary skill in the art, the articulating linkage of device  100  may comprise other designs that permit rotation about one or more axes of the anchor assembly  110 . For example, ball  210  may comprise a portion of the compressor assembly  120  and socket  220  may be formed in end  118  of anchor assembly  110 . In certain embodiments, ball  210  may comprise a spherical shape, semi-spherical shape, or other shape, that permits movement within the conical zone described hereinabove. In certain embodiments, the articulating linkage may comprise one or more hinged connections that permit motion within a respective plane, or a combination thereof. 
     The articulating linkage of Applicants&#39; DIP fusion device  100  may be locked in a certain configuration through a high friction interlocking surface-to-surface compression between the anchor assembly  110  and the compressor assembly  120 . In certain embodiments, outer surface  212  of ball  210 , and/or wall  230  of socket  220 , comprises a plurality of microscopic grooves and dimples formed using Electric Discharge Machining (EDM). In certain embodiments, outer surface  212  of ball  210 , and/or wall  230  of socket  220 , comprises a plurality of microscopic grooves and dimples formed using an abrasion process. In certain embodiments, outer surface  212  of ball  210 , and/or wall  230  of socket  220 , comprises a chemical or material coating disposed thereon. 
     For example, if outer surface  212  of ball  210 , and/or wall  230  of socket  220 , comprise a plurality of microscopic grooves and dimples formed using Electric Discharge Machining (EDM) that mechanically interlock, when a tensile force is exerted on anchor assembly  110  and compressor assembly  120  the textured surfaces impact one another, and a high friction interlocking connection is created between the anchor assembly  110  and the compressor assembly  120 . In this manner, once the articulating linkage is rotated to define a preferred configuration of compressor assembly  120  relative to anchor assembly  110 , that preferred configuration can be fixated by pulling the compressor assembly  120  away from the anchor assembly  110 , thereby putting anchor assembly  110  and compressor assembly  120  in tension. Placing the ball and socket elements in tension thereby secures or fixates Applicants&#39; DIP fusion device  100  in a preferred configuration. 
       FIG. 2.1  illustrates Applicants&#39; DIP fusion device  100  removeably disposed on Applicants&#39; delivery tool  300 . Delivery tool comprises handle  310 , shaft  320 , and loading portion  330 .  FIG. 2.2  shows a cross-section view of DIP fusion device  100  disposed on loading portion  330  of delivery tool  300 . Referring now to  FIGS. 2.2  and  2 . 3 , loading portion  330  comprises a series of cylindrical assemblies having differing diameters. In the illustrated embodiment of  FIGS. 2.2  and  2 . 3 , loading portion  330  comprises tubular assemblies  332 ,  334 , and  336 . 
     Tubular assembly  332  comprises a diameter  109 . Interior lumen  131 A formed in access port assembly  130  comprises a diameter  109 . Therefore, tubular assembly  332  can be inserted into lumen  131 A. 
     Tubular assembly  334  comprises a diameter  107  wherein diameter  107  is less than diameter  109 . Interior lumen  121 A formed in compressor assembly  120  comprises a diameter  107 . Therefore, tubular assembly  332  can be inserted into lumen  131 A and lumen  121 A. 
     Tubular assembly  336  comprises a diameter  106  wherein diameter  106  is less than diameter  107 . Interior lumen  111 A formed in anchor assembly  110  comprises a diameter  106 . Therefore, tubular assembly  336  can be inserted into lumen  131 A, lumen  121 A, and lumen  111 A. 
     Tubular assembly  334  is formed to include an asymmetrical pattern of grooves extending inwardly from an outer surface. A total of 7 grooves are formed in an octagonal arrangement with a missing eighth groove. The missing eighth groove in the otherwise octagonal pattern creates an asymmetry. The afore-described asymmetrical pattern of ridges  129  formed in wall  121 B defining lumen  121 A can mesh with the asymmetrical pattern of grooves formed in tubular assembly  334  if, and only if, the “missing” ridge of wall  121 B is aligned with the “missing” groove of tubular assembly  334 . 
     Tubular assembly  336  is formed to include an asymmetrical pattern of grooves extending inwardly from an outer surface. A total of 7 grooves are formed in an octagonal arrangement with a missing eighth groove. The missing eighth groove in the otherwise octagonal pattern creates an asymmetry. The afore-described asymmetrical pattern of rounded ridges  119  formed in wall  111 B defining lumen  111 A can mesh with the asymmetrical pattern of grooves formed in tubular assembly  336  if, and only if, the “missing” ridge of wall  111 B is aligned with the “missing” groove of tubular assembly  336 . 
     In certain embodiments, delivery tool  300  is “clocked” or marked to indicate the orientation of the “missing” grooves. Using this indication, the plane of operation of the DIP fusion device  100  can be determined visually. Examples or markings or indicators of orientation can include: color markings on the delivery tool  300  and/or DIP fusion device  100 , delivery tool handle  310  or delivery tool neck shape or texture, a lock-and-key fit between the out surface of the delivery tool  300  and the inner surface of the DIP fusion device  100 , or a combination thereof. 
       FIG. 3.1  illustrates a compressor tool  400  with DIP fusion device  100  loaded thereon. In the illustrated embodiment of  FIG. 3.1 , compressor tool  400  comprises a compressor tool handle  410 , a neck  420 , and a loading region or portion  430 . 
       FIG. 3.2  shows a cross-section view of DIP fusion device  100  disposed on loading portion  430  of compression tool  400 . Referring now to  FIGS. 3.2  and  3 . 3 , loading portion  430  comprises a series of cylindrical elements having differing diameters. In the illustrated embodiment of  FIGS. 3.2  and  3 . 3 , loading portion  430  comprises tubular assemblies  432  and  434 . 
     Tubular assembly  432  comprises a diameter  109 . Interior lumen  131 A formed in access port assembly  130  comprises a diameter  109 . Therefore, tubular assembly  432  can be inserted into lumen  131 A. 
     Tubular assembly  434  comprises a diameter  107  wherein diameter  107  is less than diameter  109 . Interior lumen  121 A formed in compressor assembly  120  comprises a diameter  107 . Therefore, tubular assembly  432  can be inserted into lumen  131 A and lumen  121 A. 
     Tubular assembly  434  is formed to include an asymmetrical pattern of grooves extending inwardly from an outer surface. A total of 7 grooves are formed in an octagonal arrangement with a missing eighth groove. The missing eighth groove in the otherwise octagonal pattern creates an asymmetry. The afore-described asymmetrical pattern of ridges  129  formed in wall  121 B defining lumen  121 A can mesh with the asymmetrical pattern of grooves formed in tubular assembly  334  if, and only if, the “missing” ridge of wall  121 B is aligned with the “missing” groove of tubular assembly  334 . 
     In certain embodiments, compression tool  400  is “clocked” or marked to indicate the orientation of the “missing” grooves. Using this indication, the plane of operation of the DIP fusion device  100  can be determined visually. Examples of markings or indicators of orientation can include: color markings on the compression tool  400  and/or DIP fusion device  100 , compression tool handle  410  or compression tool neck shape or texture, a lock-and-key fit between the outer surface of the compression tool  400  and the inner surface of the DIP fusion device  100 , or a combination thereof. 
     In certain embodiments, the loading region  430  of the compressor tool  400  may be shorter than the loading portion  330  of the delivery tool  300 . For example, as shown in an enlarged cut away perspective of  FIG. 3.2 , the compressor tool  400  may be inserted into DIP fusion device  100  such that loading region  430  extends into the compressor assembly  120  and access port assembly  130  but does not extend into the anchor assembly  110 . In this manner, the compressor tool  400  may be used to manipulate (e.g, rotate) the compressor assembly  120  independent of the anchor assembly  110 . 
     Two implementations of a second embodiment of Applicants&#39; distal interphalangeal (“DIP”) fusion device include an articulating linkage comprising a pair of interlocking and moveable assemblies. The first implementation, shown in  FIGS. 4.1A  to  4 . 5 A, DIP fusion device  500  includes anchor assembly  510 , a compressor base assembly  520 , a compressor sleeve assembly  530 , and an access port assembly  540 , interlinked such that end  518  of anchor assembly  510  is rotatably coupled to end  526  of compressor base assembly  520 , and wherein end  528  of compressor base assembly  520  is threadably coupled to end  536  of compressor sleeve assembly  530 , and wherein end  538  of compressor sleeve assembly  530  is threadably coupled to end  542  of access port assembly  540 . In certain embodiments, distal end  544  of access port assembly  540  comprises a knurled configuration. 
     The second implementation, shown in  FIGS. 4.1B  to  4 . 5 B, DIP fusion device  501  includes anchor assembly  510 , a compressor base assembly  525 , a compressor sleeve assembly  535 , and an access port assembly  540 , interlinked such that end  518  of anchor assembly  510  is rotatably coupled to end  526  of compressor base assembly  525 , and wherein end  528  of compressor base assembly  525  is rotatably coupled to end  536  of compressor sleeve assembly  535 , and wherein end  538  of compressor sleeve assembly  535  is threadably coupled to end  542  of access port assembly  540 . In certain embodiments, distal end  544  of access port assembly  540  comprises a knurled configuration. 
     Referring to  FIG. 4.2B , compressor base assembly  525  comprises tubular member  522  attached to, and extending outwardly from, attachment portion  620 . An annular ridge  523  is disposed on the distal end of tubular member  522 . A groove  524  bifurcates annular ridge  523 . 
     Referring to  FIGS. 4.4B  and  4 . 5 B, compressor sleeve assembly  535  comprises annular groove  534  formed in wall  531 B of lumen  531 A. Tubular member  522  is inserted into lumen  531 A such that annular ridge  523  is disposed in annular groove  534  thereby rotatably interconnecting compressor base assembly  525  and compressor sleeve assembly  535 . 
     Anchor assembly  510  comprises a tubular cylindrical body  515 . In certain embodiments, anchor assembly  510  is formed from titanium. In certain embodiments, anchor assembly  510  is formed from stainless steel. 
     Anchor assembly  510  further comprises a longitudinal axis  513  extending from first end  516  to second end  518 . In certain embodiments, anchor assembly  510  comprises a cannular form wherein a bore, lumen or cavity  511 A extends from first end  516  to second end  518 . 
     In certain embodiments, anchor assembly  510  comprises a length along longitudinal axis  513  from about 10 mm and about 40 mm. In certain embodiments, anchor assembly  510  comprises a diameter from about 2 mm to about 5 mm. 
     In certain embodiments, compressor base assembly  520 / 525  is formed from titanium. In certain embodiments, compressor base assembly  520 / 525  is formed from stainless steel. Compressor base assembly  520 / 525  further comprises a longitudinal axis  527  extending from first end  526  to second end  528 . In certain embodiments, compressor base assembly  520 / 525  comprises a cannular form wherein a bore, lumen or cavity  521  extends from first end  526  to second end  528 . 
     In certain embodiments, compressor base assembly  520 / 525  comprises a length along longitudinal axis  527  from about 5 mm and about 40 mm. In certain embodiments, compressor base assembly  520 / 525  comprises a diameter from about 2 mm to about 5 mm. 
     Compressor sleeve assembly  530 / 535  comprises a tubular cylindrical body  506 . In certain embodiments, compressor sleeve assembly  530 / 535  is formed from titanium. In certain embodiments, compressor sleeve assembly  530 / 535  is formed from stainless steel. 
     Compressor sleeve assembly  530 / 535  further comprises a longitudinal axis  533  extending from first end  536  to second end  538 . In certain embodiments, compressor sleeve assembly  530 / 535  comprises a cannular form wherein a bore, lumen or cavity  531 A extends from first end  536  to second end  538 . 
     In certain embodiments, compressor sleeve assembly  530 / 535  comprises a length along longitudinal axis  533  from about 10 mm and about 40 mm. In certain embodiments, compressor sleeve assembly  530 / 535  comprises a diameter from about 2 mm to about 5 mm. 
     Access port assembly  540  comprises a tubular cylindrical body  545 . In certain embodiments, access port assembly  540  is formed from titanium. In certain embodiments, access port assembly  540  is formed from stainless steel. 
     Access port assembly  540  further comprises a longitudinal axis  543  extending from first end  542  to second end  544 . In certain embodiments, access port assembly  540  comprises a cannular form wherein a bore, lumen or cavity  541 A extends from first end  542  to second end  544 . 
     In certain embodiments, access port assembly  540  comprises a length along longitudinal axis  543  from about 10 mm and about 40 mm. In certain embodiments, access port assembly  540  comprises a diameter from about 2 mm to about 5 mm. 
     As shown in  FIGS. 4.1A  to  4 . 4 A and in  FIGS. 4.1B  to  4 . 4 B, in a straight configuration DIP fusion device  500 / 501  comprises a composite longitudinal axis  505  created by aligning longitudinal axis  513  of anchor assembly  510 , longitudinal axis  527  of compressor base assembly  520 / 525 , longitudinal axis  533  of compressor sleeve assembly  530 / 535 , and longitudinal axis  543  of access port assembly  540 . In this straight configuration, cavities  511 A,  521 A,  531 A, and  541 A, are also aligned to form a continuous lumen extending from a first open end  507  formed in end  544  of access port assembly  540  to second open end  508  formed in end  516  of anchor assembly  510 . 
     In certain embodiments, anchor assembly  510  and compressor sleeve assembly  530 / 535 , comprise one or more external features that facilitate advancement or retraction of DIP fusion device  500 , or elements thereof, into or out of hard and/or soft tissues. In the illustrated embodiments, first end  516  of anchor assembly  510  comprises a bit or blade shape. 
     In certain embodiments, each of the anchor assembly  510  and the compressor sleeve assembly  530 / 535  comprise external threading  512 , and  532 , respectively, that facilitates advancing DIP fusion device  500 / 501  into hard tissue. In certain embodiments, the respective external threadings are formed to include grooves  503  that facilitate cutting of hard tissue, and removal of the debris formed thereby. 
     Referring now to  FIG. 4.3A , in DIP fusion device  500  a compressor base threading  522 A comprises a compressor base pitch  724  that matches a compressor sleeve pitch  537  of compressor sleeve threading  532 . In certain embodiments, the matching pitches comprise a 1:1 ratio. In certain embodiments, the matching pitches comprise a ratio, such as 1:2, 2:1 or 4:3, for example. 
     In certain embodiments, anchor assembly  510 , and/or compressor base assembly  520 / 525 , and/or compressor sleeve assembly  530 / 535 , and/or access port assembly  540 , comprise internal features that facilitate collective or independent manipulation, i.e. rotation, of each. In certain embodiments, ridges disposed in one or more lumens formed within Applicants&#39; DIP fusion device releaseably mate with grooved portions formed in Applicants&#39; delivery tool  700  and/or compressor tool  800 . 
     In certain embodiments, a diameter of a lumen formed in anchor assembly  510 , differs from a diameter of a lumen formed in compressor base assembly  520 / 525 , and further differs from a diameter of a lumen formed in compressor sleeve assembly  530 / 535 , and further differs from a diameter of a lumen formed in access port assembly  540 . For example, in certain embodiments the diameter of an anchor assembly lumen is less than the diameter of a compressor assembly lumen. In certain embodiments, the delivery tool and/or the compressor tool is formed to comprise complementary diameter elements such that different portions of the delivery tool  700  and/or the compressor tool  800  can only be inserted to and releaseably mesh with the anchor assembly  510 , or with the compressor base assembly  520 / 525 , or with the compressor sleeve assembly  530 / 535 , or with access port assembly  540 . For example, in certain embodiments different portions of a delivery tool and/or a compressor tool can mesh with different asymmetrical groupings of ridges formed in an anchor assembly lumen, or in a compressor base lumen, or in the a compressor sleeve lumen, or in an access port lumen, to collectively or independently manipulate, i.e. rotate, one or more of those elements. 
     Referring now to  FIGS. 4.4A ,  4 . 4 B,  4 . 5 A,  4 . 5 B, and  4 . 6 , lumen  511 A formed in anchor assembly  510  comprises a diameter  517 . In certain embodiments, diameter  527  is between about 0.5 mm and about 2 mm, Lumen  511 A is defined by wall  511 B. In the illustrated embodiment of  FIG. 4.6 , an asymmetrical grouping of rounded ridges  519  is disposed longitudinally on wall  511 B. Further in the illustrated embodiment of  FIG. 4.6 , seven rounded ridges  519  comprises an octagonal arrangement with a missing eighth ridge. The missing eighth rounded ridge in the otherwise octagonal pattern creates an asymmetry. 
     Referring now to  FIGS. 4.4A ,  4 . 4 B,  4 . 5 A,  4 . 5 B, and  4 . 6 , lumen  521 A formed in compressor base assembly  520 / 525  comprises a diameter  527 . In certain embodiments, diameter  517  equals diameter  527 . In other embodiments, diameter  517  differs from diameter  527 . 
     Lumen  521 A is defined by wall  521 B, In the illustrated embodiment of  FIG. 4.6 , an asymmetrical grouping of rounded ridges  529  is disposed longitudinally on wall  521 B. Further in the illustrated embodiment of  FIG. 4.6 , seven rounded ridges  529  comprises an octagonal arrangement with a missing eighth ridge. The missing eighth rounded ridge in the otherwise octagonal pattern creates an asymmetry. 
     Referring now to  FIGS. 4.4A ,  4 . 4 B,  4 . 5 A,  4 . 5 B, and  4 . 6 , lumen  531 A formed in compressor sleeve assembly  530 / 535  comprises a diameter  537 . Lumen  531 A is defined by wall  531 B. In the illustrated embodiment of  FIG. 4.6 , an asymmetrical grouping of rounded ridges  539  is disposed longitudinally on wall  531 B. Further in the illustrated embodiment of  FIG. 4.6 , seven rounded ridges  539  comprises an octagonal arrangement with a missing eighth ridge. The missing eighth rounded ridge in the otherwise octagonal pattern creates an asymmetry. 
     Referring now to  FIGS. 4.4A  and  4 . 6 , lumen  541 A formed in access port assembly  540  comprises a diameter  547 . In certain embodiments, diameter  547  is between about 1.5 mm and about 4.5 mm. 
     Referring now to  FIGS. 4.7  and  4 . 8 , compressor base assembly  520 / 525  comprises attachment portion  620 , and anchor assembly  510  comprises attachment portion  630 . Attachment portion  630  comprises locking wedge  632 , locking wedge  634 , semi-circular platform  636 , and semi-circular platform  638 . In the illustrated embodiment of  FIG. 4.7 , locking wedge  632  and semi-circular platform  636  are disposed on one side of lumen  531 A. Locking wedge  634  and semi-circular platform  638  are disposed on an opposite side of lumen  531 A. Attachment portion  620  comprises locking wedge  622 , locking wedge  624 , semi-circular platform  626 , and semi-circular platform  628 . 
     Referring now to  FIG. 4.9A , attachment portion  620  is formed to include annular groove  640 . Annular groove  640  is defined in part by wall  642  and opposing wall  646 . Wall  642  and wall  646  are not parallel. Rather, a distance  643  separates end  648  of wall  642  and the corresponding end  647  of wall  646 . Line  644  is an extension of wall  642 . A distance  641  separates end  645  of wall  646  from extension  644 . Distance  641  is less than distance  643 . As a result wall  646  inclines downwardly with respect to wall  642 . 
     Locking wedge  622  comprises surface  662  and opposing surface  664 . Surfaces  662  and  664  are not parallel. Rather, a distance  668  separates end  661  of surface  662  from end  665  of surface  664 . Line  663  is an extension of surface  662 . A distance  666  separates end  667  of surface  664  from extension  663 . Distance  666  is less than distance  668 . As a result, surface  664  of locking wedge  622  inclines with respect to surface  662 . 
     Locking wedge  624  is formed and dimensioned in accord with the above-recited description of locking wedge  622 . Therefore, both locking wedge  622  and locking wedge  624  comprise trapezoidal-shaped elements with inclining distal surfaces. 
     Attachment portion  630  is formed to include annular groove  650 . Annular groove  650  is defined in part by wall  652  and opposing wall  656 . Wall  652  and wall  656  are not parallel. Rather, a distance  653  separates end  658  of wall  652  and the corresponding end  657  of wall  656 . Line  654  is an extension of wall  652 . A distance  651  separates a end  655  of wall  656  from extension  654 . Distance  651  is less than distance  653 . As a result wall  656  inclines upwardly with respect to wall  652 . 
     Locking wedge  634  comprises surface  672  and opposing surface  674 . Surfaces  672  and  674  are not parallel. Rather, a distance  678  separates end  671  of surface  672  from end  677  of surface  674 . Line  673  is an extension of surface  672 . A distance  676  separates end  675  of surface  674  from extension  673 . Distance  676  is less than distance  678 . As a result, surface  674  of locking wedge  634  inclines with respect to surface  672 . 
     Locking wedge  632  is formed and dimensioned in accord with the above-recited description of locking wedge  634 . Therefore, both locking wedge  632  and locking wedge  634  comprise trapezoidal-shaped elements with inclining distal surfaces. 
     Distance  668  is less than distance  653 , but greater than distance  651 . Similarly, distance  678  is less than distance  643 , but greater than distance  641 . 
       FIG. 4.9B  illustrates attachment portion  620  interconnected with attachment portion  630  in an unlocked configuration. Locking wedge  622  is rotatably disposed within annular groove  650  such that a gap  680  exists between wall  652  of annular groove  650  and surface  662  of locking wedge  622 . Locking wedge  624  is similarly rotationally disposed within annular groove  650 . 
     Locking wedge  634  is rotatably disposed within annular groove  640  such that a gap  690  exists between wall  646  of annular groove  640  and surface  674  of locking wedge  634 . Locking wedge  632  is similarly rotationally disposed within annular groove  640 . 
     When attachment portions  620  and  630  are interconnected as shown in  FIG. 4.9B , anchor assembly  510  can be rotated in both a first direction and an opposing second direction with respect to compressor base assembly  520 / 525 .  FIG. 4.10  illustrates such a first rotation of anchor assembly  510  with respect to compressor base assembly  520 / 525 . In the illustrated embodiment of  FIG. 4.10 , longitudinal axis  533  of anchor assembly  510  and longitudinal axis  527  of compressor base assembly  520 / 525  define an angle −Φ. 
       FIG. 4.11  illustrates rotation of anchor assembly  510  with respect to compressor base assembly  520 / 525  in a second direction. In the illustrated embodiment of  FIG. 4.11 , longitudinal axis  533  of anchor assembly  510  and longitudinal axis  527  of anchor assembly  510  define an angle +Φ. 
     In certain embodiments, angle Φ can vary between 0 degrees and 70 degrees. In certain embodiments and prior to insertion, anchor assembly  510  can be moved with respect to compressor base assembly  520 / 525  such that the angle Φ comprises a value of 0 to +/−70° off-axis rotation along one plane. Applicants&#39; DIP fusion device  500 / 501  permits articulation of anchor assembly  510  with respect to compressor base assembly  520 / 525  in one plane only, that is, through a single plane of rotation. Anchor assembly  510  cannot rotate with respect to compressor base assembly  520 / 525  in the X/Z plane or in the Y/Z plane. 
     After insertion of DIP fusion device  500 / 501  into an intermediate phalanx and a distal phalanx, rotation of compressor base assembly  520 / 525  with respect to anchor assembly  510  is limited by hard tissues disposed adjacent to device  500 / 501 . For example, in certain embodiments after insertion of device  500 / 501  into an intermediate phalanx and a distal phalanx compressor base assembly  520 / 525  can be rotated with respect to anchor assembly  510  about +/−30° off-axis in one plane. 
       FIG. 4.9C  illustrates attachment portion  620  interconnected with attachment portion in a locked configuration. Referring now to  FIGS. 4.9A  and  4 . 9 C, if tensile force  601  is exerted on the interconnected attachment portions  620  and  630 , inclined surface  664  of locking wedge  622  slides upwardly along inclined wall  656  of annular groove  650 . Because distance  668  is greater than distance  651 , surface  664  of locking wedge  622  impacts wall  656  of annular groove  650 , thereby forcing surface  662  of locking wedge  622  into wall  652  of annular groove  650 , and thereby precluding rotation of attachment portion  620  with respect to attachment portion  630 , and locking the configuration of attachment portions  620  and  630  in place. The tensile force  601  similarly jams inclined locking wedge  624  into annular groove  650  further locking the configuration of attachment portions  620  and  630  in place. 
     Similarly, if tensile force  601  is exerted on the interconnected attachment portions  620  and  630 , inclined surface  674  of locking wedge  634  slides downwardly along inclined wall  646  of annular groove  640 . Because distance  678  is greater than distance  641 , surface  674  of locking wedge  634  impacts wall  646  of annular groove  640 , thereby forcing surface  672  of locking wedge  634  into wall  642  of annular groove  640 , and thereby precluding rotation of attachment portion  620  with respect to attachment portion  630 , and locking the configuration of attachment portions  620  and  630  in place. The tensile force  601  similarly jams inclined locking wedge  632  into annular groove  640  further locking the configuration of attachment portions  620  and  630  in place. 
     In certain embodiments, surfaces  662  and  664  of locking wedge  622 , the corresponding surfaces of locking wedge  634 , surfaces  672  and  674  of locking wedge  634 , the corresponding surfaces of locking wedge  632 , the surfaces of walls  642  and  646  of annular groove  640 , and the surfaces of walls  652  and  654  of annular groove  650 , comprise a plurality of microscopic grooves and dimples formed using Electric Discharge Machining (EDM). In certain embodiments, surfaces  662  and  664  of locking wedge  622 , the corresponding surfaces of locking wedge  634 , surfaces  672  and  674  of locking wedge  634 , the corresponding surfaces of locking wedge  632 , the surfaces of walls  642  and  646  of annular groove  640 , and the surfaces of walls  652  and  654  of annular groove  650 , comprise a plurality of microscopic grooves and dimples formed using an abrasion process. In certain embodiments, surfaces  662  and  664  of locking wedge  622 , the corresponding surfaces of locking wedge  634 , surfaces  672  and  674  of locking wedge  634 , the corresponding surfaces of locking wedge  632 , the surfaces of walls  642  and  646  of annular groove  640 , and the surfaces of walls  652  and  654  of annular groove  650 , comprise a chemical or material coating disposed thereon. 
     When a tensile force is exerted on anchor assembly  510  and compressor base assembly  520 / 525 , textured surfaces of locking wedges  622  and  624  impact textured walls of annular groove  650 , and textured surfaces of locking wedges  632  and  634  impact textured walls of annular groove  640 , and a high friction interlocking connection is created between the anchor assembly  510  and the compressor base assembly  520 / 525 . In this manner, once the articulating linkage between anchor assembly  510  and compressor base assembly  520 / 525  is rotated to define a preferred configuration, that preferred configuration can be fixated by pulling the compressor base assembly  520 / 525  away from the anchor assembly  510  in tension. Placing compressor base assembly  520 / 525  and anchor assembly  510  in tension thereby secures or fixates Applicants&#39; DIP fusion device  500 / 501  in a preferred configuration. 
       FIG. 5.1  illustrates Applicants&#39; DIP fusion device  500  removeably disposed on Applicants&#39; delivery tool  700 . Delivery tool comprises handle  710 , shaft  720 , and loading portion  730 .  FIG. 5.2  shows a cross-section view of DIP fusion device  500  disposed on loading portion  730  of delivery tool  700 . Referring now to  FIGS. 5.2  and  5 . 3 , loading portion  730  comprises a series of cylindrical elements having differing diameters. In the illustrated embodiment of  FIGS. 5.2  and  5 . 3 , loading portion  730  comprises tubular assemblies  740 ,  750 ,  760 , and  770 . 
     Tubular assembly  770  comprises a diameter  547 . Interior lumen  541 A formed in access port assembly  540  comprises a diameter  547 . Therefore, tubular assembly  770  can be inserted into lumen  541 A. 
     Tubular assembly  760  comprises a diameter  537  wherein diameter  537  is less than diameter  547 . Interior lumen  531 A formed in compressor sleeve assembly  530 / 535  comprises a diameter  537 . Therefore, tubular assembly  760  can be inserted into lumen  541 A and lumen  531 A. 
     Tubular assembly  750  comprises a diameter  527  wherein diameter  527  is less than diameter  537 . Interior lumen  521 A formed in compressor base assembly  520 / 525  comprises a diameter  537 . Therefore, tubular assembly  750  can be inserted into lumen  541 A, lumen  531 A, and lumen  521 A. 
     Tubular assembly  740  comprises a diameter  517  wherein diameter  517  is less than diameter  527 . Interior lumen  511 A formed in anchor assembly  510  comprises a diameter  517 . Therefore, tubular assembly  740  can be inserted into lumen  541 A, lumen  531 A, and lumen  521 A, and lumen  511 A. 
     Tubular assembly  760  is formed to include an asymmetrical pattern of grooves extending inwardly from an outer surface. A total of 7 grooves are formed in an octagonal arrangement with a missing eighth groove. The missing eighth groove in the otherwise octagonal pattern creates an asymmetry. The afore-described asymmetrical pattern of rounded ridges  539  formed in wall  531 B defining lumen  531 A disposed in compressor sleeve assembly  530 / 535  can mesh with the asymmetrical pattern of grooves formed in tubular assembly  760  if, and only if, the “missing” ridge of wall  531 B is aligned with the “missing” groove of tubular assembly  760 . 
     Tubular assembly  750  is formed to include an asymmetrical pattern of grooves extending inwardly from an outer surface. A total of 7 grooves are formed in an octagonal arrangement with a missing eighth groove. The missing eighth groove in the otherwise octagonal pattern creates an asymmetry. The afore-described asymmetrical pattern of rounded ridges  529  formed in wall  529 B defining lumen  521 A formed in compressor base assembly  520 / 525  can mesh with the asymmetrical pattern of grooves formed in tubular assembly  750  if, and only if, the “missing” ridge of wall  521 B is aligned with the “missing” groove of tubular assembly  750 . 
     Tubular assembly  740  is formed to include an asymmetrical pattern of grooves extending inwardly from an outer surface. A total of 7 grooves are formed in an octagonal arrangement with a missing eighth groove. The missing eighth groove in the otherwise octagonal pattern creates an asymmetry. The afore-described asymmetrical pattern of rounded ridges  519  formed in wall  519 B defining lumen  511 A formed in anchor assembly  510  can mesh with the asymmetrical pattern of grooves formed in tubular assembly  740  if, and only if, the “missing” ridge of wall  511 B is aligned with the “missing” groove of tubular assembly  740 . 
     In certain embodiments, delivery tool  700  is “clocked” or marked to indicate the orientation of the “missing” grooves. Using this indication, the plane of operation of the DIP fusion device  500  can be determined visually. Examples or markings or indicators of orientation can include: color markings on the delivery tool  700  and/or DIP fusion device  500 , delivery tool handle  710  or delivery tool neck shape or texture, a lock-and-key fit between the out surface of the delivery tool  700  and the inner surface of the DIP fusion device  500 , or a combination thereof. 
       FIG. 6.1  illustrates a compressor tool  800  with DIP fusion device  500  loaded thereon. In the illustrated embodiment of  FIG. 6.1 , compressor tool  800  comprises a compressor tool handle  810 , a neck  820 , and a loading region  830 . 
       FIG. 6.2  shows a cross-section view of DIP fusion device  500  disposed on loading portion  830  of compression tool  800 . Referring now to  FIGS. 6.2  and  6 . 3 , loading portion  830  comprises a series of cylindrical elements having differing diameters. In the illustrated embodiment of  FIGS. 6.2  and  6 . 3 , loading portion  830  comprises tubular assemblies  840  and  850 . 
     Tubular assembly  850  comprises a diameter  547 . Interior lumen  541 A formed in access port assembly  540  comprises a diameter  547 . Therefore, tubular assembly  850  can be inserted into lumen  541 A. 
     Tubular assembly  840  comprises a diameter  537  wherein diameter  537  is less than diameter  547 . Interior lumen  531 A formed in compressor sleeve assembly  530 / 535  comprises a diameter  537 . Therefore, tubular assembly  840  can be inserted into lumen  541 A and lumen  531 A. 
     Tubular assembly  840  is formed to include an asymmetrical pattern of grooves extending inwardly from an outer surface. A total of 7 grooves are formed in an octagonal arrangement with a missing eighth groove. The missing eighth groove in the otherwise octagonal pattern creates an asymmetry. The afore-described asymmetrical pattern of rounded ridges  539  formed in wall  531 B defining lumen  531 A formed in compressor sleeve assembly can mesh with the asymmetrical pattern of grooves formed in tubular assembly  840  if, and only if, the “missing” ridge of wall  531 B is aligned with the “missing” groove of tubular assembly  840 . 
     In certain embodiments, compression tool  800  is “clocked” or marked to indicate the orientation of the “missing” grooves. Using this indication, the plane of operation of the DIP fusion device  500  can be determined visually. Examples or markings or indicators of orientation can include: color markings on the compression tool  800  and/or DIP fusion device  500 , compression tool handle  810  or compression tool neck shape or texture, a lock-and-key fit between the out surface of the compression tool  800  and the inner surface of the DIP fusion device  500 , or a combination thereof. 
     In certain embodiments, the loading region  830  of the compressor tool  800  may be shorter than the loading region  730  of the delivery tool  700 . For example, as shown in an enlarged cut away perspective of  FIG. 6.2 , the compressor tool  800  may be inserted into DIP fusion device  500  such that loading region  830  extends into the compressor sleeve assembly  530 / 535  and access port assembly  540  but does not extend into the anchor assembly  510  or the compressor base assembly  520 / 525 . In this manner, the compressor tool  800  may be used to manipulate (e.g., rotate) the compressor sleeve assembly  530 / 535  independent of the anchor assembly  510  and/or the compressor base assembly  520 / 525 . 
       FIGS. 7 through 11  illustrate the utility of Applicants&#39; DIP fusion device  100  and  500 / 501 . Referring to  FIG. 7 , DIP fusion device  100  or  500 / 501  is inserted into two adjacent bones, such as an intermediate phalanx  920  and a distal phalanx  910 . The surfaces of the two adjacent bones are altered in preparation for fixation, such as by removal of cartilage and debris to facilitate bone-to-bone contact and shaped to facilitate angular fixation. For example, as shown in  FIG. 7 , the surfaces of the intermediate and distal phalanx have been shaped to facilitate a flexed fixation between the two adjacent bones  910  and  920 . 
     The DIP fusion device  100  or  500 / 501  is advanced into the two adjacent bones using delivery tool  200  or  700 , respectively. Using DIP fusion device  100 , loading portion  330  of delivery tool  200  is inserted into DIP fusion device  100  such that a plurality of grooves formed in tubular assembly  336  portion of loading portion  330  mate with a plurality of rounded ridges  119  disposed on wall  111 B of lumen  111 A formed in anchor assembly  110 , and such that a plurality of grooves formed in tubular assembly  334  portion of loading portion  330  mate with a plurality of ridges  129  disposed on wall  121 B of lumen  121 A formed in compressor assembly  120 . Delivery tool is rotated clockwise to insert DIP fusion device  100  into bones  910  and  920 . 
     Using DIP fusion device  500 / 501 , loading portion  730  of delivery tool  700  is inserted into DIP fusion device  500 / 501  such that a plurality of grooves formed in tubular assembly  740  portion of loading portion  730  mate with a plurality of rounded ridges  519  disposed on wall  511 B of lumen  511 A formed in anchor assembly  110 , and such that a plurality of grooves formed in tubular assembly portion  750  of loading portion  730  mate with a plurality of rounded ridges  529  disposed on wall  521 B of lumen  521 A formed in compressor base assembly  520 / 525 , and such that a plurality of grooves formed in tubular assembly portion  760  of loading portion  730  mate with a plurality of rounded ridges  539  disposed on wall  531 B of lumen  531 A formed in compressor sleeve assembly  530 / 535 . Delivery tool  300  or  700  is rotated clockwise to insert DIP fusion device  500  into bones  910  and  920 . 
       FIG. 8  illustrates DIP fusion device  100  or  500 / 501  disposed in bones  910  and  920  such that anchor assembly  110 , or anchor assembly  510  in combination with compressor base assembly  520 / 525 , is disposed in medial phalanx  920 , and such that compressor assembly  120 , or compressor sleeve assembly  530 / 535 , is disposed in distal phalanx  910 , and such that access port assembly  130  or  540  extends outwardly from distal phalanx  910 . DIP fusion device  100  or  500 / 501  is positioned such that the articulating joint formed by anchor assembly  110  and compressor assembly  120 , or the articulating joint formed by anchor assembly  510  in combination with compressor base assembly  520 / 525  and compressor sleeve assembly  530 / 535 , is disposed in the joint separating phalanges  910  and  920 . 
       FIG. 9  illustrates distal phalanx  910  having been moved into a “flex” position with respect to medial phalanx  920 . By moving distal phalanx  910  with respect to medial phalanx  920 , compressor assembly  120  or compressor base assembly  520 / 525  is caused to articulate around the joint interconnecting compressor assembly  120  or compressor base assembly  520 / 525  and anchor assembly  110  or anchor assembly  510 , respectively. 
       FIG. 10  illustrates compressor tool  400  or  800  inserted into compressor assembly  120  or compressor sleeve assembly  530 / 535 , but not inserted into anchor assembly  110  or either anchor assembly  510  or compressor base assembly  520 / 525 , respectively. When using DIP fusion device  100 , loading portion  330  of compressor tool  400  is inserted into DIP fusion device  100  such that a plurality of ridges formed in tubular assembly portion  434  of loading portion  430  mate with a plurality of ridges  129  disposed on wall  121 B of lumen  121  formed in compressor assembly  120 . Compressor Tool  400  is rotated counter-clockwise to move compressor assembly  120  away from anchor assembly  110 . Such movement of compressor assembly  120  away from anchor assembly  110  places Applicants&#39; DIP fusion device  100  under tensile forces  610 . In addition, such movement of compressor assembly  120  away from anchor assembly  110  places distal phalanx  910  and medial phalanx  920  in compression by compressive forces  620 . 
     When using DIP fusion device  500 / 501 , loading portion  830  of compressor tool  800  is inserted into DIP fusion device  500 / 501  such that a plurality of grooves formed in tubular assembly portion  760  of loading portion  730  mate with a plurality of rounded ridges  539  disposed on wall  531 B of lumen  531 A formed in compressor sleeve assembly  530 / 535 . Compressor Tool  800  is rotated counter-clockwise to move compressor sleeve assembly  530 / 535  and compressor base assembly  520 / 525  move away from the Anchor Assembly  510 . Such movement of compressor sleeve assembly  530 / 535  and compressor base assembly  520 / 525  move away from the Anchor Assembly  510  places Applicants&#39; DIP fusion device  500 / 501  under tensile forces  610 . In addition, such movement of/ 525  places distal phalanx  910  and medial phalanx  920  in compression by compressive forces  620 . 
       FIG. 11  illustrates compressor tool  400  or  800  inserted into compressor assembly  120  or compressor sleeve assembly  530 / 535 , but not inserted into anchor assembly  110  or either anchor assembly  510  or compressor base assembly  520 / 525 , respectively, as described hereinabove. When using DIP fusion device  100 , loading portion  330  of compressor tool  400  is inserted into DIP fusion device  100  such that a plurality of ridges formed in tubular assembly portion  434  of loading portion  430  mate with a plurality of ridges  129  disposed on wall  121 B of lumen  121 A formed in compressor assembly  120 . Delivery tool  300  is rotated clockwise to move compressor assembly  120  toward from anchor assembly  110 . Such movement of compressor assembly  120  toward anchor assembly  110  removes Applicants&#39; DIP fusion device  100  from the tensile forces of  FIG. 10 . In addition, such movement of compressor assembly  120  toward anchor assembly  110  removes distal phalanx  910  and medial phalanx  920  from compression. 
     When using DIP fusion device  500 / 501 , loading portion  830  of compressor tool  800  is inserted into DIP fusion device  500 / 501  such that a plurality of grooves formed in tubular assembly portion  760  of loading portion  730  mate with a plurality of rounded ridges  539  disposed on wall  531 B of lumen  531 A formed in compressor sleeve assembly  530 / 535 . If Compressor Tool  800  is rotated clockwise, then compressor sleeve assembly  530 / 535  moves toward compressor base assembly  520 / 525 . Such movement of compressor sleeve assembly  530 / 535  and compressor base assembly  520 / 525  toward the Anchor Assembly  510  removes Applicants&#39; DIP fusion device  500 / 501  from the tensile forces  610  of  FIG. 10 , In addition, such movement of compressor sleeve assembly  530 / 535  and compressor base assembly  520 / 525  toward the Anchor Assembly  510  removes distal phalanx  910  and medial phalanx  920  from compression. 
     Iterative rotation of Applicants&#39; compressor tool in opposite directions as shown in  FIGS. 10 and 11  may be used to bring distal phalanx  910  and medial phalanx  920  into and out of compression. Such iterative movement of the phalanges may be needed to adjust the orientation of distal phalanx  910  with respect to medial phalanx  920 . 
       FIG. 12  shows access port assembly  130  or  540  having been removed from the inserted DIP fusion device  100 ,  500 ,  501 . When using DIP fusion device  100 , anchor assembly  110  remains disposed in medial phalanx  920 , and compressor assembly  120  remains disposed in distal phalanx  920 , such that distal phalanx  910  and medial phalanx  920  are held in compression with respect to one another. 
     When using DIP fusion device  500 / 501 , anchor assembly  510  remains disposed in intermediate phalanx  920 , and compressor sleeve assembly  530 / 535  in combination with compressor base assembly  520 / 525  remains disposed in distal phalanx  910 , such that distal phalanx  910  and medial phalanx  920  are held in compression with respect to one another. 
     The embodiments of the invention also comprise kits that include one or more of the bone fusion apparatus of varying sizes and diameters to fit the application, delivery and compression tools, K-wires, drills and drill bits and a case for holding the tools and parts. Components of the kit may be sterile and/or sterilizable (e.g., autoclavable). In some examples, components of the kit, such as bone fusion apparatus and/or wires, may be intended for single use. In some examples, components of the kit, such as drills and/or drivers, may be intended or suitable for repeated use. 
     It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications that come within the scope and spirit of the claims appended hereto. All patents and references cited herein are explicitly incorporated by reference in their entirety.