Summary The NeoSpan® Compression Implant System (CIS) is a product expansion of the NeoSpan® Compression Staple System. It includes Nitinol implants in various configurations, such as Fixed-Leg and In-Line Implants with up to three screw holes, and T-Shape Implants with three legs and up to two screw holes. Related Implants Fixed-Leg (In-Line) Two fixed legs bridged by a bowed body; select variants incorporate one to three threaded screw holes (“+1H/+2H/+3H”). Threaded holes accept compatible 3.0 mm or 3.5 mm locking and non‑locking screws; all screws use a T15 driver. T-Shape Three fixed legs arranged in a T configuration, with up to two threaded screw holes for optional screw augmentation; accepts the same compatible screws (T15 driver). Indications NeoSpan® Compression Implant device is a nitinol implant intended to provide foot fixation Fractures Fusions Osteotomies Anatomy Osteology Typical small‑bone targets include phalanges, metatarsals, and select tarsal bones. Bony preparation aims to achieve flat, congruent fusion surfaces or stable osteotomy cuts prior to fixation. Leg trajectory should remain within cortical confines; placement can be verified during trialing with K‑wires and fluoroscopy. Muscles/Tendons Protect dorsal/plantar tendons in the foot through gentle retraction and avoidance of interposition at the fusion/osteotomy site. Ligaments/Capsule Exposure may require capsulotomy or ligament release; preserve or repair structures that contribute to adjacent joint stability. Nerves Guard digital nerves in the dorsal cutaneous/plantar digital nerves in the foot during incision, K‑wire placement, and drilling. Blood supply Minimize periosteal stripping; avoid injury to digital arteries and regional branches to support bone healing. Approach Foot — incision Position supine with limb exsanguination and tourniquet as indicated. Make a dorsal or medial incision according to the target fusion or osteotomy site (e.g., phalanx, metatarsal, midfoot). Protect dorsal cutaneous nerves and extensor tendons; confirm intended implant leg trajectory with a trial and fluoroscopy before opening the implant kit. Technique Trialing Open the Sterile Implant Trial Kit with K‑wires (T05 S0002). Use the trial to select configuration and size; K‑wires may hold the trial for fluoroscopic confirmation of placement and leg trajectory. After confirming, open the corresponding NeoSpan® CIS implant kit. Note: trial markers indicate leg and screw‑hole positions relative to the trial’s reference line. Prepare First Pilot Hole Using the provided calibrated drill and drill guide, prepare the first leg hole; reference the drill’s laser markings for depth. Without moving the guide, remove the drill and place a locator pin in the hole. Prepare Other Pilot Hole(s) Drill remaining hole(s) stepwise with the calibrated drill, again using laser markings for depth. For T‑shape configurations, place a second locator pin after the second hole to maintain guide position while preparing the final hole. Prepare and Insert Implant Remove the implant/inserter assembly from the sterile kit (handle carefully; the implant is not fully secured to the inserter in the package). Seat the implant firmly in the inserter prongs, then twist the handle clockwise to extend the internal plunger and spread the legs until they are parallel. Align legs with pilot holes and advance with a mallet until the inserter prongs contact bone. Important: legs must be parallel for proper insertion. Release Implant and Remove Inserter Twist the inserter handle counter‑clockwise to retract the plunger and disengage from the implant. Slide the inserter away parallel to the bone surface and remove it. Do not rock vertically to avoid lifting the implant. Seat Implant If needed, place inserter prongs on the implant’s top surface and gently tamp to ensure full seating. For configurations with threaded screw holes, achieve complete seating before any screw preparation. Prepare Screw Insertion For implants with threaded holes, open the sterile NeoSpan® Implant Screw Kit (T05 S0003). Use the kit’s drill and guide to prepare each open hole; determine screw length with the depth gauge or by referencing calibrated drill markings. Screw Placement Assemble the disposable AO Quick Connect Fixed Handle with the T15 driver from the screw kit. Select the indicated 3.0 mm or 3.5 mm screw(s) and fully seat them into the prepared location(s). Closure Close by preferred methods. Removal. If removal is desired, first remove all screws with the T15 driver. Then remove the implant with an osteotome and/or the inserter instrument. Technical Specifications Material & compression mechanics Superelastic Nitinol implants arrive preloaded on an inserter in the Natural state; when deployed from the Active state, they return to a preformed bowed body that generates compression across the construct. Barbed legs Implant legs incorporate a barbed feature to help resist pull‑out once implanted. Implant legs incorporate a barbed feature to help resist pull‑out once implanted. Threaded screw holes (select models) Enable optional placement of screws for additional fixation; threaded holes are compatible with 3.0 mm and 3.5 mm locking/non‑locking screws. Sizes & configurations Fixed‑Leg/In‑Line implants (two legs) 18 × 14 mm 18 × 16 mm 18 × 18 mm 20 × 20 mm 25 × 22 mm Fixed‑Leg/In‑Line implants +1H/+2H/+3H screw‑hole variants 18 × 14 mm 18 × 22 mm T‑Shape implants are provided with 0–2 holes (three legs) T-shape T-shape +1H T-shape +2H Packaging & instruments All implants are provided sterile. The system utilizes separate sterile instrument sets, including a Trial Kit for size determination and a Screw Kit with disposable instruments dedicated for screw implantation. Screw material & driver Compatible screws are titanium alloy; all screws accept a T15 driver. Screws Threaded Screw Holes — compatible with 3.0mm locking & non‑locking screws — lengths 10–30mm. 3.5mm locking & non‑locking screws — lengths 10–40mm.