Screw driver, combination, and related methods

1. A screw driver for a surgical screw, comprising:

a housing;

a drive shaft rotatably supported by the housing;

a first gear operably coupled to the drive shaft to rotate with the drive shaft;

a second gear rotatably supported by the housing in meshing engagement with the first gear to rotate in response to rotation of the first gear, the second gear comprising a passage defining an inwardly facing screw engagement periphery configured to receive a threaded portion of the screw and, when positioned within the passage, to rotate the screw via engagement with a cooperating outwardly facing periphery defined by the threaded portion of the screw in response to rotation of the second gear; and

at least one engagement feature disposed in the passage for engaging a mating engagement feature along an axial length of at least a portion of the threaded portion of the screw.

2. The screw driver of claim 1 , wherein the housing comprises a head member disposed at a distal end thereof, the head member defining a throughbore coincident with the passage of the second gear for receiving the screw, the throughbore including a timing feature for engaging the threaded portion of the screw in the passage causing the screw to axially advance when rotated relative to the housing.

3. The screw driver of claim 2 , wherein the timing feature comprises a thread engaging member movably disposed in an opening disposed in the head member that is substantially perpendicular to and in communication with the throughbore.

4. The screw driver of claim 3 , wherein the engaging member is biased towards the throughbore.

5. The screw driver of claim 1 , wherein the at least one engagement feature disposed in the passage of the second gear comprises a lug and the mating engagement feature of the threaded portion of the screw comprises an elongated channel disposed therein.

6. The screw driver of claim 1 , wherein the drive shaft has a drive shaft axis of rotation, and the passage has a passage axis of rotation which is disposed at a non-perpendicular angle relative to the drive shaft axis of rotation.

7. The screw driver of claim 1 , further comprising an implant positioning member releasably coupled to at least a proximal end of the housing.

8. The screw driver of claim 1 , wherein a distal end of the housing comprises an engagement member configured to mate with a cooperating engagement member or surgical implant to properly position the screw driver relative to the surgical implant.

9. An instrument for driving a surgical screw at a set angle relative to an implant, the instrument comprising:

a first gear disposed within a housing and coupled to a distal end of a drive shaft;

a hollow driven gear disposed within the housing in meshing engagement with the first gear, the hollow driven gear including an axially extending cylindrical sleeve at least partially defining a central passage configured to receive the surgical screw, at least a portion of the central passage including a screw mating feature to drive rotation of the surgical screw upon rotation of the hollow driven gear; and

a thread engaging member disposed adjacent to the central passage and configured to engage a threaded portion of the surgical screw to cause advancement of the surgical screw within the central passage upon rotation of the surgical screw by the hollow driven gear

wherein the drive shaft has a drive shaft axis of rotation, and the central passage has a passage axis of rotation which is disposed at an angle relative to the drive shaft axis of rotation, and wherein the angle is a non-perpendicular angle.

10. The instrument of claim 9 , wherein the screw mating feature disposed in the central passage of the hollow driven gear comprises a lug configured to engage an elongated channel disposed along a length of the surgical screw.

11. The instrument of claim 9 , wherein the thread engaging member is biased towards the central passage.

12. A method for inserting a surgical screw into an implant along a set angle, the method comprising:

inserting the surgical screw through a first end of a central passage, the central passage formed in part by a cylindrical driven gear configured to rotatably engage a portion of the surgical screw;

aligning an axis of rotation of the surgical screw within the central passage in a first direction which is disposed at a non-perpendicular angle to an axis of rotation of a drive shaft;

rotating the drive shaft in driving engagement with the hollow driven gear imparting rotation on the surgical screw which causes the surgical screw to linearly advance within the central passage; and

engaging the surgical screw within a threaded aperture of an orthopedic implant which pulls the surgical screw forward during rotation of the surgical screw.

13. The method of claim 12 , wherein rotating the surgical screw within the central passage comprises rotating the surgical screw relative to a thread engaging member of a housing supporting the hollow driven gear to linearly advance the surgical screw.

14. The method of claim 13 , wherein the surgical screw comprises a thread including a first thread pitch portion and a second thread pitch portion different than the first thread pitch portion, and

wherein rotating the drive shaft comprises causing the second thread pitch portion of the bone screw to bind against the thread engaging member to linearly advance the surgical screw.

15. The method of claim 12 , wherein aligning the surgical screw within the central passage comprises aligning an inwardly facing screw engagement periphery defined by a cylindrical passage within the hollow driven gear with a cooperating outwardly facing periphery defined by a threaded portion of the surgical screw.

16. The method of claim 12 , wherein the central passage is a through passage, and wherein rotating the drive shaft results in the surgical screw passing through the central passage and exiting a distal end of the central passage into an implant.