U.S. patent application number 12/635182 was filed with the patent office on 2010-12-23 for adjustable bone plate.
Invention is credited to James D. Ralph, Stephen L. Tatar, Thomas N. Troxell.
Application Number | 20100324559 12/635182 |
Document ID | / |
Family ID | 38286470 |
Filed Date | 2010-12-23 |
United States Patent
Application |
20100324559 |
Kind Code |
A1 |
Ralph; James D. ; et
al. |
December 23, 2010 |
ADJUSTABLE BONE PLATE
Abstract
The invention pertains to adjustable bone plates which comprise
one or more sets of first members and second members. The first
members and second members are releaseably secured to each other by
attachment means and locking means, and two or more set of first
members and second members are connected by bridging means. The
longitudinal and lateral dimensions of the bone plates may be
adjustable.
Inventors: |
Ralph; James D.; (Bethlehem,
PA) ; Tatar; Stephen L.; (Montville, NJ) ;
Troxell; Thomas N.; (Pottstown, PA) |
Correspondence
Address: |
NORRIS MCLAUGHLIN & MARCUS, P.A.
721 ROUTE 202-206, P.O.BOX 5933
BRIDGEWATER
NJ
08807-5933
US
|
Family ID: |
38286470 |
Appl. No.: |
12/635182 |
Filed: |
December 10, 2009 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11334696 |
Jan 18, 2006 |
7695473 |
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12635182 |
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Current U.S.
Class: |
606/71 ;
606/281 |
Current CPC
Class: |
A61B 17/8023 20130101;
A61B 17/80 20130101 |
Class at
Publication: |
606/71 ;
606/281 |
International
Class: |
A61B 17/80 20060101
A61B017/80; A61B 17/88 20060101 A61B017/88 |
Claims
1-20. (canceled)
21. A bone plate having an adjustable longitudinal length
comprising: a first member having a proximal end and a distal end
and an upper surface and a lower surface, the proximal end
comprising a projection and the distal end comprising at least one
bone screw bore; a second member having a proximal end and a distal
end and an upper surface and a lower surface, the proximal end
comprising a recess in the upper surface shaped to receive and
guide the projection and the distal end comprising at least one
bone screw bore; the recess having an open end at the proximal end
of the second member, a distal wall opposite the open end and
opposing side walls extending from the open end to the distal wall;
the projection slideably engaged with the recess; and locking means
for releaseably locking the projection in the recess; wherein the
lower surfaces of the first and second members being shaped to
overlie a bone, wherein the length of the bone plate is adjustable
by sliding the projection longitudinally within the recess, the
side walls of the recess guide the projection to prevent lateral
movement, and the locking means locks the projection at a point
within the recess when the bone plate is adjusted to a desired
length.
22. The bone plate of claim 21 wherein the projection comprises an
opening and the recess has a locking means bore proximate to the
recess and the locking means is translated through the opening and
the locking means bore.
23. The bone plate of claim 22 wherein the first member comprises a
first member first end, a first member second end, a first member
forward side and a first member distal side and the second member
comprises a second member first end, a second member second end, a
second member forward side and a second member distal side and
wherein i) the first member has a second end surface at the first
member second end with the projection protruding from the second
end surface, the projection having a projection forward side, a
projection distal side, a projection end, a projection upper
surface and projection lower surface wherein the projection forward
side is opposed and parallel to the projection distal side with the
projection end there between perpendicular to the projection
forward side and projection distal side and opposite to the second
end surface.
24. The bone plate of claim 23 wherein a) the first member first
end comprises i) a first member forward circular element, a first
member first forward termination point and a first member second
forward termination point with the first member forward circular
element having a continuous side from the first member first
forward termination point to the first member second forward
termination point; ii) a first member distal circular element, a
first member first distal termination point and a first member
second distal termination point with the first member distal
circular element having a continuous side from the first member
first distal termination point to the first member second distal
termination point; and iii) a first member center section adjacent
to the first member first forward termination point and the first
member first distal termination point which extends from the first
member first forward termination point to the first member first
distal termination point; and b) the second member first end
comprises i) a second member forward circular element, a second
member first forward termination point and a second member second
forward termination point with the second member forward circular
element having a continuous side from the second member first
forward termination point to the second member second forward
termination point; ii) a second member distal circular element, a
second member first distal termination point and a second member
second distal termination point with the second member distal
circular element having a continuous side from the second member
first distal termination point to the second member second distal
termination point; and iii) a second member center section adjacent
to the second member first forward termination point and the second
member first distal termination point which extends from the second
member first forward termination point to the second member first
distal termination point. The plate of claim 5 comprising a first
set of first member and second member and a second set of first
member and second member wherein a first bridging means connects
the first member of the first set with the second member of the
second set and a second bridging means connects the second member
of the first set with the first member of the second set.
25. The bone plate of claim 24 wherein a) the first member of each
set comprises a first member protuberance which extends from the
first member forward side at a point between the first member first
end and first member second end with the first member protuberance
having a top surface, a bottom surface and a first member
protuberance end wall and a first member bridging rod bore defined
by the first member bridging rod bore wall having a first member
bridging rod bore opening at the first member protuberance end wall
with the first member bridging rod bore extending from the first
member bridging rod bore opening to a point between the first
member forward side and first member distal side, and b) the second
member of each set comprises a second member protuberance which
extends from the second member forward side at a point between the
second member first end and second member second end with the
second member protuberance having a top surface, a bottom surface
and a second member protuberance end wall and a second member
bridging rod bore defined by the second member bridging rod bore
wall having a second member bridging rod bore opening at the second
member protuberance end wall with the second member bridging rod
bore extending from the second member bridging rod bore opening to
a point between the second member forward side and second member
distal side.
26. The bone plate of claim 25 wherein each second member further
comprises a bridging means locking bore defined by a bridging means
locking bore wall which has an upper opening at the second member
upper surface and/or the top surface of the second member
protuberance and a lower opening at the second member bridging rod
bore wherein the bridging means locking bore extends from the upper
opening and bisects the second member bridging rod bore.
27. The bone plate of claim 25 wherein the bridging means locking
bore wall is threaded.
28. The bone plate of claim 25 wherein each first member comprises
a retaining pin hole proximate to the first member protuberance
which is defined by a retaining pin hole wall and bisects the first
member bridging means bore.
29. The bone plate of claim 27 wherein the retaining pin hole
comprises one or more threaded sections.
30. The bone plate of claim 24 wherein each bridging means
comprises a) a bridging rod having a circular end and a tapered end
opposite thereto with a cylindrical section having a continuous
curved outer section extending from the circular end to a
cylindrical section termination point between the cylindrical end
and the tapered end and a tapered section which extends from the
cylindrical section termination point to the tapered end the
tapered section comprising a top side having a slanted piece and a
level piece having a first end and a second end at the tapered end
wherein the slanted piece extends from the cylindrical section
termination point to the first end of the slanted piece and b)
bridge locking means.
31. A method for applying a bone plate to a patient comprising the
steps of a) providing a bone plate having one or more sets of first
members and second members which may be releaseably secured
together by attachment means wherein each first member and second
member comprises one or more bone screw bores defined by bone screw
bore walls, b) securing a first member to the broken bone of a
patient by placing the first member over the bone and translating
one or more bone attachment means through one or more of the bone
screw bores and into the bone; c) securing a second member to the
broken bone of a patient by placing the second member over the bone
and translating one or more bone attachment means through one or
more of the bone screw bores and into the bone; d) moving the first
member and/or second member to bring the pieces of broken bone
together; and e) providing locking means and applying the locking
means to restrict or inhibit the first member and/or second member
from moving.
32. The method of claim 30 wherein the attachment means comprises a
projection at the second end of each first member or second member
the projection having an opening and each first member or second
member which does not have the projection has a recess proximate to
the second end with the recess having a locking means bore wherein
the projection is aligned within the recess and the locking means
is translated through the opening and the locking means bore.
33. The method of claim 30 wherein the bone plate comprises a first
member having a proximal end and a distal end and an upper surface
and a lower surface, the proximal end comprising a projection and
the distal end comprising at least one bone screw bore; a second
member having a proximal end and a distal end and an upper surface
and a lower surface, the proximal end comprising a recess in the
upper surface shaped to receive and guide the projection and the
distal end comprising at least one bone screw bore; the recess
having an open end at the proximal end of the second member, a
distal wall opposite the open end and opposing side walls extending
from the open end to the distal wall; the projection slideably
engaged with the recess; and locking means for releaseably locking
the projection in the recess; wherein the first member and second
member are applied to the bone of the patient and the method
further comprises translating the projection within the recess.
34. The method of claim 30 wherein each first member comprises a
bridge locking means bore and each second member comprises a
retaining pin bore and at least one set screw and at least one
retaining pin are provided and the first bridging means and second
bridging means are releaseably secured to each first member by, at
least, set screws translated within bridge locking means bore and
are releaseably secured to each second member by the use of at
least retaining pins.
35. The method of claim 33 wherein each set of first member and
second member are laterally moved to move pieces of broken bone
together and, when the prices of bone are set in the desired
location, the set screw is tightened.
Description
BACKGROUND OF THE INVENTION
[0001] 1. Field of the Invention
[0002] The invention pertains to adjustable bone plates which
comprise one or more sets of first and second members releaseably
secured to each other. The members are capable of sliding thereby
allowing the surgeon to adjust the longitudinal length of the bone
plate and also to move pieces of broken bone closer to each other
prior to setting the longitudinal length of the bone plate. The
invention also pertains to bone plates that may be adjusted in both
a longitudinal and lateral dimension.
[0003] 2. The Relevant Art
[0004] Conventional bone plates have fixed dimensions and multiple
holes for accommodating bone screws. Surgeons generally use bone
plates to join sections of fractured bone by placing the bone plate
atop the fracture, inserting bone screws through the holes in the
plate which overlie the healthy part of the bone and securing the
bone about the fracture. Bone plates of many sizes are provided for
the surgeon, each having a number of holes so that the surgeon can
arrange the plate over the fracture and have bone screw holes
available above the healthy bone.
[0005] Direct Compression Plates ("DCP") are also available to
stabilize fractured bone. DCP generally have angulated openings,
through which screws are "toed" into the bone with the tightening
of the toed screws operating to move the bone, slightly, under the
DCP. DCP have been used to move bone pieces on either side of the
fracture closer together. However, with a DCP, only slight and not
easily controllable movements occur. Generally, the underlying bone
is pulled into place by the threads of a screw, providing no
control over the twisting or turning of the bone, and the bending
of the plate. In addition, the bone is pulled at an angle to the
attached plates, which can result in a cocked bone or at an angle
to the longitudinal direction of the bone. This angulation,
together with the micromotion in the bone, has led to backing out
of the screws after the bone plate is secured to the bone.
[0006] Thus, there is a need for bone plates which are adjustable
that allow the surgeon to move the broken pieces of bone while
inhibiting or preventing the bone from twisting or cocking either
during the process of applying the bone plate to the fractured bone
or afterwards.
SUMMARY OF THE INVENTION
[0007] The bone plate, or bone plate assembly, of the invention
comprises one or more sets of first member and second member. In
each set, a first member and a second member are releaseably
secured to each other through attachment means. The attachment
means provides each first member and second member with the
capability of being releaseably secured in a manner which allows
longitudinal adjustment of the location of the first member and
second member with relation to each other thereby allowing the bone
plate assembly to have an adjustable longitudinal length or
dimension. The attachment means generally functions with a locking
means which restricts or inhibits the longitudinal movement of the
members thereby setting the longitudinal length of the bone plate
assembly. For example, in use, the surgeon may secure a first
member to one side of a break in a broken bone and secure the
second member to another side of the break of the broken bone and
then can move one or both members to bring the pieces of broken
bone together. Once the surgeon has moved the pieces of bone as
desired for healing, the surgeon may then apply the locking means
to set the longitudinal length of the bone plate assembly. In
embodiments of the invention, more than one set of first member and
second member can be applied to broken bones with the set of first
member or second member connected to each other, such as through
bridging means, to provide adjustment to the lateral dimension of
the bone plate assembly.
[0008] The attachment means for example may comprise a flange in
one member and corresponding recess in another member. The flange
is capable of sliding within the recess thus providing the bone
plate with adjustability. Another example of an attachment means is
a one or more connecting rods which are capable of translating
within rod bores in the first member and/or second member.
[0009] The locking means may be any mechanical device that can
prevent the first member and second member from physically moving
in relation to each other. In general, the locking means may be one
or more of the following: heat shrinking, glue, molding of the
first member and second member together, screws, pins or anchors,
and combinations of these.
[0010] For example, the locking means may be a large head screw
which engages a slot in the flange of one member and a screw bore
at the recess of a second member which, upon tightening, locks the
flange within the recess thereby preventing the first member and
second member from moving in relation to each other. Another
example of a locking means is a set screw which engages a locking
means bore on the first member and/or second member effectively
crushing elements of the first member and second member over the
attachment means creating frictional forces that preclude movement
of the first member and second member with respect to each other.
In an embodiment of the invention, the attachment means is one or
more connecting rods which translate within rod bores on the first
member and/or second member and a set screw applied within the
locking means bore of the first member and/or second member forces
the walls of the rod bores against the connecting rods creating
frictional forces between the outer surfaces of the connecting rods
and the rod bore walls which preclude movement. Other locking means
include physical bonding such as a biocompatible adhesive or heat
which forms a physical bond between the first member and second
member, such as between surfaces of the flange and recess. For
example, once the first member and second member are set in place
the surgeon can apply an adhesive or other bonding agent which
secures the first member and second member in a fixed relationship
to each other or can apply heat which effectively melts the
surfaces of the first member or second member that are aligned and
in contact with each other causing the melted material of each
plate to mix together thereby physically connecting the two members
when the heat source is removed and the first member and second
member cool.
[0011] The adjustable bone plate may further comprise bridging
means which allows two or more sets of adjustable first member and
second member to be connected to each other to form a bone plate
assembly that has adjustability with respect to both the
longitudinal and lateral dimensions. In this embodiment of the
invention, the adjustable bone plate comprises one or more windows
to allow the surgeon to observe broken pieces of bone coming
together while the longitudinal and/or lateral dimensions of the
bone plate are being adjusted. For example, each the adjustable
bone plate assembly may comprise one or more bridging rods which
are capable of translating within one or more bridging rod bores in
the first member and/or second member. The bridging means may also
have the same or similar structure as the attachment means
discussed above.
[0012] The adjustable bone plate assemblies may further comprise a
bridge locking means for use in conjunction with the bridging means
to inhibit or restrict movement of one set of first member and
second member in relation to an adjoined set of first member and
second member thereby setting the lateral dimension of the
adjustable bone plate assembly. For example, the bridge locking
means may be screw member, such as a set screw, which is screwed
into a bore on a first member and/or second member and directly
interfaces a surface of the bridging means thereby inhibiting or
preventing the movement of one set of first and second member in
relation to an adjoined set of first and second members by
preventing or inhibiting the translation of the bridging means
within the bridging means bores. In addition to a set screw or
other screw member, the bridge locking means also be any of the
locking means discussed above.
[0013] The bone plates may be made by a biologically acceptable
material. Combinations of materials can be used.
[0014] The invention further pertains to the methods for applying
the bone plate assembly for healing broken bones of a patient. For
example, in one method only one set of first member and second
member is used. In this method, the first member or second member
is placed over a bone on one side of the break and the first member
or second member is placed over the bone on the other side of the
break and the first member and second member are then releasably
secured to each other with the attachment means and/or locking
means. The bone screws or other bone attachment means may be
applied to secure the first member and second member to the bone of
a patient by translating bone screws or other bone attachment means
through bone screw holes in the first member and second member and
into the bone after the attachment means is engaged, such as being
partially or loosely engaged to allow for movement. In an
embodiment of the invention, the bone attachment means may be
applied prior to engagement of the attachment means. As such, the
first member and second member may be releaseably secured to each
other either prior to the bone plate being secured to the bone of a
patient or after the bone plate is secured to the bone of a
patient. Bone attachment means are bone screws, surgical fasteners
or any other device capable of securing the bone plates, or any
component of the bone plate, to the bone of a patient. Also, the
first member and second member may first be releasably secured and
then placed over the broken bone with one member on one side and
another member on another side and then the bone screws are applied
to secure the bone plate assembly to the broken bone. In any event,
once the first member and second member are secured to the bone,
the surgeon may then move the first member or second member to
bring the pieces of the broken bone together and then further apply
or tighten the attachment means and/or locking means to prevent
further movement of the first member and second member to fix the
longitudinal dimension of bone plate assembly and set the bone in a
place for healing.
[0015] In a further embodiment, the method comprises applying one
or more additional sets of first member and second member. In this
embodiment a first member and second member set are applied to the
broken bone of a patient, generally as discussed above, and then
the bridging means is applied and next a second first member and
second member set is applied. Further, first member and second
member sets may be applied with the bridging means between each
additional set and the prior set of first member and second member.
Each set of first member and second member may be adjusted with
respect to the longitudinal dimension of each, as discussed above,
and the lateral dimension may be adjusted by moving sets of the
first member and second member in conjunction with the bridging
means. Once the pieces of broken bone have been moved to the
desired location, the longitudinal and lateral dimension of the
bone plate assembly can be fixed by applying and/or tightening the
attachment means and/or locking means (for the longitudinal
direction) and the bridge locking means (for the lateral
direction). Also, in an embodiment of the invention, the method
comprises having the longitudinal and/or lateral dimensions of the
bone plate fixed prior to applying the bone plate to the bone of a
patient by securing the bone plate to the bone of a patient. The
location of each first member and second member with respect to
various sides of the break will depend on the nature of the broken
bone. For example, a bone may have bisecting breaks in which case
each separate first member and second member in the bone plate
assembly, such as one having two sets of first member and second
member connected by bridging means, may be secured in different
sections of the broken bone.
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] FIG. 1 is a perspective view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0017] FIG. 2 is a top view of the first member and second member
of an adjustable bone plate in accordance with an embodiment of the
invention.
[0018] FIG. 3 is a bottom view of the first member and second
member of an adjustable bone plate in accordance with an embodiment
of the invention.
[0019] FIG. 4 is an end view of a first member of an adjustable
bone plate in accordance with an embodiment of the invention.
[0020] FIG. 5 is an end view of a second member of an adjustable
bone plate in accordance with an embodiment of the invention.
[0021] FIG. 6 is an end view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0022] FIG. 7 is a side view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0023] FIG. 8 is a front view of a locking means in accordance with
an embodiment of the invention.
[0024] FIG. 9 is a top view of a locking means in accordance with
an embodiment of the invention.
[0025] FIG. 10 is a perspective view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0026] FIG. 11 is a top view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0027] FIG. 12 is a bottom view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0028] FIG. 13 is a side view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0029] FIG. 14 is an end view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0030] FIG. 15 is a side view of an adjustable bone plate in
accordance with an embodiment of the invention.
[0031] FIG. 16 is an exploded perspective view of an adjustable
bone plate in accordance with an embodiment of the invention.
[0032] FIG. 17 is a perspective view of first member of an
adjustable bone plate in accordance with an embodiment of the
invention.
[0033] FIG. 18 is a top view of first member of an adjustable bone
plate in accordance with an embodiment of the invention.
[0034] FIG. 19 is a top view of second member of an adjustable bone
plate in accordance with an embodiment of the invention.
[0035] FIG. 20 is a perspective end view of a bridging means in
accordance with an embodiment of the invention.
[0036] FIG. 21 is a perspective side view of a bridging means in
accordance with an embodiment of the invention.
DETAILED DESCRIPTION OF THE INVENTION
[0037] FIGS. 1-7 show a bone plate assembly 1, in an embodiment of
the invention, wherein the bone plate assembly comprises a first
member 2, a second member 3 and a locking means 4. In this
embodiment of the invention each of the first member and second
member comprises two ends and at least one end of each has one or
more, preferably, two circular elements. Each circular element has
at least one bone screw bore therein. In this embodiment of the
invention, one of the ends of each of the first member and second
member comprise or may accommodate the attachment means such that
the first member and second member may be integrated into an
adjustable bone plate assembly. In the embodiment of the invention
shown in FIGS. 1-7, the attachment means comprises a flange 8 at
the second end of the first member and a corresponding recess 59
proximate to the second end of the second member and extending from
the second end to a point between the first end and second end of
the second member.
[0038] As shown in FIGS. 2 and 3, the first member comprises a
first member first end 204, a first member second end 5, a first
member forward side 6 and a first member distal side 7. The flange
8 protrudes from the first member second end 5. The first member
first end 204, in the embodiment of the invention shown in FIGS.
1-7, comprises a first member forward circular element 9 and a
first member distal circular element 10 joined by a first member
center section 11 having curvature. The first member 2 further
comprises a first member upper surface 12 and a first member lower
surface 13 which comprises a first member lower surface curved
section 13a which is generally a concave arcuate section which
further facilitates the snug fit of the first member and adjustable
bone plate against the curvature of the bone structure.
[0039] The first member forward circular element 9 has a continuous
side 14 which extends from a first member first forward termination
point 15 to a first member second forward termination point 16 such
that the side is circular or semi-circular in orientation.
Likewise, the first member distal circular element 10 has a
continuous side 17 which extends from a first member first distal
termination point 18 to a first member second distal termination
point 19. The first member center section 11 is adjacent to the
first member first forward termination point 15 and the first
member first distal termination point 18, and extends from the
first member first forward termination point 15 to the first member
first distal termination point 18. In a preferred embodiment, the
first member first forward termination point 15 and the first
member first distal termination point 18 oppose each other and the
first member center section side 20 of the first member center
section 11 has curvature creating a void between the first member
forward circular element 9 and first member distal circular element
10 having semicircular surface which is such that the sides of the
first member forward circular element 9, first member center
section 11 and first member distal circular element 10 represent a
continuous curved surface. The first member center section may also
comprise one or more locking slots that may be engaged by closure
means which may be provided with the bone plate assembly, to assist
in moving of the first member when engaged with the second member
forming the adjustable bone plate. The first member center section
11, in this embodiment of the invention, comprises a first member
locking slot 20a at about the centerline of the first member (which
is shown for example as centerline 24 on FIGS. 2 and 3 along both
the first member 2 and second member 3).
[0040] The first member 2, in the embodiment of the invention shown
in FIGS. 1-7, and particularly in FIG. 2, further comprises a first
member forward side edge 21 extending from the first member second
forward termination point 16 to the first member second end 5.
Preferably, the first member forward side edge comprises a first
member first forward edge section 22 adjacent to the first member
second forward termination point 16 and extending to a point more
proximate to the first member second end 5 and may be slanted from
a forward position at the first member second forward termination
point 16 to a more distal position at a first member third forward
termination point 23, i.e., slanted towards the centerline 24 of
the first member. Adjacent to the first member first forward edge
section 22 is a first member second forward edge section 25, which
extends to a first member fourth forward termination point 26.
Adjacent to the first member second forward edge section 22 is a
first member third forward edge section 27 which extends to the
first member second end 5 and is generally parallel to the
centerline 24. In a preferred embodiment, because the first member
first forward edge section 22 is slanted with respect to the
centerline of the first member and the first member third forward
edge section 27 is generally parallel to the centerline 24, the
first member second forward edge section 25 may have curvature to
provide a curved surface to join the first member first forward
edge section 22 and a first member third forward edge section 27
such that the first member forward side edge 21 has a continuous
curved surface without any sharp edges joining the sides.
[0041] As shown in FIGS. 1-7, and particularly in FIG. 2, the first
member 2 further comprises a first member distal side edge 28
extending from the first member second distal termination point 19
to the first member second end 5. Preferably, the first member
distal side edge 28 comprises first member first distal edge
section 29 adjacent to the first member second distal termination
point 19 and extending to a point more proximate to the first
member second end 5 and may be slanted from a distal position at
the first member second distal termination point 19 to a more
forward position at a first member third distal termination point
30, i.e. slanted towards the centerline 24 of the first member.
Adjacent to the first member first distal edge section 29 is a
first member second distal edge section 31, which extends to a
first member fourth distal termination point 32. Adjacent to the
first member second distal edge section 29 is a first member third
distal edge section 33 which extends to the first member second end
5 and is generally parallel to a centerline 24. In a preferred
embodiment, because the first member first distal edge section 29
is slanted with respect to the centerline 24 of the second member
and the first member third distal edge section 33 is generally
parallel to the centerline, the first member second distal edge
section 31 may have curvature to provide a curved surface to join
the first member first distal edge section 29 and a first member
third distal edge section 33 such that the first member distal side
has a continuous curved surface without any sharp edges joining the
sides.
[0042] Referring for example to FIGS. 2 and 3, each of the
continuous sides of the first member forward circular element and
first member distal circular element, as well as the first member
center section side have upper longitudinally curved sections (34a,
34b and 34c) and lower longitudinally curved sections (35a, 35b,
and 35c) which provide the sides with concave curvature. Also the
edges of the first member forward side and first member distal side
have upper longitudinally curved sections (36a and 36b) and lower
longitudinally curved sections (37a and 37b). These longitudinally
curved sections provide the sides and edges of the first member
with concave curvature and an uninterrupted longitudinal curve
which allow the bone plates to fit snugly against the curvature of
the bone structure. The second end, however, may not have
longitudinally curved sections.
[0043] The second end 5 of the first member (2 and 501) has, as
shown in FIG. 4, and also in FIGS. 16 and 19 with respect to other
embodiments of the invention, a second end surface 38 which is
generally flush and extends from the forward side to the distal
side of the first member, such as from the third forward edge
section 27 to the third distal edge section 33. The flange 8
protrudes from the second end surface 38 of the first member,
preferably, as shown in the drawings more proximate to the first
member upper surface (12 and 510) than the first member lower
surface (13 and 511). As shown in the drawings, the flange has a
flange forward side 39, flange distal side 40 and a flange end 41.
The flange forward side 39 generally extends from the second end
surface 38 proximate to the forward side of the first member to the
flange end 41, and the flange distal side generally extends from
the second end surface 38 proximate to the distal side of the first
member to the flange end 41. The flange forward side 39 and flange
distal side 40 may protrude at defined angles to each other or may,
as shown in the drawings, be parallel to each other. The flange end
extends between the ends of the flange forward side 39 and flange
distal side 40 and may extend perpendicular to the flange forward
side 39 and flange distal side 40, or at any angle or orientation.
In the embodiment of the invention shown in the drawings, the
flange end is a convex curved piece which provides the flange with
a continuous curved profile at the end. The flange further
comprises, particularly as shown in FIGS. 2-4, upper longitudinally
curved sections (42a, 42b and 42c) and lower longitudinally curved
sections (43a, 43b, and 43c) which facilitate sliding of the flange
into the recess, as described below.
[0044] The flange comprises a flange upper surface 44 and a flange
lower surface 45. The flange also comprises an opening 46 which
extends from the flange upper surface 44 to the flange lower
surface 45. The opening 46 is defined by a flange opening inner
wall 47. The opening may be any geometric shape such as, as shown
in the drawings, an oval. The opening 46 of the flange is generally
centered on the center line 24 of the first member. As shall be
discussed below, the flange operates in conjunction with the recess
of the second member and locking means and has a shape consistent
with the shape of the recess and a size which enables the flange
and the first member to move or slide in a longitudinal direction
to vary the longitudinal length of a bone plate when the first
member is conjoined with a second member to form the bone
plate.
[0045] The first member comprises one or more bone screw bores. In
the embodiment of the invention shown in FIGS. 1-7, the first
member comprises a first member forward bone screw bore 48
proximate to the forward circular element 9, and a first member
distal bone screw bore 49, proximate to the distal circular element
10. The first member forward bone screw bore 48 extends from the
upper surface to the lower surface of the first member and is
defined by first member forward bone screw bore inner wall 48a
there between. The first member distal bone screw bore 49 extends
from the upper surface to the lower surface of the first member and
is defined by first member distal bone screw bore inner wall 49a
there between. The bone screw bores are generally cylindrical and
when a bone screw or other bone attachment means is inserted into
the bone screw bore, the top surface of the bone screw or other
bone attachment means is flush, or about flush, with the upper
surface of the longitudinal plate such that they are recessed into
the first member longitudinal plate. Also, the bone screws will
lock with the bone screw bores and also the bone of the
patient.
[0046] As discussed above, the first member may optionally have
curvature, for example, the first member bottom surface comprises
the first member bottom surface curved section 13a which is
generally a concave arcuate section. This means that the upper
surface has a convex appearance and the first member when observed
from the end, as shown particularly in FIG. 4, has a curved
appearance. Because the first member has curvature, when bone
screws or other bone attachment means are inserted into the first
member forward bone screw bore 48 and the first member distal bone
screw bore 49, the ends of the bone screws or other bone attachment
means within the bone point towards each other, e.g., toe, which
provides greater assurance that the bone screws or other bone
attachment means will not pull out of the bone. This arrangement
may also inhibit twisting of the bone plate.
[0047] In the embodiment of the invention shown in FIGS. 1-7,
particularly referring to FIGS. 2 and 3, the second member
comprises a second member first end 50, a second member second end
51, a second member forward side 52 and a second member distal side
53. The second member first end 50 comprises a second member
forward circular element 54 and a second member distal circular
element 55 joined by a second member center section 56 having
curvature. The second member further comprises a second member
upper surface 57 and a second member lower surface 58 which
comprises a curved section 58a which is generally a concave arcuate
section that facilitates the snug fit of the bone plate against the
curvature of the bone structure. The second member further
comprises a recess 59 on the second member upper surface 57 which
extends from the second member second end 51 to a point proximate
to the second member first end 50, such as, as shown in FIGS. 2-4,
proximate to the second member center section 56.
[0048] The second member forward circular element 54 has a second
member forward continuous side 60 which extends from a second
member first forward termination point 61 to a second member second
forward termination point 62 such that the second member forward
continuous side is circular or semi-circular in orientation.
Likewise, the second member distal circular element 55 has a second
member distal continuous side 63 which extends from a second member
first distal termination point 64 to a second member second distal
termination point 65. The second member center section is adjacent
to the second member first forward termination point 61 and the
second member first distal termination point 64, and extends from
the second member first forward termination point 61 to the second
member first distal termination point 64. In a preferred
embodiment, the first forward termination point 61 and the first
distal termination point 64 oppose each other and the second member
center section side 66 of the second member center section 56 has
curvature creating a void between the second member forward
circular element 60 and second member distal circular element 63
having semicircular surface which is such that the sides of the
forward circular element, center section and distal circular
element of the second member represent a continuous curved surface.
The second member center section may also comprise one or more
locking slots which may be engaged by closure means provided with
the bone plate assembly, to assist in moving of the first member
when engaged with the second member forming the bone plate. In the
embodiment of the invention shown in the drawings, the center
section comprises a locking slot 67 at about the centerline 24 of
the second member.
[0049] The second member 3, in this embodiment of the invention,
further comprises a second member forward side edge 67 extending
from the second member second forward termination point 62 to the
second member second end 51. Preferably, the forward side edge
comprises a second member first forward edge section 68 adjacent to
the second member second forward termination point 62 and extending
to a point more proximate to the second member second end 51 and
may be slanted from a forward position at the second member second
forward termination point 62 to a more distal position at a second
member third forward termination point 69, i.e., slanted towards
the centerline 24 of the second member. Adjacent to the second
member first forward edge section 68 is a second member second
forward edge section 70, which extends to a second member fourth
forward termination point 71. Adjacent to the second member second
forward edge section 71 is a second member third forward edge
section 72 which extends to the second member second end 51 and is
generally parallel to the centerline 24. In a preferred embodiment,
because the second member first forward edge section 69 is slanted
with respect to the centerline 24 of the second member and the
second member third forward edge section 72 is generally parallel
to the centerline 24, the second member second forward edge section
70 may have curvature to provide a curved surface to join the
second member first forward edge section 69 and second member third
forward edge section 72 such that the second member forward side
edge has a continuous curved surface without any sharp edges
joining the sides.
[0050] The second member 3, in this embodiment if the invention,
further comprises a second member distal side edge 73 extending
from the second member second distal termination point 65 to the
second member second end 5. Preferably, the second member distal
side edge 73 comprises a second member first distal edge section 74
adjacent to the second member second distal termination point 65
and extending to a point more proximate to the second member second
end and may be slanted from a distal position at the second member
second distal termination point 65 to a more forward position at a
second member third distal termination point 75, i.e. slanted
towards the centerline 24 of the second member. Adjacent to the
second member first distal edge section 74 is a second member
second distal edge section 76, which extends to a second member
fourth distal termination point 77. Adjacent to the second member
second distal edge section 76 is a second member third distal edge
section 78 which extends to the second member second end 51 and is
generally parallel to a centerline 24. In a preferred embodiment,
because the second member first distal edge section 74 is slanted
with respect to the centerline of the second member and the second
member third distal edge section 78 is generally parallel to the
centerline 24, the second member second distal edge section 76 may
have curvature to provide a curved surface to join the second
member first distal edge section 74 and second member third distal
edge section 78 such that the second member distal side has a
continuous curved surface without any sharp edges joining the
sides.
[0051] Referring to the drawings, particularly FIGS. 2-4, each of
the continuous sides of the second member forward circular element
and second member distal circular element, as well as the second
member center section side have upper longitudinally curved
sections (79a, 79b and 79c) and lower longitudinally curved
sections (80a, 80b, and 80c) which provide the sides with concave
curvature. Also the edges of the second member forward side and
second member distal side have upper longitudinally curved sections
(81a and 81b) and lower longitudinally curved sections (82a and
82b). These longitudinally curved sections provide the sides and
edges of the first member with concave curvature and an
uninterrupted longitudinal curve which allow the bone plates to fit
snugly against the curvature of the bone structure. The second end,
however, may not have longitudinally curved sections.
[0052] The second member second end (51 and 532), as shown, for
example in FIG. 5, and in FIGS. 16-18, comprises a second end
surface 83 which comprises a bottom section 83a which extends from
the second end forward side to the second end distal side proximate
to the second end bottom 83 to the recess 59, particularly recess
opening 84 and opposing forward upright section 83b and distal
upright section 83c so that the second end, when observed from the
second end of the second member, has a "U-shaped" appearance
framing the recess opening 84. The forward upright section 83b
extends, on the forward side of the second member, from the bottom
section 83a to the top surface of the second member, and the distal
upright section 83c extends on the distal side of the second member
from the bottom section 83a to the top surface of the second
member. The edge 85 of the bottom section 83a opposite the bottom
surface of the second member, the edge 86 of the forward section
83b opposite the second member third forward edge section 72 and
the edge 87 of the distal section 83c opposite the second member
third distal edge section 78 define the recess opening 84 at the
second end (51 and 532) of the second member.
[0053] The recess 59 of the second member extends from the recess
opening 84 at the second end (51 and 532) to a point between the
second end (51 and 532) of the second member to the first end (50
and 531) of the second member. The recess which is shown in FIGS. 2
and 5 and also in FIGS. 16-18, for example, is defined by a recess
bottom surface 88 and a recess wall 89. The recess wall 89 may be
continuous and extending from the edge 86 of the forward section
83b and the edge 87 of the distal section 83c. The recess may have
any geometric shape, however, as shown in the figures, the recess
wall may have a forward recess wall 89a and an opposed distal
recess wall 89b each extending from the second end (51 and 532) of
the second member to a point between the second end (51 and 532)
and first end (50 and 531) of the second member with a joining
recess wall 89c there between. In an embodiment of the invention,
the joining recess wall is arcuate having a convex curvature having
a distant point 90, i.e. the point of the recess joining wall 89c
most distant from the second end 51. In the embodiment of the
invention shown in FIGS. 1-7, this is proximate to the second
member curved end 66 of the first end, at about the centerline 24
of the second member. Preferably the forward recess wall and distal
recess wall are about equidistant from the centerline 24 of the
second member. The shape of the recess should complement the shape
of the flange such as, as shown in the drawings, the flange having
convex curvature which is accommodated by the convex curvature of
the joining recess wall.
[0054] In the embodiment of the invention shown in the drawings,
the second member further comprises a locking means bore 91 within
the recess, which extends from the recess bottom surface 88 to a
point between the recess bottom surface 88 to the bottom surface 58
of the second member, and may extend through the bottom surface 58.
The locking means bore is defined by a locking means bore wall 91a.
In an embodiment of the invention, the locking means bore is
threaded. The locking means bore interacts with the locking means
as shall be discussed below.
[0055] The second member comprises one or more bone screw bores. In
the embodiment of the invention shown in FIGS. 1-7, the second
member comprises a second member forward bone screw bore 92
proximate to the second member forward circular element 54, and a
second member distal bone screw bore 93, proximate to the second
member distal circular element 63. The second member forward bone
screw bore 92 extends from the upper surface to the lower surface
of the first member and is defined by second member forward bone
screw bore inner wall 92a there between. The second member distal
bone screw bore 93 extends from the upper surface to the lower
surface of the first member and is defined by second member distal
bone screw bore inner wall 93a there between. The bone screw bores
are generally cylindrical and when a bone screw or other bone
attachment means is inserted into the bone screw bore, the top
surface of the bone screw or other bone attachment means is flush,
or about flush, with the upper surface of the longitudinal plate
such that they are recessed into the second member longitudinal
plate. Also, the bone screws, or other bone attachment means will
lock with the bone screw bores and also the bone of the
patient.
[0056] As discussed above, the second member has curvature in that
the second member bottom surface comprises the second member bottom
surface curved section which is generally a concave arcuate section
shown, for example, as 58 in FIG. 5. This means that the upper
surface has a convex appearance and the second member when observed
from the end has a curved appearance. Because the second member has
curvature, in the embodiment of the invention shown in FIGS. 1-7,
when bone screws or other bone attachment means are inserted into
the second member forward bone screw bore 92 and the second member
distal bone screw bore 93, the ends of the bone screws or other
bone attachment means within the bone point towards each other,
e.g., toe, which provides greater assurance that the bone screws or
other bone attachment means will not pull out of the bone. This
arrangement may also inhibit twisting of the bone plate.
[0057] The locking means may be any device or apparatus capable of
releaseably securing the first member and the second member such
that the flange of the first member may translate within the recess
of the second member, such as by having the flange slide within the
recess, and be secured when the bone plate is at a therapeutically
appropriate longitudinal length. Any of the locking means described
above may be used in conjunction with the flange and recess in the
embodiment of the bone plates shown in FIGS. 1-7, as well as in the
other drawings. An example of a locking means useful in the
invention is shown particularly in FIGS. 8-9. The locking means 94
comprises a top section 95 and a bottom section 96. The top section
95 comprises an upper surface 97, a top section body 98 which has
an oversized element outer surface 99 and a bottom surface 100. The
top section is generally cylindrical and has a dimension that is
greater in a longitudinal direction than the bottom section 96,
such that the locking means 94 has the appearance of a large top
set screw. The bottom section 96 comprises a shaft 101, which is
preferably, as shown in FIGS. 8-9, threaded to mate with the
locking means bore 91 and releaseably secures the locking means to
the second member when releaseably securing the first member and
second member to each other to form the bone plate, as shall be
discussed in more detail below. The shaft 101 has an end attached
to or integral with the top section 95 and extends from the bottom
surface 100 of the top section body 98, preferably at about the
center, or at the center, of the bottom surface 100 to the lower
end 102 of the shaft. The locking means may further have a recessed
section 98a to accommodate a tool for tightening the locking means.
For example, the recessed section 98 may be configured as a hex, as
shown, or may be slotted or cruciform.
[0058] The first and second members are assembled into a bone
plate, or a component of a bone plate wherein the bone plate
comprises two or more sets of first member and second member, by
arranging the first member and second member such that the flange
is capable of sliding within the recess. The locking means is
translated through the opening of the flange and through the
locking means bore. Because the opening is generally oval or
oblong, the flange is capable of sliding within recess in a
longitudinal direction after the locking means is applied to the
locking means bore of the second member provided the locking means
is not tightened against the flange upper surface. Thus, the
locking means may be translated through the opening and locking
means bore and maintained at a position wherein the flange is
capable of sliding within the recess thereby allowing the surgeon
to select a longitudinal length by moving the first member and/or
second member because the opening of the flange has a larger
dimension than the bottom section of the locking means. The top
section of the locking means has a larger dimension than the
opening of the flange such that the bottom surface of the top
section of the locking means is at least partially in contact with
the flange upper surface. The locking means functions like a set
screw in that once a longitudinal dimension of the bone plate is
obtained, the locking means may be tightened by further translating
the locking means within the locking means bore so that the flange
applies pressure to the recess with the bottom surface of the
locking means applying pressure to the top surface of the flange
which inhibits or precludes the flange from further sliding within
the recess thereby fixing the longitudinal length of the bone plate
and setting the bone in place.
[0059] As shown in the drawings, the flange 8 is oriented on the
second end of the first member so that it may interact with the
recess 59 such that the upper surfaces of the first member and
second member and bottom surfaces of the first member and second
member are aligned to provide that the top and bottom of the bone
plate are continuous or approximately continuous. That is that the
top surface of the bone plate and bottom surface of the bone plate
are approximately at the same longitudinal plane. Also, in a
preferred embodiment of the invention, the recess, flange and
locking means have dimensions such that the upper surface of the
top section of the locking means does not extend above, or
substantially above, the upper surfaces of the first member and
second member of the assembled bone plate to provide the top
surface of the assembled bone plate with a smooth surface.
[0060] A further embodiment of the invention is shown in FIGS.
10-19, in which the bone plate assembly 500 comprises two sets of a
first member 501 and a second member 502 joined by first bridging
means 503 and second bridging means 504. In this embodiment of the
invention, the bone plate assembly 500 comprises an observation
window 505 defined by the opposing sets of first member and second
member and the first bridging means and second bridging means. The
bone plate assembly in this embodiment of the invention may be
adjusted in both the longitudinal dimension, i.e. longitudinal
length, through the attaching means and/or locking means, and in
the lateral dimension by the bridging means.
[0061] Referring particularly to FIG. 19, in this embodiment of the
invention each first member 501 of the bone plate assembly 500
comprises a first member first end 506, a first member second end
507, a first member forward side 508 and a first member distal side
509. As shown in the drawings, for example FIGS. 11 and 12, each
first member 501 also comprises a first member upper surface 510
and a first member lower surface 511. The first member lower
surface 511 of each first member comprises a first member lower
surface curved section 511a (shown for example in FIG. 14) which is
generally a concave arcuate section which, as discussed above,
facilitates the snug fit of the first member and adjustable bone
plate against the curvature of the bone structure.
[0062] The first member 502 further comprises a first member
protuberance 512 which extends from the first member forward side
508 at a point between the first member first end 506 and first
member second end 507. As shown in FIGS. 16 and 19, for example,
the first member protuberance 512 comprises a top surface 513 which
is generally contiguous with, and an extension of, the first member
upper surface 510 and a bottom surface 514 which is generally
contiguous with, and an extension of, the first member lower
surface 511. The first member protuberance 512 comprises a first
member protuberance end wall 514. The first member protuberance 512
comprises a first member bridging rod bore 515 which has a first
member bridging rod bore opening 515a at the first member
protuberance end wall 514. The first member bridging rod bore 515
is defined by the first member bridging rod bore wall 515b which
extends from the first member bridging rod bore opening 515a to a
point between the first member forward side 508 and first member
distal side 509 of the first member. The first member protuberance
further comprises a first side wall 522 and second side wall 523
which extend from the first member forward wall to the first member
protuberance end wall.
[0063] The first end of each first member comprises lateral
curvature having an upper arc point 516 about equidistant from the
first member forward side 508 and first member distal side 509
generally about the centerline 24 of each first member. The first
member first end comprises a locking slot 517 at about the upper
arc point 516. In addition, the first member first end comprises a
first end upper longitudinally curved surface 518 and a first end
lower longitudinally curved surface 519. The locking slot may be
engaged by closure means provided with plate assembly, to assist in
moving of the first member and second member together, i.e. to
adjust the longitudinal dimension.
[0064] The first member forward side 508 of each first member
comprises a forward side upper longitudinally curved surface 520
and a forward side lower longitudinally curved surface 521. Also,
the first member distal side 509 of each first member comprises a
distal side upper longitudinally curved surface 513 and a distal
side lower longitudinally curved surface 514. Likewise the first
side wall of the first member protuberance may, optionally, have an
upper longitudinally curved surface 524 and a lower longitudinally
curved surface 525, and the second side wall of the first member
protuberance may, optionally, have an upper longitudinally curved
surface 526 and a lower longitudinally curved surface 527. The
forward side upper longitudinally curved surface, forward side
lower longitudinally curved surface, the distal side upper
longitudinally curved surface and distal side lower longitudinally
curved surface, together with the first end upper longitudinally
curved surface and a first end lower longitudinally curved surface
provide each first member with an uninterrupted longitudinal curve,
and with similar features on the second member provide the bone
plate assembly with an uninterrupted longitudinal curve. The first
side wall of the first member protuberance upper longitudinally
curved surface 524 and a lower longitudinally curved surface 525,
and the second side wall of the first member protuberance upper
longitudinally curved surface 526 and a lower longitudinally curved
surface 527 also add to this feature of the first member and the
bone plate assembly in this embodiment of the invention.
[0065] The first member second end 507 in this embodiment of the
invention has flange 8 protruding there from. The first member
second end 507 and flange 8 in this embodiment of the invention
have the same structure, elements and function as discussed above.
In FIGS. 10-19, these elements of the first member 501 are provided
the same element numbers as set forth in FIGS. 1-9, and reference
is made to the description of these features above for these
elements applicable to these features of the first member 501 in
this embodiment of the invention.
[0066] The first member further comprises a retaining pin bore 528
which is proximate to the first member protuberance 512. The
retaining pin bore 528 is defined by a retaining pin bore wall and
has an upper opening at the first member top surface and/or first
member protuberance and a lower opening at the first member bottom
surface and/or first member protuberance. The retaining pin bore
extends from the upper opening to the lower opening and preferably
bisects the bridging means bore. The retaining pin bore may be
threaded at one or both ends.
[0067] The first member also comprises one or more bone screw
bores, which are defined by bone screw bore walls and extend from
an opening at the upper surface of the first member to the lower
surface of the first member. The bone screw bores of the first
member in this embodiment of the invention have the same structure,
elements and function as described above with respect to other
embodiments of the invention. As shown in FIGS. 11-19, each first
member 501 of the bone plate assembly 500 has a first bone screw
bore 529 proximate to first end and a second bone screw bore 530
proximate to the second end.
[0068] As shown particularly in FIGS. 17 and 18, the second member
502 in this embodiment of the invention comprises a second member
first end 531, a second member second end 532, a second member
forward side 533 and a second member distal side 534. As shown in
the drawings, for example FIGS. 11 and 12, each second member 502
also comprises a second member upper surface 535 and a second
member lower surface 536. The second member lower surface 536
comprises a second member lower surface curved section 536a (shown,
for example, in FIG. 14) which is generally a concave arcuate
section which, as discussed above, facilitates the snug fit of the
second member and adjustable bone plate against the curvature of
the bone structure.
[0069] The second member 502 further comprises a second member
protuberance 537 which extends from the second member forward side
533 at a point between the second member first end 531 and second
member second end 532. As shown in FIGS. 16-18, for example, the
second member protuberance 537 comprises a top surface 538 which is
generally contiguous with, and an extension of, the second member
upper surface 535 and a bottom surface 539 which is generally
contiguous with, and an extension of, the second member lower
surface 536. The second member protuberance 537 comprises a second
member protuberance end wall 540. The second member protuberance
537 comprises a second member bridging rod bore 541 which has a
second member bridging rod bore opening 541a at the second member
protuberance end wall 540. The second member bridging rod bore 541
is defined by the second member bridging rod bore wall 541b which
extends from the second member bridging rod bore opening 541a to a
point between the second member forward side 533 and second member
distal side 534. The second member protuberance further comprises a
first side wall 542 and second side wall 543 which extend from the
second member forward wall to the second member protuberance end
wall.
[0070] The second member first end 531 has the same features and
function as the first end of the first member as discussed above in
this embodiment of the invention. Thus, the second member first end
comprises lateral curvature having an upper arc point 544 about
equidistant from the second member forward side 533 and second
member distal side 534 generally about the centerline of each
second member. The second member first end comprises a locking slot
545 at about the upper arc point 544. In addition, the second
member first end comprises a first end upper longitudinally curved
surface 546 and a first end lower longitudinally curved surface
547. As discussed above, the locking slot which may be engaged by
closure means provided with plate assembly, to assist in moving of
the first member and second member together, i.e. to adjust the
longitudinal dimension.
[0071] The second member forward side 533 and second member distal
side 534 have the same longitudinal curvature as the first member
forward side 508 and first member distal side 509 of the bone plate
assembly 500. Thus, the second member forward side comprises a
forward side upper longitudinally curved surface 548 and a forward
side lower longitudinally curved surface 549. Also, the second
member distal side 509 comprises a distal side upper longitudinally
curved surface 550 and a distal side lower longitudinally curved
surface 551. Likewise, the first side wall of the second member
protuberance may, optionally, have an upper longitudinally curved
surface 552 and a lower longitudinally curved surface 553 (shown,
for example, in FIG. 12), and the second side wall of the second
member protuberance may, optionally, have an upper longitudinally
curved surface 554 and a lower longitudinally curved surface 555.
The forward side upper longitudinally curved surface, forward side
lower longitudinally curved surface, the distal side upper
longitudinally curved surface and distal side lower longitudinally
curved surface, together with the first end upper longitudinally
curved surface and a first end lower longitudinally curved surface
provide each second member with an uninterrupted longitudinal
curve, and with similar features on the first member provide the
bone plate assembly with an uninterrupted longitudinal curve. The
first side wall of the second member protuberance upper
longitudinally curved surface and lower longitudinally curved
surface, and the second side wall of the second member protuberance
upper longitudinally curved surface and a lower longitudinally
curved surface also add to this feature of the second member and
the bone plate assembly in this embodiment of the invention.
[0072] The second member second end 532 in this embodiment has the
same structure, elements and functions as the second end of the
second member in the other embodiments of the invention discussed
above. Also, the second member has a recess proximate to the second
member second end 532. The recess in this embodiment of the
invention has the same structure, elements and function as
discussed above with respect to other embodiments of the invention.
Also, the second member comprises the locking means bore 91 within
the recess which has the same structure, elements and function as
discussed above with respect to other embodiments of the invention.
In FIGS. 10-19, these elements of the second member 502 are
provided the same element numbers as set forth in FIGS. 1-9, and
reference is made to the description of these features above for
these element numbers which is applicable to these features of the
second member 502 in this embodiment of the invention.
[0073] The second member further comprises a bridging means locking
bore 556 which is proximate to the second member protuberance 537.
The bridging means locking bore 556 is defined by a bridging means
locking bore wall, which may be threaded, and has an upper opening
at the second member upper surface and/or top surface of the second
member protuberance and a lower opening into the top of the second
member bridging rod bore 541. The bridging means locking bore 556
extends from the upper opening to the lower opening and preferably
bisects the bridging means rod bore.
[0074] The second member also comprises one or more bone screw
bores, which are defined by bone screw bore walls and extend from
an opening at the second member upper surface to the second member
lower surface. The bone screw bores of the second member in this
embodiment of the invention have the same structure, elements and
function as described above with respect to other embodiments of
the invention. As shown in FIGS. 11-19, each second member 502 of
the bone plate assembly 500 has a first bone screw bore 557
proximate to second member first end and a second bone screw bore
558 proximate to the recess 89.
[0075] In the embodiment of the invention shown in FIGS. 10-19, the
bone plate assembly 500 is assembled by connecting one set of
attached first member and second member with another set of
attached first member and second member by use of the bridging
means. In this embodiment of the invention, the bridging means
comprises a bridging rod 559. The bridging rod 559 is particularly
shown in FIGS. 20 and 21. The bridging rod 559 has a generally
cylindrically shape with a tapered section at one end. As shown the
drawings the bridging rod 559 comprises a circular end 560 and a
tapered end 561. The bridging rod comprises a cylindrical section
562 which has a continuous curved outer section providing the
cylindrical section 562 with a cylindrical shape and extends from
the cylindrical end 560 to the cylindrical section termination
point 563, which is between the cylindrical end 560 and the tapered
end 561. A tapered section 564 of the bridging rod 559 extends from
the cylindrical section termination point 563 to the tapered end
559. The tapered section 564 comprises a top side 565 which has a
slanted piece 566 and a level piece 567 with the slanted piece 566
extending from the cylindrical section termination point 563 to a
first end of the level piece 567 and the level piece extends from
its first end where it joins the slanted piece 566 to the tapered
end 561 of the bridging rod 559. The tapered section further
comprises a bottom side 568 which may, as shown in the drawings, be
a continuation of the cylindrical curvature of the cylindrical
section 562. The bridging rod may further comprise a retaining pin
hole 569 proximate to the cylindrical end 560. The retaining pin
hole is defined by a retaining pin hole wall and in embodiments of
the invention wherein the bridging rod is solid, it extends from
one point on the outer wall of the bridging rod to another point
and in embodiments wherein the bridging rod is hollow, the
retaining pin hole may be two holes which correspond to allow a
retaining pin to extend from both holes in the bridging rod. The
retaining pin and the retaining pin hole may be threaded such that
the outer surface of the retaining pin has one or more threaded
sections, or is continuously threaded from the top to the bottom,
and the retaining pin hole wall is continuously threaded or
comprises threaded sections.
[0076] A retaining pin 577 may be used in conjunction with the bone
plate assembly 500. As shown in FIG. 16, for example, the retaining
pin 577 generally comprises a first end 578, a second end 579 and
an outer surface 580 which is a continuous curved surface between
the first end 578 and second end 579 such that the retaining pin
577 is cylindrical in shape. The retaining pin 577 may be threaded
or comprise threaded sections such that the outer surface comprises
one or more threaded sections.
[0077] The bridging means is generally used to join sets of first
members and second members as shown in FIG. 10 for example. As
shown in FIGS. 10 and 16, for example, the bridging means may
comprise a bridging rod 559 used in conjunction with a bridge
locking means which as shown in the drawings may be a set screw 570
having an upper end 571 and a lower end 572 and a continuous outer
wall 573 there between. The continuous outer wall 573 is,
preferably, threaded, although it may not be threaded. The upper
end 571 may comprise a set screw recessed section 574 to
accommodate a tool for tightening the bridge locking means. The
bridging means is also used in conjunction with the retaining pin
577, the retaining pin bore 528 of the first member 501 and the
retaining pinhole 569 of the bridging rod 559 to affix the bridging
rod 559, proximate to the cylindrical end 560 to the first member
501.
[0078] The bone plate assembly, such as that shown in FIGS. 10-19,
is generally assembled by first adjoining two sets of first members
and second members by aligning the flange of the first member with
the recess of the second member and then applying the locking means
such that the locking means is translated through the opening of
the flange and through the locking means bore of each set of first
member and second member, in a similar fashion as discussed above
with respect to the other embodiments of the invention. The same
locking means as described above may be used. Once the sets of
first members and second members are formed, the bridging means is
applied by translating the bridging rod through the bridging means
bores in the first member and second member. The bridging rod may
be attached or releaseably secured to the first members and second
members in adjoining first member and second member set through the
use of retaining pins and bridge locking means, such as by
translating the retaining pin through the retaining pin bore of the
first member and retaining pinhole of bridging rod and translating
the set screw through the bridge locking means bore such that it
interacts with the bridging rod, particularly the level piece of
the bridging rod.
[0079] Because the bridging rods are capable of sliding within the
bridging rod bores in the first member and second member and the
flanges are capable of sliding within the recesses of the second
member, the assembled bone plate in the embodiment of the invention
comprising bridging means has both longitudinal and lateral
adjustability. The longitudinal dimension can be adjusted by
sliding the flanges within the recess and when the desired
longitudinal dimension is obtained, the locking means may be
tightened to prevent further movement. Also, when the appropriate
lateral dimension is obtained then the bridge locking means, such
as set screw, can be applied and/or tightened to prevent further
movement of the bridging rod within the bridging means bores. In a
preferred embodiment of the invention, one end of the bridging rod
is held into the first member by translating a retaining pin into
the retaining pin bore of the first member and bridging rod, and
the tapered end 561 of the bridging rod is free to move within the
bridging means bore of the opposite second member. The lower
surface 572 of the set screw applies pressure to the top surface of
the level piece 567 to secure the bridging rod and prevent further
movement thereby setting the lateral dimension of the bone plate
assembly. When assembled, as shown in FIG. 10, for example, the
second member of the first set of first member/second member is
connected by the bridging means opposite to the first member of the
second set of first member/second member, and the first member of
the first set of first member/second member is connected by the
bridging means opposite to the second member of the second set of
first member/second member. It should be understood that more than
two sets of first member/second member may be laterally secured to
each other using bridging means.
[0080] The bone plate assembly shown in FIGS. 11-19 comprises a
first set of first member/second member 575 and a second set of
first member/second member 576. The first set 575 and second set
576 of first member/second member are connected by first bridging
means 503 which connect the second member 502 of the first set 575
to the first member 501 of the second set 576 and by second
bridging means 504 which connect the first member 501 of the first
set 575 to the second member 502 of the second set 576. The various
members and sets are connected and both longitudinally and
laterally adjustable as discussed above.
[0081] The bridging rods may have curvature such that when
connecting one or more sets of first members and second members,
the assembled bone plate has curvature in that the bottom has a
concave appearance and the top has a convex appearance. This can
generally be seen with respect to the end view of the embodiment of
the invention shown in FIG. 14. As shown in FIG. 14, the first set
of the first member and second member and second set of the first
member and second member each have a concave appearance on the
bottom as shown with respect to the curvature of the first member
lower surface curved section 511a and second member lower surface
curved section 536a. As such, the entire bone plate has a bottom
which has global bottom curvature 599 across the bottom of the
assembled bone plate in this embodiment of the invention. Thus,
when the bone plate is applied to the patient by translating bone
screws or other bone attachment means through the bone screw bores
of the first set of first member and second member and second set
of first member and second member and securing the bone screws or
other bone attachment means to the bone, the bone screws or other
bone attachment means applied to the first set and bone screws or
other bone attachment means applied to the second set will point
towards each other, e.g. toe, which provides greater assurance that
the bone screws or other bone attachment means will not pull out of
the bone, and may inhibit twisting of the bone plate. Also, the
global bottom curvature 599 facilitates the fit of the bone plate
on the bone of a patient.
[0082] The invention comprises a method for setting the broken bone
of a patient. The method comprises the steps of providing the first
member, second member and locking means as described herein. In an
embodiment of the invention, the second member is secured to the
bone of the patient, on one side of the break, by translating bone
screws or other bone attachment means through the second member
forward bone screw bore 92 and a second member distal bone screw
bore 93. The first member is secured to the bone of the patient, on
the side of the break opposite to the side of the break where the
second member is attached, by translating bone screws or other bone
attachment means through the first member forward bone screw bore
48 and first member distal bone screw bore 49 with the flange 8
within the recess 59 such that the opening of the flange 8 is at
least aligned with the locking means bore such that the locking
means can be translated within both the opening 46 of the flange 8
and locking means bore 59. In the method, the locking means is
translated through the opening 46 of the flange 8 and locking means
bore 59 and the pieces of broken bone are moved proximate to each
other for healing by adjusting the position of the first member
and/or second member to set a longitudinal length or dimension of
the bone plate. The first member and second member may be applied
to the broken bone and the pieces of broken bone may be moved
together, with the locking means then translated through the
opening 46 of the flange 8 and the locking means bore 59 and
tightened to prevent the flange from sliding within the recess and
fix the longitudinal length or dimension of the bone plate to set
the bone in place. Alternatively, however, the surgeon may
translate the locking means through the opening 46 of the flange
and locking means bore 91 without tightening the locking means so
that the flange 8 may slide within the recess 59, then move the
first and/or second member with the flange sliding within the
recess to bring pieces of broken bone together and then tighten the
locking means to inhibit or prevent further sliding of the flange
within the recess thereby fixing the longitudinal length or
dimension of the bone plate to set the bone in place.
[0083] In a further embodiment, the first member and second member
may be assembled into the bone plate prior to applying the bone
plate to the broken bone of a patient. In this embodiment, the
method involves translating the locking means through the opening
46 and locking means bore 91 without tightening the locking means
to preclude the flange 8 from sliding within the recess 59 prior to
applying the bone plate or either the first member or second member
to a patient. Next, the assembled bone plate is applied to the
broken bone of a patient by placing the first member over the one
side of the break and placing the second member over the bone on
the opposite side of the break and securing the bone plate to the
patient by translating bone screws or other bone attachment means
through the first member forward bone screw bore 48 and first
member distal bone screw bore 49 and translating bone screws or
other bone attachment means through the second member forward bone
screw bore 92 and a second member distal bone screw bore 93, with
the bone screws applied through the various bone screw bores in any
order. The pieces of broken bone may be moved together and then the
surgeon then tightens the locking means to prevent further sliding
of the flange within the recess thereby fixing the longitudinal
length of the bone plate and setting the bone in place. In yet
another embodiment of the invention, the surgeon may releasably
secure the first member and second member and apply the locking
means to fix the longitudinal length of the bone plate prior to
applying the bone plate to the broken bone of a patient.
[0084] An implant procedure with two ends of bone properly aligned
may be described as follows: [0085] 1. Loosely assembly the first
member and second member with the locking means loosely tightened
to allow the flange to move within the recess. [0086] 2. Translate
one bone screw through a bone screw bore in either the first member
or second member and into the bone. [0087] 3. With assembly fully
extended, translate a second bone screw into a bone screw bore of
either the first member or second member (opposite of the one to
which the bone screw is applied in step 2) and into the bone.
[0088] 4. Implant bone screws into any remaining bone screw bores
of the first member and/or second member. [0089] 5. Compress the
first member and second member (i.e., move the members toward each
other) to set the bone in place and tighten the locking means to
prevent further movement of the first member and second member.
[0090] The method may further comprise providing one or more
bridging means to apply one or more first member and second member
sets to a broken bone of a patient such that the bone plate
assembly has both longitudinal and lateral adjustability. In this
embodiment, which may generally concern applying the bone plate
shown in FIGS. 10-19, a first member 501 is applied to a broken
bone and a second member 502 is applied to the broken bone using
bone screws or other bone attachment means translated through one
or more bone screw bores on the first member and second member with
the flange 8 of the first member 501 within the recess 59 of the
second member 502, optionally with the locking means applied and
loosely tightened to allow movement of the first member and/or
second member, thus forming a first first member and second member
applied to the bone, such as that discussed above with respect to
the embodiment shown in FIGS. 1-8. Next, a first bridging means is
translated into a bridging means bore, such as the second member
bridging rod bore 541, and a second bridging means is translated
into a bridging means bore, such as a first member bridging rod
bore 515, which may be held by a retaining pin. A second first
member and second member set may then be applied over a side of the
break opposite the break or breaks on the bone. This is
accomplished by translating the first bridging means within a
bridging means bore, such as a first bridging rod bore 518 of the
first member of the second first member and second member set,
which may be held by a retaining pin, and translating the second
bridging means in bridging means bore, such as a second bridging
rod bore 541, of the second member of the second first member and
second member set in a manner in which the flange of the first
member is within the recess of the second member of the second
first member and second member set, as discussed above with respect
to the first first member and second member set. The first member
and second member of the second first member and second member set
may be secured to the bone by translating bone screws or other bone
attachment means through some or all of the first member and second
member bone screw bores of the second first member and second
member set. The surgeon may then move the first member and second
member of the first first member and second member set
longitudinally with respect to each other, the first member and
second member of the second first member and second member set
longitudinally with respect to each other and the first first
member and second member set and the second first member and second
member set laterally with respect to each other in order to move
the broken pieces of bone together. The bone may then set the bone
in place for healing by applying the locking means to fix the
longitudinal dimension of both the first first member and second
member set and second first member and second member set as
discussed above by use, for example, of a large top screw, and
apply the bridge locking means to set the lateral dimension of the
adjustable bone plate such as by translating a set screw within the
bridging means locking bore 556 in each second member of each first
member and second member set. The surgeon may observe the pieces of
bone in the observation window. In a preferred embodiment of this
method, the bridging means comprises the bridging rod and set
screw. The surgeon may also fix the longitudinal and/or lateral
dimensions of the bone plate prior to applying the bone plate to a
broken bone of a patient.
[0091] The bone plate and its components may be constructed of any
suitable biocompatible material known to have sufficient structural
strength and durability, such as stainless-steel, alloys, cobalt
alloys or titanium alloys, including any suitable ASTM or ISO
standard materials as set forth on the United States Food and Drug
Administration website. Some examples include unalloy titanium,
titanium alloyed with aluminum, niobium and/or vanadium, stainless
steels and other irons alloyed with molybdenum, chromium, cobalt,
tungsten, nickel, manganese in various combinations, various other
stainless steels or other iron alloys, such as, with aluminum
oxides, zirconium oxides, tantalom and calcium phosphates. Any
acceptable polymeric material may be used, such as PEEK (poly ethyl
ethylketone), with sufficient flex to mimic the micromotion of
normal bone, to stimulate bone growth. The PEEK may be combined
with other materials or polymers. Also, ceramic filled
biocompatible polymers, or other biocompatible materials of
sufficient strength to stabilize the bone during healing, or
correct a fracture of the bone may be used to make the bone plate,
or any component or member of the bone plate. Other materials which
may be used include bioabsorbable materials and collagen. One or
more materials may be used in building, manufacturing and
assembling the bone plates or any component of the bone plates. For
example, combinations of the materials discussed herein may be
used.
[0092] The bone plate or any component or member of the bone plate,
may further comprise bioabsorbable drug delivery devices, such as
implantable modular drug delivery devices. Examples of
bioabsorbable drug delivery devices are described in the co-pending
application, U.S. Ser. No. 11/135,256 filed May 23, 2005,
IMPLANTABLE PROSTHETIC DEVICES CONTAINING TIMED RELEASE THERAPEUTIC
AGENTS, which is incorporated herein in its entirety by reference.
Such devices, for example, may be placed within a dedicated bore,
such as a drug delivery bore, or within a bone screw bore or
locking means bore. Accordingly, the bone plate can be used to
deliver drugs, if needed.
[0093] Bioabsorbable surgical fasteners or bone screws made from
bioabsorbable materials may be used to apply the bone plate, i.e.
to apply the first member and/or second member, to the bone of a
patient. For example, the materials described in the co-pending
patent application, U.S. Ser. No. 11/025,231, filed Dec. 29, 2004,
SURGICAL FASTENERS AND RELATED IMPLANT DEVICES HAVING BIOABSORBABLE
COMPONENTS, which is incorporated herein in its entirety by
reference, may be used for the bone screws and the bone screws may
be the surgical fasteners described in this co-pending patent
application.
* * * * *