U.S. patent application number 14/569401 was filed with the patent office on 2017-02-16 for bone plate with elevated suture hole structures.
The applicant listed for this patent is Extremity Designs, LLC. Invention is credited to Sergio Gutierrez, Mark Alan Mighell.
Application Number | 20170042596 14/569401 |
Document ID | / |
Family ID | 56110034 |
Filed Date | 2017-02-16 |
United States Patent
Application |
20170042596 |
Kind Code |
A9 |
Mighell; Mark Alan ; et
al. |
February 16, 2017 |
BONE PLATE WITH ELEVATED SUTURE HOLE STRUCTURES
Abstract
The present invention relates to an improved bone plate for use
in repairing bone fractures, the bone plate having a first upper
surface and a first opposed bone-facing surface, the first
bone-facing surface shaped to generally conform to a plate-facing
surface of the bone, a bone plate thickness, at least one fastener
hole extending between the first upper surface and the first
bone-facing surface, and a suture hole structure extending from at
least a portion of a boundary or boundary edge of the bone plate
and having a second upper surface and a second opposed bone-facing
surface, a suture hole structure thickness, at least one suture
hole extending between the second upper surface and the second
bone-facing surface, wherein the suture hole structure thickness is
less than the bone plate thickness, and the second bone-facing
surface of the suture hole structure is elevated above the first
bone-facing surface of the bone plate by a distance greater than 0
mm. The present invention also relates to the method of fixation of
the device.
Inventors: |
Mighell; Mark Alan; (Tampa,
FL) ; Gutierrez; Sergio; (Tampa, FL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Extremity Designs, LLC |
Tampa |
FL |
US |
|
|
Prior
Publication: |
|
Document Identifier |
Publication Date |
|
US 20160166298 A1 |
June 16, 2016 |
|
|
Family ID: |
56110034 |
Appl. No.: |
14/569401 |
Filed: |
December 12, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61915119 |
Dec 12, 2013 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/8061 20130101;
A61B 17/80 20130101; A61B 17/8057 20130101; A61B 17/0401
20130101 |
International
Class: |
A61B 17/80 20060101
A61B017/80 |
Claims
1. A bone plate system for securing a bone plate to a bone, the
system comprising: a bone plate having a first upper surface and a
first opposed bone-facing surface, a bone plate thickness, at least
one fastener hole extending between the first upper surface and the
first bone-facing surface; a bone fastener adapted to couple the
bone plate to the bone; and a suture hole structure extending from
at least a portion of a boundary of the bone plate and having a
second upper surface and a second opposed bone-facing surface, a
suture hole structure thickness, at least one suture hole extending
between the second upper surface and the second bone-facing
surface, wherein at least a portion of the second bone-facing
surface of the suture hole structure is elevated above the first
bone-facing surface of the bone plate by a distance "d" greater
than 0 mm.
2. The bone plate system of claim 1, wherein the suture hole
structure thickness is less than the bone plate thickness.
3. The bone plate system of claim 2, wherein the suture hole
structure includes a plurality of suture holes extending between
the second upper surface and the second bone-facing surface.
4. The bone plate system of claim 2, wherein the second bone-facing
surface of the suture hole structure is elevated above the first
bone-facing surface of the bone plate by a distance "d" less than
about 4 mm.
5. The bone plate system of claim 2, wherein the second upper
surface of the suture hole structure is flush with the first upper
surface of the bone plate.
6. The bone plate system of claim 5, wherein the second upper
surface of the suture hole structure has a similar contour to a
contour of the portion of the boundary of the bone plate from which
the suture hole structure extends.
7. The bone plate system of claim 6, wherein the bone plate
comprises a plurality of the suture hole structures.
8. The bone plate system of claim 7, wherein the plurality of the
suture hole structures are integral to the bone plate.
9. The bone plate system of claim 2, wherein the second upper
surface of the suture hole structure is set below the first upper
surface of the bone plate by a distance less than about 1 mm.
10. The bone plate system of claim 2, wherein the suture hole
structure has a width "w" in the range of about 1-3 mm.
11. The bone plate system of claim 3, wherein the suture hole
structure is a continuous structure extending from and surrounding
the boundary of the bone plate.
12. The bone plate system of claim 1, wherein the second
bone-facing surface of the suture hole structure is substantially
parallel to or at an angle with respective to the first bone facing
surface of the bone plate.
13. The bone plate system of claim 1, wherein at least one of the
bone plate, the suture hole structure and the fastener is
constructed from titanium, titanium alloys, stainless steel,
tantalum, composite materials, resorbable materials, biocompatible
materials or combinations thereof.
14. The bone plate system of claim 2, wherein the fastener hole
includes a plurality of sets of threads with intersecting axes.
15. The bone plate system of claim 14, wherein the intersecting
axes of the plurality of sets of threads lie in a plane
substantially parallel to at least one of a longitudinal plane
which divides the plate into left and right portions and a
transverse plane which divides the bone plate into proximal and
distal portions.
16. The bone plate system of claim 14, wherein the fastener hole
comprises a countersunk region, a middle threaded region, and a
lower smooth, non-threaded region.
17. The bone plate system of claim 14, wherein the fastener
comprises a head having a thread for forming a threaded connection
with at least one of the sets of threads of the fastener hole.
18. The bone plate system of claim 14, wherein at least one of the
plurality of sets of threads is selected from a group consisting of
left-hand threads and right-hand threads.
19. The bone plate system of claim 15, wherein the bone plate
further comprises a second fastener hole having three sets of
threads with intersecting axes.
20. The bone plate system of claim 19, wherein the bone plate
further comprises an elongated slot having at least a portion of an
inner wall surface being smooth for receiving a non-locking
fastener.
21. The bone plate system of claim 19, wherein the bone plate
includes an opening defined by two adjacent threaded holes
communicating with one another.
22. The bone plate system of claim 17, wherein the threads of the
fastener hole engage the bone fastener at a variable angle relative
to the bone plate.
23. The bone plate system of claim 15, wherein the intersecting
axes form an angle of about 5 to 45 degrees relative to one
another.
24. A bone plate system of claim 1, wherein the bone is one of
humerus, ulna, radius, clavicle, femur, tibia, fibula, tarsals,
metatarsals, carpals, metacarpals and phalanges.
25. A bone plate system for securing a bone plate to a bone, the
system comprising: a bone plate having a first upper surface and a
first opposed bone-facing surface, the first bone-facing surface
shaped to generally conform to a plate-facing surface of the bone,
a bone plate thickness, at least one fastener hole extending
between the first upper surface and the first bone-facing surface;
a bone fastener adapted to couple the bone plate to the bone; and a
suture hole structure extending from at least a portion of a
boundary of the bone plate and having a second upper surface and a
second opposed bone-facing surface, a suture hole structure
thickness, at least one suture hole extending between the second
upper surface and the second bone-facing surface, wherein at least
a portion of the second bone-facing surface of the suture hole
structure is elevated above the first bone-facing surface of the
bone plate, wherein the suture hole structure thickness is less
than the bone plate thickness, and wherein the second upper surface
of the suture hole structure is flush with the first upper surface
of the bone plate.
26. The bone plate system of claim 25, wherein the fastener hole
comprises two or more sets of threads with intersecting axes.
27. The bone plate system of claim 26, wherein the bone plate
further comprises a second fastener hole having two or more sets of
threads with intersecting axes and a second bone fastener
engageable with at least a portion of the threads of the second
fastener hole.
28. The bone plate system of claim 27, wherein at least one of the
fastener holes is located in a proximal portion of the bone plate
and comprises intersecting axes lying in a plane substantially
parallel to at least one of a longitudinal plane which divides the
plate into left and right portions and a transverse plane which
divides the bone plate into proximal and distal portions.
29. A bone plate system for securing a bone plate to a bone, the
system comprising: a bone plate having an upper surface and an
opposed bone-facing surface, the bone-facing surface shaped to
generally conform to a plate-facing surface of the bone, at least a
first fastener hole extending between the upper surface and the
bone-facing surface; and a first bone fastener having a head with
external threads engageable with the bone plate in the first
fastener hole, wherein the first fastener hole comprises a
plurality of sets of threads with intersecting axes, and wherein
the intersecting point of two or more of the axes is within the
fastener hole and substantially in the same plane as one of the
upper surface and the bone facing surface of the bone plate, or
outside the fastener hole and below the bone-facing surface of the
bone plate.
30. The bone plate system of claim 29, wherein the two or more of
the intersecting axes form an angle of about 5-45 degrees relative
to one another.
31. The bone plate system of claim 30, wherein the bone plate
further comprises a second fastener hole having a plurality of sets
of threads with intersecting axes and a second bone fastener having
a head with external threads engageable with at least a portion of
the threads of the second fastener hole.
32. The bone plate system of claim 31, wherein the intersecting
axes of the plurality of sets of threads of at least one of the
first and second fastener holes lie in a plane substantially
parallel to at least one of a longitudinal plane which divides the
plate into left and right portions and a transverse plane which
divides the bone plate into proximal and distal portions.
33. The bone plate system of claim 31, wherein at least one of the
first and second fastener holes comprises a countersunk region and
an opposed non-threaded region located adjacent to the bone-facing
surface, the non-threaded region is either conically shaped or
partially spherically shaped with increasing diameter toward the
bone-facing surface.
34. The bone plate system of claim 31, wherein at least one of the
first and second fastener holes is located in the proximal portion
of the bone plate, and the bone plate further comprises an
elongated slot having at least a portion of an inner wall surface
being smooth for cooperating with a non-threaded head of a
fastener.
35. A bone plate system for securing a bone plate to a bone, the
system comprising: a bone plate having a first upper surface and a
first opposed bone-facing surface, a bone plate thickness, at least
one fastener hole extending between the first upper surface and the
first bone-facing surface; a bone fastener adapted to couple the
bone plate to the bone; and a suture hole structure located
proximate at least a portion of a boundary of the bone plate and
having a second upper surface and a second opposed bone-facing
surface, a suture hole structure thickness, at least one suture
hole extending between the second upper surface and the second
bone-facing surface, wherein at least a portion of the second
bone-facing surface of the suture hole structure is elevated above
the first bone-facing surface of the bone plate by a distance "d"
greater than 0 mm.
36. The bone plate system of claim 35, wherein the suture hole
structure thickness is less than the bone plate thickness.
37. The bone plate system of claim 36, wherein the second
bone-facing surface of the suture hole structure is elevated above
the first bone-facing surface of the bone plate by a distance "d"
less than about 4 mm.
38. The bone plate system of claim 36, wherein the second upper
surface of the suture hole structure is flush with the first upper
surface of the bone plate.
39. The bone plate system of claim 38, wherein the second upper
surface of the suture hole structure has a similar contour to a
contour of the portion of the boundary of the bone plate.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application claims priority to U.S. provisional
patent application Ser. No. 61/712,257, filed Dec. 12, 2013,
entitled "Humeral Fracture Plate with Suture Hole Projections", the
contents of which are hereby incorporated by reference in their
entirety.
FIELD OF INVENTION
[0002] This invention relates to a bone plate for use in repairing
bone fractures.
BACKGROUND OF THE INVENTION
[0003] Proximal humerus fractures are most commonly repaired with
open reduction and internal fixation using plates and screws
attached via bi-cortical or uni-cortical fixation. The preferred
method to gain access to the fracture site is by making a large
incision through the skin and muscles. Once the fracture has been
exposed, the fragments of bone are approximated to the plate,
including fragments that are attached to muscles via tendons. These
muscles (e.g., rotator cuff) are attached to the plate via suture
holes designed into it. Problems arise when the plate is first
attached to the bone since it is difficult to pass the sutures
between the plate and the bone. Thus, manufactures have provided
bone plates with suture holes including undulations or
suture-clearance recesses or lateral channels formed into the
bottom surface and the edge of the plate and placed in relative
proximity with corresponding suture holes such that a straight or
curved suture needle and attached suture material may be passed
through the hole even when the plate is fixed to the bone. This
solution still presents challenges during surgery as there is
insufficient space or clearance between the bone plate and the
bone. Additionally, the superior screws often have the problem of
exiting the humeral head superiorly, thus these screws must be able
to be adjusted inferiorly to be directed completely into the
humeral head.
[0004] The present invention seeks to remedy these problems. The
object of the invention is to provide an internal fixation system
with a plate which provides the surgeon with flexibility, ease of
use, and operational efficiency such that a suture can be easily
and quickly passed through a suture hole.
[0005] Another object of the invention is to provide a bone plate
that supports both unidirectional and surgeon-directed or
omnidirectional fixation of the screws relative to the plate.
SUMMARY OF INVENTION
[0006] This invention achieves the objective with a bone plate
having a first upper surface and a first opposed bone-facing
surface, the first bone-facing surface shaped to generally conform
to a plate-facing surface of the bone, a bone plate thickness, at
least one fastener hole extending between the first upper surface
and the first bone-facing surface, and a suture hole structure
extending from at least a portion of a boundary or boundary edge of
the bone plate and having a second upper surface and a second
opposed bone-facing surface, a suture hole structure thickness, at
least one suture hole extending between the second upper surface
and the second bone-facing surface, wherein the suture hole
structure thickness is less than the bone plate thickness, and the
second bone-facing surface of the suture hole structure is elevated
above the first bone-facing surface of the bone plate by a distance
greater than 0 mm.
[0007] In another embodiment of the invention, the second upper
surface of the suture hole structure is flush with and, optionally,
has a substantially similar contour as the contour of that portion
of the first upper surface of the bone plate where the suture hole
structure extends from.
[0008] In accord with another embodiment, the fastener hole of the
bone plate comprises two or more sets of threads with intersecting
axes, wherein the angle of each axis is predetermined during
manufacturing.
[0009] In a further development of the invention, the intersecting
axes of sets of threads of the fastener hole lie in a plane
substantially parallel to at least one of a longitudinal plane
which divides the plate into left and right portions and a
transverse plane which divides the bone plate into proximal and
distal portions.
[0010] Various bone fasteners, such as screws and pegs, can be used
with the current invention, for example, those with partially
spherical or conical heads with or without external threads
engageable with the threads on the inner wall surface of the
fastener hole.
[0011] These and other features of various embodiments can be
understood from a review of the following detailed description in
conjunction with the accompanying drawings.
[0012] It is to be understood that both the foregoing general
description and the following detailed description and accompanying
drawings are exemplary and explanatory and are not restrictive of
the present invention, as claimed.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] The present invention and its developments will become more
fully understood from, but not limited by, the detailed description
and the accompanying drawings, wherein:
[0014] FIG. 1A shows a top view of a bone plate with elevated
suture hole structures;
[0015] FIG. 1B shows a bottom view of the bone plate according to
FIG. 1A;
[0016] FIG. 1C shows a side view of the bone plate according to
FIG. 1A;
[0017] FIG. 1D shows another side view of the bone plate according
to FIG. 1A;
[0018] FIG. 1E shows an end view of the bone plate according to
FIG. 1A;
[0019] FIG. 1F shows another end view of the bone plate according
to FIG. 1A;
[0020] FIG. 2A shows a top perspective view of a bone plate with
the bone screws inserted and the top two screws angled
superiorly;
[0021] FIG. 2B shows a bottom perspective view of the bone plate
according to FIG. 2A;
[0022] FIG. 2C shows another bottom perspective view of the bone
plate according to FIG. 2A;
[0023] FIG. 2D shows a side perspective view of the bone plate
according to FIG. 2A;
[0024] FIG. 2E shows an end perspective view of the bone plate
according to FIG. 2A;
[0025] FIG. 3A shows a top perspective view of the bone plate
according to FIG. 2A with the top two screws angled inferiorly;
[0026] FIG. 3B shows a bottom perspective view of the bone plate
according to FIG. 3A;
[0027] FIG. 3C shows another bottom perspective view of the bone
plate according to FIG. 3A;
[0028] FIG. 3D shows a side perspective view of the bone plate
according to FIG. 3A;
[0029] FIG. 3E shows an end perspective view of the bone plate
according to FIG. 3A;
[0030] FIG. 4A shows a cross sectional view of the bone plate shown
in FIG. 3A taken along sectional line 4A-4A of FIG. 3A;
[0031] FIG. 4B shows an alternative embodiment of the threaded hole
shown in FIG. 4A; and
[0032] FIG. 5 shows a cross sectional view of the bone plate shown
in FIG. 3A taken along sectional line 5-5 of FIG. 3A.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0033] The following detailed description and the appended drawings
describe and illustrate various bone plate systems, methods, and
components. The description and drawings are exemplary in nature
and are provided to enable one skilled in the art to make and use
one or more exemplary bone plate systems and/or components, and/or
practice one or more exemplary methods. They are not intended to
limit the scope of the claims in any manner.
[0034] The use of "e.g.," "etc.," "for instance," "in example," and
"or" and grammatically related terms indicates non-exclusive
alternatives without limitation, unless otherwise noted. The use of
"optionally" and grammatically related terms means that the
subsequently described element, event, feature, or circumstance may
or may not be present/occur, and that the description includes
instances where said element, event, feature, or circumstance
occurs and instances where it does not. The use of "exemplary"
refers to "an example of" and is not intended to convey a meaning
of an ideal or preferred embodiment. The use of "attached" and
"coupled" grammatically related terms refers to the fixed,
releasable, or integrated association of two or more elements
and/or devices with or without one or more other elements in
between. Thus, the term "attached" or "coupled" and grammatically
related terms includes releasably attaching or fixedly attaching
two or more elements and/or devices in the present or absence of
one or more other elements in between. As used herein, the terms
"proximal" and "distal" are used to describe opposing axial ends of
the particular elements or features being described in relation to
anatomical placement.
[0035] While the systems, methods, and components described herein
are exemplified by systems and methods for internal fixation of
humeral bones, the systems, methods, and components described and
illustrated herein can be used to treat any short and long bones
within the body of a human, including, but not limited to, animals.
Skilled artisans will be able to select a suitable ailment and/or
bone within the body of an animal to utilize a system and/or method
described herein according to a particular embodiment based on
various considerations, including the type of ailment and/or the
structural arrangement at a treatment site. Example bones
considered suitable to utilize a system, method, and/or component
described herein include, but are not limited to, humerus, ulna,
radius, clavicle, femur, tibia, fibula, tarsals, metatarsals,
carpals, metacarpals and phalanges.
[0036] FIGS. 1A-F shows a bone plate configuration in accordance
with the invention. Bone plate 10 may be shaped and configured for,
but not limited to, fractures of the humerus. The bone plate 10
includes an upper surface 12, a lower or opposed bone-facing or
bone-contacting surface 14 and a plurality of fastener holes 16,
18, 20, 22, 24 and k-wire holes 26 extending between the upper
surface 12 and the opposed bone-facing surface 14 for receiving
corresponding bone fasteners (not shown) and guide-wires (not
shown) respectively. The bone-facing surface 14 can be shaped to
substantially conform to or mate with a corresponding plate-facing
surface of the bone (not shown) and may be provided with radiused
or scalloped cutouts between fastener holes to limit and/or
minimize contact between the bone-facing surface 14 and the bone.
Limiting and/or minimizing contact between the bone plate 10 and
bone has a number of biological and mechanical advantages including
reduced damage to blood supply and easier plate removal. Bone plate
10 may have various sizes (various diameters and/or lengths) and
may be constructed from biocompatible materials such as titanium,
alloys of titanium, cobalt chrome, stainless steel, ceramics,
composite materials such as carbon fiber-reinforced PEEK,
resorbable materials, and combinations thereof, although one of
ordinary skill in the art will know and appreciate that any
biocompatible material may be used.
[0037] Referring now to FIGS. 1C-D, the upper surface 12 and the
opposed bone-facing surface 14 run substantially parallel defining
a first nominal thickness "t.sub.1" of the bone plate 10. The bone
plate 10 further includes a plurality of elevated suture hole
projections or structures 30 each extending from at least a portion
of a boundary or boundary edge of the bone plate 10. Each suture
hole structure 30 includes an upper surface 32 and an opposed
bone-facing surface 34 defining a second nominal thickness
"t.sub.2" of the suture hole structure 30 wherein the thickness
"t.sub.2" may be less than the thickness "t.sub.1" of the bone
plate 10, and the bone-facing surface 34 or at least a portion
thereof of the suture hole structure 30 is elevated above the
bone-facing surface 14 of the bone plate 10 by a distance "d" as
shown in FIGS. 1C-D. The distance "d" may be in the range of about
1-4 mm. Alternatively, the distance "d" can be lesser or greater,
depending on a specific surgical application.
[0038] The suture hole structures 30 can be dimensioned and
configured to provide a low profile for reducing soft tissue
irritation and minimizing patient discomfort. The suture hole
structure 30 may have a width "w" of about 1-4 mm. The width "w"
may also be lesser or greater, depending on a specific surgical
application. The upper surface 32 and the lower bone-facing surface
34 of the suture hole structure 30 may be substantially parallel,
at an angle relative to one another, or tapered inwardly and/or
outwardly along its length or width. The upper surface 32 and the
lower bone-facing surface 34 of the suture hole structure 30 each
may also have a convex or concave shape, or a combination
thereof.
[0039] The suture hole structures 30 each comprises a plurality of
suture holes 28 extending between the upper surface 32 and the
bone-facing surface 34. The suture hole structure 30 may be
provided with any number of suture holes 28 as may be suitable for
a specific surgical application. Alternatively, the suture hole
structure 30 may have only one suture hole 28. The shape of the
suture holes 28 can be circular, oval or non-circular. The suture
holes 28 can be of a size adequate for passing a suture with a
curved or straight suture needle and can be non-threaded for
reducing suture damage.
[0040] The upper surface 32 of the suture hole structure 30 may be
flush with the upper surface 12 of the bone plate 10.
Alternatively, the upper surface 32 of the suture hole structure 30
can be slightly higher or lower than the upper surface 12 of the
bone plate 10 and/or can have a substantially similar contour to a
contour of the portion of the boundary or boundary edge of the bone
plate 10 from which the suture hole structure 30 extends. The
suture hole structure 30 may be at an angle with respective to the
bone plate 10. The suture hole structure 30 may have at least a
portion of its body being as thick or thicker than the bone plate
10 as long as at least a portion of the bone-facing surface 34 of
the suture hole structure 30 is elevated above the bone-facing
surface 14 of the bone plate 10 to provide a suture-clearance or
spacing "d" for easy access to the suture holes 28.
[0041] The suture hole structure 30 can be permanently or removably
attached or coupled to the bone plate 10 by any attachment means
known to one skilled in the art. The suture hole structures 30 and
the bone plate 10 can be an unitary device machined from a single
block of materials, or can also be a multi-component device which
can be assembled before or during surgery to provide the surgeon
the flexibility in designing the bone plate to meet his or her
needs.
[0042] An alternative embodiment of the present invention (not
shown) includes a bone plate substantially similar to the bone
plate 10 in FIGS. 1A-F, wherein the suture hole structure or
structures may be folded toward the bone to provide a low profile
implant. One method of manufacturing such an implant is to have the
portion of the suture hole structure proximate the boundary or
boundary edge of the bone plate be thinner than the remaining part
of the suture hole structure to allow the surgeon to bend or fold
the suture hole structure toward the bone after passing a suture
for reducing soft tissue irritation and minimizing patient
discomfort. Another design may require a hinged mechanism for
coupling the suture hole structure to the perimeter of the bone
plate.
[0043] Still another embodiment of the invention (not shown)
comprises a bone plate substantially similar to the bone plate 10
in FIGS. 1A-F, wherein the bone plate is provided with a rail
extending along its periphery or boundary edge. One or more suture
hole structures similar to the suture hole structure 30 are coupled
to the rail. This configuration provides the surgeon the
flexibility to reposition the suture hole structure(s) anywhere on
or along the bone plate to meet his or her specific surgical
applications and needs.
[0044] According to another embodiment, the bone plate 10 can be
provided with a single continuous suture hole structure (not shown)
surrounding the boundary or boundary edge of the bone plate 10.
This feature provides the surgeon the flexibility of attaching any
muscles associated with the fractured bone to any locations on the
plate to meet his or her needs for a specific surgical
application.
[0045] These and other similar variations and modifications may be
made without departing from the scope of the present invention.
[0046] Referring to FIGS. 2A-E, 3A-E, bone plate 100 is configured
substantially similar to bone plate 10 with screws 140, 160
inserted. Bone plate 100 comprises elevated suture hole structures
130 each includes a plurality of suture holes 128. The bone plate
100 is further provided with, but not limited to, two fastener
holes 122 each formed with two sets of threads having intersecting
axes, also referred to as bi-axial fastener holes in some
embodiments. In some embodiments (not shown), the fastener holes
122 each may have more than two sets of threads with intersecting
axes, depending on a specific surgical application. Where the axes
cross is the intersect point or pivot point "P" which can be
determined during manufacturing to be either within the fastener
hole 122, or within the fastener hole 122 and generally in the same
plane as the upper surface 112 of the bone plate 100 as shown in
FIG. 4A, or within the fastener hole 122 and generally in the same
plane as the bone-facing surface 114 of the bone plate 100 as
illustrated in FIG. 4B. The provision of these bi-axial fastener
holes 122 in the bone plate 100, particularly in the proximal or
head portion of the bone plate 100, offers the surgeon with choice
of two different and opposed trajectories, such as superiorly and
inferiorly as illustrated in FIGS. 2A-E and FIGS. 3A-E
respectively, for locking the bone fasteners 140 relative to the
bone plate 100.
[0047] The two intersecting axes, axis 1 and axis 2, as illustrated
in FIGS. 4A-B, may be configured to lie in a plane substantially
parallel to a longitudinal plane dividing the bone plate into left
and right halves, and form an angle a of about 5-45 degrees
relative to one another. However, other angles are possible. In an
alternative embodiment (not shown), the fastener holes 122 may
include two sets of threads with intersecting axes lying on a plane
substantially parallel to a transverse or cross-section plane
dividing the bone plate into proximal and distal portions.
[0048] Additionally or alternatively, the bone plate 100 can be
provided with one or more fastener holes, such as fastener hole 119
located in the distal portion of the bone plate 100, formed with
three sets of threads with intersecting axes, such as axis 1, axis
2, axis 3 as shown in FIG. 5, wherein the intersect point or pivot
point "P" of the axes is outside the fastener hole 119 and below
the bone-facing surface 114 of the bone plate 100. The fastener
hole 119 may have more than three sets of threads with intersecting
axes. These intersecting axes each form an angle o of about 5-45
degrees relative to one another. However, other angles are
possible.
[0049] The bi-axial and tri-axial fastener holes 122, 119 can be
formed in one of two methods. Referring to FIGS. 4A-B, the bi-axial
hole 122 may be formed by drilling a hole along axis 1 at a
predetermined angle relative to the bone plate 100 and another hole
along axis 2 at a different predetermined angle relative to the
bone plate 100 so that axis 1 and axis 2 intersect at a point "P"
proximate the upper surface 112 of the bone plate 100, or proximate
the bone-facing surface 114 of the bone plate 100. The countersinks
138A, 138B may be formed during or after drilling the holes. The
threads 136, 137 may be right-hand threads and cut out with a
machine tap that follows the individual axes of the respective
drilled holes. The bi-axial hole, such as fastener hole 122, may
have, but is not limited to, an oval or elongated shape from a top
view of the fastener hole 122. The shape and size of the bi-axial
holes 122 may vary throughout the thickness of the bone plate 100.
Alternatively, the threads 136, 137 of the bi-axial hole 122 may
not extend all the way from the upper surface 112 to the
bone-facing surface 114 of the bone plate 100. A smooth,
non-threaded, conical inward or outward taper may be formed into
the upper or lower region of the bi-axial hole 122 (not shown) to
provide for a broader range of angles for angularly positioning a
non-locking bone fastener.
[0050] The tri-axial hole 119 as illustrated in FIG. 5 can be
formed by drilling three separate holes through the bone plate 100
such that the hole axes intersect at a point below the bone facing
surface 114 of the bone plate 100. The method of forming the
countersinks and the threads may be similar to that of forming the
bi-axial fastener hole 122.
[0051] Different types of screws/pegs may be used with the bi-axial
and tri-axial holes 122, 119, including non-locking, locking,
unidirectional and omnidirectional or surgeon-directed screws. One
type of screw may be a locking screw that has a conically-tapered
or cylindrical threaded head such as bone screws 140. The external
threads of heads of the screws 140 may mate with the internal
threads 136, 137 of the holes 122, 119 to angularly lock the
screws/pegs 140 while the helical threads of the shaft of the
screws/pegs 140 engage the bone.
[0052] The bone plate 100 further includes a non-threaded elongated
slot 120 configured and dimensioned to engage a substantially
spherical or hemi-spherical screw-head of a bone screw, such as
bone screw 160. Alternatively, a conically shaped screw head, with
or without threads, may engage the elongated slot 120. The
elongated slot 120 may have a concave, substantially spherical
portion or recess that opens toward the upper surface 112 of the
bone plate 100. When the shaft of a bone screw 160 having a
spherical or semi-spherical head is located eccentrically in the
elongated slot 120, the spherical or semi-spherical head may engage
the recess and bias the bone plate to provide compression of the
bone fracture. The bone plate 100 may be provided with other
non-locking, locking and/or combination holes for specific surgical
applications.
[0053] The bone plate system of the present invention provides for
any tissue repair and attachment of soft tissue to bone as part of
fracture management repair. Although there have been described and
illustrated herein various embodiments of a humeral fracture bone
plate, it is not intended that the invention be limited thereto, as
it is intended that the invention be as broad in scope as the art
will allow and that the specification be read likewise. Thus, while
the exemplary embodiment is described and illustrated as a humeral
fracture bone plate system, it is appreciated that the system is
well adapted to bone fractures of any bones with or without an
articular convex-shape surface. Thus, the system of the invention
could similarly be used to treat fracture of other bones, e.g., a
fracture of the femoral head, a fracture of a radius. In addition
to the use of the present bone plate system for treatment of
fractures, it is appreciated that the present invention may also be
used in the treatment of osteotomies and non-unions of the proximal
humerus and other bones with or without an articular convex-shape
surface.
[0054] The principles, preferred embodiments and modes of operation
of the present invention have been made apparent in the foregoing
description.
[0055] Although the embodiments are numbered with, for example,
"first," "second," or "third," or "fourth," the ordinal numbers do
not imply priorities of the embodiments.
[0056] Since many modifications, variations and changes in detail
can be made to the described embodiments of the invention, it is
intended that all matters in the foregoing description and shown in
the accompanying drawings be interpreted as illustrative and not in
a limiting sense. Thus, the scope of the invention should be
determined by the appended claims and their legal equivalents.
* * * * *