Periprosthetic bone plate system

Abstract

Prosthetic periprosthetic bone fixation plates are disclosed, including, for example, prosthetic periprosthetic proximal femoral plates, prosthetic periprosthetic distal femoral plates, prosthetic periprosthetic humeral plates, prosthetic periprosthetic ring plates, and prosthetic periprosthetic trochanteric plates. In use, the prosthetic periprosthetic bone fixation plates are arranged and configured for use in periprosthetic bone fractures. That is, the prosthetic periprosthetic plates include one or more features to facilitate positioning and fixation of the bone fixation plate onto a patient's bone that previously received a surgically implanted orthopedic device or implant, such as, for example, an intramedullary nail, a hip prosthesis, a knee prosthesis, etc. In use, the one or more features are designed and configured to facilitate avoidance of the previously surgically implanted orthopedic device or implant. Additionally, the prosthetic periprosthetic bone fixation plates are arranged and configured to facilitate longer working length plate placement as compared to existing bone fixation plates (e.g., plate placement from, for example, the femoral condyle to the greater trochanter).

Description

[0001] Cross Reference to Related Applications

[0002] This application is a non-provisional application of pending U.S. Provisional Patent Application No. 62 / 927,478, filed October 29, 2019, entitled “Periprosthetic Bone Plate Systems,” and claims the benefit of the filing date thereof, the entire contents of which are incorporated herein by reference. TECHNICAL FIELD

[0003] The present disclosure relates to orthopedic implants for coupling to one or more bones, bone portions, bone fragments, etc. of a patient, and more particularly to bone plate systems for facilitating stabilization of periprosthetic fractures. BACKGROUND

[0004] Fractures are often repaired by securing orthopedic implants or devices to one or more bones, bone portions, bone fragments, etc. (used interchangeably without intent to limit) of a patient. For example, it is not uncommon for a patient to receive an orthopedic knee prosthesis, an orthopedic hip prosthesis, an intramedullary (“IM”) nail, etc. to repair one or more fractures in the patient’s bone.

[0005] Sometimes, a fracture can occur in the area surrounding a previously surgically implanted orthopedic implant or device. For example, a fracture can occur during a surgical implantation procedure. However, alternatively, as is the case in most scenarios, a patient can develop a periprosthetic fracture years after the initial surgical implantation procedure. In some cases, the surgically implanted orthopedic implant can make the patient’s bone more susceptible to later fractures.

[0006] Regardless of the cause, periprosthetic fractures surrounding previously surgically implanted orthopedic implants present unique challenges for fixation. For example, the previously surgically implanted orthopedic device or implant can interfere with placement of a subsequently implanted orthopedic bone fixation plate.

[0007] For example, in one scenario, a periprosthetic hip fracture can occur near or around a previously surgically implanted hip replacement prosthesis. As the number of hip replacement prostheses increases, so does the number of periprosthetic fractures associated therewith. Once a fracture occurs in the area surrounding a previously surgically implanted hip replacement prosthesis, treatment can be complicated by osteoporosis, defects in the bone, and the presence of the previously surgically implanted hip replacement prosthesis. For example, the stem, shaft, screws, and bone cement associated with the previously surgically implanted hip replacement prosthesis can obstruct the medullary canal of the patient, preventing intramedullary fixation of the subsequent fracture. Additionally, the stem and shaft can also prevent the screws from passing through the medullary canal to secure a subsequent bone plate to the patient’s bone. Thus, due to the limited options, periprosthetic fractures and corresponding techniques for treating periprosthetic fractures are generally more difficult.

[0008] However, periprosthetic fractures require treatment. For example, unstable periprosthetic fractures can require surgical stabilization and / or implant replacement to restore function. Surgical stabilization can include implanting a bone fixation plate to fix adjacent segments of fractured bone to facilitate healing, which can occur with or without implant replacement.

[0009] The design of many currently known bone fixation plates does not take into account periprosthetic fractures, and thus they often exhibit one or more deficiencies or shortcomings. The present disclosure is provided with this in mind. SUMMARY

[0010] This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the DETAILED DESCRIPTION section. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to determine the scope of the claimed subject matter.

[0011] Many bone fixation plates (e.g., periprosthetic bone plates) are disclosed herein. The bone fixation plates are arranged and configured for use in periprosthetic fractures. For example, in one embodiment, the bone fixation plate can be in the form of a proximal femur plate for use in a periprosthetic fracture around a hip arthroplasty prosthesis. Alternatively, in one embodiment, the bone fixation plate can be in the form of a distal femur plate for use in a periprosthetic fracture around a knee arthroplasty prosthesis. In another embodiment, the bone fixation plate can be in the form of a periprosthetic ring plate or a periprosthetic hook plate for use in a periprosthetic fracture around a hip arthroplasty prosthesis. In another embodiment, the bone fixation plate can be in the form of a humerus plate. In any case, the bone fixation plate is designed and configured for fixation across a subsequent fracture in a patient’s bone while being designed and configured with one or more features to facilitate avoidance of a previously surgically implanted orthopedic implant.

[0012] In one embodiment, a bone fixation plate (e.g., a periprosthetic bone plate) can include a head portion, a shaft portion, an upper surface, a lower surface or bone-facing surface, a central longitudinal axis, and a peripheral surface (e.g., a peripheral edge surface). The shaft portion includes a plurality of threaded locking screw openings arranged and configured to receive a plurality of locking screws, respectively. Additionally, the shaft portion can include a plurality of variable angle fastener openings arranged and configured to receive a plurality of variable angle screws, respectively. In one embodiment, the plurality of variable angle fastener openings can be positioned along the peripheral surface of the shaft portion, while the plurality of locking screw openings can be positioned centrally (e.g., positioned closer to or substantially adjacent to the central longitudinal axis of the shaft portion).

[0013] In one embodiment, the threaded locking screw openings can be larger than the variable angle fastener openings, e.g., positioned along the perimeter of the shaft portion (e.g., the plurality of threaded locking screw openings comprise a first diameter and the plurality of variable angle fastener openings comprise a second diameter, the first diameter being larger than the second diameter). For example, in one embodiment, the threaded locking screw openings can be sized and configured to receive, e.g., 4.5 mm locking screws. The variable angle fastener openings can be sized and configured to receive, e.g., 3.5 mm bone screws. Alternatively, in some embodiments, the threaded locking screw openings and the variable angle fastener openings can have the same size. For example, in some embodiments, the threaded locking screw openings and the variable angle fastener openings can be sized and configured to receive, e.g., 3.5 mm bone screws.

[0014] In various embodiments, the shaft portion of the bone fixation plate can comprise a first region and a second region, the first region positioned proximal to the head portion of the bone fixation plate. The plurality of variable angle fastener openings formed in the first region are arranged and configured such that a first variable angle fastener opening and a second variable angle fastener opening are laterally aligned in a row. That is, the first region can comprise variable angle fastener openings that are laterally aligned along the perimeter of the first region of the shaft portion (e.g., the plurality of variable angle fastener openings in the first region are arranged and configured such that a first variable angle fastener opening and a second variable angle fastener opening are positioned laterally aligned with each other on either side of a central longitudinal axis). The plurality of variable angle fastener openings formed in the second region are non-laterally aligned. That is, the second region can comprise non-laterally aligned variable angle fastener openings. The plurality of variable angle fastener openings in the second region are arranged and configured such that the variable angle fastener openings alternate on both sides relative to each other (e.g., a single row of variable angle fastener openings are positioned, wherein as each row of variable angle fastener openings moves distally on the shaft portion, each row of variable angle fastener openings alternates on both sides). Arranged as such, the first region of the shaft portion comprises a greater number of variable angle fastener openings to provide the surgeon with more options to place variable angle bone fasteners proximal to the head portion of the bone fixation plate.

[0015] In one embodiment, the bone fixation plate can comprise a plurality of undercuts formed in the lower surface of the bone plate. In various embodiments, the plurality of undercuts can be respectively aligned with or coincident to the plurality of variable angle fastener openings.

[0016] In one embodiment, the bone fixation plate can include a head portion and a shaft portion. The head portion can be contoured to match an anatomical structure of a patient (e.g., such as a patient's bone joint, trochanter, etc.). The shaft portion, opposite the head portion, can be arranged and configured such that an end portion of the shaft portion can be contoured. That is, for example, the end portion of the shaft portion, opposite the head portion, can be thinned (e.g., have a decreasing cross-sectional area or tapered cross-sectional area extending from the end portion toward the head portion) to improve the contouring of the end portion of the bone fixation plate to match the patient's anatomical structure.

[0017] In one embodiment, the end portion can include a plurality of locking screw openings formed therein, the plurality of locking screw openings formed in the end portion including a first distal locking screw opening and a second distal locking screw opening, each of the first distal locking screw opening and the second distal locking screw opening including a counterbore formed in a lower surface of the bone plate. In one embodiment, the shaft portion further includes one or more K-wire openings arranged and configured such that a K-wire can be passed therethrough, at least one of the one or more K-wire openings positioned between the first distal locking screw opening and the second distal locking screw opening. In one embodiment, the end portion of the shaft portion, opposite the head portion, includes a plurality of variable angle fastener openings formed in an array.

[0018] In one embodiment, the bone plate is selected from one of a proximal femoral plate, a distal femoral plate, a periprosthetic ring plate, a periprosthetic hook plate, and a humeral plate.

[0019] In one embodiment, the head portion of the bone plate includes a plurality of variable angle screw openings and no locking screw openings.

[0020] In one embodiment, the head portion of the bone plate includes a plurality of locking screw openings and no variable angle fastener openings.

[0021] In one embodiment, the head portion includes a plurality of locking screw openings and a plurality of variable angle fastener openings, the plurality of locking screw openings being more centrally located than the plurality of variable angle fastener openings.

[0022] In one embodiment, the plurality of variable angle fastener openings formed in the head portion are arranged and configured in a double row such that the variable angle fastener openings are positioned in transverse rows, with a first variable angle fastener opening and a second variable angle fastener opening positioned in each row.

[0023] In one embodiment, the bone fixation plate can be in the form of a ring-shaped plate. That is, the bone fixation plate can include a head portion and a shaft portion, the head portion being in the form of a ring arranged and configured to be positioned adjacent to a patient's trochanter. In one embodiment, the ring-shaped head portion can be integrally formed with the shaft portion. In one embodiment, the ring-shaped head portion includes a first segment, a second segment spaced apart from the first segment, and a bridging segment coupling the first segment and the second segment, the ring-shaped head portion including an opening between the first segment and the second segment and the bridging segment. In one embodiment, the bridging segment can include a plurality of variable angle fastener openings positioned centrally thereon.

[0024] Additionally and / or alternatively, the ring-shaped head portion can include a plurality of threaded locking screw openings arranged and configured to receive a plurality of locking screws, respectively, and a plurality of variable angle fastener openings arranged and configured to receive a plurality of variable angle fasteners, respectively, the plurality of variable angle fastener openings being dispersed about the plurality of threaded locking screw openings.

[0025] In one embodiment, the head portion can include a first hook-shaped member and a second hook-shaped member arranged and configured to engage a patient's trochanter, the first hook-shaped member and the second hook-shaped member being asymmetrical such that the first hook-shaped member is different from the second hook-shaped member. In one embodiment, the first hook-shaped member and the second hook-shaped member have one of different sizes, different configurations, or a combination thereof.

[0026] In one embodiment, a periprosthetic bone plate is disclosed. In one embodiment, the bone plate includes a head portion, a shaft portion, an upper surface, a lower surface, a central longitudinal axis, and an outer peripheral surface. The shaft portion further includes a plurality of threaded locking screw openings arranged and configured to receive a plurality of locking screws, respectively, and a plurality of variable angle fastener openings arranged and configured to receive a plurality of variable angle screws, respectively; wherein the plurality of threaded locking screw openings includes a first diameter and the plurality of variable angle fastener openings includes a second diameter, the first diameter being greater than the second diameter.

[0027] Embodiments of the present disclosure provide a number of advantages. For example, by incorporating one or more features of the present disclosure, the surgeon is provided with more options for fixing a bone fixation plate across a subsequent bone fracture adjacent to a previously surgically implanted orthopedic device or implant. Additionally, by incorporating one or more features of the present disclosure, the bone fixation plate is arranged and configured to allow the plate to be disposed across a major length of a bone. So arranged, stress risers that occur at the ends of the plate are eliminated or at least minimized (e.g., as will be appreciated by one of ordinary skill in the art, increased stress risers occur at the ends of the plate, which causes increased stress on the bone, which is a contributing factor to periprosthetic bone fractures. By disposing the plate across the entire length of the bone (e.g., a patient's femur), the stress risers are eliminated or at least greatly minimized).

[0028] The following describes in detail, with reference to the accompanying drawings, at least some of the additional features and advantages of embodiments of the invention, as well as the structure and operation of various embodiments of the invention. Attached Figure Description

[0029] Specific embodiments of the apparatus of this disclosure will now be described by way of example only in the accompanying drawings, in which:

[0030] Figure 1 This is a top view of bone fixation plates of various lengths according to this disclosure;

[0031] Figure 2 yes Figure 1 The bottom view of the bone fixation plate shown;

[0032] Figure 3A yes Figure 1 A top perspective view of an exemplary embodiment of the bone fixation plate shown;

[0033] Figure 3B yes Figure 3A The bottom perspective view of the bone fixation plate shown;

[0034] Figure 4 This is a top view of bone fixation plates of various lengths according to this disclosure;

[0035] Figure 5 yes Figure 4 The bottom view of the bone fixation plate shown;

[0036] Figure 6A yes Figure 4 A top view of an exemplary embodiment of the bone fixation plate shown;

[0037] Figure 6B yes Figure 6A The bottom view of the bone fixation plate shown;

[0038] Figure 7 This is a top view of bone fixation plates of various lengths according to this disclosure;

[0039] Figure 8 yes Figure 7 The bottom view of the bone fixation plate shown;

[0040] Figure 9 yes Figure 7 A top perspective view of an exemplary embodiment of the bone fixation plate shown;

[0041] Figure 10 This is a top view of an exemplary embodiment of the bone fixation plate according to the present disclosure;

[0042] Figure 11 yes Figure 10 The bottom view of the bone fixation plate shown;

[0043] Figure 12 is a top view of an exemplary embodiment of a bone fixation plate according to the present disclosure;

[0044] Figure 13 is a bottom view of the bone fixation plate shown in Figure 12

[0045] Figure 14 is a top view of bone fixation plates according to the present disclosure of various lengths;

[0046] Figure 15 is a bottom view of the bone fixation plate shown in Figure 14

[0047] Figure 16 Figure 14 is a bottom perspective view of an exemplary embodiment of a bone fixation plate shown in

[0048] It should be understood that the drawings are sometimes shown schematically and in partial view. In certain instances, detailed information vital to an understanding of the disclosed methods and apparatus can be omitted so as not to make the other details difficult to understand. It should further be understood that the present disclosure is not limited to the particular embodiments illustrated herein. DETAILED DESCRIPTION

[0049] Various features, aspects, and the like of orthopedic bone fixation plates will be described hereinafter with reference to the drawings, in which one or more aspects or features of the bone fixation plates will be shown and described. It should be appreciated that the various features, aspects, or the like can be used independently, or in combination with one another. It should be appreciated that the bone fixation plates as disclosed herein can take many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will convey the certain aspects or features of the bone fixation plates to those skilled in the art. In the drawings, like numerals refer to like elements, unless otherwise noted.

[0050] Disclosed herein are bone fixation plates that include one or more aspects or features for enabling improved flexibility for coupling the bone fixation plates to a patient’s bone, bone portion, bone fragment, or the like (terms used interchangeably herein without intent to limit) adjacent to a previously surgically implanted orthopedic implant. That is, as noted previously, and as will be appreciated by one of ordinary skill in the art, many patients undergo surgical procedures each year that involve implantation of one or more orthopedic devices. For example, knee joint replacements, hip joint replacements, IM nail implantation, and the like are common. At times, fractures can occur in the area surrounding a surgically implanted orthopedic implant or device. These fractures are often referred to as periprosthetic fractures because they occur near a previously surgically implanted orthopedic device or implant.​​​

[0051] Periprosthetic fractures present unique challenges for fixation. For example, previously surgically implanted orthopedic devices or implants can interfere with placement and / or fixation of a bone fixation plate. For example, in one scenario, an IM nail or stem portion of a previously surgically implanted orthopedic device or implant can interfere with positioning of a bone fixation plate and / or placement of bone fasteners, screws, etc. (the terms are used interchangeably herein without intent to limit) used to fixate the bone fixation plate to a patient's bone. Additionally, degradation of a patient's bone surrounding a previously surgically implanted orthopedic device or implant, for example, due to osteoporosis, defects in the bone, etc., can further complicate fixation and positioning of a bone fixation plate on a patient's bone. Thus, due to limited options, periprosthetic fractures and corresponding techniques for treating periprosthetic fractures are generally more difficult.

[0052] Thus, as will be described herein, the present disclosure discloses a number of bone fixation plates (e.g., periprosthetic bone plates) including one or more features or aspects that can be used in combination or individually, which are designed and configured to provide increased flexibility, enabling a surgeon to position and fixate a bone fixation plate across a fracture in a patient's bone adjacent to a previously surgically implanted orthopedic device or implant.

[0053] As will be described herein, a bone fixation plate can have various shapes and / or configurations. It should be appreciated that a bone fixation plate can be provided in any suitable shape and / or configuration, as will be appreciated by one of ordinary skill in the art, which can depend on the location and type of patient bone being fixed. For example, a bone fixation plate can include an arcuate surface that conforms to a bone. Further, a bone fixation plate can be arranged and configured to span, contact, etc. a distal femur, a proximal femur, a distal tibia, a proximal tibia, a proximal humerus, a distal humerus, a fibula, an ulna, a radius, a distal radius, a foot bone, or a hand bone, a diaphyseal fracture across a long bone, etc.

[0054] Further, a bone fixation plate can include any additional features now known or later developed, for example, one or more openings or slots designed to receive, for example, a surgical implant tool, a different fastener (e.g., a non-locking fastener), etc.

[0055] The bone fixation plate can be manufactured from any suitable material now known or later developed, including, for example, metals, polymers, plastics, ceramics, absorbable composites, non-absorbable composites, and the like. Suitable materials can include, for example, titanium, stainless steel, cobalt-chrome, polyether ether ketone (PEEK), polyethylene, ultra-high molecular weight polyethylene (UHMWPE), absorbable polylactic acid (PLA), polyglycolic acid (PGA), combinations or alloys of such materials, or any other suitable material that has sufficient strength to be fixed to and hold bone, while having sufficient biocompatibility to be implanted in a patient's body. In some embodiments, the bone fastener can be made of the same material as the bone fixation plate. In other embodiments, the fastener can be made of a different material than the bone fixation plate.

[0056] The fastener can be any type of fastener now known or later developed. For example, the fastener can include any type of external threading, including standard or non-standard threading. For example, the external threading can be arranged in continuous ridges or non-continuous ridges. The external threading can form a portion of a revolution, a complete revolution, multiple revolutions, single lead, multiple lead, or any other threading known in the art. Additionally and / or alternatively, in the case of a locking screw, the head portion of the fastener can include any surface that will engage with and sit within a locking screw opening formed in the bone fixation plate. For example, the head portion can include threading. Alternatively, the head portion can include a series of dimples, ridges, bumps, textured areas, or any other surface that can secure the fastener.

[0057] The fastener can be any fastener now known or later developed made of any suitable material now known or later developed. The fastener can include an opening for receiving a driver in order to drive the fastener through the bone fixation plate and into the patient's bone. The opening can be any size and shape, for example, it can have a hexagonal configuration to receive a corresponding hexagonal driver, a Phillips head, a flat head, a star configuration, a Torx, or any other suitable configuration that can cooperate with a driver to drive the fastener through the bone fixation plate and into the patient's bone.

[0058] The shaft of the fastener can be fully threaded, partially threaded, or helical vanes, and / or can include one or more spikes, deployable claws, expandable elements, or any feature that allows the shaft to engage with the patient's bone. The shaft can also be unthreaded, such that the fastener takes the form of a spike or pin. In certain procedures, for example, the primary goal is to prevent the bone segments from tilting, or there is no concern that the fastener will pull out of the patient's bone, so the shaft need not be threaded or otherwise configured to engage with the patient's bone, and such an alternative embodiment can be preferred. The end of the shaft can be a self-tapping or self-drilling point.

[0059] In any event, as will be apparent from the remaining disclosure, the focus of the present disclosure is on exemplary embodiments of a bone fixation plate that include one or more features or aspects arranged and configured to provide improved flexibility for positioning and fixation of the bone fixation plate adjacent to an area having a previously surgically implanted orthopedic device or implant. Thus, it should be appreciated that the present disclosure should not be limited to any particular configuration of a bone fixation plate having any particular configuration, unless specifically stated.

[0060] Periprosthetic proximal femur bone fixation plate

[0061] Reference Figures 1-3B Various embodiments of a bone fixation plate 100 having various lengths for repairing a fracture in a patient's bone are disclosed. As will be described herein, the bone fixation plate 100 can be in the form of a proximal femur plate. That is, the bone fixation plate 100 is arranged and configured to be positioned adjacent to a patient's proximal femur. Additionally, as will be described herein, the bone fixation plate 100 includes one or more features such that the bone fixation plate 100 facilitates positioning and fixation to a patient's proximal femur that has previously been implanted with a surgical orthopedic implant or device, such as, for example, an IM nail, a hip prosthesis, etc. As such, the bone fixation plate 100 is arranged and configured for periprosthetic fractures and can thus be referred to as a periprosthetic bone fixation plate or a periprosthetic proximal femur bone fixation plate.

[0062] As shown, the periprosthetic proximal femur bone fixation plate 100 can include a lower side, lower surface, or bone-facing surface 102 (the terms are used interchangeably herein without intent to limit) and an upper surface 104. Additionally, the periprosthetic proximal femur bone fixation plate 100 includes a head portion 110 and a shaft portion 115. Further, the periprosthetic proximal femur bone fixation plate 100 includes a plurality of openings 120 formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic proximal femur bone fixation plate 100 to a patient's bone.

[0063] As will be described herein, in accordance with one aspect or feature of the present disclosure, the openings 120 can be in the form of locking screw (or fastener) openings 122 or variable angle openings or variable angle fastener (or screw) openings 124 (the terms are used interchangeably herein without intent to limit). That is, as will be appreciated by those of ordinary skill in the art, the locking screw openings 122 can include a plurality of threads formed on an inner surface thereof for mating with threads formed on an outer surface of a head portion of a bone fastener. So arranged, the bone fastener can be said to be locked to the prosthetic periprosthetic proximal femoral bone fixation plate 100 via the locking screw openings 122. That is, as will be appreciated by those of ordinary skill in the art, a bone fastener is screwed through one of the locking screw openings 122 formed in the prosthetic periprosthetic proximal femoral bone fixation plate 100 and into the patient's bone. The bone fastener is secured to the prosthetic periprosthetic proximal femoral bone fixation plate 100 via threads formed on a head portion of the bone fastener that cooperate with the threads of the locking screw openings 122 formed in the prosthetic periprosthetic proximal femoral bone fixation plate 100. This secures the prosthetic periprosthetic proximal femoral bone fixation plate 100 relative to the patient's bone and provides rigid fixation between the prosthetic periprosthetic proximal femoral bone fixation plate 100 and the bone fastener. That is, because the head portion of the bone fastener interdigitates with the threads in the locking screw openings 122 of the prosthetic periprosthetic proximal femoral bone fixation plate 100, the plate 100 and fastener form a stable system or construct and the stability of the bone fracture can rely on or be aided by the rigidity of the structure. Locking the bone fastener into the prosthetic periprosthetic proximal femoral bone fixation plate 100 can achieve angular and axial stability and eliminate the possibility of the bone fastener being toggled, slipped or displaced, thereby reducing the risk of post-operative loss of reduction.

[0064] As noted previously, the prosthetic periprosthetic proximal femoral bone fixation plate 100 also includes a plurality of variable angle openings 124 formed therein for receiving non-locking or variable angle (e.g., polyaxial) bone fasteners. In use, the variable angle openings 124 are arranged and configured so that the bone fasteners inserted therein can achieve a greater range of insertion angles than, for example, conventional locking screws that are threadably coupled to the prosthetic periprosthetic proximal femoral bone fixation plate 100. For example, in one embodiment, the angular position of the bone fastener can be rotated through a range of about ± 15 degrees, although the allowable range of polyaxial rotation can vary, including greater and less than fifteen degrees. In use, the variable angle openings 124 can be provided in any suitable manner, configuration, etc. now known or hereafter developed to enable polyaxial positioning or angling of the bone fasteners relative to the prosthetic periprosthetic proximal femoral bone fixation plate 100.

[0065] As shown, in one embodiment, the variable angle opening 124 can include a fin or protrusion that extends radially inward from an inner surface of the variable angle opening 124 and into an interior region of the variable angle opening 124 and is configured to engage or cooperate with a head portion of a bone fastener. In use, the fin engages the head portion of the bone fastener to secure the bone fastener in a desired position and desired angle orientation within the variable angle opening 124. Further information regarding the operation and configuration of the fin can be found in U.S. Patent Application No. 15 / 706,877 entitled “Systems and Methods for Using Polyaxial Plates” with a first filing date of July 25, 2005, now U.S. Patent No. 10,092,337; U.S. Patent Application No. 13 / 524,506 entitled “Variable Angle Locking Implant” filed June 15, 2012, and International PCT Patent Application No. PCT / US20 / 35729 entitled “Orthopedic Implant with Improved Variable Angle Locking Mechanism” filed June 2, 2020, the entire contents of which are incorporated herein by reference.

[0066] According to one aspect of the present disclosure, the locking screw opening 122 can be arranged and configured to receive a larger diameter bone fastener relative to the variable angle opening 124. That is, for example, the locking screw opening 122 can be arranged and configured to receive a 4.5 mm bone fastener, while the variable angle opening 124 can be arranged and configured to receive a 3.5 mm bone fastener, although these sizes are merely exemplary and other sizes of bone fasteners are contemplated. By arranging and configuring the periprosthetic proximal femoral bone fixation plate 100 to receive a larger diameter locking screw, the periprosthetic proximal femoral bone fixation plate 100 can better secure to a patient’s bone. At the same time, by incorporating the smaller variable angle opening 124, the periprosthetic proximal femoral bone fixation plate 100 can better facilitate the positioning of non-locking screws (e.g., polyaxial variable angle bone screws) around a previously surgically implanted orthopedic device or implant (e.g., the smaller non-locking bone fasteners enable a surgeon to better navigate the previously surgically implanted orthopedic device or implant).

[0067] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, the locking screw openings 122 can be positioned within the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100. For example, in one embodiment of the periprosthetic proximal femoral bone fixation plate 100, as shown, the head portion 110 of the periprosthetic proximal femoral bone fixation plate 100 can be completely devoid of any locking screw openings 122, but it is contemplated that the head portion 110 can include one or more locking screw openings 122. Further, as shown, the locking screw openings 122 can be more centrally positioned as compared to the variable angle openings 124 formed in the shaft portion 115. For example, in one embodiment, the shaft portion 115 can include a central longitudinal axis C L , the locking screw openings 122 can be positioned substantially along the central longitudinal axis C L of the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100, while the variable angle openings 124 formed in the shaft portion 115 (as shown) can be positioned along and / or adjacent to the outer periphery or surface 106 of the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100. That is, the locking screw openings 122 are positioned more inward, closer to the central longitudinal axis C L of the shaft portion 115, while the variable angle openings are positioned more outward, closer to the outer periphery or peripheral surface 106 of the shaft portion 115.

[0068] With this arrangement, by positioning the variable angle openings 124 along and / or adjacent to the outer periphery 106 of the shaft portion 115, the periprosthetic proximal femoral bone fixation plate 100 can better position the variable angle bone fasteners to avoid previously surgically implanted orthopedic devices or implants (e.g., the surgeon can better position and insert one or more bone fasteners through the variable angle openings 124 formed in the periprosthetic proximal femoral bone fixation plate 100 while, for example, avoiding the shaft portion or IM nail of a previously surgically implanted orthopedic device or implant in the patient’s proximal femur).

[0069] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100 can include a first region 116 and a second region 118. As shown, the first region 116 can be positioned proximate to the head portion 110 of the periprosthetic proximal femoral bone fixation plate 100. In one or more embodiments, the variable angle openings 124 can be arranged and configured such that they are positioned laterally to one another within the first region 116 of the shaft portion 115. That is, as shown, the variable angle openings 124 can be considered to be positioned in lateral rows, with two variable angle openings 124 positioned in a row, one along each side or perimeter surface 106 of the periprosthetic proximal femoral bone fixation plate 100. Arranged as such, the variable angle openings 124 in the first region 116 of the shaft portion 115 can be referred to as being positioned in double rows. Meanwhile, as shown, the variable angle openings 124 formed in the second region 118 of the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100 can be arranged such that they alternate with respect to one another. That is, as shown, the variable angle openings 124 can be considered to be positioned in lateral rows, with only a single variable angle opening 124 positioned in a row, with the variable angle openings 124 alternating along the side or perimeter surface 106 of the periprosthetic proximal femoral bone fixation plate 100 adjacent to which they are positioned. Arranged as such, as shown, the first region 116 of the shaft portion 115 can include more (e.g., double the number of) variable angle openings 124 as compared to the second region 118 of the shaft portion 115, even though the first region 116 and the second region 118 of the shaft portion 115 can have the same number of rows of variable angle openings 124, though it is contemplated that the first region 116 and the second region 118 can also have different numbers of rows. By positioning the variable angle openings 124 in double rows in the first region 116 of the shaft portion 115, the surgeon is provided with more options when inserting a variable angle bone fastener into a patient’s bone in the vicinity of a previously surgically implanted orthopedic device or implant’s stem portion or IM nail. Meanwhile, by providing only a single row of alternating variable angle openings 124 in the second region 118 of the shaft portion 115, the strength of the bone fixation plate 100 is better maintained.

[0070] Reference Figure 2 and 3BHowever, additionally and / or alternatively, according to another aspect or feature of the present disclosure, the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100 can include a plurality of undercuts or recesses 130 formed in the bone-facing surface 102. That is, the variable angle openings 124 formed in the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100 can be positioned or reside within the undercuts 130 formed in the bone-facing surface 102. In use, the size of the undercuts 130 can be set and configured to provide clearance for cables to pass underneath the proximal femoral bone fixation plate 100. In one embodiment, the plurality of undercuts 130 are co-located with the variable angle openings 124 formed in the shaft portion 115 of the periprosthetic proximal femoral bone fixation plate 100 to provide increased bone plate strength (e.g., the undercuts 130 and variable angle openings 124 are centrally located between the central locking screw openings 122, which is a location of peak stress. If the undercuts 130 or variable angle openings 124 are positioned closer to one of the central locking screw openings 122, the overall strength of the plate will be reduced).

[0071] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, the distal portion 119 of the periprosthetic proximal femoral bone fixation plate 100 (e.g., the end portion opposite the head portion 110) can include a thinning. That is, the distal portion 119 can include a reduced or tapered cross-sectional area to facilitate contouring of the distal portion 119 relative to the patient's anatomy. Generally, as will be appreciated by one of ordinary skill in the art, during use, a surgeon typically selects a bone fixation plate having a length that is sized and configured to bridge or span the entire area of a fracture. For example, it is not uncommon for a bone fixation plate to extend from the femoral condyle or trochanter or higher of a patient and / or to the femoral condyle or trochanter or higher. In use, the head portion of the bone fixation plate can be highly contoured to match the patient's anatomy. However, providing a bone fixation plate having both ends contoured to the anatomy presents a number of problems. For example, generally, providing a bone fixation plate that is anatomically constrained or contoured at both ends will not fit individual patients as well as desired. Thus, it is beneficial to relieve the anatomical constraint on one end of the bone plate to enable the bone plate to be contoured to provide a better fit for each individual patient. Additionally and / or alternatively, providing a bone fixation plate having both ends contoured presents a number of manufacturing problems. According to one aspect or feature of the present disclosure, the distal portion 119 (e.g., the end portion opposite the head portion 110) can include a reduced cross-sectional area to better enable a surgeon to contour the distal portion 119 to accommodate the patient's anatomy.

[0072] Reference is made to Figure 3BIn accordance with another aspect of the present disclosure, the locking screw openings 122 formed in the distal portion 119 of the shaft portion 115 can include underside counterbores 126 formed in the underside or bone-facing surface 102 thereof. For example, as shown, the two most distal locking screw openings 122 formed in the shaft portion 115 of the proximal femoral bone fixation plate can include underside counterbores 126, although it is contemplated that more or fewer locking screw openings can be counterbored on the underside or bone-facing surface 102. In use, by providing counterbores 126 in the underside or bone-facing surface 102 of the locking screw openings 122 formed in the distal portion 119 of the plate 100, the underside counterbore locking screw openings 126 can be used in combination with instrumentation to grab and compress a fracture.

[0073] The shaft portion 115 of the proximal femoral bone fixation plate 100 can also include a plurality of k-wire openings 128 for enabling a k-wire to pass therethrough. As shown, additionally and / or alternatively, in accordance with another aspect or feature of the present disclosure, an initial k-wire opening 128 can be positioned between the two most distal locking screw openings 122. Additionally, the shaft portion 115 can include a plurality of additional k-wire openings 128 formed therein. In use, the plurality of k-wire openings 128 allow a surgeon to temporarily hold the bone fixation plate 100 to a patient's bone after they have reduced a fracture.

[0074] As generally shown, and as will be appreciated by one of ordinary skill in the art, the number of undercut, variable angle openings, locking screw openings, etc. will vary between various bone fixation plates depending on the length of the plate.

[0075] Periprosthetic distal femoral bone fixation plate

[0076] Reference Figures 4-6B Various embodiments of alternative bone fixation plates 200 having various lengths for repairing a fracture in a patient's bone are disclosed. As will be described herein, in conjunction with Figures 4-6B The bone fixation plates 200 shown and described can be substantially similar to the periprosthetic proximal femoral bone fixation plate 100 described above in conjunction with Figures 1-3B However, the bone fixation plates 200 can be in the form of a distal femoral plate. That is, the bone fixation plates 200 are arranged and configured to be positioned adjacent to a patient's distal femur. Additionally, as will be described herein, the bone fixation plates 200 include one or more features such that the bone fixation plates 200 facilitate positioning and fixation to a patient's distal femur that previously received a surgically implanted orthopedic device or implant, such as an IM nail, a knee prosthesis, etc. As such, the bone fixation plates 200 are arranged and configured for periprosthetic fractures and can thus be referred to as periprosthetic bone fixation plates or periprosthetic distal femoral bone fixation plates.

[0077] As shown, the periprosthetic distal femoral bone fixation plate 200 can include a lower, inferior, or bone-facing surface 202 and an upper surface 204. Additionally, the periprosthetic distal femoral bone fixation plate 200 includes a head portion 210 and a shaft portion 215. Further, the periprosthetic distal femoral bone fixation plate 200 includes a plurality of openings 220 formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic distal femoral bone fixation plate 200 to the bone of a patient.

[0078] As previously described in connection with the proximal femoral bone fixation plate 100, the periprosthetic distal femoral bone fixation plate 200 can include a plurality of locking screw openings 222 and a plurality of variable angle openings 224. Similar to the locking screw openings 222 and the variable angle openings 224 described in connection with the proximal femoral bone fixation plate 100, and in accordance with one aspect of the present disclosure, the locking screw openings 222 formed in the periprosthetic distal femoral bone fixation plate 200 can be arranged and configured to receive a larger diameter bone fastener relative to the variable angle openings 224 formed in the periprosthetic distal femoral bone fixation plate 200. That is, for example, the locking screw openings 222 can be arranged and configured to receive 4.5 mm bone fasteners, while the variable angle openings 224 can be arranged and configured to receive 3.5 mm bone fasteners, although these sizes are merely exemplary and other sizes of bone fasteners are contemplated. By arranging and configuring the periprosthetic distal femoral bone fixation plate 200 to receive larger diameter locking screws, the periprosthetic distal femoral bone fixation plate 200 can be better secured to the bone of a patient. At the same time, by incorporating smaller variable angle openings 224, the periprosthetic distal femoral bone fixation plate 200 can better facilitate the positioning of non-locking screws (e.g., polyaxial variable angle bone screws) about a previously surgically implanted orthopedic device or implant.

[0079] Additionally and / or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described, the locking screw openings 222 can be positioned within the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200. As shown, the locking screw openings 222 can be more centrally positioned as compared to the variable angle openings 224 formed in the shaft portion 215. As shown, the variable angle openings 224 can be positioned along and / or adjacent to the outer periphery or surface 206 of the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200. For example, in one embodiment, the shaft portion 215 can include a central longitudinal axis C L , the locking screw openings 222 can be substantially along the central longitudinal axis C Lpositioned along and / or adjacent to the outer periphery or surface 206 of the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200. That is, the locking screw openings 222 are positioned more proximally, closer to the central longitudinal axis C of the shaft portion 215 relative to the variable angle openings 224. L The variable angle openings are positioned more proximally relative to the outer periphery or peripheral surface 206 of the shaft portion 215.

[0080] With this arrangement, by positioning the variable angle openings 224 along and / or adjacent to the outer periphery 206 of the shaft portion 215, the periprosthetic distal femoral bone fixation plate 200 can better position the variable angle bone fasteners to avoid previously surgically implanted orthopedic devices or implants (e.g., the surgeon can better position and insert one or more bone fasteners through the variable angle openings 224 formed in the periprosthetic distal femoral bone fixation plate 200 while, for example, avoiding a previously surgically implanted orthopedic device or implant, such as a stem portion of a knee prosthesis or an IM nail, in the distal femur of the patient).

[0081] As shown, in one embodiment, in connection with the periprosthetic distal femoral bone fixation plate 200, the head portion 210 of the periprosthetic distal femoral bone fixation plate 200 can include a plurality of locking screw openings 222. In one embodiment, the head portion 210 can also include one or more larger diameter variable angle holes 224a (e.g., arranged and configured to receive 4.5 mm bone fasteners). Alternatively, the head portion 210 of the periprosthetic distal femoral bone fixation plate 200 can be completely devoid of any variable angle openings 224 (e.g., the head portion 215 of the periprosthetic distal femoral bone fixation plate 200 can only include locking screw openings 222). Alternatively, it is contemplated that the head portion 210 of the periprosthetic distal femoral bone fixation plate 200 can include one or more smaller diameter variable angle openings 224 (arranged and configured to receive 3.5 mm bone fasteners).

[0082] Additionally, as shown in connection with the periprosthetic distal femoral bone fixation plate 200, the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200 can include only a single row of alternating variable angle openings 224 (e.g., the shaft portion 215 can be devoid of any double row of variable angle openings 224 as previously described). However, although not shown, it is contemplated that the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 100 can include a first region and a second region similar to the periprosthetic proximal femoral bone fixation plate 100, wherein in the first region the variable angle openings are positioned / aligned laterally from one another, and in the second region the variable angle openings can be positioned alternatingly such that the first region of the shaft portion includes more variable angle openings as compared to the second region, thereby providing the surgeon with more options when inserting the bone fasteners in the patient's bone in the expected vicinity of a previously surgically implanted orthopedic device or implant.

[0083] With reference to Figure 5 and 6B The shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200 can include a plurality of undercuts or grooves 230 formed in the lower or bone-facing surface 202. However, additionally and / or alternatively, according to another aspect or feature of the present disclosure, the plurality of undercuts 230 can coincide or be co-located with the variable angle openings 224 formed in the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200. That is, the variable angle openings 224 formed in the shaft portion 215 can be positioned or reside within the undercuts 230 formed in the bone-facing surface 202. In use, the undercuts 230 can be sized and configured to provide clearance for cables to pass underneath the distal femoral bone fixation plate 100. As previously described, in one embodiment, the plurality of undercuts 230 are co-located with the variable angle openings 224 formed in the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200 to provide increased bone plate strength (e.g., the undercuts 230 and variable angle openings 224 are centered between the central locking screw openings 222, which is a location of peak stress. If the undercuts 230 or variable angle openings 224 are positioned closer to one of the central locking screw openings 222, the overall strength of the plate will be reduced).

[0084] Additionally and / or alternatively, according to another aspect or feature of this disclosure, and as previously described in conjunction with the proximal femoral fixation plate 100, the end portion 219 of the distal femoral fixation plate 200 (e.g., the proximal portion 219 opposite the head portion 210 of the distal femoral fixation plate 200) may include thinning. That is, the end portion 219 of the axial portion 215 may include a reduced or tapered cross-sectional area to facilitate contouring of the end portion relative to the patient's anatomy. In other words, as described above, according to one aspect or feature of this disclosure, the end portion 219 of the axial portion 215 (e.g., the end portion 219 opposite the head portion 210) may include a reduced cross-sectional area to better enable the surgeon to contour the end portion 219 to fit the patient's anatomy. For example, as described above, providing a bone fixation plate with contoured ends presents numerous problems. For example, generally, providing a bone fixation plate that provides anatomical constraint or contouring at both ends will not be as suitable as intended for individual patients. Therefore, it is beneficial to relieve the anatomical constraints on one end of the bone plate so that the bone plate can be contoured to provide a better fit for each individual patient. According to one aspect or feature of this disclosure, the end portion 219 (e.g., the end portion opposite the head portion 210) may include a reduced cross-sectional area to better enable the surgeon to contour the end portion 219 to fit the patient's anatomy.

[0085] In addition, such as Figure 6B As shown, the end portion 219 of the distal femoral bone fixation plate 200 around the prosthesis may include a plurality of variable-angle openings 224 (e.g., the end portion 219 may include only the variable-angle openings 224 or a majority of the variable-angle openings). As shown, for example, the variable-angle openings 224 formed in the end portion 219 may be arranged in an array, such as a 2x2 array, but this is merely exemplary and other arrays and / or configurations are contemplated. By providing an array of variable-angle openings 224 in the end portion 219, surgeons are given more options for positioning variable-angle bone fasteners in the patient's bone (e.g., in use, the end portion 219 is designed to reach the proximal femur, where the bone is no longer the diaphysis, and the variable-angle holes allow the screw to reach more desired bone and length. For example, the screw may be targeted at the lesser trochanter, the femoral head, or some other desired area in the proximal femur).

[0086] Additionally, refer to Figure 6BAccording to another aspect of the present disclosure and as described above in connection with the periprosthetic proximal femoral bone fixation plate 100, the locking screw openings 222 formed in the end portion 219 (e.g., opposite the head portion 210) can include a lower side counterbore 226 formed in the lower side or bone-facing surface 202 thereof. For example, as shown, two of the most proximal locking screw openings 222 formed in the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 210 can include a lower side counterbore 226, although it is contemplated that more or fewer locking screw openings 222 can be counterbored on the lower side or bone-facing surface 202. In use, by providing a counterbore 226 in the lower side or bone-facing surface 202 of the locking screw openings 222 formed in the end portion 219 of the plate 200, the lower side counterbore locking screw openings can be used in combination with an instrument to grab and compress a fracture.

[0087] As described previously, the shaft portion 215 of the periprosthetic distal femoral bone fixation plate 200 can also include a plurality of k-wire openings 228 for enabling a k-wire to pass therethrough. As shown, additionally and / or alternatively, according to another aspect or feature of the present disclosure, an initial k-wire opening 228 can be positioned between the array of variable angle openings 224 and the most proximal locking screw opening 222. Additionally, the shaft portion 215 can include a plurality of additional k-wire openings 228 formed therein. In use, the plurality of k-wire openings 228 allow a surgeon to temporarily hold the bone fixation plate 200 to a patient's bone after they have reduced a fracture.

[0088] As generally shown, and as will be appreciated by one of ordinary skill in the art, the number of undercut, variable angle openings, locking screw openings, etc. will vary between various bone fixation plates depending on the length of the plate.

[0089] Periprosthetic humeral or utility bone fixation plate

[0090] Reference Figures 7-9 Various embodiments of alternative bone fixation plates 300 having various lengths for repairing a fracture in a patient's bone are disclosed. As will be described herein, in connection with the periprosthetic proximal femoral bone fixation plate 100, the periprosthetic distal femoral bone fixation plate 200, and the periprosthetic humeral bone fixation plate 300, the bone fixation plates 100, 200, 300 can be used to repair a fracture in a patient's bone, such as a femur, a humerus, or a tibia, for example. Figures 7-9The bone fixation plate 300 shown and described can include some or all of the features or aspects described above in connection with the periprosthetic proximal femoral bone fixation plate 100 and the periprosthetic distal femoral bone fixation plate 200. However, the bone fixation plate 300 can be in the form of a humeral or utility plate. That is, the bone fixation plate 300 is arranged and configured for positioning against a long bone of a patient, such as the humerus of a patient. Additionally, generally speaking, in periprosthetic long bone fractures, the remaining bone stock for receiving bone fixation screws can be minimal. Typically, the remaining bone portion can only be aligned with the shaft portion of the plate. Thus, generally speaking, the utility plate can be less profiled as compared to the various other bone fixation plates described herein. One advantage of such is that the utility plate can be arranged and configured to work with many long bones, such as the humerus of a patient, and thus the utility plate can function or be referred to as a periprosthetic humeral plate.

[0091] Further, as will be described herein, the bone fixation plate 300 includes one or more features that facilitate positioning and fixation of the bone fixation plate 300 to a long bone of a patient, such as a humerus, that previously received a surgically implanted orthopedic implant or device, such as an IM nail or the like. As such, the bone fixation plate 300 is arranged and configured for periprosthetic fractures, and thus can be referred to as a periprosthetic bone fixation plate, a periprosthetic utility bone fixation plate, or a periprosthetic humeral fixation plate.

[0092] As shown, the periprosthetic utility bone fixation plate 300 can include a lower, lower or bone-facing surface 302 and an upper surface 304. Additionally, the periprosthetic utility bone fixation plate 300 includes a head portion 310 and a shaft portion 315. Further, the periprosthetic utility bone fixation plate 300 includes a plurality of openings 320 formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic utility bone fixation plate 300 to a bone of a patient.

[0093] As previously described in connection with the proximal femoral bone fixation plate 100, the periprosthetic utility bone fixation plate 300 can include a plurality of locking screw openings 322 and a plurality of variable angle openings 324. Similar to the locking screw openings 122 and the variable angle openings 124 described in connection with the proximal femoral bone fixation plate 100, and in accordance with one aspect of the present disclosure, the locking screw openings 322 formed in the periprosthetic utility bone fixation plate 300 can be arranged and configured to receive a larger diameter bone fastener relative to the variable angle openings 324 formed in the periprosthetic utility bone fixation plate 300. That is, for example, the locking screw openings 322 can be arranged and configured to receive 4.5 mm bone fasteners, while the variable angle openings 324 can be arranged and configured to receive 3.5 mm bone fasteners, although these sizes are merely exemplary and other sizes of bone fasteners are contemplated. For example, in some embodiments, the locking screw openings 322 can be arranged and configured to receive other sizes of bone fasteners, such as 3.5 mm bone fasteners.

[0094] By arranging and configuring the periprosthetic utility bone fixation plate 300 to receive larger diameter locking screws, the periprosthetic utility bone fixation plate 300 can better secure to a patient’s bone. At the same time, by incorporating smaller variable angle openings 324, the periprosthetic utility bone fixation plate 300 can better facilitate the positioning of non-locking screws (e.g., polyaxial variable angle bone screws) around previously surgically implanted orthopedic devices or implants.

[0095] In conjunction with the periprosthetic utility bone fixation plate 300, the locking screw openings 322 can be positioned within the shaft portion 315 of the periprosthetic utility bone fixation plate 300. As shown, the locking screw openings 322 can be centrally positioned. For example, in one embodiment, the shaft portion 315 can include a central longitudinal axis C L , the locking screw openings 322 can be substantially centrally positioned along the central longitudinal axis C L of the periprosthetic utility bone fixation plate 300. Moreover, as shown, the shaft portion 315 of the periprosthetic utility bone fixation plate 300 can be completely devoid of any variable angle openings 324, although it is contemplated that the shaft portion 315 can include one or more variable angle openings 324.

[0096] Additionally and / or alternatively, as shown, the head portion 310 of the periprosthetic utility bone fixation plate 300 can include a plurality of locking screw openings 322 and a plurality of variable angle openings 324. As shown, the locking screw openings 322 can be centrally positioned. For example, in one embodiment, the locking screw openings 322 can be substantially centrally positioned along the central longitudinal axis C L of the head portion 310 of the periprosthetic utility bone fixation plate 300 as compared to the variable angle openings 324 as shown, the variable angle openings can be positioned along and / or adjacent to the outer periphery or surface 306 of the periprosthetic utility bone fixation plate 300. That is, the locking screw openings 322 are more inward, closer to the central longitudinal axis C L of the head portion 310, the variable angle openings are closer to the outer periphery or peripheral surface 306 of the head portion 310. With this arrangement, by positioning the variable angle openings 324 along and / or adjacent to the outer periphery 306 of the head portion 310, the periprosthetic utility bone fixation plate 300 can better position variable angle bone fasteners to avoid previously surgically implanted orthopedic devices or implants (e.g., a surgeon can better position and insert one or more bone fasteners through the variable angle openings 324 formed in the periprosthetic utility bone fixation plate 300 while, for example, avoiding an IM nail or other previously surgically implanted orthopedic device or implant in a patient’s bone).

[0097] Additionally and / or alternatively, as shown, the variable angle openings 324 formed in the head portion 310 of the periprosthetic utility bone fixation plate 300 can be configured and arranged in a double row arrangement as previously described (e.g., the variable angle openings 324 can be considered to be positioned in transverse rows, with two variable angle openings 324 positioned in each row, such as, for example, one on each lateral surface of the central longitudinal axis C L

[0098] Referring to Figure 8 , the shaft portion 315 of the periprosthetic utility bone fixation plate 300 can include a plurality of undercuts or grooves 330 formed in the lower or bone-facing surface 302. The undercuts 330 can be positioned on either side of the locking screw openings 322 (e.g., the undercuts or grooves 330 can be positioned between adjacent locking screw openings 322). In use, the undercuts 330 can be sized and configured to provide clearance for cables to pass beneath the periprosthetic utility bone fixation plate.

[0099] Additionally, referring to Figure 8 , in accordance with another aspect of the present disclosure and as described above in connection with the periprosthetic proximal femoral bone fixation plate 100 and the periprosthetic distal femoral bone fixation plate 200, the locking screw openings 322 formed in the end portion 319 (e.g., the end portion opposite the head portion 310) of the periprosthetic utility bone fixation plate 300 can include a lower countersink 326 formed in the lower or bone-facing surface 302 thereof. For example, as shown, the two most distal locking screw openings 322 formed in the shaft portion 315 of the periprosthetic utility bone fixation plate 300 can include a lower countersink 326, although it is contemplated that more or fewer locking screw openings can be countersunk on the lower or bone-facing surface. In use, by providing a countersink 326 in the lower or bone-facing surface 302 of the locking screw openings 322 formed in the end portion 319 of the plate 300, the lower countersunk locking screw openings can be used in combination with an instrument to grab and compress a fracture.

[0100] The shaft portion 315 of the periprosthetic utility bone fixation plate 300 can also include a plurality of k-wire openings 328 for enabling a k-wire to pass therethrough. As shown, additionally and / or alternatively, in accordance with another aspect or feature of the present disclosure, an initial k-wire opening 328 can be positioned between the two most distal locking screw openings 322. Additionally, although not shown, it is contemplated that the shaft portion 315 can include a plurality of additional k-wire openings 328 formed therein.

[0101] As generally shown, and as will be appreciated by one of ordinary skill in the art, the number of undercuts, variable angle openings, locking screw openings, etc. will vary between various bone fixation plates depending on the length of the plate.

[0102] ​While not shown, it is contemplated that the shaft portion of the periprosthetic utility bone fixation plate 300 can include a first region and a second region similar to the periprosthetic proximal femoral bone fixation plate 100, where in the first region the variable angle openings are positioned / aligned laterally from one another and in the second region the variable angle openings can be positioned alternately such that the first region of the shaft portion can include more variable angle openings compared to the second region of the shaft portion, thereby providing the surgeon with more options when inserting the bone fasteners in the patient's bone in the expected vicinity of a previously surgically implanted orthopedic device or implant. Additionally and / or alternatively, it is contemplated that the shaft portion of the periprosthetic utility bone fixation plate can include a plurality of variable angle openings and a plurality of undercuts, which can coincide or be co-located with the variable angle openings.

[0103] Additionally and / or alternatively, it is contemplated that the end portions of the periprosthetic utility bone fixation plate can include a thinning (e.g., a reduced or tapered cross-sectional area to facilitate contouring of the end portions relative to the patient's anatomy). For example, as previously described, providing a periprosthetic utility bone fixation plate with contoured ends creates a number of problems. For example, generally speaking, providing a bone fixation plate that is anatomically constrained or contoured at both ends will not fit individual patients as expected. Thus, it is beneficial to relieve the anatomical constraints on one or both ends of the periprosthetic bone fixation plate to enable the bone plate to be contoured to provide a better fit for each individual patient. In accordance with one aspect or feature of the present disclosure, one or both end portions of the periprosthetic utility bone fixation plate can include a reduced cross-sectional area to better enable the surgeon to contour the end portions to accommodate the patient's anatomy.

[0104] Periprosthetic ring bone fixation plate

[0105] Reference Figures 10-13 Various embodiments of alternative bone fixation plates 400 having various lengths for repairing a fracture in a patient's bone are disclosed. As will be described herein, the bone fixation plates 400 described and illustrated in conjunction with Figures 10-13 The bone fixation plates 400 shown and described can be substantially similar to the periprosthetic proximal femoral bone fixation plate 100 described above in conjunction with Figures 1-3B However, the bone fixation plates 400 can be in the form of a ring plate. That is, the bone fixation plates 400 include a head portion 410 that is arranged and configured in the configuration of a ring for positioning adjacent to a patient's trochanter. Additionally, as will be described herein, the bone fixation plates 400 include one or more features such that the bone fixation plates 400 facilitate positioning and securing to a patient's bone, such as for example a patient's femur, that previously received a surgically implanted orthopedic implant or device, such as for example an IM nail, a hip prosthesis, etc. As such, the bone fixation plates 400 are arranged and configured for periprosthetic fractures and thus can be referred to as periprosthetic bone fixation plates or periprosthetic ring bone fixation plates.

[0106] As shown, the periprosthetic annular bone fixation plate 400 can include a lower, inferior, or bone-facing surface 402 and an upper surface 404. Additionally, the periprosthetic annular bone fixation plate 400 includes a head portion 410 and a shaft portion 415. Further, the periprosthetic annular bone fixation plate 400 includes a plurality of openings 420 formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic annular bone fixation plate 400 to the bone of the patient.

[0107] As shown, the head portion 410 of the periprosthetic annular bone fixation plate 400 can be arranged and configured to contact the collar of the trochanter of the patient. That is, as shown, the head portion 410 can include a first leg or segment 412, a second leg or segment 413 spaced apart from the first leg or segment 412, and a bridging segment 414 for coupling the ends of the first leg 412 and the second leg 413. With this arrangement, the head portion 410 includes an opening 411 between the first leg 412 and the second leg 413 and the bridging segment 414. However, in contrast to known annular plates, the periprosthetic annular bone fixation plate 400 can be integrally formed. That is, the annular head portion 410 of the periprosthetic annular bone fixation plate 400 can be integrally formed with the shaft portion 415 of the periprosthetic annular bone fixation plate 400. By providing an integrally formed periprosthetic annular bone fixation plate 400, the periprosthetic annular bone fixation plate 400 is less likely to break when subjected to fatigue loading. Additionally, there are fewer surgical steps required because there is no need to assemble a ring to a plate. Further, in contrast to having fewer larger openings (e.g., in the case of a femoral stem block, smaller 3.5 mm openings enable the surgeon to better avoid the femoral stem while maintaining stability against deformation forces from the attached muscles), the periprosthetic annular bone fixation plate 400 facilitates the incorporation of more smaller openings 420 for receiving a plurality of fasteners.

[0108] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, the head portion 410 of the periprosthetic annular bone fixation plate 400 can include a plurality of locking screw openings 422 and a plurality of variable angle openings 424. That is, the head portion 410 of the periprosthetic annular bone fixation plate 400 can include alternating locking screw openings 422 and variable angle openings 424 in the first leg 412 and the second leg 413. In one embodiment, the bridging segment 414 can include a plurality of variable angle openings 424, alternatively it is contemplated that the bridging segment 414 can also include one or more locking screw openings 422. By providing a plurality of locking screw openings 422 and variable angle openings 424 in the head portion 410 of the periprosthetic annular bone fixation plate 400, the surgeon is provided with more options in comparison to conventional known ring fixation plates.

[0109] As shown, in one embodiment, an opening 420 (e.g., a variable angle opening 424a) is centrally positioned on the bridging segment 414. With this arrangement, the periprosthetic annular bone fixation plate 400 can be cut as needed. As such, the integrally formed annular head portion 410 of the periprosthetic annular bone fixation plate 400 can be divided into two arms (e.g., the first leg 412 and the second leg 413 can be converted into first and second hook-type members).

[0110] Additionally, as previously described in connection with the proximal femoral bone fixation plate 100, the periprosthetic annular bone fixation plate 400 can include a plurality of locking screw openings 422 and a plurality of variable angle openings 424 in the shaft portion 415 of the periprosthetic annular bone fixation plate 400. Similar to the locking screw openings 122 and the variable angle openings 124 described in connection with the proximal femoral bone fixation plate 100, and in accordance with one aspect of the present disclosure, the locking screw openings 422 formed in the shaft portion 415 of the periprosthetic annular bone fixation plate 400 can be arranged and configured to receive a larger diameter bone fastener relative to the variable angle openings 424 formed in the shaft portion 415 of the periprosthetic annular bone fixation plate 400. That is, for example, the locking screw openings 422 formed in the shaft portion 415 can be arranged and configured to receive 4.5 mm bone fasteners, while the variable angle openings 424 formed in the shaft portion 415 can be arranged and configured to receive 3.5 mm bone fasteners, although these sizes are merely exemplary and other sizes of bone fasteners are contemplated. By arranging and configuring the periprosthetic annular bone fixation plate 400 to receive larger diameter locking screws, the periprosthetic annular bone fixation plate 400 can be better secured to the patient’s bone. At the same time, by incorporating smaller variable angle openings 424 in the shaft portion 415, the periprosthetic annular bone fixation plate 400 can better facilitate the positioning of non-locking screws (e.g., polyaxial variable angle bone screws) around a previously surgically implanted orthopedic device or implant.

[0111] Additionally and / or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described, the locking screw openings 422 positioned within the shaft portion 415 of the periprosthetic annular bone fixation plate 400 can be more centrally positioned relative to the variable angle openings 424, which as shown can be positioned along and / or adjacent to the outer periphery or surface 406 of the shaft portion 415 of the periprosthetic annular bone fixation plate 400. For example, in one embodiment, the shaft portion 415 can include a central longitudinal axis C L , the locking screw openings 422 positioned within the shaft portion 415 of the periprosthetic annular bone fixation plate 400 can be substantially along the central longitudinal axis C LCentrally positioned. That is, the locking screw openings 422 are positioned more inward relative to the variable angle openings 424, closer to the central longitudinal axis C of the shaft portion 415 L The variable angle openings are positioned closer to the outer circumference or peripheral surface 406 of the shaft portion 415.

[0112] With this arrangement, by positioning the variable angle openings 424 along and / or adjacent to the outer circumference or surface 406 of the shaft portion 415, the periprosthetic annular bone fixation plate 400 can better position the variable angle bone fasteners to avoid previously surgically implanted orthopedic devices or implants (e.g., the surgeon can better position and insert one or more bone fasteners through the variable angle openings formed in the periprosthetic annular bone fixation plate 400 while, for example, avoiding a previously surgically implanted orthopedic device or implant in the femur of the patient, such as a stem portion of a hip prosthesis or an IM nail).

[0113] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, and as previously described in connection with the periprosthetic proximal femoral bone fixation plate 100, the shaft portion 415 of the periprosthetic annular bone fixation plate 400 can include a first region 416 and a second region 418. As shown, the first region 416 can be positioned adjacent to the head portion 410 of the periprosthetic annular bone fixation plate 400. In one or more embodiments, the variable angle openings 424 can be arranged and configured such that they are positioned laterally from one another. That is, as shown and as previously described, the variable angle openings 424 can be considered to be positioned in lateral rows, with two variable angle openings 424 positioned in each row, for example, one on each lateral surface of the central longitudinal axis C of the shaft portion 415 of the periprosthetic annular bone fixation plate 400 L Meanwhile, as shown, the variable angle openings 424 formed in the second region 418 of the shaft portion 415 of the periprosthetic annular bone fixation plate 400 can be arranged such that they alternate relative to one another. That is, as shown, the variable angle openings 424 can be considered to be positioned in lateral rows, with only a single variable angle opening 424 positioned in a row, with the variable angle openings 424 alternating on each lateral surface of the central longitudinal axis C of the shaft portion 415 of the periprosthetic annular bone fixation plate 400 Lalternating. Thus, as shown, the first region 416 of the shaft portion 415 can include more (e.g., double) variable angle openings 424 than the second region 418 of the shaft portion 415. By positioning the variable angle openings 424 in double rows in the first region 416 of the shaft portion 415, the surgeon is provided with more options when inserting the bone fastener in the patient's bone in the anticipated vicinity of a previously surgically implanted orthopedic device or implant's shank portion or IM nail. At the same time, by providing only a single row of alternating variable angle openings 424 in the second region 418 of the shaft portion 415, the strength of the bone fixation plate 400 is better maintained.

[0114] With reference to Figure 11 and 13 The shaft portion 415 of the periprosthetic annular bone fixation plate 400 can include a plurality of undercuts or grooves 430 formed in the lower or bone-facing surface 402. However, additionally and / or alternatively, according to another aspect or feature of the present disclosure, and as previously described, the plurality of undercuts 430 can coincide or be co-located with the variable angle openings 424 formed in the shaft portion 415 of the periprosthetic annular bone fixation plate 400. That is, the variable angle openings 424 formed in the shaft portion 415 can be positioned or reside within the undercuts 430 formed in the bone-facing surface 402. In use, the undercuts 430 can be sized and configured to provide a gap for the cable to pass beneath the periprosthetic annular bone fixation plate 400.

[0115] As previously described, in one embodiment, the plurality of undercuts 430 are co-located with the variable angle openings 424 formed in the shaft portion 415 of the periprosthetic annular bone fixation plate 400 to provide increased bone plate strength (e.g., the undercuts 430 and variable angle openings 424 are centered between the center locking screw openings 422, which is a location of peak stress. If the undercuts 430 or variable angle openings 424 are positioned closer to one of the center locking screw openings 422, the overall strength of the plate will be reduced).

[0116] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, and as previously described in connection with the periprosthetic proximal femoral bone fixation plate 100, the distal end portion 419 of the shaft portion 415 of the periprosthetic annular bone fixation plate 400 (e.g., the end portion 419 of the plate 400 opposite the head portion 410) can include a thinning. That is, the end portion 419 can include a reduced or tapered cross-sectional area to facilitate contouring of the end portion 419 to the patient’s anatomy. According to one aspect or feature of the present disclosure, the distal end portion 419 of the shaft portion 415 can include a reduced cross-sectional area to better enable the surgeon to contour the end portion 419 to the patient’s anatomy. For example, as previously described, providing a bone fixation plate that anatomically constrains or contours at both ends would not fit individual patients as well as intended. Thus, it is beneficial to release the anatomical constraint on one end of the bone plate to enable the bone plate to be contoured to provide a better fit for each individual patient.

[0117] Additionally, with reference to Figure 11 and 13 According to another aspect of the present disclosure and as previously described above in connection with the periprosthetic proximal femoral bone fixation plate 100, the locking screw openings 422 formed in the end portion 419 of the plate 400 can include an undersink 426 formed in the underside or bone-facing surface 402 thereof. For example, as shown, the two most distal locking screw openings 422 formed in the shaft portion 415 of the periprosthetic annular bone fixation plate 400 can include an undersink 426, but it is contemplated that more or fewer locking screw openings can be undersunk on the underside or bone-facing surface. In use, by providing an undersink 426 in the underside or bone-facing surface 402 of the locking screw openings 422 formed in the end portion 419 of the plate 400, the undersink locking screw openings can be used in combination with an instrument to grab and compress a fracture.

[0118] The shaft portion 415 of the periprosthetic annular bone fixation plate 400 can also include a plurality of k-wire openings 428 for enabling a k-wire to pass therethrough. As shown, additionally and / or alternatively, according to another aspect or feature of the present disclosure, an initial k-wire opening 428 can be positioned between the two most distal locking screw openings 422. Additionally, the shaft portion 415 can include a plurality of additional k-wire openings 428 formed in the second region 418 of the shaft portion 415. In use, the plurality of k-wire openings 428 allow the surgeon to temporarily hold the bone fixation plate 400 to the patient’s bone after they have reduced a fracture.

[0119] As generally shown, and as will be appreciated by one of ordinary skill in the art, the number of undercut, variable angle openings, locking screw openings, etc. will vary between various bone fixation plates depending on the length of the plate.

[0120] Periprosthetic trochanteric hook plate

[0121] Reference Figures 14-16 Various embodiments of alternative bone fixation plates 500 having various lengths for repairing a fracture in a patient's bone are disclosed. As will be described herein, the bone fixation plates 500 shown and described can be substantially similar to the periprosthetic proximal femoral bone fixation plates 100 described above in connection with Figures 14-16 The bone fixation plates 500 shown and described can be substantially similar to the periprosthetic proximal femoral bone fixation plates 100 described above in connection with Figures 1-3B That is, the bone fixation plates 500 include a head portion 510 that includes hook members 540 (e.g., first and second hook members 542, 544) arranged and configured for engaging a patient's trochanter. Additionally, as will be described herein, the bone fixation plates 500 include one or more features that facilitate positioning and fixation of the bone fixation plates 500 to a patient's bone, e.g., such as a patient's femur that previously received a surgically implanted orthopedic implant or device, such as, for example, an IM nail, a hip prosthesis, etc. As such, the bone fixation plates 500 are arranged and configured for periprosthetic fractures and can thus be referred to as periprosthetic bone fixation plates or periprosthetic trochanteric hook plates.

[0122] As shown, the periprosthetic trochanteric hook plate 500 can include a lower, lower or bone-facing surface 502 and an upper surface 504. Additionally, the periprosthetic trochanteric hook plate 500 includes a head portion 510 and a shaft portion 515. Further, the periprosthetic trochanteric hook plate 500 includes a plurality of openings 520 formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic trochanteric hook plate 500 to a patient's bone.

[0123] As shown, the head portion 510 of the periprosthetic trochanteric hook plate 500 includes hook members 540 (e.g., first and second hook members 542, 544) arranged and configured for engaging a patient's trochanter. That is, as shown, the periprosthetic trochanteric hook plate 500 includes first and second hook members 542, 544 that extend from its head portion 510 (e.g., from a proximal end of the head portion 510). According to one aspect of the present disclosure, the periprosthetic trochanteric hook plate 500 includes asymmetric first and second hook members 542, 544 as compared to known hook plates. That is, the first hook member 542 is different than the second hook member 544. For example, the first hook member 542 can have a different size and / or configuration as compared to the second hook member 544. By incorporating asymmetric hook members 540, the periprosthetic trochanteric hook plate 500 is able to better match the anatomical bevel of a patient's trochanter.

[0124] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, the head portion 510 of the periprosthetic trochanteric hook bone fixation plate 500 can include a plurality of variable angle openings 524. That is, the head portion 510 of the periprosthetic trochanteric hook bone fixation plate 500 can be devoid of any locking screw openings 522 (as shown in FIG. 5A), but it is contemplated that locking screw openings can also be incorporated in some embodiments. As shown, for example, the variable angle openings 524 formed in the head portion 510 can be arranged in an array, such as a 2x4 array, but this is merely exemplary and other arrays and / or configurations are contemplated. By providing an array of variable angle openings 524 in the head portion 510, the surgeon is provided with more options for positioning variable angle bone fasteners in the patient's bone. Figure 14 As best shown in FIG. 5B, the variable angle openings 524 formed in the head portion 510 of the periprosthetic trochanteric hook bone fixation plate 500 can be arranged in a 2x4 array, but this is merely exemplary and other arrays and / or configurations are contemplated. By providing an array of variable angle openings 524 in the head portion 510, the surgeon is provided with more options for positioning variable angle bone fasteners in the patient's bone.

[0125] Additionally, as previously described in connection with the proximal femoral bone fixation plate 100, the periprosthetic trochanteric hook bone fixation plate 500 can include a plurality of locking screw openings 522 and a plurality of variable angle openings 524 in the shaft portion 515 of the periprosthetic trochanteric hook bone fixation plate 500. Similar to the locking screw openings 122 and the variable angle openings 124 described in connection with the proximal femoral bone fixation plate 100, and according to one aspect of the present disclosure, the locking screw openings 522 formed in the periprosthetic trochanteric hook bone fixation plate 500 can be arranged and configured to receive a larger diameter bone fastener relative to the variable angle openings 524 formed in the periprosthetic trochanteric hook bone fixation plate 500. That is, for example, the locking screw openings 522 can be arranged and configured to receive 4.5 mm bone fasteners, while the variable angle openings 524 can be arranged and configured to receive 3.5 mm bone fasteners, but these sizes are merely exemplary and other sizes of bone fasteners are contemplated. By arranging and configuring the periprosthetic trochanteric hook bone fixation plate 500 to receive larger diameter locking screws, the periprosthetic trochanteric hook bone fixation plate 500 can be better secured to the patient's bone. At the same time, by incorporating smaller variable angle openings 524, the periprosthetic trochanteric hook bone fixation plate 500 can better facilitate the positioning of non-locking screws (e.g., polyaxial variable angle bone screws) around previously surgically implanted orthopedic devices or implants.

[0126] Additionally and / or alternatively, according to another aspect or feature of the present disclosure and as previously described, the locking screw openings 522 can be more centrally positioned within the shaft portion 515 of the periprosthetic trochanteric hook bone fixation plate 500 as compared to the variable angle openings 524. For example, in one embodiment, the shaft portion 515 can include a central longitudinal axis C L the locking screw openings 522 can be substantially along the central longitudinal axis C LMore centrally positioned within the axial portion 515 of the periprosthetic trochanteric hook-shaped bone fixation plate 500, as shown in the figure, the variable-angle opening can be positioned along and / or adjacent to the outer periphery or surface 506 of the axial portion 515 of the periprosthetic trochanteric hook-shaped bone fixation plate 500. That is, the locking screw opening 522 is positioned more inwardly than the variable-angle opening 524, closer to the central longitudinal axis C of the axial portion 515. L The variable angle opening is positioned closer to the outer periphery or peripheral surface 506 of the shaft portion 515.

[0127] This arrangement allows the periprosthetic trochanteric hook-shaped bone fixation plate 500 to better position variable-angle bone fasteners by positioning variable-angle openings 524 along and / or adjacent to the outer periphery or surface 506 of the axial portion 515, thus avoiding previously surgically implanted orthopedic devices or implants (e.g., the surgeon can better position and insert one or more bone fasteners through the variable-angle openings 524 formed in the periprosthetic trochanteric hook-shaped bone fixation plate 500, while avoiding, for example, the stem portion of the hip prosthesis or an IM nail of a previously surgically implanted orthopedic device or implant in the patient's femur).

[0128] Additionally and / or alternatively, according to another aspect or feature of this disclosure, and as previously described in conjunction with the periprosthetic proximal femoral fixation plate 100, the axial portion 515 of the periprosthetic trochanteric hook-shaped bone fixation plate 500 may include a first region 516 and a second region 518. As shown, the first region 516 may be located adjacent to the head portion 510 of the periprosthetic trochanteric hook-shaped bone fixation plate 500. In one or more embodiments, as Figure 14As shown in the middle, in the first region 516 of the shaft portion 515, the variable angle openings 524 can be arranged and configured such that multiple variable angle openings 524 are positioned on one side of the locking screw openings 522, with the position of the variable angle openings 524 alternating on either side of each locking screw opening 522. Thereafter, as shown, the variable angle openings 524 formed in the second region 518 of the shaft portion 515 of the periprosthetic trochanteric hook bone fixation plate 500 can be arranged with a single variable angle opening 524 for each locking screw opening 522. In use, the periprosthetic trochanteric hook bone fixation plate 500 can be less wide as compared to, for example, the periprosthetic circumferential bone fixation plate 400. Additionally, the periprosthetic trochanteric hook bone fixation plate 500 can be loaded during insertion. As such, the variable angle openings 524 in the shaft portion 515 are arranged and configured to be as spread out as possible (e.g., across the width of the shaft portion 515). With this arrangement, as shown, the first region 516 of the shaft portion 515 can include more (e.g., double) variable angle openings 524 as compared to the second region 518 of the shaft portion 515, thereby providing the surgeon with more options when inserting a bone fastener in the patient's bone in the intended vicinity of a previously surgically implanted orthopedic device or implant's stem portion or IM nail.

[0129] Additionally and / or alternatively, although not shown, it is contemplated that the shaft portion 515 of the periprosthetic trochanteric hook bone fixation plate 500 can include a plurality of undercuts or grooves formed in the lower or bone-facing surface 502. In use, the undercuts can be sized and configured to provide clearance for cables to pass under the periprosthetic trochanteric hook bone fixation plate 500.

[0130] Additionally and / or alternatively, according to another aspect or feature of the present disclosure, and as previously described in connection with the periprosthetic proximal femoral bone fixation plate 100, the end portion 519 of the periprosthetic trochanteric hook bone fixation plate 500 (e.g., the end portion 519 of the plate 500 opposite the head portion 510) can include a thinning. That is, the end portion 519 can include a reduced or tapered cross-sectional area to facilitate contouring of the end portion 519 to the patient's anatomy. According to one aspect or feature of the present disclosure, the end portion 519 can include a reduced cross-sectional area to better enable the surgeon to contour the end portion 519 to the patient's anatomy. For example, as previously described, providing a bone fixation plate with contoured ends creates a number of problems. For example, generally, providing a bone fixation plate that is anatomically constrained or contoured at both ends will not fit individual patients as well as desired. Thus, it is beneficial to relieve the anatomical constraint on one end of the bone plate to enable the bone plate to be contoured to provide a better fit for each individual patient. According to one aspect or feature of the present disclosure, the end portion 519 (e.g., the end portion opposite the head portion 510) can include a reduced cross-sectional area to better enable the surgeon to contour the end portion 519 to the patient's anatomy.

[0131] Additionally, with reference to Figure 15 and 16 , according to another aspect of the present disclosure and as described above in connection with the proximal femoral bone fixation plate 100, the locking screw openings 522 formed in the end portion 519 can include an underside counterbore 526 formed in the underside or bone-facing surface 502 thereof. For example, as shown, the two most distal locking screw openings 522 formed in the shaft portion 515 of the periprosthetic trochanteric hook bone fixation plate 500 can include an underside counterbore, but it is contemplated that more or fewer locking screw openings can be counterbored on the underside or bone-facing surface. In use, by providing a counterbore in the underside of the locking screw openings formed in the distal end portion of the plate, the underside counterbore locking screw openings can be used in combination with an instrument to grab and compress a fracture.

[0132] The shaft portion of the periprosthetic trochanteric hook bone fixation plate 500 can also include a plurality of k-wire openings 528 for enabling a k-wire to pass therethrough. As shown, additionally and / or alternatively, according to another aspect or feature of the present disclosure, an initial k-wire opening 528 can be positioned between the two most distal locking screw openings 522. Additionally, the shaft portion 515 can include a plurality of additional k-wire openings 528 formed therein. In use, the plurality of k-wire openings 528 allow the surgeon to temporarily hold the bone fixation plate 500 to the patient's bone after they have reduced a fracture.

[0133] As generally shown, and as will be appreciated by one of ordinary skill in the art, the number of undercuts, variable angle openings, locking screw openings, etc. will vary between various bone fixation plates depending on the length of the plate.

[0134] The foregoing description has broad application. Thus, the discussion of any embodiment is meant only to be illustrative of that description, and is not intended to suggest that the scope of the disclosure (including claims) is limited to these example embodiments. In other words, although illustrative embodiments of the present disclosure have been described in detail herein, with reference to the accompanying drawings, it is to be understood that the inventive concepts are not limited to the embodiments discussed herein, but instead include any alternatives, modifications, omissions, combinations, sub-combinations, and equivalents. In addition, it is intended that changes in details of the described embodiments, including in substitution, addition or deletion of elements therefrom, can be made by those skilled in the art, without departing from the spirit of the present disclosure and that the present disclosure is intended to cover such changes if they fall within the scope of the claims.

[0135] As used herein, the term "one" or "an" entity means one or more of that entity. As such, the terms "one," "an," and "at least one" are used interchangeably herein. The use of "including," "containing," or "having" and variations thereof herein are meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Accordingly, "including," "containing," or "having" and variations thereof are open-ended expressions that are meant to encompass items listed there after, as well as equivalents thereof, and additional items. As used herein, the phrases "at least one of," "one or more of," and "and / or" are open-ended expressions that are meant to encompass both a number zero and a number one, as well as greater than one. Accordingly, "at least one of," "one or more of," and "and / or" should be construed in various ways, such as being conjunctive or disjunctive.

[0136] All directional references (e.g., proximal, distal, upper, lower, under, upward, downward, left, right, lateral, longitudinal, front, back, top, bottom, above, below, vertical, horizontal, radial, axial, clockwise, and counterclockwise) are only used for identification purposes to aid the reader’s understanding of the present disclosure, and do not create limitations, particularly as to the position, orientation, or use of the disclosure. Connection references (e.g., attached, coupled, connected, and joined) are to be construed broadly and will be given their ordinary and accustomed meaning to an artisan without undue experimentation to the determine that two elements are directly connected and in fixed relation to each other. Identifying references (e.g., first, second, third, fourth, etc.) are not intended to imply importance or a priority, but are used only to distinguish one feature from another. The drawings are for purposes of illustration only and the dimensions, positions on the drawings and the relative sizes reflected in the attached drawings can vary.

Claims

1. A periprosthetic bone plate, comprising: a head portion; and a shaft portion, an upper surface, a lower surface, a central longitudinal axis, and an outer peripheral surface, the shaft portion further comprising: a plurality of threaded locking screw openings respectively arranged and configured to receive a plurality of locking screws; and a plurality of variable angle fastener openings respectively arranged and configured to receive a plurality of variable angle screws; wherein the plurality of variable angle fastener openings are positioned along the outer peripheral surface of the shaft portion while the plurality of locking screw openings are positioned closer to the central longitudinal axis of the shaft portion; wherein the shaft portion comprises a first region and a second region, the first region positioned adjacent to the head portion of the bone plate, the plurality of variable angle fastener openings formed in the first region arranged and configured such that a first variable angle fastener opening and a second variable angle fastener opening are laterally aligned in a row, the plurality of variable angle fastener openings formed in the second region not laterally aligned; wherein: the plurality of variable angle fastener openings in the first region are arranged and configured such that the first variable angle fastener opening is positioned on one side of the central longitudinal axis and the second variable angle fastener opening is positioned on another side of the central longitudinal axis, and the first variable angle fastener opening and the second variable angle fastener opening are laterally aligned with each other; and the plurality of variable angle fastener openings in the second region are arranged and configured such that individual variable angle fastener openings are positioned in a row, wherein as the variable angle fastener openings of each row move distally along the shaft portion, the variable angle fastener openings of each row alternate on both sides.

2. The periprosthetic bone plate of claim 1, wherein the plurality of threaded locking screw openings comprise a first diameter and the plurality of variable angle fastener openings comprise a second diameter, the first diameter being greater than the second diameter.

3. The periprosthetic bone plate of claim 1 or 2, further comprising a plurality of undercuts formed in the lower surface of the shaft portion of the bone plate, the plurality of undercuts respectively coinciding with the plurality of variable angle fastener openings.

4. The periprosthetic bone plate of claim 1 or 2, wherein an end portion of the shaft portion opposite the head portion comprises a thinning such that the end portion of the shaft portion comprises a tapered cross-sectional area extending from the end portion toward the head portion, the tapered cross-sectional area arranged and configured to enable contouring of the end portion of the shaft portion.

5. The periprosthetic bone plate of claim 4, wherein the plurality of locking screw openings formed in the end portion of the shaft portion comprise a first distal locking screw opening and a second distal locking screw opening, each of the first distal locking screw opening and the second distal locking screw opening comprising a counterbore formed in the lower surface of the bone plate.

6. The periprosthetic bone plate of claim 5, further comprising one or more K-wire openings arranged and configured to enable a K-wire to pass therethrough, at least one of the one or more k-wire openings is positioned between the first distal locking screw opening and the second distal locking screw opening.

7. The periprosthetic bone plate of Claims 1 or 2, wherein the head portion of the periprosthetic bone plate includes a plurality of variable angle fastener openings and is devoid of any locking screw openings.

8. The periprosthetic bone plate of Claims 1 or 2, wherein the head portion of the periprosthetic bone plate includes a plurality of locking screw openings and is devoid of any variable angle fastener openings.

9. The periprosthetic bone plate of Claims 1 or 2, wherein the head portion includes a plurality of locking screw openings and a plurality of variable angle fastener openings, the plurality of locking screw openings being more centrally located than the plurality of variable angle fastener openings.

10. The periprosthetic bone plate of Claims 1 or 2, wherein the head portion is arranged and configured as a loop, the loop being arranged and configured to be positioned adjacent a trochanter of a patient, the looped head portion including a first segment, a second segment spaced apart from the first segment, and a bridging segment coupling the first segment and the second segment, the looped head portion including openings between the first segment and the second segment and the bridging segment, the looped head portion being integrally formed with the shaft portion.

11. The periprosthetic bone plate of Claim 10, wherein the bridging segment includes a plurality of variable angle fastener openings centrally located on the bridging segment.

12. The periprosthetic bone plate of Claim 1, wherein the head portion includes a first hook-shaped member and a second hook-shaped member arranged and configured to engage a trochanter of a patient, the first hook-shaped member and the second hook-shaped member being asymmetric such that the first hook-shaped member is different than the second hook-shaped member, the first hook-shaped member and the second hook-shaped member having one of different sizes, different configurations, or a combination thereof.

13. The periprosthetic bone plate of Claims 1 or 2, wherein the periprosthetic bone plate is selected from one of a proximal femoral plate, a distal femoral plate, a periprosthetic looped plate, a periprosthetic hook-shaped plate, and a humeral plate.

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