Lateral proximal tibial plate with extended arms

Abstract

A method for treating an articular fracture of a tibia using a tibial plate having an extended arm, the method comprising: making an incision to expose the tibia; the joint fracture of the tibia is reduced; the outline of the tibia plate is shaped to be matched with the tibia; preliminarily fixing the tibia plate to the tibia; partially placing a screw into the tibia through a laterally elongated hole in the tibia plate; applying compression between the plate screw hole in the extension arm and the anterior surface of the tibia; and placing an additional plate screw in the tibia through an additional screw hole in the tibia plate.

Description

Cross-references to related applications

[0001] This application claims priority to U.S. Nonprovisional Patent Application No. 18 / 351983, filed July 13, 2023, with the United States Patent and Trademark Office, the contents of which are incorporated herein by reference in their entirety. Technical Field

[0002] The various exemplary embodiments disclosed herein relate to a lateral proximal tibial plate with an extension arm. Background Technology

[0003] Tibial plates have been developed for resolving fractures in the tibia, including those of the proximal tibia. Specifically, treating fractures at the posterolateral bend of the proximal tibia is challenging due to the difficulty in accessing such fractures caused by surrounding soft tissues such as arteries and nerves. A laterally proximal tibial plate may include a head and a body. The body may extend along the tibia and include screw holes, allowing the tibial plate to be attached to the tibia. The head may include a row of screw holes at the end of the tibial plate. When screws are placed in these holes, they can be used to capture, reduce, and secure the bone fragments of the fracture. Summary of the Invention

[0004] The following presents an overview of various exemplary implementation schemes.

[0005] Various embodiments relate to a tibial plate for treating joint fractures of the tibia, the tibial plate comprising: a head having a plurality of screw holes and guide holes, wherein the head is configured to extend along the joint margin of the tibia; a body attached to the head, the body being configured to extend along the length of the tibia, the body including: a plurality of screw holes; a plurality of guide holes; and a lateral elongated hole extending along the width of the body; and an extension arm including screw holes configured to extend along the joint margin of the tibia and engage a posterior portion of the tibia.

[0006] Various implementation schemes involve a body including a longitudinally elongated hole that extends along the length of the body.

[0007] Other embodiments relate to a tibial plate system for treating joint fractures of the tibia, the tibial plate system comprising: a tibial plate including: a head having a plurality of screw holes and guide holes, wherein the head is configured to extend along the articular edge of the tibia; a body attached to the head, the body being configured to extend along the length of the tibia, the body including: a plurality of screw holes; a plurality of guide holes; and a lateral elongated hole extending along the width of the body; and an extension arm including screw holes configured to extend along the articular edge of the tibia. The extension arm extends and engages the posterior portion of the tibia; and a clamping tool configured to engage the screw hole in the extension arm and the anterior surface of the tibia, the clamping tool comprising: a first arm and a second arm connected at a pivot point; a locking mechanism configured to lock the first arm and the second arm in a specific position; a ball joint at the end of the first arm and the second arm configured to engage the screw hole in the extension arm; and a pointed tip extending from the ball joint configured to engage the anterior surface of the tibia.

[0008] Various embodiments are described, wherein the body includes a longitudinally elongated hole that extends along the length of the body.

[0009] Other embodiments relate to a method for treating a joint fracture of the tibia using a tibial plate with an extension arm, the method comprising: making an incision to expose the tibia; reducing the joint fracture of the tibia; initially fixing the tibial plate to the tibia; partially placing a screw into the tibia through a laterally elongated hole in the tibial plate; applying compression between a plate screw hole in the extension arm and an anterior surface of the tibia; and placing an additional plate screw into the tibia through an additional screw hole in the tibial plate.

[0010] Various implementation schemes are described, including shaping the tibial plate to match the tibia.

[0011] Various implementation schemes are described, in which the incision is a lateral S-shaped incision.

[0012] Various implementation schemes are described, in which the incision is an anterolateral incision using an anterolateral approach.

[0013] Various implementation schemes are described, including: creating another cut to open the rear outer access window; and placing an additional screw in a hole near the end of the extension arm.

[0014] Various implementation schemes are described, including: performing arthroplasty to expose the joint before reducing the fracture.

[0015] Various implementation schemes are described, including the application of one of an external fixator or traction device to facilitate joint reduction and visualization.

[0016] Various implementation schemes are described, which utilize Kirschner wires placed through guide holes in the tibial plate to temporarily fix the repositioned bone fragments.

[0017] Various implementation schemes are described, including determining the plate type of the tibial plate before shaping its contour.

[0018] Various implementation schemes are described, in which shaping the tibial plate to match the tibia includes providing preload to the posterolateral bone fragments.

[0019] Various implementation schemes are described, in which initial fixation of the tibial plate includes inserting multiple Kirschner wires through multiple guide holes in the tibial plate.

[0020] Various implementation schemes are described, including the use of either clinical examination or fluoroscopy to confirm the initial fixation of the tibial plate.

[0021] Various implementation schemes are described, including tightening the screw that is partially inserted into the tibia through a lateral elongated hole in the tibial plate after compression is applied.

[0022] Various implementation schemes are described, including clinical examination and fluoroscopic examination before placing the additional plate screws in the tibia to confirm that: the tibial plate is correctly oriented on the tibial platen; the plate trajectory in the proximal plate screw hole is parallel to the joint in the transverse plane; and the alignment of the tibial plate with the axis of the tibia is correct in both anterior and posterior and lateral views.

[0023] Various embodiments are described, wherein the tibial plate includes: a head having a plurality of screw holes and guide holes, wherein the head is configured to extend along the articular edge of the tibia; a body attached to the head, the body being configured to extend along the length of the tibia, the body including: a plurality of screw holes; a plurality of guide holes; and a lateral elongated hole extending along the width of the body; and an extension arm including screw holes configured to extend along the articular edge of the tibia and engage the posterior portion of the tibia.

[0024] Various implementations are described, in which compression is applied between the plate screw hole in the extension arm and the anterior surface of the tibia by using a clamping tool.

[0025] Various embodiments are described, wherein the clamping tool configured to engage the plate screw hole in the extension arm and the anterior surface of the tibia includes: a first arm and a second arm connected at a pivot point; a locking mechanism configured to lock the first arm and the second arm in a specific position; a ball joint at the end of the first arm and the second arm configured to engage the screw hole in the extension arm; and a pointed tip extending from the ball joint configured to engage the anterior surface of the tibia.

[0026] The foregoing has provided a fairly broad overview of the features and technical advantages of the examples according to this disclosure in order to better understand the detailed description that follows. Additional features and advantages will be described below. The disclosed concepts and specific examples can be readily used as the basis for modifying or designing other structures for the same purposes of this disclosure. Such equivalent constructions do not depart from the scope of the appended claims. The characteristics of the concepts disclosed herein (both their organization and manner of operation) and the associated advantages will be better understood from the following description when considered in conjunction with the accompanying drawings. Each drawing in the accompanying drawings is provided for illustrative and descriptive purposes and not as a definition of limitation of the claims. Attached Figure Description

[0027] To gain a more detailed understanding of the foregoing features of this disclosure, reference can be made to various aspects of the brief overview, some of which are illustrated in the accompanying drawings. However, it should be noted that the drawings illustrate only certain typical aspects of this disclosure and should not be construed as limiting the scope of the disclosure, as other equivalent aspects are permissible in this description. The same reference numerals in different drawings may identify the same or similar elements.

[0028] Figures 1A to 1D Examples include perspective views, close-up perspective views, top views, and side views of the tibial plate on the tibia.

[0029] Figures 2A to 2F Examples of perspective view, top view, first side view, second side view, bottom view, and end view of the tibial plate are shown.

[0030] Figures 3A to 3D Perspective, close-up perspective, end view, and side view of a clamping tool applied to the tibia are shown.

[0031] Figure 4A and Figure 4B The perspective and side views of the clamping tool are shown. Detailed Implementation

[0032] Various aspects of this disclosure are described more fully below with reference to the accompanying drawings. However, this disclosure may be embodied in many different forms and should not be construed as limited to any particular structure or function given throughout this disclosure. Rather, these aspects are provided to make this disclosure thorough and complete and to fully communicate the scope of this disclosure to those skilled in the art. Based on the teachings herein, those skilled in the art will understand that the scope of this disclosure is intended to cover any aspect of this disclosure disclosed herein, whether implemented independently of or in combination with any other aspect of this disclosure. For example, an apparatus or method may be implemented using any number of aspects set forth herein. Furthermore, the scope of this disclosure is intended to cover such apparatuses or methods practiced using structures, functionalities, or structures and functionalities other than or different from the aspects of this disclosure set forth herein. It should be understood that any aspect of this disclosure disclosed herein may be embodied by one or more elements of the claims.

[0033] Several aspects of the tibial plate system will now be presented with reference to various devices and techniques. Treating fractures at the posterolateral flank of the proximal tibia is challenging due to the difficulty in accessing such fractures caused by surrounding soft tissues such as arteries and nerves. However, the incidence of these fractures is increasing, for example, due to a rise in scooter accidents in which the distal femoral component of the bent knee impacts the posterior portion of the proximal tibia. Experienced surgeons can use other plates, such as a general-purpose T-plate or an inclined T-plate, which can serve as a direct posterior support over fracture fragments when the patient is treated in the prone position. However, these fractures often occur alongside other proximal tibial fractures, including bicondylar fractures and complex fractures, where treatment of all fractures in the supine position is preferred and provides a more convenient access.

[0034] The novel tibial plate disclosed herein is a laterally proximal tibial plate with a posterolateral extension arm. This plate is designed to be positioned close to the joint margin to allow for the insertion of screws close to the articular surface below the joint surface for the required support. The extension arm is an extension of the proximal screw hole to the posterior corner, including, for example, three to four additional screw holes. The shape of the extension arm allows for adaptability to address variability in tibial morphology between subjects through its external shape, material, and / or thickness. The tibial plate disclosed herein is intended as a flexible and adaptable support plate that provides a valuable complement / improvement in patient care for complex proximal tibial fractures.

[0035] Figures 1A to 1D Examples include perspective views, close-up perspective views, top views, and side views of the tibial plate on the tibia. Figures 1A to 1DThe tibia 2 and fibula 4 are shown, with a tibial plate 6 attached to the tibia 2. The tibial plate 6 includes an extension arm 18 extending from a head 14. The extension arm 18 wraps around a posterior corner to engage the posterior portion of the tibia. The extension arm 18 may extend along the joint margin near the articular surface of the tibia 2.

[0036] Figures 2A to 2F The diagram illustrates a perspective view, top view, first side view, second side view, bottom view, and end view of the tibial plate 6. The tibial plate 6 has a body 16 and a head 14. As shown, the tibial plate 6 is generally L-shaped, but may have a head 14 extending beyond both sides of the body 16, thus creating a T-shape. Extending arms 18 extend from the head 14 and curve rearward toward the head 14 of the tibial plate 6.

[0037] The extension arm 18 may have one or more plate screw holes 10. The plate screw holes 10 can be various types of screw holes, i.e., unthreaded screw holes, threaded screw holes, variable-angle screw holes, locking screw holes, etc. The plate screw holes 10 in the extension arm 18 are... Figures 2A to 2F The example shown is threaded.

[0038] The head 14 of the tibial plate 6 extends along the joint margin of the tibia 2 near the articular surface of the tibia 2. The head 14 is shown as having four plate screw holes 10, but the head 14 may include fewer or more plate screw holes 10. As mentioned above, the plate screw holes 10 can be various types of screw holes, i.e., unthreaded screw holes, threaded screw holes, variable-angle screw holes, locking screw holes, etc.

[0039] The head 14 may also include multiple plate guide holes 12. The plate guide holes 12 can be used to guide the placement of Kirschner wires in the tibia 2. This can be done, for example, during the initial placement of the tibial plate 6. Additionally, the plate guide holes 12 can also be used as suture holes.

[0040] The body 16 is generally located away from the head 14 and extends along the length of the tibia 2. The body 16 may include various types of holes. A plate guide hole 12 may be included near the tip of the body 16 away from the head 14. This can be used to assist in securing the tibial plate 6 during initial placement. The body 16 may include any number (including zero) of plate screw holes 10. Additionally, the body 16 may include combination screw holes 24. Combination screw holes 24 receive both standard screws and locking screws. The number and location of combination screw holes 24 may vary depending on the specific clinical need to be addressed. Combination screw holes 24 provide the flexibility to secure the tibial plate 6 to the tibia 2 using either standard screws or threaded screws. The body 16 may include a longitudinally elongated hole 22, which is a hole extending along the length of the body 16 and therefore along the length of the tibia 2. This longitudinally elongated hole 22 allows for a degree of flexibility and adjustment when securing the tibial plate 6 to the tibia 2. Plate screws 8 may be placed in the longitudinally elongated hole 22 but not fully tightened. This helps to initially secure the tibial plate 6 to the tibia 2. Because the plate screws 8 are not fully tightened, the tibial plate 6 can move along the longitudinal elongated hole 22 to allow adjustment of the tibial plate 6's positioning on the tibia 2. When the tibial plate 6 is in its final position, the plate screws 8 in the longitudinal elongated hole 22 can be tightened to help secure and fasten the tibial plate 6.

[0041] The body 16 also includes a lateral elongated hole 20. This lateral elongated hole 20 is an extension across the width of the body 16, thus being laterally elongated. After the cortical screw has been pre-placed in the lateral elongated hole 20 during initial plate positioning, this lateral elongated hole 20 can be used during surgery to generate the desired anterior-posterior compression of the posterolateral fragment to the tibia. Thus, the tibial plate 6 can slide anteriorly beneath the cortical screw. After the plate screw 8 has been placed in the lateral elongated hole 20, a reduction force can be applied to the tibia to reduce the fracture. This reduction can be performed using various known techniques. One way to reduce the fracture is by using a clamping tool 100, which will be further described below. Once the fracture is reduced and compressed, additional screws can be placed in the other plate screw holes 10 in the head 14 to secure the reduced fracture. Once the fracture is reduced, the plate screw holes 10 in the lateral elongated hole 20 can be tightened.

[0042] Figures 3A to 3D Examples of the clamping tool applied to the tibia are shown in perspective, close-up perspective, end view, and side view. The clamping tool 100 can be applied to a tibia fracture by engaging one of the plate screw holes 10 in the extension arm 18 and the tibia 2 opposite to the extension arm 18. Additionally, the clamping tool 100 can bend the extension arm 18 to conform to the articular margin of the tibia 2.

[0043] Figure 4Aand Figure 4B Perspective and side views of a clamping tool 100 are illustrated. The clamping tool 100 includes two arms 102 connected at a pivoting fastener 116 that allows the arms 102 to pivot. One arm 102 includes a slotted protrusion 108 having a slot for receiving a screw 104. The end of the screw 104 is attached to the other arm 102. A nut 106 is on the screw 104 and can be tightened to engage the slotted protrusion 108, thereby retaining the clamping tool 100 clamped to the tibia 2. An extended head 104, an extended body 106, and an interface surface 108 act as a locking mechanism to lock the clamping tool in a specific position. The screw 104 can be unscrewed from the slotted protrusion 108 to release the clamping tool 100. The arm 102 may include a handle 114 that allows a user to hold and apply the clamping tool 100.

[0044] The ends of arms 102 are curved inward toward each other and have a pointed tip 112 for engaging the tibia 2. The ends are shown as symmetrical, but they can also be asymmetrical and have other shapes including multiple bends. Additionally, a spherical interface 110 is located at the end of arm 102. The spherical interface 110 is configured to engage the plate screw hole 10 in the extension arm 18 of the tibial plate 6. The spherical shape of the spherical interface 110 allows it to be easily placed in the plate screw hole even when the plate screw hole 10 is not visible. The pointed tip 112 extends from the spherical interface 110 to clamp the tibia 2. In use, one spherical interface 110 on the first arm 102 engages the plate screw hole 10 in the extension arm 18, and the pointed tip 112 on the second arm 102 engages the tibia 2 on the side opposite the extension arm 18. The surgeon can apply a reduction force to the fracture to achieve reduction. Additionally, this force can cause the extension arm 18 to bend in order to conform to the joint edge of the tibia 2.

[0045] The method of using the tibial plate 6 and clamping tool 100 will now be described. First, the surgeon can make an incision to open the tibia 2, thereby applying the tibial plate 6. A lateral “S” incision can be used when there is a simple joint fracture or an extra-articular fracture. In the case of a complex intra-articular fracture, an anterolateral approach is used to form an anterolateral incision. Next, arthroplasty is performed to expose the joint for reduction. If necessary, the incision can be extended to adequately expose the joint for reduction and anatomical fixation. Regardless of the surgical incision used, care should be taken to minimize soft tissue dissection.

[0046] The next step involves reducing the articular surface of the tibia 2. Note that applying an external fixator or traction device before reduction can facilitate joint reduction and visualization. The fracture fragments are reduced, and image enhancement and direct visualization are used, if possible, to confirm the reduction. After reduction, the fragments can be temporarily fixed using individual Kirschner wires. The individual Kirschner wires can be positioned flush with the lateral platen cortex to prevent interference with plate insertion. Plate guide holes 12 are also provided on the tibial plate 6 to help maintain temporary reduction and establish temporary plate position.

[0047] Next, the surgeon determines the type of plate to be used to treat the fracture. It's important to note that the fractured bone may be widened, leading to the identification of the wrong plate type. In such cases, X-ray images of the other limb can be used for comparison and planning.

[0048] Next, the tibial plate 6 and its extension arm 18 are contoured as needed to match the specific tibia 2 to the fracture. The tibial plate 6 with the extension arm 18 is anatomically pre-contoured, but the extension arm 18 may need to be contoured to achieve some preloading of the posterolateral bone fragment.

[0049] The surgeon then inserts a Kirschner wire through the plate guide hole 12 in the plate head to initially fix the tibial plate 6 to the tibia 2. Prior to this procedure, the surgeon confirms the placement of the tibial plate 6 through clinical examination and fluoroscopy, and readjusts the position of the tibial plate 6 if necessary.

[0050] Next, the tibial plate 6 is initially secured to the anterior side of the lateral elongated hole 20 in the neck of the tibial plate 6 using a screw (such as a cortical screw). A drill bit is then inserted into a universal drill guide. In this example, the drill bit can be 2.5 mm, but other sizes can also be used. The drill bit is then advanced until it reaches the desired depth. The drill bit and drill guide are then removed. At this point, the surgeon uses a depth gauge to measure the length of the plate screw 8 to use or read the calibrated drill bit. The surgeon then inserts the plate screw 8 of the appropriate length into the drilled hole. This can be, for example, a 3.5 mm cortical screw, but other lengths and types of screws can also be used.

[0051] Before final tightening, the surgeon uses a clamping tool 100 to apply compression between the plate screw hole 10 in the extension arm 18 (e.g., the plate screw hole 10 could be a plate screw hole 10 at the end of the extension arm 18) and the anterior surface of the tibia 2. The inserted plate screw 8 is then tightened to maintain the compression.

[0052] After applying compression using clamping tool 100 to the posterolateral bone fragment, this compression must be maintained using a screw plate fixation system. One way to maintain this compression is to insert a cortical screw into the first hole in the extension arm along a trajectory from posterolateral to anteromedial. This will push the extension arm toward the fragment. The cortical screw can be angled distally so that its trajectory does not collide with a lateral raft screw positioned below the articular surface.

[0053] For final tightening, the screwdriver shaft can be assembled with the handle for manual tightening of the screws. Before proceeding, clinical examination and fluoroscopy are used to confirm that: the plate is correctly oriented on the tibial plateau; the trajectory of the plate screw 8 in the proximal plate screw hole 10 is parallel to the joint in the transverse plane (this may vary slightly based on individual anatomy and any bending that occurs in the tibial plate 6 during tightening of the plate screw 8); and the alignment of the plate with the axis of the tibia is correct in both the anterior-posterior (AP) and lateral views.

[0054] The Kirschner wires inserted for initial fixation can be removed. It is important to note that proper positioning of the tibial plate 6 is crucial for successful treatment of tibial fractures. Positioning the tibial plate 6 too distally does not provide sufficient raft support to the articular surface, while positioning it too proximally may damage the joint area with proximal screws. To avoid screw collisions between the plate screws 8 in the extension arm 18 and the plate screw holes 8 in the head (i.e., the plate screw holes 10 at the end of the head 14 of the tibial plate 6), a long drill guide can be inserted to check the trajectory.

[0055] Finally, the plate screws 8 are inserted into the plate screw holes 10 in the proximal raft row (i.e., the plate screw holes 10 at the end of the head 14 of the tibial plate 6). These screws can be 3.5 mm variable-angle locking screws, but other screw sizes and types can also be used. The plate screw holes 10 are then positioned in the axis of the tibial plate 6. These screws can be 3.5 mm cortical screws, but other sizes and types of screws can also be used.

[0056] Optionally, a cut can be made to open an additional rear-outer access window to place a screw in a hole at the end of the extension arm.

[0057] Tibial Plate 6 is designed as a flexible and adaptable support plate that provides a valuable supplement / improvement in patient care for complex proximal tibial fractures.

[0058] The foregoing disclosure provides explanations and descriptions, but is not intended to be exhaustive, nor to limit the aspects to the precise form disclosed. Modifications and variations can be made based on the foregoing disclosure, or modifications and variations can be derived from the practices of the various parties involved.

[0059] Unless otherwise stated, terms such as “first” and “second” are used to arbitrarily distinguish the elements described by such terms. Therefore, these terms are not necessarily intended to indicate the temporal or other priority of such elements.

[0060] Those skilled in the art will understand that any block diagrams herein represent conceptual diagrams of illustrative hardware that embody the principles of various aspects.

[0061] Although each implementation scheme has been described above in terms of its structural arrangement, it should be understood that the related methods using the above implementation schemes are also covered.

[0062] Although specific combinations of features are described in the claims and / or disclosed in the specification, these combinations are not intended to limit the disclosure of the aspects. In fact, many of these features can be combined in ways not specifically described in the claims and / or not disclosed in the specification. Although each dependent claim listed below may be directly subordinated to only one claim, the disclosure of the aspects includes combinations of each dependent claim with each other claim in the claim set. The phrase “at least one of” in the list of items refers to any combination of those items, including single members. As an example, “at least one of a, b, or c” is intended to cover a, b, c, ab, ac, bc, and abc, as well as any combination with multiple identical elements (e.g., aa, aaa, aab, aac, abb, acc, bb, bbb, bbc, cc, and ccc, or any other ordering of a, b, and c).

[0063] Unless explicitly stated otherwise, no element, action, or instruction used herein should be construed as essential or necessary. Furthermore, as used herein, the articles “a” and “an” are intended to include one or more items and may be used interchangeably with “one or more.” Additionally, as used herein, the terms “set” and “group” are intended to include one or more items (e.g., related items, unrelated items, a combination of related and unrelated items, etc.) and may be used interchangeably with “one or more.” Where only one item is intended to be described, the phrase “only one” or similar language is used. Also, as used herein, the terms “have,” “possess,” “contain,” etc., are intended as open-ended terms. Furthermore, unless explicitly stated otherwise, the phrase “based on” is intended to mean “at least partially based on.”

Claims

1. A tibial plate for treating joint fractures of the tibia, comprising: A head having multiple screw holes and guide holes, wherein the head is configured to extend along the joint edge of the tibia; A body, attached to the head, configured to extend along the length of the tibia, the body comprising: Multiple screw holes; Multiple guide holes; and Laterally elongated apertures, the laterally elongated apertures extending along the width of the body; and An extension arm, the extension arm including a screw hole configured to extend along the joint edge of the tibia and engage the posterior portion of the tibia.

2. The tibial plate of claim 1, wherein the body includes a longitudinally elongated hole that extends along the length of the body.

3. A tibial plate system for treating joint fractures of the tibia, comprising: Tibial plate, the tibial plate comprising: A head having multiple screw holes and guide holes, wherein the head is configured to extend along the joint edge of the tibia; A body, attached to the head, configured to extend along the length of the tibia, the body comprising: Multiple screw holes; Multiple guide holes; and Laterally elongated holes, which extend along the width of the body; An extension arm, the extension arm including a screw hole configured to extend along the joint edge of the tibia and engage the posterior portion of the tibia; and A clamping tool configured to engage the screw hole in the extension arm and the anterior surface of the tibia, the clamping tool comprising: The first arm and the second arm are connected at the pivot point; A locking mechanism configured to lock the first arm and the second arm in a specific position; A spherical interface, located at the ends of the first and second arms, configured to engage the screw holes in the extension arms; and The tip, which is sharp, extends from the spherical interface and is configured to engage the anterior surface of the tibia.

4. The tibial plate system of claim 3, wherein the body includes a longitudinally elongated hole that extends along the length of the body.

5. A method for treating a joint fracture of the tibia using a tibial plate with an extension arm, the method comprising: Make an incision to expose the tibia; To reduce the fracture of the joint of the tibia; This allows the tibial plate to be initially fixed to the tibia; The screw is partially inserted into the tibia through a lateral, elongated hole in the tibial plate; Compression is applied between the plate screw hole in the extension arm and the anterior surface of the tibia; as well as The additional plate screw is placed in the tibia through the additional screw hole in the tibial plate.

6. The method according to claim 5, further comprising: The tibial plate is shaped to match the tibia.

7. The method of claim 5, wherein the incision is a lateral S-incision.

8. The method of claim 5, wherein the incision is an anterolateral incision using an anterolateral approach.

9. The method according to claim 5, further comprising: Create another incision to open the posterolateral access window; as well as Place the additional screw in the hole near the end of the extension arm.

10. The method of claim 5, further comprising: Before reducing the fractured joint, an arthroplasty is performed to expose the joint.

11. The method of claim 5, further comprising: Apply one of the external fixators or traction devices to facilitate joint reduction and visualization.

12. The method of claim 5, wherein the repositioned bone fragment is temporarily fixed using a Kirschner wire placed through a guide hole in the tibial plate.

13. The method of claim 5, further comprising: Before shaping the contour of the tibial plate, the plate type of the tibial plate is determined.

14. The method of claim 5, wherein shaping the tibial plate to match the tibia comprises: Provide preload to the posterolateral bone fragments.

15. The method of claim 5, wherein preliminary fixation of the tibial plate comprises: Multiple Kirschner wires are inserted through multiple guide holes in the tibial plate.

16. The method of claim 5, further comprising: The initial fixation of the tibial plate was confirmed using either clinical examination or fluoroscopy.

17. The method of claim 5, further comprising: After compression is applied, the screw, which is partially inserted into the tibia through a lateral elongated hole in the tibial plate, is tightened.

18. The method of claim 5, further comprising: A clinical examination and fluoroscopic examination were performed before placing the additional plate screws in the tibia to confirm that the tibial plate was correctly oriented on the tibial plateau. The plate trajectory in the proximal plate screw holes is parallel to the joint in the transverse plane; and in both the anterior and posterior views and the side view, the alignment of the tibial plate with the axis of the tibia is correct.

19. The method of claim 5, wherein the tibial plate comprises: A head having multiple screw holes and guide holes, wherein the head is configured to extend along the joint edge of the tibia; A body, attached to the head, configured to extend along the length of the tibia, the body comprising: Multiple screw holes; Multiple guide holes; and The lateral elongated aperture extends along the width of the body; and The extension arm includes a screw hole configured to extend along the joint edge of the tibia and engage the posterior portion of the tibia.

20. The method of claim 18, wherein the compression is applied between the plate screw hole in the extension arm and the anterior surface of the tibia by using a clamping tool.

21. The method of claim 20, wherein the clamping tool configured to engage the plate screw hole in the extension arm and the anterior surface of the tibia comprises: The first arm and the second arm are connected at the pivot point; A locking mechanism configured to lock the first arm and the second arm in a specific position; A spherical interface is located at the ends of the first arm and the second arm, and the spherical interface is configured to engage the screw holes in the extension arm; and The tip, which is sharp, extends from the spherical interface and is configured to engage the anterior surface of the tibia.

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