Fracture plating system

Abstract

To provide a device, a system and a method for promoting healing and stability for bone fractures.SOLUTION: A bone stabilization system may include a variety trauma and / or reconstruction plates and one or more bone fasteners configured to secure the plate to bone. The bone plates may be used for the fixation of fractures and fragments in forefoot, midfoot, and hindfoot applications. The foot fracture plating may be used to create a rigid construct using permanent fixation to promote primary healing and stability.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present disclosure relates to surgical devices and, more particularly, to stabilization systems for trauma applications. [Background technology]

[0002] Trauma plates are orthopedic devices used to stabilize and fix fractures in bones. For fractures of the foot, specialized plates can be used to address fractures and bone fragmentation in the foot to ensure proper alignment and promote healing. The foot and ankle have over 25 bones and 33 joints. The foot can be divided into three main regions: the forefoot, midfoot, and hindfoot. These regions work together with the ankle to provide support, balance, and mobility to the body. The forefoot region can include fractures in the metatarsals and phalanges. The midfoot region can include fractures in the tarsal bones, including the navicular, cuboid, and cuneiform bones. The hindfoot region can include fractures in the tarsal bones, including the talus and calcaneus (heel bone). For complex fractures or bone fractures with complex three-dimensional geometries, repair plates can be used for correction and bone stabilization. A variety of plates can be used to help treat fractures and broken segments in different parts of the body, however, there remains a need for improved plate styles and plating systems that can treat a wide variety of fracture patterns and accommodate multiple deformities. Summary of the Invention

[0003] To meet this and other needs, and with its objectives in mind, the present application provides devices, systems, and methods for promoting healing and stabilization of fractures. Specifically, plates can include a comprehensive offering of plate styles capable of treating numerous fracture patterns. Plates can be used for both final permanent fixation as well as temporary or supplemental fixation according to other systems. Multiple fracture patterns can be accommodated with specific plate styles. Plates can be cut and contoured to accommodate extreme patient anatomies. A wide range of screw and plate sizes can accommodate multiple anatomies and anatomical regions.

[0004] According to one embodiment, a bone stabilization system includes a collection of bone plates configured for stabilizing fractures, dislocations, or repairing deformities. Each bone plate is configured to be positioned against the exterior surface of a bone in the forefoot, midfoot, and / or hindfoot. The system includes one or more fasteners, such as locking and / or non-locking bone screws, that a surgeon can select based on their preference for a particular anatomical case. Locking fasteners can connect to the plate and bone, thereby locking the plate to the bone. Non-locking fasteners can dynamically compress the bone, creating interfragmentary and / or articular compression. The plate can include one or more K-wire holes or slots to help guide and temporarily hold the plate in place.

[0005] According to one embodiment, the bone stabilization plate includes a fifth metatarsal hook plate having a body extending from a first proximal end configured to rest on the tuberosity of the fifth metatarsal to a second distal end configured to rest on the body of the fifth metatarsal. The plate includes a curved proximal hook configured to grip or anchor to the tuberosity of the fifth metatarsal. The hook may terminate in two parallel curved prongs with sharply pointed tips. Alternatively, the bone stabilization plate is a fifth metatarsal tab plate in which the hook is replaced with a curved tab.

[0006] According to one embodiment, the bone stabilization plate includes first and second combined Lisfranc tarsometatarsal plates. The combined plate has a bifurcated body extending from a first proximal end configured to rest on the medial and intermediate cuneiform bones to a second distal end configured to rest on the bodies of the first and second metatarsals, respectively. The combined plate includes first and second legs connected by a proximal crossbeam and a bridge linking the two legs of the plate together for added strength. Alternatively, the bone stabilization plate is a combined second and third combined Lisfranc tarsometatarsal plate with proximal ends configured to rest on the intermediate and lateral cuneiform bones and distal ends configured to rest on the second and third metatarsals, respectively.

[0007] According to one embodiment, the bone stabilization plate includes a flower plate configured to be positioned on the dorsal side of the cuboid bone. The flower plate may have petal-like or protrusion-like extensions radiating outward from a central circular region. Each protrusion and the central region may define a multiaxial hole for receiving a respective locking fastener, thereby securing the flower plate to the bone.

[0008] According to one embodiment, the bone stabilization plate includes, for example, a utility plate having an H-shaped body with one end positioned on the navicular bone and the other end positioned on the cuneiform bone. The H-shape may be formed by four protrusions or tabs that define the four corners of the H-shape. Dynamic compression slots may be aligned along a central axis to provide compression to bone fragments and / or joints. Alternatively, the H-plate may be used to fix or fuse the navicular-cuneiform joint, talo-navicular joint, calcaneocuboid joint, tarso-metatarsal joint, or other joints or fractures.

[0009] According to one embodiment, the bone stabilization plate includes a sinus tarsi wave plate, a sinus tarsi lingual plate, or a rafting circumferential plate. The plate may have an elongated body having a top surface and an opposing bottom surface configured to contact the bone. The elongated body may have a first section, a main body, and a second section. The elongated body defines a plurality of screw holes therethrough. The first section is offset from the main body by two tabs. The main body includes a three-hole polyaxial cluster with the axes of each hole positioned at the vertices of an equilateral triangle. The second section includes a series of polyaxial holes that follow a wave pattern.

[0010] The bone stabilization plate may include one or more of the following features. The plate may be contoured to lie laterally on the calcaneus below the talus. The two tabs may be angled inward toward each other toward the main body. The elongated body may define K-wire holes having a diameter smaller than the diameter of each of the screw holes. The elongated body may include a posterior extension including a linear continuation of the second section. The posterior extension may include a linear arrangement of polyaxial holes. The elongated body may include a plantar offset extension extending from the second section. The plantar offset extension may include a second linear continuation of the second section angled relative to the posterior extension. The plantar offset extension may include a solid linear body terminating in a three-hole cluster. The plantar offset extension may be connected to the posterior extension by a cross member. The main body may be connected to the plantar offset extension by the posterior extension.

[0011] According to one embodiment, the bone stabilization plate may include a pericalcaneal plate. The plate includes a body having a top surface and an opposing bottom surface configured to contact bone. The body has a plurality of rings defining screw holes therethrough. The rings are connected together via struts forming a lattice structure with one or more through-spaces remaining between the connections. The periphery of the rings may be connected together with perimeter struts and one or more medial rings, which may provide cross-bracing for the plate. The plate may include, for example, a cuboid plate, a navicular plate, or a calcaneal plate.

[0012] The bone stabilization plate may include one or more of the following features: The periphery of the rings and peripheral struts may be aligned with the calcaneus; Each ring may be connected to another ring with one strut; The medial ring may be connected to two or more peripheral rings; The bottom of the plate may define a series of peripheral rings and peripheral struts arranged in a straight line; One end of the plate may form a square shape, and the opposite end of the plate may form a rounded shape that is larger than the square shape.

[0013] According to one embodiment, a bone system includes a bone plate and a plurality of bone fasteners. The bone plate has a top surface and an opposing bottom surface configured to contact bone. The bone plate defines a plurality of polyaxial screw holes therethrough. The screw holes include a three-hole polyaxial cluster with axes of each hole positioned at the vertices of an equilateral triangle. The plurality of bone fasteners are configured to lock within the polyaxial screw holes.

[0014] The bone stabilization system may include one or more of the following features: The bone plate may define a compression slot configured to receive a non-locking fastener to apply compression; The bone plate may define a K-wire slot configured to achieve further compression with a K-wire; The bone plate may include one or more markings to indicate the location of the joint.

[0015] According to one embodiment, the bone stabilization plate comprises a talar T-plate contoured to lie laterally on the neck of the talus. The talar T-plate may have a body having a substantially T-shaped profile with elongated posterior legs and a transverse anterior cross-sectional portion. Alternatively, the plate may comprise an L-plate with one wing or extension of the cross section removed.

[0016] According to one embodiment, the bone stabilization plate includes a talar butterfly plate contoured to rest laterally on the neck of the talus. The talar butterfly plate may have a symmetrical butterfly-like shape with opposing wings. The wings may include protrusions that define each polyaxial hole. Alternatively, a larger talar butterfly plate may have wings or protrusions that extend into additional holes for fixation.

[0017] According to one embodiment, the bone stabilization plate includes a metatarsophalangeal (MTP) plate contoured to rest on the dorsal aspect of the first metatarsophalangeal (MTP) joint. The plate may have an elongated body extending from a first end to a second end along a central longitudinal axis. The plate includes a straight bridge section configured to extend over the MTP joint. Compression slots and K-wire slots may be aligned along the central longitudinal axis to apply compression to the bone fragments and / or joint. Alternatively, the plate is a narrow MTP plate with fewer distal screw holes for a lower profile on the phalanges.

[0018] According to one embodiment, the bone stabilization plate includes a lapidus plate contoured to rest on the medial aspect of the first tarsometatarsal (TMT) joint. The plate may be angled with a bridge section configured to span the joint. The lapidus plate may include four polyaxial fixation holes—two for the metatarsals and two for the cuneiform bones—and one compression slot on the lateral side of the metatarsal.

[0019] According to one embodiment, the bone stabilization plate includes a tarsometatarsal (TMT) plate extending from a first proximal end configured to rest on the cuneiform bone to a second distal end configured to rest on the metatarsal bone. The distal section of the plate may include two or four polyaxial holes with compression slots aligned along a central longitudinal axis to provide compression to the joint.

[0020] According to one embodiment, the bone stabilization plate includes a navicular-cuneiform (NC) plate configured to stabilize the medial and central cuneiforms relative to the navicular and allowing interfragmentary screws to be positioned through recessed holes in the plate, which may be positioned along the central axis of the plate, but the hole axes may be angled to allow lag screws to be inserted distally.

[0021] According to one embodiment, a bone stabilization plate includes a medial column plate configured to bridge across the metatarsus over the talus, navicular, medial cuneiform, and first metatarsal. The plate can have an elongated body with four sections extending along a central longitudinal axis: a proximal talus section, a navicular section, a cuneiform section, and a distal metatarsal section. Each section includes a cluster of polyaxial holes for receiving a locking bone fastener in the respective bone. A pair of K-wire slots can be aligned along the central longitudinal axis to provide compression to the bone fragments and / or joint.

[0022] According to one embodiment, the bone stabilization plate includes an Evans osteotomy wedge plate configured to accommodate a calcaneal osteotomy. The plate may have a symmetrical dogbone-like shape, and the wedge may include angled flats or surfaces configured to spread the bone portions at an angle, for example, for lateral column lengthening in flatfoot deformities.

[0023] According to one embodiment, the bone stabilization plate includes a cotton aperture wedge plate configured to accommodate a medial wedge osteotomy. The plate may have a symmetrical shape with four lobes, and the wedge includes angled planes or surfaces configured to spread the bone at an angle, for example, to help create an arch in the foot.

[0024] According to one embodiment, the bone stabilization plate includes a calcaneal slide plate configured to secure a calcaneal osteotomy. The plate can include a plate portion having a protrusion defining a polyaxial hole and a wedge portion defining a polyaxial hole, thereby allowing two polyaxial fixators to be placed on either side of the osteotomy.

[0025] According to one embodiment, a method for stabilizing a fracture includes one or more of the following steps, in any suitable order: (1) positioning a bone plate against an exterior surface of one or more bones of the foot, (2) optionally applying compression to bone fragments and / or joints via compression slots or K-wire slots, and (3) securing the bone plate to the bones by attaching a first set of fasteners through the bone plate to one bone or bone fragments and a second set of fasteners through the bone plate to another bone or bone fragments. The plate may be configured to extend across one or more fractures and / or joints in the foot.

[0026] Also provided are kits for the stabilization systems that include bone plates of various types and sizes, fasteners of various types and sizes, including locking fasteners, non-locking fasteners, compression fasteners, polyaxial fasteners, fixed-angle fasteners, or any other suitable fasteners, drill guides, K-wires, sutures, and other components for their placement. [Brief explanation of the drawings]

[0027] A more complete understanding of the present invention and its attendant advantages and features will be more readily appreciated by reference to the following detailed description when considered in conjunction with the accompanying drawings. [Figure 1] 1 shows a collection of plate styles configured for fixation of fractures and bone fragments in the forefoot, midfoot, and hindfoot. [Figure 2] 10A-10C illustrate a series of screw styles configured to secure the fracture plate to the bone. [Figure 3] 1 illustrates some hole types available in one or more fracture plates. [Figure 4A] 1 depicts a fifth metatarsal hook plate positioned on the lateral aspect of the fifth metatarsal, according to one embodiment. [Figure 4B] 1 depicts a fifth metatarsal hook plate positioned on the lateral aspect of the fifth metatarsal, according to one embodiment. [Figure 4C] 1 depicts a fifth metatarsal hook plate positioned on the lateral aspect of the fifth metatarsal, according to one embodiment. [Figure 4D] 1 depicts a fifth metatarsal hook plate positioned on the lateral aspect of the fifth metatarsal, according to one embodiment. [Figure 5A] 1 depicts a fifth metatarsal tab plate positioned on the lateral surface of the fifth metatarsal, according to one embodiment. [Figure 5B] 1 depicts a fifth metatarsal tab plate positioned on the lateral surface of the fifth metatarsal, according to one embodiment. [Figure 5C] 1 depicts a fifth metatarsal tab plate positioned on the lateral surface of the fifth metatarsal, according to one embodiment. [Figure 6A] 1 depicts the combined Lisfranc first and second tarsometatarsal plates located on the dorsal aspects of the medial cuneiform, intermediate cuneiform, and first and second metatarsals, respectively, according to one embodiment. [Figure 6B] 1 depicts the combined Lisfranc first and second tarsometatarsal plates located on the dorsal aspects of the medial cuneiform, intermediate cuneiform, and first and second metatarsals, respectively, according to one embodiment. [Figure 6C] 1 depicts the combined Lisfranc first and second tarsometatarsal plates located on the dorsal aspects of the medial cuneiform, intermediate cuneiform, and first and second metatarsals, respectively, according to one embodiment. [Figure 6D] 1 depicts the combined Lisfranc first and second tarsometatarsal plates located on the dorsal aspects of the medial cuneiform, intermediate cuneiform, and first and second metatarsals, respectively, according to one embodiment. [Figure 6E]1 depicts the combined Lisfranc first and second tarsometatarsal plates located on the dorsal aspects of the medial cuneiform, intermediate cuneiform, and first and second metatarsals, respectively, according to one embodiment. [Figure 7A] 1 depicts the combined Lisfranc second and third tarsometatarsal plates located on the dorsal aspects of the middle cuneiform, lateral cuneiform, and second and third metatarsals, respectively, according to one embodiment. [Figure 7B] 1 depicts the combined Lisfranc second and third tarsometatarsal plates located on the dorsal aspects of the middle cuneiform, lateral cuneiform, and second and third metatarsals, respectively, according to one embodiment. [Figure 7C] 1 depicts the combined Lisfranc second and third tarsometatarsal plates located on the dorsal aspects of the middle cuneiform, lateral cuneiform, and second and third metatarsals, respectively, according to one embodiment. [Figure 7D] 1 depicts the combined Lisfranc second and third tarsometatarsal plates located on the dorsal aspects of the middle cuneiform, lateral cuneiform, and second and third metatarsals, respectively, according to one embodiment. [Figure 8A] 1 depicts a cuboid plate located on the dorsal aspect of the cuboid bone, according to one embodiment. [Figure 8B] 1 depicts a cuboid plate located on the dorsal aspect of the cuboid bone, according to one embodiment. [Figure 9A] 1 depicts a flower plate placed on the dorsal aspect of the cuboid bone, according to one embodiment. [Figure 9B] 1 depicts a flower plate placed on the dorsal aspect of the cuboid bone, according to one embodiment. [Figure 10A] 1 depicts a dorsally located navicular plate having a plantar bundle and optional plantar extension that wraps around the plantar portion of the navicular bone, according to one embodiment. [Figure 10B] 1 depicts a dorsally located navicular plate having a plantar bundle and optional plantar extension that wraps around the plantar portion of the navicular bone, according to one embodiment. [Figure 10C]1 depicts a dorsally located navicular plate having a plantar bundle and optional plantar extension that wraps around the plantar portion of the navicular bone, according to one embodiment. [Figure 11A] 1 depicts a utility plate positioned medially above the scapho-cuneiform joint, according to one embodiment. [Figure 11B] 1 depicts a utility plate positioned medially above the scapho-cuneiform joint, according to one embodiment. [Figure 12A] 1 depicts an H-plate positioned laterally above the calcaneocuboid joint, according to one embodiment. [Figure 12B] 1 depicts an H-plate positioned laterally above the calcaneocuboid joint, according to one embodiment. [Figure 13A] 1 depicts a sinus tarsus wave plate positioned laterally on the calcaneus and rafting the subtalar joint, according to one embodiment. [Figure 13B] 1 depicts a sinus tarsus wave plate positioned laterally on the calcaneus and rafting the subtalar joint, according to one embodiment. [Figure 13C] 1 depicts a sinus tarsus wave plate positioned laterally on the calcaneus and rafting the subtalar joint, according to one embodiment. [Figure 14A] 1 depicts a sinus tarsi linguale-type plate positioned laterally on the calcaneus, according to one embodiment. [Figure 14B] 1 depicts a sinus tarsi linguale-type plate positioned laterally on the calcaneus, according to one embodiment. [Figure 14C] 1 depicts a sinus tarsi linguale-type plate positioned laterally on the calcaneus, according to one embodiment. [Figure 14D] 1 depicts a sinus tarsi linguale-type plate positioned laterally on the calcaneus, according to one embodiment. [Figure 15A] 1 depicts a pericalcaneal plate positioned laterally on the calcaneus, with perimeter and mesh screw holes, according to one embodiment. [Figure 15B] 1 depicts a pericalcaneal plate positioned laterally on the calcaneus, with perimeter and mesh screw holes, according to one embodiment. [Figure 16A]1 depicts a rafted perimeter plate positioned laterally on the calcaneus with rafted and perimeter screw hole locations, according to one embodiment. [Figure 16B] 1 depicts a rafted perimeter plate positioned laterally on the calcaneus with rafted and perimeter screw hole locations, according to one embodiment. [Figure 17A] 1 depicts a talar T-plate positioned laterally on the neck of the talus, according to one embodiment. [Figure 17B] 1 depicts a talar T-plate positioned laterally on the neck of the talus, according to one embodiment. [Figure 18A] 1 depicts a talar L-plate positioned laterally on the neck of the talus, according to one embodiment. [Figure 18B] 1 depicts a talar L-plate positioned laterally on the neck of the talus, according to one embodiment. [Figure 19A] 1 depicts a talar butterfly plate positioned laterally on the neck of the talus, according to one embodiment. [Figure 19B] 1 depicts a talar butterfly plate positioned laterally on the neck of the talus, according to one embodiment. [Figure 20] 1 depicts a large talar butterfly plate positioned laterally on the neck of the talus, according to one embodiment. [Figure 21] 1 illustrates a collection of repair plate styles configured for fixation of complex fractures or fractures of foot bones having complex three-dimensional geometries. [Figure 22A] 1 depicts a metatarsophalangeal (MTP) plate positioned on the dorsal aspect of the MTP joint, according to one embodiment. [Figure 22B] 1 depicts a metatarsophalangeal (MTP) plate positioned on the dorsal aspect of the MTP joint, according to one embodiment. [Figure 23A] 1 depicts a narrow metatarsophalangeal (MTP) plate positioned on the dorsal aspect of the MTP joint, according to one embodiment. [Figure 23B] 1 depicts a narrow metatarsophalangeal (MTP) plate positioned on the dorsal aspect of the MTP joint, according to one embodiment. [Figure 24A]1 depicts a lapidus plate located on the medial aspect of the first metatarsal and medial cuneiform joint, according to one embodiment. [Figure 24B] 1 depicts a lapidus plate located on the medial aspect of the first metatarsal and medial cuneiform joint, according to one embodiment. [Figure 25A] 1 depicts a narrow tarsometatarsal (TMT) plate positioned on the dorsal aspect of the second TMT or Lisfranc joint, according to one embodiment. [Figure 25B] 1 depicts a narrow tarsometatarsal (TMT) plate positioned on the dorsal aspect of the second TMT or Lisfranc joint, according to one embodiment. [Figure 26] 1 depicts a scapho-cuneiform (NC) fusion plate configured to be positioned dorsally across the NC joint, according to one embodiment. [Figure 27A] 1 depicts a medial column plate spanning from the medial aspect of the talus to the first metatarsal, according to one embodiment. [Figure 27B] 1 depicts a medial column plate spanning from the medial aspect of the talus to the first metatarsal, according to one embodiment. [Figure 28A] 1 depicts an Evans osteotomy wedge plate positioned on the lateral aspect of the calcaneus over the osteotomy site, according to one embodiment. [Figure 28B] 1 depicts an Evans osteotomy wedge plate positioned on the lateral aspect of the calcaneus over the osteotomy site, according to one embodiment. [Figure 29A] 1 depicts a Cotton aperture wedge plate positioned on the dorsal medial aspect of the medial cuneiform bone, according to one embodiment. [Figure 29B] 1 depicts a Cotton aperture wedge plate positioned on the dorsal medial aspect of the medial cuneiform bone, according to one embodiment. [Figure 30A] 1 depicts a calcaneal slide plate positioned on the lateral aspect of a calcaneal osteotomy site, according to one embodiment. [Figure 30B] 1 depicts a calcaneal slide plate positioned on the lateral aspect of a calcaneal osteotomy site, according to one embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0028] Embodiments of the present disclosure are generally directed to devices, systems, and methods for healing and stabilizing bone fractures. Plates may include a comprehensive offering of plate modalities for stabilizing fractures, dislocations, or repairing deformities. Bone plates may be used to create very rigid constructs with permanent fixation to promote primary healing and stability. Alternatively, plates can also be used as temporary or supplemental fixation.

[0029] A series of trauma and / or repair plates can be used to fix fractures and bone fragments in forefoot, midfoot, and hindfoot applications. Foot fracture plates can be used to address fractures and bone fragments in the foot to ensure proper alignment and promote healing. The foot includes three main anatomical regions: the forefoot, midfoot, and hindfoot.

[0030] The forefoot includes the five toes, also known as phalanges, and the long bones, or metatarsals, that connect them. Several smaller bones together form a single phalange, or toe. Four of the five toes have three phalanges, each connected by two joints. The big toe, or hallux, has two phalanges, one distal and one proximal, with a joint between them called the interphalangeal joint. The big toe articulates with the head of the first metatarsal at the first metatarsophalangeal (MTP) joint, and two muscle tendons lie on the plantar side of the metatarsal head. The phalanges connect to the metatarsals at the ball of the foot. The forefoot balances pressure on the ball of the foot and supports a significant amount of body weight.

[0031] The bones of the midfoot, from medial to lateral, are the first three cuneiform bones, the cuboid, and the crescent-shaped navicular bone behind the cuneiform bones. The navicular articulates with the talus and establishes the basis for the ankle joint, where the tibia, fibula, and foot converge at a hinge junction. The five tarsal bones of the midfoot work together to form the transverse and longitudinal arches, which help absorb shock.

[0032] The hindfoot, the most posterior aspect of the foot, contains three joints that connect the midfoot to the ankle: the subtalar, calcaneus-cuboid, and talonavicular. The calcaneus, also known as the heel bone, is found on the bottom of the foot near the ankle, just below the talus, tibia, and fibula of the lower leg. The calcaneus joins with the talus at the subtalar joint, which allows the foot to rotate.

[0033] 1, there is shown a collection of plate styles 10 configured for fixation of fractures and bone fragments in the forefoot, midfoot, and hindfoot. Seventeen different foot plate styles may be used in the treatment of various fractures of the foot, including: (a) fifth metatarsal hook plate, (b) fifth metatarsal tab plate, (c) combined Lisfranc first and second tarsometatarsal plate, (d) combined Lisfranc second and third tarsometatarsal plate, (e) cuboid plate, (f) flower plate, (g) navicular plate, (h) navicular plate with plantar bundle, (i) utility plate, (j) H plate, (k) sinus tarsi wave plate, (l) sinus tarsi tongue type plate, (m) rafting perimeter plate, (n) talar T plate, (o) talar L plate, (p) talar butterfly plate, and (q) perimeter calcaneal plate.

[0034] Each bone plate 10 is configured to be positioned against the outer surface of a bone and / or joint, for example, of the foot. The bone plates 10 hold bone fragments together across the fracture and / or joint, allowing the bones to heal in proper alignment. These plates 10 may be provided in several variations, for example, in surgical trays, including various types, sizes, and configurations. The tray selection allows the surgeon to select the desired plate during surgery after opening the wound and considering the patient's plating needs. While the collection of plates 10 is generally described with respect to stabilizing the foot, it will be understood that the stabilization system described herein may be used or adapted for use for fixation of other parts or bones, including the femur, tibia, humerus, clavicle, fibula, ulna, radius, bones of the hand, or other suitable bones or joints. The bone plates 10 may be available in various lengths, widths, and styles based on the patient's anatomy and the type of fracture. The system may be adapted to fix small or large bone fragments, single or multiple bone fragments, or otherwise fix one or more fractures or joints.

[0035] Referring now to FIG. 2 , four different screw types 12 are shown that can be used with or without the plate 10 in the treatment of various fractures, including (a) locking screws, (b) non-locking screws, (c) cancellous screws, and (d) speed screws. Each plate 10 can be configured to receive one or more bone fasteners or screws 12. The screws 12 can be configured to pass through the plate 10 and enter the bone, thereby securing the plate 10 to the bone. While screws are illustrated, the fasteners 12 can also include other fasteners or anchors configured to be secured to or engaged with bone, such as nails, spikes, staples, pegs, barbs, hooks, etc. The fasteners 12 can be cannulated so that they can be guided into position over a guidewire or K-wire.

[0036] Each screw 12 may include a head portion configured to engage the plate and a threaded shaft portion configured to engage the bone. The screws 12 may be available in locking and non-locking options. In the case of a locking screw of screw type (a), the head portion may include threads or a textured portion configured to lock the screw 12 to the plate 10. In the case of a non-locking screw of screw type (b), the head portion may be substantially rounded and smooth to allow dynamic compression of the bone. In the case of a cancellous screw of screw type (c), the screw 12 is a non-locking screw designed for insertion into cancellous bone. Cancellous screws may have wider threads than cortical screws to allow better engagement in softer cancellous bone. In the case of a speed screw of screw type (d), the screw may have a sharp self-drilling tip with a narrower shaft diameter designed for rapid insertion. Plate 10 can be configured to accept multiple thread sizes representing the major diameter of the screw threads provided with each screw type (e.g., 2.0 mm, 2.5 mm, 3.0 mm). In some cases, the screws can be hybrid screws, having one major diameter on the threads (e.g., 3.0 mm) but a head size that matches another diameter (e.g., 2.5 mm). This provides the surgeon with a greater selection of screw options to use and can also serve as a bailout option.

[0037] Referring now to FIG. 3 , the plate 10 can include one or more opening or hole types 14, 16, 18, 20. The fastener openings 14, 16 can include cylindrical openings, conical openings, elongated openings, threaded openings, textured openings, non-threaded and / or non-textured openings, etc. The openings 14, 16 extending through the plate 10 are configured to accept locking fasteners, non-locking fasteners, or a combination of both locking and non-locking fasteners, which can dynamically compress the bone and / or attach the plate 10 to the bone. For example, a first opening type can include an elongated opening or dynamic compression slot 14, which allows for static insertion of a non-locking screw 12 into the bone and / or compression along the bone (e.g., between 0.5 and 2 mm, such as 1 mm of compression) through eccentric insertion of the non-locking screw 12. A second opening type can include a polyaxial locking hole 16 having a textured portion configured to engage the head portion of a locking fastener. The locking screw 12 can include threads or textured portions configured to deform and / or engage with the locking hole 16, thereby locking the fastener 12 to the plate 10. A third opening type can include a K-wire hole 18 configured to receive a K-wire guidewire therethrough. A fourth opening type can include an elongated K-wire slot 20 that allows compression by a guidewire or K-wire. Additional details about these and other types of openings are provided in greater detail in U.S. Pat. No. 11,432,857, which is incorporated herein by reference in its entirety for all purposes. The plate 10 can include any suitable number of openings 14, 16, 18, 20 in any suitable configuration. These openings allow the surgeon flexibility for fastener placement based on preference, anatomy, and fracture location. Surgeons may have different opinions regarding the number, location, and type of fasteners 12. The complexity of the fracture location and shape may make it desirable to have as many fastener locations as possible to treat the fracture.

[0038] Bone plate 10 may be made of titanium, stainless steel, cobalt chrome, carbon composite, plastics or polymers such as polyetheretherketone (PEEK), polyethylene, ultra-high molecular weight polyethylene (UHMWPE), resorbable polylactic acid (PLA), polyglycolic acid (PGA), combinations or alloys of such materials, or any other suitable material that is strong enough to be secured to and retain bone and that is also biocompatible enough to be implanted in the body. Similarly, fasteners 12 may be made of titanium, cobalt chrome, cobalt-chromium-molybdenum, stainless steel, tungsten carbide, combinations or alloys of such materials, or other suitable biocompatible materials. While the above list of materials includes many typical materials from which bone plates and bone fasteners are made, it should be understood that bone plates and fasteners made of any suitable material are contemplated.

[0039] 4A-4D, a fifth metatarsal hook plate 100 is shown according to one embodiment. FIG. 4A depicts the anatomy of a foot 4 in which the fifth metatarsal hook plate 100 is contoured to rest on the lateral aspect of the base of the fifth metatarsal. The hook plate 100 has a body extending from a first or proximal end 102 configured to rest on the tuberosity of the fifth metatarsal to a second or distal end 104 configured to rest on the body of the fifth metatarsal. The plate 100 includes a top surface 106 and an opposing bottom surface 108 configured to contact an adjacent bone. The top surface 106 and the bottom surface 108 are connected by bilateral surfaces extending from the first end 102 to the second end 104 of the plate 100. The plate 100 can be separated into three sections: a distal portion 110, a bent portion 112, and a proximal hook 114. Distal portion 110 may have an elongated longitudinal body with a generally flat profile. Bend portion 112 may be angled relative to distal portion 110, and proximal hook 114 may extend from bend portion 112. While one version of plate 100 is shown, it will be understood that any suitable shape and profile of plate 100 may be provided depending on the location and type of fracture to be plated.

[0040] As further highlighted in FIG. 4C , the proximal end 102 of the plate 100 extends into a pronounced curved hook 114 configured to grip or secure to the tuberosity of the fifth metatarsal bone. The proximal hook 114 may define double hook ends that terminate in a pair of separate curved projections 116 with sharp tips or pointed ends 118. The curved projections 116 may be separated from one another by a gap or spacing. The pair of projections 116 may be aligned parallel or otherwise configured. The curved hook 114 and projections 116 may curve downward in an arc or crescent shape such that the pointed end 118 curves back toward the distal end 104. The hook 114 may be used to capture an avulsion fracture or Jones fracture at the base of the fifth metatarsal bone.

[0041] The hook plate 100 may include any suitable number and type of openings 14, 16, 18 in any suitable configuration. In the illustrated embodiment, multiple polyaxial locking holes 16 are positioned along the body of the plate 100. For example, one polyaxial hole 16 may be positioned near the distal end 104 and several polyaxial holes 16 may be positioned toward the proximal end 102. One polyaxial hole 16 may be defined through the curved hook 114 and adjacent to the prong 116. The curvature of the hook 114 allows for different screw insertion orientations. Specifically, the hole axes of the polyaxial holes 16 defined in the hook 114 may be aligned and configured to place the screws 12 intramedullarily through the tunnel of the fifth metatarsal bone. The remaining polyaxial holes 16 may be used to secure the plate 100 to bone. Three K-wire holes 18 are provided along the length of the plate 100. The K-wire holes 18 provide additional fixation points for the plate 100. Driving K-wires through the appropriate holes 18 in the plate 100 allows the plate 100 to be held on the bone while adjacent bone screws 12 can be inserted through the polyaxial holes 16 .

[0042] As best seen in FIG. 4D , the plate 100 may define two dynamic compression slots 14 toward its distal end 104. The dynamic compression slots 14 may be aligned with the central axis of the implant 100 and positioned between opposing K-wire holes 18. The dynamic compression slots 14 of the plate 100 may aid in compression of fifth metatarsal avulsion or Jones fractures. The outer edge of the plate 100 may be scalloped or wavy to follow the hole pattern and minimize potential soft tissue irritation. The fifth metatarsal hook plate 100 may be offered in small and large sizes and left and right configurations. The large plate may feature a slight distal bend to match the curvature of the fifth metatarsal.

[0043] 5A-5C, a fifth metatarsal tab plate 200 is shown, according to one embodiment. The tab plate 200 is similar to the hook plate 100, except that a curved tab 214 replaces the curved hook and prong on the proximal end. FIG. 5A depicts the anatomy of a foot 4 with a fifth metatarsal tab plate 200 having the same contour as the fifth metatarsal hook plate 100, positioned on the base of the lateral surface of the fifth metatarsal. The tab plate 200 extends from a proximal end 202 configured to position on the tuberosity of the fifth metatarsal to a distal end 204 configured to position on the body of the fifth metatarsal. The plate 200 includes a top surface 206 and a bottom surface 208 having openings 14, 16, and 18 extending therethrough. The plate 200 may include a distal portion 210, a bent portion 212, and a proximal tab 214. As further highlighted in FIG. 5C , the proximal end 202 of the plate 200 includes a curved tab 214 configured to grip or secure to the tuberosity of the fifth metatarsal. The curved tab 214 may be curved in an arc or crescent shape. The curved tab 214 may be used to capture an avulsion fracture or a Jones fracture at the base of the fifth metatarsal. One polyaxial hole 16 may be defined through the curved tab 214. The curvature of the tab 214 allows for different screw insertion orientations. Specifically, the bore axis of the polyaxial hole 16 defined in the tab 214 may be aligned and configured to place the screw 12 intramedullarily through the tunnel of the fifth metatarsal. The tab plate 200 may be provided in small and large sizes and left and right configurations.

[0044] 6A-6E, a combined Lisfranc first and second tarsometatarsal plate 300 is shown, according to one embodiment. FIG. 6A depicts the anatomy of a foot 4 having combined Lisfranc first and second tarsometatarsal plates 300 contoured to rest on the dorsal aspects of the medial cuneiform, intermediate cuneiform, first metatarsal, and second metatarsal, respectively. Combined plate 300 has a bifurcated body extending from a first or proximal end 302 configured to rest on the medial cuneiform and intermediate cuneiform to a second or distal end 304 configured to rest on the bodies of the first and second metatarsals, respectively. Plate 300 includes a top surface 306 and an opposing bottom surface 308 configured to contact an adjacent bone. 6B, the combined plate 300 includes a first leg 310 and a second leg 312 connected by a proximal cross beam 314. The cross beam 314 is a cross beam or connector for the legs 310, 312 at the proximal end 302 of the plate 300. The plate 300 may also include a bridge 316 that connects the two legs 310, 312 of the plate 300 together for added strength.

[0045] As highlighted in FIG. 6C , the proximal end 302 of the plate 300 includes a cluster of three polyaxial holes 16 configured to place one or more screws 12 in the medial cuneiform. The three-hole cluster may be defined at the proximal-most intersection of the legs 312 and the cross beam 314. The three-hole cluster may be aligned in a symmetrical pattern at the apex of a triangle, such as an equilateral triangle. A K-wire hole 18 may be positioned centrally between the clusters. As shown in FIG. 6D , two additional polyaxial holes 16 may be positioned adjacent to the cluster of polyaxial holes 16 configured to place one or more screws 12 in the medial cuneiform. The two additional polyaxial holes 16 may be defined along the intersection of the legs 310 and the cross beam 314. A K-wire hole 18 may be positioned between them. The two additional polyaxial holes 16 may be spaced apart or separated to create space for Lisfranc independent screws, which may be placed outside the plate 300.

[0046] As shown in FIG. 6E, the distal end 304 of the plate 300 includes two free legs 310, 312 that provide a series of polyaxial holes 16 for fixation of the first and second metatarsals. For example, three polyaxial holes 16 may be provided in each leg 310, 312 in a linear arrangement. The legs 310, 312 may be angled so that the free ends of the legs 310, 312 are furthest apart, mimicking the normal intermetatarsal (IM) angle between the first and second metatarsals. Each leg 310, 312 may also define one dynamic compression slot 14 to aid in joint compression. The dynamic compression slot 14 may be positioned between the second and third polyaxial holes 16. A K-wire hole 18 may be provided between the first and second polyaxial holes 16. Some portions of the outer edge of the plate 300 may be scalloped or wavy to follow the hole pattern, minimizing potential soft tissue irritation.

[0047] The connection plate 300 may further include a fixture connection interface 318, which allows a separate fixture (not shown) to be connected to the plate 300 to aid in the placement of the Lisfranc screws. The fixture connection interface 318 may include a threaded connection having multiple recesses. For example, three circular recesses may be spaced around the threaded through-hole. The fixture connection interface 318 may be located on the top surface 306 of the leg 312 adjacent to the bridge 316. The connection plate 300 may be offered in small, medium, and large sizes, as well as left- and right-hand configurations.

[0048] 7A-7D, a combined Lisfranc second and third tarsometatarsal plate 400 is shown, according to one embodiment. The combined plate 400 is similar to plate 300 with an additional cluster of polyaxial holes 16 at the proximal end 402. As shown in FIG. 7A, the combined Lisfranc second and third tarsometatarsal plates 400 are contoured to rest on the dorsal aspects of the middle cuneiform, lateral cuneiform, second metatarsal, and third metatarsal, respectively. Similar to plate 300, the combined plate 400 has a bifurcated body extending from a first or proximal end 402 configured to rest on the middle and lateral cuneiform to a second or distal end 404 configured to rest on the bodies of the second and third metatarsals, respectively. The plate 400 includes a top surface 406 and an opposing bottom surface 408 configured to contact the adjacent bone. 7B, the connecting plate 400 includes a first leg 410 and a second leg 412 connected by a proximal cross beam 414. The cross beam 414 may be a horizontal or transverse beam for the legs 410, 412 at the proximal end 402 of the plate 400.

[0049] As best seen in FIG. 7C , the proximal end 402 of the plate 400 may include two symmetric clusters of three polyaxial holes 16 designed to place one or more screws 12 in the medial and lateral cuneiform bones, respectively. Each hole cluster may be arranged with the hole axes aligned in an equilateral triangle. A bridge 416 may include a thin, curved connector linking the two legs 410, 412 of the plate 400 together to add strength to the plate 400. As shown in FIG. 7D , the distal end 404 of the plate 400 includes the free ends of the two legs 410, 412, which provide polyaxial hole options for fixation of the first and second metatarsals, respectively. The holes in a given leg 410, 412 may be aligned with one another in a linear fashion. The legs 410, 412 may be generally parallel to one another and may be narrower than the proximal end 402 of the plate 400. Each leg 410, 412 may define a dynamic compression slot 14 to assist in compression of the joint and / or K-wire opening 18 to temporarily secure the plate 400. The outer edges of the distal legs 410, 412 may be scalloped or wavy to follow the hole pattern, minimizing potential soft tissue irritation. These plates 400 may be offered in small, medium, and large sizes and can be used on either the left or right foot.

[0050] 8A-8B, a cuboid bone plate 500 is shown, according to one embodiment. As shown in FIG. 8A, the cuboid plate 500 is contoured to lie laterally on the cuboid bone, which is generally cuboid-shaped. Depending on its orientation, the plate 500 may extend from a first end 502 aligned generally dorsally and superiorly to a second end 504 aligned generally plantarly and inferiorly on the cuboid bone. The plate 500 may have an external trapezoidal shape to match the general shape of the cuboid bone. For example, the first end 502 may have a greater width than the second end 504, and the first and second ends 502, 504 may be generally parallel to one another. The plate 500 includes a top surface 506 and an opposing bottom surface 508 configured to contact the bone.

[0051] The cuboid bone plate 500 defines a plurality of polyaxial holes 16 between the top surface 506 and the bottom surface 508. Each hole 16 may be surrounded by a thin ring 510. One or more rings 510 may be connected together via struts 512 forming a lattice-like structure. For example, the cuboid bone plate 500 may include eight polyaxial holes 16 linked with thin struts 512. Seven polyaxial holes 16 may be connected around a trapezoidal periphery, and an eighth hole 16 may be interconnected near the center of the plate 500. Larger openings or through-spaces 514 may remain between the connections. The thinner configuration of the rings 510 and struts 512 along the through-spaces 514 may allow the plate 500 to be shaped or contoured. The network of rings 510 and struts 512 maintains plate strength and provides the plate 500 with some flexibility. The cuboid plate 500 can be used on either the left or right foot.

[0052] 9A-9B, a flower plate 600 according to one embodiment is shown. As shown in FIG. 9A, the flower plate is contoured to lie laterally on the cuboid bone. Due to its symmetrical design, the plate 600 looks the same in any orientation. The plate 600 includes a top surface 606 and an opposite bottom surface 608 configured to contact the bone. The flower plate 600 has petal-like or protrusion-like extensions 610 radiating outward from a central circular region 612. Each protrusion extension 610 may begin with a narrower end connected to the central circular region 612 that diverges toward a rounded free end. In one embodiment, the flower plate 600 has six petal-like or protrusion-like extensions 610 radiating outward from the central circular region 612. The central circular region 612 surrounds one central polyaxial hole 16 located at the core of the plate 600. Each of the protrusions or extensions 610 also defines the polyaxial hole 16, for example, as a rim or ring surrounding the hole 16. The flower shape better conforms to the shape of the cuboid bone and is configured to fix fractures of the cuboid bone. The flower plate 600 can be used on either the left or right foot.

[0053] 10A-10E, a navicular plate 700 is shown, according to one embodiment. As shown in FIG. 10A, the navicular plate 700 is contoured to rest dorsally on the navicular bone. The navicular bone is one of seven bones that make up the ankle and tarsus of the foot. The navicular bone is located on the upper medial side of the metatarsus, next to the cuboid, anterior to the head of the talus, and posterior to the cuneiform bone. As shown in FIG. 10B, the navicular plate 700 has a body extending from a first or upper dorsal end 702 configured to rest on the top of the navicular bone to a second or lower medial end 704 configured to rest toward the medial and / or bottom of the navicular bone. The plate 700 includes a top surface 706 and an opposing bottom surface 708 configured to contact an adjacent bone. The navicular plate 700 defines a plurality of polyaxial holes 16 between a top surface 706 and a bottom surface 708. Each hole 16 may be surrounded by a thin ring 710. One or more rings 710 may be connected together via struts 712. One or more larger openings or through-spaces 714 may remain between some connections. The plate 700 may be divided into a dorsolateral section 716, a main section 718, and an optional plantar bundle extension 720.

[0054] As shown in FIG. 10C , the dorsal lateral section 716 of the plate 700 can include a three-hole cluster that laterally embraces the unique shape of the navicular bone. The cluster of three polyaxial holes 16 is configured to place one or more screws 12 on the superior dorsal aspect of the navicular bone. The three-hole cluster can be a symmetrical pattern at the apex of a triangle with struts 712 connecting each ring 710 in a triangular shape. The triangle can be an equilateral triangle, and the rings 710 can be curved or contoured so that the axes of each hole 16 point together centrally into the bone. The dorsal lateral section 716 can be curved or contoured to mimic the convex dorsal surface of the navicular bone. The dorsal lateral section 716 can be attached to the main section 718 using one strut 706.

[0055] The main section 718 of the plate 700 may include two rows of polyaxial holes 16 for fixation of scaphoid fractures. The main section 718 may include a second central three-hole cluster connected to the dorsolateral section 716 by a single strut 706. Similar to the dorsolateral section 716, the three-hole cluster may be a symmetrical pattern at the apex of a triangle with struts 712 connecting each ring 710 in a triangular shape. A K-wire hole 18 may be centered between the clusters of polyaxial holes 16. A pair of struts 712 of unequal lengths and defining an open space 714 between them separates the second central three-hole cluster from the third hole cluster. The open space 714 may have an irregular shape defined by the outer sides of the rings 710 and struts 712. In the case of the scaphoid plate 700, the third cluster forms the lower medial end 704 of the plate 700. The third cluster may have struts 712 connecting each ring 710 together and an asymmetric pattern of polyaxial holes 16 with one or more K-wire holes 18 positioned within the cluster. For example, as best seen in FIG. 10B , the third cluster may include an asymmetric triangle of three polyaxial holes 16 with a single K-wire hole 18. When aligned with the second three-hole cluster, two rows of polyaxial holes 16 are available to receive one or more screws 12 on the medial surface of the navicular bone. The main section 718 may be curved or contoured to mimic the convex medial surface of the navicular bone, including the navicular tuberosity. The outer edge of the plate 700 may be scalloped or wavy to follow the hole pattern, minimizing potential soft tissue irritation.

[0056] FIG. 10D illustrates a navicular plate 700′ with a plantar bundle extension 720, according to one embodiment. The navicular plate 700′ with plantar bundle extension 720 is identical to the navicular plate 700, but includes a plantar extension 720 that wraps around the plantar and medial sides of the navicular. In the case of the navicular plate 700′, the plantar extension 720 forms the lower plantar end 704 of the plate 700. As best seen in FIG. 10E , the plantar extension 720 includes a fourth cluster of three polyaxial holes 16 configured for placement of one or more screws 12 on the inferior-medial aspect of the navicular. Similar to the dorsolateral section 716, the plantar extension 720 includes a three-hole polyaxial cluster with a symmetrical pattern at the apex of a triangle with struts 712 connecting each ring 710 in a triangular shape at the central K-wire hole 18. The cluster may be arranged as an equilateral triangle, but the ring 710 may be curved or contoured so that the axis of each hole 16 points in a different direction into the bone. A plantar extension 720 connects to the main section 718 and adds additional K-wire holes 18 to the main section 718. The plantar bundle extension 720 may be curved or contoured to mimic the convex plantar surface of the navicular bone. The navicular plates 700, 700' may be provided in left and right configurations.

[0057] 11A-11B, a utility plate 800 is shown, according to one embodiment. The utility plate 800 is configured to fit multiple bones and / or spanning joints in the forefoot, midfoot, and hindfoot. For example, the utility plate 800 may be used to fixate and / or fuse together the naviculo-cuneiform (NC) joint, the talo-navicular (TN) joint, the calcaneocuboid (CC) joint, or the tarso-metatarsal (TMT) joint. FIG. 11A shows the utility plate 800 positioned medially above the naviculo-cuneiform joint. Other fractures of bones in the foot or elsewhere may also be fixed using the utility plate 800.

[0058] As shown in FIG. 11B , the utility plate 800 may have an H-shaped body extending from a first end 802 configured to rest on one bone (e.g., the navicular bone) to a second end 804 configured to rest on another bone (e.g., the cuneiform bone). The plate 800 includes a top surface 806 and an opposing bottom surface 808 configured to contact an adjacent bone. The H-shape may be formed by four protrusions or tabs 810 that define the four corners of the H-shape. In this case, the plate 800 may be oriented so that the tabs 810 point generally superior / inferior or dorsal / plantar toward the bone. The ends 802, 804 may have a concave or inward curvature between the tabs 810.

[0059] The utility plate 800 defines a plurality of polyaxial holes 16 between the top surface 806 and the bottom surface 808 for receiving one or more screws 12 for securing the plate 800 to bone. For example, one polyaxial hole 16 may be positioned within each of the projections or tabs 810 that span the joint. The plate 800 may include polyaxial holes 16 and dynamic compression slots 14 aligned along a central axis between the first end 802 and the second end 804. The dynamic compression slots 14 are incorporated into the plate 800 where compression through the plate 800 may be beneficial. For example, the polyaxial hole 16 may receive one screw 12 in one bone (e.g., the navicular bone), and the dynamic compression slot 14 may receive another screw 12 in an adjacent bone (e.g., the cuneiform bone). This allows for compression of bone fragments and / or joints, for example, to reduce joint space, improve stability, and promote fusion of the articular surfaces. The second pair of central polyaxial holes 16 may be aligned along a transverse axis that is horizontal to the central axis. These central holes 16 may generally align with the joints between the bones. However, it will be understood that the utility plate 800 may be oriented in any suitable manner to fixate the joints and / or bones. The utility plate 800 may be provided in small, medium, and large configurations that may be used on the left or right foot.

[0060] 12A-12B, an H-plate 900 is shown, according to one embodiment. Similar to the utility plate 800, the H-plate 900 can have an H-shaped body configured to span joints in the forefoot, midfoot, or hindfoot. The H-plate 900 is configured to fit across multiple joints in the forefoot, midfoot, and hindfoot. For example, the H-plate 900 can be used to fix or fuse the navicular-cuneioid (NC) joint, the talo-navicular (TN) joint, the calcaneocuboid (CC) joint, or the tarso-metatarsal (TMT) joint, or other joints or fractures. FIG. 12A depicts the H-plate 900 positioned laterally over the calcaneocuboid (CC) joint.

[0061] As shown in FIG. 12B , the H-plate 900 may have a solid, H-shaped body extending from a first end 902 configured to rest on one bone (e.g., the calcaneus) to a second end 904 configured to rest on another bone (e.g., the cuboid). The plate 900 includes a top surface 906 and an opposing bottom surface 908 configured to contact an adjacent bone. The H-shape may be formed by four protrusions or tabs 910 that define the four corners of the H-shape. In this case, the plate 900 may be rotated and oriented so that the tabs 910 generally point proximally / distally and extend away from the joint. Each tab 910 may define a single polyaxial hole 16. The plate 900 may be shaped like an H to provide two screw holes 16 per bone across the joint line. The screw holes 16 may be positioned on the tabs 910 to allow for easier bending. This allows the surgeon to bend the screw holes across the joint line and into the bone, which may be out of plane relative to the adjacent bone. This plate style can be offered in small, medium, and large configurations for left and right feet.

[0062] 13A-13C, a sinus tarsus wave plate 1000 is shown according to one embodiment. The sinus tarsus wave plate 1000 is contoured to sit laterally on the calcaneus below the talus. The sinus tarsus approach is used for minimally invasive reduction and percutaneous fixation of displaced intra-articular calcaneal fractures. As shown in FIG. 13A, the sinus tarsus wave plate 1000 sits on the lateral aspect of the calcaneus just plantar of the subtalar joint, following the natural wave shape created by this joint line. The plate contour can match Gissane's critical angle (e.g., between approximately 130 and 145 degrees) to provide screw hole locations for rafting the subtalar joint surface to prevent collapse.

[0063] 13B, the sinus tarsi wave plate 1000 can have an elongated body extending from a first anterior end 1002 configured to rest on the anterior aspect of the calcaneus to a second posterior end 1004 configured to rest on the lateral aspect of the calcaneus below the subtalar joint. The plate 1000 includes a top surface 1006 and an opposing bottom surface 1008 configured to contact the adjacent bone. The sinus tarsi wave plate 1000 can be divided into an anterior section 1010, a main body 1012, and a posterior section 1014.

[0064] 13C, the anterior portion 1010 of the plate 1000 provides screw holes 16 for any fractures in the anterior aspect of the calcaneus. The three anterior-most screw holes 16 may be offset from the main body 1012 of the plate 1000 with two tabs 1016 connecting them. The anterior portion 1010 may be separated from the main body 1012 by irregular spacing 1018. The tabs 1016 may be angled toward each other as they connect to the main body 1012. These tabs 1016 can be easily cut when the anterior portion of the calcaneus is intact.

[0065] The main body 1012 may include, for example, a three-hole polyaxial cluster with a symmetrical pattern. The axes of each hole 16 in the three-hole cluster may be positioned at the vertices of an equilateral triangle. A central K-wire hole 18 may be positioned within the cluster. The posterior section 1014 may include a tail extending posteriorly from the main body 1012. The posterior section 1014 may include multiple polyaxial holes 16 that follow the wave of the subtalar joint. For example, five holes 16 may be provided in succession to mimic the wave or undulating curvature. The wave troughs may begin at the main body 1012, and the wave ridges may peak toward the posterior end 1004. The outer edge of the plate 1000 may be scalloped or wavy to follow the hole pattern and minimize potential soft tissue irritation. Additional K-wire holes 18 may be positioned, for example, between the most posterior hole 16 and an adjacent hole 16, and between the three-hole cluster and the next adjacent hole 16 along the posterior section 1014. The sinus tarsi wave plate 1000 can be provided in small and large sizes with left and right configurations.

[0066] 14A-14D, a sinus tarsi lingual plate 1000' is shown, according to one embodiment. The sinus tarsi lingual plate 1000' is the same as the sinus tarsi wave plate 1000, but with the addition of a posterior extension 1020 and a plantar offset extension 1022. The sinus tarsi lingual plate 1000' is contoured to sit laterally on the calcaneus below the talus and subtalar joint. Like the sinus tarsi wave plate 1000, the sinus tarsi lingual plate 1000' sits plantar of the subtalar joint and rafts the subtalar joint.

[0067] The sinus tarsi lingual plate 1000' includes an anterior section 1010, a main body 1012, and a posterior section 1014. The anterior section 1010 includes the same three-hole anterior portion 1010, which can be easily cut and removed. The main body 1012 includes a three-hole cluster, and the posterior section 1014 includes an undulation that follows the contours of the subtalar joint. As best seen in FIG. 14C , a posterior extension 1020 extends posteriorly from the free end of the posterior section 1014. The posterior extension 1020 may include a first linear continuation of the posterior section 1014. The posterior extension 1020 may include a series of multiaxial holes 16, for example, aligned in a linear arrangement. The outer edge of the posterior extension 1020 may be scalloped or undulating to follow the hole pattern. The polyaxial hole 16 in the posterior extension 1020 can act as a rafting screw hole extending posteriorly to capture bone fragments that may have been displaced in a tongue-type fracture of the calcaneus.

[0068] As further highlighted in FIG. 14D , a plantar offset extension 1022 can extend posteriorly and plantarly from the free end of the posterior section 1014. The plantar offset extension 1022 can include a second shaped continuation of the posterior section 1014 that is angled relative to the posterior extension 1020. The plantar offset extension 1022 can have a solid linear body terminating in a three-hole cluster. The three-hole cluster can define holes 16 with axes in a symmetrical pattern at the apex of a triangle. The addition of extensions 1020, 1022 can create another three-hole cluster at the intersection of the posterior section 1014 and the extensions 1020, 1022. One or more K-wire holes 18 can be positioned along the length of the extensions 1020, 1022. The posterior plantar offset 1022 defines screw holes 16 that can receive screws 12 configured to capture bone fragments that may be displaced plantarly within the calcaneus. Either or both of the plate extensions 1020, 1022 can be cut off by the surgeon if they are not needed. The sinus tarsi lingual plate 1000' can be provided in small and large sizes with left and right configurations.

[0069] 15A-15B, a calcaneal periphery plate 1100 is shown according to one embodiment. As shown in FIG. 15A, the calcaneal periphery plate 1100 is contoured to lie laterally on the calcaneus. The calcaneal periphery plate 1100 may be utilized in severe fractures of the calcaneus where multiple fractures and displaced bone fragments are present. The calcaneal periphery plate 1100 is configured to line the periphery of the calcaneus to thread into the cortical bone for structural stability and to articulate the calcaneus as closely as possible to its original shape. The calcaneal periphery plate 1100 may act as a backboard to hold the calcaneal fragments until the bone begins to heal.

[0070] The calcaneal circumferential plate 1100 extends from a first anterior end 1002 configured to lie laterally on the anterior aspect of the calcaneus to a second posterior end 1004 configured to lie laterally on the posterior aspect of the calcaneus. The plate 1100 includes a top surface 1106 and an opposing bottom surface 1108 configured to contact bone. The calcaneal circumferential plate 1100 defines a plurality of polyaxial holes 16 between the top surface 1106 and the bottom surface 1108. Each polyaxial hole 16 may be surrounded by a ring 1110. One or more rings 1110 may be connected together via struts 1112 forming a lattice structure. Larger openings or through-spaces 1114 may remain between the connections. In one embodiment, thirteen circumferential rings 1110 may be connected together with the circumferential struts 1112. The perimeter may mimic the outside of the calcaneus, for example, having a smaller quadrilateral shape at the anterior end 1102 and a larger rounded shape at the posterior end 1104. In an exemplary embodiment, the perimeter ring 1110 matches the perimeter of the calcaneus so that the screws 12 can be inserted directly into the cortical bone of the calcaneus, ensuring structural stability.

[0071] Additional screw holes 16 and internal posts 112 may be positioned inside the perimeter of the plate 1100. In one embodiment, three internal rings 1110 may be connected together and with a surrounding peripheral ring 1110. The internal rings 1110 and internal posts 112 may provide cross-bracing to maintain plate strength and provide some flexibility to the plate 1100. The internal holes 16 provide additional fixation points for displaced bone fragments and a surface for tensioning the bone. The calcaneal perimeter plate 1100 may be offered in small, medium, and large sizes, and in left and right configurations.

[0072] 16A-16B, a rafter perimeter plate 1200 is shown, according to one embodiment. The rafter perimeter plate 1200 offers a hybrid approach, raftering the subtalar joint like the sinus tarsus plate 1000 and providing circumferential fixation to the calcaneus like the calcaneal perimeter plate 1100. This gives surgeons the option to fix severe calcaneal fractures along the perimeter while providing rafter screw options and support for the subtalar joint. The rafter perimeter plate 1200 also features struts that help contain displaced bone fragments in the fracture. As shown in FIG. 16A, the rafter perimeter plate 1200 sits laterally on the calcaneus with rafter and circumferential screw hole locations.

[0073] 16B, a rafting perimeter plate 1200 extends from a first anterior end 1202 configured to lie laterally on the anterior aspect of the calcaneus to a second posterior end 1204 configured to lie laterally on the posterior aspect of the calcaneus below the subtalar joint. The plate 1200 includes a top surface 1206 and an opposing bottom surface 1208 configured to contact an adjacent bone. The components of the rafting perimeter plate 1200 may include an anterior section 1210, a main body 1212, a posterior section 1214, a posterior extension 1220, a plantar offset extension 1222, a cross member 1224, and a posterior connecting extension 1226.

[0074] Similar to the sinus tarsi wave plate 1000, the anterior section 1210 of the plate 1200 may include three anterior screw holes 16 offset from the main body 1212 of the plate 1200. A pair of angled tabs 1216 may connect the three anterior screw holes 16 to the main body 1212 and may be easily cut off if that portion of the plate 1200 is not needed because the anterior portion of the calcaneus is intact. The main body 1212 of the plate 1200 may include a three-hole polyaxial cluster, for example, having a symmetrical pattern with a central K-wire hole 18. The axes of each hole 16 in the three-hole cluster may be positioned at the vertices of an equilateral triangle. The posterior section 1214 may include a wavy tail extending posteriorly from the main body 1212. The posterior section 1214 may define multiple polyaxial holes 16 that follow the wave of the subtalar joint.

[0075] Similar to the sinus tarsi lingual plate 1000′, the plate 1200 includes a posterior extension 1220 and a plantar offset extension 1222. The posterior extension 1220 extends posteriorly from the free end of the posterior section 1214. The posterior extension 1220 may comprise a first linear continuation of the posterior section 1214. The posterior extension 1220 may include, for example, a series of polyaxial holes 16 aligned in a linear arrangement. The polyaxial holes 16 in the posterior extension 1220 may act as rafting screw holes extending posteriorly to capture bone fragments that may be displaced in a tongue-type fracture of the calcaneus.

[0076] The plantar offset extension 1222 may extend posteriorly and plantarly from the free end of the posterior section 1214. The plantar offset extension 1222 may include a second linear continuation of the posterior section 1214 that is angled relative to the posterior extension 1220. The plantar offset extension 1222 may have a solid linear body that terminates in a polyaxial bore 16. The posterior plantar offset 1222 defines a screw bore 16 that may receive a screw 12 configured to capture a bone fragment that may be displaced plantarly within the calcaneus.

[0077] The plantar offset extension 1222 is connected to the posterior extension 1220 by a cross member 1224. The cross member 1224 may be a straight beam connecting the free end of the plantar offset extension 1222 to the free end of the posterior extension 1220. Multiaxial holes 16 may be provided at the corners or ends of the cross member 1224. Additional multiaxial holes 16 may be provided along the length of the cross member 1224. The three holes 16 in the cross beam 1224 may be aligned.

[0078] The rear extension 1226 can connect the main body 1212 to the plantar offset extension 1222 and the cross member 1224. The rear extension 1226 can be a straight beam connecting the main body 1212 to the free end of the plantar offset extension 1222. The rear extension 1226 can be aligned generally parallel to the posterior extension 1220. The series of multiaxial holes 16 defined through the rear extension 1216 can be aligned in a straight line. For example, one pair of holes 16 can be positioned toward the main body 1212 and another pair of holes 16 can be positioned with the plantar offset extension 1222.

[0079] The posterior section 1214, posterior extension 1220, cross member 1224, and rear extension 1226 of the plate 1200 may form a generally rectangular exterior shape. The planar offset extension 1222 may be a diagonal line dividing the rectangle into two triangles with an open space 1228 on the inside. The posterior section 1214 and posterior extension 1220 provide a row of rafting screw options beneath the subtalar joint, which may act as a raft to support the subtalar joint fragments. The multiple screw options around the periphery of the implant 1200 target the cortical bone surrounding the calcaneus, which improves structural stability. Screw holes 16 located on the medial and bottom sides of the plate 1200 provide additional fixation points for displaced fragments that may be displaced at the plantar surface of the foot. The rafting periphery plate 1200 may be offered in small and large sizes and left and right configurations.

[0080] 17A-17B, a talus T-plate 1300 is shown, according to one embodiment. As shown in FIG. 17A, the talus T-plate is contoured to lie laterally on the neck of the talus. Most fractures of the talus occur at the neck, and the plate 1300 is configured to provide fixation to the anterior and posterior fracture fragments. Referring now to FIG. 17B, the talus T-plate 1300 extends from a first anterior end 1302 configured to lie laterally on the neck of the talus to a second posterior end 1304 configured to lie laterally on the body of the talus. The plate 1300 includes a top surface 1306 and an opposing bottom surface 1308 configured to contact the adjacent bone.

[0081] The talar T-plate 1300 has a body with a substantially T-shaped profile. The T-plate 1300 has elongated posterior portions or legs 1310 and transverse anterior cross portions 1312. The legs 1310 may be curved or angled relative to the cross portions 1312. The posterior portions 1310 or legs of the T-shape may be contoured to mimic the natural anatomy of the talus. The anterior portion 1312 or top of the T-shape may be contoured to wrap slightly around the neck. The transverse cross portion 1312 may include one or more wings or extensions extending outward from the legs 1310. The cross portions 1312 may be approximately perpendicular to the legs 1310 of the plate 1300. The plate 1300 may include multiple polyaxial holes 16 and / or K-wire holes 18. The outer edge of the plate 1300 may be scalloped or wavy to follow the hole pattern, minimizing potential soft tissue irritation. The talar T-plate 1300 may be available in various lengths with various hole options. The talar T-plate 1300 may be offered in both left and right configurations.

[0082] Referring now to FIGS. 18A-18B, a talus L-plate 1300' is shown, according to one embodiment. The talus L-plate 1300' is similar to the talus T-plate, except that one wing or extension of the cross section 1312 has been removed. As shown in FIG. 18A, the talus L-plate 1300' is contoured to lie laterally on the neck of the talus. Like the talus T-plate 1300, the L-plate 1300' provides fixation on both anterior and posterior fracture fragments. FIG. 18B shows the talus L-plate 1300' with a substantially L-shaped profile. The L-plate 1300' offers fewer screw holes anteriorly when additional fixation is not needed or when the T-plate 1300 is too large to fit the anatomy. The L-plate 1300' may be provided in both left and right configurations.

[0083] 19A-19B, a talus butterfly plate 1400 is shown, according to one embodiment. As shown in FIG. 19A, the talus butterfly plate 1400 can be contoured to lie laterally on the neck of the talus. The talus butterfly plate 1400 is configured to provide fixation to anterior and posterior fracture fragments and provides two rows of screw holes for a more stable construct. As shown in FIG. 19B, the talus butterfly plate 1400 extends from a first anterior end 1402 configured to lie laterally on the neck of the talus to a second posterior end 1404 configured to lie laterally on the body of the talus. The plate 1400 includes a top surface 1406 and an opposing bottom surface 1408 configured to contact the adjacent bone.

[0084] The talar butterfly plate 1400 may have a symmetrical butterfly-like shape with opposing wings 1410. The wings 1410 may include protrusions that define each polyaxial hole 16. For example, each wing 1410 may have an upper protrusion and a lower protrusion. The upper protrusion may be slightly larger than the lower protrusion. One wing 1410 with two holes 16 may be provided at the anterior end 1402, and a mirror image wing 1410 with two holes 16 may be provided at the posterior end 1404. The wings 1410 may be mirror images and curved about a centerline. The outer edge of the plate 1400 may be scalloped or wavy to follow the outer hole pattern. A central K-wire hole 18 may be provided through the plate 1400. The talar butterfly plate 1400 may be provided in small and large configurations that may be used on left or right feet. As shown in FIG. 20, a large talar butterfly plate 1400' may have extending wings or protrusions to provide four additional holes for fixation.

[0085] Referring now to FIG. 21 , a series of repair plates 10′ can be used for fixation of bony anatomical structures after anatomical correction. The plates 10′ can be used in the treatment of various fractures of the foot in the forefoot, midfoot, and hindfoot. Nine different plate styles for the treatment of various repairs include: (a) metatarsophalangeal (MTP) plate, (b) MTP low-profile plate, (c) lapidus plate, (d) tarsometatarsal (TMT) plate, (e) navicular-cuneiform (NC) plate, (f) medial column plate, (g) Evans osteotomy wedge plate, (h) Cotton aperture wedge plate, and (i) calcaneal slide plate.

[0086] 22A-22B, a metatarsophalangeal (MTP) plate 1500 is shown, according to one embodiment. As shown in FIG. 22A, the MTP plate 1500 is contoured to rest on the dorsal aspect of the first MTP joint. The MTP plate 1500 has a body extending from a first or proximal end 1502 configured to rest on the first metatarsal bone to a second or distal end 1504 configured to rest on the first proximal phalanx. The plate 1500 includes a top surface 1506 and an opposing bottom surface 1508 configured to contact an adjacent bone. The plate 1500 may include three sections: a proximal section 1510, a bridge section 1512, and a distal section 1514.

[0087] As shown in FIG. 22B , the proximal section 1510 defines at least two holes 16 proximally for fixation to the metatarsal bones. The proximal section 1510 further defines compression holes 14 for achieving compression. The plate 1500 also defines K-wire slots 20 for achieving further compression with a guidewire or K-wire. The bridge section 1512 may be a straight beam extending over the MTP joint. The distal section 1514 defines three distal holes 16 for fixation to the phalanges. K-wire holes 18 may also be provided distally. The compression slots 14, K-wire slots 20, K-wire holes 18, and distal-most multiaxial hole 16 may be aligned along the central longitudinal axis of the plate 1500. The outer edges of the proximal and distal sections 1510, 1514 may be scalloped or wavy to follow the hole pattern. The plate 1500 may include one or more markings 1520, indicators, notches, radiopaque markers, etc., that indicate the general location of the joint. For example, a single line 1520 may indicate the location of the MTP joint across the top surface 1506 of the plate 1500. This marking 1520 may help the surgeon optimally align the plate 1500 to the joint. The MTP plate 1500 may be left / right specific in small, medium, large, extra large, and revision options that offer more holes and longer bridge lengths to fit a larger section of the population.

[0088] 23A-23B, a metatarsophalangeal (MTP) narrow plate 1500′ is shown, according to one embodiment. The MTP narrow plate 1500′ is the same as the MTP plate 1500, except that it is a slimmer version of the MTP plate with only two distal screw holes for a lower profile on the phalanges. As shown in FIG. 23A, the MTP narrow plate 1500′ is contoured to sit on the dorsal aspect of the first MTP joint. Similar to the MTP plate 1500, the proximal end 1510 of the plate 1500′ includes two polyaxial locking holes 16, one compression slot 14, and a K-wire slot 20 to aid in compressing the joint. The distal end 1504 includes a linear extension away from the bridge section 1512. The distal section 1514 defines two polyaxial locking holes 16 for fixation to the phalanges. The K-wire holes 18 may be positioned between the distal holes 16. The width of the distal section 1514 may be the same as the bridge section 1512, thereby creating a narrow, low profile.

[0089] 24A-24B, a Lapidus plate 1600 is shown, according to one embodiment. As shown in FIG. 24A, the Lapidus plate 1600 is contoured to rest on the medial aspect of the first tarsometatarsal joint. The Lapidus plate 1600 has a body extending from a first or proximal end 1602 configured to rest on the medial cuneiform bone to a second or distal end 1604 configured to rest on the first metatarsal bone. The plate 1600 includes a top surface 1606 and an opposing bottom surface 1608 configured to contact an adjacent bone. The plate 1600 may include three sections: a proximal section 1610, a bridge section 1612, and a distal section 1614.

[0090] The proximal section 1610 includes a polyaxial locking hole 16 configured to secure the plate 1600 to the medial cuneiform bone. The proximal section 1610 may include an upward protrusion or tab. The bridge section 1612 is angled or sloped downward toward the distal end 1604. The distal section 1614 includes a polyaxial locking hole 16 configured to secure the plate 1600 to the first metatarsal bone. The distal section 1614 may include a downward protrusion or tab. A compression slot 14 may be provided along the sloped central axis of the plate 1600 toward the distal end 1604. In one embodiment, the lapidus plate 1600 includes four polyaxial locking holes 16, two for the metatarsals and two for the cuneiform bones, with one compression slot 14 on the side of the metatarsal. In another embodiment, a more robust plate offering may include six polyaxial holes 16 for receiving screws 12, three in the metatarsals and three in the cuneiforms. Plate 1600 may be left / right specific, with short and long options that vary the bridge length proximally and distally.

[0091] 25A-25B, a tarsometatarsal (TMT) plate 1700 is shown according to one embodiment. As shown in FIG. 25A, the TMT plate 1700 is contoured to rest dorsally on the second tarsometatarsal (TMT) joint. The TMT plate 1700 may be configured to fit the first, second, and third TMT joints or the Lisfranc joint. The TMT plate 1700 has an elongated body extending from a first or proximal end 1702 configured to rest on the cuneiform bone to a second or distal end 1704 configured to rest on the metatarsal bone. The plate 1700 includes a top surface 1706 and an opposing bottom surface 1708 configured to contact an adjacent bone. The plate 1700 may include three sections: a proximal section 1710, a bridge section 1712, and a distal section 1714.

[0092] The proximal section 1710 or head of the plate 1700 can be provided with multiple screw hole configurations, including left- and right-handed T, L, oblique T, oblique L, and cloverleaf shape. In the embodiment shown, two polyaxial holes 16 are defined off-axis in the proximal section 1710, with K-wire holes 18 provided between them. The bridge section 1712 can be a straight solid beam that spans the TMT joint. The distal section 1714 can include two or four polyaxial holes 16 with compression slots 14, thereby providing compression to the joint. The holes 16 and slots 14 can be aligned with the central longitudinal axis of the plate 1700. In the embodiment shown, the compression slot 14 is positioned between the holes 16, and two K-wire holes 18 are positioned between the slot 14 and the adjacent hole 16. It will be understood that the plate 1700 can have any suitable arrangement of holes 16 for optimal fit. The plate 1700 may include one or more markings 1720 or other indicators to indicate the general location of the joint. For example, a pair of parallel lines 1720 may indicate the location of the TMT joint across the top surface 1706 of the plate 1700. These markings 1720 may aid the surgeon in optimally aligning the plate 1700 relative to the joint.

[0093] 26, a scapho-cuneiform (NC) plate 1800 is shown, according to one embodiment. The NC fusion plate 1800 is contoured to lie dorsally over the scapho-cuneiform (NC) joint. The NC plate 1800 is configured to stabilize the medial and central cuneiforms relative to the scaphoid and also allows interfragment screws 12 to be routed through the plate 1800 through the use of recessed holes 22.

[0094] The NC plate 1800 has an elongated body extending from a first or proximal end 1802 configured to rest on the navicular bone to a second or distal end 1804 configured to rest on the cuneiform bone. The plate 1800 includes a top surface 1806 and an opposing bottom surface 1808 configured to contact the adjacent bone. The plate 1800 may include three sections: a proximal section 1810, a bridge section 1812, and a distal section 1814.

[0095] The proximal section 1810 includes a pair of polyaxial locking holes 16 configured to secure the plate 1800 to the dorsal side of the navicular bone. The proximal holes 16 may be positioned within protrusions or ears at the proximal end 1802 of the plate 1800. The proximal section 1810 may further define a recessed hole 22. The recessed hole 22 may be a polyaxial locking hole that serves as a proximal cortex for a lag screw. The recessed hole 22 may be positioned along the central axis of the plate 1800, but the axis of the hole may be angled so that the lag screw 12 is inserted distally. The recessed hole 22 is located in the plate 1800, and the surgeon may use a reamer to create a pocket in the bone for the plate 1800 to fit.

[0096] The bridge section 1812 may include a solid section that is angled or sloped downward toward the distal end 1804. One or more K-wire holes 18 may also be aligned along the central axis of the plate 1800. The distal section 1814 includes a polyaxial locking hole 16 configured to secure the plate 1800 to the dorsal side of the cuneiform bone. The distal hole 16 may be positioned within a protrusion or ear at the distal end 1804 of the plate 1800. One of the distal protrusions may be extended relative to the other protrusion. The NC plate 1800 may be provided in both left and right configurations.

[0097] 27A-27B, a medial column plate 1900 is shown, according to one embodiment. The medial column plate 1900 spans from the medial aspect of the talus to the first metatarsal. As shown in FIG. 27A, the medial column plate 1900 is contoured to bridge across the talus, navicular, medial cuneiform, and midfoot covering the first metatarsal. The medial column plate 1900 allows for at least three screws to be placed in each of these bones while providing a rigid structure to hold the bones in place.

[0098] The medial post plate 1900 has an elongated body extending from a first or proximal end 1902 configured to rest on the talus to a second or distal end 1904 configured to rest on the metatarsal. The plate 1900 includes a top surface 1906 and an opposing bottom surface 1908 configured to contact an adjacent bone. The plate 1900 may include four sections: a proximal talus section 1910, a navicular section 1912, a cuneiform section 1914, and a distal metatarsal section 1916.

[0099] The proximal talar section 1910 includes three polyaxial holes 16 at the proximal-most end 1902 of the plate 1900 configured to secure the screws 12 to the talus. One of the polyaxial holes 16 in the proximal talar section 1910 may protrude dorsally via a tab 1918. The scaphoid section 1912 includes an arrangement of three polyaxial holes 16 configured to secure the screws 12 to the scaphoid. The polyaxial holes 16 may be arranged in a triangular pattern with a first K-wire slot 22 configured to achieve compression with a guidewire or K-wire. The cuneiform section 1914 includes a triangular arrangement of three polyaxial holes 16 configured to secure the screws 12 to the cuneiform with a second K-wire slot 22 for receiving a K-wire for further compression. The first and second K-wire slots 22 may be centered along the longitudinal axis of the plate 1900.

[0100] The distal metatarsal section 1916 includes a plurality of polyaxial holes 16 configured to secure the screws 12 within the metatarsals. For example, six polyaxial holes 16 are arranged in two rows: two dorsally and four plantarly. However, it will be understood that any suitable arrangement of holes 16 may be used to secure the metatarsals. K-wire holes 18 may be provided in the distal metatarsal section 1916 to provide guides or additional fixation points for the plate 1900. The plate 1900 may include one or more markings 1920 or other indicators to indicate the general location of the joint. For example, a pair of parallel stripes 1920 may indicate the location of the tarsometatarsal joint across the upper surface 1906 of the plate 1900. These markings 1920 may aid the surgeon in optimally aligning the plate 1900 relative to the tarsometatarsal joint. It will be understood that additional markings may be added for other joints as well.

[0101] 28A-28B, an Evans osteotomy wedge plate 2000 is shown, according to one embodiment. As best seen in FIG. 28A, the Evans osteotomy wedge plate 2000 is configured to fit a calcaneal osteotomy. The Evans procedure may involve creating an osteotomy on the lateral surface of the calcaneus and inserting a wedge 2012 to lengthen the lateral column of the foot. The process of inserting the wedge 2012 fixes the heel valgus deformity by mediating the portion of the calcaneus posterior to the osteotomy. A plate portion sits over the osteotomy site and secures the implant to the calcaneus.

[0102] As shown in FIG. 28B , the Evans osteotomy wedge plate 2000 extends from a first proximal end 2002 configured to rest proximally on the calcaneus to a second distal end 2004 configured to rest distally on the calcaneus. The plate 2000 includes a top surface 2006 and an opposing bottom surface 2008 configured to contact adjacent bone. The plate 2000 may have a symmetrical dogbone-like shape that is wider at both ends and narrower at the center. The ends include protrusions 2010 that each define one polyaxial hole 16. The protrusions 2010 may be curved or contoured to mimic the shape of the calcaneus. The outer edges of the protrusions 2010 may be rounded to follow the hole pattern. A resting wedge 2012 protrudes from the bottom surface 2008 and is configured to fit within an osteotomy cut into the calcaneus. The wedge 2012 includes one or more angled flats or surfaces configured to spread the bone at an angle. The plate 2000 may then be secured with two polyaxial screws 12 on either side of the osteotomy. The plate 2000 may include, for example, a bone graft window 2014 that passes through the face of the plate 2000 and into the wedge 2012, which may be filled before or after implantation.

[0103] 29A-29B, a Cotton aperture wedge plate 2100 is shown, according to one embodiment. As best seen in FIG. 29A, the Cotton aperture wedge plate 2100 is configured to accommodate a medial wedge osteotomy. The Cotton procedure may involve creating an osteotomy on the medial aspect of the cuneiform bone and inserting a wedge 2112 to lengthen the top of the medial cuneiform bone and create an arch in the foot. This procedure is commonly performed to help correct a depressed arch or flatfoot condition. A plate portion rests on the dorsal-medial aspect of the medial cuneiform bone over the osteotomy site and secures the implant to the cuneiform bone.

[0104] As shown in FIG. 29B , the cotton aperture wedge plate 2100 extends from a first proximal end 2102 configured to be positioned proximal to the cuneiform bone to a second distal end 2104 configured to be positioned distal to the cuneiform bone. The plate 2100 includes a top surface 2106 and an opposing bottom surface 2108 configured to contact adjacent bone. The plate 2100 may have a symmetrical shape with protrusions 2110 at four corners, each defining one polyaxial hole 16. The plate 2100 may be substantially flat or planar. The outer edges of the protrusions 2110 may be rounded or contoured to follow the hole pattern. A resting wedge 2112 protrudes from the bottom surface 2108 and is configured to fit within an osteotomy cut into the cuneiform bone. The wedge 2112 includes one or more angled flats or surfaces configured to spread the bone at an angle. The plate 2100 can then be secured with two polyaxial screws 12 on either side of the osteotomy. The plate 2100 can include, for example, a central bone graft window 2114 that passes through the face of the plate 2100 and into the wedge 2112, which can be filled before or after implantation.

[0105] 30A-30B, a calcaneal slide plate 2200 is shown, according to one embodiment. As best seen in FIG. 30A, the calcaneal slide plate 2200 is positioned on the lateral aspect of a calcaneal osteotomy site. The calcaneal slide plate 2200 is configured to secure the calcaneal osteotomy after being moved to correct a deformity. A calcaneal slide osteotomy changes the alignment of the calcaneus, or heel bone. The procedure involves cutting the calcaneus, adjusting or shifting the posterior portion of the bone, and stabilizing the bone with an implant. A calcaneal slide osteotomy can be used to correct problems such as flat feet or abnormally high arches.

[0106] As shown in FIG. 30B , the calcaneus slide plate 2200 extends from a first proximal end 2202 configured to be positioned proximally on the calcaneus to a second distal end 2104 configured to be positioned distally on the calcaneus. The plate 2200 includes a top surface 2206 and an opposing bottom surface 2208 configured to contact adjacent bone. The plate 2200 may include a plate portion having a protrusion 2210 that defines the polyaxial hole 16 and a wedge portion 2212 that also defines the polyaxial hole 16. The plate portion and the wedge portion 2212 may be curved or angled relative to one another. The wedge portion 2212 may include one or more inclined planes or surfaces. The wedge portion 2212 may be configured to protrude laterally. The plate 2200 may be offered in several different sizes to allow for slide adjustment based on implant height. Plate 2200 allows for two polyaxial screws 12 to be placed on either side of the osteotomy. The screws 12 secure the two halves of the calcaneus together so that the calcaneus can heal in the corrected position.

[0107] The collection of foot plates 10 includes a comprehensive offering for treating numerous fracture patterns in the forefoot, midfoot, and hindfoot. Plates 10 can be used for both definitive fixation, permanent fixation, and temporary or supplemental fixation according to other systems. Multiple fracture patterns can be accommodated depending on the specific plate style. Plates can be cut and contoured to accommodate extreme patient anatomies. A wide range of screw and plate sizes can accommodate multiple anatomies and anatomical regions.

[0108] It should further be understood that various changes in the details, materials, and arrangements of parts described and illustrated to explain the nature of the invention may be made by those skilled in the art without departing from the scope of the invention as expressed in the claims. Those skilled in the art will appreciate that the above-described embodiments are non-limiting. It will also be understood that one or more features of one embodiment may be incorporated, in part or in whole, into one or more other embodiments described herein.

Claims

1. 1. A bone stabilization plate comprising: an elongate body having a top surface and an opposing bottom surface configured to contact bone, the elongate body having a first section, a main body, and a second section, the elongate body defining a plurality of screw holes extending therethrough; A bone stabilization plate, wherein the first section is offset from the main body using two tabs, the main body includes a three-hole polyaxial cluster with the axis of each hole positioned at the vertex of an equilateral triangle, and the second section includes a series of polyaxial holes that follow a wave pattern.

2. The plate of claim 1 , wherein the plate is contoured to lie laterally on the calcaneus below the talus.

3. The plate of claim 1 , wherein the two tabs are angled inwardly toward the main body and toward each other.

4. The plate of claim 1 , wherein the elongated body defines k-wire holes having a diameter smaller than a diameter of each of the screw holes.

5. The plate of claim 1 , wherein the elongated body includes a rearward extension that includes a linear continuation of the second section.

6. The plate of claim 5 , wherein the rearward extension comprises a linear arrangement of multiaxial holes.

7. The plate of claim 5 , wherein the elongated body includes a plantar offset extension extending from the second section.

8. The plate of claim 7 , wherein the plantar offset extension includes a second linear continuation of the second section that is angled relative to the posterior extension.

9. The plate of claim 7 , wherein the plantar offset extension comprises a solid linear body terminating in a three-hole cluster.

10. 8. The plate of claim 7, wherein the plantar offset extension is connected to the rearward extension by a cross member, and the main body is connected to the plantar offset extension by a rearward extension.

11. 1. A bone stabilization plate comprising: a body having a top surface and an opposing bottom surface configured to contact bone, the body having a plurality of rings defining screw holes therethrough, the rings connected together via struts forming a lattice structure with through spaces remaining between connections; A bone stabilization plate in which the periphery of the rings are connected together with peripheral struts, and one or more internal rings and internal struts provide cross bracing for the plate.

12. The plate of claim 11 , wherein the perimeter of the ring and the perimeter post are aligned with the calcaneus.

13. 12. The plate of claim 11, wherein each ring connects to another ring with one strut.

14. The plate of claim 11 , wherein the inner ring connects to two or more peripheral rings.

15. The plate of claim 11 , wherein a plantar portion of the plate defines a series of aligned peripheral rings and posts.

16. 12. The plate of claim 11, wherein one end of the plate forms a square shape and an opposing end of the plate forms a rounded shape that is larger than the square shape.

17. 1. A bone stabilization system comprising: a bone plate having a top surface and an opposing bottom surface configured for contacting a bone, the bone plate defining a plurality of polyaxial screw holes therethrough, the screw holes including a three-hole polyaxial cluster with axes of each hole positioned at vertices of an equilateral triangle; and a plurality of bone fasteners configured to lock within the polyaxial screw holes.

18. The system of claim 17 , wherein the bone plate defines compression slots configured to receive non-locking fasteners for applying compression.

19. 20. The system of claim 17, wherein the bone plate defines K-wire slots configured to achieve additional compression with K-wires.

20. The system of claim 17 , wherein the bone plate includes one or more markings to indicate a location of a joint.

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