Implants, systems and methods of using them

Abstract

Implants, devices, systems and methods for replacing bone fixation, such as scapular fixation. The bone plate system includes a plate and at least one fastener for insertion through the plate. The plate has a body portion, a base portion below and spaced from the body portion, and a connecting member coupled at a first end to the body portion and at a second end to the base portion. A method for embedding the implant is also disclosed.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Application No. 63 / 307,090, filed February 5, 2022, which is incorporated by reference herein in its entirety. [Technical field]

[0002] The present invention relates to general surgery, orthopedic systems, and implants used in bone fixation, such as scapular fixation. More specifically, but not exclusively, the present invention relates to plating systems and implants for acromion fractures and methods for their use. [Background technology]

[0003] The acromion is the part of the scapula that serves as the bony area of ​​origin for several muscles of the shoulder.

[0004] Within the past decade, a new shoulder arthroplasty design, the reverse total shoulder arthroplasty, has been used to solve the previously intractable problem of shoulder dysfunction with rotator cuff deficiency. This technique increases the strain on the deltoid muscle to provide force to the shoulder, as well as the acromion process of the scapula, where the deltoid muscle originates.

[0005] Therefore, there is an increasing number of acromion fractures. Fixation of acromion fractures in the typical osteoporotic patient population is challenging, and current plate designs do not adequately address the unique characteristics and biomechanical stresses of this anatomical region. Summary of the Invention [Problem to be solved by the invention]

[0006] Therefore, there is a need for improved plating systems that provide stable and more rigid fixation of these fractures that increases the likelihood of osteounion and improved patient function.

[0007] Aspects of the present disclosure provide a glenoid implant for anatomic shoulder arthroplasty. The present invention also provides a method for using the glenoid implant. [Means for solving the problem]

[0008] In one aspect, provided herein is a bone plate system including a plate and at least one fastener for insertion through the plate, the plate including a body portion, a base portion below and spaced from the body portion, and a connecting member coupled at a first end to the body portion and coupled at a second end to the base portion.

[0009] In another aspect, provided herein is a plate including a body portion, a base portion below and spaced apart from the body portion, and a connecting member coupled at a first end to the body portion and coupled at a second end to the base portion.

[0010] In yet another aspect, provided herein is a surgical method for using a plate. The method includes surgically exposing a desired bone and making a slit in the deltoid muscle. The method also includes inserting a plate having a base inserted through the slit in the deltoid muscle and below the acromion. Additionally, the method includes inserting at least one fastener to secure the plate.

[0011] These and other objects, features and advantages of the present invention will become apparent from the following detailed description of various embodiments of the invention taken in conjunction with the accompanying drawings. [Brief description of the drawings]

[0012] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the present invention and, together with the detailed description herein, serve to explain the principles of the present invention. The drawings are only for the purpose of illustrating preferred embodiments and are not to be construed as limiting the present invention. It is emphasized that, in accordance with standard industry practice, various features are not drawn to scale. In fact, dimensions of various features may be arbitrarily increased or decreased for clarity of illustration. The foregoing and other objects, features and advantages of the present invention will become apparent from the following detailed description taken in conjunction with the accompanying drawings. [Figure 1] FIG. 1 is a first perspective view of a bone plate system according to one embodiment of the present disclosure. [Diagram 2] FIG. 2 is a second perspective view of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Diagram 3] FIG. 2 is an exploded perspective view of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Figure 4] FIG. 2 is a first perspective view of a plate of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Diagram 5] FIG. 5 is a second perspective view of the plate of FIG. 4 according to one embodiment of the present disclosure. [Figure 6] FIG. 5 is a first side view of the plate of FIG. 4 according to one embodiment of the present disclosure. [Figure 7] FIG. 5 is a second side view of the plate of FIG. 4 according to one embodiment of the present disclosure. [Figure 8] FIG. 5 is a first end view of the plate of FIG. 4 according to one embodiment of the present disclosure. [Figure 9] FIG. 5 is a second end view of the plate of FIG. 4 according to one embodiment of the present disclosure. [Figure 10] FIG. 5 is a top view of the plate of FIG. 4 according to one embodiment of the present disclosure. [Figure 11] FIG. 5 is a bottom view of the plate of FIG. 4 in accordance with the present disclosure. [Figure 12] FIG. 2 is a first perspective view of another plate according to one embodiment of the present disclosure. [Figure 13] FIG. 13 is a second perspective view of the plate of FIG. 12 according to one embodiment of the present disclosure. [Figure 14] FIG. 13 is a first perspective view of yet another plate according to an embodiment of the present disclosure. [Figure 15] FIG. 15 is a second perspective view of the plate of FIG. 14 according to one embodiment of the present disclosure. [Figure 16] FIG. 13 is a posterior view of another plate placed on a scapula having a supracromial bone according to one aspect of the present disclosure. [Figure 17] FIG. 17 is an inferior posterior view of the plate of FIG. 16 on the scapula, according to one embodiment of the present disclosure. [Figure 18] FIG. 17 is a side view of the plate of FIG. 16 on the scapula, according to one embodiment of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0013] Generally speaking, plate systems and implants for fixation of acromion fractures are disclosed herein. Additionally, surgical methods for using the systems and implants are described.

[0014] In this detailed description and in the claims that follow, the terms proximal, distal, anterior, posterior, medial, lateral, superior and inferior are defined by their standard usage to refer to specific portions of a bone or implant according to the relative placement of natural bone or directional terms of reference. For example, "proximal" refers to the portion of the device or implant closest to the torso and "distal" refers to the portion of the device or implant furthest from the torso. With respect to directional terms, "anterior" refers to a direction toward the front of the body, "posterior" refers to a direction toward the back of the body, "medial" refers to a direction toward the midline of the body, "lateral" refers to a direction toward either side of the body or away from the midline, "superior" refers to above another object or structure, and "inferior" refers to below another object or structure.

[0015] Similarly, a location or orientation may be used herein with reference to an anatomical structure or surface. For example, the present implants, devices, systems, and methods are described herein with reference to use with the bones of the shoulder, and therefore the bones of the shoulder and upper arm may be used to describe the surfaces, locations, directions, or orientations of the implants, devices, systems, and methods. Additionally, the implants, devices, systems, and methods disclosed herein, as well as their aspects, components, features, etc., are described with respect to one side of the body for brevity. However, because the human body is relatively symmetrical or mirror image with respect to a line of symmetry (the midline), it is hereby expressly contemplated that the implants, devices, systems, and methods described and / or illustrated herein, as well as their aspects, components, features, etc., may be altered, modified, modified, reconfigured, or otherwise modified for use or association with another side of the body for the same or similar purposes without departing from the spirit and scope of the present invention. For example, the implants, devices, systems, and methods described herein with respect to the right shoulder, as well as their aspects, components, features, etc., may be mirrored to function similarly with the left shoulder, and vice versa. Additionally, while the implants, devices, systems and methods disclosed herein, and their aspects, components, features, etc., are described with respect to the shoulder for brevity, it should be understood that the implants, devices, systems and methods may be used with other bones of the body having a similar structure, such as the bones of the lower extremities, and more specifically, the ankle, foot, and leg.

[0016] Referring to the drawings, where like reference numbers are used to indicate like or similar components throughout the several views, and with particular reference to FIGS. 1-3, one embodiment of a bone plate system or acromion plate system 100 is shown. The system 100 includes an implant or bone plate 110, at least one fastener 102 for insertion through the bone plate 110, and a locking screw 104 for insertion through the bone plate 110. The at least one fastener 102 may be, for example, five fasteners 102. The fastener 102 may be, for example, a screw, a cortical screw, a bone screw, a cable, a wire, or the like. The thread may be, for example, threaded along a portion or the entire length. The locking screw 104 may include, for example, threads along at least a portion of its shaft. Additionally, the locking screw 104 may include threads on at least a portion of a head.

[0017] With continued reference to Figures 1-3 and with reference to Figures 4-11, a plate 110 is shown. The plate 110 includes a first side or front side 112 opposite a second side or rear side 114, a first end or outer end 116 opposite a second end or inner end 118, and a top or upper surface 120 opposite a bottom or lower surface 122. The plate 110 also includes a body portion 130, a connecting member 150, a base portion 160, and an extension portion 180. The body portion 130 is located near the first end 116 of the plate 110. The base portion 160 is disposed below the body portion 130 and spaced apart therefrom. The connecting member 150 couples the body portion 130 and the base portion 160 and extends from the body portion 130 to the base portion 160. The connecting member 150 is coupled to a first end of the body portion 130. The extension portion 180 extends away from the body portion 130 at a second end.

[0018] Continuing to refer to FIGS. 1-11, the body portion 130 of the plate 110 includes a first portion 132 on a first side and a second portion 134 on a second side. The plate 110 may be, for example, oval or rectangular. The plate 110 may have, for example, rounded ends and flat or planar long sides. The first portion 132 may extend from the second side 114 of the plate 110 beyond the connecting member 150 and the extension 180. The first portion 132 may extend a first length away from the extension 180. The second portion 134 may extend from the first side 112 of the plate 110 beyond the connecting member 150 and the extension 180. The second portion 134 may extend a second length away from the extension. The first length of the first portion 132 may be, for example, less than the second length of the second portion 134. In some embodiments, the plate 110 may also include at least one tab 136 extending away from the outer surface of the body portion 130, as shown in FIGS. 1-11. Alternative embodiments may include a plate 200 that does not include a tab 136, as shown in FIGS. 12-13 and described in more detail below. With continued reference to FIGS. 1-11, the at least one tab 136 may be, for example, three tabs 136. The plate 110 may include a first tab 136 that extends away from the first portion 312 of the body portion 130. The plate 110 may also include a second tab 136 and a third tab 136 that extend away from the second portion 134. The second tab 136 may extend away from the front side 112 of the second portion 134, and the third tab 136 may extend away from the outer end 116 of the second portion 134. The body portion 130 of the plate 110 may also include a plurality of openings 138, 140, 142 spaced across the body portion 130. The plurality of openings 138, 140, 142 may include a first opening 138 located intermediate the first portion 132 and the second portion 134 of the body portion 130. The first opening 138 may be located, for example, at a midpoint between the first side 112 and the second side 114 of the plate 110. The first opening 138 extends through the body portion 130 from the top surface 120 to the bottom surface 122.The plurality of openings 138, 140, 142 may also include at least one second opening 140. The at least one second opening 140 may be, for example, two second openings 140 located in the first portion 132 of the body portion 130. The two second openings 140 may be, for example, spaced apart from each other along a length between the first end 116 and the second end 118. The second openings 140 extend through the body portion 130 from the top surface 120 to the bottom surface 122. The plurality of openings 138, 140, 142 may also include at least one third opening 142. The at least one third opening 142 may be, for example, two third openings 142 located in the second portion 134 of the body portion 130. The two third openings 142 may be, for example, spaced apart from each other along a length between the first end 116 and the second end 118. A third opening 142 extends through the body portion 130 from the top surface 120 to the bottom surface 122. The plurality of openings 138, 140, 142 are configured or sized and shaped to receive the fasteners 102.

[0019] The connecting member 150 is also shown in FIGS. 1-11. The connecting member 150 has a first end 152 and a second end 154. The first end 152 is coupled to and extends away from the outer end 116 of the body portion 130. The second end 154 is coupled to and extends away from the outer end 116 of the base portion 160. As shown in FIGS. 1-11, the connecting member 150 may be directly coupled, for example, to the body portion 130 at one end and to the base portion 160 at the other end. However, in alternative embodiments, the connecting member 150 may be removably coupled, for example, to the body portion 130 and the base portion 160. The connecting member 150 may be coupled to the body portion 130 and the base portion 160 during, for example, insertion into a patient, and the connecting member 150 may be removed from the patient once the body portion 130 and the base portion 160 are secured to the patient's bone. The connecting member 150 may be coupled to the body portion 130 and the base portion 160 by, for example, tongue and groove, tenon and mortise, protrusion and slot, or another known mechanical attachment means that allows for fixation during insertion and removal after insertion is complete.

[0020] As shown in FIGS. 1-11, in some embodiments, the connecting member 150 may extend offset from the center of the body portion 130. Alternative positioning of the connecting member 150 relative to the body portion 130 is also contemplated, for example, the connecting member 150 may extend from a central portion of the body portion 130, or may be offset forward or rearward from a midpoint of the body portion 130. The connecting member 150 extends from at least a first portion 132 of the body portion 130. The connecting member 150 may also extend from the base portion 160 offset from the center of the base portion 160 in some embodiments. It is also contemplated that in alternative embodiments, the connecting member 150 may extend from a central portion of the base portion 160, or may be offset forward or rearward from a midpoint of the base portion 160, for example. The connecting member 150 further extends from at least a first portion 162 of the base portion 160. The connecting member 150 may be, for example, curved or arcuate as the connecting member 150 extends between the body portion 130 and the base portion 150. The connecting member 150 may have a C-shape, for example. The connecting member 150 may also have an opening 156 that extends through the connecting member 150 from the outer surface to the inner surface. The opening 156 may be located, for example, at a midpoint of the connecting member 150 between the first end 152 and the second end 154. The opening 156 may be configured or sized and shaped to receive the locking screw 104, for example.

[0021] As shown in FIGS. 1-11, the base portion 160 of the plate 110 includes a first portion 162 on a first side and a second portion 164 on a second side. The plate 110 may be, for example, oval or rectangular. The plate 110 may have, for example, rounded ends and flat or planar long sides. The first portion 162 may extend from the second side 114 of the plate 110 beyond the connecting member 150 and the extension 180. The first portion 162 may extend a first length away from the extension 180. The second portion 164 may extend from the first side 112 of the plate 110 beyond the connecting member 150 and the extension 180. The second portion 164 may extend a second length away from the extension 180. The first length of the first portion 162 may be, for example, less than the second length of the second portion 164. The body portion 130 of the plate 110 may also include a plurality of openings 166, 168, 170 spaced across the base portion 160. The plurality of openings 166, 168, 170 may include a first opening 166 located midway between the first portion 162 and the second portion 164 of the base portion 160. The first opening 166 may be located, for example, at a midpoint between the first side 112 and the second side 114 of the plate 110. The first opening 166 extends through the base portion 160 from the top surface 120 to the bottom surface 122. The plurality of openings 166, 168, 170 may also include at least one second opening 168. The at least one second opening 168 may be, for example, two second openings 168 located in the first portion 162 of the base portion 160. The two second openings 168 may be spaced apart from each other, for example, along a length between the first end 116 and the second end 118. The second openings 168 extend through the base portion 160 from the top surface 120 to the bottom surface 122. The plurality of openings 166, 168, 170 may also include at least one third opening 170. The at least one third opening 170 may be, for example, two third openings 170 located in the second portion 164 of the base portion 160. The two third openings 170 may be spaced apart from each other, for example, along a length between the first end 116 and the second end 118.A third opening 170 extends through the base 160 from the top surface 120 to the bottom surface 122. The plurality of openings 166, 168, 170 are configured or sized and shaped to receive the fasteners 102.

[0022] As shown in FIGS. 1-11 , the body portion 130 may be spaced apart from and positioned directly above the base portion 160. The body portion 130 may be spaced apart from the base portion 160 based on the height of the connecting member 150, for example. The body portion 130 may be positioned to align the openings 138, 140, 142 with the openings 166, 168, 170 of the base portion 160 to allow the fastener 102 to extend through the body portion 130 and into the base portion 160. Although the body portion 130 and the base portion 160 are shown as mirror images of one another in the illustrated embodiment, it is also contemplated that the base portion 160 may have a different shape or smaller size than the body portion 130. For example, an alternative shape may be a dog-bone shape or other shape that provides only a surface sufficient to contain the openings 166, 168, 170 for coupling the base portion 160 with the body portion 130.

[0023] 1-11, an extension 180 is shown and includes a first end 182 and a second end 184. The first end 182 of the extension 180 is coupled to and extends away from the body portion 130. The extension 180 may be, for example, curved or arcuate along the length of the extension 180 between the first end 182 and the second end 184. The extension 180 may be configured or sized and shaped to correspond to the shape of the upper surface of the patient's scapula, for example. The extension 180 couples to the body portion 130 offset to the second side 114 of the plate 110. The extension 180 couples to at least the first portion 132 of the body portion 130. The extension 180 includes at least one enlarged bone screw hole 186 disposed along the length of the extension 180. The screw hole 186 may include a threaded portion 188 along at least a portion of the hole 186. The threaded portion 188 may be disposed, for example, on an inner or outer portion of each screw hole 186. The at least one enlarged bone screw hole 186 may be any number of screw holes 186 based on the length of the extension 180, for example, one to six or more holes 186. The extension 180 may also include at least one slot 190 along the length of the extension 180 between the first end 182 and the second end 184. The at least one slot 190 may be, for example, oval or rectangular. The at least one slot 190 may be, for example, one slot 190. The slot 190 may be disposed along the length of the extension 180 along which the screw holes 186 are aligned. The extension 180 may also include at least one relief passage 192 disposed along the length of the extension 180 between the first end 182 and the second end 184. Each of the at least one relief passage 192 extends to one of the first side 112 and the second side 114 of the extension 180. As shown, the relief passages 192 may be arranged in pairs, with a first relief passage 192 extending to the first side 112 of the extension 180 and a second relief passage 192 extending to the second side 114 of the extension 180. The first relief passage 192 may be located directly opposite the second relief passage 192, for example.The extension 180 may include multiple pairs of relief passages 192 along the length between the first end 182 and the second end 184. The extension 180 may further include at least one groove 194 disposed along the length of the extension 180 between the first end 182 and the second end 184. Each groove 194 of the at least one groove 194 extends into the extension 180 from the lower surface. As shown, the grooves 194 may be arranged in pairs, with a first groove 194 extending into the lower surface near the first side 112 of the extension 180 and a second groove 194 extending into the lower surface near the second side 114 of the extension 180. The first groove 194 may be disposed directly opposite the second groove 194, for example. The extension 180 may include multiple pairs of grooves 194 along the length between the first end 182 and the second end 184. The pairs of relief passages 192 may alternate with pairs of grooves 194 along the length of the extension 180. The relief passages 192 and grooves 194 may allow for bending or flexing of the extension 180 of the plate 110 during surgery.

[0024] 12-13, another plate 200 is shown. Plate 200 has a body portion 202, a connecting member 150, a base portion 160, and an extension portion 180. Connecting member 150, base portion 160, and extension portion 180 are as described above with reference to plate 110 and will not be described again here for the sake of brevity. Body portion 202 is similar to body portion 130, except that, as shown in FIGS. 12-13, body portion 202 does not have tab 136. The remainder of body portion 202 is as described above with reference to body portion 130 and will not be disclosed again here for the sake of brevity.

[0025] 14-15, another plate 250 is shown. The plate 250 has a body portion 130, a base portion 160, an extension portion 180, and at least one connecting member 252 that secures the body portion 130 and the base portion 160. The body portion 130, the base portion 160, and the extension portion 180 are as described above with reference to the plate 110, and will not be described again here for brevity. The at least one connecting member 252 may be, for example, five connecting members 160 housed in the openings 138, 140, 142 of the body portion 130 and the openings 166, 168, 170 of the base portion 160. The at least one connecting member 252 may be, for example, wires, screws, cables, posts, pegs, etc. The connecting member 252 may be, for example, fixed to each of the body portion 130 and the base portion 160 to connect the body portion 130 to the base portion 160.

[0026] A method of using the bone plate system 100 includes obtaining the bone plate system 100; creating an incision at a surgical site on a patient; preparing the patient's shoulder bone for surgery; inserting the plate 110 into the patient and sliding the base portion 160 of the plate 110 through the deltoid slit. More specifically, the first side 112 or the second portion 164 of the base portion 160 may be positioned to be inserted through the deltoid slit. The second portion 164 of the base portion 160 may then be inserted through the deltoid slit and the plate 110 may be rotated, for example, counterclockwise approximately 90° to insert the remaining portion of the base portion 160 through the deltoid slit and under the lateral side of the acromion. Insertion of the base portion 160 may be performed, for example, from the lateral side of the patient. The connecting member 150 is then wrapped around the lateral side of the acromion, positioning the base portion 160 under the acromion and the remaining portion of the plate 110 on the superior surface of the scapula. The fasteners 102 and / or locking screws 104 may then be inserted through the plate 110 and into a portion of the bone. In embodiments having tabs 136, the tabs 136 may be activated to assist in securing the plate 110 to the patient's bone. The tabs 136 may be used before or after inserting the fasteners 102 and / or locking screws 104. Additional fasteners or bone screws may then be inserted into the extension 180 of the plate 110 to secure the extension 180 along the scapula. Once all of the fasteners and / or screws have been inserted into the patient's bone, the surgery is complete and the patient's incisions may be closed.

[0027] The plates 110, 200, 250 are made of sufficient material to attach to the medial side of the scapula with a portion that connects to the subacromial portion. The plates 110, 200, 250 include a portion that is located below the acromion. The acromion is a thin piece of bone that is often prone to osteoporosis. The plates 110, 200, 250 include a portion that supports the acromion bone at the subacromial portion, which reduces failure of the screw pull-out mechanism.

[0028] 16-18, an alternative plate is shown, which sits both above and below the acromion.

[0029] As can be recognized by those skilled in the art based on the teachings herein, numerous changes and modifications can be made to the above and other embodiments of the present disclosure without departing from the scope of the present disclosure. The components of the implants, devices, and / or systems disclosed herein, including the accompanying abstract and drawings, can be replaced with alternative components or features, such as those disclosed in another embodiment, that serve the same, equivalent or similar purpose as known by those skilled in the art to achieve the same, equivalent or similar result by such alternative components or features, to provide a similar function for the intended purpose. Furthermore, the implants, devices, and / or systems can include more or fewer components or features than the embodiments described and illustrated herein. For example, the components and features of the implants 110, 200, 250 may be used interchangeably and in alternative combinations, as modified or changed by those skilled in the art. Furthermore, the steps of the surgical method associated with the implants 100, 200, 250 may be used interchangeably and in alternative combinations, as modified or changed by those skilled in the art. Thus, this detailed description of the presently preferred embodiments should be interpreted as illustrative, as opposed to restrictive, of the present disclosure.

[0030] The terms used herein are for the purpose of describing particular embodiments only and are not intended to be limiting of the invention. As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms unless the context clearly dictates otherwise. It will be further understood that the terms "comprise" (and any form of comprise, such as "comprises" and "comprising"), "have" (any form of have, such as "has" and "having"), "include" (any form of include, such as "includes" and "including"), and "contain" (any form of contain, such as "contains" and "containing") are open-ended linking verbs. As a result, a method or apparatus that "comprises," "has," "includes," or "contains" one or more steps or elements possesses those one or more steps or elements, but is not limited to possessing only those one or more steps or elements. Similarly, a method step or apparatus element that "comprises," "has," "includes," or "contains" one or more features possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, an apparatus or structure that is configured in a particular way may be configured in at least that way, but in ways not recited.

[0031] The present invention has been described with reference to preferred embodiments. It will be understood that the operational embodiments described herein are examples of multiple possible configurations for providing the same general features, characteristics, and general system operations. Modifications and alterations will occur to others upon reading and understanding the foregoing detailed description. It is intended that the present invention be construed as including all such modifications and alterations.

Claims

1. a plate including a main body portion and a base portion disposed below the main body portion and spaced apart from the main body portion; and at least one fastener for insertion through said plate.

2. The plate is The system of claim 1 , further comprising a connecting member coupled at a first end to the body portion and at a second end to the base portion.

3. The plate is The system of claim 2 , further comprising an extension coupled to and extending from the body portion.

4. The main body portion is a first portion disposed near a first side of the plate; a second portion located near a second side of the plate.

5. The main body portion is The system of claim 4 , further comprising at least one opening for receiving the at least one fastener.

6. The at least one opening is a first opening through the body portion near a midpoint of the body portion; at least one second opening through the first portion of the body; and at least one third opening through the second portion of the body.

7. The main body portion is at least one tab extending away from the first portion of the body; The system of claim 6 , further comprising at least one tab extending away from the second portion of the body.

8. The connecting member is The system of claim 5 further comprising an opening extending through the connecting member from the outer surface to the inner surface.

9. The base portion is a first portion disposed near a first side of the plate; a second portion disposed near a second side of the plate.

10. The base portion is The system of claim 9 , further comprising at least one opening for receiving the at least one fastener.

11. The at least one opening is a first opening through the base near a midpoint of the base; at least one second opening through the first portion of the base; and at least one third opening through the second portion of the base.

12. The system of claim 2 , wherein the body portion is a mirror image of the base portion.

13. The extension portion is at least one screw hole disposed along the length of the extension between the first end and the second end; at least one slot disposed along the length of the extension between the first end and the second end; The system of claim 3 , wherein the at least one screw hole is offset from the at least one slot.

14. The extension portion is at least one relief passage extending into the extension from at least one of the first side and the second side; and at least one groove extending into a lower surface of the extension.

15. The system of claim 2 , wherein the connecting member is detachable.

16. a main body; a base portion disposed below the main body portion and spaced apart from the main body portion, The body portion is coupled to the base portion by at least one fastener.

17. The plate is 17. The plate of claim 16, further comprising a connecting member coupled at a first end to the body portion and at a second end to the base portion.

18. The plate is 18. The plate of claim 17, further comprising an extension coupled to and extending from the body portion.

19. 20. The plate of claim 18, wherein the body portion is a mirror image of the base portion.

20. The connecting member is 18. The plate of claim 17, further comprising an opening extending through the connecting member from the outer surface to the inner surface.

21. 21. The plate of claim 17 or 20, wherein the midpoint of the connecting member is offset from the midpoint of the body portion and the midpoint of the base portion.

22. 20. The plate of claim 18, wherein a midpoint of the extension is offset from a midpoint of the body portion as the extension extends from the body portion.

23. The main body portion is a first portion disposed near a first side of the plate; a second portion located near a second side of the plate.

24. The main body portion is 24. The plate of claim 23, further comprising at least one opening through the body portion.

25. The at least one opening is a first opening through the body portion near a midpoint of the body portion; at least one second opening through the first portion of the body; and at least one third opening through the second portion of the body.

26. The main body portion is at least one tab extending away from the first portion of the body; 26. The plate of claim 25, further comprising: at least one tab extending away from the second portion of the body.

27. The connecting member is 25. The plate of claim 24, further comprising an opening extending through the connecting member from the outer surface to the inner surface.

28. The base portion is a first portion disposed near a first side of the plate; and a second portion disposed near a second side of the plate.

29. The base portion is 30. The plate of claim 28, further comprising at least one opening through the base portion.

30. The at least one opening is a first opening through the base near a midpoint of the base; at least one second opening through the first portion of the base; and at least one third opening through the second portion of the base.

31. The extension portion is at least one screw hole disposed along the length of the extension between the first end and the second end; at least one slot disposed along the length of the extension between the first end and the second end; The plate of claim 18, wherein the at least one screw hole is offset from the at least one slot.

32. The extension portion is at least one relief passage extending into the extension from at least one of the first side and the second side; and at least one groove extending into a lower surface of the extension.

33. The plate of claim 17 , wherein the connecting member is removable.

34. A method of using a plate, comprising: surgically exposing a desired bone; Steps to make a slit in the deltoid muscle, inserting a base portion of the plate through the slit in the deltoid muscle so that it is inserted beneath the acromion; and inserting at least one fastener to secure the plate.

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