Bone plate having multiple-use screw holes for locking and compression screws

Abstract

The bone plate has an outer surface, a bone-facing surface opposite the outer surface, and an inner surface defining a hole extending from the outer surface to the bone-facing surface along a central bore axis. The inner surface further defines a ramp extending from the outer surface toward the bone-facing surface and a plate thread extending from the ramp toward the bone-facing surface and configured for optional locking engagement with the male threads on the first head of the locking bone fixation member. The inner surface further defines a contact contour in a reference plane extending along the central bore axis. The contact contour is defined by at least the ramp and is spaced from the central bore axis in an offset direction perpendicular to the central bore axis. The contact contour is configured to translate the bone plate in the offset direction in response to contact with the outer surface of the second head of the compressible bone fixation member as the second head advances through the hole along an insertion axis offset in the offset direction from the central bore axis.

Description

Technical Field

[0001] (Cross - reference to related applications) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 107,699, filed Oct. 30, 2020, in the names of Aebi et al., under 35 U.S.C. § 119(e), the entire content of which is incorporated herein by reference.

[0002] (Technical Field) The present invention relates to a bone plate for receiving a bone anchor and fixing the bone plate to bone, and more particularly to a bone plate having threaded fixing holes configured to be selectively screwed and locked, particularly by the threaded head of a locking bone anchor, or to be dynamically compressed through sliding engagement with the head of a compression bone anchor for multiple uses.

Background Art

[0003] Bone plate systems for internal fixation of fractures are well known. Conventional bone plate systems are particularly well suited to promoting fracture healing. Bone anchors, such as bone screws, are inserted through fixation openings or holes in the bone plate and threaded into the bone to compress, neutralize, support, tension, bind, and / or bridge the fracture ends together. To transfer a load from one fractured bone portion over the plate onto another fractured bone portion without pulling the bone against the plate, and to avoid loosening or backing out the bone screw with respect to the plate (which can lead to inadequate alignment and poor clinical outcomes), bone screws can be used that lock the bone plate. One known embodiment of such a screw uses a screw head having a male thread for engaging a corresponding thread on the inner surface of a fixation hole, hereinafter referred to as a "locking hole", for locking the screw to the plate. These screws are hereinafter referred to as "locking screws" and are configured to lock only within the fixation hole in a substantially "nominal" orientation, whereby a standard type locking screw in which the central screw axis is substantially aligned with the central hole axis, as well as a "variable-angle" (VA) locking screw configured to lock within the fixation hole in either a nominal orientation or an "angled" orientation, whereby the central screw axis is oriented at an acute angle with respect to each central hole axis, may be included.

[0004] The bone plate system can also be adapted to provide anatomical reduction between fractured bone portions. The bone plate of such a system includes one or more holes with ramp geometry that engage the smooth outer surface of the screw head of a "compression screw" in a manner that causes dynamic compression, which means that the bone plate translates along a direction substantially perpendicular to the screw axis of the compression screw and relative to the compression screw and the underlying bone. Such holes are hereinafter referred to as "compression holes". The bone plate can include locking holes and compression holes. For example, one or more of the locking holes can be used to receive locking screws that fix the bone plate to a first underlying bone segment. Then, one or more of the compression holes can be used to receive compression screws, which are driven into a second underlying bone segment to effectively push the bone plate in a translational direction that reduces the gap between the first and second underlying bone segments through the engagement of the head of the compression screw in the hole with the ramp geometry.

SUMMARY OF THE INVENTION

MEANS FOR SOLVING THE PROBLEM

[0005] According to one embodiment of the present disclosure, a bone plate has an outer surface, a bone-facing surface opposite the outer surface, and an inner surface that defines a hole extending from the outer surface to the bone-facing surface along a central hole axis. The inner surface further defines a ramp extending from the outer surface toward the bone-facing surface, and a plate thread configured to extend from the ramp toward the bone-facing surface and optionally engage in a locking engagement with a male thread on a first head of a locking bone fixation member. The inner surface further defines a contact profile within a reference plane that extends along the central hole axis. The contact profile is defined at least by the ramp and is spaced in an offset direction perpendicular to the central hole axis from the central hole axis. The contact profile is configured to translate the bone plate in the offset direction in response to contact with the outer surface of a second head of a compression bone fixation member as the second head advances through the hole along an insertion axis offset in the offset direction from the central hole axis.

[0006] According to another embodiment of the present disclosure, a method of seating a bone screw in a hole defined by the inner surface of a bone plate includes inserting the shaft of the bone screw through the hole with an offset distance measured between the central axis of the bone screw and the central axis of the hole along a first direction perpendicular to the central axis of the hole into the underlying bone. The method includes contacting an outer surface of the head of the bone screw with at least one ramp surface defined by the inner surface within the hole. The inner surface includes an internal thread that extends between the at least one ramp surface and the underlying bone. The method further includes driving the bone screw downward along the central axis of the screw toward the underlying bone during the contacting step, thereby translating the bone plate in a first direction relative to the bone screw.

Brief Description of the Drawings

[0007] The foregoing summary and the following detailed description of exemplary embodiments of the present application will be better understood when read in conjunction with the accompanying drawings. For the purpose of illustrating the locking structure of the present application, exemplary embodiments are shown in the drawings. However, it should be understood that the present application is not limited to the exact arrangements and means shown. Of the drawings:

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DETAILED DESCRIPTION OF THE INVENTION

[0008] The present disclosure can be more easily understood by referring to the following detailed description related to the accompanying drawings and examples, which form a part of the present disclosure. The present disclosure is not limited to the specific devices, methods, uses, conditions or parameters described and / or illustrated herein, and the technical terms used herein are for the purpose of describing specific embodiments using examples only and are not intended to limit the scope of the present disclosure. It should also be understood that when used in the specification including the appended claims, the singular forms "a", "an", and "the" include the plural, and references to a particular numerical value include at least this particular value unless the context clearly indicates otherwise.

[0009] As used herein, the term "plurality" means more than one. When a range of values is represented, in another embodiment, it includes from a certain specific value and / or up to another specific value. Similarly, when a value is expressed in an approximate form by the preceding "about", it will be understood that another embodiment is formed by that specific value. All ranges include boundary values and combinations are possible.

[0010] When used herein with respect to dimensions, angles, and other shapes, the terms "about" and "substantially" take into account manufacturing tolerances. Further, the terms "about" and "substantially" can include those that are 10% larger or smaller than the specified dimension or angle. Further, the terms "about" and "substantially" can also be equally applied to the specified particular value.

[0011] The embodiments disclosed herein relate to multiple-use holes in a bone plate. In some of the embodiments disclosed herein, the multiple-use holes include (1) a threaded locking structure (e.g., a “locking bone screw”) for optionally locking engagement with the threaded head of a locking bone anchor, and (2) a structure for optionally dynamically compressing in response to the eccentric (axially offset) insertion of the head of a non-locking bone anchor (e.g., a “cortical screw” or a “compression screw”) into the hole. As used herein, the term “dynamic compression” refers to the action of engaging a bone anchor with a bone plate in a manner that translates the bone plate relative to the bone anchor and the underlying patient anatomical structure along a direction that is substantially perpendicular to the axis along which the bone anchor is inserted into the underlying bone. Dynamic compression is particularly useful for moving the fractured portions of bone relative to each other, such as in response to an anatomical rejection reaction to the treatment of a fracture. Such multiple-use holes provide the physician with options such as using the holes for locking engagement by a locking bone anchor or for dynamic compression by a compression bone anchor.

[0012] The inventors have surprisingly and unexpectedly discovered that a threaded locking hole having a specific hole geometry can alternatively be used with a compression bone anchor to achieve dynamic compression even when contact between the anchor head and the internal plate surface within the hole occurs on or along the internal thread within the hole. Accordingly, the threaded locking holes of the present disclosure that include a portion of the hole having an internal thread can provide dynamic compression when the hole is used with a compression anchor. In this way, the multi-use holes of the present disclosure can provide selective locking engagement or dynamic compression without the need for a dedicated compression portion of the hole. Accordingly, the multi-use holes of the present disclosure provide a significant advantage over combination holes (also referred to as "combi-holes") known in the art. One such advantage is that by eliminating the need for a dedicated compression portion of the hole, the multi-use holes of the present disclosure occupy less plate space. Accordingly, the bone plates described herein can include a greater number / higher density of holes than prior art bone plates without sacrificing the selective locking and compression functions. Additionally, such a higher density of holes combined with the option to use each hole for locking or dynamic compression provides improved patient-specific fracture fixation treatment, which provides a further advantage in that such treatment can be less invasive and require only a shorter healing and recovery period.

[0013] Referring to FIGS. 1A-1C, a bone plate 4 has a plate body 5 that defines one or more multi-use holes 6 in the plate body 5. As used herein, the term "multi-use hole" refers to a plate hole configured to be selectively used with either a compression bone anchor, such as a compression screw 7 (see FIGS. 3A-4B), or a locking bone anchor, such as a locking screw. The plate body 5 defines an inner surface 24 that each defines a hole 6. Within each multi-use hole 6, the inner surface 24 is a ramp surface or a "ramp" (i.e., inclined plane)One or more compression structures, such as 33, and one or more locking structures, such as the internal thread 9 in the hole 6, are further defined. The internal thread 9 can also be referred to as the "plate thread" or the "hole thread". The compression structure is configured to engage with the head of the compression bone anchor 7, and the locking structure is configured to engage with the head of the locking bone anchor. In this embodiment, the multiple-use hole 6 is specifically configured to translate the plate 4 substantially along the longitudinal direction X oriented along the longitudinal axis 3 of the plate 4. In other embodiments, one or more of the holes 6 can be configured to translate the plate 4 along a direction angularly offset from the longitudinal direction X.

[0014] As shown, the bone plate 4 can be a bridge plate, but other types and configurations of bone plates are within the scope of the present disclosure. The plate body 5 is elongated along the longitudinal axis 3 and can define a first end 10 and a second end 12 spaced apart from each other along the longitudinal direction X. The plate body 5 can also define a first lateral side 14 and a second lateral side 16 spaced apart from each other along the lateral direction Y that is substantially perpendicular to the longitudinal direction X. The bone plate 4 can also define an upper plate surface 18 (also referred to herein as the "outer surface" 18) configured to face the opposite side of the bone, and an opposite lower plate surface 20 (also referred to herein as the "bone-facing surface") configured to face the bone. The upper plate surface 18 and the lower plate surface 20 are spaced apart from each other along the vertical direction Z that is substantially perpendicular to each of the longitudinal direction X and the lateral direction Y. As used herein, it should be understood that the terms "longitudinal direction", "in the longitudinal direction", and their derivatives refer to the longitudinal direction X, the terms "lateral direction", "in the lateral direction", and their derivatives refer to the lateral direction Y, and the terms "vertical", "vertically", and their derivatives refer to the vertical direction Z. It should also be understood that the plane including the longitudinal direction X and the lateral direction Y can be referred to herein as the "horizontal" plane X-Y.

[0015] The multiple-use holes 6 extend along the central hole axis 22 from the upper plate surface 18 to the lower plate surface 20. The central hole axis 22 is oriented along the axial hole direction. As used herein, the term "axial" (e.g., "axial hole direction" and "axial screw direction") is defined as the direction in which each axis extends. Further, the directional terms "axial" and "axially", and their derivatives, refer to the respective axial directions. Thus, as used herein, the directional term "axially upward" and its derivatives refer to the axial hole direction from the lower plate surface 20 toward the upper plate surface 18. Conversely, the term "axially downward" and its derivatives refer to the axial hole direction from the upper plate surface 18 toward the lower plate surface 20. Thus, "axially upward" and "axially downward" are each unidirectional components of the bidirectional "axial" direction. In the embodiments represented in the figures, the axial hole direction (and thus also the central hole axis 22) is oriented along the vertical direction Z. Thus, the axial hole direction is also represented throughout the present disclosure by "Z". However, it should be understood that the scope of the present disclosure encompasses embodiments in which the axial hole direction (and thus also the central hole axis 22) is offset at an angle from the vertical direction Z. Also, terms such as "axially upper", "axially lower", etc., when used with reference to the compression screw 7 or the locking screw, should also be understood to refer to the central axis 52 of the screw, particularly when the screw is oriented within the hole 6 (see FIGS. 3A - 4B).

[0016] Referring now to FIG. 1C, the multiple-use holes 6 can be arranged in the plate 4 in a manner that provides multi-directional compression to the plate 4. For example, the holes 6 can be arranged in a first group of holes 6 along a first longitudinal region 4a of the plate 4 and a second group of holes 6 along a second longitudinal region 4b of the plate 4. In this embodiment, the first longitudinal region 4a and the second longitudinal region 4b extend to a common boundary at the longitudinal midpoint XM of the plate 4, and each of the first group of holes 6 is configured to provide dynamic compression (i.e., translation of the plate 4) in a first translational direction T1, such as a first longitudinal direction X1 along the longitudinal axis 3 towards the first end 10 of the plate 4, and each of the second group of holes 6 is configured to provide dynamic compression in a second translational direction T2, such as a second longitudinal direction X2 opposite to the first longitudinal direction X1. It should be understood that the arrangement of the multiple-use holes 6 can be adapted as needed to provide the plate 4 with dynamic compression capabilities in various directions according to the requirements of a particular surgical therapy.

[0017] Referring now to FIGS. 2A and 2B, among the plurality of use holes 6, the inner surface 24 extends axially downward from the upper outer periphery 30 of the hole 6 positioned at the interface with the upper plate surface 18 (FIG. 2A). The inner surface 24 can also define an undercut surface 36 (also referred to herein as a "relief surface") that extends axially upward from the lower outer periphery 32 of the hole 6 positioned at the interface with the lower plate surface 20 (FIG. 2B). The locking structure of the hole 6 can be configured to provide for variable angle insertion of the locking bone anchor therein. For example, the locking structure can include rows 26 defined by the inner surface 24 within the hole 6. The rows 26 are sequentially positioned around the periphery of the inner surface 24. The inner surface 24 also defines a plurality of recesses 28 sequentially positioned circumferentially between the rows 26. In other words, the rows 26 and the recesses 28 are alternately disposed along the periphery of the inner surface 24. The rows 26 and the recesses 28 extend axially between the upper plate surface 18 and the lower plate surface 20. The rows 26 and the recesses 28 can be evenly spaced along the periphery of the hole 6. However, in other embodiments, the rows 26 and / or the recesses 28 can be unevenly spaced around the periphery of the hole 6. Each of the recesses 28 can define a central recess axis 37 that can each be parallel to the central hole axis 22, although other orientations with respect to the central recess axis 37 are possible. Each central recess axis 37 can also be radially spaced from the central hole axis 22 by a distance R1. The plate thread 9 extends between the upper plate surface 18 and the lower plate surface 20 along one or more thread paths through at least a portion of the rows 26 and the recesses 28. The portion of the plate thread 9 that crosses the rows 26 can be referred to herein as the "row thread" 9.

[0018] As shown in FIG. 2A, each column 26 can define a first surface 42 that substantially faces the central hole axis 22. The first surface 42 can also be referred to as the "innermost surface" of the column 26. Thus, the first surface 42 defines the crest 56 of the thread 9 of the column. The first surface 42 of each column 26 extends between a first side 44 of the column 26 and a second side 45 that is circumferentially opposite the first side 44. The first side 44 and the second side 45 of each column 26 can define a boundary surface between the column 26 and the recess 28 that is circumferentially adjacent thereto. The first surface 42 of the column 26 can collectively define segments that are tapered downward and generally frustoconical in shape, particularly segments that define a central conical axis that coincides with the central hole axis 22.

[0019] One or more thread paths can include a pair of non-intersecting thread paths (i.e., double lead), but in other embodiments, one or more thread paths can include a single thread path (i.e., single lead), or three or more thread paths (e.g., triple lead, etc.). The thread path is preferably helical, but other types of thread paths are within the scope of the present disclosure. As shown, the plate thread 9 can cross each of the columns 26 and the recesses 28 in a continuous manner in the circumferential direction. However, in other embodiments, portions of the recess 28 can interrupt the plate thread 9 in the circumferential direction, or put another way, the plate 9 can "bottom out" along one or more and all of the recesses 28.

[0020] Column 26 is configured such that, during insertion of the locking screw into hole 6, the inner surface 24 within hole 6 engages the head of the compression screw or locking screw such that the screw shaft of the locking screw or compression screw bypasses column 26. In the latter case, the plate thread 9 engages the male thread on the head of the locking screw in a manner that, after the screw shaft has bypassed column 26, it now provides a locking engagement between the locking screw and the bone plate 4. The structure and operation of column 26 are described more fully in U.S. Patent No. 10,772,665, issued September 15, 2020, in the name of Bosshard et al. (the "Reference 665"), U.S. Patent Application Publication No. 2019 / 0328430 (A1), published October 31, 2019, in the name of Bosshard et al. (the "Reference 430"), U.S. Patent Application No. 16 / 437,105, filed June 11, 2019, in the name of Oberli et al. (the "Reference 105"), and U.S. Patent Application No. 17 / 062,708, filed October 5, 2020, in the name of Oberli et al. (the "Reference 708"), each of which is incorporated herein by reference in its entirety. The references described above are attached hereto as Appendix 1 (Reference 665), Appendix 2 (Reference 430), Appendix 3 (Reference 105), and Appendix 4 (Reference 708), each of which is included as part of this disclosure.

[0021] Referring back to FIG. 2A, the multiple-use holes 6 define a hole shape or “outer profile” in the horizontal reference plane X-Y. Thus, the shape of the holes 6 can be referred to as the “horizontal hole outer profile”. In this embodiment, at least an axial portion of the holes 6 has a generally polygonal horizontal hole outer profile. Specifically, as will be discussed in more detail below, the holes 6 of this embodiment have a triangular (i.e., generally triangular) horizontal outer profile, but in other embodiments, the holes 6 can have other types of polygonal horizontal outer profiles (e.g., rectangular, pentagonal, hexagonal, etc.) or a circular horizontal outer profile. The holes 6 can have a first row 26a, a second row 26b, and a third row 26c positioned in a clockwise order along the periphery of the inner surface 24. The first row 26a of this embodiment is aligned with the longitudinal axis 3. The holes 6 also have a first recess 28a facing the first row 26a, a second recess 28b facing the second row 26b, and a third recess 28c facing the third row 26c. The plate thread 9 can extend along a thread path corresponding to the horizontal outer profile of the holes 6. Further, other features defined by the inner surface 24 can have a corresponding polygonal (e.g., triangular) horizontal outer profile, including the upper outer periphery 30 and the neutral biting surface 34 (at least a portion of which is separated from the compression lamp 33), one or more undercut surfaces 36, and the lower outer periphery 32.

[0022] In the illustrated embodiment, the first surface 42 of the row 26 has a linear horizontal outer profile. In other embodiments, one or more of the first surfaces 42 can have an arcuate outer profile with a relatively large radius (when measured from the central hole axis 22). Each row 26 can define a row centerline 43 that is equally spaced between a first side 44 and a second side 45 of the row 26. In the horizontal reference plane X-Y, the holes 6 can define a major radius R2 that is measured from the central hole axis 22 to the first surface 42 of the row 26 at the row centerline 43.

[0023] In this embodiment, the recess 28 extends in a tangential direction from the first side 44 and the second side 45 of the associated row 26. In this way, when viewed in the horizontal reference plane respectively, the first surface 42 of the row 26 effectively defines the side of a triangle, while the recess 28 effectively defines the corner of the triangle. Therefore, the row 26 and the recess 28 of this embodiment can also be referred to as the "side" and the "corner" 28 of the triangular hole 6 respectively. Each corner 28 can define a corner radius R3 measured from the corner axis 37. The plate thread 9 extends along each spline that rotates spirally about the central hole axis 22 along the triangular outer shape of the inner surface 24 between the upper plate surface 18 and the lower plate surface 20. Additionally, the inner surface 24 including the row 26 and the corner 28 tapers inwards towards the central hole axis 22 from the upper plate surface 18 towards the lower plate surface 20. Further, as shown, the plate thread 9 can cross the row 26 and the corner 28 in a circumferential direction in a continuous manner (i.e., the plate thread 9 does not need to bottom out at the corner 28). Therefore, the plate thread 9 can transition smoothly and continuously between the row 26 and the corner 28.

[0024] The first surface 42 of each row 26 defines a row length LC measured between the sides 44, 45 of the row 26. In this embodiment, the row length LC can be substantially consistent within each row 26 when the thread path travels between the upper surface 18 and the lower surface 20 of the plate 4. In such an embodiment, the row length LC can also be referred to as the "side length" LC of the triangular hole 6. The rows 26 of this embodiment can have a substantially equal row length LC as shown, and thus provide a hole 6 having a substantially equilateral triangular shape. Alternatively, as will be described in more detail below, the row lengths LC of two or all of the rows can be different from each other. In a further embodiment, the row length LC of one or two or more and all of the rows 26 can increase continuously as the thread path progresses from the upper surface 18 towards the lower surface 20 of the plate 4, thereby allowing the corner radius R3 to gradually decrease towards the lower surface 20 of the plate 4.

[0025] Referring back to FIGS. 2A and 2B, one or more compression structures of the plurality of reuse holes 6 can include at least one biting surface 33 or "compression ramp" 33 that tapers axially downward from the upper outer periphery 30 toward the lower plate surface 20. Each compression ramp 33 is configured to translate the plate 4 in a specific translational direction T1 within the horizontal plane X-Y in response to engagement with the head of the compression bone anchor 7. In this embodiment, the hole 6 extends less than one revolution about the central hole axis 22 and includes a compression ramp 33. For example, the ramp 33 can be positioned on a specific side of the hole 6 in the intended translational direction T1. Stated another way, the translational direction T1 extends substantially horizontally from the central hole axis 22 toward the ramp 33.

[0026] As shown in FIG. 2A, the compression lamp 33 is positioned centrally along the longitudinal axis 3 such that the translation direction T1 is oriented or “converged” along the longitudinal direction X or otherwise affected, such that the lamp 33 is configured. For example, the compression lamp 33 can define a crescent shape when viewed in the horizontal reference plane X-Y such that the maximum transverse dimension L0 of the crescent shape occurs along the longitudinal axis 3. The lamp 33 can orbit about the central hole axis 22 from the first end 35 to the second end 35. In this way, the lamp 33 can define an angular lamp width A1 measured between the ends 35 in the horizontal plane X-Y. As shown, the lamp 33 can orbit about the central hole axis 22 such that one or both of the ends 35 are positioned across the column centerline 43 of the adjacent column 26. However, in other embodiments, the compression lamp 33 can have an angular width A1 such that one or both of the ends 35 are positioned respectively in front of the column centerline 43 of the adjacent column 26. In other words, the first compression lamp 33 need not extend across one or both of the adjacent column centerlines 43. In a further embodiment, it should be understood that any and each of the corner portions 28 can include a compression lamp 33 for directing dynamic compression in response to eccentric insertion of the compression screw 27 towards each respective corner portion 28. Such compression lamps 33 can be separate from each other or can be defined by different portions of a single lamp surface.

[0027] The angular lamp width A1 can range from about 10 degrees to a maximum of about 360 degrees, more specifically from about 40 degrees to 180 degrees, and more specifically from about 120 degrees to about 160 degrees. The hole 6 can also include a neutral biting surface 34 that extends axially downward into the hole 6 from the upper outer periphery 30, orbits about the central hole axis 22, and also extends to connect with the compression lamp 33. (i.e., second inclined plane) can include.

[0028] Referring now to FIG. 2B, the compression ramp 33 tapers axially downward from the upper outer periphery 30 and can intersect the plate thread 9. In the present embodiment, the compression ramp 33 has a linear surface profile within a reference plane that extends along the central hole axis 22 and the longitudinal direction X. This reference plane is also referred to herein as the "axial reference plane". The ramp 33 is oriented at a ramp angle A2 that is acute with respect to the central hole axis 22. The ramp angle A2 can be in the range of about 0.5 degrees to about 85 degrees, more specifically in the range of about 30 degrees to about 60 degrees, and more specifically in the range of about 42 degrees to about 48 degrees. In other embodiments, it should be understood that the compression ramp 33 can have a concave arcuate profile within the axial reference plane. In such embodiments, the ramp angle A2 can be measured between the central hole axis 22 and a tangent axis that intersects the compression ramp 33 at that location within the axial reference plane.

[0029] In the illustrated embodiment, the compression ramp 33 extends from the upper outer periphery 30 to the thread 9 and intersects the thread 9. In other embodiments, a portion of the neutral biting surface 34 can extend axially downward from the compression ramp 33, such as the first recess 28a. In this way, the compression ramp 33 can define a first compression ramp 33, and such a portion of the neutral biting surface 34 can define a second axially lower compression ramp along the first corner portion 28a or the like. In such embodiments, the second compression ramp 34 can extend axially downward from the first compression ramp 33 to the plate thread 9. The first ramp 33 can define a first ramp angle A2, and the second compression ramp 34 can define a second ramp angle, and the second ramp angle can be smaller (i.e., steeper) or larger (i.e., shallower) than the first ramp angle A2 with respect to the central hole axis 22 in the axial reference plane along the longitudinal axis 3.

[0030] Referring back to FIG. 2B, the plate thread 9 has a cross-sectional outer shape in the axial reference plane. Such a cross-sectional outer shape is also referred to as a "thread profile" and includes a thread crest 56, a thread root 58, and an upper flank 55 and a lower flank 57 extending between the thread crest 56 and the thread root 58. As used herein with reference to the plate thread 9, the term "thread crest" refers to the apex of the completed thread profile. The thread profile of the plate thread 9 is configured to complementarily engage (mesh) with the male thread of the locking screw head, particularly to provide a preferred mating engagement therebetween. The thread profile of the plate thread 9 is also configured to engage with the outer surface of the head of the compression screw that is eccentrically inserted into the hole 6. In this way, the plate thread 9 can be characterized as defining a compression ramp for providing dynamic compression. It should be understood that in this way, the compression ramp 33 and the plate thread 9 can together provide complementary dynamic compression.

[0031] The thread crest 56 of the plate thread 9 can be sharpened, but one or more and all of the thread crests 56 can be rounded to reduce stress concentration and, further, to reduce undesirable mechanical interference with the male thread on the head of the locking screw. In other embodiments, as will be described in more detail below, one or more of the thread crests 56 can be chamfered and can have a linear thread crest outer shape.

[0032] On the reference plane, the crest 56 of the plate thread 9 extends along the crest orbital axis 46. In the present embodiment, the crest orbital axis 46 is linear and can be oriented at an acute crest orbital angle A3 with respect to the central hole axis 22. The crest orbital angle A3 can be in the range of about 5 degrees to about 30 degrees, more specifically in the range of about 10 degrees to about 20 degrees, and preferably in the range of about 13 degrees to about 17 degrees. As shown, the crest orbital angle A3 can be made smaller (i.e., steeper) than the lamp angle A2, but in other embodiments, the crest orbital angle A3 can be equal to or larger (i.e., shallower) than the lamp angle A2. In still other embodiments, one or both of the compression lamp 33 and the crest orbital axis 46 can be curved such that various portions of the crest orbital axis 46 can be shallower than, equal to, and / or steeper than various portions of the compression lamp 33, and vice versa. The crest orbital angle A3 is configured, inter alia, to prevent the head of the locking screw or compression screw from passing completely through the plurality of use holes 6.

[0033] The thread 9 can also define a thread pitch P that extends axially between adjacent crests 56 in the axial direction and is in the range of about 0.05 mm to about 5.0 mm. The plate thread 9 can also define a lead L that can be in the range of 0.05 mm to about 5.00 mm. The thread pitch P and the thread lead L can be as described more fully in References 105 and 708. The hole 6 can define a minimum inner diameter D1 that can be measured at the axially lowermost crest 56 along the crest orbital axis 46. The undercut surface 36 can cut off at least a part of one or more of the plate threads 9. The undercut surface 36 can extend continuously in the circumferential direction and without interruption along a complete circle centered on the central hole axis 22. Alternatively, the undercut surface 36 can be interrupted circumferentially by one or more of the corner portions 28.

[0034] The plate thread 9 described in this specification is configured to increase the mechanical strength of the locking thread boundary surface between the plate thread 9 and the male thread on the head of the locking screw, and further to be robust enough to provide dynamic compression in response to the engagement with the head 27 of the compression screw 7.

[0035] Continuing to refer to FIG. 2B, the inner surface 24 defines at least one contact outer shape 50 at an axial reference plane extending along the translational direction T1. Each contact outer shape 50 can be characterized as the path along which the head 27 of the compression anchor 7 (FIGS. 3A - 4B) contacts the inner surface 24 within the hole 6 when the head 27 advances axially downward within the hole 6 along the central axis 52 of the compression anchor 7 that is eccentric with respect to the central hole axis 22, which means that the central screw axis 52 is offset in an offset direction from the central hole axis 22 during insertion. It should be understood that the central screw axis 52 can also be referred to as the "insertion axis" 52 along which the screw is inserted through the hole 6. The geometry of each contact outer shape 50 can be adjusted to enhance the translation of the bone plate 4 in its respective translational direction during the insertion of the eccentric head 27 into the hole 6. In this embodiment, the compression ramp 33 intersects the thread 9 and is thus part of the compression structure within the hole 6. Thus, the inner surface 24 of this embodiment can define a first contact outer shape 50 defined at least by the compression ramp 33 and further partially by the plate thread 9. In this way, portions of the thread 9 such as the thread crest 56 can also define a compression ramp within the hole 6. In this embodiment, the compression structure is configured such that the first offset direction B1 is within the same axial reference plane as the first contact outer shape 50.

[0036] Referring now to FIGS. 3A and 3B, a method of using the multi-use hole 6 of the present embodiment in a bone plating surgery for selective dynamic compression will be described herein in accordance with an exemplary technique of eccentrically inserting a compression screw 7 towards an associated corner portion 28 and a compression ramp 33 aligned with a first translation direction T1. During the bone plating surgery, a physician can insert the shaft 25 of the compression screw 7 into the hole 6 along an insertion axis 52 and drive the shaft 25 into the bone underlying, such as a bone segment 100. In this example, the physician can offset the insertion axis 52 towards the corner portion 28 and the compression ramp 33 by a first offset distance 01 measured in a first offset direction B1. In this example, the first offset direction B1 is the first translation direction T1. As shown in FIG. 3A, the physician can further drive the shaft 25 through the hole 6 along the insertion axis 52 at the first offset distance 01 in a manner that engages the outer surface 74 of the head 27 of the compression screw 7 with the inner surface 24 of the hole 6 at a first position of the screw head 27 relative to the inner surface 24. At the first position, the outer surface 74 of the screw head 27 contacts the inner surface 24 at a first initial contact location 75, such as on the compression ramp 33, along a contact profile 50 or the like. It should be understood that the maximum value of the first offset distance 01 can be determined by various factors, such as the corner radius R3, the minimum inner diameter D1 of the plate thread 9, and the outer diameter of the threaded shaft 25 of the compression screw 7, such that the threads of the threaded shaft 25 of the compression screw 7 can wind towards the corner portion 28 along the insertion axis 52 during insertion.

[0037] As shown in FIG. 3B, after the outer surface 74 of the head 27 contacts the inner surface 24 at the first initial contact location 75 (FIG. 3A), the physician further drives the compression screw 7 axially downward along the insertion shaft 52 to move the outer surface 74 of the head 27 along the inner surface 24 to a second position of the screw head 27 relative to the inner surface 24 along the first contact outer shape 50 (FIG. 2B), etc., or to overlap, and the second position can be a position where the screw head 27 is fully seated within the hole 6. The connection geometry between the inner surface 24 of the hole 6 and the outer surface 74 of the head 27 along the contact outer shape 50, etc., translates the plate 4 and the underlying bone segment 100 in a first translation direction T1 such that the outer surface 74 overlaps along the inner surface 24 as the screw head 27 advances axially downward along the insertion shaft 52. In this way, the bone segment 100 can translate in the translation direction T1 in a manner that reduces the gap G (FIG. 3A) between the bone segment 100 and the adjacent bone segment 102.

[0038] In this embodiment, the size and shape of the screw head 27 are configured such that when the screw head 27 is fully seated within the hole 6, the screw axis 52 extends in a substantially the same range as the central hole axis 22, as shown. In such an embodiment, the first offset distance 01 effectively defines the first translation distance L1 of the plate 4 (along the first translation direction T1) provided by the eccentric insertion of the screw. The triangular shape of the hole 6 in this embodiment can cause the outer surface 74 of the screw head 27 to contact the row 26 and move away from the corner portion 28 including the contact outer shape 50 when the screw head 27 is fully seated within the hole 6.

[0039] The multiple-use hole 6 of the present disclosure is versatile in that it can also achieve dynamic compression occurring in a second translation direction T2 opposite to the first translation direction T1 by using the side surface of the hole 6 on the opposite side of the compression ramp 33. Referring now to FIGS. 4A and 4B, a method of using the multiple-use hole 6 of the present embodiment for selective dynamic compression in the second translation direction T2 will be described herein in accordance with an exemplary technique of eccentrically inserting the compression screw 7 toward the associated row 26 on the opposite side of the compression ramp 33 along the second translation direction T2. In this example, the physician can insert the shaft 25 of the compression screw 7 through the hole 6 into the underlying bone segment 100 along an insertion axis 52 offset from the central hole axis 22 by a second offset distance 02 measured in a second offset direction B2. In this example, the second offset direction B2 is the second translation direction T2. As shown in FIG. 4A, the physician inserts the shaft 25 along the insertion axis 52 at the second offset distance 02 in a manner that engages the outer surface 74 of the head 27 with the inner surface 24 of the hole 6 at a third position of the screw head 27 relative to the inner surface 24. At the third position, the outer surface 74 of the screw head 27 contacts the inner surface 24 at a second initial contact location 77 that may occur at the interface between the upper outer periphery 30 and the neutral bite surface 34. Similar to the eccentric insertion of the screw 7 toward the compression ramp 33 (FIGS. 3A and 3B), the maximum second offset distance 02 can be determined by the minimum inner diameter D1 of the plate thread 9 and the outer diameter of the threaded shaft 25 of the compression screw 7 such that the threads of the threaded shaft 25 can bypass the plate thread 9 during insertion along the insertion axis 52. However, since the geometry of the corner portion 28 is provided such that the first surface 42 of the row 26 is closer to the central hole axis 22 than the inner surface 24 along the corner portion 28, the maximum second offset distance 02 is shorter than the offset distance 01 in the present embodiment of the hole 6.

[0040] As shown in FIG. 4B, after the outer surface 74 of the head 27 contacts the inner surface 24 at the second initial contact location 77, the physician further drives the compression screw 7 axially downward into the bone segment 100 below along the insertion shaft 52, moving the outer surface 74 of the head 27 to a fourth position of the screw head 27 relative to the inner surface 24 along the neutral seating surface 34 and the row 26 and optionally along a portion of the plate thread 9 of the row 26, or it can be overlapped. The fourth position can be a position where the screw head 27 is fully seated within the hole 6 and thus can be equal to the second position (see FIG. 3B). In this way, the neutral seating surface 34, the row, and a portion of its thread 9 can define a second contact profile 51 within the axial reference plane (see FIG. 2B). The connection geometry of the outer surface 74 of the screw head 27 and the inner surface 24 along the second contact profile 51 and the like translates the plate 4 and the bone segment 100 in a second translation direction T2 when the outer surface 74 overlaps along the inner surface 24, optionally until the screw head 27 is fully seated within the hole 6, at which position the screw axis 52 extends within substantially the same range as the central hole axis 22. In such an embodiment, the second offset distance 02 effectively defines a second translation distance L2 of the plate 4 along the second translation direction T2. Since the maximum first offset distance 01 is longer than the maximum second offset distance 02 in this embodiment, the maximum first translation distance T1 is longer than the maximum second translation distance T2.

[0041] It should be understood that the configuration of the hole 6 according to this embodiment provides a number of additional options for dynamic compression along other translation directions. For example, the physician can choose to translate the plate 4 in a third translation direction T3 by eccentrically inserting the compression screw 7 towards the second corner portion 28b or in a fourth translation direction T4 by eccentrically inserting the compression screw 7 towards the third corner portion 28c.

[0042] Referring to FIGS. 5A to 5C, in other embodiments, the bone plate 4 can use a plurality of reuse holes 6 having a plurality of compression ramps such as a first ramp 33a and a second ramp 33b facing each other along the longitudinal axis 3. Similar to the embodiments described above (FIGS. 2A to 2B), the first ramp 33a can be centered along the longitudinal axis 3 at the first corner portion 28a. The second ramp 33b can be centered along the longitudinal axis 3 in the first row 26a and can alternatively be a substantial mirror image of the first ramp 33a. Thus, like the first ramp 33a, the second ramp 33b can be configured to direct, converge, or otherwise affect such that the second translation direction T2 is along the longitudinal direction X. In the present embodiment, the neutral bite surface 34 can extend axially downward from the upper outer periphery 30 into the hole 6 and can orbit around the central hole axis 22, and can also extend so as to connect to the first compression ramp 33a and the second compression ramp 33b.

[0043] Referring to FIGS. 6A-6D, in an additional embodiment, the shape of the hole 6 can be further adapted to provide an increased translation distance L1. As shown in FIGS. 6A and 6B, the second row 26b and the third row 26c of this embodiment define a row length LC-2 that is longer than the length LC of the first row 26a, thereby creating an elongated hole 6 in the horizontal reference plane X-Y, particularly along the first translation direction T1. In this embodiment, the corner axis 37 of the first corner portion 28a can be spaced from the central hole axis 22 by a distance R1-2 that is longer than the distance R1 by which the corner axes 37 of the second corner portion 28b and the third corner portion 28c are spaced from the central hole axis 22. The first corner portion 28a can have a corner portion radius R3-2 that is shorter than the corner portion radius R3 of the second corner portion 28b and the third corner portion 28c. The aforementioned adjustment to the geometry of the hole 6 can effectively provide additional space between the central hole axis 22 and the first corner portion 28a for the eccentric insertion of the compression screw 7, enhancing dynamic compression. In other words, the hole 6 of this embodiment can provide a longer maximum offset distance 01 and translation distance L1 (FIG. 6D) compared to the embodiment described above.

[0044] As shown in FIGS. 6B and 6C, the doctor can eccentrically insert the compression screw 7 into the hole 6 along a longitudinal axis 3' such that the insertion shaft 52 is offset in a first offset direction B1 toward the first corner portion 28a, such as intersecting the column center line 43 of the first column 26a. In this embodiment, the first offset direction B1 is the first translation direction T1. As shown in FIG. 6B, with such an offset, the outer surface 74 of the head 27 of the compression screw 7 can engage the inner surface 24 at a first position of the screw head 27 relative to the inner surface 24 of the hole 6. At the first position, the outer surface 74 of the screw head 27 contacts the inner surface 24 at a first initial contact position 75a and a second initial contact position 75b that can be offset from the longitudinal axis 3'. As shown, the first initial contact position 75a and the second initial contact position 75b can be on the second column 26b and the third column 26c. Thus, in this embodiment, the screw head 27 can travel along at least two contact outer profiles 50a, 50b (FIG. 6B) that face each other with respect to the longitudinal axis 3'. Thus, the second column 26b and the third column 26c can define corresponding compression ramps.

[0045] As shown in FIGS. 6B and 6D, after the outer surface 74 of the head 27 contacts the inner surface 24 at the first initial contact position 75a and the second initial contact position 75b, the doctor further drives the compression screw 7 axially downward along the insertion shaft 52 to move the outer surface 74 of the head 27 along the inner surface 24, along the contact outer shapes 50a, 50b, etc., from the first position to the second position of the screw head 27 relative to the inner surface 24, or they can be overlapped. In this embodiment, the inner surface 24 of the hole 6 can be characterized as providing a pair of compression rails. Along the pair of compression rails, the outer surface 74 of the screw head 27 can move along the translation direction T1 to the first translation distance L1 until the screw head 27 reaches the second position during the plate translation. The first translation distance L1 can be the position where the screw head 27 is fully seated in the hole 6. As in the embodiment described above, the screw shaft 52 can extend in substantially the same range as the central hole axis 22 when the screw head 27 is fully seated in the hole 6. Also as described above, the first offset distance 01 can effectively define the first translation distance L1. In this embodiment, it should be understood that the dynamic compression towards the first row 26a through the insertion of the eccentric screw can be substantially similar to that described above with reference to FIGS. 4A and 4B.

[0046] Referring now to FIGS. 7A and 7B, in an additional embodiment of the multi-use hole 6, one or more of the plate threads 9 adjacent to the axial lower part of the hole 6 can be cut off, such as by having a truncated crest 56a in a manner that provides an additional gap along the radial direction R for the threads of the threaded shaft 25 of the compression screw 7 during the eccentric insertion towards the compression ramp 33.

[0047] As described above, the multi-use hole 6 can have a circular hole shape at the horizontal reference plane. Examples of such circular holes 6 are shown in FIGS. 8A - 9B. The plate threads 9 of the circular multi-use hole 6 can extend along respective splines that spiral around the central hole axis 22 along the circular outer shape of the inner surface 24 of the hole 6.

[0048] As shown in FIGS. 8A and 8B, the circular multi-use hole 6 can include a compression ramp 33 positioned on a particular side of the hole 6, such as an intended translation direction T1 from the central hole axis 22. For example, the compression ramp 33 can be positioned centrally along the longitudinal axis 3 in the same manner as described above with reference to FIG. 2A. The ramp 33 can be configured to direct, converge, or otherwise affect dynamic compression along the translation direction T1.

[0049] As shown in FIGS. 9A and 9B, the circular multi-use hole 6 can have a plurality of compression ramps, such as a first ramp 33a and a second ramp 33b, that face each other along the longitudinal axis 3. Each of the first ramp 33a and the second ramp 33b can be centered along the longitudinal axis 3 and can be substantially mirror images of each other, as described above with reference to FIGS. 5B and 5C. The first compression ramp 33a and the second compression ramp 34b can be configured to direct, converge, or otherwise affect dynamic compression along respective first translation direction T1 and second translation direction T2 extending from the central hole axis 22. The circular multi-use hole 6 can be used for dynamic compression in various other translation directions in response to eccentric insertion of a screw. For example, the circular hole 6 can provide dynamic compression along substantially any translation direction extending radially outward from the central hole axis 22 to the eccentric insertion position of the screw within the hole 6.

[0050] The illustrated embodiments of the present disclosure show the multi-use hole 6 having a minimum thread inner diameter that is smaller than the maximum diameter of the head 27 of the compression screw 7. However, it should be understood that the hole 6 and / or the compression screw 7 of the present disclosure can be adapted such that the compression screw 7 can engage the inner surface 24 within the hole 6 in a manner that provides dynamic compression even when the minimum inner diameter of the hole 6 is larger, and even significantly larger, than the maximum diameter of the head 27 of the compression screw 7.

[0051] Each of the plate body 5, compression screw 7, and locking screw described in this specification can include one or more biocompatible materials. By way of non-limiting example, the plate body 5 can be made of a material selected from the group consisting of metals such as titanium, titanium alloys (e.g., titanium-aluminum-niobium (TAN) alloys such as Ti-6Al-7Nb, and titanium-aluminum-vanadium (TAV) alloys such as Ti-6Al-4V, titanium molybdenum alloys (Ti-Mo) or any other molybdenum metal alloy, and nickel-titanium alloys such as nitinol), stainless steel, and cobalt-based alloys (e.g., cobalt-chromium alloys); composite materials; polymer materials; ceramic materials, and / or resorbable materials including resorbable versions of the aforementioned material categories (metals, composites, polymers, ceramics). Similarly, by way of non-limiting example, the compression screw 7 and the locking screw can be made of a material selected from the group consisting of metals such as titanium, titanium alloys (e.g., TAN alloys, TAV alloys such as Ti-6Al-4V, titanium molybdenum alloys (Ti-Mo) or any other molybdenum metal alloy, and nickel-titanium alloys such as nitinol), stainless steel, cobalt-based alloys (e.g., cobalt-chromium alloys); composite materials; polymer materials; ceramic materials, and / or resorbable materials including resorbable versions of the aforementioned material categories (metals, composites, polymers, ceramics). Preferably, the materials of the compression screw 7 and the locking screw have a higher hardness than the hardness of the material of the plate body 5. This parameter contributes to the threaded locking characteristics and dynamic compression characteristics described throughout the present disclosure. Preferably, the plate body 5 mainly or entirely comprises titanium, and the compression screw 7 and the locking screw mainly or entirely comprise TAN. However, other material compositions of the bone plate 4 and / or the screws are to be understood to be within the scope of the present disclosure.

[0052] Furthermore, the surface of the plate body 5 and / or the screw can optionally undergo one or more processes such as a coating process, a treatment process, and / or a finishing process, which can be carried out to provide specific properties to such surface or the underlying subject body material, such as adjusting the hardness, softness, and / or friction parameters of the body material, as described in more detail in References 105 and 708.

[0053] It should be understood that the various parameters of the holes 6 described above are provided as exemplary features for adapting the holes 6 to achieve selective dynamic compression or locking engagement therewith by the heads of the respective compression and locking screws. These parameters can be adjusted as needed without departing from the scope of the present disclosure.

[0054] Also, in additional embodiments, it should be understood that the inner surface 24 of any of the multiple-use holes 6 can be defined by an insert plate body (e.g., an "insert" or "inlay") that fits within the axial opening or receptacle of the plate body 5. In such embodiments, the bone plate 4 can be provided in a kit that includes a plurality of interchangeable inserts having different shapes and geometries for the holes 6 so that a physician can select a specific insert having the desired dynamic compression properties required.

[0055] Although the present disclosure has been described in detail, it should be understood that various changes, substitutions, and modifications can be made herein without departing from the spirit and scope of the invention as defined by the appended claims. Furthermore, the scope of the present disclosure is not limited to the specific embodiments described herein. In particular, one or more of the features from the foregoing embodiments can be used in other embodiments herein. As will be readily understood by those skilled in the art, machines, manufacturing methods, compositions, means, methods, or processes that currently exist or will be developed later and that perform substantially the same function or achieve substantially the same result as the corresponding embodiments described herein can be utilized in accordance with the present disclosure.

[0056] 〔Embodiment〕 (1) An osteosynthesis plate, an outer surface and a bone-facing surface opposite to the outer surface, an inner surface defining a hole extending from the outer surface to the bone-facing surface along a central hole axis, the inner surface being a ramp extending from the outer surface toward the bone-facing surface, a plate thread extending from the ramp toward the bone-facing surface and configured to optionally engage in a locking engagement with a male thread on a first head of a locking bone fixation member, an inner surface further defining at least by the ramp a contact profile defined by a reference plane extending along the central hole axis, the contact profile being spaced in an offset direction perpendicular to the central hole axis from the central hole axis, and the contact profile being configured to translate the osteosynthesis plate in the offset direction in response to contact with an outer surface of a second head of a compression bone fixation member as the second head advances through the hole along an insertion axis offset in the offset direction from the central hole axis. (2) The osteosynthesis plate according to Embodiment 1, wherein the plate thread defines a crest, a trough, and a flank extending from a relevant trough of the troughs to a relevant crest of the crests, and the contact profile is further defined by at least some of the crests. (3) The bone plate according to Embodiment 1, wherein the lamp is oriented at an acute angle with respect to the central hole axis, and the acute angle is in the range of about 30 degrees to about 80 degrees. (4) The bone plate according to Embodiment 1, wherein the plate thread intersects at least a part of the lamp. (5) The bone plate according to Embodiment 1, wherein the lamp is a first lamp, the inner surface defines a second lamp on the contact outer shape, and the second lamp is positioned between the first lamp and the bone-facing surface.

[0057] (6) The bone plate according to Embodiment 5, wherein the first lamp is oriented at a first lamp angle with respect to the central hole axis, the second lamp is oriented at a second lamp angle with respect to the central hole axis, and the second lamp angle is smaller than the first lamp angle. (7) The bone plate according to Embodiment 1, wherein the inner surface also defines a relief surface extending from the plate thread to the bone-facing surface, and at least some of the plate threads adjacent to the relief surface are chamfered. (8) The bone plate according to Embodiment 1, wherein the hole has a polygonal hole outer shape in a second reference plane orthogonal to the central hole axis. (9) The bone plate according to Embodiment 8, wherein the inner surface defines a plurality of rows and a plurality of recesses alternately arranged along the periphery of the hole, and the offset direction extends from the central hole axis toward one of the recesses. (10) The bone plate according to Embodiment 8, wherein the polygonal hole outer shape is a triangular hole outer shape.

[0058] (11) The contact profile is a first contact profile, the offset direction is a first offset direction, the inner surface is spaced apart from the central hole axis in a second offset direction that is angularly offset from the first offset direction, the second contact profile is defined, and when the second head advances along the insertion axis when the insertion axis is offset from the central hole axis in the second offset direction, the bone plate is configured to translate in a translation direction offset from the first offset direction in response to contact with the outer surface of the second head, the bone plate according to Embodiment 1. (12) The translation direction is in the second offset direction, the second offset direction is opposite to the first offset direction, and the first offset direction and the second offset direction are oriented along the longitudinal axis of the bone plate, the bone plate according to Embodiment 11. (13) A method of seating a bone screw in a hole defined by the inner surface of a bone plate, inserting the shaft of the bone screw through the hole into the underlying bone, the shaft being inserted through the hole at an offset distance measured between the central axis of the bone screw and the central axis of the hole along a first direction perpendicular to the central axis of the hole, inserting; contacting an outer surface of the head of the bone screw against at least one ramp surface defined by the inner surface within the hole, the inner surface including an internal thread extending between the at least one ramp surface and the underlying bone, contacting; during the contacting step, driving the bone screw toward the underlying bone along the central axis of the screw, thereby translating the bone plate in the first direction relative to the bone screw, a method comprising. (14) The hole has a triangular shape in a reference plane orthogonal to the central axis of the hole, the triangular shape is defined by three sides of the inner surface and three corner portions of the inner surface, and each of the three corner portions extends between adjacent ones of the three sides, the method according to Embodiment 13. (15) The method according to embodiment 14, wherein the inserting step includes positioning the central axis of the bone screw between the central axis of the hole and a first corner portion of the three corner portions, and the longitudinal axis of the bone plate intersects the first corner portion such that the first direction is along the longitudinal axis.

[0059] (16) The method according to embodiment 15, wherein the at least one lamp orbits about the central axis of the hole along the first corner portion, and the at least one lamp is centered along the longitudinal direction. (17) The method according to embodiment 14, wherein the inserting step includes positioning the central axis of the bone screw between the central axis of the hole and a first side of the three sides, and the longitudinal axis of the bone plate intersects the first side such that the first direction is along the longitudinal axis. (18) The method according to embodiment 13, wherein the driving step engages the outer surface of the head of the bone screw with one or more of the female threads. (19) The method according to embodiment 13, wherein the underlying bone is a first bone segment, and translating the bone plate in the first direction with respect to the bone screw reduces the gap between the first bone segment and a second bone segment.

Claims

1. An osteosynthesis plate, having an outer surface and a bone-facing surface opposite to the outer surface, and an inner surface defining a hole extending from the outer surface to the bone-facing surface along a central hole axis, the inner surface having, a slope extending from the outer surface towards the bone-facing surface, and a plate thread extending from the slope towards the bone-facing surface, the plate thread being configured to optionally engage in a locking engagement with a male thread on a first head of a locking bone fixation member in the form of a screw, and a contact profile defined by at least the slope on a reference plane along which the central hole axis extends, the contact profile being spaced in an offset direction perpendicular to the central hole axis from the central hole axis, the contact profile being along an insertion axis offset in the offset direction from the central hole axis, and being a path along which a second head of a compression bone fixation member in the form of a screw advances through the hole and contacts the inner surface when the second head advances through the hole, the contact profile being configured to translate the osteosynthesis plate in the offset direction in response to contact with an outer surface of the second head when the second head advances through the hole along the insertion axis, and further defining, together with the inner surface, the hole having a polygonal hole profile in a second reference plane perpendicular to the central hole axis, the polygonal hole profile being a triangular hole profile, the osteosynthesis plate.

2. The osteosynthesis plate according to claim 1, wherein the plate thread defines a thread crest, a thread root, and a flank extending from a relevant thread root to a relevant thread crest of the thread roots, and the contact profile is further defined by at least some of the thread crests.

3. The osteosynthesis plate according to claim 1, wherein the slope is oriented at an acute angle with respect to the central hole axis, the acute angle being in the range of 30 degrees to 80 degrees.

4. The osteosynthesis plate according to claim 1, wherein the plate thread intersects at least a part of the slope.

5. The inclined surface is a first inclined surface, the inner surface defines a second inclined surface on the contact outer shape, and the second inclined surface is positioned between the first inclined surface and the bone-facing surface. The bone plate according to claim 1.

6. The first inclined surface is oriented at a first inclined surface angle with respect to the central hole axis, the second inclined surface is oriented at a second inclined surface angle with respect to the central hole axis, and the second inclined surface angle is smaller than the first inclined surface angle. The bone plate according to claim 5.

7. The inner surface also defines a relief surface extending from the plate thread to the bone-facing surface, and at least some of the plate threads adjacent to the relief surface are chamfered. The bone plate according to claim 1.

8. The inner surface defines a plurality of rows and a plurality of recesses alternately arranged along the periphery of the hole, and the offset direction extends from the central hole axis toward one of the recesses. On the second reference plane, the rows define sides of the triangle, and the recesses define corner portions of the triangle. The bone plate according to claim 1.

9. The contact outer shape is a first contact outer shape, the offset direction is a first offset direction, the inner surface defines a second contact outer shape spaced apart from the central hole axis in a second offset direction angularly offset from the first offset direction, and the second contact outer shape is configured to translate the bone plate in a translation direction offset from the first offset direction in response to contact with the outer surface of the second head when the second head advances along the insertion axis when the insertion axis is offset from the central hole axis in the second offset direction. The bone plate according to claim 1.

10. The translation direction is in the second offset direction, the second offset direction is opposite to the first offset direction, and the first offset direction and the second offset direction are oriented along the longitudinal axis of the bone plate. The bone plate according to claim 9.

11. The bone plate according to claim 2, wherein at least some of the peaks are rounded on the reference plane.

12. The slope is a first slope, the inner surface defines a second slope on the contact outer shape, and the second slope is positioned between the first slope and the bone-facing surface. The bone plate according to claim 11.

13. The slope is a first slope, The inner surface extends axially downward from the upper outer periphery of the hole positioned at the boundary with the outer surface into the hole and extends partially around the central hole axis to connect to the first slope. The bone plate according to claim 1, further defining a second slope.

14. A part of the second slope extends between the first slope and the bone-facing surface. The bone plate according to claim 13.

15. The first slope is oriented at a first slope angle with respect to the central hole axis, the second slope is oriented at a second slope angle with respect to the central hole axis, and the second slope angle is smaller than the first slope angle. The bone plate according to claim 13.

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