Bone plate hole caps, bone plate systems, and methods of using them

Abstract

The bone plate system, for example, includes a bone plate and at least one bone plate hole cap. The bone plate includes a body having a first surface, a bone-engaging surface, and a plurality of through-openings. The bone plate hole cap includes a body having a first surface, a second surface, and a peripheral surface. The bone plate hole cap is securable to at least one of the through-openings of the bone plate. When the bone plate hole cap is secured to the through-opening, the second surface of the bone plate hole cap is positioned adjacent to the bone-engaging surface of the bone plate. A bone plate having a bone plate hole cap secured within a through-opening increases the bending strength of a portion of the bone plate across the bone plate hole cap compared to a corresponding portion of the bone plate without the bone plate hole cap.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 62 / 976,662, filed February 14, 2020, and entitled "Bone Plate Hole Caps, Bone Plate Systems, and Methods of Using the Same," the disclosure of which is incorporated herein by reference in its entirety.

[0002] FIELD OF THE DISCLOSURE The present disclosure relates generally to the repair of bones, such as fractured or injured bones, or the correction of bone deformities, such as those of the foot and ankle. [Background technology]

[0003] Bone plates are used in orthopedic surgery, for example, to fix bone segments after a fracture. Typically, bone plates are metal rods or plates with holes for inserting screws, and are used to fix fractures and / or correct deformities.

[0004] To prevent screw backout, fixation elements have been used to secure the head of the screw to the bone plate, for example, a fixation element is attached to the bone plate to engage the top of the installed screw to prevent movement of the installed screw. Summary of the Invention [Problem to be solved by the invention]

[0005] Aspects of the present disclosure provide for the repair of bones, such as fractured or injured bones, or the correction of bone deformities, such as in the foot and ankle. [Means for solving the problem]

[0006] The shortcomings of the prior art are overcome and further advantages are provided by providing an embodiment of a bone plate system. A bone plate system according to one embodiment of the present disclosure includes, for example, a bone plate and at least one bone plate hole cap. The bone plate includes a body having a first surface, a bone-engaging surface, and a plurality of through-openings extending from the first surface to the bone-engaging surface. The plurality of through-openings defines an inner surface extending between the first surface and the bone-engaging surface of the bone plate. The at least one bone plate hole cap includes a body having a first surface, a second surface, and a circumferential surface disposed between the first surface and the second surface of the at least one bone plate hole cap. The at least one bone plate hole cap is securable within at least one of the plurality of through-openings of the bone plate. When the bone plate hole cap is secured in at least one of the plurality of through-openings, the second surface of the bone plate hole cap is disposed adjacent to the bone-engaging surface of the bone plate. A bone plate having at least one bone plate hole cap secured to one of the plurality of through openings increases the bending strength of a portion of the bone plate across the bone plate hole cap compared to a corresponding portion of the bone plate without the bone plate hole cap.

[0007] In another embodiment, a surgical method is provided, the method including, for example, providing a bone plate having a first surface, a second surface, and a plurality of through-openings extending from the first surface to the second surface, providing a bone plate hole cap having the first surface, the second surface, and a peripheral surface extending between the first and second surfaces of the bone plate hole cap, selectively securing the bone plate hole cap within one of the plurality of through-openings of the bone plate, accessing a bone, selectively positioning the bone plate such that the bone plate hole cap is adjacent an outer surface of the bone and positioned at a joint line, and securing the bone plate to the bone with a plurality of fixation elements extending through at least some others of the plurality of through-openings of the bone plate. The bone plate having at least one bone plate hole cap in one of the plurality of through-openings increases the bending strength of the bone plate positioned adjacent the joint line and secured relative to a bone plate without the bone plate hole cap positioned adjacent the joint line.

[0008] These and other objects, features and advantages of the present disclosure will become apparent from the following detailed description of various embodiments thereof, taken in conjunction with the accompanying drawings.

[0009] The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate embodiments of the present disclosure and, together with the detailed description herein, serve to explain the principles of the disclosure. The drawings are for the purpose of illustrating preferred embodiments only and are not to be construed as limiting the disclosure. It is emphasized that, in accordance with standard industry practice, various features have not been drawn to scale. In fact, the 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 disclosure will be apparent from the following detailed description taken in conjunction with the accompanying drawings. [Brief explanation of the drawings]

[0010] [Figure 1]FIG. 1 is a top perspective view of a bone plate system according to an embodiment of the present disclosure; [Figure 2] FIG. 2 is an exploded top perspective view of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Figure 3] FIG. 2 is a side perspective view of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Figure 4] FIG. 2 is a top perspective view of the bone plate system of FIG. 1 according to an embodiment of the present disclosure. [Figure 5] FIG. 2 is a bottom perspective view of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Figure 6] FIG. 2 is a side view of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Figure 7] FIG. 2 is an enlarged end view of the bone plate system of FIG. 1 according to one embodiment of the present disclosure. [Figure 8] FIG. 2 is an enlarged top perspective view of the bone plate hole cap of FIG. 1 according to an embodiment of the present disclosure. [Figure 9] FIG. 9 is a bottom perspective view of the bone plate hole cap of FIG. 8 according to an embodiment of the present disclosure. [Figure 10] FIG. 9 is a side view of the bone plate hole cap of FIG. 8 according to an embodiment of the present disclosure. [Figure 11] FIG. 9 is a top view of the bone plate hole cap of FIG. 8 according to an embodiment of the present disclosure. [Figure 12] FIG. 9 is a bottom view of the bone plate hole cap of FIG. 8 in accordance with an embodiment of the present disclosure. [Figure 13] 13 is an enlarged, exploded cross-sectional view of a bone plate and bone plate hole cap according to one embodiment of the present disclosure taken along line 13-13 of FIG. 1. [Figure 14] 13 is an enlarged cross-sectional view of a bone plate and bone plate hole cap according to one embodiment of the present disclosure taken along line 13-13 of FIG. 1. [Figure 15] FIG. 10 is a top perspective view of another bone plate hole cap according to an embodiment of the present disclosure. [Figure 16]FIG. 16 is a bottom perspective view of the bone plate hole cap of FIG. 15 in accordance with an embodiment of the present disclosure. [Figure 17] 17 is a cross-sectional view of a bone plate hole cap taken along line 17-17 of FIG. 15 according to an embodiment of the present disclosure. [Figure 18] FIG. 10 is a top perspective view of a cover receivable in an opening of a bone plate hole cap according to an embodiment of the present disclosure; [Figure 19] FIG. 10 is a top perspective view of another bone plate hole cap according to an embodiment of the present disclosure. [Figure 20] FIG. 1 is a perspective view of another bone plate system according to an embodiment of the present disclosure. [Figure 21] FIG. 21 is an exploded perspective view of the bone plate system of FIG. 20 according to one embodiment of the present disclosure. [Figure 22] FIG. 21 is an enlarged top perspective view of the bone plate hole cap of FIG. 20 according to an embodiment of the present disclosure. [Figure 23] FIG. 23 is a bottom perspective view of the bone plate hole cap of FIG. 22 in accordance with an embodiment of the present disclosure. [Figure 24] FIG. 23 is a side view of the bone plate hole cap of FIG. 22 in accordance with an embodiment of the present disclosure. [Figure 25] FIG. 23 is a top view of the bone plate hole cap of FIG. 22 in accordance with an embodiment of the present disclosure. [Figure 26] FIG. 23 is a bottom view of the bone plate hole cap of FIG. 22 in accordance with an embodiment of the present disclosure. [Figure 27] FIG. 1 is a perspective view of another bone plate system according to an embodiment of the present disclosure. [Figure 28] FIG. 10 is a top perspective view of another bone plate hole cap having a ratchet mechanism according to an embodiment of the present disclosure; [Figure 29] FIG. 10 is an exploded perspective view of another bone plate system according to an embodiment of the present disclosure. [Figure 30] 1 is a flowchart of a surgical method using a bone plate system with bone plate hole caps according to an embodiment of the present disclosure. [Figure 31]FIG. 10 is an enlarged top view of another bone plate hole cap according to an embodiment of the present disclosure. [Figure 32] FIG. 10 is an enlarged top perspective view of another bone plate hole cap according to an embodiment of the present disclosure. [Figure 33] FIG. 10 is an enlarged top perspective view of another bone plate hole cap according to an embodiment of the present disclosure. [Figure 34] FIG. 34 is a side cross-sectional view of the bone plate system of FIG. 33 according to an embodiment of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0011] Generally, disclosed herein are bone plate hole caps, bone plate systems, and methods for repairing bones, such as fractured or injured bones, or for correcting bone deformities, such as in the foot and ankle. It should be understood that the bone plate hole caps, bone plate systems, and methods are also applicable to repairing other types of bones.

[0012] In the detailed description and the claims that follow, the terms proximal, distal, anterior or bottom side, posterior or back side, medial, lateral, superior, and inferior are defined according to standard usage to refer to a particular part or portion of a bone, joint (or other anatomical structure), or implant, according to reference to the relative location or direction of the natural bone, joint (or other anatomical structure). For example, "proximal" means the portion of the device or instrument closest to the torso, and "distal" refers to the portion of the device or instrument farthest from the torso. With respect to directional terms, "anterior" means a direction toward the front of the body, "posterior" means a direction toward the back of the body, "medial" means a direction toward the midline of the body, "lateral" means a direction toward the side or away from the midline of the body, "superior" means an upward direction, and "inferior" means an inferior direction of another object or structure. Further, with respect to the foot and / or ankle specifically, the term "dorsal" refers to the top of the foot and the term "plantar" refers to the bottom of the foot.

[0013] Similarly, location or direction may be used herein with reference to an anatomical structure or surface. For example, because the instruments, guides, systems, and related methods (and their components) are described herein with respect to use on the ankle bone, the bones of the foot, ankle, and lower leg may be used to describe the surface, location, direction, or orientation of the instruments, guides, systems, and related methods (and their components). Furthermore, the instruments, guides, systems, and related methods disclosed herein, as well as their aspects, components, features, etc., may be described with respect to one side of the body (e.g., the left or right ankle) for the sake of brevity. However, because the human body is relatively symmetrical or mirrored about a line of symmetry (the midline), the instruments, guides, systems, and related methods, as well as their aspects, components, features, etc., described and / or illustrated herein may be changed, altered, modified, reconfigured, or otherwise modified for use on or in association with another side of the body for the same or similar purposes without departing from the spirit and scope of the present disclosure. For example, the instruments, guides, systems, and associated methods, and their aspects, components, features, etc., described herein with respect to a patient's right ankle, can be mirrored to function similarly with the patient's left ankle. Furthermore, although the instruments, guides, systems, and associated methods, and their aspects, components, features, etc., disclosed herein are described with respect to the ankle for the sake of brevity, the instruments, guides, systems, and associated methods (and their components) can be used with other joints in the human body (or other mammalian body).

[0014] 1-3 illustrate a bone plate system 10 according to one embodiment of the present disclosure. For example, the bone plate system 10 may include a bone plate 20, a plurality of fixation elements 100 and 200, and at least one bone plate hole cap 300. It will be appreciated from the present description that the combination of the bone plate 20 and the bone plate hole cap 300 can provide increased strength to the bone plate 20, particularly when no fixation elements are attached to the corresponding through-openings 30 (FIG. 2).

[0015] Referring to FIG. 3 , the bone plate system 10 is operable to attach to a first bone or segment 12 and a second bone or segment 14. The combination of the bone plate 20 and the bone plate hole cap 300 can provide increased strength to the bone plate 20 across a region of the bone, such as the joint line JL. For example, through-openings in a bone plate without a screw inserted therein are inherently weak in bending at that location. Filling the through-openings with a structural member or bone plate hole cap can improve or enhance the bending strength of the bone plate with the bone plate hole cap compared to when the through-openings in the bone plate are left empty. As described further below, the bone plate hole cap configuration can provide an additional fulcrum or tendon tensioner. In some embodiments, the bone plate hole cap configuration can provide an eyelet for fixation to soft tissue or a “pulley fulcrum” for soft tissue tape and a predetermined direction of tension / vector.

[0016] 4 and 5, a bone plate 20 can include a body 21 having a first surface 22 and a second surface 24, such as a bone-engaging surface. A first end 26 is operable for attachment to a first bone portion 12 (FIG. 3), and a second end 28 is operable for attachment to a second bone 14 (FIG. 3). The bone plate 20 can also include one or more through-openings 30 extending from the first surface 22 to the second surface 24 of the bone plate 20. The bone plate 20 can include one or more through-openings 45, such as compression slots, extending from the first surface 26 to the second surface 28 of the bone plate 20. The through-openings 30 can be threaded through-holes or similar configurations. The through-openings 30 can be used to insert fixation elements, such as bone screws 100 (FIG. 3), into the first bone 12 (FIG. 3), e.g., the distal bone, and the second bone 14 (FIG. 3), e.g., the proximal bone. At least one through opening 30 can be used to insert a fixation element, such as a bone screw 100, into a second bone 14 (FIG. 3), such as a proximal bone. The compression slot 45 can allow for the insertion of a fixation element 200, which can move within the compression slot 45 while the distal and proximal bones 12 (FIG. 3) are moved or compressed.

[0017] As shown in Figures 6 and 7, bone plate 20 can have a curved second surface 24 extending along the length of bone plate 20. For example, bottom surface 24 can be configured to conform to the natural shape of the cortical bone or bone portion to which it is to be attached. In other embodiments, the second surface of the bone plate can be flat or planar. Bone plate 20 can be made from a metal, such as titanium, stainless steel, cobalt chromium, or a biocompatible material, including, but not limited to, a polymer, a composite, or the like.

[0018] Referring again to FIG. 2 , the bone screw 100 can include an elongate body 101 having a proximal portion 102 and a distal portion 104. The proximal portion 102 can have a diameter that is larger than the diameter of the distal portion 104. For example, the distal portion 104 can have a diameter sized to pass through the through-opening 30 of the bone plate 20. The proximal portion 102 can have a diameter sized to mate and engage with the through-opening 30 of the bone plate 20. The proximal portion 102 can be a threaded proximal portion, e.g., threaded into mate and engage with the threaded through-opening 30 of the bone plate 20 to secure the bone plate 20 to the patient's bone. The distal portion 104 can be a threaded distal portion, e.g., threaded into mate and engage with the patient's bone to secure the bone plate 20 to the patient's bone. The distal portion 104 can be configured or sized and shaped to secure the bone, for example. In some embodiments, the threaded distal portion 104 may have a texture or coating, for example, to provide porous fixation. The proximal portion 102 may have a recess or drive feature 106 for engaging a tool, such as a hex driver, for inserting or removing the bone screw 100.

[0019] The bone screw 200 can include an elongate body 201 having a proximal portion 202 and a distal portion 204. The proximal portion 202 can have a diameter that is larger than the diameter of the distal portion 204. For example, the distal portion 204 can have a diameter sized to pass through a through opening or compression slot 45 of the bone plate 20. The proximal portion 202 can have a diameter sized to matingly engage with the compression slot 45 of the bone plate 20. The proximal portion 202 can have a frustoconical configuration and be sized to matingly engage with a portion of the compression slot 45 of the bone plate 20. The distal portion 204 can be a threaded distal portion, for example, threaded to engage and secure the bone plate 20 to the patient's bone. The distal portion 204 can be configured or sized and shaped, for example, to conserve bone. In some embodiments, the threaded distal portion 204 can have a texture or coating, for example, to provide porous fixation. The proximal portion 202 of the bone screw 200 can have a recess or drive feature 206 for engaging a tool, such as a hex driver, for inserting or removing the bone screw 200. The bone screws 100 and 200 can be made from biocompatible materials, including, but not limited to, metals such as titanium, stainless steel, cobalt chrome, or other suitable materials.

[0020] 8-12 illustrate a bone plate hole cap 300, which may include a body 301 having a first surface 322 and a second surface 324, and a circumferential surface 326 disposed between the first surface 322 and the second surface 324 of the bone plate hole cap 300. The circumferential surface 326 may be sized to be restrained or secured to one of a plurality of through openings 30 (FIG. 2) of the bone plate 20 (FIG. 2). The circumferential surface 326 may be sized to mate and engage with the through opening 30 of the bone plate 20. For example, the circumferential surface 326 may be a threaded circumferential surface that mate and engage with the threaded through opening 30 of the bone plate 20. The bone plate hole cap 300 may include a through opening 330 extending from the first surface 322 of the body 301 of the bone plate hole cap 300 to the second surface 324 of the body 301 of the bone plate hole cap 300. The through opening 330 in the body 301 can have a drive feature for engaging a tool, such as a hex driver, for inserting or removing the bone plate hole cap 300 from the bone plate 20 (FIG. 2). For example, as shown in FIG. 11, the bone plate hole cap 300 can be formed from a solid blank disk. The through opening 330 in the body 301 can be formed by drilling six holes having a diameter D1 and then drilling a hole having a diameter D2 in the center of the disk.

[0021] 13 and 14 , in some embodiments, a bone plate hole cap 300 can be secured and / or locked within at least one of the plurality of through openings 30 ( FIG. 13 ) of a bone plate 20. For example, the through opening 30 ( FIG. 13 ) of the bone plate 20 can have a tapered configuration from the first surface 22 to the second surface 24 of the bone plate 20. The peripheral surface 326 ( FIG. 13 ) of the bone plate hole cap 300 can have a mating tapered circumferential configuration from the first surface 322 to the second surface 324 of the bone plate hole cap 300. The tapered configuration of the bone plate hole cap 300 can be disposed at an angle A1 of about 2 degrees to about 10 degrees, about 4 degrees to about 8 degrees, 6 degrees, or any other suitable angle. The tapered configuration of the through opening 30 (FIG. 13) of the bone plate 20 may be disposed at an angle A2 of about 2 to about 10 degrees, about 4 to about 8 degrees, 6 degrees, or any other suitable angle. The bone plate hole cap 300 may have a first thickness T1 (FIG. 13) between the first surface 322 and the second surface 324 of the bone plate hole cap 300. The bone plate 20 around the through opening 30 may have a second thickness T2 (FIG. 13) between the first surface 22 and the second surface 24 of the bone plate 20. In some embodiments, the first thickness T1 (FIG. 13) may be the same as the second thickness T2 (FIG. 13). It will be understood that other through openings 30 (FIG. 2) of the bone plate 20 may be similarly configured, and one or more similarly configured bone plate hole caps 300 may be attached to the other through openings.

[0022] 14, when the bone plate hole cap 300 is secured and / or locked within the through opening 30 (FIG. 13), the second surface 324 of the bone plate hole cap 300 is positioned adjacent to the second surface 24 of the bone plate 20. In some embodiments, the first surface 322 of the bone plate hole cap can be aligned with the first surface 22 of the bone plate 20.

[0023] 15-17 illustrate a bone plate hole cap 400 according to another embodiment of the present disclosure. Bone plate hole cap 400 is essentially similar to bone plate hole cap 300 (FIGS. 8-12), except that body 401 of bone plate hole cap 400 does not include an opening therethrough. For example, body 401 can include a recess or cavity 425 that does not extend through the entire thickness of body 401.

[0024] FIG. 18 illustrates a cover 500 receivable within the through opening 330 ( FIG. 8 ) of the bone plate hole cap 30 ( FIG. 8 ) or the recess 425 ( FIG. 15 ) of the bone plate hole cap 400 ( FIG. 15 ), according to one embodiment of the present disclosure. For example, the cover 500 can include a body 501 operable as a soft tissue button or cover. The cover 500 can include an upper portion 502 and a lower portion 504, which can be sized to be press-fit into the through opening 33 ( FIG. 8 ) of the bone plate hole cap 30 ( FIG. 8 ) or the recess 425 ( FIG. 15 ) of the bone plate hole cap 400 ( FIG. 15 ). In other embodiments, the cover 500 can be attached to the bone plate hole cap via a snap-fit ​​or other suitable connection. The first surface 522 of the cover 500 may be matable with the first surface 322 (FIG. 8) of the bone plate hole cap 30 (FIG. 8) or the first surface 422 (FIG. 15) of the bone plate hole cap 400. The upper portion 502 may be a solid cover and may include one or more holes 505 operable with one or more sutures 550 for attachment to soft tissue or tendons. In other embodiments, the holes in the body of the cover may be oval, slotted, or of other suitable configurations. The cover may be a biopolymer material, a metal, or other suitable material. The cover may be formed of a material that is softer than the material used to form the bone plate hole cap. Referring again to FIG. 8, in other embodiments, the bone plate hole cap 300 may include one or more holes or passages 360 operable with one or more sutures (not shown) for attachment to soft tissue or tendons. For example, the holes 360 may extend from the first surface 322 to the inner surface 332 defining the through opening 330. It should be appreciated that other holes or passageways may be provided around the first surface to allow the surgeon to select desired holes or passageways for use with one or more sutures.

[0025] FIG. 19 illustrates a bone plate hole cap 600 according to another embodiment of the present disclosure. The bone plate hole cap 600 is essentially similar to the bone plate hole cap 400 ( FIGS. 8 through 12 ), except that the body 601 of the bone plate hole cap 400 is not configured to accept a male drive tool, but instead is configured to accept a female socket drive. For example, the body 601 can have a recess 625 including a protrusion 640, such as a hexagonal protrusion. The protrusion 640 can have a hole or passageway 645 for attachment to soft tissue or tendon. A suitable cover (not shown) can be configured to cover the recess 625 in the body 601 of the bone plate hole cap 600. The cover can be a biopolymer material, a metal, or other suitable material. The cover can be formed of a material softer than the material used to form the bone plate hole cap.

[0026] 20 and 21 illustrate another bone plate system 11 according to one embodiment of the present disclosure. For example, the bone plate system 11 may include a bone plate 20 (only a portion of which is shown), a plurality of fixation elements 100 (only two of which are shown), and at least one bone plate hole cap 700. From this description, it will be appreciated that the combination of the bone plate 20 and the bone plate hole cap 700 can provide increased strength to the bone plate 20, particularly when the fixation elements are not attached to the corresponding through-openings 30 (FIG. 21). Furthermore, the bone plate hole cap 700 may include a button portion 750 and an attachment portion 710 (FIG. 21). For example, the button portion 750 may operate to protect against irritation and wear from tendons or other soft tissue that may travel / move over the bone plate hole cap 700.

[0027] 22-26 illustrate a bone plate hole cap 700. The bone plate hole cap 700 can include a body 701 having an outwardly extending first surface 722, a second surface 724, and a circumferential surface 726 disposed between the first surface 722 and the second surface 724 of the bone plate hole cap 700. The circumferential surface 726 can be sized to be restrained or secured within one of the through openings 30 (FIG. 21) of the bone plate 20 (FIG. 21). For example, the circumferential surface 726 can be sized to matingly engage with the through opening 30 (FIG. 21) of the bone plate 20 (FIG. 21). The circumferential surface 726 can also be a threaded circumferential surface that matingly engages with the threaded through opening 30 (FIG. 21) of the bone plate 20 (FIG. 21). The first surface 722 may be slightly curved, such as convex, such that the first surface 722 extends over the first surface 22 (FIG. 20) of the bone plate 20 (FIG. 20). The bone plate hole cap 700 may include a cavity or recess 725 (FIGS. 23 and 26) that extends into the second surface 722 of the body 701 of the bone plate hole cap 700. The cavity or recess 725 (FIGS. 23 and 26) in the body 701 may have drive features for engaging with a tool, such as a hex drive, for inserting or removing the bone plate hole cap 700 from the bone plate 20 (FIG. 21).

[0028] In some embodiments, the mounting portion 710 (FIG. 21) can be configured and formed essentially the same as the body 301 (FIG. 8) of the bone plate hole cap 300 (FIG. 8). In some embodiments, the button portion 750 (FIG. 21) and the mounting portion 710 (FIG. 21) can be formed separately and attached together.

[0029] FIG. 27 illustrates another bone plate system 15 according to one embodiment of the present disclosure. For example, the bone plate system 15 can include a bone plate 20, a plurality of fixation elements 100 and 200, and at least one bone plate hole cap 800. From this description, it will be appreciated that the combination of the bone plate 20 and the bone plate hole cap 800 can provide increased strength to the bone plate 20, particularly when the fixation elements are not attached to the corresponding through-openings. Furthermore, the bone plate hole cap 800 can include a button portion 850 and an attachment portion (not shown in FIG. 27 ). For example, the button portion 850 can operate to protect against irritation and wear from tendons or other soft tissue that may travel / move over the bone plate hole cap 800. In the illustrated embodiment, bone plate hole cap 800 is essentially the same as bone plate hole cap 700 (FIG. 20), except that button portion 850 of bone plate hole cap 800 may have a larger or taller profile compared to button portion 750 (FIG. 20) of bone plate hole cap 700 (FIG. 20). The taller button portion is operable to apply tension to the tendon crossing button portion 850, increasing the stability of the soft tissue in that area.

[0030] In some embodiments, the attachment portion may be formed from a metal such as titanium, stainless steel, cobalt chrome, etc., and the button portion may be formed from a softer material such as a polymer such as a PEEK or PE material. In other embodiments, the bone plate hole cap 700 may be a monolithic, one-piece, and / or single-piece structure formed from a metal such as titanium, stainless steel, cobalt chrome, etc., a polymer such as PEEK, PE, etc., or a composite material, and / or combinations thereof.

[0031] 28 illustrates a bone plate hole cap 900 according to another embodiment of the present disclosure. The bone plate hole cap 900 may be essentially the same as the bone plate hole caps previously described, except that the body 901 of the bone plate hole cap 900 may include a tensioning or winding feature 950, such as a ratchet mechanism attachable to a suture 975. In some embodiments, the ratchet assembly may be located within a through opening or cavity in the body of the bone plate hole cap 900, or may be integrated into a cover that is attached to the through opening or cavity of the bone plate hole cap 900.

[0032] 29 illustrates a bone plate system 19 according to another embodiment of the present disclosure. For example, the bone plate system 19 may include a bone plate 20, a plurality of fixation elements 100 and 200, and a plurality of bone plate hole caps 300. It will be appreciated from the present description that the combination of the bone plate 20 and the bone plate hole caps 300 can provide increased strength to the bone plate 20, particularly when fixation elements are not installed within the corresponding through openings 30.

[0033] It will be understood from the description herein that various embodiments of bone plate hole caps may be formed from metals such as titanium, stainless steel, cobalt chromium, polymers such as PEEK, PE, or composite materials, and / or combinations thereof.

[0034] It will be appreciated that the bone plate hole cap can be operably secured and / or locked within the through opening of the bone plate using different attachment means. For example, the bone plate hole cap can be operably secured and / or locked within the through opening of the bone plate using an interference fit, a cam lock arrangement, a key lock arrangement, or other suitable method. In some embodiments, the bone plate hole cap can be thinner in size than the bone plate and configured to be secured or locked within the through opening between the first surface and the bone-engaging surface.

[0035] 30 illustrates a surgical method 1000 according to another embodiment of the present disclosure. The surgical method 1000 using the bone plate system of the present disclosure is applicable to achieving bone fixation, for example, fixation of bones in a patient's arm, hand, leg, or foot, and / or preparing a joint for fixation. The method 1000 may, for example, include the steps of: providing a bone plate having a first surface, a second surface, and a plurality of through-openings extending from the first surface to the second surface; providing a bone plate hole cap having a first surface, a second surface, and a circumferential surface extending between the first and second surfaces of the bone plate hole cap; selectively securing the bone plate hole cap within one of the plurality of through-openings of the bone plate; and accessing a bone at 1400. , at 1500, selectively positioning the bone plate so that the bone plate hole cap is adjacent to an outer surface of the bone and positioned at the joint line; and, at 1600, securing the bone plate to the bone using a plurality of fixation elements extending through some of the other plurality of through-openings of the bone plate, wherein the bone plate having the bone plate hole cap in at least one of the plurality of through-openings increases the bending strength of the bone plate secured adjacent to the joint line compared to a bone plate secured adjacent to the joint line without the bone plate hole cap.

[0036] The method can further include holding the bone plates in place on the distal and proximal bones, for example, by inserting temporary fixation pins, olive wires, k-wires, etc. The physician can then use fluoroscopy to confirm that the bone plates are in the desired positions on the distal and proximal bones.

[0037] FIG. 31 illustrates another bone plate hole cap 1700 according to one embodiment of the present disclosure. The bone plate hole cap 1700 has a body 1701, which can include a first surface 1722 and a second surface 1724, an inner surface 1732, and a circumferential surface 1726 disposed between the first surface 1722 and the second surface 1724 on the opposite side of the inner surface 1732 of the bone plate hole cap 1700 (e.g., on the outer side rather than the inner side). The circumferential surface 1726 can be sized to be restrained or secured within one or more through openings (e.g., through openings 30 shown in the bone plate 20 (FIG. 2)). Furthermore, the circumferential surface 1726 can be sized (at least as shown and described with reference to FIG. 2) to matingly engage with the through openings 30 of the bone plate 20. For example, the circumferential surface 1726 can be a threaded surface that matingly engages with the threaded through openings 30 of the bone plate 20. The bone plate hole cap 1700 can include a through opening 1730 extending along an inner surface 1732 from a first surface 1722 of the body 1701 of the bone plate hole cap 1700 to a second surface 1724 of the body 1701 of the bone plate hole cap 1700. The through opening 1730 in the body 1701 can have drive features for engaging with a tool (e.g., a hex drive, a Torx® drive, etc.) for inserting or removing the bone plate hole cap 1700 from the bone plate 20 ( FIG. 2 ). For example, as shown in FIG. 11 , the bone plate hole cap 1700 can be formed from a solid blank disk. The through opening 1730 in the body 1701 can be formed by drilling six holes having a diameter D1 and then drilling a hole having a diameter D2 in the center of the disk.

[0038] The bone plate hole cap 1700 is further shown to include a cross member 1740. The cross member 1740 is shown to extend from a first portion of the inner surface 1732 to a second portion of the inner surface 1732 substantially opposite the through opening 1730 from the first portion, and to extend diametrically across the through opening 1730. A suture and / or suture tape (e.g., as previously described herein) may be threaded downwardly relative to the cross member 1740, passed under the cross member 1740 within the through opening 1730, and then threaded upwardly relative to the cross member 1740 to releasably couple (e.g., thread) with the bone plate hole cap. The cross member 1740 is shown to be positioned flush with (or slightly offset upwardly or downwardly from) the first surface 1722 of the bone plate hole cap 1700.

[0039] It is contemplated that in some embodiments, the bone plate hole cap 1700 may include multiple cross members, similar and / or similar to the cross members 1740 positioned adjacent to and / or across the through opening 1730 (e.g., they may be perpendicular to one another, spaced at various intervals such as every 60 degrees, or spaced unevenly around the inner surface 1732 of the through opening 1730). The cross members 1740 may also be configured with one or more protrusions extending therefrom at an oblique or orthogonal angle to the cross member 1740 (some of which may terminate in contact with the inner surface 1732 or within / adjacent the opening 1730). In some embodiments, the cross members 1740 may be positioned to accommodate a conventional drive instrument (e.g., hex, torx, etc.) for manipulating the bone plate hole cap 1700. In some embodiments, an instrument with drive features that match the particular shape of the cross members 1740 and bone plate hole cap 1700 may be provided as part of a surgical kit. 31 , the cross member 1740 is shown as having a substantially cylindrical shape with a flat disposed on the top of the cross member 1740. In some embodiments, the cross member 1740 may include one or more flats disposed about the substantially cylindrical shape. Additionally, the cross member 1740 may also have alternative geometric shapes (e.g., hexagonal, octagonal, symmetrical geometries, asymmetrical geometries, etc.) in some embodiments.

[0040] In some embodiments, the cross member 1740 may be integral with the inner surface 1732 of the body 1701 of the bone plate hole cap 1700. Further, in some embodiments, the cross member 1740 may be coupled to the inner surface 1732 of the body 1701 of the bone plate hole cap 1700. The cross member 1740 may also have a dynamic configuration, as opposed to the static configuration shown in FIG. 31 . For example, the cross member 1740 may be configured to rotate about its longitudinal axis while fixed and / or coupled to one or more portions of the inner surface 1732 of the body 1701. Such a dynamic configuration may accommodate movement of a suture while in contact with the cross member 1740 to rotate the cross member 1740 about its longitudinal axis to thread the suture under / through the cross member 1740.

[0041] 32 , another bone plate hole cap 1800 according to one embodiment of the present disclosure is shown. The bone plate hole cap 1800 has a body 1801, which can include a first surface 1822 and a second surface 1824, an inner surface 1832, and a circumferential surface 1826 disposed between the first surface 1822 and the second surface 1824 on the opposite side of the inner surface 1832 of the bone plate hole cap 1800 (e.g., on the outer side rather than the inner side). The circumferential surface 1826 can be sized to be restrained or secured within one or more through openings (e.g., through openings 30 shown in the bone plate 20 ( FIG. 2 )). Furthermore, the circumferential surface 1826 can be sized (at least as shown and described with reference to FIG. 2 ) to matingly engage with the through openings 30 of the bone plate 20. For example, the circumferential surface 1826 can be a threaded surface that matingly engages with the threaded through openings 30 of the bone plate 20. The bone plate hole cap 1800 can include a through opening 1830 extending along an inner surface 1832 from a first surface 1822 of the body 1801 of the bone plate hole cap 1800 to a second surface 1824 of the body 1801 of the bone plate hole cap 1800. The through opening 1830 in the body 1801 can have drive features for engaging with a tool (e.g., a hex drive, a Torx® drive, etc.) for inserting or removing the bone plate hole cap 1800 from the bone plate 20 ( FIG. 2 ). For example, as shown in FIG. 11 , the bone plate hole cap 1800 can be formed from a solid blank disk. The through opening 1830 in the body 1801 can be formed by drilling six holes having a diameter D1 and then drilling a hole having a diameter D2 in the center of the disk.

[0042] The bone plate hole cap 1800 is further shown to include a pivot member 1840. As shown in FIG. 32 , the pivot member 1840 extends upwardly from the through opening 1830 and has a substantially hemispherical or arcuate shape. In some embodiments, the pivot member 1840 has a substantially hemispherical or arcuate shape, a portion of which is disposed within the through opening 1830. In alternative embodiments, the pivot member 1840 may have one or more shapes other than those shown and described herein. In some embodiments, the bone plate hole cap 1800 may have one or more access points or openings disposed on the periphery 1826 of the bone plate hole cap 1800 to facilitate access to and manipulation of the pivot member 1840 (e.g., positioning, threading sutures, etc.). The pivot member 1840 is shown disposed within the through opening 1830 and occupies a majority of the through opening 1830. The pivot member 1840 can be releasably, rotatably, and / or pivotally coupled to the inner surface 1832 of the body 1801 of the bone plate hole cap 1800 such that the pivot member 1840 can move (e.g., pivot, rotate, etc.) independently of the body 1801 of the bone plate hole cap 1800. The pivot member 1840 is further shown to include a bore 1842 extending from a first portion of the outer surface of the pivot member 1840 to a second portion of the outer surface. Fluid communication can be established through the bore 1842. As shown in FIG. 32 , the bore 1842 extends substantially tangentially (e.g., not diametrically) through the pivot member 1840, although other embodiments can have other configurations for the pivot member 1840 (e.g., extending diametrically, along a linear or non-linear, symmetrical or asymmetrical path). The perforations 1842 are configured to allow a suture or suture tape, such as those previously shown and described herein, to be threaded (e.g., received, passed, etc.) within the perforations 1842 to releasably couple the bone plate hole cap 1800 with said suture. When threading / coupling, the pivot member 1840 allows free rotation of the bone plate hole cap 1800 relative to the threaded suture.Such free rotation can facilitate implantation. For example, one or more threads of the bone plate hole cap 1800 engage complementary threads of a bone plate as previously shown and described herein. In some embodiments, the pivot member 1840 can be configured so that the suture passes through an outer surface of the pivot opening and passes downwardly through the through opening 1830 so that the suture is positioned adjacent to the patient's bone and / or bone plate. The pivot member 1840 can be positioned flush with (or slightly offset upwardly or downwardly from) the first surface 1822 of the bone plate hole cap 1800. In some embodiments, a majority of the pivot member 1840 can be enclosed within the through opening 1830 (which can function as a socket or other similar retaining space / cavity) to allow free rotation of the pivot member 1840 within the through opening 1830. In some embodiments, the pivot member 1840 can be positioned to accommodate a conventional drive instrument (e.g., hex, torx, etc.) for manipulating the bone plate hole cap 1800. In some embodiments, an instrument with drive features that match the particular shape of the pivot member 1840 and bone plate hole cap 1800 can be provided as part of a surgical kit.

[0043] 33-34 , a bone plate system 1910 including a bone plate 1920 and an alternative bone plate hole cap 1900 is shown according to one aspect of the present disclosure. The bone plate hole cap 1900 has a body 1901, which can include a first surface 1922 and a second surface 1924, an inner surface 1932, and a circumferential surface 1926 disposed between the first surface 1922 and the second surface 1924 on the opposite side of the inner surface 1932 of the bone plate hole cap 1900 (e.g., on the outer side rather than the inner side). The circumferential surface 1926 can be sized to be restrained or secured within one or more through openings (e.g., through openings 30 shown in the bone plate 20 ( FIG. 2 )). Furthermore, the circumferential surface 1926 can be sized (at least as shown and described with reference to FIG. 2 ) to matingly engage with the through openings 30 of the bone plate 20. For example, the peripheral surface 1926 may be a threaded peripheral surface that mates and engages with the threaded through-opening 30 of the bone plate 20. The bone plate hole cap 1900 may include a through-opening 1930 that extends along an inner surface 1932 from a first surface 1922 of the body 1901 of the bone plate hole cap 1900 to a second surface 1924 of the body 1901 of the bone plate hole cap 1900. The through-opening 1930 of the body 1901 may have drive features for engaging with a tool (e.g., a hex drive, a Torx® drive, etc.) for inserting or removing the bone plate hole cap 1900 from the bone plate 20 ( FIG. 2 ), for example. For example, as shown in FIG. 11 , the bone plate hole cap 1900 may be formed from a solid blank disk. The through openings 1930 in the body 1901 may be formed by drilling six holes with diameter D1 and then drilling a hole with diameter D2 in the center of the disk.

[0044] The bone plate hole cap 1900 is shown releasably coupled to a bone plate 1920, which may be similar and / or similar to bone plate 20 and / or other bone plates shown and described herein. A peripheral surface 1926 of the bone plate hole cap 1900 is shown including threads disposed circumferentially about the peripheral surface 1926, which engage complementary threads 1921 disposed within complementary openings in the bone plate 1920. The bone plate system 1900 is further shown to include a resilient member 1940 disposed below the bone plate hole cap 1900. In some embodiments, the resilient member 1940 may be constructed of nitinol or other materials known to have shape memory properties. The resilient member 1940 may be coupled (releasably or otherwise) to a portion of the bone plate hole cap 1900 (e.g., the second surface 1924) and / or the bone plate 1920. Additionally, the resilient member 1940 can be configured to have a press-fit configuration. In some embodiments, the resilient member 1940 can include threads and / or other engagement features configured to facilitate engagement and / or coupling with the bone plate hole cap 1900 and / or bone plate 1920. The resilient member 1940 is shown to have a substantially cylindrical shape. In some embodiments, for example, as shown in FIGS. 33-34 , the resilient member 1940 can have a lateral dimension that is greater than its vertical dimension. In some embodiments, the resilient member 1940 can include a through opening having a shape and dimensions similar to the through opening 1930 of the bone plate hole cap 1900. The resilient member 1940 can be positioned flush with (or slightly offset upward or downward from) the second surface 1924 of the bone plate hole cap 1900. In some embodiments, the resilient member 1940 can be positioned to accommodate a conventional drive instrument (e.g., hex, torx, etc.) for manipulating (e.g., implanting, removing, etc.) the bone plate hole cap 1900.In some embodiments, an instrument with drive features that match the particular shape of the resilient member 1940 and bone plate hole cap 1900 can be provided as part of a surgical kit.

[0045] The bone plate hole caps 1700, 1800, 1900 (and one or more components of the bone plate system 1910) can be implemented in conjunction with (e.g., compatible / interchangeable with) one or more previously shown and described systems and / or components thereof. For example, the bone plate hole caps 1700, 1800, 1900 (or, in some embodiments, one or more of the bone plate hole caps 1700, 1800, 1900) can be implemented in conjunction with the bone plate system 10 and / or other similar bone plate systems. For example, the bone plate 20 can be implemented in conjunction with the bone plate hole caps 1700, 1800, 1900 and the resilient members 1940 disposed within the various through-openings 30. Furthermore, the bone plate hole caps 1700, 1800, 1900 can be compatible with various sutures, suture tapes, or other similar components commonly used in surgical and soft tissue fixation procedures.

[0046] It will be appreciated from this specification that a bone plate hole cap and bone plate system using at least one bone plate hole cap can provide the following advantages, including increased strength of the bone plate at the joint line, e.g., in high flexion situations; providing a tendon fulcrum or post-implant tensioning means, providing a soft tissue-friendly button / cover; and providing an auxiliary means for attaching sutures / tapes for soft tissue adjustment and attachment, e.g., suture anchors that attach to holes in the bone plate. Furthermore, the disclosed technique of filling or occupying one or more through-openings in a bone plate can inhibit bone growth into through-openings not used to attach the bone plate to the bone.

[0047] As will 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. As will 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. Components of the implant disclosed in the specification, including the accompanying abstract and drawings, may be replaced with alternative components or features, such as those disclosed in another embodiment that serve the same, equivalent, or similar purpose as known to those skilled in the art, and that provide similar functionality for their intended purpose. Furthermore, the implant may include more or fewer components or features than the embodiments described and illustrated herein. Therefore, this detailed description of the presently preferred embodiments should be interpreted as illustrative, rather than limiting, of the present disclosure.

[0048] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the disclosure. As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms as well, unless the context clearly dictates otherwise. Furthermore, the term "comprise" (and any forms of "comprise," e.g., "comprises" and "comprising"), the terms "have" and "have," e.g., "has" and "having," the terms "include" and "include," e.g., "includes" and "including," and the terms "contain" and "contain," e.g., "contains" and "containing") are open-ended linking verbs. Thus, a method or device that "comprises," "has," "includes," or "contains" one or more steps or elements has those one or more steps or elements, but is not limited to having only those one or more steps or elements. Similarly, a method step or device element that "comprises," "has," "includes," or "contains" one or more features has those one or more features, but is not limited to having only those one or more features. Furthermore, a device or structure that is configured in a particular way is configured in at least that way, but may also be configured in ways not listed.

[0049] This disclosure has been described with reference to preferred embodiments. It is understood that the architectural and operational embodiments described herein are illustrative of multiple possible configurations providing similar general features, characteristics, and general system operation. Modifications and alterations will occur to others upon reading and understanding the foregoing detailed description. It is intended that this disclosure be construed to include all such modifications and alterations.

Claims

1. a bone plate including a body having a first surface, a bone-engaging surface, and a plurality of through-openings extending from the first surface to the bone-engaging surface, the plurality of through-openings defining an inner surface extending between the first surface and the bone-engaging surface of the bone plate; at least one bone plate hole cap including a body, the body having a first surface, a second surface, and a circumferential surface disposed between the first surface and the second surface of the at least one bone plate hole cap, the at least one bone plate hole cap being securable within at least one of the plurality of through openings of the bone plate; Equipped with the second surface of the bone plate hole cap is positioned adjacent to the bone engaging surface of the bone plate when the bone plate hole cap is secured to at least one of the plurality of through openings; a bone plate having at least one bone plate hole cap secured to one of the plurality of through-openings, the bone plate increasing the bending strength of a portion of the bone plate intersecting the bone plate hole cap compared to a corresponding portion of the bone plate without the bone plate hole cap; the first surface of the bone plate hole cap defines a button having a convex surface, and the second surface of the bone plate hole cap is configured to receive a drive tool operable to insert and / or remove the bone plate hole cap from the bone plate. Bone plate system.

2. the second surface of the bone plate hole cap is configured to receive a male drive tool operable to insert and / or remove the bone plate hole cap from the bone plate. The bone plate system of claim 1 .

3. the second surface of the bone plate hole cap is configured to receive a female drive tool operable to insert and / or remove the bone plate hole cap from the bone plate. The bone plate system of claim 1 .

4. the convex surface of the button is disposed on the first surface of the bone plate around at least one of the plurality of through openings of the bone plate. The bone plate system of claim 1 .

5. The bone plate hole cap comprises a monolithic bone plate hole cap.

5. The bone plate system of claim 4.

6. the drive tool includes a hex drive; The bone plate system of claim 1 .

7. some of the plurality of through openings of the bone plate include tapered internal threads, and the peripheral surface of at least one of the bone plate hole caps includes corresponding tapered external threads. The bone plate system of claim 1 .

8. the tapered configuration of at least one of the bone plate hole caps has an angle between 2 degrees and 10 degrees.

8. The bone plate system of claim 7.

9. the tapered configuration of at least one of the bone plate hole caps has an angle of 6 degrees.

9. The bone plate system of claim 8.

10. the bone plate comprises a metal; The bone plate system of claim 1 .

11. the bone plate hole cap comprises a metal. The bone plate system of claim 1 .

12. the bone plate hole cap comprises a biopolymer material. The bone plate system of claim 1 .

13. at least one of the plurality of through-openings of the bone plate includes a compression opening; the compression opening is used to insert a bone fixation element into a patient's bone, the bone fixation element being movable within the compression opening when the bone is moved or compressed; The bone plate system of claim 1 .

14. The at least one bone plate hole cap includes a plurality of bone plate hole caps. The bone plate system of claim 1 .

15. further comprising a plurality of bone fixation elements; a plurality of the bone fixation elements extendable through at least some of the plurality of through-openings of the bone plate to secure the bone plate to the patient's bone; The bone plate system of claim 1 .

16. a plurality of bone screws; a plurality of bone screws extendable through at least some of the plurality of through-openings in the bone plate to secure the bone plate to the patient's bone; The bone plate system of claim 1 .

17. a bone plate including a body having a first surface, a bone-engaging surface, and a plurality of through-openings extending from the first surface to the bone-engaging surface, the plurality of through-openings defining an inner surface extending between the first surface and the bone-engaging surface of the bone plate; at least one bone plate hole cap including a body, the body having a first surface, a second surface, and a circumferential surface disposed between the first surface and the second surface of the at least one bone plate hole cap, the at least one bone plate hole cap being securable within at least one of the plurality of through openings of the bone plate; a cover attachable to at least one of the bone plate hole caps, the cover including a passage for receiving a suture; and Equipped with the second surface of the bone plate hole cap is positioned adjacent to the bone engaging surface of the bone plate when the bone plate hole cap is secured to at least one of the plurality of through openings; A bone plate having at least one bone plate hole cap secured to one of the plurality of through-openings increases the bending strength of a portion of the bone plate intersecting the bone plate hole cap compared to a corresponding portion of the bone plate without the bone plate hole cap. Bone plate system.

18. the first surface and / or the second surface of the bone plate hole cap are configured to receive a drive tool operable to insert and / or remove the bone plate hole cap from the bone plate.

18. The bone plate system of claim 17.

19. the cover comprises a first material and the bone plate hole cap comprises a second material different from the first material.

18. The bone plate system of claim 17.

20. a bone plate including a body having a first surface, a bone-engaging surface, and a plurality of through-openings extending from the first surface to the bone-engaging surface, the plurality of through-openings defining an inner surface extending between the first surface and the bone-engaging surface of the bone plate; at least one bone plate hole cap including a body, the body having a first surface, a second surface, and a circumferential surface disposed between the first surface and the second surface of the at least one bone plate hole cap, the at least one bone plate hole cap being securable within at least one of the plurality of through openings of the bone plate; Equipped with the second surface of the bone plate hole cap is positioned adjacent to the bone engaging surface of the bone plate when the bone plate hole cap is secured to at least one of the plurality of through openings; a tensioning device disposed within the bone plate hole cap, the tensioning device being attachable to a suture; A bone plate having at least one bone plate hole cap secured to one of the plurality of through-openings increases the bending strength of a portion of the bone plate intersecting the bone plate hole cap compared to a corresponding portion of the bone plate without the bone plate hole cap. Bone plate system.

Images