Patent Grant
12059185
This disclosure relates generally to bone plate devices and methods for fixing a bone plate device to one or more bones.
Bones, such as the bones of a foot, may be anatomically misaligned. In certain circumstances, surgical intervention is required to correctly align the bones to reduce patient discomfort and improve patient quality of life. Surgical intervention may involve cutting one or more of the misaligned bones and then physically realigning the bones into an anatomically corrected position. A bone plate or multiple bone plates may be used to hold the bones in the anatomically corrected position, helping to prevent the bones from shifting back to their misaligned position.
In general, this disclosure is directed to bone plates, systems incorporating bone plates, and methods of using bone plates. In some examples, a bone plate is formed of an elongated body having a length greater than a maximum width and thickness. For example, the bone plate may have a length defining a central longitudinal axis, a width perpendicular to the central longitudinal axis, and a thickness perpendicular to both the length and width. The thickness of the bone plate may be the dimension between a top facing surface of the bone plate and a bone facing surface of the bone plate, e.g., when the bone plate is applied to one or more bones during fixation. The bone plate can have one or more fixation holes extending through the thickness of the bone plate, allowing a clinician to insert bone fasteners through the holes to secure the bone plate to the one or more bones being fixated. In addition, the bone plate can have one or more pads extending outwardly from the bone facing surface of the bone plate. The one or more pads may be positioned next to the one or more fixation holes along the length of the bone plate. For example, a pad may be positioned at least partially, and in some configurations fully, about a circumference of a region of the bone plate forming a fixation hole. As a result, the region of the bone plate defining the fixation hole may be thicker where the pad is located than adjacent locations of the bone plate not containing a pad. Configuring the bone plate with a pad in the region of the fixation hole can reduce the amount of trauma caused to the periosteal membrane of the bone or bones to which the bone plate is attached. This can help minimize blood flow disruption, helping to heal the area of the bone interfacing with the bone plate.
Although a bone plate according to the disclosure can have a variety of different configurations, in some applications, the bone plate has a helical curvature extending between opposed fixation holes. The helical curvature can cause fixation hole(s) positioned in a distal section of the bone plate to be positioned in a different plane than fixation holes(s) positioned in a proximal section of the bone plate. For example, the helical curvature may follow a path traced along an imaginary cylinder or cone at an oblique angle so as to define a spiral or curved fold. In some examples, the angle and/or extent of curvature may be formed or adjusted in-situ by fabricating the bone plate out of a malleable material. In one application, the helical curvature of the bone plate is configured to extend from the plantar region of a first metatarsal to the medial region of a medial cuneiform, thereby positioning the curvature across a metatarsal-cuneiform joint.
In one example, a bone plate is described that includes a body, one or more fixation holes, and a pad. The body has a length defining a central longitudinal axis and a width defining an extent of the bone plate transverse to the central longitudinal axis. The body includes a top surface and a bone facing surface opposite the top surface, with the bone facing surface including a first surface. The fixation hole extends through the body from the top surface to the bone facing surface. The pad extends out a distance from the first surface at a location on the bone facing surface adjacent any or all of the fixation holes.
In another example, a method of fixating a bone plate is described. The method includes positioning a bone facing surface of the bone plate in contact with a bone and contacting the bone with a pad that extends out a distance from a first surface of the bone facing surface at a location on the bone facing surface adjacent a first fixation hole. The method further includes positioning a bridge of the bone plate across a target area and inserting a first fastener through the first fixation hole and into the bone.
In another example, a bone plate is described that includes a body, a helical curvature, a first fixation hole, and a second fixation hole. The body has a length defining a central longitudinal axis extending from a proximal region of the body to a distal region of the body and a width defining an extent of the bone plate transverse to the central longitudinal axis. The body includes a top surface and a bone facing surface opposite the top surface. The helical curvature is positioned between the proximal and distal regions of the body. The helical curvature includes both a bend of the body along the central longitudinal axis and a twist of the body about the central longitudinal axis. The example specifies that the distal region lies in a first plane and the proximal region lies in a second plane offset from the first plane both along and about the longitudinal axis such that the helical curvature provides a transition from the first plane to the second plane. In addition, the example further specifies that the first fixation hole is at the proximal region, the second fixation hole is at the distal region, and the first fixation hole and second fixation hole each extend through the body from the top surface to the bone facing surface.
The following detailed description is exemplary in nature and is not intended to limit the scope, applicability, or configuration of the invention in any way. Rather, the following description provides some practical illustrations for implementing exemplary embodiments of the present invention. Examples of constructions, materials, and dimensions are provided for selected elements, and all other elements employ that which is known to those of ordinary skill in the field of the invention. Those skilled in the art will recognize that many of the noted examples have a variety of suitable alternatives.
The present disclosure is generally directed to bone plates, systems and kits that include one or multiple bone plates, and method of using one or multiple bone plates. In an exemplary application, a bone plate according to the disclosure can be useful for internal fixation of a bone or bones during a surgical procedure, such as a bone alignment, osteotomy, fusion procedure, fracture repair, and/or other procedures where one or more bones are to be set in a desired position. Such a procedure can be performed, for example, on bones (e.g., adjacent bones separated by a joint or different portions of a single bone) in the foot or hand, where bones are relatively small compared to bones in other parts of the human anatomy. In one example, a procedure utilizing an embodiment of the bone plate can be performed to correct an alignment between a metatarsal (e.g. a first metatarsal) and a cuneiform (e.g., a first/medial cuneiform), such as a bunion correction. An example of such a procedure is a lapidus procedure. In another example, the procedure can be performed by modifying an alignment of a metatarsal (e.g. a first metatarsal). An example of such a procedure is a basilar metatarsal osteotomy procedure.
The body 30 of the bone plate 20 has a major length which defines the central longitudinal axis L. The body 30 can include a proximal region 51 at or near a first longitudinal end and a distal region 52 at or near a second longitudinal end that is opposite the first longitudinal end of the bone plate 20. The proximal region 51 may be separated from the distal region 52 by an intermediate region. For example, the body 30 may include one or more fixation holes. In these examples, body 30 may include one or more fixation holes in proximal region 51, one or more additional fixation holes in distal region 52, and an intermediate region devoid of fixation holes positioned between proximal region 51 and distal region 52.
In the illustrated embodiment, the distal region 52 has at least one fixation hole, which is illustrated as two fixation holes 60A and 60B, and the proximal region 51 has at least one additional fixation hole, which is illustrated as two fixation holes 60C and 60D. In other examples, body 30 may include fewer fixation holes (e.g., one, none) or more fixation holes (e.g., three, four) in proximal region 51 and/or distal region 52. Moreover, the dimensions (e.g., length) of the proximal and distal regions 51, 52 can be adjusted to accommodate the particular number of fixation holes included.
In the example shown, the proximal region 51 extends longitudinally from the first longitudinal end of the bone plate 20 to an end of the fixation hole 60C on the axis L furthest from the first longitudinal end. In addition, in this example, the distal region 52 extends longitudinally from the second longitudinal end of the bone plate 20 to an end of the fixation hole 60B on the axis L furthest from the second longitudinal end. Thus, in the illustrated example, the bone plate 20 includes a region between proximal region 51 and distal region 52, specifically between the terminal edge of fixation hole 60B and the terminal edge of fixation hole 60C, which is devoid of fixation holes and is sometimes referred to herein as a “bridge.”
As shown in
In the embodiment of the bone plate 20 shown in
The twist of helical curvature 62 about longitudinal axis L can rotate the proximal region of body 30 relative to the distal region 52 about axis L. For example, the twist may rotate regions 55C and 55D relative to regions 55A and 55B such that regions 55C and 55D, and the corresponding fixation holes defined therein, are radially offset from regions 55A and 55B, and the corresponding fixation holes defined therein. In some embodiments, the twist is concentrated in one or more portions of the body 30, such as the portion of the body between the proximal and distal portions. Further, in some examples, the twist of the body 30 ranges from approximately 45° to less than 180° about the axis L, such as from approximately 60° to approximately 100° about the axis L, or from approximately 70° to approximately 90° about the axis L. In other examples, the twist of the body 30 ranges from 25° to 100°, such as from 35° to 65°. Other angles of twist are also possible depending on the application.
While the bone plate 20 is described as having helical curvature 62, it should be appreciated that the curvature provided by the bone plate need not be a mathematically perfect helix. Rather, the helical curvature 62 may be a generally helical shape, such as a shape that follows the general contours of a helix even if the angles of contortion do not form a perfect helix. Therefore, it should be appreciated that a bone plate described as having a helical curvature according to the disclosure may, in practice, have a generally helical shape without forming a mathematically perfect helix.
In some embodiments, the helical curvature 62 can be concentrated or entirely within a region of the body 30 between the proximal region 51 and distal region 52. Thus, any bend of the body 30 along the axis L and any twist of the body 30 about the axis L of the helical curvature 62 can begin at or near an end of the distal region 52 (e.g., begin at or adjacent fixation hole 60B) and proceed in a proximal direction toward the proximal region 51 (e.g., terminating at or adjacent fixation hole 60C). For instance, the helical curvature 62 (e.g., the bend along the axis L and the twist about the axis L) of the illustrated embodiment begins at the end of the distal region 52 and ends at the beginning of the proximal region 51. Thus, the helical curvature 62 as shown is located on a bridge portion of the body 30 between the fixation holes 60B and 60C. In such embodiments, the helical curvature 62 provides the transition of the body 30 from the first plane to the second plane. Moreover, in this embodiment, fixation holes 60A and 60B are positioned in the same plane, fixation holes 60C and 60D are also positioned in the same plane, and the plane fixation holes 60A and 60B are positioned in is offset from the plane fixation holes 60C and 60D are positioned in by helical curvature 62.
Using the example of bones in the foot, bone portion B1 can be, for instance, a metatarsal (e.g. a first metatarsal) while bone portion B2 can be, for instance, a cuneiform (e.g. a medial cuneiform). Bone portions B1 and B2 can each have, among other regions, respective plantar regions P1 and P2 and medial regions M1 and M2. Plantar region P1 is offset, relative to a longitudinal axis of the bones LB, from medial region M2. Similarly, plantar region P2 is offset, relative to the longitudinal axis LB, from the medial region M2. Plantar regions P1 and P2 can interface with respective medial regions M1 and M2 at interface I, which can be referred to as a dorsal-medial region. Thus, interface I may represent a location along an outer perimeter surface of each bone portion B1 and B2 where the respective plantar regions P1 and P2 transition to the respective medial regions M1 and M2.
In one example, the bone plate 20 can be positioned on a plantar region P1 or P2 of one bone portions B1 or B2 and positioned on a medial region M1 or M2 of another bone portion B1 or B2. Therefore, the bone plate 20 can cross over the interface I such that the bone plate 20 can have a portion of the body 30 on each side of the interface I. The plantar regions P1 and P2 may be any region on a plantar half of bone portion B1 and B2, respectively, while the medial regions M1 and M2 may be any region on the medial half of bone portions B1 and B2 respectively.
In some examples, the bone plate 20 may be positioned on a plantar region that is more specific than the entire plantar half of the bone B. For example, the bone plate 20 may be positioned on a plantar region that ranges from the plantar position 322 to a location within a 60° arc toward the medial position 324, such as a position that ranges from the plantar position 322 to a location within a 45° arc toward the medial position 324. In some examples, the plantar region extends beyond the plantar position 322 toward the lateral position 326 in addition to extending toward medial position 324, such as a position ranging from a location within a 20° arc beyond the plantar position 322 toward the lateral position 326. For example, the plantar region may be a region formed by an arc ranging from 20° past the plantar position 322 toward the lateral position 326 and to 60° past the plantar position toward the medial position 324.
In addition to or in lieu of the plantar regions discussed above, the bone plate 20 may be positioned on a medial region that is more specific than the entire medial half of the bone B. For example, the bone plate 20 may be positioned on a medial region that ranges from the medial position 324 to a location within an arc plus or minus 45° from the medial position 324, such a location within an arc plus or minus 30° from the medial position 324.
With further reference to the embodiment shown in
The helical curvature 62 can be included on the bone plate 20 so as to provide a twist and/or bend suitable for a particular application, e.g., such as facilitating positioning of the bone plate across the joint J and/or the interface I as described. In the example of
When the helical curvature 62 of bone plate 20 is configured to wrap from a first surface (e.g., in plantar region P1) of a first bone portion (e.g., B1) to a second surface (e.g., in medial region M2) of a second bone portion (e.g., B2), the bone plate may resist separation between the first and second bone portions. For instance, where the bone portion B1 is a metatarsal and the bone portion B2 is a cuneiform, loading can act to separate the plantar regions P1 and P2, creating tensile stresses. By configured bone plate 20 to extend from the plantar region P1 at the distal region 52 to the medial region M2 at the proximal region 51, the bone plate can support the tension side across the plantar regions P1 and P2 (e.g., bottom of the foot containing bones B1 and B2 on which tension is placed). This can reduce or eliminate any gapping between the surfaces (e.g., separation between bone B1 and bone B2 and joint J) that could otherwise occur.
In some embodiments, the helical curvature 62 of the bone plate 20 is pre-formed, such that the bone plate includes the helical curvature when it is removed from its packaging. For example, helical curvature 62 may be formed in bone plate 20 before packaging, and the bone plate may be sufficiently rigid to hold the helical curvature until use. In some additional embodiments of the bone plate 20, body 30 can include malleable materials that allow for in-situ bending of the helical curvature 62. In still other embodiments, the bone plate may contain a pre-formed helical curvature 62 yet be formed of malleable materials such that the bone plate can be further bent during a surgical procedure. This can allow a clinician to adjust the radius of curvature and/or amount of bend of helical curvature 62 during a procedure to best fit the particular anatomy and/or patient undergoing the procedure (e.g., depending on the dimensions of the bones to which the bone plate 20 is to be fixed). For example, a clinician may remove the bone plate 20 from a sterile package and then bend the bone plate between proximal region 51 and distal region 52 until the shape of the helical curvature 62 best matches the anatomy across which the bone plate 20 is being positioned. In applications where bone plate 20 includes a pre-formed helical curvature 62, the amount of bending provided by the clinician may range from plus 20° (making the body 30 flatter) to minus 20°, such as from plus 10° to minus 10°, or from plus 5° to minus 5°, although other degrees of bending may also be used depending on the application.
The bone plate 20 can fabricated from any biocompatible material or combinations of materials. Example materials that the bone plate 20 may be fabricated from include metals and metal alloys, such a titanium, stainless steel, cobalt, nickel and alloys thereof (e.g., titanium-containing alloys, cobalt-containing alloys, nickel-containing alloys). The bone plate 20 may or may not be fabricated from a shape-memory alloy, such as nitinol. As another example, the bone plate 20 may be fabricated from a carbon fiber material. In general, any the foregoing materials may be configured as a material that is malleable under human hand pressure by controlling the compositional characteristics and/or thicknesses of the material.
When the bone plate 20 is fabricated from a malleable material(s) and has been positioned across the interface I as described, the body 30 can be further contoured (e.g., beyond what is provided with a pre-established helical curvature 62) to better fit a particular application. In addition, fabricating body 30 from malleable materials can allow the clinician to adjust the positioning of proximal region 51 and/or distal region 52, e.g., independent of any adjustments being made to helical curvature 62. For example, the clinician may manipulate the position of one or more of fixation holes 60A-60D relative to each other (e.g., 60A and 60B relative to each other, fixation holes 60C and 60D relative to each other, fixation holes 60A and 60D relative to each other). A clinician may desire to adjust the position of a particular fixation hole extending through body 30 to adjust the trajectory of a fixation member/bone fastener (e.g., screw) inserted through the fixation hole. In general, when the body 30 is fabricated from malleable materials, the materials may be sufficiently pliable (e.g., have a thickness and/or composition) to allow the clinician to bend the body under hand pressure but sufficiently rigid to maintain any bending applied by the clinician after removing such hand pressure.
In some examples, the proximal region 41 and/or distal region 52 can be contoured such that the fixation holes in each region (in examples where the proximal region and/or distal region contains multiple fixation holes) are in a single plane, e.g., after applying any desired contouring or bending. When so configured, bone fasteners inserted through fixation holes in a particular region (e.g., proximal region, distal region) can have parallel trajectories. In other examples, the proximal region 51 and/or distal region 52 may be contoured such that the fixation holes in each region are in different planes. When so configured, bone fasteners inserted through fixation holes in a particular region can have trajectories that are offset (e.g. “toe nail” trajectories).
To attach bone plate 20 to one or more bones, a clinician can position the bone plate on or about the one or more bones and insert bone fasteners through one or more (e.g., all) of the fixation holes 60A-D. The bone fasteners can be any mechanical fixation element that secures the bone plate to an underlying bone or bones, such as screws, pins, rivets, spikes, or the like. In one application, fixation screws are used as the bone fasteners. The fixation screws can be either locking screws or non-locking screws. Therefore, although the term “fixation screw” and “screw” is used herein, it should be appreciated that any suitable bone fastener can be used and a fixation screw is merely an exemplary bone fastener.
In the example of
In some applications, one or more additional bone plates may be used. For example, a second bone plate (with or without a helical curvature) can be fixed to the bone portions B1 and B1. In one such example, a second bone plate is positioned from a dorsal (not shown) or medial M1 surface of the bone B1 across the joint J to a dorsal or medial M2 surface of the bone B2. In addition or alternatively, one or more cross screws may be placed through the joint J from bone B1 to bone B2 for additional bone fixation.
A bone plate as described herein can be used a part of a procedure to fixate a bone or bones. For example, a site at which the bone plate is to be applied can be prepared for application of the bone plate. A bone facing surface of the distal region of the bone plate can be positioned on a first surface of a first bone portion, and a bone facing surface of the proximal region of the bone plate can be positioned on a second surface of a second bone portion. In such applications, the first and second surfaces can be offset from each other relative to a longitudinal axis of the bone portions. In one embodiment of such a procedure, the distal region of the bone plate can be positioned on a bottom (e.g., plantar) surface of the first bone portion while the proximal region can be positioned on a side (e.g., medial) surface of the second bone portion. A helical curvature of the bone plate can span a joint or fracture between the first and second bone portions. A fastener can be inserted through a fixation hole of the proximal and/or distal region to fixate the bone plate relative to the bone portions.
In the illustrated example, body 30 includes the top surface 40 and the bone facing surface 50, which is on a side of the body 30 opposite the top surface 40. In an exemplary application, the bone plate 20 can be positioned so that the bone facing surface 50 contacts one or more bones. Additionally, the body 30 has a length defining the central longitudinal axis L and one or more widths W1, W2, and W3 defining an extent of the body 30 (and thus the bone plate 20). The widths W1, W2, and W3 are orthogonal to the central longitudinal axis L.
The body 30 may include regions 55A, 55B, 55C, and 55D extending from the top surface 40 to the bone facing surface 50, and which can be spaced from one another along the axis L. For instance, regions 55A and 55B can be of the distal region while regions 55C and 55D can be of the proximal region. Regions 55A, 55B, 55C, and 55D can each extend a distance along the axis L from a region leading edge 55AL, 55BL, 55CL, and 55DL to a region trailing edge 55AT, 55BT, 55CT, and 55DT, respectively. The width W1 can correspond to a width of the body 30 at each region 55A, 55B, 55C, and 55D, and in the illustrated embodiment the width W1 is the greatest extent of the body 30 transverse to the axis L.
As shown for example in
Regions 55A, 55B, 55C, and 55D in
In the illustrated embodiment, the bone plate 20 has four regions 55A, 55B, 55C, and 55D and four fixation holes 60A, 60B, 60C, and 60D. However, any number of regions and fixation holes can be included, regardless of whether a particular region does or does not include a corresponding fixation hole extending through the region. Additionally, while the regions 55A, 55B, 55C, and 55D on the body 30 are shown as rounded, in other embodiments the regions 55A, 55B, 55C, and 55D can have other geometries.
In the illustrated example, the bone facing surface 50 includes at least one pad 70 that extends outward from first surface 74 (e.g., projects away from first surface 74 to increase the thickness of body 30 in the region of pad 70). The bone plate 20 can include pads 70 in regions 55A, 55B, 55C, and/or 55D. For example, the pads can be arrayed partially or fully about the circumference of fixation holes 60A, 60B, 60C, and/or 60D. In the embodiment shown, the first surface 74 is included on a region 76A that includes the thinnest cross-section of the bone plate 20. One or more additional regions 76B-E may be provided, each having the first surface 74 at generally the same thickness.
In one application, the pad 70 can extend outward from the first surface 74 in a direction that is generally perpendicular to the first surface 74 (e.g., in the direction of the thickness of body 30). In other applications, the pad 70 may project outward from the first surface 74 at various angles (e.g., such that the pad does not define a planar face that contacts bone but instead has an angled face). In one example, the pad extends outward about 0.3 millimeters to about 0.5 millimeters (e.g., about 0.42 millimeters) relative to the first surface 74. For instance, where the pad 70 extends out perpendicular to the surface 74 a ratio of a thickness of the bone plate 20 including the pad 70 to a thickness of the bone plate 20 at the first surface can be between approximately 1.01 and 1.5 (e.g., about 1.3).
The pad 70 can be a point of contact with a bone on the bone facing surface 50, when the bone plate 20 is applied to one or more bones. As shown, the bone facing surface 50 of the bone plate 20 includes a pad 70 at each of the regions 55A, 55B, 55C, and 55D such that the pads 70 are adjacent the fixation holes 60A, 60B, 60C, and 60D at the respective regions. In the illustrated embodiment, the pads 70 extend a length along the axis L from each region leading edge 55AL, 55BL, 55CL, and 55DL to each region trailing edge 55AT, 55BT, 55CT, and 55DT, respectively. The pads 70 as shown also extend from a first end of the width W1 of the body 30 to a first point on a perimeter of the fixation holes 60A, 60B, 60C, and 60D nearest the first end of the width W1, and from a second end of the width W1, located opposite the first end of the width W1, of the body 30 to a second point on the perimeter of the fixation holes 60A, 60B, 60C, and 60D nearest the second end of the width W1. Thus, in the embodiment shown, the pads 70 do not span an entire width, including width W1, of the regions 55A, 55B, 55C, and 55D on the bone facing surface 50. Instead, pads 70 in each of regions 55A-55D are bisected by a channel of reduced thickness (e.g., compared to pads 70) having a width equal to (or approximately equal to W3), which is the width of regions 76A-76E separating adjacent regions 55A-55D having fixation holes.
In some embodiments, the sum total of the surface area of the pads 70 is less than 50% of the total surface area of the bone facing surface area 50 of the bone plate. Although the embodiment of bone plate 20 shown includes the pads 70 adjacent the fixation holes 60A, 60B, 60C, and 60D, any number of the pads 70 can be included on the bone facing surface 50. Further, the location and geometries of the pads 70 can vary according to the particular application of the bone plate 20.
The span of the pads 70 along the width of the regions 55A, 55B, 55C, and 55D is interrupted in the embodiment of bone plate 20 by channels 80, which bisect each of the regions 55A, 55B, 55C, and 55D along the length L of body 30. In the embodiment shown, the channels 80 extend outward a distance from the first surface 74 (e.g., projects away from first surface 74 to increase the thickness of body 30 in the region of channels 80 compared to first surface 74). In other embodiments, the channels 80 can be flush with the first surface 74.
In embodiments where one or more channels 80 project out a distance from the first surface 74, the distance the channels 80 project out may be less than the distance the pads 70 project out from the first surface 74. In such embodiments, the pads 70 are raised relative to the channels 80, and the channels 80 are elevated relative to the first surface 74. That is, the thickness of the body 30 may be greater across channels 80 than across regions 76A-E defining first surface 74, and the thickness of body 30 may be greater across pads 70 than channels 80.
The channels 80 may extend a length along the axis L on the bone plate 20 from each region leading edge 55AL, 55BL, 55CL, and 55DL to each fixation hole 60A, 60B, 60C, and 60D of the respective region and from each fixation hole 60A, 60B, 60C, and 60D to each respective region trailing edge 55AT, 55BT, 55CT, and 55DT. The channels 80 may also extend a width along the width of each region 55A, 55B, 55C, and 55D between the pads 70. As such, in the illustrated embodiment, fixation holes 60A, 60B, 60C, and 60D are bounded by opposed pads 70 and opposed channels 80 along the perimeters of the fixation holes 60A, 60B, 60C, and 60D. In addition, in the illustrated example, each channel 80 in regions 55A, 55B, 55C, and 55D is aligned with the channels 80 in each other region along the axis L, providing a co-linearly aligned series of channels.
At locations where the channel 80 interfaces with the pad 70, a radiused surface 90 can be included to transition from the channel 80 to the pad 70. For example, the radiused surface 90 can provide a slope from the raised pad 70 to the relatively lower channel 80. The slope may have a constant radius of curvature or a variable radius of curvature. The radiused surface 90 may act, for example, to reduce stresses in the bone plate 20, and therefore can be useful for applications of the bone plate 20 where a greater strength is desired. In other configurations, the bone plate 20 may not have a curved transition between channel 80 and pad 70 but may instead have a sharp junction between the channel and pad.
Including one or more pads 70 and/or one or more channels 80 can provide benefits during application of the bone plate 20. For instance, including a pad 70 and/or a channel 80 on the bone facing surface 50 may decrease trauma to a periosteal membrane of a bone when the bone plate 20 is attached to a bone in a surgical procedure. Decreasing trauma to the periosteal membrane of the bone can result in less disruption of blood flow, which can help with healing the area of the bone interfacing with the bone plate 20.
Additionally, the pad 70 and/or channel 80 can increase the bending strength of the bone plate 20 without impeding the ability of a clinician to bend the bone plate 20 at a specific location (e.g., to form or modify helical curvature 62). For example, the bone plate 20 may be desirably bent at one or more of regions 76A-E to adjust position of fixation holes 60A-D relative to specific patient anatomy. In such embodiments, one or more of the regions 76A-E can be configured to concentrate bending forces applied to the bone plate. For example, regions 76A-E may be configured to concentrate bending stresses by having a smaller minimum bending force required to bend the plate at the region as compared to other regions of the plate. In the embodiment shown, the smaller minimum bending stress is provided by configuring regions 76A-E with the thinnest cross-section thickness of the plate. This can allow the bone plate 20 to be bent as desired for a particular application and anatomy without deforming any threads included in any of the fixation holes 60A-D.
In the example of
The bridge 100 as illustrated has sides running parallel to the axis L that are generally linear. In other embodiments, the bridge 100 can have rounded sides similar to the regions 55A, 55B, 55C, and 55D or any other geometry suited for the specific application of the bone plate 20. In some embodiments, the bridge is devoid of any apertures and extends between regions having fixation holes, such as regions 55B and 55C having fixation holes 60B, 60C, respectively.
The bridge 100 may include one or more pads 110 on the bone facing surface 50. The one or more pads 110 can be similar to the pad 70, such that the one or more pads 110 extend outward from the first surface 74 (e.g., increasing the thickness of body 30 in the region of the pads 110 as compared to sections of the bridge 100 that do not have pads 110). Also on the bone facing surface 50, the bridge 100 can have one or more channels 120 included along the width W2 between the pad 110. The one or more channels 120 can be similar to the channel 80.
In the embodiment shown, the channels 120 extend outward a distance from the first surface 74 (e.g., project away from first surface 74 to increase the thickness of body 30 in the region of channels 120 compared to first surface 74). In other embodiments, the channels 120 can be flush with the first surface 74. In embodiments where one or more channels 120 extend out a distance from the first surface 74, the distance the channels 120 project out may be less than the distance the pads 110 project out from the first surface 74. In such embodiments, the pads 110 are raised relative to the channels 120, and the channels 120 are elevated relative to the first surface 74, as shown in
The bridge 100 shown in
Extending along the axis L between regions 55A and 55B as well as between regions 55C and 55D are branches 130. The branches 130 form a portion of the body 30 that connects the region 55A to the region 55B as well as the region 55C to the region 55D. The branches 130 have a width W3. The width W3 of the branches 130 as illustrated in less than the width W1 and W2, but in other embodiments the width W3 can be equal to or greater than the width W1 and/or the width W2. Thus, for the bone plate 20 illustrated in
Similar to the bone plate 20, the bone plate 170 has regions 55A, 55B, 55C, and 55D including fixation holes 60A, 60B, 60C, and 60D respectively. The pads 70 and channels 80 can be included on the bone facing surface of bone plate 170 (not illustrated) at the regions 55A, 55B, 55C, and 55D as described previously.
When configured as illustrated in
The bone plate 170 defines a width W4 at the regions 55A, 55B, 55C, and 55D, a width W5 along the bridge 100, and a width W6 along the branches 130. The widths W4, W5, and W6 can be dimensioned consistent with widths W1, W2, and W3, respectively, as discussed above. Other widths and thicknesses can be used depending on the desired application.
In
In
The bone plate 20 as shown in
The attachment members 200 can be utilized, for example, to assist in locating and aligning pilot tools and drill bits and/or bending the bone plate 20 to better align with a contour of the bone 190 or other anatomy. For instance, it may be necessary to bend the bone plate 20 so that each of the pads 70 and 110 is in contact with the bone 190. The attachment members 200 can be, for example, cylindrical along an axial length of the attachment members 200 and include apertures that are aligned with the respective fixation holes 60A, 60B, 60C, and 60D. As shown, the attachment members 200 have an elongated aperture, relative to the fixation holes 60A, 60B, 60C, and 60D, that can help align tools and/or drill bits used during various applications of the bone plate 20. Also, the extension of the attachment members 200 out from the top surface 40 can allow for greater leverage for bending the bone plate 20. The attachment members 200 are illustrated as having a length greater than a maximum thickness of bone plate 20, although other sized attachment members can be used depending on the application.
Fasteners 220, such as bone screws having a head and a threaded shaft, are also shown in
A bone plate according to the disclosure may be provided as part of a kit that is intended to be used by a clinician during a procedure. Such a kit can include one or more embodiments of a bone plate according to the disclosure, as well as attachment members, fixation screws, one or more pilot tools, one or more bending tools, and/or one or more drive members.
The pilot tool 240 may be used to create an initial hole in a bone. Creating this initial hole with the pilot tool 240 can assist in later inserting the fastener 220 into the bone. The bending tools 250 can each have an end with a geometry adapted to mate with an end of the attachment members 200. Once one bending tool 250 has been mated to an attachment member 200, it may be desirable to mate a second bending tool 250 to a second attachment member 200 depending on the desired curvature of the bone plate 20. The bending tools 250 can then be used to bend the bone plate 20 to better align with the contour of the bone to which the bone plate 20 is to be fixed as desired. For example, it can be beneficial to bend the bone plate 20 such that any pads on the bone plate 20 are in contact with the bone. The drive member 260 can have an end adapted to mate with the attachment members 200 so that the drive member 260 may be used to both insert and remove the attachment members 200 from the fixation holes of the bone plate 20. The drive member 260 can also be used to insert the fasteners 220 through the fixation holes in the bone plate 20 and into the bone to which the bone plate 20 is to be fixed. The kit 230 including the described components may be included in a sterile pack for a single use.
In an exemplary embodiment, the kit 230 contains two bone plates (e.g., at least one of which includes a helical curvature) and a first set of fasteners with a first length, a second set of fasteners with a second length, a third set of fasteners with a third length, and a fourth set of fasteners with a fourth length, where each of the first, second, third, and fourth lengths are different. In another exemplary embodiment, the kit 230 includes two bone plates (e.g., at least one of which includes a helical curvature) and a first set of fasteners with a first length, a second set of fasteners with a second length, and a third set of fasteners with a third length, where each of the first, second, and third lengths are different. In yet another exemplary embodiment, the kit 230 contains two bone plates (e.g., at least one of which includes a helical curvature) and a first set of fasteners with a first length and a second set of fasteners with a second length, where the first and second lengths are different. In yet another exemplary embodiment, the kit 230 contains two bone plates (e.g., at least one of which includes a helical curvature) and only one set of fasteners each having the same length.
A bone plate and/or bone plate kit according to the disclosure can be used in a procedure to fixate one or more bones (e.g., two bones). For example, a site at which the bone plate is to be applied can be prepared for application of the bone plate. Attachment members can be secured in one or more of the fixation holes of the bone plate. If needed, the bone plate may be bent to align with a contour of the bone or other anatomy to which the bone plate is to be fixated. The bone plate can be aligned along this bone or anatomy, for instance, such that any pad on the bone plate's bone facing surface is made to contact the bone or anatomy. Pilot holes aligned with the fixation holes can be created in the bone. Any attachment members provided may be removed from the bone plate. The bone plate can then be attached to the bone or anatomy using appropriate fasteners, such as bone screws. After attaching the bone plate to the bone or anatomy, the surgical site can be closed.
In some applications, it may be desirable to attach more than one bone plate to a particular bone or anatomy. In these applications, two or more bone plates may be aligned with respect to the bone or bones being fixated such that the two or more bone plates reside in different planes. For example, two bone plates can be attached to bone(s) with the two bone plates positioned approximately 90 degrees, with respect to each other, along the outer circumference of the bone(s) (e.g., left side and top, or top and right side). In certain embodiments, the longitudinal axes of the bone plates can be substantially parallel. This can be beneficial to provide strong fixation across multiple planes.
As discussed above with respect to
In applications where the bone plate 20 is configured with at least one bend and at least one twist, the bone plate may have only a single bend and/or single twist or may have multiple bends and/or multiple twists. For example, the bone plate 20 may have a bend that angles the proximal region 51 toward the distal region 52, a twist that rotates the proximal region 51 relative to the distal region 52, and another bend that angles the proximal region 51 further toward or away from the distal region 52. The angle of the first bend may be similar or different (e.g., greater or smaller) than the angle of the second bend. As another example, the bone plate 20 may have a twist that rotates the proximal region 51 relative to the distal region 52, a bend that angles the proximal region 51 toward the distal region 52, and another twist that further rotates the proximal region 51 relative to the distal region 52. Other configurations of bends and twists are possible.
In the illustrated example, the bone plate 20 containing bend 300 is twisted as shown in
In
In
In addition, while
Although the present invention has been described with reference to certain disclosed embodiments, the disclosed embodiments are presented for purposes of illustration, and not limitation, and other embodiments of the invention are possible. Those of ordinary skill in the art will appreciate that various changes, adaptations, and modifications may be made without departing from the spirit of the invention.
This application is a continuation of U.S. patent application Ser. No. 16/278,255, filed Feb. 18, 2019, which is a continuation of U.S. patent application Ser. No. 14/990,368, filed Jan. 7, 2016, issued as U.S. Pat. No. 10,245,088 on Apr. 2, 2019, which in turn claims the benefit of U.S. Provisional Patent Application Nos. 62/100,541, filed Jan. 7, 2015 and 62/145,964, filed Apr. 10, 2015. The entire contents of each of these applications are incorporated herein by reference.
| Number | Name | Date | Kind |
|---|---|---|---|
| 4959065 | Arnett et al. | Sep 1990 | A |
| 5304180 | Slocum | Apr 1994 | A |
| 5665089 | Dall et al. | Sep 1997 | A |
| 5667510 | Combs | Sep 1997 | A |
| 5690639 | Lederer et al. | Nov 1997 | A |
| 5702396 | Hoenig et al. | Dec 1997 | A |
| 5709686 | Talos et al. | Jan 1998 | A |
| 5709687 | Pennig | Jan 1998 | A |
| 5785712 | Runciman et al. | Jul 1998 | A |
| 6183475 | Lester et al. | Feb 2001 | B1 |
| 6540746 | Bhler et al. | Apr 2003 | B1 |
| 6786909 | Dransfeld et al. | Sep 2004 | B1 |
| 7037309 | Weil et al. | May 2006 | B2 |
| 7175667 | Saunders et al. | Feb 2007 | B2 |
| 7229445 | Hayeck et al. | Jun 2007 | B2 |
| 7344538 | Myerson et al. | Mar 2008 | B2 |
| 7537596 | Jensen | May 2009 | B2 |
| 7695473 | Ralph et al. | Apr 2010 | B2 |
| 7722653 | Young et al. | May 2010 | B2 |
| 7785355 | Mohr et al. | Aug 2010 | B2 |
| 7931680 | Myerson et al. | Apr 2011 | B2 |
| 8133283 | Wilson | Mar 2012 | B2 |
| 8162996 | Schelling | Apr 2012 | B2 |
| 8167918 | Strnad et al. | May 2012 | B2 |
| 8172884 | Bouman | May 2012 | B2 |
| 8172886 | Castaneda et al. | May 2012 | B2 |
| 8177819 | Huebner et al. | May 2012 | B2 |
| 8177820 | Anapliotis et al. | May 2012 | B2 |
| 8177822 | Medoff | May 2012 | B2 |
| 8231662 | Huebner | Jul 2012 | B2 |
| 8235994 | Hollawell | Aug 2012 | B2 |
| 8236034 | Binder et al. | Aug 2012 | B2 |
| 8241338 | Castaneda et al. | Aug 2012 | B2 |
| 8246661 | Beutter et al. | Aug 2012 | B2 |
| 8257403 | Den Hartog et al. | Sep 2012 | B2 |
| 8257405 | Haidukewych et al. | Sep 2012 | B2 |
| 8382807 | Austin et al. | Feb 2013 | B2 |
| 8398687 | Vasta et al. | Mar 2013 | B2 |
| 8403966 | Ralph et al. | Mar 2013 | B2 |
| 8444679 | Ralph et al. | May 2013 | B2 |
| 8496690 | Sixto et al. | Jul 2013 | B2 |
| 8512339 | Medoff et al. | Aug 2013 | B2 |
| 8529608 | Terrill et al. | Sep 2013 | B2 |
| 8545540 | Castaneda et al. | Oct 2013 | B2 |
| 8652142 | Geissler | Feb 2014 | B2 |
| 8702762 | Jacene et al. | Apr 2014 | B2 |
| 8734492 | Mohr et al. | May 2014 | B2 |
| 8764807 | Michel et al. | Jul 2014 | B2 |
| 8784498 | Scheland | Jul 2014 | B2 |
| 8808334 | Strnad et al. | Aug 2014 | B2 |
| 8828063 | Blitz et al. | Sep 2014 | B2 |
| 8834532 | Velikov et al. | Sep 2014 | B2 |
| 8834537 | Castaneda et al. | Sep 2014 | B2 |
| 8852249 | Ahrens et al. | Oct 2014 | B2 |
| 8888824 | Austin et al. | Nov 2014 | B2 |
| 8940026 | Hilse et al. | Jan 2015 | B2 |
| 8940029 | Leung et al. | Jan 2015 | B2 |
| 9138244 | Mebarak et al. | Sep 2015 | B2 |
| 9149313 | Strnad et al. | Oct 2015 | B2 |
| 9220515 | Castaneda et al. | Dec 2015 | B2 |
| 9271769 | Batsch et al. | Mar 2016 | B2 |
| D765844 | DaCosta | Sep 2016 | S |
| D766434 | DaCosta | Sep 2016 | S |
| D766437 | DaCosta | Sep 2016 | S |
| D766438 | DaCosta | Sep 2016 | S |
| D766439 | DaCosta | Sep 2016 | S |
| 9452057 | Dacosta et al. | Sep 2016 | B2 |
| 9622805 | Santrock et al. | Apr 2017 | B2 |
| 9642656 | Kotuljac et al. | May 2017 | B2 |
| 9668793 | Gaudin | Jun 2017 | B2 |
| 9867642 | Simon | Jan 2018 | B2 |
| 10226287 | Langford et al. | Mar 2019 | B2 |
| 10238437 | Simon | Mar 2019 | B2 |
| 11058467 | Lueth et al. | Jul 2021 | B2 |
| 11141204 | Davison et al. | Oct 2021 | B2 |
| 11154340 | Dayton | Oct 2021 | B2 |
| 11160590 | Davison et al. | Nov 2021 | B2 |
| 11213327 | Gault et al. | Jan 2022 | B2 |
| 11278332 | Davison et al. | Mar 2022 | B2 |
| 20030060827 | Coughln | Mar 2003 | A1 |
| 20040116930 | O'Driscoll et al. | Jun 2004 | A1 |
| 20050033430 | Powers et al. | Feb 2005 | A1 |
| 20050192578 | Horst | Sep 2005 | A1 |
| 20060116679 | Lutz et al. | Jun 2006 | A1 |
| 20060149264 | Castaneda et al. | Jul 2006 | A1 |
| 20060235397 | Sanders et al. | Oct 2006 | A1 |
| 20060241607 | Myerson et al. | Oct 2006 | A1 |
| 20060241608 | Myerson et al. | Oct 2006 | A1 |
| 20060276795 | Orbay et al. | Dec 2006 | A1 |
| 20070123884 | Abdou | May 2007 | A1 |
| 20070191848 | Wack et al. | Aug 2007 | A1 |
| 20080015591 | Castaneda et al. | Jan 2008 | A1 |
| 20090118768 | Sixto, Jr. et al. | May 2009 | A1 |
| 20090210010 | Strnad et al. | Aug 2009 | A1 |
| 20090210013 | Kay et al. | Aug 2009 | A1 |
| 20090222047 | Graham | Sep 2009 | A1 |
| 20090281543 | Orbay et al. | Nov 2009 | A1 |
| 20100004691 | Amato et al. | Jan 2010 | A1 |
| 20100023010 | Nelson et al. | Jan 2010 | A1 |
| 20100069973 | Castaneda | Mar 2010 | A1 |
| 20100125300 | Blitz et al. | May 2010 | A1 |
| 20110008745 | McQuillan et al. | Jan 2011 | A1 |
| 20110087295 | Kubiak et al. | Apr 2011 | A1 |
| 20110093017 | Prasad et al. | Apr 2011 | A1 |
| 20110137351 | Huebner et al. | Jun 2011 | A1 |
| 20110166607 | Castaneda et al. | Jul 2011 | A1 |
| 20110264149 | Pappalardo et al. | Oct 2011 | A1 |
| 20120065689 | Prasad et al. | Mar 2012 | A1 |
| 20120265204 | Schmierer et al. | Oct 2012 | A1 |
| 20130090695 | Bernstein et al. | Apr 2013 | A1 |
| 20130172942 | Lewis et al. | Jul 2013 | A1 |
| 20130226248 | Hatch et al. | Aug 2013 | A1 |
| 20130238032 | Schilter | Sep 2013 | A1 |
| 20130261670 | Laeng et al. | Oct 2013 | A1 |
| 20140012887 | Tamano | Jan 2014 | A1 |
| 20140052193 | Prandi et al. | Feb 2014 | A1 |
| 20140081341 | Lin et al. | Mar 2014 | A1 |
| 20140107650 | Dacosta et al. | Apr 2014 | A1 |
| 20140107798 | Jeng et al. | Apr 2014 | A1 |
| 20140172021 | Castaneda et al. | Jun 2014 | A1 |
| 20140180343 | Gaudin | Jun 2014 | A1 |
| 20140214093 | Courtney et al. | Jul 2014 | A1 |
| 20140257291 | Houff | Sep 2014 | A1 |
| 20140277176 | Buchanan et al. | Sep 2014 | A1 |
| 20150032168 | Orsak et al. | Jan 2015 | A1 |
| 20150039033 | Biedermann | Feb 2015 | A1 |
| 20150045839 | Dacosta et al. | Feb 2015 | A1 |
| 20150313652 | Burckhardt et al. | Nov 2015 | A1 |
| 20150335366 | Dacosta et al. | Nov 2015 | A1 |
| 20150359580 | Dacosta et al. | Dec 2015 | A1 |
| 20160030098 | Dacosta et al. | Feb 2016 | A1 |
| 20160192970 | Dayton et al. | Jul 2016 | A1 |
| 20160235454 | Treace et al. | Aug 2016 | A1 |
| 20160256204 | Patel et al. | Sep 2016 | A1 |
| 20180344371 | Monk et al. | Dec 2018 | A1 |
| 20190357950 | Bernstein et al. | Nov 2019 | A1 |
| Number | Date | Country |
|---|---|---|
| 2006252612 | Apr 2012 | AU |
| 2715491 | Apr 2014 | CA |
| 2701408 | May 2005 | CN |
| 101836888 | Sep 2010 | CN |
| 201912210 | Aug 2011 | CN |
| 102755186 | Oct 2012 | CN |
| 103892954 | Jul 2014 | CN |
| 2389884 | Jul 2013 | EP |
| 2441406 | Sep 2013 | EP |
| 2379929 | May 2012 | ES |
| 184773 | Aug 2012 | IL |
| 200607174 | Aug 2007 | IN |
| H07313522 | Dec 1995 | JP |
| 101081268 | Nov 2011 | KR |
| 2004024009 | Mar 2004 | WO |
| 2006065512 | Jun 2006 | WO |
| 2007006430 | Jan 2007 | WO |
| 2007106962 | Sep 2007 | WO |
| 2008029142 | Mar 2008 | WO |
| 2008029143 | Mar 2008 | WO |
| 2014152535 | Sep 2014 | WO |
| 2015094410 | Jun 2015 | WO |
| 2016003477 | Jan 2016 | WO |
| 200808914 | Feb 2012 | ZA |
| Entry |
|---|
| Acumed, “Acu-Loc Wrist Plating System,” Brochure and Surgical Technique, effective date Apr. 2012, reported publication date Sep. 23, 2013, 19 pages. |
| Acumed, “Hand Fracture System,” Brochure, effective date Sep. 2014, reported publication date Jan. 29, 2016, 6 pages. |
| Acumed, “Hub Cap Fusion Plates,” Retrieved from <http://www.acumed.net/products/hand-wrist/carpal/hub-cap-fusion-plates>, 2016, 8 pages. |
| Arthrex, “Double Compression Plates,” Retrieved from <https://www.arthrex.com/foot-ankle/double-compression-plates>, 2016, 3 pages. |
| Arthrex, “Plantar Lapidus Plate,” 2015, 6 pages. |
| Arthrex, “Proximal Metatarsal Osteotomy using Plates,” Retrieved from <http://www.arthrex.com/foot-ankle/proximal-metatarsal-osteotomy-using-plates>, 2016, 2 pages. |
| Couzens et al., “Stainless Steel Versus Titanium Volar Multi-Axial Locking Plates for Fixation of Distal Radius Fractures: A Randomised Clinical Trial,” BMC Musculoskeletal Disorders, vol. 15, No. 74, Mar. 2014, 7 pages. |
| Diaconu et al., “Locking Plates for Fixation of Extra-Articular Fractures of the First Metacarpal Base: A Series of 15 Cases,” Chirurgie de la Main, vol. 30, No. 1, pp. 26-30, Abstract only. |
| European Patent Application No. 16735405.9, Extended European Search Report mailed Aug. 17, 2018, 9 pages. |
| International Patent Application No. PCT/US2016/012462, International Search Report and Written Opinion mailed Jun. 3, 2016, 12 pages. |
| Merete GMBH, “MetaFix OpenWedge,” Retrieved from <http://www.merete-medical.com/de/produkte/fuss/hallux-valgus/metafixr-openwedge.html>, 2016, 4 pages (Google Translation). |
| Osteomed, “ExtremiLock Ankle Plating System,” Brochure, published prior to Nov. 20, 2014, 6 pages. |
| Osteomed, “ExtremiLock Foot Plating System,” Brochure, published prior to Nov. 20, 2014, 6 pages. |
| Osteomed, “Hand Plating System,” Brochure, published prior to Nov. 20, 2014, 8 pages. |
| Plaass et al., “Anterior Double Plating for Rigid Fixation of Isolated Tibiotalar Arthrodesis,” Foot and Ankle International, vol. 30, No. 7, Jul. 2009, pp. 631-639. |
| Plaass et al., “Placement of Plantar Plates for Lapidus Arthrodesis: Anatomical Considerations,” Foot and Ankle International, vol. 37, No. 4, Apr. 2016, pp. 427-432. |
| Rochet et al., “Proximal Ulna Comminuted Fractures: Fixation Using a Double-Plating Technique,” Revue de Chirurgie Orthopédique et Traumatologique, vol. 96, No. 7, Nov. 2010, pp. 800-807. |
| Smith & Nephew, Inc, “D-RAD Smart Pack,” Single-Use Volar Distal Radius Plating System, Brochure, Jun. 2014, 8 pages. |
| Smith & Nephew, Inc, “EVOS MINI,” Plating System, Brochure, May 2015, 12 pages. |
| Smith & Nephew, Inc, “Proximal Humerus Locking Plate,” Peri-Loc Upper Extremity Locked Plating System, Surgical Technique, Sep. 2006, 36 pages. |
| Smith & Nephew, Inc, “Medial col. Fusion for Midfoot Deformity Correction,” VLP Foot Variable Angle Locked Plating System, Surgical Technique, 2013, 20 pages. |
| Stryker, “Anchorage Plating System,” Operative Technique, Rev. 2, Aug. 2015, 32 pages. |
| Stryker, “VariAx Foot Locked Plating System,” Jun. 2008, 25 pages. |
| Synthes, “LCP Periprosthetic System,” 2009, 8 pages. |
| Tornier, “Hand and Wrist,” Retrieved from <http://www.tornier-us.com/upper/hand/>, 2016, 1 page. |
| Tornier, “CoverLoc Volar Plate,” Retrieved from < http://www.tornier-us.com/upper/hand/writra003/>, 2016, 2 pages. |
| Tornier, “DFX Distal Fibula and DTX Distal Tibia Plates,” Retrieved from < http://www.tomier-us.com/lower/ankle/anktra003/>, 2016, 2 pages. |
| Tornier, “CalcLock Extreme,” Retrieved from < http://www.tornier-us.com/lower/foot/footra011/>, 2014, 2 pages. |
| Vilex, “The Vilex Plate System,” Brochure, 2011, 4 pages. |
| Wright Medical Group N.V., “Foot & Ankle,” Retrieved from < http://www.wright.com/physicians/foot-ankle>, 2016, 4 pages. |
| Wright Medical Group N.V., “DARCO Modular Rearfoot System (MRS) LPS Lapidus Plating System,” Brochure, Aug. 2016, 1 page. |
| Zimmer, Inc. “Foot and Ankle Solutions,” Retrieved from <http://www.zimmer.com/medical-professionals/products/foot-and-ankle.html>, 2014, 3 pages. |
| U.S. Appl. No. 62/293,189, Tarsal-Metatarsal Joint Procedure Utilizing Fulcrum filed Feb. 9, 2016, 78 pages. |
| Chang et al., “Lapidus Arthrodesis: A Different Perspective,” Journal of the American Podiatric Medical Association, vol. 84, No. 6, Jun. 1994, pp. 281-288. |
| Horton et al., “Deformity Correction and Arthrodesis of the Midfoot with a Medial Plate,” Foot & Ankle, vol. 14, No. 9, Nov./Dec. 1993, pp. 493-499. |
| Number | Date | Country | |
|---|---|---|---|
| 20220039848 A1 | Feb 2022 | US |
| Number | Date | Country | |
|---|---|---|---|
| 62100541 | Jan 2015 | US | |
| 62145964 | Apr 2015 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 16278255 | Feb 2019 | US |
| Child | 17510107 | US | |
| Parent | 14990368 | Jan 2016 | US |
| Child | 16278255 | US |
