JP2005529721A - Bone plate - Google Patents

Abstract

A set (12) of bone plates (14) and components thereof for use with a specific bone or bone site, such as the elbow joint perimeter. These bone plates can be configured, inter alia, to be easily identifiable and easily attachable and / or as an anatomical template.

Description

[Cross-reference]
This application is a 35 U.S. filed of US Provisional Patent Application No. 60 / 297,008, June 8, 2001, which is incorporated herein by reference in its entirety. S. C. Claims priority under §119.

  The present invention relates to bone plates, and more particularly to a set of bone plates and components thereof for use with a particular bone or bone site, such as the elbow.

  The human skeleton consists of 206 individual bones that perform various important functions including support, exercise, protection, mineral storage and blood cell formation. These bones can be grouped into two categories: mid-axis skeleton and limb skeleton. The limb skeleton includes, among other things, the long bones of the upper and lower limbs, including the humerus, radius and ulna.

  To ensure that the skeleton maintains its ability to perform its important functions and reduce pain and deformation, the broken bone must be repaired quickly and correctly. Typically, broken bone is treated with a fixation device that reinforces the broken bone and maintains it in alignment during treatment. The fixation device can take various forms, including, inter alia, a cast bandage for external fixation and a bone plate for internal fixation.

  The bone plate, usually metal, is specifically contoured (ie, bent) by the surgeon to fit the portion of the bone that runs through a fracture, and then fractured during and / or after treatment. A sturdy plate that can be secured to the bone on both sides of the fracture by means of a suitable fixation device such as one or more screws and / or wires to hold the bones together. Bone plates can be supplied in various lengths, widths and shapes to suit various bone sizes and shapes.

  Bone plates are considered an excellent treatment for many fractured bones that allow them to move quickly. However, bone plates have a number of drawbacks. In particular, in the case of the joining of several bone fractures, such as the distal end of the humerus, two or more bone plates must be used, especially if the fracture and / or the affected area of the bone is complex. It may not be possible. In addition, if more than one plate is difficult to distinguish before use and / or must be adapted to a complex shape, especially if there is an urgent need, such as an operating room, two or more plates can be used. The fracture joints used can be complex.

  The present invention provides a set of bone plates and components thereof for use with a specific bone or bone site, such as the elbow joint perimeter. These bone plates can be configured to be easily identifiable, easily adaptable, and / or as an anatomical template, among others.

  The present invention provides a set of bone plates and components thereof for use in reducing and / or fixing bone discontinuities. The set of bone plates can be selected for use with a particular bone or bone site, such as the elbow joint perimeter, as described below. The bone plate can be configured, inter alia, to be easily identifiable, to be readily adaptable to its intended goal, and / or to serve as a template for bone reduction. The plate can also be configured to enhance the stability of the target fracture.

  Other aspects of the invention are described in the following sections: (I) bone plate indicator, (II) targeting structure, (III) bone plate set, (IV) bone plate structure, (V) for elbow Periarticular bone plate, (VI) lateral condyle plate, (VII) medial condyle plate, (VIII) posterior humeral bone plate, (IX) olecranon bone plate, (X) hip bone plate, (XI) periarticular An example usage of the elbow plate is described in the section on usage.

I. Bone Plate Indicator Bone plate includes, among other things, one or more indicators to identify (1) dimensions, (2) dominant hand, (3) orientation and / or (4) intended anatomical target site By using, it can be configured so that it can be easily identified. Indicators typically comprise any mechanism for distinguishing one bone plate from another, excluding features such as the dimensions or shape required for the function of a particular plate.

  Bone plates can use color as an indicator, for example by using different colors for different plates or parts thereof. Accordingly, different colored plates can be used on different anatomical target sites and / or on different sides of the body (left / right). Colors can include red, blue, purple, green, silver and / or gold, among others. The color can be selected arbitrarily or according to preselected criteria, such as green for the right side and blue for the left side. This is because green and right contain five letters and blue and left contain four letters. Alternatively, green can be selected for the right and red for the left. This is because green is used for starboard and red is used for port on ships. Plates configured for use on the left and right sides of the body (no distinction between left and right) can have the same color, but the color must be different from the color used to represent the dominant hand I must. Alternatively, the left and right indistinguishable plates can have a color different from the color that indicates the dominant hand and different from each other to correlate the intended anatomical target of the plate. The plate can include two or more colors, for example, one color to indicate the anatomical target site of the bone and another color to represent the dominant hand. The color may be one that can be seen on one or more faces of the bone plate. For example, the color may be visible on a bone-facing surface, a surface facing away from the bone, a side surface, and / or an area thereof.

  Alternatively or additionally, the bone plate can use the label as an indicator, for example using different marks (writing, etching, etc.) on different plates or parts thereof. The mark may include, among other things, the name of the bone or bone part (eg, condyles, elbow head, etc.) and / or the dominant hand of the bone (eg, left, right, etc.). For example, the indicator can be selected so as not to interfere with the function of the corresponding plate by adversely affecting size, shape, strength and / or biological compatibility.

II. The target-forming structural bone plate can also be configured to easily fit its intended target. For example, a bone plate can be adjusted only slightly before being applied only in the presence of a surgeon, and in other cases at least approximately aligns with a particular region of bone so that no adjustment is required. And / or can be pre-shaped (ie, pre-folded, cast, machined, or otherwise processed). This preforming (or preforming) can also alleviate or eliminate the need to have the fracture fixed before attaching the plate. This is because the fracture part can be easily fixed if the bone and the plate are aligned.

  The plate can be pre-contoured in various ways. The plate can be pre-contoured in two or three dimensions to wrap around the intended area of the bone. In addition, these plates include, inter alia, additional plates configured such that each successive plate wraps around an additional portion of the intended target site of the bone, such as, for example, the diaphysis and / or periarticular region. It can also be configured to include a pre-contoured portion. In some cases, the bone plate may be somewhat more convoluted so that it requires some additional folding to align the bone plate with the bone contour. Alternatively or additionally, the bone plate can have the dominant hand necessary to fit the left or right bone.

  Other aspects of pre-contouring such as the dominant hand of the plate and / or the three-dimensional structure are described in Section VX below.

III. Bone Plate Set A bone plate or set of bone plates can be accompanied by various auxiliary materials including instructions, fixation devices and cases, among others. The instructions can include how to use the plate, the relationship between the color and the target anatomical region, additional medical instructions, and the like. The fixation device can include any device capable of fixing the plate to the bone, such as a bone screw, wire or the like. The case can include a protective cover and an internal partition for separating bone plates, fixation devices and the like. The case can be made easier to use by organizing the material so that the material can be quickly placed and identified during use.

  A pre-contoured (or pre-formed) set of bone plates can be supplied for any suitable periarticular and / or anatomical region or set of regions. Bone plates can be sold together, for example, in any combination selected for specific bones, bone sites, bone dimensions, and the like. For example, a set of bone plates may include elbows, knees, shoulders, buttocks, wrists, heels, skulls, spines, arms, legs, hands, feet, pelvic periarticular parts, diaphyseal parts, plate parts, joints, and / or Or it can be configured for use on the inter-articular portion. Bone plates can be sold and used individually and / or collectively. Plates can be sold to replenish plates used separately or from kits for certain applications.

IV. The bone plate structure plate may be a structure that is strong and can be stretched. Typically, the plate must be stiffer and stronger than the portion of the bone it connects to, and still have sufficient elasticity to not significantly deform the bone. Suitable materials include titanium, stainless steel and / or other biologically compatible materials.

  The plate can be configured to reduce irritation to bone and surrounding tissue. For example, the plate can be made from a biologically compatible material as described above. Further, the plate may have a low and / or wing-like profile to reduce the impact of protrusions, to reduce the portion protruding into adjacent tissues and surfaces without surrounding burrs. it can.

  The plate can be sized, inter alia, to fit a specific area of bone or different parts of the same area of bone. The plate typically has a length L, a width W, and a thickness T, and has an elongated shape (at least before bending). In this case, length L> width W> thickness T. In use, the long axis of the elongated plate can be aligned with the long axis of the corresponding bone, or relative to the long axis, for example, in some of the mouthplates described later in Section X. It can extend diagonally. The length and / or width of the plate can vary depending on the intended use, for example, to align the plate with a preselected bone site. The term “in profile” or “profile” refers throughout this specification to a side view of a bone plate that is generally parallel to the axis that forms the width of the plate.

  The thickness of the plate is generally formed by the distance between the inner surface of the plate (facing towards the bone) and the outer surface (facing away from the bone). The thickness of the plate is varied, for example when extending over protrusions (projections, condyles, nodules, etc.), depending on the intended use, in order to thin the plate, in particular to reduce its profile and / or stiffness. be able to. The thickness of the plate can also be varied to facilitate its use for thinning the plate, for example where it is usually necessary to form a profile to facilitate the bending operation. In this way, the plate can be thicker and hence stronger, usually in the region of the bone where it does not need to be contoured, generally along the bone shaft.

  In particular, the plate and its surface can be shaped to fit a particular anatomical site of bone on the same or other bone. More specifically, the plate can be pre-formed. That is, for example, preliminary contouring (preliminary formation) can be performed so as to be almost suitable for the average target anatomy such as the population average shape of a specific anatomical region. The average anatomy here is averaged over any suitable group (for example, adults, adult boys, adult girls, people in a certain size range, children of a given age, etc.) Or the anatomy of other animals). Pre-formation allows the inner surface of the plate or the surface facing the bone to be approximately aligned according to the three-dimensional contour of the bone along the length of the plate and / or across the width of the plate. . For example, the plate may grasp and hold bone fragments to initially enhance fixation and / or mold bone reduction, and then face the bone to enhance stability and It may include a curved, bent, twisted and / or tubular inner surface adapted to guide for setting on the bone. In some embodiments, the plate, among other things, can be operated in advance or around, for example, to accommodate soft tissue between a portion of the plate and the bone, or additional custom contouring. Therefore, it is possible to obtain a somewhat more comfortable contour along the long axis.

  The plate may also include members for spacing such as prongs or other protrusions. The spacing member can be configured to project substantially perpendicular to the near face of the bone when the plate is attached to the bone in its intended direction. Thus, the spacing member may protrude from the side of the bone plate and / or from the side facing the bone in a direction substantially perpendicular to the plane formed locally by the length and width of the bone plate. it can. A wide prong-like spacing member is used to move the plate away from the bone so that tendons and possibly nerves, blood vessels, etc. can be pinched or passed under the plate without damage. Can be used to position at least a portion. Alternatively, or in addition, the bone may be fixed for the purpose of further securing the spacing member, such as a thin and / or sharp prong, together with and / or independently of the additional securing mechanism. Can be used to figure out. For example, prongs and screws are used in juxtaposition with the elbow head plate in the IX node. On the other hand, the prongs and screws are used far apart in the mouth plate in the X section (FIGS. 43-48). Further, in the shed plate, the prongs function as a primary or dedicated fixing mechanism on one end of the plate, and the screws function as a primary or dedicated fixing mechanism on the other end of the plate.

  The plate can include at least one, preferably two fixation portions, configured to receive a fixation device for attaching the plate to the bone. In some embodiments, like the fixation portions described below, the fixation portions can be configured separately to attach plates to different areas of the bone. For example, the fixation portion can be configured for fixation on the diaphysis (diaphysis) portion using a plurality of bone screws. The diaphyseal part generally includes all the central part of the long bone, gives strength to the long bone and mainly forms its length. Alternatively or additionally, the fixation portion can be configured to stabilize the metaphyseal (end) portion of the bone. The ends can include periarticular structures (projections, cavities, cavities, condyles, protrusions, nodules, etc.) so that they can be restricted, formed, protected, and articulated, among others. In some cases, such as the mouthplate described below at Section X, instead of a fixed part at the end of the plate, it is not attached by a fixing device, but by a member or protrusion for spacing, A support portion that stabilizes the bone can be used.

  The plate may also include a bridge portion or intermediate portion configured to join the fixation portions located on the sides and / or to connect discontinuous portions of the bone. The bridge portion is a modified flexibility with respect to the laterally located securing part, such as, for example, a mutual bending operation of the stationary parts located on the 2 lateral sides, and / or an increased flexibility to facilitate twisting operations; It can have a thickness and / or a width. The bending and / or twisting operations can be performed during the manufacture and / or use of the bone plate, as described in more detail below. The bridge portion can have an opening (see description below) or no opening. The bridge part and the fixing part can be formed statically (eg depending on the plate profile and / or position of the fixing location for the fixing device) and / or can be formed dynamically (eg plate) Depending on the position of the discontinuity relative to the part of

  The plate typically includes a plurality of apertures or openings that can perform different functions. The opening can accommodate a fixation device for fixing the plate to the bone. Alternatively, or in addition, the opening can change the local stiffness of the plate and / or facilitate blood flow to the fracture to facilitate treatment.

  The openings can have various geometric shapes and dimensions. For example, some openings may be elongated (especially, generally oval), while other openings may be substantially circular. The elongated opening can be used as a reduction slot, and after fixing the fixation device to the bone through the opening, slide the plate back and forth along the longitudinal axis of the opening to finally position the plate Can be made. Alternatively or additionally, the insertion angle of the fixation device can be made more flexible by an elongated opening. In contrast, the circular opening can be used to attach the fixed portion of the plate to the bone that is ultimately positioned relative to the fixed portion. For example, a circular opening may be formed in the diaphyseal portion of the plate for use in installing additional fixation devices within the diaphysis after the plate is finally positioned with respect to the diaphysis. Can do. Alternatively, or in addition, when installing the fixation device in the bone around the joint where the circular opening is ultimately positioned (or being positioned) relative to the end fixation portion of the plate For use, it can be formed in the end fixing part of the plate. The fixation device can be placed in the bone using a circular opening in the end fixation portion of the plate before and / or after final positioning of the corresponding diaphysis fixation portion relative to the diaphysis. The opening can include a counterbore that allows the fixation device to be approximately flush with the top surface of the plate. In addition, the opening (especially an elongated opening) includes a tapered counterbore that biases the fixation device to one side, for example, towards a bone discontinuity (or away from the discontinuity) for pressing. Can do.

  The opening can have various dimensions depending on its intended use. For example, when used with a fixation device, to increase the size, the opening may be of a different size, such as a 2.7, 3.5 and / or 4.0 bone screw. Can be sized to receive and effectively hold. In general, the smaller the opening, the smaller the screw, so that a relatively small number of screws can be used with a given plate. Also, typically, the larger the plate, the greater the number of openings, so that a larger plate can use a relatively larger number of screws. The opening may have a hybrid device having a size of 3.5 for the diaphysis and a size of 2.7 for the end portion.

  The openings can also have an appropriate location or density within each fixation portion of the bone plate. The openings can be positioned along the central axis of the plate with the center of each opening crossing the width at each position. Alternatively, one or more openings can be placed off center. That is, it can be arranged asymmetrically or transversely or perpendicularly to the local width of the bone plate. For example, the position can be shifted so that some or all of the openings are alternately arranged laterally on opposite sides of the central axis. Alternatively or additionally, two or more openings can be aligned side by side as described below in Section IX for the elbow head plate. The laterally arranged openings or the openings before and after the side-by-side openings can be positioned along the central axis of the bone plate to increase the density of screws that can be used. The interval between the openings (between the centers or the sides) can be constant or can be various lengths. For example, to increase the number of screws that can be used to fix (stabilize) the relevant segment of the bone with the plate, some or all of the openings in the end fixation part are more densely packed Can be made. The openings can be located at different locations on the curved plate so that the screws interact with the bone and / or with each other in a three-dimensional pattern, and in some cases, the screws can be used in addition to just the bone. In order to fix, the openings are engaged with each other or locked together. Under such circumstances, it may be preferable to use tapered screws that can pass through each other or deflect or bend away from each other rather than hitting each other and the stop. . The opening also allows the screw to protrude along the long axis of the bone rather than the transverse axis, extending the length of the screw and increasing the number of threads that contact the bone, thereby increasing the purchase. It can also be positioned to increase.

  The fixation device comprises any mechanism for attaching a bone plate to the bone, including, inter alia, screws and wires. Suitable fixation devices include bone screws, including monolayers, bilayers and / or cancellous bone screws, as described above. Monodermal and bidermal bone screws usually have relatively closely spaced threads for use in hard bones such as the diaphysis of the bone, whereas cancellous bone screws usually have long bone ends. For use in soft bones such as near the neck (periarticular area), it has relatively widely spaced threads. A single cortical bone screw penetrates the bone cortex adjacent to the bone plate once. A bicortical bone screw penetrates the bone cortex twice, adjacent to and opposite the bone plate. In general, the supporting force of a single skin layer screw is weaker than that of a double skin layer screw. This is because the depth that penetrates the cortex of the screw for the single skin layer is shallow. The size and shape of the fixation device can be selected based on the size and shape of the opening, as described above, or vice versa. It is preferable to use the bone screw particularly when fixing the diaphysis fixing portion of the bone plate. On the other hand, various fixation devices can be used to fix and stabilize the bone at the end fixation portion. A suitable fixation device for each part is an Acumed bone screw with a screw head that can be adapted to the plate structure.

V. Elbow Periarticular Plate This section describes a set of pre-contoured bone plates that can be used to fix bone discontinuities within the periarticular joint. Please refer to FIGS. Throughout this specification, relative dimensions have been assigned to bone plates to provide terminology that aids in the description of the plates. These dimensions are for clarity of explanation and are not intended to define or limit the scope of the invention. More particularly, other plates having smaller, larger or intermediate dimensions and having fewer or more openings when compared to the plates described and illustrated herein are also contemplated by the present invention. Within range.

  The humerus is the only bone in the humerus. The humerus includes a proximal region closest to the body articulated with the glenoid scapula and a distal region farthest from the body articulated to corresponding portions of the ulna and radius. The distal humerus includes various regions. The medial and lateral columns represent the structural transitions linking the elbow joint and the humeral shaft. The medial and lateral condyles are processes from each columnar part of the distal humerus. The humeral head is the outer convex part of the distal condyle. The humeral head is connected to the radius with a joint. The pulley is the more spool-like part of the distal condyle that is articulated with the ulna. The inguinal fossa is a small depression on the front surface on the pulley that houses the ulnar fistula when the elbow is bent (bent). The elbow fossa is a deep depression on the rear surface on the pulley. The elbow fossa accommodates the ulna elbow when the elbow is extended (straightened).

  The ulna and radius are the only bones in the forearm. The ulna is located on the inside and the radius is located on the outside. These bones include a proximal region articulated with the distal portion of the humerus as previously described. These bones also include a distal region articulated with the various bones of the wrist. The proximal ulna includes various regions including the posterior elbow head and anterior groin that interact with the humerus, as previously described. The proximal ulna also includes a pulley (or meniscus) notch, a smooth joint concave surface located on the front surface of the elbow head and extending over the articular surface of the ostium.

  1 and 2 show the bone of the left elbow 10 being secured by an exemplary member of a set 12 of pre-contoured bone plates 14. The left elbow 10 shown in these figures, including a hand (not shown) pointing down, includes a distal humerus 16 and a proximal ulna 18. The distal humerus and proximal ulna include diaphysis 20, 22 and periarticular (edge) regions 24, 26, respectively. Each bone plate 14 connects bone discontinuities 28 such as fractures, bone cut portions, and the like. In addition, each bone plate is attached with a fixation device, in which case the bone screw 30 extends through an opening or aperture 32 in the plate 14 and reaches into the bone. In this case, the proximal radius 34 does not have a bone plate.

  The lateral condyle plate 40 is attached to the distal humerus 16. The plate 40 is attached to the diaphyseal (or proximal) portion 42 that is secured to the outer portion of the diaphysis 20 and the outer portion of the periarticular portion 24, particularly the lateral condyle 48, to stabilize it. A part securing (or distal) portion 46 is included. In addition, various aspects of the lateral condylar plate are described later in Section VI.

  A medial condyle plate 50 is also attached to the distal humerus 16. The bone plate 50 includes a diaphyseal (or proximal) portion 52 attached to the medial portion of the periarticular portion 24 and an end fixation (or distal) portion 56 attached to the medial condyle 58. The medial condyle plate 50 is a medium sized embodiment that extends to an intermediate position along the proximal-distal axis of the medial condyle 58. Smaller embodiments may end, for example, at a closer location along the medial condyle 58 (see FIGS. 16-20). In contrast, a larger embodiment, for example, extends farther over the medial condyle 58 and attaches the distal portion to the inner surface of the pulley 60 (see FIGS. 23-26). Another aspect of the medial condyle plate is described later in Section VII.

  1 and 2 also show an olecranon plate 70 attached to the proximal ulna 18. The plate 70 includes a diaphyseal fixation (or distal) portion 72 that is attached to the proximal diaphysis 22. The plate 70 also includes an end fixation (or proximal) portion 74 that is attached to the posterior side of the periarticular portion 26, in particular to the elbow head 76. As shown in these figures, the elbow head plate has a diaphyseal portion with the diaphyseal portion fixed so that the surface of the plate facing the bone is oriented substantially perpendicular to the anterior-posterior axis of the proximal ulna. 22 can be configured to be attached to the rear surface.

  The elbow head plate can have any suitable dimensions. Plate 70 is a smaller embodiment of the elbow head plate. For larger embodiments, among other things, the shaft fixation portion can be configured to extend further along the shaft portion 22 (see FIGS. 37-42) and / or the end fixation portion is , Can be configured to extend further in the direction of the proximal tip 78 of the elbow head 76 (see FIGS. 37-38). Other aspects of the elbow head plate will be described later in section IX.

  FIG. 2 is a ostium plate 80 attached to the proximal ulna 18. The plate 80 includes a diaphyseal fixation (or distal) portion 82 that is attached to the inside of the diaphysis 22. The shed plate 80 also includes a support portion 84 that stabilizes the shed 86, for example by contact with a surface 88 facing the distal direction of the shed 86, primarily by the prongs 90. For larger embodiments, the ostium plate 80 may extend further along the inside of the diaphysis 22, for example. Other aspects of the well plate will be described later in Section X.

  FIG. 3 illustrates another method of fixation with the posterior plate 100 on the periarticular portion 24 of the distal humerus 16 instead of the lateral condyle plate 40 (shown in dashed lines). In the case of this fixation method, the posterior plate 100 and the medial condyle plate 50 are arranged so that the lateral and medial plates 40, 50 are not substantially opposed or parallel, but are substantially orthogonal. Therefore, the posterior plate 100 includes a diaphyseal fixation (or proximal) portion 102 attached to the posterior side 104 of the diaphysis 20. In addition, the posterior plate 100 includes an end fixation (or distal) portion 106 attached to the posterior side of the periarticular portion 24 that includes the humeral head 108. Other aspects of the rear plate are described later in Section VIII.

VI. Lateral Condyle Plate This section describes a lateral condyle plate that is configured to secure the periarticular and / or diaphyseal portion of the left and / or right distal humerus, particularly the fracture portion of the lateral condyle. See FIGS. Many features or aspects of the lateral condyle plate described in this section are also suitable for the other plates described above and below in Sections VII to X, and vice versa.

  4-8 are a top view, a side view, a bottom view, and two cross-sectional views, respectively, of a smaller sized lateral condyle plate 120. The plate 120 includes an outer (or facing away from bone) surface 122, an inner (or facing bone) surface 124, a side surface 126, a proximal (or shaft fixation) portion 128, And a distal (or end-fixed) portion 130. A set of proximal and distal openings 132, 134 are formed by openings in the proximal and distal portions 128, 130, respectively.

  The outer surface 122 is configured to face away from the bone when the plate 120 is attached. 7 and 8 can take a generally convex and / or linear shape, shown in cross section with a linear region located in the center, as shown by outer surface 122, eg, 136 and 138. Show. Thus, the proximal and / or distal portion regions 128, 130 are generally planar on the outer surface 122. A rounded or chamfered corner 140 can join the side surface 126 to the top surface 122. A rounded corner 140 can also join one or both of the proximal end 142 and the distal end 144 (see FIG. 4) with the outer surface 122 to form a generally rounded perimeter.

  7 and 8 also show an inner surface 124 that is configured to face the bone. Thus, the inner surface 124 may take a generally concave shape with the tubular surfaces 146, 148 at different locations, which may have different radii of curvature, for example when measured in the lateral direction. In this case, the tubular surface 146 disposed near the proximal end 142 has a radius of curvature at the distal portion 130 that is less than the radius of curvature of the tubular surface 148. The tubular surface can contact a longitudinal chamfer (see FIGS. 6 and 7). For example, the tubular surface 146 can in this case contact a chamfered surface 152 that forms a flat region on the inner surface 124 near the proximal end 142.

  The thickness of the lateral condyle plate 120 can vary along the longitudinal and / or lateral direction of the plate 120. 7 and 8 show that the average thickness of the proximal portion of the plate 120 is thinner between the proximal portion 128 and the distal portion 130 such that it is thicker than the average thickness of the distal portion. . (The average thickness (or width) can be determined without taking into account that the proximal and / or distal ends are thinned). It can be thinned at a position having a center in between. The thickness may be tapered gradually from the proximal portion 128 toward the distal portion 130, or may be thinned at one or more significant locations along the length of the plate. it can. For example, the thinner distal portion can locally thin the bone plate profile to minimize irritation. Alternatively, or in addition, the proximal portion 128 can be made approximately as thin as the proximal end 142 to form a tapered region 156 (see FIG. 5). The tapered region 156 can be formed, for example, by performing an angle chamfer on the outer surface 122 and / or the inner surface 124, among others. The tapered region 156 is useful, for example, to facilitate sliding of the proximal end 142 of the plate 120 under the soft tissue when positioning the plate over the bone. Alternatively or additionally, it can be thinned laterally along an axis corresponding to the width. For example, as shown in FIGS. 7 and 8, the plate 120 is thinner or tapered from the side 126 toward the central portion 157. In some embodiments, the plate 120 can taper in the direction from the central portion 157 to the side 126. Whether thinning in the direction of the side and / or thinning in the direction of the central part, the plate can be thinned laterally at its proximal and / or distal part. .

  The width of the lateral condyle plate 120 can vary along the length of the plate when measured between opposing sides 126. In certain embodiments, the plate 120 is narrowed between the proximal portion 128 and the distal portion 130 such that the average width of the proximal portion 128 is wider than the average width of the distal portion 130. . (The proximal and distal ends are not taken into account when calculating the average width.) For example, the plate 120 is one of one or more pairs of bone plate sets 134 along its length. One or more narrow areas 160 in the form of scallops may be included at an intermediate location of the opening. The narrow region 160 is an example of a structure that can provide a localized region with reduced stiffness, for example, to direct the bending direction so that it can be moved forward or circumferentially, for example. This local region can be limited to a zone 162 located in the middle of the opening along the length of the proximal portion 130. In some embodiments, region 160 can be narrowed relative to other regions of distal portion 130, but cannot be narrowed relative to proximal portion 128. Alternatively or additionally, for example, the stiffness between the openings can be locally reduced, for example, by changing the thickness of the plate at zone 162.

  The opening can vary in the structure depending on the position in the plate 120. Some or all openings of the set of bone plates 132 in the proximal portion 128 may be elongated. The elongate openings can have the same length or different lengths. In this case, the opening 164 is shorter than the opening 166. The longer opening 166 can be placed in any suitable position relative to the shorter opening 164, for example, a second elongated opening from the distal portion. The openings 164, 166 can function during compression and therefore can have sloped perimeters or counterbores 168 that create a ramping behavior. The ramping behavior applies a horizontal force on the plate parallel to the long axis of the opening when the fixation device is tightened in the opening. If it includes elongate openings of different lengths, such as openings 164 and 166, first tighten the bone screw within the opening 166 and then within the elongate opening 164 contacting the sides. One can reduce and compress bones in stages (sequentially) by tightening bone screws. In contrast, some or all of the openings 134 formed by the distal portion can be located in a fixed position, or can be located in a circular opening 170 that typically includes a counterbore 172. Thus, as shown here, the elongated openings 164, 166 and the circular opening 170 are substantially and completely separated according to their location within the bone plate 120 and other bone plates described herein. be able to.

  The openings can have a spacing or density that varies within different portions or sub-portions of the bone plate. Typically, the openings are arranged at a higher density (number of openings per unit length of plate) within the distal portion of the plate. For example, the plate 120 includes a plurality of circular openings 170 in the distal portion 130 that are more closely spaced (center-to-center) and thus have a higher density than the elongated openings 164, 166 in the proximal portion 128.

  The lateral condyle plate 120 can be bent or shaped along its length so that the bone facing surface 124 is at least substantially aligned with the lateral portion of the distal humerus. For example, as shown in FIG. 4, when viewed from a right external surface 122, the plate 120 is formed near the proximal end 142 when the plate extends from the proximal end 142 to the distal end 144. An arc that turns to the right from the long axis 174 is formed. The arc can extend near the distal end 144 at an angle of about 20-40 degrees, or about 30 degrees, with respect to the major axis 174. This arc can place the distal portion 130 before the proximal portion 128 on the distal humerus when the plate 120 is mounted as intended (see FIG. 1). When viewed in profile, when the distal end 144 is to the right (as shown in FIG. 5), the plate 120 is concave with respect to the bridge (or middle) portion 176 and the outer surface 122 along the longitudinal direction. To form a bend, it turns upward (counterclockwise) from the major axis 174 at an angle 175 of about 10-30 degrees, about 15-25 degrees, or about 20 degrees. The bridge portion 176 is, for example, substantially the same as the distal portion 130 that maintains a length of about 3: 1 to 0.5: 1, or about 2: 1 to 1: 1 relative to the distal portion 130, or more Can have long dimensions. The bridge portion 176 can have one or more elongated openings, as shown. Within the profile, the distal portion is below the long axis formed by the bridge portion 176 (shown in dashed lines) to form a convex curve along the longitudinal direction and with respect to the outer surface 122. Forming an angle 177 that can bend (clockwise) and is at least equal to angle 175, or about twice as large, or about 20-60 degrees, about 30-50 degrees, or about 40 degrees Can do. The distal portion 130 can have a length of about 1-3 centimeters or about 2 centimeters.

  FIG. 9 is a plan view of the right hand embodiment of the left hand plate 120, ie, the lateral condyle plate 120R. Plate 120R is configured to secure a bone discontinuity in the right upper humerus distal to the outside of the body. Therefore, the plate 120R is bent arcuately to the left rather than to the right as described above. Plates 120 and 120R and all other left-hand and right-hand plates described herein can be related to each other with near or perfect mirror image symmetry. Therefore, only the embodiments of the left hand of each pair of bone plate right hand and left hand are shown and described below. In other embodiments, the lateral condyle plate can be configured without the right / left hand distinction. That is, both fractures can be fixed to the left and right distal humerus.

  FIGS. 10-15 are plan, side, and side views, respectively, of exemplary embodiments of lateral condyle plates 40, 180 of medium dimensions (FIGS. 10-12) and large dimensions (FIGS. 13-15). FIG. 3 is a bottom view (also see FIGS. 1 and 2 for the bone plate 40). Each plate 40, 180 is a left hand embodiment for use on the left distal humerus. These plates may lengthen the proximal and / or distal portion to fit any bone plate described herein on the adjacent (or farther) adjacent bone. It is an example of a method of correcting by (or shortening). Plates 40 and 180 can be considered as an elongated version of the labeled plate 120 with the outline of its proximal portion drawn in dotted lines. Within these plates, the proximal portion 128 of the plate 120 extends linearly to form the proximal portions 42 and 182, respectively. The linear extension can extend the chamfered surface 152 to form the chamfered surfaces 184, 186 (see FIG. 6), and the elongated aperture 164 to maintain a substantially constant density of the apertures. Alternatively, the number of 166 (or circular openings) can be increased and / or the tubular surface 146 can be extended to form the surfaces 188, 190. In other embodiments, any suitable extension can be selected.

  The plates 40, 180 can have a three-dimensional structure and contour formed by adding a linear extension proximal portion 128 of the plate 120. When viewed from the exterior as in FIGS. 10 and 13, each plate 40 and 180 extends linearly from the proximal end 142 to the bridge portion 176. At the bridge portion 176, each plate bends upward and then bends downward to transition to the distal portion as described at plate 120. Therefore, as shown in FIGS. 11 and 14, when viewed in profile, the bone plates 40, 180 are distal to the outer surface and longitudinally from the proximal end 142 to the distal end. It has a concave curved portion along 144, followed by a convex curved portion. The proximal portion, the bridge portion and the distal portion are generally generally straight, as shown in this figure, in a profile adjacent to a concave and / or convex curve, or an arcuate shape. It can also be.

VII. In this section, the medial condyle plate configured to fix the periarticular and / or diaphysis of the left and / or right distal humerus, in particular the fracture of the medial condyle, is described (FIG. 16). To FIG. 26).

  FIGS. 16-20 are a top view, a side view, a bottom view, and two cross-sectional views, respectively, of a smaller sized medial condyle plate 230. The plate 230 includes an outer surface (or a surface facing away from the bone) 232, an inner surface (or a surface facing toward the bone) 234 and a side surface 236. Proximal (or metaphyseal) portion 238 extends to join bridge (or intermediate) portion 240, and the bridge portion joins to distal (or end fixation) portion 242. The proximal and distal portions form a set of openings 244 and 246 and extend in a generally opposite direction to the proximal end 248 and the distal end 250.

  The entire medial condyle plate and in particular the plate 230 includes any suitable features already described above for the lateral condyle plates 40, 120, 200, or described elsewhere herein for other bone plates. Can do. For example, the medial condyle plate 230 can include a tapered region 252 at the proximal end 248 (see FIGS. 17 and 18). The tapered region 252 can be formed by top and / or bottom chamfered surfaces 254, 256 similar to the tapered region 156 of the plate 120. Plate 230 can include a cross-sectional configuration in the proximal and distal portions shown in FIGS. 19 and 20, similar to the proximal and distal portions of the lateral condyle plate. Thus, the plate 230 can be thinned distally or laterally, for example, to taper toward the center in the cross-sectional portion. Alternatively, or in addition, the plates 230 in the cross-sectional portion can be separated into proximal and distal portions 238, 242 on the inner surface 234, for example, having a larger radius in the distal portion. A radius of curvature can be included. The plate 230 in the cross section can have a straight region 258 along the outer surface 232. The width of the plate 230 can vary, for example, to narrow at the bridge portion 240, the distal portion 242, and / or have a varying width as previously described at the plate 120.

  The aperture sets 244 and 246 can have any of the features already described in the aperture sets 132, 134 of the plate 120. Therefore, the sets of openings 244, 246 are spatially separated according to type by elongated openings located within the proximal portion 238, including openings 164, 166 of different lengths as shown. May be. However, plate 230 and any other plate described herein can have three or more lengths of openings in proximal portion 238. For example, the plate 230 can also have a circular opening 170 located at the proximal end 248. The bridge portion 240 may not have an opening. The distal portion 242 may have a plurality of circular openings 170 and may or may not have an elongated opening.

  The medial condyle plate may be a left-right distinction. That is, it can be configured to be attached around the medial joint of both the left and right distal humerus and / or around the diaphysis. Therefore, plate 230 and other left and right medial condyle plates may be substantially or completely symmetrical on both sides. That is, the plate 230 can be substantially or completely mirror-symmetrical across a plane located in the middle of the side 236 and substantially perpendicular to an axis parallel to the width direction. Symmetry can be related to the location of the opening and / or the periphery of the plate. Therefore, the plate 230, as shown in FIGS. 16 and 18, appears substantially linear when viewed along a line perpendicular to the plane of length and width. In other embodiments, the medial condyle plate can be configured to be left and right different. That is, it can be configured to fix a fracture of either the left or right distal humerus (but not both).

  When the profile of the plate 230 is viewed in a profile as shown in FIG. 17, a part or the whole of the profile can be a non-linear profile. More particularly, the plate 230 can have a straight profile in the proximal portion that extends centrally from the proximal end 248 along the major axis 260. The plate 230 can then be bent up more centrally along the longitudinal direction to form a concave arc with respect to the outer surface 232 and length, for example, when the plate extends into the bridge region 240. . As a result, the bridge portion 240 can form an angle 262 of about 20-50 degrees, about 25-about 45 degrees, or about 35 degrees relative to the major axis 260 at the distal location. The distal portion 242 can be bent downward toward the inner surface 234 to form a convex arc in the distal portion 242 (relative to the outer surface 232). The closer located concave arc may have a radius that is at least twice the radius of the convex arc. The convex arc can have a radius of about 0.4-2 cm, about 0.5-1.5 cm, or about 0.8 cm.

  FIGS. 21-26 are plan and side views, respectively, of three separate embodiments of the medial condyle plates 50, 290 and 291 (see FIGS. 1 and 2 for plate 50). Each plate 50, 290, and 291 is associated with a plate 230, as indicated by the dashed outline and a labeled profile that indicates the distal extension of 230. However, each of these plates extends further along the medial condyle to form a respective distal portion 56, 292 or 293 to provide additional distal extensions of different lengths and / or radii. including. Thus, each plate can include an extension of the convex arc described above. Plates 50 and 290 seen in the profile form an arc having a radius similar to that of plate 230 (see FIGS. 22 and 24). However, the plate 291 forms an arc having a radius that is about 10-30% longer (compare FIGS. 24 and 26). Thus, the set of medial condyle plates can include distal portions that extend at different lengths on the medial condyle, with more openings in the distal portion and / or portions that form arcs of different radii. Can have. Different radii may be suitable for medial condyles such as different dimensions, different amounts of soft tissue, separating the plate from the bone.

  The distal portions 292, 293 can extend farther from the arc they form. The distal extensions 294, 296, 298 can include regions in the profile that are generally perpendicular to the major axis 260 shown in FIGS. 22, 24, and 26, respectively. In certain embodiments, such as plates 290 and 291, the distal extensions 296, 298 can traverse the long axis 260, and thus the longitudinal-transverse formed by the long axis 260 and the transverse axis 298. It can extend across the plane of direction. Alternatively, or in addition, distal extensions 296, 298 are arc curvatures from which these extensions extend closer to form distal tabs or feet 302, 304. You can turn in the opposite direction. The tabs 302, 304 can be formed by a generally perpendicular curvature that forms an arc that is concave with respect to the outer surface and length, so that the tabs have an axis 260 as shown in FIGS. , 298 form a second longitudinal-lateral surface that is substantially parallel to the first longitudinal-lateral surface. The first and second longitudinal-lateral surfaces can be slightly separated from each other. Each of the tabs 302, 304 can include one or more openings to accommodate a securing device for attaching a face facing the inside of the pulley. One or more openings may be separated by a spacer region 306 from a group of openings located more centrally on the distal portion, as shown in FIGS.

VIII. Rear Humeral Bone Plate This section describes a posterior plate that is configured to secure the posterior-lateral periarticular and / or diaphyseal fractures of the left and / or right distal humerus (FIG. 27 to 30).

  27 to 30 are a plan view, a side view, and a cross-sectional view, respectively, of the rear plate 100 (see also FIG. 3). Plate 100 includes an outer surface (or surface facing away from the bone) 332, an inner surface (or surface facing toward the bone) 334, and a side surface 336. The proximal (or diaphyseal) portion 102 extends to join the bridge (or intermediate) portion 340, and the bridge portion joins the distal (or end fixation) portion 106. The proximal and distal portions form a set of openings 344 and 346 and extend in a direction generally opposite to the proximal and distal ends 348 and 350.

  The entire posterior plate, and in particular the plate 100, can include any suitable features of the lateral and / or medial condyle plates (or described below at the elbow head plate and the inguinal plate). For example, as shown in FIGS. 28-30, the rear plate 100 is thinner toward the distal portion 106. Alternatively or additionally, the width of the plate 100 can be varied, for example, to have a narrow set of intermediate openings 346. Thus, the plate 100 can have a varying cross-section or cross-sectional area. The plate 100 can be thinned at a portion near the proximal end 348. Plate 100 includes an aperture positioned and dimensioned as described above, such as elongated apertures 164 and 166 in proximal portion 102 and circular aperture 170 in distal portion 106. be able to. The chamfered surface 352 can be installed in the inner surface 334.

  The rear plate may or may not have a left-right difference. Thus, the posterior plate can be configured to secure a left or right distal humerus (but not both) fracture. Alternatively, as described above for the posterior plate 100, the posterior plate can be configured for use on the left and right distal humerus. FIG. 27 shows that the rear plate 100, when viewed from the outer surface 332, can be substantially straight, perpendicular to the longitudinal-lateral plane formed by the major axis 354 and the transverse (width) axis 356. The rear plate 100 can be symmetrical on both sides in the contour and / or opening installation. In this case, the centers of the openings 164, 166, and 170 form one line when the plate is projected on the longitudinal-lateral surface (see FIG. 27). Other plates can have this arrangement of openings. See, for example, the medial condyle plate of FIGS. 16, 21, 23 and 25.

  FIG. 28 shows the contouring method within the profile of the rear plate. The plate 100 can extend linearly from the proximal end 348 along the major axis 354 and through some or all of the proximal portions 102. The plate 100 can bend to form a convex arc with respect to the outer surface as the transition portion of the plate to the bridge portion 340 and the distal portion 106. The convex arc can include two arcs, a proximal convex arc and a distal convex arc. The proximal convex arc directs the bridge portion 340 in the profile distally from the major axis 354 at an angle of about 3-20 degrees, about 5-15 degrees, or about 8 degrees. The distal convex arc directs the distal portion distally relative to the major axis 354 at an angle 358 of about 35-75 degrees, about 45-65 degrees, about 50-60 degrees, or about 55 degrees. Thus, the distal convex arc can have a much larger radius than the distal convex arc, or at least about twice as large.

IX. Elbow head bone plate In this section, the elbow head plate for fixing the periarticular and / or diaphyseal part of the left and / or right proximal-posterior ulna, in particular the elbow head fracture, is described (FIGS. 31-42). reference).

  FIGS. 31 to 36 are a plan view, a side view, a bottom view, and two cross-sectional views, respectively, of the smaller-sized elbow head plate 70 (see also FIGS. 1 and 2). Plate 70 includes an outer surface (432 facing away from the bone) 432, an inner surface (or facing toward bone) 434, and a side surface 436. The distal (or diaphyseal fixation) portion 72 extends to join the bridge (or intermediate) portion 440, and the bridge portion joins the proximal (or end fixation) portion 74. The distal and proximal portions form a set of openings 444 and 446, respectively, and extend in generally opposite directions to the distal and proximal ends 448 and 450. The plate 70 can also be described in relation to a set of generally perpendicular axes, ie, a major axis 452, a transverse or width axis 454, and a thickness axis 456 formed by the distal portion 72. Each axis is usually associated with a local axis corresponding to a tangential direction with respect to a local axis corresponding to the length and thickness, for example, when the surface is bent.

  It should be noted that the elbow head plate and the inguinal plate described below extend in a generally “opposite” direction on the bone relative to the surface. Therefore, for these surfaces, the end anchoring portion is mounted closer on the bone than the shaft anchoring portion. Thus, throughout this specification and throughout this specification, the terms proximal and distal represent relative positions upon intended attachment to bone.

  The entire elbow head plate, and in particular the elbow head plate 70, can include any suitable features described above relative to other bone plates. For example, the elbow head plate 70 can include elongated openings 164, 166 in the distal portion 72 and / or a proximal portion such as one opening 170 near the distal end 448 and / or Alternatively, a circular opening 170 can be included in the distal portion. Some or all of the openings in the proximal portion 74 may be more closely spaced than the openings in the distal portion 70 as already described at the outer plate 120. Alternatively or additionally, the thickness of the plate 70 may be adjusted to the lateral and / or central position as shown in FIGS. 34-36 and also as described in the lateral condyle plate 120. By the way, you may become thin toward the proximal direction in an edge part fixing | fixed part. For example, the thin side 436 shown in FIG. 460 is formed like a plate 70 that extends toward and into the bridge region 440 along the distal portion 72 (see FIG. 32). The thickness can be reduced by the chamfered surfaces 462 located on the side surfaces that can extend on substantially the same plane as each other (see FIG. 33). The inner surface 434 can be formed, for example, in a generally tubular shape having approximately the same radius of curvature across the distal portion 72 and the bridge portion 440 (when measured laterally). The distal end 448 may be somewhat tapered in the distal direction in thickness and / or width, as already described for other plates.

  Plate 70 can include a wide area 464 within proximal portion 74. Wide region 464 typically includes any region having a width that is greater than the average width of distal portion 70. Region 464 can be located near or at a point along the longitudinal direction where plate 70 is bent away from major axis 452 (see below). Region 464 may have a radius of curvature on inner surface 434 that is larger than tubular recess 466 in distal portion 70 as measured in a transverse direction, as shown in comparison in FIGS. 34 and 35. The large region can also be somewhat curved or bent along its length (usually along the major axis 452), thereby forming a recess 468 on the inner surface 434. The recess 468 can be concave along a normal major axis 452 and a transverse axis 454. Therefore, the recess 468 can be placed at or near the ridge formed by the elbow head at the posterior-proximal portion junction.

  The plate 70 can include an aperture configuration that is suitable for performing more effective elbow fixation. For example, one or more openings in the set of openings 446 can be placed off-center. The term off-center means that the opening is not centered between the side surfaces 436, i.e., the opening is positioned offset laterally. In this case, the plate 70 includes a plurality of off-center openings 470 and 472. The off-center opening can be arranged laterally. That is, the centers of the openings 470 and 472 can form a single line substantially parallel to the lateral axis 454 or can be diagonally arranged, for example, in a staggered pattern. Within the plate 70, the spacing of the openings 470, 472 can be made closer to the centrally located opening 474 to form a triangular collection of central openings in the intermediate region of the proximal portion. . However, any set arrangement may be suitable. Alternatively or additionally, the elbow head plate can include one or more proximal openings, such as an opening 476 disposed closer to the proximal end 450. . The proximal opening forms a surface that is disposed obliquely or at a right angle to the surface formed by the opening in the intermediate region, such as the off-center openings 470, 472. Can be formed by a region or end region 478 having an angle of the proximal portion 74 (described below).

  The plate 70 can include one or more spacing members or protrusions, such as prongs 480 disposed near the proximal end 450 on the angled region 478. The prongs 480 can project substantially perpendicular to the longitudinal-lateral surface that is locally formed by the substantially perpendicular portion to the surface formed by the angled portion 478 and / or the proximal opening 476. Thus, the prongs 480 can project substantially perpendicular to both the transverse axis 454 and the local major axis 484 (see FIG. 32). The prongs 480 can be positioned at a position that aligns with the opening 476 in the angled region 478 along the local major axis 484, or can be positioned near or far from this opening. . The prongs are typically formed by an inner surface 434, as shown in FIG. 32, and can be formed by a thick region along the side 436, and / or an ellipse along the transverse axis 454, as shown in FIG. It can be formed by a shape or a circular cross section. The prong tip 486 may be sharp or somewhat rounded. Further, the prongs 480 may be suitable for grasping a triceps tendon or other soft tissue, among other things, so that it can operate during positioning of the plate 70 and / or after final positioning. Good. The prong 480 can reduce pressure on the triceps tendon due to the region 478 having an angle that is substantially spaced from the bone. The term spaced means that a region of the inner surface 434 within the angled region 478 is held spaced from the elbow surface.

  The elbow head plate may be a left-right distinction or a left-right distinction (see below). The elbow head plate can have an inner contour that allows the plate to approximately match the bone contour of the proximal posterior ulna. Therefore, bone contours may have a left-right distinction, but usually there is no left-right distinction. The elbow head plate, such as plate 70, is generally straight when viewed from the outer surface 432, and is generally perpendicular to the longitudinal-lateral surface formed by the longitudinal axis 452 and the transverse axis 454, as shown in FIG. The plate 70 can have a perimeter and / or opening configuration that is substantially symmetric with respect to both sides to form a substantially indistinguishable plate.

  FIG. 32 shows how to bend within the profile of the elbow head plate. The proximal portion 74 of the plate 70 can bend away from the major axis 452 to form a convex arc or curve 488 relative to the outer surface 432 and generally along the length. To form a local major axis 484, the portion angled with respect to the major axis may be bent distally at an angle 490 of about 40-80 degrees, 50-70 degrees, or about 60 degrees. it can. By doing so, the inner surface 434 can be aligned with the bone contour from the posterior to proximal direction along the elbow head that defines an obtuse or approximately 120 degree angle range. Proximal portion 74 is preferably curved, narrow or thin, preferably so that the pre-contoured plate angle 490 can be easily modified in advance or can be moved around Can include parts. In this case, the proximal portion 74 is narrowed between the intermediate openings 470, 472, 474 and the proximal opening 476 at a zone that does not include an opening located along the longitudinal direction. In addition, the proximal portion 74 includes a locally thin region formed by a recess 492 that is laterally disposed on the inner surface 434 in this case. The recess 492 is formed by a portion that is tapered outward from the center in the lateral direction. However, the proximal portion 74 can be thinned in any suitable manner to form a suitable bending location, such as, for example, a laterally extending groove or channel.

  37 to 42 are a plan view and a side view of the modified elbow head plates 520, 530, and 540, respectively. Each plate 520, 530, 540 includes a cross-section associated with the elbow plate 70, but has a proximal or distal portion that is modified relative to the proximal and / or distal portion of the plate 70.

  Plate 520 includes a modified distal portion 552 and a proximal portion 554 that are associated with corresponding portions of plate 70. See FIGS. 37 and 38. Distal portion 552 is extended with respect to distal portion 72 and includes additional openings. Further, the distal portion 552 is shown at 556 relative to the distal portion 72, as shown at 460 in FIG. 32, along its longitudinal direction when this portion extends in the closest direction. It can be further thinned along the side 436. Proximal portion 554 includes an angled or end region 558 that can extend at an angle similar to angled region 478 of plate 70 (see above). However, the angled region 558 may be longer than the angled region 478 shown in FIG. 32 configured to extend further proximally and forward along the elbow head when applied to bone. it can. Due to its increased length, the angular region 558 can include more openings in a linear array centered laterally, as shown, for example. Angular region 558 may also be along a local major axis 560 formed by, for example, a locally narrow region 562, such as recess 492 in FIG. 33, or a locally thin region (not shown). , A region for determining a direction of bending located at a plurality of locations may be included. The region that determines the bending direction can be located in the middle opening of the proximal portion 554 as previously described.

  The plate 520 and the entire elbow plate can be formed with or without a spacing member (protrusion) or prong, such as the prong 480 of the plate 70. In this case, the plate 520 does not contain prongs. Prongs may not be necessary or appropriate for the plate 520. This is because this plate is used more frequently in the case of severe elbow crush fractures. In the case of such a fracture, soft tissue such as the triceps tendon can be removed more completely during surgery, so that this tissue is no longer located between the plate and the bone. As a result, the plate 520 is also less likely to be thinned along the sides in the distal portion 552, as shown at 556.

  The elbow head plate 530 includes a modified distal portion 572 but includes a proximal portion that is approximately equal to the proximal portion 74 of the plate 70. See FIGS. 39 and 40. The distal portion 572 includes an elongated straight portion, and the plate 540 can secure a longer diaphysis on the ulna, such as an elongated opening 164 (or 166) or a circular opening (not shown). Can contain more parts.

  Elbow head plate 540 is associated with plate 530 but includes an extended distal portion 574. See FIGS. 41 and 42. Distal portion 574 can include additional openings, as shown, to maintain a relatively constant density of openings within distal portion 574. The distal portion 574 may be straight in the profile (when viewed from the side) as shown in FIG. However, when viewed from the outer surface 576, the distal portion 574 should not be rectilinear substantially perpendicular to the longitudinal-lateral surface formed by the major axis 578 and the transverse (width) axis 580, as shown in FIG. . Therefore, in contrast to the short plate described above, the plate 540 is configured for use on the left ulna, so there is a left-right distinction. The distal portion forms at least two separate major axes 578, 582 that are parallel to an axis 584 along which the thickness is formed and bend at an angle of about 2-10 degrees, or about 5 degrees relative to each other. be able to. This rotation causes the non-linear distal portion 574 to turn right as the plate extends from the distal portion to the proximal portion when viewed from the exterior for the left hand embodiment (as in FIG. 41). Form. Such a non-linear configuration allows the distal portion 574 to follow one side of the proximal-posterior ulna when the ulna is bent distally.

X. This section describes embodiments of the left and / or right proximal-anterior ulna, in particular, the hip plate that is configured to secure the perioarticular joint perimeter and / or the fracture of the diaphysis. (See FIGS. 43 to 48). The hip bone plate can include any suitable features described above relative to other bone plates.

  43-45 show a top view, a side view, and a bottom view, respectively, of an embodiment for the left hand of a smaller sized well plate 80. FIG. The right-hand embodiment can be configured as a substantially mirror image copy (not shown). Plate 80 includes an exterior (or facing away from bone) surface 632, an interior (or facing bone) 634, and generally concave and convex sides 636 and 637, respectively. . The distal (or diaphyseal) portion 82 extends to join the bridge portion 640 and the bridge portion 640 joins the support portion 84. The distal portion 82 forms a set of openings 644 that typically include a plurality of openings 32 such as circular openings 170 and / or elongated openings 164, 166. Distal and support portions 82, 84 extend outwardly to distal and proximal ends 648, 650, respectively. The plate 80 is also a set of generally perpendicular axes within the central region 651 of the distal portion 82, ie, a long (or longitudinal) axis 652, a transverse or width axis 654, and (perpendicular to the page of FIG. 43). It can be described relative to the thickness axis 656. Each axis can be associated with a corresponding local axis formed by bending of the plate, usually by rotation.

  The support portion 84 stabilizes and supports the shed. Portion 84 is generally parallel to the front side facing the distal direction of the ostium with the generally convex side 637 positioned farther forward and / or closer than the generally concave side 636. It can comprise so that it may be located in. The support part 84 can be constituted by contact between the support part 84 and the shed as the main method of fixing by this part. Thus, the support portion 84 can be substantially or completely free of openings, or the openings can be used in a fixed auxiliary role. The support portion can resist separation from the inguinal process, at least in part, by attachment of the distal portion 82 to the diaphysis by a fixation device. To support the bone, the support portion can include one or more spacing members or protrusions, such as prongs 90. Plate 80 can include two prongs, but in certain cases, three or more protrusions may be suitable. The prongs 90 can be housed within the inner surface 634 and can project substantially perpendicular to the longitudinal-lateral surface formed by the support portion in the direction of the bone. In this case, the prong 90 is formed as a thick region of the substantially convex side surface 637. However, the protrusions can extend from any suitable side or inner region of the inner surface of the support portion 84. The prong can include a pointed or rounded tip.

  The fistula plate 80 can be configured to attach to any suitable side of the ulna, such as, for example, to support the distal-facing side of the fistula. Therefore, by twisting and / or bending, the contour of the plate 80 can be pre-shaped so that its inner surface substantially conforms to the differently facing sides of the ulna. Torsion and / or bending of the plate 80 during its assembly and / or application can be effected by the less rigid regions 660, 662. The less rigid region 660 can generally correspond to the bridge portion 640, the region 662 can separate the opening, and / or the region 662 can be a central region from the distal end 648 of the diaphysis fixing portion 82. 651 can be separated. Each region can be formed, for example, by locally narrowing and / or thinning the plate 80 as already described for other plates.

  46 and 47 are end views of the plate 80 showing how to twist the support portion 84 and the distal region 664 relative to the central region 651, respectively. Portion 84 and region 664 can be twisted counterclockwise and clockwise with respect to central region 651. Thus, the proximal and distal ends 648, 650 are each along an axis or axes that are generally parallel to the major axis 652 or oblique to both the major axis 652 and the transverse axis 654. Can be twisted. In the case of this counterclockwise embodiment, as shown in FIGS. 46 and 47, each end extends in the direction of the central region 651, so that twisting is performed clockwise. Since the plate extends from the distal to the proximal ends 648, 650, twisting can be done in much the same way. Thus, each end can be associated with the central region 651 at a generally similar angle 666 of about 20-60 degrees, 30-50 degrees, or about 40 degrees. Thus, portion 84 and region 664 can form surfaces that are rotated relative to each other by a sum of these rotations at an angle of about 80 degrees so that the surfaces are positioned substantially perpendicular to each other. . Plate 80 is configured for the left ulna, but the screw orientation of plate 80 is right so that it rotates clockwise as the plate extends between the distal and proximal ends. The mirror image plate for the right ulna can include a left-handed twist. In other embodiments, the angle 666 may be different between both ends so that one end bends or twists more with respect to the central region 651 than the other end.

  The plate 80 can be formed in a twisted crescent-like shape having a generally concave side 636 and a generally convex side 637. Such concave and convex assignments eliminate, for example, local width variations formed by narrow regions 660, 662. 43, when viewed from the outer surface 632 along the axis 656, the counterclockwise plate 80 arcs to the right as the plate extends through the support portion 84 from the distal portion to the proximal portion. A substantially straight distal portion 82 can be included. The support portion 84 may form a local major axis 668 near the distal end 650 that is generally perpendicular to the major axis 652. As shown in FIG. 2, the distal portion 82 may be configured to extend obliquely with respect to the long axis of the ulnar shaft, for example, at an angle of about 20-60 degrees.

  FIG. 48 is a bottom view of another embodiment of a ostial plate for the left ulna plate 680. The inguinal plate 680 is, for example, a larger plate 80 that is suitable for fixing a wider range of damage to the ulna shaft. The plate 680 can be configured as an extension of the plate 80, as shown by the distal portion of the plate 80, as indicated by the dashed line and labeled. Plate 680 has an extended distal portion 682 that can initially be formed as an arc and then can be a generally linear extension of distal portion 82 of plate 80. Distal portion 682 can include an elongated opening, a circular opening, or a combination of the two. For example, an elongated opening can be formed only at the distal end 684 and a circular opening can be formed only at the central portion 686. Support portion 84 may be the same as plates 80 and 680. The distal portion 682 can be configured to extend obliquely with respect to the long axis of the ulna in the central portion 686, but thereafter parallel to the long axis of the ulna extending in the distal direction within the distal end 684. Can be bent or arched.

XI. Illustrative use of peri-articular elbow plates These plates and associated fixation devices, in certain instances, determine how well one or more of the following technical objectives are met: Can be selected as a base. (1) How many screws can be reliably passed through the plate, (2) How many screws can be reliably engaged with the bone piece on the opposite side fixed to the plate as well (3) how many screws can be securely placed in the distal bone fragment, (4) how many screws can be reliably engaged in each joint bone piece, (5) how long each screw can be reliably lengthened, (6) that the plate can be reliably applied so that crimping occurs at the supracondylar level for both columns, and (7) Whether the plate is sufficiently strong and rigid enough to prevent fracture or bending before bonding occurs at the supracondylar level.

  The bone plate can be used as follows. Discontinuities in the bone (eg, humerus and / or ulna) can be reduced by appropriate means including manual. A suitable bone plate can be selected and positioned by surgical incision such that a portion of the plate connects the discontinuity and a portion contacts the reduced bone on the opposite side of the discontinuity. The bone plate can be formed to engage the bone before and / or during fixation. The bone can be drilled and the bone plate can be secured to the bone with a suitable fixation device, such as a bone screw, through the openings in the plate and the holes in the bone. After the bone has healed sufficiently, the bone plate and the fixation device can be removed, or the bone plate and the fixation device are left in place to prevent (temporarily) the bone from decreasing in strength. You can also keep it. In order to reduce pain to a minimum, the fractured patient can be anesthetized during reduction, fixation and removal.

  The above disclosure may include a number of different inventions for independent utility. While each of these inventions has been disclosed in its preferred form, the specific embodiments of the invention disclosed and described herein are not to be considered as limiting the invention. Because many changes can be made. The subject matter of the present invention includes all novel and non-obvious combinations and subcombinations of various elements, features, functions and / or properties disclosed herein.

FIG. 10 is a side view of a left elbow secured by an embodiment of a pre-contoured bone plate for the lateral and medial condyles of the distal humerus and the proximal ulna elbow in accordance with aspects of the present invention. FIG. 2 is a view of the inside of the left elbow of FIG. 1 secured as shown in FIG. 1, in accordance with an embodiment of a pre-contoured bone plate for a proximal ulna fistula according to aspects of the present invention. It is a figure in which fixing is performed. FIG. 2 is a posterior view of the distal humerus of the elbow of FIG. 1 fixed as shown in FIG. 1, with fixation performed by an embodiment of the posterior bone plate used in place of the plate for the lateral condyle. It is a figure. FIG. 6 is a plan view of an embodiment of a lateral condylar plate for securing the outer distal portion of the left humerus, particularly the lateral condyle, constructed in accordance with aspects of the present invention. It is a side view (profile) of the bone plate of FIG. FIG. 5 is a bottom view of the bone plate of FIG. 4. FIG. 7 is a cross-sectional view of the bone plate of FIG. 4 taken generally along line 7-7 of FIG. FIG. 8 is another cross-sectional view of the bone plate of FIG. 4 taken generally along line 8-8 of FIG. FIG. 5 is a plan view of the right hand embodiment of the lateral condyle plate of FIG. 4 constructed in accordance with aspects of the present invention. FIG. 5 is a plan view of another embodiment of a lateral condylar plate that includes a longer diaphyseal fixation portion constructed in accordance with aspects of the present invention. It is a side view (profile) of the bone plate of FIG. FIG. 11 is a bottom view of the bone plate of FIG. 10. FIG. 11 is a plan view of yet another embodiment of a lateral condyle plate that includes a longer shaft fixation portion constructed in accordance with aspects of the present invention than that of the embodiment of FIG. It is a side view (profile) of the bone plate of FIG. FIG. 14 is a bottom view of the bone plate of FIG. 13. FIG. 6 is a plan view of an embodiment of a medial condyle plate for securing the medial-distal portion of a left or right humerus, particularly the medial condyle, constructed in accordance with aspects of the present invention. It is a side view (profile) of the bone plate of FIG. FIG. 17 is a bottom view of the bone plate of FIG. 16. FIG. 19 is a cross-sectional view of the bone plate of FIG. 16 taken generally along line 19-19 of FIG. FIG. 20 is a cross-sectional view of the bone plate of FIG. 16 taken generally along line 20-20 of FIG. FIG. 17 is a plan view of another embodiment of a medial condyle plate that includes an end anchoring portion longer than that of the embodiment of FIG. 16 constructed in accordance with aspects of the present invention. It is a side view (profile) of the bone plate of FIG. FIG. 22 is a plan view of yet another embodiment of a medial condyle plate that includes an end anchoring portion that is longer than that of the embodiment of FIG. 21 constructed in accordance with aspects of the present invention. It is a side view (profile) of the bone plate of FIG. FIG. 24 is a plan view of yet another embodiment of a medial condyle plate including an end fixation portion having a radius of curvature greater than that of the embodiment of FIG. 23 in accordance with aspects of the present invention. It is a side view (profile) of the bone plate of FIG. FIG. 6 is a plan view of an embodiment of a posterior bone plate for securing the distal portion of the left and right humerus—posterior, particularly the lateral condyles and bone head, constructed in accordance with aspects of the present invention. It is a side view (profile) of the bone plate of FIG. FIG. 28 is a cross-sectional view of the bone plate of FIG. 27, taken generally along line 29-29 of FIG. FIG. 30 is a cross-sectional view of the bone plate of FIG. 27, taken generally along line 30-30 of FIG. FIG. 6 is a plan view of an embodiment of an olecranon bone plate for securing the proximal portion of the left and right ulna-posterior, particularly the olecranon, constructed in accordance with aspects of the present invention. FIG. 32 is a side view (profile) of the bone plate of FIG. 31. FIG. 32 is a bottom view of the bone plate of FIG. 31. FIG. 33 is a cross-sectional view of the bone plate of FIG. 31 viewed generally along line 34-34 of FIG. FIG. 33 is a cross-sectional view of the bone plate of FIG. 31 viewed generally along line 35-35 of FIG. FIG. 33 is a cross-sectional view of the bone plate of FIG. 31 viewed generally along line 36-36 of FIG. FIG. 32 is a plan view of another embodiment of an olecranon bone plate that is constructed in accordance with aspects of the present invention and includes a longer diaphysis and end fixation portion than that of the embodiment of FIG. 31, but without prongs. It is a side view (profile) of the bone plate of FIG. FIG. 32 is a plan view of yet another embodiment of an olecranon bone plate that includes a diaphysis fixation portion that is longer than that of the embodiment of FIG. 31 constructed in accordance with aspects of the present invention. FIG. 40 is a side view (profile) of the bone plate of FIG. 39. FIG. 40 is a plan view of yet another embodiment of an olecranon bone plate that includes a shaft fixation portion that is longer than that of the embodiment of FIG. 39 and configured to attach to the left ulna, in accordance with aspects of the present invention. 42 is a side view (profile) of the bone plate of FIG. 41. FIG. FIG. 6 is a plan view of an embodiment of a heel bone plate for securing the anterior-proximal portion of the left ulna, in particular the ostium, according to aspects of the present invention. FIG. 44 is a side view (profile) of the bone plate of FIG. 43. FIG. 44 is a bottom view of the bone plate of FIG. 43. FIG. 44 is an end view of the bone plate of FIG. 43, looking at the central region from the proximal end of the plate. FIG. 44 is another end view of the bone plate of FIG. 43, looking at the central region from the distal end of the plate. FIG. 44 is a bottom view of another embodiment of a hip bone plate that includes a shaft fixation portion longer than that of the embodiment of FIG. 43 in accordance with aspects of the present invention.

Explanation of symbols

10 left elbow 12 bone plate set 14 bone plate 16 distal humerus 18 proximal ulna 20, 22 diaphysis 24, 26 periarticular (edge) region 28 bone discontinuity 30 bone screw 32 opening or aperture 34 proximal radius 40 outer condyle plate 42 diaphysis (or proximal) portion 46 end fixation (or distal) portion 48 outer condyle 50 medial condyle plate 52 diaphysis (or proximal) portion 56 end fixation (Or distal) portion 58 medial condyle 60 pulley 70 elbow head plate 72 diaphyseal fixation (or distal) portion 74 end fixation (or proximal) portion 76 elbow head 78 proximal tip 80 ostial plate 82 diaphysis ( Or distal) portion 84 support portion 86 ostium 88 surface 90 prong 100 posterior plate 102 diaphysis (or proximal) portion 104 posterior side 106 end fixation The distal) portion 108 humeral head 120 lateral condylar plate 120R lateral condylar plate 122 external (or facing away from bone) surface 124 internal (or facing bone) surface 126 Side 128 Proximal (or diaphyseal) portion 130 Distal (or end-fixed) portion 132, 134 Set of openings 136, 138 Convex and concave outer surface 140 Round corner 142 Proximal end 144 Distal end Portions 146, 148 Tubular surface 152 Chamfered surface 156 Tapered region 157 Central portion 160 Narrow region 162 Zone 164, 166 Elongated opening 168 Counter bore 170 Circular opening 172 Counter bore 174 Long axis 175 Angle 176 Bridge (or middle) portion 177 Angle 180 Plate 182 Proximal portion 184, 186 Chamfer 188, 190 Surface 230 Medial condyle plate 232 External surface (or surface facing away from bone)
234 Inner surface (or surface facing the bone)
236 Side 238 Proximal (or shaft fixation) portion 240 Bridge portion 242 Distal (or end fixation) portion 244, 246 Set of openings 248 Proximal end 250 Distal end 252 Tapered region 254, 256 Top chamfer and / or bottom chamfer 258 Straight region 260 Long axis 262 Angle 290, 291 Medial condyle plate 292, 293 Distal portion 294, 296, 298 Distal extension 302, 304 Distal tab or foot 306 Spacer region 332 outer surface (or surface facing away from bone)
334 Inner surface (or surface facing the bone)
336 Side 340 Bridge (or middle) portion 344, 346 Set of openings 348, 350 Proximal and distal end 352 Chamfered surface 354 Long axis 356 Lateral (width) axis 358 Angle 432 Outer (or opposite bone direction) Face 434 inward (or bone-facing) face 436 side face 440 bridge (or middle) portion 444, 446 set of openings 448, 450 distal and proximal ends 452 major axis 454 Lateral axis or width axis 456 Thickness axis 460 Thin side portion 462 Chamfered surface 464 Wide region 466 Tubular recess 468 Recess 470, 472 Open portion 474 Open portion 476 Open portion 478 End region 480 Prong 484 Local Long axis 486 Prong tip 488 Convex arc or curve 490 Angle 492 Recess 520 530, 540 Elbow head plate 552 Distal portion 554 Proximal portion 558 End region 560 Local long axis 562 Locally narrow region 572 Modified distal portion 574 Distal portion 576 Outer surface 578 Long axis 580 Horizontal (width) Axis 582 Long axis 584 Axis 632 Outside (or facing away from bone) face 634 Inside (or facing bone) face 636, 637 Generally concave and convex sides 640 Bridge portion 644 Opening Set of parts 648, 650 Distal and proximal end 651 Central region 652 Long axis 654 Axis 656 Axis 660, 662 Rigid region 664 Distal region 666 Angle 668 Local long axis 680 Ulna plate or fistula plate 682 Distal portion 684 Distal end 686 Central portion

Claims (187)

A bone plate for fixing the fracture of the elbow,
A diaphysis fixing portion forming a plurality of openings configured to receive bone screws for fixation to the diaphysis of the humerus;
An end fixation portion that is joined to the diaphysis fixation portion and forms a plurality of openings configured to accommodate a fixation device for stabilizing a discontinuity of the bone in the periphery of the elbow joint of the humerus; With
The bone plate includes a surface facing the bone, and the surface facing the bone has an anatomical contour formed along the humerus from the diaphysis to the periphery of the elbow joint. Is at least approximately the same,
A bone plate in which each of the diaphyseal fixation portion and the end fixation portion has an average width, and the average width of the end fixation portion is narrower than the average width of the diaphysis fixation portion.   The bone plate of claim 1, wherein the end fixation portion has a varying width.   The bone plate according to claim 1, wherein the end fixing portion is narrowed at an intermediate position of at least one pair of the plurality of openings of the end fixing portion.   The bone plate according to claim 3, wherein the end fixing portion is narrowed at an intermediate position between each adjacent pair of the plurality of openings of the end fixing portion.   The diaphyseal fixation part has a surface facing in a direction opposite to the bone configured to face away from the diaphyseal part, and the diaphysis fixation part faces in a direction opposite to the bone The bone plate of claim 1, comprising a cross-section that is at least substantially straight.   The bone plate according to claim 5, wherein the surface facing away from the bone includes a substantially flat region.   The bone plate according to claim 1, wherein the diaphyseal fixation portion and the end fixation portion each have an average thickness, and the average thickness of the end fixation portion is thinner than the average thickness of the diaphysis fixation portion.   8. The diaphyseal fixation portion and the end fixation portion form substantially opposing side surfaces that extend substantially along the longitudinal direction of the bone plate, and the average thickness is formed by the opposing side surfaces. Bone plate.   The shaft fixation portion and the end fixation portion form substantially opposite side surfaces extending substantially along the longitudinal direction of the bone plate, and the average thickness is formed by a position having a center between the opposite side surfaces; The bone plate according to claim 7.   The bone plate according to claim 1, wherein the diaphyseal fixation portion forms substantially opposing sides, and a cross-section within at least one region of the diaphysis fixation portion is thin between the opposing sides.   The bone plate according to claim 1, wherein at least two of the plurality of openings of the diaphyseal fixation portion are elongated openings.   The bone plate of claim 11, wherein each elongated opening of the shaft fixation portion has a length and at least two of the elongated openings are different in length.   The bone plate according to claim 12, wherein at least one of the plurality of openings of the diaphysis fixing portion is a circular opening.   The bone plate according to claim 1, wherein the plurality of openings of the end fixing portion are circular.   The bone plate according to claim 1, wherein the plurality of openings of the diaphysis fixing portion are arranged at a higher density than the plurality of openings of the end portion fixing portion.   The plurality of openings of the diaphysis fixing portion have an average interval, and the plate is separated from the plurality of openings of the end fixing portion by a distance that does not include the opening, and the distance is the average The bone plate according to claim 1, wherein the bone plate is longer than the interval.   The bone plate according to claim 1, wherein the humerus is a humerus.   The bone plate according to claim 1, wherein the elbow joint perimeter is selected from a lateral condyle, a medial condyle, and an elbow head.   The diaphyseal fixation portion forms a plane based on length and width, and projections of the bone plate on the plane at least substantially straight line the plurality of openings in the diaphysis fixation portion and end fixation portion. The bone plate of claim 1 for placement.   The bone plate of claim 1, wherein the bone plate is configured for use only on one of the left and right sides of the body.   The anatomical contour is an averaged target shape, and the contour of a surface facing the bone is preformed to at least approximately match the averaged target shape. Bone plate.   The bone plate of claim 21, wherein the target shape is an average of a set of adults.   The bone plate further comprises first and second opposing ends, the first end joined to the diaphysis fixing portion, and the second end joined to the end fixing portion. The bone plate according to claim 1.   24. The bone plate of claim 23, wherein the surface facing the bone substantially matches the anatomical contour from the first end to the second end. A bone plate for fixing the fracture of the distal humerus,
A proximal portion forming a plurality of openings configured to receive bone screws for fixation to the diaphysis of the distal humerus;
A distal portion defining a plurality of openings configured to receive a fixation device for stabilizing a discontinuity of bone within the periarticular portion of the distal humerus,
The bone plate includes a surface facing the bone, and the surface facing the bone is formed along the distal humerus from the diaphysis to the periphery of the joint. At least approximately matches the contour,
A bone plate configured for use on each of the left and right sides of the body.   26. The bone plate of claim 25, wherein the diaphysis and the periarticular portion are disposed on one of the medial and lateral sides on the distal humerus.   27. The bone plate of claim 26, wherein the diaphysis is disposed posteriorly on the distal humerus.   The bone plate has a surface facing away from the bone that is configured to face away from the bone, and when viewed in a direction perpendicular to the surface facing away from the bone; 26. The bone plate of claim 25, wherein the bone plate appears substantially straight.   The bone plate has a surface facing away from the bone that is configured to face away from the bone, and when viewed in a direction perpendicular to the surface facing away from the bone; 26. The bone plate of claim 25, wherein the plurality of openings in both portions appear to be arranged along a straight line.   26. The bone plate of claim 25, wherein at least two of the plurality of openings in the proximal portion are elongated openings.   26. The bone plate of claim 25, wherein at least two of the plurality of openings in the distal portion are circular.   26. The bone plate of claim 25, wherein the proximal portion and the distal portion each have an average width, and the average width of the distal portion is narrower.   26. The bone plate of claim 25, wherein the proximal portion and the distal portion each have an average thickness, and the average thickness of the distal portion is thinner.   26. The bone plate of claim 25, wherein the bone plate forms a perimeter and the perimeter is at least approximately symmetrical in the lateral direction.   26. The bone plate of claim 25, wherein the bone plate forms generally opposing sides, and the plurality of openings in each of the proximal and distal portions are at least substantially centered between the opposing sides. .   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is preformed to at least approximately match the averaged target shape. 25. Bone plate according to 25.   38. The bone plate of claim 36, wherein the target shape is an average of a set of adults.   The bone plate further comprises first and second opposing ends, the first end joined to the proximal portion, the second end joined to the distal portion, and the bone 26. The bone plate of claim 25, wherein the surface facing toward substantially coincides with an anatomical contour from the first end to the second end. A bone plate for fixing the fracture of the distal humerus,
A proximal portion forming at least one opening configured to receive at least one bone screw for fixation to the diaphysis of the distal humerus;
An intermediate portion joined to the proximal portion;
A distal portion joined to the intermediate portion and forming a plurality of openings configured to receive a fixation device for stabilizing bone discontinuities within the periarticular portion of the distal humerus; With
The bone plate has a surface facing away from the bone and a surface facing toward the bone, and the surface facing toward the bone extends from the diaphysis to the periphery of the joint. At least approximately matches the anatomical contour formed along the lateral part of the distal humerus,
The intermediate portion in the profile extends at a first angle from the proximal portion to the proximal portion to form a recess with respect to a surface facing away from the bone; A distal portion in the profile extends from the intermediate portion at a second angle relative to the intermediate portion to form a convex portion with respect to a surface facing away from the bone Bone plate.   40. The bone plate of claim 39, wherein the second angle is greater than or equal to the first angle.   40. The bone plate of claim 39, wherein the intermediate portion forms at least one opening.   40. The bone plate of claim 39, wherein the second angle is about twice the first angle.   40. The bone plate of claim 39, wherein the intermediate portion and the distal portion each have a length, the length of the intermediate portion being equal to or greater than the length of the distal portion.   44. The bone plate of claim 43, wherein the length of the distal portion is about 1-3 centimeters.   40. The bone plate of claim 39, wherein the proximal portion is at least substantially straight.   40. The bone plate of claim 39, wherein the distal portion has at least three circular openings.   40. The bone plate of claim 39, wherein the first angle is about 20 degrees.   40. The bone plate of claim 39, wherein the second angle is about 40 degrees.   40. The medium of claim 39, wherein the intermediate portion and the distal portion in a profile each include a generally straight region disposed adjacent to a convex portion of a surface facing away from the bone. Bone plate.   When the bone plate is configured for use on the left humerus and the surface facing away from the bone is viewed from a right angle, the plate is moved from the proximal portion to the distal portion. 40. The bone plate of claim 39, wherein the bone plate turns right as it extends.   40. A bone plate according to claim 39, wherein the bone-facing surface as viewed in cross-section is concave to form a radius and the radius of the intermediate portion is greater than the radius of the proximal portion. .   52. The bone plate of claim 51, wherein the radius of the distal portion is at least approximately equal to the radius of the intermediate portion.   40. The middle portion and the proximal portion together form a plurality of elongate openings, each of the plurality of elongate openings having a length, at least two of the lengths being different. Bone plate.   54. The bone plate of claim 53, wherein the intermediate portion has one elongated opening whose length is greater than the length of each elongated opening in the proximal portion.   40. The bone plate of claim 39, wherein the bone plate forms generally opposing sides and the plurality of openings in each portion are at least substantially centered between the opposing sides.   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is pre-formed to at least approximately match the averaged target shape. 39. Bone plate according to 39.   57. The bone plate of claim 56, wherein the target shape is an average of a set of adults.   The bone plate further comprises first and second opposing ends, the first end joined to the proximal portion, the second end joined to the distal portion, and the bone 40. The bone plate of claim 39, wherein a surface facing toward substantially coincides with the anatomical contour from the first end to the second end. A bone plate for fixing the fracture of the distal humerus,
A proximal portion forming at least one opening configured to receive a bone screw for securing to the diaphysis of the distal humerus;
An intermediate portion joined to the proximal portion;
A distal portion joined to the intermediate portion and forming a plurality of openings configured to receive a fixation device for stabilizing bone discontinuities within the periarticular portion of the distal humerus; With
The bone plate includes a surface facing away from the bone and a surface facing toward the bone, and the surface facing toward the bone extends from the diaphysis to the periphery of the joint. At least approximately the anatomical contour formed along the medial part of the humerus,
The proximal and intermediate portions in the profile form a concave arc with respect to the surface facing away from the bone, and the distal portion in the profile faces away from the bone A bone plate that forms a convex arc with respect to the surface.   60. The bone plate of claim 59, wherein the concave arc has a first radius, the concave arc has a second radius, and the first radius is at least twice the second radius. .   60. The proximal portion forms a major axis in a proximal direction, and the intermediate portion in a profile extends distally at an angle of about 25-45 degrees relative to the major axis. Bone plate.   60. The bone plate of claim 59, wherein the convex arc has a radius of about 0.5 to 1.5 centimeters.   60. The bone plate of claim 59, wherein the proximal portion forms a major axis in a proximal direction and the distal portion in a profile crosses the major axis.   The distal portion of the profile forms a concave arc with respect to a surface facing away from the bone, and the concave arc of the distal portion is located distal to the convex arc; 60. A bone plate according to claim 59.   65. The bone plate of claim 64, wherein the distal portion forming the concave arc also forms at least one opening.   60. A bone plate according to claim 59, wherein a cross-sectionally facing surface facing the bone is concave, forming a radius, and the radius of the intermediate portion is greater than the radius of the proximal portion.   At least one opening in the proximal portion includes a plurality of sets of openings, each opening in the set of openings has a length, and at least three of the sets of openings 60. The bone plate of claim 59, wherein the lengths of the openings are different.   68. The bone plate of claim 67, wherein at least one of the sets of openings is a circular opening.   60. The bone plate of claim 59, wherein the intermediate portion does not form an opening.   60. The bone plate of claim 59, wherein the proximal portion and the intermediate portion each have an average width, and the average width of the intermediate portion is less than the average width of the proximal portion.   60. The bone plate of claim 59, wherein the intermediate portion and the distal portion each have an average width, and the average width of the distal portion is thicker than the average width of the intermediate portion.   60. The bone plate of claim 59, wherein the bone plate forms generally opposing sides, and the plurality of openings in each portion are at least substantially centered between the opposing sides.   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is preformed to at least approximately match the averaged target shape. 59. Bone plate according to 59.   74. The bone plate of claim 73, wherein the target shape is an average of a set of adults.   The bone plate further comprising first and second opposing ends, wherein the first end is joined to the diaphysis fixing portion, the second end is joined to the end fixing portion, 60. The bone plate of claim 59, wherein a surface facing the bone substantially coincides with the anatomical contour from the first end to the second end. A bone plate for fixing the fracture of the distal humerus,
A proximal portion forming at least one opening configured to receive a bone screw for securing to a posterior diaphysis of a distal humerus and forming a longitudinal axis in a proximal direction;
An intermediate portion joined to the proximal portion;
A distal portion joined to the intermediate portion and forming a plurality of openings configured to receive a fixation device for stabilizing bone discontinuities within the periarticular portion of the distal humerus; With
The bone plate includes a surface facing away from the bone and a surface facing toward the bone, the surface facing toward the bone extending from the posterior diaphysis to the periphery of the joint; At least approximately matches the anatomical contour formed along the lateral part of the distal humerus,
The bone plate in a profile to form a convex curvature relative to a surface facing away from the bone as the bone plate extends from the proximal portion to the distal portion; A bone plate that bends away from the long axis.   77. The bone plate of claim 76, wherein the distal portion within a profile forms an angle of about 35 to 75 degrees with respect to the long axis.   The convex curve includes a first arc in which the bone plate extends from the proximal portion to the intermediate portion and a second arc in which the bone plate extends from the intermediate portion through the distal portion; 77. The bone plate of claim 76, wherein the first and second arcs have a radius, and the radius of the first arc is substantially greater than the radius of the second arc.   77. The bone plate of claim 76, wherein at least one opening in the proximal portion is a plurality of openings and the intermediate portion forms at least one opening.   77. The bone plate of claim 76, wherein the proximal portion and the intermediate portion form a plurality of elongated openings having a length together, and at least two of the plurality of elongated openings have different lengths. .   The distal portion has a proximal region and a distal region, the proximal region in a profile forms at least a portion of the convex curve of the bone plate, and the distal region in the profile is approximately 77. The bone plate of claim 76, wherein the bone plate is straight.   77. The bone plate of claim 76, wherein the bone plate forms substantially opposing sides, and the plurality of openings in each portion are at least substantially centered between the opposing sides.   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is pre-formed to at least approximately match the averaged target shape. 76. Bone plate according to 76.   84. The bone plate of claim 83, wherein the target shape is an average of a set of adults.   The bone plate further comprises first and second opposing ends, the first end joined to the proximal portion, the second end joined to the distal portion, and the bone 77. The bone plate of claim 76, wherein the surface facing toward substantially coincides with the anatomical contour from the first end to the second end. A bone plate for fixing the fracture of the proximal ulna,
A distal portion forming a plurality of openings configured to receive bone screws for fixation to the posterior diaphysis of the proximal ulna;
A proximal portion joined to the distal portion and forming a plurality of openings configured to receive a fixation device for stabilizing a bone discontinuity in the elbow head of the proximal ulna; With
The bone plate includes a surface facing away from the bone and a surface facing toward the bone, the surface facing toward the bone from the posterior diaphysis to the elbow head. At least approximately the anatomical contour formed along the ulna,
A bone plate configured such that a surface of the distal portion facing away from the bone faces the bone in a direction substantially perpendicular to the posterior-anterior axis of the proximal ulna.   87. The bone plate of claim 86, wherein the bone plate in the profile forms a convex arc with respect to a surface facing away from the bone.   90. The bone plate of claim 86, wherein the convex arc is at least substantially formed by the proximal portion.   87. The bone plate of claim 86, wherein the proximal portion includes an end region and an intermediate region, and the end region in a profile extends obliquely with respect to the distal portion.   90. The bone plate of claim 89, wherein the end region in a profile extends at an angle of about 40-80 degrees relative to the distal portion.   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is preformed to at least approximately match the averaged target shape. 86. Bone plate according to 86.   The bone plate further comprises first and second opposing ends, the first end joined to the distal portion, the second end joined to the proximal portion, and the bone 87. The bone plate of claim 86, wherein the surface facing toward substantially coincides with the anatomical contour from the first end to the second end. A bone plate for fixing the fracture of the proximal ulna,
A distal portion forming a plurality of openings configured to receive bone screws for fixation to the diaphysis of the proximal ulna;
A proximal portion joined to the distal portion and forming a plurality of openings configured to receive a fixation device for stabilizing a bone discontinuity in the elbow head of the proximal ulna; With
The bone plate includes a surface facing away from the bone and a surface facing toward the bone, the surface facing toward the bone from the diaphysis to the elbow head At least approximately matches the anatomical contour formed along the ulna,
A bone plate comprising a wide region wherein the distal portion has an average width and the proximal portion has a width greater than the average width of the distal portion.   94. The bone plate of claim 93, wherein the wide region forms at least two of a plurality of openings in the proximal portion.   94. The bone plate of claim 93, wherein the wide region has side surfaces and forms at least one opening having no center between the side surfaces.   96. The distal portion forms a major axis, and the at least one opening in the large region is at least two openings that are aligned at least approximately transverse to the major axis. Bone plate.   94. The proximal portion has a proximal end region and a distal intermediate region, the intermediate region includes the wide region, and the end region in a profile extends obliquely from the intermediate region. Bone plate.   98. The bone plate of claim 97, wherein the end region forms at least one of the plurality of openings in the proximal portion.   98. The bone plate of claim 97, wherein the end region has at least one spacing member formed by a surface facing the bone.   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is preformed to at least approximately match the averaged target shape. 93. A bone plate according to 93.   The bone plate further comprises first and second opposing ends, wherein the first end is joined to the distal portion, and the second end is joined to the proximal portion; 94. The bone plate of claim 93, wherein a surface facing the bone substantially coincides with the anatomical contour from the first end to the second end. A bone plate for fixing the fracture of the proximal ulna,
A distal portion forming a first set of a plurality of openings configured to receive a bone screw for securing to a diaphysis of a proximal ulna;
Joining the distal portion and forming a second set of openings configured to receive a fixation device for stabilizing a bone discontinuity in the proximal ulna elbow A proximal portion that includes:
The proximal portion has a proximal end region and a distal intermediate region, the end region forming at least one opening in the second set, and the intermediate region is the second region Forming at least two openings in the set, wherein the at least two openings in the intermediate region are closer to each other relative to the at least one opening in the proximal region;
The bone plate includes a surface facing away from the bone and a surface facing toward the bone, the surface facing toward the bone extending from the diaphysis to the elbow head to the proximal ulna A bone plate that at least approximately conforms to the anatomical contour formed along.   103. The bone plate of claim 102, wherein the at least two openings in the intermediate region include three openings arranged to form a triangle.   103. The bone plate of claim 102, wherein the plurality of openings in the second set are circular.   105. The bone plate of claim 102, wherein the end region in a profile extends obliquely from the intermediate region.   105. The bone plate of claim 102, wherein the end region includes a member for spacing at least one formed by a surface facing the bone. A bone plate for fixing the fracture of the proximal ulna,
A distal portion forming a plurality of openings configured to receive bone screws for fixation to the diaphysis of the proximal ulna;
A proximal portion forming a plurality of openings configured to receive a fixation device for stabilizing a bone discontinuity in the elbow head of the proximal ulna,
The proximal portion has generally opposing sides, and at least one of the plurality of openings in the proximal portion is asymmetrically disposed between the opposing sides;
The bone plate includes a surface facing away from the bone and a surface facing toward the bone, the surface facing toward the bone from the diaphysis to the elbow head A bone plate that at least approximately matches the anatomical contour formed along the ulna.   The distal portion forms a central long axis, the at least one asymmetrically disposed opening in the proximal portion is at least two openings, and the at least two openings are in the central long axis. 108. The bone plate of claim 107, having a center disposed on opposite sides.   108. The bone plate of claim 107, wherein the at least two openings disposed on opposite sides are aligned so as to at least substantially intersect the central longitudinal axis.   108. The anatomical profile extends to a proximally facing surface of the elbow head, forming an obtuse angle between the diaphysis and the proximally facing surface. Bone plate. A bone plate for fixing the fracture of the proximal ulna,
A distal portion forming a first set of a plurality of openings configured to receive a bone screw for securing to a diaphysis of a proximal ulna;
Joining the distal portion and forming a second set of openings configured to receive a fixation device for stabilizing a bone discontinuity in the proximal ulna elbow A proximal portion that includes:
The proximal portion has a proximal end region and a distal intermediate region, and the end region is bent with respect to the intermediate region to form at least one opening in the second set. And
The bone plate includes a surface facing away from the bone and a surface facing toward the bone, the surface facing toward the bone from the diaphysis to the elbow head A surface that conforms at least approximately to an anatomical contour formed along the ulna and faces toward the bone in the end region, and is configured to extend toward an adjacent surface of the elbow head. A bone plate comprising at least one spaced member.   112. The bone plate of claim 111, wherein the end region is bent at an angle with respect to the intermediate portion within a profile, and the angle is approximately 40-80 degrees.   112. The bone plate of claim 111, wherein the at least one spacing member is at least two prongs.   112. The bone plate of claim 111, wherein the at least two prongs are in lateral contact with one of the at least one opening in the end region.   112. The bone plate of claim 111, wherein the bone plate forms substantially opposing sides and the at least two prongs are formed by thickening the opposing sides.   112. The bone plate of claim 111, wherein the end region of the proximal portion forms a plane based on length and width, and the at least one spacing member extends substantially perpendicular to the plane.   The end region of the proximal portion is configured to be disposed on a triceps tendon, and the triceps tendon is located on a surface facing the proximal direction of the elbow head 112. A bone plate according to claim 111.   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is preformed to at least approximately match the averaged target shape. 111. A bone plate according to 111. A bone plate for fixing the fracture portion of the inguinal tract,
A first portion configured to be attached to the diaphysis of the proximal ulna by at least one fixation device and having at least one opening configured to receive the at least one fixation device;
A second portion configured to support the ostial portion of the ulna when joined to the first portion and when the first portion is attached to the diaphysis,
The bone plate includes a surface facing the bone, the surface facing the bone being formed along the proximal ulna from the diaphysis to the ostium along the proximal ulna; A bone plate that matches at least approximately.   120. The bone plate of claim 119, wherein the anatomical contour extends from the inside of the diaphysis to the face of the ostium that is generally distally directed.   120. The bone plate of claim 119, wherein the first portion is configured to be located further away than the second portion.   120. The bone plate of claim 119, wherein the first portion forms a plurality of openings.   120. The bone plate of claim 119, wherein the at least one opening is a circular opening.   120. The bone plate of claim 119, wherein the first portion has a width and thickness to form a major axis, and at least one of the width and the thickness varies along the major axis.   The first portion includes a pair of openings separated by a spacer region, the first portion having a width at each of the two openings and at the spacer region; 125. The bone plate of claim 124, wherein the width at is narrower than the width at the at least two openings.   The first portion includes a plurality of openings, the diaphysis of the ulna forms a long axis, and the first portion extends through the center of the pair of openings. 120. The bone plate of claim 119, configured to be attached to the diaphysis so as to extend obliquely with respect to the long axis.   The first portion is further configured to be attached to the diaphysis so that lines extending through the centers of different pairs of the plurality of openings extend substantially parallel to the major axis. 127. A bone plate according to claim 126.   120. The bone plate of claim 119, wherein the second portion is configured to be at least substantially not separated from the ostium by attaching the first portion to the diaphysis.   129. The bone plate of claim 128, wherein the second portion does not form an opening.   120. The bone plate of claim 119, wherein the second portion includes at least one protrusion configured to contact the shed.   135. The second portion includes a prong having a length and a width forming a plane, and wherein the at least one protrusion includes a plurality of spaced apart projections extending substantially perpendicular to the plane. Bone plate.   The second portion forms first and second substantially opposing side surfaces, the first side surface being configured to be disposed in front of the second side surface on the mouth portion, 132. The bone plate of claim 131, wherein a plurality of spaced prongs protrude from the first side.   120. The bone plate of claim 119, wherein the first and second portions each form a plane having a length and a width, the planes being substantially perpendicular to each other.   120. The bone plate of claim 119, wherein the first portion is twisted relative to the second portion.   120. The bone plate of claim 119, further comprising an intermediate portion joining the first and second portions, the intermediate portion being narrower than the first and second portions.   The first and second portions form a surface facing away from the bone that is configured to face away from the bone, and the bone plate faces away from the bone 120. The bone plate of claim 119, wherein when viewed from a plane, the bone plate is generally crescent-shaped.   120. The bone plate of claim 119, wherein the first and second portions each form a major axis, and the two major axes are substantially orthogonal.   120. The bone plate of claim 119, wherein the bone plate is configured for use only on one of the left and right ulna.   The anatomical contour has an averaged target shape, and a contour of a surface facing the bone is preformed to at least approximately match the averaged target shape. 119. A bone plate according to 119.   140. The bone plate of claim 139, wherein the target shape is averaged for a set of adults.   The bone plate further comprises first and second opposing ends, the first end joined to the first portion, and the second end joined to the second portion. 120. The bone plate of claim 119, wherein a surface facing the bone substantially coincides with the anatomical contour from the first end to the second end. A bone plate for fixing the fracture portion of the inguinal tract,
A first portion configured to be attached to the diaphysis of the proximal ulna by at least one fixation device and having at least one opening configured to receive the at least one fixation device;
At least one connected to the first portion and configured to protrude toward one face of the proximal ulna ostium when the first portion is attached to the diaphysis A bone plate comprising: a second portion having a protrusion.   143. The bone plate of claim 142, wherein the first portion is configured to be positioned further than the second portion.   143. The bone plate of claim 142, wherein the first portion forms a plurality of openings.   143. The bone plate of claim 142, further comprising a third portion joining the first and second portions, each portion having an average width, wherein the average width of the third portion is the narrowest. .   143. The bone plate of claim 142, wherein the second portion is configured to be at least substantially not separated from the ostium by attaching the first portion to the diaphysis.   147. The bone plate of claim 146, wherein the second portion does not include an opening.   The second portion has a length and a width forming one plane, and the at least one projection has a plurality of intervals protruding in a direction substantially perpendicular to the plane and in the direction of the hook projection. 143. The bone plate of claim 142, comprising a prong with.   The second portion has a surface facing the bone configured to face the mouth portion, and at least two of the at least one protrusion formed by a surface facing the bone 143. The bone plate of claim 142, wherein the bone plate is a single prong.   143. The bone plate of claim 142, wherein the first and second portions each form a plane based on length and width, the planes being substantially perpendicular to each other.   143. The bone plate of claim 142, wherein the first portion is twisted relative to the second portion. A set of bone plates for fixing the fractured part of the elbow,
Comprising a plurality of pre-contoured bone plates configured to secure overlapping anatomical regions of bone, each bone plate comprising:
A diaphysis fixing portion forming a plurality of openings configured to receive bone screws for fixation to the diaphysis of the humerus;
An end fixation portion that is joined to the diaphysis fixation portion and forms a plurality of openings configured to accommodate a fixation device for stabilizing a discontinuity of the bone in the periphery of the elbow joint of the humerus; Including
The plurality of bone plates includes a surface facing the bone, the surface facing the bone being from the first position in the diaphysis to the second position in the periarticular region. Almost coincides with the anatomical contour formed along the
A set of bone plates wherein the first position in the diaphysis is at least substantially the same and the second position in the periarticular region is different.   153. The set of bone plates of claim 152, wherein each diaphyseal fixation portion has a length and the plurality of lengths are at least approximately the same. A set of bone plates for fixing the fractured part of the elbow,
Comprising a plurality of pre-contoured bone plates configured to secure overlapping anatomical regions of bone, each bone plate comprising:
A diaphysis fixing portion forming a plurality of openings configured to receive bone screws for fixation to the diaphysis of the humerus;
An end fixation portion that is joined to the diaphysis fixation portion and forms a plurality of openings configured to accommodate a fixation device for stabilizing a discontinuity of the bone in the periphery of the elbow joint of the humerus; Including
Each bone plate includes a surface facing the bone, the surface facing the bone from the first position in the diaphysis to a second position in the periarticular region to the humerus Almost coincides with the anatomical contours formed along,
A set of bone plates in which the anatomical contour substantially coincides with the plurality of overlapping portions and the second positions in the joint perimeter are different.   Each bone plate includes an opposite end, the opposite end being a first end joined to the diaphyseal fixation portion and a second end joined to the end fixation portion; 157. The set of bone plates of claim 154, wherein a surface facing the bone substantially matches the anatomical contour from the first end to the second end.   155. The set of bone plates according to claim 154, wherein the plurality of end fixation portions each have a length and at least two of the lengths are different.   155. The set of bone plates of claim 154, wherein the plurality of shaft fixation portions each have a length, and at least two of the lengths are at least approximately the same. A set of bone plates for fixing the fractured part of the elbow,
A plurality of pre-contoured bone plates configured to secure the distal humerus, each of the plurality of bone plates comprising:
A proximal portion forming a plurality of openings configured to receive bone screws for securing to the diaphysis of the distal humerus;
A distal portion joined to the proximal portion and forming a plurality of openings configured to receive a fixation device for stabilizing a bone discontinuity within a periarticular portion of the distal humerus; Including,
Each of the plurality of bone plates includes a surface facing the bone, and the surface facing the bone is formed along the distal humerus from the diaphysis to the periphery of the joint. Almost coincides with the anatomical contour,
A set of bone plates configured such that for at least two of the plurality of bone plates, the proximal portion is attached to a generally opposing surface of the diaphysis.   159. The set of bone plates of claim 158, wherein the generally opposed surfaces are the outer and inner surfaces of the distal humerus.   159. The set of bone plates of claim 158, wherein the proximal portion for at least two of the plurality of bone plates is configured to be attached to a generally orthogonal surface of the diaphysis.   169. The set of bone plates of claim 160, wherein the substantially orthogonal planes are the medial and posterior surfaces of the distal humerus. A set of bone plates for fixing the fractured part of the elbow,
A plurality of pre-contoured bone plates configured to secure the proximal ulna, each bone plate comprising:
A distal portion forming a plurality of openings configured to receive bone screws for fixation to the diaphysis of the proximal ulna;
A proximal portion that joins to the shaft fixation portion and forms a plurality of openings configured to receive a fixation device for stabilizing a discontinuity of bone within a periarticular portion of the proximal ulna; Including
Each of the plurality of bone plates includes a surface facing the bone, and the surface facing the bone is formed along the proximal ulna from the diaphysis to the periphery of the joint. Almost coincides with the anatomical contour,
A set of bone plates in which the periarticular portion of at least two of the plurality of bone plates is an elbow head and a groin. A set of bone plates for fixing the fracture,
A plurality of bone plates, each of the plurality of bone plates forming a plurality of openings, and configured to be attached to an anatomical region of the bone by a fixation device received through the openings; The anatomical regions for at least two of the bone plates are different, and each of the at least two bone plates is one of the at least two different anatomical regions from which the bone plate is constructed. A set of bone plates with different colors associated with one.   166. The set of bone plates of claim 163, wherein the at least two different anatomical regions are formed of a single bone.   166. The set of bone plates of claim 163, wherein the at least two different anatomical regions are contained within one joint perimeter.   166. The set of bone plates of claim 165, wherein the one joint perimeter corresponds to an elbow.   166. The set of bone plates of claim 163, wherein the at least two bone plates are selected from the group consisting of bone plates configured to secure a lateral condyle, a medial condyle, an olecranon, and a heel.   166. 166. The 163 of claim 163, wherein each of the at least two bone plates is pre-contoured to at least approximately match an averaged target shape corresponding to the different anatomical regions that the bone plate comprises. A set of bone plates.   The at least two bone plates include a first bone plate configured to attach only to the left side of the body and a second bone plate configured to attach only to the right side of the body; 166. The set of bone plates of claim 163, wherein the different colors included in each of the first and second bone plates correspond to a side configured to attach the bone plate.   The first bone plate is configured to attach to the left anatomical region and the second bone plate is configured to attach to the right analog of the left anatomical region; 170. A set of bone plates according to claim 169.   One of a plurality of first bone plates configured to be attached to the left side of the first bone plate, and a plurality of configured to be attached to the right side of the second bone plate. 166. One of the second bone plates, wherein each of the first bone plates includes a first color and each of the second bone plates includes a different second color. A set of bone plates.   The at least two bone plates include a bone plate configured for use on each of a left side and a right side, the bone plate including a color different from the first and second colors. 169. A set of bone plates according to item 169.   166. The set of bone plates of claim 163, wherein the different colors are disposed on a plurality of surfaces of each of the at least two bone plates.   166. The set of bone plates of claim 163, wherein each of the at least two bone plates includes marks associated with the different anatomical regions from which the bone plate is constructed.   166. The set of bone plates of claim 163, further comprising instructions associating each of the at least two bone plates with the different anatomical regions from which the bone plates are constructed. A set of bone plates for fixing bone fractures,
A plurality of bone plates, each bone plate forming a plurality of openings, and configured to be attached to a bone site by a fixing device received through the openings; Is configured to be attached only to the left side of the body and has a first bone plate having a first color and a second bone plate configured to be attached only to the right side of the body and having a different second color A bone plate, and a set of bone plates.   The first bone plate is one of a first subset of a plurality of bone plates of the plurality of bone plates configured to be attached only to the left side, the second bone plate comprising: 177. The set of bone plates of claim 176, wherein the set of bone plates is one of a second subset of the plurality of bone plates in the plurality of bone plates configured to attach only to the right side.   178. The set of bone plates of claim 177, wherein each bone plate of the first subset includes the first color and each bone plate of the second subset includes the second color.   178. The set of bone plates of claim 177, wherein the bone region is different for at least two bone plates in each of the first and second subsets.   The plurality of bone plates includes a third bone plate configured for use on each of a left side and a right side, the bone plate including a color different from the first and second colors. 176. A set of bone plates according to item 176.   181. The 180 of claim 180, wherein the third bone plate is one of a plurality of bone plate subsets in the plurality of bone plates configured for use on the left and right sides, respectively. A set of bone plates.   The bone regions for at least two bone plates in the subset are different, the at least two bone plates being different from each other and having a color different from the first and second colors. 184. A set of bone plates according to item 181.   177. The set of bone plates of claim 176, wherein at least a subset of the plurality of bone plates is configured to attach to a periarticular portion.   187. The bone plate set of claim 183, wherein the periarticular portion is an elbow.   185. The set of bone plates of claim 184, wherein the first and second bone plates are selected from the group consisting of bone plates configured to secure a lateral condyle, a medial condyle, an olecranon, and a ostium. .   177. The set of bone plates of claim 176, wherein the first color is blue and the second color is green. 177. The set of bone plates of claim 176, wherein each of the first and second bone plates is pre-contoured to at least approximately match an averaged target shape.

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