Abstract:
The channeled bone plate includes a substantially rigid and elongated member for use in stabilizing and splinting fractured sections of a broken bone. This elongated member includes a bottom surface and a top surface, with at least one transverse channel formed from the bottom surface. The transverse channel has a size and shape to at least partially accommodate selective insertion of a cable to permit flush mounting of the bottom surface of the elongated member to the fractured sections of the broken bone simultaneously with flush wrapping of the cable around an external surface of the fractured sections of the broken bone. The elongated member and the cable cooperate to support the broken bone as an implant splint.

Description:
BACKGROUND OF THE INVENTION 
     The present invention generally relates to a channeled bone plate and related methods for implanting the same for use in repairing bone fractures. More specifically, the present invention relates to a bone plate including one or more channels that permit flush mounting of wires or cables around a fractured bone as part of splinting fractured sections of a broken bone. 
     Open reduction with internal fixation (ORIF) has long been a method for repairing severe long bone fractures in orthopedic surgery. Typically, a long intramedullary rod or bone plate is used to stabilize the fracture once it is reduced. Without proper reduction, a high percentage of fractures fail to properly heal. That is, fractured sections of the bone may not properly grow back together in proper alignment. 
     Temporary clamps, pins, and/or cables are typically used to achieve proper reduction and to hold two sides of a severe long bone fracture together to allow the bone plate to be implanted. The bone plate acts as a buttress or brace to hold the fractured bone in the proper orientation, which in turn encourages proper aligned healing and fusion of the fractured bone. Clamps are typically used initially to hold the fracture together. Unfortunately, clamps cannot be used alone for reduction because the shape of the clamp interferes with proper implantation of the bone plate. More specifically, the surgical opening through which an ORIF procedure is performed exposes only a small portion of the fractured bone. To hold the fractured bone in proper alignment, the clamp must cover a large portion of the exposed bone. The bone plate cannot be implanted because the clamp is in the way. Alternatively, temporary pins can be inserted away from the location where the bone plate will be implanted to provide added support in conjunction with the clamps while preventing interference with bone plate implantation. The pins may stabilize the fracture enough to remove the clamps to allow for attachment of the bone plate via a series of screws that insert into and threadingly engage the bone. 
     Unfortunately, the pins are not suitable for use in certain fracture patterns. For example, in periprosthetic fractures (e.g., as shown in  FIG. 1 ) that occur around previously implanted orthopedic devices (e.g., total knee or hip replacements) require cables or wires to hold pieces of the fractured bone together. These cables or wires are typically between 1.02 millimeters (18 gauge wire) and 2.0 millimeters in diameter. Once the wires stabilize the fractured bone, a bone plate is placed on top of the cables and screwed into the bone. It is preferable that the cables or wires remain wrapped around the bone after bone plate implantation since the cables or wires aid the bone plate in bracing and supporting the fractured bone. Although, the cables or wires may be removed while the screws in the bone plate are tightened so that the bone plate more securely seats flush with the bone, otherwise the bone plate may be biased away from the bone by an approximate width of the wire or cable wrapped around fractured portions of the fractured bone. If the bone plate does not remain flush during the healing process, the bone may become misaligned and improperly heal. 
     Two devices are known in the prior art that facilitate bone plate implantation for purposes of setting severe long bone fractures. One prior art solution is shown in  FIG. 2  and includes a buttoned bone plate  10  that couples to a fractured bone  12  through use of a button  14  that permits slidethrough mounting of a cable  16 . The button  14  threadingly attaches to a top surface  18  of the buttoned bone plate  10  and contains a through-hole  20  to permit slide through engagement of the cable  16 . To implant, the buttoned bone plate  10  is placed on top of the fractured bone  12  and the cable  16  is routed through the through-hole  20  and around both the buttoned bone plate  10  and the bone  12 . The drawback of this device is that a gap  22  exists between the bone  12  and the cable  16  since the cable  16  wraps around both the buttoned bone plate  10  and the bone  12 . The gap  22  reduces the ability of the cable  16  to snugly hold the two fragments of the bone  12  in the proper position. This may, in turn, lead to misalignment of the bone  12  and improper healing. 
     The other prior art solution shown in  FIGS. 3 and 4  is a tunneled bone plate  24  that includes one or more tunnels  26  that permit slide-through mounting of the cables  16  to the tunneled bone plate  24 , in much the same way as the button  14 . The tunnels  26  extend through the width of the tunneled bone plate  24  and are generally parallel to the top surface  18 . In this solution, the cable  16  routes through the width of the plate  24  via the tunnels  26  as shown in  FIGS. 3 and 4 , as opposed to being connected to the top surface  18  of the buttoned bone plate  10  via the button  14 , as in shown in  FIG. 2 . Threading the cable  16  through the tunneled bone plate  24  in the manner shown generally in  FIGS. 3 and 4  prevent the cable  16  from sitting flush against the fractured bone  12 , thereby also creating a gap  28  between the bone  12  and the cable  16 . While this gap  28  may be smaller than the gap  22  shown in  FIG. 2  with respect to the buttoned bone plate  10 , the gap  28  is still large enough to permit undesired relative movement of fractured sections of bone, which can lead misalignment. Thus, the buttoned bone plate  10  and the tunneled bone plate  24  are insufficient solutions to adequately maintain fractured sections of bone in preferred alignment to facilitate proper healing. 
     There exists, therefore, a significant need in the art for a channeled bone plate and methods for implanting the same that permits flush mounting of one or more cables or wires designed to wrap around and secure fractured sections of a bone underneath the bone plate, while simultaneously permitting the bone plate to sit flush against fractured bone sections substantially along its length, thereby substantially eliminating the undesirable gap that exists between the wrapped cables or wires and fractured bone that permits movement of relative sections of the bone fracture. The present invention fulfills these needs and provides further related advantages. 
     SUMMARY OF THE INVENTION 
     The channeled bone plate disclosed herein includes a substantially rigid and elongated member for use in stabilizing and splinting fractured sections of a broken bone. The elongated member generally includes a top surface, and a bottom surface having at least one transverse channel formed therein. The transverse channel preferably has a size and shape to at least partially accommodate selective insertion of a cable to permit flush mounting of the bottom surface of the elongated member to the fractured sections of the broken bone simultaneously with flush wrapping of the cable around an external surface of the fractured sections of the broken bone. This feature, unlike the prior art, allows both the elongated member and the cable to simultaneously sit flush against the fractured bone. To this end, the cable is also able to stay in substantially direct contact with the outer circumference of the fractured bone section, unlike the prior art devices which create relatively large gaps between the cables and the bone. Flush mounting of the cable greatly reduces the risk of misalignment and improper healing of the bone. So, in this respect, the channeled bone plate disclosed herein provides superior support as an implant splint for the repair of severely fractured long bones. 
     In one embodiment, the transverse channel may include a pair of channels at opposite ends of the elongated member, or multiple transverse channels spaced intermittently along the length of the elongated member. Preferably, the transverse channel is of a size and shape to enclose the entire outer diameter of the cable, such as cables having between a 1.02-2.0 millimeter diameter. The shape of the transverse channel may include a concave arcuate indentation, such as a bell-curve shape, or a concave hemispherical indentation that intersects the bottom surface of the elongated member at a 90-degree angle. A fillet may be included between the transverse channel and the bottom surface to smooth or round out the transition between the channel and the bottom surface of the elongated member. 
     The elongated member may also include one or more apertures sized to accommodate selective insertion of one or more screws for securing the elongated member to the broken bone. Here, the screws may be at least flush with the top surface of the elongated member when fully inserted therein and exert a downward pressure thereon to force the bottom surface into flush engagement with the broken bone about the cable in the transverse channel. The elongated member may also optionally have one or more scallops cut into or formed from the edges of the top and/or bottom surfaces to reduce surface-to-surface interference between the elongated member and the blood vessels in the bone. The scallops may include depressions or indentations in the bottom surface or top surface, and may further aid in the healing process. In one embodiment, each scallop may be at least 50% of the width of the elongated member. 
     One method for implanting a channeled bone plate, as disclosed herein, includes placing a substantially rigid and elongated member having at least one transverse channel formed in a bottom surface thereof along an outer surface of fractured sections of a broken bone. Additionally, at least one cable is wrapped around the outer surface of the fractured sections of the broken bone. The cable is aligned with the elongated member for at least partial insertion of the cable into the transverse channel to permit flush mounting of the bottom surface of the elongated member to the outer surface of the fractured sections of the broken bone simultaneously with flush wrapping of the cable around the outer surface of the fractured sections of the broken bone. The elongated member is secured to the fractured sections of the broken bone, wherein the elongated member and the cable cooperate to support the broken bone as an implant splint. 
     A screw may be inserted into an aperture in the elongated member, wherein the screw exerts a downward pressure thereon to force the bottom surface into flush engagement with the outer surface of the fractured sections of the broken bone about the cable in the transverse channel. Of course, the method may further include the step of tightening the screw in the aperture and/or tightening the cable, especially when the cable is initially loosely wrapped around the outer surface of the fractured sections of the broken bone. In this respect, the placing step may occur after the wrapping step, wherein the aligning step includes the step of sliding the cable along the length of the broken bone. Alternatively, the wrapping step may include sliding the cable through the transverse channel when the elongated member is first at least partially secured to the broken bone. Preferably, the fractured sections of the broken bone are aligned and may be clamped together to help stabilize the fracture when implanting the splint. 
     Other features and advantages of the present invention will become apparent from the following more detailed description, when taken in conjunction with the accompanying drawings, which illustrate, by way of example, the principles of the invention. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings illustrate the invention. In such drawings: 
         FIG. 1  illustrates a severe peri-prosthetic fracture of a femur; 
         FIG. 2  is a perspective view of a prior art buttoned bone plate having a cable or wire coupled thereto and tied to a bone; 
         FIG. 3  is a side view of a prior art tunneled bone plate, illustrating fixation to a bone via a cable or wire extending therethrough; 
         FIG. 4  is an alternative perspective view of the prior art tunneled bone plate of  FIG. 3 ; 
         FIG. 5  is a perspective of a channeled bone plate as disclosed herein; 
         FIG. 6  is a partial cut-away side view of the channeled bone plate of  FIG. 5 ; 
         FIG. 7  is a top view of the channeled bone plate of  FIG. 5 , further illustrating a series of screw holes therein; 
         FIG. 8  is a side view similar to  FIG. 6 , further illustrating flush mounting of the channeled bone plate to a bone; 
         FIG. 9  is an enlarged side view taken about the circle  9  in  FIG. 8 , further illustrating a filleted channel; 
         FIG. 10  is an enlarged side view taken about the circle  10  in  FIG. 8 , further illustrating a hemispherical channel; 
         FIG. 11  is a flow chart illustrating a method for implanting the channeled bone plate over already implanted cables or wires wrapped around fractured sections of bone; 
         FIG. 12  is a side view of a fractured bone set with a clamp; 
         FIG. 13  is a side view illustrating a pair of cables or wires securely holding sections of the fractured bone of  FIG. 12  in alignment; 
         FIG. 14  is a side view similar to  FIGS. 12-13 , illustrating implanting a channeled bone plate over the cables or wires; 
         FIG. 15  is a side view similar to  FIGS. 12-14 , illustrating the implanted channeled bone plate and wires or cables implanted flush with the surface of the fractured bone; 
         FIG. 16  is a cross-sectional view taken about the line  16 - 16  in  FIG. 15 , further illustrating flush mounting of the channeled bone plate and cables or wires to the surface of the fractured bone; 
         FIG. 17  is a flow chart illustrating an alternative method of implanting the channeled bone plate prior to implanting the wires or cables; and 
         FIG. 18  is a side view similar to  FIGS. 12-15 , illustrating implanting the wires or cables after implanting the channeled bone plate. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     As shown in the drawings for purposes of illustration, the present invention for a channeled bone plate is shown generally by the reference numeral  30  in  FIGS. 5-10, 14-15 and 18 . The channeled bone plate  30  is a generally elongated and reinforced structure designed to provide support as a splint between fractured sections of bone, such as the periprosthetic fracture shown in  FIG. 1 . The channeled bone plate  30  is preferably rectangular, but may be any shape known in the art suitable for splinting sections of a fractured bone. In one embodiment, as shown in  FIGS. 5 and 7 , the channeled bone plate  30  may include a plurality of screw holes  34  that extend through the width of the plate  30 . These screw holes  34  are of a size and shape to permit insertion of a screw  46  (e.g., as shown in  FIG. 14 ) for purposes of screwing or securing the channeled bone plate  30  to fractured sections of the bone  12 . In this respect, the screw head preferably sits flush or below the top surface  18  of the channeled bone plate  30  and exerts a generally downward pressure thereon to force the bottom surface  32  of the channeled bone plate  30  into flush engagement with the outer surface of the bone  12 , as shown, e.g., in  FIGS. 8, 14-15 and 18 . 
     The bottom surface  32  of the channeled bone plate  30  may contain one or more scallops  36  ( FIG. 2 ) to improve blood flow in and around the bone  12 . The scallops  36  are indentations or depressions located along the outer edges the channeled bone plate  30  and improve blood flow in and around the surface of the bone  12  by offsetting the channeled bone plate  30  from the bone  12 . That is, the relatively small space formed between the bone  12  and bottom surface  32  of the channeled bone plate  30  permits enhanced blood flow around this region. Adequate vascular pathways in and around the bone are important for controlling bone processes, such as osteochondral ossification. The scallops  36  are relatively wide (e.g., 50%-100% of the width of the channeled bone plate  30 ), but only extend across a small portion thereof (e.g., 30%). This allows the center of the channeled bone plate  30  to be in direct contact along the entire length of the bone  12 . Incorporation of the scallops  36  advantageously results in the channeled bone plate  30  interfering with fewer blood vessels in the bone  12 , thereby improving blood flow and aiding the healing process. Preferably, the scallops  36  only extend across part of the width of the channeled bone plate  30  (e.g., 30% as mentioned above), so the channeled bone plate  30  maintains adequate direct contact with the bone  12  for purposes of providing splinting support. Otherwise, the channeled bone plate  30  may not sufficiently brace the bone  12 , which may lead to misalignment during the healing process. Of course, the scallops  36  may be of any shape, size or configuration (e.g., extending across the width or length of the channeled bone plate  30 ), so long as there is sufficient direct contact between the channeled bone plate  30  and the bone  12  to properly support fractured sections of the bone  12 . The channeled bone plate  30  may include any number of scallops  36  on the top surface  18 , the bottom surface  32 , or a combination of the top and bottom surfaces  18  and  32 . But, it is not necessary for the channeled bone plate  30  to include any scallops  36 . 
     The bottom surface  32  of the channeled bone plate  30  includes one or more channels  38  that extend across part or the entire width of the bottom surface  32  as best shown in  FIGS. 5-6, and 8-10 . The channel  38  is an indentation or hollowed out space having a size and shape to accommodate partial or full reception of the cables  16 . In one embodiment, the channel  38  is a concave arcuate indentation having the general structure of a bell-curve  38   a , as shown in  FIG. 9 . In an alternative embodiment, the channel  38  may define a more rigid arcuate channel that includes a concave hemispherical indentation or cut-out  38   b  as shown in  FIG. 10 . The bell-curve channel  38   a  provides a smoother transition to the bottom surface  32 , such as by way of a fillet  40 , while the hemispherical channel  38   b  forms harsher, near 90 degree intersection with the bottom surface  32 . The former bell-curve channel  38   a  may be preferred for installation of the channeled bone plate  30  after the cables  16  are wrapped around fractured sections of the bone  12 , as described in more detail below with respect to the method shown in  FIG. 11 . Alternatively, the latter hemispherical channel  38   b  is preferably used in association with the method shown and described in more detail below with respect to  FIG. 17 , as this channel  38   b  may more securely retain the cable  16  therein as the hemispherical cut-out more closely fits the exterior diameter of the cable  16 . 
     In one embodiment, the channeled bone plate  30  may include a single bell-curve channel  38   a . Although, more preferably, the channeled boned plate  30  includes at least two bell-curve channels  38   a  at opposing ends of the channeled bone plate  30  for holding together opposite sides of a fractured bone. Of course, the channeled bone plate  30  may include any number of the bell-curve channels  38   a  as may be needed to provide adequate splinting of fractured sections of the bone  12 . Likewise, the channeled bone plate  30  may include a single hemispherical channel  38   b , at least two hemispherical channels  38   b  at opposing ends of the channeled bone plate  30 , or multiple hemispherical channels  38   b  intermittently spaced along the length of the channeled bone plate  30 , as may be needed to provide adequate splinting of fractured sections of the bone  12 . In another embodiment, the channeled bone plate  30  may include a combination of the bell-curve channels  38   a  and the hemispherical channels  38   b . Here, the bell-curve channels  38   a  and the hemispherical channels  38   b  may alternate along the length of the channeled bone plate  30 . Of course, the channeled bone plate  30  could include various combinations of the channels  38   a ,  38   b , depending on the specific needs of the surgery. In general, for example,  FIGS. 5-6  illustrate an embodiment wherein the channeled bone plate  30  includes four of the channels  38  and  FIGS. 8 and 14-15 and 18  illustrate another embodiment wherein the channeled bone plate  30  includes two of the channels  38 . In another alternative embodiment, the bell-curve channels  38   a  and/or the hemispherical channels  38   b  may be combined together or alone with other variously shaped channels  38  designed to accommodate reception and retainment of one or more cables  16 . In this respect, the cables  16  and/or the channels  38  may be virtually any shape known in the art. 
     Importantly, the channel  38  should be of a size and shape that fully accommodates slide-fit reception of the cable  16  when wrapped around fractured sections of the bone  12  (e.g., as shown in  FIGS. 14-15 and 19 ). The cables  16  are preferably 1.02 millimeters to 2.0 millimeters in diameter. Although, the cables  16  may be any diameter known in the art capable for use in combination with the channeled bone plate  30  to repair a bone fracture. For example, to accommodate the cable  16 , the channel  38  is preferably a substantially elongated channel (i.e., longer than it is wide) formed transverse to the elongated channeled bone plate  30 . Although, the channel  38  may be any size that allows the channeled bone plate  30  to fit flush against the bone  12 . Narrower channels  38  advantageously increase direct contact between the channeled bone plate  30  and the bone  12 , thereby increasing support. Although, if the width of the channel  38  is too small, i.e. smaller than the diameter of the cable  16 , the cable  16  may not adequately fit into the channel  38  and the channeled bone plate  30  may not mount flush with the bone  12 , thereby decreasing the overall support provided by an implanted channeled bone plate  30 . Therefore, for the channeled bone plate  30  to provide maximum support, the channel  38  should be narrow enough to allow sufficient direct contact between the channeled bone plate  30  and the bone  12  to adequately brace the bone  12 , yet be wide enough to fully accommodate the cable  16  so both the channeled bone plate  30  and the cable  16  are flush with the bone  12  after implantation. 
     The channels  38  are notably different than and advantageous over the buttons  14  used with the buttoned bone plate  10  ( FIG. 2 ) and the tunnels  26  used with the tunneled bone plate  24  ( FIGS. 3 and 4 ) because the channeled bone plate  30  is able to sit flush over the cables  16 , thereby surrounding the exterior surface of the cables  16  (i.e., the portion of the cable  16  not sitting flush against the surface of the bone  12 ), which eliminates the undesirable gaps  22  or  28  created as a result of implanting the buttoned bone plate  10  or the tunneled bone plate  24 . That is, mounting the cable  16  to a portion of the bone plate biases the cable  16  away from the surface of the bone  12 , thereby preventing full flush mounting. The channeled bone plate  30  advantageously provides increased direct surface area contact with the bone  12 , as compared to the buttoned bone plate  10  and/or the tunneled bone plate  24 . Since there is a portion of the buttoned bone plate  10  or the tunneled bone plate  24  between the cable  16  and the bone  12 , the buttons  14  or the tunnels  26  prevent direct contact between the cable  16  and the outer circumference of the bone  12 . Accordingly, the channels  38  in the channeled bone plate  30  eliminate the undesirable gaps  22 ,  28  to allow the full circumference of the bone  12  to optimally be in direct contact with the cable  16 . Therefore, the channeled bone plate  30  provides more support to the bone  12  than the buttoned bone plate  10  or the tunneled bone plate  24 . The surface area contact between the channeled bone plate  30  and the bone  12  lost because of the channels  38  is relatively negligible when compared to the buttoned bone plate  10  and the tunneled bone plate  24 , for purposes of providing support in splinting fractured sections of the bone  12 . In fact, wrapping the cables  16  directly around the bone  12  and mounting the channeled bone plate  30  flush with the bone  12  provides enhanced support relative to the bone plates  10 ,  24 . 
     More specifically, the channeled bone plate  30  is able to achieve greater support than the prior art because the channeled bone  30  plate allows both the cable  16  and the channeled bone plate  30  to be in their respective optimal positions, i.e., the channeled bone plate  30  and the cables  16  both sit flush with the surface of the bone  12 , thereby supporting the bone  12  to the greatest possible extent. The cable  16  is wrapped tightly around the bone  12  without the relatively large gaps (numerals  22  and  28  in  FIGS. 2 and 4 , respectively) created by the buttoned bone plate  10  and the tunneled bone plate  24 . When in this position, the cable  16  provides the most support for the bone  12 . Similarly, the bone plate provides the most support when in direct contact with the bone  12  (e.g., as shown in  FIGS. 14-15 and 18 ). The channels  38  allow the channeled bone plate  30  to be in direct contact with the bone  12  unlike the prior art where a non-channeled bone plate is implanted on top of the cables  16 , thereby creating large gaps between the bone plate  10  or  24  and the bone  12 . Therefore, even though the amount of direct contact between the channeled bone plate  30  and the bone  12  is somewhat reduced by the channels  38 , the support provided by the channeled bone plate  30  is increased since the channeled bone plate  30  and the cables  16  are in their ideal positions. 
     With respect to the methods disclosed herein,  FIG. 11  illustrates one method ( 100 ) for implanting the channeled bone plate  30  after implanting the cables  16 . The steps of this method ( 100 ) are more specifically shown and described below with respect to  FIGS. 12-16 . In this respect, the first step is to correctly align the broken bone fragments with respect to one another ( 102 ). This is typically accomplished with a clamp  42  ( FIG. 12 ) or other pliers-like device or surgical tool that squeezes the fragments of the bone  12  back into proper alignment. For example,  FIG. 12  illustrates the clamp  42  holding fragments of the bone  12  such that a fracture line  44  is visible when the fractured sections of the bone  12  are in proper alignment and ready for implantation of the channeled bone plate  30  and/or the cable(s)  16 . 
     As shown in  FIG. 11 , the next step is to wrap one or more of the cables  16  around the fractured portions of the bone  12  in and around the fracture line  44  ( FIG. 12 ) in accordance with step ( 104 ). In this embodiment, the cables  16  hold the fractured pieces of the bone  12  in proper alignment before implanting the channeled bone plate  30 , and to facilitate healing. Preferably, the cables  16  wrap tight and flush to the surface of the bone  12  in the manner generally shown best in the cross-sectional view of  FIG. 16 . This, in turn, minimizes and preferably eliminates any gaps between the bone  12  and the cables  16 , as are existent with the buttoned bone plate  10  and the tunneled bone plate  24 , to the extent the gaps can be eliminated since the bone  12  may not be perfectly cylindrical. Importantly, however, these gaps are substantially relatively smaller than the gap  22  ( FIG. 2 ) and the gap  28  ( FIG. 4 ) created by the prior art bone plates  10  and  24  by way of bone plate material interference. During step ( 104 ), the cables  16  may be initially wrapped loosely around the bone  12 , thereby allowing the cables  16  to slide longitudinally along the length of the bone  12  for purposes of alignment. Once the cables  16  are positioned as desired, the cables  16  are pulled tight to hold the fractured sections of the bone  12  together so the clamp  42  may be removed without the fractured sections separating. In other words, the cables  16  preferably maintain the bone  12  in the position generally shown in  FIG. 12 , without losing the fracture line  44 . Accordingly,  FIG. 13  shows the bone  12  after implantation of the cables  16  and removal of the clamp  42 . 
     The next step as shown in  FIG. 11  is to place the channeled bone plate  30  over the fractured portion of the bone  12  in accordance with step ( 106 ). The channeled bone plate  30  is aligned with the already wrapped cables  16  for insertion into respective channels  38  formed from the bottom surface  32  of the channeled bone plate  30 , in accordance with step ( 108 ). The channels  38  allow the channeled bone plate  30  to sit flush against the bone  12 , as described above. As shown in  FIG. 14 , and in accordance with steps ( 110 ) and ( 112 ) in  FIG. 11 , once the channeled bone plate  30  is correctly aligned with the cables  16 , one or more screws  46  are inserted into respective screw holes  34  ( FIGS. 5 and 7 ) to secure the channeled bone plate  30  to the bone  12 .  FIG. 15  illustrates the bone  12  after implantation of both the channeled bone plate  30  and cables  16 . Furthermore, as illustrated in  FIG. 16 , the channeled bone plate  30 , unlike the prior art bone plates  10  and  24  described above, permits flush mounting of the cables  16  to the exterior surface of the bone  12 . 
       FIG. 17  is an alternative flow chart illustrating another method ( 200 ) for implanting the channeled bone plate  30  prior to implanting the cables  16 . Here, the first step ( 202 ) is to align fractured sections of the bone  12  using the clamp  42 , similar to step ( 102 ) described above with respect to  FIGS. 11  and  12 . The next step is to place the channeled bone plate  30  on top of the bone  12 , in accordance with step ( 204 ). The position of the channeled bone plate  30  may be adjusted until the channels  38  ( FIGS. 5-6 and 8-10 ) are positioned where the cables  16  are intended to be implanted. In this method ( 200 ), the next step is to insert the bone screws  46  into the screw holes  34  and secure the channeled bone plate  30  to the bone  12 , similar to the step described above with respect to step ( 110 ) in  FIG. 11 , and as shown in  FIG. 14 . The screws  46  may then be tightened ( 208 ) to more fully secure the channeled bone plate  30  to the bone  12 . The next step is to slide a cable  16  through each respective channel  38  in accordance with step ( 210 ) in  FIG. 17 , and as illustrated in  FIG. 18 . This step is different than the method ( 100 ) as it requires threading the cable  16  through a channel  38  in the already implanted and screw mounted channeled bone plate  30 . To this end,  FIG. 15  illustrates the channeled bone plate  30  after implantation of both the channeled bone plate  30  and the cables  16 . Similarly,  FIG. 16  illustrates the flush mounting between the cable  16  and the bone  12  via the channels  38  ( FIGS. 5-6 and 8-10 ) in the channeled bone plate  30 . 
     Although several embodiments have been described in detail for purposes of illustration, various modifications may be made without departing from the scope and spirit of the invention. Accordingly, the invention is not to be limited, except as by the appended claims.