Patent Publication Number: US-2017348030-A1

Title: Orthopedic plate, orthopedic device, method of coupling bone segments, and method of assembling an orthopedic plate

Description:
CLAIM OF PRIORITY 
     This patent application is a continuation-in-part of U.S. patent application Ser. No. 15/358,439, filed on Nov. 22, 2016; which is a continuation of U.S. patent application Ser. No. 13/767,462 filed on Feb. 14, 2013 and issued as U.S. Pat. No. 8,778,000 on Jul. 15, 2014; which is a continuation of U.S. patent application Ser. No. 13/708,213 filed on Dec. 7, 2012 and issued as U.S. Pat. No. 9,522,023 on Dec. 20, 2016; which claims the benefit of priority under 35 U.S.C. §119(e) of U.S. Provisional Patent Application No. 61/569,052 filed Dec. 9, 2011; each of which is hereby incorporated by reference herein in its entirety. 
    
    
     TECHNICAL FIELD 
     The present disclosure relates generally to devices for and methods of repairing bones and/or bone joints and methods of assembling said devices. More specifically, the disclosure relates to an orthopedic plate or an orthopedic device for coupling bone segments, a method of doing the same, and a method of assembling an orthopedic plate. 
     BACKGROUND 
     The statements in this section merely provide background information related to the present disclosure and may not constitute prior art. 
     When treating bone fractures, where a single bone is broken into two or more bone segments, a medical professional often desires to promote union between the two or more bone segments. The same is the case when a medical professional desires to cause or help to cause bone fusions, i.e., uniting two bones into one bone by eliminating a joint there between. When promoting union of two or more bone segments via standard biologic healing, whether the bone segments are pieces of a single bone or whether the bone segments are separate bones, it is often desirable to have precise alignment of bone segments and complete or substantially complete contact between the involved surfaces. 
     Alignment of the bone segments is desirable not only to enhance a union of bone segments, but also to prevent or reduce the likelihood of subsequent deformity following union. If malalignment is created at the time of fracture fixation, the ability of the bones to heal may be compromised and, if union is achieved, an alteration in force distribution may occur across formerly precisely balanced joints that may lead to increased contact stresses and subsequent arthritis. Joints often require precise balance to prevent portions of the cartilage from accelerated wear (wearing away the cartilage with repetitive cycles of loading), which may lead to early onset arthritis. 
     Thus, under the above-mentioned circumstances, the ability of the medical professional to achieve an outcome that both the patient and clinician approve of is often directly related to the quality of the reduction of the bone segments. 
     Traditionally, medical professionals, such as orthopedic surgeons, use plate fixation to hold the various bone segments into the correct position while they heal. 
     The plates themselves are typically primarily alignment devices. While they may provide some element of structural support, if the fracture or fusion does not heal (nonunion), the plate and screw construct often eventually fails due to cyclic loading. 
     Dynamic compression plates have been used by medical professionals to attempt to promote biologic healing by creating a more complete and flush bond between bone segments. One type of dynamic compression plate includes oblong, rather than circular, holes to allow the medical professional to compress the fracture/fusion site by placing the screw against the side of the hole that is farthest from the fracture/fusion site. This type of compression plate is utilized with fasteners, such as screws, having a cone-shaped head with its largest diameter at the top of the fastener head. As the medical professional tightens the screw against the plate, the screw head engages the far end of the plate screw hole. Then, as the medical professional continues to tighten the fastener, the cone-shaped fastener head pushes the plate in a direction away from the fracture/fusion site as long as two conditions are met: (1) the bottom side of the plate is in contact with the bone to prevent the plate from moving downward as the fastener moves downward, and (2) the other end of the plate is secured to the bone on the opposite side of the fracture/fusion site. 
     The first of the above-mentioned conditions, namely that the bottom side of the plate is in contact with the bone while the fastener is being driven downward into the bone, may diminish the plate&#39;s effectiveness or render the plate unusable with bones that are not relatively flat. For example, as the medical professional tightens a fastener and causes the plate to contact an uneven bone surface, the bone may become distorted or otherwise damaged. Distortion of the fracture or fusion site may alter the alignment of said site or may limit the contact surface area between the bone segments. In either case, the desired goal of anatomic restoration of the bone or fusion site with maximal surface area available for healing may not be achieved. As a result, this type of dynamic compression plate may be undesirable for use with curved or uneven bone surfaces. 
     This type of dynamic compression plate may also be undesirable because the amount of compression is dependent on the screw height. In other words, the position of the plate along a first axis is dependent on the position of the fastener along a second axis that is generally perpendicular to the first axis. The dependent relationship between the plate and the screw height may not be desirable because it may prevent the medical professional from creating a desired compression force acting on the bone segments while the fasteners are at their desired positions. 
     Therefore, it is desirous to provide an orthopedic plate, device, or method that can be used with bone segments having various shapes while allowing dynamic compression of multiple bone segments and/or that can be used to create a desired compression force acting on the bone segments while the fasteners are at their desired positions. 
     Overview 
     In overcoming the limitations and drawbacks of the prior art, the present orthopedic plate, device, and methods facilitate and/or provide dynamic compression between multiple bone segments. 
     In one aspect, an orthopedic plate is provided, comprising a frame portion, and a bearing rotatably coupled with the frame portion, wherein the bearing defines an opening configured to receive a fastener for fastening the orthopedic plate to a body, wherein the bearing includes an outer surface that is eccentric to the opening such that a position of the opening with respect to the frame portion is adjustable as the bearing rotates, and wherein the bearing includes at least a first ridge that is an anchoring ridge and a second ridge that is a locking ridge. 
     The anchoring ridge may have an inner diameter that is smaller than an inner diameter of the locking ridge. Furthermore, the anchoring ridge may be configured to mate with a first set of fastener threads and the locking ridge is configured to mate with a second set of fastener threads. The bearing may be configured to expand in diameter when the second set of fastener threads is received within the locking ridge. 
     The anchoring ridge may be configured to mate with a first set of fastener threads and the locking ridge is configured to receive a locking head. The bearing may be configured to expand in diameter when the locking head is received within the locking ridge. 
     The orthopedic plate may also include a second bearing rotatably coupled with the frame portion, wherein the second bearing defines a second opening configured to receive a second fastener for further fastening the orthopedic plate to a body, wherein the second bearing includes an outer surface that is eccentric to the second opening. 
     In another aspect an orthopedic plate is provided, having a frame portion and a bearing rotatably coupled with the frame portion, wherein the bearing defines an opening configured to receive a fastener for fastening the orthopedic plate to a body, wherein the bearing includes an outer surface that is eccentric to the opening such that a position of the opening with respect to the frame portion is adjustable as the bearing rotates and wherein the bearing includes at least one key hole to facilitate rotation of the bearing with respect to the frame portion. 
     The bearing may include at least two key holes to facilitate rotation of the bearing with respect to the frame portion. The bearing may also be configured to facilitate rotation of the bearing with respect to the frame portion while the fastener is received within the opening. 
     In one aspect, an orthopedic plate is provided, comprising a frame portion that can comprise a longitudinal body defining a longitudinal axis, wherein at least one side arm extends outward from the longitudinal body. A bearing can be rotatable coupled with the side arm, wherein the bearing defines an opening configured to receive a fastener for fastening the orthopedic plate to a body. The bearing is rotatable about a rotational axis, wherein the opening is offset from the rotational axis such that a position of the opening with respect to the side arm and the longitudinal axis is adjustable as the bearing rotates. 
     The longitudinal body can have two side arms each having a bearing with an offset opening, wherein a fastener can be inserted through each of the openings to engage one of two bone segments separated by a fracture. The longitudinal body can be laid across the two bone segments such that one of the two side arms is positioned against each bone segment on either side of the fracture. In this configuration, each of the side arms is operably connected to one of the two bone segments by a corresponding fastener, wherein the longitudinal body operably joins the two bone segments via the connection to each bone segment by the corresponding side arm and fastener. 
     The bearings can be rotated to draw the two bone segments together into engagement and close the gap defining the fracture. Each fastener can be inserted into the corresponding bone segment along an axis parallel to the ends of the bone segments defining the fracture such that rotation of the bearings can apply a compression force along the length of the fastener toward the fracture. In an example, the offset arrangement of the two side arms can cause greater compression forces at the edges of the contact surfaces between the two bone segments such as at the compact bone and/or periosteum of the bone. As certain bones or bone segments are hollow with the most rigid portion of the bone being the compact bone, the offset arrangement places the greatest compression force at those regions of the contact surfaces thereby improving the joining of the bones. 
     The side arms can be positioned to extend from opposite sides of the longitudinal body. The fastener of the first side arm engages the first bone segment on a first side of the longitudinal axis and the fastener of the second side arm engages the second bone segment on a second side of the longitudinal axis. In this configuration, rotating the bearings of the first and second bone segments moves the first and second bone segments into engagement along the fracture and applies compression pressure to the joined first and second bone segments from at least two opposing sides to the longitudinal axis, which more evenly joins the bone segments across the fracture. 
     The longitudinal body can be laid across the two bone segments and can comprise a planer body defining a plane. The side arms can extend from the longitudinal body along an axis transverse to the plane of the longitudinal body. In an embodiment, the side arms can be angled relative to the longitudinal body along mirrored or different axes to conform to the contour of the first or second bone segment. The fastener of the first side arm is inserted into the first bone segment along a first axis and the fastener of the second side arm is inserted into the second bone segment along a second axis transverse to the first axis. The fasteners can each extend through the first and second bone segments such that the fasteners apply compression force toward the fracture across the entire fracture along first and second axis. The transverse angle of the first axis to the second axis more evenly applies compression pressure across the face of the fracture. 
     In yet another aspect, an orthopedic device is provided, configured to facilitate cutting at least one of first and second bone segments of a body and comprising a jig configured to be secured to the first and second bone segments of the body and a cutting guide coupled with the jig, wherein a position of the cutting guide with respect to the jig is adjustable along a first axis. 
     In another aspect, an orthopedic device is configured to facilitate coupling first and second bone segments of a body and comprising a jig having a first arm configured to be secured to the first bone segment, a second arm configured to be secured to the second bone segment, and a jig adjustment mechanism configured to adjust the position of the first arm with respect to the second arm to adjust a distance between the first and second bone segments. 
     In yet another aspect, a method of coupling first and second bone segments of a body is provided, comprising coupling a first arm of a jig with the first bone segment and coupling a second arm of the jig with the second bone segment, coupling a cutting guide with the jig to facilitate cutting at least one of the first and second bone segments, cutting at least one of the first and second bone segments, decoupling the cutting guide from the jig, coupling a plate holding mechanism with the jig, coupling an orthopedic plate with the plate holding mechanism, adjusting the plate holding mechanism so as to move the orthopedic plate into a desired position with respect to the first and second bone segments, securing a first portion of the orthopedic plate to the first bone segment and securing a second portion of the orthopedic plate to the second bone segment, adjusting at least one of the following: a position of at least one of the first and second arms of the jig so as to adjust a distance between the first and second bone segments and a plate adjusting mechanism to adjust a distance between the first and second bone segments. 
     Further objects, features and advantages of the orthopedic plate, device, and method will become readily apparent to persons skilled in the art after a review of the following description, with reference to the drawings and claims that are appended to and form a part of this specification. 
     This overview is intended to provide an overview of subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive explanation of the present subject matter. The detailed description is included to provide further information about the present patent application. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document. 
         FIG. 1  shows an isometric view of an orthopedic device embodying principles of the present disclosure and having a jig with first and second arms and an orthopedic plate: 
         FIG. 2  is a top view of the orthopedic device shown in  FIG. 1 ; 
         FIG. 3  is a front view of the orthopedic device shown in  FIG. 1 ; 
         FIG. 4  is a side view of the orthopedic device shown in  FIG. 1 ; 
         FIG. 5 a    is a top view of the orthopedic plate shown in  FIG. 1  where first and second bearings of the orthopedic plate are each in a non-compressed position; 
         FIG. 5 b    is a top view of the orthopedic plate shown in  FIG. 1  where the first and second bearings of the orthopedic plate are each in a compressed position; 
         FIG. 6  is a cross-sectional view of the orthopedic plate shown in  FIG. 5 b    taken along line  6 - 6 ; 
         FIG. 7  is an isometric view of an alternative embodiment of an orthopedic device coupled with first and second bone segments of a patient&#39;s body; 
         FIG. 8  shows the orthopedic device shown in  FIG. 7 , further including a cutting guide coupled with the jig; 
         FIG. 9  shows the orthopedic device shown in  FIG. 7 , further including a surgical saw received within a slot of the cutting guide; 
         FIG. 10  shows the orthopedic device shown in  FIG. 7 , where portions of the first and second bone segments have been removed to form complimentary bonding surfaces; 
         FIG. 11  shows the orthopedic device shown in  FIG. 7 , where a medical professional is adjusting the position of the jig first arm with respect to the jig second arm, thereby adjusting the position of the first bone segment with respect to the second bone segment; 
         FIG. 12  shows the orthopedic device shown in  FIG. 7 , where the medical professional has adjusted the position of the jig first arm with respect to the jig second arm such that the first and second bone segments are abutting each other; 
         FIG. 13  shows the orthopedic device shown in  FIG. 7  coupled with a plate holding mechanism, where the plate holding mechanism is configured to position an orthopedic plate with respect to the first and second bone segments; 
         FIG. 14  shows the orthopedic device shown in  FIG. 7 , further including drill guides coupled with the orthopedic plate and where the medical professional is drilling along the drill guides and into the first and second bone segments; 
         FIG. 15  shows the orthopedic device shown in  FIG. 7 , where a medical professional is securing the orthopedic plate to the first and second bone segments; 
         FIG. 16  shows the orthopedic plate shown in  FIG. 15 , where the jig and orthopedic plate holding mechanism have been decoupled from the orthopedic plate; 
         FIG. 17  shows an isometric view of the orthopedic plate shown in  FIG. 15  and a plate adjustment mechanism configured to mate with the orthopedic plate and adjust the position of bearings therein; 
         FIG. 18A  shows an isometric view of the orthopedic plate and plate adjustment mechanism shown in  FIG. 17 , where the orthopedic plate and plate adjustment mechanism are mated with each other; 
         FIG. 18B  shows an isometric view of an orthopedic plate and a plate adjustment mechanism configured to mate with the orthopedic plate and adjust the position of bearings therein, the plate adjustment mechanism having a fastener port for turning the fastener with the plate adjustment mechanism coupled to the orthopedic plate; 
         FIG. 19  shows an isometric view of the underside of the bearing for the orthopedic plate shown in  FIG. 17 ; 
         FIG. 20  shows the bearing being coupled with the orthopedic plate frame; 
         FIG. 21  shows the bearing coupled with the orthopedic plate frame; 
         FIG. 22  shows a fastener configured to couple an orthopedic plate to one or more bone segments, wherein the fastener includes first and second threads; 
         FIG. 23  shows an alternative embodiment of an orthopedic plate embodying principles of the present disclosure; 
         FIG. 24  is another alternative embodiment of an orthopedic plate embodying principles of the present disclosure; 
         FIG. 25  is a fastener coupled with the orthopedic plate shown in  FIG. 24 ; 
         FIG. 26  is a cross-sectional view of the orthopedic plate shown in  FIG. 24  taken along line  26 - 26 ; 
         FIG. 27  is an alternative embodiment of a fastener configured to couple an orthopedic plate to one or more bone segments; 
         FIG. 28  is an isometric view of an orthopedic plate embodying principles of the present disclosure; 
         FIG. 29A  is a top view of the orthopedic plate shown in  FIG. 28  prior to adjustment of the orthopedic plate to draw a first bone segment and a second bone segment together; 
         FIG. 29B  is a top view of the orthopedic plate shown in  FIG. 28  after adjustment of the orthopedic plate to draw the first bone segment and the second bone segment together; 
         FIG. 30  is a longitudinal view of the orthopedic plate shown in  FIG. 28 ; 
         FIG. 31A  is a side view of the orthopedic plate shown in  FIG. 28  prior to adjustment of the orthopedic plate to draw a first bone segment and a second bone segment together; 
         FIG. 31B  is a side view of the orthopedic plate shown in  FIG. 28  after adjustment of the orthopedic plate to draw the first bone segment and the second bone segment together. 
     
    
    
     DETAILED DESCRIPTION 
     The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or uses. 
     Referring now to the drawings,  FIG. 1  shows an orthopedic device  10  for coupling bone segments of a patient&#39;s body. The orthopedic device  10  includes a jig  12 , an orthopedic plate  14 , and a plate holding mechanism  16 . Although these components are shown being used with each other, many or all of the components may be used independently of each other. For example, a medical professional may choose to use the orthopedic plate  14  without using the jig  12  or may choose to use the jig  12  with another orthopedic plate or another device altogether. 
     The jig  12  shown in the figures is coupled with the patient&#39;s body to facilitate installation of the orthopedic plate  14 . The jig  12  shown in the figures includes a first portion  18  having a first arm  20  that is able to be coupled with the patient&#39;s body and a second portion  22  having a second arm  24  that is also able to be coupled with the patient&#39;s body. 
     For example,  FIG. 7  shows a patient&#39;s body  26 , particularly a patient&#39;s foot, having a first bone segment  28  and a second bone segment  30  that have been separated via a fracture  32 . In the embodiment of the jig  12  shown in  FIG. 7 , the first and second arms  20 ,  24  each have two fastener holes  21   a ,  21   b ,  23   a ,  23   b  that may be used to secure the jig  12  to the bone segments, whereas the first and second arms  20 ,  24  of the jig  12  shown in  FIG. 1  each include one fastener hole  25   a ,  25   b . Although the figures focus on the foot portion of the patient&#39;s body  26 , the present disclosure may be used with any suitable portion of a patient&#39;s body, such as the hands, ankles, wrists, legs, arms, oral or maxillofacial areas, or any other portion of a patient&#39;s body. The patient shown in the drawings is human, but the devices and methods disclosed herein may also be used on animals, such as through veterinarian medicine, and thus the term “medical professional” includes all types of medicine, including veterinarian medicine. 
     Referring to  FIG. 7-16 , although these figures show first and second bone segments  28 ,  30  of a metatarsal bone that have been separated via a fracture  32 , the present disclosure may be used with any suitable injury, condition, disease, malady, or weakness to a patient&#39;s body, such as a fracture, fusion, crack, or damaged joint. The term “bone segments” may refer to two portions of a single bone or two different bones. The metatarsal bone shown in the figures is, for illustrative purposes, longer and extends more proximal than a typical metatarsal bone in a normal adult patient. Also, for illustrative purposes, other bones of the patient&#39;s foot are not shown. If the jig  12  was used for a fusion application, rather than a fracture, in a similar area of a patient&#39;s foot, then the first and second arms of the jig likely would be secured to a metatarsal distally and a cuneiform proximally. However, as discussed above, the orthopedic device  10  may be used with any suitable bone segments. 
     Referring to  FIGS. 1-4 , the second portion  22  of the jig  12  is slidably received within the first portion  18  so that the respective portions  18 ,  22  are movable with respect to each other. The first and second portions  18 ,  22  shown in the figures further include a jig adjustment mechanism  34  and a locking key  36  for adjusting a distance  38  between the first arm  20  and the second arm  24  of the jig  12 . The locking key includes a locked position  36   a  ( FIGS. 1-4, 8-10, 12-15 ), in which the first and second portions  18 ,  22  of the jig  12  are movable with respect to each other, and an unlocked position  36   b  ( FIGS. 7 and 11 ), in which the first and second portions  18 ,  22  of the jig  12  are not movable with respect to each other. The jig  12  shown in the figures also includes a gear  40  and track  42 , such as a rack and pinion, that cooperate to define the jig adjustment mechanism  34 , but any other suitable adjustment mechanism may be used. The gear  40  in the figures is located within a cavity defined by the jig first portion  18  and is accessible from outside the jig  12  via a key hole  44  in the jig  12 . The orthopedic device  10  further includes an adjustment key  46  ( FIGS. 4, 11 ) configured to be inserted into the key hole  44  ( FIGS. 2, 8-10 ) and rotate the gear  40 , thereby adjusting the distance  38  between the first and second arms  20 ,  24 . When the jig  12  is coupled with the first and second bone segments  28 ,  30 , by turning the adjustment key  46 , a medical professional is able to adjust the relative position of the first and second bone segments  28 ,  30  with respect to each other. As a result, a medical professional is able to use the jig  12  to cause the first and second bone segments to dynamically compress, or cause the bone segments  28 ,  30  to come into contact with each other, and potentially promote biological healing. 
     As best shown in  FIGS. 1 and 2 , the plate holding mechanism  16  is coupled to the jig  12  via a tab-slot connection  48  and securing pin  50  ( FIG. 2 ) which secures the tab-slot connection  48 . The plate holding mechanism  16  further includes a vertical adjustment mechanism  52  configured to adjust the position of the orthopedic plate  14  along a y-axis  54  ( FIG. 1 ). For example, the vertical adjustment mechanism  52  shown in the figures includes a tab-slot connection  56  and securing pin  58  securing the tab-slot connection  56  ( FIG. 1 ). The plate holding mechanism  16  further includes a horizontal adjustment mechanism  60  configured to adjust the position of the orthopedic plate  14  along an x-axis  62  ( FIG. 1 ). For example, the horizontal adjustment mechanism  60  shown in the figures includes a tab-slot connection  64  and securing pin  66  securing the tab-slot connection  64  ( FIG. 1 ). By using the vertical adjustment mechanism  52  and the horizontal adjustment mechanism  60 , a medical professional is able to adjust the position of the orthopedic plate  14  with respect to the first and second bone segments  28 ,  30  so as to properly align the orthopedic plate  14  before coupling it with the bone segments  28 ,  30 . In an alternative embodiment, the vertical adjustment mechanism and the horizontal adjustment mechanism include gear and track mechanisms such as the rack and pinion mechanism discussed with respect to the jig adjustment mechanism  34 . 
     As is best shown in  FIGS. 5 a  and 5 b   , the orthopedic plate  14  includes a frame portion  68  and first and second plate adjustment mechanisms  78 ,  79  that are each configured to adjust a distance  80  ( FIG. 16 ) between first and second fasteners  74 ,  76  ( FIGS. 15, 16 ), respectively. The plate adjustment mechanisms  78 ,  79  shown in the figures include a first bearing  84  that is rotatable with respect to the frame portion  68  and a second bearing  86  that is rotatable with respect to the frame portion  68 . 
     The orthopedic plate  14  shown in the figures defines a first opening  70  and a second opening  72  that are configured to receive the first and second fasteners  74 ,  76 , to couple the orthopedic plate  14  to the first and second bone segments  28 ,  30 . The distance  80  is measured at the center of each of the fasteners  74 ,  76  and is therefore, in the embodiments shown in the figures, the same distance as that measured from the respective centers of each of the openings  70 ,  72  ( FIGS. 5 a , 5 b   ). 
     As best shown in  FIGS. 5 a , 5 b   , and  6 , the first and second bearings  84 ,  86  each include two annular ridges: a anchoring ridge  65  and a locking ridge  67 . The anchoring ridge  65  defines the opening  70 ,  72  in each of the bearings  84 ,  86 . As best shown in  FIG. 22 , the fasteners  74 ,  76  each include two sets of threads: anchoring threads  69 ,  73  and locking threads  71 ,  75 . The anchoring threads  69 ,  73  are configured to mate with the anchoring ridges  65  in the first and second bearings  84 ,  86 , respectively, while the fasteners  74 ,  76  are being screwed into the bone segments  28 ,  30 . The locking threads  71 ,  75  are configured to mate with the locking ridge  67  when the fasteners  74 ,  76  are substantially or completely screwed down into the bone segments  28 ,  30  so as to prevent the bearings from rotating with respect to the plate portion  68 . More specifically, the diameter of the locking threads  71 ,  75  is sized so as to cause the bearings  84 ,  86  to expand and form a friction engagement with the plate portion  68 . The bearings  84 ,  86  are able to rotate with respect to the plate portion  68  except when the locking threads  71 ,  75  cause the bearings  84 ,  86  to expand and form a friction engagement with the plate portion  68 . The locking feature of the fasteners  74 ,  76  make ti easier and more effective for the medical professional to “float” the orthopedic plate  14  above the bone segments  28 ,  30  (i.e., to space the plate  14  apart from the bone segments  28 ,  30 ). The locking feature of the fasteners  74 ,  76  also may improve or stabilize the connection between the bone segments  28 ,  30 , even when a jig  12  is not being used. The locking feature also prevents or minimizes undesired rotation the bearings  84 ,  86  after the plate  14  has been installed. 
     Referring to  FIGS. 5 a  and 5 b   , the bearings  84 ,  86  each include an outer surface  88 ,  90  that is eccentric to the inner surface (e.g., the anchoring ridge  65 ) of the bearing  84 ,  86 . In other words, the outer surface  88 ,  90  of the bearings  84 ,  86  and the anchoring ridge  65  each generally define circles that have different centerpoints. As a result, the distance  80  is adjusted as one of the bearings  84 ,  86  is rotated with respect to the frame portion  68 . A medical professional is able to use the orthopedic plate  14  to cause the first and second bone segments  28 ,  30  to dynamically compress, or cause the bone segments  28 ,  30  to come into contact with each other, and potentially promote biological healing. 
     The plate adjustment mechanism  78  shown in the figures is configured to be able to adjust the distance  80  while the orthopedic plate  14  is spaced apart from at least one of the first and second bone segments  28 ,  30 , as is measured generally along a fastener axis  82  ( FIG. 15 ). In other words, the orthopedic plate  14  does not need to abut the bone segments  28 ,  30  to be able to adjust the distance  80 , thereby permitting dynamic compression of the bone segments  28 ,  30  while minimizing, reducing, or avoiding distortion to the bone segments  28 ,  30  by the orthopedic plate  14 . Utilizing the orthopedic plate  14  in this manner may be particularly advantageous where the bone segments  28 ,  30  are uneven along the length of the orthopedic plate  14 . However, the orthopedic plate  14  is also usable and adjustable when it is abutting the bone segments  28 ,  30 . In some cases, such as where the bone segments  28 ,  30  are relatively flat, it may be desirable for the orthopedic plate  14  to abut the bone segments  28 ,  30 . 
     As is illustrated in  FIGS. 5 a  and 5 b   , the distance  80  is largest (and the orthopedic plate  14  offers the least amount of compression) when the first and second bearings  84 ,  86  are each rotated such as to be in a non-compressed position  94  (i.e., where the centerpoints of the first and second bearings  84 ,  86  are furthest from each other). Conversely, the distance  80  is smallest (and the orthopedic plate  14  offers the maximum amount of compression) when the first and second bearings  84 ,  86  are each rotated such as to be in a compressed position  96  (i.e., where the centerpoints of the first and second bearings  84 ,  86  are closest to each other). Each of the first and second bearings  84 ,  86  defines a compression adjustment distance  98 . The compression adjustment distance  98  is the distance measured along the longitudinal axis of the orthopedic plate  14  between the centerpoint of a bearing in the non-compressed position  94  and the compressed position  96 . The distance  80  is therefore adjustable by an amount equal to the compression adjustment distance  98  of the first bearing  84  plus the compression adjustment distance  98  of the second bearing  86 . In the embodiment shown in  FIGS. 5 a  and 5 b   , the orthopedic plate  14  has a compression adjustment distance of approximately 1.5 millimeters, thereby allowing a medical professional to adjust the distance  80  of the orthopedic plate  14  by approximately 3.0 millimeters. 
     Another advantage to the orthopedic plate  14  shown in  FIGS. 5 a  and 5 b    is that it allows a medical professional to adjust a horizontal distance (i.e., the distance  80 ) of the first and second fasteners  74 ,  76  independently of a vertical positioning (i.e., the position of the fasteners  74 ,  76  along the fastener axis  83 ) of the first and second fasteners  74 ,  76 . This configuration allows a medical professional to have more control over the position (both horizontally and vertically) of the orthopedic plate  14  when coupling the same with the first and second bone segments  28 ,  30 . 
     The orthopedic device  10  shown in the figures also includes a cutting guide  100  coupled with the jig  12  and configured to guide a surgical saw  102  or other cutting instrument. For example, the cutting guide  100  has a pair of cutting slots  104 ,  106  configured to receive the surgical saw  102  and allow a medical professional to cut through the bone segments  28 ,  30  in a relatively straight line by following the slots  104 ,  106 . Often times, a medical professional will desire or need to cut opposing faces of bone segments  28 ,  30  so as to create two complimentary surfaces that will easily and effectively achieve a union through normal biological healing. It is often advantageous for the complimentary surfaces to be flat surfaces that are generally perpendicular to the longitudinal axis of the bone(s). The cutting guide is adjustable along the y-axis  54  ( FIG. 1 ) by way of a tab-slot connection  108  and a securing pin  110  ( FIG. 8 ). The cutting guide is adjustable along the x-axis  62  ( FIG. 1 ) by way of the jig adjustment mechanism  34  ( FIG. 1 ). 
     For illustrative purposes, a method of coupling first and second bone segments  28 ,  30  of a patient&#39;s body  26  is herein described. A medical professional (generally designated by numeral  120  in  FIG. 11 ) makes an incision in the patient&#39;s body  26  and exposes the bone segments  28 ,  30  to be coupled via clamps  122 ,  124 . As shown in  FIG. 7 , the medical professional couples the first arm  20  of the jig  12  with the first bone segment  28  and couples the second arm  24  of the jig  12  with the second bone segment  30  by using fasteners  126 ,  128 . Turning to  FIGS. 8 and 9 , the medical professional then couples the cutting guide  100  with the jig  12  to facilitate cutting at least one of the first and second bone segments  28 ,  30  with the surgical saw  102 . For example, the cutting guide  100  may be coupled with the jig  12  via a setscrew  129  ( FIGS. 2, 9 ) and a dovetailed holding clamp  131  ( FIG. 9 ). The cutting slots  104 ,  106  shown in the figures are approximately 3.0 millimeters apart from each other, but may have any suitable distance therebetween. Also, the medical professional can adjust the distance between the two cuts by making a first cut in the first bone segment  28  and then horizontally adjusting the position of the cutting guide  100  via the securing pin  110 . The medical professional then decouples the cutting guide  100  from the jig  12 . 
     As shown in  FIG. 10 , after cutting the bone segments  28 ,  30  preferably have flat, complimentary surfaces  130 ,  132  that will promote union when said surfaces are compressed together. As shown in  FIG. 11 , with the locking key  36  in the unlocked position  36   b , the medical professional  120  rotates the adjustment key  46  so as to move the first and second arms  20 ,  24  with respect to each other. For example, the medical professional  120  rotates the adjustment key  46  until the bone segments  28 ,  30  are in contact with each other or close to being in contact with each other. The medical professional may also, or alternatively, adjust the distance between the bone segments  28 ,  30  by unlocking the locking key  36  and manually pressing together or pulling apart the first and second portions of the jig  12 . 
     Once the arms  20 ,  24  of the jig  12  are positioned as desired, the medical professional then moves the locking key  36  into the locked position  36   a  ( FIG. 12 ) thereby coupling the plate holding mechanism  16  with the jig  12 . The medical professional can adjust the horizontal or vertical position of the orthopedic plate  14  via the vertical adjustment mechanism  52  and the horizontal adjustment mechanism  60 , respectively. 
     As shown in  FIG. 14 , once the orthopedic plate  14  is in the desired position with respect to the bone segments  28 ,  30 , the medical professional secures drilling guides  134 ,  136  to the orthopedic plate  14  and uses a surgical drill  138  to drill through the drill guides  134 ,  136  and into the bone segments  28 ,  30 . The drilling guides  134 ,  136  shown in the figures are perpendicular to the orthopedic plate  14  and are coupled therewith by a threaded connection. Specifically, the drilling guides  134 ,  136  mate with the locking ridge  67 . The inside diameter of the drilling guides  134 ,  136  corresponds to the diameter of the first and second openings  70 ,  72  (i.e., the diameter defined by the anchoring ridge) to assist with alignment of the drill bit as it creates holes in the bone segments  28 ,  30 . The medical professional then removes the drilling guides  134 ,  136  from the orthopedic plate  14  and, as is shown in  FIG. 15 , secures a first portion of the orthopedic plate  14  to the first bone segment  28  and secures a second portion of the orthopedic plate  14  to the second bone segment  30 . For example, the medical professional shown in  FIG. 15  is securing the orthopedic plate  14  to the bone segments  28 ,  30  via the fasteners  74 ,  76  and a screwdriver  140 . 
     When the fastener heads are flush with the bearings, the bearings outwardly expand, thereby locking the bearings in place with respect to the orthopedic plate frame portion and prevent rotation of the bearing. When the bearing is expanded (and thus locked) it forms an interference fit with the orthopedic plate frame portion, thereby substantially or completely preventing the bearing from back spinning into an uncompressed position under physiologic loads. The bearings  84 ,  86  include bearing key holes  148 ,  150  that facilitate rotation of the bearings  84 ,  86 , as well as facilitate compression of the bone segments  28 ,  30 , as will be described in more detail below. In other words, the first and second bearings  84 ,  86  are configured to facilitate rotation of the bearings with respect to the frame portion  68  while the fasteners  74 ,  76  are received within the first and second openings  70 ,  72 , respectively. 
     Next, the plate holding mechanism  16  is decoupled from the orthopedic plate  14  and the jig is decoupled from the bone segments  28 ,  30 . The medical professional then, if desired, uses the first and/or second plate adjustment mechanisms  78 ,  79  to adjust the distance  80  between the first and second bone segments  28 ,  30 . For example, as shown in  FIGS. 16-18B , the medical professional first loosens the fastener by at least one-half of a turn to unlock the bearing with respect to the frame portion. The medical professional may then use a bearing key  142  to rotate the first and/or second bearings  84 ,  86  with respect to the frame portion  68  of the orthopedic plate  14 . The bearing key  142  shown in the figures includes a first key tooth  144  and a second key tooth  146  that correspond to and fit within the bearing key holes  148 ,  150 , respectively. The bearing key holes  148 ,  150  are spaced apart and shaped so as to permit the medical professional to apply a torque force thereon and rotate the bearings  84 ,  86 , thereby permitting dynamic compression of the bone segments  28 ,  30 . For example, the bearing key holes  148 ,  150  shown in the figures are generally opposite each other on the bearings  84 ,  86 . Additionally, the bearing key holes  148 ,  150  shown in the figures have a generally curved shape to promote a torque force on the bearings  84 ,  86 . 
     The desired distance  80  may vary depending on various circumstances, but it is typically 0.00 to 0.05 millimeters. After rotationally adjusting the bearings and obtaining a desired distance  80  and, if applicable, compression force, the medical professional tightens the fasteners so the fastener heads are flush with the bearings and the bearings are locked with respect to the frame portion. The fastener heads shown in the figures are conical, but they may be flat or any other shape. As best shown in  FIGS. 17 and 18B , the bearing key  142  can define a fastener port  151  for inserting a tightening tool (not shown) through the bearing key  142  to engage the fastener heads and tighten the fastener. The fastener port  151  can be positioned to align with a fastener positioned to engage the first or second bearing when the bearing key  142  is coupled to the first or second bearing  84 ,  86 . In this configuration, the bearing key  142  can remain coupled to the first or second bearing  84 ,  86  while the tightening tool is inserted through the bearing key  142 . 
     As shown in  FIGS. 19-21 , the bearing  84  may be coupled with the frame portion  68  of the orthopedic plate  14  via a spring connection. For example, the bearing has a notch  152  that allows the bearing to act like a C-shaped spring and compress and expand depending on the lateral force applied. The bearing  84  is inserted within a guide sleeve  154  that is coupled with or positioned flush with the frame portion  68  of the orthopedic plate  14 . A punch mechanism  156  pushes down on the bearing  84  and forces it downward in the guide sleeve  154 , until the bearing  84  is in a desired position with respect to the frame portion  68 . For example, in the embodiment shown in the figures, the bearing  84  is in the desired location when an outer surface  85  of the bearing contacts an inner surface  87  of the frame portion  68 . More specifically, in the embodiment shown in the figures, the bearing  84  is in the desired location when it snaps into place in the frame portion  68 . The outer surface  85  of the bearing  84  includes a notch  89  that is configured to mate with a ring  91  in the inner surface  87  of the frame portion  68  to secure the bearing  84  with respect to the frame portion  68 . The guide sleeve  154  shown in the figures includes an inner wall  155  that is tapered inwardly to increase the compression of the bearing  84  as it is forced downward by the punch mechanism  156 . 
     In one alternative embodiment, as shown in  FIG. 23 , an orthopedic plate  214  is provided having a bearing  268  with a first notch  352  in one portion of the bearing  268  and a second notch  356  diametrically opposed to the first notch  352  to alter the spring coefficient of the bearing  268  compared to the bearing shown in the prior figures. The bearing key holes  348 ,  350  are also larger than those shown in the prior figures and define portions of the outer surface of the bearing  268 . 
     In another alternative embodiment, as shown in  FIGS. 24-26 , an orthopedic plate  414  is provided having a frame portion  468  and first and second plate adjustment mechanisms  478 ,  479  that are each configured to adjust a distance between first and second fasteners received within the plate adjustment mechanisms  478 ,  479 . The plate adjustment mechanisms  478 ,  479  shown in the figure include first and second bearing  484 ,  486  that are each rotatable with respect to the frame portion  468 . The frame portion  468  is generally curved along a longitudinal axis  410  so as to match the curvature of a bone. The orthopedic plate  414  also defines openings  412 ,  413 ,  414  for receiving fasteners and thereby further securing the orthopedic plate  414  to the bone. Alternatively, the opening  413  may be used as a connection point to a jig  12  or other device. 
     In one alternative embodiment, as shown in  FIGS. 28-31B , an orthopedic plate  514  can be provided with a frame portion  568  having a longitudinal body defining a longitudinal axis  510 . The longitudinal body can be positioned to extend across a fracture  32  between a first bone segment  28  and a second bone segment  30 . The longitudinal body can comprise a first portion for interfacing with the first bone segment  28 , wherein a first side arm  592 A extends outward from the first portion of the longitudinal body. The longitudinal body can comprise a second portion for interfacing with the second bone segment  30 , wherein a second side arm  592 B extends outward from the second portion of the longitudinal body. In at least one embodiment, the longitudinal body can include at least one fixation opening  599  for receiving a fixation fastener to fixedly secure the longitudinal body to at least one of the first and second bone segments  28 ,  30  after the first and second bone segments  28 ,  30  are rejoined. 
     As best shown in  FIGS. 28 and 31A -B, in an embodiment, the first side arm  592 A can define an opening/port for rotatably receiving a first bearing  584 , the first bearing  584  defining a first opening  570  for receiving a first fastener  574 . The first fastener  574  can be advanced along a first axis  582 A through the first opening  570  to engage the first bone segment  28  and operably secure the first bone segment  28  to the first bearing  584 . Correspondingly, the second side arm  592 B can define an opening/port for rotatably receiving a second bearing  586 , the second bearing  586  defining a second opening  572  for receiving a second fastener  576 . The second fastener  576  can be advanced along a second axis  582 B through the second opening  572  to engage the second bone segment  30  and operably secure the second bone segment  30  to the second bearing  586 . In this configuration, the longitudinal body operates to secure the first bone segment  28  and the second bone segment  30  together across the fracture  32  when the first fastener  574  and the second fastener  576  are secured to the respective bone segments  28 ,  30 . 
     As best shown in  FIG. 29A , in an embodiment, the first bearing  584  can be rotated about a first rotational axis, wherein the first opening  570  is offset from the first rotational axis. The second bearing  586  can be rotated about a second rotational axis, wherein the second opening  572  is offset from the second rotational axis. In this configuration, the offset of the openings  570 ,  572  from the rotational axis moves the openings  570 ,  572  between a non-compressed position  594  and a compressed position  596 . For example, the opening  570  for the first bearing  584  is oriented away from the second portion in the non-compressed position  594  and oriented toward the second portion in the compressed position  596 . Correspondingly, the opening  572  for the second bearing  584  is oriented away from the first portion in the non-compressed position  594  and oriented toward the first portion in the compressed position  596 . As best shown in  FIG. 29B , each of the first bearing  584  and the second bearing  586  can define a compression adjustment distance  598  corresponding to the distance between the non-compressed position  594  and the compressed position  596  along a compression axis parallel to the longitudinal axis  510  defined by the longitudinal body. In this configuration, the first bearing  584  and the second bearing  586  can be rotated between the compressed position and non-compressed position to change a distance  580  between the first fastener  574  and the second fastener  576 . 
     When the first fastener  574  and the second fastener  576  are engaged to the corresponding bone segments  28 ,  30 , rotating the bearings  584 ,  586  can change the distance  580  between the first bone segment  28  and the second bone segment  30 . The distance  580  is therefore adjustable by an amount equal to the compression adjustment distance  598  of the first bearing  584  plus the compression adjustment distance  598  of the second bearing  586 . The orthopedic plate  514  can have a compression adjustment distance of approximately 1.5 millimeters, thereby allowing a medical professional to adjust the distance  580  of the orthopedic plate  514  by approximately 3.0 millimeters. 
     As best shown in  FIGS. 29A-B , the first side arm  592 A and the second side arm  592 B can extend outward from the longitudinal body along an axis generally transverse to the longitudinal axis  510 . In at least one embodiment, the first side arm  592 A can extend outward from the longitudinal body on a first side of the longitudinal axis  510  and the second side arm  592 B can extend outward from the longitudinal body on a second side of the longitudinal axis  510 . In this configuration, the first side of the longitudinal body is positioned opposite to the second side of the longitudinal body. In this configuration, the first side arm  592 A and the second side arm  592 B can be oriented such that the first fastener  574  and the second fastener  576  extend into the first bone segment  28  and the second bone segment  30  from opposite directions. 
     Rotation of the first bearing  584  (and the corresponding first fastener  574 ) can move the first bone segment  28  toward the second bone segment  30  to reduce the distance  580 . Similarly, rotation of the second bearing  586  (and the corresponding second fastener  576 ) can move the second bone segment  30  toward the first bone segment  28  to reduce the distance  580 . In an embodiment, the angle of the first side arm  592 A relative to the angle of the second arm  592 B can cause the first bone segment  28  to move into engagement with the second bone segment  30  along arcs in non-linear, intersecting arcs. This configuration can improve the alignment of the first bone segment  28  to the second bone segment  30 . In an embodiment, the longitudinal body can provide a third point of contact that cooperates with the first fastener  574  and the second fastener  576  to further improve alignment of the first bone segment to the second bone segment  30 . The opposing orientation of the first side arm  592 A and the second side arm  592 B can also apply compression forces on opposing sides of the fracture  32 , which more evenly mates the first bone segment  28  and the second bone segment  30  across the fracture  32 . In an embodiment, the planar longitudinal body can extend across the fracture  32  between the first bone segment  28  and the second bone segment  30 . 
     As best shown in  FIGS. 31A-B , the first axis  582 A can be parallel to the end of the first bone segment  28  at the fracture  32  such that the first fastener  574  is oriented parallel to the end of the first bone segment  28 . Similarly, the second axis  582 B can be parallel to the end of the second bone segment  30  at the fracture  32  such that the second fastener  576  is oriented parallel to the end of the second bone segment  30 . In this configuration, rotation of the first and second bearings  584 ,  586  applies compression forces inward toward the fracture  32  along the length of the first and second fastener  574 ,  576  as best shown in  FIG. 31A . 
     As best shown in  FIGS. 30 and 31A -B, the longitudinal body can generally define a plane when positioned across the fracture  32  between the first bone segment  28  and the second bone segment  30 . The first side arm  592 A and/or the second side arm  592 B can extend from the longitudinal body along axes transverse to the plane defined by the longitudinal body. In this configuration, the first side arm  592 A and/or the second side arm  592 B can cooperate with the longitudinal body to correspond to the shape and contours of the first and second bone segments  28 ,  30 . In this configuration, the first side arm  592 A and the second side arm  592 B can be oriented at the same deflection angle or angled at different offset angles. In at least one embodiment, the first side arm  592 A, the second side arm  592 B, or both can be oriented to be parallel to the plane defined by the longitudinal body to correspond to the curvature of the underlying bone. 
     As best shown in  FIGS. 30 and 31A -B, the deflection of the first side arm  592 A and/or the second side arm  592 B relative to the longitudinal axis  510  alters the first and second axis  582 A,  582 B along which the corresponding first or second fastener  574 ,  576  are inserted. In an embodiment, the first fastener  574  and the second fastener  576  are oriented along transverse axes when viewed along the longitudinal axis  510 . In the offset orientation, the compression forces applied to the first and second bone segments  28 ,  30  at the fracture  32  from the first fastener  574  and the second fastener  576  are offset to apply compression forces over a greater surface area of a face of the fracture  32 . As defined in the present disclosure, the face of the fracture  32  is the adjoining surfaces of the first and second bone segments  28 ,  30  that are rejoined. As best shown in  FIG. 30 , in an example, the first and second fasteners  574 ,  576  can extend through most of or the entirety of the corresponding first and second bone segments  28 ,  30 . In this configuration, the first side arm  592 A and the second side arm  592 B are oriented such that the first and second fasteners  574 ,  576  are along mirroring axes when viewed along the longitudinal axis  510  to evenly distribute the compression forces across the face of the fracture  32 . 
     As shown in  FIG. 27 , in an alternative design, fasteners  174 ,  176  include a locking head  171 ,  175  configured to be received by the locking ridge  67  of the bearings. The locking head  171 ,  175  is tapered so as to increase the radially expansion of the diameter of the bearings as the locking head  171 ,  175  is driven downward with respect to the orthopedic plate. As with the locking threads  71 ,  75 , the locking heads  171 ,  175  are configured to mate with the locking ridge  67  when the fasteners  174 ,  176  are substantially or completely screwed down into the bone segments  28 ,  30  so as to prevent the bearings from rotating with respect to the plate portion  68 . More specifically, the diameter of the locking threads  171 ,  175  is sized so as to cause the bearings  84 ,  86  to expand and form a friction engagement with the plate portion  68 . The bearings  84 ,  86  are able to rotate with respect to the plate portion  68  except when the locking threads  171 ,  175  cause the bearings  84 ,  86  to expand and form a friction engagement with the plate portion  68 . 
       FIG. 25  shows another alternative design for a fastener  374 , where a locking head  371  is tapered so as to increase the radially expansion of the diameter of the bearings as the locking head  371  is driven downward with respect to the orthopedic plate  414 . Additionally, the locking head  371  includes threads  372  configured to mate with threads in the orthopedic plate  414 . 
     VARIOUS NOTES &amp; EXAMPLES 
     Example 1 is an orthopedic plate assembly for joining a first bone segment and a second bone segment, comprising: a frame portion comprising: a longitudinal body comprising a first portion for interfacing with the first bone segment and a second portion for interfacing with the second bone segment, and a first side arm extending outwards from the first portion of the longitudinal body; a first fastener; a first bearing rotatably coupled with the side arm and defining an opening configured to receive the first fastener, wherein the first fastener is advanceable in the opening in a first direction to a set position in which the first fastener engages the first bone segment; wherein the first bearing is rotatable about a first rotational axis, wherein the opening is offset from the first rotational axis. 
     In Example 2, the subject matter of Example 1 optionally includes wherein the first bearing is rotatable about the first rotational axis between a non-compressed position where the opening is positioned distal to the second portion and a compressed position where the opening is positioned proximate to the second portion. 
     In Example 3, the subject matter of Example 2 optionally includes wherein the frame portion further comprises: a second side arm extending outwards from the second portion of the longitudinal body. 
     In Example 4, the subject matter of Example 3 optionally includes a second fastener; a second bearing rotatably coupled with the second side arm and defining an opening configured to receive the second fastener, wherein the second fastener is advanceable in the opening in a second direction to a set position in which the second fastener engages the second bone segment; wherein the second bearing is rotatable about a second rotational axis, wherein the opening is offset from the second rotational axis. 
     In Example 5, the subject matter of Example 4 optionally includes wherein the second bearing is rotatable about the second rotational axis between a non-compressed position where the opening is positioned distal to the first portion and a compressed position where the opening is positioned proximate to the first portion. 
     In Example 6, the subject matter of Example 5 optionally includes wherein the first fastener is advanceable into the set position when the first bearing is in the non-compressed position such that rotating the first bearing into the compressed position draws the first bone segment toward the second portion of the longitudinal body; wherein the second fastener is advanceable into the set position when the second bearing is in the non-compressed position such that rotating the second bearing into the compressed position draws the second bone segment toward the first portion of the longitudinal body and into engagement with first bone segment. 
     In Example 7, the subject matter of Example 6 optionally includes wherein the first fastener is advanceable in the first opening to a lock position when the first bearing is rotated into the compressed position, wherein an expansion portion of the first fastener is configured to engage the first bearing in the lock position to cause the first bearing to expand radially and become non-rotatably locked in the first side arm. 
     In Example 8, the subject matter of any one or more of Examples 6-7 optionally include wherein the second fastener is advanceable in the second opening to a lock position when the second bearing is rotated into the compressed position, wherein an expansion portion of the second fastener is configured to engage the second bearing in the lock position to cause the second bearing to expand radially and become non-rotatably locked in the second side arm. 
     In Example 9, the subject matter of any one or more of Examples 3-8 optionally include wherein the first side arm extends from the first portion on a first side of the longitudinal body and the second side arm extends from the second portion on a second side of the longitudinal body, wherein the first side is opposite to the second side. 
     In Example 10, the subject matter of any one or more of Examples 3-9 optionally include wherein the longitudinal body comprises a planer shape defining a plane. 
     In Example 11, the subject matter of Example 10 optionally includes wherein at least one of the first side arm and the second side arm extends from the longitudinal body transversely from the plane defined by the longitudinal body. 
     In Example 12, the subject matter of any one or more of Examples 1-11 optionally include wherein at least one of the first portion and the second portion defines a set opening for receiving a set fastener for fixing the longitudinal body to at least one of the first bone segment and the second bone segment. 
     Example 13 is a method of connecting a first bone segment to a second bone segment with an orthopedic plate assembly, comprising: positioning a longitudinal body of a frame portion of the orthopedic plate assembly such that a first portion of the longitudinal body is adjacent to the first bone segment and a second portion of the longitudinal body is adjacent to the second bone segment; coupling a first bearing to a first side arm extending outwards from the first portion of the frame portion, the bearing comprising an opening that defines a first direction of travel; advancing a first fastener in the first direction to a set position in which the first fastener engages the first bone segment; and rotating the first bearing about a first rotational axis, wherein the opening is offset from the first rotational axis. 
     In Example 14, the subject matter of Example 13 optionally includes wherein the first bearing is rotatable about the first rotational axis between a non-compressed position where the opening is positioned distal to the second portion and a compressed position where the opening is positioned proximate to the second portion. 
     In Example 15, the subject matter of Example 14 optionally includes coupling a second bearing to a second side arm extending outwards from the second portion of the frame portion, the bearing comprising an opening that defines a second direction of travel; advancing a second fastener in the second direction to a set position in which the second fastener engages the first bone segment; and rotating the second bearing about a second rotational axis, wherein the opening is offset from the second rotational axis. 
     In Example 16, the subject matter of Example 15 optionally includes wherein the second bearing is rotatable about the second rotational axis between an non-compressed position where the opening is positioned distal to the first portion and a compressed position where the opening is positioned proximate to the first portion. 
     In Example 17, the subject matter of Example 16 optionally includes wherein rotating the first bearing to the compressed position and the second bearing to the compressed position draws the first bone segment and the second bone segment into engagement. 
     In Example 18, the subject matter of Example 17 optionally includes advancing the first fastener in the first direction to a lock position where an expansion portion of the first fastener engages the first bearing causing the first bearing to expand radially and become non-rotatably locked in the first side arm. 
     In Example 19, the subject matter of any one or more of Examples 17-18 optionally include advancing the second fastener in the second direction to a lock position where an expansion portion of the second fastener engages the second bearing causing the second bearing to expand radially and become non-rotatably locked in the second side arm. 
     In Example 20, the subject matter of any one or more of Examples 17-19 optionally include wherein the first bone segment and the second bone segment are moved into engagement along non-linear paths. 
     In Example 21, the subject matter of any one or more of Examples 15-20 optionally include wherein the longitudinal body comprises a planer shape defining a plane. 
     In Example 22, the subject matter of any one or more of Examples 19-21 optionally include wherein at least one of the first side arm and the second side arm extends from the longitudinal body transversely from the plane defined by the longitudinal body. 
     In Example 23, the subject matter of any one or more of Examples 13-22 optionally include advancing a set fastener through a set opening in at least one of the first portion and the second portion of the longitudinal body to engage at least one of the first bone segment and the second bone segment. 
     Each of these non-limiting examples can stand on its own, or can be combined in any permutation or combination with any one or more of the other examples. 
     The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the present subject matter can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein. 
     In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls. 
     In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects. 
     The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to comply with 37 C.F.R. §1.72(b), to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the present subject matter should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.