Patent Publication Number: US-2022233222-A1

Title: Orthopedic implant with improved variable angle locking mechanism

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims the benefit of U.S. Provisional Patent Application No. 62/858,727, filed Jun. 7, 2019, entitled “Orthopedic Implant with Improved Variable Angle Locking Mechanism,” the entire contents of which application is hereby incorporated by reference in its entirety. 
    
    
     TECHNICAL FIELD 
     The present disclosure is directed to orthopedic implants for coupling to one or more patient&#39;s bones, bone portions, bone fragments, etc., and more specifically to orthopedic implants having improved variable angle locking mechanisms for enabling polyaxial placement and fixation of a fastener. 
     BACKGROUND 
     Bone fractures are often repaired by securing an orthopedic implant to one or more patient&#39;s bone(s), bone portions, bone fragments, etc. (used interchangeably without the intent to limit). For example, in one procedure, a bone plate is coupled to a patient&#39;s bone across the fracture. Generally speaking, in use, a bone plate is positioned so that portions thereof are placed on either side of the fracture and fasteners (e.g., screws) are placed through openings formed in each bone plate portion. Depending upon which bone is to be treated, the bone plate may be straight or curved to match the contour of the bone for which it is designed. Bone plates may also be provided in many shapes and sizes. In use, the bone plate promotes healing of the fracture by providing a rigid fixation or support structure between the bone and the plate. 
     Bone plates may be secured to the bone in a number of ways. An existing solution is a plate and screw system where the fasteners, screws, etc. (used interchangeably herein without the intent to limit) are locked to the plate. A bone screw is threaded through an opening in the plate and into the bone. The screw is then secured to the bone plate via threads formed on the head portion of the bone screw that cooperate with the threaded opening formed in the bone plate. This secures the plate with respect to the bone and provides rigid fixation between the bone plate and screw(s). That is, because the head portion of the bone screw interdigitates with the threads formed in the bone plate, the plate and screws(s) form a stable system or construct, and the stability of the fracture can be dependent on or aided by the stiffness of the construct. Locking a screw into the plate can achieve angular and axial stability and eliminate the possibility for the screw to toggle, slide, or be dislodged, reducing the risk of postoperative loss of reduction. 
     However, although locking screws may reduce the incidence of loosening, they provide a limited range of fixation between the plate and the screw(s). That is, because of the interlocking screw threads between the head portion of the bone screw and the threaded opening formed in the bone plate, the insertion angle of the bone screw through the bone plate is limited. Generally speaking, the longitudinal axis of the bone screw lines up with a central axis of the opening, and no, or limited, angular variation is allowed. Thus, limiting use of locking screws in some instances. 
     For example, when treating a severe fracture, bone fragments may be shattered and located in irregular positions. Although a surgeon may wish to obtain the benefits of a locking screw and bone plate used together, the angle at which the locking screw extends from the plate at a certain opening may not be the angle that would allow the surgeon to grab, seize, fix, or otherwise secure, the desired, random bone fragment. In this case, the surgeon may need to secure the plate to the bone somewhere else, or use a non-locking screw. Although non-locking screws do not lock into the plate, they can be inserted at various angles. 
     Specifically, non-locking screws are secured into bone in the same way that locking screws are, but they are not secured to the plate. That is, non-locking screws typically include rounded and/or smooth head portions. Thus, one advantage of non-locking screws is that they can be inserted at various angles because they are not limited by the thread-to-thread connection of locking screws with the bone plate. However, if the surgeon desires the rigid stable construct of a locking screw and plate, the use of a non-locking screw to obtain the desired angular orientation is not necessarily optimal. 
     There have been bone plating systems developed that provide the surgeon with the option of choosing a non-locking screw or a locking screw. For example, systems have been developed where the bone plate includes threaded holes for receiving locking screws or non-locking screws, and non-threaded holes for receiving non-locking screws. Also, systems have been developed where the bone plate includes partially threaded slots to allow either non-locking or locking screws to be used together. Such combination slots provide surgeons with the intraoperative choice about whether to use the plate with locking screws, non-locking screws, or with a combination of both. However, these systems have inherent disadvantages. For example, the combination slots may not be able to maintain the fixed angular relationship between the screw(s) and plate under physiological loads. 
     There have been other attempts to provide increased polyaxial locking systems that provide increased range of angular displacement. For example, U.S. Pat. No. 8,105,367, issued on Jan. 31, 2012, entitled Bone Plate and Bone Plate Assemblies including Polyaxial Fasteners, incorporated herein by reference in its entirety. In particular, U.S. Pat. No. 8,105,367 describes an implant having fastener receiving openings with a single layer of fins that project into the opening. In use, the fins permit a fastener to be positioned off-axis within the opening. 
     While currently-available implants have produced excellent results, many of these implants exhibit one or more shortcomings or disadvantages. For example, it would be beneficial to provide orthopedic implants such as, for example, bone plates, that provide for increased angular displacement of the fasteners with respect to the implant while maintaining secure engagement between the fasteners and the implant. It is with this in mind that the present disclosure is provided. 
     SUMMARY 
     This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended as an aid in determining the scope of the claimed subject matter. 
     Disclosed herein is an orthopedic implant such as, for example, a bone plate. In one embodiment, the implant includes at least one opening formed therein for receiving a fastener such as, for example, a bone screw. The at least one opening including a plurality of fins, tabs, projections, etc. (used interchangeably herein without the intent to limit). The plurality of fins being arranged in first and second layers, rows, etc. (used interchangeably herein without the intent to limit). Each row including a plurality of fins such as, for example, four fins orientated ninety-degrees apart from each other. In one embodiment, at least one of the fins has a different configuration from at least one of the other remaining fins. 
     In one embodiment, each of the first or upper fins and the second or lower fins in the first and second rows may be arranged and configured in a vertically stacked relationship so that the second/lower fin is aligned with, positioned beneath, etc. the first/upper fin in a vertical stack. 
     In one embodiment, for each of the vertical stacks of first/upper and second/lower fins, the first/upper fin may have a different configuration as compared to the second/lower fin in its vertical stack. 
     In one embodiment, each of the first/upper fins and second/lower fins may alternate configurations as the fins are circumferentially disposed in the at least one opening. For example, with the at least one opening including four first/upper fins and four second/lower fins orientated in a vertically stacked relationship so that, for example, first/upper and second/lower fins are located at 12 O&#39;clock, 3 O&#39;clock, 6 O&#39;clock, and 9 O&#39;clock, the first/upper fin at 12 O&#39;clock and 6 O&#39;clock may have a different configuration as compared to the second/lower fin at 12 O&#39;clock and 6 O&#39;clock (e.g., the first/upper fins may have a first configuration and the second/lower fins may have a second configuration). Similarly, the first/upper fins located at 3 O&#39;clock and 9 O&#39;clock may have a different configuration as compared to the second/lower fin at 3 O&#39;clock and 9 O&#39;clock (e.g., the first/upper fins may have the second configuration and the second/lower fins may have the first configuration). Thus arranged, as one moves about the circumference of the at least one opening, the first/upper fin at each clock position may have a different configuration from the second/lower fin at the same clock position, with the first/upper and second/lower fins alternating configurations as one traverses about the circumference of the opening. 
     In one embodiment, the different configurations may correspond to a different length (e.g., as measured from a base of the fin to a terminal end of the fin), or a different thickness (e.g., cross-sectional diameter, thickness, etc.), or a combination thereof. Thus arranged, for example, as one moves about the circumference of the at least one opening, the first/upper fin at a first clock position may have a longer length and/or thinner cross-section than the second/lower fin at the first clock position. Thereafter, at a subsequent clock position, the second/lower fin at a second clock position may have a longer length and/or thinner cross-section than the first/upper fin at the second clock position, and so on as one traverses about the circumference of the opening. 
     In one embodiment, the orthopedic implant may be a bone plate. The bone plate including at least one opening including first and second rows of fins. In one embodiment, each of the first and second rows of fins may include four fins orientated ninety-degrees apart. The first and second fins being orientated in a vertically stacked relationship. In one embodiment, the first fin in a stacked relationship may extend into the opening farther than the second fin in the stacked relationship (e.g., the first fin may have a longer length as measured from its base to its tip than the second fin). Alternatively, and/or in addition, the first fin in the stacked relationship may be thinner (e.g., have a smaller cross-sectional area) than the second fin in the stacked relationship. 
     In addition, and/or alternatively, adjacent sets of first and second vertically stacked fins may alternate configurations so that, at the next adjacent position, the first fin may be shorter than the second fin. Alternatively, and/or in addition, the first fin may be thicker than the second fin, and so on as one traverses about the circumference of the opening. 
     In one embodiment, an orthopedic implant is disclosed. The orthopedic implant include an outer surface and at least one opening extending through the outer surface and including a plurality of first fins and a plurality of second fins circumferentially disposed about the at least one opening. The plurality of first fins are positioned in a vertically stacked relationship relative to the plurality of second fins. The plurality of first fins and the plurality of second fins are adapted and configured to deflect or deform in order to secure a position of a head of a bone fastener inserted into the at least one opening. In one embodiment, at least one of the plurality of fins includes a different configuration from at least one of the other plurality of fins. 
     In one embodiment, the at least one of the plurality of fins includes a first configuration and the at least one of the other plurality of fins includes a second configuration, the first configuration being different from the second configuration. 
     In one embodiment, the different configurations is selected from one of a different size or length, or a different thickness (e.g., cross-sectional area), or a combination thereof. 
     In one embodiment, the plurality of first and second fins orientated in a vertically stacked relationship are arranged and configured so that a first fin in a first vertically stacked position includes a different configuration from a second fin in the first vertically stacked position. 
     In one embodiment, the plurality of first and second fins each include four fins orientated ninety-degrees apart so that the first and second fins are vertically stacked at position A, position B, position C, and position D. The first fins at positions A, B, C, and D each having a different configuration than the second fin at positions A, B, C, and D, respectively. 
     In one embodiment, the first fins at positions A and C each include a first configuration, the second fins at positions A and C each include a second configuration different from the first configuration. In one embodiment, the second fins at positions B and D include the first configuration and the first fins at positions B and D include the second configuration. 
     In one embodiment, an orthopedic implant is disclosed. The orthopedic implant includes a bone contacting surface, an upper surface opposite the bone contacting surface, and a plurality of openings extending between the bone contacting surface and the upper surface, each of the plurality of openings being arranged and configured to receive a fastener for coupling the orthopedic implant to a patient&#39;s bone in use. At least one of the plurality of openings including first and second rows of fins. Each of the first and second rows of fins including a plurality of fins circumferentially disposed about the at least one opening, the plurality of fins being arranged and configured to engage a head portion of a respective fastener inserted therein. At least one of the plurality of fins in the first and second rows of fins has a different configuration from at least one of another one of the plurality of fins in the first and second rows of fins. 
     In one embodiment, each of the plurality of fins in the first row of fins is arranged and configured in a vertically stacked relationship with one of the plurality of fins in the second row of fins so that the second row of fins is circumferentially aligned with the first row of fins. 
     In one embodiment, for each of the vertical stacks of first and second rows of fins, the fin in the first row of fins has a different configuration as compared to the fin in the second row of fins in its respective vertical stack. 
     In one embodiment, each fin in the first and second rows of fins includes an alternating configuration of fins as the fins are circumferentially disposed in the at least one opening. 
     In one embodiment, each of the first and second rows of fins include four fins orientated ninety-degrees apart so that the four fins in the first and second rows of fins are positioned in circumferential positions A, B, C, and D. The fin in the first row of fins at positions A and C includes a first configuration, the fin in the first row of fins at positions B and D includes a second configuration, the fin in the second row of fins at positions A and C includes the second configuration, and the fin in the second row of fins at positions B and D includes the first configuration. 
     In one embodiment, as one moves about a circumference of the at least one opening, each fin in the first row of fins has a different configuration as compared to each fin in the second row of fins in its respective vertical stack, with each fin in the first row of fins and each fin in the second row of fins alternating configurations. 
     In one embodiment, the different configuration of fins is selected from one of a different length, a different thickness, or a combination thereof. 
     In one embodiment, at least one of the fins in the first row of fins extends into the at least one opening farther than the fin in the second row of fins in the vertically stacked relationship. 
     In one embodiment, at least one of the fins in the first row of fins has a thinner cross-sectional area at a tip thereof as compared to the fin in the second row of fins in the vertically stacked relationship. 
     In one embodiment, the orthopedic implant is a bone plate. 
     In one embodiment, a bone plate is disclosed. The bone plate includes a top surface, a bone contacting surface, and at least one opening extending between the top surface and the bone contacting surface, the at least one opening including first and second rows of fins, each of the first and second rows of fins including a plurality of fins circumferentially disposed about the at least one opening, the fins in the first row of fins being aligned in a vertically stacked relationship with the fins in the second row of fins. For each vertically stacked relationship, the fin in the first row of fins has one of a first configuration and a second configuration, the fin in the second row of fins has the other one of the first configuration and the second configuration, the first configuration being different than the second configuration. 
     In one embodiment, the first configuration is a different length as measured from a base of the fin to a tip of the fin, the second configuration is a thinner cross-sectional area at the tip of the fin. 
     In one embodiment, the fins in the first row of fins alternate first and second configurations as one moves about a circumference of the at least one opening; and the fins in the second row of fins alternate first and second configurations as one moves about the circumference of the at least one opening. 
     In one embodiment, the first configuration is a different length as measured from a base of the fin to a tip of the fin, the fins in the first and second row of fins alternating first and second configurations as one moves about a circumference of the at least one opening so that a longer length fin alternates between the first and second rows of fins as one moves about the circumference of the at least one opening. 
     In one embodiment, each of the first and second rows of fins include four fins orientated ninety-degrees apart so that the four fins in the first and second rows of fins are positioned in circumferential positions A, B, C, and D. The fin in the first row of fins at positions A and C includes the first configuration, the fin in the first row of fins at positions B and D includes the second configuration, the fin in the second row of fins at positions A and C includes the second configuration, and the fin in the second row of fins at positions B and D includes the first configuration. 
     In one embodiment, the orthopedic implant further includes at least one fastener for receipt within the at least one opening. The fastener being at least partially threaded and having a head portion and a shaft portion. The plurality of first and second fins are deflectable, deformable, or a combination thereof, relative to the head portion of the fastener so that when the fastener is inserted into the opening, the fastener is retained at any one of a plurality of angles relative to the opening. In use, the plurality of first and second fins are deformable, deflectable, or a combination thereof, so that at least some of the first and second fins are interposed between adjacent threads formed on the head portion of the fastener. 
     In one embodiment, an orthopedic implant including an outer surface and at least one opening extending through the outer surface for receiving a fastener for coupling the implant to a patient&#39;s bone or bone portion/fragment is disclosed. The opening including a plurality of fins circumferentially disposed about the opening for engaging threads formed on a head portion of the fastener to secure the fastener to the implant. The plurality of fins being arranged and configured in first and second vertically spaced rows of fins. At least one of the fins including a different configuration, property, etc. relative to at least one of the other plurality of fins. In one embodiment, each of the first and second fins in a vertically stacked relationship includes a different configuration from the other of the first and second fins in that stack. In one embodiment, the different configuration includes a different length, a different thickness, or a combination thereof. 
     Embodiments of the present disclosure provide numerous advantages. For example, use of the coupling mechanism of the present disclosure enables a surgeon to polyaxially position the fastener relative to the implant to provide increased versatility while providing a better coupling between the fastener and the implant to avoid, or at least minimize, the risk of the fastener dislodging from the implant after implantation. 
     Further features and advantages of at least some of the embodiments of the present invention, as well as the structure and operation of various embodiments of the present invention, are described in detail below with reference to the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       By way of example, a specific embodiment of the disclosed device will now be described, with reference to the accompanying drawings, in which: 
         FIG. 1  is an illustration of an example embodiment of an orthopedic implant (shown as a bone plate positioned on a bone); 
         FIG. 2  is a cross-sectional view of the orthopedic implant taken along line II-II of  FIG. 1 ; 
         FIG. 3  is a perspective view of a variable angle locking mechanism for receiving a fastener that may be used in connection with the orthopedic implant shown in  FIG. 1 ; 
         FIG. 4  is an alternate perspective view of the variable angle locking mechanism shown in  FIG. 3 ; 
         FIG. 5  is an alternate perspective view of the variable angle locking mechanism shown in  FIG. 3 ; 
         FIG. 6  is an alternate perspective view of the variable angle locking mechanism shown in  FIG. 3 ; 
         FIG. 7  is a top view of the variable angle locking mechanism shown in  FIG. 3 ; and 
         FIG. 8  is a bottom view of the variable angle locking mechanism shown in  FIG. 3 . 
     
    
    
     It should be understood that the drawings are not necessarily to scale and that the disclosed embodiments are sometimes illustrated diagrammatically and in partial views. In certain instances, details which are not necessary for an understanding of the disclosed methods and devices or which render other details difficult to perceive may have been omitted. It should be further understood that this disclosure is not limited to the particular embodiments illustrated herein. 
     DETAILED DESCRIPTION 
     Various features, aspects, or the like of an orthopedic implant or device (used interchangeably herein without the intent to limit) will now be described more fully hereinafter with reference to the accompanying drawings, in which one or more aspects or features of the orthopedic implant will be shown and described. It should be appreciated that the various features, aspects, or the like may be used independently of, or in combination, with each other. It will be appreciated that an orthopedic implant as disclosed herein may be embodied in many different forms and should not be construed as being limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will convey certain aspects or features of the orthopedic implant to those skilled in the art. In the drawings, like numbers refer to like elements throughout unless otherwise noted. 
     Disclosed herein is an orthopedic implant including an improved variable angled coupling, securing, locking, etc. (used interchangeably herein without the intent to limit) mechanism for enabling increased polyaxial angular rotation of fasteners relative to the implant. As will be illustrated and described, in one embodiment, the orthopedic implant may be in the form of a bone plate. However, as will be appreciated by one of ordinary skill in the art, the orthopedic implant may be any now known or hereafter developed implant that receives a fastener for coupling to a patient&#39;s bone, bone portions, bone fragments, etc. (used interchangeably herein without the intent to limit) including, for example, an intramedullary nail, a knee replacement device, a hip replacement device, an acetabular cup, an acetabular cage, an external fixation device, etc. 
     Moreover, the orthopedic implant may have any shape and/or configuration, which, as will be appreciated by one of ordinary skill in the art, may be dependent on the location and type of patient&#39;s bone being fixed. For example, a bone plate may include a bone conforming arcuate surface. In addition, the bone plate may be arranged and configured to contact a distal femur, a proximal femur, a distal tibia, a proximal tibia, a proximal humerus, a distal humerus, a clavicle, a fibula, an ulna, a radius, a distal radius, a rib, pelvis, a vertebra, bones of the foot, or bones of the hand, shaft fractures on long bones, or any of the aforementioned adjacent bones in the case of a joint fusion plate. 
     In addition, the implant such as, for example, the bone plate, may include any now known or hereafter developed additional features such as, for example, one or more openings or slots designed to receive, for example, surgical implantation tools, different fasteners (e.g., non-locking fasteners), k-wires, or the like. 
     The orthopedic implant may be manufactured from any suitable material now known or hereafter developed, including, for example, metals, polymers, plastics, ceramics, resorbable, non-resorbable, composite materials, etc. Suitable materials may include, for example, titanium, stainless steel, cobalt chrome, polyetheretherketone (PEEK), polyethylene, ultra-high molecular weight polyethylene (UHMWPE), resorbable polylactic acid (PLA), polyglycolic acid (PGA), combinations or alloys of such materials or any other appropriate material that has sufficient strength to be secured to and hold bone, while also having sufficient biocompatibility to be implanted into a patient&#39;s body. In some embodiments, the fastener may be manufactured from the same material as the implant. In other embodiments, the fasteners may be manufactured from a different material as compared to the implant. 
     The fastener can be any type of fastener now known or hereafter developed. For example, the fastener may include any type of external thread including standard or non-standard threads. For example, the external threads can be arranged as a continuous ridge or a non-continuous ridge. The external threads can form a portion of a revolution, one complete revolution, multiple revolutions, a single lead, multiple leads, or any other threads known in the art. Additionally, and/or alternatively, in the case of locking screws, the head portion of the fastener can include any surface that will engage with and seat within the opening. For example, the head portion can include threads (as will be described herein). Alternatively, the head portion can include a series of dimples, ridges, bumps, textured areas, or any other surface that can secure the fastener. 
     The fastener may be any typical fastener, made out of any appropriate material. The fastener may include a bore for receiving a driver in order to drive the fastener through the implant and into the patient&#39;s bone. The bore may be any size and shape, for example, it may have a hexagonal configuration to receive a corresponding hexagonal driver, a Phillips screw head, a flat-head, a star configuration, Torx, or any other appropriate configuration that can cooperate with a driver to drive the fastener through the implant and into the patient&#39;s bone. 
     The shaft of the fastener may be fully threaded, partially threaded, or a helical blade, and/or may include one or more tacks, deployable talons, expandable elements, or any feature that allows the shaft to engage the patient&#39;s bone. It is also possible that shaft be non-threaded so that the fastener takes the form of a peg or a pin. This alternative implementation may be preferred in certain procedures where, for instance, the main goal is to prevent tilting of a bone segment or in procedures where there is no concern of the fastener pulling out from the patient&#39;s bone and hence no need for the shaft to be threaded or otherwise configured to engage the patient&#39;s bone. The end of the shaft may be a self-tapping or self-drilling tip. 
     In any event, as will be readily apparent from the remaining disclosure, the focus of the present disclosure is on example embodiments of finned openings formed in the orthopedic implant for receiving a fastener. Thus, it should be appreciated that the present disclosure should not be limited to any particular type of orthopedic implant having any particular configuration unless specifically claimed. 
     Referring to  FIGS. 1 and 2 , an orthopedic implant  100  may be a bone plate for repairing fractures in a patient&#39;s bone or bone portions B. That is, as shown, the orthopedic implant  100  may be in the form of a bone plate  140  including one or more fasteners  190  for securing the implant (e.g., bone plate)  140  to the patient&#39;s bone B. As previously mentioned, the orthopedic implant  100  may be any now known or hereafter developed implant receiving a fastener for securing to a patient&#39;s bone or bone portions B. Similarly, the fastener  190  may be any now known or hereafter developed fastener. As shown, in one embodiment, the fastener  190  includes a head portion  194  and a shaft portion  192 . The shaft portion  192  may be threaded or non-threaded. The head portion  194  of the fastener  190  includes at least one thread or the like. The head portion  194  may include a bore for receiving a driver in order to drive the fastener  190  through the plate  140  and into the patient&#39;s bone B. 
     As shown, the bone plate  140  may include one or more openings  200  for receiving a head portion  194  of a fastener  190  inserted therein. That is, as will be appreciated by one of ordinary skill in the art, the bone plate  140  may include a lower or bone contacting surface  142 , an upper surface  144  opposite the lower or bone contacting surface  142 , and a plurality of openings  200  extending between the upper surface  144  and the lower or bone contacting surface  142  for receiving a plurality of fasteners  190 , respectively, for coupling the bone plate  140  to the patient&#39;s bone or bone portions B. As will be described herein, one or more of the openings  200  include a plurality of fins for coupling with, engaging, etc. the head portion  194  of the fastener  190  inserted therein (referred to herein as a finned opening). In use, the finned openings  200  can be positioned anywhere on the implant (e.g., bone plate)  100 . In use, the fastener  190  can be inserted into the finned opening  200  and fixed relative to the plate  140  at various insertion angles to capture random bone portions, fragments, etc. that have split from the bone during fracture and secure the bone portions, fragments, etc. to the plate  140 . 
     As schematically shown in  FIG. 2 , the finned openings  200  enable a fastener  190  inserted therein to achieve a greater range of insertion angles as compared to, for example, a conventional locking screw  90  that is threadably coupled to the bone plate  140 . For example, in one embodiment, the angular position of the fastener  190  may be rotated through a range of approximately ±15 degrees, although the range of allowable polyaxial rotation can vary, including greater and less than the fifteen degrees. 
     Referring to  FIGS. 3-8 , in accordance with preferred embodiments of the present disclosure, the finned opening  200  formed in the bone plate  140  includes an inner surface  202  and a plurality of inwardly protruding fins  210  that extend toward a central axis  201  of the finned opening  200 . Each fin  210  includes a base  212 , a terminal end or tip  214 , and side surfaces  216 ,  218 . The bases  212  forming concave portions  220 . 
     In one embodiment, the concave portions  220  are smooth and non-threaded, and as illustrated, the entire inner surface  202  of the finned opening  200  can be devoid of any threads. The bases  212  can extend from the inner surface  202  of the finned opening  200 . 
     As shown, in some embodiments, the fins  210  are integrally connected to, and protruding from, the inner surface  202  of the finned opening  200 . The finned opening  200  may include a radius between the inner surface  202  and the top of the fins  210  and each fin  210  may taper in thickness from its base  212  to its terminal end or tip  214 . Thus arranged, the finned opening  200  may be seen to have a jagged circumference formed by protruding fins  210 . The protruding fins  210  may form a concave portion of the inner surface  202 . The protruding fins  210  have bases  212  that meet the inner surface  202  along planes as described in greater detail below. 
     As shown, in some embodiment, as the fins  210  extend toward the central axis  201  of the finned opening  200 , the fins  210  can taper to form inwardly tapered side surfaces  216 ,  218 . Alternatively, the side surfaces  216 ,  218  of the fins  210  may taper outwardly or may be parallel with each other. The terminal ends or tips  214  can have any shape suitable for engaging the head portion  194  of the fastener  190 . For example, the terminal ends or tips  214  can be rounded, pointed, square, rectangular, or any other appropriate configuration. Generally speaking, the fins  210  may be trapezoidally-shaped, rounded, oval, square, rectangular, curved, rhomboid, diamond-shaped, triangular, or the like. The fins  210  may be provided as a series of concavely indented, inwardly protruding fins that are adapted to secure a head  194  of a fastener  190  in place at varying angles (e.g., fins  210  engage the threads or other surfaces formed on the head portion  194  of the fastener  190 ). Additional information on the configuration and nature of the fins can be found in U.S. Pat. No. 8,105,367, which is incorporated herein by reference in its entirety. 
     By providing a non-threaded inner surface  202 , the fastener  190  can be inserted into the finned opening  200  at a desired insertion angle (e.g., an angle between a longitudinal axis  196  ( FIG. 2 ) of the fastener  190  and the central axis  201  of the finned opening  200 ). The central axis  201  and the longitudinal axis  196  can be co-linear so that the insertion angle is zero, or the central axis  201  and the longitudinal axis  196  can be non-co-linear with an insertion angle of up to about +/−15 degrees. Varying the insertion angle is possible because there are not any threads in the finned opening  200  to interfere with the desired insertion angle. As will be described in greater detail, in use, the fins  210  are intended to slightly bend or deform in order to secure the fastener  190  in place in the finned opening  200 . 
     As shown in  FIGS. 3-8 , in one example embodiment, the finned openings  200  include a plurality of first or upper fins  210 A and a plurality of second or lower fins  210 B. That is, the finned openings  200  may include a first or upper row of fins including a plurality of first or upper fins  210 A and a second or lower row of fins including a plurality of second or lower fins  210 B, wherein the first or upper row of fins is spaced from the second or lower rows of fins. In use, the first or upper row of fins are positioned closer to a first or upper surface of the implant and the second or lower fins are positioned closer to the opposite or lower surface of the implant. In use, the upper fins  210 A and the lower fins  210 B are axially spaced from each other so that there is a space therebetween so that a threaded portion or the like of the head portion  194  of the fastener  190  may be positioned within this space. 
     In one embodiment, as shown, the upper fins  210 A may be stacked or aligned with the lower fins  210 B. That is, in one embodiment, the upper fins  210 A and the lower fins  210 B are positioned circumferentially about the finned opening  200  in a vertically stacked position. For example, in one embodiment, the upper and lower rows of fins may each include four fins positioned ninety-degrees apart in a vertically stacked position. That is, in one embodiment, the upper row of fins and the lower row of fins may include four upper fins  210 A oriented ninety-degrees apart around the finned opening  200  and four lower fins  210 B oriented directly beneath the upper fins  210 A. Alternatively, it is envisioned that the upper and lower rows of fins may include more of less fins. For example, the upper and lower rows of fins may each include three fins positioned 120 degrees apart in a vertically stacked position, six fins positioned 60 degrees apart in a vertically stacked position, etc. Moreover, it is envisioned that the upper and lower fins may be positioned offset, or partially offset, from each other. That is, the upper and lower fins may not be positioned in a vertically stacked relationship but rather the upper fins may be positioned offset, or partially offset, from the lower fins (e.g., the upper fins may be positioned in-between the lower fins). In an alternate embodiment, it is envisioned that the upper row of fins and the lower row of fins may include different number of fins such as, for example, the upper row may include four fins and the lower row of fins may include five fins, or the like. 
     In addition, and/or alternatively, as will be described in greater detail below, one or more of the individual fins  210  residing within the upper and lower rows of fins may have different properties, configurations, etc. (used interchangeably herein without the intent to limit) from one or more of the other fins residing within the upper and lower rows of fins. That is, at least one of the fins  210  has a different configuration from at least one of the other remaining fins. As shown, in one embodiment, the different configuration may correspond to a different length or relative inscribed diameter (used interchangeably) (e.g., measured from a base  212  of the fin  210  to a terminal end  214  of the fin  210 ), or a different thickness (e.g., a different cross-sectional diameter, thickness, etc.), or a combination thereof. Thus arranged, at least one of the fins may be said to have a first configuration and at least one of the fins may be said to have a second configuration. Generally speaking, the second configuration is smaller, less material fins that will enhance/improve the construct. For example, in one embodiment, the first configuration may have a thickness at the terminal end  214  of the fin  210  of approximately 0.009 inches. The second configuration may have a thickness at the terminal end  214  of the fin  210  of approximately 0.009 inches or less, although as will be appreciated by one of ordinary skill in the art these dimensions are just one example and the fins may have other dimensions. Moreover, in one embodiment, the second configuration may have a larger inscribed diameter as compared to the first configuration. 
     As shown, in one embodiment, each of the upper fins  210 A and the lower fins  210 B in the first and second rows may be arranged and configured in a vertically stacked relationship so that the lower fins  210 B are aligned with, positioned beneath, etc. the upper fins  210 A in a vertical stack. In one embodiment, for each of the vertical stacks of upper and lower fins  210 A,  210 B, the upper fin  210 A may have a different configuration as compared to the lower fin  210 B in its vertical stack (e.g., positioned directly above it). That is, for example, the upper fin  210 A in a vertical stack may have a first configuration and the lower fin  210 B in the vertical stack may have the second configuration. 
     That is, for example, in one embodiment, the upper and lower fins  210 A,  210 B may extend into the opening toward the central axis  201  of the finned opening  200  by a different amount, extent, or the like. In addition, the shorter fins may have a different cross-sectional area (e.g., a different thickness) relative to the longer fins. Thus arranged, during insertion of a fastener  190  into a finned opening  200 , the threads formed on the head portion  194  of the fastener  190  will start to engage the longer fins  210  first thus providing initial fixation. Subsequently, the head portion  194  of the fastener  190  will engage the shorter fins thereby providing increased fixation strength. 
     In addition, and/or alternatively, each of the upper fins  210 A and the lower fins  210 B may alternate configurations as the fins  210  are circumferentially disposed in the finned opening  200 . For example, as shown, with the finned opening  200  including four upper fins  210 A and four lower fins  210 B, although the number of fins may be varied, orientated in a vertically stacked relationship so that, for example, the upper and the lower fins may be said to reside at positions A, B, C and D, respectively, corresponding to, for example, 12 O&#39;clock, 3 O&#39;clock, 6 O&#39;clock, and 9 O&#39;clock, the upper fin  210 A at position A (e.g., 12 O&#39;clock) and position C (e.g., 6 O&#39;clock) may have a different configuration as compared to the lower fin  210 B at position A (e.g., 12 O&#39;clock) and position C (e.g., 6 O&#39;clock) (e.g., the upper fins  210 A may have a first configuration and the lower fins  210 B may have a second configuration). Similarly, the upper fins  210 A located at position B (e.g., 3 O&#39;clock) and position D (e.g., 9 O&#39;clock) may have a different configuration as compared to the lower fins at position B (e.g., 3 O&#39;clock) and position D (e.g., 9 O&#39;clock) (e.g., the upper fins  210 A may have the second configuration and the lower fins  210 B may have the first configuration). Thus arranged, as one moves about the circumference of the finned opening  200 , the upper fin  210 A at each clock position may have a different configuration from the lower fin  210 B at the same clock position, with the upper and lower fins  210 A,  210 B alternating configurations as one traverses about the circumference of the finned opening  200 . That is, as one moves about the circumference of the finned opening  200 , the first fin at a first clock position may have a different length and/or different cross-section than the second fin at the first clock position. Thereafter, at a subsequent clock position, the second fin at a second clock position may have a different length and/or different cross-section than the first fin at the second clock position, and so on as one traverses about the circumference of the finned opening  200 . For example, in one embodiment, the first fin at a first clock position may have a longer length than the second fin at the first clock position. In addition, and/or alternatively, the first fin at the first clock position may have a smaller cross-sectional area (e.g., reduced thickness) than the second fin at the first clock position. Thereafter, at a subsequent clock position, the second fin at a second clock position may have a longer length than the first fin at the second clock position. In addition, and/or alternatively, the second fin at the second clock position may have a smaller cross-sectional area (e.g., reduced thickness) than the first fin at the second clock position, and so on as one traverses about the circumference of the finned opening  200 . 
     In use, as will be appreciated by one of ordinary skill in the art, insertion of a fastener  190  into a finned opening  200  results in the upper and lower fins  210 A,  210 B being threaded into the head portion  194  of the fastener  190 . Thus arranged, in use, the fins  210  act to prevent backing out of the fastener  190  from the implant  100 . In use, the fastener  190  may be inserted into the finned opening  200  at a variety of angles, while still securing the fastener  190  to the implant  100 . 
     As will be appreciated by one of ordinary skill in the art, the dimensions of each individual fin  210  is typically dependent at least in part upon the pitch and threads on the head portion  194  of the fastener  190 . For example, a larger plate/implant  100  for use with a larger fastener  190  (for example, for use on a femur bone) will likely be thicker and will have larger and thicker fins than a smaller plate/implant  100  (for example, for use on a smaller bone). In specific implementations, the fins  210  are particularly thin so that they can be moved up or down and deform under pressure. That is, upon insertion of a fastener  190  into a finned opening  200 , the upper and lower fins  210 A,  210 B will either deform, deflect, or combinations thereof. Thus arranged, in some embodiments, the fins  210  may be pressed toward the edges of the finned opening  200 . A non-limiting exemplary range of thicknesses for the fins  210  is from about 0.1 mm to about 5 mm, although larger and smaller sizes are possible. In use, the fins  210  are intended to fit between threads or the like formed on the head portion  194  of the fastener  190 . In one embodiment, a ratio of a thread pitch formed on the head portion  194  of the fastener  190  to the distance or spacing between the upper and lower fins  210 A,  210 B is between 0.85 to 1.15. 
     In some embodiments, the finned openings  200  may include a countersink. In use, as will be appreciated by one of ordinary skill in the art, by providing a countersink, the head portion  194  of the fastener  190  may interact with the countersink to facilitate improved polyaxial rotation of the fastener  190  relative to the implant  100 . 
     In some embodiments, the bases  212  of the upper fins  210 A all meet, for example, in substantially the same plane and then angle downwardly and inwardly at a similar angle or slope. Similarly, the bases  212  of the lower fins  210 B all meet, for example, in substantially the same plane and then angle downwardly and inwardly at a similar angle or slope. The downward angle of the upper and lower fins  210 A,  210 B may be the same, although it is envisioned that the upper fins  210 A may be angled at a different angle than the lower fins  210 B. In some embodiments, one or both of the upper and lower planes may be parallel to a surface of the implant. Alternatively, one or both of the upper and lower planes may be non-parallel to a surface of the implant. 
     In some embodiments, the central axis  201  of the finned openings  200  may be perpendicular to the surface of the implant or the central axis  201  may be non-perpendicular to the implant. 
     As will be appreciated, the finned openings  200  provide an improved stable connection between the fasteners  190  and the implant  100  that permits different angles to be obtained between the fasteners  190  and the implant  100 , while securing the fastener  190  to the implant  100 . This allows the surgeon greater versatility to reach denser areas of bone or capture random bone fragments that are in irregular positions, for example, in cases of severe fractures with highly fragmented bones. The fastener and implant system advantageously allows the surgeon to choose the angle at which the fastener  190  is inserted through, and rigidly affixed in, an opening of the implant  100 . 
     In use, the plurality of fins  210  may engage the head portion  194  of the fastener  190  when the fastener  190  is inserted into the finned opening  200  such that the fastener  190  can be inserted and retained at any one of a plurality of angles relative to the finned opening  200  (e.g., the configuration of the fins act to improve the resistance to cantilever load on the fastener  190  when locked into the fins regardless of the direction or angle of screw relative to the implant  100 ). The fins  210  may deflect and/or deform so that the fins  210  are interposed between the threads or the like on the head  194  of the fastener  190 . Thus arranged, the fins  210  grasp, for example, the threads formed on the head  194  of the fastener  190  in order to secure the fastener  190  in place relative to the implant  100  at any desired insertion angle. As previously mentioned, the fins  210  can be very thin so that as the threads start to grab the fins  210 , the fins  210  can move up or down as appropriate to engage the threads and secure the fastener  190  in the finned opening  200 . The threads engage the fins  210  so that the fins  210  fit between the threads. The movement of fins  210  can be a permanent deformation, so that the fins  210  cannot flex back and allow the fastener  190  to work its way out. 
     The foregoing description has broad application. Accordingly, the discussion of any embodiment is meant only to be explanatory and is not intended to suggest that the scope of the disclosure, including the claims, is limited to these example embodiments. In other words, while illustrative embodiments of the disclosure have been described in detail herein, it is to be understood that the inventive concepts may be otherwise variously embodied and employed, and that the appended claims are intended to be construed to include such variations, except as limited by the prior art. 
     The term “a” or “an” entity, as used herein, refers to one or more of that entity. As such, the terms “a” (or “an”), “one or more” and “at least one” can be used interchangeably herein. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Accordingly, the terms “including,” “comprising,” or “having” and variations thereof are open-ended expressions and can be used interchangeably herein. The phrases “at least one”, “one or more”, and “and/or”, as used herein, are open-ended expressions that are both conjunctive and disjunctive in operation. 
     All directional references (e.g., proximal, distal, upper, lower, upward, downward, left, right, lateral, longitudinal, front, back, top, bottom, above, below, vertical, horizontal, radial, axial, clockwise, and counterclockwise) are only used for identification purposes to aid the reader&#39;s understanding of the present disclosure, and do not create limitations, particularly as to the position, orientation, or use of this disclosure. Connection references (e.g., attached, coupled, connected, and joined) are to be construed broadly and may include intermediate members between a collection of elements and relative movement between elements unless otherwise indicated. As such, connection references do not necessarily infer that two elements are directly connected and in fixed relation to each other. Identification references (e.g., primary, secondary, first, second, third, fourth, etc.) are not intended to connote importance or priority but are used to distinguish one feature from another. The drawings are for purposes of illustration only and the dimensions, positions, order and relative sizes reflected in the drawings attached hereto may vary.