Abstract:
A bone fracture fixation system includes a substantially rigid plate defining a first hole having at least one first thread at a first depth, and a second hole, a first fastener having a head portion and a shaft portion, with the head portion having a second thread with a second depth substantially greater than said first depth, and a second fastener sized for use within the second hole. In addition, a bone fracture fixation system includes a rigid plate defining at least one cylindrical first hole having at least two discrete helical threads each with a entry lead offset by a predetermined angular displacement, a fastener having a head portion with a thread sized for engagement within the first hole and a shaft portion, wherein when the first fastener is engaged in the first hole, the thread of the head engages with only one of the discrete helical threads.

Description:
[0001]    This application is a continuation-in-part of U.S. Ser. No. 10/689,797, filed Oct. 21, 2003, which is a continuation-in-part of U.S. Ser. No. 10/664,371, filed Sep. 17, 2003, which is a continuation-in-part of U.S. Ser. No. 10/401,089, filed Mar. 27, 2003, all of which are hereby incorporated by reference herein in their entireties. 
     
    
     
       BACKGROUND OF THE INVENTION  
         [0002]    1. Field of the Invention  
           [0003]    This invention relates broadly to surgical implants. More particularly, this invention relates to a bone fracture fixation system for distal radius fractures.  
           [0004]    2. State of the Art  
           [0005]    Fracture to the metaphyseal portion of a long bone can be difficult to treat. Improper treatment can result in deformity and long-term discomfort.  
           [0006]    By way of example, a Colles&#39; fracture is a fracture resulting from compressive forces being placed on the distal radius, and which causes backward or dorsal displacement of the distal fragment and radial deviation of the hand at the wrist. Often, a Colles&#39; fracture will result in multiple bone fragments which are movable and out of alignment relative to each other. If not properly treated, such fractures may result in permanent wrist deformity and limited articulation of the wrist. It is therefore important to align the fracture and fixate the bones relative to each other so that proper healing may occur.  
           [0007]    Alignment and fixation of a metaphyseal fracture (occurring at the extremity of a shaft of a long bone) are typically performed by one of several methods: casting, external fixation, interosseous wiring, and plating. Casting is non-invasive, but may not be able to maintain alignment of the fracture where many bone fragments exist. Therefore, as an alternative, external fixators may be used. External fixators utilize a method known as ligamentotaxis, which provides distraction forces across the joint and permits the fracture to be aligned based upon the tension placed on the surrounding ligaments. However, while external fixators can maintain the position of the wrist bones, it may nevertheless be difficult in certain fractures to first provide the bones in proper alignment. In addition, external fixators are often not suitable for fractures resulting in multiple bone fragments. Interosseous wiring is an invasive procedure whereby screws are positioned into the various fragments and the screws are then wired together as bracing. This is a difficult and time-consuming procedure. Moreover, unless the bracing is quite complex, the fracture may not be properly stabilized. Plating utilizes a stabilizing metal plate typically against the dorsal side of the bones, and a set of parallel pins extending from the plate into holes drilled in the bone fragments to provide stabilized fixation of the fragments. However, many currently available plate systems fail to provide desirable alignment and stabilization.  
           [0008]    In particular, with a distal radius fracture the complex shape of the distal radius, including the bulky volar rim of the lunate fossa, relatively flat volar rim of the scaphoid fossa, and volar marginal fragment from the lunate fossa should be accommodated. A fixation plate should provide desirable alignment and stabilization of both the subchondral bone and the articular surfaces of the distal radius.  
         SUMMARY OF THE INVENTION  
         [0009]    It is therefore an object of the invention to provide an improved fixation system for distal radius fractures.  
           [0010]    It is another object of the invention to provide a distal radius volar fixation system that desirably aligns and stabilizes multiple bone fragments in a fracture to permit proper healing.  
           [0011]    It is also an object of the invention to provide a distal radius volar plate system which provides support for articular and subchondral surfaces.  
           [0012]    It is an additional object of the invention to provide a distal radius volar plate system which accommodates the anatomical structure of the metaphysis of the distal radius.  
           [0013]    It is a further object of the invention to provide a distal radius volar plate system which provides support without interfering with ligaments and soft tissues near the edge of the articular surface.  
           [0014]    In accord with these and other objects, which will be discussed in detail below, a distal radius volar fixation system is provided. The system generally includes a plate intended to be positioned against the volar side of the radius, a plurality of bone screws for securing the plate along a non-fractured portion of the radius bone, a plurality of bone pegs sized to extend from the plate and into bone fragments at the metaphysis of a radius bone, and one or more K-wires to facilitate alignment and fixation of the plate over the bone and guide the process of application. Preferred bone pegs and peg holes within the plate are provided which facilitate entry and retention of the bone pegs within the peg holes.  
           [0015]    The plate is generally T-shaped, defining an elongate body and a generally transverse head angled upward relative to the body, and includes a first side which is intended to contact the bone, and a second side opposite the first side. The body includes a plurality of countersunk screw holes for the extension of the bone screws therethrough, and optionally one or more substantially smaller alignment holes. The lower surfaces of the radial and ulnar side portions of the head are contoured upward (in a Z direction) relative to the remainder of the head to accommodate the lunate and scaphoid processes. An extension is provided at the head portion along the distal ulnar side of the head to buttress the volar lip (marginal fragment) of the lunate fossa of the radius bone, thereby providing support to maintain the wrist within the articular socket. Moreover, the contoured shape provides a stable shape that prevents rocking of the plate on the bone. The upper and lower surfaces are chamfered to have a reduced profile that limits potential interface with the ligaments and soft tissue near the edge of the lunate fossa. The head includes a plurality of threaded peg holes for receiving the pegs therethrough. The peg holes are arranged into a first set provided in a proximal portion of the head, and a second relatively distal set preferably provided in the tapered portion of the head.  
           [0016]    The first set of the peg holes is substantially linearly arranged generally laterally across the head. The line of pegs is preferably slightly oblique relative to a longitudinal axis through the body of the plate. Axes through the first set of holes are preferably oblique relative to each other, and are preferably angled relative to each other in two dimensions such that pegs inserted therethrough are similarly obliquely angled relative to each other. The pegs in the first set of peg holes provide support for the dorsal aspect of the subchondral bone fragments.  
           [0017]    The second set of peg holes is provided relatively distal of the first set. The holes of the second set, if more than one are provided, are slightly out of alignment but generally linearly arranged. The pegs in the second set of peg holes provide support for the volar aspect of the subchondral bone, behind and substantially parallel to the articular bone surface.  
           [0018]    A distal alignment hole is provided generally between two peg holes of the second set of peg holes. At the upper surface of the plate, the distal alignment hole is substantially cylindrical, while at the lower surface, the hole is laterally oblong. One or more proximal alignment holes of a size substantially smaller than the peg holes are provided substantially along a distal edge defined by a tangent line to shafts of pegs inserted in the first set of peg holes, and facilitate temporary fixation of the plate to the bone with K-wires. Furthermore, along the body two longitudinally displaced alignment holes are also provided. All of the alignment holes are sized to closely receive individual K-wires.  
           [0019]    The plate may be used in at least two different manners. According to a first use, the surgeon reduces a fracture and aligns the plate thereover. The surgeon then drills K-wires through the proximal alignment holes to temporarily fix the orientation of the head of the plate to the distal fragment. Once the alignment is so fixed, the fracture is examined, e.g., under fluoroscopy, to determine whether the K-wires are properly aligned relative to the articular surface. As the axes of the proximal alignment holes correspond to axes of adjacent peg holes, the fluoroscopically viewed K-wires provide an indication as to whether the pegs will be properly oriented. If the placement is correct, the K-wires maintain the position of the plate over the fracture. The peg holes may then be drilled with confidence that their locations and orientations are proper. If placement is not optimal, the K-wires can be removed and the surgeon has an opportunity to relocate and/or reorient the K-wires and drill again. Since each K-wire is of relatively small diameter, the bone is not significantly damaged by the drilling process and the surgeon is not committed to the initial drill location and/or orientation.  
           [0020]    According to a second use, the plate may be used to correct a metaphyseal deformity (such as malformed fracture or congenital deformity). For such purposes, a K-wire is drilled into the bone parallel to the articular surface in the lateral view under fluoroscopy until one end of the K-wire is located within or through the bone and the other end is free. The free end of the K-wire is guided through the distal oblong alignment hole of the head of the plate, and the plate is slid down over the K-wire into position against the bone. The oblong alignment hole permits the plate to tilt laterally over the K-wire to sit flat on the bone, but does not permit movement of the plate over the K-wire in the anterior-posterior plane. The surgeon drills holes in the bone in alignment with the peg holes and then fixes the plate relative the bone with pegs. The bone is then cut, and the body of the plate is levered toward the shaft of the bone to re-orient the bone. The body of the plate is then fixed to the shaft to correct the anatomical defect.  
           [0021]    Additional objects and advantages of the invention will become apparent to those skilled in the art upon reference to the detailed description taken in conjunction with the provided figures.  
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0022]    [0022]FIG. 1 is a radial side elevation of a right-hand volar plate according to the invention, shown with pegs coupled thereto;  
         [0023]    [0023]FIG. 2 is an ulnar side elevation of a right-hand volar plate according to the invention, shown with pegs coupled thereto;  
         [0024]    [0024]FIG. 3 is top view of a right-hand volar plate according to the invention, shown with pegs and screws;  
         [0025]    [0025]FIG. 4 is bottom view of a right-hand volar plate according to the invention, shown with pegs coupled thereto;  
         [0026]    [0026]FIG. 5 is a perspective view of a right-hand volar plate according to the invention, shown with pegs coupled thereto and K-wires extending through body and proximal head alignment holes;  
         [0027]    [0027]FIG. 6 is a front end view of a right-hand volar plate according to the invention, shown with pegs coupled thereto and K-wires extending through alignment holes;  
         [0028]    [0028]FIGS. 7 through 12 illustrate a method of performing an osteotomy of the distal radius according to the invention;  
         [0029]    [0029]FIG. 13 is a side elevation of a partially threaded peg according to the invention; and  
         [0030]    [0030]FIG. 14 is a schematic illustration of a peg coupled within a peg hole according to one embodiment of the invention. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0031]    Turning now to FIGS. 1 through 6, a fracture fixation system  100  according to the invention is shown. The system  100  is particularly adapted for aligning and stabilizing multiple bone fragments in a dorsally displaced distal radius fracture (or Colles&#39; fracture). The system  100  generally includes a substantially rigid T-shaped plate  102 , commonly called a volar plate, bone screws  104  (FIG. 3), pegs  106 ,  108 , and K-wires  110  (FIGS. 5 and 6). Pegs  106  have a threaded head and a non-threaded shaft, and pegs  108  have both a threaded head and a threaded shaft. Either pegs  106  or  108 , or a combination thereof may be used at the discretion of the surgeon. Exemplar pegs are described in more detail in U.S. Pat. No. 6,364,882, which is hereby incorporated by reference herein in its entirety.  
         [0032]    In addition, a preferred partially threaded shaft peg  108  is shown best in FIGS. 6 and 13. Peg  108  includes a head portion  200  with preferably a single helical machine thread  202  of a first pitch and a shaft  204  portion having one or more threads  206  of a larger second pitch. (The head portion of non-threaded shaft pegs  106  also preferably includes a single helical thread.) The threads  206  preferably extend along a distal portion  208  of the shaft  204 , and most preferably where such distal portion comprises approximately one-half the length of the shaft. Alternatively, or in addition, one or more pegs may be used where the threads extend along substantially the entirety, or the entirety, or the length of the shaft.  
         [0033]    The volar plate  102  shown in the figures is a right-hand plate intended to be positioned against the volar side of a fractured radius bone of the right arm. It is appreciated that a left-hand volar plate is substantially a mirror image of the plate shown and now described. The T-shaped plate  102  defines an elongate body  116 , and a head  118  angled upward (in the Z-direction) relative to the head. The angle a between the head  118  and the body  116  is preferably approximately 25°. The head  118  includes a distal buttress  120  (i.e., the portion of the head distal a first set of peg holes  134 , discussed below). The plate  102  has a thickness of preferably approximately 0.1 inch, and is preferably made from a titanium alloy, such as Ti-6A1-4V.  
         [0034]    Referring to FIG. 4, the body  116  includes four preferably countersunk screw holes  124 ,  125 ,  126 ,  127  for the extension of bone screws  104  therethrough (FIG. 2). One of the screw holes,  127 , is preferably generally oval in shape permitting longitudinal movement of the plate  102  relative to the shaft of a bone screw when the screw is not tightly clamped against the plate.  
         [0035]    Referring to FIGS. 3 and 4, according to one preferred aspect of the plate  102 , the head portion  118  includes a first set of threaded preferably cylindrical peg holes  134  (for placement of pegs  106  and/or  108  therein) and a second set of threaded preferably cylindrical peg holes  138  (for placement of pegs  106  and/or  108  therein). Referring to FIG. 14, the peg holes  134 ,  138  optionally have double lead internal threads  210 ,  212 , with entries to these threads located 180° apart. Each of the threads  210 ,  212  is adapted to mate securely with the thread  202  on a peg head  200 , however thread  202  can only mate with one of the threads  210 ,  212  at any one time. The depth of each of the double lead internal threads  210 ,  212  is preferably substantially less than the depth of thread  202  on peg head  200 , and most preferably approximately one half such depth. The double lead threads  210 ,  212  facilitate alignment and entry of the peg head thread  202  into a thread of the peg hole, as the peg will require rotation by at most 180° in a single rotational direction before thread engagement. Furthermore, in distinction from a conical head and hole, the cylindrical double lead thread hole does not compromise the secure interlock attained from full travel of the thread  202  of the peg head  200  through the cylindrical peg hole  134 ,  138  through, e.g., 900°. Moreover, the double lead threads reduce cross-threading by fifty percent, whether a single lead thread or a double-lead thread peg is used.  
         [0036]    Referring back to FIGS. 3 and 4, the peg holes  134  of the first set are arranged substantially parallel to a line L 1  that is preferably slightly skewed (e.g., by 5°−10°) relative to a perpendicular P to the axis A of the body portion  116 . Axes through the first set of peg holes (indicated by the pegs  106  extending therethrough) are preferably oblique relative to each other, and are preferably angled relative to each other in two dimensions, generally as described in commonly-owned U.S. Pat. No. 6,364,882, which is hereby incorporated by reference herein in its entirety. This orientation of the pegs operates to stabilize and secure the head  118  of the plate  102  on the bone even where such pegs  106  do not have threaded shafts.  
         [0037]    The second set of peg holes  138  is provided relatively distal of the first set of peg holes  134  and is most preferably primarily located in the buttress  120 . Each of the peg holes  138  preferably defines an axis that is oblique relative to the other of peg holes  136  and  138 . Thus, each and every peg  106 ,  108  when positioned within respective peg holes  134 ,  138  defines a distinct axis relative to the other pegs. Moreover, the axes of the peg holes  138  are preferably oriented relative to the axes of peg holes  134  such that pegs  106 ,  108  within peg holes  138  extend (or define axes which extend) between pegs (or axes thereof) within peg holes  134  in an interleaved manner.  
         [0038]    Referring specifically to FIGS. 1, 2,  5  and  6 , according to another preferred aspect of the plate  102 , in order to approximate the anatomy for ideal fracture support and maintain a low profile, the upper and lower surfaces  140 ,  142 , respectively of the buttress  120  are chamfered, with the chamfer of the lower surface  142  being contoured for the anatomical structure that it will overlie. In particular, the lower surface  142  at an ulnar-side portion  144  of the head portion  118  is elevated primarily in a distal direction to accommodate the bulky volar rim of the lunate fossa, and the lower surface  142  at a radial side portion  146  of the head  118  is elevated laterally relative to the remainder of the head to accommodate a prominence at the radial aspect of the bone, as indicated by the visibility of these lower surfaces in the side views of FIGS. 1 and 2 and head-on view of FIG. 6. The contoured shape (with generally three defined planes) provides a stable shape that prevents rocking of the plate on the bone. In addition, the upper and lower surfaces  140 ,  142  are chamfered to have a reduced profile that limits potential interface with the ligaments and soft tissue (e.g., tendons) near the edge of the articular surface. A distal extension  148  is also provided at the ulnar side portion  146  to further buttress the volar lip (volar marginal fragment of the lunate fossa) of the articular socket of the radius bone, thereby providing support to maintain the wrist within the articular socket.  
         [0039]    Referring specifically to FIGS. 3 and 4, according to a further preferred aspect of the invention, the plate  102  is provided with body alignment holes  150 , proximal head alignment holes  152   a ,  152   b ,  152   c  (generally  152 ), and a distal head alignment hole  154 , each sized to closely accept standard Kirschner wires (K-wires), e.g., 0.7-1.2 mm in diameter. The upper openings of all the alignment holes  150 ,  152 ,  154  are substantially smaller in diameter (e.g., by thirty to fifty percent) than the shafts of screws  104  (approximately 3.15 mm in diameter) and the shafts of pegs  106 ,  108  (approximately 2.25 mm in diameter). The body alignment holes  150  are longitudinally displaced along the body portion  116  and provided at an oblique angle (preferably approximately 70°, as shown in FIG. 5) relative to the lower surface  158  of the body portion  116 . The proximal head alignment holes  152  alternate with the peg holes  134 . A tangent line H to the distalmost points of the head alignment holes  152  is preferably substantially coincident or closely parallel with a line tangent to points on the circumferences of the shafts of pegs  106  inserted through holes  134  adjacent the head portion  118  of the plate  102 . With respect to the proximal head alignment holes, it is appreciated that a shaft  106   a  of a peg is generally smaller in diameter than a head  106   b  of a peg (FIG. 6). Thus, a line tangent to the peg holes  134  (each sized for receiving the head  106   b  of peg  106 ) will be closely located, but parallel, to a line tangent to a distalmost point on the respective alignment hole  152 . Nevertheless, for purposes of the claims, both (i) a tangent line which is preferably substantially coincident with a line tangent to points on the circumferences of the shafts of pegs and (ii) a tangent line to a set of peg holes shall be considered to be “substantially coincident” with a line tangent to a distalmost point of an alignment hole  152 . Axes through alignment holes  152  preferably generally approximate (within, e.g., 3°) the angle of an axis of an adjacent peg hole  134 . Moreover, the axis through each proximal alignment hole  152  is preferably oriented substantially equidistantly between the axes through peg holes  134  on either side of the alignment hole. As such, K-wires  110  inserted into the proximal alignment holes  152  (and extending coaxial with the axes therethrough) define a virtual surface which is substantially the same virtual surface defined by pegs  106 ,  108  inserted through peg holes  134 . This common virtual surface follows the dorsal aspect of the subchondral bone. Thus, as described in more detail below, the insertion of K-wires  110  through proximal alignment holes  152  provides a visual cue to the surgeon regarding the alignment of the plate  102  and subsequently inserted pegs  106 ,  108 . Distal head alignment hole  154  is provided between the central and radial-side peg holes  138 , and has a circular upper opening, and a laterally oblong lower opening, as shown best in FIG. 6.  
         [0040]    The plate may be used in at least two different applications: fracture fixation and correction of a metaphyseal deformity. In either application, an incision is first made over the distal radius, and the pronator quadratus is reflected from its radial insertion exposing the entire distal radius ulnarly to the distal radioulnar joint. For fracture fixation, the surgeon reduces the fracture and aligns the plate  102  thereover. The surgeon then drills preferably two K-wires  110  through respective body alignment holes  150 , and preferably a plurality of K-wires through selected proximal head alignment holes  152  at the location at which the surgeon believes the pegs  106 ,  108  should be placed based on anatomical landmarks and/or fluoroscopic guidance. The K-wires temporarily fix the orientation of the plate to the distal fragment. While the fixation is temporary, it is relatively secure in view of the fact that the body alignment holes  150 , proximal head alignment holes  152 , and K-wires  110  therethrough are angled in different orientations relative to the lower surface of the plate. Once the alignment is so fixed, the fracture is examined, e.g., under fluoroscopy, to determine whether the K-wires  110  are properly aligned relative to the articular surface. As the axes of the proximal head alignment holes  152  correspond to axes of the adjacent peg holes  134 , the fluoroscopically viewed K-wires  110  provide an indication as to whether the pegs  106 ,  108  will be properly oriented. If the placement is correct, the K-wires  110  maintain the position of the plate  102  over the fracture while holes in the bone are drilled through the screw holes  124 ,  125 ,  126 ,  127  for the screws  104  and peg holes  134 ,  138  for pegs  106 ,  108 , with confidence that the locations and orientation of the screws and pegs inserted therein are anatomically appropriate. In addition, where pegs  108  are used, due to the difference in pitch between the head threads  202  and shaft threads  206 , slight compression of a distally or dorsally displaced fragment toward a proximal fragment or bone (e.g., 1.5 mm of travel) is effected even though the head  200  will lock relative to the head  118  of the plate  100 . Once the screws  104  and pegs  106 ,  108  have secured the plate to the bone, the K-wires are preferably removed.  
         [0041]    If fluoroscopic examination indicates that placement of the K-wires  110  is not optimal, the K-wires can be removed and the surgeon has an opportunity to relocate and/or reorient the K-wires and drill again. Since each K-wire is of relatively small diameter, the bone is not significantly damaged by the drilling process and the surgeon is not committed to the initial drill location and/or orientation.  
         [0042]    The pegs  106  within peg holes  138  define projections that provide support at the volar aspect behind the articular surface of the bone surface. The sets of pegs  106 ,  108  through peg holes  134 ,  138  laterally overlap so that the pegs preferably laterally alternate to provide closely-spaced tangential cradling of the subchondral bone. A preferred degree of subchondral support is provided with four peg holes  134  (and associated pegs) through the proximal portion of the head  118  of the plate, and three peg holes  138  (and associated pegs) through the distal portion of the head  118 . The fracture fixation system thereby defines a framework which substantially tangentially supports the bone fragments in their proper orientation. In accord with an alternate less preferred embodiment, suitable support may also be provided where the pegs  106  and  108  are parallel to each other or in another relative orientation or with fewer peg holes and/or pegs.  
         [0043]    The method particularly facilitates stabilization of a metaphyseal fracture which may include a smaller distal bone fragment spaced apart from a larger proximal fragment. The insertion of one or more threaded pegs  108  (preferably in conjunction with several non-threaded pegs  106 ) in which the threads on the shaft  206  have a pitch greater than the threads  202  on the head  200  causes a limited amount of compression of the smaller distal bone fragment toward the larger proximal bone fragment, and thus toward the plate.  
         [0044]    According to a second use, the plate may be used to correct a metaphyseal deformity  200  (such as malformed fracture or congenital deformity), as shown in FIG. 7. For such purposes, a K-wire  110  is drilled into the bone parallel to the articular surface S in the lateral view under fluoroscopy (FIG. 8). The free end of the K-wire  110  is guided through the oblong distal head alignment hole  154 , and the plate  102  is slid down over the K-wire into position against the bone (FIG. 9). The oblong alignment hole  154  permits the plate  102  to tilt laterally over the K-wire  110  to sit flat on the bone, but does not permit tilting of plate relative to the K-wire in the anterior-posterior plane. Once the plate  102  is seated against the bone, the surgeon drills holes in the bone in alignment with the peg holes  134 ,  138  (FIG. 3) and then fixes the plate relative the bone with pegs  106 ,  108  (FIG. 10). The K-wire  110  is removed. The bone is then saw cut at  202  proximal the location of the head  118  of the plate  102  (FIG. 11), and the body  116  of the plate is levered toward the proximal diaphyseal bone  204 , creating an open wedge  206  at the deformity (FIG. 12). When the body  116  of the plate  102  is in contact and longitudinal alignment with the diaphysis of the bone, the bone distal of the cut has been repositioned into the anatomically correct orientation relative to the shaft of the bone. The body  116  of the plate  102  is then secured to the bone with screws  104 . Post-operatively, the open wedge in the bone heals resulting in an anatomically correct distal radius.  
         [0045]    While fixed single-angle pegs have been disclosed for use with the plate (i.e., the pegs may be fixed in respective threaded peg holes  134 ,  136  only coaxial with an axis defined by the respective peg holes), it is appreciated that an articulating peg system, such as that disclosed in co-owned U.S. Pat. No. 6,440,135 or co-owned and co-pending U.S. Ser. No. 10/159,612, both of which are hereby incorporated by reference herein in their entireties, may also be used. In such articulating peg systems, the peg holes and pegs are structurally adapted such that individual pegs may be fixed at any angle within a range of angles. In addition, while less preferable, one or both sets of the pegs may be replaced by preferably blunt tines which are integrated into the plate such that the plate and tines are unitary in construct. Similarly, other elongate projections may be coupled to the plate to define the desired support.  
         [0046]    There have been described and illustrated herein embodiments of a fixation plate, and particularly plates for fixation of distal radius fractures, as well as a method of aligning and stabilizing a distal radius fracture and performing an osteotomy. While particular embodiments of the invention have been described, it is not intended that the invention be limited thereto, as it is intended that the invention be as broad in scope as the art will allow and that the specification be read likewise. Thus, while particular materials, dimensions, and relative angles for particular elements of the system have been disclosed, it will be appreciated that other materials, dimensions, and relative angles may be used as well. In addition, while a particular number of screw holes in the volar plate and bone screws have been described, it will be understood another number of screw holes and screws may be provided. Further, fewer screws than the number of screw holes may be used to secure to the plate to the bone. Also, fewer or more peg holes and bone pegs may be used, preferably such that at least two pegs angled in two dimensions relative to each other are provided. In addition, while a particular preferred angle between the head and body has been disclosed, other angles can also be used. Moreover, while the cylindrical double lead thread hole and single thread head interface has been disclosed with respect to a fracture plate for distal radius fractures, it is appreciated that such a system has advantage to other orthopedic stabilization devices such as fragment plates (which may be rectangular in shape or a different shape) and plates specifically designed for fractures of other bones. Similarly, a threaded peg (i.e., locking screw) with threads of different pitches on the head and along the shaft may also be used in other applications. Furthermore, while a double lead thread hole is preferred for use with a peg having a single thread on its head, it is appreciated that, e.g., a triple lead thread hole can be used where the entry leads are angularly offset by 120°. Such will reduce cross threading by two-thirds, but will also reduce hole thread depth further. Also, while the double lead thread system is described with respect to a bone plate, it is appreciated that it can be applied to other orthopedic implants, such as rods, nails, prostheses, etc., having holes for fixation. Furthermore, while the double lead thread hole has been shown in conjunction with a peg having a single lead thread on its head portion, it is appreciated that the double lead thread hole is perfectly adapted for use with a peg having a double lead thread on its head portion. It will therefore be appreciated by those skilled in the art that yet other modifications could be made to the provided invention without deviating from its spirit and scope.