Patent Description:
The disclosure relates generally to implant positioning apparatuses and devices. More particularly, the disclosure relates to implant positioning apparatuses and devices for use in bone fixation, sternum fixation, and other orthopaedic fixation procedures.

In some surgical procedures involving bones, for instance, the procedure may involve separating a bone into portions, which are thereafter reunited. This happens, for example, in entries into the chest cavity, as for heart surgery, where the sternum is required to be separated along its length. There may be other instances where a bone has undergone fracturing through some trauma, and is thereafter to have portions rejoined for proper healing. Additionally, in applications involving the spine, there may be independent bones that benefit from holding a particular position relative to each other to allow for healing of the disc and other surrounding tissues.

The bones or skeletal tissue, or combinations of bone and tissue, can be held secure to one another in adjacency using a fixation device, or system. Many kinds of conventional fixation devices include wires or cables that are organized to pull the bone portions together, laterally across a divide or fracture. However, these types of fixation devices can be relatively complex to emplace. For instance, if a plate-type structure is to be attached to a bone, it is important to locate the fixation points (e.g., for screws) very accurately, as for drilling pilot holes for the screws. Plainly, speed and ease in then attaching the structure are significant considerations. <CIT> discloses an implant positioning device including a frame or body portion and a handle portion coupled to the body portion. The body includes one or more sets of fastener guides.

The invention relates to an implant positioning device and a plating system as defined in the appended claims.

Implant fixation devices and implant positioning devices are disclosed for assisting in positioning orthopaedic fixation devices (such as bone plates, etc.) for use in bone fixation, sternum fixation, and other orthopaedic fixation procedures. According to the invention, the implant positioning device includes a body with fastener guides. The fastener guides may include retaining arms formed at a proximal end of the fastener guide. The retaining arms may be configured to releasably hold a fastener in the fastener guide such that a head of the fastener is exposed at a proximal end and engageable by a fastener driver. The implant positioning device also includes a through-bore formed in the body at the proximal end and a retaining beam inserted into the through-bore. The beam extends past or beyond a distal end of the body. The implant positioning device may also include a first recess formed on the body and configured to receive a handle. In addition, the implant positioning device may also include a second recess formed at the distal end of body with rails configured to prevent movement of an orthopaedic fixation device coupled to the implant positioning device.

In another embodiment, an implant positioning device is disclosed, wherein a plate is to be affixed to a bone. In this embodiment, the device includes an implant positioning device releasably coupled to the plate. The implant positioning device includes a through-bore formed in the body at the proximal end and a retaining beam inserted into the through-bore. The beam extends past or beyond a distal end of the body. The implant positioning device may also include a first recess formed on the body and configured to receive a handle. In addition, the implant positioning device may also include a second recess formed at the distal end of body with rails configured to prevent movement of an orthopaedic fixation device coupled to the implant positioning device. The device may also include a handle releasably coupled to the first recess. The handle includes a first end for gripping by a user of the device and a second end that includes a leaf spring engageable with the first recess to releasably couple the handle to the device.

Embodiments of devices, systems, and methods are illustrated in the figures of the accompanying drawings which are meant to be exemplary and not limiting, in which like references are intended to refer to like or corresponding parts, and in which:.

While the embodiments described hereinafter are in the environment of positioning devices, systems and methods for use in positioning orthopaedic fixation devices for bones and other body parts, it should be appreciated that the disclosure has broader application, such as other calcaneus body parts require fixation features, such as screws, pins, or other fastener, to be located and placed.

<FIG> illustrate an implant positioning device <NUM> for use with an implant fixation device, such as a plate, according to an embodiment of the disclosure. As illustrated in <FIG>, the implant positioning device <NUM> includes a frame or a body <NUM> with one or more fastener guides <NUM>. Each fastener guide <NUM> includes one or more retaining arms <NUM> (which may be finger-like structures) formed on a first end or proximal end of the fastener guide <NUM> by slits or apertures <NUM>. The retaining arm <NUM> is configured to releasably hold, guide, and position a fastener that may be used to couple an orthopaedic fixation device, such as a plate, to a bone or other body part. Each fastener guide <NUM> may also include an angled surface <NUM> formed inside the fastener guide <NUM> at the proximal or top end of the fastener guide <NUM>. The angled surface <NUM> facilitates insertion and positioning of a fastener in the guide <NUM>. The angled surface <NUM> may also form a lip at the proximal or top end of the fastener guide <NUM> that retains a fastener in the fastener guide <NUM> and reduces the risk of a fastener falling out of the fastener guide <NUM> if the positioning device <NUM> is tilted or turned upside down.

The proximal end of the implant positioning device <NUM> also allows a top of the fastener to be exposed. This allows access for a fastener driver to access and engage a head of the fastener. The fastener may be a screw, pin, rivet, and other type of fastener, etc., and the retaining arm <NUM> and slits <NUM> may serve as expansion zones to help capture a wide variety of fasteners effectively. As illustrated, the slits <NUM> are positioned on opposing sides of the retaining arm <NUM>. The slits <NUM> also allow the retaining arm <NUM> to elastically move or flex away from the guide <NUM> to allow the fastener to be moved or pushed through the fastener guide <NUM>, when the fastener is driven into a bone or other body part.

As illustrated in <FIG>, the implant positioning device <NUM> may include six fastener guides <NUM>. However, the implant positioning device <NUM> may include more or less than six fastener guides <NUM> as needed to reattach bones after a sternotomy or other procedure. The retaining arms <NUM> may also be used to guide other instruments, for example, drills/drill bits, marking instruments to place markings, pegs, headless pins, etc. in a bone, which then serve as locating features to place plates or any other device before or after a resection is made, or after a fracture occurs.

In addition, the body <NUM> may include one or more lumens, boreholes, channels or through-bores <NUM> extending through the body <NUM> from the first/proximal end of the implant positioning device <NUM> to a second/distal end of the implant positioning device <NUM>. Each through-bore <NUM> is configured to receive a retaining beam <NUM>. The retaining beam <NUM> may be inserted into the corresponding through-bore <NUM> and retained within the through-bore <NUM> by being press-fit within the through-bore <NUM>. The retaining beam <NUM> may be welded at the first/proximal end of the body <NUM> to ensure the retaining beam <NUM> remains within the through-bore <NUM>. However, the retaining beams <NUM> may also be inserted into the through-bores <NUM> using a number of different methods. For example, the retaining beams <NUM> may be screwed into the through-bores <NUM> using threads that are formed on the proximal end of the retaining beam and through-bore.

Each retaining beam <NUM>, as shown in more detail in <FIG>, is configured to removably couple the implant positioning device <NUM> to a plate, such that the implant positioning device <NUM>, such that a fastener disposed within the implant positioning device <NUM> is in alignment with a fastener aperture in a plate <NUM>. While two retaining beam <NUM> are illustrated, the implant positioning device <NUM> may have additional or fewer retaining beams <NUM> as needed, to removably couple the fastener guide <NUM> with the plate <NUM>.

Each retaining beam <NUM> has a first or proximal portion that is substantially the same size as a diameter of the through-bore <NUM> to ensure the retaining beam <NUM> can be press-fit into the through-bore <NUM>. The retaining beam <NUM> also has a second or distal portion that is opposite the first/proximal portion that has a diameter less than the diameter of the first portion. The smaller second portion of the retaining beam <NUM> allows the retaining beam to flex within the through-bore <NUM> to removably couple with a plate. In addition, the through-bore <NUM> may prevent the retaining beam <NUM> from becoming deformed due to over flexing.

Further, the second end has a retaining beam channel <NUM> formed around the retaining beam <NUM> to receive a side of a plate. The retaining beam channel <NUM> may be shaped to reflect a shape of the side of the plate to be received to removably couple the implant positioning device <NUM> to the plate, as shown in <FIG>.

According to one embodiment, the body <NUM> may have a substantially H-shape, and the through-bores <NUM> and retaining beams <NUM> may be positioned in the horizontal between the legs of the "H". However, the body <NUM> may be shaped in a number of different ways to match a shape of a plate to be used. For example, during a median sternotomy, a vertical inline incision is made along a sternum of a patient and the sternum is divided along this incision. The implant positioning device <NUM> may be used to attach a plate that is substantially H-shaped (shown in <FIG>) to reattach the sternum of the patient once the procedure is complete.

The implant positioning device <NUM> may also include rails <NUM> (as shown in <FIG>) that extend from the second/distal side of the body <NUM> proximal to an inner side of the legs of the H-shaped body <NUM>. The rails <NUM> may be contoured to a shape of the plate and used to couple the implant positioning device <NUM> to the plate and prevent the plate from spinning and/or angular or rotational movement of the plate when removably coupled to the implant positioning device <NUM>. Multiple rails <NUM> may be used to help position the plate in the proper orientation for attachment onto a bone or other body part. In addition, each rail <NUM> may also have a rail channel <NUM> adapted to receive an edge of the plate to removably couple the plate to the implant positioning device <NUM> and further limit movement of the plate, as show in <FIG>.

The body <NUM> may also have one or more handle recesses <NUM>. The handle recesses <NUM> are configured to receive and removably couple a handle <NUM> (shown in <FIG>) to the implant positioning device <NUM>. The handle recesses <NUM> may help prevent rotation of the implant positioning device <NUM> when attached to the handle <NUM>. As illustrated, handle recesses <NUM> may be positioned between two adjacent fastener guides <NUM> on an exterior side of the body <NUM> and may also be positioned in a middle portion of the H-shaped body. The handles recesses <NUM> may also have secondary recesses <NUM> to provide an additional connection point for the handle <NUM>. For example, the secondary recesses <NUM> may provide a connection point that rigidly attaches the handle <NUM> to the body <NUM>.

According to one aspect of the disclosure, the implant positioning device <NUM> may be disposable or reusable, and pre-loaded with fasteners. Additionally, the body <NUM> may be made of a semi-elastic material such that the retaining arms <NUM> and retaining beams <NUM> are able to expand without substantial deformation, such as a metal, polymer, plastic, etc. For example, the body <NUM> may be made of a metal material that allows the retaining arms <NUM> and retaining beams <NUM> to expand without substantial deformation.

<FIG> illustrates a plate <NUM> that is attachable to a bone. The plate <NUM> includes one or more fastener apertures <NUM>, each with grooves or threads <NUM> configured to receive a fastener to couple the plate <NUM> to a bone. The plate <NUM> includes an aperture <NUM> that is substantially in the middle of the plate <NUM>. The aperture <NUM> may be configured to receive the retaining beams <NUM> of the implant positioning device <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>. For example, as shown in <FIG>, each retaining beam <NUM> may have a channel <NUM> and a side of the plate <NUM> forming the aperture <NUM> may be configured to fit within the channel <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>. The plate <NUM> may also include protrusions <NUM> that extend from a middle portion of the plate <NUM>. The protrusions <NUM> may be keyed to the implant positioning device <NUM> and used to prevent the plate <NUM> from being coupled to the implant positioning device <NUM> in an incorrect orientation, i.e., upside down.

In one example, the implant positioning device <NUM> may be preloaded with a fastener by placing the fastener in the first end of the fastener guide <NUM>. This may include pushing the fastener into the fastener guide <NUM> until a head of the fastener is gripped and held in place by the retaining arms <NUM>. The implant positioning device <NUM> may then be coupled to a plate, such as plate <NUM>, by pushing the retaining beams <NUM> of the implant positioning device <NUM> onto the plate <NUM>. This may cause the retaining beams <NUM> to move or flex, and then snap onto the side of the plate <NUM>, for example, into cutouts or recesses <NUM> formed in the plate <NUM>. The cutouts or recesses <NUM> may be keyed to receive the retaining beams <NUM> and couple the plate <NUM> to the implant positioning device <NUM>. It should be appreciated that the implant positioning device <NUM> may be coupled to a plate, such as plate <NUM>, prior to the insertion of the fastener.

Once the implant positioning device <NUM> is coupled to the plate <NUM> and the fastener is inserted into the fastener guide <NUM>, the implant positioning device <NUM> may provide a type of handle or holding zone that can be gripped by a user or other instrument. This allows the plate <NUM> to be positioned on a bone or other body part. Referring to <FIG>, the retaining beams <NUM> couple to the inner profile of the plate <NUM> within the aperture <NUM>, and an outer peripheral shape of the implant positioning device <NUM> is smaller than an outer peripheral shape of the plate <NUM>. This allows the entire periphery of the plate <NUM> to be visible when the implant positioning device <NUM> is coupled to the plate <NUM>. Accordingly, the peripheral shapes of the plate <NUM> and the implant positioning device <NUM> allow a user to view where the plate <NUM> is ultimately going to be placed in relation to the bone, tissue, or other body part.

Once the plate <NUM> is positioned, the fastener can be driven through the fastener guide <NUM> and fastener aperture <NUM>, and into the bone or other body part by a fastener driver to couple the plate <NUM> to the bone or other body part. As the fastener is driven through the fastener guide <NUM>, the retaining arms <NUM> move or flexes away from the body <NUM> to allow the fastener to move through the fastener guide <NUM>.

It should be appreciated that the implant positioning device <NUM> can be coupled to the plate <NUM> with the fastener guides <NUM> in alignment with the corresponding fastener apertures <NUM>. This may facilitate ease of alignment and insertion of separate fasteners into each of the fastener apertures <NUM>. It should also be appreciated that the size, shape, and number of fastener apertures of the plate can be modified and adapted for a specific application. Similarly, the implant positioning device <NUM> may be adapted or modified to accommodate different plate geometries and features. The implant positioning device <NUM> may be used in conjunction with any type of bone plate or other type of plate. For example, the implant positioning device <NUM> may be used for alignment and fixation of boney elements to prevent motion in a particular direction as well as providing dynamic stabilization. The implant positioning device <NUM> may also be used prior to or after a separation of a bone or other calcaneus body parts to align one or more plates.

<FIG> illustrate the handle <NUM> that may be coupled to the implant positioning device <NUM>. The handle <NUM> includes a first end that has a gripping portion <NUM> that allows a user of the handle <NUM> to grip the handle. The gripping portion <NUM> is coupled to a connecting portion <NUM> that connects the gripping portion <NUM> to a head portion <NUM>. The head portion <NUM> includes two prongs configured to fit around a body of an implant positioning device, for example implant positioning device <NUM>.

The head portion <NUM> may be configured to slide into the handle recess <NUM> of the implant positioning device <NUM>, as shown in <FIG> and <FIG>. The handle <NUM> may releasably couple to the implant positioning device <NUM> and the handle recess <NUM> may minimize movement of the implant positioning device <NUM> relative to the handle <NUM>. This assists in ease of use of the implant positioning device <NUM> to properly position the plate <NUM> on the bone. Further, the head portion <NUM> may include a leaf spring <NUM> on at least one of the two prongs to assist handle <NUM> in coupling more securely to the body <NUM> of the implant positioning device <NUM> and further limit movement of the implant positioning device <NUM> relative to the handle <NUM>. For example, when the handle <NUM> is coupled to the handle recess <NUM>, the leaf spring <NUM> deforms and the leaf spring exerts a spring-force against the body <NUM>. The deformation and spring-force provides a frictional engagement between the leaf spring <NUM> and the body <NUM> that retains the implant positioning device <NUM> on the handle <NUM>.

<FIG> illustrate an implant positioning device <NUM> for use with an implant fixation device according to an embodiment of the disclosure. As illustrated in <FIG>, the implant positioning device <NUM> includes a frame or a body <NUM> that has one fastener guide <NUM>. The fastener guide <NUM> is configured to releasably hold, guide, and position a fastener that may be used to couple an orthopaedic fixation device, such as a plate, to a bone or other body part. The proximal end of the implant positioning device <NUM> also allows a top of the fastener to be exposed. This allows access for a fastener driver to access and engage a head of the fastener. The fastener may be a screw, pin, rivet, and other type of fastener, etc. The fastener guide <NUM> may have expansion zones to help capture a wide variety of fasteners effectively. For example, the fastener guide <NUM> may include one or more retaining arms (which may be finger-like structures) formed by slits or apertures, as described above with respect to the implant positioning device <NUM>.

As illustrated in <FIG>, the implant positioning device <NUM> may include a single fastener guide <NUM>. However, the implant positioning device <NUM> may include more than one fastener guide <NUM> as needed to reattach bones or other body parts. In addition, the fastener guide <NUM> may also be used to guide other instruments, for example, drills/drill bits, marking instruments to place markings, pegs, headless pins, etc. in a bone, which then serve as locating features to place plates or any other device before or after a resection is made, or after a fracture occurs.

The body <NUM> may include one or more lumens, boreholes, channels or through-bores <NUM> at the first/proximal end of the implant positioning device <NUM> that extend to a second/distal end opposite the first end. Each through-bore <NUM> is configured to receive a retaining beam <NUM>. The retaining beam <NUM> may be inserted into the corresponding through-bore <NUM> and retained within the through-bore <NUM> by being press-fit within the through-bore <NUM>. Further, the retaining beam <NUM> may be welded at the first/proximal end of the body <NUM> to ensure the retaining beam <NUM> remains within the through-bore <NUM>. However, the retaining beams <NUM> may also be inserted into the through-bore <NUM> using a number of different methods. For example, the retaining beams <NUM> may be screwed into the through-bore <NUM> using threads that are formed on the proximal end of the retaining beam and through-bore.

The retaining beams <NUM>, as described above and shown in more detail in <FIG>, are configured to removably couple the implant positioning device <NUM> around a fastener aperture of a plate, such that the implant positioning device <NUM>, or fastener disposed within the implant positioning device <NUM>, is in alignment with a fastener aperture in the plate. While three retaining beams <NUM> are illustrated, the implant positioning device <NUM> may have additional or fewer retaining beams <NUM> as needed, to removably couple the fastener guide <NUM> with the plate.

Each retaining beam <NUM> has a first or proximal portion that is substantially the same size as a diameter of the through-bore <NUM> to ensure the retaining beam <NUM> can be press-fit into the through-bore <NUM>. The retaining beam <NUM> also has a second or distal portion that is opposite the first/proximal portion that has a diameter less than the diameter of the first end. The smaller second portion of the retaining beam <NUM> allows the retaining beam to flex within the through-bore <NUM> to removably couple with a plate. In addition, the through-bore <NUM> may prevent the retaining beam <NUM> from becoming deformed due to over flexing.

Further, the second end has a retaining beam channel <NUM> formed around the retaining beam <NUM> to receive a side of a plate. The retaining beam channel <NUM> may be shaped to reflect a shape of the side of the plate to be received to removably couple the implant positioning device <NUM> to a plate, as shown in <FIG>.

According to one embodiment, the body <NUM> may have a substantially triangular shape. However, the body <NUM> may be shaped in a number of different ways to allow for implant positioning device <NUM> to removably couple around any fastener aperture on a plate, as illustrated in <FIG>.

As described above with respect to the implant position device <NUM>, the implant positioning device <NUM> may be disposable or reusable, and pre-loaded with fasteners. Similarly, the body <NUM> may be made of a semi-elastic material such that the fastener guide <NUM> is able to expand without substantial deformation.

The body <NUM> may also have a handle <NUM> that extends from the body <NUM> and is adapted to couple to a grip (not shown). The handle <NUM> may minimize movement of the implant positioning device <NUM>. The handle <NUM> also assists in ease of use of the implant positioning device <NUM> to properly position a plate.

<FIG> illustrate another implant positioning device <NUM> for use with an implant fixation device according to another embodiment of the disclosure. As illustrated in <FIG>, the implant positioning device <NUM> includes a frame or a body <NUM> that has fastener guides <NUM>. Each fastener guide <NUM> includes one or more retaining arms <NUM> (which may be finger-like structures) formed on a first end or proximal end of the fastener guide <NUM> by slits or apertures <NUM>. Each retaining arm <NUM> is configured to releasably hold, guide, and position a fastener that may be used to couple an orthopaedic fixation device, such as a plate, to a bone or other body part. The proximal end of the implant positioning device <NUM> also allows a top of the fastener to be exposed. This allows access for a fastener driver to access and engage a head of the fastener. The fastener may be a screw, pin, rivet, and other type of fastener, etc., and the retaining arm <NUM> and slits <NUM> may serve as expansion zones to help capture a wide variety of fasteners effectively. As illustrated, the slits <NUM> are positioned on opposing sides of the retaining arm <NUM>. The slits <NUM> also allow the retaining arm <NUM> to elastically move or flex to allow the fastener to be moved or pushed through the corresponding fastener guide <NUM>, when the fastener is driven into a bone or other body part.

As illustrated in <FIG>, the implant positioning device <NUM> may include two fastener guides <NUM>. However, the implant positioning device <NUM> may include more or less than two fastener guides <NUM> as needed to reattach bones after a sternotomy. The retaining arms <NUM> may also be used to guide other instruments, for example, drills/drill bits, marking instruments to place markings, pegs, headless pins, etc. in a bone, which then serve as locating features to place plates or any other device before or after a resection is made, or after a fracture occurs.

In addition, the body <NUM> may include lumens, boreholes, channels or through-bores <NUM> at the first/top end of the implant positioning device <NUM> that are disposed at opposite ends and sides from each other. The through-bores <NUM> are configured to receive a retaining beam <NUM>, similar to one described above and shown in <FIG>. Each retaining beam <NUM> may be inserted into the corresponding through-bore <NUM> and retained within the through-bore <NUM> by being press-fit within the through-bore <NUM>. Further, the retaining beam <NUM> may be welded at the first/proximal end of the body <NUM> to ensure the retaining beam <NUM> remains within the through-bore <NUM>. However, the retaining beam <NUM> may also be inserted into the through-bore <NUM> using a number of different methods. For example, the retaining beam <NUM> may be screwed into the through-bore <NUM> using threads that are formed on the proximal end of the retaining beam and through-bore.

The retaining beam <NUM> is configured to removably couple the implant positioning device <NUM> to a portion of a plate, such that the implant positioning device <NUM>, or fastener disposed within the implant positioning device <NUM>, is in alignment with a fastener aperture in the plate. While two retaining beams <NUM> are illustrated, the implant positioning device <NUM> may have additional or fewer retaining beams <NUM> as needed, to removably couple the fastener guide <NUM> with the plate.

Each retaining beam <NUM> has a first or proximal portion that is substantially the same size as a diameter of the through-bore <NUM> to ensure the retaining beam <NUM> can be press-fit into the through-bore <NUM>. The retaining beam <NUM> also has a second or distal portion that is opposite the first/proximal end that has a diameter less than the diameter of the first portion. The smaller second portion of the retaining beam <NUM> allows the retaining beam to flex within the through-bore <NUM> to removably couple with a plate. In addition, the through-bore <NUM> may prevent the retaining beam <NUM> from becoming deformed due to over flexing.

Further, the second end has a retaining beam channel <NUM> formed around the retaining beam <NUM> to receive a side of the plate. The retaining beam channel <NUM> may be shaped to reflect a shape of the side of the plate to be received to removably couple the implant positioning device <NUM> to the plate, as shown in <FIG>.

According to one embodiment, the body <NUM> may have a substantially linear shape where the two fastener guides <NUM> form a line with each other. However, the body <NUM> may be shaped in a number of different ways to match a shape of a plate to be used.

The implant positioning device <NUM> may also include rails <NUM> that extend from the second/distal side of the body <NUM> between the two fastener guides <NUM> of the body <NUM>. The rails <NUM> may couple to the plate and be used to prevent the plate from spinning and/or angular or rotational movement of the plate when removably coupled to the implant positioning device <NUM>. Multiple rails <NUM> may be used to help position the plate in the proper orientation for attachment onto a bone or other body part. In addition, each rail <NUM> may also have a rail channel <NUM> to receive an edge of the plate to removably couple the implant positioning device <NUM> to the plate and further limit movement of the plate, as show in <FIG>.

The body <NUM> may also have a handle recess <NUM>. The handle recess <NUM> is configured to receive and removably couple to a handle (such as handle <NUM> described above and shown in <FIG>) to the implant positioning device <NUM>. In addition, the handle recess <NUM> may help prevent rotation of the implant positioning device <NUM> when attached to the handle <NUM>. As illustrated, the handle recess <NUM> may be positioned between the two fastener guides <NUM> on an exterior of the body <NUM>. The handles recess <NUM> may also have a secondary recess (not shown) to provide an additional connection point for the handle. For example, the secondary recesses may provide a connection point that rigidly attaches the handle <NUM> to the body <NUM>.

As described above with respect to implant positioning devices <NUM> and <NUM>, the implant positioning device <NUM> may be disposable or reusable, and pre-loaded with fasteners. In one example, the implant positioning device <NUM> may be preloaded with a fastener by placing the fastener in the first end of the fastener guide <NUM>. This may include pushing the fastener into the fastener guide <NUM> until a head of the fastener is gripped and held in place by the retaining arm <NUM>. The implant positioning device <NUM> may then be coupled to a plate by pushing the retaining beams <NUM> of the implant positioning device <NUM> onto the plate. This may cause the retaining beams <NUM> to move or flex and snap onto the side the plate. It should be appreciated that the implant positioning device <NUM> may be coupled to the plate prior to the insertion of the fastener.

Once the implant positioning device <NUM> is coupled to the plate and the fastener is inserted into the fastener guide <NUM>, the implant positioning device <NUM> may provide a type of handle or holding zone that can be gripped by a user or other instrument. This allows the plate to be positioned on a bone or other body part. Once positioned, the fastener can be driven through the fastener guide <NUM> and fastener aperture on the plate, and into the bone or other body part by a fastener driver to couple the plate to the bone or other body part. As the fastener is driven through the fastener guide <NUM>, the retaining arm <NUM> moves or flexes away from the body <NUM> to allow the fastener to move through the fastener guide <NUM>.

<FIG> illustrate another implant positioning device <NUM> for use with an implant fixation device according to an embodiment of the disclosure. As illustrated, the implant positioning device <NUM> includes a frame or a body <NUM> that has fastener guides <NUM>. As described above with reference to the implant positioning device <NUM>, each fastener guide <NUM> includes one or more retaining arms <NUM> (which may be finger-like structures) formed on a first side or top side of the fastener guide <NUM> by slits or apertures <NUM>. The retaining arms <NUM> are configured to releasably hold, guide, and position a fastener that may be used to couple an orthopaedic fixation device, such as a plate, to a bone or other body part. Each fastener guide <NUM> may also include an angled surface <NUM> formed inside the fastener guide <NUM> at the proximal or top end of the fastener guide <NUM>. The angled surface <NUM> facilitates insertion and positioning of a fastener in the guide <NUM>. The angled surface <NUM> may also form a lip at the proximal or top end of the fastener guide <NUM> that retains a fastener in the fastener guide <NUM> and reduces the risk of a fastener falling out of the fastener guide <NUM> if the positioning device <NUM> is tilted or turned upside down.

The top side of the implant positioning device <NUM> also allows a top of the fastener to be exposed. The fastener may be a screw, pin, rivet, and other type of fastener, etc., and the retaining arm <NUM> and slits <NUM> may serve as expansion zones to help capture a wide variety of fasteners effectively. As illustrated, the slits <NUM> are positioned on opposing sides of the retaining arms <NUM> and allow the retaining arms <NUM> to elastically move or flex to allow the fastener to be moved or pushed through the fastener guide <NUM>, when the fastener is driven into a bone or other body part.

As illustrated, the implant positioning device <NUM> may include four fastener guides <NUM> oriented in a box type shape. However, the implant positioning device <NUM> may include more or less than four fastener guides <NUM> as needed. The retaining arm <NUM> may also be used to guide other instruments, for example, drills/drill bits, marking instruments to place markings, pegs, headless pins, etc. in a bone, which then serve as locating features to place plates or any other device before or after a resection is made, or after a fracture occurs.

The body <NUM> may include lumens, boreholes, channels or through-bores <NUM> at the first/top side of the implant positioning device <NUM> that extend to a second/bottom side, opposite for the first side. Each through-bore <NUM> is configured to receive a retaining beam <NUM>, similar to one described above with reference to the implant positioning device <NUM> and shown in <FIG>. Each retaining beam <NUM> may be inserted into the corresponding through-bore <NUM> and retained within the through-bore <NUM> by being press-fit within the through-bore <NUM>. The retaining beam <NUM> may also be welded at the first/top side of the body <NUM> to ensure the retaining beam <NUM> remains within the through-bore <NUM>. However, the retaining beam <NUM> may also be inserted into the through-bore <NUM> using a number of different methods. For example, the retaining beams <NUM> may be screwed into the through-bore <NUM> using threads that are formed on the top side of the retaining beam and through-bore.

The retaining beams <NUM>, which are similar to retaining beams <NUM> described above and shown in <FIG>, are configured to removably couple the implant positioning device <NUM> to a portion of a plate, such that the implant positioning device <NUM>, or fastener disposed within the implant positioning device <NUM>, is in alignment with a fastener aperture in the plate, for example, the plate <NUM> shown. While two retaining beams <NUM> are illustrated, the implant positioning device <NUM> may have additional or fewer retaining beams <NUM> as needed, to removably couple the fastener guide <NUM> with the plate.

Each retaining beam <NUM> has a first or top portion that is substantially the same size as a diameter of the through-bore <NUM> to ensure the retaining beam <NUM> can be press-fit into the through-bore <NUM>. The retaining beam <NUM> also has a second or bottom portion that is opposite the first/top portion that has a diameter less than the diameter of the first portion. The second portion has a retaining beam channel <NUM> formed around the retaining beam <NUM> to receive a side of the plate. The retaining beam channel <NUM> may be shaped to reflect a shape of the side of the plate to be received to removably couple the implant positioning device <NUM> to the plate.

According to one embodiment, the body <NUM> may have a substantially square or box type shape. However, the body <NUM> may be shaped to in a number of different ways to match a shape of the plate to be used. The implant positioning device <NUM> may also include rails <NUM> that extend from the second/bottom side of the body <NUM>. The rails <NUM> may be used to prevent a plate from spinning and/or angular or rotational movement of the plate when removably coupled to the implant positioning device <NUM>. Multiple rails <NUM> or one rail <NUM> shaped to fit in an aperture of a plate, such as aperture <NUM> of plate <NUM>, may be used to help position the plate in the proper orientation for attachment onto a bone or other body part. In addition, each rail <NUM> may also have a rail channel <NUM> to receive an edge of the plate to removably couple the plate to the implant positioning device <NUM> and further limit movement of the plate.

As described above with respect to the implant positioning device <NUM>, the body <NUM> may also have a handle recess <NUM>. The handle recess <NUM> is configured to receive and removably couple to a handle, for example, the handle <NUM> described above and shown in <FIG>, to the implant positioning device <NUM>. As illustrated, handle recesses <NUM> may be positioned between two adjacent fastener guides <NUM>. The handles recesses <NUM> may also have secondary recesses <NUM> to provide an additional connection point for the handle. For example, the secondary recesses <NUM> may provide a connection point that rigidly attaches the handle <NUM> to the body <NUM>.

The plate <NUM> includes one or more fastener apertures <NUM>, each with grooves or threads <NUM> configured to receive a fastener to couple the plate <NUM> to a bone. The plate <NUM> includes an aperture <NUM> that is substantially in the middle of the plate <NUM>. The aperture <NUM> may be configured to receive the rails <NUM> and retaining beams <NUM> of the implant positioning device <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>. For example, each retaining beam <NUM> may have a channel <NUM> and a side of the plate <NUM> may be configured to fit within the channel <NUM> disposed on a bottom end of the retaining beam <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>. The plate <NUM> may also include protrusions <NUM> that extend from a middle portion of the plate <NUM>. The protrusions may be keyed to the rails <NUM> and/or implant positioning device <NUM> and used to prevent the plate <NUM> from being coupled to the implant positioning device <NUM> in an incorrect orientation, i.e., upside down.

As described above with respect to the implant positioning device <NUM>, the implant positioning device <NUM> may be preloaded with a fastener by placing the fastener in the first end of the fastener guide <NUM>. This may include pushing the fastener into the fastener guide <NUM> until a head of the fastener is gripped and held in place by the retaining arm <NUM>. The implant positioning device <NUM> may then be coupled to a plate, such as plate <NUM>, by pushing the retaining beams <NUM> of the implant positioning device <NUM> onto the plate <NUM>. This may cause the retaining beams <NUM> to move or flex towards each other, and then snap outwards away from each other onto the side of the plate <NUM>, for example, into cutouts or recesses <NUM>. The cutouts or recesses <NUM> may be keyed to receive the retaining beams <NUM> and couple the plate <NUM> to the implant positioning device <NUM>. It should be appreciated that the implant positioning device <NUM> may be coupled to a plate, such as plate <NUM>, prior to the insertion of the fastener.

As described above with respect to the implant positioning device <NUM>, once the implant positioning device <NUM> is coupled to the plate <NUM> and the fastener is inserted into the fastener guide <NUM>, the implant positioning device <NUM> may provide a type of handle or holding zone that can be gripped by a user or other instrument. This allows the plate <NUM> to be positioned on a bone or other body part. As illustrated, the retaining beams <NUM> couple to the inner profile of the plate <NUM> within the aperture <NUM>, and an outer peripheral shape of the implant positioning device <NUM> is smaller than an outer peripheral shape of the plate <NUM>. This allows the entire periphery of the plate <NUM> to be visible when the implant positioning device <NUM> is coupled to the plate <NUM>.

Once the plate <NUM> is positioned, the fastener can be driven through the fastener guide <NUM> and fastener aperture <NUM>, and into the bone or other body part by a fastener driver to couple the plate <NUM> to the bone or other body part. As the fastener is driven through the fastener guide <NUM>, the retaining arm <NUM> moves or flexes away from the body <NUM> to allow the fastener to move through the fastener guide <NUM>.

As illustrated, the implant positioning device <NUM> may include four fastener guides <NUM> oriented in a V-type or U-type shape. However, the implant positioning device <NUM> may include more or less than four fastener guides <NUM> as needed. The retaining arm <NUM> may also be used to guide other instruments, for example, drills/drill bits, marking instruments to place markings, pegs, headless pins, etc. in a bone, which then serve as locating features to place plates or any other device before or after a resection is made, or after a fracture occurs.

The retaining beams <NUM>, which are similar to retaining beams <NUM> described above and shown in <FIG>, are configured to removably couple the implant positioning device <NUM> to a portion of a plate, such that the implant positioning device <NUM>, or fastener disposed within the implant positioning device <NUM>, is in alignment with a fastener aperture in the plate, for example, the plate <NUM> shown. While two retaining beam <NUM> are illustrated, the implant positioning device <NUM> may have additional or fewer retaining beams <NUM> as needed, to removably couple the fastener guide <NUM> with the plate.

According to one embodiment, the body <NUM> may have a substantially V-type or U-type shape. However, the body <NUM> may be shaped to in a number of different ways to match a shape of the plate to be used. The implant positioning device <NUM> may also include rails <NUM> that extend from the second/bottom side of the body <NUM>. The rails <NUM> may be used to prevent a plate from spinning and/or angular or rotational movement of the plate when removably coupled to the implant positioning device <NUM>. Multiple rails <NUM> may be used to help position the plate in the proper orientation for attachment onto a bone or other body part. In addition, each rail <NUM> may also have a rail channel <NUM> to receive an edge of the plate to removably couple the plate to the implant positioning device <NUM> and further limit movement of the plate.

The plate <NUM> includes one or more fastener apertures <NUM>, each with grooves or threads <NUM> configured to receive a fastener to couple the plate <NUM> to a bone. The plate <NUM> is substantially V-shaped or U-shaped and may be configured to receive the rails <NUM> and retaining beams <NUM> of the implant positioning device <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>. For example, each retaining beam <NUM> may have a channel <NUM> and a side of the plate <NUM> may be configured to fit within the channel <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>.

As described above with respect to the implant positioning device <NUM>, the implant positioning device <NUM> may be preloaded with a fastener by placing the fastener in the first end of the fastener guide <NUM>. This may include pushing the fastener into the fastener guide <NUM> until a head of the fastener is gripped and held in place by the retaining arm <NUM>. The implant positioning device <NUM> may then be coupled to a plate, such as plate <NUM>, by pushing the retaining beams <NUM> onto the plate <NUM>. This may cause the retaining beams <NUM> to move or flex towards each other, and then snap outwards away from each other onto the side of the plate <NUM>, for example, into cutouts or recesses <NUM>. The cutouts or recesses <NUM> may be keyed to receive the retaining beams <NUM> and couple the plate <NUM> to the implant positioning device <NUM>. It should be appreciated that the implant positioning device <NUM> may be coupled to a plate, such as plate <NUM>, prior to the insertion of the fastener.

As illustrated, the retaining beams <NUM> couple to the inner profile of the V-shape of plate <NUM>, and an outer peripheral shape of the implant positioning device <NUM> is smaller than an outer peripheral shape of the plate <NUM>. This allows the outer periphery of the plate <NUM> to be visible when the implant positioning device <NUM> is coupled to the plate <NUM>.

As illustrated, the implant positioning device <NUM> may include six fastener guides <NUM> oriented in a circular type or O-type shape. However, the implant positioning device <NUM> may include more or less than six fastener guides <NUM> as needed. The retaining arm <NUM> may also be used to guide other instruments, for example, drills/drill bits, marking instruments to place markings, pegs, headless pins, etc. in a bone, which then serve as locating features to place plates or any other device before or after a resection is made, or after a fracture occurs.

According to one embodiment, the body <NUM> may have a substantially circular shape. However, the body <NUM> may be shaped in a number of different ways to match a shape of the plate to be used. The implant positioning device <NUM> may also include rails <NUM> that extend from the second/bottom side of the body <NUM>. The rails <NUM> may be used to prevent a plate from spinning and/or angular or rotational movement of the plate when removably coupled to the implant positioning device <NUM>. Multiple rails <NUM> or one rail <NUM> shaped to fit in an aperture of a plate, such as aperture <NUM> of plate <NUM>, may be used to help position the plate in the proper orientation for attachment onto a bone or other body part. In addition, each rail <NUM> may also have a rail channel <NUM> to receive an edge of the plate to removably couple the plate to the implant positioning device <NUM> and further limit movement of the plate.

As described above with respect to the implant positioning device <NUM>, the body <NUM> may also have a handle recess <NUM>. The handle recess <NUM> is configured to receive and removably couple to a handle, for example, the handle <NUM> described above and shown in <FIG>, to the implant positioning device <NUM>. As illustrated, handle recess <NUM> may be positioned between two adjacent fastener guides <NUM>. The handles recess <NUM> may also have a secondary recess <NUM> to provide an additional connection point for the handle. For example, the secondary recesses <NUM> may provide a connection point that rigidly attaches the handle <NUM> to the body <NUM>.

The plate <NUM> includes one or more fastener apertures <NUM>, each with grooves or threads <NUM> configured to receive a fastener to couple the plate <NUM> to a bone. The plate <NUM> includes an aperture <NUM> that is substantially in the middle of the plate <NUM>. The aperture <NUM> may be configured to receive the rails <NUM> and retaining beams <NUM> of the implant positioning device <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>. For example, each retaining beam <NUM> may have a channel <NUM> and a side of the plate <NUM> may be configured to fit within the channel <NUM> to removably couple the implant positioning device <NUM> to the plate <NUM>. The aperture <NUM> may be keyed to the rails <NUM> and/or implant positioning device <NUM> and used to prevent the plate <NUM> from being coupled to the implant positioning device <NUM> in an incorrect orientation.

As illustrated, the retaining beams <NUM> couple to the inner profile of the plate <NUM> within the aperture <NUM>, and an outer peripheral shape of the implant positioning device <NUM> is smaller than an outer peripheral shape of the plate <NUM>. This allows the periphery of the plate <NUM> to be visible when the implant positioning device <NUM> is coupled to the plate <NUM>.

It should be appreciated that the plates described herein may have an anatomical concave or convex shape based on a contour of the shape of the bone or body part to which the plate is to be attached. Accordingly, an implant positioning device, such as the implant positioning devices described above, may have a contour that matches the contour of the plate to allow the implant positioning device to removably couple with the plate. In addition, the plates may be different shapes based on a shape of a plate needed to be used to reattach bones or other calcaneus body parts.

For example, <FIG> illustrate an implant positioning device <NUM> and plate <NUM> that are contoured. The implant positioning device <NUM> and plate <NUM> are essentially the same as the implant positioning device <NUM> and plate <NUM> described above, and include the same features. For example, the implant positioning device <NUM> includes a substantially H-shaped frame or a body <NUM> with one or more fastener guides <NUM>. Each fastener guide <NUM> includes one or more retaining arms <NUM> (which may be finger-like structures) formed on a first end or proximal end of the fastener guide <NUM> by slits or apertures <NUM>. Each fastener guide <NUM> may also include an angled surface <NUM> formed inside the fastener guide <NUM> at the proximal or top end of the fastener guide <NUM> that forms a lip and facilitates insertion and retention of a fastener in the guide <NUM>. The implant positioning device <NUM> includes six fastener guides <NUM>. The body <NUM> includes one or more lumens, boreholes, channels or through-bores <NUM>, and each through-bore <NUM> is configured to receive a retaining beam <NUM>. Each retaining beam <NUM> has a first or proximal portion and a second or distal portion that is opposite the first/proximal portion that has a diameter less than the diameter of the first portion. The second end has a retaining beam channel <NUM> formed around the retaining beam <NUM> to receive a side of a plate. The implant positioning device <NUM> includes rails <NUM> that extend from the second/distal side of the body <NUM> proximal to an inner side of the legs of the H-shaped body <NUM>. Each rail <NUM> may also have a rail channel <NUM> adapted to receive an edge of the plate to removably couple the plate to the implant positioning device <NUM> and further limit movement of the plate. The body <NUM> also has one or more handle recesses <NUM> configured to receive and removably couple a handle <NUM> (shown in <FIG>) to the implant positioning device <NUM>. The handles recesses <NUM> may also have secondary recesses <NUM> to provide an additional connection point for the handle <NUM>. For example, the secondary recesses <NUM> may provide a connection point that rigidly attaches the handle <NUM> to the body <NUM>.

The difference between the implant positioning device <NUM> and the implant positioning device <NUM> is that the implant positioning device <NUM> includes fastener guides <NUM> that are oriented to align with a flat plate, and the implant positioning device <NUM> includes fastener guides <NUM> that are oriented to align with a curved or contoured plate <NUM>.

Similarly, the plate <NUM> includes one or more fastener apertures <NUM>, each with grooves or threads <NUM> configured to receive a fastener to couple the plate <NUM> to a bone. The plate <NUM> includes an aperture <NUM> that is substantially in the middle of the plate <NUM>. The plate <NUM> may also include protrusions <NUM> that extend from a middle portion of the plate <NUM> to prevent the plate <NUM> from being coupled to the implant positioning device <NUM> in an incorrect orientation, i.e., upside down. When, the implant positioning device <NUM> is coupled to the plate <NUM>, the retaining beams <NUM> move or flex, and then snap onto the side of the plate <NUM>, for example, into cutouts or recesses <NUM> formed in the plate <NUM>.

The difference between the plate <NUM> and the plate <NUM> is that the plate <NUM> is substantially flat, and the plate <NUM> is curved or contoured, for example to a shape of a bone or other body part to which the plate <NUM> is to be attached.

For example, as illustrated in <FIG>, an axis extending perpendicular to the fastener apertures <NUM> of plate <NUM> is angled by about <NUM> degree to about <NUM> degrees with respect to an axis extending perpendicular to the aperture <NUM>. However, the fastener apertures <NUM> may be disposed at any angle based on a contour of a bone or other body part to which the plate <NUM> is to be attached.

In a similar manner, a longitudinal axis extending through to the fastener guides <NUM> of implant positioning device <NUM> is angled by about <NUM> degree to about <NUM> degrees with respect to a longitudinal axis of the retaining beams <NUM> or through-bores <NUM>. However, the fastener guides <NUM> may be disposed at any angle based on a contour of a plate to which the implant positioning device <NUM> is to be coupled.

It should be appreciated that the plates described herein may have varying thicknesses, and a single plate may have more than one thickness based on a contour of the shape of the bone or body part to which the plate is to be attached. A plate may include one or more bridge portions (also referred to as a bridge plate) that provide clearance over a circumferential fixation modality (such as circumferential plates, wires, etc.). This allows a user to incorporate the benefits of using a plate (such as the plates described herein) along with circumferential techniques. Accordingly, an implant positioning device, such as the implant positioning devices described above, may be adapted to match the contour of the bridge plate to allow the implant positioning device to removably couple with the bridge plate.

For example, <FIG> illustrate an implant positioning device <NUM> and a plate <NUM> that is adapted to bridge a circumferential fixation modality (such as a circumferential plate, wire, etc.) coupled to a bone or other body part. The implant positioning device <NUM> and plate <NUM> are essentially the same as the implant positioning device <NUM> and plate <NUM> described above, and include the same features. For example, the implant positioning device <NUM> includes a substantially H-shaped frame or a body <NUM> with one or more fastener guides <NUM>. Each fastener guide <NUM> includes one or more retaining arms <NUM> (which may be finger-like structures) formed on a first end or proximal end of the fastener guide <NUM> by slits or apertures <NUM>. Each fastener guide <NUM> may also include an angled surface <NUM> formed inside the fastener guide <NUM> at the proximal or top end of the fastener guide <NUM> that forms a lip and facilitates insertion and retention of a fastener in the guide <NUM>. The implant positioning device <NUM> includes six fastener guides <NUM>. The body <NUM> includes one or more lumens, boreholes, channels or through-bores <NUM>, and each through-bore <NUM> is configured to receive a retaining beam <NUM>. Each retaining beam <NUM> has a first or proximal portion and a second or distal portion that is opposite the first/proximal portion that has a diameter less than the diameter of the first portion. The second end has a retaining beam channel <NUM> formed around the retaining beam <NUM> to receive a side of a plate. The implant positioning device <NUM> includes rails <NUM> that extend from the second/distal side of the body <NUM> proximal to an inner side of the legs of the H-shaped body <NUM>. Each rail <NUM> may also have a rail channel <NUM> adapted to receive an edge of the plate to removably couple the plate to the implant positioning device <NUM> and further limit movement of the plate. The body <NUM> also has one or more handle recesses <NUM> configured to receive and removably couple a handle <NUM> (shown in <FIG>) to the implant positioning device <NUM>. The handles recesses <NUM> may also have secondary recesses <NUM> to provide an additional connection point for the handle <NUM>. For example, the secondary recesses <NUM> may provide a connection point that rigidly attaches the handle <NUM> to the body <NUM>.

The difference between the implant positioning device <NUM> and the implant positioning device <NUM> is that the implant positioning device <NUM> includes fastener guides <NUM> that all have a same length, and the implant positioning device <NUM> includes fastener guides <NUM> that have differing lengths to couple to a bridge plate, such as plate <NUM>.

Similarly, the plate <NUM> includes one or more fastener apertures <NUM>, each with grooves or threads <NUM> configured to receive a fastener to couple the plate <NUM> to a bone. The plate <NUM> includes an aperture <NUM> that is substantially in the middle of the plate <NUM>. When, the implant positioning device <NUM> is coupled to the plate <NUM>, the retaining beams <NUM> move or flex, and then snap onto the side of the plate <NUM>, for example, into cutouts or recesses <NUM> formed in the plate <NUM>.

The difference between the plate <NUM> and the plate <NUM> is that the plate <NUM> is substantially flat, and the plate <NUM> includes a bridge section <NUM>. For example, as illustrated in <FIG>, the plate <NUM> includes the bridge section <NUM> that is adapted to provide a gap or space to accommodate a circumferential fixation modality (such as a circumferential plate, wire, etc.) coupled to a bone or other body part prior to the plate <NUM>, without interfering with the circumferential fixation modality. This causes the plate <NUM> to have the bridge section <NUM> and a varying thickness.

To accommodate the varying thickness and bridge section <NUM>, the fastener guides <NUM> of implant positioning device <NUM> have lengths that allow the implant positioning device <NUM> to couple to the plate <NUM>. For example, two of the fastener guides <NUM> of implant positioning device <NUM> proximal to a bottom (or top depending on orientation) of the legs of the "H" have a length greater than a length of the other fastener guides <NUM>. Said another way, four of the fastener guides <NUM> have a shorter length than a length of two of the fastener guides <NUM> proximal to a bottom (or top depending on orientation) of the legs of the "H", in order to accommodate the raised bridge portion <NUM> of the plate <NUM>.

It should be appreciated that the plates described herein may have any geometric shape, number of fastener apertures, be concave or convex, etc. based on a size and shape of the bone or body part to which the plate is to be attached. For example, <FIG> illustrates a non-exhaustive example of a number of various plates that can be used. It should be appreciated that any of the plates described herein may be modified or adapted to be bridge plates and/or contoured plates, and the corresponding implant positioners may be appropriately modified or adapted to accommodate the appropriate plate.

Claim 1:
An implant positioning device (<NUM>) for an orthopaedic positioning device, comprising:
a body (<NUM>) having a top side and a bottom side;
a fastener guide (<NUM>) coupled to the body (<NUM>) and configured to releasably hold a fastener in the implant positioning device (<NUM>); and
a through-bore (<NUM>) formed in the body (<NUM>) and extending from the top side of the body (<NUM>) to the bottom side of the body (<NUM>);
characterized by:
a retaining beam (<NUM>) positioned in the through-bore (<NUM>) and configured to elastically deflect and removably couple the implant positioning device (<NUM>) to a plate (<NUM>).