Patent Description:
The present disclosure is directed to orthopedic implants for coupling to one or more patient's bones, bone portions, bone fragments, etc., and more specifically to bone plate systems for facilitating stabilization of periprosthetic fractures.

Bone fractures are often repaired by securing an orthopedic implant or device to one or more patient's bone(s), bone portions, bone fragments, etc. (used interchangeably without the intent to limit). For example, it is not uncommon for a patient to receive an orthopedic knee prosthesis, an orthopedic hip prosthesis, an intramedullary ("IM") nail, etc. to repair one or more factures in a patient's bone.

On occasion a bone fracture may occur in the area surrounding a previous surgically implanted orthopedic implant or device. For example, a fracture may occur during a surgical implant procedure. Alternatively, however, as is the case in most scenarios, a periprosthetic fracture may occur in a patient years after the original surgical implant procedure. In some cases, a surgically implanted orthopedic implant may predispose a patient's bone to later fractures.

Whatever the cause, periprosthetic fractures surrounding a previous surgically implanted orthopedic implant pose unique fixation challenges. For example, the previous surgically implanted orthopedic device or implant may interfere with the placement of a subsequently implanted orthopedic bone fixation plate.

For example, in one scenario, a periprosthetic hip fracture may occur adjacent or around a previous surgically implanted hip replacement prosthesis. As the number of hip replacement prosthesis has increased, so too has the number of periprosthetic fractures associated therewith. Once a fracture occurs in the area surrounding a previous surgically implanted hip replacement prosthesis, treatment may be complicated by osteoporosis, defects in the bone, and the presence of the previous surgically implanted hip replacement prosthesis. For example, stems, rods, screws, and cement associated with the previous surgically implanted hip replacement prosthesis may block the patient's medullary canal, preventing intramedullary fixation of the subsequent fracture. Moreover, stems and rods may also block screw fixation through the medullary canal to secure a subsequent bone plate to the patient's bone. As a result, periprosthetic factures and the corresponding techniques for treating periprosthetic fractures are generally more difficult, with limited options.

Nevertheless, periprosthetic fractures require treatment. For example, an unstable periprosthetic fracture may require surgical stabilization and/or implant replacement to restore function. Surgical stabilization may include implantation of a bone fixation plate to secure the adjacent sections of the fractured bone to facilitate healing, which may occur with or without implant replacement.

Many currently known bone fixation plates are not designed with periprosthetic fractures in mind, as a result they often exhibit one or more shortcomings or disadvantages. It is with this in mind that the present disclosure is provided. <CIT> describes a bone plate for engaging bone members. <CIT> describes a bone plate for fixing bone segments. <CIT> describes devices, systems, and methods for bone stabilization. <CIT> describes plates for treating periarticular fractures.

Disclosed herein is a number of bone fixation plates (e.g., periprosthetic bone plates). The bone fixation plates are arranged and configured for use in periprosthetic fractures. For example, in one embodiment, the bone fixation plate may be in the form of a proximal femur plate for use in a periprosthetic fracture surrounding, for example, a hip replacement prosthesis. Alternatively, in one embodiment, the bone fixation plate may be in the form of a distal femur plate for use in a periprosthetic fracture surrounding, for example, a knee replacement prosthesis. In another embodiment, the bone fixation plate may be in the form of a periprosthetic ring plate or a periprosthetic hook plate for use in a periprosthetic fracture surrounding, for example, a hip replacement prosthesis. In another embodiment, the bone fixation plate may be in the form of a humerus plate. In either event, the bone fixation plate is designed and configured for fixation across a subsequent fracture in the patient's bone while being designed and configured with one or more features to facilitate avoidance of a previous surgically implanted orthopedic implant.

In one embodiment, the bone fixation plate (e.g., periprosthetic bone plate) may include a head portion, a shaft portion, an upper surface, a lower or bone facing surface, a central longitudinal axis, and an outer periphery surface (e.g., an outer perimeter surface). The shaft portion including a plurality of threaded locking screw openings arranged and configured to receive a plurality of locking screws, respectively. In addition, the shaft portion may include a plurality of variable angled fastener openings arranged and configured to receive a plurality of variable angled screws, respectively. In one embodiment, the plurality of variable angled fastener openings may be positioned along the outer periphery surface of the shaft portion while the plurality of locking screw openings may be centrally located (e.g., positioned closer or substantially adjacent to the central longitudinal axis of the shaft portion).

In one embodiment, the threaded locking screw openings may be larger than the variable angled fastener openings positioned, for example, along the periphery of the shaft portion (e.g., the plurality of threaded locking screw openings include a first diameter and the plurality of variable angled fastener openings include a second diameter, the first diameter being larger than the second diameter). For example, in one embodiment, the threaded locking screw openings may be sized and configured to receive, for example, <NUM> locking screws. The variable angled fastener openings may be sized and configured to receive, for example, <NUM> bone screws. Alternatively, in some embodiments, the threaded locking screw openings and the variable angled fastener openings may be the same size. For example, in some embodiments, the threaded locking screw openings and the variable angled fastener openings may be sized and configured to receive, for example, <NUM> bone screws.

In various embodiments, the shaft portion of the bone fixation plate may include a first region and a second region, the first region being positioned adjacent to the head portion of the bone fixation plate. The plurality of variable angled fastener openings formed in the first region are arranged and configured so that first and second variable angled fastener openings are transversely aligned in a row. That is, the first region may include variable angled fastener openings transversely aligned along the peripheral of the first region of the shaft portion (e.g., the plurality of variable angled fastener openings in the first region are arranged and configured so that first and second variable angled fastener openings are positioned on either side of the central longitudinal axis transversely aligned with each other). The plurality of variable angled fastener openings formed in the second region are non-transversely aligned. That is, the second region may include non-transversely aligned variable angled fastener openings. The plurality of variable angled fastener openings in the second region are arranged and configured so that variable angled fastener openings alternate sides relative to one another (e.g., a single variable angled fastener opening is positioned in a row with each row alternating sides for the variable angled fastener openings as one moves distally on the shaft portion). Thus arranged, the first region of the shaft portion includes a greater number of variable angled fastener openings to provide surgeons with increased options for placing variable angled bone fasteners adjacent to the head portion of the bone fixation plate.

In one embodiment, the bone fixation plate may include a plurality of undercuts formed in the lower surface of the bone plate. In various embodiments, the plurality of undercuts may be aligned or coincident with the plurality of variable angled fastener openings, respectively.

In one embodiment, the bone fixation plate may include a head portion and a shaft portion. The head portion may be contoured for mating with the patient's anatomy such as, for example, the patient's condyle, trochanter, etc. The shaft portion, opposite the head portion, may be arranged and configured to enable contouring of the end portion of the shaft portion. That is, for example, an end portion of the shaft portion, opposite the head portion, may be thinned (e.g., have a reduced cross-sectional area or a tapering cross-sectional area extending from the end portion towards the head portion) to increase the contourablity of the end portion of the bone fixation plate to match the patient's anatomy.

In one embodiment, the end portion may include a plurality of locking screw openings formed therein, the plurality of locking screw openings formed in the end portion including first and second distal locking screw openings, each of the first and second distal locking screw openings including a counterbore formed in the lower surface of the bone plate. In one embodiment, the shaft portion further includes one or more K-wire openings arranged and configured to enable a K-wire to pass therethrough, at least one of the one or more K-wire openings is positioned between the first and second distal locking screw openings. In one embodiment, the end portion of the shaft portion, opposite the head portion, includes a plurality of variable angled fastener openings formed in an array.

In one embodiment, the bone plate is selected from one of a proximal femur plate, a distal femur plate, a periprosthetic ring plate, a periprosthetic hook plate, and a humerus plate.

In one embodiment, the head portion of the bone plate includes a plurality of variable angled screw openings and is devoid of any locking screw openings.

In one embodiment, the head portion of the bone plate includes a plurality of locking screw openings and is devoid of any variable angled fastener openings.

In one embodiment, the head portion includes a plurality of locking screw openings and a plurality of variable angled fastener openings, the plurality of locking screw openings are more centrally located as compared to the plurality of the variable angle fastener openings.

In one embodiment, the plurality of variable angled fastener openings formed in the head portion are arranged and configured in double rows such that the variable angled fastener openings are positioned in transverse rows with first and second variable angled fastener openings positioned in each row.

In one embodiment, the bone fixation plate may be in the form of a ring plate. That is, the bone fixation plate may include a head portion and a shaft portion, the head portion being in the form of a ring arranged and configured for positioning adjacent to a patient's trochanter. In one embodiment, the ring-shaped head portion may be integrally formed with the shaft portion. In one embodiment, the ring-shaped head portion includes a first segment, a second segment spaced from the first segment, and a bridge segment coupling the first and second segments, the ring-shaped head portion including an opening between the first and second segments and the bridge segment. In one embodiment, the bridge segment may include a plurality of variable angle fastener openings centrally positioned thereon.

In addition, and/or alternatively, the ring-shaped head portion may include a plurality of threaded locking screw openings arranged and configured to receive a plurality of locking screws, respectively, and a plurality of variable angled fastener openings arranged and configured to receive a plurality of variable angled fasteners, respectively, the plurality of variable angled fastener openings being dispersed about the plurality of threaded locking screw openings.

In one embodiment, the head portion may include first and second hook members arranged and configured for engaging a patient's trochanter, the first and second hook members being asymmetrical so that the first hook member is different than the second hook member. In one embodiment, the first and second hook members have one of a different size, a different configuration, or a combination thereof.

In one embodiment, a periprosthetic bone plate is disclosed. In one the bone plate includes a head portion, a shaft portion, an upper surface, a lower surface, a central longitudinal axis, and an outer periphery surface. The shaft portion further including a plurality of threaded locking screw openings arranged and configured to receive a plurality of locking screws, respectively and a plurality of variable angled fastener openings arranged and configured to receive a plurality of variable angled screws, respectively; wherein the plurality of threaded locking screw openings include a first diameter and the plurality of variable angled fastener openings include a second diameter, the first diameter being larger than the second diameter.

Embodiments of the present disclosure provide numerous advantages. For example, by incorporating one or more features of the present disclosure, surgeons are provided with increased options for securing a bone fixation plate across a subsequent fracture adjacent to a previous surgically implanted orthopedic device or implant. In addition, by incorporating one or more features of the present disclosure, the bone fixation plates are arranged and configured to allow plating across the major length of the bone. Thus arranged, stress risers that occur at the end of the plate are eliminated, or at least minimized (e.g., as will be appreciated by one of ordinary skill in the art, increased stress risers occur at the end of the plate, which causes increased stress on the bone, which is one contributing factor of periprosthetic fractures. By plating the entire length of the bone such as, for example, the patient's femur, the stress riser is eliminated, or at least greatly minimized).

Further features and advantages of at least some of the embodiments of the present invention, as well as the structure and operation of various embodiments of the present invention, are described in detail below with reference to the accompanying drawings.

By way of example, a specific embodiment of the disclosed device will now be described, with reference to the accompanying drawings, in which:.

It should be understood that the drawings are not necessarily to scale and that the disclosed embodiments are sometimes illustrated diagrammatically and in partial views. In certain instances, details which are not necessary for an understanding of the disclosed methods (not claimed) and devices or which render other details difficult to perceive may have been omitted. It should be further understood that this disclosure is not limited to the particular embodiments illustrated herein.

Various features, aspects, or the like of orthopedic bone fixation plates will now be described more fully hereinafter with reference to the accompanying drawings, in which one or more aspects or features of the bone fixation plates will be shown and described. It should be appreciated that the various features, aspects, or the like may be used independently of, or in combination, with each other. It will be appreciated that a bone fixation plate as disclosed herein may be embodied in many different forms and should not be construed as being limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will convey certain aspects or features of the bone fixation plate to those skilled in the art. In the drawings, like numbers refer to like elements throughout unless otherwise noted.

Disclosed herein are bone fixation plates including one or more aspects or features for enabling increased flexibility for coupling the bone fixation plates to a patient's bone, bone portions, bone fragments, etc. (terms used interchangeably herein without the intent to limit) adjacent to a previous surgically implanted orthopedic implant. That is, as previously mentioned and as will be appreciated by one of ordinary skill in the art, numerous patient's every year undergo surgery where one or more orthopedic devices are implanted. For example, knee replacements, hip replacements, implantation of an IM nail, etc. are commonplace. Occasionally, a bone fracture may occur in the area surrounding the surgically implanted orthopedic implant or device. These fractures are commonly referred to as periprosthetic fractures as they occur adjacent to a previous surgically implanted orthopedic device or implant.

Periprosthetic fractures pose unique fixation challenges. For example, the previous surgically implanted orthopedic device or implant may interfere with the placement and/or securement of the bone fixation plate. For example, in one scenario, an IM nail or stem portion of the previous surgically implanted orthopedic device or implant may interfere with positioning of the bone fixation plate and/or placement of the bone fasteners, screws, or the like (terms used interchangeably herein without the intent to limit) used to secure the bone fixation plate to the patient's bone. In addition, deterioration of the patient's bone surrounding the previous surgically implanted orthopedic device or implant via, for example, osteoporosis, defects in the bone, etc. may further complicate securement and positioning of the bone fixation plate to the patient's bone. As a result, periprosthetic factures and the corresponding techniques for treating periprosthetic fractures are generally more difficult, with limited options.

As such, as will be described herein, the present disclosure discloses a number of bone fixation plates (e.g., periprosthetic bone plates) including one or more features or aspects that may be used in combination or singularly, these features are designed and configured to provide increased flexibility in enabling a surgeon to position and secure a bone fixation plate across a fracture in a patient's bone adjacent to a previous surgically implanted orthopedic device or implant.

As will be described herein, the bone fixation plates may have various shapes and/or configurations. It should be appreciated that the bone fixation plates may be provided in any suitable shape and/or configuration, which, as will be appreciated by one of ordinary skill in the art, may be dependent on the location and type of patient's bone being fixed. For example, a bone fixation plate may include a bone conforming arcuate surface. In addition, the bone fixation plate may be arranged and configured to span, contact, etc. a distal femur, a proximal femur, a distal tibia, a proximal tibia, a proximal humerus, a distal humerus, a fibula, an ulna, a radius, a distal radius, bones of the foot, or bones of the hand, shaft fractures on long bones, etc..

In addition, the bone fixation plate, may include any now known or hereafter developed additional features such as, for example, one or more openings or slots designed to receive, for example, surgical implantation tools, different fasteners (e.g., non-locking fasteners), or the like.

The bone fixation plates may be manufactured from any suitable material now known or hereafter developed, including, for example, metals, polymers, plastics, ceramics, resorbable, non-resorbable, composite materials, etc. Suitable materials may include, for example, titanium, stainless steel, cobalt chrome, polyetheretherketone (PEEK), polyethylene, ultra-high molecular weight polyethylene (UHMWPE), resorbable polylactic acid (PLA), polyglycolic acid (PGA), combinations or alloys of such materials or any other appropriate material that has sufficient strength to be secured to and hold bone, while also having sufficient biocompatibility to be implanted into a patient's body. In some embodiments, the bone fastener may be manufactured from the same material as the bone fixation plate. In other embodiments, the fasteners may be manufactured from a different material as compared to the bone fixation plate.

The fastener can be any type of fastener now known or hereafter developed. For example, the fastener may include any type of external thread including standard or non-standard threads. For example, the external threads can be arranged as a continuous ridge or a non-continuous ridge. The external threads can form a portion of a revolution, one complete revolution, multiple revolutions, a single lead, multiple leads, or any other threads known in the art. Additionally, and/or alternatively, in the case of locking screws, the head portion of the fastener can include any surface that will engage with and seat within a locking screw opening formed in the bone fixation plates. For example, the head portion can include threads. Alternatively, the head portion can include a series of dimples, ridges, bumps, textured areas, or any other surface that can secure the fastener.

The fastener may be any fastener now known or hereafter developed, made out of any appropriate material now known or hereafter developed. The fastener may include a bore for receiving a driver in order to drive the fastener through the bone fixation plate and into the patient's bone. The bore may be any size and shape, for example, it may have a hexagonal configuration to receive a corresponding hexagonal driver, a Phillips screw head, a flat-head, a star configuration, Torx, or any other appropriate configuration that can cooperate with a driver to drive the fastener through the bone fixation plate and into the patient's bone.

The shaft of the fastener may be fully threaded, partially threaded, or a helical blade, and/or may include one or more tacks, deployable talons, expandable elements, or any feature that allows the shaft to engage the patient's bone. It is also possible that shaft be non-threaded so that the fastener takes the form of a peg or a pin. This alternative implementation may be preferred in certain procedures where, for instance, the main goal is to prevent tilting of a bone segment or in procedures where there is no concern of the fastener pulling out from the patient's bone and hence no need for the shaft to be threaded or otherwise configured to engage the patient's bone. The end of the shaft may be a self-tapping or self-drilling tip.

In any event, as will be readily apparent from the remaining disclosure, the focus of the present disclosure is on example embodiments of bone fixation plates including one or more features or aspects arranged and configured to provide increased flexibility for positioning and securing the bone fixation plate adjacent to an area having a previous surgically implanted orthopedic device or implant. Thus, it should be appreciated that the present disclosure should not be limited to any particular configuration of bone fixation plate having any particular configuration unless specifically claimed.

Referring to <FIG>, various embodiments of a bone fixation plate <NUM> having various lengths for repairing fractures in a patient's bone is disclosed. As will be described herein, the bone fixation plates <NUM> may be in the form of a proximal femur plate. That is, the bone fixation plate <NUM> is arranged and configured for positioning adjacent to the proximal femur of a patient. In addition, as will be described herein, the bone fixation plate <NUM> includes one or more features so that the bone fixation plate <NUM> facilitates positioning and securement to a patient's proximal femur, which previously was implanted with a surgical orthopedic implant or device such as, for example, an IM nail, a hip prosthetic, etc. As such, the bone fixation plate <NUM> is arranged and configured for periprosthetic fractures and thus may be referred to as a periprosthetic bone fixation plate or periprosthetic proximal femur bone fixation plate.

As shown, the periprosthetic proximal femur bone fixation plate <NUM> may include an underside, lower, or bone facing surface <NUM> (terms used interchangeably herein without the intent to limit) and an upper surface <NUM>. In addition, the periprosthetic proximal femur bone fixation plate <NUM> includes a head portion <NUM> and a shaft portion <NUM>. Moreover, the periprosthetic proximal femur bone fixation plate <NUM> includes a plurality of openings <NUM> formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic proximal femur bone fixation plate <NUM> to the patient's bone.

As will be described herein, in accordance with one aspect or feature of the present disclosure, the openings <NUM> may be in the form of a locking screw (or fastener) opening <NUM> or a variable angled opening or variable angled fastener (or screw) opening <NUM> (terms used interchangeably herein without the intent to limit). That is, as will be appreciated by one of ordinary skill in the art, locking screw openings <NUM> may include a plurality of threads formed on an inner surface thereof for mating with threads formed on an outer surface of a head portion of a bone fastener. Thus arranged, the bone fastener may be said to be locked to the periprosthetic proximal femur bone fixation plate <NUM> via the locking screw openings <NUM>. That is, as will be appreciated by one of ordinary skill in the art, the bone fastener is threaded through one of the locking screw openings <NUM> formed in the periprosthetic proximal femur bone fixation plate <NUM> and into the patient's bone. The bone fastener is secured to the periprosthetic proximal femur bone fixation plate <NUM> via threads formed on the head portion of the bone fastener that cooperate with the threaded locking screw opening <NUM> formed in the periprosthetic proximal femur bone fixation plate <NUM>. This secures the periprosthetic proximal femur bone fixation plate <NUM> with respect to the patient's bone and provides rigid fixation between the periprosthetic proximal femur bone fixation plate <NUM> and the bone fasteners. That is, because the head portion of the bone fastener interdigitates with the threads formed in the locking screw openings <NUM> of the periprosthetic proximal femur bone fixation plate <NUM>, the plate <NUM> and the fasteners form a stable system or construct, and the stability of the fracture can be dependent on or aided by the stiffness of the construct. Locking a bone fastener into the periprosthetic proximal femur bone fixation plate <NUM> can achieve angular and axial stability and eliminate the possibility for the bone fastener to toggle, slide, or be dislodged, reducing the risk of postoperative loss of reduction.

As previously mentioned, the periprosthetic proximal femur bone fixation plate <NUM> also includes a plurality of variable angled openings <NUM> formed therein for receiving a non-locking or variable angled (e.g., polyaxial) bone fastener. In use, the variable angled openings <NUM> are arranged and configured to enable the bone fastener inserted therein to achieve a greater range of insertion angles as compared to, for example, a conventional locking screw that is threadably coupled to the periprosthetic proximal femur bone fixation plate <NUM>. For example, in one embodiment, the angular position of the bone fastener may be rotated through a range of approximately ± <NUM> degrees, although the range of allowable polyaxial rotation can vary, including greater and less than the fifteen degrees. In use, the variable angled openings <NUM> may be provided in any suitable manner, configuration, etc. now known or hereafter developed for enabling polyaxial positioning or angling of the bone fastener relative to the periprosthetic proximal femur bone fixation plate <NUM>.

As shown, in one embodiment, the variable angled openings <NUM> may include fins or projections that extend radially inward from an inner surface of the variable angled openings <NUM> and into an interior region of the variable angled openings <NUM>, and which are configured to engage or cooperate with the head portion of the bone fastener. In use, the fins engage the head portion of the bone fastener in order to secure the bone fastener at a desired position and at a desired angular orientation within the variable angled opening <NUM>. Additional information on the operation and configuration of the fins can be found in <CIT>, now <CIT> entitled "Systems and Methods for Using Polyaxial Plates"; <CIT>, entitled "Variable Angle Locking Implant", and International PCT Patent Application No. <CIT>, entitled "Orthopedic Implant with Improved Variable Angle Locking Mechanism".

In accordance with one aspect of the present disclosure, the locking screw openings <NUM> may be arranged and configured to receive larger diameter bone fasteners relative to the variable angled openings <NUM>. That is, for example, the locking screw openings <NUM> may be arranged and configured to receive <NUM> bone fasteners while the variable angled openings <NUM> may be arranged and configured to receive <NUM> bone fasteners, although these dimensions are merely exemplary and other dimensioned bone fasteners are envisioned. By arranging and configuring the periprosthetic proximal femur bone fixation plate <NUM> to receive larger diameter locking screws, the periprosthetic proximal femur bone fixation plate <NUM> is better able to be secured to the patient's bone. Meanwhile, by incorporating smaller, variable angled openings <NUM>, the periprosthetic proximal femur bone fixation plate <NUM> is better able to facilitate positioning of the non-locking screws (e.g., polyaxial variable angled bone screws) around the previous surgically implanted orthopedic device or implant (e.g., smaller non-locking bone fasteners enable a surgeon to better navigate the previous surgically implanted orthopedic device or implant).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, the locking screw openings <NUM> may be positioned within the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM>. For example, in one embodiment of the periprosthetic proximal femur bone fixation plate <NUM>, as illustrated, the head portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> may be completely devoid of any locking screw openings <NUM>, although it is envisioned that the head portion <NUM> may incorporate one or more locking screw openings <NUM>. Moreover, as shown, the locking screw openings <NUM> may be more centrally located as compared to the variable angled openings <NUM> formed in the shaft portion <NUM>. For example, in one embodiment, the shaft portion <NUM> may include a central longitudinal axis CL, the locking screw openings <NUM> may be positioned substantially along the central longitudinal axis CL of the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> while the variable angled openings <NUM> formed in the shaft portion <NUM>, as illustrated, may be positioned along and/or adjacent to an outer periphery or surface <NUM> of the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM>. That is, the locking screw openings <NUM> are positioned more interior, closer to the central longitudinal axis CL of the shaft portion <NUM> relative to the variable angled openings <NUM>, which are positioned closer to the outer periphery or perimeter surface <NUM> of the shaft portion <NUM>.

Thus arranged, by positioning the variable angled openings <NUM> along and/or adjacent to the outer periphery <NUM> of the shaft portion <NUM>, the periprosthetic proximal femur bone fixation plate <NUM> is better able to position the variable angled bone fastener to avoid the previous surgically implanted orthopedic device or implant (e.g., the surgeon is better able to position and insert one or more bone fastener through the variable angled openings <NUM> formed in the periprosthetic proximal femur bone fixation plate <NUM> while avoiding, for example, the stem portion or IM nail of a previous surgically implanted orthopedic device or implant in the patient's proximal femur).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> may include a first region <NUM> and a second region <NUM>. As illustrated, the first region <NUM> may be positioned adjacent to the head portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM>. In one or more embodiments, the variable angled openings <NUM> may be arranged and configured so that they are positioned transversely to one another within the first region <NUM> of the shaft portion <NUM>. That is, as illustrated, the variable angled openings <NUM> may be seen as being positioned in transverse rows with two variable angled openings <NUM> positioned in a row, one along each side or periphery surface <NUM> of the periprosthetic proximal femur bone fixation plate <NUM>. Thus arranged, the variable angled openings <NUM> in the first region <NUM> of the shaft portion <NUM> may be referred to be positioned in a double row. Meanwhile, as illustrated, the variable angled openings <NUM> formed in the second region <NUM> of the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> may be arranged so that they alternate relative to each other. That is, as illustrated, the variable angled openings <NUM> may be seen as being positioned in transverse rows with only a single variable angled opening <NUM> positioned in a row, with the variable angled openings <NUM> alternating which side or periphery surface <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> it is positioned adjacent too. Thus arranged, as illustrated, the first region <NUM> of the shaft portion <NUM> may include more (e.g., double the number of) variable angled openings <NUM> as compared to the second region <NUM> of the shaft portion <NUM> even though the first and second regions <NUM>, <NUM> of the shaft portion <NUM> may have the same number of rows of variable angled openings <NUM>, although it is envisioned that the first and second regions <NUM>, <NUM> may also have different numbers of rows. By positioning the variable angled openings <NUM> in double rows in the first region <NUM> of the shaft portion <NUM>, the surgeon is provided with increased options when inserting variable angled bone fasteners into the patient's bone in the expected vicinity of the stem portion or IM nail of the previous surgically implanted orthopedic device or implant. Meanwhile, by providing only a single row of alternating variable angled openings <NUM> in the second region <NUM> of the shaft portion <NUM>, the strength of the bone fixation plate <NUM> is better maintained.

Referring to <FIG> and <FIG>, the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> may include a plurality of undercuts or grooves <NUM> formed in the underside or bone facing surface <NUM>. However, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, the plurality of undercuts <NUM> may be coincidence with or collocated with the variable angled openings <NUM> formed in the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM>. That is, the variable angled openings <NUM> formed in the shaft portion <NUM> may be positioned or reside within the undercuts <NUM> formed in the bone facing surface <NUM>. In use, the undercuts <NUM> may be sized and configured to provide clearance for a cable to pass underneath the proximal femur bone fixation plate <NUM>. In one embodiment, the plurality of undercuts <NUM> are collocated with the variable angled openings <NUM> formed in the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> to provide increased bone plate strength (e.g., the undercuts <NUM> and the variable angled openings <NUM> are centered between the central locking screw openings <NUM>, which is the location of the peak stress. If either the undercuts <NUM> or the variable angled openings <NUM> were positioned closer to one of the central locking screw openings <NUM>, the overall strength of the plate would be diminished).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, the distal end portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> (e.g., end portion opposite the head portion <NUM>) may include thinning. That is, the distal end portion <NUM> may include a reduced or tapering cross-sectional area to facilitate contouring of the distal end portion <NUM> relative to the patient's anatomy. Generally speaking, as will be appreciated by one of ordinary skill in the art, during use, surgeons often select a bone fixation plate having a length sized and configured to bridge or span the entire area of the fracture. For example, it is not uncommon for a bone fixation plate to extend from and/or to the femur condyle or the patient's trochanter or higher. In use, the head portion of the bone fixation plate may be highly contoured to match the patient's anatomy. However, providing a bone fixation plate with both ends contoured creates numerous issues. For example, generally speaking, providing a bone fixation plate anatomically constrained or contoured at both ends will not fit individual patients as intended. Thus, it is beneficial to anatomically un-constrain one end of the bone plate to enable contouring of the bone plate to provide a better fit for each individual patient. In addition, and/or alternatively, providing a bone fixation plate with both ends contoured creates numerous manufacturing issues. In accordance with one aspect or feature of the present disclosure, the distal end portion <NUM> (e.g., end portion opposite the head portion <NUM>) may incorporate a reduced cross-sectional area to better enable the surgeon to contour the distal end portion <NUM> to accommodate the patient's anatomy.

Referring to <FIG>, in accordance with another aspect of the present disclosure, the locking screw openings <NUM> formed in the distal end portion <NUM> of the shaft portion <NUM> may include an underside counterbore <NUM> formed in the underside or bone facing surface <NUM> thereof. For example, as illustrated, the two distal most locking screw openings <NUM> formed in the shaft portion <NUM> of the proximal femur bone fixation plate may include an underside counterbore <NUM>, although it is envisioned that more or less locking screw openings may be counterbored on the underside or bone facing surface <NUM>. In use, by providing a counterbore <NUM> in the underside or bone facing surface102 of the locking screw openings <NUM> formed in the distal end portion <NUM> of the plate <NUM>, the underside counterbored locking screw openings <NUM> may be used in combination with an instrument to grab and compress the bone fracture.

The shaft portion <NUM> of the proximal femur bone fixation plate <NUM> may also include a plurality of K-wire openings <NUM> for enabling a K-wire to pass therethrough. As illustrated, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, an initial K-wire opening <NUM> may be positioned between the distal two most locking screw openings <NUM>. In addition, the shaft portion <NUM> may include a plurality of additional K-wire openings <NUM> formed therein. In use, the plurality of K-wire openings <NUM> allow a surgeon to provisionally hold the bone fixation plate <NUM> to the patient's bone after they have reduced the fracture.

As generally shown, and as will be appreciated by one of ordinary skill in the art, the number of undercuts, variable angled openings, locking screw openings, etc. will be variable between the various bone fixation plates depending on the length of the plate.

Referring to <FIG>, various embodiments of an alternate bone fixation plate <NUM> having various lengths for repairing fractures in a patient's bone is disclosed. As will be described herein, the bone fixation plates <NUM> illustrated and described in connection with <FIG> may be substantially similar to the periprosthetic proximal femur bone fixation plate <NUM> described above in connection with <FIG>, however the bone fixation plate <NUM> may be in the form of a distal femur plate. That is, the bone fixation plate <NUM> is arranged and configured for positioning adjacent to the distal femur of a patient. In addition, as will be described herein, the bone fixation plate <NUM> includes one or more features so that the bone fixation plate <NUM> facilitates positioning and securement to a patient's distal femur, which previously received a surgical implanted orthopedic device or implant such as, for example, an IM nail, a knee prosthetic, etc. As such, the bone fixation plate <NUM> is arranged and configured for periprosthetic fractures and thus may be referred to as a periprosthetic bone fixation plate or periprosthetic distal femur bone fixation plate.

As shown, the periprosthetic distal femur bone fixation plate <NUM> may include an underside, lower, or bone facing surface <NUM> and an upper surface <NUM>. In addition, the periprosthetic distal femur bone fixation plate <NUM> includes a head portion <NUM> and a shaft portion <NUM>. Moreover, the periprosthetic distal femur bone fixation plate <NUM> includes a plurality of openings <NUM> formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic distal femur bone fixation plate <NUM> to the patient's bone.

As previously described in connection with the proximal femur bone fixation plate <NUM>, the periprosthetic distal femur bone fixation plate <NUM> may include a plurality of locking screw openings <NUM> and a plurality of variable angled openings <NUM>. Similar to the locking screw openings <NUM> and variable angled openings <NUM> described in connection with the proximal femur bone fixation plate <NUM>, and in accordance with one aspect of the present disclosure, the locking screw openings <NUM> formed in the periprosthetic distal femur bone fixation plate <NUM> may be arranged and configured to receive larger diameter bone fasteners relative to the variable angled openings <NUM> formed in the periprosthetic distal femur bone fixation plate <NUM>. That is, for example, the locking screw openings <NUM> may be arranged and configured to receive <NUM> bone fasteners while the variable angled openings <NUM> may be arranged and configured to receive <NUM> bone fasteners, although these dimensions are merely exemplary and other dimensioned bone fasteners are envisioned. By arranging and configuring the periprosthetic distal femur bone fixation plate <NUM> to receive larger diameter locking screws, the periprosthetic distal femur bone fixation plate <NUM> is better able to be secured to the patient's bone. Meanwhile, by incorporating smaller, variable angled openings <NUM>, the periprosthetic distal femur bone fixation plate <NUM> is better able to facilitate positioning of the non-locking screws (e.g., polyaxial variable angled bone screws) around the previous surgically implanted orthopedic device or implant.

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described, the locking screw openings <NUM> may be positioned within the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM>. As shown, the locking screw openings <NUM> may be more centrally located as compared to the variable angled openings <NUM> formed in the shaft portion <NUM>. As illustrated, the variable angled openings <NUM> may be positioned along and/or adjacent to an outer periphery or surface <NUM> of the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM>. For example, in one embodiment, the shaft portion <NUM> may include a central longitudinal axis CL, the locking screw openings <NUM> may be positioned substantially along the central longitudinal axis CL of the shaft portion <NUM> of the periprosthetic proximal femur bone fixation plate <NUM> while the variable angled openings <NUM> may be positioned along and/or adjacent to an outer periphery or surface <NUM> of the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM>. That is, the locking screw openings <NUM> are positioned more interior, closer to the central longitudinal axis CL of the shaft portion <NUM> relative to the variable angled openings <NUM>, which are positioned closer to the outer periphery or perimeter surface <NUM> of the shaft portion <NUM>.

Thus arranged, by positioning the variable angled openings <NUM> along and/or adjacent to the outer periphery <NUM> of the shaft portion <NUM>, the periprosthetic distal femur bone fixation plate <NUM> is better able to position the variable angled bone fastener to avoid the previous surgically implanted orthopedic device or implant (e.g., the surgeon is better able to position and insert one or more bone fastener through the variable angled openings <NUM> formed in the periprosthetic distal femur bone fixation plate <NUM> while avoiding, for example, a stem portion of a knee prosthetic or IM nail of a previous surgically implanted orthopedic device or implant in the patient's distal femur).

As shown, in one embodiment, in connection with the periprosthetic distal femur bone fixation plate <NUM>, the head portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may include a plurality of locking screw openings <NUM>. In one embodiment, the head portion <NUM> may also include one or more larger-diameter variable angled holes 224a (e.g., arranged and configured to receive <NUM> bone fasteners). Alternatively, the head portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may be completely devoid of any variable angled openings <NUM> (e.g., the head portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may include exclusively locking screw openings <NUM>). Alternatively, it is envisioned that the head portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may include one or more smaller diameter variable angled openings <NUM> (arranged and configured to receive <NUM> bone fasteners).

In addition, as shown, in connection with the periprosthetic distal femur bone fixation plate <NUM>, the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may exclusively incorporate single rows of alternately variable angled openings <NUM> (e.g., shaft portion <NUM> may be devoid of any double rows of variable angled openings <NUM> as previously described). However, while not shown, it is envisioned that the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may include first and second regions similar to the periprosthetic proximal femur bone fixation plate <NUM> wherein, in the first region, the variable angled openings are transversely positioned/aligned with each other and in the second region, the variable angled openings may be alternately positioned so that the first region of the shaft portion includes more variable angled openings as compared to the second region thereby providing the surgeon with increased options when inserting bone fasteners into the patient's bone in the expected vicinity of the previous surgically implanted orthopedic device or implant.

Referring to <FIG> and <FIG>, the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may include a plurality of undercuts or grooves <NUM> formed in the underside or bone facing surface <NUM>. However, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, the plurality of undercuts <NUM> may be coincidence with or collocated with the variable angled openings <NUM> formed in the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM>. That is, the variable angled openings <NUM> formed in the shaft portion <NUM> may be positioned or reside within the undercuts <NUM> formed in the bone facing surface <NUM>. In use, the undercuts <NUM> may be sized and configured to provide clearance for a cable to pass underneath the distal femur bone fixation plate <NUM>. As previously mentioned, in one embodiment, the plurality of undercuts <NUM> are collocated with the variable angled openings <NUM> formed in the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> to provide increased bone plate strength (e.g., the undercuts <NUM> and the variable angled openings <NUM> are centered between the central locking screw openings <NUM>, which is the location of the peak stress. If either the undercuts <NUM> or the variable angled openings <NUM> were positioned closer to one of the central locking screw openings <NUM>, the overall strength of the plate would be diminished).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described in connection with the periprosthetic proximal femur bone fixation plate <NUM>, an end portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> (e.g., a proximal end portion <NUM> opposite the head portion <NUM>) of the periprosthetic distal femur bone fixation plate <NUM> may include thinning. That is, the end portion <NUM> of the shaft portion <NUM> may include a reduced or tapering cross-sectional area to facilitate contouring of the end portion relative to the patient's anatomy. That is, as previous mentioned, in accordance with one aspect or feature of the present disclosure, the end portion <NUM> of the shaft portion <NUM> (e.g., end portion <NUM> opposite the head portion <NUM>) may incorporate a reduced cross-sectional area to better enable the surgeon to contour the end portion <NUM> to accommodate the patient's anatomy. For example, as previously mentioned, providing a bone fixation plate with both ends contoured creates numerous issues. For example, generally speaking, providing a bone fixation plate anatomically constrained or contoured at both ends will not fit individual patients as intended. Thus, it is beneficial to anatomically un-constrain one end of the bone plate to enable contouring of the bone plate to provide a better fit for each individual patient. In accordance with one aspect or feature of the present disclosure, the end portion <NUM> (e.g., end portion opposite the head portion <NUM>) may incorporate a reduced cross-sectional area to better enable the surgeon to contour the end portion <NUM> to accommodate the patient's anatomy.

In addition, as illustrated in <FIG>, the end portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may include a plurality of variable angled openings <NUM> (e.g., the end portion <NUM> may include exclusively, or a majority of, variable angled openings <NUM>). As shown, for example, the variable angled openings <NUM> formed in the end portion <NUM> may be arranged in an array such as, for example, a 2x2 array, although this is merely exemplary and other arrays and/or configurations are envisioned. By providing an array of variable angled openings <NUM> in the end portion <NUM>, a surgeon is provided with increased options for positioning variable angled bone fasteners into the patient's bone (e.g., in use, the end portion <NUM> is designed to reach the proximal femur at which point the bone is no longer diaphyseal, the variable angle holes allow screws to reach more desirable bone and lengths. For example, screws may target the lesser trochanter, femoral head, or some other desired region in the proximal femur).

In addition, referring to <FIG>, in accordance with another aspect of the present disclosure and as previously described above in connection with the periprosthetic proximal femur bone fixation plate <NUM>, the locking screw openings <NUM> formed in the end portion <NUM> (e.g., opposite the head portion <NUM>) may include an underside counterbore <NUM> formed in the underside or bone facing surface <NUM> thereof. For example, as illustrated, the two proximal most locking screw openings <NUM> formed in the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may include an underside counterbore <NUM>, although it is envisioned that more or less locking screw openings <NUM> may be counterbored on the underside or bone facing surface <NUM>. In use, by providing a counterbore <NUM> in the underside or bone facing surface <NUM> of the locking screw openings <NUM> formed in the end portion <NUM> of the plate <NUM>, the underside counterbored locking screw openings may be used in combination with an instrument to grab and compress the bone fracture.

As previously mentioned, the shaft portion <NUM> of the periprosthetic distal femur bone fixation plate <NUM> may also include a plurality of K-wire openings <NUM> for enabling a K-wire to pass therethrough. As illustrated, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, an initial K-wire opening <NUM> may be positioned between the array of variable angled openings <NUM> and the proximal most locking screw opening <NUM>. In addition, the shaft portion <NUM> may include a plurality of additional K-wire openings <NUM> formed therein. In use, the plurality of K-wire openings <NUM> allow a surgeon to provisionally hold the bone fixation plate <NUM> to the patient's bone after they have reduced the fracture.

Referring to <FIG>, various embodiments of an alternate bone fixation plate <NUM> having various lengths for repairing fractures in a patient's bone is disclosed. As will be described herein, the bone fixation plates <NUM> illustrated and described in connection with <FIG> may include some or all of the features or aspects described above in connection with the periprosthetic proximal and distal femur bone fixation plates <NUM>, <NUM>. However, the bone fixation plate <NUM> may be in the form of a humerus or utility plate. That is, the bone fixation plate <NUM> is arranged and configured for positioning against a long bone of a patient such as, for example, the humerus of a patient. In addition, generally speaking, in a periprosthetic long bone fracture, the amount of remaining bone for receiving bone fixation screws may be minimal. Typically, the remaining bone portion will likely only be in alignment with the shaft portion of the plate. Thus, generally speaking, the utility plate may be less contoured as compared to various other bone fixation plates described herein. One advantage of this, is that the utility plate may be arranged and configured to work with many long bones such as, for example, the patient's humerus, thus the utility plate may act or be referred to as a periprosthetic humerus plate.

Moreover, as will be described herein, the bone fixation plate <NUM> includes one or more features so that the bone fixation plate <NUM> facilitates positioning and securement to a patient's long bone (such as, for example, humerus bone), which previously received a surgically implanted orthopedic implant or device such as, for example, an IM nail, etc. As such, the bone fixation plate <NUM> is arranged and configured for periprosthetic fractures and thus may be referred to as a periprosthetic bone fixation plate, a periprosthetic utility bone fixation plate, or a periprosthetic humerus bone fixation plate.

As shown, the periprosthetic utility bone fixation plate <NUM> may include an underside, lower, or bone facing surface <NUM> and an upper surface <NUM>. In addition, the periprosthetic utility bone fixation plate <NUM> includes a head portion <NUM> and a shaft portion <NUM>. Moreover, the periprosthetic utility bone fixation plate <NUM> includes a plurality of openings <NUM> formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic utility bone fixation plate <NUM> to the patient's bone.

As previously described in connection with the proximal femur bone fixation plate <NUM>, the periprosthetic utility bone fixation plate <NUM> may include a plurality of locking screw openings <NUM> and a plurality of variable angled openings <NUM>. Similar to the locking screw openings <NUM> and variable angled openings <NUM> described in connection with the proximal femur bone fixation plate <NUM>, and in accordance with one aspect of the present disclosure, the locking screw openings <NUM> formed in the periprosthetic utility bone fixation plate <NUM> may be arranged and configured to receive larger diameter bone fasteners relative to the variable angled openings <NUM> formed in the periprosthetic utility bone fixation plate <NUM>. That is, for example, the locking screw openings <NUM> may be arranged and configured to receive <NUM> bone fasteners while the variable angled openings <NUM> may be arranged and configured to receive <NUM> bone fasteners, although these dimensions are merely exemplary and other dimensioned bone fasteners are envisioned. For example, in some embodiments, the locking screw openings <NUM> may be arranged and configured to receive other sized bone fasteners such as, for example, <NUM> bone fasteners.

By arranging and configuring the periprosthetic utility bone fixation plate <NUM> to receive larger diameter locking screws, the periprosthetic utility bone fixation plate <NUM> is better able to secure to the patient's bone. Meanwhile, by incorporating smaller, variable angled openings <NUM>, the periprosthetic utility bone fixation plate <NUM> is better able to facilitate positioning of the non-locking screws (e.g., polyaxial variable angled bone screws) around the previous surgically implanted orthopedic device or implant.

In connection with the periprosthetic utility bone fixation plate <NUM>, the locking screw openings <NUM> may be positioned within the shaft portion <NUM> of the periprosthetic utility bone fixation plate <NUM>. As shown, the locking screw openings <NUM> may be centrally located. For example, in one embodiment, the shaft portion <NUM> may include a central longitudinal axis CL, the locking screw openings <NUM> may be substantially centrally located along the central longitudinal axis CL of the periprosthetic utility bone fixation plate <NUM>. Moreover, as illustrated, the shaft portion <NUM> of the periprosthetic utility bone fixation plate <NUM> may be completely devoid of any variable angled openings <NUM>, although it is envisioned that the shaft portion <NUM> may include one or more variable angled openings <NUM>.

In addition, and/or alternatively, as illustrated, the head portion <NUM> of the periprosthetic utility bone fixation plate <NUM> may include a plurality of locking screw openings <NUM> and a plurality of variable angled openings <NUM>. As shown, the locking screw openings <NUM> may be centrally located. For example, in one embodiment, the locking screw openings <NUM> may be substantially centrally located along the central longitudinal axis CL of the head portion <NUM> of the periprosthetic utility bone fixation plate <NUM> as compared to the variable angled openings <NUM>, which as illustrated, may be positioned along and/or adjacent to an outer periphery or surface <NUM> of the periprosthetic utility bone fixation plate <NUM>. That is, the locking screw openings <NUM> are positioned more interior, closer to the central longitudinal axis CL of the head portion <NUM> relative to the variable angled openings <NUM>, which are positioned closer to the outer periphery or perimeter surface <NUM> of the head portion <NUM>. Thus arranged, by positioning the variable angled openings <NUM> along and/or adjacent to the outer periphery or surface <NUM> of the head portion <NUM>, the periprosthetic utility bone fixation plate <NUM> is better able to position the variable angled bone fasteners to avoid the previous surgically implanted orthopedic device or implant (e.g., the surgeon is better able to position and insert one or more bone fastener through the variable angled openings <NUM> formed in the periprosthetic utility bone fixation plate <NUM> while avoiding, for example, an IM nail or other previous surgically implanted orthopedic device or implant in the patient's bone).

In addition, and/or alternatively, as illustrated, the variable angled openings <NUM> formed in the head portion <NUM> of the periprosthetic utility bone fixation plate <NUM> may be arranged and configured in double rows as previously described (e.g., the variable angled openings <NUM> may be seen as being positioned in transverse rows with two variable angled openings <NUM> positioned in each row, such as, for example, one on each side surface of the central longitudinal axis CL).

Referring to <FIG>, the shaft portion <NUM> of the periprosthetic utility bone fixation plate <NUM> may include a plurality of undercuts or grooves <NUM> formed in the underside or bone facing surface <NUM>. The undercuts <NUM> may be positioned on either side of the locking screw openings <NUM> (e.g., an undercut or groove <NUM> may be positioned in-between adjacent locking screw openings <NUM>). In use, the undercuts <NUM> may be sized and configured to provide clearance for a cable to pass underneath the periprosthetic utility bone fixation plate.

In addition, referring to <FIG>, in accordance with another aspect of the present disclosure and as previously described above in connection with the periprosthetic proximal and distal femur bone fixation plates <NUM>, <NUM>, the locking screw openings <NUM> formed in the end portion <NUM> of the periprosthetic utility bone fixation plate <NUM> (e.g., end portion opposite the head portion <NUM>) may include an underside counterbore <NUM> formed in the underside or bone facing surface <NUM> thereof. For example, as illustrated, the two distal most locking screw openings <NUM> formed in the shaft portion <NUM> of the periprosthetic utility bone fixation plate <NUM> may include an underside counterbore <NUM>, although it is envisioned that more or less locking screw openings may be counterbored on the underside or bone facing surface. In use, by providing a counterbore <NUM> in the underside or bone facing surface <NUM> of the locking screw openings <NUM> formed in the end portion <NUM> of the plate <NUM>, the underside counterbored locking screw openings may be used in combination with an instrument to grab and compress the bone fracture.

The shaft portion <NUM> of the periprosthetic utility bone fixation plate <NUM> may also include a plurality of K-wire openings <NUM> for enabling a K-wire to pass therethrough. As illustrated, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, an initial K-wire opening <NUM> may be positioned between the distal two most locking screw openings <NUM>. In addition, while not shown, it is envisioned that the shaft portion <NUM> may include a plurality of additional K-wire openings <NUM> formed therein.

While not shown, it is envisioned that the shaft portion of the periprosthetic utility bone fixation plate <NUM> may include first and second regions similar to the periprosthetic proximal femur bone fixation plate <NUM> wherein, in the first region, the variable angled openings are transversely positioned/aligned with each other and in the second region, the variable angled openings may be alternately positioned so that the first region of the shaft portion may include more variable angled openings as compared to the second region of the shaft portion thereby providing surgeons with increased options when inserting bone fasteners into the patient's bone in the expected vicinity of the previous surgically implanted orthopedic device or implant. In addition, and/or alternatively, it is envisioned that the shaft portion of the periprosthetic utility bone fixation plate may include a plurality of variable angled openings and a plurality of undercuts that may be coincidence with or collocated with the variable angled openings.

In addition, and/or alternatively, it is envisioned that the end portions of the periprosthetic utility bone fixation plate may include thinning (e.g., a reduced or tapering cross-sectional area to facilitate contouring of the end portion relative to the patient's anatomy). For example, as previously mentioned, providing a periprosthetic utility bone fixation plate with both ends contoured creates numerous issues. For example, generally speaking, providing a bone fixation plate anatomically constrained or countered at both ends will not fit individual patients as intended. Thus, it is beneficial to anatomically un-constrain one or both ends of the periprosthetic utility bone fixation plate to enable contouring of the bone plate to provide a better fit for each individual patient. In accordance with one aspect or feature of the present disclosure, one or both end portions of the periprosthetic utility bone fixation plate may incorporate a reduced cross-sectional area to better enable the surgeon to contour the end portions to accommodate the patient's anatomy.

Referring to <FIG>, various embodiments of an alternate bone fixation plate <NUM> having various lengths for repairing fractures in a patient's bone is disclosed. As will be described herein, the bone fixation plates <NUM> illustrated and described in connection with <FIG> may be substantially similar to the periprosthetic proximal femur bone fixation plate <NUM> described above in connection with <FIG>, however the bone fixation plate <NUM> may be in the form of a ring plate. That is, the bone fixation plate <NUM> includes a head portion <NUM> that is arranged and configured in the configuration of a ring for positioning adjacent to the trochanter of a patient. In addition, as will be described herein, the bone fixation plate <NUM> includes one or more features so that the bone fixation plate <NUM> facilitates positioning and securement to a patient's bone such as, for example, a patient's femur, which previously received a surgically implanted orthopedic implant or device such as, for example, an IM nail, a hip prosthetic, etc. As such, the bone fixation plate <NUM> is arranged and configured for periprosthetic fractures and thus may be referred to as a periprosthetic bone fixation plate or periprosthetic ring bone fixation plate.

As shown, the periprosthetic ring bone fixation plate <NUM> may include an underside, lower, or bone facing surface <NUM> and an upper surface <NUM>. In addition, the periprosthetic ring bone fixation plate <NUM> includes a head portion <NUM> and a shaft portion <NUM>. Moreover, the periprosthetic ring bone fixation plate <NUM> includes a plurality of openings <NUM> formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic ring bone fixation plate <NUM> to the patient's bone.

As shown, the head portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may be arranged and configured as a ring for contacting a patient's trochanter. That is, as shown, the head portion <NUM> may include a first leg or segment <NUM>, a second leg or segment <NUM> spaced from the first leg or segment <NUM>, and a bridge segment <NUM> for coupling the ends of the first and second legs <NUM>, <NUM>. Thus arranged, the head portion <NUM> includes an opening <NUM> between the first and second legs <NUM>, <NUM> and the bridge segment <NUM>. However, in contrast to known ring plates, the periprosthetic ring bone fixation plate <NUM> may be integrally formed. That is, the ring shaped, head portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may be integrally formed with the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. By providing an integrally formed periprosthetic ring bone fixation plate <NUM>, the periprosthetic ring bone fixation plate <NUM> is less likely to break when subjected to fatigue loading. In addition, there are fewer required surgical steps as there is no required assembling of the ring to the plate. Moreover, the periprosthetic ring bone fixation plate <NUM> facilitates incorporation of more, smaller openings <NUM> for receiving a plurality of fasteners as compared to fewer, larger openings (e.g., with the hip stem in the way, the smaller <NUM> openings enable a surgeon to better avoid the hip stem while maintaining the stability to resist the deforming forces from attached muscles).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, the head portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may include a plurality of locking screw openings <NUM> and a plurality of variable angled openings <NUM>. That is, the head portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may include alternating locking screw openings <NUM> and variable angled openings <NUM> in the first and second legs <NUM>, <NUM>. In one embodiment, the bridge segment <NUM> may include a plurality of variable angle openings <NUM>, alternatively it is envisioned that the bridge segment <NUM> may also include one or more locking screw openings <NUM>. By providing a plurality of locking screw openings <NUM> and variable angled openings <NUM> in the head portion <NUM> of the periprosthetic ring bone fixation plate <NUM>, a surgeon is provided with increased options as compared to conventional known ring fixation plates.

As illustrated, in one embodiment, an opening <NUM> (e.g., a variable angle opening 424a) is centrally positioned on the bridge segment <NUM>. Thus arranged, the periprosthetic ring bone fixation plate <NUM> can be cut as needed. As such, the integrally formed ring-shaped head portion <NUM> of the periprosthetic ring bone fixation plate <NUM> can be divided into two arms (e.g., first and second legs <NUM>, <NUM> can be converted into first and second hook-type members).

In addition, as previously described in connection with the proximal femur bone fixation plate <NUM>, the periprosthetic ring bone fixation plate <NUM> may include a plurality of locking screw openings <NUM> and a plurality of variable angled openings <NUM> in the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. Similar to the locking screw openings <NUM> and variable angled openings <NUM> described in connection with the proximal femur bone fixation plate <NUM>, and in accordance with one aspect of the present disclosure, the locking screw openings <NUM> formed in the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may be arranged and configured to receive larger diameter bone fasteners relative to the variable angled openings <NUM> formed in the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. That is, for example, the locking screw openings <NUM> formed in the shaft portion <NUM> may be arranged and configured to receive <NUM> bone fasteners while the variable angled openings <NUM> formed in the shaft portion <NUM> may be arranged and configured to receive <NUM> bone fasteners, although these dimensions are merely exemplary and other dimensioned bone fasteners are envisioned. By arranging and configuring the periprosthetic ring bone fixation plate <NUM> to receive larger diameter locking screws, the periprosthetic ring bone fixation plate <NUM> is better able to secure to the patient's bone. Meanwhile, by incorporating smaller, variable angled openings <NUM> in the shaft portion <NUM>, the periprosthetic ring bone fixation plate <NUM> is better able to facilitate positioning of the non-locking screws (e.g., polyaxial variable angled bone screws) around the previous surgically implanted orthopedic device or implant.

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described, the locking screw openings <NUM> positioned within the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may be more centrally located as compared to the variable angled openings <NUM>, which as illustrated, may be positioned along and/or adjacent to an outer periphery or surface <NUM> of the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. For example, in one embodiment, the shaft portion <NUM> may include a central longitudinal axis CL, the locking screw openings <NUM> positioned within the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may be substantially centrally located along the central longitudinal axis CL of the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. That is, the locking screw openings <NUM> are positioned more interior, closer to the central longitudinal axis CL of the shaft portion <NUM> relative to the variable angled openings <NUM>, which are positioned closer to the outer periphery or perimeter surface <NUM> of the shaft portion <NUM>.

Thus arranged, by positioning the variable angled openings <NUM> along and/or adjacent to the outer periphery or surface <NUM> of the shaft portion <NUM>, the periprosthetic ring bone fixation plate <NUM> is better able to position the variable angled bone fastener to avoid the previous surgically implanted orthopedic device or implant (e.g., the surgeon is better able to position and insert one or more bone fastener through the variable angled openings formed in the periprosthetic ring bone fixation plate <NUM> while avoiding, for example, a stem portion of a hip prosthetic or IM nail of a previous surgically implanted orthopedic device or implant in the patient's femur).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described in connection with the periprosthetic proximal femur bone fixation plate <NUM>, the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may include a first region <NUM> and a second region <NUM>. As illustrated, the first region <NUM> may be positioned adjacent to the head portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. In one or more embodiments, the variable angled openings <NUM> may be arranged and configured so that they are positioned transversely to one another. That is, as illustrated and as previously described, the variable angled openings <NUM> may be seen as being positioned in transverse rows with two variable angled openings <NUM> positioned in each row, such as, for example, one on each side surface of the central longitudinal axis CL of the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. Meanwhile, as illustrated, the variable angled openings <NUM> formed in the second region <NUM> of the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may be arranged so that they alternate relative to each other. That is, as illustrated, the variable angled openings <NUM> may be seen as being positioned in transverse rows with only a single variable angled opening <NUM> positioned in a row, with the variable angled openings <NUM> alternating which side of the central longitudinal axis CL of the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> it is positioned on. Thus arranged, as illustrated, the first region <NUM> of the shaft portion <NUM> may include more (e.g., double) variable angled openings <NUM> as compared to the second region <NUM> of the shaft portion <NUM>. By positioning the variable angled openings <NUM> in double rows in the first region <NUM> of the shaft portion <NUM>, the surgeon is provided with increased options when inserting bone fasteners into the patient's bone in the expected vicinity of the stem portion or IM nail of the previous surgically implanted orthopedic device or implant. Meanwhile, by providing only single row of alternating variable angled openings <NUM> in the second region <NUM> of the shaft portion <NUM>, the strength of the bone fixation plate <NUM> is better maintained.

Referring to <FIG> and <FIG>, the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may include a plurality of undercuts or grooves <NUM> formed in the underside or bone facing surface <NUM>. However, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described, the plurality of undercuts <NUM> may be coincidence with or collocated with the variable angled openings <NUM> formed in the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM>. That is, the variable angled openings <NUM> formed in the shaft portion <NUM> may be positioned or reside within the undercuts <NUM> formed in the bone facing surface <NUM>. In use, the undercuts <NUM> may be sized and configured to provide clearance for a cable to pass underneath the periprosthetic ring bone fixation plate <NUM>.

As previously mentioned, in one embodiment, the plurality of undercuts <NUM> are collocated with the variable angled openings <NUM> formed in the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> to provide increased bone plate strength (e.g., the undercuts <NUM> and the variable angled openings <NUM> are centered between the central locking screw openings <NUM>, which is the location of the peak stress. If either the undercuts <NUM> or the variable angled openings <NUM> were positioned closer to one of the central locking screw openings <NUM>, the overall strength of the plate would be diminished).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described in connection with the periprosthetic proximal femur bone fixation plate <NUM>, the distal end portion <NUM> of the shaft portion <NUM> (e.g., an end portion <NUM> of the plate <NUM> opposite the head portion <NUM>) of the periprosthetic ring bone fixation plate <NUM> may include thinning. That is, the end portion <NUM> may include a reduced or tapering cross-sectional area to facilitate contouring of the end portion <NUM> relative to the patient's anatomy. In accordance with one aspect or feature of the present disclosure, the distal end portion <NUM> of the shaft portion <NUM> may incorporate a reduced cross-sectional area to better enable the surgeon to contour the end portion <NUM> to accommodate the patient's anatomy. For example, as previously mentioned, providing a bone fixation plate anatomically constrained or contoured at both ends will not fit individual patients as intended. Thus, it is beneficial to anatomically un-constrain one end of the bone plate to enable contouring of the bone plate to provide a better fit for each individual patient.

In addition, referring to <FIG> and <FIG>, in accordance with another aspect of the present disclosure and as previously described above in connection with the periprosthetic proximal femur bone fixation plate <NUM>, the locking screw openings <NUM> formed in the end portion <NUM> of the plate <NUM> may include an underside counterbore <NUM> formed in the underside or bone facing surface <NUM> thereof. For example, as illustrated, the two distal most locking screw openings <NUM> formed in the shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may include an underside counterbore <NUM>, although it is envisioned that more or less locking screw openings may be counterbored on the underside or bone facing surface. In use, by providing a counterbore <NUM> in the underside or bone facing surface <NUM> of the locking screw openings <NUM> formed in the end portion <NUM> of the plate <NUM>, the underside counterbored locking screw openings may be used in combination with an instrument to grab and compress the bone fracture.

The shaft portion <NUM> of the periprosthetic ring bone fixation plate <NUM> may also include a plurality of K-wire openings <NUM> for enabling a K-wire to pass therethrough. As illustrated, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, an initial K-wire opening <NUM> may be positioned between the two distal most locking screw openings <NUM>. In addition, the shaft portion <NUM> may include a plurality of additional K-wire openings <NUM> formed in the second region <NUM> of the shaft portion <NUM>. In use, the plurality of K-wire openings <NUM> allow a surgeon to provisionally hold the bone fixation plate <NUM> to the patient's bone after they have reduced the fracture.

Referring to <FIG>, various embodiments of an alternate bone fixation plate <NUM> having various lengths for repairing fractures in a patient's bone is disclosed. As will be described herein, the bone fixation plates <NUM> illustrated and described in connection with <FIG> may be substantially similar to the periprosthetic proximal femur bone fixation plate <NUM> described above in connection with <FIG>, however the bone fixation plate <NUM> may be in the form of a hook plate. That is, the bone fixation plate <NUM> includes a head portion <NUM> incorporating hook members <NUM> (e.g., first and second hook members <NUM>, <NUM>) arranged and configured for engaging the trochanter of a patient. In addition, as will be described herein, the bone fixation plate <NUM> includes one or more features so that the bone fixation plate <NUM> facilitates positioning and securement to a patient's bone such as, for example, a patient's femur, which previously received a surgically implanted orthopedic implant or device such as, for example, an IM nail, a hip prosthetic, etc. As such, the bone fixation plate <NUM> is arranged and configured for periprosthetic fractures and thus may be referred to as a periprosthetic bone fixation plate or periprosthetic troch hook bone fixation plate.

As shown, the periprosthetic troch hook bone fixation plate <NUM> may include an underside, lower, or bone facing surface <NUM> and an upper surface <NUM>. In addition, the periprosthetic troch hook bone fixation plate <NUM> includes a head portion <NUM> and a shaft portion <NUM>. Moreover, the periprosthetic troch hook bone fixation plate <NUM> includes a plurality of openings <NUM> formed therein for receiving a plurality of fasteners (not shown) for coupling the periprosthetic troch hook bone fixation plate <NUM> to the patient's bone.

As shown, the head portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> includes hook members <NUM> (e.g., first and second hook members <NUM>, <NUM>) arranged and configured for engaging a patient's trochanter. That is, as shown, the periprosthetic troch hook bone fixation plate <NUM> includes first and second hook members <NUM>, <NUM> extending from the head portion <NUM> thereof (e.g., extending from the proximal end of the head portion <NUM>). In accordance with one aspect of the present disclosure, in contrast to known hook plates, the periprosthetic troch hook bone fixation plate <NUM> includes first and second hook members <NUM>, <NUM> that are asymmetrical. That is, the first hook member <NUM> is different than the second hook member <NUM>. For example, the first hook member <NUM> may have a different size and/or configuration as compared to the second hook member <NUM>. By incorporating asymmetrical hook members <NUM>, the periprosthetic troch hook bone fixation plate <NUM> is better able to match the anatomic slant of a patient's trochanter.

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, the head portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> may include a plurality of variable angled openings <NUM>. That is, the head portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> may be devoid of any locking screw openings <NUM> (as best shown in <FIG>), although it is envisioned that in some embodiments, locking screw openings may also be incorporated. As shown, for example, the variable angled openings <NUM> formed in the head portion <NUM> may be arranged in an array such as, for example, a 2x4 array, although this is merely exemplary and other arrays and/or configurations are envisioned. By providing an array of variable angled openings <NUM> in the head portion <NUM>, a surgeon is provided with increased options for positioning variable angled bone fasteners into the patient's bone.

In addition, as previously described in connection with the proximal femur bone fixation plate <NUM>, the periprosthetic troch hook bone fixation plate <NUM> may include a plurality of locking screw openings <NUM> and a plurality of variable angled openings <NUM> in the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM>. Similar to the locking screw openings <NUM> and variable angled openings <NUM> described in connection with the proximal femur bone fixation plate <NUM>, and in accordance with one aspect of the present disclosure, the locking screw openings <NUM> formed in the periprosthetic troch hook bone fixation plate <NUM> may be arranged and configured to receive larger diameter bone fasteners relative to the variable angled openings <NUM> formed in the periprosthetic troch hook bone fixation plate <NUM>. That is, for example, the locking screw openings <NUM> may be arranged and configured to receive <NUM> bone fasteners while the variable angled openings <NUM> may be arranged and configured to receive <NUM> bone fasteners, although these dimensions are merely exemplary and other dimensioned bone fasteners are envisioned. By arranging and configuring the periprosthetic troch hook bone fixation plate <NUM> to receive larger diameter locking screws, the periprosthetic troch hook bone fixation plate <NUM> is better able to secure to the patient's bone. Meanwhile, by incorporating smaller, variable angled openings <NUM>, the periprosthetic troch hook bone fixation plate <NUM> is better able to facilitate positioning of the non-locking screws (e.g., polyaxial variable angled bone screws) around the previous surgically implanted orthopedic device or implant.

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described, the locking screw openings <NUM> may be positioned within the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> more centrally as compared to the variable angled openings <NUM>. For example, in one embodiment, the shaft portion <NUM> may include a central longitudinal axis CL, the locking screw openings <NUM> may be positioned within the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> more centrally, substantially along the central longitudinal axis CL, as compared to the variable angled openings <NUM>, which as illustrated, may be positioned along and/or adjacent to an outer periphery or surface <NUM> of the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM>. That is, the locking screw openings <NUM> are positioned more interior, closer to the central longitudinal axis CL of the shaft portion <NUM> relative to the variable angled openings <NUM>, which are positioned closer to the outer periphery or perimeter surface <NUM> of the shaft portion <NUM>.

Thus arranged, by positioning the variable angled openings <NUM> along and/or adjacent to the outer periphery or surface <NUM> of the shaft portion <NUM>, the periprosthetic troch hook bone fixation plate <NUM> is better able to position the variable angled bone fastener to avoid the previous surgically implanted orthopedic device or implant (e.g., the surgeon is better able to position and insert one or more bone fastener through the variable angled openings <NUM> formed in the periprosthetic troch hook bone fixation plate <NUM> while avoiding, for example, a stem portion of a hip prosthetic or IM nail of a previous surgically implanted orthopedic device or implant in the patient's femur).

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described in connection with the periprosthetic proximal femur bone fixation plate <NUM>, the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> may include a first region <NUM> and a second region <NUM>. As illustrated, the first region <NUM> may be positioned adjacent to the head portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM>. In one or more embodiments, as shown in <FIG>, in the first region <NUM> of the shaft portion <NUM>, the variable angled openings <NUM> may be arranged and configured so that there are multiple variable angled openings <NUM> positioned on one side of the locking screw opening <NUM> with the position of the variable angled openings <NUM> alternating sides with every locking screw opening <NUM>. Thereafter, as illustrated, the variable angled openings <NUM> formed in the second region <NUM> of the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> may be arranged with a single variable angled opening <NUM> for each locking screw opening <NUM>. In use, as compared to, for example, the periprosthetic ring bone fixation plate <NUM>, the width of the periprosthetic troch hook bone fixation plate <NUM> may be less. In addition, the periprosthetic troch hook bone fixation plate <NUM> may be loaded during insertion. As such, the variable angled openings <NUM> in the shaft portion <NUM> are arranged and configured to be as spread out (e.g., across the width of the shaft portion <NUM>) as possible. Thus arranged, as illustrated, the first region <NUM> of the shaft portion <NUM> may include more (e.g., double) variable angled openings <NUM> as compared to the second region <NUM> of the shaft portion <NUM> thereby providing the surgeon with increased options when inserting bone fasteners into the patient's bone in the expected vicinity of the stem portion or IM nail of the previous surgically implanted orthopedic device or implant.

In addition, and/or alternatively, although not shown, it is envisioned that the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> may include a plurality of undercuts or grooves formed in the underside or bone facing surface <NUM>. In use, the undercuts may be sized and configured to provide clearance for a cable to pass underneath the periprosthetic troch hook bone fixation plate <NUM>.

In addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure and as previously described in connection with the periprosthetic proximal femur bone fixation plate <NUM>, an end portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> (e.g., the end portion <NUM> of the plate <NUM> opposite the head portion <NUM>) may include thinning. That is, the end portion <NUM> may include a reduced or tapering cross-sectional area to facilitate contouring of the end portion <NUM> relative to the patient's anatomy. In accordance with one aspect or feature of the present disclosure, the end portion <NUM> may incorporate a reduced cross-sectional area to better enable the surgeon to contour the end portion <NUM> to accommodate the patient's anatomy. For example, as previously mentioned, providing a bone fixation plate with both ends contoured creates numerous issues. For example, generally speaking, providing a bone fixation plate anatomically constrained or countered at both ends will not fit individual patients as intended. Thus, it is beneficial to anatomically un-constrain one end of the bone plate to enable contouring of the bone plate to provide a better fit for each individual patient. In accordance with one aspect or feature of the present disclosure, the end portion <NUM> (e.g., end portion opposite the head portion <NUM>) may incorporate a reduced cross-sectional area to better enable the surgeon to contour the end portion <NUM> to accommodate the patient's anatomy.

In addition, referring to <FIG>, in accordance with another aspect of the present disclosure and as previously described above in connection with the proximal femur bone fixation plate <NUM>, the locking screw openings <NUM> formed in the end portion <NUM> may include an underside counterbore <NUM> formed in the underside or bone facing surface <NUM> thereof. For example, as illustrated, the two distal most locking screw openings <NUM> formed in the shaft portion <NUM> of the periprosthetic troch hook bone fixation plate <NUM> may include an underside counterbore, although it is envisioned that more or less locking screw openings may be counterbored on the underside or bone facing surface. In use, by providing a counterbore in the underside of the locking screw openings formed in the distal end portion of the plate, the underside counterbored locking screw openings may be used in combination with an instrument to grab and compress the bone fracture.

The shaft portion of the periprosthetic troch hook bone fixation plate <NUM> may also include a plurality of K-wire openings <NUM> for enabling a K-wire to pass therethrough. As illustrated, in addition, and/or alternatively, in accordance with another aspect or feature of the present disclosure, an initial K-wire opening <NUM> may be positioned between the two distal most locking screw openings <NUM>. In addition, the shaft portion <NUM> may include a plurality of additional K-wire openings <NUM> formed therein. In use, the plurality of K-wire openings <NUM> allow a surgeon to provisionally hold the bone fixation plate <NUM> to the patient's bone after they have reduced the fracture.

The foregoing description has broad application. Accordingly, the discussion of any embodiment is meant only to be explanatory and is not intended to suggest that the scope of the disclosure, including the claims, is limited to these example embodiments. In other words, while illustrative embodiments of the disclosure have been described in detail herein, it is to be understood that the inventive concepts may be otherwise variously embodied and employed, and that the appended claims are intended to be construed to include such variations, except as limited by the prior art.

Accordingly, the terms "including," "comprising," or "having" and variations thereof are open-ended expressions and can be used interchangeably herein. The phrases "at least one", "one or more", and "and/or", as used herein, are open-ended expressions that are both conjunctive and disjunctive in operation.

Claim 1:
A periprosthetic bone plate (<NUM>) comprising:
a head portion (<NUM>); and
a shaft portion (<NUM>), an upper surface (<NUM>), a lower surface (<NUM>), a central longitudinal axis (CL), and an outer periphery surface, the shaft portion (<NUM>) further including:
a plurality of threaded locking screw openings (<NUM>) arranged and configured to receive a plurality of locking screws, respectively; and
a plurality of variable angled fastener openings (<NUM>) arranged and configured to receive a plurality of variable angled screws, respectively;
wherein the plurality of variable angled fastener openings (<NUM>) are positioned along the outer periphery surface of the shaft portion (<NUM>) while the plurality of locking screw openings (<NUM>) are positioned closer to the central longitudinal axis (CL) of the shaft portion (<NUM>).