Patent Description:
Bone fractures are often repaired by internal fixation of the bone, such as diaphyseal bone, including tibia and fibula bones, using one or more plates. The plate is held against the fractured bone with screws, for example, which engage the bone and heads which provide a compressive force against the plate. The plate and bone are thus forced against each other in a manner that transfers load primarily between a bone contacting surface of the plate and the bone surface to reinforce the fractured bone during healing. This manner of plating generally creates relatively low stress concentration in the bone, as there may be a large contact area between the plate and the diaphyseal bone surface permitting transfer of load to be dispersed. There may be a desire to use locking screws, non-locking screws, or a combination of both that are able to dynamically compress the bone. Of course, the designs of the plates, types of screws, and locking and/or non-locking capabilities may vary based on the location and type of fracture.

<CIT>, <CIT>, <CIT>, <CIT> and <CIT> describe devices known in the art.

Accordingly, there is a need for plating systems that provide stabilization to the appropriate anatomical area while providing appropriate locking and/or unlocking capability for dynamic compression of the bone.

According to the invention it is provided a plate according to claim <NUM>. Further advantageous aspects of the invention are set forth in the dependent claims.

According to embodiments, a stabilization system may include a plurality of plates configured to fix bone in the treatment of ankle fractures. Anatomic bone plates facilitate the well-known and established treatment methods for bone fractures. An advantage of the exemplary stabilization systems is the availability to use various treatment options. It is often a surgeon's preference whether to use a screw or a suture button system to repair a syndesmosis, and it is advantageous to provide a plate that can accept either.

In one example, the stabilization system comprises a bone plate having an upper surface and a lower surface configured to be in contact with bone. The bone plate has a through-opening extending from the upper surface to the lower surface. The through-opening includes a threaded portion proximate to the lower surface and a non-threaded portion proximate to the upper surface. A fastener is configured to engage the through-opening and to secure the bone plate to the bone. The through-opening is configured to receive one of a locking fastener and a compression fastener.

In another example, the stabilization system comprises a bone plate having an upper surface and a lower surface configured to be in contact with bone. The bone plate has a through-opening extending from the upper surface to the lower surface. The through-opening includes a threaded portion proximate to the lower surface and a non-threaded portion proximate to the upper surface. A locking fastener is configured to be received by the through-opening and configured to be inserted into the bone. The locking fastener has a threaded head portion configured to lock to the bone plate. A compression fastener is configured to be received by the through-opening and configured to be inserted into the bone. The compression fastener has a substantially smooth portion configured to dynamically compress the bone.

In an embodiment, a stabilization system comprises a bone plate having an upper surface and a lower surface configured to be in contact with bone. The bone plate has a through-opening extending from the upper surface to the lower surface. The through-opening is formed by at least three different co-axial bores including a first bore having an internal thread and a first diameter; a second bore having an unthreaded conical side wall and a second diameter, greater than the first diameter; and a third bore having an annular surface surrounding the side wall and a third diameter, greater than the second diameter.

The stabilization system comprises a bone plate having an elongate body extending from a proximal end to a distal end along a longitudinal axis and having an enlarged head portion proximate the distal end, wherein the bone plate is generally symmetric about the longitudinal axis, the bone plate having an elongated slot located along the longitudinal axis having a length greater than its width, the bone plate having a plurality of syndesmotic openings located along the longitudinal axis, wherein one of the syndesmotic openings is located adjacent to the elongated slot, the syndesmotic openings being sized and dimensioned to accept a suture button, a non-locking screw, or a locking screw, and the bone plate having a plurality of openings in the enlarged head portion.

In yet another example, a stabilization system comprises a bone plate having an elongate body extending from a proximal end to a distal end along a longitudinal axis and having an enlarged head portion proximate the distal end, wherein the bone plate is symmetric about the longitudinal axis, the bone plate having first and second stacked openings located along the longitudinal axis and positioned proximate to the proximal end of the bone plate, the first and second stacked openings configured to accept either locking or non-locking fasteners, the bone plate having an elongated slot located along the longitudinal axis having a length greater than its width, wherein the elongated slot is located adjacent to the second stacked opening, the bone plate having a plurality of syndesmotic openings located along the longitudinal axis, wherein one of the syndesmotic openings is located adjacent to the elongated slot, the syndesmotic openings being sized and dimensioned to accept a suture button, a non-locking screw, or a locking screw, and the bone plate having a plurality of openings in the enlarged head portion.

Also described are additional stabilization systems, bone plates, and kits including bone plates, fasteners, and components for installing the same.

It is further described but does not fall within the scope of the invention a stabilization system comprising: a bone plate having an elongate body extending from a proximal end to a distal end along a longitudinal axis and having an enlarged head portion proximate the distal end, wherein the bone plate is symmetric about the longitudinal axis, the bone plate having first and second stacked openings located along the longitudinal axis and positioned proximate to the proximal end of the bone plate, the first and second stacked openings configured to accept either locking or non-locking fasteners, the bone plate having an elongated slot located along the longitudinal axis having a length greater than its width, wherein the elongated slot is located adjacent to the second stacked opening, the bone plate having a plurality of syndesmotic openings located along the longitudinal axis, wherein one of the syndesmotic openings is located adjacent to the elongated slot, the syndesmotic openings being sized and dimensioned to accept a suture button, a non-locking screw, or a locking screw, and the bone plate having a plurality of openings in the enlarged head portion.

In a version, the stabilization system further comprises a first fastener configured to engage the elongated slot to secure the bone plate to the bone.

In another version the stabilization system further comprises a second fastener configured to engage one of the syndesmotic openings, wherein the second fastener is sized and dimensioned to engage the tibia and the fibula.

In another version the plurality of openings in the enlarged head portion comprise conically-threaded locking holes.

In another version one of the plurality of openings in the enlarged head portion is a non-threaded hole configured to receive a non-locking fastener in order to compress the plate to the bone.

In a further version an edge of the bone plate includes a scalloped section.

In a further version the plurality of syndesmotic openings includes first, second, and third syndesmotic openings, wherein the plurality of openings in the enlarged head portion includes a first locking hole positioned proximate to the third syndesmotic opening, and wherein the scalloped section includes a first cutout positioned along the edge between the second and third syndesmotic holes and a second cutout positioned along the edge between the third syndesmotic hole and the first locking hole.

In still another version the enlarged head portion is contoured to mimic the lateral malleolus of the fibula.

In a further version the bone plate is configured to contact the distal fibula.

In another version the bone plate is generally symmetric about the longitudinal axis such that plate can accommodate left or right fibulas.

Other aspects, features, and advantages of the present invention will become more fully apparent from the following detailed description, the appended claims, and the accompanying drawings in which like reference numerals identify similar or identical elements.

In the drawings, like numerals indicate like elements throughout. Certain terminology is used herein for convenience only and is not to be taken as a limitation on the present invention. The terminology includes the words specifically mentioned, derivatives thereof and words of similar import. The embodiments illustrated below are not intended to be exhaustive or to limit the invention to the precise form disclosed. These embodiments are chosen and described to best explain the principle of the invention and its application and practical use and to enable others skilled in the art to best utilize the invention.

Reference herein to "one embodiment" or "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment can be included in at least one embodiment of the invention.

As used in this application, the word "exemplary" is used herein to mean serving as an example, instance, or illustration. Any aspect or design described herein as "exemplary" is not necessarily to be construed as preferred or advantageous over other aspects or designs. Rather, use of the word exemplary is intended to present concepts in a concrete fashion.

Additionally, the term "or" is intended to mean an inclusive "or" rather than an exclusive "or". That is, unless specified otherwise, or clear from context, "X employs A or B" is intended to mean any of the natural inclusive permutations. In addition, the articles "a" and "an" as used in this application and the appended claims should generally be construed to mean "one or more" unless specified otherwise or clear from context to be directed to a singular form.

Unless explicitly stated otherwise, each numerical value and range should be interpreted as being approximate as if the word "about" or "approximately" preceded the value of the value or range.

Also for purposes of this description, the terms "couple," "coupling," "coupled," "connect," "connecting," or "connected" refer to any manner known in the art or later developed of joining or connecting two or more elements directly or indirectly to one another, and the interposition of one or more additional elements is contemplated, although not required. Conversely, the terms "directly coupled," "directly connected," etc., imply the absence of such additional elements.

The present disclosure provides embodiments of plates, securing devices, systems that can be used to repair, for example, bone fractures, particularly ankle fractures.

Specifically, embodiments are directed to bone plating with locking and/or non-locking fasteners for dynamic compression of bone. The hole designs may allow for fixed angle and/or polyaxial locking and/or non-locking of the fasteners. Some embodiments include locking fasteners with self-forming threads configured to displace the plate material, thereby locking the fastener to the plate.

While exemplary embodiments of the plates are used to repair ankle fractures, those skilled in the art will recognize that the plates may be adapted to contact one or more of a femur, a distal tibia, a proximal tibia, a proximal humerus, a distal humerus, a clavicle, a fibula, an ulna, a radius, bones of the foot, bones of the hand, or other suitable bone or bones. The bone plate may be curved, contoured, straight, or flat. The plate may have a head portion that is contoured to match a particular bone surface, such as a metaphysis or diaphysis, flares out from the shaft portion, forms an L-shape, T-shape, Y-shape, etc., with the shaft portion, or that forms any other appropriate shape to fit the anatomy of the bone to be treated.

The bone plate may be comprised of titanium, stainless steel, cobalt chrome, carbon composite, plastic or polymer-such as 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 body. Similarly, the fasteners may be comprised of titanium, cobalt chrome, cobalt-chrome-molybdenum, stainless steel, tungsten carbide, combinations or alloys of such materials or other appropriate biocompatible materials. Although the above list of materials includes many typical materials out of which bone plates and fasteners are made, it should be understood that bone plates and fasteners comprised of any appropriate material are contemplated.

The embodiments of the disclosure and the various features and advantageous details thereof are explained more fully with reference to the nonlimiting embodiments and examples that are described and/or illustrated in the accompanying drawings and detailed in the following description. The features of one embodiment may be employed with other embodiments as the skilled artisan would recognize, even if not explicitly stated herein. Descriptions of well-known components and processing techniques may be omitted so as to not unnecessarily obscure the embodiments of the disclosure. The examples used herein are intended merely to facilitate an understanding of ways in which the disclosure may be practiced and to further enable those of skill in the art to practice the embodiments of the disclosure. Accordingly, the examples and embodiments herein should not be construed as limiting the scope of the disclosure, which is defined solely by the appended claims and applicable law.

Referring to <FIG>, a lateral distal fibula plate <NUM> ("plate <NUM>") according to a first exemplary embodiment is shown. Referring specifically to <FIG> and <FIG>, plate <NUM> is fixed to the lateral surface <NUM> of a fibula <NUM>. Plate <NUM> may be used to treat fractures of the distal fibula <NUM> and/or disruption of the syndesmosis, and can have a pre-contoured shape, such as is shown in <FIG>. Alternatively, plate <NUM> can be contoured prior to use in order to conform to a particular bone structure.

Plate <NUM> has an elongate body <NUM> extending generally along a central longitudinal axis <NUM>. Plate <NUM> has an upper surface <NUM> extending between a proximal end <NUM> and a distal end <NUM> and a lower surface <NUM> configured to be in contact with bone. A body portion <NUM> extends between proximal end <NUM> and distal end <NUM> and has a transition section <NUM> where body portion <NUM> transitions from a generally planar portion <NUM> proximate to proximal end <NUM> and a contoured portion <NUM> proximate to distal end <NUM>.

As used herein, the term "contoured" means "curved" such that contoured portion <NUM> includes surfaces (upper surface <NUM>, lower surface <NUM>, or both) with non-infinite radii. The contours do not necessarily need to be constant; the radius of curvature of contoured portion <NUM> can vary along the length and width of contoured portion <NUM>. In an exemplary embodiment, contoured portion <NUM> can be contoured to match the contours of the bone to which plate <NUM> is to be fixed, such as a fibula.

In an exemplary embodiment, proximal end <NUM> and distal end <NUM> each includes a smooth, rounded ends and edges. Body portion <NUM> is contoured, with smooth, rounded edges. The smooth, rounded ends and edges eliminate the potential for inadvertently engaging and ripping any adjoining tissue.

Body portion <NUM> also includes a plurality of different types of through-openings formed therein and extending from upper surface <NUM> to lower surface <NUM>. The different types of through-openings disclosed in plate <NUM> will discussed from proximal end <NUM> to distal end <NUM>, although those skilled in the art will recognize that the through-openings can be located at different places, in different orders, and intermixed together throughout the length of plate <NUM>.

Referring to <FIG>, through-openings <NUM> are shaft holes including a threaded portion <NUM> proximate to lower surface <NUM> and a non-threaded portion <NUM> proximate to upper surface <NUM>. Through-openings <NUM> may extend along longitudinal axis <NUM>.

Threaded portion <NUM> and non-threaded portion <NUM> are co-axial. The shaft holes can accept both locking and non-locking screws, resulting in a "stacked" design, in which a non-locking hole geometry, non-threaded portion <NUM>, is on top of locking threaded portion <NUM> below.

Through-openings <NUM> can alternatively receive fasteners comprised of locking screws or non-locking (compression) screws. In exemplary embodiments, screw <NUM> can be <NUM> or <NUM> screws, for example.

<FIG> shows a non-locking screw <NUM> inserted into through-opening <NUM>. Non-threaded portion <NUM> is generally conical in shape such that non-threaded portion <NUM> is wider near upper surface <NUM> of plate <NUM> and narrower toward threaded portion <NUM>. Screw <NUM> has a substantially smooth convex portion <NUM> of a head <NUM> configured to be received by and engage with non-threaded portion <NUM> and to dynamically compress bone <NUM> after fixation of plate <NUM> to bone <NUM>. Non-threaded portion <NUM> has a generally concave surface <NUM> to mate with convex surface portion <NUM> of head <NUM> of screw <NUM>.

A shaft <NUM> of screw <NUM> has distal threads <NUM> that are configured to screw into bone <NUM>. Shaft <NUM> and threads <NUM> have a narrower diameter than that of through-opening <NUM> so that shaft <NUM> can pass through through-opening <NUM> without engaging threaded portion <NUM> of through-opening <NUM>.

A locking screw <NUM> is shown in <FIG>. Locking screw <NUM> has a threaded head portion <NUM> configured to engage threaded portion <NUM> of through-opening <NUM> and to lock screw <NUM> to plate <NUM>. In some embodiments, threaded head portion <NUM> is a self-forming thread that is configured to displace material in threaded portion <NUM> of plate <NUM> to lock fastener <NUM> to plate <NUM>.

A second type of through-opening <NUM>, shown in <FIG>, may be sized and dimensioned to allow a K-wire <NUM> to pass therethrough. In an exemplary embodiment, through-opening <NUM> is sized to allow a <NUM> K-wire, to pass therethrough, although those skilled in the art will recognize that other size through-openings <NUM> can be provided for other size K-wires. As noted in <FIG>, one or more through-openings <NUM> are spaced along a length of plate <NUM> and are not necessarily aligned with longitudinal axis <NUM>.

A third type of through-opening that can be provided in plate <NUM> is an elongate slot <NUM>. Elongate slot <NUM> may extend along longitudinal axis <NUM>, for example. The elongated slot <NUM> may have a length greater than its width, for example, a length two times its width, a length three times its width, or more. Elongate slot <NUM> may allow for a range of securing member insertion locations. In an exemplary embodiment, one elongate through-opening <NUM> is provided, although those skilled in the art will recognize, depending on the length of plate <NUM> and through-opening <NUM>, one or more than through-opening <NUM> can be provided.

Slots <NUM> include generally smooth side walls to allow a securing member, such as screw <NUM>, to be inserted at infinite locations along the length of each slot <NUM>. A rib <NUM> extends around the inner perimeter of slot <NUM> below upper surface <NUM>. In an exemplary embodiment, screws <NUM> can be <NUM> or <NUM> non-locking screws and can provide up to <NUM> of compression or distraction. Screws <NUM> may engage rib <NUM> along under surface <NUM> of head <NUM> of screw <NUM> so that head <NUM> is largely, if not entirely, within slot <NUM> to minimize the amount of head <NUM> extending above upper surface <NUM> of plate <NUM>.

Referring to <FIG> and <FIG>, a fourth type of through-opening that can be provided in plate <NUM> is a syndesmotic hole <NUM> located at transition portion <NUM>. Syndesmotic hole <NUM> can accept three different types of fixation: (<NUM>) a suture button <NUM>; (<NUM>) non-locking screw <NUM>; or (<NUM>) locking screw <NUM>.

Referring specifically to the cross-section of hole <NUM> in <FIG>, hole <NUM> includes, from lower surface <NUM> of plate <NUM> to upper surface <NUM> of plate <NUM>, at least three different co-axial bores. A first bore includes a threaded portion <NUM>, similar to threaded portion <NUM> of through-opening <NUM>, with its bore having a first diameter D1.

Similar to through-opening <NUM>, a second bore of hole <NUM> is has an unthreaded conical portion <NUM> with a conical side wall <NUM> located above and adjacent to threaded portion <NUM>. The second bore of hole <NUM> has a maximum diameter D2, larger than diameter D1.

In contrast to through-opening <NUM>, hole <NUM> further includes a third bore comprising a bowl portion <NUM> having a diameter D3, larger than maximum diameter D2. Bowl portion <NUM> is for the use of a suture button system that includes, for example, two metal buttons <NUM>, <NUM>, connected via suture. Button <NUM> interfaces with the far cortex of bone <NUM> (shown in <FIG>), while button <NUM> interfaces with bone plate <NUM>. This button system provides stability for a disrupted joint or bone fracture and also provides a type of mobile stability. The use of buttons <NUM>, <NUM> may be a method of treatment for the syndesmosis when the syndesmosis is disrupted. Another type of fixation of a disrupted syndesmosis is a bone screw as described above, which is a more rigid fixation than the suture button system.

Referring to <FIG>, bowl portion <NUM> is above and adjacent to conical portion <NUM>. Conical portion <NUM> has a maximum diameter of diameter D2 proximate to bowl portion <NUM>. Bowl portion <NUM> comprises a bowl diameter, larger than the maximum diameter. The transition between bowl portion <NUM> and threaded portion <NUM> (i.e. conical portion <NUM>) is shown in <FIG> as a chamfer, but could alternatively be a round.

Bowl portion <NUM> includes a side wall <NUM> that circumscribes bowl portion <NUM> and an annular surface <NUM> between the side wall <NUM> and conical portion <NUM>. Annular surface <NUM> surrounds side wall <NUM> of conical portion <NUM>. Bowl portion <NUM> is configured to receive and retain a button <NUM> having a lower surface <NUM> (shown in <FIG>) configured to engage annular surface <NUM> and fit within side wall <NUM>.

Referring to <FIG>, button <NUM> also includes at least one thread hole <NUM> that is in communication with hole <NUM> when lower surface <NUM> is in engagement with annular surface <NUM>.

Referring to <FIG>, first button <NUM> is configured for insertion into bowl portion <NUM> of hole <NUM> and a second button <NUM> is configured to engage bone <NUM>, distal from bone plate <NUM>. A suture (not shown) extends through thread hole <NUM>, through plate <NUM> and a passage <NUM> drilled through bone <NUM>, to second button <NUM> to compress bone <NUM> and plate <NUM> between buttons <NUM>, <NUM>.

A fifth set of through holes <NUM> are provided at distal end <NUM> of plate <NUM>. Holes <NUM> may be configured to receive locking screws <NUM>. In an exemplary embodiment, holes <NUM> may be threaded to accept <NUM> locking screws <NUM>, for example. A plurality of holes <NUM> (about seven as shown in plate <NUM>) are provided to fix distal end <NUM> of plate <NUM> securely in bone <NUM>. Holes <NUM> are not constrained along longitudinal axis <NUM> but instead are located along the width of plate <NUM> to provide a plurality of screw connections for a secure fixation to bone.

<FIG> depicts an alternative version of a lateral distal fibula plate <NUM>. <FIG> show close up views of the distal portion of the plate <NUM>. The plate <NUM> is substantially the same as that disclosed in <FIG>, with the addition of a sixth type of through hole <NUM>. This through hole <NUM> may be a non-threaded hole located within the distal head of the plate <NUM>. Through hole <NUM> may have smaller diameter than the other distal through holes <NUM>. The through hole <NUM> may be positioned near or surrounded by distal locking holes <NUM>. The through hole <NUM> may be configured accept a non-locking fastener or screw <NUM> that can act as a suck-down screw. In a preferred embodiment, this hole <NUM> is not threaded. When used, the non-locking screw <NUM> may be placed first in order to get the plate <NUM> to be compressed down to the bone <NUM>. This screw <NUM> can be left in after the other distal locking screws <NUM> are placed in holes <NUM> or screw <NUM> can be removed. As shown in <FIG>, the middle non-threaded hole <NUM> is configured to accept the non-locking screw <NUM>, but it is envisioned that either a proximal or distal non-threaded hole <NUM> could accept a non-locking screw <NUM>.

A second embodiment of a plate <NUM>, shown in <FIG>, is a posterolateral distal fibula plate. Plate <NUM> sits on the posterior face of the fibula distally, and wraps around to the lateral surface as plate <NUM> travels proximally. Plate <NUM> can be used to facilitate a posterior surgical approach. Similar to plate <NUM>, plate <NUM> can have a variety of different through-openings, including syndesmotic holes <NUM>, similar to syndesmotic holes <NUM> described above.

Plate <NUM> has a generally planar body <NUM> with a transition portion <NUM> proximate to syndesmotic holes <NUM>, where body <NUM> transitions to a contoured shape to conform to the posterior face of the fibula.

<FIG> depicts an alternative version of posterolateral distal fibula plate <NUM>. The plate <NUM> is substantially the same as that disclosed in <FIG>, with the addition of one or more scalloped edges <NUM>. The scalloped edge or edges <NUM> may be positioned along the transition region <NUM> of the plate <NUM>. The scalloped edge <NUM> may extend along one or both sides of the plate <NUM>. As shown, the scalloped edge <NUM> may be positioned on a first side of the plate <NUM>. The scalloped edge <NUM> may include a first recess or cutout positioned along the edge between the second and third syndesmotic holes <NUM> and a second recess or cutout positioned along the edge between the third syndesmotic hole <NUM> and the first locking hole <NUM>. Because the posterolateral plate <NUM> is configured to sit on the posterior side of the fibula <NUM>, syndesmotic screws <NUM>, <NUM> (placed lateral to medial) or suture buttons <NUM> often cannot be placed through the plate <NUM>. In some embodiments, these scallops <NUM> are configured to allow additional screws or suture buttons to be placed outside of the plate <NUM> and aids in these treatment options by not directly contacting the plate <NUM>. In some embodiments, one or more fasteners (e.g., screws <NUM>, <NUM>) may be placed outside the plate <NUM>, but in close proximity or in contact with the scalloped edge <NUM>.

A third embodiment of a hook plate <NUM> ("plate <NUM>") is shown in <FIG>. Plate <NUM> can be used for very distal fractures of the tibia or fibula, for example. Hook plate <NUM> has an elongate body <NUM> extending generally along a central longitudinal axis <NUM>. Plate <NUM> has a generally planar top surface <NUM> extending between a proximal end <NUM> and a distal end <NUM>. A body portion <NUM> extends between proximal end <NUM> and distal end <NUM>. Plate <NUM> is symmetrical about a plane extending through central longitudinal axis <NUM> perpendicular to top surface <NUM>.

In an exemplary embodiment, proximal end <NUM> includes a smooth, rounded face. The smooth, rounded face eliminates the potential for inadvertently engaging and ripping any adjoining tissue.

Body portion <NUM> is generally planar, with smooth, rounded surfaces, again to eliminate the potential for inadvertently engaging and ripping any adjoining tissue. Body portion <NUM> also includes a plurality of through-openings <NUM> formed therein. Through-openings <NUM> are elongate slots and allow for a range of securing member insertion locations. In an exemplary embodiment, two elongate through-openings <NUM> are provided, although those skilled in the art will recognize, depending on the length of plate <NUM> and through-openings <NUM>, more or less than two through-openings <NUM> can be provided.

Through-openings <NUM> include generally smooth side walls to allow securing members <NUM> to be inserted at infinite locations along the length of each through-opening <NUM>. A rib <NUM> may extend around the inner perimeter of through-opening <NUM> below top surface <NUM>. In an exemplary embodiment, securing members <NUM> can be <NUM> or <NUM> non-locking screws and can provide up to <NUM> of compression or distraction. Securing members <NUM> engage rib <NUM> along an under surface of the head <NUM> of securing member <NUM> so that head <NUM> is largely, if not entirely, within through-opening <NUM> to minimize the amount of head <NUM> extending above top surface <NUM> of plate <NUM>.

Through-openings <NUM> may be located at either end of plate <NUM>. Through-openings <NUM> are shaft holes that can accept either one of locking and non-locking screws via the "stacked" design described above. A first through-opening <NUM> is located at proximal end <NUM> and a second through-opening <NUM> is located at distal end <NUM>.

Referring to <FIG> and <FIG>, distal end <NUM> includes an arcuate surface <NUM> that extends away from the plane of body portion <NUM>, and is used to capture the distal bone fragment of either the tibia or the fibula. Arcuate surface <NUM> extends in an arc having an angle β of between about <NUM> degrees and about <NUM> degrees, about <NUM> degrees and about <NUM> degrees, or about <NUM> degrees and about <NUM> degrees from body portion <NUM>. At least one through-opening <NUM> extends through arcuate surface <NUM>.

A most distal end <NUM> of arcuate surface <NUM> includes a hook assembly having two separate hooks <NUM>, <NUM>. Each hook <NUM>, <NUM> includes a flat surface <NUM>, <NUM>, respectively and each flat surface <NUM>, <NUM> includes a corresponding cutting edge <NUM>, <NUM>, respectively. Cutting edges <NUM>, <NUM> extend along a single line <NUM> that is perpendicularly skew to longitudinal axis <NUM> and are used to engage and dig into bone material in the tibia or fibula.

With the exception of cutting edges <NUM>, <NUM>, all edges of arcuate surface <NUM> and hooks <NUM>, <NUM> have smooth, rounded surfaces, again to eliminate the potential for inadvertently engaging and ripping any adjoining tissue.

<FIG> depicts an embodiment of a universal distal fibula plate <NUM>. In <FIG>, the universal distal fibula plate <NUM> is positioned against a distal portion of the fibula <NUM>. This plate <NUM> is similar to the lateral distal fibula plate <NUM> described above. Plate <NUM> has an elongate body <NUM> extending generally along a central longitudinal axis <NUM>. The plate <NUM> has a transition section <NUM> between proximal end <NUM> and distal end <NUM> where body <NUM> transitions from a generally planar portion proximate to proximal end <NUM> to an enlarged head portion proximate to distal end <NUM>. The enlarged head portion may have a width greater than the width of the remainder of the plate <NUM>. The enlarged distal head portion of the plate <NUM> may be bent or contoured to mimic the anatomy of the fibula <NUM> (e.g. the lateral malleolus of the fibula). In an exemplary embodiment, proximal end <NUM> and distal end <NUM> each includes smooth, rounded ends and edges. The plate <NUM> is generally symmetric about the longitudinal axis <NUM>, such that plate <NUM> can accommodate left or right fibulas.

Similar to plate <NUM>, plate <NUM> includes a plurality of different types of through-openings formed therein and extending therethrough. Through-openings <NUM>, similar to through-openings <NUM> described herein, may feature a "stacked" design where the holes can accept both locking and non-locking fasteners <NUM>, <NUM> or screws. In exemplary embodiments, the openings <NUM> are configured to accept fasteners including <NUM> or <NUM> screws, for example. Through-openings <NUM> may extend along longitudinal axis <NUM>. Through-openings <NUM>, similar to through-openings <NUM>, may be sized and dimensioned to allow a K-wire to pass therethrough. Through-opening <NUM>, similar to elongate slot <NUM>, may extend along longitudinal axis <NUM>, for example. Syndesmotic openings <NUM>, similar to syndesmotic holes <NUM>, are each configured to accept a suture button <NUM>, a non-locking screw <NUM>, or a locking screw <NUM>. In particular, the syndesmotic holes <NUM> can accept <NUM> or <NUM> locking or non-locking screws. As best seen in <FIG>, at least one of the fasteners is positioned through the syndesmotic hole <NUM> has a length sufficient to engage the fibula <NUM> and the tibia <NUM>. As shown, a non-locking fastener <NUM> connects the plate <NUM> to the fibula <NUM> and the tibia <NUM>. In this embodiment, the other fasteners <NUM>, <NUM> have a length sufficient to only engage the fibula <NUM>.

Through-openings <NUM>, similar to through holes <NUM>, are provided in the enlarged distal head portion at the distal end <NUM> of plate <NUM>. These holes <NUM> may be conically-threaded locking holes configured to receive locking fasteners <NUM>. Holes <NUM> may be located along the width of plate <NUM> to provide a plurality of screw connections for a secure fixation to the fibula <NUM>. One or more of the holes <NUM> may be replaced with a non-threaded hole <NUM> as described for the lateral distal fibula plate <NUM>, which may be configured accept a non-locking fastener or screw <NUM> that can act as a suck-down screw. Plate <NUM> is universal and configured to secure the bone on left or right fibulas.

The bone plates <NUM>, <NUM>, <NUM>, <NUM> described herein may be especially configured for treatment of an ankle fracture. In particular, these plates <NUM>, <NUM>, <NUM>, <NUM> may be especially suitable for treatment of the distal fibula including lateral distal fibula or the posterolateral distal fibula, and/or the distal tibia. These anatomic bone plates <NUM>, <NUM>, <NUM>, <NUM> may facilitate improved treatment methods of ankle fractures and can provide a number of treatment options based on surgeon preference.

Claim 1:
A stabilization system comprising:
a bone plate (<NUM>; <NUM>) having an elongate body (<NUM>; <NUM>) extending from a proximal end (<NUM>; <NUM>) to a distal end (<NUM>; <NUM>) along a longitudinal axis (<NUM>; <NUM>) and having an enlarged head portion proximate the distal end (<NUM>; <NUM>), wherein the bone plate is generally symmetric about the longitudinal axis (<NUM>; <NUM>),
wherein the bone plate (<NUM>; <NUM>) having an elongated slot (<NUM>; <NUM>) located along the longitudinal axis having a length greater than its width,
wherein the bone plate (<NUM>; <NUM>) has a plurality of syndesmotic openings (<NUM>; <NUM>) located along the longitudinal axis (<NUM>; <NUM>), wherein one of the syndesmotic openings (<NUM>; <NUM>) is located adjacent to the elongated slot (<NUM>; <NUM>), the syndesmotic openings (<NUM>; <NUM>) being sized and dimensioned to accept a suture button (<NUM>), a non-locking screw (<NUM>), or a locking screw (<NUM>),
wherein each of the syndesmotic openings (<NUM>; <NUM>) includes from a lower surface (<NUM>) of the plate (<NUM>) to upper surface (<NUM>) of the plate (<NUM>) at least three different co-axial bores,
wherein the bone plate having a plurality of openings (<NUM>; <NUM>) in the enlarged head portion, characterized in that
the at least three co-axial bores_include a first bore including a threaded portion (<NUM>) having a first diameter (D1), a second bore having an unthreaded conical portion (<NUM>) with conical side wall (<NUM>) located above and adjacent to the threaded portion (<NUM>) having a maximum diameter (D2) larger than diameter (D1), and a third bore comprising a bowl portion (<NUM>) above and adjacent to conical portion (<NUM>) having a diameter (D3) larger than the maximum diameter (D2) proximate to the bowl portion (<NUM>), the bowl portion (<NUM>) includes a side wall (<NUM>) that circumscribes bowl portion (<NUM>) and an annular surface (<NUM>) between the side wall (<NUM>) and conical portion (<NUM>), the annular surface (<NUM>) surrounding a side wall (<NUM>) of the conical portion (<NUM>), wherein the bowl portion (<NUM>) is configured to receive and retain a button (<NUM>) having a lower surface (<NUM>) configured to engage the annular surface (<NUM>) and fit within side wall (<NUM>).