Title of Invention

A FIXATION PLATE FOR USE WITH A PLURALITY OF FIXATION PEGS AND K-WIRES

Abstract A fixation plate for use with a plurality of fixation pegs and K-wires, comprising: a substantially rigid plate having a bone contacting surface and defining a first set of peg holes each structurally adapted to engage a fixation peg with a threaded head and retain the fixation pegs in a fixed angle relationship such that the fixation pegs are obliquely oriented in at least one dimension relative to each other, and a first plurality of non-threaded alignment holes substantially smaller in diameter than said first set of peg holes, each of said alignment holes sized to closely receive a K-wire such that the K-wires will be in a fixed angle relationship relative to said plate, said alignment holes positioned in said plate and having predefined axial orientations such that when a plurality of the K-wires are inserted into said alignment holes, the K-wires approximate a three dimensional surface defined by fixation pegs inserted into said peg holes.
Full Text ANATOMICAL DISTAL RADIUS FRACTURE FIXATION PLATE
AND METHODS OF USING THE SAME
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates broadly to surgical implants. More particularly, this invention
relates to a bone fracture fixation system for distal radius fractures.
2. State of the Art
Fracture to the metaphyseal portion of a long bone can be difficult to treat. Improper
treatment can result in deformity and long-term discomfort.
By way of example, a Colles' fracture is a fracture resulting from compressive forces
being placed on the distal radius, and which causes backward or dorsal displacement of the
distal fragment and radial deviation of the hand at the wrist. Often, a Colles' fracture will
result in multiple bone fragments which are movable and out of alignment relative to each
other. If not properly treated, such fractures may result in permanent wrist deformity and
limited articulation of the wrist. It is therefore important to align the fracture and fixate the
bones relative to each other so that proper healing may occur.
Alignment and fixation of a metaphyseal fracture (occurring at the extremity of a shaft
of a long bone) are typically performed by one of several methods: casting, external fixation,
interosseous wiring, and plating. Casting is non-invasive, but may not be able to maintain
alignment of the fracture where many bone fragments exist. Therefore, as an alternative,
external fixators may be used. External fixators utilize a method known as ligamentotaxis,
which provides distraction forces across the joint and permits the fracture to be aligned based
upon the tension placed on the surrounding ligaments. However, while external fixators can
maintain the position of tlie wrist bones, it may nevertheless be difficult in certain fractures to
first provide the bones in proper alignment. In addition, external fixators are often not
suitable for fractures resulting in multiple bone fragments. Interosseous wiring is an invasive
procedure whereby screws are positioned into the various fragments and the screws are then
wired together as bracing. This is a difficult and time-consuming procedure. Moreover,

unless the bracing is quite complex, the fracture may not be properly stabilized. Plating
utilizes a stabilizing metal plate typically against the dorsal side of the bones, and a set of
parallel pins extending from the plate into holes drilled in the bone fragments to provide
stabilized fixation of the fragments. However, many currently available plate systems fail to
provide desirable alignment and stabilization.
In particular, with a distal radius fracture the complex shape of the distal radius,
including the bulky volar rim of the lunate fossa, relatively flat volar rim of the scaphoid
fossa, and volar marginal fragment from the lunate fossa should be accommodated. A fixation
plate should provide desirable alignment and stabilization of both the subchondral bone and
the articular surfaces of the distal radius.
SUMMARY OF THE INVENTION
It is therefore an object of the invention to provide an improved fixation system for
distal radius fractures.
It is another object of the invention to provide a distal radius volar fixation system that
desirably aligns and stabilizes multiple bone fragments in a fracture to permit proper healing.
It is also an object of the invention to provide a distal radius volar plate system which
provides support for articular and subchondral surfaces.
It is an additional object of the invention to provide a distal radius volar plate system
which accommodates the anatomical structure of the metaphysis of the distal radius.
It is a further object of the invention to provide a distal radius volar plate system which
provides support without interfering with ligaments and soft tissues near the edge of the
articular surface.
In accord with these and other objects, which will be discussed in detail below, a distal
radius volar fixation system is provided. The system generally includes a plate intended to be
positioned against the volar side of the radius, a plurality of bone screws for securing the plate

along a non-fractured portion of the radius bone, a plurality of bone pegs sized to extend from
the plate and into bone fragments at the metaphysis of a radius bone, and one or more K-wires
to facilitate alignment and fixation of the plate over the bone and guide the process of
application. Preferred bone pegs and peg holes within the plate are provided which facilitate
entry and retention of the bone pegs within the peg holes.
The plate is generally T-shaped, defining an elongate body and a generally transverse
head angled upward relative to the body, and includes a first side which is intended to contact
the bone, and a second side opposite the first side. The body includes a plurality of
countersunk screw holes for the extension of the bone screws therethrough, and optionally one
or more substantially smaller alignment holes. The lower surfaces of the radial and ulnar side
portions of the head are contoured upward (in a Z direction) relative to the remainder of the
head to accommodate the lunate and scaphoid processes. An extension is provided at the head
portion along the distal ulnar side of the head to buttress the volar lip (marginal fragment) of
the lunate fossa of the radius bone, thereby providing support to maintain the wrist within the
articular socket. Moreover, the contoured shape provides a stable shape that prevents rocking
of the plate on the bone. The upper and lower surfaces are chamfered to have a reduced
profile that limits potential interface with the ligaments and soft tissue near the edge of the
lunate fossa. The head includes a plurality of threaded peg holes for receiving the pegs
therethrough. The peg holes are arranged into a first set provided in a proximal portion of the
head, and a second relatively distal set preferably provided in the tapered portion of the head.
The first set of the peg holes is substantially linearly arranged generally laterally
across the head. The line of pegs is preferably slightly oblique relative to a longitudinal axis
through the body of the plate. Axes through the first set of holes are preferably oblique
relative to each other, and are preferably angled relative to each other in two dimensions such
that pegs inserted therethrough are similarly obliquely angled relative to each other. The pegs
in the first set of peg holes provide support for the dorsal aspect of the subchondral bone
fragments.
The second set of peg holes is provided relatively distal of the first set. The holes of
the second set, if more than one are provided, are slightly out of alignment but generally

linearly arranged. The pegs in the second set of peg holes provide support for the volar aspect
of the subchondral bone, behind and substantially parallel to the articular bone surface.
A distal alignment hole is provided generally between two peg holes of the second set
of peg holes. At the upper surface of the plate, the distal alignment hole is substantially
cylindrical, while at the lower surface, the hole is laterally oblong. One or more proximal
alignment holes of a size substantially smaller than the peg holes are provided substantially
along a distal edge defined by a tangent line to shafts of pegs inserted in the first set of peg
holes, and facilitate temporary fixation of the plate to the bone with K-wires. Furthermore,
along the body two longitudinally displaced alignment holes are also provided. All of the
alignment holes are sized to closely receive individual K-wires.
The plate may be used in at least two different manners. According to a first use, the
surgeon reduces a fracture and aligns the plate thereover. The surgeon then drills K-wires
through the proximal alignment holes to temporarily fix the orientation of the head of the plate
to the distal fragment. Once the alignment is so fixed, the fracture is examined, e.g., under
fluoroscopy, to determine whether the K-wires are properly aligned relative to the articular
surface. As the axes of the proximal alignment holes correspond to axes of adjacent peg
holes, the fluoroscopically viewed K-wires provide an indication as to whether the pegs will
be properly oriented. If the placement is correct, the K-wires maintain the position of the
plate over the fracture. The peg holes may then be drilled with confidence that their locations
and orientations are proper. If placement is not optimal, the K-wires can be removed and the
surgeon has an opportunity to relocate and/or reorient the K-wires and drill again. Since each
K-wire is of relatively small diameter, the bone is not significantly damaged by the drilling
process and the surgeon is not committed to the initial drill location and/or orientation.
According to a second use, the plate may be used to correct a metaphyseal deformity
(such as malformed fracture or congenital deformity). For such purposes, a K-wire is drilled
into the bone parallel to the articular surface in the lateral view under fluoroscopy until one
end of the K-wire is located within or through the bone and the other end is free. The free end
of the K-wire is guided through the distal oblong alignment hole of the head of the plate, and
the plate is slid down over the K-wire into position against the bone. The oblong alignment
hole permits the plate to tilt laterally over the K-wire to sit flat on the bone, but does not

permit movement of the plate over the K-wire in the anterior-posterior plane. The surgeon
drills holes in the bone in alignment with the peg holes and then fixes the plate relative the
bone with pegs. The bone is then cut, and the body of the plate is levered toward the shaft of
the bone to re-orient the bone. The body of the plate is then Fixed to the shaft to correct the
anatomical defect.
Additional objects and advantages of the invention will become apparent to those
skilled in the art upon reference to the detailed description taken in conjunction with the
provided figures.
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 is a radial side elevation of a right-hand volar plate according to the invention,
shown with pegs coupled thereto;
Fig. 2 is an ulnar side elevation of a right-hand volar plate according to the invention,
shown with pegs coupled thereto;
Fig. 3 is top view of a right-hand volar plate according to the invention, shown with
pegs and screws;
Fig. 4 is bottom view of a right-hand volar plate according to the invention, shown
with pegs coupled thereto;
Fig. 5 is a perspective view of a right-hand volar plate according to the invention,
shown with pegs coupled thereto and K-wires extending through body and proximal head
alignment holes;
Fig. 6 is a front end view of a right-hand volar plate according to the invention, shown
with pegs coupled thereto and K-wires extending through alignment holes;
Figs. 7 through 12 illustrate a method of performing an osteotomy of the distal radius
according to the invention;

Fig 13 is a side elevation of a partially threaded peg according to the invention; and
Fig. 14 is a schematic illustration of a peg coupled within a peg hole according to one
embodiment of the invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Turning now to Figs. 1 through 6, a fracture fixation system 100 according to the
invention is shown. The system 100 is particularly adapted for aligning and stabilizing
multiple bone fragments in a dorsally displaced distal radius fracture (or Colles' fracture).
The system 100 generally includes a substantially rigid T-shaped plate 102, commonly called
a volar plate, bone screws 104 (Fig. 3), pegs 106, 108, and K-wires 110 (Figs. 5 and 6). Pegs
106 have a threaded head and a non-threaded shaft, and pegs 108 have both a threaded head
and a threaded shaft. Either pegs 106 or 108, or a combination thereof may be used at the
discretion of the surgeon. Exemplar pegs are described in more detail in U.S. Pat. No,
6,364,882, which is hereby incorporated by reference herein in its entirety.
In addition, a preferred partially threaded shaft peg 108 is shown best in Figs. 6 and
13. Peg 108 includes a head portion 200 with preferably a single helical machine thread 202
of a first pitch and a shaft 204 portion having one or more threads 206 of a larger second
pitch. (The head portion of non-threaded shaft pegs 106 also preferably includes a single
helical thread.) The threads 206 preferably extend along a distal portion 208 of the shaft 204,
and most preferably where such distal portion comprises approximately one-half the length of
the shaft. Alternatively, or in addition, one or more pegs may be used where the threads
extend along substantially the entirety, or the entirety, or the length of the shaft.
The volar plate 102 shown in the figures is a right-hand plate intended to be positioned
against the volar side of a fractured radius bone of the right arm. It is appreciated that a left-
hand volar plate is substantially a mirror image of the plate shown and now described. The T-
shaped plate 102 defines an elongate body 116, and a head 118 angled upward (in the Z-
direction) relative to the head. The angle a between the head 118 and the body 116 is
preferably approximately 25°. The head 118 includes a distal buttress 120 (i.e., the portion of

the head distal a first set of peg holes 134, discussed below). The plate 102 has a thickness of
preferably approximately 0.1 inch, and is preferably made from a titanium alloy, such as Ti-
6A1-4V.
Referring to Fig. 4, the body 116 includes four preferably countersunk screw holes
124, 125,126,127 for the extension of bone screws 104 therethrough (Fig. 2). One of the
screw holes, 127, is preferably generally oval in shape permitting longitudinal movement of
the plate 102 relative to the shaft of a bone screw when the screw is not tightly clamped
against the plate.
Referring to Figs. 3 and 4, according to one preferred aspect of the plate 102, the head
portion 118 includes a first set of threaded preferably cylindrical peg holes 134 (for placement
of pegs 106 and/or 108 therein) and a second set of threaded preferably cylindrical peg holes
138 (for placement of pegs 106 and/or 108 therein). Referring to Fig. 14, the peg holes 134,
138 optionally have double lead internal threads 210, 212, with entries to these threads located
180° apart. Each of the threads 210, 212 is adapted to mate securely with the thread 202 on a
peg head 200, however thread 202 can only mate with one of the threads 210, 212 at any one
time. The depth of each of the double lead internal threads 210, 212 is preferably
substantially less than the depth of thread 202 on peg head 200, and most preferably
approximately one half such depth. The double lead threads 210, 212 facilitate alignment and
entry of the peg head thread 202 into a thread of the peg hole, as the peg will require rotation
by at most 180° in a single rotational direction before thread engagement. Furthermore, in
distinction from a conical head and hole, the cylindrical double lead thread hole does not
compromise the secure interlock attained from full travel of the thread 202 of the peg head
200 through the cylindrical peg hole 134,138 through, e.g., 900°. Moreover, the double lead
threads reduce cross-threading by fifty percent, whether a single lead thread or a double-lead
thread peg is used.
Referring back to Figs. 3 and 4, the peg holes 134 of the first set are arranged
substantially parallel to a line L1 that is preferably slightly skewed (e.g., by 5°-10°) relative to
a perpendicular P to the axis A of the body portion 116. Axes through the first set of peg
holes (indicated by the pegs 106 extending therethrough) are preferably oblique relative to
each other, and are preferably angled relative to each other in two dimensions, generally as

described in commonly-owned U.S. Pat. No. 6,364,882, which is hereby incorporated by
reference herein in its entirety. This orientation of the pegs operates to stabilize and secure
the head 118 of the plate 102 on the bone even where such pegs 106 do not have threaded
shafts.
The second set of peg holes 138 is provided relatively distal of the first set of peg
holes 134 and is most preferably primarily located in the buttress 120. Each of the peg holes
138 preferably defines an axis that is oblique relative to the other of peg holes 136 and 138.
Thus, each and every peg 106, 108 when positioned within respective peg holes 134, 138
defines a distinct axis relative to the other pegs. Moreover, the axes of the peg holes 138 are
preferably oriented relative to the axes of peg holes 134 such that pegs 106, 108 within peg
holes 138 extend (or define axes which extend) between pegs (or axes thereof) within peg
holes 134 in an interleaved manner,
Referring specifically to Figs. 1, 2, 5 and 6, according to another preferred aspect of
the plate 102, in order to approximate the anatomy for ideal fracture support and maintain a
low profile, the upper and lower surfaces 140, 142, respectively of the buttress 120 are
chamfered, with the chamfer of the lower surface 142 being contoured for the anatomical
structure that it will overlie. Tn particular, the lower surface 142 at an ulnar-side portion 144
of the head portion 118 is elevated primarily in a distal direction to accommodate the bulky
volar rim of the lunate fossa, and the lower surface 142 at a radial side portion 146 of the head
118 is elevated laterally relative to the remainder of the head to accommodate a prominence at
the radial aspect of the bone, as indicated by the visibility of these lower surfaces in the side
views of Figs. 1 and 2 and head-on view of Fig. 6. The contoured shape (with generally three
defined planes) provides a stable shape that prevents rocking of the plate on the bone. In
addition, the upper and lower surfaces 140, 142 are chamfered to have a reduced profile that
limits potential interface with the ligaments and soft tissue (e.g., tendons) near the edge of the
articular surface. A distal extension 148 is also provided at the ulnar side portion 146 to
further buttress the volar lip (volar marginal fragment of the lunate fossa) of the articular
socket of the radius bone, thereby providing support to maintain the wrist within the articular
socket.

Referring specifically to Figs. 3 and 4, according to a further preferred aspect of the
invention, the plate 102 is provided with body alignment holes 150, proximal head alignment
holes 152a, 152b, 152c (generally 152), and a distal head alignment hole 154, each sized to
closely accept standard Kirschner wires (K-wires), e.g., 0.7 - 1.3 mm in diameter. The upper
openings of all the alignment holes 150,152, 154 are substantially smaller in diameter (e.g.,
by thirty to fifty percent) than the shafts of screws 104 (approximately 3.15 mm in diameter)
and the shafts of pegs 106, 108 (approximately 2.25 mm in diameter). The body alignment
holes 150 are longitudinally displaced along the body portion 116 and provided at an oblique
angle (preferably approximately 70°, as shown in Fig. 5) relative to the lower surface 158 of
the body portion 116. The proximal head alignment holes 152 alternate with the peg holes
134. A tangent line H to the distalmost points of the head alignment holes 152 is preferably
substantially coincident or closely parallel with a line tangent to points on the circumferences
of the shafts of pegs 106 inserted through holes 134 adjacent the head portion 118 of the plate
102. With respect to the proximal head alignment holes, it is appreciated that a shaft 106a of a
peg is generally smaller in diameter than a head 106b of a peg (Fig. 6). Thus, a line tangent to
the peg holes 134 (each sized for receiving the head 106b of peg 106) will be closely located,
but parallel, to a line tangent to a distalmost point on the respective alignment hole 152.
Nevertheless, for purposes of the claims, both (i) a tangent line which is preferably
substantially coincident with a line tangent to points on the circumferences of the shafts of
pegs and (ii) a tangent line to a set of peg holes shall be considered to be "substantially
coincident" with a line tangent to a distalmost point of an alignment hole 152. Axes through
alignment holes 152 preferably generally approximate (within, e.g., 3°) the angle of an axis of
an adjacent peg hole 134. Moreover, the axis through each proximal alignment hole 152 is
preferably oriented substantially equidistantly between the axes through peg holes 134 on
either side of the alignment hole. As such, K-wires 110 inserted into the proximal alignment
holes 152 (and extending coaxial with the axes therethrough) define a virtual surface which is
substantially the same virtual surface defined by pegs 106, 108 inserted through peg holes
134. This common virtual surface follows the dorsal aspect of the subchondral bone. Thus,
as described in more detail below, the insertion of K-wires 110 through proximal alignment
holes 152 provides a visual cue to the surgeon regarding the alignment of the plate 102 and
subsequently inserted pegs 106, 108. Distal head alignment hole 154 is provided between the
central and radial-side peg holes 138, and has a circular upper opening, and a laterally oblong
lower opening, as shown best in Fig. 6.

The plate may be used in at least two different applications: fracture fixation and
correction of a metaphyseal deformity. In either application, an incision is first made over the
distal radius, and the pronator quadrarus is reflected from its radial insertion exposing the
entire distal radius ulnarly to the distal radioulnar joint. For fracture fixation, the surgeon
reduces the fracture and aligns the plate 102 thereover. The surgeon then drills preferably two
K-wires 110 through respective body alignment holes 150, and preferably a plurality of K-
wires through selected proximal head alignment holes 152 at the location at which the surgeon
believes the pegs 106, 108 should be placed based on anatomical landmarks and/or
fluoroscopic guidance. The K-wires temporarily fix the orientation of the plate to the distal
fragment. While the fixation is temporary, it is relatively secure in view of the fact that the
body alignment holes 150, proximal head alignment holes 152, andK-wires 110 therethrough
are angled in different orientations relative to the lower surface of the plate. Once the
alignment is so fixed, the fracture is examined, e.g., under fluoroscopy, to determine whether
the K-wires 110 are properly aligned relative to the articular surface, As the axes of the
proximal head alignment holes 152 correspond to axes of the adjacent peg holes 134, the
fluoroscopically viewed K-wires 110 provide an indication as to whether the pegs 106,108
will be properly oriented. If the placement is correct, the K-wires 110 maintain the position of
the plate 102 over the fracture while holes in the bone arc drilled through the screw holes 124,
125, 126, 127 for the screws 104 and peg holes 134, 138 for pegs 106, 108, with confidence
that the locations and orientation of the screws and pegs inserted therein are anatomically
appropriate. In addition, where pegs 108 are used, due to the difference in pitch between the
head threads 202 and shaft threads 206, slight compression of a distally or dorsally displaced
fragment toward a proximal fragment or bone (e.g., 1.5 mm of travel) is effected even though
the head 200 will lock relative to the head 118 of the plate 100. Once the screws 104 and pegs
106, 108 have secured the plate to the bone, the K-wires are preferably removed.
If fluoroscopic examination indicates that placement of the K-wires 110 is not optimal,
the K-wires can be removed and the surgeon has an opportunity to relocate and/or reorient the
K-wires and drill again. Since each K-wire is of relatively small diameter, the bone is not
significantly damaged by the drilling process and the surgeon is not committed to the initial
drill location and/or orientation.

The pegs 106 within peg holes 138 define projections that provide support at the volar
aspect behind the articular surface of the bone surface. The sets of pegs 106,108 through peg
holes 134, 138 laterally overlap so that the pegs preferably laterally alternate to provide
closely-spaced tangential cradling of the subchondral bone. A preferred degree of
subchondral support is provided with four peg holes 134 (and associated pegs) through the
proximal portion of the head 118 of the plate, and three peg holes 138 (and associated pegs)
through the distal portion of the head 118. The fracture fixation system thereby defines a
framework which substantially tangentially supports the bone fragments in their proper
orientation. In accord with an alternate less preferred embodiment, suitable support may also
be provided where the pegs 106 and 108 are parallel to each other or in another relative
orientation or with fewer peg holes and/or pegs.
The method particularly facilitates stabilization of a metaphyseal fracture which may
include a smaller distal bone fragment spaced apart from a larger proximal fragment. The
insertion of one or more threaded pegs 108 (preferably in conjunction with several non-
threaded pegs 106) in which the threads on the shaft 206 have a pitch greater than the threads
202 on the head 200 causes a limited amount of compression of the smaller distal bone
fragment toward the larger proximal bone fragment, and thus toward the plate.
According to a second use, the plate may be used to correct a metaphyseal deformity
200 (such as malformed fracture or congenital deformity), as shown in Fig. 7. For such
purposes, a K-wire 110 is drilled into the bone parallel to the articular surface S in the lateral
view under fluoroscopy (Fig. 8). The free end of the K-wire 110 is guided through the oblong
distal head alignment hole 154, and the plate 102 is slid down over the K-wire into position
against the bone (Fig. 9). The oblong alignment hole 154 permits the plate 102 to tilt laterally
over the K-wire 110 to sit flat on the bone, but does not permit tilting of plate relative to the
K-wire in the anterior-posterior plane. Once the plate 102 is seated against the bone, the
surgeon drills holes in the bone in alignment with the peg holes 134, 138 (Fig. 3) and then
fixes the plate relative the bone with pegs 106,108 (Fig. 10). The K-wire 110 is removed.
The bone is then saw cut at 202 proximal the location of the head 118 of the plate 102 (Fig.
11), and the body 116 of the plate is levered toward the proximal diaphyseal bone 204,
creating an open wedge 206 at the deformity (Fig. 12). When the body 116 of the plate 102 is
in contact and longitudinal alignment with the diaphysis of the bone, the bone distal of the cut

has been repositioned into the anatomically correct orientation relative to the shaft of the
bone. The body 116 of the plate 102 is then secured to the bone with screws 104. Post-
operatively, the open wedge in the bone heals resulting in an anatomically correct distal
radius.
While fixed smgle-angle pegs have been disclosed for use with the plate (i.e., the pegs
may be fixed in respective threaded peg holes 134, 136 only coaxial with an axis defined by
the respective peg holes), it is appreciated that an articulating peg system, such as that
disclosed in co-owned U.S. Pat. No. 6,440,135 or co-owned and co-pending U.S. Serial No.
10/159,612, both of which are hereby incorporated by reference herein in their entireties, may
also be used. In such articulating peg systems, the peg holes and pegs are structurally adapted
such that individual pegs may be fixed at any angle within a range of angles. In addition,
while less preferable, one or both sets of the pegs may be replaced by preferably blunt tines
which are integrated into the plate such that the plate and tines are unitary in construct.
Similarly, other elongate projections may be coupled to the plate to define the desired support.
There have been described and illustrated herein embodiments of a fixation plate, and
particularly plates for fixation of distal radius fractures, as well as a method of aligning and
stabilizing a distal radius fracture and performing an osteotomy. While particular
embodiments of the invention have been described, it is not intended that the invention be
limited thereto, as it is intended that the invention be as broad .in scope as the art will allow
and that the specification be read likewise. Thus, while particular materials, dimensions, and
relative angles for particular elements of the system have been disclosed, it will be appreciated
that other materials, dimensions, and relative angles may be used as well. In addition, while a
particular number of screw holes in the volar plate and bone screws have been described, it
will be understood another number of screw holes and screws may be provided. Further,
fewer screws than the number of screw holes may be used to secure to the plate to the bone.
Also, fewer or more peg holes and bone pegs may be used, preferably such that at least two
pegs angled in two dimensions relative to each other are provided. In addition, while a
particular preferred angle between the head and body has been disclosed, other angles can also
be used. Moreover, while the cylindrical double lead thread hole and single thread head
interface has been disclosed with respect to a fracture plate for distal radius fractures, it is
appreciated that such a system has advantage to other orthopedic stabilization devices such as

fragment plates (which may be rectangular in shape or a different shape) and plates
specifically designed for fractures of other bones. Similarly, a threaded peg (i.e., locking
screw) with threads of different pitches on the head and along the shaft may also be used in
other applications. Furthermore, while a double lead thread hole is preferred for use with a
peg having a single thread on its head, it is appreciated that, e.g., a triple lead thread hole can
be used where the entry leads are angularly offset by 120°. Such will reduce cross threading
by two-thirds, but will also reduce hole thread depth further. Also, while the double lead
thread system is described with respect to a bone plate, it is appreciated that it can be applied
to other orthopedic implants, such as rods, nails, prostheses, etc., having holes for fixation.
Furthermore, while the double lead thread hole has been shown in conjunction with a peg
having a single lead thread on its head portion, it is appreciated that the double lead thread
hole is perfectly adapted for use with a peg having a double lead thread on its head portion. It
will therefore be appreciated by those skilled in the art that yet other modifications could be
made to the provided invention without deviating from its spirit and scope.

WE CLAIM
1. A fixation plate adaptable to a plurality of fixation pegs having
threaded heads and a K-wire, comprising :
a substantially rigid plate having a shaft and a head portion angled
relative to said shaft, said head portion defining a first set of peg holes
each structurally adapted to engage the threaded head of one of the
fixation pegs and at least one non-threaded first alignment hole, each
of said peg holes having a first diameter, and said at least one first
alignment hole having a second relatively smaller diameter sized to
closely receive the K-wire in a predetermined fixed axial orientation
which is oblique relative to a fixable component contacting surface of
said plate, each of at least one first alignment hole being located
entirely within the proximal-distal and medial-lateral boundaries
defined between the edges of two adjacent peg holes.
2. A fixanon plate as claimed in claim 1 wnerein :
said at least one first alignment hole defining a tangent line which is
substantially coincident with a line tangent to said first set of peg
holes.
3. A fixation plate as claimed in claim 1 wherein :
said head has a lower surface, and said lower surface is non-planar.
4. A fixation plate as claimed in claim 1 wherein:
said head comprises medial and lateral sides, and said medial said
extends distally relative to said lateral side.

5. A fixation plate as claimed in claim 1 wherein:
said head comprises a second set of peg holes having means to
engage fixation pegs with threaded heads, said first set being linearly
arranged, said second set being linearly arranged, and said second set
being longitudinally offset relative to said first set.
6. A fixation plate as claimed as claim 5, wherein:
said head comprises a distal non-threaded alignment hole between
two pegs holes of said second set of peg holes.
7. A fixation plate as claimed in claim 1, wherein:
said head and body together form a T-shaped plate configuration, and
said head comprises a lower surface, a lateral side, a medical side and
a central portion, and said lower surface at said lateral and medical
sides is directed upward relative to said lower surface at said central
portion.
Q A fixtion plate as claimed in claim 1, wherein;
each of said peg holes is structurally adapted to engage a fixation peg
by an internal thread.
9. A fixation plate as claimed in claim 1, wherein:
for n peg holes in said first set, a substantially linear arrangement of n-
1 first alignment holes is provided, said peg holes and said first
alignment holes provided in an alternating arrangement.

10. A fixation plate as claimed in claim 1, wherein said shaft having a
plurality of screw holes and a second non-threaded alignment hole
longitudinally displaced relative to two of said plurality of screw holes,
said second non-threaded alignment hole sized to closely receive the
K-wire in a predetermined fixed axial orientation which is oblique
relative to a fixable component contacting surface of said plate.
11. A fixation plate as claimed in claim 10, wherein:
said head defines a second set of peg holes each structurally adapted
to engage the threaded head of one of the fixation pegs, wherein said
first set is arranged substantially along a first line, and said second set
is arranged substantially along a second line, and said first second
lines are longitudinally displaced relative to each other, said head
additionally comprising a third non-threaded alignment hole
substantially smaller in diameter than each of said second set of peg
holes and laterally displaced between two peg holes of said second set
of peg hole, said third non-threaded alignment hole sized to closely
receive the K-wire in a predetermined axial orientation which is oblique
relative to said fixable component contacting surface of said plate.
12. A fixation plate as claimed in claim 11, wherein:
said first set of peg holes and said first alignment hole are all obliquely
orientated in at least one dimension relative to each other.
13. A fixation plate as claimed in claim 10, wherein:
said first set of peg holes and said first alignment hole are all obliquely
oriented in two dimensions relative to each other.

14. A fixation plate as claimed in claim 10, wherein:
said first alignment hole has an upper circular and a lower laterally
oblong opening.
15. A fixation plate as claimed in claim 10, wherein:
said first alignment hole defines a tangent line which is substantially
coincident with a line tangent to one of said threaded peg holes.
16. A fixation plate as claimed in claim 10, wherein:
said head defines as distal taper.
17. A fixation plate as claimed in claim 10, wherein:
said plate comprises a third alignment hole, and first alignment hole
and third alignment hole are longitudinally displaced along said head.
18. A fixation plate as claimed in claim 10, wherein:
a longitudinal axis through said plate extends through said first non-
threaded alignment hole.
19. A system for fracture fixation of the distal radius, comprising:
- a fixation plate as claimed in claims 1 to 18;
- at least one screw sized for insertion into said at least one screw hole
configured on the shaft portion of the fixation plate; and

a plurality of K-wires, wherein the plurality of alignment holes
configured on the fixation plate are sized to closely receive said K-
wires.


A fixation plate for use with a plurality of fixation pegs and K-wires,
comprising: a substantially rigid plate having a bone contacting surface and
defining a first set of peg holes each structurally adapted to engage a fixation
peg with a threaded head and retain the fixation pegs in a fixed angle
relationship such that the fixation pegs are obliquely oriented in at least one
dimension relative to each other, and a first plurality of non-threaded
alignment holes substantially smaller in diameter than said first set of peg
holes, each of said alignment holes sized to closely receive a K-wire such
that the K-wires will be in a fixed angle relationship relative to said plate,
said alignment holes positioned in said plate and having predefined axial
orientations such that when a plurality of the K-wires are inserted into said
alignment holes, the K-wires approximate a three dimensional surface
defined by fixation pegs inserted into said peg holes.

Documents:

00630-kolnp-2006-abstract.pdf

00630-kolnp-2006-claims.pdf

00630-kolnp-2006-description complete.pdf

00630-kolnp-2006-drawings.pdf

00630-kolnp-2006-form 1.pdf

00630-kolnp-2006-form 2.pdf

00630-kolnp-2006-form 3.pdf

00630-kolnp-2006-form 5.pdf

00630-kolnp-2006-international exm report.pdf

00630-kolnp-2006-international publication.pdf

00630-kolnp-2006-international search report.pdf

00630-kolnp-2006-pct others.pdf

00630-kolnp-2006-priority document.pdf

630-KOLNP-2006-ABSTRACT 1.1.pdf

630-kolnp-2006-assignment.pdf

630-KOLNP-2006-CLAIMS 1.2.pdf

630-KOLNP-2006-CLAIMS_1.1.pdf

630-KOLNP-2006-CORRESPONDENCE 1.2.pdf

630-KOLNP-2006-CORRESPONDENCE-1.1.pdf

630-KOLNP-2006-CORRESPONDENCE.pdf

630-kolnp-2006-correspondence1.3.pdf

630-kolnp-2006-examination report.pdf

630-KOLNP-2006-FORM 1 1.2.pdf

630-KOLNP-2006-FORM 1.1.1.pdf

630-kolnp-2006-form 18.pdf

630-KOLNP-2006-FORM 2 1.2.pdf

630-KOLNP-2006-FORM 2.1.1.pdf

630-kolnp-2006-form 26.pdf

630-kolnp-2006-form 3.pdf

630-kolnp-2006-form 5.pdf

630-KOLNP-2006-FORM-27.pdf

630-kolnp-2006-granted-abstract.pdf

630-kolnp-2006-granted-claims.pdf

630-kolnp-2006-granted-description (complete).pdf

630-kolnp-2006-granted-drawings.pdf

630-kolnp-2006-granted-form 1.pdf

630-kolnp-2006-granted-form 2.pdf

630-kolnp-2006-granted-specification.pdf

630-KOLNP-2006-OTHERS.pdf

630-KOLNP-2006-PCT REQUEST FORM.pdf

630-KOLNP-2006-REPLY TO EXAMINATION REPORT.pdf

630-kolnp-2006-reply to examination report1.1.pdf

abstract-00630-kolnp-2006.jpg


Patent Number 249513
Indian Patent Application Number 630/KOLNP/2006
PG Journal Number 43/2011
Publication Date 28-Oct-2011
Grant Date 24-Oct-2011
Date of Filing 17-Mar-2006
Name of Patentee HAND INNOVATIONS, LLC
Applicant Address 8905, S.W.87TH AVENUE, MIAMI, FL 33176, U.S.A
Inventors:
# Inventor's Name Inventor's Address
1 ORBAY, JORGE, L 390 CAMPANA AVENUE, MIAMI, FL 33158, U.S.A
PCT International Classification Number A61B17/56,17/58;A61F2/30
PCT International Application Number PCT/US2004/008752
PCT International Filing date 2004-03-22
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 10/664,371 2003-09-17 U.S.A.
2 10/689,797 2003-10-21 U.S.A.