Method and apparatus for osteosynthesis

Abstract

A bone plate assembly including a first plate, a coupler, a second plate, and a guide; the first plate defining a window and having a first major surface adapted to conform to a native bone structure. The coupler such as a beveled edge and/or slide mechanism can be formed on a second major surface of the first plate opposite the first major surface. The second plate can be adapted to engage the coupler, to cover the window, and to conform to the native bone structure. The second plate can include through holes adapted to receive bone screws. The guide can be adapted to engage the coupler and to guide at least one of a cutting tool and/or a dilation tool. The native bone structure is distal radius, proximal femur, distal femur, proximal tibia, distal tibia or calcaneus.

What is claimed is: 
     
         1 . A bone plate assembly comprising:
 a first plate defining a window, the first plate having a first major surface adapted to conform to a native bone structure;   a coupler formed on a second major surface of the first plate opposite the first major surface;   a second plate adapted to engage the coupler and cover the window, the second plate including through holes adapted to receive bone screws, the second plate further adapted to conform to the native bone structure;   a guide adapted to engage the coupler and to guide at least one of a cutting tool and a dilation tool; and   wherein the native bone structure is selected from the group consisting of distal radius, proximal femur, distal femur, proximal tibia, distal tibia and calcaneus.   
     
     
         2 . The bone plate assembly of  claim 1 , wherein the first plate includes a first partial hole and the second plate includes a second partial hole, the first partial hole and the second partial hole being adapted to receive a set screw to fix the second plate to the first plate. 
     
     
         3 . The bone plate assembly of  claim 2 , wherein the coupler is a beveled edge adapted to receive the second plate and the guide. 
     
     
         4 . The bone plate assembly of  claim 1 , wherein the coupler is a slide mechanism adapted to slidingly receive the second plate and the guide. 
     
     
         5 . The bone plate assembly of  claim 1 , wherein the guide is adapted to align the at least one of the cutting tool and the dilation tool at a predetermined angle with respect to the first plate. 
     
     
         6 . The bone plate assembly of  claim 1 , wherein the guide includes a hollow shaft sized to receive the at least one of the cutting tool and the dilation tool. 
     
     
         7 . The bone plate assembly of  claim 1 , wherein the window is non-circular and has a length extending generally parallel to a longitudinal axis of the first plate. 
     
     
         8 . The bone plate assembly of  claim 4 , wherein the first plate includes an I-shaped cross-section proximate to longitudinal sides of the window. 
     
     
         9 . The bone plate assembly of  claim 4 , wherein the coupler includes an L-shaped cross section. 
     
     
         10 . The bone plate assembly of  claim 4 , wherein the slide mechanism and the first plate define a longitudinal channel adjacent to the window. 
     
     
         11 . The bone plate assembly of  claim 4 , wherein the guide includes a base adapted to slidably engage the longitudinal channel. 
     
     
         12 . The bone plate assembly of  claim 11 , further comprising a rail formed on the second plate and adapted to engage the longitudinal channel. 
     
     
         13 . The bone plate assembly of  claim 1 , wherein the second plate includes a pin hole oriented to receive a pin at an angle. 
     
     
         14 . The bone plate assembly of  claim 3 , wherein the second plate is adapted to engage the coupler, securing the second plate to the first plate in all directions except the lateral direction away from the native bone, further wherein set screws secure the second plate to the first plate. 
     
     
         15 . The bone plate assembly of  claim 14 , wherein the second plate sits flush with the first plate. 
     
     
         16 . The bone plate assembly of  claim 3 , wherein the guide is adapted to engage the coupler, securing the guide to the first plate in all directions except the lateral direction away from the native bone. 
     
     
         17 . A bone plate assembly comprising:
 a first plate having through holes adapted to receive bone screws, a bone-engaging first surface and an opposed second surface, the first plate defining a window extending through the first and second surfaces, the bone-engaging first surface adapted to conform to a target bone;   a coupler that is a beveled edge formed on the opposed second surface of the first plate;   a second plate that is the exact size as the window allowing for a flush fit between the two plates and supported by the first plate within the window, the second plate including through holes adapted to receive bone screws, the second plate further adapted to conform to the target bone;   a guide adapted to engage the coupler to guide at least one of a cutting tool and a dilation tool; and   wherein the target bone is selected from the group consisting of distal radius, proximal femur, distal femur, proximal tibia, distal tibia and calcaneus.   
     
     
         18 . The bone plate assembly of  claim 16 , wherein the guide is adapted to engage the coupler. 
     
     
         19 . A method for osteosynthesis of a fracture in a target bone, comprising:
 fixing a first plate to the target bone when a fractured portion of the target bone is anatomically aligned and accessible through a window included in the first plate;   engaging a guide with a coupler formed on the first plate;   removing a lateral cortex of the target bone using a cutting tool inserted through a hole in the guide;   filling the dilated cancellous portion of the target bone by delivering a filler through the hole in the guide;   disengaging the guide;   engaging with the coupler and securing a second plate to the first plate; and   wherein the target bone is selected from the group consisting of distal radius, proximal femur, distal femur, proximal tibia, distal tibia and calcaneus.   
     
     
         20 . The method of  claim 19 , further comprising replacing the removed lateral cortex of the target bone. 
     
     
         21 . The method of  claim 19 , further comprising measuring a depth of the dilated cancellous portion of the target bone and sizing the filler based on the depth. 
     
     
         22 . The method of  claim 21 , wherein the filler is a bone graft and sizing the bone filler includes cutting the bone graft to fill the dilated cancellous portion. 
     
     
         23 . The method of  claim 19 , wherein the coupler is a beveled edge adapted to engage the guide and the second plate. 
     
     
         24 . The method of  claim 19 , wherein the coupler is a slide mechanism adapted to engage the guide and the second plate. 
     
     
         25 . The method of  claim 19 , further comprising dilating a cancellous portion of the target bone using a dilation tool inserted through the hole in the guide.