Modular femoral fixation system

Claim 2

A kit for use in the amelioration of a number of different types of femoral disorders resulting from injury, disease or congenital defect with a minimal number of interconnectable components, characterized in that said kit comprises at least the following components: an elongated epiphyseal/metaphyseal implant (1) having a leading end portion and a trailing end portion and adapted to grip bone at its leading end portion; an intramedullary rod (109) having a distal end (113) and a proximal end (111); an angled side plate (149) comprising an elongated plate portion (151) adapted to be secured to the outer cortical wall of the femoral shaft and an integral hollow sleeve (153) extending at an angle from one end of the plate portion (151) so that said hollow sleeve (153) extends into the femur when the plate portion (151) is secured to said cortical wall; and means (139, 141, 142, 147) for connecting the epiphyseal/metaphyseal implant (1) to the intra­medullary rod (109) adjacent to one of the ends (111, 113) of the rod (109) with the epiphyseal/metaphyseal implant (1) at an angle with respect to the intra­medullary rod (109), with the components of said kit being dimensioned such that the elongated epiphyseal/metaphyseal implant (1) is capable of being connected to the angled side plate (149) by the insertion of the trailing end portion of the epiphyseal/metaphyseal implant (1) into said hollow sleeve (153) and the elongated epiphy­ seal/metaphyseal implant (1) is also capable of being connected to the intramedullary rod (109) with the use of said connecting means (139, 141, 142, 147).

Claim 3

A kit of claim 1 further characterized in that said kit further comprises an elongated bone plate (69) adapted to be secured to the outer cortical wall of the femoral shaft, with the angled side plate (149) and elongated bone plate (69) being dimensioned such that the elongated bone plate (69) is capable of being connected in axial alignment to the plate portion (151) of the angled side plate (149) at the end thereof opposed to said hollow sleeve (153) so as to provide an extension of the effective length of said plate portion (151).

Claim 4

A kit of claim 1 further characterized in that said elongated epiphyseal/metaphyseal implant (1), intramedullary rod (109) and angled side plate (149) are all made of a resilient titanium-base alloy.

Claim 5

A kit of claim 2 further characterized in that said kit further comprises a distal buttress plate (171) adapted to be secured to the outer cortical wall of the lateral distal femur, said distal buttress plate (171) including a relatively flat elongated proximal portion (173) adapted to be secured to the lateral distal femoral shaft and a relatively curved distal portion (175) adapted to be secured to the lateral distal femoral condyle, with said distal buttress plate (171) and said elongated bone plate (69) being dimensioned such that the elongated bone plate (69) is capable of being connected in axial alignment to the elongated proximal portion (173) of the distal buttress plate (171) at the end thereof opposed to said relatively curved distal portion (175) so as to provide an extension of the effective length of said proximal portion (173).

Claim 6

A kit of claim 1 further characterized in that said connecting means comprises an elongated connection piece (139) having a longitudinal axis and provided with an elongated cavity (143) open to one end of said piece (139) aligned with said longitudinal axis and adapted to receive the trailing end portion of the epiphyseal/metaphyseal implant (1) and a through bore (145) at an angle to said longitudinal axis adapted to receive an end of said intramedullary rod (109) so as to permit movement of said piece (139) along said rod (109) and rotation of said piece (139) around the axis of said rod (109), and locking means (141, 142, 147) to releasably lock the connection piece (139) to the intramedullary rod (109) so as to prevent relative translational and rotational movement between said piece (139) and said rod (109).

Claim 7

A kit of claim 2 further characterized in that said intramedullary rod (109) is provided with at least one transverse through bore (115) adjacent its distal end (113), and said kit further comprises a plurality of threaded self-tapping bone screws (89, 91) each having a head (93) and a threaded shank (97, 99) for use in securing said plate portion (151) and said elongated bone plate (69) to the outer cortical wall of the femoral shaft, securing the distal end (113) of said intramedullary rod (109) to the distal femur and connecting said elongated bone plate (69) to said plate portion (151), with said elongated bone plate (69) and said plate portion (151) being provided with apertures (79, 163) to receive said bone screws (89, 91), said screws (89, 91) being identical except for variations in the lengths of said threaded shanks (97, 99), the heads (93) of said screws (89, 91) and said apertures (79, 163) being dimensioned such that said screws (89, 91) are capable of universal rotation with respect to said elongated bone plate (69) and plate portion (151) within a cone having an apex angle of at least about 20° when the heads (93) of said screws (89, 91) are fully advanced within said apertures (79, 163), and with each of said bone screws (89, 91) being capable of being used by itself independently of the other com­ponents of said kit as a bone fixation screw to hold fragments of bone together during healing of a fracture.

Claim 8

A kit for use in the amelioration of a number of different types of femoral disorders resulting from injury, disease or congenital defect with a minimal number of interconnectable components, characterized in that said kit comprises at least the following components: first and second elongated epiphyseal/metaphyseal implants (1), each having a leading end portion and a trailing end portion and adapted to grip bone at its leading end portion, the first epiphyseal/metaphyseal implant (1) having a greater length than the second epiphyseal/metaphyseal implant (1); an intramedullary rod (109) having a distal end (113) and a proximal end (111); first and second angled side plates (43, 149), each comprising an elongated plate portion (45, 151) adapted to be secured to the outer cortical wall of the femoral shaft and an integral hollow sleeve (47, 153) extending at an angle from one end of the plate portion (45, 151) so that the hollow sleeve (47, 153) extends into the femur when the plate portion (45, 151) is secured to said cortical wall, with the hollow sleeve (47) and plate portion (45) of the first angled side plate (43) being mutually oriented at an oblique angle so that said hollow sleeve (47) is adapted to extend into the intertrochanteric region of the femur when said plate portion (45) is secured to the outer cortical wall of the adjacent femoral shaft and the hollow sleeve (153) and plate portion (151) of the second angled side plate (149) being substantially perpendicular so that said hollow sleeve (153) is adapted to extend into the distal condylar region of the femur when said plate portion (151) is secured to the outer cortical wall of the adjacent distal femoral shaft; and means (139, 141, 142, 147) for connecting said second epiphyseal/metaphyseal implant (1) to the intramedullary rod (109) adjacent to the proximal end (111) of the rod (109) to form a Y-nail type of assembly, with the components of said kit being dimensioned such that said first epiphyseal/metaphyseal implant (1) is capable of being connected to said first angled side plate (43) by the insertion of its trailing end portion into the hollow sleeve (47) of the first angled side plate (43) and said second epiphyseal/metaphyseal implant (1) is capable of being connected to said second angled side plate (149) by the insertion of its trailing end portion into the hollow sleeve (153) of the second angled side plate (149), and the second elongated epiphyseal/metaphyseal implant (1) is also capable of being connected to the intramedullary rod (109) with the use of said connecting means (139, 141, 142, 147).

Claim 9

A kit for use in the amelioration of a number of different types of femoral disorders resulting from injury, disease or congenital defect with a minimal number of interconnectable components, characterized in that said kit comprises at least the following components: first and second elongated epiphyseal/metaphyseal implants (1), each having a leading end portion and a trailing end portion and adapted to grip bone at its leading end portion, the first epiphyseal/metaphyseal implant (1) having a greater length than the second epiphyseal/metaphyseal implant (1); an intramedullary rod (109) having a distal end (113) and a proximal end (111); first and second angled side plates (43, 149), each comprising an elongated plate portion (45, 151) adapted to be secured to the outer cortical wall of the femoral shaft and an integral hollow sleeve (47, 153) extending at an angle from one end of the plate portion (45, 151) so that the hollow sleeve (47, 153) extends into the femur when the plate portion (45, 151) is secured to said cortical wall, with the hollow sleeve (47) and plate portion (45) of the first angled side plate (43) being mutually oriented at an oblique angle so that said hollow sleeve (47) is adapted to extend into the intertrochanteric region of the femur when said plate portion (45) is secured to the outer cortical wall of the adjacent femoral shaft and the hollow sleeve (153) and plate portion (151) of the second angled side plate (149) being substantially perpendicular so that said hollow sleeve (153) is adapted to extend into the distal condylar region of the femur when said plate portion (151) is secured to the outer cortical wall of the adjacent distal femoral shaft; and means (139, 141, 142, 147) for connecting said second epiphyseal/metaphyseal implant (1) to the intramedullary rod (109) adjacent to the proximal end (111) of the rod (109) to form a Y-nail type of assembly, with the components of said kit being dimensioned such that said first epiphyseal/metaphyseal implant (1) is capable of being connected to said first angled side plate (43) by the insertion of its trailing end portion into the hollow sleeve (47) of the first angled side plate (43) and said second epiphyseal/metaphyseal implant (1) is capable of being connected to said second angled side plate (149) by the insertion of its trailing end portion into the hollow sleeve (153) of the second angled side plate (149), and the second elongated epiphyseal/metaphyseal implant (1) is also capable of being connected to the intramedullary rod (109) with the use of said connecting means (139, 141, 142, 147).

Claim 10

A kit of claim 7 further characterized in that said kit further comprises an elongated bone plate (69) adapted to be secured to the outer cortical wall of the femoral shaft, with the first and second angled side plates (43, 149) and said elongated bone plate (69) being dimensioned such that the elongated bone plate (69) is capable of being connected in axial alignment to the plate portion (45, 151) of each of the first and second angled side plates (43, 149) at the end thereof opposed to the hollow sleeve (47, 153) so as to provide an extension of the effective length of said plate portion (45, 151).

Claim 11

A bone implant (1) for use in the stabilization of a bone fracture characterized in that said bone implant comprises an integral substantially cylindrical expansion sleeve (3) having a smoothly rounded circumferentially-­closed dome (7) at one end, a circumferentially-closed circular ring (9) at its other end, and a plurality of thin elongated strips (11) extending between, and connected at their opposed ends by, said circumferent­ially-closed dome (7) and ring (9), with said plurality of strips (11) defining together a cylindrical sleeve wall, said strips (11) being of varying radial thickness along their length and having textured outer surfaces, and said cylindrical sleeve wall having in the rest position of the sleeve an outer diameter equal to the outer diameter of the circular ring (9), an inner diameter adjacent said ring (9) equal to the inner diameter of said ring (9) and an inner diameter in a region (r₂) spaced from said ring (9) reduced from the inner diameter of said ring (9); and an elongated plunger (5) having at one end thereof a substantially cylindrical body portion (17) having a diameter essentially equal to the inner diameter of said circumferentially-closed circular ring (9) of the expansion sleeve (3), whereby when said expansion sleeve (3) is held in a cavity in a bone fragment on one side of a fracture and the plunger (5) is then advanced through said circular ring (9) and into the interior of said sleeve (3) with its substantially cylindrical body portion (17) in the leading position, said plurality of strips (11) having textured outer surfaces are caused to expand radially outwardly and thereby securely grip said bone fragment.

Claim 12

A bone implant (1) for use in the stabilization of a bone fracture characterized in that said bone implant comprises an integral substantially cylindrical expansion sleeve (3) having a smoothly rounded circumferentially-­closed dome (7) at one end, a circumferentially-closed circular ring (9) at its other end, and a plurality of thin elongated strips (11) extending between, and connected at their opposed ends by, said circumferent­ially-closed dome (7) and ring (9), with said plurality of strips (11) defining together a cylindrical sleeve wall, said strips (11) being of varying radial thickness along their length and having textured outer surfaces, and said cylindrical sleeve wall having in the rest position of the sleeve an outer diameter equal to the outer diameter of the circular ring (9), an inner diameter adjacent said ring (9) equal to the inner diameter of said ring (9) and an inner diameter in a region (r₂) spaced from said ring (9) reduced from the inner diameter of said ring (9); and an elongated plunger (5) having at one end thereof a substantially cylindrical body portion (17) having a diameter essentially equal to the inner diameter of said circumferentially-closed circular ring (9) of the expansion sleeve (3), whereby when said expansion sleeve (3) is held in a cavity in a bone fragment on one side of a fracture and the plunger (5) is then advanced through said circular ring (9) and into the interior of said sleeve (3) with its substantially cylindrical body portion (17) in the leading position, said plurality of strips (11) having textured outer surfaces are caused to expand radially outwardly and thereby securely grip said bone fragment.

Claim 13

A bone implant of claim 9 further characterized in that said dome (7) is provided with means (15) for releasably securing an elongated rod thereto so that said rod extends within said expansion sleeve (3) and through said ring (9) along the longitudinal axis of said sleeve (3) and can thereby be used to insert and hold said expansion sleeve (3) in said cavity, and said plunger (5) is cannulated along its longitudinal axis to receive said elongated insertion rod.

Claim 14

A bone implant of claim 9 further characterized in that said plurality of strips (11) are resilient and expand radially outwardly in elastic deformation when said plunger (5) is advanced into the interior of said sleeve (3).

Claim 15

A bone implant of claim 11 further characterized in that said expansion sleeve (3) is made of a resilient titanium-base alloy.

Claim 16

A bone implant of claim 10 further characterized in that said means for releasably securing an elongated insertion rod to said dome (7) comprises a centrally-disposed threaded axial through bore (15) provided in said dome (7).

Claim 17

A bone implant of claim 9 further characterized in that said elongated plunger (5) has a cylindrical stem portion (19) extending from said substantially cylindrical body portion (17) to the other end of the plunger (5), with the diameter of said cylindrical stem portion (19) being less than the diameter of said substantially cylindrical body portion (17).

Claim 18

A bone implant of claim 9 in combination with means for connecting said plunger (5) to another bone fragment on the other side of the fracture, said plunger (5) connecting means comprising a hollow sleeve (47) dimensioned to receive said plunger (5) in a sliding fit, said hollow sleeve (47) being an integral portion of an angled side plate (43) secured to said other bone fragment.

Claim 19

A bone implant of claim 9 further characterized in that a plurality of openings (13) are provided in said expansion sleeve (3), in the rest position of said sleeve (3), so that an extrudable material placed within said expansion sleeve (3) can be extruded through said openings (13) when the plunger (5) is advanced into the interior of the expansion sleeve (3).

Claim 20

A bone implant of claim 9 further characterized in that said bone implant further comprises means (10, 12, 18) to lock said expansion sleeve (3) and elongated plunger (5) against axial disengagement after implantation of said implant (1).

Claim 21

A bone implant of claim 17 further characterized in that said locking means comprises a raised annular lip (18) on said plunger body portion (17) and a groove (10) provided in the inner wall of said sleeve circular ring (9), with said lip (18) adapted to fit into said groove (10) in a snap fit when said plunger (5) is fully advanced within said sleeve (3).

Claim 22

An assembly for the stabilization of a fractured femur characterized in that said assembly comprises. an elongated cross-member (1,139) having a leading portion adapted to be received within a cavity in and grip the femoral head and a trailing portion adapted to extend from the leading portion through the femoral neck into the intertrochanteric region of a patient's femur, with said trailing portion being provided with a cylindrical through bore (145), said through bore (145) being at an oblique angle with respect to the longitudinal axis of the cross-member (1,139) so that it can be brought into approximate alignment with the femoral intramedullary canal when the leading portion of the cross-member (1,139) is inserted into the femoral head; an intramedullary rod (109) having a distal end portion (117) and a proximal end portion (119), with the maximum cross-sectional dimension of said proximal end portion (119) being just slightly less than that of said cylindrical through bore (145) in the trailing portion of the cross-member (1,139) so that said proximal end portion (119) of the intramedullary rod (109) can be received in a close sliding fit within said through bore (145) permitting rotational and translational adjustment of the cross-member (1,139) with respect to the intramedullary rod (109); and distinct, positive and active means (141, 142, 147) to releasably lock the elongated cross-member (1,139) and intramedullary rod (109) to prevent their relative translational and rotational movement when assembled together.

Claim 23

An assembly for the stabilization of a fractured femur characterized in that said assembly comprises. an elongated cross-member (1,139) having a leading portion adapted to be received within a cavity in and grip the femoral head and a trailing portion adapted to extend from the leading portion through the femoral neck into the intertrochanteric region of a patient's femur, with said trailing portion being provided with a cylindrical through bore (145), said through bore (145) being at an oblique angle with respect to the longitudinal axis of the cross-member (1,139) so that it can be brought into approximate alignment with the femoral intramedullary canal when the leading portion of the cross-member (1,139) is inserted into the femoral head; an intramedullary rod (109) having a distal end portion (117) and a proximal end portion (119), with the maximum cross-sectional dimension of said proximal end portion (119) being just slightly less than that of said cylindrical through bore (145) in the trailing portion of the cross-member (1,139) so that said proximal end portion (119) of the intramedullary rod (109) can be received in a close sliding fit within said through bore (145) permitting rotational and translational adjustment of the cross-member (1,139) with respect to the intramedullary rod (109); and distinct, positive and active means (141, 142, 147) to releasably lock the elongated cross-member (1,139) and intramedullary rod (109) to prevent their relative translational and rotational movement when assembled together.

Claim 24

An assembly of claim 19 further characterized in that said proximal end portion (119) of the intramedullary rod (109) is substantially straight and said assembly further comprises a substantially straight and substantially cylindrical hollow sleeve (131) adapted to be detachably secured to the proximal end portion (119) of the intramedullary rod (109) and having a substantially smooth outer surface, with said sleeve (131), when so secured, extending at least to the point of maximum applied bending moment in normal use but not up to the midway point along the rod (109) between its distal and proximal tips (127, 129), said point of maximum bending moment applied to the intramedullary rod (109) being in the subtrochanteric region of the femur.

Claim 25

An assembly of claim 19 further characterized in that said elongated cross-member (1,139) and said intramedullary rod (109) are made of a resilient titanium-base alloy.

Claim 26

An assembly of claim 19 further characterized in that said intramedullary rod (109) is hollow and has a closed profile in transverse cross-section along substantially its entire length, and the outer periphery of the transverse cross-section of said intramedullary rod (109) is a plurality of smoothly rounded peaks (121), all terminating on the same first circle, connected by a plurality of smoothly rounded valleys (123), all bottoming on the same second circle concentric with and of smaller diameter than said first circle.

Claim 27

An assembly of claim 19 further characterized in that said intramedullary rod (109) has a longitudinally-splined external contour and said releasable locking means comprises a locking screw (141) and a locking shoe (142) adapted to fit within a partially threaded bore (147) in said elongated cross-member (1,139) with said locking shoe (142) between said locking screw (141) and said cylindrical through bore (145), with said locking shoe (142) presenting a surface (144) opposite said locking screw (141) having a grooved contour adapted to fit closely and mesh with the splined external contour of said intramedullary rod (109), whereby said locking screw (141) can be advanced by screwing said screw (141) within said partially threaded bore (147) so as to firmly press said grooved-contoured surface (144) of said locking shoe (14) against the longitudinally-splined exterior contour of said intramedullary rod (109).

Claim 28

An assembly of claim 19 further characterized in that said elongated cross-member comprises a bone implant (1) of claim 14 and an elongated connection piece (139) non-integral with said bone implant (1), with said stem portion (19) of said elongated plunger (5) being received in a sliding fit within a cylindrical bore (143) in said connection piece (139), and with said intramedullary rod-receiving cylindrical cross-member through bore (145) being in said connection piece (139).

Claim 29

An instrument (27) for use in inserting a surgical implant into a cavity in a patient's bone characterized in that said instrument (27) comprises: an elongated rod (21) having a first end and a second end, said rod (21) having an externally threaded portion (23) adjacent said first end and an externally smooth portion (29) extending from said externally threaded portion (23) towards said second end, and said rod (21) being axially cannulated over at least a portion of its length so as to be capable of fitting over a surgical guide wire; a hollow sleeve (31) receiving said elongated rod (21), said sleeve (31) being capable of sliding movement upon said externally smooth portion (29) of the rod (21); and means (35) for advancing the hollow sleeve (31) along the externally smooth portion (29) of the rod (21) towards said externally threaded portion (23), said advancing means (35) positively preventing movement of the sleeve (31) along the rod (21) in a direction away from said externally threaded portion (23) while it is engaged with the sleeve (31), whereby advancement of the sleeve (31) can be stopped without relaxing the force being placed upon it by said advancing means (35).

Claim 30

An instrument (27) for use in inserting a surgical implant into a cavity in a patient's bone characterized in that said instrument (27) comprises: an elongated rod (21) having a first end and a second end, said rod (21) having an externally threaded portion (23) adjacent said first end and an externally smooth portion (29) extending from said externally threaded portion (23) towards said second end, and said rod (21) being axially cannulated over at least a portion of its length so as to be capable of fitting over a surgical guide wire; a hollow sleeve (31) receiving said elongated rod (21), said sleeve (31) being capable of sliding movement upon said externally smooth portion (29) of the rod (21); and means (35) for advancing the hollow sleeve (31) along the externally smooth portion (29) of the rod (21) towards said externally threaded portion (23), said advancing means (35) positively preventing movement of the sleeve (31) along the rod (21) in a direction away from said externally threaded portion (23) while it is engaged with the sleeve (31), whereby advancement of the sleeve (31) can be stopped without relaxing the force being placed upon it by said advancing means (35).

Claim 31

An elongated bone plate (69) adapted to be secured to a patient's bone having an upper surface (71), a lower surface (73) intended to be adjacent the patient's bone in use and two side surfaces (75, 77) connecting the upper and lower surfaces (71, 73), with the thickness of the plate (69) being substantially constant between the two side surfaces (75, 77), characterized in that the width of the upper surface (71) is greater than the width of the lower surface (73), said side surfaces (75, 77) being tapered inwardly toward one another from said upper surface (71) to said lower surface (73), with said bone plate (69) being adapted to be secured to the patient's bone by means of bone fasteners received in apertures (79, 80, 85) in the bone plate (69).

Claim 32

An elongated bone plate (69) adapted to be secured to a patient's bone having an upper surface (71), a lower surface (73) intended to be adjacent the patient's bone in use and two side surfaces (75, 77) connecting the upper and lower surfaces (71, 73), with the thickness of the plate (69) being substantially constant between the two side surfaces (75, 77), characterized in that the width of the upper surface (71) is greater than the width of the lower surface (73), said side surfaces (75, 77) being tapered inwardly toward one another from said upper surface (71) to said lower surface (73), with said bone plate (69) being adapted to be secured to the patient's bone by means of bone fasteners received in apertures (79, 80, 85) in the bone plate (69).

Claim 33

An elongated bone plate of claim 26 further characterized in that said bone plate is made of a resilient titanium-base alloy.

Claim 34

An elongated bone plate of claim 26 further characterized in that said upper and lower surfaces (71, 73) are defined in transverse bone plate cross-sections by arcs of two concentric circles and said two side surfaces (75, 77) are defined therein by two straight lines which, when extended, form an angle (A) bisected by a diametrical line of said concentric circles.

Claim 35

An elongated bone plate of claim 26 further characterized in that said bone plate further comprises two parallel integral rails (81, 83) extending downwardly along substantially the entire length of the plate (69), with said rails (81, 83) being located at opposite sides of said lower surface (73), whereby only said rails (81, 83) contact the patient's bone when the bone plate (69) is secured thereto.

Claim 36

A bone implant assembly comprising: an elongated bone plate (69) of claim 26 and a surgical implant (43) having an elongated plate portion (45), having an upper surface (49) and a lower surface (51), adapted to be secured to the patient's bone by means of bone fasteners received in apertures (55, 57, 59) in said elongated plate portion (45), with a cavity (63) being formed in the lower surface (51) of the elongated plate portion (45) at a free end (65) of said plate portion (45), said cavity (63) extending longitudinally from said free end (65) to a shoulder (67) defining an end of cavity (63) and said cavity (63) having a transverse cross-section complimentary to that of said elongated bone plate (69) so that said elongated bone plate (69) can enter and be removed from said cavity (63) only by relative axial movement between said elongated bone plate (69) and said elongated plate portion (45), and with the distribution of bone fastener-receiving apertures (57, 59, 79, 85) in said elongated bone plate (69) and said elongated plate portion (45) being such that when said bone plate (69) is inserted into said cavity (63) and an end of said bone plate (69) abuts said shoulder (67) at least one of said apertures (57, 59) in said elongated plate portion (45), which at least one aperture (57, 59) is in communication with said cavity (63), overlies an aperture (79, 85) in said elongated bone plate (69).

Claim 37

A bone implant assembly of claim 30 further characterized in that said surgical implant is an angled side plate (43).

Claim 38

A bone implant assembly of claim 30 further characterized in that said surgical implant is a distal buttress plate (171).

Claim 39

A distal buttress plate (171) adapted to be secured to the outer cortical wall of the lateral distal femur by means of bone fasteners received in apertures in said plate, characterized in that said plate (171) includes a relatively flat elongated proximal portion (173) adapted to be secured to the lateral distal femoral shaft and a relatively curved distal portion (175) curved out of the plane of said proximal portion (173) adapted to be secured to the lateral distal femoral condyle, with said distal portion (175) comprising a generally rounded head (177) at the distal end of the plate (171) and a generally widened body (179) having a greater maximum width than both said head (177) and said proximal portion (173), with said head (177) and body (179) being connected by a neck (181) having a minimum width substantially smaller than the maximum widths of said head (177) and body (179) so as to leave spaces for the accommodation of a pair of fracture reduction lag screws (195, 197) against said neck (181) on the two sides of said neck (181).

Claim 40

A distal buttress plate (171) adapted to be secured to the outer cortical wall of the lateral distal femur by means of bone fasteners received in apertures in said plate, characterized in that said plate (171) includes a relatively flat elongated proximal portion (173) adapted to be secured to the lateral distal femoral shaft and a relatively curved distal portion (175) curved out of the plane of said proximal portion (173) adapted to be secured to the lateral distal femoral condyle, with said distal portion (175) comprising a generally rounded head (177) at the distal end of the plate (171) and a generally widened body (179) having a greater maximum width than both said head (177) and said proximal portion (173), with said head (177) and body (179) being connected by a neck (181) having a minimum width substantially smaller than the maximum widths of said head (177) and body (179) so as to leave spaces for the accommodation of a pair of fracture reduction lag screws (195, 197) against said neck (181) on the two sides of said neck (181).

Claim 41

A distal buttress plate of claim 33 further characterized in that said distal buttress plate (171) is provided with at least one elongated aperture (189) in said head (177) and a pair of elongated apertures (191, 193) in said body (179), one on each side of the body (179).

Claim 42

A bone screw (89, 90, 101) having a head (93) and a partially or fully threaded shank (97, 101) characterized in that said bone screw is made of a resilient titanium-base alloy, and in that an axially-extending recess (95) of generally star-shaped cross-section having substantially parallel axially-extending walls is provided in said head (93) for receipt of a driving instrument for the screw (89, 90, 101).

Claim 43

A bone screw (89, 90, 101) having a head (93) and a partially or fully threaded shank (97, 101) characterized in that said bone screw is made of a resilient titanium-base alloy, and in that an axially-extending recess (95) of generally star-shaped cross-section having substantially parallel axially-extending walls is provided in said head (93) for receipt of a driving instrument for the screw (89, 90, 101).

Claim 44

A hollow intramedullary rod (109) having a closed profile in transverse cross-section and a longitudinally-splined external contour along substantially its entire length, characterized in that said intramedullary rod (109) is an extruded hollow body made of Ti-3Al-2.5V alloy.

Claim 45

A hollow intramedullary rod (109) having a closed profile in transverse cross-section and a longitudinally-splined external contour along substantially its entire length, characterized in that said intramedullary rod (109) is an extruded hollow body made of Ti-3Al-2.5V alloy.

Claim 46

A distal buttress plate (171) adapted to be secured to the outer cortical wall of the lateral distal femur by means of bone fasteners received in apertures in said plate, characterized in that said plate (171) includes a relatively flat elongated proximal portion (173) adapted to be secured to the lateral distal femoral shaft and a relatively curved distal portion (175) curved out of the plane of said proximal portion (173) adapted to be secured to the lateral distal femoral condyle, with at least one elongated aperture (189) capable of accommodating multiple bone fasteners being provided in said distal portion (175).

Claim 47

A distal buttress plate (171) adapted to be secured to the outer cortical wall of the lateral distal femur by means of bone fasteners received in apertures in said plate, characterized in that said plate (171) includes a relatively flat elongated proximal portion (173) adapted to be secured to the lateral distal femoral shaft and a relatively curved distal portion (175) curved out of the plane of said proximal portion (173) adapted to be secured to the lateral distal femoral condyle, with at least one elongated aperture (189) capable of accommodating multiple bone fasteners being provided in said distal portion (175).