Bone plate with two different sizes of discrete drill guides connected to the plate

A bone plate and guide system for fixation of a bone extending within soft tissue, the bone having an exterior surface, the system comprising:

• a) a metal plate having an upper surface and a bone contacting lower surface for seating over the exterior surface of the bone, and defining an arrangement of a plurality of through-holes situated over the exterior surface, and at least three of said plurality of through-holes are threaded holes;
• b) a plurality of first-type guides for a guiding a bone penetrator as the bone penetrator drills a hole into bone through and beneath said first-type drill guides, each including,
• i) a tubular body having a proximal end, a distal end, a first length extending between said proximal and distal ends, and a first outer diameter,
• ii) an axial cylindrical bore extending through said first-type drill guide of a diameter and length suitable for stably guiding the bone penetrator,
• iii) a threaded portion extending distally from said distal end of said body to threadedly engage said tubular body with said threaded holes such that said proximal end of said body extends above said upper surface of said plate and said cylindrical bore is co-linear with a central axis of said threaded hole in which said threaded portion is threadedly engaged, and
• iv) an internal non-cylindrical tool engagement feature within said bore of said body for engagement with a tool for applying a rotational force for removal of the drill guide from the threaded hole, and
• said first-type drill guides being directly threadedly connected into respective ones of said threaded holes;
• and
• c) at least one second-type drill guide, each including,
• i) a body having a proximal end, a distal end, a second length extending between said proximal and distal ends that is different than said first length, and a second outer diameter larger than said first outer diameter,
• ii) an axial cylindrical bore extending through said second-type drill guide of a diameter and length suitable for stably guide a bone penetrator as the bone penetrator drills a hole into bone through and beneath said second-type drill guides,
• iii) a threaded portion extending distally from said distal end of said body to threadedly engage said body with one of said threaded holes such that said proximal end of said body extends above said upper surface of said plate and said cylindrical bore is co-linear with a central axis of said threaded hole in which said threaded portion is threadedly engaged, and
• iv) an internal non-cylindrical tool engagement feature within said bore of said body adapted for engagement with a tool for applying a rotational force for removal of the drill guide from threaded engagement within the threaded hole,
• said second-type drill guide being directly threadedly connected into at least one of said threaded holes at a same time as said first-type drill guides are directly threadedly connected into others of said threaded holes,
• wherein said second length of said second-type drill guides is sufficiently short such that when said bone contacting lower surface seats on the exterior surface of the bone, said proximal end of said second-type drill guide is configured for placement under retracted soft tissue, and
• wherein after holes are drilled through said first-type drill guide and second-type drill guide, each of said drill guides is removable from said plate by application of rotational force.

A method of implanting a bone plate against a bone, comprising:

• a) providing a system having,
• i) a metal bone plate having an upper surface and a bone contacting lower surface for seating over the exterior surface of the bone, and defining an arrangement of a plurality of through-holes situated over the exterior surface, and at least three of said plurality of through-holes are threaded holes,
• ii) a plurality of first-type drill guides threadedly connected in respective ones of said threaded holes, said first-type drill guides each unitarily formed for handling as a single element and consisting essentially of,
• a tubular body having a proximal end, a distal end, a first length extending between said proximal and distal ends, and a first outer diameter,
• an axial cylindrical bore extending through said first-type drill guide of a diameter and length suitable for stably guiding a drill,
• a threaded portion extending distally from said distal end of said body to threadedly engage said tubular body with said threaded holes such that said proximal end of said body extends above said upper surface of said plate and said cylindrical bore is co-linear with a central axis of said threaded hole in which said threaded portion is threadedly engaged, and
• an internal non-cylindrical tool engagement feature within said bore at said proximal end of said body for engagement with a tool for applying a rotational force for removal of the drill guide from the threaded hole, and
• said first-type drill guides being directly threadedly connected into respective ones of said threaded holes, and
• iii) at least one second-type drill guide threadedly connected in respective ones of said threaded holes, each said second-type drill guide unitarily formed for handling as a single element and consisting essentially of,
• a body having a proximal end, a distal end, a second length extending between said proximal and distal ends that is less than said first length, said second length sufficiently short such that said proximal end can be situated under retracted soft tissue when said bone contacting lower surface seats on the exterior surface of the bone, and a second outer diameter larger than said first outer diameter,
• an axial cylindrical bore extending through said second-type drill guide of a diameter and length suitable for stably guiding a drill,
• a threaded portion extending distally from said distal end of said body to threadedly engage said body with one of said threaded holes such that said proximal end of said body extends above said upper surface of said plate and said cylindrical bore is co-linear with a central axis of said threaded hole in which said threaded portion is threadedly engaged, and
• an internal non-cylindrical tool engagement feature within said bore at said proximal end of said body adapted for engagement with a tool for applying a rotational force for removal of the drill guide from threaded engagement within the threaded hole;
• b) making an incision in the soft tissue to separate the soft tissue from the bone;
• and
• c) inserting the system through the incision with the bone contacting surface of said plate against the exterior surface of the bone and said proximal end of said second-type drill guide under the soft tissue.