Abstract
Surgical stabilization of fractures with plate and screw constructs continues to be a common contemporary method of fracture fixation. Plate design has evolved significantly over the last century. While the modern plating armamentarium commonly includes anatomically precontoured locking plates with off-axis locking screw technology for many areas of the body, the basis of plate and screw fracture stabilization stems from nonlocking plate constructs. There are numerous different plate designs with varying shapes, sizes, and thicknesses. Regardless of the plate design, the function of the plate is determined by how the plate is applied by the surgeon to the specific fracture. The main functions that a plate can serve are compression, neutralization, buttress, tension band, and bridging. The purpose of this chapter is to describe and demonstrate each primary function possible by plate and screw constructs through both correct and incorrect clinical examples.
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References
Uhthoff HK, Poitras P, Backman DS. Internal plate fixation of fractures: short history and recent developments. J Orthop Sci. 2006;11(2):118–26.
Buckley R, Moran CG, Apivatthakakul T. AO principles of fracture management, Principles, vol. 1. 3rd ed. New York: Thieme; 2017.
Anderson LD, Sisk D, Tooms RE, Park WI 3rd. Compression-plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg Am. 1975;57(3):287–97.
Chapman MW, Gordon JE, Zissimos AG. Compression-plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Joint Surg Am. 1989;71(2):159–69.
Hadden WA, Reschaver R, Seggl W. Results of AO plate fixation of forearm shaft fractures in adults. Injury. 1982;15:448.
Hertel R, Pisan M, Lambert S, Ballmer FT. Plate osteosynthesis of diaphyseal fractures of the radius and ulna. Injury. 1996;27:545–8.
Allende C, Vanoli F, Gentile L, Gutierrez N. Minimally invasive plate osteosynthesis in humerus nonunion after intramedullary nailing. Int Orthop. 2018;42(11):2685–9.
Hakeos WM, Richards JE, Obremskey WT. Plate fixation of femoral nonunions over an intramedullary nail with autogenous bone grafting. J Orthop Trauma. 2011;25(2):84–9.
Rupp M, Biehl C, Budak M, Thormann U, Heiss C, Alt V. Diaphyseal long bone nonunions – types, aetiology, economics, and treatment recommendations. Int Orthop. 2018;42(2):247–58.
Patel R, Neu CP, Curtiss S, Fyhrie DP, Yoo B. Crutch weightbearing on comminuted humeral shaft fractures: a biomechanical comparison of large versus small fragment fixation for humeral shaft fractures. J Orthop Trauma. 2011;25(5):300–5.
Lindvall EM, Sagi HC. Selective screw placement in forearm compression plating: results of 75 consecutive fractures stabilized with 4 cortices of screw fixation on either side of the fracture. J Orthop Trauma. 2006;20(3):157–62.
Nauth A, McKee MD. Open reduction and internal fixation of both-bones forearm fractures. JBJS Essent Surg Tech. 2015;5(4):e28.
Lucas JF, Lee MA, Eastman JG. Optimizing compression: comparing eccentric plate holes and external tensioning devices. Injury. 2016;47(7):1461–5.
Virkus WV, Goldberg SH, Lorenz EP. A comparison of compressive force generation by plating and intramedullary nailing techniques in a transverse diaphyseal humerus fracture model. J Trauma. 2008;65(1):103–8.
Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br. 2002;84(8):1093–110.
Schildhauer TA, Nork SE, Mills WJ, Henley MB. Extensor mechanism-sparing paratricipital posterior approach to the distal humerus. J Orthop Trauma. 2003;17(5):374–8.
Gerwin M, Hotchkiss RN, Weiland AJ. Alternative operative exposures of the posterior aspect of the humeral diaphysis with reference to the radial nerve. J Bone Joint Surg Am. 1996;78(11):1690–5.
Brunner CF, Weber BG. Anti-glide plate. In: Special techniques in internal fixation. Berlin/Heidelberg: Springer; 1982. p. 115–32.
Wegner AM, Wolinsky PR, Robbins MA, Garcia TC, Maitra S, Amanatullah DF. Antiglide plating of vertical medial malleolus fractures provides stiffer initial fixation than bicortical or unicortical screw fixation. Clin Biomech (Bristol, Avon). 2016;31:29–32.
Switaj PJ, Wetzel RJ, Jain NP, Weatherford BM, Ren Y, Zhang LQ, Merk BR. Comparison of modern locked plating and antiglide plating for fixation of osteoporotic distal fibular fractures. Foot Ankle Surg. 2016;22(3):158–63.
Ratcliff JR, Werner FW, Green JK, Harley BJ. Medial buttress versus lateral locked plating in a cadvaver medial tibial plateau fracture model. J Orthop Trauma. 2007;21(7):444–8.
Patel PB, Tejqani NC. The Hoffa fracture: coronal fracture of the femoral condyle a review of literature. J Orthop. 2018;15(2):726–31.
Barei DP, O’Mara TJ, Taitsman LA, Denbar RP, Nork SE. Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns. J Orthop Trauma. 2008;22(3):176–82.
Hommel GJ, Lobrano C, Ogden AL, Mukherjee DP, Anissian L, Marymont JV. A quantitative analysis of tension band plating of the femur diaphysis. Arch Orthop Trauma Surg. 2011;131(10):1325–30.
Duckworth AD, Clement ND, White TO, Court-Brown CM, McQueen MM. Plate versus tension-band wire fixation for olecranon fractures: a prospective randomized trial. J Bone Joint Surg Am. 2017;99(15):1261–73.
Zderic I, Stoffel K, Sommer C, Höntzsch D, Gueorguiev B. Biomechanical evaluation of the tension band wiring principle. A comparison between two different techniques for transverse patella fracture fixation. Injury. 2017;48(8):1749–57.
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Eastman, J.G. (2020). Nonlocking Plate Functions. In: Crist, B., Borrelli Jr., J., Harvey, E. (eds) Essential Biomechanics for Orthopedic Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-36990-3_13
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DOI: https://doi.org/10.1007/978-3-030-36990-3_13
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