GeneralG21LockedPlatingOTACC幻灯片.pptVIP

* * * * * * * * * * * * * * * * * * * * Fracture zone is undisturbed, permitting callus formation and secondary healing * Bridging fixation on both sides, with locked bridge plating OR with nail, yields callus formation, secondary bone healing, and good alignment at union. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Failed varus nonunion revised to this, allowing more motion in the metaphysis and a callus response. One other potential response to the problem of excess stiffness in locking constructs has been so called “far cortical locking”. This entails over-drilling the near cortex and then placing a screw that engages the far cortex and locks in the plate (see diagram, next slide). This may theoretically allow more motion in the construct, and reduce strain at the screw – plate interface. At the time of this publishing, this technology has not been proven clinically, but may have some promise in the future. “Far cortical locking” Locked Plating Mechanics Summary Understand the biomechanical difference from conventional plating Understand the limitations Reduce and lag before locking Locked Plating Indications Summary Biological Fixation Plate as a reduction tool Metaphyseal / Articular Fractures Short articular segments / periprosthetics Osteoporosis Thank You Locked Plating Huge advance in plating Must understand biomechanics and what the various constructs accomplish Need to know and understand the new “rules” of locked plating, as we understand them, and not just apply locked plating blindly Return to General/Principles Index E-mail OTA about Questions/Comments If you would like to volunteer as an author for the Resident Slide Project or recommend updates to any of the following slides, please send an e-mail to ota@aaos.org * * Hopefully, the pendulum is now swinging toward a better understanding of locked plating and judicious use * * (Animation) (In slide show-Bone first shown with no screws showing reduced condyles) First, insert m