What are the Orthopedic Plates and Its Uses?

Conventional compression plate fixation, using techniques of absolute stability leading to direct bone healing, has usually been recommended for operative fracture treatment since Danis’ and the AO group’s pioneering work in the mid- 20^th century. Now, this approach is being challenged by less invasive, so-called biological, methods of fracture fixation. However, osteosynthesis with bone plates providing absolute stability still has an important place in the treatment of fracture, which is provided by orthopedic implants product suppliers.

Intraarticular fractures need anatomical reduction, as well as absolute stability and plates, are mostly used for fixation of the metaphysis. In these fractures, the anatomical reduction is necessary to minimize arthrosis, and callus formation is not desired. Diaphyseal fractures of long bones are mostly treated with intramedullary nailing, but good indications for plating include the need for anatomical reduction (for example, forearm) and the presence of a short distal or proximal fragment, which makes nailing technically tough. Plate osteosynthesis may be preferred to external fixation in some cases of nonunion and in some of the polytraumatized patients. Fixation with relative stability results in fracture healing by callus. Callus formation after attempts at fixation with absolute stability shows a degree of instability that ultimately may lead to implant fatigue and failure. Absolute stability results in direct fracture healing and usually takes longer than healing by callus. A plate- in the direct contract and pressed down onto the bone surface- can disturb blood flow to the underlying cortex. This may lead to local cortical necrosis. The procedure of bony remodeling and revascularization is slow and local osteoporosis is observed in cortical bone at the contact points (footprints) with the plate.

The disturbance of the cortical blood supply can be reduced by minimizing stripping of the periosteum. The plate can be placed on top of it.

Gentle use of pointed reduction forceps and small pointed hooks is recommended for reduction, and whenever possible, indirect reduction techniques should be used to reduce the insult to soft tissues and bone. because of its reduced area of contact with bone, the LC-DCP appears to preserve the blood supply better than the original DCP, and effect which is even more evident with locking plates, which don’t depend on fiction and compression between the plate and bone for stability. It was previously theorized that plates weakened the local bone because of stress protecti, a theory that is no longer widely accepted. It is more likely that disturbed vascularity leads to slower remodeling of the cortex underneath a plate.

The classical plating technique, providing absolute stability, needs strict adherence to the principles of interfragmentary compression.

Errors of technique and misapplied principles may lead to complications such as implant failure, delayed healing, and nonunion.

Plate designs:

There are many different plates, most of which may be used to serve in different biochemical functions, depending upon how the surgeon applies for the plate.

The surgeon, not the plate’s designer determines how a plate will function and how it will be applied.

This is the main element of preoperative planning. Any plate can be used to provide any of the main functions of a plate. However, the design and application of the plate must consider the biochemical environment. Thus, a thin, one-third tubular plate is an excellent choice to protect a lag screw fixation of the lateral malleolus but is mostly not strong enough to act as a bridging plate for a multi-fragmentary fracture at the same site. This bone plates are supplied by orthopedic implants manufacturers.