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J Am Acad Orthop Surg, Vol 16, No 6, June 2008, 347-355.
© 2008 the American Academy of Orthopaedic Surgeons
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Locked Plating in Orthopaedic Trauma: A Clinical Update

George J. Haidukewych, MD and William Ricci, MD

Dr. Haidukewych is Orthopedic Traumatologist, Florida Orthopaedic Institute, Tampa, FL. Dr. Ricci is Associate Professor of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.

Dr. Haidukewych or a member of his immediate family has received royalties from and serves as a consultant to or is an employee of DePuy. Dr. Ricci or a member of his immediate family has received research or institutional support from AONA, Synthes, and Smith & Nephew; has received royalties from Smith & Nephew; and serves as a consultant to or is an employee of Smith & Nephew, Wright Medical Technology, and OrthoVita.

Reprint requests: Dr. Haidukewych, Florida Orthopaedic Institute, 13020 N Telecom Parkway, Tampa, FL 33637.

Locked plating for fracture fixation has enjoyed widespread popularity despite a paucity of published data on outcomes. Anatomically precontoured locked plates that allow fixation in various anatomic regions are widely available. New technologies incorporate subchondral support locking pegs, polyaxial bushings, and locking washers to improve intraoperative versatility. However, limited data are available on the efficacy of these new implants. The clinical performance of locked plates generally has been good. However, several unique complications have been noted, such as difficulty with implant removal, malalignment, fracture distraction, and loss of diaphyseal fixation, especially with percutaneous techniques and unicortical screws. The expense of locked plate constructs is a concern. This technology typically costs three times more than similar unlocked constructs. Locked constructs should be reserved for problematic fractures that have demonstrated poor outcomes with unlocked constructs.






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.