Poor bone quality, which is frequent in older persons, increases the technical difficulties and complications of fracture therapy. The purpose of surgery is to improve bone and/or joint alignment, maintain blood flow to facilitate healing, and offer stability to allow for early movement. Plates are used to close the bone gap at the fracture site and provide rigid fixation. Locking plates are especially beneficial for patients with osteoporosis and multiple section fractures.
The locking plate has gradually, but most lately, entered the arsenal of osteosynthesis techniques used by today’s orthopedic and traumatology surgeons. However, the concept of the locking plate itself is frequently misinterpreted and, as a result, misjudged. In summary, the locking plate functions similarly to an external fixator, but without the disadvantages of an external system, not only in terms of soft tissue transfixion, but also in terms of mechanics and the risk of infection. It is more of an “internal fixator.”
Disadvantages of conventional plates
Screws are free to move independently of the plate. As force is applied, they may loosen over time. Premature screw loosening can cause fracture instability, loss of fracture gap reduction, and bone nonunion.
Plate-to-bone compression and friction caused by movement of the plate, screws, and bone may impair blood circulation to the bone.
The high screw torque required for stability may be too much for osteoporotic bone.
Locking vs non-locking plates
There are several advantages to a locking plate/screw system:
- In all regions, a locking plate does not have to exactly contact the underlying bone. When the screws are tightened, they “lock” into the plate’s threaded screw holes, supporting the segments but without dragging the bone to the plate. Locking screws prevent screw insertion from changing the reduction. Nonlocking plate/screw systems necessitate careful plate adaptation to the underlying bone. Tightening the screws without this close contact will move the bone segments toward the plate, resulting in loss of reduction and perhaps the occlusal connection.
- Traditional plates, which compress the plate to the cortical bone, disrupt the underlying cortical bone perfusion more than locking plate/screw systems.
- Screws will most likely not come loose from the plate. Similarly, if a bone transplant is fastened to the plate, a locking head screw will not loosen during the integration and healing phases of the graft. This aspect of a locking plate/screw system may have the advantage of lowering the risk of inflammatory problems caused by hardware loosening.
- Locking plate/screw systems have been demonstrated to be more stable than non-locking plate/screw systems.
Common Types of Locking Plates
Most reputable plates serve the following types of hospitals and healthcare facilities.
- Variable angle lock technology is used in the distal radius variable angled and double column locking plate of 2.4mm. It is beneficial for distal radius osteotomies as well as extra and intraarticular fracture treatment.
- A 2.4mm plate with a distal radius buttress type cures difficult extra and intra-articular fractures. They also treat minor bone osteotomies and distal radius problems.
- Clavicle anterior distal plates for both the left and right legs combine plating techniques with modern locking screw technology. These plates include bone plate holes to give angular stability by fixation with locking screws found in the threaded section. A 3.5mm clavicle anterior locking plate is available.
- Many locking manufacturers offer 4.5mm condylar buttress type plates. These are beneficial in the treatment of supracondylar fractures produced by femoral condyle fractures, distal femur malunions, and non-unions. Furthermore, condylar buttress plates provide support for articular fractures in the medial or lateral condyle femur.
Uses of Locking Plates
There is no need for intimate contact with the underlying bones.
The standard screw, which had previously been utilized to provide stability to fracture portions, had to be precisely adapted with the underlying bone. In the case of locking plates, this is no longer a criteria. In all regions, there is no intimate contact between the locking plate and the underlying bones, therefore tightening the plate does not compress the bone to the plate. When the doctor employs locking plates instead of a screw to fix a complicated fracture, the chances of success increase.
There is no disruption of the underlying cortical bone
The second benefit of adopting the locking plate technology is that it does not affect the underlying cortical bone perfusion.
No possibility of screw loosening from plate
Another key advantage of employing the locking plate is that the screw is unlikely to come loose from the plate, even if the doctor inserts it into the fracture gap. This is also true if the doctor employs a bone graft to treat the fracture.
The locking plates offer a more secure fastening than traditional screws. There have been fewer cases of an inflammatory response or infection forming on the underlying bone.
What makes the locking plates preferable apart from other implants?
Plates effectively treat fractures and have a reasonably strong pull-out strength on plate head screws. Plates are particularly effective in treating biologically fixed fractures, shaft fractures, fractures with short metaphyseal segments, and fractures in osteoporotic bone.
By conducting placement without coming into touch with the bone, this reduces the requirement for friction between the bone and the plate. It offers a high degree of hard fixation, in other words. In order to maintain the flow of periosteal blood and the perfusion of bone, a plate’s design also minimizes potential contact between the bone and the plate.
As a result, by offering the proper plate and screw connections, it improves the functionality and performance of joints and bones.
Preferable Materials for Locking Plates
When designing locking plates, Zealmax Ortho favors using two distinct types of materials. These materials include the premium metals titanium and stainless steel.
When it comes to the production of locking plates, we favor metal materials such as stainless steel, PEEK, and titanium. Stainless steel orthopedic implants are frequently used as a temporary fixation. Surgical-grade stainless steel offers a high resistance quality and a high fatigue resistance. The exterior surface of stainless steel implants is virtually corrosive-resistant, making them suitable for providing interim support while the surgical site heals. Implants are preferred for permanent implantation in bone-deficient areas.
Medical-grade titanium is robust, has a low elastic modulus, and is highly corrosion resistant. Furthermore, it releases organic particles in the implanted area that truly blend with the surrounding tissue and provide great support to the cracked area.
Advantages of Locking Plates
Screws become “one” with the plate, lowering the chance of hardware failure. Instead of a single screw, the aggregate of all locked screws determines stability and “pullout” strength. When screws are secured into fixed-angles, the shattered bones on both ends of the break stay closer together, enhancing the likelihood of proper healing.
Locking plates prevent movement of the plate, screws, and bone. Direct plate-to-bone compression is not necessary, which helps to preserve the bone’s blood supply.
Locking plates are more suitable for osteoporotic bone and multi-segment fractures because the plate-screw arrangement distributes stress over the whole length of the plate.
ZealMax Ortho are among the most established, well-known, and reliable manufacturers and exporters of locking plates for orthopedic implants. We have a committed group of experts on staff with specialized knowledge in the production and supply of various plates and implants. We have a wide range of goods for the orthopedic implants and healthcare industries, including Bone Screw, Cancellous Screw, DHS Plate, Tibia Nail, etc.