Trauma Plates, Screws, Nails – Orthopaedic Trauma

What is Trauma Implants?

Trauma implants are the devices in orthopedic surgery. They are used to treat various traumas depending upon the type of injury. Trauma refers to ‘wound’ in Greek and any physical injury such as fracture, dislocation, sprains, strains, burns, etc comeunder a trauma.

In orthopaedics, trauma devices especially trauma plates are used to cure fractures, especially in long bones. These implants are applied to the injury in order to cure it temporarily or permanently. These trauma implants used for bone fixation as well as to replace articulate surfaces in the joint.

Increments in physical injuries have caused trauma implants to ensure their market presence. The different types of trauma implants enable the medical doctors to choose a proper fitting implant according to the weight, size and type of the individual.

Nails, screws, fixators and plates are a few of the trauma implants that are used to repair fractured bones in orthopedic surgery. Plates are further divided into non-locking and locking plates while the screws are further divided into non-locking and locking screws.

Materials used in trauma implants:

  • Stainless Steel
  • Titanium Alloys
  • Plastic Coating
  • Sometimes cemented for improved adhesion.
What care should be taken while using trauma implants?

Intense care should be taken while designing, manufacturing and installing Trauma implants. Care must be taken while installing because the heat produced by the friction can cause damage to tissue bones.

Benefits of Trauma Implants:

  • Repairs broken bone in short time
  • No need to remove titanium bone plates from body if you are older than 60 years of age
  • No need to remove plates from body if you are underweight.
  • No need to remove plates from body if it is implanted in your lower body.

Features of Trauma Implants:

  • Biocompatible
  • Low or No Osseo integration
  • Excellent Gliding Characteristics
  • High Tensile Strength and Load
  • Relatively Low Modules of Elasticity
  • High Ductility
  • Non-Magnetic
Trauma is further divided into:

Nails – 

Orthopedic nails are used for fractures like femur, tibia, etc. Its main purpose is to immobilize the bone in proper alignment so that the bone’s ends do not overlap and cause discomfort. Nails are the metal rods that are fixed in the medullar canal of long bones to hold the broken ends together. Just like plates, these nails are also of different types and that depend upon the size of fracture.

The nails are further divided into 2 types:
  • Enders Nails
  • TENS Nails
  • Kuntscher Nails
  • Square Nails
  • Rush Nails

Screws – 

It is proved that the fracture heals properly if the fracture fragments are pressed firmly together. Orthopaedic screws are designed to do the same. Its primary function is to stabilize the fracture in anatomic alignment. It helps in decreasing the gap between fractures.

Screws are the hardware device that is presents everywhere. They may be used alone to provide fixation or can be used as a partner to other devices. A screw that is used to achieve interfragmental compression is termed a lag screw. Such screws do not protect fractures from bending, rotation or axial loading forces

There are two types of screws:

  1. Non locking screws
  2. Locking screws

Non Locking Screws:

Some locking screw:

Plates – 

Orthopedic plates are used to fix bone fractures and allow it to heal. These orthopedic plates for were first recorded in 1886 by Hansmann, of Heidelberg University, Germany. Different anatomical locations require different shapes and sizes of plates. Plates are now broadly acknowledged with diverse standard techniques of osteosynthesis.

Plates should meet the following requirements in order to be helpful:
  • Appropriate width and thickness for the given bone
  • Must have enough and symmetric hold on either side of the fracture
  • Must be closely different from the contour of bone.
  • The plate must neutralize all bending, shear, etc. that happens on the fracture

Plates are further divided into:

  • Non-Locking Plates
  • Locking Plates

Some of Locking Plates:

Locking and Non-Locking Plates & Screws:

Locking plates/screws are costlier as compared to non-locking plates/screws but the use of both types of plates yields similar output while treating the fractures.

Non-locking plate/screw systems involve an accurate adaptation of the plate to the underlying bone. Without this close contact, tightening of the screws will draw the bone segments toward the plate, resulting in alterations in the position of the osseous segments.

To contact the underlying bone closely, in all areas is needless for the locking plates. The screw gets ‘locked’ with the plate as it gets tightened and stabilizes the segment without compressing the bone to the plate.

This makes it impossible for the screw insertion to change the reduction. Locking plates/screws do not disturb the underlying cortical bone perfusion as much as non-locking plates/screws, which compresses the under surface of the plate to the cortical bone.

In locking plate/screws systems, the screws are not likely to loosen from the plate. Locking plates/screws have reduced the number of inflammatory complexities from the loosening of the hardware. It is known that loose hardware creates an inflammatory response and encourages contamination.

It is seen that more durable fixation is provided by locking plates/screws than the non-locking plates/screws.