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There are two magic weapons for trauma orthopedics, steel plate, and intramedullary screw. Steel plates are also the most commonly used internal fixation devices, but there are many types of steel plates. Although they are all a piece of metal but their usages can be different. Do you know all about these?
1. Tension Band
When the mechanics of some bones are transferred to eccentric fixation, the steel plate is the tension band, such as the femur, and the steel plate should be placed on the tension side.
2. Compression Plate
The compression plate is made by screwing the screw into the sloping lock, which belongs to the principle of spherical sliding.
However, the pressure will make the pressure between the plate and the bone too large and sometimes affect the healing of the bone, so the LCP (limited compression plate) was invented.
3. Locking Plate
The locking plate, that is, the screw and the plate, are previously combined in a locked form. Usually, the locking hole and the pressurizing hole are combined, but the functions of the two are completely different.
Locking screws can effectively increase the internal fixation strength and have better pull-out resistance, especially angle-stabilized locking screws, most notably the proximal humeral Philos locking plate.
4. Neutralization Plate
The neutralization plate does not produce compression of the fracture ends but only a linking effect of the fracture ends. Because the fracture ends are pressurized by the lag screws, but the strength of the lag screws against bending, rotation, and shearing forces is limited, the steel plate is needed for assistance.
In the neutralized steel plate, the main force is the lag screw. When the fracture line is larger and longer, 2-3 lag screws can pull the fracture line perpendicular to the fracture line and then assist with neutralization plate fixation.
Neutralization plates are most commonly used to fix the lateral malleolus and clavicle.
5. Buttress Plate
How to apply buttresses in orthopedics? Primarily the application is for fractures against shear forces placed in the direction of relative movement. The supporting steel plate is not necessary to be so thick compared to the ordinary pressurized steel plate, and it is unnecessary to fill all the screws.
The steel plate needs to be pre-bent, screw in the cortical screws in turn from far to near, and use the cortical screws to attach the steel plate. Due to its elastic recoil, the steel plate has a tendency to resume bending, and this force is used to perform the buttress function.
6. Anti-glide Plate
After the plate is fixed, it prevents the fracture fragment from sliding outward after being subjected to longitudinal force. Mainly used in the distal fibula.
7. Span Plating or Bridge Plating
This is a modified version of the neutralization plate aimed at the comminuted fracture of the cadre. Through fluoroscopy monitoring, the plate crosses the fracture area and fixes the proximal and distal ends of the fracture, and the fracture area is not fixed.
This type of technology mainly emphasizes alignment, alignment, length, and rotation. The middle crushing can be done without treatment, effectively protecting the blood supply of the broken end of the fracture. However, it should be noted that the steel plate must have sufficient length, and the number of screws at both ends must also be sufficient. At present, some non-unions are prone to occur, which need to be treated with caution.
