Musculoskeletal Imaging

Plate

a type of hardware used in internal fracture fixation of fractures. Plates are usually placed directly across the fractured site and are used for static or dynamic compression, neutralization and buttressing. In static compression more rigid fixation can be achieved, the gap to be bridged is smaller and the amount of external immobilization required is less. Dynamic compression is achieved either by attaching a tension device to a plate or by using a special dynamic compression plate. However, compression plating requires a longer surgical incision to allow insertion of the tension device and the possibility of refracture after the plate is removed. A neutralization plate is used to bridge a comminuted fracture; it also transmits bending or torsional forces from the proximal to the distal fragment. Plates used for buttressing prevent collapse by supporting an area of thin cortex or cancellous bone graft.

When plates are used, atrophy of the bone beneath the plate may predispose the bone to fracture. After removal of plates, fractures may occur through the screw holes.

One particular type of plate, the sliding screw plate (dynamic compression screw, dynamic hip screw) may be used to treat intertrochanteric fractures as well as other injuries. This device consists of a lag screw and a side plate with a barrel. The sliding screw telescopes and provides fixation while allowing impaction to occur at the fracture during healing and weight-bearing. Among the complications of sliding screw plate fixation are "cutting out" of the nail, penetration of the screw into the joint, bending or breaking of the nail, and disengagement of the screw from the barrel and even protrusion of the screw into the pelvis.

DR