Plating techniques remain the mainstay for managing most periarticular and selected long bone fractures. However, movement toward more biologically appropriate plating techniques is occurring in an attempt to minimize soft-tissue stripping, decrease the need for bone grafting, and improve union rates. Internal fixation with locking plates creates a toggle-free, fixed-angle construct. Early data on the biomechanical and clinical performance of these implants are encouraging. Current indications for locked plating include periarticular fractures, typically those with metaphyseal comminution. Although impressive union rates have been reported, malunion remains a concern, especially when percutaneous techniques are used. Further clinical and biomechanical research on locking plate technology is needed to define its place fully alongside existing technology in orthopaedic trauma.
Dr. Haidukewych is an Orthopaedic Traumatologist, Tampa General Hospital and Florida Orthopedic Institute, Tampa, FL.
Dr. Haidukewych or the department with which he is affiliated serves as a consultant to or is an employee of DePuy, a Johnson & Johnson Company.
Reprint requests: Dr. Haidukewych, Florida Orthopedic Institute, 13020 Telecom Parkway, Temple Terrace, FL 33637.