The Noncontact Bridging (NCB) Plate System: A Rationale of a Hybrid Polyaxial Locking Plate : Techniques in Orthopaedics

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The Noncontact Bridging (NCB) Plate System

A Rationale of a Hybrid Polyaxial Locking Plate

Kuster, Markus S. MD, PhD*,†; Erhardt, Johannes MD; Grob, Karl R. MD

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Techniques in Orthopaedics 28(3):p 250-259, September 2013. | DOI: 10.1097/BTO.0b013e3182a0d1a8

Abstract

The noncontact bridging system is a true hybrid and polyaxial locking plate. Each screw is first inserted into the screw hole of the plate using a conventional technique and can be locked at any time during the procedure with a locking cap. This allows the surgeon to use the plate for fracture reduction, to assess bone quality when tightening the screw, and to lock or unlock the screw head at any time. Several biomechanical and clinical studies have been published over the years, and noncontact bridging has proven a reliable plating system for complex fractures around the knee joint and the proximal humerus, and for osteoporotic fractures. Several features such as plate to bone compression, the possibilities for indirect reduction onto the plate, polyaxiality, and buttressing are discussed. A specially designed periprosthetic plating system exists with a wider plate around the hip joint or the knee joint to reliably bypass intramedullary stems or nails. The drawback of this locking system is its requirement for a minimal thickness to accommodate the locking cap, which reduces its usage to large bones. Despite the advancement of locking plates, periprosthetic fractures remain a challenge with a high number of complications including plate failure. A sound knowledge about arthroplasty, biomechanics, and fracture treatment is important to improve the results.

© 2013 by Lippincott Williams & Wilkins

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