Principles of lock plate fixation AO

principles of locking plate fixation (AO concept) and its complications - done in AO basic course Bengbu, China

1. Locking compression plates (LCP) - principles Ahmad Fadzli Sulong – IIUM, Malaysia

2. By the end of this lecture Plates and screws serves multiple functions Benefits of the locking compression plates Indications for locking compression plates Identify common abuses of the locking compression plates

3. Evolution of plates DCP LC - DCP

4. LISS fixation

5. Locking Compression Plate (LCP)

6. Function of plates Compression Neutralization Buttressing Bridging Tension band As a fixed angle construct – LOCKING plates

7. What is it?

8. IS IT GOOD?

9. Preserves biology No compression of plate unto bone - biological

10. Fixed angle construct Forms a fixed angle construct

11. Fixed angle construct Increase screw pullout strength Prevent sequential failure Resists bending and torsional forces

12. Acts as internal splint Acts as a load sparing device Allows micromovement at the fracture site - healing through secondary fracture healing

13. INDICATIONS?

14. Osteoporotic bone

15. Periprosthetic fractures Often in osteoporotic bone Locked screw can purchase limited bone around prosthesis

16. Peri articular fractures Especially in short metaphyseal segments Provides good control of the segment

17. Peri articular fractures Plates are often precontoured Once fixed unto the articular segment, it helps reduction unto the metaphysis due to its precontoured nature

18. Peri articular fractures Locking constructs are angularly stable Resists collapse and Prevents toggle

19. Biological fixation Using the plate as an internal ext -fix / splint Bridging the fracture Preserving fracture haematoma Percutaneous insertion (MIO technique) Achieves relative stability

20. SOME ABUSES

21. Too many screws! What happens?

22. Too enthusiastic! What happened?

23. Too ‘advanced’? Which plate would you use?

24. SURGICAL TECHNIQUE WILL BE DEMONSTRATED IN WORKSHOPS!!

25. Conclusion Excellent tool for fracture management if indicated Does not substitute proper pre-op planning Plan which LCP to use Especially plan how to achieve reduction – direct vs indirect MIO technique? Avoid abuses COST! – main consideration nowadays