Locked plating in orthopaedic trauma: a clinical update
George J Haidukewych1, William Ricci
1Florida Orthopaedic Institute, Tampa, FL 33637, USA.
Summary
Locked plating offers good fracture fixation outcomes but has unique complications and high costs. Reserve locked plates for complex fractures where unlocked methods have failed.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Locked plating is popular for fracture fixation, but evidence on its outcomes is limited.
- Anatomically contoured locked plates and advanced features like subchondral pegs are available, yet their efficacy data is scarce.
Purpose of the Study:
- To evaluate the clinical performance and complications associated with locked plating in fracture fixation.
- To compare the efficacy and cost-effectiveness of locked versus unlocked fracture fixation constructs.
Main Methods:
- Review of published literature on locked plating outcomes.
- Analysis of clinical performance data, including complications and implant removal.
- Cost comparison between locked and unlocked plating constructs.
Main Results:
- Clinical performance of locked plates is generally good, but specific complications like malalignment and difficulty with removal exist.
- Percutaneous techniques and unicortical screws are associated with loss of diaphyseal fixation.
- Locked plating constructs are significantly more expensive, approximately three times the cost of unlocked constructs.
Conclusions:
- Locked plating is effective for fracture fixation but requires careful consideration due to potential complications and higher costs.
- These constructs should be reserved for complex fractures where traditional unlocked methods have shown poor results.
