Lecture 13 Short Notes Flashcards
What is the concept of load sharing in fracture treatment?
the bone and implants sharing the forces transmitted across the fracture site by weight-bearing
Which fracture patterns are amenable to compression plating?
-transverse
-short oblique
What is required to achieve compression in fracture treatment?
anatomic reduction (direct contact of the bone fragments or osteotomy edges)
What is the function of the screw holes in DCP plates?
they allow insertion of screws in both neutral mode and compression mode
How does the LC-DCP plate design differ from the DCP?
-scalloped undersurface to allow preservation of periosteal blood supply
-trapezoid cross-section to further enhance vascular ingrowth
-angled edges of screw holes allow for greater screw angulation
-evenly spaced screw holes
-ability to compress from either end of each screw hole
What is a primary advantage of compression plating?
lack of need for expensive locking screws and associated instrumentation
What are the disadvantages of compression plating?
-negative impact on periosteal blood supply
-need for anatomic reconstruction to achieve load sharing
What happens if the far cortex is not compressed during compression plating?
a gap opposite the plate can develop, leading to excessive cyclic strain and potential plate breakage
What is the purpose of pre-stressing the plate?
to compress the far cortex as screws are tightened and pull the bone to the plate
What determines the extent to which compression plating can reduce a fracture gap?
plating system and size of plate
What is neutralization plating?
placing a plate in a neutralization function to protect anatomically reduced fractures
What types of fractures are typically treated with neutralization plating?
-long oblique
-spiral
-butterfly fractures
What is the role of secondary implants in neutralization plating?
they provide some interfragmentary compression but cannot fully counteract weight-bearing forces
What are the advantages of using a neutralization plate?
-increases load sharing
-avoids the need for additional implants
What complications can arise from neutralization plating?
-delays in healing
-premature implant failure
What is the step-wise procedure for applying a compression plate on a long bone fracture?
-contouring the plate
-securing with screws
-achieving anatomic reduction
