Buttress plate Bridge plate
Wave plate

Tension band plate
Axial Compression plate

Simple fracture Anatomic reduction Plate applies axial compression

DISTRACTION TO COMPRESSION
(RESISTS DISTRACTION FORCES)
Bridge Plate

Non-Locking or locking Wave plate Spans zone of injury Preserves blood supply fracture site to to at
Stability by plate-bone friction
•Requires Adequate Bone Quality •Intimate contact between plate and bone
Pre-Load
2000
DCP Dynamic Compression Plate
1995 1990 1985 1980
May 20-22, 2011
Objectives

Follow the design evolution of plates
Correlate plate design with plate function Comprehend the different functional applications of plates

Absolute stability
Direct bone healing
Buttress Plate

Anti-Glide Plate Resists shearing forces
TENSION BAND

PLACED ON TENSION SIDE OF ECCENTRALLY LOADED BONE


Relative stability
Healing with callus
1985 Evolution in Techniques

Standard implants More emphasis on soft tissue handling Minimally Invasive application (MIPO)
Plate function

Most plates can Function in several different ways
Depends on the fracture Depends on the reduction
Depends on how it is applied
Form and Function of Plates
“Coapteur”
History 1958 AO Original Principles


Anatomic reduction
Rigid fixation Early mobilization and functional recovery Excelled in mechanical fixation
Distinguish between the function and mode of failure of
Compression plates Locked plates
The ―very‖ old days (Pre-AO era)

Designed by surgeon


Anatomic Name
3.5 mm Titanium LC-DCP 1/3 SS Tubular Plate 4.5 mm Distal Femoral LCP Etc.


Functional Name
Axial compression plate
Neutralization (protection) plate
Evolution of Plate Design and Function
Noel B. Carilo, MD
Philippine Orthopedic Center and St. Luke„s Medical Center
AO Trauma Advance Course
Shenyang, Liaoning, China

AO Plate Line
2000 1995 1990 1985 1980 1975 1970 1965 1960
b.AO
AO Round Hole Plate
2000 1995 1990 1985 1980 1975 1970 1965 1960
Prototype AO Implant b.AO
Closed technique Indirect reduction


Better use of distractors
―BIOLOGIC‖ Fixation Technique
Circlage wires common Functioned as splints
Poor stability
More carpentry than science Large approach

Complications frequent
Danis Compression Plate
<1958
1975
1970 1965
Self Compressing plate
1960
b.AO
Price to Pay for stability

Extensive surgical approach


Manipulation of bone for reduction
Precise contourinlate and bone Periosteal damage from plate Compression of cortex under plate Localized osteopenia under plate