Extract
Locking plates are fracture fixation devices with threaded screw holes,
which allow screws to thread to the plate and function as a fixed-angle
device1-3.
These plates may have a mixture of holes that allow placement of both locking
and traditional nonlocking screws (so-called combi
plates)4,5.
The first locking plates were introduced about two decades ago for use in
spinal and maxillofacial
surgery6-8.
In the late 1980s and into the 1990s, experimentation with various types of
internal fixation devices led to the development of locking plates for
fracture
care9-11.
The initial emphasis was on developing stable fixation that would not require
extensive soft-tissue stripping or
disruption12. The
clinical care impetus for development of these plates has been a combination
of factors, including the increasing survival of patients with high-energy
injuries, aging Western European and North American populations with an
increasing rate of fragility fractures, and dissatisfaction of patients and
surgeons with the outcomes of treatment of specific periarticular fractures.
Nonclinical factors likely include a push by industry for new technology and
new markets as well as the general interest of the public in "minimally
invasive" surgery.