Plates Aplications in Osteosynthesis

The 3 main groups of plates

Straight Plates
Special Plates Angle Blade Plates

Function of plates
Protection or neutralization plates Buttress Plate Compression plate Tension band plate

Protection or neutralization plate

A plate used to protect a lag screw

Buttress Plate

A plate used to support a bone fragment/s

Compression Plate
The Plate is used to exert compression in the direction of the long axis of the bone

Tension Band Plate

A tension band is a device which exerts a force equal to but opposite in direction to the bending force

Large Fragment Plates

4.5mm Semi-Tubular Plate

Originally designed to used as a tension band plate on radius, ulna and tibia

Advantages of the 4.5mm Semitubular Plate

Good rotational stability is achieved due to the edges that dig into the bone. Axial compression can be achieved if the screw is placed eccentrically on each side of the fracture

2 to 12 holes

Disadvantage of the 4.5mm Semi-tubular Plate

The plate hole allows for deep penetration of the screw head into the cortex which has a risk of splitting the cortex. This can be prevented by enlarging the cortex.

DCP Dynamic Compression Plate

DCP Dynamic Compression Plate

The plate hole allows for self compression and a congruent fit between screw head and plate hole at different angles of inclination. Design based on 2 cylinders.

DCP Dynamic Compression Plate

The plate hole design allows the plate to fulfil different plate functions, eg compression,tension band, neutralization and buttress plating

Advantages of the DCP Plate

25 longitudinal and 7 sideways angulation

Placement of screw in neutral position without danger of distraction of fragments.

Advantages of the DCP Plate

Insertion of a load screw in any plate hole.

Screw may be inserted in the buttress position in articular areas where a buttress plate is required.

Advantages of the DCP Plate

Advantages of the DCP Plate

After one load screw has been used in each main fragment, (1mm displacement) the horizontal track allows for a further 1.8mm of gliding.

Advantages of the DCP Plate

A second load screw can therefore be placed in the next hole creating a further 1mm of compression. The first screw must be slightly loosened before the second screw is inserted.

Advantages of the DCP Plate

Compression of individual fragments can be achieved in comminuted fractures. Notches on underside of both ends of the plate for the tension device.

Advantages of the DCP Plate

End holes accept 6.5mm cancellous screws.

Advantages of the DCP Plate

Narrow 4.5mm DCP Plate

Designed to be used on the tibia and occasionally on the radius or ulna.

Narrow 4.5mm DCP Plate

Enlarged mid section for placement over the fracture. 2 16 holes

Broad 4.5mm DCP Plate

Designed to be used on femur and humerus Thicker and wider than the narrow DCP

Broad 4.5mm DCP Plate

Enlarged mid section for placement over the fracture.

6 18 holes.
Staggered holes to prevent longitudinal fissuring of the bone.

LC-DCP, Limited Contact Dynamic Compression Plate

Top View

Bottom View

A further development to the DCP with the same indications. Same hole size as the DCP, 8.5mm.

Advantages of the LC-DCP Plate

Evenly distributed undercuts reduce contact between bone and plate. This reduces the damage to the blood supply and allows for the formation of a small callus bridge. 3 positions of screw placement Neutral, load & buttress.

Advantages of the LC-DCP Plate

A constant degree of stiffness is created along the axis of the plate due to the enlarged screw holes and the plate under cuts. No stress concentration occurs at the holes when the plate is exposed to bending. No enlarged mid section

Advantages of the LC-DCP Plate

The plate holes are evenly spaced which permits easy placement of the plate. Symmetrical plate holes, compression either side.

Advantages of the LC-DCP Plate

Advantages of the LC-DCP Plate

40 longitudinal and +/- 7 sideways angulation

4.5mm Reconstruction Plates

As these plates can be bent in 2 planes, they designed for use in the pelvic area.

4.5mm Reconstruction Plates

The plate should not be bent more than 15 at any one point.

The oval holes allow for self compression.

Pelvic Plate

2 & 4 hole Narrow LC-DCP/DCP plates also used to treat Symphyseal ruptures

Narrow & Broad Lengthening Plates

These plates are designed for stabilizing lengthened bone.

Narrow & Broad Lengthening Plates

Narrow used on the tibia & broad on the femur.

Plates have an enlarged mid section without any holes. Shaft is similar to a narrow & broad DCP respectively.

Narrow & Broad Lengthening Plates

The round holes accept 4.5mm cortex screws and the end holes 6.5mm cancellous screws.

Compatible with the tension device.

Narrow & Broad Lengthening Plates

Narrow plates are available in 4, holes at either end of the plate.
Broad plates are available in 4 or 5 holes at either end of the plate.

Special 4.5mm Plates

These are shaped to conform to the specific anatomical locations in the metaphysis. They are applied according to the same principals as the straight plates ie Compression Neutralization or Buttress

T-Plates

Designed to be used as buttress plates on the medial aspect of the tibial plateau.

Can also be used on the proximal humerus and distal tibia and femur

T-Plates
Also used on the proximal humerus for a large head fragment.

The head accommodates 6.5mm screws.

Compatible with the tension device.

T-Plates
Elongated hole in the shaft for lag screw application and temporary fixation and adjustment. 3, 4, 5, 6 & 8 holes

T & L Buttress Plates

Designed to be used as buttress plates on the humeral head lateral aspect of the tibial plateau.

Have a double bend which contours to the lateral side of the proximal tibia.

T & L Buttress Plates

L-Plates are available in left & right to avoid disturbing the fibula.

The head accommodates 6.5mm screws.

Compatible with the tension device.

T & L Buttress Plates

Elongated hole in the shaft for lag screw application and temporary fixation & adjustment.

T-Plates are available in 4, 5 & 6 holes.

L-Plate is available in 4 holes only.

Spoon Plate

Designed as an anterior buttress for distal tibial joint fractures (pilon).

Spoon Plate
Experience has shown that the plate is too bulky for this application and is now indicated for metaphyseal non unions of the tibia.

The plate is available in 5 & 6 holes.

Lateral Tibial Head Buttress Plate

Designed to be used a buttress plate on the lateral aspect of the tibial plateau with proximal diaphyseal involvement.

 Have an expanded and shaped head.

Lateral Tibial Head Buttress Plate

The round holes in the thinner head accommodate 6.5mm screws.

Compatible with the tension device.

 Elongated hole in the shaft for lag screw application and temporary fixation & adjustment. Plates are available in 5, 7 & 9 holes in the shaft and for both left and right tibia.

Lateral Tibial Head Buttress Plate

Distal Femoral Buttress Plate

These plates are used for comminuted fractures in the distal femur.

Shaft is similar to a broad DCP & holes are staggered.

Distal Femoral Buttress Plate

Have an expanded and shaped head.

The round holes in the thinner head accommodate 6.5mm screws.

Compatible with the tension device.

Distal Femoral Buttress Plate

Plates are available in 7, 9, 11, 13 & 15 holes in the shaft and for both left and right femurs.

Cobra Head Plate

These plates are designed for arthrodesis of the hip.

Shaft is similar to a broad DCP & holes are staggered.

Cobra Head Plate

Have an expanded and shaped head. The round holes in the head accommodate 4.5mm cortex screws. Compatible with the tension device.

Cobra Head Plate

Plates are available in 8, 9, 10 & 11 holes in the shaft.

Hook Plate

These plates are designed for stabilizing of the greater trochanter of the femur. (after distal transportation of the GT with intertrochanteric osteotomy)

Hook Plate
Shaft is similar to a broad DCP. The 2 round holes accept 6.5mm screws. Compatible with the tension device. Plates are available in 4 holes.

Small Fragment Plates

LC-DCP/DCP
Indicated for radius and ulna fractures. Same principals as large fragment LC-DCP/DCP plates
Available from 2 to 20 holes.

1 Third Tubular Plate

Indicated for fractures of the fibula, lateral malleolus, metatarsals & metacarpals. Also used on the distal ulna and the olecranon.

1 Third Tubular Plate

Compression is exerted by eccentric positioning of the screws.
Available from 2 to 12 holes.

3.5mm straight & curved Reconstruction Plates

As these plates can be bent in 2 planes, they designed for use in the pelvic area.

3.5mm Reconstruction Plates

The plate should not be bent more than 15 at any one point.

The oval holes allow for self compression.

Small T-Plate

Indicated for fractures of the distal radius (volar aspect). Also olecranon, distal tibia & lateral clavicle.

Small T-Plate
Elongated hole in the shaft for lag screw application and temporary fixation & adjustment.
Available from 3 to 6 holes with either 3 or 4 holes in the head.

Small Oblique T-Plate

Indicated for fractures of the distal radius (dorsal aspect). Can be used left or right.

Small Oblique T-Plate

Elongated hole in the shaft for lag screw application and temporary fixation & adjustment. Available in 3, 4 & 5 holes with 3 holes in the head.

Cloverleaf Plate

Indicated for distal intra-articular tibia & proximal humerus fractures.

Cloverleaf Plate
Elongated hole in the shaft for lag screw application and temporary fixation & adjustment.

Available in 3 to 6 holes with 6 holes in the head.

Calcaneal Plate

Fractures of the calcaneus.

Available in 60 & 70mm lengths. Can be used left or right.

Calcaneal Plate

Fractures of the calcaneus.

9 hole plate and 4 holes in the arm. Can be used left or right.

Clavicular Hook Plate

Indicated for lateral clavicular fractures and acromion joint separations. 4 & 6 holes with 15 or 18mm hook depth. Left & right plates.