The use of locking plates in fracture care

Locked plating represents a major advance in fracture care. Advantages over traditional plating include improved construct stability, targeting devices that permit percutaneous insertion of screws and preservation of fracture biology, and, in some studies, higher union rates with lower infection rates. As with any new technique, there is a learning curve for fracture reduction and implant insertion. When using percutaneous techniques, fracture reduction may prove to be more challenging than with traditional open incisions. A locked construct is not a justification for improper fracture reduction. Compared with nonlocked plates, removal of locked plates may be more difficult and often requires larger incisions and special extraction devices. Copyright 2006 by the American Academy of Orthopaedic Surgeons.