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ortho > Bone Plating > Flashcards

Bone Plating Flashcards

1
Q

Bond plate constructs counter act these forces

A

Bending
Rotation
Tension
Compression
Shear

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2
Q

Advantages of bone plating

A

Allows early return to function
Fewer rechecks
Avoids bandage morbidity

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3
Q

Contraindications of bone plating

A

Physeal fractures
High-grade open fractures

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4
Q

Disadvantages of bone plating

A

Disruption of soft tissue/blood supply (by opening/stabilizing

Expense of equipment + large stock needed (overhead cost)

Training/experience required

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5
Q

Materials used for bone plates

A

316L stainless steel
Titanium alloy

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6
Q

Types of bone plates

A

Compression
Locking
Specialty

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7
Q

Types of screws

A

Cortical
Cancellous
Locking

Fully/partially threaded

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8
Q

Modern plates

A

LC-DCP (dynamic compression plate)
LCP

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9
Q

Methods of reconstruction

A

Anatomic reconstruction

Biological fixation (uses body to direct healing)

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10
Q

Anatomic reconstruction

A

Meticulous reconstruction of bone

Allows load-sharing by bone (not as strong of an implant required

Rigid stabilization —> direct bone healing

indications: simple fractures, articular or peri-articular fractures

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11
Q

Biological fixation

A

Restore joint alignment + limb length

Fragment apposition left to the body

Minimize disruption to fragment site, minimally invasive

Indirect bone healing -> development of primary callus to stabilize

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12
Q

Examples of bridging implants for biological fixation

A

Plate-rod
Locking plate
Double plate

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13
Q

Application of bone screws

A

Plate
position
Lag

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14
Q

Plate screw

A

Hold plate to surface

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15
Q

Position screw

A

Maintain fragment position
No compression

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16
Q

Lag screw

A

Fragment reduction

Applies compression across fracture (glide who in near cortex, thread hole in far cortex - slightly smaller than screw shaft)

Perpendicular to fracture

17
Q

Non-locking plates

A

Must be in contact with bone
Screws need to be tight

Friction between bone + plate provides stability

18
Q

Basics of bone plate installation

A

Minimum of 2 screws/major fragment
3-4 ideal

Plate length ~ bone

19
Q

Types of plating

A

Compression
Neutralization
Bridging

20
Q

Compression plating

A

Transverse fractures

Anatomic reconstruction

Compression to enhance stability

Plate on “tension surface” + contoured

21
Q

Neutralization plating

A

Anatomic reconstruction; bone shares load/protects implants

Oblique fractures - Cerclage wire/lag screw before plating

22
Q

Bridging plating

A

Biological fixation
Bone doesn’t share load
Maintain bone length/joint alignment

23
Q

Examples of bridging plates

A

Dynamic compression plats
Limb lengthening plates
Plate/rod constructs
Locking plates

24
Q

Indications for bridging plates

A

Comminuted diaphyseal fractures
Mal-union or angular limb deformity

25
Q

Locking plates

A

Screw interlocks with plate (threading on screw hea)
Acts as single-beam construct
Require plate-bone contact

Little tolerance for inaccurate screw placement —> use drill guide
Reduce fracture BEFORE placing plate
CANNOT move fragment after locking screw placed

26
Q

Advantages of locking plates

A

Do not need to contour to bone as much
Can place monocortical screws (bicortical preferred)
Less likely to fail in weak bone

27
Q

Disadvantages of locking plates

A

Expensive
Screwed inserted at fixed angle
May not work for all fractures (small fracture gap)

28
Q

Locking plate systems

A

LCP - locking compression plate (compression or locking screw)

SOP - String-of-pearls - contouring with 6 deg of freedom, standard cortical screws

29
Q

Post-op care with bone plating

A

Early return to function - preserve joint/soft tissues

Restrict activity until union

Monitor by radiography (healing/failure/complications)

30
Q

Bone plating complications

A

Infection
Delayed healing/non-union
Implant failure/loosening
Stress protection (implant too strong to facilitate healing —> osteopenia)

31
Q

Reasons for implant complications

A

Improper selection and/or application
Disruption of soft tissue/blood supply
Break in sterile technique
Inadequate postoperative restriction

ortho (15 decks)

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