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Selected Instructional Course Lecture   |    
Locking Plates: Tips and Tricks
Wade R. Smith, MD1; Bruce H. Ziran, MD2; Jeff O. Anglen, MD3; Philip F. Stahel, MD1
1 Department of Orthopedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock Street, Denver, CO 80204. E-mail address for W.R. Smith: wade.smith@dhha.org
2 Department of Orthopaedic Surgery, St. Elizabeth Health Center, Youngstown, OH 44501
3 Department of Orthopaedics, Indiana University School of Medicine, Indianapolis, IN 46202
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2008 in Instructional Course Lectures, Volume 57. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Oct 01;89(10):2298-2307
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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.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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