One Third Tubular Plate Applied as a Neutralisation Plate

- Discussion:
    - one third tubular plate is applied as a neutralization plate in spiral frx or frxs w/ butterfly fragment, eg. in fibula & distal ulna;
    - it is applied after primary interfragmentary fixation with lag screws;
    - function of the plate is to neutralise any shearing or bending forces which could disrupt an unprotected lag screw fixation;
- Prerequisites:
    - lag screw fixation first
    - contouring of the plate
    - four to five cortices in each main fragment should be engaged;
- Technique:
    - fracture is reduced and temporary fixation is applied;
    - separate 3.5 mm cortex screw is inserted as a lag screw in the butterfly fragment using standard techniques;
    - 2.5 mm drill is used over 1st hole & 3.5 mm cortical screw is inserted;
    - second screw is placed on the opposite side of the fracture;
    - if screw hole lies over cancellous bone, use the 4.0 mm fully threaded cancellous bone screw is used in the last plate hole, usually in the  
         last screw hole

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, September 9, 2011 1:48 pm