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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

T Plates   



- Discussion:
    - T plates are designed to be used as a butress plates, esp for lateral or medial tibial plateau frx;
           - they are also applied in volar Barton's frx and proximal humerus fractures;
    - butress compression:
           - these plates can be used to support the cortex of a metaphysis from crumbling or displacing by applying axial compression from a
                  pre-contoured plate;
           - the first screw inserted is always in the oval hole (on the near side of the joint) which causes the plate to move toward the joint, 
                 which effects a compression butress force;
          - if two ends of the plate are fixed to bone first and there is a gap between plate and the bone, plate is brought under tension, as 
                 remaining screws are inserted, which risks frx displacement and deformity;
    - butress plates must be accurately contoured;
          - if a butress plate were to be accidentally placed under tension, it might lead to iatrogenic displacement of fracture;
          - by contouring the plate w/ a slight prebend (undercontour), movement of the plate towards the joint (which occurs from eccentric 
                 screw placement) will cause compression of the periarticular fracture fragments;          

- Large T Plate Characteristics:
    - head of the plate accomodates 6.5 mm cancellous bone screws;
    - elongated hole is for loose temporary fixation with a cortex screw;
    - distal holes accept 4.5 mm cortex screws;
    - thickness 2.0
    - width 17 mm
    - available w/ 3,4,5,6, & 8 holes in the shaft and 68, 84, 100, 116, & 148 mm in length;
    - L butress plates have 4 holes only and are 81 long;
    - width shaft T butress plate: 17 mm
    - Width shaft buttress plate: 16 mm;

- Lateral Tibial Head Butress Plates:
    - designed as buttress plates for fractures of lateral tibial plateau w/ proximal diaphyseal involvement;
    - L plate allows more butressing w/o getting in the way of proximal fibula;
    - comes in a right and left version;
    - DCP holes in the shaft accept 4.5 mm cortex screws;
    - round holes in the slightly thinner head accomodate 6.5 mm cancellous bone screws;
    - available in 5, 7, and 9 holes in the shaft;
    - thickness 3.8 mm



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

Last updated by Data Trace Staff on Friday, September 9, 2011 1:55 pm