locked plates

am looking for an evidence based or anecdotal answer for this

AO recommends 6 cortices on either side of a fracture when using the non locked plates. My Q is that with the advent of the locking plates, there are no operative guidelines on how many cortices are needed. you ogt these plates with a million holes, how many do u lock on each side of a fracture???


thanks

check out the nov 2003 issue of Injury

seems to be nithing in the nov2003 issuw of injury re locked plating techniques

www.sciencedirect.com/science?_o ... 3bab98744e

nov 2003 supplement injury

ok found it. many thanks. will read and give feedback

There is no really good science regarding this topic.....we use retrospective evidence to help validate what we did.... what makes if even more difficult is that we often will use combinations of locked/bicortical screws within a plate. THe reduction also plays a critical factor. If there's bone touching and good interdigitation....you probably need less screws (logical). If the bones is osteoporotic....probably need more...but who actually gets DEXAs on a patient to determine how much fixation we need? Lots of variables

Just remember though, as long as your not sacrificing biology out the wazoo to get more screws in, you can't go wrong with additional screws (exponentially increases stiffness and torsional strength). Smaller bones typically 3 cortices on each side....larger bones and weight bearing...4-5 each side....this seems to be a safe generalization for most fractures. This does nothing to answer your question...