Variable angle locking plates are essential components in modern orthopaedic surgery, particularly in the fixation of fractures. These specialized plates provide surgeons with a flexible, stable, and reliable method for securing fractured bones in both simple and complex fractures. Their versatility, combined with advanced engineering, has made them a go-to tool in various surgical applications. In this blog, we will explore what locking variable angle plates are, their design features, and their common surgical uses.

Understanding Locking Variable Angle Plates

Locking variable angle plates are a type of orthopaedic fixation device designed to stabilize fractured bones. Unlike traditional plates, which use screws that apply compression to stabilize fractures, locking plates use screws that "lock" into the plate, creating a fixed angle between the plate and the screws. This locking mechanism allows for greater stability and is especially useful in fractures where bone quality is poor or in cases where traditional plates may fail.

The term “variable angle” refers to the ability of the screws to be placed at different angles within the plate, providing flexibility in terms of screw placement. This is particularly beneficial when it comes to dealing with complex or angled fractures where precise alignment of the bones is critical for healing.

What Are the Common Surgical Applications for Variable Angle Locking Plates?

Fractures of Long Bones

One of the primary uses of locking variable angle plates is in the fixation of fractures of long bones, such as the femur, tibia, and humerus. Long bones are subject to a variety of trauma, from simple fractures to comminuted (shattered) fractures, which can be difficult to stabilize. Locking plates allow surgeons to maintain the bone fragments in correct alignment, ensuring better healing outcomes.

In these cases, locking variable angle plates are especially advantageous as they do not rely on compression to stabilize the fracture. This is particularly important when dealing with bones that are osteoporotic or fragile, as excessive compression can lead to further damage. The locking screws offer enhanced stability without the need for aggressive compression, reducing the risk of complications.

Spine Surgery

In spinal surgery, particularly in the fixation of vertebral fractures or deformities, locking variable angle plates play a crucial role. Vertebral fractures often occur in complex, multi-directional angles, making their stabilization challenging. Locking plates with variable angles allow the surgeon to place screws at precise angles, ensuring optimal alignment and fusion of the vertebrae. These plates help achieve better bone union and reduce the need for additional corrective procedures.

In cases of spinal deformities such as scoliosis, the ability to angle the screws according to the patient's anatomy provides a more customized, effective solution for correction. Locking variable angle plates can also be used in conjunction with rods to provide further stabilization.

Fractures of the Pelvis and Acetabulum

Pelvic fractures, particularly those involving the acetabulum (the socket of the hip joint), present unique challenges due to the complexity of the anatomy and the need for precise fixation. Locking variable angle plates are commonly used to fix fractures in these regions. The variable angle screws allow for placement in different directions, which is important for addressing fractures that affect multiple areas of the pelvis or acetabulum.

These plates provide the surgeon with more flexibility to adapt to the varying angles of the fracture, ensuring better alignment and stability of the pelvic bones. This is critical for the proper healing of the joint and the prevention of long-term complications such as arthritis.

Fractures in Osteoporotic Bone

Osteoporotic bone is fragile and more prone to fractures, especially in the elderly. Treating fractures in osteoporotic bone requires careful consideration to avoid complications like screw loosening or implant failure. Locking variable angle plates are particularly effective in these cases as they offer greater stability without relying on the compression forces that may be too aggressive for fragile bones. The locking mechanism of the screws ensures that the plate remains securely in place, even in the absence of strong bone stock.

Complex Fractures and Non-Union

Complex fractures, such as those with multiple bone fragments or fractures involving joints, often require precise fixation to avoid malunion or non-union (failure of the bone to heal). Locking variable angle plates provide the necessary stability in these challenging cases. Their design helps to maintain alignment even when bone quality is poor, making them invaluable in preventing complications like delayed healing or the need for additional surgeries.


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