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Locking System

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What are Bone Locking Systems?

Bone locking systems are internal fixation devices for bone fractures and osteotomies. They have a threaded connection between locking screws and the plate, creating a fixed – angle construct. This offers enhanced stability, better load transfer than non – locking plates, reduced soft – tissue trauma through minimally invasive insertion, and is well – suited for osteoporotic bones.

 

Types of Bone Locking Systems

  • Multiaxial Locking System: It enables screws to be inserted at multiple angles. This flexibility is particularly useful in complex fractures, as it allows surgeons to adapt the fixation according to the specific anatomy and alignment needs of the fractured area.
  • Mini Locking System: Specifically designed for smaller bones like those in the hands and feet. Given the delicate nature and smaller size of these bones, this system provides appropriate fixation while minimizing damage to surrounding tissues.
  • Locking Plate System: The most commonly used type, it’s applicable to a vast variety of fractures. It offers reliable fixation and stability, making it a go-to choice for many orthopedic surgeons in different fracture scenarios.
  • Pediatric Locking System: Tailored for children’s bones which are smaller and more delicate compared to adult bones. It takes into account the unique characteristics of growing bones and provides suitable support during fracture treatment.
  • Osteotomy Locking System: Created for use in osteotomies, which involve cutting bone during surgical procedures. It ensures proper fixation and alignment of the bone segments after the cut has been made, facilitating the healing process.
  • Sternum & Rib Locking System: Geared towards fractures of the sternum (breastbone) and ribs. These areas have their own anatomical considerations, and this system is designed to address the specific requirements for stabilizing fractures in these regions.

 

When Are Bone Locking Systems Needed?

Bone locking systems are needed for complex fractures like comminuted fractures (where the bone is in multiple pieces) and fractures with bone loss. They’re also essential for osteoporotic or osteopenic bones, as they provide more reliable fixation than traditional methods.

Comminuted Fractures

When bones break into multiple pieces in comminuted fractures, traditional non-locking plates struggle to offer stable fixation. Bone locking systems are great for these as they can secure screws at various angles and give rigid fixation.

Osteopenic Bone

In osteopenic patients with reduced bone density, non-locking screws don’t grip well. Bone locking systems are preferred due to their ability to minimize bone compression and enhance stability for fractures in such bones.

Minimally Invasive Surgery

These systems work well in minimally invasive surgeries. They allow for smaller incisions, less tissue damage, and quicker recovery. Their stable fixation with less dissection suits minimally invasive fracture repair.

Fractures with Poor Bone Quality

If bone quality is affected by infection, trauma, etc., bone locking systems offer more secure fixation than non-locking plates. Their features like minimizing compression and even stress distribution are helpful.

Fractures in Specific Anatomical Locations

For fractures in areas like the distal radius, distal tibia, and acetabulum, locking systems are effective. The complex bone geometry and need for multi-angle screw placement make them a good fit.

Revision Surgery

In revision surgeries after failed internal fixation, bone locking systems enhance stability and can handle bone loss or damage from the initial procedure.

Osteotomies

Bone locking systems are commonly used in osteotomies as their stable fixation during healing is vital for successful procedures.

Fractures in Children

Pediatric bone locking systems are designed for children’s smaller and more delicate bones, providing suitable fixation for pediatric fractures.
Overall, orthopedic surgeons decide to use bone locking systems based on various factors. These systems have improved treatment for complex fractures and osteotomies, with better stability and outcomes.

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