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11Additional screw insertion

Distal femoral shaft fracture – Minimally invasive LISS bridge plate - Additional screw insertion

Screw placement

Additional locking-head screws (LHS) are subsequently inserted both proximally and distally. In general, a total of five proximal and five distal LHS are placed for the LISS or 4 bicortical screws with the LCP. In case of severe osteoporosis, six proximal and six distal LHS can be used. Bicortical self-tapping LHS are recommended for shaft fixation in severe osteoporosis.

In simple fracture types, 2-3 plate holes should be left unused over the fracture zone to avoid high stress concentration of the implant.