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3Plate fixation to proximal fragment

Plate fixation to proximal fragment

Plate and screw combination

Next, the plate barrel is slid over the condylar screw shank.

In transverse fractures, where a supplementary lag screw can not be used, the plate should be prebent slightly, so that, when the load screw in the distal fragment is tightened, the medial cortex is compressed first. This avoids gapping of the medial cortex, which would otherwise occur and result in cyclical motion, leading to excessive strain in the healing tissues, delayed union and fatigue failure of the plate.

In order to determine the exact point of prebending, fit the plate barrel partially over the screw shank, note the appropriate level, then remove the plate to prebend it.