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3Principles

Buttressing the intermediate and radial columns

In dorsal double plating, the intermediate column and the radial column are buttressed, each with a separate plate. The radial column is buttressed by a plate placed radially, deep to the first extensor compartment. The intermediate column is buttressed with a separate, precontoured plate on the dorsal aspect of the intermediate column.

A buttress plate resists axial load by applying a force at 70°-90° to the axis of potential displacement. In meta-/epiphyseal shear, or split, fractures, fixation with lag screws alone is not sufficient. A plate with buttress function will protect a lag screw from shear forces in the fracture plane. Plates can be used to provide buttress with or without lag screws.