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Principles

Indication

Minimally invasive plate osteosynthesis can be reasonably considered for non-impacted surgical neck fractures.

Reduction

A satisfactory reduction should be stabilized with K-wires before the plate is applied. Comminuted metaphyseal fractures may not be stable with K-wires. Using the plate as a reduction aid, perhaps adding a distractor as well, may be more effective.

Unless a satisfactory closed or minimally open reduction can be achieved, an open reduction should be employed.

Choose the approach best suited for planned reduction maneuvers or plate position.