Most surgically treated fractures do not require locking plate fixation. As long as the principles of orthopedic surgery are followed, most fractures can be healed by traditional steel plates or intramedullary nails.
However, it is true that some special types of fractures are prone to loss of reduction, plate or screw breakage, and subsequent nonunion of bone. These types are often referred to as "unresolved" or "problematic" fractures, including comminuted fractures in the joints and around the joints. Short bone fractures and osteoporotic fractures. Such fractures are indications for locking plates.
The classic and ideal indications of locking plate fixation of fractures: bridging principle and joint principle, suitable for severely comminuted fractures-high energy fractures in young patients or osteoporotic fractures in elderly patients.
Although the locking plate has been widely used and its indications are broad, we must recognize and avoid several contraindications of the locking plate. If the locking plate is used indiscriminately, fixation failure and fracture nonunion may occur.
Simple fractures that require compression between fragments, such as the use of locking internal fixation to treat simple forearm shaft fractures, are prone to fracture nonunion.
Similarly, the use of minimally invasive techniques to treat simple fractures with percutaneous locking plates is also one of the contraindications.