Introduction
Reconstruction plates have been traditionally used in fractures of
bones with complex 3-D geometry such as the pelvis and distal
humerus.
In the distal humerus, the advent of modern precontoured anatomical
periarticular locking plates has superseded the use of
reconstruction plates. The following information regarding the
application of reconstruction plates is only applicable to
situations where more modern plates are not available.
The reconstruction plate is not as stiff as an LCP or a
precontoured plate. Because of the nonanatomical nature, they
require extensive contouring to match the bony anatomy. This
process is technically demanding and may further weaken the plate,
especially if repeated contouring is performed or sharp bends are
incorporated into the contouring.
The consequence of these factors is a risk of plate deformation and
breakage, and loss of fracture reduction when the construct is
loaded.
Plate faetures
1.Precontoured plate for anatomical shape
2.Fixed-angle stability
3.Reduced plate thickness in the periarticular section
4.Rounded edges and trapered plate tip
5.Limited contacts design
Reconstruction plates have deep notches on the edge of the plate.
These notches are situated between the holes and allow contouring
of the plate in all planes.
Three plate sizes are available for use with 2.7, 3.5, and 4.5
cortex screws.
The holes are oval to allow dynamic compression. They may have
combiholes for dynamic compression and insertion of locking head
screws.
The plate should extend distally enough to engage all articular
fracture fragments and proximally enough so that three cortical
screws engage both cortices of the proximal (shaft) fragment.
Select a plate long enough so that the resulting construct respects
the principle of balanced fixation. This includes considerations of
screw type, screw density and direction, and plate working length.
