Description
In this lecture, Anish Amin, a trauma and orthopedics surgeon based in Edinburgh, discusses the use of locking plates for ankle fractures, outlining both their advantages and disadvantages. Amin begins by acknowledging the evolution of locking plates in orthopedic surgery, noting their utility in providing rigid fixation, especially for osteopenic bone common in elderly patients. He highlights their benefits for posterior tibial fixation while suggesting they may not be as effective around the fibula.
Amin emphasizes the anatomical contouring of locking plates, which reduces the need for intraoperative adjustments. He argues that they enable additional fixation options that conventional plates lack. However, he raises questions about why the widespread adoption of these plates for fibular fractures has not yet occurred.
He elaborates on the importance of proper fibular reduction and the complexities introduced by various surgical techniques. Reviewing the existing literature, he points out that while there are biomechanical studies supporting their use, they often lack robust evidence on complication rates and clinical outcomes. He addresses the misconceptions some surgeons have regarding the use of locking plates that might lead to malreductions.
Amin concludes by acknowledging the high costs associated with locking plates and suggests they may only be indicated in specific cases of inadequate bone stock. He calls for further research and standardization in their application within surgical practices.