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Excellent results of fractured bones by plate and screws can be achieved not only by following biomechanical principles but also depends on the quality and design of plate, screw and bone health.
Various Factors Can Be Responsible for Good Results.
Plate material should be adequate in its strength. The strength of the plate varies with the cube of the thickness of the material. Titanium material’s plate stiffness is less than steel. Moreover, the very stiff plate can weaken the bone after fracture healing is complete. Hence, titanium has a distinct advantage over stainless steel.
The contact surface of the plate also has an important role in the excellent results. Conventional plate due to larger contactareahampers the underneath blood supply of bone leading into immediate post-fixation osteoporosis.
Based on Above Observations the Need for New Design Was Felt.
To minimize the surface contact area substantial material is removed from the undersurface of the plate between the screw holes. This arched appearance has following distinct advantages over the conventional plates.
A: = It reduces the stiffness of the plate to the same level as that of the screw hole area Resulting in less chance of breakage as compared to conventional plates.
B: = Since it has uniform stiffness throughout the plate in spite of holes. The newer Designed plates can be contoured in a continuous curvature. It evenly distributes the Bending and torsional stresses over a long segment along with the plate. Moreover the Screw head has a good fit despite the bending of the plate. Also, the even distribution of holes in Long length plate prolongs the fatigue life of the plate.
C: = The design of plate holes also contributes to the longevity and modularity of the Implant. Plate holes are distributed evenly and symmetrically along with the plate with Oblique undercuts on the inner side of the plate.
Undercut allows unhindered inclination of lag screw up to 40 degrees Longitudinally and 7 degrees in the transverse plane. A proper compression across the fracture can be achieved through plate holes with the modularity of bi-directional Screws.
One more advantage of even distribution of holes is that in case of an exchange or Revision surgery of plates, the longer plate can be used without conflicting with Previously drilled holes.
As regards the surgeon’s factor, proper exposure of fracture, good surgical Technique and choosing the proper length of the ortho implant (plate) also contributes to the excellent Final result. Choosing the short implant (plate) will make the construct unstable while Too long an implant (plate) will cause unnecessary damage to soft tissues and prolongs the operating time as well.
Ulna and Radius are two main bones in the forearm. Ulna runs along the outside of the wrist and Radius runs along the inside. A bony projection at the end of the ulna is called the ulnar styloid process.
It fits into the cartilage of the wrist joint and plays an important role in the strength and flexibility of the wrist and forearm. A break if the bone in this area is called an ulnar styloid fracture.
The symptoms of Fracture:
The main symptom of an ulnar styloid fracture is immediate pain. This type of fracture is usually accompanied by a radius fracture. In such a case, the pain is felt more on the inside of the wrist than near the ulnar styloid process.
Additional symptoms include:
One may also notice the wrist and hand hanging at a different angle than the usual configuration.
Hand and wrist fractures (the latter is basically an ulnar styloid fracture) are mostly caused by an injury sustained while trying to break a fall with an outstretched arm.
Other common causes include:
- Motor Vehicle accidents
- Hard falls
- Sports injuries
Further, osteoporotic conditions can also increase the risk of fractures. Such condition weakens the bones and makes them brittle. One needs to take extra precautions to avoid bone injuries.
Options to treat broken bones include both with and without surgery.
Mild ulnar styloid fractures often need a basic wrist cast. The doctor may have to realign bones before adding a cast. This process is called reduction and can sometimes be done without an incision (closed reduction).
For severe fractures, which may also involve other nearby bones, one would require surgery. This involves an open reduction: The doctor makes an incision near the fracture and uses the opening to reset the affected bones. Severe breaks may require using metal orthopedic bone screws or pins to keep the bones in place while they heal.
Following an open reduction, a durable cast is needed, which may be made from plaster or fiberglass.