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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In the distal humerus, the advent of modern precontoured anatomical periarticular locking plates has superseded the use of reconstruction plates.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.
