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Use of fixed angle devices (such as the Tomofix™ plate, Synthes, Switzerland) appears to have optimised the balance between stability and micro-motion.
McCoy blades and obtuse angle devices (e.g. polio blade) are commonly stocked, although the latter are rarely used [ 12].
Fixed angle devices have the theoretical advantage of improved biology preservation and therefore, improved rates of healing compared to compression plating.
Similarly, minimally invasive and less invasive reduction techniques with and without fixed angle devices have been studied clinically in the tibia and distal femur.
Hip screw cut-out with penetration into the hip joint has been reported to be one of the major complications in the treatment of per-trochanteric hip fractures with fixed angle devices.
The treatment options for these fractures include a primary hip arthroplasty, internal fixation using various implants such as two or more cannulated screws, fixed angle devices; sliding hip screw (SHS) or intramedullary nail, or the combination of a SHS and an additional screw to gain rotational stability.
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If the extra-articular component extends towards the neck of the distal ulna a fixed angle device such as a condylar blade plate (Fig. 11) or an internal locking plate [35] is recommended.
Additionally, locking screws may be used as a fixed angle device for short metaphyseal fragments and juxta-articular shaft fractures, in which anatomic constraints limit the uses of compression plating.
A similar result was reported by Aminian et al. [ 12] who studied simulated Pauwels type 3 fractures in cadavers, and found that a fixed angle device (locking femoral plate, dynamic condylar screw or SHS) provided a stronger construction compared to screws alone.
Recently, there have been further refinements in the design of fixed-angle devices, pegs, locking plates and screws as well as arthroscopic instruments to assist management.
The study used traditional (non-'locking' plates) rather than the newer fixed-angle devices.
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