In contrast to adults, surgical procedures have to consider open physis and the potential risk of growth plate injury (Nelitz et al. 2013; Nelitz et al. 2017; Vavken et al. 2013).
Notably, ACL reconstruction in younger patients with significant growth remaining carries a risk of growth plate injury and growth disruption [ 39].
Despite these advances in treatment and outcome, controversies still exist regarding bone grafting for acute fractures, type and length of the plate and the risk of refractor after plate removal [13, 14].
Controversies focused on bone grafting for acute fractures [ 7– 10], the type and length of the plate [ 5, 11, 12], and the risk of refracture after plate removal [ 13– 16].
The ability to use locked unicortical screws theoretically lowers the risk of refracture following plate removal.
There is a relatively small risk of refracture after plate removal, between 1 and 5% [ 4, 31, 36].
A buccal or lingual undercut increases the risk of alveolar cortical plate perforation and surgical complication, or indicates the need for additional grafting procedures.
4 6 The potential advantages include fixed angle fixation, improved construct stability, especially in osteoporotic bone and the ability to use locked unicortical screws potentially decreasing the risk of refracture following plate removal.
These plates are based on LCDCP designs, but offer the option of locked fixation and the theoretical advantages of fixed angle fixation with improved construct stability, improved preservation of biology, improved fixation in osteoporotic bone and less risk of refracture following plate removal.
