Use of 2nd Locking Compression Plate as a Jig in Percutaneous Screw Insertion

Abstract

Locking compression plates are commonly used internal fixation systems in orthopaedic surgery. Due to lack of a jig system, precise placement of skin incision for screw insertion can often pose problems to the operating surgeon. The two most commonly used methods to locate screw holes are, use of C-arm and transcutaneous palpation. We would like to share our technique in which we have use a 2nd LCP as a jig to overcome this problem to a certain extent. METHODS We use a 2nd LCP of same size, as one being used to fix the fracture. The 2nd LCP is slided on the K-wires being used to hold the 1st LCP on the bone across the fracture site, as a superimposed plate on the skin extenally. This configuration makes the holes of the1st LCP superimposed on that of 2nd LCP. The screw holes on the 2nd LCP can now be used for precise skin incision for screw inserion on to the 1st LCP. Trancutaneous palpation of screw holes on LCP can be inaccurate many times, especially in patients with thick sucutaneous tissue over the fracture site. The use of C-arm in locating screw holes is a time consuming technique which can increase the duration of surgery. Our technique has definite advantage over above mentioned popular techniques. CONCLUSION In our experience the use of 2nd LCP has not only reduced unnecessary skin incision, which in turn has reduced the iatrogenic soft tissue trauma but also decreased the total duration of the operating time. This technique can be used wherever LCP system is being use to treat a fracture. This is a simple, cheap and, an effective technique to be used in day-to-day practice of orthopaedic surgery.FIG. 1.: A second LCP being used as a jig system.