Plates and screws are used for complicated bone fractures. They hold the bone in place until it has grown back together. Under certain circumstances, however, a false joint formation (pseudarthrosis) can occur. This usually involves a fracture of the inserted plate. After a period of minor pain, this manifests itself in sudden severe pain or even a malposition in the area of the fracture. Here you will find further information as well as selected plate fracture specialists and centers.
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Article overview
Definition and causes of a plate fracture in fractures
In a few cases, false joint formation(pseudarthrosis) occurs after surgical treatment. This is usually accompanied by a plate fracture of the inserted plate. A plate fracture occurs if the fracture does not heal, i.e. the function of the plate is not taken over by the bone after a certain period of time.
As long as the bone has not healed, every plate is subject to permanent bending stress in both directions. Similar to bending a piece of floral wire back and forth, a plate will also break in the long term.
The other possibility, that a faulty panel has been installed, is largely ruled out under normal conditions. The typical case is that the fracture has not healed in time.
Symptoms and diagnosis of a plate fracture
After a period of minor pain, severe pain suddenly occurs in the area of the fracture. Sometimes there is also a deformity in the area of the fracture. In some cases, the plate can also protrude from the skin, which means that not only is there a plate fracture and a false joint formation, but also an infection in the fracture area.
The diagnosis of a plate fracture or implant fracture is usually made after an X-ray has been taken.
Individual screws break much more frequently than the entire plate. The fracture of individual screws often only leads to a slight worsening of the symptoms. It then heals spontaneously.
Ankle joint treatment using plates and screws in an X-ray image © Fotokon | AdobeStock
Treatment of a plate fracture
The broken plate is usually treated by removing the plate. Subsequently
- the existing false joint formation is cleaned,
- the fracture is rejoined and
- stabilized with a new plate or another surgical fracture treatment method, e.g. an intramedullary nail.
In many cases, it is also necessary to transfer bone, either artificial bone or bone from the iliac crest. In the case of an additional infection, a multi-stage procedure may also be necessary, i.e. first cleaning and then stabilization.
Aftercare for a plate fracture
Aftercare consists of mobilization and weight bearing in a pain-free area. Full weight-bearing or 15 kg partial weight-bearing after discharge is usual. After 4 to 6 weeks, full weight-bearing can usually be resumed.
Metal removal is often necessary for surgically treated ankle fractures. Otherwise, the plates and screws would be disturbing under the relatively thin layer of skin and fatty tissue on the ankle joint. If no local symptoms occur, no metal removal is necessary.
A return to sport is typically possible after 3 to 6 months.
Healing prospects for a plate fracture
The prospects of healing after a plate fracture depend on the one hand on which fracture was initially involved and whether it heals well. On the other hand, it is of course important whether the fracture can be bridged in the further course.
The chances of healing are also limited in the case of additional illnesses such as diabetes mellitus. Smoking also leads to a deterioration in the chances of healing, especially after a plate fracture.