Independent Locking Screws for Articular Fragment Fixation in the Elbow

We describe a technique in which small locking screws are used independently from a plate as a substitute for headless or other traditional screws. This method of fixation negates the need for countersinking the screw head, or over drilling a guide wire, and enables the use of smaller diameter screws which provide excellent purchase in very small fragments. Independent locking screws can be considered for any fracture that previously would have been amenable to cortical or headless compression screw fixation. Locking screws from several manufacturers have been used with equal success. Screws can be used in a unicortical manner if necessary, as the grip comes from engaging the subchondral bone with the locking thread. This technique has been used on 35 consecutive articular elbow fractures with a minimum 6-month follow-up. All fractures have achieved bony union within this period, and there have been no loss of fixations or requirement for further surgeries to remove prominent metalwork.

Source: Techniques in Hand and Upper Extremity Surgery - February 21, 2019 Category: Surgery Tags: Techniques Source Type: research