- See: Synthes Plates and Screws:3.5 MM DCP, LC-DCP 3.5 MM LCP 4.5 MM LCP RECONSTRUCTION PLATE
- Discussion:
- this technique is used in oblique frxs, where optimal stability can be achieved by combining the self compression effect of DCP for axial
compression, and the interfragmentary compression of a lag screw;
- Prerequisites:
- plate is contoured to the bone and placed such that one plate hole can be used for the lag screw;
- six cortices in each main fragment should be engaged by the screws;
- Technique:
- fracture is reduced and the contoured plate is placed on the bone with the wider middle portion over the fracture;
- plate hole is left vaccant for an angled screw thru the plate;
- plate is held in position with two reduction forceps;
- on fracture side (w/ obtuse angle), the 2.5 mm drill with the neutral drill bit, and a 3.5 mm cortical screw is inserted;
- 3.5 mm cortex screw is inserted but not fully tightened;
- plate is pulled towards the opposite fragment to place the screw in the eccentric position in the plate hole;
- on opposite side of the fracture, the first screw hole is left vaccant for the lag screw;
- in the next screw hole, the load (yellow) DCP drill guide, 3.5 mm is placed with the arrow pointing towards the fracture;
- drill hole is drilled with the 2.5 mm drill bit;
- hole is tapped, and the 3.5 mm cortical screw is inserted but not fully tightened, until the first screw (on the other side of fracture) is fully tightened;
- position for the oblique lag screw thru the plate is determined;
- angulation of the screw must not exceed 25 deg longitudinally (40 deg for LC-DCP) and 7 deg transversely;
- gliding hole is drilled in the near cortex using the 3.5 mm drill bit in the double drill sleeve end, 3.5 mm;
- 2.5 mm end of this sleeve is then pushed into the hole until it abuts the endosteal cortex of the far fragment;
- the thread hole is drilled with the 2.5 mm drill bit;
- the 3.5 mm cortical lag screw is inserted