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Herpringga Lara Sakti
PRODI ILMU BEDAH
FAKULTAS KEDOKTERAN UGM – RSUP Dr. SARDJITO
YOGYAKARTA
2017
ORTHOPEDIC
PLATES & SCREWS
Form and Function
HISTORY
Plates for fixation of long bone fractures were
first recorded by Hansmann, of Heidelberg
University, Germany in 1886.
FORMS
• Straight plates
• Angled blade plates
• Anatomical plates
Straight plates
• Semitubular plates
– Tulang radius – fibula
– cortex screw 4.5mm dan cancellous bone screw
• Narrow plates
– Ukuran 39 mm (2hole) – 263mm (16hole)
– Tulang tibia – ulna
– Dipakai dengan cortex screw 4.5mm
• Broad plates
– Ukuran 103mm (6hole) – 295mm (18hole)
– Tulang femur – pseudoarthrosis humerus
– Dipakai dengan cortex screw 4.5mm
Angled Blade Plates
• Condylar plate
– Fraktur intertrochanter dan distal femur
– Menggunakan cancellous bone screw
6.5mm
• Femoral neck plates
– Digunakan pada fraktur femoral neck
– Panjang bagian yang menyudut mulai
50mm -110 mm (4-12 hole)
Anatomical plates
• T Plate
– Dapat digunakan pada fraktur
phalang, tulang proksimal tibia
• L Buttress plate
– Digunakan pada fraktur distal
radius
• Ulna plate
– Digunakan pada fraktur proksimal
ulna dan distal radius
FUNCTION
COMPRESSION
• Plat dapat memberikan gaya kompresi secara
bersamaan pada fragmen fraktur yang
menghasilkan stabilitas absolut karena
pergerakan antar fragmen tulang yang
berhenti
NEUTRALIZATION
• Plat mentransmisikan kekuatan
atau gaya yang mendisrupsi
stabilitas antarfragmen
(physiological bending atau
rotasi) sehingga gaya
antarfragmen menjadi netral
BUTTRESSING
• Plat bekerja sebagai mana
ibu jari pada gambar
terserbut, menopang
fragmen fraktur sehingga
reduksi tepat
BRIDGING
• Pada fraktur kominutif, plat digunakan sebagai
jembatan zona multifragmen untuk
mengembalikan axial alignment dan rotational
alignment
SCREWS
• Cortical screws
– Digunakan untuk fiksasi tulang kortikal
– Ukuran diameter lebih besar, lebih kuat,
permukaan alur halus, jarak antar alur
pendek
• Cancellous screws
– Digunakan untuk fiksasi tulang
cancellous
– Permukaan alur kasar, jarak antar alur
lebih lebar
FUNCTION
• Kompresi antar fragment
• Untuk melekatkan implant pada permukaan
tulang melalui gaya kompresi
• Menghasilkan stabilitas angular
• Mengikat 2 fragmen pada correct position
TERIMA KASIH

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Internal fixation

  • 1. Herpringga Lara Sakti PRODI ILMU BEDAH FAKULTAS KEDOKTERAN UGM – RSUP Dr. SARDJITO YOGYAKARTA 2017 ORTHOPEDIC PLATES & SCREWS Form and Function
  • 2. HISTORY Plates for fixation of long bone fractures were first recorded by Hansmann, of Heidelberg University, Germany in 1886.
  • 3. FORMS • Straight plates • Angled blade plates • Anatomical plates
  • 4. Straight plates • Semitubular plates – Tulang radius – fibula – cortex screw 4.5mm dan cancellous bone screw • Narrow plates – Ukuran 39 mm (2hole) – 263mm (16hole) – Tulang tibia – ulna – Dipakai dengan cortex screw 4.5mm • Broad plates – Ukuran 103mm (6hole) – 295mm (18hole) – Tulang femur – pseudoarthrosis humerus – Dipakai dengan cortex screw 4.5mm
  • 5. Angled Blade Plates • Condylar plate – Fraktur intertrochanter dan distal femur – Menggunakan cancellous bone screw 6.5mm • Femoral neck plates – Digunakan pada fraktur femoral neck – Panjang bagian yang menyudut mulai 50mm -110 mm (4-12 hole)
  • 6. Anatomical plates • T Plate – Dapat digunakan pada fraktur phalang, tulang proksimal tibia • L Buttress plate – Digunakan pada fraktur distal radius • Ulna plate – Digunakan pada fraktur proksimal ulna dan distal radius
  • 7. FUNCTION COMPRESSION • Plat dapat memberikan gaya kompresi secara bersamaan pada fragmen fraktur yang menghasilkan stabilitas absolut karena pergerakan antar fragmen tulang yang berhenti
  • 8. NEUTRALIZATION • Plat mentransmisikan kekuatan atau gaya yang mendisrupsi stabilitas antarfragmen (physiological bending atau rotasi) sehingga gaya antarfragmen menjadi netral
  • 9. BUTTRESSING • Plat bekerja sebagai mana ibu jari pada gambar terserbut, menopang fragmen fraktur sehingga reduksi tepat
  • 10. BRIDGING • Pada fraktur kominutif, plat digunakan sebagai jembatan zona multifragmen untuk mengembalikan axial alignment dan rotational alignment
  • 11. SCREWS • Cortical screws – Digunakan untuk fiksasi tulang kortikal – Ukuran diameter lebih besar, lebih kuat, permukaan alur halus, jarak antar alur pendek • Cancellous screws – Digunakan untuk fiksasi tulang cancellous – Permukaan alur kasar, jarak antar alur lebih lebar
  • 12. FUNCTION • Kompresi antar fragment • Untuk melekatkan implant pada permukaan tulang melalui gaya kompresi • Menghasilkan stabilitas angular • Mengikat 2 fragmen pada correct position