3.5 mm LCP Proximal Tibia Low Bend

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3.5 mm LCP Proximal Tibia Low Bend

Matthew Graves, Sean Nork

Low bend plate (lower picture) and plate with standard bend (upper picture).

The 3.5 mm LCP proximal tibia plates are indicated for fractures of the proximal tibia, including comminuted, depression, bicondylar combination of lateral wedge and depression, periprosthetic, and fractures associated with shaft fractures.

In addition to the existing plate, a version with a lower proximal bend has been developed to provide more options to match the different anatomies of the proximal tibia. The low bend version is contoured to fit closer to the bone under the lateral condyle and slightly lower to the tibial plateau compared to the current plate. This low bend is the result of human specimen and CT scan studies. The proximal head/neck contour is similar to the 3.5 mm LC-DCP proximal tibia plate. But even with this alternative version, bending will be required in certain cases due to the highly variable anatomy of the proximal tibia with various shapes and inclinations.

Another change in the low bend plate is an elongated combination hole in the plate shaft (instead of a regular combination hole) designed to aid in plate placement.

As for the existing plate with the standard bend, the plate head is contoured to match the lateral proximal tibia. The plate head profiles of both plate versions have been made thinner at the anterior edges. Suture undercuts to the proximal K-wire holes have been added. Both plates are available in lengths of 4-16 holes.

Clinical Cases
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A 36-year-old man sustained a motorcycle injury: right femoral shaft fracture and right hyperextension bicondylar tibial plateau variant (Fig 1, Fig 2).

Staged management with initial rodding of femur and placement of spanning knee external fixator with closed manipulative reduction of tibial plateau (Fig 3).

The patient returned to the operating room once soft tissue allowed for open reduction and internal fixation of the tibial plateau fracture via a lateral utility and anteromedial approach. Placement of low bend 3.5 mm proximal tibia plate laterally and 3.5 mm locking T-plate anteromedially to buttress the impacted anterior rim (Fig 4, Fig 5).

Fig 1a-b Preoperative x-rays.

Fig 2a-c CT scans (axial, post coronal).

Fig 3a-b CT scans after intramedullary nailing of femur and external fixation of knee.

Fig 3c-d CT scans after intramedullary nailing of femur and external fixation of knee.

Fig 4a-b Postoperative x-rays of knee.

Fig 5a-b X-rays at 3 months follow-up.

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