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J Am Acad Orthop Surg, Vol 16, No 8, August 2008, 436-441.
© 2008 the American Academy of Orthopaedic Surgeons
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The Use of Locked Plating in Skeletally Immature Patients

Kelly Vander Have, MD, Jose Herrera, MD, Robert Kohen, MD and Madhav Karunakar, MD

Dr. Vander Have is Assistant Professor, University of Michigan, Ann Arbor, MI. Dr. Herrera is Pediatric Orthopaedic Surgeon, Orlando Regional Medical Center, Orlando, FL. Dr. Kohen is Orthopaedic Resident, University of Michigan, Ann Arbor. Dr. Karunakar is Orthopaedic Traumatologist, Carolinas Medical Center, Charlotte, NC.

Perspectives on Modern Orthopaedics articles provide an objective appraisal of new or controversial techniques or areas of investigation in orthopaedic surgery.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Vander Have, Dr. Herrera, Dr. Karunakar, and Dr. Kohen.

Reprint requests: Dr. Vander Have, Department of Orthopaedic Surgery, University of Michigan, TC2912, Box 5328, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5328.

The philosophy and techniques for the management of fractures in the pediatric patient have changed over the past several decades. The immature skeleton has unique properties, and injuries in children have different characteristics, management options, and complications than do similar injuries in adults. The basic surgical techniques used in the management of pediatric fractures include closed reduction and casting, closed or open reduction with internal fixation, and external fixation. The concept of bridging plate osteosynthesis has evolved based on scientific insight into bone biology and the importance of blood supply to bone. The use of locked plating is gaining favor in the treatment of certain fractures in adults. However, the role for this technique in the skeletally immature patient has not been described.






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