Plate and screw fixation of fracture is one of the most common orthopaedic intervention for fracture management. The procedure involves reducing the displaced fracture fragments and fixing it rigidly by a long linear metal implant (plate) to the bone. Screws are used to facilitate this fixation. 

When is this surgery performed?

This is one of the most common and successful orthopaedic surgery, used when:

• The fracture is displaced
• Fracture cannot heal properly with immobilization alone
• Multiple fracture fragments
• Weight/stress bearing bone
• Intra-articular fracture

The surgery is performed by the concept of Open reduction internal fixation (ORIF). The steps involved in any plate fixation are as follows:

• The surgery is done by General, Spinal or regional anasthesis depending on the site of fracture and surgeons preference.
• An incision is made over the fractured bone (based on years of research done to reduce the number of muscle split and safely avoid any nerves and blood vessels)
• The fracture site is approached by retracting the overlying muscles and structures.
• The fracture is reduced with the help of special instruments and reduction is confirmed both visibly and by C-arm (xray machine).
• A plate of appropriate length is selected and placed over the bone and fixed on either end using multiple screws (number of screws deemed necessary by the surgeon).
• The reducion instruments are removed and the fracture stability is assessed by moving the joints above and below.
• Once the fixation is confirmed to be stable the wound is closed and dressing applied.
• Sometimes a plaster slab may be applied in certain fractures to reduce post-operative edema, added stability and faster recovery.

Lifting heavy weights is avoided for few days in upperlimb fracture fixation. Weight-bearing is avoided for few days in lower limb fracture fixation.