Conical coupling angular stable plate fixation: a retrospective study

Main Article Content

Fabrizio Rivera
Alessio Maiello
Alessio Maiello
Maniscalco Pietro
Giovanni Di Stefano
Fabrizio Quattrini


stable plate fixation, conical coupling, locked plate


Backgrounds. Conical coupling represents an alternative to screw coupling on angular stable plate fixation. Aims of the present study was to evaluate clinical effectiveness  and ease of plate removal of conical coupling locking plates into different scenario regarding quality of bone, type of fracture and operative technique. Methods. From May 2013 to December 2017, 198 patients with 206 fractures underwent open reduction and internal fixation with conical locking plate. In most cases fixation involved wrist (38%) and clavicle (24%) fractures but a varied type of fractures and bone were included in the study. Results. Ten complications related to plate fixation were observed (5,1%). Two case of intra-articular positioning of screws of wrist plate. One case of loss of reduction and breakage of wrist plate due to an inappropriate proximal fracture fixation.  Five cases of complications involved clavicle fixation: three cases of non-union, one case of peri-implant fracture, one screw loosening. One non-union of distal tibial fracture, one non-union in olecranon fracture were finally observed. Thirty-four patients that have symptoms that could be traceable to the implants in-situ underwent plate removal. No complications were observed during surgical plates removal. Conical coupling angular stability plate represents an actractive alternative to threaded angular stability plate.  Bush titanium insert, eliminating the problems of cold welding and cross-threading, simplifies surgical screws and plate removal


Download data is not yet available.
Abstract 250 | PDF Downloads 109


1. Perren SM. Evolution and rationale of locked internal fixator technology. Introductory remarks. Injury. 2001;32 S2:B3–9.
2. Wagner M. General principles for the clinical use of the LCP. Injury. 2003;34 S2:B31-42
3. Bae JH, Oh JK, Oh CW, Hur CR. Technical difficulties of removal of locking screw after locking compression plating. Arch Orthop Trauma Surg. 2009;129:91–95
4. Valentini R, Martinelli B, Cosmi F, Hoglievina M, Nogherotto P. Mechanical Behavior of one internal fixator (O’nil plate and screws system): a finite element study and clinical experiences. Tech Orthop. 2007;22: 173-180.
5. DeKeyser GJ, Kellam PJ, Haller JM. Locked plating and advanced augmentation techniques in osteoporotic fractures. Orthop Clin N Am. 2019; 50: 159–169
6. Sato K, Kikuchi Y, Mimata Y, Murakami K, Takahashi G, Doita M. Volar locking plates not touching the flexor pollicis longus tendon appear as prominences on radiographs: a cadaver study. J Orthop Traumatol. 2019; 20:29
7. McGonagle L., Cordier T, Link BC, Rickman MS, Solomon LB. Tibia plateau fracture mapping and its influence on fracture fixation. J Orthop Traumatol. 2019; 20:12
8. Friggs R. Locking Compression Plate (LCP). An osteosynthesis plate based on the Dynamic Compression Plate and the Point Contact Fixator (PC-Fix). Injury. 2001; 32: 63-66
9. Tepic S, Perren SM. The biomechanics of the PC­Fix internal fixator. Injury. 1995;26(S2): SB51­56
10. Haas N, Hauke C, Schutz M, Kaab M, Perren SM. Treatment of diaphyseal fractures of the forearm using the Point Contact Fixator (PC-Fix): results of 387 fractures of a prospective multicentric study (PC-Fix II). Injury. 2001;32SB:51–62.
11. Perren SM. Backgrounds of the technology of internal fixators. Injury. 2003; 34:1-3.
12. Tremolada G, Lewis DD, Paragnani KM, Conrad BP, Kim SE, Pozzi A. Biomechanical comparison of a 3.5-mm conical coupling plating system and a 3.5-mm locking compression plate applied as plate-rod constructs to an experimentally created fracture gap in femurs of canine cadavers. Am J Vet Res .2017;78 :712–717
13. Hernanz González, Y,Díaz Martín, A,Jara Sánchez, F,Resines Erasun, C. Early results with the new internal fixator systems LCP and LISS: a prospective study. Acta Orthop Belg. 2007;73: 60-69

Most read articles by the same author(s)

1 2 > >>