The journal of knee surgery
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The management of fractures with traditional plating techniques has undergone a paradigm shift over the past 20 years. For many fractures, anatomic reduction using a dynamic compression plate has been the gold standard. However, minimally invasive approaches combined with biologically friendly internal fixation have become accepted methods of complex fracture treatment. ⋯ The literature demonstrates low rates of nonunion and overall complication rates with locking plates in difficult metaphyseal and diaphyseal fractures. Anatomic reduction of the articular surface remains paramount. Hybrid techniques that combine the benefits of compression plate fixation with the biological and biomechanical advantages of locking plates are the most likely end result of current locking plate applications.