Proximal Tibial Locking Plate

Hunter Graver, MD

Content Contributor

Evolution of Proximal Tibial Locking Plate

Fixation of the tibial plateau is usually performed using plates and screws. Due to the poor quality of bone in the tibial plateau, however, normal plates and screws have been insufficient for fixation in some patients, and special locked plates are usually used.

Locked plating was introduced in the early 19th century and popularized in the 1960s. Locked plates describe plates in which the screw has threads around the head which thread into the plate. This increases the stiffness of the construct, which helps to hold softer bone in place. Locked plating around the upper end, or proximal end, of the tibia continues to evolve to provide strong, stable fixation while striving to remain small enough so that the plates don’t bother patients.

In modern plating systems there are specialized plates that sit on specific parts of the bone to provide fixation in those areas. These plates are usually made of titanium, but can be made of stainless steel for stiffer fixation. Large screws are usually used as close to the joint as possible to act as large rafters to keep the joint surface fixed in place, while screws farther down the plate fix the actual plate to the bone.

Technology Spotlight

Zimmer Biomet A.L.P.S.® Proximal Tibia Plating System

The Zimmer-Biomet ALPS proximal tibia plating system is one of the next evolutions of locked plating. The plates included in this system are low profile and are designed to minimize discomfort to the patient. There are several different sizes and style of plate included in order to provide as many fixation options as possible to meet the unique anatomy of each patient’s plateau.

Each style is designed to be contoured to the speciﬁc anatomy of a different part of the plateau. Plates are made of titanium and provide multiple screw hole options for optimal fixation. Each of these screw holes also comes with special guides in order to allow for locked screws to be inserted into the plate.