Locking compression plating: a new solution for fractures in rheumatoid patients.

Osteoporosis is a well-known phenomenon in rheumatoid arthritis (RA) that is characterized by marked loss of peripheral bone. It was found that the frequency of osteoporosis in RA can be increased significantly compared with the reference population, which implies a higher risk of fracture in this group of patients. Osteoporosis makes the treatment of fracture in RA patients more challenging, including the difficulty of fracture fixation, delayed union, secondary loss of reduction, and fixation failure. The locking compression plate was designed using the concept of "internal fixator," which provides a new solution for the fixation of osteoporotic fractures. The fixed angle between the screw and the plate increases the pull-out strength of the system, so the stability of the fixation no longer depends totally on the quality of the bone. The other benefits of this system include the fact that no accurate contouring is required, it protects the local blood supply, and it supports minimally invasive plate osteosynthesis.