Stable fixation of osteoporotic fractures and nonunions in the upper limb - life before the "locking plate".

I have had a wonderful opportunity over the past 30 years to surgically reconstruct many complex fractures and non- unions in the upper limb in the elderly patient with underlying osteoporosis and prior to the development of the "locked plate". This article will present a number of specific techniques using standard LC-DCP and screw in a variety of applications to provide stable internal fixation. These include the use of long plates; creating a "waved plate" initially described by Blatter and Weber; double plating; 3.5 mm intramedullary plate combined with a larger plate on the cortex; custom and machi- ned blade plates as well as enhancement of screw fixation with bone cement and/ or Norian SRS cement.