Supercutaneous Plating Technique: A Case Report of Locking Plate Used as an External Fixator

Vol. 11 | Issue 1 | January-February 2023 | Page: 23-26 | Shashiraj K Shetty, Edward L Nazareth, Nirath S Hegde, Ajay Kumar, Shushruth M Devanna


Authors: Shashiraj K Shetty [1], Edward L Nazareth [1], Nirath S Hegde [1], Ajay Kumar [1], Shushruth M Devanna [1]

[1] Department of Orthopaedics, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Mangalore, Karnataka, India.

Address of Correspondence

Dr. Nirath S Hegde
Department of Orthopaedics, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Mangalore, Karnataka, India.


Introduction: Open fracture is one of the most common and challenging healthcare problem in orthopedic practice1.Despite improvements in implant design, management of open fractures remain a challenge for the orthopedic surgeon. Locked compression plates (LCP) have advantages of angular stability from the locking-head mechanism and less irritation when compared with traditional external fixators due to their low profiles. Here is a case report of the same.
Case Report: A 50-year-old lady, a municipal worker by occupation, came to casualty with alleged history of road traffic accident and injury to right thigh and knee. Plain radiograph of of right femur with knee revealed a supracondylar fracture of right femur.
As a definitive treatment, patient underwent open reduction and supercutaneous plating. Skin grafting was done for the external wound over distal thigh. The External fixation plate for right distal knee was removed after 6 weeks and knee ROM of 0 to 100 degree flexion was achieved by one year.
Conclusion: Open fractures can be treated by external fixation using the LCP plates, which are safe, reliable and have acceptable functional outcomes with minimal complication rates. Its advantages also include ease of performing surgery and ease of removing plate after fracture healing.
Keywords: Supercutaneous plating, LCP- locking compression plate, External fixator


1. M griffin, M Malahias, S Hindocha, and W khan Update on the management of compound lower limb fractures
2. Kloen P. Supercutaneous plating: use of a locking compression plate as an external fixator. Journal of orthopaedic trauma. 2009 Jan 1;23(1):72-5.
3. Kerkhoffs GM, Kloen P, van der Werken C, et al. Supercutaneous plate fixation. Alternative use of the dynamic compression plate as an external fixator.TechnOrthop. 2004;18:338–343.
4. Hopf T, Osthege S. Interfragmental compression of the Zespol osteosynthesis system. Experimental biomechanical studies. Z Orthop Ihre Grenzgeb. 1987; 125(5):546-52.
5. C Xiao, F Tang, Y Zhou, et al. A locking compression plate as an external fixator for treating infected nonunion of the humeral diaphysis. BMC Surg. 2016; 16:53.
6. Ramotowski W, Granowski R Zespol: Anoriginal method of stable osteosynthesis.ClinOrthopRelat Res 1991;272: 67-75
7. Ching-HouMaa, Chin-HsienWua, Yuan-Kun Tu , Ting-Sheng Lin -Metaphyseal locking plate as a definitive external fixator for treating open tibial fractures—Clinical outcome and a finite element study: Injury, Int. J. Care Injured 2013;44:1097–1101.Source of Support:NilConflict of Interest: Nil
8. Ahmad M, Nanda R, Bajwa AS et al. Biomechanical testing of the locking compression plate: when does the distance between bone and implant significantly reduce construct stability J Injury. 2007; 38:358-64.
9. Ang BF, Chen JY, Yew AK, Chua SK, Chou SM, Chia SL, Koh JS, Howe TS. Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness.Bone & joint research. 2017 Apr;6(4):216-23.
10. Marti RK, Van der Werken C. The AO-plate for external fixation in cases.ActaOrthop Scand. 1991;62:60–62.
11. Panda SS, Panda D, Suri N. Supracutaneous plating: Use of locking compression plate as external fixator for intra-articular compound fractures. International Journal of Medical Research & Health Sciences. 2016;5(8):62-7.
12. J. B. Giles, J. C. DeLee, J. D. Heckman, and J. E. Keever, “Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw,” Journal of Bone and Joint Surgery A, vol. 64, no. 6, pp. 864–870,1982.

How to Cite this article: Shetty SK, Nazareth EL, Hegde NS, Kumar A, Devanna SM | Supercutaneous Plating Technique: A Case Report of Locking Plate Used as an External Fixator | Journal of Karnataka Orthopaedic Association | January-February 2023; 11(1): 23-26 |


                                          (Abstract Text HTML)      (Download PDF)