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What Are Plates, Screws and Rods?

Plates, screws and rods—in the context of orthopedics—are all forms of internal fixation. Internal fixation is a method of fracture care, the goal of which is to hold the broken ends of a bone together so it can begin to heal. Internal fixation is different from external fixation in that the hardware used on the bone is not attached to a frame outside the skin. Internal fixation is also different from a cast because it requires surgery, whereas a cast is nonsurgical.

How Plates, Screws and Rods Are Applied

Internal fixation requires surgery. It is often done at the same time as an open reduction—surgically realigning the broken ends of a bone. After the broken ends of the fractured bones are aligned, the surgeon will use plates, screws, rods or wires to hold them in place while the bone knits itself back together.

Uses

Internal fixation is used when a bone cannot be set (reduced) from the outside of the skin. Cases where internal fixation is the best option include:

  • Fractures that extend to joint cartilage
  • Fractures that have caused other wounds that require surgery, such as damaged arteries or nerves
  • Fractures that heal better with surgery, such as hip fractures
  • Fractures that would otherwise require long healing times, such as femoral head fractures
  • Open fractures that have broken the skin, so the risk of infection is high and the wound must be cleared of debris

Advantages and Disadvantages

Internal fixation has a number of advantages, such as:

  • Faster healing time
  • Less chance of malunion (the bone heals in the wrong position)
  • Less chance of nonunion (the bone does not heal)
  • Shorter hospital stay

The main disadvantage of internal fixation is the increased chance of infection compared with nonsurgical reduction and external fixation.

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