Locking Vs Non-Locking Plate: How To Choose The Right Fixation

How Each Plate Type Achieves Stability Non-Locking Plate (DCP / LC-DCP / Reconstruction)The screw threads through the plate's compression hole and into the bone. As the screw is tightened, the screw head pulls the plate against the bone surface, generating friction. This friction is what holds the bone fragments in place. Stability depends on: Bone quality (cortical thickness, density)Plate-bone contact areaScrew torque and axial preload In osteoporotic bone, screws can toggle and pull out — a phenomenon called screw cut-out — leading to fixation failure. Locking Plate (LCP)The locking screw head has machine threads that match threaded conical holes in the plate. When the screw is fully inserted and tightened, it locks into the plate, creating a single rigid beam construct. Stability is independent of bone quality because load is transferred through the screw-plate junction, not via bone-plate friction. This makes locking plates the preferred choice for osteoporotic and metaphyseal fractures. Side-by-Side Comparison

FeatureNon-Locking PlateLocking Plate (LCP)Stability mechanismBone-plate frictionScrew-plate fixed angleBone quality requirementGood cortical bone preferredIndependent of bone qualityCompressionYes (via DCP hole geometry)Optional (via combi-hole)ContourabilityFree bendingLimited (locking screws must align with holes)MIPO suitabilityLimitedExcellentCostLowerHigher (1.5-2x)Best forDiaphyseal with good bonePeriarticular, osteoporotic, MIPOCut-out risk in osteoporosis5-10%

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