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Dr. Ebraheim’s educational animated video describes bone healing and buttress plating of fractures. Some fractures can shorten and displace under axial load, and these fractures are best stabilized with a buttress plate. Buttress plates are mainly used in the metaphysis area to support an intra-articular fracture. When a buttress plate is used in the diaphyseal area to support a fracture, it is called an anti-glide plate. Apply the plate to one main fragment to buttress the other fragment and to prevent displacement. The plate acts like a finger, pushing the other fragment into the reduced position (buttress means "push) and the plate holds the bone up. The plate neutralizes the shear forces during axial load. In fact, it may compress the fracture during axial loading. If the fracture is antra-articular, the the plate can be used with or without lag screws (usually partially threaded screws are used). Examples of buttress plates: Volar Barton fracture anterior plate is applied to the distal radius to hold the reduced anterior marginal distal radius fracture. If the fragment is large enough, screws can be put through it. But, if the fragment is small, a plate can be used without screws. Tibial plateau fracture: The split fracture used buttress plating. -Vertical fracture of the medial malleolus ( a supination/adduction fracture) -Posterior malleolar ankle fracture. Example of the anti-glide plate -Diaphyseal fracture of the fibula: Some physicians believe it is mechanically superior to the lateral plate, but it can cause irritation of the peroneal tendons. The stiff plate should match the contour of the bone. Most plates used now are pre-contoured or anatomic. A metaphyseal shear fracture, or split fracture, fixation with screws alone may not be sufficient. Lag screws should be combined with a plate with anti-glide or buttress effect. You will get primary bone healing using a buttress plate because of the anatomic reduction, the stable fixation, and adequate blood supply. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC