At the head end of a periarticular locking plate, the screws do their most consequential work. Fanned side by side beneath the subchondral bone, they form the raft that holds the articular block to height — and they do it in trabecular bone that offers a conventional thread almost nothing to grip.
The cancellous thread form answers the bone, and the locking head answers the construct. Deep threads engage the trabecular lattice across a broad span, while the locked angle keeps the raft level as the fracture loads and settles. This is the combination on which plate fixation of plateau, plafond and condyle fractures rests. Screw length, number and configuration remain selections of the operating surgeon.
