Fixation

The screw configuration should always be determined based on the fracture type and bone quality. The NCB System technology allows polyaxial screw placement in a 30° cone. Screw locking is achieved through the use of locking caps that are threaded into the holes in the plate.
Before the screws are placed in the metaphyseal area a control of the axis has to be performed. The control is performed with  the cable-technique. This technique is shown in the case example for a Vancouver C Complex fracture.
In this case example the proximal NCB Screws were inserted first and could be placed bicortical anterior or posterior. All screws in the diaphyseal region were inserted percutaneously.

Surgeons Tip
The offset holes of the NCB Periprosthetic Plates allow  for easier screw placement  anterior or posterior to the prosthesis. While tightening the first screw, ensure that the plate does not tilt in order to keep the reduction in place and ensure a correct anatomical alignment of the axis.