Locking maxillofacial reconstruction plates have become the backbone of modern jaw and facial surgery. They are designed to handle the toughest jobs—large defects, comminuted fractures, and post-tumor reconstructions—where ordinary plates simply are not strong or stable enough.
What Makes Them Different?
Locking reconstruction plates use special threaded holes that accept matching locking screws, so the screw head locks firmly into the plate rather than just compressing bone. This creates a fixed-angle construct where the plate and screws act as a single rigid frame, highly resistant to bending and torsion. Because stability comes from the screw–plate interface, the plate does not need to be pressed tightly against bone, which helps preserve periosteal blood supply and promotes healthier healing.
These plates are usually thicker and stronger than standard miniplates—systems like 2.4 mm mandibular reconstruction plates are classified as true load-bearing devices. In heavy functional areas such as the lower jaw, they can safely carry chewing forces while fractured or grafted bone recovers.
Key Features
- High-strength profile: Robust 2.4 mm or similar plates designed to bridge segmental defects and support full masticatory load.
- Fixed-angle stability: Locking screws engage plate threads, reducing screw loosening and plate migration even under repeated loading.
- Stress shielding and internal fixator behavior: The plate acts as a bridge, absorbing functional stresses and protecting bone grafts and comminuted fragments from micromotion.
- Anatomical contours: Many systems are preformed for mandible body, angle, and symphysis, simplifying adaptation in complex reconstructions.
Together, these features give surgeons a rigid, predictable scaffolding when bone stock is limited or heavily damaged.
Main Clinical Applications
Locking maxillofacial reconstruction plates are used most often in the mandible, where loading is highest.
- Segmental mandibulectomy reconstruction: After tumor or pathology removal, long segments of the jaw may be missing; the plate bridges the gap and maintains jaw shape and occlusion.
- Comminuted or continuity-loss fractures: In high-energy trauma or firearm injuries, locking reconstruction plates span shattered segments and provide stable fixation across large defects.
- Fixation of vascularized bone grafts: Free fibula or scapula flaps are commonly secured to the remaining jaw using locking plates, giving immediate stability so the graft can integrate.
Clinical series have reported sound bone healing and very low rates of fixation loss when locking systems are used in these demanding situations.
Advantages Over Conventional Plates
Compared to non-locking reconstruction plates, locking systems offer several practical and biological advantages:
- Less dependence on perfect plate adaptation: Because stability does not rely on plate–bone compression, minor gaps under the plate do not compromise fixation.
- Preserved blood supply: Reduced pressure on cortical bone helps maintain periosteal circulation, lowering risk of necrosis, delayed union, or infection.
- Higher fatigue resistance: Mechanical testing shows locking constructs tolerate more load cycles before failure than conventional screw–plate combinations.
Clinical reports describe locking reconstruction plates as simple to use, with stable occlusion and low complication rates in mandibular trauma and reconstruction cases.
Practical Considerations
These systems require careful preoperative planning: plate length, contour, and screw positions must be chosen to match defect size and planned grafts. Thick orthopedic implants plates need strong benders and accurate shaping, but once fixed, they allow early functional loading, such as controlled jaw movement and gradual diet progression. Surgeons still need to monitor soft tissue coverage and graft viability, yet the rigid framework created by locking plates makes long-term structural and functional restoration far more predictable.
In simple terms, locking maxillofacial reconstruction plates are the heavy-duty workhorses of facial surgery—built to hold the jaw together, protect grafts, and stand up to daily chewing forces while everything beneath them heals.
Siora Surgicals Pvt. Ltd. 