"Shimming" a locking plate with washers to correct axial alignment.

The use of fixed-angle locking metaphyseal plate and screw constructs for articular and periarticular injuries has become commonplace. Given the restraints of bone stock in the epiphyseal region or possibly with misplacement of the plate, the use of these fixed-angle devices may produce varus or valgus malalignment. The described surgical technique entails the use of washers to elevate the plate from one end of the diaphyseal bone segment, thereby correcting potential varus or valgus.