## Introduction
The **Locking Compression Plate (LCP)** is the most versatile tool in trauma surgery, largely due to the **Combi-Hole**. This “figure-eight” hole allows the surgeon to combine traditional compression techniques with modern locking stability in a single plate.
## Anatomy of the Combi-Hole
One side of the hole is **threaded** for locking screws, while the other side is **smooth and tapered** for cortex screws.
### 1. The Compression Function
By placing a cortex screw eccentrically in the non-threaded side, the plate “slides,” pulling the bone fragments together. This is the **Dynamic Compression (DC)** principle, essential for primary bone healing in simple fractures.
### 2. The Locking Function
Placing a locking screw in the threaded side creates a fixed-angle construct. This is essential for:
* **Bridge Plating:** Spanning a shattered (comminuted) area.
* **Osteoporotic Bone:** Where traditional screws would fail to hold.
## The “Golden Rule” of Sequencing
If a surgeon wants to use both functions in the same plate: **Compression screws must be placed BEFORE locking screws.**
* *Why?* Locking screws fix the plate’s position. If you lock a screw first, the plate cannot slide to provide compression when the second screw is added.
## Conclusion
Mastering the sequencing of the Combi-Hole allows surgeons to tailor the mechanical environment of every fracture. Ortholyx LCP systems are precision-manufactured to ensure that every Combi-Hole provides smooth, reliable performance in the OR.