The Fixin system differs from other locking systems because it is a locking screw‐insert (bushing)‐plate construct [1–4]. Locking is achieved between the screwhead and the bushing by a conical coupling locking mechanism. The bushing is an intermediary insert that screws into the plate and couples with the screwhead (Figure 8.1). Fixin screws have a 1.0° and 1.5° (large and mini system, respectively) conical head that will lock into a corresponding tapered cone within the bushing [2–4]. The screw‐bushing coupling is achieved by friction, micro‐welding, and elastic deformation between the screwhead and the bushing insert [1, 2] (Figure 8.2). An advantage of the screw‐bushing‐plate construct is that it allows for an easier option if the implant needs to be removed, as opposed to both nonlocking and locking screw to plate interfaces. In other systems, if the screw has deformed (cold welding) to the screw hole or the screwhead does not engage the screwdriver, many times the screw cannot be removed without cumbersome methods such as burring the screwhead. If the screwhead is no longer able to engage the screwdriver the bushing‐screw complex can be removed with the bushing extractor. The bushing construct also allows for even force distribution over the screwhead. If the screw hole is not filled with a screw, the bushing still maintains even force distribution, decreasing the risk of plate failure over this site, in comparison to previous plate designs (dynamic compression plates, combination locking compression plates, etc.). The addition of the bushing increases the screws resistance to shear forces and also allows for a thinner plate design overall. With the bushing–plate construct, the bushings allow for the plate design to be decreased in thickness and of comparable strength to other, thicker locking plate systems. Due to the decreased thickness, the plate allows for more elasticity (elastic deformation), which promotes earlier callous formation around the fracture or osteotomy and earlier clinical and radiographic union. Also, a thinner plate design allows for less irritation and impingement on surrounding soft tissue structures (proximal tibia, distal tibia, carpus, tarsus, and other distal extremities) [2–4].