Fixed-angle implants are becoming increasingly important in trauma surgery. Besides indications generally accepted in surgery on the limbs, the question of their use in spine and pelvis surgery is discussed. Whereas anatomical preformed fixed-angle implants for pelvis surgery are not available commercially from the industry, several different angle-stable implants have been created for the anterior instrumentation of spinal injuries, all of which can be inserted in minimally invasive procedures. In cervical injuries the advantage of fixed-angle plate systems over conventional plates, is the monocortical fixation of the screws; from the biomechanical point of view, however, in the majority of fractures they do not lead to a higher fusion rate. In the treatment of thoracic and lumbar spine injuries fixed-angle implants have to be suitable for insertion by endoscopic/minimally invasive techniques. Nevertheless, adequate fusion cannot be expected without correct patient selection and detailed analysis of the fracture type.