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Objective To compare biomechanical properties of the traditional and novel locking compression plate （LCP） for treating femoral shaft fracture, so as to provide theoretical basis for selecting more effective bone plate. Methods The bending strength and fatigue tests on the plate were performed, and the finite element analysis on deformation, stress and life of the plate were conducted by using ANSYS Workbench. Results The average bending yield load and bending strength of the novel LCP were 1.4 times of that of the traditional LCP, and the average cycle times of the novel and traditional LCP were 106 and 47 091, respectively. The difference of service life for two LCPs was 33.8%. ConclusionsThe failure probability of the novel LCP is smaller than that of the traditional LCP, and the novel LCP has more effective biomechanical stability.
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ObjectiveTo study the clinical effect of locking compression plate fixation in treatment of the elders with unstable fractures of the distal radius. Methods17 cases with unstable distal radius fractures were treated by volar locking compression plate. The function of the carpal joints and the bone healing conditions were evaluated after operations. ResultsAll cases were followed-up for 7 to 16 months ( mean 12. 6 months). Union was obtained in all the patients after 11.4 weeks. The clinical outcomes were evaluated according to modified X-rays and wrist assessment. 12 cases were graded as excellent and 4 as good. 1 case were graded as poor. The overall satisfactory rate was 94. 1％. ConclusionThe unstable distal radial fractures could be effectively treated with open reduction and LCP fixation through volar approach.
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@#ObjectiveTo investigate the clinical efficacy of the fixation of elderly fracture of proximal humerus with locking compression plate(LCP) by mini-incision approach from lateral shoulder.Methods31 elderly patients suffered from elderly fracture of proximal humerus were treated with locking compression plate(LCP) by mini-incision approach from lateral shoulder, male 13 cases, female 18 cases; aged from 56 to 72, average 62-8 years old; fractures according to Neer classification: type Ⅱ(8 cases), type Ⅲ (19 cases), type Ⅳ (4 cases). Cause of injuries: traffic accident (9 cases), falling (20 cases), other injuries(2 cases).ResultsThe patients were followed up 6 to 36 months, an average of about 24 months. Fracture healing time was 2-2 ～ 6-4 months, on average 3-7 months; No wound infection occurred. Post-operative functional score (Neer score) revealed: excellent(18 cases), good (11 cases), fair (2 cases), the ratio of excellent(18 cases), good (11 cases) was 93-5%. ConclusionFixation of elderly fracture of proximal humerus with locking compression plate(LCP) by minimally invasive approach from lateral shoulder is a safe, reliable and minimally invasive procedure with good reduction and stable fixation. Early post-operative functional exercise may be permitted for preventing shoulder joint adhesion.
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PURPOSE: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. MATERIALS AND METHODS: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. RESULTS: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. CONCLUSION: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.
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Animals , Humans , Ankle , Follow-Up Studies , Fracture Healing , Intra-Articular Fractures , Necrosis , Skin , TibiaABSTRACT
PURPOSE: To evaluate the usefulness of locking compression plate (LCP) and volar plating through anterior approach for distal radius fracture. MATERIALS AND METHODS: We retrospectively analysed that 15 distal radius fracture, which would not be reduced by closed reduction or too comminuated to maintain reduction or articular surface inconguency, were treated by open reduction through anterior approach and volar plating using LCP. The results were evaluated by preoperative and postoperative radiographs. Functional results were analysed using the Modified Mayo Wrist Scoring System. RESULTS: All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (9.0 mm vs. 11.8 mm), radial inclination (14.7degrees vs. 20.9degrees ), volar tilt (-6.3degrees vs. 8.3degrees ) and articular step-off (1.4 mm vs. 0.3 mm) were improved. The average Modified Wrist Score was 89. Nonunion or malunion was not occurred. CONCLUSION: Open reduction through anterior approach and volar plating using LCP is a useful method that provides excellent results with few complications in the treatment of fracture of the distal radius.
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Radius Fractures , Radius , Retrospective Studies , WristABSTRACT
PURPOSE: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. MATERIALS AND METHODS: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. RESULTS: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. CONCLUSION: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.
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Humans , Ankle , ArthritisABSTRACT
Objective To report and evaluate the treatment results of unstable distal radial fractures with volar locking compression plate (LCP). Methods 46 cases of unstable fractures of distal radius were treated with open reduction and LCP fixation through volar approach from April 2002 to May 2004. 14 of which underwent bone graft and 12 postoperative immobilization with plaster sprint. Results A follow-up of 6 to 30 (mean 21) months revealed bone union in all cases with a mean volar deviation angle of 9.7?and a mean ulna deviation of 21.3?of the distal radius. The wrist functions were evaluated by the modified Gartland and Werley system only to find 32 excellent cases, 11 good ones, 2 fair ones, and 1 poor one. Conclusions The unstable distal radial fractures can effectively be treated with open reduction and LCP fixation through volar approach. The subsidence of the radial articular surface can well be prevented and bone healing accelerated with supplementary bone graft.
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Objective To evaluate minimally invasive plate osteosynthesis (MIPO) technique in the treatment of humeral shaft fractures using locking compression plate (LCP). Methods Between February 2004 and January 2005, 17 consecutive patients with 17 humeral shaft fractures were treated with LCP by MIPO technique. There were 12 men and 5 women with a mean age of 48 years (range, 18 to 75). According to AO classification, three fractures were type12-A, 10 type 12-B, and four type 12-C. Results The mean duration of follow-up was 19. 1 months (range 14 to 25) . Union occurred in all patients with a mean healing time of 11. 3 weeks (range 9 to 14) . With regard to ROM of the shoulder, the mean flexion was 174 degrees (range, 135 to 180 ), the mean extension was 38 degrees (range, 20 to 40), and the mean abduction was 87 degree (range, 70 to 90). For the elbow, the mean flexion was 133 degree (range, 115 to 135), the mean extension was -1 degree(range, - 10 to 0). Using the patient-rated functional questionnaire, the mean DASH (disabilities of the arm, shoulder and hand) score of 11 points (range, 6 to 44) at the latest follow-up indicated a mild to moderate impairment. There were three postoperative complications. One superficial infection occurred in a Custilo type MB open fracture and was uneventfully healed with conservative managements. One patient experienced transient radial nerve palsy which showed complete remission within 3 months. The third one demonstrated a dysfunction of shoulder and elbow. There were no cases of secondary malalignment or late hardware failure in this cohort. Conclusions Internal fixation using LCP in MIPO can attain a stable fixation, a high union rate as well as a low complication rate. The neurovascular structures may be at less risk of iatrogenic injuries through the anterior approach. It may be considered a reliable and efficient method for humeral shaft fractures, especially for comminuted ones and those with poor bone quality.
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Objective To evaluate the effects of treatment for the distal radial osteoporotic fractures in elder patients with Volar Locking Compression Plating (LCP)fixation. Methods 30 old patients who suffered from the severe osteoporotic distal radial fractures were treated with LCP. In this group all the fractures were more severe than type 2B according to Melone classification. The results of treatment were evaluated by comparing pre and post operative functions and X rays of involved wrists. Results 26 of the 30 patients experienced no wrist pain and were satisfied with the functions of the suffered wrists in their daily postoperative activities. 2 patients still felt wrist pain and needed to take some pain killers and other 2 experienced mild finger movement limitations. These data were improved postoperatively to the average palmar tilt of 3.38 degrees, radial inclination of 18.9 degrees and the radial length 0.9cm longer between the ulnar head and the tip of the radial styloid. The radial length was found 0.2 mm shorter in 2 cases in the latest follow up than that measured before. No severe complications were found in this group. Conclusion For the unstable distal radial osteoporotic fractures in the elderly patients, Volar Locking Compression plating (LCP)fixation is one of the effective treatments, because this procedure can restore and sustain the distal radial length and smooth articular surface after the fracture reduction.
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The importance of the biology and the care for the soft tissues and bone during internal fixation of the fracture, as the fourth AO principle, had been stressed. A conventional AO compression plate pressed against the bone surface interferes with the cortical blood flow and induces structural changes underneath the plate. Low contact dynamic contact plate(LC- DCP) could reduce the area of contact between plate and bone undercuts. Locking head screws, the Point Contact Fixator (PC Fix), and the Less Invasive Stabilisation System (LISS) had the next evolution.The so- called internal fixator can be considered as an external fixator, which has been approximated very close to the bone, however, without actually touching or compressing bone. This feature prevents any additional damage to bone vascularity. The stability of the internal fixator depends on the angular stability of the screw- plate combination. The new LISS and Locking Compression Plate( LCP) offer new options and challenges in modern operative fracture care. These implants are ideal for the MIPO (minimally invasive (percutaneous) plate osteosynthesis) and appear to have a considerably better purchase in osteoporotic bone. Nevertheless, it must be stated that these new plates and screws do not solve all problems, either as they too demand a very careful planning of every procedure, which includes a re- thinking of the classical AO principles, especially when addressing meta- and diaphyseal fractures.
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Objective To discuss the clinical effects of open reduction and internal fixation with locking compression plate(LCP)to treat elderly women with comminuted distal radius fracture.Methods 32 elderly women(35 sides)with comminuted distal radius fractures were treated by open reduction and internal fixation with LCP from March 2002 to October 2004 in our department.Their mean age was 65 years old.According to AO classification,11 sides were type A3,15 sides type C2 and nine sides type C3.Volar approach was used in 32 sides and dorsal approach in three sides.Bone graft was applied for five sides.Results The follow-up period was 10 to 41 months(mean 21.5 months)and the union period was three to five months.According to Dienst criteria of joint functions,the result s showed that 13 sides were excellent,19 sides good,two sides fair and one side poor.Complications included wound dehiscence and superficial infection in five sides and median nerve injury in two sides.Conclusion The LCP method in this study is one of the good options to treat elder women with comminuted distal radius fractures.
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Objective To explore diagnosis of nonunion following intramedullary nailing of femoral and tibial fractures and the treatment of nonunion of femoral and tibial fractures with Less Invasive Stabilization System (LISS) or locking compression plate (LCP). Methods From February 2003 to December 2004, 7 cases of nonunion after intramedullary nailing of femoral and tibial fractures were diagnosed by X-ray or CT scanning or CT-3D. LISS or LCP fixation and bone grafting were employed to treat the 7 cases of nonunion in the femur and tibia. Their case histories ranged from 10 to 49 (mean 23.3) months. Results All the 7 patients were followed up for a mean of 9.1 (4 to 16) months. The bone union time for all the fractures averaged 4.7 months (ranging from 4 to 6 months). No loosening or breakage of the implants occurred in this series. Conclusions The operation should be done for the patients who feel pain in the lower extremities or the fracture line still exists at the fracture ends long time after intramedullary nailing. In order to improve the healing of bone fractures, micromovement and bone defects at the fracture site should be eliminated. Because of its merits in design, the LISS can be used to effectively treat nonunion at the distal femur or the proximal tibia.