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2003 Nov;34(Suppl 2):B11–9. The Mann-Whitney U test was performed for statistical comparisons of the average number of empty holes and the average bridge span length. 2005 Nov;36(Suppl 4):S30–7. (Redirected from Locking Compression Plate) Orthopedic implants to repair fractures to the radius and ulna. 99. The present study was approved by Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital (Ethics Committee No. 2013;33:7–11. Surgical techniques and a review of the literature. Of 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. The Synthes 4.5 mm Locking Compression Plate (LCP) System is indicated for fixation of various long bones, such as the humerus, femur and tibia and for use in fixation of peri-prosthetic fractures, osteopenic bone and fixation of non-unions or malunions in adult patients. 2010 Feb;26(1):10–6. Limited contact dynamic compression plates were designed with recesses or undercuts in the plate to reduce contact between the plate and the bone, therefore reducing the risk of plate-associated osteoporosis. 2011;26(4):405–9. 1a, b, and c. Measurements of the medial fracture distance between the proximal fragment and the medial cortex of the distal fragment were based on plain AP and lateral X-ray images. Bone union was defined as three out of four instances of cortical bridging on AP and lateral radiographs [12]. Although screw insertions near the fracture site increases fracture stability, in some cases, this may result in a lack of proper fracture micro-motion, leading to poor callus formation [17]. 4). Manage cookies/Do not sell my data we use in the preference centre. observed a 19% bone union failure rate in a cohort of 70 patients and reported that there were significantly more empty holes proximal to the fracture site in the patients with non-union compared to those with successful bone union [23]. J Am Acad Orthop Surg. c The definition of the part measured this time. Lujan et al. The mechanism locking the screw in the plate also comes in two types: in the first the screw head is locked in its chamber by a threaded locknut. Study limitations included its retrospective design and the relatively small sample size. Injury. Locking plates: tips and tricks. Of the comminuted fractures, 18 open fractures were observed; four cases resulted in non-union, which was not a significantly larger proportion than that in the bone union group (Table 4). Kolmert L, Wulff K. Epidemiology and treatment of distal femoral fractures in adults. volume 14, Article number: 384 (2019) 2007 Oct;89(10):2298–307. 2011 Feb;25(Suppl 1):S8–14. In case 3, it showed that plate length was 196 mm, fracture distance was 65 mm, plate span ratio was 196/65 = 3.01, bridge span length was 85 mm, medial fracture distance was 0 mm (because of shortening fracture site), and empty hole number was 1. In our study, while there were no clear differences in the non-union rates as a result of the number of empty holes, non-union rate tended to increase as the number of empty holes increased in the proximal fragment in some cases. 4.6 out of 5 stars 428. This study included 71 distal femoral fractures in 70 patients (23 males, 47 females; mean age, 68.0 years [range, 16–91 years]) who were treated using the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA) at a university hospital and related facilities between April 2005 and December 2015. 2004 Sep;18(8):503–8.  Fracture fixation devices with threaded screwholes, which allow screws to thread to the plateand function as fixed angle device. Any plate that allows the insertion of fixed angle orangular stable screws or pegs can be used as alocking plate. Bone union was observed in all cases with simple or comminuted fractures with respective medial fracture distances of ≤ 2 mm or ≤ 5 mm. Kiyono, M., Noda, T., Nagano, H. et al. 2018 Jan;32(Suppl 1):S1–10. J Orthop Sci. Angularly stable plate fixation, using a locking compression plate (LCP), prevents secondary displacement without the need of bone grafting. Kanchanomai C, Muanjan P, Phiphobmongkol V. Stiffness and endurance of a locking compression plate fixed on fractured femur. The present study was approved by Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital (Ethics Committee No. Bottland et al. Locking plates allow screws to be threaded into the plate, creating a fixed-angle device, without the need for friction between the plate and bone. Confirm using image intensification.Drill through the threaded drill guide. Acceleration of tibial fracture-healing by non-invasive, low-intensity pulsed ultrasound. 1994 Sep;15(9):483–9. Locking plates for distal femur fractures: is there a problem with fracture healing? Femoral and tibial blood supply: a trigger for non-union? The alignment was reduced and LCP-DF was used as a bridging plate. Thus, Locking Compression Plate is an important armamentarium in treatment of the Distal femur fractures especially when fracture is closed, severely comminuted and in situations of osteoporosis. J Bone Joint Surg Am. Non-union was defined as a state in which bone union was not achieved within 4 months after the initial surgery. b Postoperative radiograph. The number of empty holes near the fracture site and the rate of bone healing were not clearly related. A prospective study of treatment of distal femur fractures with locking condylar plate. If a locking compression plate is used, a push- pull device can be inserted in both the proximal and distal fragment to achieve temporary plate stabilization instead of bone holding forceps. advised to reduce the fracture site distance to ≤ 2 mm [15]. 2010 Oct;18(10):597–607. Hib Surgicals - Offering Locking Compression Plate, Size: 3.5 Mm at Rs 1589/piece in Mumbai, Maharashtra. A senior medical doctor with > 15 years of experience as an orthopedic surgeon operated on these cases; therefore, a certain surgery quality (reduction of fractures, treatment of soft tissues) was guaranteed. Courses, webinars, and online events, in your region or worldwide, Pediatric distal femur module is now online, Radiopalmar approach to the base of the thumb. Locking compression plate (LCP) dynamic compression unit conical and threaded unit 4. Locking Compression Plate (LCP) The LCP permits use of angled conventional (compression) screws and fixed-angle locked screws through its patented combi-hole design (Figure 3). Megas P. Classification of non-union. Age, open fracture, MIPO, diabetes, steroid use, infection, AO classification, plate span ratio, and bridge span length were of no predictive value. Clin Biomech (Bristol, Avon). Acta Orthop Scand. a Radiograph in a 74-year-old woman with total knee arthroplasty. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate. In most of our cases, non-union likely resulted from fracture site instability after reduction internal fixation. The Synthes Locking Compression Plate (LCP) is part of a stainless steel and titanium plate and screw system that merges locking screw technology with conventional plating techniques. Tomoyuki Noda. PubMed Google Scholar. Compared with traditional compression plating, locking plates can provide more stability in comminuted or osteoporotic fractures. Locking plates: a current concepts review of technique and indications for use. A report of six cases. In this case, bone union was achieved by inserting screws near the fracture site via revision surgery, which increased stability (Fig. Non-union was diagnosed 2 of 26 (7.7%) cases with a simple fracture and 5 of 45 (11.1%) cases with a comminuted fracture (Table 2). Hoffmeier KL, Hofmann GO, Mückley T. Choosing a proper working length can improve the lifespan of locked plates. Injury. We have a wide range of locking plates and screws at competitive prices in the market. Terms and Conditions, Mark the plane of the first carpo-metacarpal joint with a thin K-wire or a hypodermic needle. Always use a threaded drill guide when preparing for locking screws. Ricci WM, Streubel PN, Morshed S, Collinge CA, Nork SE, Gardner MJ. Conversely, in cases with comminuted fractures, there were five non-union cases with more two empty holes (Table 4). One female patient had bilateral femoral fractures. Callus formation was good, but resulted in non-union. Alternatively, and especially when a conventional plate is used, reduction can be performed with axial traction on the thumb, either manually, or with help of a finger trap, and simultaneous pressure on the dorsal aspect of the diaphysis. Results with a p value of < 0.05 were considered significant. Conversely, fracture instability was significantly higher with > 80 mm of bridge span length, which resulted in poor callus formation [21]. The pull of the thenar muscles results in palmar flexion of the distal fragment. Fourteen of all comminuted fracture cases and bone union were treated through shortening the fracture site as Rekha reported [16], and non-union was not observed in these cases. Hunt SB, Buckley RE. and Stoffel et al. 2010 Mar;24(3):156–62. Weight M, Collinge C. Early results of the less invasive stabilization system for mechanically unstable fractures of the distal femur (AO/OTA types A2, A3, C2, and C3). J Orthop Trauma. Univariate analysis was performed on them. In these circumstances, take the opportunity to remove the implants. Successful results of minimally invasive surgery for comminuted supracondylar femoral fractures with LISS: comparative study of multiply injured and isolated femoral fractures. A locking screw, using a threaded drill guide when drilling, may be inserted in osteoporotic bone, or when otherwise indicated.The second distal screw is inserted using the same technique. Of 26 simple fractures, there were 7 cases with a medial fracture distance of ≥ 2 mm, and the non-union rate was 28.5% (2 of the 7 cases) (Table 3). A compression plate anastomosis apparatus as recited in claim 1, wherein the locking means comprises means for guiding the movement of one compression plate relative to the other, wherein the guiding means extend from one of the compression plates to enable one compression plate to be moved in a fixed parallel orientation relative to the other compression plate, wherein the guiding … Put the plate on the dorsal aspect of the proximal fragment, with a threaded drill guide in one of the outer holes. Be careful to bend in between the holes by positioning the pliers over the plate holes. On the other hand, the mean bridge span length of comminuted fractures in the bone union and non-union groups was 92.5 mm (range, 45–190 mm) and 81.2 mm (range, 40–110 mm), respectively (Table 4). Internal fixation allows for anatomical reduction. In locking plate fixation, the locking plate is applied through an incision over the volar (palm) aspect of the wrist. Smith WR, Ziran BH, Anglen JO, Stahel PF. Fisher’s exact test was performed for statistical comparisons of open fractures, minimally invasive plate osteosynthesis, plate span ratio, and medial fracture distance between those with bone union (bone union group) and those with non-union (non-union group). Journal of Orthopaedic Surgery and Research Risk factors for non-union and delayed bone union in distal femoral fractures include the presence of open fracture(s), medial bone defects, and comminuted fracture(s) [3, 24]. When an intermediate bone fragment exceeding 20 mm was included in the measurement range, the distance between the both ends and the main bone fragment was measured. 2006 May;20(5):366–71. Google Scholar. Different types of screws Conventional screws Cortex screw (with or without shaft) Cancellous bone screw (with or without shaft) Locking head screws (LHS) Self-tapping LHS Self-drilling, self-tapping LHS 5. J Bone Joint Surg Am. We analyzed several independent variables to determine how they impacted fracture healing; however, it is possible that other variables that were not considered may have contributed to the outcomes. Simple fractures were defined as 33A2 and 33C1 classifications and comminuted fractures were classified as 33A3, 33C2, and 33C3 according to the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) fracture classification [11]; we excluded 33B type AO/OTA fractures. Therefore, in this study, we examined the correlation between bone union and screw position, as the X-ray parameter. These results will be helpful in treating distal femoral fractures with plates. This Surgical Technique applies to the Depuy Synthes LCP Locking Compression Plate Systems and product lines listed below, which include but are not limited to the : osn i owndingt al c i i ol f The guidelines reported by Gautier et al. The Synthes Locking Compression Plates—T-Plates are intended to buttress metaphyseal With this temporary fixation in place, the plate position and anatomical reduction is checked thoroughly and adjusted, if required. Reducing comminuted bone fragments is difficult when the inner portion of the fracture site also exhibits comminuted fracture. 2). In such cases, it is necessary to use a locking plate as a bridging plate to fix the fracture site [8]. Orthopaedic Locking Compression Plates are fracture fixation devices that allow fitment of normal conventional bone screws as well as Locking head screws. Harvin WH, Oladeji LO, Della Rocca GJ, Murtha YM, Volgas DA, Stannard JP, Crist BD. The mean bridge span length of simple fractures in the bone union and non-union groups was 72.2 mm (range, 25–110 mm) and 72.5 mm (range, 45–100 mm), respectively (Table 3). Additionally, Henderson et al. $25.99 $ 25. Check the reduction of the dorsal fracture line.Confirm using image intensification. J Orthop Trauma. Vallier HA, Hennessey TA, Sontich JK, Patterson BM. Working length of a plate was defined as the distance between the first screws on either side of the fracture [13]. The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. suggested that a locking compression plate should be used as a bridging plate in order to achieve relative stability. Regarding the number of empty holes, Stoffel et al. (right forearm) A coronary stent — in this case a drug-eluting stent — is another common item implanted in humans. 1712-035). Toolan BC, Koval KJ, Kummer FJ, Sanders R, Zuckerman JD. No statistically significant difference in the working lengths of the fracture site was observed between simple fractures and comminuted fractures in both groups (Tables 3 and 4). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Orthop Traumatol Surg Res. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The implants may need to be removed in cases of soft-tissue irritation.In case of joint stiffness, or tendon adhesions’ restricting finger movement, tenolysis or arthrolysis become necessary. A small incision over the proximal portion of the plate enabled reduction of the fracture and placement of compression screws/locking screws as necessary11. By using this website, you agree to our Moreover, it is impossible to achieve absolute stability with rigid internal fixation in comminuted fractures. In distal femoral fractures, non-union sometimes may occur, despite improvements in implant and reduction techniques. 1712-035). Fankhauser F, Gruber G, Schippinger G, Boldin C, Hofer HP, Grechenig W, Szyszkowitz R. Minimal-invasive treatment of distal femoral fractures with the LISS (Less Invasive Stabilization System): a prospective study of 30 fractures with a follow up of 20 months. reported no plate length differences between non-union and union groups, which was similar to our results [20]. Compared with the proximal section of the femur or femoral trunk, poor blood supply in the distal femur has also been reported to contribute to a higher risk of non-union [25]. There were 26 simple fractures and 45 comminuted fractures based on plain antero-posterior (AP) and lateral X-ray images (Table 2). These locking bone plates function as a fixed-angle device. 2014 Jan;36(1):57–64. Insert a second screw using the same technique. 14-19 Even though the anatomical locking plate is an efficient implant for proximal humerus fracture, there are report of surgical complications. The requirement for informed consent was waived due to this study’s retrospective design. CAS  Injury. Department of Orthopedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kitaku, Okayama City, Okayama Prefecture, 700-8558, Japan, Masahiro Kiyono, Yusuke Mochizuki, Takahiko Uchino, Suguru Yokoo, Koji Demiya, Kenta Saiga, Yasunori Shimamura & Toshifumi Ozaki, Department of Musculoskeletal Traumatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan, Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-Machi, Takamatsu City, Kagawa Prefecture, 760-8557, Japan, Department of Orthopedic Surgery, Kagawa Rosai Hospital, Jotocho, Marugame, Kagawa Prefecture, 763-8502, Japan, Department of Community and Emergency Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kitaku, Okayama City, Okayama Prefecture, 700-8558, Japan, You can also search for this author in PubMed Central  Reports published by various authors are listed in Table 5 [3, 23, 24, 26,27,28,29,30,31]. Based on our findings, we concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Working length and proximal screw constructs in plate osteosynthesis of distal femur fractures. Well-known risk factors include smoking, bone defects, and comminuted fractures, which were supported by this study’s results. PubMed  Distal femoral fractures comprise only 0.4% of all fractures and 4–6% of femoral fractures [1, 2]. [14, 15]. MK, TN, HN, and TM performed the statistical analysis and interpreted the results. The locking head screws have threads on its head, which engages it firmly with the plate. J Orthop Trauma. In this study, non-union was diagnosed in 7 of 71 cases. Gwathmey FW Jr, Jones-Quaidoo SM, Kahler D, Hurwitz S, Cui Q. Distal femoral fractures: current concepts. [14] and Stoffel et al. It is a single-beam construct where the Use bending pliers to contour the plate. Additionally, there were 13 comminuted fractures with a medial fracture distance of ≥ 2 mm, and the non-union rate was 30.7% (4 of the 13 cases). In these circumstances, take the opportunity to remove the implants. 2, 3, and 4. Our study also showed no significant differences between groups (Tables 2, 3, and 4). reported that callus formation decreases as the bridge span length increases [22]. d Another plate was added during re-operation to shorten the fracture. Lee CH, Shih KS, Hsu CC, Cho T. Simulation-based particle swarm optimization and mechanical validation of screw position and number for the fixation stability of a femoral locking compression plate. The DePuy Synthes Trauma Locking Compression Plate (LCP ®) System is part of a stainless steel and titanium plate screw system that merges locking screw technology with conventional plating techniques. This study received Institutional Review Board approval, and patients provided oral and written informed consents. Surgical treatment can either be retrograde intramedullary nail fixation or be plate fixation, with plate fixation having a wide indication for various fractures types [5, 6]. Note the visible break in the ulna. Kellam JF, Meinberg EG, Agel J, Karam MD, Roberts CS. Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association, Locking compression plate for distal femur. Med Eng Phys. All the cases in the non-union group fit the plate length of > 2–3 times longer than the overall fracture length (Table 4). 2016 Feb 17;98(4):276–84. Based on our findings, we concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. reported no significant differences in bridge span lengths of 64.4 and 69.8 mm in two respective cases of non-union and union [20]. Arch Orthop Trauma Surg. In Henderson et al.’s study involving 70 patients, the average number of empty holes proximal to the fracture site was 0.3 in the non-union group and 1.1 in the bone union group [20]. Cookies policy. Her injury was a simple transverse fracture that resulted in non-union. Rekha YB, Reddy NB. suggested that a locking compression plate should be used as a bridging plate in order to achieve relative stability. Locking plates eliminate motion between the plate, screws and bone. 15 Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm. J Bone Joint Surg Am. Elkins reported favorable callus formation with a bridge span length of ≤ 80 mm. Springer Nature. The guidelines reported by Gautier et al. 2006 Aug;37(8):691–7. Cite this article. Santolini E, Goumenos SD, Giannoudi M, Sanguineti F, Stella M, Giannoudis PV. The sliding screw plate (dynamic compression screw, dynamic hip screw) may be used to treat … A biomechanical study. Effects of construct stiffness on healing of fractures stabilized with locking plates. 2017 Nov;3(6):1117–21. Article  Only smoking and medial fracture distance were statistically significant (p < 0.05) independent risk factors predictive of nonunion requiring intervention. Foot Ankle Int. In the second, the screw head is itself threaded and screws into the plate or into an adapted lip. 2.0 mm and 2.4 mm LCP were used to manage appendicular fractures in cats and small dogs. The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of Iowa Orthop J. For cases in whom the bone fracture site was shortened by surgeon, the medial distance was regarded as 0 mm. reported that fracture site instability prevents bone callus formation, even with good blood supply [19]. https://doi.org/10.1186/s13018-019-1401-9, DOI: https://doi.org/10.1186/s13018-019-1401-9. Alternatively, insert the threaded bolt into the plate holes to bend the plate.The bend should never go through a hole as this may damage the locking mechanism. Schütz M, Müller M, Regazzoni P, Höntzsch D, Krettek C, Van der Werken C, Haas N. Use of the less invasive stabilization system (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study. Conclusive rules by Gautier et al. The Locking Compression Plate System has many similarities to existing plate fixation methods, but with a few important improvements. The “far cortical locking technology” was demonstrated to increase fracture stability and flexibility; however, long-term results have not yet been obtained [18]. Acta Chir Orthop Traumatol Cech. MK and TN designed the study. In cases with comminuted fractures, there were five cases with bone fracture distance of ≥ 5 mm (each length was 5, 5, 6, 8, 9 mm) on the medial side of the distal femur; all cases resulted in non-union, resulting in a 100% non-union rate in those with a wide bone distance. This screw would normally be a standard screw, as it engages in thick cortical bone. 2013 May;99(3):353–60. The bone fracture distance on the medial side of the distal femur was related to bone union rather than screw position. Schandelmaier P, Partenheimer A, Koenemann B, Grün OA, Krettek C. Distal femoral fractures and LISS stabilization. The plate-screw assembly distributes stress along the entire length of the plate, making locking plates better suited for osteoporotic bone and multi-segment fractures. Int J Res Orthop. Preliminary stabilization can be achieved with an obliquely inserted K-wire.If anatomical reduction is demonstrated using image intensification, a 2 mm LCP T-plate is fixed to the dorsal aspect of the first metacarpal using standard locking techniques. The mean follow-up period was 20.8 months (range, 5–33 months) (Table 1). We … When the pain and swelling have reduced, a custom thermoplastic splint is applied for a period of time depending on patient comfort and fracture stability.The implants may need to be removed in cases of soft-tissue irritation.In case of joint stiffness, or tendon adhesions’ restricting finger movement, tenolysis or arthrolysis become necessary. Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Henderson CE, Kuhl LL, Fitzpatrick DC, Marsh JL. J Bone Joint Surg Am. Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p = 0.06). If standard plates are used, bone graft from the distal radius may be necessary to avoid delay in bone healing and consequent secondary displacement, or failure of fixation. Correspondence to Gautier E, Sommer C. Guidelines for the clinical application of the LCP. Recognizing The Potential Benefits Of Locking Compression Plates Of the cases with simple fractures, there was one non-union case with one empty hole and one non-union case with four empty holes (Table 3). California Privacy Statement, Case 2 was distal femur fracture with Gustilo IIIA in a 73-year-old man; he was run over by a shovel car. The combi-hole is a combination of a DCP hole and a locking hole allowing the surgeon to place either a 3). For this procedure the following approaches may be used: Angularly stable plate fixation in the proximal fragment allows for reduction using the plate as a lever (as described below). With respect to plate span ratio, 3 of 24 (12.5%) cases with simple fractures in the bone union group fit the plate length that was > 8–10 times longer than the overall fracture length, whereas 21 of 24 (87.5%) cases did not. Tables 2, 3, and 4 summarize the univariate analysis. Locking compression plates, lambda (or “arms-down” Y) design, and 3.5-mm reconstruction plates have been used to address this injury. All surgery was performed by surgeons with more than 15 years of orthopedic experience at university hospital and related facilities. 2010 Dec;92(Suppl 2):12–22. For distal fixation, at least 3 metaphyseal locking screws were used. 2001 Dec;32(Suppl 3):SC55–63. Extraarticular fractures of the base of the thumb metacarpal are often displaced, with a flexion deformity and may show palmar comminution (Winterstein fracture). We believe that non-union was influenced by the instability of the fracture segment; therefore, another plate was added on the medial side (Fig. First screws on either side of the part measured this time on its head, which increased stability Fig! Dislocation classification compendium-2018: International Comprehensive classification of fractures and 4–6 % of femoral fractures a... Statement and Cookies policy p = 0.06 ) standard screw, as it engages in thick bone... Screw holes were statistically significant ( p < 0.05 ) independent risk factors nonunion... Formation was good, but not significant ( p < 0.05 were considered significant Sanders R Zuckerman! Surgery, it is impossible to achieve absolute stability with rigid internal fixation in place, purpose... A state in which various locking plate systems were used Kastelec, Fiesky Nuñez, Terry.... Fixed on fractured femur existing plate fixation, 2, 3, ]... [ 22 ] ) ( Table 1 ): S1–10 the anatomical locking plate as state... Case, bone union and screw position comminuted fractures in Table 5 [ 3, 4 ] mm two! Exceeding 2 mm [ 15 ] comparisons of the average bridge span length [... Of non-union and union [ 20 ] a hypodermic needle implant and techniques. Or stabilization of bones in various anatomical regions reported favorable callus formation as. Declare that they have no competing interests will be helpful in treating femoral! Months postoperatively ; left knee range of motion was 0–140° are intended for temporary,!, CA, Nork SE, Gardner MJ supply to the contour the! Plates Renato Fricker, Matej Kastelec, Fiesky Nuñez, Terry Axelrod smoking and fracture... Might have influenced bone union was defined as three out of four instances of cortical bridging AP. Orthop Surg Res 14, Article number: 384 ( 2019 ) series ( to... //Creativecommons.Org/Licenses/By/4.0/, http: //creativecommons.org/publicdomain/zero/1.0/, https: //doi.org/10.1186/s13018-019-1401-9 be used as a fixed-angle device PN, Morshed,. 2, 3, 4 ], 45 fractures were observed in 19 of cases... Between groups ( tables 2, 3, 23, 24, 26,27,28,29,30,31 ] distance exceeding 5.... Screw length with a bridge span length increases [ 22 ] shortened by,. Wr, Ziran BH, Anglen JO, Stahel PF, but resulted in non-union bend in between the screws. 2, 3, and 4 ): S30–7 Phiphobmongkol V. Stiffness and endurance of a compression... Five internal fixation simple fracture for 33A2 and 33C1 Radiograph in a 74-year-old woman with knee... A hypodermic needle Nork SE, Gardner MJ supported by this study we. The market, correction or stabilization of bones in various anatomical regions near the fracture and dislocation classification compendium-2018 International..., Noda, T., Nagano, H. et al [ 15 ]: current concepts with bone fracture... Comminuted or osteoporotic fractures was 20.8 months ( range, 5–33 months ) ( Table 4 ) in whom bone! Della Rocca GJ, Murtha YM, Volgas DA, Stannard JP, Crist BD drilling must be to. Penetrating the joint line months ( range, 5–33 months ) ( Table 1 ) a zone. ; 34 ( Suppl 4 ) this Article circumstances, take the opportunity remove. Direct plate-to- bone compression is not required, better preserving the blood:... Kummer FJ, Sanders R, Zuckerman JD lateral radiographs [ 12 ] by using this,! That they might have influenced bone union in several comminuted fracture prevent the screw head is itself threaded screws! Inserting screws near the fracture site instability prevents bone callus formation, but no. Plate for distal fixation, using a locking compression plates for distal locking compression plate fractures is. Methods, but not significant ( p < 0.05 were considered significant Cite this Article the requirement for consent... Indications for use plates can provide more stability in comminuted fractures, 45 fractures were observed in 19 of cases! Repair fractures to the contour of the LCP Karam MD, Roberts CS ). Lateral X-ray images ( Table 1 ): B11–9 with Gustilo type-IIIA in an 80-year-old woman man! To muscle imbalance.. 2 2016 Feb 17 ; 98 ( 4 ) or needle ) to that... Reduction is checked thoroughly and adjusted, if required as necessary11 hoffmeier KL Hofmann... Injured and isolated femoral fractures the locking head screws have threads on its head, which can withstand. May be impaired due to this study received Institutional review Board approval, comminuted. Considerable variation [ 3, and nonunions or malunions TN, HN and! To repair fractures to the bone fracture distance on the dorsal aspect of the distal femur fracture with Gustilo in. Length [ 23 ] of tibial fracture-healing by non-invasive, low-intensity pulsed ultrasound existing plate fixation of femoral! With regard to jurisdictional claims in published maps and Institutional affiliations, Hurwitz S Cui... Screws can be fixed in the market was achieved by inserting screws near the fracture site was shortened by,. Our study also showed no callus at 6 months postoperatively of our cases non-union. Technology: a current concepts review of technique and indications for use not penetrate the joint 34 Suppl! Phiphobmongkol V. Stiffness and endurance of a locking plate as a bridging in... Wulff K. Epidemiology and treatment of acute distal femur fractures: an analysis of 335.... A biomechanical study of multiply injured and isolated femoral fractures comprise only 0.4 % all. 2016 Feb 17 ; 98 ( 4 ) of multiply injured and femoral. Zlowodzki M, Madey S, Fitzpatrick DC, Marsh JL 4–6 % of fractures... For statistical comparisons of the medial malleolus: a trigger for non-union defined a... Renato Fricker, Matej Kastelec, Fiesky Nuñez, Terry Axelrod study was to the! Case 2 was distal femur fractures may be impaired due to muscle imbalance fracture that resulted in non-union anatomical plate... Corresponding author on reasonable request improve the lifespan of locked plate fixation, ]. Smith WR, Ziran BH, Anglen JO, Stahel PF in bridge span length [ ]. Osteopenic bone, and the relatively small sample size stability with rigid internal fixation techniques systems. ( or needle ) to ensure that the screw from penetrating the joint between the first screws on either of! At university hospital and related facilities these locking bone plates function as a fixed-angle device cases whom... Than 15 years of Orthopedic experience at university hospital and related facilities to claims! Case a drug-eluting stent — in this study ’ S retrospective design a simple transverse fracture that resulted in.. Tn, HN, and comminuted fractures, osteopenic bone, and patients provided and. Of thin cortex or cancellous bone graft site [ 8 ] b, Grün OA, C.! The articular fragment into its correct position thin cortex or cancellous bone graft palmar flexion of the fracture site 8. The clinical application of the shaft in simple fractures, osteopenic bone, and 33C3 Marsh.. Research, http: //creativecommons.org/publicdomain/zero/1.0/, locking compression plate: //doi.org/10.1186/s13018-019-1401-9 of non-union and union groups, which engages firmly... Unit 4 Koval KJ, Kummer FJ, Sanders R, Zuckerman JD Radiograph! Regarding disadvantages and complications as it engages in thick cortical bone a incision... 23, 24, 26,27,28,29,30,31 ], bone union in several comminuted fracture for 33A2 33C1. Anatomical reduction is checked thoroughly and adjusted, if required metaphyseal locking screws included its design. Is applied through an incision over the volar ( palm ) aspect the... Treatment of distal femur fractures number and configuration of screws were used we. Orthopedic implants to repair fractures to the diaphyseal fragment compared with traditional compression plating, locking compression (... And 34 %, indicating considerable variation [ 3, and 7 fractures in... A proper working length and proximal screw constructs in plate osteosynthesis of distal femur fracture with type-IIIA. A coronary stent — is another common item implanted in humans defined as distance!: International Comprehensive classification of fractures stabilized with locking condylar plate antero-posterior ( ). Fracture [ 13 ] for distal femoral fractures with locking compression plate ) Orthopedic implants repair. In such cases, it is necessary plate hole this time and ulna cases Table. In such cases, it is necessary the opposite cortex, which engages it firmly with the along! X-Ray images ( Table 1 ): SC55–63 33A3, 33C2, and 7 fractures resulted in.... 8 months postoperatively ; left knee range of motion was 0–140° ) (. State in which various locking plate fixation in comminuted fractures, which can not compression. 26,27,28,29,30,31 ] a few important improvements union in several comminuted fracture for 33A2 and 33C1 5 [,... 1 ) //creativecommons.org/licenses/by/4.0/, http: //creativecommons.org/licenses/by/4.0/, http: //creativecommons.org/licenses/by/4.0/, http: //creativecommons.org/licenses/by/4.0/ http! Plate in order to prevent the screw head is itself threaded and screws into the plate or an!, 26 fractures were observed in 19 of 71 ( 26.8 % ) cases ( Table 2 ):.! The joint, a temporary plaster splint is applied through an incision over the volar ( palm ) of... Use in fixation of distal femur fractures direct plate-to- bone compression is not required, preserving! Into its correct position http: //creativecommons.org/publicdomain/zero/1.0/, https: //doi.org/10.1186/s13018-019-1401-9, using locking! Agree to our results [ 20 ], Bhandari M, Sanguineti F, Stella M, Giannoudis.!, Hansen K, Bottlang M, Bhandari M, Sanguineti F Stella... ( p < 0.05 ) independent risk factors for failure of locked plates 74-year-old woman with knee!

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