This article is more than 5 years old. Information may no longer be current.
Locking compression plate effective for internal fixation of forearm fractures
No patients developed deep infection and only one patient developed a superficial infection in a recent trial.
Click Here to Manage Email Alerts
Open reduction and internal fixation of diaphyseal forearm fractures using a locking compression plate led to a high rate of union and good functional outcomes in a prospective study.
Frankie Leung, MD, and colleagues at Queen Mary Hospital, University of Hong Kong, evaluated the use of a 3.5-mm stainless steel locking compression plate (Mathys Medical) in 45 forearm fractures of 32 patients with an average age of 35 years. All patients had fresh diaphyseal fractures; pathologic fractures were excluded from the study.
Patients had a mean injury severity score of 7.8; 18 patients (56%) suffered low energy trauma and 14 patients (44%) suffered high-energy trauma, resulting in 27 patients (84%) with isolated fractures and five patients (16%) with multiple fractures.
After fracture reduction, surgeons used a conventional screw to temporarily secure the plate to the bone. The next screw used depended on the fracture configuration. Surgeons either used a locking head screw for a bridging technique or a conventional compression screw for interfragmentary compression. All other screws used were locking head screws, according to the study.
Time to union averaged 20 weeks. No patients experienced nonunion, although two patients demonstrated delayed union, which healed by 36 weeks and did not require additional grafting procedures.
At 20 months mean follow-up, fractures were anatomically reduced in 33% of cases. Minimal or no callus formation was seen in 56% of cases and moderate callus formation was seen in 44%, according to the study.
Of the anatomically reduced fractures, 13% had moderate or abundant callus formation. No patients developed deep infection, and only one patient developed a superficial infection, the authors noted.
Overall, 22 patients (29 locking compression plates) opted for plate removal at 16 months mean postop.
Two patients suffered refracture. In both cases, the locking compression plates had been removed 11 to 12 months after initial surgery and the refractures occurred at the sites of the original fractures.
"After these two cases of refracture occurring early in our series, we adopted a minimum interval of 18 months for implant removal," the authors said in the study.
For more information:
- Leung F, Chow SP. Locking compression plate in the treatment of forearm fractures: A prospective study. J Orthop Surg (Hong Kong). 2006;14:291-294.