Locking plate as a definitive external fixator for treating tibial fractures with compromised soft tissue envelop

Qiu, Xusheng; Han, Yuan; Zheng, Xi; Wang, Junfei; Xiong, Jie; Chen, Yixin

doi:10.1007/s00402-013-1916-1

Cited by 32 publications

(47 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Allografts were added if there was insufficient iliac bone grafts. The external fixator was used for definitive fixation in some patients, while in other patients, the external fixator or cast was changed by internal fixation or a locking plate was used as the external fixator as the terminal treatment [14]. Intravenous antibiotic therapy was continued for 2 weeks postoperatively.…”

Section: Methodsmentioning

confidence: 99%

Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis

Qiu

Chen

et al. 2017

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

BackgroundCement spacers (Masquelet technique) have traditionally been used for the treatment of segmental bone defects. However, no reports have used cement spacers for the treatment of small/partial segmental bone defects associated with osteomyelitis and compared the outcomes with cement beads.MethodsWe retrospectively analysed 40 patients with post-traumatic osteomyelitis of the tibia who underwent treatment, which was performed in two stages. In the first stage, thorough debridement was performed, and bone defects were filled with either antibiotic-impregnated cement beads (bead group, 18 patients) or spacers (spacer group, 22 patients). In the second stage, the cement beads or spacers were removed (for the spacer group, the induced membrane formed by the spacer was preserved) and the bone defects were filled with cancellous autografts.ResultsAll patients in the bead group had small/partial segmental bone defects after debridement, while 3 patients in the spacer group had large/segmental bone defects.The mean volume of bone defects of the spacer group (40.4 cm3) was significantly larger than that of the bead group (32.4 cm3). The infection control rate (88.9%,16/18 vs 90.9%, 20/22), bone healing time (8.5 months vs 7.5 months) and complication rates (22.2%, 4/18 vs 27.2%, 6/22) were comparable between bead group and spacer group.ConclusionThe results of this study suggest that cement spacers may have an infection control rate comparable to cement beads in the treatment of bone defects associated with post-traumatic osteomyelitis. Furthermore, cement spacers could be used for the reconstruction of small/partial segmental bone defects as well as for large/segmental bone defects, whereas cement beads were not suitable for the reconstruction of large/segmental bone defects.

show abstract

Section: Methodsmentioning

confidence: 99%

Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis

Qiu

Chen

et al. 2017

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

show abstract

“…7,29,30 However, the most common region is the tibia. 2,4-6,8,31,32 Our experience with the externalised LCP as an external fixator is also in the tibia. There have been several comparisons made between the externalised LCP and traditional external fixators.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several comparisons made between the externalised LCP and traditional external fixators. 1,4 However, the stiffness of external locked plating is not clear 2 as mechanical testing was not reported in the case reports and case series.…”

Section: Discussionmentioning

confidence: 99%

“…External fixators allow for better soft-tissue management and preservation of blood supply to the fractured bone. 1,2 They can be used for temporary or definitive fixation. However, acceptance of external fixation is low due to the high profile of the constructs, which makes it obstructive and inconvenient during ambulation and dressing.…”

Section: Introductionmentioning

confidence: 99%

“…Besides the obstructive nature of the high profile construct, some patients are also self-conscious of these fixators and find them less socially acceptable. 2-8 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness

Ang

Chen

Yew

et al. 2017

Bone & Joint Research

View full text Add to dashboard Cite

ObjectivesExternal fixators are the traditional fixation method of choice for contaminated open fractures. However, patient acceptance is low due to the high profile and therefore physical burden of the constructs. An externalised locking compression plate is a low profile alternative. However, the biomechanical differences have not been assessed. The objective of this study was to evaluate the axial and torsional stiffness of the externalised titanium locking compression plate (ET-LCP), the externalised stainless steel locking compression plate (ESS-LCP) and the unilateral external fixator (UEF).MethodsA fracture gap model was created to simulate comminuted mid-shaft tibia fractures using synthetic composite bones. Fifteen constructs were stabilised with ET-LCP, ESS-LCP or UEF (five constructs each). The constructs were loaded under both axial and torsional directions to determine construct stiffness.ResultsThe mean axial stiffness was very similar for UEF (528 N/mm) and ESS-LCP (525 N/mm), while it was slightly lower for ET-LCP (469 N/mm). One-way analysis of variance (ANOVA) testing in all three groups demonstrated no significant difference (F(2,12) = 2.057, p = 0.171).There was a significant difference in mean torsional stiffness between the UEF (0.512 Nm/degree), the ESS-LCP (0.686 Nm/degree) and the ET-LCP (0.639 Nm/degree), as determined by one-way ANOVA (F(2,12) = 6.204, p = 0.014). A Tukey post hoc test revealed that the torsional stiffness of the ESS-LCP was statistically higher than that of the UEF by 0.174 Nm/degree (p = 0.013). No catastrophic failures were observed.ConclusionUsing the LCP as an external fixator may provide a viable and attractive alternative to the traditional UEF as its lower profile makes it more acceptable to patients, while not compromising on axial and torsional stiffness.Cite this article: B. F. H. Ang, J. Y. Chen, A. K. S. Yew, S. K. Chua, S. M. Chou, S. L. Chia, J. S. B. Koh, T. S. Howe. Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness. Bone Joint Res 2017;6:216–223. DOI: 10.1302/2046-3758.64.2000470.

show abstract

External fixation using locking plate in distal tibial fracture: a finite element analysis

Zhang

Ebraheim

et al. 2015

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

show abstract

Locking plate as a definitive external fixator for treating tibial fractures with compromised soft tissue envelop

Cited by 32 publications

References 19 publications

Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis

Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis

Externalised locking compression plate as an alternative to the unilateral external fixator: a biomechanical comparative study of axial and torsional stiffness

External fixation using locking plate in distal tibial fracture: a finite element analysis

Contact Info

Product

Resources

About