Stabilisation of diaphyseal fractures of both bones forearm with limited contact dynamic compression or locked compression plate: comparison of clinical outcomes

Abstract

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The inception of Locking Compression Plate (LCP) has revolutionized fracture management. With their dramatic success for articular fractures, there is a speculation that they might be more appropriate for diaphyseal fractures as well.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">In this randomized prospective cohort study, 56 patients with diaphyseal fractures involving both bones of forearm were segregated into two groups based on internal fixation with Limited contact dynamic compression plate (LC-DCP)(n=28) or with Locking compression plate (LCP)(n=26). Clinical and radiological parameters were studied and functional evaluation was done with Disabilities of arm, shoulder, and hand (DASH) score</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Andersons’ criteria was employed to categorize the functional results. The mean duration of surgery and time to union were discovered to be less in favor of LCP group although statistically insignificant. No significant differences in two groups with respect to the functional evaluation (range of movement, Andersons’ criteria and DASH score) and complications could be discerned. No incidence of refracture or synostosis was encountered in any of the group. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Although LCP is an effective treatment alternative and may have a subtle edge over LC-DCP in the management of these fractures, their supremacy could not be certified. We deduce that surgical planning and expertise rather than the choice of implant are more pivotal for outstanding results.</span></p>

Results of locking compression plate in closed diaphyseal forearm fractures in adults

“…Transverse Wedge Comminuted Chapman [10] 53% -47% Leung [12] 37.5% 46.8% 15.6% Sharma [13] 76.7% 23.3% -SPS Gill [17] 61.5% 34.6% 3.8% Our study 15.8% 44.7% 39.5%…”

“…Operative time: In our study, we had average operative time of 68 minutes with average tourniquet time of 54 minutes. [15] 76 Meena [16] 70.25 Saikia [14] 93.5 SPS Gill [17] 80.8+/-15.7 Our study 68…”

“…Age distribution: In our study, diaphyseal fractures of forearm bones were common in 3rd & 4th decade, with an average age of 32.77 years (16-60 years) which was comparable to previously conducted studies. [8] 16 57 44.8 Herbert dodge [9] 13 59 24 Chapman [10] 13 79 33 Moed B R [11] 14 65 22 F. Leung [12] 11 90 36 Sharma [13] 15 60 34 Saikia [14] 16 60 30.5 Ibrahim azboy [15] 16 74 28 Meena [16] 18 64 31.15 SPS Gill [17] 18 60 32.4 Rijal [18] 19 70 36.77 Our study 16 60 32.77…”

“…Male preponderance could be due to involvement of males in outdoor activities, industrial labour and sports activities as compared to their female counterparts. [9] 89 11 Chapman [10] 78 22 F. Leung [12] 82.6 17.4 Sharma [13] 86.6 13.4 Saikia [14] 70 30 Ibrahim azboy [15] 77.3 22.7 SPS Gill [17] 73.07 26.93 Rijal [18] 60 [13] 63.6 36.4 -Meena [16] 50 30 20 Rijal [18] 33. [8] 50% 50% Chapman [10] 55% 45% Meena [16] 61% 39% SPS Gill [17] 53.8% 46.2% Claudio Iacobellis [19] 38.3% 61.7% Rijal [18] 43.3% 56.7% Our study 22.72% 72.28%…”

Effects of long-term plate fixation with different fixation modes on the radial cortical bone in dogs

“…Locking plates with a small periosteal contact area reportedly reduce the risk of early postoperative osteoporosis [ 10 ]. However, studies have not yet clarified whether the locking plate system, which should be biologically superior to the conventional plate system, has better clinical outcomes than the conventional plate system [ 11 ]. In addition, the histological and molecular biological findings for a comparison of the long-term effects of the locking and conventional systems on bone have not been identified.…”