The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation

Abstract

Purpose: The purpose of this study was to evaluate the efficacy of the surgical treatment through the comparison of LC-DCP (Limited Contact-Dynamic Compression Plate) versus LCP (Locking Compression Plate) fixation in the plate augmentation for the nonunion of femur shaft fractures after intramedullary nail fixation. Materials and Methods: Twenty-four patients with the nonunion of femur shaft fractures after intramedullary nail fixation who underwent plate augmentation were evaluated from Mar. 2001 to Sept. 2005. The group with LC-DCP augmentation was done bicortical screw fixation and the group with LCP was done monocortical fixation. Results: There was one case of nail breakage in LC-DCP group, but sound bony union were achieved uneventfully in all the cases of both group. LCP fixation was slightly superior to LC-DCP fixation in view of the bony union time, operating time, postoperative Hb down, amount of postoperative transfusion, but there was no statistical difference (p＞0.05). Conclusion:We got the satisfactory results after monocortical LCP augmentation as well as bicortical LC-DCP fixation and have concluded that monocortical LCP fixation was an effective treatment option for nonunion of femur shaft fracture occurred after Intrmedullary nail fixation.

RETRACTED ARTICLE: An experimental study on stress-shielding effects of locked compression plates in fixing intact dog femur

“…It was reported that LCP constructs were significantly more resistant to compression than LC-DCP constructs in an in vitro comparison in the femur of newborn calves [ 15 ]. In addition, monocortical LCP fixation was considered as a more effective treatment option than LC-DCP for nonunion of femur shaft fracture occurred after intramedullary nail fixation [ 16 ]. Moreover, in a canine femoral fracture-gap model, the LC-DCP with an intramedullary rod (LC-DCP-R) showed higher stiffness and resistance to failure, lower interfragmentary motion, and lower plate strain and stress compared to LCP [ 12 ].…”

“…Nevertheless, more intensive comparisons on the efficacy of the surgical treatments with LCP and LC-DCP, especially the long-term stress shielding effect, are required to provide better guidance for clinical therapy. In recent years, MicroCT (micro-computed tomography) has been applied to achieve accurate segmentation of images to better characterize the properties of cortical bone, trabecular bone, and newborn bone after plate fixation [ 15 , 16 ]. In addition, the critical parameters derived from the MicroCT analyses, including tissue mineral density (TMD), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation (Tb.Sp), are considered to be able to more accurately reflect the degree of osteopenia and osteoporosis in quantities [ 17 , 18 ].…”

Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review

“…In general, fixed-beam constructs such as locking plates elicit secondary bone healing through stable fixation without the degree of interfragmentary compression that compression plating provides [ 15 ]. However, recent research posits that the mechanics of successful bone union are dynamic, with ideal strain, hydrostatic stresses, and interfragmentary motion changing throughout the course of bone healing [ 10 , 16 , 17 , 18 , 19 ]. This may account for similar nonunion rates between compressive and fixed-beam constructs.…”