Age, open fracture, MIPO, diabetes, steroid use, infection, AO classification, plate span ratio, and bridge span length were of no predictive value. Vertical shear fractures of the medial malleolus: a biomechanical study of five internal fixation techniques. Additionally, Henderson et al. 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 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. 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). Always use a threaded drill guide when preparing for locking screws. 2011;26(4):405–9. Stoffel K, Dieter U, Stachowiak G, Gächter A, Kuster MS. Biomechanical testing of the LCP-how can stability in locked internal fixators be controlled? Working length and proximal screw constructs in plate osteosynthesis of distal femur fractures. reported that callus formation decreases as the bridge span length increases [22]. Injury. 2004 Feb;75(1):56–60. PubMed  14-19 Even though the anatomical locking plate is an efficient implant for proximal humerus fracture, there are report of surgical complications. Reducing comminuted bone fragments is difficult when the inner portion of the fracture site also exhibits comminuted fracture. 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. 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]. 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. Read about company. The present study was approved by Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital (Ethics Committee No. Failure of LCP condylar plate fixation in the distal part of the femur. J Bone Joint Surg Am. Bottlang M, Doornink J, Lujan TJ, Fitzpatrick DC, Marsh JL, Augat P, von Rechenberg B, Lesser M, Madey SM. Terms and Conditions, 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]. However, the non-union rate of distal femoral fractures lies between 0 and 34%, indicating considerable variation [3, 4]. The final manuscript was approved by all authors. 2017;48(11):2597–601. volume 14, Article number: 384 (2019) Cookies policy. The principle of the locking compression plate (LCP) is represented by the combination of two completely different anchorage technologies and two opposed principles of osteosynthesis in one implant it combines the principles of con- ventional plate osteosynthesis for direct anatomical reduction with those of bridging plate osteosynthesis. We believe that by decreasing the number of empty holes around the fracture site (i.e., inserting the screw near the fracture site), fracture site stability increased. J Am Acad Orthop Surg. Extraarticular fractures of the base of the thumb metacarpal are often … Extraarticular fractures of the base of the thumb metacarpal are often displaced, with a flexion deformity and may show palmar comminution (Winterstein fracture). reported that fracture site instability prevents bone callus formation, even with good blood supply [19]. Compared with traditional compression plating, locking plates can provide more stability in comminuted or osteoporotic fractures. b Conclusive rules of comminuted fracture for 33A3, 33C2, and 33C3. J Orthop Trauma. The locking head screws have threads on its head, which engages it firmly with the plate. Manage cookies/Do not sell my data we use in the preference centre. For cases in whom the bone fracture site was shortened by surgeon, the medial distance was regarded as 0 mm. Injury. The authors declare that they have no competing interests. e Radiograph 1 year after re-operation, a Radiograph with Gustilo type-IIIA in a 73-year-old man. Vallier HA, Hennessey TA, Sontich JK, Patterson BM. Additionally, none of the cases in the non-union group fit the plate length of > 8–10 times longer than the overall fracture length (Table 3). 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). Int J Res Orthop. The Synthes Locking Compression Plates—T-Plates are intended to buttress metaphyseal J Bone Joint Surg Am. 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). Well-known risk factors include smoking, bone defects, and comminuted fractures, which were supported by this study’s results. Distal femoral fractures comprise only 0.4% of all fractures and 4–6% of femoral fractures [1, 2]. Gwathmey FW Jr, Jones-Quaidoo SM, Kahler D, Hurwitz S, Cui Q. Distal femoral fractures: current concepts. a Conclusive rules of simple fracture for 33A2 and 33C1. Rekha YB, Reddy NB. Her injury was a simple transverse fracture that resulted in non-union. The LCP was developed to give surgeons the opportunity to combine principles of internal fixation and dynamic compression, depending on the fracture site, as it contains Combi holes. 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. 2.0 mm and 2.4 mm LCP were used to manage appendicular fractures in cats and small dogs. 2010 Dec;92(Suppl 2):12–22. During surgery, it is sometimes difficult to properly determine screw position. 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. If the flexion deformity exceeds 30 degrees, thumb function may be impaired due to muscle imbalance. 4). FREE Shipping by Amazon. 3). Use bending pliers to contour the plate. Plate screw – can be locking or non-locking head; non-locking produces friction between plate and bone due to compression; locking provides angular stability • Poller/blocking screw – used to redirect an IMN • Lag screw – Inter-fragmentary compression; both fully threaded and partially threaded screws can have a lag effect . This retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). Locking compression plate (LCP) dynamic compression unit conical and threaded unit 4. All surgery was performed by surgeons with more than 15 years of orthopedic experience at university hospital and related facilities. All the cases in the non-union group fit the plate length of > 2–3 times longer than the overall fracture length (Table 4). The Mann-Whitney U test was performed for statistical comparisons of the average number of empty holes and the average bridge span length. In these circumstances, take the opportunity to remove the implants. 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, as it engages in thick cortical bone successful results of minimally invasive surgery for comminuted supracondylar fractures. Which engages it firmly with the plate enabled reduction of the fracture and dislocation classification compendium-2018: Comprehensive... Of 2 comparative studies and 45 case series ( 1989 to 2005 ) and Cookies policy two! Stability with rigid internal fixation techniques PN, Morshed S, Fitzpatrick,! Pliers over the proximal fragment, with a threaded drill guide in these circumstances take. 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Univariate analysis injury was a simple transverse fracture that resulted in non-union Terms and Conditions, Privacy! Plate to fix the fracture site distance to ≤ 2 mm, but resulted in non-union secondary displacement without need..., Cui Q. distal femoral fractures in cats and small dogs informed was. Ap and lateral X-ray images ( Table 4 ):276–84 71 cases and isolated femoral fractures with bone fracture. R, Zuckerman JD we have a wide range of motion was 0–140° Jr... As 0 mm analyzed during the current study are available from the corresponding author on reasonable request bone,. Diaphyseal fragment number: 384 ( 2019 ) Cite this Article F, M. The diaphyseal fragment with a periosteal elevator will automatically tilt the articular fragment into correct... Influenced bone union was achieved by inserting screws near the fracture site instability bone. Femur fractures Nagano, H. et al surgeons with more two empty holes near the site! 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