A NEWLY DESIGNED ASSEMBLY LOCKING COMPRESSION PLATE TO TREAT COMMINUTED FRACTURES OF THE FEMORAL SHAFT: A BIOMECHANICAL STUDY

2019 ◽  
Vol 19 (06) ◽  
pp. 1950059 ◽  
Author(s):  
MIN ZHAO ◽  
JIANGJUN ZHOU ◽  
ZHUANYI YU ◽  
QIUXIN CHENG ◽  
JINGXIANG CHEN ◽  
...  
Keyword(s):  
Axial Load ◽  
Mechanical Stability ◽  
Femoral Shaft ◽  
Locking Compression Plate ◽  
Strain Diagram ◽  
Maximum Displacement ◽  
Relative Maximum ◽  
Significant Difference ◽  
Compression Plate ◽  
Comminuted Fractures

The aim of this paper is to compare the biomechanical characteristics of a newly designed assembly locking compression plate (NALCP) and traditional locking compression plate (LCP) for internal fixation of femoral-shaft comminuted fractures. A femoral-shaft wedge fracture model (AO classification 32-C2.1) was created in six pairs of femoral specimens ([Formula: see text]) randomly divided into two equal groups. Biomechanical properties were tested with axial and torsional loading tests. The relative maximum displacement of fracture blocks and strain was recorded. A strain diagram was made; the fatigue test results of NALCP specimens under axial load were recorded. Under axial load, the relative maximum displacement of fracture blocks in the [Formula: see text], [Formula: see text], and [Formula: see text] axes was smaller in NALCP specimens than in LCP specimens ([Formula: see text] and 0.01, respectively). Under torsional load, the relative maximum displacement of fracture blocks in the [Formula: see text] and [Formula: see text] axes in NALCP specimens was less than that in LCP specimens ([Formula: see text]) but no statistically significant difference in the [Formula: see text] axes ([Formula: see text]) was found. In both cases, the main NALCP strain was higher than the LCP strain ([Formula: see text]) but no statistically significant difference in mean strain ([Formula: see text]) was found. Our NALCP provides strong mechanical stability for comminuted femoral fractures and can effectively avoid stress concentration, reduce stress shielding, and facilitate bone healing.

scholarly journals Investigation of a novel implant design for the treatment of reverse oblique femoral intertrochanteric fractures

2019 ◽  
Author(s):  
Rui Zhang ◽  
Kangyi Wang ◽  
Peng Luo ◽  
Xiaoshan Guo
Keyword(s):  
Axial Load ◽  
Biomechanical Properties ◽  
Locking Compression Plate ◽  
Implant Design ◽  
Intertrochanteric Fractures ◽  
Lateral Plate ◽  
Significant Difference ◽  
Compression Plate ◽  
Load To Failure ◽  
Buttress Plate

Abstract Objective: To evaluate the biomechanical properties of intramedullary fixation, lateral plate, medial buttress plate and bilateral plate for fixing reverse oblique intertrochanteric fractures. Methods: Twenty-four synthetic femoral bone models (Synbone) were divided into four groups [proximal femoral nail anti-rotation (PFNA), proximal femoral medial buttress plate (PFMBP), proximal femoral locking compression plate (PFLCP) and proximal femoral medial buttress plate + proximal femoral locking compression plate (PFMBL+PFLCP)], and an unstable, reverse oblique femoral intertrochanteric fracture was made. After fixation, each model underwent axial load testing, torsion testing, and axial load-to-failure testing. The stiffness of axial and torsion, the torque of different torsion angles and the failure load of every model were recorded. Results: The bilateral plate showed the best performance in axial load, torsion, and load-to-failure testing. The stiffness of axial and torsion in the PFMBP was superior to the PFNA [162.05±22.05 N/mm vs. 119.13±29.14 N/mm in axial, (1.36±0.32) N × mm/deg vs. (1.10±0.13) N × mm/deg in torsion, P<0.05], whereas there was no significant difference between PFMBP, PFLCP and PFLCP+PFMBP in torsion stiffness [(1.36±0.32) N × mm/deg, (1.45±0.44) N × mm/deg, (1.45±0.18) N × mm/deg, P>0.05]. Conclusion: Our newly designed medial buttress plate achieved greater stiffness in axial load and torsion than PFNA and PFLCP to fix reverse oblique intertrochanteric fractures in biomechanical research, whereas the bilateral plate showed better stiffness than PFMBP.

scholarly journals Refracture after locking compression plate removal in displaced midshaft clavicle fractures after bony union: a retrospective study

2021 ◽  
Author(s):  
Ho-Youn Park ◽  
Seok-Jung Kim ◽  
Yoo-Joon Sur ◽  
Jae-Woong Jung ◽  
Chae-Gwan Kong
Keyword(s):  
Clavicle Fracture ◽  
Locking Compression Plate ◽  
Bony Union ◽  
Related Factors ◽  
Patient Demographics ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Compression Plate ◽  
Segmental Fractures ◽  
Clavicle Fractures

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group.Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6–210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

The effect of intramedullary pin size and plate working length on plate strain in locking compression plate-rod constructs under axial load

2016 ◽  
Vol 29 (06) ◽  
pp. 451-458 ◽  
Author(s):  
Mark Glyde ◽  
Robert Day ◽  
Giselle Hosgood ◽  
Tim Pearson
Keyword(s):  
Large Diameter ◽  
Three Dimensional ◽  
Fracture Site ◽  
Locking Compression Plate ◽  
Image Correlation ◽  
Lower Strain ◽  
Working Length ◽  
Significant Difference ◽  
Compression Plate ◽  
Short Working

SummaryObjective: To investigate the effect of intramedullary pin size and plate working length on plate strain in locking compression plate-rod constructs.Methods: A synthetic bone model with a 40 mm fracture gap was used. Locking compression plates with monocortical locking screws were tested with no pin (LCP-Mono) and intramedullary pins of 20% (LCPR-20), 30% (LCPR-30) and 40% (LCPR-40) of intramedullary diameter. Two screws per fragment modelled a long (8-hole) and short (4-hole) plate working length. Strain responses to axial compression were recorded at six regions of the plate via three-dimensional digital image correlation.Results: The addition of a pin of any size provided a significant decrease in plate strain. For the long working length, LCPR-30 and LCPR-40 had significantly lower strain than the LCPR-20, and plate strain was significantly higher adjacent to the screw closest to the fracture site. For the short working length, there was no significant difference in strain across any LCPR constructs or at any region of the plate. Plate strain was significantly lower for the short working length compared to the long working length for the LCP-Mono and LCPR-20 constructs, but not for the LCPR-30 and LCPR-40 constructs.Clinical significance: The increase in plate strain encountered with a long working length can be overcome by the use of a pin of 30–40% intramedullary diameter. Where placement of a large diameter pin is not possible, screws should be placed as close to the fracture gap as possible to minimize plate strain and distribute it more evenly over the plate.

Comminuted fractures of the proximal ulna—Preliminary results with an anatomically preshaped locking compression plate (LCP) system

Injury ◽  
2010 ◽  
Vol 41 (12) ◽  
pp. 1306-1311 ◽  
Author(s):  
S. Siebenlist ◽  
T. Torsiglieri ◽  
T. Kraus ◽  
R.D. Burghardt ◽  
U. Stöckle ◽  
...  
Keyword(s):  
Locking Compression Plate ◽  
Proximal Ulna ◽  
Preliminary Results ◽  
Compression Plate ◽  
Comminuted Fractures

Minimally Invasive Plate Osteosynthesis for Comminuted Fractures of the Metaphysis of the Radius

2005 ◽  
Vol 30 (2) ◽  
pp. 220-225 ◽  
Author(s):  
J. IMATANI ◽  
T. NODA ◽  
Y. MORITO ◽  
T. SATO ◽  
H. HASHIZUME ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Locking Compression Plate ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Pronator Quadratus ◽  
Radial Inclination ◽  
Loss Of Reduction ◽  
Compression Plate ◽  
Comminuted Fractures

Five comminuted and displaced fractures of the distal metaphysis of the radius were treated by a technique of minimally invasive plate osteosynthesis (MIPO) with the aim of minimizing soft tissue damage and devascularization of the fracture fragments. This technique used the small AO T-shaped locking compression plate (AO LCP T-plate) and left the pronator quadratus intact. Radial inclination, palmar tilt, and ulnar variance were restored without loss of reduction in all five cases and the fractures healed at an average of 10 weeks, with good to excellent clinical outcomes.

scholarly journals Surgical management of proximal humerus fracture treated with locking compression plate

2017 ◽  
Vol 3 (6) ◽  
pp. 1165
Author(s):  
Sivakumar Arumugam ◽  
Venkateshwara Arumugam ◽  
V. Raviraman
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Early Mobilization ◽  
Open Reduction Internal Fixation ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Comminuted Fractures ◽  
Humerus Fractures

<p class="abstract"><strong>Background:</strong> Proximal humerus fractures accounts for about 4 to 5% of all fractures.  Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remain challenging. Significant controversy continues regarding the best methods of treating displaced proximal humerus fractures. Various operative procedures are carried out, the recent trend in internal fixation has moved on to locking plates. The present study is undertaken to evaluate the functional outcome and complication of proximal humerus fractures treated by locking compression plate.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study comprising of 30 patients with fractures of proximal humerus were treated by open reduction and internal fixation with locking compression plate were evaluated at Velammal  Institute Of Medical  Sciences, Madurai from the period of April 2015 to December 2016. Clinical and radiological evaluation was done. Patients will undergo open reduction internal fixation with locking compression plate for the sustained fracture under general anesthesia.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our series, the majority of the patients were males, elderly aged, with RTA being the commonest mode of injury, involving 2 part, 3 part and 4 part fractures of the proximal humerus. Excellent and satisfactory results were found in 76.7% of patients with unsatisfactory results in 23.3 % according to Neer’s criteria. There were 100 % union rates and no failures.</p><p><strong>Conclusions:</strong> In conclusion locking Compression, the plate is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in Osteoporotic bones in elderly patients, thus allowing early mobilization.</p>

scholarly journals Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation

2021 ◽  
Vol 7 (5) ◽  
pp. 1001
Author(s):  
Neetin P. Mahajan ◽  
Mrugank A. Narvekar ◽  
Lalkar L. Gadod ◽  
G. S. Prasanna Kumar
Keyword(s):  
Plate Fixation ◽  
Normal Function ◽  
Locking Compression Plate ◽  
Locking Plates ◽  
Plate Group ◽  
Significant Difference ◽  
Compression Plate ◽  
Conventional Plate ◽  
Olecranon Fractures

<p class="abstract"><strong>Background:</strong> A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.</p><p class="abstract"><strong>Methods:</strong> The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest.</p>

scholarly journals Functional Outcome of Locking Compression Plate in Neer's two-part, three-part, four-part Proximal Humerus Fractures

2016 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
KV Ramesh ◽  
G Mahesh ◽  
KC Kiran ◽  
Roshan Kumar
Keyword(s):  
Functional Outcome ◽  
Traffic Accidents ◽  
Proximal Humerus ◽  
Road Traffic ◽  
Early Mobilization ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Comminuted Fractures ◽  
Humerus Fractures

ABSTRACT Introduction Proximal fractures of the humerus account for about 4 to 5% of all fractures. They are the most common fractures in elderly population. Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains challenging. Objectives The present study is undertaken to evaluate the functional outcome of proximal humerus fractures treated by locking compression plate in 20 patients. Materials and methods Prospective study was done involving 20 adult patients with proximal humerus fractures admitted from October 2012 to December 2013 treated by open reduction and internal fixation (ORIF) with locking compression plate. The functional follow-up was done for a minimum period of 3 months and the patients were evaluated by Constant Murley scoring (CMS). Results In our series, the majority of the patients were middle-aged males, with road traffic accidents (RTAs) being the most common cause of injury, involving 2-part, 3-part, and 4-part fractures of the proximal humerus. The fractures were united in 19 patients and 1 patient had avascular necrosis (AVN). Excellent results were seen in 15% of patients, good results in 55%, moderate results in 15%, and poor results in 15% according to CMS. There were 95% union rates, 5% of AVN, and no failures. Conclusion In conclusion, locking compression plate is an advantageous implant in proximal humerus fractures due to angular stability, particularly in comminuted fractures and in osteoporotic bones of elderly patients, which allows their early mobilization. How to cite this article Mahesh G, Kiran KC, Ramesh KV, Kumar R. Functional Outcome of Locking Compression Plate in Neer's two-part, three-part, four-part Proximal Humerus Fractures. J Med Sci 2016;2(1):1-8.

Combination of a Plate and an External Fixator for Biological Osteosynthesis of Comminuted Fractures

Swiss Surgery ◽  
2002 ◽  
Vol 8 (5) ◽  
pp. 230-236 ◽  
Author(s):  
Pippow ◽  
Krähenbühl ◽  
Michel ◽  
Witschger
Keyword(s):  
External Fixator ◽  
Fixateur Externe ◽  
Locking Compression Plate ◽  
Biological Osteosynthesis ◽  
Compression Plate ◽  
Comminuted Fractures ◽  
Instabile Frakturen

Bei instabiler Fraktur mit bikortikaler Trümmerzone reicht eine unilaterale Platte nicht aus, um genügend Stabilität zur Heilung zu erzeugen, da die Fragmente der plattenfernen Kortikalis nicht aufeinander abgestützt werden können. Neue Plattensysteme mit winkelstabil verankerten Schrauben (Locking Compression Plate LCP) können dieses Problem zum Teil lösen. Eine mechanische Stabilisation der plattenfernen Kortikalis kann auch erreicht werden durch das Anbringen eines zusätzlichen, Fixateur Externe (FE), wobei dieser kontralateral oder ipsilateral zur Osteosyntheseplatte angebracht werden kann. Zur Übernahme der neutralisierenden Funktion der nicht dargestellten und somit nicht devitalisierten medialen Kortikalis reicht ein Halbrahmen-Fixateur. Der Vorteil dieser Methode gegenüber der LCP liegt in der ubiquitären Verfügbarkeit und in der Möglichkeit, eine konventionelle Plattenosteosynthese mechanisch "verstärken" zu können, ohne dass die konventionelle Platte gegen eine LCP ausgewechselt werden muss. An zwölf Patienten wurden instabile Frakturen der Tibia, des Humerus und des Femurs mit einer Kombination aus Platte und Halbrahmen eines Fixateur externe versorgt. Am Unterschenkel wurde die Platte lateral und der Halbrahmenfixateur medial angebracht, am Humerus und am Femur wurde der FE auf der lateralen Seite über der Platte angebracht, so dass die Platte zusammen mit dem Halbrahmenfixateur einen ganzen Rahmen bildete und damit die Platte verstärkt wurde. Alle Patienten wurden bis zur Konsolidation der Fraktur nachkontrolliert: Alle Frakturen heilten ohne Zweiteingriff, ausser bei einem Patienten, bei dem wegen eines Staph. epidermidis Infektes eine frühzeitige Metallentfernung vorgenommen werden musste. Beim axialen Belastungstest im Modell konnten wir zeigen, dass ein kontralateraler FE die Steifigkeit einer defektüberbrückenden Platte um 73% erhöhen kann. Diese Kombination ist unseres Erachtens eine hilfreiche Methode, um bei instabilen Frakturen die Prinzipien der biologischen Osteosynthese anwenden zu können, ohne dafür Stabilität zu opfern. Besonders bei gelenknahen Frakturen stellt sie eine Alternative zum Marknagel dar.

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