Problems of bridging plate fixation for the treatment of forearm shaft fractures with the locking compression plate.
BACKGROUND
Treatment of diaphyseal forearm fractures by open reduction and internal plate fixation is a well-accepted strategy. In a variety of fracture localizations, the use of bridging plate fixation with locking compression plates (LCP) has been shown to improve biomechanical and biological characteristics. Only very limited clinical data are available on bridging plate fixation using LCPs for the treatment of diaphyseal forearm fractures. The aims of this study were to assess both clinical outcomes of LCP fracture treatments, and the implant-specific advantages and disadvantages.


METHODS
The study consisted of 53 patients. All relevant data were extracted from the medical reports and radiographs. Of the 53 patients, 39 completed the disabilities of the arm, shoulder and hand (DASH) questionnaire and 35 patients were available for clinical examination. The mean time of follow-up was 23.3 months.


RESULTS
Thirty-nine fractures of the radius and 45 fractures of the ulna were treated with 3.5 mm LCPs. Due to a fracture non-union, four patients underwent a second operation. In 13 patients, hardware had already been removed at the time of follow-up. Complete documentation of the removal operation was available for ten patients; in seven of these, procedures difficulties occurred. Mean ranges of motion were 138°, 141° and 162° for elbow flexion-extension, wrist flexion-extension and pronation-supination, respectively. The mean DASH score was calculated at 14.9.


CONCLUSIONS
In conclusion, our data show that clinical and functional outcomes of LCP plating of diaphyseal forearm fractures are comparable to the use of conventional implants. However, implant-specific problems during hardware removal must be considered.
Henle
Philipp
P
Department of Orthopaedics and Traumatology, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany. philipp.henle@insel.ch
Ortlieb
Kevin
K
Kuminack
Kerstin
K
Mueller
Christof A
CA
Suedkamp
Norbert P
NP
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D004551:Elbow Joint / Q000503:physiopathology; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009011:Monteggia's Fracture / Q000601:surgery; D009104:Multiple Trauma / Q000601:surgery; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology; D055815:Young Adult