Controlled dynamic stability as the next step in "biologic plate osteosynthesis" - a pilot prospective observational cohort study in 34 patients with distal tibia fractures.
BACKGROUND
Delayed bone healing is an eminent problem in the operative treatment of distal tibia fractures. To address this problem from a biomechanical perspective, the DLS 3.7 (Dynamic Locking Screw 3.7 mm) as a new generation of locking screws has been developed. This screw enables the surgeon to control the rigidity of the plate osteosynthesis and thereby to expand clinical options in cases where the bridge plating is chosen for fracture treatment.


OBJECTIVE
The purpose of the present prospective study was to evaluate the safety use of the DLS 3.7 in distal tibia fractures where bridge plating osteosynthesis is recommended.


METHODS
In a prospective non-controlled cohort study, 34 patients with acute distal tibia fractures (AO 43 A-C) were treated with an angular stable plate fixation using DLS 3.7 or LHS 3.5. Follow-up examinations were performed three, six, twelve, and twenty-four weeks postoperatively and all registered complications were carefully collected.


RESULTS
A total of 34 patients were prospectively enrolled in this study with a minimum follow-up of 6 months or obvious osseous consolidation at an earlier stage. No complications directly related to the DLS 3.7 were recorded and no infections were observed.


CONCLUSIONS
This observational study could show that the DLS 3.7 in combination with locking compression plates provides a secure and easy application. According to the recent literature inter-fragmentary micro-motion is one evident goal to increase the reliability in fracture healing. The new DLS 3.7 with a maximum micro-motion of 0.2 mm combines the advantage of micro-motion with the well-known advantages of angular stable plate fixation.
Department of Traumatology and Reconstructive Surgery, BG Trauma Center, University of Tübingen, SS 95, D-72076 Tübingen, Germany.
Thomas
T
Freude
Department of Traumatology and Reconstructive Surgery, BG Trauma Center, University of Tübingen, SS 95, D-72076 Tübingen, Germany.
Steffen
S
Schröter
Department of Traumatology and Reconstructive Surgery, BG Trauma Center, University of Tübingen, SS 95, D-72076 Tübingen, Germany.
Christoph Emanuel
CE
Gonser
Department of Traumatology and Reconstructive Surgery, BG Trauma Center, University of Tübingen, SS 95, D-72076 Tübingen, Germany.
Ulrich
U
Stöckle
Department of Traumatology, Kantonsspital Graubünden, SS 170, CH-7000 Chur, Schweiz.
Yves P
YP
Acklin
Department of Traumatology and Reconstructive Surgery, BG Trauma Center, University of Tübingen, SS 95, D-72076 Tübingen, Germany.
Dankwart
D
Höntzsch
Department of Traumatology and Reconstructive Surgery, BG Trauma Center, University of Tübingen, SS 95, D-72076 Tübingen, Germany.
Stefan
S
Döbele