2007, Number 6
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Acta Ortop Mex 2007; 21 (6)
Radiographic and functional results of plate of oxnamic ram compression versus plate of compression bolted in radial and cubital fractures
Martínez-Padilla LA, Peñafort-García JA
Language: Spanish
References: 46
Page: 306-312
PDF size: 254.39 Kb.
ABSTRACT
Objective: To determine if there are statistically significant differences in radiographic and functional outcome in postoperative patients with DCP (dynamic compression plate)
vs. LCP (locking compression plate) in fractures radial and/or ulnar shaft.
Material and methods: Quasi-experimental, observational, longitudinal, comparative and prospective study, with patients surgically stabilized using the implants mentioned before with diaphyseal forearm fractures in the Balbuena General Hospital from September 1
st to February 28
th of 2005, with 2 years of follow-up.
Results: 22 patients were surgically stabilized with dynamic compression plate and 11 with locking compression plate, gender male in 88%, predominantly in 3
rd life decade, earlier consolidation in the group of locking compression plate but with greater functional limitation. The differences decreased after 3 months and 6 months of clinical follow up, with no statistically significant differences at 2 years of follow-up.
Conclusions: Although there are differences at the 1
st and 3
rd months of postoperative period, attributable to stability provided by each one of the implants, the beginning of mobilization and the soft-tissue handling, there are no statistically significant differences in the preliminary results at 6 months and finally at 2 years of follow-up. We consider that implants in study, even though of acting in a relatively different way, both of them are excellent alternatives of treatment in patients with forearm shaft fractures.
REFERENCES
Perren SM: Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg (Br) 2002; 84B: 1093-1110.
Perren SM, Russenberger M, Steinmann S, et al: The dynamic compression plate. Act Orthop Scand 1969; 31(Suppl 125): 31-41.
Anderson LD, Meyer FN: Fractures of the shafts of the radius and ulna. In: Rockwood and Green’s Fractures in adults, ed by Rockwood CA, Green DP, Bucholz RW. Philadelphia, JB Lippincott, 1991: 679-737.
Anderson LD, Sisk TD, Tooms RD, Park WI III: Compression-plate fixation in acute diaphyseal fractures of radius and ulna. J Bone Joint Surg (Am) 1975; 57: 287-97.
Chapman MW, Gordon JE, Zissimos AG: Compression-plate fixation of acute fractures of the diaphysis of the radius and ulna. J Bone Joint Surg (Am) 1989; 71: 159-69.
Dodge HS, Cady GW: Treatment of fractures of the radius and ulna with compression plates. J Bone Joint Surg (Am) 1972; 54: 1167-76.
Grace TG, Eversmann WW Jr: Forearm fractures: treatment by rigid fixation and early motion. J Bone Joint Surg (Am) 1980; 62(3): 433-8.
Kellam JF, Jupiter JB: Diaphyseal fractures of the forearm. In: Skeletal Trauma; Fractures, Dislocations, and Ligamentous Injuries, ed by Browner BD, Jupiter JB, Levine AM, Trafton PG. Philadelphia, WB Saunders, 1992: 1095-1124.
Moed BR, Kellam JF, Foster RJ, Tile M, Hansen ST: Immediate internal fixation of open fractures of the diaphysis on the forearm. J Bone Joint Surg (Am) 1986; 68: 1008-17.
Hertel R, Pisan M, Lambert S, Ballmer FT: Plate osteosynthesis of diaphyseal fractures of the radius and ulna. Injury 1996; 27(8): 545-8.
Field JR, Hearn TC, Caldwell CB: The influence of screw torque, object radius of curvature, mode of bone plate application and bone plate design on bone-plate interface mechanics. Injury 1998; 29(3): 233-41.
Perren SM, Klaue K, Pohler O, et al: The limited contact dynamic compression plate (LC-DCP). Arch Orthop Trauma Surg 1990; 109: 304.
Jacobs RR, Rahn BA, Perren SM: Effects of plates on cortical bone perfusion. J Trauma 1981; 21: 910.
Luethi U, Dueland T, Rahn BA: Relationship between plate-bone contact area and blood supply in internal fixation. J Biomech 1980; 13: 779.
Swiontkowski MF, Senft D, Taylor S, et al: Plate design has an effect on cortical bone perfusion. Trans Orthop Res Soc 1991; 15:.
Lobo LJ, Shekhman M, Mishra S, et al: Effect of cortical contact area on biomechanical properties of LC-DCP plates for fixation of transverse fractures. In: Proceedings of the 68th AAOS 2001: 339.
Schatzker J. Changes in the AO/ASIF principles and methods. Injury 1995; 26(Suppl 2): SB51-56.
Ganz R, Mast J, Weber BG, et al: Clinical aspects of «biological» plating. Injury 1991; 22: 4-5.
Leunig M, Hertel R, Siebenrock KA, et al: The evolution of indirect reduction techniques for the treatment of fractures. Clin Orthop 2000; 375: 7-14.
Field JR, Edmonds-Wilson R, Stanley RM: An evaluation of interface contact profiles in two low contact bone plates. Injury 2004; 35: 551-6.
Perren SM, Buchanan JS: Basics concepts relevant to the design and development of the point-contact fixator (PC-Fix). Injury 1995; 26(Suppl 2) SB1-4.
Miclau T, Remiger A, Tepic S, et al: A mechanical comparison of the dynamic compression plate, limited contact-dynamic compression plate and the point-contact fixator. J Orthop Res 1995; 9: 170.
Frigg R: Locking Compression Plate (LCP): an osteosynthesis plate based on the dynamic compression plate and the point-contact fixator (PC-Fix). Injury 2001; 322: SB63-66.
Klaue K: Principles of plate and screw osteosynthesis. In: Oxford Textbook of Orthopaedics and Trauma, ed by Bulstrode C, Buckwalter J, Carr A, Oxford University Press, 2002: 1697-1710.
Baumgaertel F, Buhl M, Rahn BA: Fracture healing in biological plate osteosynthesis. Injury 1998; 29: C3-6.
Fernandez Dell’Oca AA, Tepic S, Frigg R, et al: Treating forearm fractures using an internal fixator: a prospective study. Clin Orthop 2001; 389: 196-205.
Leung F, Chow SP: A prospective, randomized trial comparing the limited contact dynamic compression plate with the point contact fixator for forearm fractures. J Bone Joint Surg (Am) 2003; 85(12): 2343-8.
Tepic S, Perren SM: The biomechanics of the PC-Fix internal fixator. Injury 1995; 26(Suppl 2): SB5-10.
Alexander AH, Cabaud HE, Johnston JO, Lichtman DM: Compression plate position: extraperiosteal or subperiosteal? Clin Orthop 1983; 175: 280-5.
Müller ME, Allgöwer M, Schneider R, et al: Manual of Internal Fixation. Techniques Recommended by the AO Group. 3rd ed Berlin, Springer-Verlag, 1991.
Sanders R, Haidukewych GJ, Milne T, Dennis J, Latta LL: Minimal versus maximal plate fixation of the ulna: the biomechanical effect of number of screws and plate length. JOT 2002; 16(3): 166-71.
Tornkvist H, Hearn TC, Schatzker J: The strength of plate fixation in relation to the number and spacing of bone screws. J Orthop Trauma 1996; 10: 204-8.
Gustilo RB, Anderson JT: Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. Retrospective and prospective analyses. J Bone Joint Surg (Am) 1976; 58: 453-8.
Woo SLY, Lothringer KS, Akeson WH: Less rigid internal fixation plates: historical perspectives and new concepts. J Orthop Res 1984; 1: 431-49.
Krettek C: Foreword: concepts of minimally invasive plate osteosynthesis. Injury 1997; 28: A1-2.
Rüedi TP, Perren SM, Frigg R, Frenk A: Locking Compression Plate. AO Teaching Series ed by Wagner M, Switzerland, 2002.
Solanki PV, Mulgaonkar KP, Rao SA: Effect of early mobilization on grip strength, pinch strength and work of hand muscles in cases of closed diaphyseal fracture radius-ulna treated with dynamic compression plating. J Postgrad Med 2000; 46: 84-7.
Langkamer VG, Ackroyd CE: Internal fixation of forearm fractures in the 1980s: lessons to be learnt. Injury 1991; 22: 97-102.
Ross ERS, Gourevitch D, Hastings GW, Wynn-Jones CE, Ali S: Retrospective analysis of plate fixation of diaphyseal fractures of the forearm bones. Injury 1989; 20: 211-4.
Wright RR, Schmeling GJ, Schwab JP: The necessity of acute bone grafting in diaphyseal forearm fractures: a retrospective review. JOT 1997; 11(4): 288-94.
Burwell HN, Charnley AD: Treatment of forearm fractures in adults with particular reference to plate fixation. J Bone Joint Surg (Br) 1964; 46: 404-25.
Hadden WA, Reschauer R, Seggl W: Results of AO plate fixation of forearm shaft fractures in adults. Injury 1985; 15: 44-52.
Gómez AOA, Bocanegra SN, Suárez FR: Fracturas abiertas diafisarias de antebrazo por armas de guerra: Osteosíntesis por abordaje limitado. Rev Col Ort Traum 2001; 15(1):.
Gustilo RB, Anderson JT: Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. Retrospective and prospective analyses. J Bone Joint Surg (Am) 1976; 58: 453-8.
Gustilo RB, Mendoza RM, Williams DN: Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 1984; 24: 742-6.
Hertel R, Eijer H, Meisser A, Hauke C, Perren SM: Biomechanical and biological considerations relating to the clinical use of the Point-Contact Fixator. Evaluation of the device handling test in the treatment of diaphyseal fractures of the radius and/or ulna. Injury 2001; 32(Suppl 2): SB10-14.