The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation

Se Dong Kim; Oog Jin Sohn; Byung Hoon Kwack

doi:10.12671/jkfs.2008.21.2.117

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Kim, Sohn, and Kwack: The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation

Original Article

Journal of the Korean Fracture Society 2008; 21(2): 117-123.

Published online: 30 April 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.2.117

The Comparison of LC-DCP versus LCP Fixation in the Plate Augmentation for the Nonunion of Femur Shaft Fractures after Intramedullary Nail Fixation

Se Dong Kim, M.D., Oog Jin Sohn, M.D., Byung Hoon Kwack, M.D.

Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Korea.

Address reprint requests to: Oog Jin Sohn, M.D. Department of Orthopedic Surgery, Yeungnam University Hospital, 317-1, Daemyeong 5-dong, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4020, ossoj@med.yu.ac.kr

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to evaluate the efficacy of the surgical treatment through the comparison of LC-DCP (Limited Contact-Dynamic Compression Plate) versus LCP (Locking Compression Plate) fixation in the plate augmentation for the nonunion of femur shaft fractures after intramedullary nail fixation.

Materials and Methods

Twenty-four patients with the nonunion of femur shaft fractures after intramedullary nail fixation who underwent plate augmentation were evaluated from Mar. 2001 to Sept. 2005. The group with LC-DCP augmentation was done bicortical screw fixation and the group with LCP was done monocortical fixation.

Results

There was one case of nail breakage in LC-DCP group, but sound bony union were achieved uneventfully in all the cases of both group. LCP fixation was slightly superior to LC-DCP fixation in view of the bony union time, operating time, postoperative Hb down, amount of postoperative transfusion, but there was no statistical difference (p>0.05).

Conclusion

We got the satisfactory results after monocortical LCP augmentation as well as bicortical LC-DCP fixation and have concluded that monocortical LCP fixation was an effective treatment option for nonunion of femur shaft fracture occurred after Intrmedullary nail fixation.

Keywords: Femur shaft fracture, Nonunion, Plate augmentation, LC-DCP, LCP

Figures and Tables

Fig. 1

Correlation with bony union time and initial fracture pattern.

Fig. 2

(A, B) Radiograph taken at 10 months after intramedullary nailing for femoral shaft frature, shows hypertrophic nonunion.

(C, D) LC-DCP plate augmentation with autogenous iliac bone graft was done to the fracture site to counter the rotational instability leaving the intramedullary nail in situ.

(E, F) At 5.7 months after osteosynthesis, radiograph shows bone union.

Fig. 3

(A, B) Radiograph taken at 12.5 months after intramedullary nailing for femoral shaft frature, shows oligotrophic nonunion.

(C, D) LCP plate augmentation with autogenous iliac bone graft was done to the fracture site to counter the rotational instability leaving the intramedullary nail in situ.

(E, F) At 7.6 months after osteosynthesis, radiograph shows bone union.

Fig. 4

(A, B) Radiograph taken at 13.8 months after intramedullary nailing for femoral shaft frature, shows hypertrophic nonunion.

(C, D) LC-DCP plate augmentation with autogenous iliac bone graft was done to the fracture site to counter the rotational instability leaving the intramedullary nail in situ

(E, F) At 4 months after osteosynthesis, intramedullary nail was broken (arrow).

(G, H) At 8 months after osteosynthesis, radiograph shows bone union.

Table 1

Initial fracture pattern by Winquist-Hansen classification

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