Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture

Yong Chan Lee; Hong Je Kang

doi:10.12790/jkssh.2015.20.4.168

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Lee and Kang: Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture

Original Article

J Korean Soc Surg Hand 2015;20(4):168-175.

Published online: 11 December 2015

DOI: https://doi.org/10.12790/jkssh.2015.20.4.168

Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture

Yong Chan Lee, Hong Je Kang

Department of Orthopedic Surgery, Wonkwang University School of Medicine, Iksan, Korea

Correspondence to: Hong Je Kang Department of Orthopaedic Surgery, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea TEL: +82-63-859-1360 FAX: +82-63-852-9329 E-mail: kanghongje@hanmail.net

*This paper was supported by Wonkwang University in 2013.

Received 25 October 201519 November 201526 November 2015 Accepted 29 November 2015

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:

To compare the clinical and radiologic outcomes of internal fixation using locking compression plate (LCP) or limited contact-dynamic compression plate (DCP) for patients with diaphyseal forearm fractures.

Methods:

Forty-four patients with diaphyseal forearm fractures treated with either LCP (22 patients) or DCP (22 patients) were compared in regards to clinical outcomes, range of motion and Grace and Eversmann criteria at the last follow-up. Union rate and mean time to radiological union were also compared depending on comminution.

Results:

Mean range of motion and Grace and Eversmann criteria between two groups did not show significant differences. Bony union was achieved in all patients. Although mean time to union was not different in simple fractures (15.5 weeks in LCP group vs. 13.8 weeks in DCP group), it was different between two groups in mutifragmentary fractures (14.8 weeks in LCP groups vs. 24 weeks in DCP group).

Conclusion:

Internal fixation using both LCP and DCP for diaphyseal forearm fractures yield satisfactory clinical and radiologic outcomes. In multifragmen-tary fractures, LCP can shorten radiologic union time than using DCP.

Keywords: Diaphyseal forearm bone fracture, Locking compression plate, Dynamic compression plate

References

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Fig. 1.

(A) Anatomic forearm midshaft locking plate system (Acumed, Hillsboro, OR, USA). (B) AO 3.5 LC-DCP (Synthes, Eimattstrasse, Oberdorf, Switzerland). AO, Association for Osteosynthesis; LC-DCP, limited contact dynamic compression plate.

Fig. 2.

(A) The preoperative radiograph of a 58-year-old male shows displaced and multifragmentary forearm both bone fracture. (B) At 4 months after operation using locking compression plate (LCP), fracture shows complete union.

Fig. 3.

(A) The preoperative radiograph of a 60-year-old female show displaced and simple forearm both bone fracture after a traffic accident. (B) At 3 months after operation using LC-DCP, fracture shows complete union. LC-DCP, limited contact dynamic compression plate.

Table 1.

Distribution of patient, sex, age

Variable	LCP	LC-DCP
Patients	22	22
Sex (male:female)	18:04	14:08
Follow-up (mo)	16 (12-22)	34 (12-47)
Age (yr)	35.4 (18-80)	45.2 (18-69)

LCP, locking compression plate; LC-DCP, limited contact dynamic compression plate.

Table 2.

Distribution of patients according to fractured bone

Variable	LCP	LC-DCP
Ulnar	5	3
Radius	4	2
Ulnar and radius	13/13	17/17
Total	35	39

LCP, locking compression plate; LC-DCP, limited contact dynamic compression plate.

Table 3.

Individual cases

AO/ASIF classification	Ulnar	Radius
Simple fracture (type A)
LCP	7	10
LC-DCP	12	13
Multifragmentary fracture (type B, C)
LCP	11	7
LC-DCP	7	7
Total
LCP	18	17
LC-DCP	19	20

AO/ASIF, Association for Osteosynthesis/Association for the Study of Internal Fixation; LCP, locking compression plate; LC-DCP, limited contact dynamic compression plate.

Table 4.

Evaluation of the forearm function (by Grace and Eversmann)

Excellent	Union of tde fracture
	At least, 90% of the normal arc of rotation of the forearm
Good	Union of the fracture
	At least, 80% of the normal arc of rotation of the forearm
Acceptable	Union of the fracture
	A minimum of 60% of the normal rotation
Unacceptable	Either nonunion of the fracture or less than 60% of the normal rotation

Table 5.

Clinical results according to Grace and Eversmann

Variable	LCP	LC-DCP
Excellent	19	18
Good	3	4
Acceptable	0	0
Unacceptable	0	0

LCP, locking compression plate; LC-DCP, limited contact dynamic compression plate.

Table 6.

Bone union period according to fracture type and implant type

AO/ASIF classification	Ulnar (wk)	Radius (wk)	Total (wk)
Simple fracture (type A)
LCP	17.3	14.2	15.5
LC-DCP	14.5	11.6	13.8
Multifragmentary fracture (type B, C)
LCP	14.9	14.7	14.8
LC-DCP	25.2	22.7	24
Total (type A, B, C)
LCP	16.3	14.4	15.1
LC-DCP	19.1	17.1	17.5

AO/ASIF, Association for Osteosynthesis/Association for the Study of Internal Fixation; LCP, locking compression plate; LC-DCP, limited contact dynamic compression plate.

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