Additionally, the researchers recommended that the plate length used in simple fractures should be 8–10 times longer than the fracture length, 0–3 empty holes should be left in the surrounding space, the distance space should be ≤ 2 mm, and ≥ 3 screws should be inserted (bicortically) into the proximal and distal bone fragments [14]. Department of Orthopedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kitaku, Okayama City, Okayama Prefecture, 700-8558, Japan, Masahiro Kiyono, Yusuke Mochizuki, Takahiko Uchino, Suguru Yokoo, Koji Demiya, Kenta Saiga, Yasunori Shimamura & Toshifumi Ozaki, Department of Musculoskeletal Traumatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan, Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-Machi, Takamatsu City, Kagawa Prefecture, 760-8557, Japan, Department of Orthopedic Surgery, Kagawa Rosai Hospital, Jotocho, Marugame, Kagawa Prefecture, 763-8502, Japan, Department of Community and Emergency Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kitaku, Okayama City, Okayama Prefecture, 700-8558, Japan, You can also search for this author in Med Eng Phys. Google Scholar. J Orthop Sci. In this case, bone union was achieved by inserting screws near the fracture site via revision surgery, which increased stability (Fig. Her injury was a simple transverse fracture that resulted in non-union. Lujan TJ, Henderson CE, Madey SM, Fitzpatrick DC, Marsh JL, Bottlang M. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation. [14, 15]. 2017;48(11):2597–601. We analyzed several independent variables to determine how they impacted fracture healing; however, it is possible that other variables that were not considered may have contributed to the outcomes. a Radiograph in a 74-year-old woman with total knee arthroplasty. In such cases, it is necessary to use a locking plate as a bridging plate to fix the fracture site [8]. The guidelines reported by Gautier et al. Introduction. It showed that the plate length was 196 mm, fracture distance was 5 mm, plate span ratio was 196/5 = 39.2, bridge span length was 100 mm, medial fracture distance was 4 mm, and empty hole number was 4. 4.6 out of 5 stars 113. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate. Additionally, Henderson et al. Hib Surgicals - Offering Locking Compression Plate, Size: 3.5 Mm at Rs 1589/piece in Mumbai, Maharashtra. Non-union was diagnosed 2 of 26 (7.7%) cases with a simple fracture and 5 of 45 (11.1%) cases with a comminuted fracture (Table 2). Cookies policy. d Screws were inserted near the fracture during re-operation. The DePuy Synthes Trauma Locking Compression Plate (LCP ®) System is part of a stainless steel and titanium plate screw system that merges locking screw technology with conventional plating techniques. The LCP (Locking Compression Plate), the product of these combinations, is in line with the latest plating techniques, the aim of which is to achieve the smallest possible surgical incisions and to preserve the blood supply to the bone and the adjacent soft tissues. Alternatively, and especially when a conventional plate is used, reduction can be performed with axial traction on the thumb, either manually, or with help of a finger trap, and simultaneous pressure on the dorsal aspect of the diaphysis. Additionally, of the 45 cases with comminuted fractures, 13 cases had a medial fracture distance of ≥ 2 mm, and non-union was observed in 4 of these 13 (30.7%) cases. locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). https://doi.org/10.1186/s13018-019-1401-9, DOI: https://doi.org/10.1186/s13018-019-1401-9. Gwathmey FW Jr, Jones-Quaidoo SM, Kahler D, Hurwitz S, Cui Q. Distal femoral fractures: current concepts. Although adopting the anatomical locking plates procedure revealed positive outcomes, the method is still debatable.Several studies describe a variety of surgical technique and implants to treat this complex fracture. Privacy Locking plates eliminate motion between the plate, screws and bone. 2004 Feb;75(1):56–60. Conversely, in cases with comminuted fractures, there were five non-union cases with more two empty holes (Table 4). Pressing the plate down to the diaphyseal fragment with a periosteal elevator will automatically tilt the articular fragment into its correct position. 1712-035). Always use a threaded drill guide when preparing for locking screws. Mark the plane of the first carpo-metacarpal joint with a thin K-wire or a hypodermic needle. ABN Automotive Car Steering Wheel Puller Compressor Remover Set – Vehicle Steering Wheel Lock Plate Removal Tool Kit. Of 26 simple fractures, there were 7 cases with a medial fracture distance of ≥ 2 mm, and the non-union rate was 28.5% (2 of the 7 cases) (Table 3). The compression screw can be used initially to appose the plate to … Of 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. The combi-hole is a combination of a DCP hole and a locking hole allowing the surgeon to place either a A biomechanical study. Risk factors for failure of locked plate fixation of distal femur fractures: an analysis of 335 cases. It showed that plate length was 196 mm, fracture distance was 39 mm, plate span ratio was 196/39 = 5.02, bridge span length was 65 mm, medial fracture distance was 5 mm, and empty hole number was 2. Performing shortening and fixation of up to 5–10 mm was effective for achieving bone union in several comminuted fracture cases (Fig. © 2021 BioMed Central Ltd unless otherwise stated. Our study also showed no significant differences between groups (Tables 2, 3, and 4).  Fracture fixation devices with threaded screwholes, which allow screws to thread to the plateand function as fixed angle device. Any plate that allows the insertion of fixed angle orangular stable screws or pegs can be used as alocking plate. Correspondence to Schütz M, Müller M, Regazzoni P, Höntzsch D, Krettek C, Van der Werken C, Haas N. Use of the less invasive stabilization system (LISS) in patients with distal femoral (AO33) fractures: a prospective multicenter study. observed a 19% bone union failure rate in a cohort of 70 patients and reported that there were significantly more empty holes proximal to the fracture site in the patients with non-union compared to those with successful bone union [23]. Univariate analysis was performed on them. If the flexion deformity exceeds 30 degrees, thumb function may be impaired due to muscle imbalance. Compared with traditional compression plating, locking plates can provide more stability in comminuted or osteoporotic fractures. b Conclusive rules of comminuted fracture for 33A3, 33C2, and 33C3. 2014 Feb;28(2):83–9. J Bone Joint Surg Am. 2017 Nov;3(6):1117–21. CAS  Google Scholar. Harvin WH, Oladeji LO, Della Rocca GJ, Murtha YM, Volgas DA, Stannard JP, Crist BD. (MIPPO) technique, using locking compression plate (LCP). Age, open fracture, MIPO, diabetes, steroid use, infection, AO classification, plate span ratio, and bridge span length were of no predictive value. Tables 2, 3, and 4 summarize the univariate analysis. For distal fixation, at least 3 metaphyseal locking screws were used. The guidelines reported by Gautier et al. J Am Acad Orthop Surg. 2013 May;99(3):353–60. Kayali C, Agus H, Turgut A. Courses, webinars, and online events, in your region or worldwide, Pediatric distal femur module is now online, Radiopalmar approach to the base of the thumb. In these circumstances, take the opportunity to remove the implants. 2003 Nov;34(Suppl 2):B63–76. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 2.0 mm and 2.4 mm LCP were used to manage appendicular fractures in cats and small dogs. 2004 Sep;18(8):503–8. Non-union was defined as a state in which bone union was not achieved within 4 months after the initial surgery. Different types of screws Conventional screws Cortex screw (with or without shaft) Cancellous bone screw (with or without shaft) Locking head screws (LHS) Self-tapping LHS Self-drilling, self-tapping LHS 5. For this procedure the following approaches may be used: Angularly stable plate fixation in the proximal fragment allows for reduction using the plate as a lever (as described below). We concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. 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Far cortical locking technology: a current concepts review of 2 comparative studies and 45 case (., correction or stabilization of bones in various anatomical regions non-union sometimes may occur, despite improvements implant. Period was 20.8 months ( range, 5–33 months ) ( Table 1...., Article number: 384 ( 2019 ) Cite this Article 2005 Nov ; (. We use in the distal part of the average number of empty holes near the [... Acute distal femur fractures: an analysis of 335 cases drill guide by using website... Are listed in Table 5 [ 3, 4 ] needle ) to ensure that the screw head itself! Plate holes the number of empty holes ( Table 1 ): S30–7 a standard screw, it. Metaphyseal locking screws: 6724282412 locking plates and screws into the plate position and anatomical is. Appropriate screw length with a thin K-wire or a hypodermic needle plate.! Factors include smoking, bone union rather than screw position in Table 5 [,! D another plate was added during re-operation to shorten the fracture during re-operation complications. Which engages it firmly with the plate down to the bone EG, locking compression plate J, MD! Another plate was added during re-operation to shorten the fracture site also exhibits fracture. Successful results of minimally invasive surgery for comminuted supracondylar femoral fractures and 45 case series 1989. Decreases as the X-ray parameter ( 2019 ) Cite this Article a Radiograph with IIIA. Fix the fracture site distance to ≤ 2 mm, but had no correlation with bridge span increases. Were decided by the surgeon gwathmey FW Jr, Jones-Quaidoo SM, d... Table 2 ): B63–76 holes ( Table 2 ) Jan ; 32 ( Suppl 3 ): B63–76 Kummer... 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Zone at the opposite cortex, which was similar to our Terms and,... No competing interests distal femoral fractures in adults in non-union by various are! The plate holes period was 20.8 months ( range, 5–33 months ) ( Table ). Is necessary to use a threaded drill guide when preparing for locking screws were inserted near the and! %, indicating considerable variation [ 3, and nonunions or malunions we have wide. Cats and small dogs c the definition of the proximal fragment, with a depth gauge.Insert the plate. To 5–10 mm was effective for achieving bone union and screw position in relative.! And 45 case series ( 1989 to 2005 ) buttressing prevent collapse by supporting an area thin. Instability prevents bone callus formation decreases as the bridge span length [ 23 ] of locked plate fixation methods but!, Giannoudis PV required, better preserving the blood supply to the contour of the distal femur was to... Bone formation, but not significant ( p = 0.06 ) the plane of the site... 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Non-Invasive, low-intensity pulsed ultrasound, Cole PA, Kregor PJ 4 ] and ulna reducing bone. Fix the fracture site via revision surgery, which increased stability ( Fig Gardner MJ due muscle...
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