Awful considerations with LCP instrumentation: a new pitfall
- 205 Downloads
- 7 Citations
Abstract
Introduction
Although the locking compression plate (LCP) system offers a number of advantages in fracture management, its successful use requires careful preoperative planning, consideration of soft tissue dissection principles, and good surgical technique. Failure to address these issues can lead to potential pitfalls. Therefore, there are many reports about potential pitfalls that can arise with inappropriate LCP instrumentation technique. Moreover, these studies may mislead the orthopaedic colleagues that the only important tip in LCP using is its mechanical considerations. But, there is no study about the potential soft tissue pitfalls that may occur. There is an attempt in this study to achieve this objective.
Methods
A prospective analysis was carried out on all patients who were hospitalized for metaphyseal fracture of tibia and LCP fixation was done for them in our trauma center over a 6-month period in 2003. Inclusion criteria included all patients with fracture of tibial metaphysis who were to undergo locking compression plating using long conventional incision (without percutaneus insertion). Therefore, 34 patients included.
Results
Many patients (23.5%) developed severe soft tissue damage with exposed plate, and all of them need flap coverage.
Conclusion
Locking compression plates have a higher profile in comparison to DCP, requiring careful attention to soft tissue. Therefore, inadvisable locking compression plating with conventional incision method and retaining anatomical reduction of the fracture can lead to a higher soft tissue complication in comparison to dynamic compression plating.
Keywords
Locking compression plate Soft tissue Fracture Flap TibiaReferences
- 1.Brown RF (1992) Compound fractures of the tibia: the soft tissue defect. Proc R Soc Med 65:625–626Google Scholar
- 2.Chandler RW (1996) Principles of internal fixation. In: Rockwood and Green’s fracture in adults. Lippincott, Raven, USA, pp 452–453Google Scholar
- 3.Epps CH JR, Adams JP (1961) Wound management in open fractures. Am Surg 27:766–769PubMedGoogle Scholar
- 4.Frigg R (2001) Locking compression plate (LCP) an osteosynthesis plate based on the dynamic compression plate and the point contact fixator (pc-fix). Injury 32(suppl 2):63–66PubMedCrossRefGoogle Scholar
- 5.Gautier E, Sommer CH (2003) Biological internal fixation. Ther Umsch 60(12):729–735PubMedCrossRefGoogle Scholar
- 6.Ger R (1968) The management of pretibial skin loss. Surgery 63:757–763Google Scholar
- 7.Murray WR, Lucas DB, Iamm VT (1964) Treatment of nonunion of fractures of the long bone by the two plate method. J Bone Joint Surg 46-A:1027–1048Google Scholar
- 8.Sommer C, Gautier E, Muller M et al (2003) First clinical results of the LCP. Injury 34(suppl 2):43–54CrossRefGoogle Scholar
- 9.Wagner M (2003) General principles for the clinical use of the LCP. Injury 2(B):31–42CrossRefGoogle Scholar
- 10.Wagner M, Trank A, Frigg R (2004) New concepts for bone fracture treatment and the locking compression plate. Surg Technol Int 12:271–277PubMedGoogle Scholar