Locking vs. dynamic compression plates for forearm fractures effectiveness
Journal name: World Journal of Pharmaceutical Research
Original article title: Effectiveness of locking versus dynamic compression plates for diaphyseal forearm fractures
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:
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Imad Hasan Qasim
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Effectiveness of locking versus dynamic compression plates for diaphyseal forearm fractures
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20175-8362
Download the PDF file of the original publication
Summary of article contents:
Introduction
This study, conducted by Dr. Imad Hasan Qasim, compares the effectiveness of Locking Compression Plates (LCP) versus Dynamic Compression Plates (DCP) in treating diaphyseal forearm fractures in adults. A total of 42 patients were analyzed retrospectively, with 22 individuals in the LCP group and 20 in the DCP group. The primary goal of the study was to evaluate the outcomes of both fixation methods and to determine the indications for employing LCPs in clinical practice.
The Role of Plate Type in Diaphyseal Fracture Treatment
The study found that both LCPs and DCPs resulted in similar rates of union and functional outcomes for diaphyseal forearm fractures. Union was achieved in all patients, with mean times to union of 15 weeks for the LCP group and 17 weeks for the DCP group. Although LCPs are often considered advantageous due to their biomechanical properties, the findings indicated no significant difference between the two plate types regarding time to union or overall efficacy. This suggests that surgical technique and proper application are more critical determinants of success than the choice of plate itself.
Impact of Fracture Reduction Quality
Anatomic reduction played a vital role in the healing process, with better callus formation observed in cases of nonanatomic reductions across both plate groups. In the LCP group, callus formation was noted to be significantly higher when anatomic reduction was not achieved compared to cases with stable fixation using the bridging technique. This illustrates the importance of maintaining blood supply and soft tissue integrity during surgery, which ultimately contributes to effective healing and recovery.
Complications and Surgical Considerations
Interestingly, complications such as delayed union and infections were reported, but they were consistent across both groups, indicating that neither type of plate was associated with a higher rate of postoperative challenges. Patients reported discomfort that occasionally necessitated the removal of the plates, particularly in the LCP group, where issues such as cold fusion were encountered. This aspect emphasizes the need to consider both the advantages and disadvantages of plate types during surgical planning, as well as patient preferences for postoperative care.
Conclusion
In conclusion, while the study demonstrates that both LCPs and DCPs are effective for treating diaphyseal forearm fractures, the overarching takeaway is that the choice of surgical technique holds greater significance than the type of plate used. Future research with larger sample sizes and specific focus on various fracture types may elucidate further insights, helping refine indications for the use of LCPs versus DCPs in clinical settings. The findings advocate for a balanced approach, weighing the benefits against the costs associated with more advanced fixation techniques.
FAQ section (important questions/answers):
What was the primary aim of the study on LCP and DCP?
The study aimed to compare the effectiveness of locking compression plates (LCP) and dynamic compression plates (DCP) in treating diaphyseal forearm fractures in adults, evaluating their outcomes and indicating when to use LCP.
How many patients were involved in the LCP and DCP study?
The study involved 42 patients, with 22 treated using locking compression plates (LCP) and 20 treated with dynamic compression plates (DCP).
What were the main outcomes assessed in the study?
The main outcomes included the time to union, functional results as per Grace-Eversmann criteria, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores.
What were the average times to union for LCP and DCP?
The average time to union was 15 weeks for the LCP group and 17 weeks for the DCP group, with no significant difference between the two.
What complications were observed in the study groups?
Complications included delayed union, superficial infections, but no deep infections, refractures, or significant surgical complications were reported in either group.
What conclusion did the study reach regarding LCP and DCP effectiveness?
The study concluded that LCPs and DCPs had similar outcomes for treating adult diaphyseal forearm fractures, emphasizing that the surgical technique is more important than the type of plate used.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Locking vs. dynamic compression plates for forearm fractures effectiveness”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Fixation:
Fixation refers to the surgical method used to stabilize fractured bones. In the context of this study, fixation methods, such as dynamic compression plates (DCP) and locking compression plates (LCP), are critical for ensuring proper alignment and stability of the fractured forearm bones during the healing process. Effective fixation facilitates bone union and restoration of function.
2) Study (Studying):
The study is a comparative analysis of two surgical techniques used for treating diaphyseal forearm fractures in adults. It examines the outcomes of patients treated with DCPs and LCPs, focusing on factors such as time to union, functional recovery, and complications, thereby contributing to understanding the effectiveness of these fixation devices.
3) Line:
In this document, 'line' often refers to the fracture line that surgeons aim to stabilize during fixation. Accurate alignment along the fracture line is vital for proper healing and restoration of limb function. The methodology outlined emphasizes various approaches to maintain alignment of the fracture line during surgical intervention.
4) Table:
Tables are used to organize and present data, such as fracture classification and demographic information about patient groups. In this study, tables summarize key findings regarding patient distributions and results from the different fixation techniques, making complex data easier to understand and interpret for analysis of surgical outcomes.
5) Hand:
The hand is a crucial anatomical structure that can be affected by forearm fractures. Proper assessment of functional outcomes involves evaluating hand movement and strength post-surgery. The study utilizes questionnaires to measure the patients' disabilities in daily activities, which is essential for understanding the overall impact of treatment choices.
6) Blood:
Blood flow is critical for bone healing, and the discussion highlights concerns about cortical perfusion with different fixation methods. Adequate blood supply is necessary to support healing tissues and prevent complications. The study contrasts the effects of DCPs and LCPs on blood flow to assess their relevance in fracture recovery.
7) Incision:
Incision refers to the surgical cut made to access the fracture site during surgery. The type and placement of incisions can influence recovery and aesthetic outcomes. In this study, different surgical approaches, including volar and dorsal incisions, are described as part of the fixation procedure for treating forearm fractures.
8) Teaching:
Teaching refers to the educational aspect of the study, aimed at informing medical professionals about the appropriate use of DCPs and LCPs in clinical practice. By comparing outcomes, the study serves to enhance surgical training and improve decision-making in orthopedic procedures, ultimately aiming for better patient care.
9) Surface:
Surface relates to the area of the bone where the plate is applied during fixation. The contact area between the bone and the plate plays a crucial role in stability and healing. The study discusses how different plate types affect surface contact and implications for vascularity and healing.
10) Pur:
Poor refers to suboptimal outcomes, such as inadequate callus formation or delayed union in fracture healing. The study evaluates how fixation techniques may lead to poor healing or complications, thereby emphasizing the need to choose appropriate surgical methods to enhance recovery and limit adverse effects.
11) Rheumatoid arthritis:
Rheumatoid arthritis is a chronic inflammatory condition that can complicate fracture healing. Patients with this condition may have altered bone quality and healing potential. The study excluded such patients to ensure a homogenous group for evaluating fixation outcomes, highlighting the importance of considering underlying health issues in surgical studies.
12) Discussion:
Discussion is the section where the authors interpret results, compare findings with existing literature, and explore the implications of their study. This part is crucial for understanding how the results of the study contribute to clinical practice and the overall body of knowledge regarding forearm fracture treatments.
13) Antibiotic (Antibacterial):
Antibiotics are medications used to prevent or treat infections, particularly significant in surgical procedures. The study indicated that all patients received prophylactic antibiotics preoperatively to mitigate the risk of infection following surgery, highlighting the importance of infection control in enhancing surgical outcomes and patient safety.
14) Relative:
Relative in this context refers to comparisons made between different surgical techniques and their outcomes. The study assesses relative merits of DCPs and LCPs in terms of effectiveness, cost, and complications, emphasizing how these comparisons guide clinical decisions and recommendations for treatment.
15) Quality:
Quality refers to the assessment of surgical outcomes, including fracture healing, alignment, and patient satisfaction. The study evaluates the quality of reduction and healing in both treatment groups using established criteria, thus ensuring that the findings provide valuable insights into the effectiveness of the fixation methods used.
16) Reason:
Reason pertains to the rationale behind choosing specific surgical techniques and assessing their outcomes. The study explores why particular fixation methods may be preferred based on patient outcomes and the relative advantages of LCPs versus DCPs, providing a basis for informed clinical decision-making in orthopedic surgery.