Journal of Musculoskeletal Trauma

Effect of Fracture Gap on Biomechanical Stability of Compression Bone-Plate Fixation System after Bone Fracture Augmentation: Duk Young Jung, Sung Jae Lee, Seon Chil Kim, Jong Keon Oh; J Korean Fract Soc 2010;23(2):220-226. Published online April 30, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.2.220

Abstract PDF: PURPOSE
The goal of this study using the biomechanical test was to evaluate the mechanical stability of the bone-plate fixation system according to changes of the fracture gap sizes and widths.
MATERIALS AND METHODS
For mechanical test, four types with different fracture models simulating the clinical situations were constructed depending on the gap size (FGS, mm) and the gap width (FGW, %) at the fracture site: 0 mm/0%, 1 mm/100%, 4 mm/100%, 4 mm/50%. For analyzing the effects of fracture gap on the biomechanical stability of the bone-plate fixation system, 4-point bending test was performed under all same conditions.
RESULTS
It was found that the fracture gap sizes of 1 and 4 mm decreased mechanical stiffness by about 50~60% or more. Furthermore, even without fracture gap size, 50% or more fracture gap width considerably decreased mechanical stiffness and suggested the possibility of plate damage through strain results.
CONCLUSION
Our findings suggested that at least 50% contact of the fracture faces in a fracture surgery would be maintained to increase the mechanical stability of the bone-plate fixation system.

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A Finite Element Analysis of Biomechanical Stability of Compression Plate Fixation System in according to Existing of Fracture Gap after Bone Fracture Augmentation: Duk Young Jung, Bong Ju Kim, Jong Keon Oh; J Korean Fract Soc 2010;23(1):83-89. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.83

PURPOSE
This study using the finite element analysis (FEA) focused on evaluating the biomechanical stability of the LC-DCP in accordance with existing of the fracture gap at the facture site after bone fracture augmentation.
MATERIALS AND METHODS
For FEM analysis, total eleven types with different fracture models considering clinical fracture cases were constructed according to the fracture gap sizes (0, 1, 4 mm)/widths (0, 25, 50, 75, 100%). Limited contact dynamic compression plate (LC-DCP) fixation system was used in this FEM analysis, and three types of load were applied to the bone-plate fixation system: compressive, torsional, bending load.
RESULTS
The results in FEM analysis showed that the 1, 4 mm fracture gap sizes and 75% or more fracture gap widths increased considerably the peak von Mises stress (PVMS) both the plate and the screw under all loading conditions. PVMS were concentrated on the center of the LC-DCP bone-plate, and around the necks of screws.
CONCLUSION
Based on the our findings, we recommend at least 50% contact of the fracture faces in a fracture surgery using the compression bone-plate system. Moreover, if x-ray observation after surgery finds 100% fracture gap or 50% or more fracture gap width, supplementary measures to improve biomechanical stability must be taken, such as restriction of walking of the patient or plastering.

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Application of Patient-Specific 3D-Printed Orthopedic Splint for Bone Fracture in Small Breed Dogs
Kwangsik Jang, Eun Joo Jang, Yo Han Min, Kyung Mi Shim, Chunsik Bae, Seong Soo Kang, Se Eun Kim
Journal of Veterinary Clinics.2023; 40(4): 268. CrossRef

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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; J Korean Fract Soc 2008;21(2):117-123. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.117

Abstract PDF

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.

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Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review
Kristin M. Bowers, David E. Anderson
Bioengineering.2024; 11(6): 525. CrossRef
RETRACTED ARTICLE: An experimental study on stress-shielding effects of locked compression plates in fixing intact dog femur
Xinwen Zhao, Wensen Jing, Zhe Yun, Xun Tong, Zhao Li, Jiajia Yu, Yaohui Zhang, Yabin Zhang, Zhixue Wang, Yanhua Wen, Heping Cai, Jun Wang, Baoan Ma, Haien Zhao
Journal of Orthopaedic Surgery and Research.2021;[Epub] CrossRef
The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal
Hyun Kook Youn, Oog Jin Shon, Dong Sung Han
Journal of the Korean Fracture Society.2008; 21(3): 200. CrossRef

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Comparison of LC-DCP versus LCP for Internal Fixation of Humeral Shaft Fractures in Elderly Patient: Chang Yong Hur, Won Yong Shon, Jun Gyu Moon, Sang Hwan Han, Jae Young Hong, Sung Kang Chun; J Korean Fract Soc 2007;20(3):246-251. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.246

Abstract PDF

PURPOSE
To compare outcomes of humeral shaft fractures fixed with locking compression plate and those fixed with dynamic compression plate in elderly patients.
MATERIALS AND METHODS
Nineteen consecutive elderly patients with a fracture of the humeral diaphysis were evaluated retrospectively. Ten patients had been fixed with LC-DCP, and nine had been fixed with LCP. Radiological and clinical results were compared and comparison of implants was done.
RESULTS
Loosening of the plate occurred in one case each from the LCP group and the LC-DCP group. The rest of the patients achieved union uneventfully without any complications. Union rate, clinical score and hardware were not significantly different between the two groups. One patient who developed loosening in the LC DCP underwent reoperation whereas one patient with loosening in the LCP was successfully managed conservatively.
CONCLUSION
Principle of fracture fixation was more important than plate selection in humeral shaft fracture of elderly patient.

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Plate osteosynthesis of fractures of the shaft of the humerus: comparison of limited contact dynamic compression plates and locking compression plates
Ashutosh Kumar Singh, Nidhi Narsaria, R. R. Seth, S. Garg
Journal of Orthopaedics and Traumatology.2014; 15(2): 117. CrossRef
Clinical and Radiographical Follow-up for Residual Displacement of Fracture Fragments after Interlocking Intramedullary Nailing in Humeral Shaft Fractures
Jae-Kwang Yum, Dong-Ju Lim, Eui-Yub Jung, Su-Een Sohn
The Journal of the Korean Shoulder and Elbow Society.2013; 16(2): 107. CrossRef

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Comparative Analysis of Interlocking IM Nailing and LC-DCP fixation in the Treatment of Distal Tibial Fracture: Hwa Yeop Na, Young Jun Park, Sang Hoon Ko, Wahn Sub Choe, Young Sang Lee, Kyung Dong Yoon; J Korean Soc Fract 2002;15(2):152-158. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.152

Abstract PDF

PURPOSE
To compare the clinical results between interlocking IM nailing and LC-DCP fixation in the treatment of distal tibial shaft fracture.
MATERIALS AND METHODS
From August 1998 to August 2001, 23 patients were treated by interlocking IM nail and 15 patients were treated by LC-DCP for distal tibial shaft fracture.
RESULTS
Accoding to Robinson classification, there were 12 type 1 fractures (52.1%) and 11 type 2a fractures (47.8%) in the interlocking IM nailing group, and 4 type 1 fractures (26.7%), 8 type 2a fractures (53.4%) and 3 type 2c fractures (20.07%) in the LC-DCP fixation group. The average time to bony union was 16 weeks in the patients treated with interlocking IM nail and 12 weeks in the patients treated with LC-DCP. In the functional outcome (according to Klemm and Borner), 18 patients treated (78.2%) with interlocking IM nail showed satisfactory results and 13 patients (86.6%) treated with LC-DCP had satisfactory results.
CONCLUSION
We concluded that more satisfactory results could be obtained with LC-DCP fixation compared with interlocking IM nailing in the treatment of the distal tibial fracture.

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A Comparison of the Results between Intramedullary Nailing and Minimally Invasive Plate Osteosynthesis in Distal Tibia Fractures
Chul-Hyun Park, Chi-Bum Choi, Bum-Jin Shim, Dong-Chul Lee, Oog-Jin Shon
Journal of the Korean Orthopaedic Association.2014; 49(4): 285. CrossRef
Comparative Study Using of Treatment with Minimally Invasive Plate Osteosynthesis Using Periarticular Plate and Interlocking Intramedullary Nailing in Distal Tibia Fractures
Chang Hwa Hong, Jong Seok Park, Sang Seon Lee, Soo Ik Awe, Woo Jong Kim, Ki Jin Jung
Journal of the Korean Fracture Society.2010; 23(3): 296. CrossRef
A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures
Kee-Byung Lee, Si-Young Song, Duek-Joo Kwon, Yong-Beom Lee, Nam-Kyou Rhee, Jun-Ha Choi
Journal of the Korean Fracture Society.2008; 21(4): 286. CrossRef
Comparative Study of Intramedullary Nailing and Plate for Metaphyseal Fractures of the Distal Tibia
Hoon Jeong, Jae-Doo Yoo, Young-Do Koh, Hoon-Sang Sohn
Journal of the Korean Fracture Society.2007; 20(2): 154. CrossRef

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Surgical Treatment of the Clavicular Nonunion: Chang Hyuk Choi, Kyung Ho Kim; J Korean Soc Fract 1997;10(3):501-508. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.501

Abstract PDF: Ten patients who had a clavicular nonunion were treated operatively at the Catholic University of Taegu Hyosung, with semitubular plate and small LC-DCP from 1987 to 1996. The most common mechanism of the initial fracture was direct injury in eight cases and the most prevalent location of the nonunion was in the middle third in eight cases also. The purpose of this study is to evaluate the functional and radiological results of the treatment of the clavicular nonunion with the technique of semitubular plate and small LC-DCP and to verify the anatomical configuration and mechanism of the clavicular fracture. The results were as follows: 1. According to the comprehensive classification system, initial fracture type consisted of 8 cases of III-B, and 1 case in II-B and I-B alternatively. 2. Initial treatment was conservative in 8 cases, operative in 2 cases and the treatment of the nonunion was an operative technique with semitubular plate and LC-DCP in 5 cases alternatively. 3. Iliac bone graft was done in all cases and radiological union was achieved by 7.5 weeks with STP group, by 8 weeks with LC-DCP group. 4. The functional result by Weitzman classification was excellent in 4 cases, fair in 1 case with STP group and excellent in 3 cases, good in 1, and fair in 1 case with LC-DCP group. 5. LC-DCP was considered as a recommendable device because it could afford sufficient strength and reduce local osteoporosis of the bone.

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Treatment of Long Bone Fracture Using LC-DCP: Byoung Ho Lee, Sang Ho Ha, Seung Kim; J Korean Soc Fract 1997;10(1):37-43. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.37

Abstract PDF: LC-DCP is the latest plate and screw system developed by AO-ASIF group. There are many merits of LC-DCP with its unique contour and material. : Reduction of surface contact between plate and bone result in preserved vascularization and then improved bone consolidation. Compression can be achieved in either longitudinal direction and a lag screw can be inserted at greater inclination. In addition, pure titanium as an LC-DCP material display optimal biocompatibility and reduce the spread of bacteria and increase resistance against infection. Between June 1994 and September 1995, 39 patients with 40 long bone fractures were treated using LC-DCP.(24 femur, 13 humerus, 3 tibia) Follow-up averaged 12 months : Bone union was achieved in 32 cases(80%) The complications were 7 cases of metal failure, 7 cases of limited joint motion, 2 cases of nonunion,2 cases of delayed union and 2 cases of deep infection.

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