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| Ashok Kumar,Himanshu Gupta,Chandra Shekhar Yadav,Shah Alam Khan,Shishir Rastogi.[J].Chin J Traumatol,2013,16(1):22-26. [doi] |
| Role of locking plates in treatment of difficult ununited fractures: a clinical study |
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| DOI： |
| KeyWord: Fractures, bone Fractures, ununited Bone plates Orthopedic fixation devices |
| FundProject: |
| Author Name | Affiliation | | Ashok Kumar | Dubai Bone & Joint Center, Mohammed Bin Rashid Al
Makotoum Academic Medical Center, Dubai Health
Carecity, Dubai 118855, UAE | | Himanshu Gupta | Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India | | Chandra Shekhar Yadav | Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India | | Shah Alam Khan | Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India | | Shishir Rastogi | Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India |
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| Abstract: |
| Objective: To present our experience in treatment of difficult ununited long bone fractures with
locking plate.
Methods: Retrospective evaluation of locking plate fixation in 10 difficult nonunions of long bone fractures was done. Fixation was done with locking plate for femoral shaft fracture (3 patients), supracondylar fracture of femur (gap nonunion), fracture of clavicle, fracture ofboth forearm bones
(radius and ulna) fracture of ulna, fracture of shaft of humerus, fracture of tibial diaphysis and supracondylar fracture of humerus (one patient each). Five fractures had more than one previous failed internal fixation. One patient had infected nonunion which was managed by debridement with
cast immobilization followed by fixation with locking plate at six weeks. Seven fractures were atrophic, two were oligotrophic, and one was hypertrophic. Fibular autograft was used in 2 cases and iliac crest cancellous bone graft used in all the patients.
Results: Minimum follow-up was 6 months (range, 6 months to 2.5 years). Average time for union was 3.4 months (range 2.5 to 6 months). None of the patients had platerelated complications or postoperative wound infections.
Conclusion: Along with achieving stability with locking compression plate, meticulous soft tissue dissection, acceptable reduction, good fixation technique and bone grafting can help achieve union in difficult nonunion cases. Though locking plate does not by itself ensure bony union, we have found it to be another useful addition to our armamentarium for treating difficult fracture nonunions. |
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