Abstract
The dynamic locking screw (DLS) in association with minimally invasive plate osteosynthesis
(MIPO) in a bridging construct for simple metadiaphyseal long bone fractures enables
modulation of the rigidity of the system and facilitates the development of early
and triplanar bone callus.
Twenty patients affected by distal tibial fracture were treated with MIPO bridging
technique and DLS at the proximal side of the fracture. Time of consolidation, quality
of the reduction, complications and American Orthopaedic Foot and Ankle Society (AOFAS)
score were monitored and the results compared with those from a control group treated
with only standard screws on both fracture sides. Student t-test for independent samples was used for the comparison of means between the two
groups. Chi-square test was used for the comparison of proportions. A multiple logistic
regression model was constructed to assess the possible confounding effects. Performance
was considered significant for p < 0.05. The mean healing time was 17.6 ± 2.8 weeks in the group treated with standard screws and 13.5 ± 1.8 weeks in the group treated with DLS (t = 5.5, p < 0.0001). The DLS was associated with early healing and triplanar bone callus.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Effects of mechanical factors on the fracture healing process.Clin Orthop Relat Res. 1998; 355: S132-S147
- Biomechanical evaluation of fracture fixation constructs using a variable-angle locked periprosthetic femur plate system.Injury. 2014; 45: 1035-1041
- Metaphyseal locking plate as a definitive external fixator for treating open tibial fractures—clinical outcome and a finite element study.Injury. 2013; 44: 1097-1101
- Developments of compression plate techniques for internal fixation of fractures.Prog Surg. 1973; 12: 152-179
- Locking compression plate with minimally invasive plate osteosynthesis in diaphyseal and distal tibial fracture: a retrospective study of 32 patients.Injury. 2007; 38: 365-370
- F1.3 Anterior knee pain after intramedullary nailing of tibia saft fractures.Injury. 2013; 44: S7
- L-T4.5 Prevalence and risk factors of reinterventions following reamed intramedullary tibia nailing.Injury. 2012; 43: S8
- Biomechanical evaluation of the schuhli nut.Clin Orthop Relat Res. 1998; 347: 79-85
- Zespol. An original method of stable osteosynthesis.Clin Orthop Relat Res. 1991; 272: 67-75
- Locking compression plates for osteoporotic nonunions of the diaphyseal humerus.Clin Orthop Relat Res. 2004; 425: 50-54
- Far cortical locking enables flexible fixation with periarticular locking plates.J Orthop Trauma. 2011; 25: S29-S34
- Biomechanics of locked plates and screws.J Orthop Trauma. 2004; 18: 488-493
- Backgrounds of the technology of internal fixators.Injury. 2003; 34: B1-B3
- Interfragmentary motion in tibial osteotomies stabilized with ring fixators.Clin Orthop Relat Res. 2002; 396: 163-172
- The influence of induced micromovement upon the healing of experimental tibial fractures.J Bone Joint Surg Br. 1985; 67: 650-655
- Effect of dynamization on gap healing of diaphyseal fractures under external fixation.Clin Biomech (Bristol, Avon). 1995; 10: 227-234
- The influence of cyclic compression and distraction on the healing of experimental tibial fractures.J Orthop Res. 2004; 22: 709-715
- Biomechanical testing of the LCP – how can stability in locked internal fixators be controlled?.Injury. 2003; 34: B11-B19
- The dynamic locking screw (DLS) can increase interfragmentary motion on the near cortex of locked plating constructs by reducing the axial stiffness.Langenbeck's Arch Surg. 2010; 395: 421-428
- Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology.J Bone Joint Surg Br. 2002; 84: 1093-1110
- Effect of mechanical stability on fracture healing – an update.Injury. 2007; 38: S3-S10
- The role of supplemental lag-screw fixation for open fractures of the tibial shaft treated with external fixation.J Bone Joint Surg Am. 1991; 73: 893-897
- Monitoring and healing analysis of 100 tibial shaft fractures.Langenbeck's Arch Surg/Deutsche Gesellschaft für Chirurgie. 2002; 387: 146-152
- Combination of interfragmentary screws and locking plates in distal meta-diaphyseal fractures of the tibia: a retrospective, single-centre pilot study.Injury. 2011; 42: 1031-1037
- Three-dimensional strain fields in a uniform osteotomy gap.J Biomech Eng. 1986; 108: 273-280
- Strain rate and timing of stimulation in mechanical modulation of fracture healing.Clin Orthop Relat Res. 1998; 355: S105-S115
- A comparative biomechanical evaluation of a noncontacting plate and currently used devices for tibial fixation.J Trauma. 1996; 40: 5-9
- Far cortical locking can reduce stiffness of locked plating constructs while retaining construct strength.J Bone Joint Surg Am. 2009; 91: 1985-1994
- Far cortical locking can improve healing of fractures stabilized with locking plates.J Bone Joint Surg Am. 2010; 92: 1652-1660
Medical Device Safety Alert: Synthes Dynamic Locking Screw Stardrive.
- Biomechanical evaluation of the less invasive stabilization system, angled blade plate, and retrograde intramedullary nail for the internal fixation of distal femur fractures.J Orthop Trauma. 2004; 18: 494-502
- Mechanical comparison of a distal femoral side plate and a retrograde intramedullary nail.J Orthop Trauma. 2000; 4: 398-404
- Technical difficulties of removal of locking screw after locking compression plating.Arch Orthop Trauma Surg. 2009; 129: 91-95
Article info
Publication history
Published online: October 31, 2014
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
