COMPARISON STUDY ON LOCKING COMPRESS PLATE EXTERNAL FIXATOR AND STANDARD EXTERNAL FIXATOR FOR TREATMENT OF TIBIAL OPEN FRACTURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Gang , LUO Xiaozhong , TAN Lun , LIN Xu , WU Chao , GUO Yong , ZHONG Zewei.

Department of Orthopaedics, the 4th People’s Hospital of Zigong, Zigong Sichuan, 643000, P.R.China. Corresponding author: WU Gang, E-mail: wgms2005@163.com;

Corresponding author：

Keywords：

Tibial open fracture; Locking compress plate; External fixator; Fracture external fixation

DOI：

10.7507/1002-1892.20130282

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Objective To compare the clinical results of locking compress plate (LCP) as an external fixator and standard external fixator for treatment of tibial open fractures. Methods Between May 2009 and June 2012, 59 patients with tibial open fractures were treated with LCP as an external fixator in 36 patients (group A), and with standard external fixator in 23 patients (group B). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, location, and interval between injury and surgery between 2 groups (P gt; 0.05). The time of fracture healing and incision healing, the time of partial weight-bearing, the range of motion (ROM) of knee and ankle, and complications were compared between 2 groups. Results The incidence of pin-track infection in group A (0) was significantly lower than that in group B (21.7%) (P=0.007). No significant difference was found in the incidence of superficial infection and deep infection of incision, and the time of incision healing between 2 groups (P gt; 0.05). Deep vein thrombosis occurred in 5 cases of group A and 2 cases of group B, showing no significant difference (χ2=0.036, P=0.085). All patients were followed up 15.2 months on average (range, 9-28 months) in group A, and 18.6 months on average (range, 9-47 months) in group B. The malunion rate and nonunion rate showed no significant difference between groups A and B (0 vs. 13.0% and 0 vs. 8.7%, P gt; 0.05); the delayed union rate of group A (2.8%) was significantly lower than that of group B (21.7%) (χ2=5.573, P=0.018). Group A had shorter time of fracture healing, quicker partial weight-bearing, greater ROM of the knee and ankle than group B (P lt; 0.05). Conclusion The LCP external fixator can obtain reliable fixation in treating tibial open fracture, and has good patients’ compliance, so it is helpful to do functional exercise, improve fracture healing and function recovery, and reduce the complication incidence.

Citation： WU Gang,LUO Xiaozhong,TAN Lun,LIN Xu,WU Chao,GUO Yong,ZHONG Zewei.. COMPARISON STUDY ON LOCKING COMPRESS PLATE EXTERNAL FIXATOR AND STANDARD EXTERNAL FIXATOR FOR TREATMENT OF TIBIAL OPEN FRACTURES. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(11): 1291-1295. doi: 10.7507/1002-1892.20130282 Copy

1.	黎文, 林志雄, 白波, 等. 胫骨开放性骨折的治疗. 中华创伤杂志, 2005, 21(2): 91-93.
2.	Chummun S, Wigglesworth TA, Young K, et al. Does vascular injury affect the outcome of open tibial fractures? Plast Reconstr Surg, 2013, 131(2): 303-309.
3.	王晓峰, 胡浩良, 徐荣明, 等. Ⅲ-C型胫骨开放性骨折的血管探查与修复. 中国骨与关节损伤杂志, 2007, 22(11): 950-951.
4.	卫力晋, 王长军, 刘岩, 等. 非扩髓髓内钉结合负压封闭引流治疗胫骨开放性骨折伴皮肤缺损. 中华创伤骨科杂志, 2009, 11(8): 794-795.
5.	Kerkhoffs GM, Kuipers MM, Marti RK, et al. External fixation with standard AO-plates: technique, indications, and results in 31 cases. J Orthop Trauma, 2003, 17(1): 61-64.
6.	Marti RK, van der Werken C. The AO-plate for external fixation in 12 cases. Acta Orthop Scand, 1991, 62(1): 60-62.
7.	董强. 胫腓骨开放性骨折术后并发感染的临床分析. 中华医院感染学杂志, 2011, 21(22): 4698-4699.
8.	张伯锋, 张英泽, 潘进社, 等. 急诊外固定架治疗胫骨开放骨折. 中华急诊医学杂志, 2011, 20(1): 90-92.
9.	秦煜. 骨折愈合、延迟愈合和骨不连. 中华创伤骨科杂志, 2004, 6(9): 1059-1062.
10.	Wagner M. General principles for the clinical use of the LCP. Injury, 2003, 34 Suppl 2: B31-42.
11.	Kim JW, Oh CW, Jung WJ, et al. Minimally invasive plate osteosynthesis for open fractures of the proximal tibia. Clin Orthop Surg, 2012, 4(4): 313-320.
12.	魏世隽, 蔡贤华, 刘曦明, 等. Ⅰ期内固定与外固定支架治疗胫骨Gustilo ⅢA 型开放性骨折的对照研究. 创伤外科杂志, 2012, 14(1): 48-52.
13.	Ziran BH, Smith WR, Anglen JO, et al. External fixation: how to make it work. J Bone Joint Surg (Am), 2007, 89(7): 1620-1632.
14.	Foster PA, Barton SB, Jones SC, et al. The treatment of complex tibial shaft fractures by the Ilizarov method. J Bone Joint Surg (Br), 2012, 94(12): 1678-1683.
15.	Apivatthakakul T, Sananpanich K. The locking compression plate as an external fixator for bone transport in the treatment of a large distal tibia defect: a case report. Injury, 2007, 38(11): 1318-1325.
16.	Kloen P. Supercutaneous plating: use of a locking compression plate as an external fixator. J Orthop Trauma, 2009, 23(1): 72-75.
17.	Schmal H, Strohm PC, Jaeger M, et al. Flexible fixation and fracture healing: do locked plating “internal fixators” resemble external fixators. J Orthop Trauma, 2011, 25 Suppl 2: S15-20.
18.	Agrawal A, Chauhan VD, Maheshwari RK, et al. Primary nailing in the open fractures of the tibia—Is it worth. J Clin Diagn Res, 2013, 7(6): 1125-1130.

1. 黎文, 林志雄, 白波, 等. 胫骨开放性骨折的治疗. 中华创伤杂志, 2005, 21(2): 91-93.
2. Chummun S, Wigglesworth TA, Young K, et al. Does vascular injury affect the outcome of open tibial fractures? Plast Reconstr Surg, 2013, 131(2): 303-309.
3. 王晓峰, 胡浩良, 徐荣明, 等. Ⅲ-C型胫骨开放性骨折的血管探查与修复. 中国骨与关节损伤杂志, 2007, 22(11): 950-951.
4. 卫力晋, 王长军, 刘岩, 等. 非扩髓髓内钉结合负压封闭引流治疗胫骨开放性骨折伴皮肤缺损. 中华创伤骨科杂志, 2009, 11(8): 794-795.
5. Kerkhoffs GM, Kuipers MM, Marti RK, et al. External fixation with standard AO-plates: technique, indications, and results in 31 cases. J Orthop Trauma, 2003, 17(1): 61-64.
6. Marti RK, van der Werken C. The AO-plate for external fixation in 12 cases. Acta Orthop Scand, 1991, 62(1): 60-62.
7. 董强. 胫腓骨开放性骨折术后并发感染的临床分析. 中华医院感染学杂志, 2011, 21(22): 4698-4699.
8. 张伯锋, 张英泽, 潘进社, 等. 急诊外固定架治疗胫骨开放骨折. 中华急诊医学杂志, 2011, 20(1): 90-92.
9. 秦煜. 骨折愈合、延迟愈合和骨不连. 中华创伤骨科杂志, 2004, 6(9): 1059-1062.
10. Wagner M. General principles for the clinical use of the LCP. Injury, 2003, 34 Suppl 2: B31-42.
11. Kim JW, Oh CW, Jung WJ, et al. Minimally invasive plate osteosynthesis for open fractures of the proximal tibia. Clin Orthop Surg, 2012, 4(4): 313-320.
12. 魏世隽, 蔡贤华, 刘曦明, 等. Ⅰ期内固定与外固定支架治疗胫骨Gustilo ⅢA 型开放性骨折的对照研究. 创伤外科杂志, 2012, 14(1): 48-52.
13. Ziran BH, Smith WR, Anglen JO, et al. External fixation: how to make it work. J Bone Joint Surg (Am), 2007, 89(7): 1620-1632.
14. Foster PA, Barton SB, Jones SC, et al. The treatment of complex tibial shaft fractures by the Ilizarov method. J Bone Joint Surg (Br), 2012, 94(12): 1678-1683.
15. Apivatthakakul T, Sananpanich K. The locking compression plate as an external fixator for bone transport in the treatment of a large distal tibia defect: a case report. Injury, 2007, 38(11): 1318-1325.
16. Kloen P. Supercutaneous plating: use of a locking compression plate as an external fixator. J Orthop Trauma, 2009, 23(1): 72-75.
17. Schmal H, Strohm PC, Jaeger M, et al. Flexible fixation and fracture healing: do locked plating “internal fixators” resemble external fixators. J Orthop Trauma, 2011, 25 Suppl 2: S15-20.
18. Agrawal A, Chauhan VD, Maheshwari RK, et al. Primary nailing in the open fractures of the tibia—Is it worth. J Clin Diagn Res, 2013, 7(6): 1125-1130.

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COMPARISON STUDY ON LOCKING COMPRESS PLATE EXTERNAL FIXATOR AND STANDARD EXTERNAL FIXATOR FOR TREATMENT OF TIBIAL OPEN FRACTURES

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