Department of Orthopaedics, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
Orthop Surg. 2013 Nov;5(4):255-60. doi: 10.1111/os.12069.
To evaluate the role of locked compression plates (LCPs) in management of peri- and intra-articular fractures around the knee.
Twenty distal femoral and 20 proximal tibial fractures were fixed with LCPs. The types of femoral fractures were A1 (four), A2 (three), A3 (two), C1 (one), C2 (seven) and C3 (three). The types of tibial fractures were A2 (one), A3 (two), B2 (two), C1 (four), C2 (five) and C3 (six). All patients were followed up for up to 18 months (mean, 12 months). Fourteen patients with distal femoral fractures and 19 with proximal tibial fractures underwent surgery using a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. The others were treated by open reduction. The average time of fixation was 8 days after injury (0-31 days). Knee Society scores were used for clinical and functional assessment.
All fractures, except one of the distal femur and one of the proximal tibia, united. The mean union times for distal femoral and proximal tibial fractures were 15.2 and 14.9 weeks, respectively. One patient with a distal femoral fracture had implant failure. One patient was quadriplegic and did not recover the ability to walk. The average Knee Society scores of the remaining 18 patients were 82.66 (excellent) and 77.77 (functional score, good). There was one case of implant failure and one of screw breakage in distal femoral fractures. One case of nonunion occurred in a proximal tibial fracture.
Provided it is applied with proper understanding of biomechanics, LCP is one of the best available options for management of challenging peri- and intra-articular fractures.
评估锁定加压钢板（LCP）在膝关节周围的关节内和关节外骨折治疗中的作用。
用 LCP 固定 20 例股骨远端和 20 例胫骨近端骨折。股骨骨折类型为 A1（4 例）、A2（3 例）、A3（2 例）、C1（1 例）、C2（7 例）和 C3（3 例）。胫骨骨折类型为 A2（1 例）、A3（2 例）、B2（2 例）、C1（4 例）、C2（5 例）和 C3（6 例）。所有患者均随访 18 个月（平均 12 个月）。14 例股骨远端骨折和 19 例胫骨近端骨折患者采用微创经皮钢板接骨术（MIPPO）技术进行手术治疗。其他患者采用切开复位治疗。骨折后平均固定时间为 8 天（0-31 天）。采用膝关节协会评分进行临床和功能评估。
除 1 例股骨远端和 1 例胫骨近端骨折外，所有骨折均愈合。股骨远端和胫骨近端骨折的平均愈合时间分别为 15.2 周和 14.9 周。1 例股骨远端骨折患者出现内固定失败。1 例患者四肢瘫痪，无法恢复行走能力。其余 18 例患者的平均膝关节协会评分为 82.66（优）和 77.77（功能评分，良好）。股骨远端骨折有 1 例内固定失败和 1 例螺钉断裂，胫骨近端骨折有 1 例骨折不愈合。
只要正确理解生物力学，LCP 就是治疗具有挑战性的关节内和关节外骨折的最佳选择之一。
