Abdus Samad Khan, Umar Hayat, Basit Hussain.
Outcome of Locking Plate in Long Bones Fractures in Adults.
Ophthalmol Update Jan ;15(3):303-5.

Background : The Locking compression plate (LCP) system consists of a range of anatomically shaped plates with specially designed combination holes. Once locked, these screws even under stress maintain their relative position with respect to the plate. The pull-out strength of locking screws is 4 times higher than the conventional screws and is particularly useful in osteoporotic bones. thus providing both angular and axial stability. Objective : To evaluate results of locking plate in metaphyseo-diaphyseal fractures of long bones in adults. Methods and Materials : The present descriptive case series study was done on patients with long bone fractures admitted in our unit at Khyber Teaching Hospital Peshawar from June, 2011 till March,2015. All patients were evaluated clinically and radiographically at the time of admission. Closed meta-physeodiaphyseal fractures in long bones i.e humerus, radius and ulna, femur and tibia in each gender from 18-80 years were chosen for LCP fixation. Open reduction and internal fixation with locking plate was done with or without image intensifier and bone grafting was done in non-union and some comminuted fracture. Regular monthly follow up till 6 months for union, infection, joint stiffness and limb length discrepancy. Results : Out of 35 patients, 22 (77%) were male and 13 (23%) females. The number of different types of long bones fixed with locking plates are femur 15 (43%) ,tibia 12 (34%), humerus 6 (17%) and radius 2 (6%). The number of failed locking plates/non-union with fracture above the end of implant due to stress riser are 4 (11 %) 3 in femur and 1 in tibia which were refixed with long locking plate and unicortical far away screw with bone grafting. In 2 failed femur locking plate choice of implant was not proper. Infection in 2 (5.7 %) cases in tibia which resolved with antibiotic and wound dressing. Knee stiffness 2 (5.7%) cases, limb length discrepancy of 2 cm in 2 patients in lower limb (6%) and 3 cm in upper limb in one patient (3%). In 31 (89%) cases fractures were united within 16-20 weeks. Conclusion :The locking plates gives good results in long bones metaphyseo-diaphyeal comminuted fractures specially in osteoporotic bones due to stable construct with negligible complication like non-union and implant failure.

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