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A preliminary, prospective, multicenter study using the 3.5 mm low contact dynamic compression plate (LCDCP) for traumatic and reconstructive problems in the upper extremity skeleton is presented. Over a 13-month period in three institutions, 26 plates were implanted in 21 patients. Twelve were male and 9 female, with an average age of 26 years. Eleven LCDCP were used for acute fractures. Fifteen plates were used in reconstructions, including nonunions; radial osteotomies; and wrist arthrodeses. Twelve were stainless steel and 14 titanium. Plate lengths ranged from 6 holes to 10 holes. Multi-directional contouring was required in 6 cases. Obliquely placed 3.5 mm design “shaft” lag screws were used in 2 cases. In 4 cases, the plate design permitted compression in 2 opposing directions along the longitudinal axis of the bone. In one case, the newer hole design allowed placement of an oblique lag screw at a 40-degree angle to the plate. All patients were treated with a functional aftercare program. Radiographic and clinical union was achieved within 3 months in each case. There were no immediate or late postoperative problems. Functional limb recovery was noted in each case. One patient had plate removal 6 months post wrist arthrodesis due to extensor tendon inflammation. The plate was securely fixed. Microscopic sections of zones of contact and non-contact clearly demonstrated increased osteoporosis in the zones of plate contact. This experience supports the fact that with the LCDCP internal fixation is secure, plate design allows easier 3-dimensional contouring, and screw placement is facilitated.
Dynamic compression plating, fracture fixation, upper extremity
Assistant professor of orthopaedic surgery, The Emory Clinic, Atlanta, GA