Locking Compression Plate.
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Biomechanical Phenomena↗
Biomedical subjects
Christoph Sommer
Publications and source records attributed to Christoph Sommer.
First clinical results of the Locking Compression Plate (LCP).
The Locking Compression Plate (LCP) is a new screw-plate system that offers the possibility of inserting conventional and locking head screws into the specially designed combination holes. It represents a further development of the PC-Fix and the LISS and was released for clinical application in March 2000. In a prospective multicentre study, the new system was used to treat 144 patients (f: 67, m: 77; average age: 51.4 years) with 169 fractures: of these, 57 were tibial fractures, 45 humerus, 19 radius and 18 femoral. After one year, clinical and radiological follow-up assessment was carried out on 127 patients with 151 fractures (88%). In 130 fractures (86%), healing took place within the expected period and without complication or secondary dislocation ("uneventful healing"). In 19 patients, a total of 27 unexpected complications occurred ("adverse events"), in which 18 revision operations were necessary in 13 patients: five for implant loosening/pull-out, four for plate failure, one for non-union, five for secondary fractures immediately adjacent to the implant after a subsequent injury and two for infection. Analysis by a committee of experts indicated that mechanical complications arose entirely from technical errors of application (incorrect fixation technique, incorrect choice of plate). No purely implant-related complications were observed. The new system can be regarded as technically mature. It offers numerous fixation possibilities and has proven its worth in complex fractures situations and in revision operations after the failure of other implants. A good knowledge of biomechanics is essential as well as precise preoperative planning.
Adolescent↗
Guidelines for the clinical application of the LCP.
The Locking Compression Plate (LCP), in combination with the LISS and the PHILOS, is part of a new plate generation requiring an adapted surgical technique and new thinking about commonly used concepts of internal fixation using plates. The following guidelines are needed to avoid failures and possible complications in the hands of surgeons not yet confident with the new implant philosophy. The importance of the reduction technique and minimal-invasive plate insertion and fixation is addressed to keep bone viability undisturbed. Understanding of mechanical background for choosing the proper implant length and the type and number of screws is essential to obtain a sound fixation with a high plate span ratio and a low plate screw density. A high plate span ration decreases the load onto the plate. A high working length of the plate in turn reduces the screw loading, thus fewer screws need to be inserted and the plate screw density can be kept low. Knowledge of the working length of the screw is helpful for the proper choice of monocortical or bicortical screws. Selection is done according to the quality of the bone structure and is important to avoid problems at the screw thread bone interface with potential pullout of screws and secondary displacement. Conclusive rules are given at the end of this chapter.
Biomechanical Phenomena↗