Locking compression plate in treatment of forearm fractures: a prospective study

Journal of Orthopaedic Surgery, Apr 2007 by Kumar, A, Khan, S A, Yadav, C S, Nag, H L

To the Editor:

We read with interest the article by Leung and Chow.1 We consider that the use of a conventional screw as a temporary hold on to the plate is not justified. Instead, locking plates are known to be stabilised (after reduction) with 2 threaded plate holders provided with the AO locking plate system. These holders and drill sleeves can be used to hold the plate across the 2 fracture ends and then the plate can be fixed, drilling across one of the holders.

Bridging plates can be positioned with threaded holders and can be secured more easily by inserting the first locking screw in one fracture end and the second in the other fragment followed by other locking screws. Using a conventional screw to secure the bridging plate after reduction may be difficult in some comminuted fractures. Implants from the upper extremity should be removed after 12 to 18 months.2 As refracture usually occurs at the old screw tracks, we routinely give external support (plaster of Paris slab) for 2 to 3 weeks.

REFERENCES

1. Leung F, Chow SP. Locking compression plate in the treatment of forearm fractures: a prospective study. J Orthop Surg (Hong Kong) 2006;14:291-4.

2. George W. Wood II. General principles of fracture treatment. In: Canale ST, editor. Campbell's operative orthopaedics. 10th ed. Philadelphia: Mosby; 2003:2669-723.

A Kumar

SA Khan

CS Yadav

HL Nag

Department of Orthopaedics

All India Institute of Medical Sciences

Ansari Nagar, New Delhi, India