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 CME 4: October, November, December 2003
Trauma Test 1: Fractures of the Long Bones and Joints
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The Journal of Bone and Joint Surgery (American) 85:2343-2348 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

A Prospective, Randomized Trial Comparing the Limited Contact Dynamic Compression Plate with the Point Contact Fixator for Forearm Fractures

Frankie Leung, FRCS1 and Shew-Ping Chow, MS, FRCS1

1 Department of Orthopaedic Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong. E-mail address for F. Leung: klleunga{at}hkucc.hku.hk

Investigation performed at the Department of Orthopaedic Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

Background: The most effective type of plate fixation for diaphyseal forearm fractures has not been defined. We performed a prospective, randomized trial in which the limited contact dynamic compression plate (LC-DCP) was compared with the Point Contact Fixator (PC-Fix) for the treatment of forearm fractures at one center.

Methods: Ninety-two patients with 125 forearm fractures were recruited for the study and were randomly assigned to fracture fixation with one of the two devices. The average age of the patients was thirty-six years. The average duration of follow-up was twenty-two months. Patients were assessed periodically with use of radiographs and were assessed with regard to pain and function at time of the latest follow-up.

Results: Three patients (four fractures) in the PC-Fix group and five patients (five fractures) in the LC-DCP group had a delayed union, but no patient in either group had a nonunion. With the numbers available, there was no significant difference between the two groups with regard to operative time, time to union, callus formation, pain, or functional outcome. Deep infection occurred in one patient with a closed fracture in the PC-Fix group and in one patient with an open fracture in the LC-DCP group. In addition, one refracture occurred in each group. Both refractures occurred at the site of a screw track.

Conclusion: Despite the differences in the concept of fracture fixation, these two implants appear to be equally effective for the treatment of diaphyseal forearm fractures.

Level of Evidence: Therapeutic study, Level I-1b (randomized controlled trial [no significant difference but narrow confidence intervals]). See Instructions to Authors for a complete description of levels of evidence.


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Related articles in JBJS:

Fixation of Forearm Fractures • F. Leung and S.-P. Chow reply
Chilamkurthi Rajasekhar, Ravi Goyal, Frankie Leung, and Shew-Ping Chow
JBJS 2004 86: 1830. [Extract] [Full Text]  



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Letters to the Editor:

Read all Letters to the Editor

On The Need for Hardware Removal following Internal Fixation for Forearm Fractures
Chilamkurthi Rajasekhar FRCS, et al.
JBJS Online, 3 Feb 2004 [Full text]
Dr. Leung responds:
Frankie Leung, et al.
JBJS Online, 3 Feb 2004 [Full text]