The application of the limited contact dynamic compression plate in the upper extremity: an analysis of 114 consecutive cases.

We sought to assess the clinical effectiveness of a new plate design which offers improved biological and biomechanical features, the limited contact dynamic compression (LCDC) plate. We analysed 114 LCDC plates applied consecutively for upper extremity fractures or reconstruction in 94 patients. Three patients were lost to follow-up, leaving 111 plates in 91 patients followed to definitive fracture/osteotomy outcome. Thirty-seven plates were applied for reconstruction in 35 patients, including 11 where standard implants had failed. Fifty-six patients had 74 plates applied for acute fractures including 12 open fractures, 23 multiply injured patients, 26 patients with concomitant fractures and seven associated neurovascular injuries. All patients were followed to definitive outcome. Union was achieved at an average of 10.7 weeks in 105 platings, while three delayed unions eventually united without further intervention, an overall union rate of 108/111, or 97.3 per cent. There were no mechanical failures of the plates or screws. In this large series a union rate of 97.3 per cent with no implant failures confirms its clinical application for traumatic and reconstructive problems in this area. Improved contouring, easier screw placement, decreased interference with cortical bone blood flow and excellent union rates are definite short-term advantages. Theoretical long-term benefits of decreased stress-shielding and lower refracture rates will require longer follow up.