Dynamic Compression Plate versus Locking Compression Plate Fixation in Adult Forearm Fractures: A Prospective Interventional Study

Abstract

Introduction: Injuries resulting from traffic accidents, industrial accidents, natural disasters, and assault are the cause of most fractures of the forearm and it is very important to regain the length, apposition, axial alignment, and rotational alignment of the radius and ulna while treating diaphyseal fractures to achieve a good range of motion. In such cases, open reduction and internal fixation are recommended. Aim: To determine the effectiveness of Locking Compression Plates (LCP) and Dynamic Compression Plates (DCP) in treating adult forearm fractures. Materials and Methods: A prospective interventional study was conducted from September 2020 to September 2021 in which 30 patients with both bone forearm fractures underwent open reduction and internal fixation with a Locking Compression Plate(n=15) or a Dynamic Compression Plate(n=15) at the Dr.D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, India. For each LCP and DCP operated patient, radiographic findings regarding fracture union and functional outcomes regarding elbow joint range of motion was evaluated. Appropriate parametric tests (Chi-square test, Independent t-test) were conducted to identify significant differences in functional outcomes between the two interventions. Results: Out of total, 13 patients (86.7%) each who underwent both the DCP and LCP fixation had excellent outcomes, though the results were not significant according to Anderson LD et al., grading system. Although it was statistically insignificant (p-value= 0.18), patients who received LCP took less time to heal their fractures than those who received DCP. There was no significant difference between patients treated with DCP and those treated with LCP when it comes to achieving a complete range of motion (p-value=0.99). Conclusion: In terms of functional outcome, both the patient groups who were operated on with DCP as well as LCP had no significant difference. Proper preoperative planning, good patient care, proper surgical technique with minimal adjacent soft tissue damage, strict aseptic conditions, proper follow-up, and rehabilitation along with patient education are all required for good functional outcomes.