- See:
- DCP and LC-DCP, 3.5 mm
- DCP, 4.5 mm
- LC-DCP, 4.5 mm in Pure Titanium
- Discussion:
- compression is appied by eccentric insertion of screws;
- slot for compression has a sloping surface at one end;
- when the spherical head of the screw impinges on this surface, plate moves away from the fracture, thereby compressing
fracture plane;
- if more compression is necessary, subsequent screws may be inserted in compression mode, but it is rarely necessary for more than
two screws to be loaded;
- when additional compression is added, the tension on initially inserted screws must be released by backing off 1-2 turns;
- each scew is then tightened in turn when all screws have been inserted;
- usage of two load screws in the main fragments for axial compression;
- after one scew has been inserted in load position in each main fragment, producing 1 mm of displacement, horizontal track in main
fragment still permits 1.8 mm of displacement;
- second screw, therefore, can be inserted in the next hole w/o being blocked by the first screw;
- first screw, however, must be slightly loosened before further1 mm compression can be produced by the second screw;
- note: that the first screw is inserted in the fragment whose spike is farthest from the plate;
- following this, after axial compression is applied, oblique lag screw is inserted for interfragment compression;
- after insertion of at least 2 screws on each side of frx, (4 cortices on each side of frx), a screw is be placed throug 1 cortex only
in most proximal and distal palte holes; - this prevents a stress riser;
- note: stratedgy for plating frx may be dictated by frx configuration
- transverse fractures are stronger in compression than oblique frx
- oblique fractures are stronger in rotation than transverse frx
- Limited Contact Dynamic Compression Plate:
- characterized by less than 50% contact between the plate and the bone.
- allows for preservation of blood supply and less osteoporosis underneath the plate;
- References:
- Optimizing compression: Comparing eccentric plate holes and external tensioning devices.
- General principles for the clinical use of the LCP.
- Biomechanical testing of the LCP--how can stability in locked internal fixators be controlled?