RESEARCH PROGRESS IN TREATMENT OF FRACTURES BY FAR CORTICAL LOCKING TECHNIQUE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIHaifeng ,  YINQudong , GUSanjun , SUNZhenzhong , RUIYongjun

Department of Orthopaedics, Wuxi No. 9 People's Hospital, Wuxi Jiangsu, 214062, P. R. China;

Corresponding author：

YINQudong, Email: yinqudong@sina.com

Keywords：

Far cortical locking; Dynamic locking; Locking plate

DOI：

10.7507/1002-1892.20160022

Video：

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Objective To summarize the research progress in the treatment of fractures by far cortical locking technique. Method The domestic and foreign related literature about the treatment of fractures by far cortical locking technique was reviewed, summarized, and analyzed. Results In order to overcome the shortcomings of high stress at the near side of the plate and high stiffness of traditional locking plate, a new far cortical locking technique has been developed recently. The structure retains the overall strength of locking plate, but decreases the stiffness of the fixation by 80%, so it can provide interfragmentary parallel micromotion and help to form symmetric callus, and satisfactory results have been achieved in theory, experiment, and clinical application of treatment of fractures by far cortical locking. Conclusions The far cortical locking technique is a major improvement of locking plate, which is expected to significantly reduce delayed healing and nonunion of some fractures treated with traditional locking plate.

Citation： LIHaifeng, YINQudong, GUSanjun, SUNZhenzhong, RUIYongjun. RESEARCH PROGRESS IN TREATMENT OF FRACTURES BY FAR CORTICAL LOCKING TECHNIQUE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(1): 110-114. doi: 10.7507/1002-1892.20160022 Copy

1.	Gardner MJ, Nork SE, Huber P, et al. Stiffness modulation of locking plate constructs using near cortical slotted holes:a preliminary study. J Orthop Trauma, 2009, 23(4) :281-287.
2.	Bottlang M, Doornink J, Byrd GD, et al. A nonlocking end screw can decrease fracture risk caused by locked plating in the osteoporotic diaphysis. J Bone Joint Surg (Am), 2009, 91(3) :620-627.
3.	Henderson CE, Bottlang M, Marsh JL, et al. Does locked plating of periprosthetic supracondylar femur fractures promote bone healing by callus formation? Two cases with opposite outcomes. Iowa Orthop J, 2008, 28:73-76.
4.	Bottlang M, Lesser M, Koerber J, et al. Far cortical locking can improve healing of fractures stabilized with locking plates. J Bone Joint Surg (Am), 2010, 92(7) :1652-1660.
5.	Bottlang M, Feist F. Biomechanics of far cortical locking. J Orthop Trauma, 2011, 25 Suppl 1:S21-28.
6.	Bottlang M, Doornink J, Daniel C, et al. Far cortical locking can reduce stiffness of locked plating constructs while retaining construct strength. J Bone Joint Surg (Am), 2009, 91(8) :1985-1994.
7.	Bottlang M, Fitzpatrick DC, Sheerin D, et al. Dynamic fixation of distal femur fractures using far cortical locking screws:a prospective observational study. J Orthop Trauma, 2014, 28(4) :181-188.
8.	Döbele S, Horn C, Eichhorn S, et al. The dynamic locking screw (DLS) can increase interfragmentary motion on the near cortex of locked plating constructs by reducing the axial stiffness. Langenbecks Arch Surg, 2010, 395(4) :421-428.
9.	Freude T, Schröter S, Gonser CE, et al. Controlled dynamic stability as the next step in "biologic plate osteosynthesis"-a pilot prospective observational cohort study in 34 patients with distal tibia fractures. Patient Saf Surg, 2014, 8(1) :3.
10.	Plecko M, Lagerpusch N, Andermatt D, et al. The dynamisation of locking plate osteosynthesis by means of dynamic locking screws (DLS)-an experimental study in sheep. Injury, 2013, 44(10) :1346-1357.
11.	Lujan TJ, Henderson CE, Madey SM, et al. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation. J Orthop Trauma, 2010, 24(3) :156-162.
12.	Gardner MJ, Nork SE, Huber P, et al. Less rigid stable fracture fixation in osteoporotic bone using locked plates with near cortical slots. Injury, 2010, 41(6) :652-656.
13.	Goodship AE, Kenwright J. The influence of induced micromovement upon the healing of experimental tibial fractures. J Bone Joint Surg (Br), 1985, 67(4) :650-655.
14.	Klein P, Schell H, Streitparth F, et al. The initial phase of fracture healing is specifically sensitive to mechanical conditions. J Orthop Res, 2003, 21(4) :662-669.
15.	Bottlang M, Doornink J, Trevor J. Effects of construct stiffness on healing of fractures stabilized with locking plates. J Bone Joint Surg (Am), 2010, 92 Suppl 2:12-22.
16.	Döbele S, Gardner M, Schröter S, et al. DLS 5.0-the biomechanical effects of dynamic locking screws. PLoS One, 2014, 9(4) :e91933.
17.	Doornink J, Fitzpatrick DC, Madey SM, et al. Far cortical locking enables flexible fixation with periarticular locking plates. J Orthop Trauma, 2011, 25 Suppl 1:s29-34.
18.	Jaeblon T. Biomechanics of far cortical locking. J Orthop Trauma, 2011, 25(6) :e60.
19.	Richter H, Plecko M, Andermatt D, et al. Dynamization at thenear cortex in locking plate osteosynthesis by means of dynamic locking screws:an experimental study of transverse tibial osteotomies in sheep. J Bone Joint Surg (Am), 2015, 97(3) :208-215.
20.	Plecko M, Lagerpusch N, Andermatt D, et al. The dynamisation of locking plate osteosynthesis by means of dynamic locking screws (DLS)-an experimental study in sheep. Injury, 2013, 44(10) :1346-1357.
21.	Ries Z, Hansen K, Bottlang M, et al. Healing results of periprosthetic distal femur fractures treated with far cortical locking technology:a preliminary retrospective study. Iowa Orthop J, 2013, 33:7-11.
22.	Ries ZG, Marsh JL. Far cortical locking technology for fixation of periprosthetic distal femur fractures:a surgical technique. J Knee Surg, 2013, 26(1) :15-18.
23.	Adams JD Jr, Tanner SL, Jeray KJ. Far cortical locking screws in distal femur fractures. Orthopedics, 2011, 38(3) :e153-156.

1. Gardner MJ, Nork SE, Huber P, et al. Stiffness modulation of locking plate constructs using near cortical slotted holes:a preliminary study. J Orthop Trauma, 2009, 23(4) :281-287.
2. Bottlang M, Doornink J, Byrd GD, et al. A nonlocking end screw can decrease fracture risk caused by locked plating in the osteoporotic diaphysis. J Bone Joint Surg (Am), 2009, 91(3) :620-627.
3. Henderson CE, Bottlang M, Marsh JL, et al. Does locked plating of periprosthetic supracondylar femur fractures promote bone healing by callus formation? Two cases with opposite outcomes. Iowa Orthop J, 2008, 28:73-76.
4. Bottlang M, Lesser M, Koerber J, et al. Far cortical locking can improve healing of fractures stabilized with locking plates. J Bone Joint Surg (Am), 2010, 92(7) :1652-1660.
5. Bottlang M, Feist F. Biomechanics of far cortical locking. J Orthop Trauma, 2011, 25 Suppl 1:S21-28.
6. Bottlang M, Doornink J, Daniel C, et al. Far cortical locking can reduce stiffness of locked plating constructs while retaining construct strength. J Bone Joint Surg (Am), 2009, 91(8) :1985-1994.
7. Bottlang M, Fitzpatrick DC, Sheerin D, et al. Dynamic fixation of distal femur fractures using far cortical locking screws:a prospective observational study. J Orthop Trauma, 2014, 28(4) :181-188.
8. Döbele S, Horn C, Eichhorn S, et al. The dynamic locking screw (DLS) can increase interfragmentary motion on the near cortex of locked plating constructs by reducing the axial stiffness. Langenbecks Arch Surg, 2010, 395(4) :421-428.
9. Freude T, Schröter S, Gonser CE, et al. Controlled dynamic stability as the next step in "biologic plate osteosynthesis"-a pilot prospective observational cohort study in 34 patients with distal tibia fractures. Patient Saf Surg, 2014, 8(1) :3.
10. Plecko M, Lagerpusch N, Andermatt D, et al. The dynamisation of locking plate osteosynthesis by means of dynamic locking screws (DLS)-an experimental study in sheep. Injury, 2013, 44(10) :1346-1357.
11. Lujan TJ, Henderson CE, Madey SM, et al. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation. J Orthop Trauma, 2010, 24(3) :156-162.
12. Gardner MJ, Nork SE, Huber P, et al. Less rigid stable fracture fixation in osteoporotic bone using locked plates with near cortical slots. Injury, 2010, 41(6) :652-656.
13. Goodship AE, Kenwright J. The influence of induced micromovement upon the healing of experimental tibial fractures. J Bone Joint Surg (Br), 1985, 67(4) :650-655.
14. Klein P, Schell H, Streitparth F, et al. The initial phase of fracture healing is specifically sensitive to mechanical conditions. J Orthop Res, 2003, 21(4) :662-669.
15. Bottlang M, Doornink J, Trevor J. Effects of construct stiffness on healing of fractures stabilized with locking plates. J Bone Joint Surg (Am), 2010, 92 Suppl 2:12-22.
16. Döbele S, Gardner M, Schröter S, et al. DLS 5.0-the biomechanical effects of dynamic locking screws. PLoS One, 2014, 9(4) :e91933.
17. Doornink J, Fitzpatrick DC, Madey SM, et al. Far cortical locking enables flexible fixation with periarticular locking plates. J Orthop Trauma, 2011, 25 Suppl 1:s29-34.
18. Jaeblon T. Biomechanics of far cortical locking. J Orthop Trauma, 2011, 25(6) :e60.
19. Richter H, Plecko M, Andermatt D, et al. Dynamization at thenear cortex in locking plate osteosynthesis by means of dynamic locking screws:an experimental study of transverse tibial osteotomies in sheep. J Bone Joint Surg (Am), 2015, 97(3) :208-215.
20. Plecko M, Lagerpusch N, Andermatt D, et al. The dynamisation of locking plate osteosynthesis by means of dynamic locking screws (DLS)-an experimental study in sheep. Injury, 2013, 44(10) :1346-1357.
21. Ries Z, Hansen K, Bottlang M, et al. Healing results of periprosthetic distal femur fractures treated with far cortical locking technology:a preliminary retrospective study. Iowa Orthop J, 2013, 33:7-11.
22. Ries ZG, Marsh JL. Far cortical locking technology for fixation of periprosthetic distal femur fractures:a surgical technique. J Knee Surg, 2013, 26(1) :15-18.
23. Adams JD Jr, Tanner SL, Jeray KJ. Far cortical locking screws in distal femur fractures. Orthopedics, 2011, 38(3) :e153-156.

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