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Plate osteosynthesis is a method of choice in the treatment of forearm fractures with senso-motorical impairment, poorly or non-reduceable, retained, fragmented and open fractures. Dislocated fractures of the forearm frequently cause problems because of their poor reduction and retention. In such cases, exclusively conservative treatment requires reduction and change of therapeutical approach to avoid functional limitations resulting from axial malpositioning. The sincere contact of bone fragments, accompanied by sufficient anatomical axial and conservative reduction techniques that maintain parossal perfusion as well as a limited osteosynthesis plate contact should be the aim of the operative strategy. The use of a new titanium osteosynthesis plate system with multi-point contact between bone and plate promotes the incorporation of vessels and callus formation at the bone-plate interface and leads to the realization of the aforementioned aim, which was revealed in animal studies before. In order to examine the results, 18 patients with forearm fractures were studied, which underwent reduction and internal fixation using this new titanium osteosynthesis plate, the multi-point contact plate (MPC) system. In these patients, functional and radiological results after plate removal were studied. Our initial clinical experiences with the MPC-plate for internal fixation confirm the animal study results. The in-growth of parossal vessels into the multiple inter-point spaces enhances the subimplant (bio-logical) formation of callus, which can be visualized radiographically and intraoperatively after plate removal. These results indicate that the MPC plate has marked advantages over conventional plates. |
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