The Concept of Biological Internal Fixation Using Limited Contact Plates

The internal fixation of bone fractures aims at early, complete and lasting recovery of limb function. for many years, emphasis was placed on precise reduction and interfragmentary compression as a means of keeping the fragment surfaces from moving. In cases of multifragmentary fractures, this procedure involves extensive surgical intervention and causes additional damage to the circulation of bone. The idea of biological fixation based on the work of Ganz and Mast aims to achieve a sufficiently stable fixation with minimal encroachment on the intact tissue.

A common phenomenon observed in relation to internal fixation using bone plates is that of temporary porosis beneath the plate. Bone remodelling occurred and infection was liable to cause the formation of a sequestrum. This porosis was initially explained in mechanical terms as the result of the stress protection function of the plate. Later the work of Gunst, Gautier, Rahn, and Perren et al. demonstrated that the disturbance of blood flow due to compression of the periosteum was the important factor. This has lead to the development of the limited contact dynamic compression plate (LC-DCP). The LC-DCP has proved its worth as an implant which complies with the concept of biological fixation and which has improved the quality of treatment in general.