Abstract
Objective: The objective of this study was to assess the time taken for surgery, tourniquet time, and clinical outcome in diaphyseal fractures of both forearms managed with locking compression plate (LCP).
 Methods: Patients underwent open reduction and internal fixation with 3.5-mm LCP. Proximal radius was approached by dorsal Thompson incision and middle and distal radius by volar henry approach. A minimum of 6 cortices were engaged with screw fixation in each fragment. Ulna was approached directly over the subcutaneous border.
 Results: Of 20 patients, 70% were men; fracture was the most common in second and third decades of life. Road traffic accident (50%) and fall (40%) were the main causes. Fractures at mid-diaphysis (70%) and transverse/short oblique (72.5%) were the most common. Closed head injury, unilateral pubic bone fracture, olecranon fracture, fracture of both bones of leg, and ipsilateral fracture shaft humerus were the associated injuries. There was no intraoperative complication. Superficial infection (n=01) and transient posterior interosseous nerve injury, in the immediate postoperative period (n=01), were the reported complications. Average time for surgery was 77 min (60–90 min) and that for tourniquet was 54 min (40–60 min). All had complete union in <6 months; 80% had healing in <4 months. 20% healed in 4–6 months. Excellent and satisfactory results were seen in 85% and 15% patients, respectively.
 Conclusion: The 3.5-mm LCP, when applied properly, yields excellent outcome in fractures of forearm bones. The use of tourniquet, separate incisions for radius and ulna, and preservation of the natural curves of radius will reduce complications. Clinical outcome in terms of healing and union is excellent.
Highlights
Higher prevalence of malunion and non-union associated with the fractures of the forearm makes the management challenging and complicated, but improvised surgical techniques have revolutionized the management and help in overcoming these challenges [1]
Reddy et al [2] reported that the use of Locking compression plate (LCP) in forearm fractures is an ideal procedure as stable fixation along with early union is ensured
LCP has features of both LC-dynamic compression plate (DCP) and a point contact fixator [3,4] as it uses screw heads that are conically threaded on the undersurface and create an angular stable plate screw device
Summary
Higher prevalence of malunion and non-union associated with the fractures of the forearm makes the management challenging and complicated, but improvised surgical techniques have revolutionized the management and help in overcoming these challenges [1]. LCP has features of both LC-dynamic compression plate (DCP) and a point contact fixator [3,4] as it uses screw heads that are conically threaded on the undersurface and create an angular stable plate screw device. This type of plate fixation relies on the threaded plate-screw interface to lock the bone fragments in position and does not require friction between the plate and bone as in conventional plating. Though limited, show that the use of LCP in Indian population yield good outcome [10,11,12,13] can be considered as a treatment option for forearm fractures [14]
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