Locking Compression Plate (LCP) is a common orthopedic instrument for internal fixation and healing of bone trauma. It is important to study on mechanical behavior and failure investigation of LCP because its failure leads to lots of cost and pain to the patient. In this paper, fatigue life of an eight-hole tibia LCP is evaluated under flexural loading. A four-point bending jig is manufactured and fatigue tests are performed for different Compression loads. Fatigue life cycles are investigated for Compression loads of 500, 600, 700, 800, 900 and 1000 N and relation between Compression load and life cycles is estimated. 125 walking days is estimated for the patient during treatment period according to life cycle results. Post failure analysis results on fracture surface revealed that the crack initiated from the edge of Compression hole and propagated from lower to the upper surface of LCP according to beach marks. Finally, Scanning electron microscopy (SEM) on the fracture surface revealed striations as a proof of fatigue crack growth. The striation spacing near the crack initiation site is found to be smaller than this spacing far from the initiation zone. The fatigue crack propagation life is estimated as 1600 cycles according to the number of striation spacings.

Background: The sub-trochanteric (ST) fracture is relatively common. It does not have a single treatment but it can be repaired in a variety of ways. Objectives: Theaimof this studywastocomparethe proximal femur Locking Compression Plate (PFLCP)andintramedullary nailing in the treatment of ST fracture. Methods: This cross-sectional study was performed on 56 patients with ST fracture who referred to Firoozgar Hospital, Tehran, Iran, between January 2014 and December 2018. The patients were equally divided into two groups, PFLCP group and nailing group. The recovery and postoperative complications were evaluated by the Harris hip score (HHS). Results: Of the 56 eligible patients examined, 49 (87. 5%) were male. The overall mean age was 42. 7  16. 2 years. The status of the union was significantly better in the PFLCP group than in the nailing group (P = 0. 038). The total mean HHS was 88. 9 14. 1 with no significant difference between the two groups. The results of the logistic regression model showed that sex and age could significantly decrease the HHS. Thus, the HHS was influenced by female sex (OR = 0. 851) and age of more than 60 (OR = 0. 829). Conclusions: PFLCP provides an appropriate union, expedites the operation, and yields a very good HHS. Therefore, it can work even better than intramedullary nailing in some parameters, such as pain after the operation.

Background: Proximal tibial fractures account for 1% of all fractures. Different treatments have been proposed for this fracture. Objectives: The present study aims to evaluate the clinical and radiological results of singleLocking and double-Locking Plate fixation methods in patients with proximal tibial fractures. Methods: The present study was carried out on 40 patients with proximal tibial fractures referred to Imam Khomeini Hospital in Sari, Iran. They were divided into two groups of double-Locking fixation with 3. 5-mm Locking Compression Plate (LCP) and single-Locking fixation with 4. 5-mm LCP. They were followed up for at least 6 months after surgery. At the time of admission, they were assessed using Lysholm Knee Scoring Scale and Visual Analogue Scale. Radiographs were taken from all patients and the articular surface, and fracture healing, . Results: Of 40 patients, 17 and 23 were treated with 3. 5-mm and 4. 5-mm LCPs, respectively. The mean Lysholm score in the groups with 3. 5-mm and 4. 5-mm LCPs was 84±, 8. 2 and 78. 3±, 16. 2, respectively. There was no statistically significant difference between the two groups (P>0. 5). Conclusion: The radiological and functional outcomes were almost the same for single-Locking and double-Locking Plate fixation methods. Both methods can be used to treat the tibial Plateau fracture. The treatment can be selected according to the surgeon and the patient’, s request.

Background: The sub-trochanteric (ST) fracture is relatively common and does not have a single treatment. It can be repaired in a variety of ways each of which has different complications as well as different treatment costs. Accordingly, the purpose of this research is comparing the side effects and cost effectiveness of proximal femur Locking Compression Plate (PFLCP) with intramedullary nailing in the treatment of sub-trochanteric fractures Methods: This cross-sectional study was performed on 56 patients with ST fracture who were referred to Firoozgar hospital between January 2014 and December 2018. Two methods were used for treatment of fractures by physicians. The method of surgery for group A was the PFLCP while for group B it was the nailing. The postoperative complications and treatment costs were evaluated and recorded in a specific sheet for each patient. Results: In this study, of the 56 eligible patients examined, 49 (87. 5%) of the participants were male. The mean age of the all patients was 42. 7± 16. 2 years. The motion restriction in group A was significantly (P=0. 041) milder than group B. So, the total cost of treatment in group A was significantly (P=0. 045) lower than in group B. Also, the results of logistic regression model revealed that sex and age could significantly reduce the incidence of side effects with males [OR=0. 851] and those younger than 30 years [OR=1. 629] having fewer side effects. Conclusions: Use of a PFLCP first causes fewer side effects and less motion restriction after operation. The cost of treatment is lower and it is more cost-effective.

Objective: To determine the time to radiological union and final functional outcome of fixation of extraarticular distal humeral fractures with extra-artricular distal humerus Locking Plate. Methods: This prospective study was conducted from March 2014 to February 2018 and included extraarticular distal humeral fractures managed by operative fixation using extra-articular distal humerus Locking Plate. All the fractures were approached using lateral para-tricepetal approach of Gervin, and stabilized with extra-articular distal humerus Locking Plate with or without lag screws. Time to radiological union was assessed in the follow up and at the final follow up functional outcome was evaluated using Mayo Performance Elbow Score (MEPS). Complications and need for any additional procedures was also recorded. Results: A total of 20 patients with mean age of 36. 5 years and an average follow up of 17 months were included. The mean time to radiological union was 17. 4 weeks (12 to 36 weeks) which included one delayed union that required bone grafting. The mean flexion at elbow was 127o with only one patient having flexion extension arc movement of less than 100o at the final follow up. The average MEPS at final follow up was 94. 7± 8 with 19 patients having excellent and good results. Conclusion: Use of extra-articular distal humeral Locking Plate using lateral para-tricepetal approach in extraarticular distal humeral fractures allows stable fixation of the fracture to allow early return to function with minimal soft tissue dissection and excellent final functional results and minimum complications.