Sir,
We read with interest the article by Saikia et al.[1] titled “Internal fixation of fractures of both bones forearm: Comparison of locked compression and limited contact dynamic compression plate” and would like to discuss a few issues regarding this manuscript.
The authors have not mentioned whether they have bent (contoured) the plate used for radius in both limited contact dynamic compression plate (LCDCP) and locking compression plate (LCP) groups as is often necessary. It is an accepted norm that restoration of the radial bow is essential for good functional outcome.[2] Bending an LCP is often difficult and it might theoretically increase the area of plate bone contact.
The authors have not mentioned as to how many of the cases were fixed with lag compression screws as it would definitely reduce the amount of callus formed (which is used as a criterion for the final outcome in the study) as it aims for primary healing.
The authors have initially claimed to have had only six patients in the LCP group and three patients in the LCDCP group to be nonanatomically reduced. However, in the same paragraph later on, the authors claim that nine out of ten forearms in the LCP group and three out of four forearms in the LCDCP group that were nonanatomically reduced showed evidence of callus. The numbers do not tally.
Considering that nine forearms in the LCP group out of the eighteen patients were nonanatomically reduced, it may be the cause for decreased functional outcome in the patients with LCP as opposed to only three forearms out of the eighteen patients in the LCDCP group that were nonanatomically reduced. It is a well known fact that anatomic reduction is a requisite for optimal outcome and restoration of functions.[3,4]
REFERENCES
- 1.Saikia K, Bhuyan S, Bhattacharya T, Borgohain M, Jitesh P, Ahmed F. Internal fixation of fractures of both bones forearm: Comparison of locked compression and limited contact dynamic compression plate. Indian J Orthop. 2011;45:417–21. doi: 10.4103/0019-5413.83762. [DOI] [PMC free article] [PubMed] [Google Scholar]
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