[Current status and progress of locking plate in the treatment of distal femoral comminuted fracture].

OBJECTIVE: To review the current status and progress of locking plate for the treatment of distal femoral comminuted fractures. METHODS: The related literature was extensively reviewed to summarize the current status and progress in the treatment of distal femoral comminuted fracture with locking plate from four aspects: the current treatment situation, the shortcomings of locking plate and countermeasures, the progress of locking technology, locking plate and digital orthopedic technology. RESULTS: Treatment of distal femoral comminuted fractures is challenging. Locking plates, the most commonly used fixation for distal femoral comminuted fractures, still face a high rate of treatment failure. Double plates can improve the mechanical stability of comminuted fractures, but specific quantitative criteria are still lacking for when to choose double plates for fixation. The far cortial locking screw has shown good application value in improving the micro-movement and promoting the growth of callus. The biphasic plating is a development of the traditional locking plate, but needs further clinical examination. As an auxiliary means, digital orthopedic technology shows a good application prospect. CONCLUSION: The inherent defect of locking plate is a factor that affects the prognosis of distal femoral comminuted fracture. The optimization of locking technology combined with digital orthopedic technology is expected to reduce the failure rate of treatment of distal femoral comminuted fracture.

[Research on the nature of micromovement and the biomechanical staging of fracture healing].

OBJECTIVE: To explore the nature of micromovement and the biomechanical staging of fracture healing. METHODS: Through literature review and theoretical analysis, the difference in micromovement research was taken as the breakthrough point to try to provide a new understanding of the role of micromovement and the mechanical working mode in the process of fracture healing. RESULTS: The process of fracture healing is the process of callus generation and connection. The micromovement is the key to start the growth of callus, and the total amount of callus should be matched with the size of the fracture space. The strain at the fracture end is the key to determine the callus connection. The strain that can be tolerated by different tissues in the fracture healing process will limit the micromovement. According to this, the fracture healing process can be divided into the initiation period, perfusion period, contradiction period, connection period, and physiological period, i.e., the biomechanical staging of fracture healing. CONCLUSION: Biomechanical staging of fracture healing incorporates important mechanical parameters affecting fracture healing and introduces the concepts of time and space, which helps to understand the role of biomechanics, and its significance needs further clinical test and exploration.