VA-LCP Elbow Plating System

Norbert Südkamp, Stefaan Nijs

The treatment of complex and/or intra-articular fractures of the elbow, when combined with poor bone quality, is a clinical challenge with a high rate of unsatisfactory results (loss of reduction, non-unions and impaired function). Significant stiffness, pain, and deformity can follow treatment of the fractures in both adults and adolescents. Prolonged immobilization usually leads to these clinical complications, as also can occur with traction. In order to overcome this, stable reduction and fixation of fractures is required so that active motion can be started early to produce the best possible results.

Founded upon the established AO principles, and based on the first generation elbow plates, the new Variable Angle LCP Elbow Plating System reduces the risk of soft tissue irritation, taking into account the poor soft tissue coverage of the elbow, by improving the plate profile, optimizing the anatomical plate contours, and enabling the screw heads to sit flush in the plate hole. The variable angle locking technology combines the simplicity of the established LCP screw insertion technique with the possibility of adapting screw angulations. Safety is enhanced during screw insertion by offering optimized redefined screw angles while allowing +/-15° off-axis angulation, if needed.

Responding to the specifics of proximal ulna fractures, the system recognizes the particular biomechanical requirements of each fracture type, offering specific implants with optimized shapes and screw configurations. The multiple distal humerus plate configurations that are provided, including parallel and perpendicular plating, address surgeon plating preferences, offering a portfolio to treat a vast array of elbow fractures.

An optimized metaphyseal plate profile, together with rounded edges and an improved anatomical plate fit, minimize the prominence of the construct without compromising stability. The 2.7 mm Variable Angle Locking Screw and a newly developed 2.7 mm Low-Profile Metaphyseal Compression Screw, an alternative to a cortex screw (non-locking) with low-profile head, assure a minimal screw-head prominence. The predefined screw angles are optimized for common fracture patterns for average anatomy. Where needed, undercuts in the metaphyseal part and recon notches enable adaptation to the plate axis to the bone-shaft axis.

The VA-LCP Elbow Plating System offers three main double-plating configurations for the distal humerus: Perpendicular; perpendicular with lateral support, and Parallel. In response to the specifics of the proximal ulna, the new system offers the Proximal Olecranon Plate, the Olecranon Plate, and the Proximal Ulna Plate, extra-articular.

Case: Elbow Surgery

Case provided by Norbert Südkamp, Freiburg, Germany

A 94-year-old man underwent surgery on his left elbow, using the VA-LCP Elbow Plating System. Plaster was used for soft tissue healing. The following images show intraoperative x-rays.

Solutions for the Elbow

Presented by Stefaan Nijs and Michael Gardner on December 2, 2012.

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