Comparison of curative effects between locking compression plate and simple plate screw internal fixation for limb fractures_West China Medical Journal

Authors：

ZHANG Naiyang ^1,2 , WU Bing ² ,  PENG Baogan ²

1. Department of Orthopedics, Shahe Hospital, Changping District, Beijing 102206, P. R. China;
2. Department of Orthopedics, the Third Medical Center, Chinese PLA General Hospital, Beijing 100039, P. R. China;

Corresponding?author：

PENG Baogan, Email: pengbaogan76611@163.com

Keywords：

Locking compression plate; simple plate screw internal fixation; limb fractures; clinical efficacy

DOI：

10.7507/1002-0179.202604223

Video：

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Objective To investigate the differences in clinical efficacy between locking compression plate fixation and conventional plate-screw fixation in the treatment of limb fractures. Methods Patients with limb fractures admitted to Shahe Hospital of Changping District, Beijing between January 2022 and June 2025 were prospectively enrolled as research subjects. The patients were divided into the control group and the trial group at a 1∶1 ratio using the random-number table method. The control group was treated with conventional plate-screw internal fixation, while the trial group received locking compression plate fixation. A difference-in-differences model was constructed to analyze the effect of locking compression plate treatment on patients’ fracture score indicators. Logistic regression was used to analyze the impact of different treatment methods on curative effect. Results A total of 120 patients were included, with 60 cases in each group. At 6 months and 12 months after treatment, the limb swelling score and Visual Analogue Scale score of the trial group were lower than those of the control group, while the Radiographic Union Scale for Tibia score was higher than that of the control group (P<0.05). The results of difference-in-differences model analysis showed that the treatment plan was significantly correlated with the improvement of fracture score indicators (P<0.05). The fracture healing time of the trial group was shorter than that of the control group, and the postoperative complications were fewer than those of the control group (P<0.05). The comparison of clinical efficacy showed that the clinical efficacy of the trial group was better than that of the control group (P<0.05). Logistic regression analysis showed that the trial group could improve the total clinical effective rate. Subgroup analysis showed that the impact of different treatment methods on patients’ clinical efficacy was more significant in the subgroups of age ≥55 years and sedentary work (P<0.05). Conclusions Locking compression plate achieves favorable clinical efficacy in the treatment of limb fractures. It can effectively relieve postoperative pain and limb swelling, promote fracture healing, shorten healing time, and reduce the incidence of postoperative complications. Compared with conventional plate-screw internal fixation, it has obvious advantages in improving functional recovery and overall efficacy without significantly increasing medical costs, and possesses good value for popularization and application in clinical practice.

Citation： ZHANG Naiyang, WU Bing, PENG Baogan. Comparison of curative effects between locking compression plate and simple plate screw internal fixation for limb fractures. West China Medical Journal, 2026, 41(9): 1471-1477. doi: 10.7507/1002-0179.202604223 Copy

1.	PREP-IT Investigators; Sprague S, Slobogean G, et al. Skin antisepsis before surgical fixation of extremity fractures[J]. N Engl J Med, 2024, 390(5): 409-420.
2.	Lobo BS, Amaral Alfonsi MD, Lima CA, et al. Preventing falls in older adults after upper limb fractures: a scoping review[J]. Phys Ther, 2025, 105(4): pzaf020.
3.	Bauer S, Levy JC, Athwal GS. Acute open reduction and internal fixation versus nonoperative treatment of scapular spine fractures after reverse shoulder arthroplasty: a propensity score-matched study[J]. J Shoulder Elbow Surg, 2025, 34(9): 2146-2156.
4.	陳金亮, 桂道坤. 鋼板螺釘內固定技術在四肢長管狀骨創傷骨折治療中的應用優勢評價[J]. 生命科學儀器, 2023, 21 (增刊1): 70, 73, 2.
5.	Capitani P, Chiodini F, Di Mento L, et al. Locking compression plate fixation in humeral shaft fractures: a comparative study to literature conservative treatment[J]. Injury, 2023, 54 (Suppl 1): S2-S8.
6.	Wu J, Chen Y, Zhu Y, et al. Clinical efficacy of internal fixation with locking compression plates in the treatment of patients with extremity fractures and the effect on the recovery of limb function[J]. Medicine (Baltimore), 2023, 102(48): e35884.
7.	趙鑫, 嚴俊偉, 尹昭偉, 等. 髓內復位與撬撥復位結合鎖定鋼板治療復雜老年肱骨近端骨折的療效比較[J]. 實用老年醫學, 2024, 38(1): 40-43, 48.
8.	Zhou X, Zhang G, Chen D, et al. The efficacy of auricular acupressure combined with emotional freedom techniques on the postoperative pain and anxiety state of patients with lower limb fractures: a randomized clinical controlled trial[J]. Medicine (Baltimore), 2025, 104(5): e41401.
9.	田玉晶, 未會朵, 王彩霞, 等. 益氣活血通絡湯聯合鎖定加壓鋼板內固定對四肢骨折患者恢復情況、血液微循環及生活質量的影響[J]. 臨床和實驗醫學雜志, 2025, 24(5): 494-498.
10.	Sun H, Li P, Du G, et al. Application of PVC pipes as an adjustable bilateral traction device in lower limb fractures[J]. BMC Musculoskelet Disord, 2023, 24(1): 733.
11.	Bandaru H, Shanthappa AH. Evaluation of functional and radiological outcomes of humeral shaft fracture treated with locking compression plate[J]. Cureus, 2023, 15(4): e37197.
12.	Reinkemeier F, Wallner C, Drysch M, et al. Limb swelling consistent with posttraumatic lymphedema after closed upper and lower extremity fractures: a retrospective cohort study[J]. PloS One, 2025, 20(12): e0337756.
13.	肖飛. 甘油果糖聯合甘露醇治療四肢骨折術后腫脹的療效分析[J]. 貴州醫藥, 2025, 49(4): 577-579.
14.	Kim HJ, Shin JY, Lee HJ, et al. Postoperative results after open-wedge high tibial osteotomy with lateral hinge fracture[J]. J Orthop Surg (Hong Kong), 2025, 33 (2): 10225536251350424.
15.	Kummer A, Nieuwoudt L, Marais LC. Application of the modified RUST score in tibial bone transport and factors associated with docking site complications[J]. Strategies Trauma Limb Reconstr, 2024, 19(2): 73-81.
16.	Stahel PF, Kaufman AM. Contemporary management of open extremity fractures: what you need to know[J]. J Trauma Acute Care Surg, 2024, 97(1): 11-22.
17.	Desai YM, Kumar BS. Evaluation of bone supported ultra lock ezy bar versus erich arch bar for the treatment of mandibular fractures[J]. J Pharm Bioallied Sci, 2024, 16 (Suppl 4): S3236-S3238.
18.	Amin TK, Patel I, Jangad AH, et al. Evaluation of radiological and functional outcome of intra-articular proximal tibia plateau fracture treated with plating[J]. Malays Orthop J, 2023, 17(1): 90-97.
19.	Xie Q, Sui L, Sun Y, et al. Comparisons of ankle arthrodesis with different internal fixation methods in the treatment of post-traumatic osteoarthritis[J]. J Orthop Sci, 2024, 29(2): 621-626.
20.	Duan Z, Hu H, Wang Y, et al. Treatment of comminuted metaphyseal distal femoral fractures with a micromotion-balancing osteosynthesis: an animal study[J]. BMC Surg, 2023, 23(1): 118.

1. PREP-IT Investigators; Sprague S, Slobogean G, et al. Skin antisepsis before surgical fixation of extremity fractures[J]. N Engl J Med, 2024, 390(5): 409-420.
2. Lobo BS, Amaral Alfonsi MD, Lima CA, et al. Preventing falls in older adults after upper limb fractures: a scoping review[J]. Phys Ther, 2025, 105(4): pzaf020.
3. Bauer S, Levy JC, Athwal GS. Acute open reduction and internal fixation versus nonoperative treatment of scapular spine fractures after reverse shoulder arthroplasty: a propensity score-matched study[J]. J Shoulder Elbow Surg, 2025, 34(9): 2146-2156.
4. 陳金亮, 桂道坤. 鋼板螺釘內固定技術在四肢長管狀骨創傷骨折治療中的應用優勢評價[J]. 生命科學儀器, 2023, 21 (增刊1): 70, 73, 2.
5. Capitani P, Chiodini F, Di Mento L, et al. Locking compression plate fixation in humeral shaft fractures: a comparative study to literature conservative treatment[J]. Injury, 2023, 54 (Suppl 1): S2-S8.
6. Wu J, Chen Y, Zhu Y, et al. Clinical efficacy of internal fixation with locking compression plates in the treatment of patients with extremity fractures and the effect on the recovery of limb function[J]. Medicine (Baltimore), 2023, 102(48): e35884.
7. 趙鑫, 嚴俊偉, 尹昭偉, 等. 髓內復位與撬撥復位結合鎖定鋼板治療復雜老年肱骨近端骨折的療效比較[J]. 實用老年醫學, 2024, 38(1): 40-43, 48.
8. Zhou X, Zhang G, Chen D, et al. The efficacy of auricular acupressure combined with emotional freedom techniques on the postoperative pain and anxiety state of patients with lower limb fractures: a randomized clinical controlled trial[J]. Medicine (Baltimore), 2025, 104(5): e41401.
9. 田玉晶, 未會朵, 王彩霞, 等. 益氣活血通絡湯聯合鎖定加壓鋼板內固定對四肢骨折患者恢復情況、血液微循環及生活質量的影響[J]. 臨床和實驗醫學雜志, 2025, 24(5): 494-498.
10. Sun H, Li P, Du G, et al. Application of PVC pipes as an adjustable bilateral traction device in lower limb fractures[J]. BMC Musculoskelet Disord, 2023, 24(1): 733.
11. Bandaru H, Shanthappa AH. Evaluation of functional and radiological outcomes of humeral shaft fracture treated with locking compression plate[J]. Cureus, 2023, 15(4): e37197.
12. Reinkemeier F, Wallner C, Drysch M, et al. Limb swelling consistent with posttraumatic lymphedema after closed upper and lower extremity fractures: a retrospective cohort study[J]. PloS One, 2025, 20(12): e0337756.
13. 肖飛. 甘油果糖聯合甘露醇治療四肢骨折術后腫脹的療效分析[J]. 貴州醫藥, 2025, 49(4): 577-579.
14. Kim HJ, Shin JY, Lee HJ, et al. Postoperative results after open-wedge high tibial osteotomy with lateral hinge fracture[J]. J Orthop Surg (Hong Kong), 2025, 33 (2): 10225536251350424.
15. Kummer A, Nieuwoudt L, Marais LC. Application of the modified RUST score in tibial bone transport and factors associated with docking site complications[J]. Strategies Trauma Limb Reconstr, 2024, 19(2): 73-81.
16. Stahel PF, Kaufman AM. Contemporary management of open extremity fractures: what you need to know[J]. J Trauma Acute Care Surg, 2024, 97(1): 11-22.
17. Desai YM, Kumar BS. Evaluation of bone supported ultra lock ezy bar versus erich arch bar for the treatment of mandibular fractures[J]. J Pharm Bioallied Sci, 2024, 16 (Suppl 4): S3236-S3238.
18. Amin TK, Patel I, Jangad AH, et al. Evaluation of radiological and functional outcome of intra-articular proximal tibia plateau fracture treated with plating[J]. Malays Orthop J, 2023, 17(1): 90-97.
19. Xie Q, Sui L, Sun Y, et al. Comparisons of ankle arthrodesis with different internal fixation methods in the treatment of post-traumatic osteoarthritis[J]. J Orthop Sci, 2024, 29(2): 621-626.
20. Duan Z, Hu H, Wang Y, et al. Treatment of comminuted metaphyseal distal femoral fractures with a micromotion-balancing osteosynthesis: an animal study[J]. BMC Surg, 2023, 23(1): 118.

West China Medical Journal

Comparison of curative effects between locking compression plate and simple plate screw internal fixation for limb fractures

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