A SYSTEMATIC LITERATURE REVIEW ON THE USE OF LOCKING COMPRESSION PLATE (LCP™) TECHNOLOGY FOR PROXIMAL AND DISTAL HUMERUS FRACTURE TREATMENT
Author(s)
Zanela OO1, Sanchez D1, Valls M2, Osorio M2, Cabra HA3, Gay Molina JG2
1Johnson & Johnson Medical, Mexico City, Mexico, 2T.I. Salud, Mexico D.F., Mexico, 3Johnson & Johnson Medical, Miami, FL, USA
OBJECTIVES: Proximal & distal humerus fractures are common injuries in elderly population and usually associated with osteoporosis. Fracture reduction through surgical approach implies the use of plates & screws, such as commercially-available LCP™ (Locking Compression Plate) system, its branded Philos™ plate for proximal humerus, and DCP™ (Dynamic Compression Plate) technology; comparative clinical evidence on their utilization could support technology choice. This study's objective was to perform a systematic literature review to assess clinical outcomes derived from the use of LCP™, Philos™ & DCP™ technology for the treatment of proximal and distal humerus fractures. METHODS: A systematic search of PubMed, Cochrane Library and Medigraphic for published literature on the use of the former technologies was conducted; considered key words included “locking compression plate”, “dynamic compression plate”, “humerus fractures”, “proximal/distal humerus”, “distal humerus plate”, “Philos plate”, “meta-analysis”, “clinical trial” and “systematic review”. Inclusion criteria included RCTs, case reports, revisions/meta-analysis, as well as studies in English or Spanish and publications in indexed journals; exclusion criteria included clinical studies in experimental models and other treatment alternatives for proximal and distal humerus fractures. RESULTS: 1,064 studies were initially identified; duplicated articles and inclusion/exclusion criteria yielded 62 articles on LCP™ and DCP™ use, with 6 studies directly comparing LCP™ and DCP™ systems, 55 studies describing LCP™ outcomes and 1 case report on DCP™ use. Further analysis revealed no comparative evidence nor publications on DCP™ use on proximal or distal humerus fractures. Comparative studies focused on other non-humerus fractures, with no statistically-significant differences in terms of functionality, fixation & bone bonding time, complications and operating time between technologies. Positive outcomes favoring LCP™ in terms of pseudoarthrosis, 1-month consolidation rate and greater bone fixation rigidity were found. CONCLUSIONS: LCP™ technology seems a safe and effective treatment for proximal and distal humerus fractures, while DCP™ has no published evidence on such injuries.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PMD2
Topic
Clinical Outcomes, Epidemiology & Public Health
Topic Subcategory
Comparative Effectiveness or Efficacy, Safety & Pharmacoepidemiology
Disease
Musculoskeletal Disorders