End result observations of X plate compression fixation. A critical review and analysis and a discussion of unsolved...

The X plate method of treatment of a diaphyseal fracture employs te internal, cortical and extramedullary compression-fixation of a shaft fracture, using a steel plate device of two components. Four wedges of the X device force the surfaces of the fracture against each other at the same time as the plate is pressed against the cortical surfaces of the reduced fracture fragments. The two components of the device are finally made to interlock firmly. Screws are not used. Plate onlay force and fracture compression force are created by the purchasing of the wedges against the rims of exactly predrilled cortical bores of the fracture fragments. A drill guide, and a device that permits pre-compression and temporary fixation of the fracture fragments are used when drilling is performed. Successvie designs of the employed X devices and auxiliary instruments are described. Clinical experience of the method so far has been satisfactory. Twenty-six forearm shaft fractures and two osteotomies of malunited shaft fractures have been successfuly treated. Present problems are related to the possible need of an implant material of a more springy character tan that of the 2353 (316L) steel implant, used at present and also to reduce the manufacturing costs.