Treating Tibia Fractures With Far Cortical Locking Implants
Compared with conventional plating, the relatively new technology of far cortical locking (FCL) allows for more flexible fixation. Increased flexibility of FCL constructs is thought to better stimulate secondary osteosynthesis and lead to improved healing for certain fracture patterns.
We conducted a study to compare healing rates and complications of tibial fractures treated with FCL or standard plating techniques. Twenty-two patients with fractures of the tibia (Orthopaedic Trauma Association 41ABC, 42C, 43C) were included in the study. Twelve tibia fractures were treated with FCL and 10 with standard plating (locking or nonlocking). Mean follow-up was 47 weeks in the FCL group and 41 weeks in the control group. The fracture healing rate was 92% in the FCL group and 100% in the control group (difference not statistically significant). Of note, there were 2 open fractures in the FCL group and 0 in the control group. The groups had similar complication rates. Our study data suggest FCL implants are not inferior to conventional plating techniques. Given that FCL-treated fractures tended to be more complex, the groups’ similar fracture healing rates may indicate improved fracture healing with FCL technology, but this possibility requires further investigation.
Together, our data show neither superiority nor inferiority of the FCL technique. This study is an important step in furthering investigations into FCL constructs. The finding of similar efficacy with FCL and conventional plating may assuage safety concerns and pave the way for more definitive studies of FCL technology and fuller evaluations of its effectiveness. These studies will be essential in determining whether the theoretical advantage of FCL translates into better clinical outcomes. Larger, prospective randomized studies with longer follow-ups will be needed to better compare FCL technology with current implants and techniques. At this early stage, however, FCL technology appears to be a viable option for complex fractures of the tibia.
