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01.12.2014 | Research | Ausgabe 1/2014 Open Access

Patient Safety in Surgery 1/2014

Controlled dynamic stability as the next step in “biologic plate osteosynthesis” - a pilot prospective observational cohort study in 34 patients with distal tibia fractures

Patient Safety in Surgery > Ausgabe 1/2014
Thomas Freude, Steffen Schröter, Christoph Emanuel Gonser, Ulrich Stöckle, Yves P Acklin, Dankwart Höntzsch, Stefan Döbele
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1754-9493-8-3) contains supplementary material, which is available to authorized users.
Thomas Freude, Steffen Schröter contributed equally to this work.

Competing interests

The authors declare that they have no competing interests. None of the authors has any financial interests with regard to the companies whose products are described in this paper, i.e. DePuy-Synthes, Zuchwil, Switzerland.

Authors’ contribution

All authors have contributed significantly to the different steps of the processing of the patient’s history as well as to the writing and to the editing of the manuscript. TF, SS, US and SD have conceived the idea for the study and have written the first draft. SS has provided research support and advice throughout the project. Furthermore, CEG has provided expertise in artwork. All authors have read and approved the final version of the manuscript.



Delayed bone healing is an eminent problem in the operative treatment of distal tibia fractures. To address this problem from a biomechanical perspective, the DLS 3.7 (Dynamic Locking Screw 3.7 mm) as a new generation of locking screws has been developed. This screw enables the surgeon to control the rigidity of the plate osteosynthesis and thereby to expand clinical options in cases where the bridge plating is chosen for fracture treatment.


The purpose of the present prospective study was to evaluate the safety use of the DLS 3.7 in distal tibia fractures where bridge plating osteosynthesis is recommended.


In a prospective non-controlled cohort study, 34 patients with acute distal tibia fractures (AO 43 A-C) were treated with an angular stable plate fixation using DLS 3.7 or LHS 3.5. Follow-up examinations were performed three, six, twelve, and twenty-four weeks postoperatively and all registered complications were carefully collected.


A total of 34 patients were prospectively enrolled in this study with a minimum follow-up of 6 months or obvious osseous consolidation at an earlier stage. No complications directly related to the DLS 3.7 were recorded and no infections were observed.


This observational study could show that the DLS 3.7 in combination with locking compression plates provides a secure and easy application. According to the recent literature inter-fragmentary micro-motion is one evident goal to increase the reliability in fracture healing. The new DLS 3.7 with a maximum micro-motion of 0.2 mm combines the advantage of micro-motion with the well-known advantages of angular stable plate fixation.
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