Locking Compression Plate Versus Dynamic or Limited Contact Dynamic Compression Plate Fixation for Forearm Fractures: A Systematic Review and Meta-Analysis.

Locking compression plates (LCPs) offer angular stability and may improve fixation in challenging forearm fractures. Still, they are substantially more expensive than dynamic compression plates (DCPs) or limited contact DCPs (LC-DCPs). This study compared union time, functional outcomes, and complications between LCPs and nonlocking compression plates for diaphyseal radius and ulna fractures. A systematic review and meta-analysis were performed in accordance with PRISMA guidelines. Eligible studies included skeletally mature patients with acute diaphyseal radius and or ulna fractures, compared LCPs with DCPs or LC-DCPs, and reported at least one clinical or radiographic outcome. Primary outcomes were time to union, delayed union, and nonunion. Secondary outcomes included functional scores, range of motion, and complications. Data were pooled using a random-effects model to calculate mean differences or odds ratios with 95% confidence intervals. Eight studies encompassing 525 patients met the inclusion criteria. Five studies comparing LCPs and DCPs showed a significantly shorter mean time to union with LCPs, while rates of delayed union, nonunion, complications, functional scores and range of motion were similar. Three studies compared LCPs and LC-DCPs. LCPs showed a non-significant trend toward shorter union time, with no differences in functional outcomes or complications. In conclusion, LCP fixation results in a modest reduction in time to radiographic union compared with DCPs but does not confer clear advantages in union rates, function, or complications. Given their higher cost and potential challenges at implant removal, LCPs should be used selectively rather than as routine implants for all forearm fractures.