摘要
作者对１０２例钢板治疗股骨干骨折失效的病例（其中普通钢板３７例，国产加压钢板６０例，进口ＡＯ钢板５例）进行了分析和总结，认为造成钢板失效的主要原因是：（１）骨折未获得解剖复位；（２）内固定不牢固；（３）对粉碎骨折或有骨缺损者未一期植骨；（４）术后未能正确指导功能锻炼及过早负重等。作者认为，普通钢板不能用于治疗股骨干骨折。强调解剖复位、牢固固定、尽量保护骨折处血运、一期植骨、正确指导功能锻炼及不过早负重是预防钢板失效的重要措施。
AbstractThe authors present the analysis and summary offailure of l02 cases of plate fixation used for treatmentof femoral shaft fractore from February,1987 toApril,1994.Male:78 cases;Female:24 cases。 Age:From l3 to 66 years old,average:34.6 years old。93%of the primary injury was high energy injury(traffic accidents of crushing injury),and 41%hadcomplications。All the patients were operated once;20cases were operated twice;three times:6 cases;fourtimes:l case,The relationship of the failure and thetype of plate used is as follows:1.common plate(37cases,36%of all cases),with this plate (1 )brokenplate l3 cases(33%);(2)plate bending 20 cases(57%);(3)plate loosening 4 cases(10%).2.Chinese making compression plate(60 cases,59%ofall),among which(l)broken plate 40 cases(66%);(2)plate bending 5 cases(8%);(3)plate loosening15 cases(25%).3.AO compression plate 5 cases,allwere broken。As to the causes of failure:1.The platesof 79 cases(78%)were not long enough.2.Anatomical reduction was not obtained in the primaryoperation of 84 cases(83%).3.34 cases were thosewhose plates were placed in the front of the femoralshaft.4.Primary bone grafting had not beenperformed in all the cases。Eightv-three cases whoseplates were broken or bend were in the middle of theplate or at the plate hole which was near the fracturesite。In 19 cases the plate was loosened:14 cases inthe distal part to the fracture line,5 cases in theproximal part.The main causes of failure are asfollows:1. Anatomical reduction of the fracture wasnot acheved 2.The internal fixation was not stable。3.Primary bone grafting was not perfromed in thosecases of comminuted fracture or fracture with bonedefect.4.Proper instruction of functional exercisewas not given, and/or too early weight bearing wastaken。We believe that a common plate should not beused fOr treatment of fractures of femoral shaft.It isemphasized that anatomic reduction,stable fixation,meticulous preservatiOn of the blood circulations of thefracture site,primary bone grafting,properinstructions concerning functional rehabilitation andavoiding of too early weight bearing are the importantmeasures for prevention of failure of plate fixation inthe femoral shaft fracture。
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1995年第9期578-580,共3页
Chinese Journal of Orthopaedics
