摘要
目的：探讨四肢长管状骨内固定术后内固定尚未取出时发生内固定区域或边缘再骨折的原因。方法：回顾性分析12例骨折内固定术后内固定区域或边缘发生再骨折的时间、受力方式、部位、治疗方法及效果。结果：内固定区域再骨折2例，为严重直接暴力导致；内固定边缘再骨折10例，为轻、中度间接暴力导致。再骨折发生时间在内固定后2～127个月，平均23．7个月。经再次手术内固定（6例髓内钉、6例钢板螺钉），随访12～24个月，骨折均重新愈合。结论：内固定边缘处再骨折的发生，主要与内固定某一端应力集中有关；内固定物存在时，内固定区域内再骨折与严重直接暴力及应力遮挡均有关，严重直接暴力可能为主要因素。
Objective To investigate the reason of refracture in the area of internal fixation and through the terminal area in long bone fracture. Method we made a retrospective analysis on the causes of refracture in 12 cases, including the refracture time,force,location, secondary fixation methods and treatment outcome. Results Two cases of refracture that occurred in the area of internal fixation were caused by severe direct force. Refracture through the terminal area occurred in 10 cases, which was resulted from minimal or moderate indirect force. The duration between primary and secondary fracture was 23.7 months （2 to 127 months）. In reoperation,the patients were refixed, 6 by intramedullary nail and 6 by plate. After 12 -24 months follow-up,the refractures were reunited. Conclusion The main reason of refracture through the terminal area of internal fixation is over stress concentration. While in the area of internal fixation,it has something to do with both severe direct force and stress shielding, and the former may be the main reason.
出处
《东南大学学报（医学版）》
CAS
2009年第6期525-527,共3页
Journal of Southeast University(Medical Science Edition)
关键词
长骨
内固定术后
再骨折
long bone
after internal fixation
refracture
