锁定钢板治疗骨折后发生并发症17例临床分析

目的：探讨锁定钢板内固定治疗骨折后出现并发症的原因及其防治，增进对锁定钢板的认识，提高应用锁定钢板治疗骨折的临床疗效。方法：回顾性分析2006年1月至2008年10月我院应用锁定钢板治疗骨折后出现并发症的17例患者的临床资料。结果：5例内固定物失效的病例中，2例由于手术操作失误，1例由于内固定物选择失误，1例由于术后负重过早，1例由于术后感染导致内固定物失效；11例骨折不愈合或延迟愈合的患者中，5例由于原始损伤严重，4例由于术中复位不佳引起不愈合或延迟愈合；1例LISS钢板近端突起于皮下引起疼痛，术后伤口感染，1例钢板近端长期外露，是由于术中钢板的放置位置不良；膝外翻畸形1例。结论：锁定钢板可以分别或联合应用两种不同的内固定原理（加压钢板和桥接钢板）对骨折进行固定，应用此类内固定系统治疗骨折成功的关键是充分掌握此内固定物的固定原理，正确选择和应用此内固定物，强调术中对骨折的良好复位和微创操作。

Discussion locked plate fixation after treatment of fractures of the causes and prevention of complications, Locking Plate enhance understanding ,Improve the application of locking plate for treatment of fractures of the clinical efficacy. Methods A retrospective analysis was done to study the causes of the17cases of complications following fractural treatment with locked plates who had been admitted to our department from january 2006 to october2008. Results Of the 5 cases of internal fixation failure,2 were caused by operative mistakes, 1 by wrong selection of internal fixators, 1 by too early weight--bearing,and 2 by postoperative infection;of the 11 cases of nonunion or delayed union, 5were caused by severe primary injury, and 4 by unsuccessful reduction. 1 cases of pain were caused by evection of proximal LISS plate, and 1 postoperative infection due to improper emplacement of the plate during the operation resulted in long exposure of plate end. Conclusion. Plate can be locked separately or in combination with two different fixation principle （compression plate and bridge plate） on the fracture fixed, the application of such fixation system key to the success of the treatment of bone fractures are a full grasp of the internal fixator fixed principle, the correct selection and application of the internal fixator, emphasis on fracture surgery in the good reduction and minimally invasive operation.