金属材料植入物钢板内固定置入治疗四肢骨折的失败原因

Analysis of metal plate fixation failure in extremities fractures

目的:探讨金属材料植入物钢板内固定置入后失败的教训,并总结再次置入成功的经验。方法:以中文"骨折,钢板,植入物,断裂,失败,失效",英文"plate,failure,breakage"为检索词,采用电子检索的方式,在中国期刊全文数据库(CNKI)、中国生物医学数据库(CBM)、维普期刊网、Wiley、Elsevier、Springer、Kluwer等数据库中进行检索(1999/2008)。结果:骨折钢板内固定置入过程中有很多可造成失败的隐患存在,再处理时应对骨折端情况做综合评价。结论:骨折后内固定置入时应严格掌握适应证,选用合理的内/外植入固定物。钢板内固定应把握相关原则,重视技巧,以符合骨折愈合生物学特性的方法处理骨折端。康复期内遵照循序渐进的原则,重视随访。再置入时选用带或不带血供的骨移植可提高骨折愈合率。

OBJECTIVE： To explore the lessons of plate fixation failure and the experiences of retreatment. METHODS： Computer-based online search of CNKI, CBM, VIP, Wiley, Elsevier, Springer and Kluwer databases were performed with key words of “plate, failure, breakage” to retrieve literature （1999/2008）. RESULTS： The risks of plate fixation failure were hidden in the whole procedure of fracture treatment and rehabilitation course. The integrated evaluation and composite methods should be used in retreatment. CONCLUSION： Strict interal fixation indication, resonable internal/external fixation methods should be emphasized on fracure treatment. Precise principles understanding, perfect operative skills, biological osteosynthesis methods should be emphasized on plate implanting. A step-by-step rehabilitation course and regular follow-up should be emphasized on post-operation. A bone graft plus vascularized periosteal flap transplanting method would greatly increase the bone union rate in retreatment.