肱骨干骨折内固定钢板断裂原因分析

Analysis of the cause of rupture of internal fixational plate for humeral shaft fractures

目的 :分析在 1995年至 2 0 0 1年间我院收治的 2 5例肱骨干骨折所行内固定钢板断裂的原因 ,探讨其防范措施。方法 :随机选取对照组 :同期在我院治疗已达到骨折临床愈合标准的肱骨干骨折钢板内固定术后患者 ,回顾并记录两组术前、术中、术后的多项相关指标并予以统计学分析。结果 :在骨折解剖复位、植骨情况、钢板选择和内固定使用、骨折愈合情况等方面钢板断裂组相比对照组均表现出明显的统计学差异。结论 :内固定钢板断裂的原因是金属疲劳 ,根本原因则在于内固定手术操作不规范、未能有效固定骨折端、术后负重过早以及钢板质量欠佳。

Objective: To delineate the cause of rupture of internal fixational plate for 25 cases of humeral shaft fractures during 1995～2001. Methods:Set up comparative group: the randomized selected patients whose humeral shaft fractures were already clinical healed and internal fixational plate were intact during the same period, the relative indexes of preoperative intra-operative postoperative situation were observed and analyzed statistically. Result:The fracture anatomical reduction and healed 、bone grafting、plate selection and fixation using Muller technique of the plate rupture group shows statistically difference comparing with the comparative group. Conclusion:The cause of rupture of internal fixational plate is the plate fatigue crack, but the root cause is ineffective internal fixation without according to Muller technique、weigh bearing too early and defect of the plate quality.