股骨干骨折钢板内固定治疗失败浅析

Analysis of the reasons for failure in internal fixation with steel plates for the treatment of femoral shaft fracture

目的 探讨股骨干骨折钢板内固定治疗失误的原因。方法 对 2 4例股骨干骨折钢板内固定失败病例 (断裂 9例、弯曲 5例、松动 10例 )进行回顾性分析。结果 2 4例病人中 2 2例取出原内固定 ,采用髓内钉或加压钢板固定 ,15个月内均获痊愈 ,2例松动程度较轻者采用管形石膏外固定半年内痊愈。结论 适应证选择不当、技术操作不正确、内固定器材选择不当、功能锻炼不正确以及钢板质量问题是造成股骨干骨折钢板内固定失败的主要原因。

Objective To analyze the reasons for failure in internal fixation with steel plates for the treatment of femoral shaft fracture and the remedial measures. Methods Reasons for the failure in internal fixation with steel plates in 24 cases of femoral shaft fracture (break in 9 cases, bent in 5 cases, and loosening in 10 cases) were analyzed retrospectively. Results After removal of the original materials for internal fixation in 22 out of 24 cases, intramedullary pins or compression plates were used for replace of the original materials for internal fixation. Complete recovery was achieved within 15 months. Slight loosening was found in 2 cases, but complete recovery was achieved half a year later after external fixation with plaster cast. Conclusion Improper choice of indications, incorrect operative procedures, improper choice of materials for internal fixation, incorrect methods for functional training, and low-quality of the steel plates are the main reasons for failure in internal fixation with steel plates for the treatment of femoral shaft fracture.