一例锁骨骨折钢板取出后钉道再骨折的思考

Analysis on a Case of Clavicular Fracture with Re-Fracture of Nail Holes after Removal of Internal Fixation Plate

目的:探讨一例锁骨骨折经普通解剖钢板内固定愈合,取出内固定术后钉道再骨折的临床原因,以及对其临床教训的总结。方法:对该病例内植物选择,手术方法分析,技术操作及病患个人因素进行分析。结果:内固定选择不当,手术技术不过关,置钉过满,术后缺乏合理的功能锻炼指导以及患者个人因素是造成钉道骨折的主要原因。结论:经皮微创(Mippo)锁定加压钢板(LCP)内固定治疗锁骨骨折有利于锁骨骨折的愈合,提高手术技术和合理的预后锻炼,有利于预防废用性骨质疏松,防止再骨折发生。

Objective:To analyze clinical causes of re-fracture of nail holes after removal of internal fixation,healed by anatomical plate after clavicular fracture,and to summarize its clinical lessons.Methods:The selection of the internal fixation plate,surgical methods and technique of operation and indi-vidual factors of the patient were all included in the summary.Results:The main causes of fracture of nail holes were choosing an unsuitable plate,poor surgical technique,over-full use of nails and others such as lack of functional exercise and personal factors.Conclusion:Mippo(Minimally inva-sive percutaneous plate osteosynthesis,Mippo)technology LCP(Locking Compression Plate,LCP)is conducive to the healing of clavicular fracture,and improving surgical techniques and appropriate prognosis exercise will help to prevent disused osteoporosis and re-fracture.