股骨中下段骨折术后钢板断裂原因分析及纠正策略.docVIP

股骨中下段骨折术后钢板断裂原因分析及纠正策略[摘要] 目的：探讨股骨中下段骨折术后钢板断裂的原因及纠正策略。方法：通过对2005年1月～2010年7月16例术后出现钢板断裂中，具有代表性的1例股骨中段，1例股骨下段，对其断裂原因进行回顾性分析，并得出纠正治疗方法。结果：造成钢板断裂的原因中，内植物放置及应用不当、骨折复位不良及碎骨块血运破坏、术后锻炼不得当三个方面是主要因素，术者尤应注意。结论：选择合适的钢板，有条件的可使用髓内钉；术中正确规范操作，必要时植骨；术后科学、合理的功能锻炼及术后定期随访能有效防止术后钢板断裂。 [关键词] 股骨骨折；钢板断裂；原因；纠正策略 [中图分类号] R683.42 [文献标识码]A [文章编号]1673-7210（2010）10（c）-022-02 Reason analysis and correction strategy on the plate break after internal fixation with plate in femoral shaft and distal fracture QIN Xiaoping, GUO Xinhui, CAO Yang, XU Xiao (Department of Orthopaedics, Hospital of PLA 421, Guangzhou 510318, China) [Abstract] Objective: To investigate the reasons of femoral shaft and distal fracture of those plate break and correction strategy after internal fixation with plate. Methods: 16 cases of femoral fracture of those plate break, representative 2 cases, one case of femoral shaft fracture, the other was femoral distal fracture, plate break reasons were analyzed retrospectively, and given correct treatment. Results: In the reason of creating the plate break, implants laying aside and the application did not work as malreduction and bone mass destruction of blood circulation, inappropriate exercise after surgery, the three aspects were the main factors. Close attention must be paid attention to. Conclusion: Choosing appropriate plate, conditionally can use intramedullary nailing. Intraoperative correct standardized operation, when necessary, bone grafting. Scientific and reasonable exercise and regular follow-up can effectively prevent the postoperative plate break. [Key words] Femoral fracture; Plate break; Reason; Correction strategy 随着现代建筑业及交通的发展，高处坠落伤及车祸的发生明显增加，股骨骨折损伤大，钢板断裂二次手术将增加患者痛苦，延长骨折愈合时间和增加经济负担，如何正确选取及使用内固定物，减少钢板断裂几率，减少患者病痛成为现在医院特别是基层医院尤其应解决的问题。现对股骨中下段有代表性的2例骨折内固定术后再骨折原因进行回顾性分析并提出相关纠正策略，以提高疗效，减少医患纠纷。 1 资料与方法 1.1 一般资料 2例均为青年男性，1例为高处坠落伤，另1例为车祸伤。高处坠落伤者为股骨中段骨折，粉碎性；车祸伤者为下段骨折，横断；2例均为闭合性，且入院后急诊行开放复位内固定手术。术后断裂时间：高处坠落伤者6周，车祸伤者12周。均无术后下地过早负重锻炼；钢板种类：均采用加