| Background: Femoral shaft fracture is a common clinical fractures. About6% of all the body's fracture, men is more than women, as the ratio of 2.8:1.Mostly occurs in young adults about 20-40 years old, the treatment is based onsuch as patient age, fracture type, and technology and equipment, includingtraditional traction and external fixation, open reduction and internal fixationand closed reduction external fixation, etc., each has its advantages anddisadvantages. Intramedullary nail fixation for a simple femoral shaft fracturescan provide better stability. However, in the surgical implantation procedure,femoral interlocking nail is often difficult for distal locking, and fat embolismmay occur. In addition, about 40% of patients who use Intramedullary nailfixation have joint dysfunction and pain in the hip, and some uncommon butimportant complications like femoral neck fracture. Kropfl and otherresearchers also shows: After femoral intramedullary nail fixation, the fatparticles in the peripheral blood of the fracture significantly increased, it maybe more likely to aggravate the existing disease condition or cause fatembolism in the patients who also have original brain injury and chest injury;There also have report that: The postoperative occurrence of adult respiratorydistress syndrome in plate fixation patients is lower than intramedullary nailingpatients, so in the above case, the plate is still a more preferred choice. In recentyears, with the development of LCP fixation system ,the LCP for the treatmentof femoral shaft fracture is a relatively new attempt.This study reviewed information of 21 patients with 23 cases of femoralshaft fractures which our department treated with LCP from April 2010 toOctober 2010. After patients were followed up ,we have a comprehensive analysis of the patients fracture healing, complications, etc., in order to providethe basis for using the LCP in long bone fractures.ObjectiveObjective:To evaluates preliminary clinical result of locking compressionplate fixation in treatment of femoral shaft fractures.Meterials and Methods:From April 2010 to October 2010, 21 patientswith 23 subjects were recruited (18 males and 3 females) at mean age of 37years old (range, 21-62 years old). According to AO classification, there were 1case of type32 A2, 12 cases of type 32A3, 2 cases of type 32B1, 6 cases of type32 B2, 1 case of type 32C1, and 1 case of type32 C3. Of them, 21 subjects wereclosed fractures and 2 were open fractures. The time from injury to operationwas 2 hours to 6 days. The X-ray films were taken after 1 day, 1,2,3,6 monthsof operation. The patients were followed up and evaluated by using Thoresenevaluation system.Results: Primary healing of surgical wounds was observed in all cases.20patients with 22 fractures were followed up, 1 patient lost. Subjects werefollowed up for 23 months on average of 9 months. ( ranged, 6-12 months). Allfractures radiographic healing times averaged 5.5 months (range, 3-11 wmonths). to 3-11. 1 case has mild discomfort after walking fractures, 1 case haspain after walking,3 cases'knee joint functions is limited. 4 cases occurrednonunion fractures, 2 fractures of the 4 cases occurred locking plate fracture.The healing rate was 81.8%.According to Thoresen evaluation system, 14patients got excellent results,1 good, and 2 fair; and the excellent and good ratewas 83.3%.Conclusion: We use locking compression plate fixation in adult femoral shaftfracture, after a preliminary analysis of effectiveness,it was less efficaciousthan intramedullary nails on the healing rate.The follow-up time was short andclinical cases were fewer, so the locking compression plate in treatment ofadult femoral shaft fracture's effect needs further study. If use LCP to treat femoral fractures, we do not recommend open reduction, MIPO techniqueshould be used.Clinical recommendations for femoral shaft fractures:Theintramedullary nail is preferred, for osteoporosis, locking compression plate is agood choice. |
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