Broken Of The Locking Plate In The Femoral Shaft Fracture Causes And It Is Managements

Objective:Explore the femoral shaft fracture of the locking plate after fracturecauses, countermeasures and preventive measures.Methods:Locking plate fixation of June2010to September2011, Jilin UniversitySino-Japanese Friendship Hospital orthopedic trauma study group treated48cases of femoral shaft fractures, of which3cases of plate fracturecases were retrospectively studied to analyze its lock factors andpreventive measures of the broken plate.Results:The48cases of femoral shaft fracture patients were followed up for6to15months. Four cases of locking plate fracture,6.25%of the totalnumber of cases. The age of34to44years, an average of39years,including three cases of male patients, female patients (n=1), thebackbone of the middle of the left femoral comminuted fracture of twocases, the middle of the right femoral shaft comminuted fracture of thetwo cases, four cases of patients are overweight patients.2patients earlyweight-bearing caused by the broken plate, respectively2,2.5monthsafter surgery, the remaining1cases the patient reports no obvious incentive to broken plate, respectively5months. These four cases werediverted to the interlocking intramedullary nail fixation and bone graftsurgery, to obtain satisfactory results.Conclusion:Fracture indications for the inappropriate choice of femoral shaft fractureafter locking plate fracture surgery, the attention of the overweightpatients is not enough, the inappropriate choice of locking plates andscrews, intraoperative surgical inexperience, improper operation of thesurgery, accompanied by bone defects patients not be a graft in treatmentof patients with premature variety of factors related to weight-bearing andplate quality. In order to avoid the femoral shaft fractures after internalfixation of fracture of the locking plate, we believe that the locking platein the middle of the femoral shaft fracture, according to the preoperativeX-ray, CT, inspection reports, made for the fracture treatment programs,that is OK to lock plate fixation for the treatment or line interlockingintramedullary nail fixed with external fixation of adjuvanttherapy.Intraoperative plate should be placed in the tension side of thefemoral shaft, ie the outside. Avoid the destruction of the blood supply ofthe fracture fragments, and follow the principle of "long steel, less screw"locking nail length should be as far as possible to reach the contralateralcortical bone, and enhance the robustness; for femoral shaft fractures withbone defect cases should be given treatment of a bone graft. After surgery for overweight patients, especially in obese patients, should take intoaccount fixed at the same time increase the use of external fixation, anddelay its load time. Avoided whenever possible in patients with prematureweightbearing and reinjury.