The Cause And Measures Of The Difficulty Of Taking Out Internal Fixing Device After Limbs Fracture Healing

Background: As high-energy accident trauma in life growing, the number oflimb fracture patients also increases.Along with the advance of medicaltechnology, orthopaedic use of extremities fractures treated by internalfixation surgery is becoming more common, and results are verysignificant.At the same time, the number of surgeries for implants removedalso rises, followed by internal fixation after fracture healing take out part ofthe screw removed extremely difficult, make originally thought the smalloperation into a time-consuming to major surgery, refractures, even causemore serious complications. As the production process and operation ofinternal fixation technology continues to progress, take out the difficultsituation of internal fixation gradually decreased, but there is still a part ofthe internal fixation after fracture healing is removed when taken out ofdifficulties, should cause enough attention.Objective: From Feb.2011to Feb.2013,22cases of extremities fracturepatient whose internal fixations were difficulty of taking out were treatedin the department of trauma in our hospital. Analyzing The causes andhandling methods during surgery has taken to guide the future treatment oflimbs fracture line within the fracture companion in installation with fixedobjects，and should pay attention to the details during the operation. Inorder to know what to do when internal fixations were difficulty to take out,and offer certain theoretical foundation in order to guide the clinical treatment.Method: A retrospective study was done, from Feb.2011to Feb.2013,253cases of extremities fracture patient whose internal fixations were taking outwere treated in the department of trauma in China Japan Union Hospital of JilinUniversity. According to the surgeons (or the first assistant) visual analoguescale and operation time to determine the difficulty of taking out the internalfixations."There is no difficult" or "very easy" defined as zero points,"Verydifficult" or even "can’t take out" defined as ten points. A total of22cases weredifficulty to take out, including14male and8female patients, aged12to65years old, the median age was33years old, the shortest time8months, thelongest43months, average26months. Randomly selected30patients fromthe231cases who were difficult to take out the internal fixations as controlgroup, Patients age, body within the remaining fixed things out of time, in timefor the fixed things routine operation time of multiple three parameters of thetwo groups of were analysised, in order to know factors which made it difficultto take out internal fixations, Reason classification and proportion, and providethe reference for the clinic.Results: A retrospective study was done, from Feb.2011to Feb.2013,253cases of extremities fracture patient whose internal fixations were takingout,,different degrees of difficulties were met inremoval the internal fixationsof22patients.4cases for preoperative preparation is insufficient, lack ofsupporting equipment;2cases of fracture end growing around a lot of callus will nail tail embedding; In1case of fixed content was bone cement embedding;15patients screw groove wear, DingMao chute, cannot take normal. Throughthe different operation methods and with different surgical instruments, theabove cases are the fixed things completely remove and no infections occurredafter and postoperative concurrent fracture situation.Conclusion:1. Limbs fracture healing in patients after fixed things out, difficult fixed thingsout patients is not rare, especially the screwdriver and screw groove skidsituation is given priority to.2. Plants remove difficulties will prolong operation time, older patients wereless likely to take out difficult, internal fixation in the remaining time too longin the human body is the important cause of take out difficultly.