The Research About Failure Reasons Of Adult Femoral Fractures By Using Lock Compression Plate

Aim:Locking compression plate (LCP) as a new internal fixation system in thetreatment of femoral shaft fractures has many advantages. LCP combined withMIPO can effectively reduce the damage of blood supply of fracture site and softtissue, which is consistent with the biological fixation (BO) principle, withbetter control force and allow patients develop early functional exercise.However, some cases have been reported about the failure of the surgery.Therefore, our study analyzed the characteristics of LCP and the biomechanicsof femoral shaft fracture to find the failure reason of the surgery, in order toreduce the implant, infection, and nonunion failure rate.Methods:529patients with femoral shaft fractures were treated by LCP in ourhospital from April2012to February2013, including417males and112females, with age between18-83years old (mean age:38.3±2.4). Fracturereasons: traffic accidents468and falls61. Single femoral shaft fractures475,bilateral femoral shaft fractures54, including lateral fractures63, cant fractures107, spiral fractures123, smash fractures198, and open fractures38. Combinedwith brain injures49and other sites fractures148. All patients were treated withLCP.Results：46Nonunion patients (8.7%) were detected, including28open fractures(60.9%), so open fractures have significant relationship with nonunion fractures(P<0.05).34patients (6.4%) had second time fractures after taking out theinterior support, but no significant relationship was detected in deferent fracture types.76patients suffered steel plate split after surgery (14.4%), compared withfractures nonunion and re-fracture after taking out the interior support,significant relationship was detected between steel plate split after surgery andfailure of the surgery (P<0.05).Conclusion：1. Steel plate split after surgery is the main reason caused the failure of thefemoral shaft fracture surgery;2. Smash fractures have significant relationshipwith steel plate split after surgery;3. Open fractures have significantrelationship with fractures nonunion.