Causes Of Failure Of Internal Fixation And Nonunion In Noninfectious Long Bone Fractures Of Extremities

Objective:The purpose of this study is to failure of internal fixation and postoperative nonunion of non infective long bone fracture of extremities,so as to provide reference for clinical treatment.Methods:From January 2017 to December 2018,the clinical data of patients with failure of internal fixation and nonunion of long bone fracture of limbs admitted to the Department of orthopaedics of the First Affiliated Hospital of Nanchang University and the Department of orthopaedics of the first people's Hospital of Jiujiang City were analyzed retrospectively.The causes of failure of internal fixation and nonunion were analyzed.Results:All patients were followed up for 3-18 months,with an average of 13 months.1.There were 48 cases of failure of internal fixation,including 35 males and 13 females,aged 6-85 years(mean 44.23 ± 12.51 years).The fracture sites were 18 cases of femur,21 cases of tibiofibula,5 cases of radius and ulna,and 4 cases of humerus.Among them,6 cases(12.5%)were fixed with intramedullary nail and 42 cases(87.5%)were fixed with steel plate.There were 39 cases(81.3%)of internal fixation fracture and 9 cases(18.7%)of internal fixation loosening.Among the reasons for failure of internal fixation,47 cases(97.9%)were caused by increased internal fixation stress,31 cases(64.6%)were caused by prolonged fracture healing time,and30 cases(62.5%)were caused by both factors.2.There were 102 cases of nonunion,68 males and 54 females,aged 10-86 years(mean 49.28 ± 13.03 years).The fracture site was 38 cases of femur,42 cases of tibiofibula,9 cases of radius and ulna,13 cases of humerus.Among them,69 cases were fixed with steel plate(67.6%),33 cases were fixed with intramedullary nail(32.4%).According to the type of nonunion,there were 66 cases of atrophic nonunion(64.7%)and 36 cases of hypertrophic nonunion(35.3%).Among the causes ofnonunion,66(64.7%)were caused by non-medical factors,76(74.5%)by medical factors and 40(39.2%)by both factors.Conclusion:The risk of internal fixation failure and nonunion of lower limb fracture was significantly higher than that of upper limb fracture.Failure of internal fixation,fracture of internal fixation and atrophic nonunion were common.Failure of internal fixation and nonunion are often caused by many factors.Local factors of fracture end combined with improper operation are the most common.