Metal failure after compression plate fixation in femoral shaft fracture

Han, Sung Ho; Yang, Bo Kyu; Kim, Chi Hong; Ahn, Tae Won; Kim, Dong Hyun

Abstract

Intramedullary nailing is one of the most available method in the treatment of femoral shaft fracture. Recemtly compression plate is not widly used. Inapproriate technique using compression plate lead to metal failure. The purpose of this study is to analyz the clinical feature, cause and treatment of metal ailure in femoral shaft fracture. We analyzed 6 cases of metal failure from Jan. 1990. to Dec. 1996 and obtained the following results. 1. Type of fracture were Winquist-Hansen Type I in 1 case, Type-II 3 cases, Type III 2 cases. 2. The interval between initial poeration and metal failure was 11 months on average, ranging from one to twenty months. 3. Metal failure occurred as plate breakage in 4 cases, plate bending and loosening in 2 cases. 4. Cause of metal failure after compression plate fixation presumed to be comminuted fracture in 5 cases, early weight bearing in 3 cases, remaining bone defect in 4 cases, inadequate surgical technique in 4 cases and empty plate hole in 4 cases. 5. Treatment of metal failure after compression plate fixation were intramedullary nailing with bone graft in all cases. Accturate preoperative evaluation of fracture site, fracture pattern, and appropiate selection of metal device necessary for the prevention of metal failure.