Metallic Failures after Compression Plate Fixation Clinical Analysis of 12 Cases

Yoo, Chong Ill; Lee, Chul Sung; Gill, Won Chull

Abstract

The twelve cases of metallic failure after compression plate fixation which were observed and treated at Department of Orthopedic Surgery, Busan National University Hospital were clinically analysed. The results were summerized as follows; 1. Age and sex of the patients was male in his active age in life. 2. The causes of fracture were traffic accidents and industrial accidents. The sites of fracture were femur in 11 cases and tibia 1 case. 3. The types of fracture were comminuted in 11 cases and short oblique in 1 case. 4. The 6 patients were not cooperative and began walking at their will after postoperative 4 weeks despite doctors order of nonweight bearing. Average duration of immobilization was 6 weeks. 5. Metallic failure occurred as screw failure in 1 case, plate failures through empty hole in 4 cases and plate failures through hole filled with screw nearest to the sites of fracture in 7 cases. 6. Interval between operation and metallic failure was 6.25 months average. The 75% of the metallic failure occurred between 4 to 7 months. 7. Treatments of metallic failures were cast immobilization with bone grafting in 1 case at tibia, intramedullary nailing with bone grafting in 1 case at femur and compression plate fixation with bone grafting in 10 cases at femur. 8. Causes of failure after internal fixation 1). Insufficient bone support Inadequate inter-fragmentary compression 9 cases Absence of cancellous bone graft 8 cases Empty plate hole 4 cases Remaining defects 3 cases 2). Inadequate postoperative treatment 6 cases.