Cause Analysis Of Plate Rupture In Internal Fixion After Clavical Fraccture

Objective:Fracture of the locking plate internal fixation for fracture analysis of the reasons for, and then after to avoid a broken plate, to improve clinical treatment and reduce patient's pain and financial burden.Methods:Four cases were treated of fracture after internal fixation of locking plate fracture cases and assess their potential plate fracture in our hospital from 2004,Jan to 2009,Apr.Results:Four cases were treated of fracture after internal fixation of locking plate fracture cases and assess their potential plate fracture in our hospital from 2004,Jan to 2009,Apr, including three cases of male, 1 female; the age of 22 ~ 28 years old, average 25 years old. Fracture occurred in two cases of the right side, left side of two cases are comminuted fracture, and displacement. Injuries from the operation time: 2h ~ 3d, with the use of reconstruction plate fixation. Among them, the clavicular fracture in 2004 after no cases of plate fracture. From 2005 to 2006 occurred in four cases of clavicular fracture after plate fracture cases in 2009 ~ 2007 clavicle fracture without internal fixation plate fracture cases.Conclusion: Plate fractures are more common after the internalfixation when we treat the fractures in the limbs, especially the femoral shaft fractures. Claviculars are upper limb bones, much less weight than the bone fracture after internal fixation of fracture plate should be attention. Internal fixator plays temporary stability and support a limited role before the fracture healing, with the fracture healing process, the power should be gradually reduced, the occurrence of the internal fixation fracture is bound to have relations with the material internal factors, the surrounding environment and overloaded of the inplants.After internal fixation of clavicle fracture is a broken plate with a variety of factors related to various factors often coexist, and a variety of factors are the results of the reasons as follows: the inherent poor quality of internal fixator, improper application of internal fixator, internal fixation were placed for too long, the primary injury, postoperative management, training errors, such as patients. Should be clinically case-by-case analysis, to prevent the occurrence of faults within the fixture. Therefore, the clinical response to specific situations should be a specific analysis: according to the site of fracture, type of steel plate of adequate length, fracture line on both sides should be maintained for more than 3-hole or screw fixed to prevent the shoulder of early weight-bearing physical exercise when the shear force caused by the screw pull-out; plate correctly placed in the supraclavicular location, transverse fracture of the clavicle placed in the top of the tension side, it can effectively avoid the tension side of the separation under external force is conducive to lateral compression fracture stress, at the same time close to bone plate acts as a fixed surface tension effects, can be against the bending stress and the rotation force; large bone chip can be used 1 ~ 2 lag screw fixation and free bone with soft tissue should be reset after the embedded steel plate under the binding; fracture site bone defect should be a bone to remove the limb of the force of gravity produced; screw fixation should be bilateral cortex, the bit to be appropriate; lateral side of the cancellous bone can only be fixed at 2 or below is recommended screw clavicle hook plate; strict compliance with minimally invasive operating principles, attention to protecting the soft tissue, to minimize the soft tissue and periosteal stripping to reduce the fracture damage of the blood supply, especially in remote fracture coracoclavicular ligaments can not be stripped; clavicle fracture after internal fixation of the middle of the appropriate outside line limb suspension triangle fixed when it is needed,and it is effective.Though it is the non-weight-bearing bone, external fixation is important as internal fixation. After internal fixation of clavicular fractures, especially after the disappearance of pain, due to the normal lower extremity, patients can be free, easy to produce "heelled" illusion. Patients should be informed the importance and necessity of the early external fixation,slap fracture healing, exercise should be based on the situation of the patient's fracture heeling situations gradually.