Factors Affecting Implant Failure of Plating in Femoral Shaft Fracture
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Abstract
Background: Plate fixation of femoral shaft fracture offers several advantages include anatomical reduction, less tools and assistants. However, the complications from implant failure are higher when compare with intramedullary nailing.
Objective: To identify factors affecting implant failure of plating in femoral shaft fracture.
Materials and Methods: Retrospective Comparative Study was conducted. 123 cases of femoral shaft fracture were treated with dynamic compression plate (AO plate) in Sisaket Hospital from 1 September 2009 to 31 October 2011. The data was collected from medical records and film x-ray. The data was analyzed by using the Chi-square test with p value < 0.05 statistically different
Results: 123 cases were studied, and divided in 2 groups.in group without implant failure. There were 105 cases. Mean age was 29.6 (12-80 years). There were 72 males (69%). One case (0.9%) had comminuted fracture. Mean proximal cortical screws was 9.2 cortices. Mean distal cortical screws was 9.3 cortices. Mean time to use axillary crutch was 13.02 weeks. In group with implant failure. There were 18 cases (17%). Mean age was 24.8 (14-52 years). There were 17 males (94%).4 cases (22%) had comminuted fracture. Mean proximal cortical screws was 8.2 cortices. Mean distal cortical screws was 7.8 cortices. Mean time to use axillary crutch was 7 weeks.
Conclusions: Factors affecting implant failure are male, number of cortical screws, comminuted fracture and time using axillary crutch. Plating of femoral shaft fracture is still be good choice of treatment especially in hospitals that have limited equipments and techniques to use intramedullary nailing. However, to avoid implant failure, surgeon must pay attention to proper surgical techniques, adequate length of plate and bone grafting as indicated, including restricted follow up and weight bearing after surgery.
Keywords: Implant failure, Femoral shaft fracture
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References
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