ภาวะล้มเหลวของการผ่าตัดใส่เหล็กในกระดูกต้นขาหัก

บทคัดย่อ

A retrospective descriptive study reviewed of 27 patients with fracture shaft of femur at Ratchaburi hospital between 2004-2007. This study presents the incidence of fracture shaft of femur in male : female = 3 2 1. 43% of these patients were less than 20 years old and the most common cause of injury was traffic accidents. 1 16 patients received dynamic compression plate with screw to treat fracture shaft of femur.

Therewere 1 1.2 % failed dynamic compression plate and 1% failed nail fixation. Autogenous cancellous bone graft applied for the augmentation at fracture site or flling the defect area in oomminuted fracture or Winquist and Hansen type 3-4 to promote bone healing. Postoperative follow up before full weight bearing can prevent the implant failure.

conclusion : Closed interlocking nail is the treatment of choice for the majority of fracture femoral shaft but in secondary hospital where the facilities of equipment and surgical expertise are still lacking. ORIF with Plate is more suitable because good success rates and beneficial in developing country. The results of this study support the use of Autogenous cancellous bone graft in comminuted fracture or Winquist and Hansen type 3-4 to prevent the implant failure.