Determinants of Plate Fracture after Osteosynthesis of Lower Limb Fractures in One Year

BACKGROUND:
The lower limb fractures are common in young and elderly people. The goal of treatment is to return the patient to normal function as quickly as possible, with minimal complications. Plate and screw is a popular and successful technique in treatment of these patients.

METHODS:
This case-control study was conducted on 108 patients (54 with plate fracture as cases and 54 without plate fracture as controls), who have been admitted in Kashani and St Alzahra hospitals affiliated to Isfahan University of Medical Sciences during 2005.A Check list including age, sex, bone fractured, site of initial fracture, use of external support, distance between plate fracture and plating, infection and etc was completed for each patient; and out coming data was analyzed.

FINDINGS:
The most common site of plate fracture was in diaphysis and the least in epiphysis of bones.
In the case group, 87% of patients had used no external support (splint, cast, brace), 3/7% of patients had infected surgery site, 44% of patients had had early weight bearing after plating, the most common bone was femur , most initial fracture lines were comminuted, in 33/3% of patients, bone graft had been used, 9/3% of first injuries had been open fracture and 92/6% close fracture, 92/6% of patients were male and 4/7% female, the mean age of patients was 31.6 ± 15.36 yr, the average time between plating and plate fracture was 5.5 ± 3.4 months, All plates were broken at the empty hole site against initial fracture line, PH in site of plate fractures was alkaline and 2 patients had an underlying disease (chronic renal failure).


CONCLUSION:
In this study, site of fracture, use of external support, early weight bearing and type of fracture line were contributing factors in plate failure. We didn't find any relation between plate fracture and fracture type (open or close), PH of fracture site, patient's sex or age.

KEY WORDS:
Osteosynthesis, Plate failure, associated factors