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. 2022 Aug 26:2022:8145438.
doi: 10.1155/2022/8145438. eCollection 2022.

Clinical Outcomes of Treatment Strategies for Postoperative Plate Fracture and In Situ Fracture of the Femoral Shaft

Junbo Tu  1 , Haixiang Jiang  1 , Cuihe Li  1 , Xiaowu Huang  1 , Xingwang Li  1
Affiliations

Clinical Outcomes of Treatment Strategies for Postoperative Plate Fracture and In Situ Fracture of the Femoral Shaft

Junbo Tu et al. Biomed Res Int. .

Retraction in

Abstract

Objective: To investigate the treatment and clinical efficacy of postoperative plate fracture and in situ fracture of the femoral stem.

Methods: We have retrospectively analyzed the clinical data, revised surgery information, and clinical efficacy of patients with postoperative plate fracture of the femoral stem in our hospital. A total of 33 cases were included whose original fractures were located in the upper and cadaveric femur and treated with paralleling intramedullary pins for revision surgery, as well as patients whose original fractures were located in the lower femur which were fixed with retrograde intramedullary nailing or anatomical locking and compression splints in the distal femur. For the selection of bone grafting, the original fracture site with Fernadez-Esteve scab grades I and II was treated with an autologous iliac bone graft. Postoperatively, patients were evaluated for fracture healing time, the clinical outcome of the affected limb, and complications in the iliac bone donor area.

Results: All patients were followed up until fracture healing, and all patients achieved clinical healing with a healing rate of 100% and a mean healing time of 6.3 months. No internal fixation failure such as rebreakage or loosening of the internal fixation occurred in all patients during the follow-up period. According to the Tohner-Wrnch criteria, 23 cases were excellent, 10 cases were good, and 0 cases were poor, with an excellent rate of 100%. Complications in the autologous iliac bone donor area amounted to 36.7%.

Conclusion: For patients with original fractures located in the upper femoral segment or cadre, it is recommended to perform revision surgery with a paralleling intramedullary pin, while patients with original fractures located in the lower femoral segment are fixed with the retrograde intramedullary nailing or an anatomical type of distal femoral locking and compression splint. Patients with postoperative plate fractures of the femoral stem do not require routine autologous bone grafting for revision surgery.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Male, 27 years old, with left femoral stem fracture. (a, b) Positive lateral radiographs of internal fixation fracture (inappropriate choice of plate indication, fracture 3 months postoperatively, Fernadez-Esteve bone fragment grade II). (c, d) Positive lateral radiographs of fracture healing 6 months after revision (intraoperative stage I bone graft). (e, f) Late postoperative fat liquefaction in the donor area of the iliac implant combined with infection.
Figure 2
Figure 2
Female, 74 years old, with a fracture of the distal left femur. (a, b) First postoperative frontal radiograph (poorly repositioned medial bone mass). (c, d) Frontal radiograph of broken internal fixation (broken 3.5 months postoperatively, Fernadez-Esteve bone fragment grade I). (e, f) Frontal radiograph of fracture healing 8 months after revision (intraoperative one-stage bone graft).
Figure 3
Figure 3
Male, 54 years old, with left femoral stem fracture. (a, b) Positive and lateral radiographs after the first operation (premature weight bearing). (c, d) Positive and lateral radiographs of fracture of internal fixation (fracture 5.5 months after operation, Fernadez-Esteve fracture callus tissue grade III). (e, f) Positive and lateral radiographs of fracture healing 8 months after revision surgery.
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References

    1. Ning P., Zhao M., Zhang Y. D. Logistic regression analysis of failure of internal fixation of locked compression plates for lower limb fractures. Chinese Journal of Orthopaedic Surgery . 2014;22(24):p. 6.
    1. Pu Y., Zhang Y. W., Wang X. Y. Analysis of causes and countermeasures for fracture of locked plate internal fixation in lower limb fractures. Chinese Journal of Trauma . 2012;28(7):p. 2.
    1. Li P., Tan X. J., Zhaoyang L. Analysis of biomechanical causes of plate fracture after bone stem fracture. Journal of Clinical and Pathological Sciences . 2015;(7):1304–1308.
    1. Carreras G., Lugo A., Gallus S., et al. Burden of disease attributable to second-hand smoke exposure: a systematic review. Preventive Medicine . 2019;129, article 105833 doi: 10.1016/j.ypmed.2019.105833. - DOI - PubMed
    1. State Council of the People’s Republic of China. Regulations on the administration of medical institutions. China Health Policy . 1994;22(10):23–24.

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