Comparative study on breakage rate of locking plate and traditional plate in treatment of femoral fractures

Abstract

Objective To compare the breakage rate of locking plate and traditional plate in treatment of femoral fractures,analyze failure reasons and offer a basis for decreasing breakage rate of the plates.Methods The study included 280 patients with femoral fractures managed by plate fixation from May 2009 and January 2011.There were 146 males and 134 females,at age of 18-92 years (mean 52.4 years).There were 136 patients with left femoral fractures and 144 patients with right femoral fractures.According to AO classification,there were 72 patients with type 31A fractures,44 with type 32A fractures,26 with type 32B fractures,30 with type 32C fractures,57 with type 33A fractures,26 with type 33B fractures and 25 with type 33C fractures.A total of 175 patients were treated with locking plate and 105 with traditional plate.Results Follow-up ranged from 9 months to 40 months,which displayed implant breakage rate of 4.0 ％ in the locking plate group and of 2.9％ in the traditional plate group (P ＞ 0.05).Breakage modes included plate fracture in six patients,screw fracture in three,plate combined with screw fractures in one.Causes for breakage were iatrogenic factors plus false rehabilitation training with implant breakage rate of 100％,simply iatrogenic factors with implant breakage rate of 36.4％,and simply false rehabilitation training with implant breakage rate of 5.4％.However,non-iatragenic factors plus correct rehabilitation training brought no implant breakage.Consequently,breakage rate of the implant related to iatrogenic factors plus false rehabilitation training were significantly higher than that associated with simply iatrogenic factors,simply false rehabilitation training,or non-iatragenic factors plus correct rehabilitation training.Conclusion Breakage rate of the locking plate and the traditional plate in treatment of femoral fractures shows no significant difference,but iatrogenic factors combined with false rehabilitation training are the leading cause for the implant breakage. Key words: Femoral fractures ; Fracture fixation, internal; Fixation breakage rate