Evaluation of Implant Failure in Long Bones Fractures-A Retrospective Study

Abstract

Background: Variety of implant design and quality are available and being used by orthopaedic surgeon to restore anatomy and enhance healing process of fractured bone. At times implants fail to achieve desired out come in few cases and a repeat surgery is required. This study evaluates causes of implant failure in fracture long bones. Methods: Retrospective study analyzing 53 patients with 66 long bone fractures with failed implants dividing them into plate, unlocked nails and locked nails group was performed at level – I trauma centre of tertiary level medical college in North India, during January 2011 to march 2014. After thorough clinico-radiological evaluation, results were analyzed. Results: Maximum implant failure occurred in 20-50 yrs of age. Lower limb long bone implant failure 48 (72.7%) was more common than upper limb long bones 18 (27.3%). In all three groups fatigue failure (39%) was most common followed by bending (27.2%), loosening (18.8%) and infection 15.5% was observed. Implants defer in design and quality from manufacturer to manufacturer. Surgeons had chosen implants according to their technical knowledge and surgical skills. Re-trauma and patient non-compliance with instructions was also important cause of implant failure. Conclusion: Cause of implant failure is multi-factorial hence we recommend use of suitable design and quality implant to match fracture configuration with proper surgical techniques. Patient should be educated and followed up according to rehabilitation protocol to avoid disappointments. Keywords: Implant failures, Fatigue failure, Long bone fractures, Implant corrosion, Implant loosening