In-Appropriate Physiotherapy: An Unusual Factor of Implant Failure in Douala

Abstract

Introduction: Osteosynthesis has well defined principles. When the surgeon does not follow these principles, implant failure is likely to happen. The purpose of this study was to study this issue in our service and to search for underlining factors. Methodology: It was a descriptive study done from September 2009 to September 2012, in the orthopaedics and traumatology service of the Laquintinie hospital of Douala in Cameroon. Were enrolled, all patients operated or referred in the service and presenting an implant failure (folding, breakage, migration, disassembly bone fixation loosening). Results: We had 58 cases (after 330 Osteosynthesis that is 17.58%), 45 men and 13 women. Sex ratio: 3.46. Mean age 25 years. The initial condition was: a close fracture in 29 (50%) of cases, an open fracture in 21 (36.21)%, a pseudarthrosis in 4 (6.90%), an osteomyelitis in 3 (5.17%), and a limb deformation in 1 (1.72%). Plating was the most involved procedure: 36 (62.07%) of failed implants were stainless steel plates; and 21(56.33%) of these were broken. In 13 (22.41%) of cases, there was a fall preceding implant failure. In 8 cases (14%), the physiotherapy was inappropriately done by a traditional healer. Conclusion: Implant failure is a real problem in our environment. Factors include- surgeon failure, implant failure and patient related failure. Good indications, surgical technique and appropriate physiotherapy can reduce implant failure in our milieu. We did not carry out mechanical studies on failed implants.