Refracture of Long Bones after Plate Removal

移位的長骨骨折，經由保守的接骨師治療已不能滿足現代病人的需求。在處理這類成人骨折時，手術解剖複位及內固定已廣被醫師所接受。主要是它提供完整的複位，避免骨折處畸形，同時有較穩定的固定，使骨折癒合前發生拆斷現象，因此較大，較寬及較硬的材料和不同原理的設計以滿足需要而問世。但是這往往導致更嚴重的局部骨質的鬆化，皮質的萎縮，壞死以及較少量的骨折處外骨痂的形成。自從一九八三年7月到一九八五年6月，馬階紀念醫院共經歷了9位重覆骨折的病例，分別為男8名，女1名。年齡由十七歲到六十五歲不等，平均27.25歲。兩名重覆骨折發包在橈骨，7名發生在體重負荷的股骨及脛骨。骨板放置期間由6個月到兩年不等，平均骨板放置體內為15個月，而骨板拔除當時，原有的骨折均有良好的x光及臨床癒合。拔除骨板後，善意的勸導病人使用拐杖或保護患肢是必要的。否則微小的外力使沒有保護且在適應期間的患肢再度發生骨折，這是可能而很冤枉的。

關鍵字

無資料

並列摘要

In modern orthopaedic concept, there is no doubt that the displaced fracture of long bones in the adult are supposed to be treated by open reduction and internal fixation. In order to achieve better stability and anatomical reduction, plate have been used more ofter than nail. Larger, thicker and more rigid plate have been designed. This causes questionable localized ostoporosis, cortical atrophy, cortical necrosis and less exocallus formation. From July 1983 to June 1985, nine cases of refracture after removal of plate are experienced. They are eight males and one female, age range from 17 years old to 65 years old, with an average 27 years and 3 months old. Two of them having radius fractures, the other seven fractured through the weight bearing (femur and tibial) bone. The average duration of plating is 15months, ranging from six months to two years. Refrctures are happened within the first three months right after removal of plate. Minor stress to the unprotected limb will cause refracture. Protective support either crutcher of PP splint should be advised for the patient when plate had been removed especially the weight bearing parts.

並列關鍵字

Refracture ； long bones fracture

國際替代計量

Refracture of Long Bones after Plate Removal

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