LCP并发症.ppt

Problems in Locked Plating,LCP,LCP,LCP,2000,Male 42y R,Whats Wrong,?,Beijing Ji Shui Tan Hospital 2005,62007,3,Complications: n=24 Femoral Fr. n= 7 cases Tibia Fr. n= 13 cases Proximal humeral Fr. n= 1 case Humeral shaft Fr. n= 1 case Forearm Fr. n= 1 case,Complications,Failure of Fixation 6 Nonunion 8 Delayed union 6 Skin irritation 2 Penetration 1 Infection 2,Failure of Fixation,Nonunion,F 26y R open fr,2006-2-16,2007-2-26,Delayed Union,05-06-09,11 months,14 months,Skin irritation /Penetration,Infection,Reasons for Complications,Disturbance of blood supply Mechanism of LCP Fx Reduction Choice of plate/screw Technical mistakes,Blood Supply,Soft tissue damage Loss of blood clot Bridge Plating-nonunion Preoperative plan: fixator/ORIF? Bone graft?,Damage of Soft Tissue,Mechanism of LCP Fx Guideline,Length of plate/length of fracture comminuted fr 2-3 simple fr 810 Plate screw density 0.50.4, Gautier E, Sommer C. Guidelines for the clinical application of the LCP.Injury. 2003;34(suppl 2):B63B76.,“ The longer the bridging plate，the better ”, Wagner M General principles for the clinical use of the LCP. Injury. 2003 Nov;34 Suppl 2:B31-42.,Length of Plate,Compression,Compression,LCP,Conventional compression plate Intra-articular /metaphyseal fr(simple) Bridging plate metaphyseal/ diaphyseal fr(comminuted) Combination (segmental fr) Simple fr.- compression Comminuted Fr- bridging plate,“to lock or not to lock”,Locking,the screw is inserted into the bone?,Placement of plate,Exposure of the other end of plate Check with X-ray,Guide device,Miss Locking,Screw placement parallel to the joint line,Reduction,Anatomical reduction is not required DOES NOT MEAN Reduction is not required!,M 44y 8 months,Not Reduced,The more simple the fracture is, the more precise the reduction must be required,monocortex fixation,Leng