Modes of failure following locking plate fixation of the distal radius: a thematic analysis of 517 fractures.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-03-01 Epub Date: 2023-06-13 DOI:10.1177/17531934231179382

Ashley Newton, Harriet Julian, Mona Theodoraki, James Redfern, Graham Cheung, Daniel Brown

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Abstract

Anterior locking plate fixation of the distal radius is a common procedure with reliable results. Failure of fixation is sometimes seen. The aim of the present study was to identify the reasons for failure. In total, 517 cases met the study inclusion criteria. Of them, 23 cases had failure of fixation (4.4%). Failure analysis generated qualitative data. Subsequent thematic analysis identified the primary mode of failure and contributing factors. Primary modes were identified as failure to support all key fracture fragments (n = 20), wrong choice of implant (n = 1), failure of union (n = 1) and poor bone quality (n = 1). Contributing factors were errors in plate positioning, fracture reduction, implant selection and screw configuration, as well as fracture pattern complexity and poor bone quality. Most failed fixations had a primary mode and two or three contributing factors. Overall anterior plating is reliable with a low rate of surgical failure. Knowledge of failure modes will aid operative planning and prevent failure.Level of evidence: V.

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桡骨远端锁定钢板固定术后的失败模式：对 517 例骨折的专题分析。

桡骨远端前锁定钢板固定术是一种效果可靠的常见手术。但有时也会出现固定失败的情况。本研究旨在找出失败的原因。共有 517 个病例符合研究纳入标准。其中 23 例（4.4%）固定失败。失败分析产生了定性数据。随后的专题分析确定了失败的主要模式和促成因素。主要失败模式包括：未能支撑所有关键骨折片（20 例）、错误选择植入物（1 例）、骨结合失败（1 例）和骨质差（1 例）。导致失败的因素包括钢板定位、骨折复位、植入物选择和螺钉配置错误，以及骨折形态复杂和骨质差。大多数失败的固定都有一个主要模式和两个或三个诱因。总的来说，前路钢板固定是可靠的，手术失败率较低。了解失败模式有助于制定手术计划和预防失败：V.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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