Destruction of Implants after Extraosseous Osteosynthesis of Long Bones Fractures

The results of treatment of 337 patients, aged from 15 to 75 years, with femur (175 patients), shin (41), arm (76) and forearm (45) fractures were analyzed. Open injuries were present in 42 (12,5%) and closed ones in 295 (87,5%) patients. According to AO classification type A fractures were diagnosed in 146 (43,3%), type В - in 103 (30,6%), type С - in 88 (26,1%) patients. In all patients osteosynthesis with plates and fixing screws was performed. In 37(11%) patients destruction of the implant took place. The dependence of that complication on the pattern of injury and type of fracture is detected: in open and comminuted fractures the rate of implant destruction was reliably higher. Mechanical destruction of the internal fixation system was presented by two variants: either break of a plate in the zone of the most intensive stress and a screw, or bone destruction in the site of screw insertion. In all cases of implant destruction the nonunion of fractures due to devitalization or absence of intermediate fragments was observed.