Clement N D, Yousif F, Duckworth A D, Teoh K H, Porter D E
The Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh EH9 1LF, UK.
J Bone Joint Surg Br. 2012 Jan;94(1):134-7. doi: 10.1302/0301-620X.94B1.27155.
Most surgeons favour removing forearm plates in children. There is, however, no long-term data regarding the complications of retaining a plate. We present a prospective case series of 82 paediatric patients who underwent plating of their forearm fracture over an eight-year period with a minimum follow-up of two years. The study institution does not routinely remove forearm plates. A total of 116 plates were used: 79 one-third tubular plates and 37 dynamic compression plates (DCP). There were 12 complications: six plates (7.3%) were removed for pain or stiffness and there were six (7.3%) implant-related fractures. Overall, survival of the plates was 85% at 10 years. Cox regression analysis identified radial plates (odds ratio (OR) 4.4, p = 0.03) and DCP fixation (OR 3.2, p = 0.02) to be independent risk factors of an implant-related fracture. In contrast ulnar plates were more likely to cause pain or irritation necessitating removal (OR 5.6, p = 0.04). The complications associated with retaining a plate are different, but do not occur more frequently than the complications following removal of a plate in children.
大多数外科医生倾向于取出儿童前臂钢板。然而，目前尚无关于保留钢板并发症的长期数据。我们呈现了一个前瞻性病例系列，涉及82例儿科患者，他们在八年时间里接受了前臂骨折钢板固定术，且至少随访两年。研究机构并不常规取出前臂钢板。总共使用了116块钢板：79块三分之一管形钢板和37块动力加压钢板（DCP）。出现了12例并发症：6块钢板（7.3%）因疼痛或僵硬而被取出，还有6例（7.3%）与植入物相关的骨折。总体而言，钢板在10年时的留存率为85%。Cox回归分析确定桡侧钢板（比值比（OR）4.4，p = 0.03）和DCP固定（OR 3.2，p = 0.02）是与植入物相关骨折的独立危险因素。相比之下，尺侧钢板更有可能导致疼痛或刺激，从而需要取出（OR 5.6，p = 0.04）。与保留钢板相关的并发症有所不同，但并不比儿童取出钢板后的并发症更频繁发生。
