Yoo Je-Hyun, Kim Seok-Woo, Kwak Yoon-Hae, Kim Hyung-Jun
Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, South Korea.
Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, South Korea.
Injury. 2015;46(6):1174-7. doi: 10.1016/j.injury.2015.01.011. Epub 2015 Jan 16.
Minimally invasive plate osteosynthesis (MIPO) using a locking plate has been widely used for distal femur fractures in the elderly with osteoporosis and yielded favourable results. However, implant failure and subsequent periplate fracture have still occurred owing to the controversy of concepts regarding locked plating. The treatment after failed MIPO in elderly patients is very challenging and has been not yet addressed definitely in the literature, although several options can be considered. We report the successful outcomes of two cases treated with overlapping intramedullary (IM) nailing for implant failure and periplate fracture after MIPO for osteoporotic distal femur fracture, along with simple tips of distal interlocking of IM nail.
使用锁定钢板的微创钢板接骨术（MIPO）已广泛应用于老年骨质疏松性股骨远端骨折，且取得了良好效果。然而，由于锁定钢板相关概念存在争议，仍有植入物失败及随后的钢板周围骨折发生。老年患者MIPO失败后的治疗极具挑战性，尽管有几种选择可供考虑，但文献中尚未明确提及。我们报告了两例采用重叠髓内钉治疗骨质疏松性股骨远端骨折MIPO术后植入物失败及钢板周围骨折的成功病例，并介绍了髓内钉远端锁定的简单技巧。
