Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
BMJ Case Rep. 2021 Dec 1;14(12):e245362. doi: 10.1136/bcr-2021-245362.
A 61-year-old polytrauma patient was admitted with a right distal comminuted metaphyseal femoral fracture with intra-articular extension (Orthopaedic Trauma Association 33C2.3 classification) among other injuries. Due to the high degree of comminution and massive bone loss, this was initially managed with a dual plating open reduction internal fixation. Dual plating has shown to be a superior fixation method than single variable angle locking compression plate (VA-LCP) plating providing greater fixation in metaphyseal bone. Our case reports the failure of dual plating which required removal of metalwork and subsequent fixation using intramedullary nail and plate technique. Failure of dual plating is not well documented in the literature. The most recent radiographs taken 15 months postrevision surgery show that the bone has started to heal with evidence of callus formation.
一位 61 岁多发创伤患者因其他损伤入院，其右股骨远端粉碎性干骺端骨折伴关节内延伸（创伤骨科协会 33C2.3 分类）。由于粉碎程度高和大量骨质丢失，最初采用双钢板切开复位内固定治疗。双钢板固定已被证明是一种比单可变角度锁定加压钢板（VA-LCP）固定更好的固定方法，在干骺端骨中提供更大的固定。我们的病例报告了双钢板固定失败的情况，需要去除金属并随后使用髓内钉和钢板技术固定。双钢板固定失败在文献中记录不佳。最近在翻修手术后 15 个月拍摄的 X 光片显示，骨开始愈合，有骨痂形成的证据。
