植入 82 年后取出 Lane 钢板：病例报告、冶金分析和历史回顾。
Retrieval of a Lane Plate 82 Years After Implantation: Case Report, Metallurgical Analysis, and Historical Review.
机构信息
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
出版信息
Iowa Orthop J. 2023;43(1):37-43.
BACKGROUND
The Lane plate was one of the first widely used bone plates, utilized in the first decades of the twentieth century. Here we present the results of a retrieval analysis on a Lane plate, and a review of the history of these plates. Our patient underwent plating of her femur with a Lane plate in 1938. She developed a sciatic nerve palsy, managed surgically later that year by Dr. Arthur Steindler at the University of Iowa. Her femur healed, her nerve recovered, and she did well until 2020, at age 94, when she presented to the University of Iowa with a draining sinus that appeared to communicate with the plate. She underwent irrigation and debridement with hardware removal. The plate was sectioned, and its composition and structure characterized.
METHODS
We retrieved hard copies of the patient's archived medical records from 1938, which document in detail the treatments performed by Dr. Steindler. The plate was analyzed using scanning electron microscopy (SEM) to characterize the surface of the plate. A cross section was taken from the plate, and the composition of the alloy was determined using energy dispersive x-ray spectroscopy (EDS). A review of the literature surrounding early plating techniques was conducted.
RESULTS
Our patient recovered from her surgery and soon returned to her baseline state of health. Intraoperative cultures grew C. acnes. Analysis of the surface of the plate demonstrated significant corrosion, and the crystal structure seen on SEM suggested a strong alloy that is prone to corrosion. Analysis of the cross section with EDS demonstrated an alloy containing 94.9% iron, 1.7% aluminum, 1.2% chromium, and 1.1% manganese.
CONCLUSION
The Lane plate was introduced around 1907 by Sir William Arbuthnot Lane, a British surgeon, and was one of the first widely used devices for the plating of fractures. Given that this patient was likely one of the last to be treated with a Lane plate, this may be the final opportunity for such a retrieval analysis. .
背景
Lane 钢板是最早广泛使用的骨板之一，于 20 世纪的头几十年使用。在此，我们报告了对 Lane 钢板的检索分析结果，并回顾了这些钢板的历史。我们的患者于 1938 年接受 Lane 钢板固定股骨。她发生了坐骨神经麻痹，同年由爱荷华大学的 Arthur Steindler 博士进行了手术治疗。她的股骨愈合，神经恢复，恢复良好，直到 2020 年，94 岁时，她因出现有窦道引流，且似乎与钢板相通，来到爱荷华大学就诊。她接受了冲洗和清创术，去除了内固定。对钢板进行了切割，并对其组成和结构进行了特征分析。
方法
我们从 1938 年的患者存档病历中检索了硬拷贝，详细记录了 Steindler 医生的治疗情况。使用扫描电子显微镜（SEM）对钢板进行分析，以对钢板表面进行特征分析。从钢板上切下一个横截面，并用能量色散 X 射线光谱（EDS）确定合金的组成。对早期钢板固定技术的文献进行了回顾。
结果
我们的患者术后恢复良好，很快恢复到基线健康状态。术中培养出痤疮丙酸杆菌。对钢板表面的分析表明存在明显腐蚀，SEM 上观察到的晶体结构表明这是一种容易腐蚀的高强度合金。用 EDS 对横截面进行分析表明，该合金含有 94.9%的铁、1.7%的铝、1.2%的铬和 1.1%的锰。
结论
Lane 钢板由英国外科医生 William Arbuthnot Lane 爵士于 1907 年推出，是最早广泛用于骨折固定的装置之一。由于这位患者可能是最后一位接受 Lane 钢板治疗的患者之一，因此这可能是最后一次进行此类检索分析的机会。
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