Lindsey R W, Fenison A T, Doherty B J, Law P, LeBlanc A
Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas.
J Orthop Trauma. 1994 Dec;8(6):462-7.
Numerous complications have been attributed to elective plate removal following successful treatment of both bone diaphyseal forearm fractures, yet the effects of retained implants are not known. Fourteen patients were reviewed for residual forearm grip strength (FGS) and bone mineral density (BMD) following uneventful union. Patients were analyzed in two groups based upon time from fixation: group I, > 2 years but < or = 5 years, and group II, > 5 years. In group I, mean 2.6 years follow-up (n = 6), mean FGS ratios (patient values/age matched general population means) were 0.65 and 0.77, respectively, for plated and normal limbs (p = 0.08). The mean BMD ratios of plated/normal sides adjacent to the plate were 0.99 (ulna) and 1.02 (radius); these values were not significantly different from more proximal forearm BMD ratios (p = 0.92 ulna; p = 0.44, radius). In group II, mean 8.4 years (n = 8), mean FGS ratios were 0.97 and 1.09, respectively, for plated and normal limbs (p > 0.05). The BMD ratio was 1.04 adjacent to the plate; this was not significantly different from the ratios measured away from the plate (p > 0.4). We conclude that retained forearm plates can be well tolerated and that their routine removal is not indicated based on FGS or BMD.
在成功治疗尺骨干前臂骨折后，许多并发症都被归因于选择性取出钢板，然而保留内植物的影响尚不清楚。对14例骨折顺利愈合的患者进行了残余前臂握力（FGS）和骨密度（BMD）的评估。根据固定时间将患者分为两组：I组，固定时间>2年但≤5年；II组，固定时间>5年。I组平均随访2.6年（n = 6），钢板固定侧和正常侧的平均FGS比率（患者值/年龄匹配的一般人群平均值）分别为0.65和0.77（p = 0.08）。钢板附近钢板侧/正常侧的平均BMD比率分别为0.99（尺骨）和1.02（桡骨）；这些值与前臂近端BMD比率无显著差异（尺骨p = 0.92；桡骨p = 0.44）。II组平均随访8.4年（n = 8），钢板固定侧和正常侧的平均FGS比率分别为0.97和1.09（p>0.05）。钢板附近的BMD比率为1.04；与远离钢板处测量的比率无显著差异（p>0.4）。我们得出结论，保留在前臂的钢板耐受性良好，基于FGS或BMD无需常规取出。
