Rozbruch S R, Müller U, Gautier E, Ganz R
Department of Orthopaedic Surgery, Beth Israel Medical Center North Division, New York, NY, USA.
Clin Orthop Relat Res. 1998 Sep(354):195-208. doi: 10.1097/00003086-199809000-00024.
There has been an evolution in the AO/Association for the Study of Internal Fixation plating technique during the past 3 decades that includes the use of longer plates and fewer plate screws, fewer lag screws outside the plate, fewer unicortical screws at the plate periphery, and greater use of the 95 degrees blade plate to achieve balanced fixation of proximal and distal shaft fractures. These changes reflect an evolving technique of plate osteosynthesis that emphasizes indirect reduction techniques, biologic internal fixation, and improved biomechanics. Outcome data suggest that there has been an improvement with time that is reflected by shorter time to union, a decrease in the frequency of implant failures, delayed unions, nonunions, malunions, number of reoperations, and in overall rate of failure. The best predictor of success was the length of plate by logistic regression analysis. With the evolution of plating techniques and a greater emphasis on biology of fracture healing, the incidence of complications and failures has decreased after femoral shaft plating. Plate osteosynthesis of the femoral shaft is particularly advantageous in many situations and can be quite successful (87% success rate in Group III).
在过去30年里，AO/内固定研究学会的接骨板技术不断发展，包括使用更长的接骨板和更少的接骨板螺钉，减少接骨板外的拉力螺钉，减少接骨板周边的单皮质螺钉，并更多地使用95度角钢板以实现股骨干近端和远端骨折的平衡固定。这些变化反映了接骨板骨接合术技术的不断发展，该技术强调间接复位技术、生物内固定和改善生物力学。结果数据表明，随着时间推移情况有所改善，表现为骨折愈合时间缩短、植入物失败、延迟愈合、不愈合、畸形愈合、再次手术次数以及总体失败率降低。逻辑回归分析显示，成功的最佳预测因素是接骨板的长度。随着接骨板技术的发展以及对骨折愈合生物学的更深入重视，股骨干接骨板固定术后并发症和失败的发生率有所下降。股骨干接骨板骨接合术在许多情况下特别具有优势，并且可能相当成功（第三组成功率为87%）。
