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Analytical study of fixation failure in adult limb fracture: Prospective study in single center institution
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| Author:
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, MUSTAFA WALEED YAHYA
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| Abstract:
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Fixation failure is a common issue in orthopedic practice that negatively impacts patients and the burden on both doctor and health system. Hence, it was essential to determine the most common failure pattern and the associated risk factors for that problem. An observational cross-sectional study was conducted at the orthopedic surgery department in Imam Al Hussein medical city in Karbala from April 2018 to December 2019. The Seventeen Patients with 20 fixed fractures met the entry criteria. They were eligible to be included in the study, where recent significant trauma near the fixation area, pathological fractures, spine and per prosthetic fractures excluded. Seventeen patients with 20 fixation failures reviewed, and 11 were male, and six were female. 70% of fixation failure occurred in lower limb while 30% in the upper limb, plates constituted 75% (15 cases) while 10% found in the DHS and cannulated hip screws and 5% (1 case) was external fixation. Inadequate surgical technique was the most common cause of fixation failure (80%), others like obesity (35.2%), poor patient compliance (17.6%), and infection (10%) were contributed to fixation failure in a lesser extent. Among technical issue; improper implant was 65%. Meanwhile, the inadequate reduction was found in 60%, and improper Implant application found in 85% of cases. Among plate-screw group (15 cases); the commonest patterns fixation failure was; screws cutout (53.3%) followed by broken plate (46.6%) and screws pullout (46.6%) and we relied on Associate Orthopedics (AO) principles in evaluating these aspects of fracture management. Improper implant choice, incorrectly performed fixation techniques, deficient post-operative care and underestimation of fracture morphology were possible causes.
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| Keyword:
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fracture fixation; failure fracture fixation; adult; limb; fixation techniques
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.04.628
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| Download:
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Request For Article
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