胸腰段骨折术后内固定断裂及松动的原因分析

目的探讨脊柱胸腰段骨折内固定术后,内固定物断裂及松动的原因与对策。方法1999年4月至2006年9月期间,采用内固定手术治疗287例胸腰段骨折患者,其中T10 12例,T11 24例,T12 40例,L1 125例,L2 48例,L3 26例,L4 12例。结果17例患者发内固定物断裂,其中12例椎弓根螺钉断裂,2例螺钉松动,2例固定棒断裂,1例连接杆断裂。结论针对患者的具体情况选用合适的内固定器材,术中充分植骨,尽早取出内固定材料以及术后常规进行外固定能有效的防止椎弓根内固定物的断裂。一旦发生内固定物的断裂应该根据具体情况进行处理,可获得较好的预后。

The analysis and countermeasures on the loosening and rupturing of internal fixators in the thoracolumbar spine

Objective To explore the causes and countermeasures of the internal fixators loosening or rupturing after internal fixation for thoracolumbar fractures. Methods From April 1999 to September 2006,287 cases of thoracolumbar fractures were treated with internal fixation,including 12 cases in T10,24 in T11,40 in T12,125 in L1,48 in L2,26 in L3,12 in L4. Results Of all the cases, 17 cases of the internal fixators loosened or ruptured,screw broke in 12 cases, screw loosened in 2 cases, rods broke in 2 cases, conjunction rods broke in 1 case. Conclusion Customerized internal fixation, sufficient bone graft,removal of the implant timely and external fixators protection during postoperative rehabilitation are valuable procedures for prevention of implant failure. Proper management according to different situation often results in a better prognosis once the internal fixations broke.