Abstract

The authors made a retrospective study of the aseptic mechanical complications noted following plate fixation of femoral diaphyseal fractures between 1984 and 1995. Thirty'"one cases were noted among 413 fractures (7.5%) among which 18 plate ruptures and 13 plate loosenings secondary to screw rupture or pullout. The mean age was 25 years in cases with plate loosening, with 54% of patients under 15 years of age. In cases with plate rupture, 83% of patients were between 20 and 35 years. The mean delay of occurrence was 3 months for loosening and 6.5 months for plate rupture. The main causes were premature weight-bearing for loosening, non union and delayed union for plate rupture. The treatment consisted of removal of fixation material after spontaneous consolidation in 16 cases, medullary nailing in 8 cases and reosteosynthesis using a plate with bone graft in 7 cases. Bone healing was obtained in all cases. Five patients had an axis deviation between 3° and 5°. The results were considered good in 27 patients, fair in 3 and poor in one. The mechanical complications observed following plate fixation of femoral diaphyseal fractures are the results of defective technique, premature weight bearing or delayed union.