A Clinico-Metallurgical Study of Implant Breakage in Diaphyseal Fractures of Humerus, Treated by Primary 316l Ss DCP Fixation

Abstract

Implant breakage is a catastrophic event for the patient and for the surgeon. Hence our aim was to assess the reasons for plate breakage in humeral diaphyseal fractures treated by 316 L SS DCP.A total of ten cases in Govt. medical college Trivandrum during period of June 2011 to November 2013, who were treated initially by plating of humerus presented with plate breakage were studied. Factors like weight bearing, osteoporosis and infection the usual confounding factors in any study does not feature in our study as only diaphyseal humeral fractures fixed with stainless steel DCP were studied and all patients were young. Pre and post-operative X-rays were evaluated by two surgeons to assess fracture and quality of fixation. Removed failed plates and controls were sent for metallurgical analysis. Presence of far cortex commination and empty screw hole (70%) at fracture site were the commonest clinical cause and corrosion especially pitting (90%) was the commonest metallurgic cause of plate breakage. When more than two clinical and metallurgical factors coincided implants failed within two years denoting a cumulative effect.