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Are there too many screw holes in plates for fracture fixation?

Overview of attention for article published in BMC Surgery, April 2017
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Title
Are there too many screw holes in plates for fracture fixation?
Published in
BMC Surgery, April 2017
DOI 10.1186/s12893-017-0244-8
Pubmed ID
Authors

Hongzhi Lv, Wenli Chang, Peizhi Yuwen, Na Yang, Xiaoli Yan, Yingze Zhang

Abstract

Implant breakage after the fixation of traumatic fractures is rare; however, when it occurs, it is debilitating for the patients and a challenge for surgeons. The purpose of this study was to analyze and identify the independent risk factors for implant breakage of traumatic fractures treated with plate osteosynthesis. We reviewed the medical records of patients with a fracture to any part of their four extremities, clavicle, hand or foot, who underwent surgical plate osteosynthesis from January 2005 to January 2015, and who sustained a subsequent implant breakage. Kaplan-Meier univariate and multivariate Cox regressions were performed to identify independent associations of potential risk factors for implant breakage in this cohort. We identified 168 patients who underwent plate osteosynthesis surgery and had subsequent internal fixator breakage. The mean patient age was 40.63 ± 16.71 years (range, 3 to 78 years), with 72.0% (121) males and 28.0% (47) females. The average time between surgery and implant breakage was 12.85 ± 12.42 months (range, 1 to 60 months). In the final regression model, we show that inserting screws close to the fracture line is an independent predictive risk factor for implant breakage (HR, 2.165, 95%CI, 1.227 to 3.822; P = 0.008). We found that inserting screws close to the fracture line is related to an increased risk of internal fixator breakage in patients treated with plate osteosynthesis after fracture. Plates with additional holes likely lead to an increased risk of implant breakage, presumably because surgeons cannot resist inserting extra screws into the holes adjacent to the fracture line, which reduces the stiffness of the plate. We have addressed this problem by designing a plate without holes adjacent to the fracture line.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 39 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 18%
Student > Bachelor 5 13%
Student > Doctoral Student 4 10%
Student > Postgraduate 4 10%
Student > Master 4 10%
Other 8 21%
Unknown 7 18%
Readers by discipline Count As %
Medicine and Dentistry 19 49%
Engineering 8 21%
Nursing and Health Professions 1 3%
Chemistry 1 3%
Veterinary Science and Veterinary Medicine 1 3%
Other 0 0%
Unknown 9 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 September 2017.
All research outputs
#10,495,554
of 11,843,218 outputs
Outputs from BMC Surgery
#318
of 418 outputs
Outputs of similar age
#228,511
of 270,683 outputs
Outputs of similar age from BMC Surgery
#6
of 6 outputs
Altmetric has tracked 11,843,218 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 418 research outputs from this source. They receive a mean Attention Score of 2.5. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 6 others from the same source and published within six weeks on either side of this one.