Abstract:

Objective To analyze the cause of re-fracture after internal fixation removal operation and explore the principles of causality assessment of re-fracture. Method A retrospective analysis was made to study the causes of 5 cases of re-fracture after internal fixation removal operation and their relations to the original injuries. Results Most objects are of middle age or youth in these 5 cases. They all had the internal fixation device removed on proper time, and had no obvious trauma history （1 case had a slight one）. Conclusion Re-fracture may be caused by bone mass decrease due to the presence of internal fixation device, improper time of internal fixation removal, improper functional training or trauma. Attentions should be paid to define each cause and determine their proportion while analyzing the causality.

Key words: internal fixation removal, re-fracture, causality

摘要：

目的 分析骨折内固定取出术后再发骨折的原因，探讨再骨折因果关系评定的原则。方法 回顾分析5例骨折内固定取出术后再发骨折的原因及其与原发损伤的因果关系。结果 5例发生再骨折者多为中青年，无过早取内固定的情形，无明显外伤史（1例有轻微外伤）。结论 内固定本身的因素导致骨折处的骨量下降、不恰当的内固定取出时机、不适当的功能锻炼及外伤都是再骨折的可能原因，在因果关系分析时需注意界定一因还是多因形式，并注意区别多因比例。

关键词: 法医临床学, 内固定取出术, 再骨折, 因果关系