Oztürk Irfan, Ertürer Erden, Uzun Metin, Akman Senol, Seçkin Faik
Department of Orthopedics and Traumatology (2. Ortopedi ve Travmatoloji Kliniği), Sişli Etfal Training and Research Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2006;40(4):269-73.
We evaluated the effect of functional bracing on union and functional results in the conservative treatment of humeral diaphyseal fractures.
The study included 38 patients (21 males, 17 females; mean age 34.8 years; range 20 to 63 years) who were treated with functional bracing for humeral diaphyseal fractures. The fractures were in the right in 23 patients, and in the left in 15 patients. Radial paralysis was detected in eight patients. Two patients had open fractures (Gustilo IIIA). According to the AO system, there were 12 AO type A1 (31.6%), 11 type A2 (29.0%), 13 type A3 (34.2%), and two type B1 (5.3%) fractures. Functional bracing was applied after a mean of 2.4 weeks of fixation of the shoulder and elbow. The radiographic and functional results were assessed using the scoring system of Kwasny et al. The mean follow-up was 48 months (range 16 to 64 months).
Complete union was achieved in all the patients in a mean of 11.4 weeks (range 10 to 16 weeks). Radiographic and functional results were very good in 31 patients (81.6%) and good in seven patients (18.4%). A mean of 0.8 cm (range 0 to 1.8 cm) shortness developed after union. In none of the patients angulation exceeded 20 degrees in the anteroposterior plane and 10 degrees in the lateral plane. Complete healing was obtained in patients with radial paralysis within three months. No complications were encountered pertaining to functional bracing.
When choosing conservative methods, functional bracing should be primarily considered in the treatment of humeral diaphyseal fractures because of low complication but very high success rates.
我们评估了功能性支具在肱骨干骨折保守治疗中对骨折愈合及功能恢复的影响。
本研究纳入了38例接受肱骨干骨折功能性支具治疗的患者（男性21例，女性17例；平均年龄34.8岁；年龄范围20至63岁）。23例患者骨折位于右侧，15例位于左侧。8例患者检测到桡神经麻痹。2例患者为开放性骨折（Gustilo IIIA 型）。根据AO系统，有12例AO A1型骨折（31.6%），11例A2型骨折（29.0%），13例A3型骨折（34.2%），以及2例B1型骨折（5.3%）。在肩部和肘部平均固定2.4周后应用功能性支具。使用Kwasny等人的评分系统评估影像学和功能结果。平均随访时间为48个月（范围16至64个月）。
所有患者平均在11.4周（范围10至16周）实现完全愈合。31例患者（81.6%）的影像学和功能结果非常好，7例患者（18.4%）结果良好。愈合后平均短缩0.8厘米（范围0至1.8厘米）。所有患者在前后位平面成角均未超过20度，在侧位平面成角均未超过10度。桡神经麻痹患者在三个月内实现完全恢复。未出现与功能性支具相关的并发症。
在选择保守治疗方法时，由于并发症少且成功率高，功能性支具应作为肱骨干骨折治疗的首选方法。
