Sarmiento A, Latta L L
Department of Orthopaedics and Rehabilitation, 72 Avenue, 10333 SW, 33156, University of Miami, Florida, USA.
Unfallchirurg. 2007 Oct;110(10):824-32. doi: 10.1007/s00113-007-1325-4.
Functional bracing of humeral diaphyseal fractures was conceived after initial experiences with a similar method was used in the management of diaphyseal tibial fractures. Over the years, tibial functional bracing underwent major evolutionary changes, and found its indications basically limited to a smaller group of fractures, consisting of closed, axially unstable fractures that experience at the time of the injury an acceptable degree of shortening, and to transverse fracture that are appropriately reduced and rendered stable. On the other hand, functional bracing of diaphyseal humeral fractures has, maintained the initial indications, contraindications and methodology. This article describes the concept, indications and contraindications of functional bracing of humeral diaphyseal fractures and provides results of 620 fractures with complete follow-up. In 97.5% of the patients, the average healing time was 11.5 weeks. 16 patients (2.5%) required operative intervention because of a nonunion and 4 patients (<1 degrees) of the patient had a refracture after brace removal. Nerve function did not return in only one of the 67 patient who had radial nerve palsy.
肱骨骨干骨折的功能性支具是在胫骨干骨折采用类似方法取得初步经验后构想出来的。多年来,胫骨功能性支具经历了重大的演变,其适用指征基本局限于一小部分骨折,包括闭合性、轴向不稳定骨折,这类骨折在受伤时出现可接受程度的短缩,以及经适当复位并固定稳定的横行骨折。另一方面,肱骨干骨折的功能性支具则保持了最初的适用指征、禁忌证和方法。本文描述了肱骨干骨折功能性支具的概念、适用指征和禁忌证,并给出了620例骨折患者完整随访的结果。97.5%的患者平均愈合时间为11.5周。16例患者(2.5%)因骨不连需要手术干预,4例患者(<1%)在支具拆除后发生再骨折。67例桡神经麻痹患者中仅有1例神经功能未恢复。