Ciernik I F, Meier L, Hollinger A
Department of Surgery, Kreisspital Maennedorf, Switzerland.
J Trauma. 1991 Feb;31(2):230-3.
A retrospective review of 23 patients after treatment of humeral fractures with hanging cast was performed. The average followup time was 8.59 years (range, 1.0 to 15.5 years). Functional results were good in eight (34.8%) and excellent in 15 patients (65.2%). To assess the flexibility of shoulder and elbow joints 24 parameters were measured on each body side using the neutral-zero method of Debrunner. A cumulative comparison of each parameter revealed decreased flexibilities of the upper limb after treatment with hanging cast: reduced abduction without moving shoulder blade (84.08 +/- 7.53 vs. 77.34 +/- 11.38; p less than 0.05), reduced free abduction (166.09 +/- 14.4 vs. 158.22 +/- 19.28; p less than 0.01), reduced anteelevation (155.26 +/- 10.12 vs. 149.35 +/- 3.22; p less than 0.01), reduced external rotation with hanging arm (48.96 +/- 19.05 vs. 41.18 +/- 16.75; p less than 0.01), increased flexion of the shoulder (25.65 +/- 10.37 vs 27.3 +/- 10.0; p less than 0.05) and reduced extension of the elbow (0.86 +/- 6.92 vs. -2.68 +/- 9.63; p less than 0.05). These findings show that longterm deficiencies of humeral mobility after treatment with hanging casts exist.
对23例采用悬吊石膏治疗肱骨骨折后的患者进行了回顾性研究。平均随访时间为8.59年（范围1.0至15.5年）。8例（34.8%）患者功能结果良好，15例（65.2%）患者功能结果优秀。为评估肩、肘关节的灵活性，采用德布勒纳中立零位法在身体两侧各测量24个参数。对每个参数进行累积比较发现，悬吊石膏治疗后上肢灵活性降低：肩胛骨不动时外展减少（84.08±7.53对77.34±11.38；p<0.05），自由外展减少（166.09±14.4对158.22±19.28；p<0.01），前屈减少（155.26±10.12对149.35±3.22；p<0.01），垂臂位时外旋减少（48.96±19.05对41.18±16.75；p<0.01），肩关节屈曲增加（25.65±10.37对27.3±10.0；p<0.05），肘关节伸展减少（0.86±6.92对-2.68±9.63；p<0.05）。这些结果表明，悬吊石膏治疗后肱骨活动度存在长期不足。
