Department of Orthopedics, Traumatology, Hand and Reconstructive Surgery, St Vinzenz Hospital, Merheimerstrasse 221-223, D-50733 Cologne, Germany.
Injury. 2012 Feb;43(2):164-8. doi: 10.1016/j.injury.2011.04.009. Epub 2011 May 25.
Fractures of the capitulum humeri are rare and challenging injuries to the elbow and outcome results are limited to case series, often with different fixation devices. This article aims to present 15 patients with a fracture of the capitulum humeri treated with the same implant, fine-threaded Kirschner wires (FFS). Besides range of motion and grip strength, outcome measurements include the following scores: the Mayo Elbow Performance index (MEPI); the American Shoulder and Elbow Surgeons' Elbow Assessment (ASES) Form; the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; and the Broberg-Morrey score. Using the modified Bryan and Morrey classification, there were seven type-I injuries, three type-II, two type-III and three type-IV fractures. In addition to fractures of the capitellum, five patients were diagnosed with a complex ligamentous injury and three had suffered radial head fractures. After a minimum follow-up of 12 months, we obtained a range of motion in flexion and extension of 124° and a pro- and supination of 173°. The mean DASH showed 10.84 and the Broberg-Morrey score reached 90.8. ASES and MEPI scores were 91.5 and 90, respectively. The mean grip strength of the injured side was 217.9N versus 236.4N on the healthy side. The use of FFS for capitellar fractures of the humerus achieved good clinical results and these implants can be considered as a treatment option for this fracture entity.
肱骨小头骨折是肘部罕见且具有挑战性的损伤,其结果主要限于病例系列研究,且通常采用不同的固定装置。本文旨在介绍 15 例肱骨小头骨折患者,均采用相同的植入物(细螺纹克氏针,FFS)进行治疗。除了关节活动度和握力外,评估结果还包括以下评分: Mayo 肘部功能指数(MEPI);美国肩肘外科医师协会(ASES)肘部评估表;手臂、肩部和手部残疾问卷(DASH);以及 Broberg-Morrey 评分。采用改良的 Bryan 和 Morrey 分类,7 例为Ⅰ型损伤,3 例为Ⅱ型,2 例为Ⅲ型,3 例为Ⅳ型骨折。除了肱骨小头骨折外,5 例患者还被诊断为复杂的韧带损伤,3 例患者发生了桡骨头骨折。随访时间至少 12 个月后,我们获得了 124°的屈伸活动度和 173°的旋前旋后活动度。平均 DASH 评分为 10.84,Broberg-Morrey 评分为 90.8。ASES 和 MEPI 评分分别为 91.5 和 90。患侧握力平均为 217.9N,健侧为 236.4N。FFS 治疗肱骨小头骨折可获得良好的临床结果,这些植入物可被视为治疗这种骨折的一种选择。