Kim Sung-Jae, Lee Sang-Hyun, Son Heejung, Lee Bong-Gun
Department of Orthopedic Surgery, College of Medicine, Hanyang University, 17 Haengdang-Dong, Sungdong-Gu, Seoul, Korea.
Int Orthop. 2016 Jul;40(7):1489-94. doi: 10.1007/s00264-015-2895-3. Epub 2015 Jul 23.
This paper analyzed outcomes of the osteosynthesis with a locking plate system for the fractures of the humerus in throwers using the anterior humeral approach.
Retrospective case series including 31 patients. Bone union was assessed through follow-up radiographs. Results of visual analogue scale (VAS) for pain, range of motion in the elbow joint, time of return to work, and the Mayo Elbow Performance Score (MEPS) were evaluated to determine functional outcomes. Direction and length of the fracture, the distal cortical length, the humeral diameter, and the total humeral length were measured as part of fracture configuration analysis.
Mean patient age was 25.8 (range, 18-34) years. The follow-up average was 16.0 months (range, 12-23). Delayed union was observed in one (3.1 %) patient. Mean final VAS was 0.4 (range, 0-2), mean time of return to work was 18.2 weeks (range, 13-36), and mean MEPS was 96.3 (range, 88-100) points. All fractures showed a spiral configuration. Mean fracture length was 79.7 (95 % CI, 72.6-86.7) mm, and mean distal cortical length was 48.3 (95 % CI, 37.8-58.8) mm.
The results of the current study indicates that plate osteosynthesis using a locking plate system combined with interfragmentary lag screws through anterior humeral approach may be a favorable option for the surgical treatment of humeral shaft fractures in throwers.
本文分析了采用肱骨前方入路,使用锁定钢板系统对投掷运动员肱骨骨折进行骨接合术的疗效。
回顾性病例系列研究,纳入31例患者。通过随访X线片评估骨愈合情况。采用视觉模拟评分法(VAS)评估疼痛程度、肘关节活动范围、重返工作时间,并采用梅奥肘关节功能评分(MEPS)来确定功能结局。作为骨折形态分析的一部分,测量骨折的方向和长度、远端皮质长度、肱骨直径以及肱骨总长度。
患者平均年龄为25.8岁(范围18 - 34岁)。平均随访时间为16.0个月(范围12 - 23个月)。1例(3.1%)患者出现延迟愈合。最终VAS平均为0.4(范围0 - 2),平均重返工作时间为18.2周(范围13 - 36周),MEPS平均为96.3分(范围88 - 100分)。所有骨折均呈螺旋形。平均骨折长度为79.7(95%CI,72.6 - 86.7)mm,平均远端皮质长度为48.3(95%CI,37.8 - 58.8)mm。
本研究结果表明,采用肱骨前方入路,使用锁定钢板系统结合骨折块间拉力螺钉进行钢板接骨术,可能是治疗投掷运动员肱骨干骨折的一种理想手术选择。