Fawi Hassan, Lewis James, Rao Prasad, Parfitt Dan, Mohanty Khitish, Ghandour Adel
University Hospital of Wales, Cardiff, UK.
Shoulder Elbow. 2015 Apr;7(2):104-9. doi: 10.1177/1758573214559320. Epub 2014 Nov 10.
Conventional management protocols for distal humeral extra-articular fractures (e.g. conservative, double columnar plating) are often associated with complications. We aimed to describe our experience of using the Synthes™ 3.5-mm extra-articular distal humeral locking compression plate for treatment of extra-articular distal humeral fractures.
We prospectively studied 23 consecutive patients who underwent fixation, in a tertiary trauma centre, over 2 years. Data, including patient demographics, duration of follow-up, patient satisfaction, visual analogue score (VAS), Oxford Elbow Score, and final outcome on discharge, were collected and analyzed.
Of the 23 patients (12 males, 11 females; mean age 47.5 years; range 18 years to 89 years), all fractures united radiologically and clinically after the index procedure, with a mean time to fracture union of 15.7 weeks (range 9 weeks to 34 weeks) and a mean time to discharge of 17.8 weeks (range 13 weeks to 34 weeks). Oxford Elbow Score was 36.5 (range 11 to 48) at 4.6 months postoperatively; at 20 months follow-up, it was 40 (range 14 to 48) and the VAS was 8.5 (range 5 to 10). One patient had radial nerve neuropraxia pre-operatively, and one postoperatively, and both recovered uneventfully 3 months postoperatively. Neither superficial, nor deep infections were observed in this cohort.
The present study reports satisfactory outcome with the usage of the Synthes plate for extra-articular fracture management. It has become the technique of choice in our centre because it provides excellent results.
肱骨远端关节外骨折的传统治疗方案(如保守治疗、双柱钢板固定)常伴有并发症。我们旨在描述使用Synthes™ 3.5毫米关节外肱骨远端锁定加压钢板治疗肱骨远端关节外骨折的经验。
我们在一家三级创伤中心对连续23例患者进行了为期2年的前瞻性研究,这些患者均接受了固定治疗。收集并分析了包括患者人口统计学资料、随访时间、患者满意度、视觉模拟评分(VAS)、牛津肘关节评分以及出院时最终结果等数据。
23例患者(12例男性,11例女性;平均年龄47.5岁;年龄范围18岁至89岁),所有骨折在初次手术后均在影像学和临床上达到愈合,骨折愈合的平均时间为15.7周(范围9周至34周),平均出院时间为17.8周(范围13周至34周)。术后4.6个月时牛津肘关节评分为36.5(范围11至48);在20个月随访时,评分为40(范围14至48),VAS评分为8.5(范围5至10)。1例患者术前出现桡神经失用,1例术后出现,两者均在术后3个月顺利恢复。该队列中未观察到浅表或深部感染。
本研究报告了使用Synthes钢板治疗关节外骨折的满意结果。它已成为我们中心的首选技术,因为它能提供优异的效果。