Wajnsztejn Andre, de Albuquerque Diego Dantas, Espinola Italo, Altoé Pablo Falchetto, Ejnisman Leandro, Lenza Mario, Pires Robinson Esteves Santos
Hospital Israelita Albert Einstein, Av Albert Einstein 627, sala 306 bloco A1, Morumbi, Sao Paulo, SP, 05651-901, Brazil.
Hospital Municipal Dr. Carmino Cariccio, São Paulo, SP, Brazil.
Eur J Orthop Surg Traumatol. 2017 Dec;27(8):1069-1074. doi: 10.1007/s00590-017-1987-8. Epub 2017 Jun 7.
The aim of our study is to show the functional outcomes and complication rates of humeral complex fractures in adults, using osteosynthesis with two bridging orthogonal submuscular plates.
The study consists of a prospective case series of 13 patients with isolated humeral complex fractures treated with two bridging orthogonal submuscular plates. Functional assessment was performed using disabilities of the arm, shoulder, and hand (DASH) score with 30 items. The age ranged from 22 to 68 years, with a mean age of 39 years. Functional assessment with DASH score was performed at the twelfth postoperative week.
All patients presented fracture healing in the fourth postoperative month. Of the 13 patients, five (38%) had a DASH score of zero (best function possible). One patient developed neuropraxis and presented with a score of 100 (worst possible). One case developed superficial infection, which was treated with oral antibiotics and local debridement.
This study demonstrated satisfactory functional outcome in patients with distal-third diaphyseal humeral complex fractures treated with two locked submuscular plates. The authors consider it as a safe method and an efficient alternative, especially in younger patients who require early functional recovery.
本研究旨在展示采用两块桥接正交肌下钢板进行接骨术治疗成人肱骨复杂骨折的功能结果和并发症发生率。
本研究为前瞻性病例系列，共纳入13例采用两块桥接正交肌下钢板治疗的孤立性肱骨复杂骨折患者。使用包含30项条目的手臂、肩部和手部功能障碍（DASH）评分进行功能评估。年龄范围为22至68岁，平均年龄39岁。术后第12周采用DASH评分进行功能评估。
所有患者均在术后第4个月实现骨折愈合。13例患者中，5例（38%）的DASH评分为零（功能最佳）。1例患者发生神经失用，评分为100分（功能最差）。1例发生浅表感染，经口服抗生素和局部清创治疗。
本研究表明，采用两块锁定肌下钢板治疗肱骨远端三分之一骨干复杂骨折的患者功能结果令人满意。作者认为这是一种安全的方法和有效的替代方案，尤其适用于需要早期功能恢复的年轻患者。
