Hussain Altaf, Nema Sandeep Kumar, Sharma Deep, Akkilagunta Sujiv, Balaji Gopisankar
Department Of Orthopedics, Jawaharlal Institute Of Postgraduate Medical Education and Research Puducherry 605006 India.
Department Of Community Medicine, Jawaharlal Institute Of Postgraduate Medical Education and Research Puducherry 605006 India.
J Clin Orthop Trauma. 2018 Mar;9(Suppl 1):S86-S91. doi: 10.1016/j.jcot.2017.12.004. Epub 2017 Dec 21.
The optimal treatment for isolated fractures of ulnar shaft is debatable. The purpose of this study was to compare functional outcomes and radiological union in patients treated for isolated fractures of the ulnar shaft by open reduction and internal fixation and a long arm cast.
This prospective study was conducted at level I trauma center from November 2014 to March 2016. 30 patients with isolated fractures of ulnar shaft were randomized to two groups to receive treatment by open reduction and internal fixation by plates and screws and a long arm cast. Outcome assessment was done by Disabilities of Arm Shoulder and Hand (DASH) score, range of motion at wrist and elbow, grip strength and radiological union. Quantitative variables were summarized Mean or Median. Normality was assessed using Kolmogorov-Smirnov test. Independent samples -test and Mann-Whitney test were used for normally distributed variables and non-normally distributed variables respectively. Categorical variables were summarized as proportions. Effect of the intervention for categorical variables was assessed using Chi-square test.
There was no difference between the groups for pain on Visual Analogue Scale (VAS), grip strength, DASH score, and union at the end of 12 months. There was no difference between the groups for range of motion at the elbow and wrist. 12 (85.7%) patients in the ORIF group and 15 (93.7%) in the cast group united at the end of 12 months. The mean time to union was 13 weeks in the ORIF group and 18 weeks in the cast group.
Open reduction and internal fixation results in anatomical restoration of ulna, but this does not translates to better functional outcomes in short term (12 months).
尺骨干孤立性骨折的最佳治疗方法存在争议。本研究的目的是比较采用切开复位内固定术和长臂石膏固定治疗尺骨干孤立性骨折患者的功能结局和影像学愈合情况。
本前瞻性研究于2014年11月至2016年3月在一级创伤中心进行。30例尺骨干孤立性骨折患者被随机分为两组，分别接受钢板螺钉切开复位内固定术和长臂石膏固定治疗。通过手臂、肩部和手部功能障碍（DASH）评分、腕关节和肘关节活动范围、握力以及影像学愈合情况进行结局评估。定量变量采用均值或中位数进行汇总。使用Kolmogorov-Smirnov检验评估正态性。分别对正态分布变量和非正态分布变量使用独立样本t检验和Mann-Whitney检验。分类变量以比例形式进行汇总。使用卡方检验评估分类变量干预措施的效果。
两组在视觉模拟量表（VAS）疼痛评分、握力、DASH评分以及12个月末的愈合情况方面无差异。两组在肘关节和腕关节活动范围方面无差异。切开复位内固定术组12例（85.7%）患者和石膏固定组15例（93.7%）患者在12个月末实现愈合。切开复位内固定术组的平均愈合时间为13周，石膏固定组为18周。
切开复位内固定术可使尺骨实现解剖复位，但在短期内（12个月）这并未转化为更好的功能结局。
