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胫骨远端内侧锁定钢板用于固定肱骨远端关节外骨折;一种固定的替代选择。

Distal medial tibial locking plate for fixation of extraarticular distal humeral fractures; an alternative choice for fixation.

作者信息

Yorukoglu Ali Cagdas, Demirkan Ahmet Fahir, Buker Nihal

机构信息

Pamukkale University, Faculty of Medicine, Department of Orthopedics and Traumatology, Pamukkale, Denizli, Turkey.

Pamukkale University, School of Physical Therapy and Rehabilitation, Pamukkale, Denizli, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2018 Jul;52(4):294-298. doi: 10.1016/j.aott.2018.02.012. Epub 2018 May 4.

Abstract

OBJECTIVE

The aim of this study was to describe an alternative fixation method for distal humeral extra-articular fractures through posterior approach using distal tibia anatomic locking plate; and to evaluate the patient's functional outcome and union condition.

METHODS

Eighteen patients (11 men and 7 women; average age of 37.0 ± 17.3 years (range: 18-73 years)) with a distal humeral extra-articular fracture who were treated with distal tibial medial locking plate were included into the study. The mean follow up time was 36.2 ± 16.7 (12-57) months. Functional results were evaluated with perception of pain, range of joint motion, grasp and pinch strengths.

RESULTS

Union was achieved in 17 of 18 patients. Only one patient had non-union due to infection and underwent debridement. The mean time for union was 7.8 ± 5.9 months (2-20). Patient perception of pain was X = 1.88 ± 2.50 and X = 4.55 ± 2.68, respectively, at rest and activity. The active ranges of joint motion were adequate for functional use. General functional state of affected extremity (DASH-T) was perfect (X = 27.14 ± 25.66), the performance of elbow joint was good (X = 84.44 ± 11.57). There were no differences in the comparison of grasp and pinch grip of patients with uninvolved extremity (p > 0.05).

CONCLUSIONS

In distal humeral extra-articular fractures, use of distal medial tibia plate has advantages such as providing high rates for union, low rates for complication, and early return to work with early rehabilitation, therefore it may be considered a fixation choice that can be used for distal humeral extra-articular fractures.

LEVEL OF EVIDENCE

Level IV, therapeutic study.

摘要

目的

本研究旨在描述一种通过后路使用胫骨远端解剖锁定钢板治疗肱骨远端关节外骨折的替代固定方法;并评估患者的功能结果和愈合情况。

方法

本研究纳入了18例采用胫骨远端内侧锁定钢板治疗的肱骨远端关节外骨折患者(11例男性,7例女性;平均年龄37.0±17.3岁(范围:18 - 73岁))。平均随访时间为36.2±16.7(12 - 57)个月。通过疼痛感知、关节活动范围、握力和捏力来评估功能结果。

结果

18例患者中有17例实现骨折愈合。仅1例患者因感染发生骨不连并接受了清创术。平均愈合时间为7.8±5.9个月(2 - 20个月)。患者休息和活动时的疼痛感知分别为X = 1.88±2.50和X = 4.55±2.68。关节活动的主动范围足以满足功能使用。患侧肢体的总体功能状态(DASH - T)良好(X = 27.14±25.66),肘关节功能表现良好(X = 84.44±11.57)。患者患侧与健侧肢体的握力和捏力比较无差异(p>0.05)。

结论

在肱骨远端关节外骨折中,使用胫骨远端内侧钢板具有骨折愈合率高、并发症发生率低以及能早期康复并早日恢复工作等优点,因此可被视为治疗肱骨远端关节外骨折的一种固定选择。

证据级别

四级,治疗性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b8/6150447/48e6a2e1ee78/gr1.jpg

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