Ali Nadeem, Ahmad Mir Naseer, Ahmad Dar Tahir, Nawaz Rather Mohmad, Ahmad Mir Wajahat, S Senin, Maajid Saheel
Department of Orthopedics, Hospital for Bone and Joint Surgery, Barzulla, GMC Srinagar, India.
Department of Orthopedics, SKIMS Medical College and Hospital, Bemina, India.
Bull Emerg Trauma. 2018 Oct;6(4):306-312. doi: 10.29252/beat-060406.
To determine the time to radiological union and final functional outcome of fixation of extra-articular distal humeral fractures with extra-artricular distal humerus locking plate.
This prospective study was conducted from March 2014 to February 2018 and included extra-articular distal humeral fractures managed by operative fixation using extra-articular distal humerus locking plate. All the fractures were approached using lateral para-tricepetal approach of Gervin, and stabilized with extra-articular distal humerus locking plate with or without lag screws. Time to radiological union was assessed in the follow up and at the final follow up functional outcome was evaluated using Mayo Performance Elbow Score (MEPS). Complications and need for any additional procedures was also recorded.
A total of 20 patients with mean age of 36.5 years and an average follow up of 17 months were included. The mean time to radiological union was 17.4 weeks (12 to 36 weeks) which included one delayed union that required bone grafting. The mean flexion at elbow was 127o with only one patient having flexion extension arc movement of less than 100o at the final follow up. The average MEPS at final follow up was 94.7±8 with 19 patients having excellent and good results.
Use of extra-articular distal humeral locking plate using lateral para-tricepetal approach in extra-articular distal humeral fractures allows stable fixation of the fracture to allow early return to function with minimal soft tissue dissection and excellent final functional results and minimum complications.
确定采用肱骨远端关节外锁定钢板固定肱骨远端关节外骨折后的影像学愈合时间及最终功能结果。
本前瞻性研究于2014年3月至2018年2月进行,纳入采用肱骨远端关节外锁定钢板手术固定治疗的肱骨远端关节外骨折患者。所有骨折均采用Gervin外侧肱三头肌旁入路,使用或不使用拉力螺钉,用肱骨远端关节外锁定钢板进行固定。随访时评估影像学愈合时间,末次随访时使用梅奥肘关节功能评分(MEPS)评估功能结果。记录并发症及是否需要任何额外手术。
共纳入20例患者,平均年龄36.5岁,平均随访17个月。影像学愈合的平均时间为17.4周(12至36周),其中1例延迟愈合需要植骨。末次随访时,肘关节平均屈曲角度为127°,只有1例患者屈伸弧运动小于100°。末次随访时MEPS平均为94.7±8,19例患者结果为优或良。
对于肱骨远端关节外骨折,采用外侧肱三头肌旁入路使用肱骨远端关节外锁定钢板,可实现骨折的稳定固定,以最少的软组织剥离实现早期功能恢复,获得优异的最终功能结果和最少的并发症。