Saha M K, Islam S S, Alam S, Rahman M W, Kamruzzaman M, Paul J, Rahman M M, Alamgir M K
Dr Malay Kumar Saha, Associate Professor, Department of Orthopaedics, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2019 Jan;28(1):60-69.
Treatment of extra-articular distal humeral shaft fractures with plating techniques is often difficult. The recent development of LCP has improved the surgical treatment of fractures by overcoming the few drawbacks of older fixators. The aim of this prospective observational study was to assess the effectiveness of osteosynthesis of extra-articular diaphyseal fractures of the distal third of the humerus using a single locking compression plate (LCP) and was conducted from July 2016 to June 2018 at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh. Thirty (30) patients with closed fracture distal 3rd extra-articular humeral shaft fractures were treated by open reduction and internal fixation by locking compression plate. Two cases were excluded from the evaluation of final outcome due to their discontinued follow up. Detailed clinical conditions of all patients, technical difficulty with the implant, postoperative hospital stay period were recorded. Patients were followed up at 2nd week, 4th week, then 4 weekly upto 6 months. The patients were evaluated clinically and radiologically for outcomes. The progresses of healing as well as occurrence of complications were recorded. The range of motion of the shoulder and elbow were evaluated according to the criteria by Rommens grading. Functional evaluation was made according to the criteria by Modified Constant and Murley Scoring System. Union was achieved in all the patients after a mean of 15 weeks (range 12-20 weeks). There were no complications like deep infection, nonunion, malunion, implant failure, or nerve injury occurs in any of the patients. Two patients had transient radial nerve palsy. Two patients developed superficial infection. All patients were relieved pain postoperatively. Functional outcome were excellent in 10 patients, good in 15 patients which constituted 89% satisfactory results. The study has shown that the LCP is an effective, dependable solution for the management of distal third diaphyseal fractures of the humerus.
采用钢板技术治疗肱骨远端干骺端骨折往往具有挑战性。锁定加压钢板（LCP）的最新发展克服了老式固定器的一些缺点，改善了骨折的手术治疗。本前瞻性观察研究的目的是评估使用单一锁定加压钢板（LCP）治疗肱骨远端三分之一干骺端关节外骨折的骨接合术的有效性，该研究于2016年7月至2018年6月在孟加拉国达卡的国家创伤与矫形康复研究所（NITOR）进行。30例闭合性肱骨远端三分之一干骺端关节外骨折患者接受了切开复位及锁定加压钢板内固定治疗。由于2例患者中断随访，故未纳入最终结果评估。记录了所有患者的详细临床情况、植入物的技术难度、术后住院时间。患者在第2周、第4周进行随访，之后每4周随访一次，直至6个月。对患者进行临床和影像学评估以观察结果。记录愈合进展以及并发症的发生情况。根据Rommens分级标准评估肩、肘关节的活动范围。根据改良Constant和Murley评分系统标准进行功能评估。所有患者平均在15周（范围12 - 20周）后实现骨愈合。所有患者均未出现深部感染、骨不连、畸形愈合、植入物失败或神经损伤等并发症。2例患者出现短暂性桡神经麻痹。2例患者发生浅表感染。所有患者术后疼痛均缓解。10例患者功能结果为优，15例为良，满意结果占89%。该研究表明，锁定加压钢板是治疗肱骨远端三分之一干骺端骨折的一种有效、可靠的方法。
