Hosseini Khameneh Seyed Mahdi, Abbasian Mohammadreza, Abrishamkarzadeh Hashem, Bagheri Shahab, Abdollahimajd Fahimeh, Safdari Farshad, Rahimi-Dehgolan Shahram
Orthopedic Surgery Department, Bone, Joint, and Related Tissues Research Center, Akhtar Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Orthopedic Surgery Department, AJA University of Medical Sciences, Tehran, Iran.
Orthop Res Rev. 2019 Sep 23;11:141-147. doi: 10.2147/ORR.S212998. eCollection 2019.
This randomized controlled trial was conducted to investigate the outcomes of humeral shaft-fracture management with the functional Sarmiento brace (nonoperative) versus open reduction internal fixation (ORIF).
Sixty humeral shaft-fracture patients with a minimum age of 18 years were randomly assigned into two groups: operative treatment with open reduction-internal fixation (ORIF) or functional brace (Sarmiento). A similar postoperative rehabilitation program was applied for all subjects for the next 12 months. The outcomes of each method were measured in terms of nonunion rate, union time, "quick" Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire scores, and rate of complications, such as malunion, infection, and radial nerve injury.
The two groups had similar baseline characteristics, including age, sex, smoking status, and type and mechanism of fracture. The mean union time was about 4.8 weeks shorter in the ORIF group (13.9 weeks in operative group versus 18.7 weeks in nonoperative group), indicating a definite significant superiority (=0.001) of ORIF management to functional Sarmiento bracing. However, a comparison of quick DASH scores revealed a borderline-significant difference between the groups (=0.065). Additionally, we found that treatment of humeral shaft fractures using functional bracing was associated with slightly higher risk of nonunion; however this was not significant (=0.492).
According to the present findings, there is remarkable superiority of ORIF over functional Sarmiento bracing in the management of patients with humeral shaft fracture.
本随机对照试验旨在研究采用功能性萨米恩托支具（非手术治疗）与切开复位内固定术（ORIF）治疗肱骨干骨折的疗效。
将60例年龄至少18岁的肱骨干骨折患者随机分为两组：切开复位内固定术（ORIF）手术治疗组或功能性支具（萨米恩托）组。在接下来的12个月里，所有受试者都接受了类似的术后康复计划。通过骨不连发生率、愈合时间、上肢、肩部和手部功能障碍快速（DASH）问卷评分以及诸如畸形愈合、感染和桡神经损伤等并发症发生率来衡量每种治疗方法的疗效。
两组患者的基线特征相似，包括年龄、性别、吸烟状况以及骨折类型和机制。ORIF组的平均愈合时间短约4.8周（手术组为13.9周，非手术组为18.7周），表明ORIF治疗相对于功能性萨米恩托支具具有明显的显著优势（=0.001）。然而，快速DASH评分比较显示两组之间存在临界显著差异（=0.065）。此外，我们发现使用功能性支具治疗肱骨干骨折的骨不连风险略高；然而，这并不显著（=0.492）。
根据目前的研究结果，在肱骨干骨折患者的治疗中，ORIF明显优于功能性萨米恩托支具。
