Yiğit Şeyhmus
Arthroscopy, Trauma, Pediatric Orthopedics, Department of Orthopaedics and Traumatology, Private Sultan Hospital, Diyarbakir, Turkey.
Medicine (Baltimore). 2020 Apr;99(17):e19858. doi: 10.1097/MD.0000000000019858.
This study aims to evaluate the timing of surgery in surgically treated humeral shaft fractures, to investigate the effects of surgical time on fracture recovery and complications.This was a retrospective and observational study, based on patient data who underwent surgical treatment of humeral shaft fractures from January 2012 to January 2019. There were 52 patients (19 were women and 33 men) with traumatic humeral shaft fractures who were treated consecutively at our hospital.There was a statistically significant difference in time to start physical therapy, time between surgery and bone union, and time between bone fracture and bone union. The mean time to start physical therapy in group 1 was 6.5 weeks (range, 5-12 weeks), it was 10 weeks (range, 6-14 weeks) in group 2 (P < .001). The mean time between surgery and bone union in group 1 was 14.58 weeks (range, 12-20 weeks), it was 17.4 weeks (range, 8-30 weeks) in group 2 (P: .009). The mean time between bone fracture and bone union in group 1 was 113.2 days (range, 86-114 days), it was 179.2 days (range, 89-355 days) in group 2 (P < .001).Classically the first treatment option for humerus shaft fractures is conservative if there is no absolute surgical indication. Surgical treatment may be the first option if patients want to return to early everyday life. Delayed surgery means delayed physical therapy and this means delayed recovery and return to everyday life. In today's technology world, it should be discussed that the initial treatment of uncomplicated humerus shaft fractures is a conservative treatment.
本研究旨在评估肱骨干骨折手术治疗的时机，探讨手术时间对骨折恢复及并发症的影响。这是一项回顾性观察研究，基于2012年1月至2019年1月接受肱骨干骨折手术治疗患者的数据。我院连续收治了52例创伤性肱骨干骨折患者（19例女性，33例男性）。在开始物理治疗的时间、手术与骨愈合之间的时间以及骨折与骨愈合之间的时间上，存在统计学显著差异。第1组开始物理治疗的平均时间为6.5周（范围5 - 12周），第2组为10周（范围6 - 14周）（P<0.001）。第1组手术与骨愈合之间的平均时间为14.58周（范围12 - 20周），第2组为17.4周（范围8 - 30周）（P = 0.009）。第1组骨折与骨愈合之间的平均时间为113.2天（范围86 - 114天），第2组为179.2天（范围89 - 355天）（P<0.001）。传统上，如果没有绝对的手术指征，肱骨干骨折的首选治疗方法是保守治疗。如果患者希望早日恢复日常生活，手术治疗可能是首选。延迟手术意味着延迟物理治疗，这意味着恢复和回归日常生活的延迟。在当今的技术时代，对于无并发症的肱骨干骨折的初始治疗是否为保守治疗，应该进行讨论。
