Chambers Lori R, Juels Parker, Mauffrey Cyril, Parry Joshua A
Department of Orthopedics, Denver Health Medical Center, 777 Bannock St, MC 0188, Denver, CO, 80204, USA.
Eur J Orthop Surg Traumatol. 2021 Aug;31(6):1129-1134. doi: 10.1007/s00590-020-02845-6. Epub 2021 Jan 8.
Humerus shaft fractures are commonly acutely immobilized with coaptation splints (CS), which can be difficult to apply and poorly tolerated by the patient. Functional splints (FS), which work on the same principle as functional braces, are an alternative to CS. The purpose of this study was to directly compare CS and FS in terms of application and fracture reduction.
A retrospective review identified humeral shaft fractures managed nonoperatively with initial immobilization in a FS (n = 19) versus a CS (n = 15). In addition, 13 residents completed a blinded survey on splint application.
The FS and CS groups did not differ in initial fracture angulation and translation on anteroposterior (AP) and lateral radiographs. Post-splint application, there was no clinically relevant difference in fracture angulation/translation between groups, and this persisted at the subsequent follow-up visit. All residents reported that the FS was easier to apply and took less time.
This study results demonstrated the FS results in similar reductions in humeral shaft fractures as CS. A survey of residents found that the FS was easier to apply, took less time, and was better tolerated by patients. Subsequently, we prefer the FS over the CS for the acute management of humeral shaft fractures.
肱骨干骨折通常采用合叶夹板（CS）进行急性固定，但其应用困难且患者耐受性差。功能夹板（FS）与功能支具原理相同，是CS的一种替代方法。本研究旨在直接比较CS和FS在应用及骨折复位方面的效果。
一项回顾性研究确定了非手术治疗的肱骨干骨折患者，其中19例初始采用FS固定，15例采用CS固定。此外，13名住院医师完成了一项关于夹板应用的盲法调查。
FS组和CS组在前后位（AP）和侧位X线片上的初始骨折成角和移位情况无差异。夹板应用后，两组间骨折成角/移位在临床上无显著差异，且在随后的随访中持续存在。所有住院医师均报告FS更容易应用且耗时更少。
本研究结果表明，FS在肱骨干骨折复位方面与CS效果相似。对住院医师的一项调查发现，FS更容易应用、耗时更少且患者耐受性更好。因此，对于肱骨干骨折的急性处理，我们更倾向于使用FS而非CS。
