Zhao Yonghui, Pu Shaoquan, Yin Hao, Lü Qian, Xu Yongqing, Zhu Yueliang
Department of Orthopedics, the 920th Hospital of Joint Logistics Support Force, Kunming Yunnan, 650032, P.R.China;Department of Orthopedics, the First People's Hospital of Yunnan Province/the Affiliated Hospital of Kunming University of Science and Technology, Kunming Yunnan, 650032, P.R.China.
Department of Orthopedics, the 920th Hospital of Joint Logistics Support Force, Kunming Yunnan, 650032, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Feb 15;35(2):144-148. doi: 10.7507/1002-1892.202009016.
To investigate the effectiveness of suspensory external fixation technique in treatment of proximal humeral fractures.
Between August 2013 and October 2018, 14 patients with proximal humeral fractures were treated with suspensory external fixation technique. There were 10 males and 4 females with an average age of 55.9 years (range, 43-76 years). There were 10 cases of falling injury and 4 cases of traffic accident injury. Among them, there were 9 cases of Neer type Ⅲ and 5 cases of Neer type Ⅳ. The time from injury to operation was 3-7 days (mean, 4.6 days). Nine cases were complicated with osteoporosis. The preoperative visual analogue scale (VAS) score was 6.1±1.2. The effectiveness was comprehensively evaluated by hospital stay, fracture healing time, removal time of external fixator, postoperative complications, VAS score, and Neer score of shoulder joint function.
All operations were successfully completed, and the hospital stay was 6-14 days, with an average of 9.4 days. All the incisions healed by first intention, and no infection or other complications occurred. All patients were followed up 16-60 months (mean, 35.4 months). X-ray films examination showed that all fractures healed, the healing time was 4-7 months (mean, 4.9 months). The removal time of external fixator was 5-8 months (mean, 6.3 months). VAS scores were 1.5±0.8 at 1 month after operation and 1.0±0.9 at last follow-up, both of which were significantly improved when compared with preoperative score, the differences were significant between different time points ( <0.05). Neer score of shoulder joint function was 75-100 (mean, 91.1); 9 cases were excellent, 4 cases were good, and 1 case was fair. The excellent and good rate was 92.9%. During follow-up, there was no adverse events such as acromion impingement, nonunion, or pseudoarthrosis.
For proximal humeral fractures, the suspensory external fixation technique is a simple and reliable treatment method that can significantly improve joint function.
探讨悬吊外固定技术治疗肱骨近端骨折的有效性。
2013年8月至2018年10月，采用悬吊外固定技术治疗14例肱骨近端骨折患者。其中男性10例，女性4例，平均年龄55.9岁（范围43 - 76岁）。坠落伤10例，交通事故伤4例。其中NeerⅢ型9例，NeerⅣ型5例。受伤至手术时间为3 - 7天（平均4.6天）。9例合并骨质疏松。术前视觉模拟评分（VAS）为6.1±1.2。通过住院时间、骨折愈合时间、外固定器拆除时间、术后并发症、VAS评分及肩关节功能Neer评分综合评价疗效。
所有手术均顺利完成，住院时间6 - 14天，平均9.4天。所有切口均一期愈合，未发生感染及其他并发症。所有患者均获随访16 - 60个月（平均35.4个月）。X线片检查示所有骨折均愈合，愈合时间4 - 7个月（平均4.9个月）。外固定器拆除时间5 - 8个月（平均6.3个月）。术后1个月VAS评分为1.5±0.8，末次随访时为1.0±0.9，均较术前明显改善，不同时间点差异有统计学意义（<0.05）。肩关节功能Neer评分为75 - 100（平均91.1）；优9例，良4例，可1例。优良率为92.9%。随访期间未出现肩峰撞击、骨不连或假关节等不良事件。
对于肱骨近端骨折，悬吊外固定技术是一种简单可靠的治疗方法，可显著改善关节功能。
