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单钢板与双钢板固定技术治疗肱骨干骨不连的比较

COMPARISON OF SINGLE- AND DOUBLE-PLATE FIXATION TECHNIQUES IN THE TREATMENT OF NONUNIONS OF THE HUMERAL SHAFT.

作者信息

Akdemir Mehmet, Biçen Çağdaş, Özkan Mustafa

机构信息

. Izmir Ekol Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey.

. Izmir University of Economics Medical Park Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey.

出版信息

Acta Ortop Bras. 2022 Jan 28;30(1):e240181. doi: 10.1590/1413-785220223001e240181. eCollection 2022.

Abstract

INTRODUCTION

Humerus shaft fractures may be treated conservatively or surgically. In 2.5% to 13% of cases, nonunion is observed, and it leads to severe pain and morbidity. Plate osteosynthesis has become popular in the treatment of nonunion of the humeral shaft. In this study, we compared the clinical outcomes of patients with humerus shaft nonunion whom we treated with single- or double-plate fixation.

MATERIALS AND METHODS

Fifty-three patients diagnosed with aseptic humeral shaft nonunion and treated with plate fixation were included in the study. Patients were evaluated according to the number of plates (single vs. double plates). The two groups were subjected to statistical evaluation according to their clinical and radiographical results.

RESULTS

The average age of the patients was 53 years (range: 1-86); 28 (52.8%) were female and 25 (47.2%) were male. The union rate was 90.32% for single plate and 90.91% for double plate fixation. There was no statistically significant difference between single and double plates in the clinical and radiographical results (union time, union rate, Q-DASH score) (p > 0.05). There was a significant correlation between age and union times / Q-DASH scores according to the Spearman correlation test (p < 0.05). Transient radial nerve neuropraxia developed in 2 patients and 1 patient suffered from an infection that was treated with debridement and antibiotic therapy.

CONCLUSION

In our study, similar good results were obtained with single and double plates. In treatment of humeral shaft nonunions, a second plate is not needed if enough stability is provided with single plate fixation.

摘要

引言

肱骨干骨折可采用保守治疗或手术治疗。在2.5%至13%的病例中,会出现骨不连,这会导致严重疼痛和功能障碍。钢板内固定术在肱骨干骨不连的治疗中已变得很普遍。在本研究中,我们比较了采用单钢板或双钢板固定治疗的肱骨干骨不连患者的临床疗效。

材料与方法

本研究纳入了53例诊断为无菌性肱骨干骨不连并接受钢板固定治疗的患者。根据钢板数量(单钢板与双钢板)对患者进行评估。根据临床和影像学结果对两组进行统计学评估。

结果

患者的平均年龄为53岁(范围:1至86岁);28例(52.8%)为女性,25例(47.2%)为男性。单钢板固定的骨愈合率为90.32%,双钢板固定的骨愈合率为90.91%。单钢板和双钢板在临床和影像学结果(愈合时间、愈合率、Q-DASH评分)方面无统计学显著差异(p>0.05)。根据Spearman相关性检验,年龄与愈合时间/Q-DASH评分之间存在显著相关性(p<0.05)。2例患者出现短暂性桡神经神经失用,1例患者发生感染,经清创和抗生素治疗。

结论

在我们的研究中,单钢板和双钢板取得了相似的良好效果。在治疗肱骨干骨不连时,如果单钢板固定能提供足够的稳定性,则无需使用第二块钢板。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7774/8979359/ac7e21ef3928/1809-4406-aob-30-01-e240181-gf01.jpg

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