Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
J Orthop Surg Res. 2023 Mar 16;18(1):209. doi: 10.1186/s13018-023-03671-2.
The purposes of this study were to investigate (1) sonographic humeral torsion (SHT) and side differences (∆SHT), and (2) to determine the relationship between SHT and range of rotational motion (RORM) as well as functional outcome scores of nonoperatively treated proximal humerus fractures (PHF) and humeral shaft fractures (HSF).
Between October 2020 and July 2021, consecutive patients with radiographically healed nonoperatively treated PHF and HSF were included in this analysis. Subjective perception of torsional side difference, correlation between SHT and RORM, Subjective Shoulder Value as well as absolute and adjusted Constant Score were determined. Degree of humeral torsional side differences were classified as follows: 0°-15°: minor; > 15°-30°: moderate; > 30°: major. Factors including gender, hand dominance, fracture type, and displacement were also assessed in order to investigate any association between these variables and ∆SHT.
Sixty-five patients with nonoperatively treated PHF (n = 47) and HSF (n = 18) were analyzed. Mean follow-up was 13.2 months (range, 2.1-72.6). The majority (80% (52)) resulted in only minor, 15.4% (10) in moderate, and 4.6% (3) in major torsional side differences. Patients with minor or moderate torsional differences did not perceive any subjective side difference. While RORM correlated fairly to highly with functional outcomes, only very low to low correlation was observed between these measures and SHT and ∆SHT. Gender, fracture displacement, and type of fracture were not related to SHT and ∆SHT. However, significantly greater torsional side differences were observed, when the dominant side was involved (p = 0.026).
Nonoperative early functional treatment of proximal humerus and humeral shaft fractures results mainly in only minor humeral torsional side differences. Minor and moderate amounts of torsional side differences might not be perceived by patients.
本研究旨在探究（1）肱骨扭转超声（SHT）和侧方差异（∆SHT），以及（2）SHT 与旋转运动范围（RORM）之间的关系，以及非手术治疗的肱骨近端骨折（PHF）和肱骨干骨折（HSF）的功能结果评分。
2020 年 10 月至 2021 年 7 月，连续纳入影像学愈合的非手术治疗 PHF 和 HSF 的患者进行分析。测量 SHT 和 RORM 之间的相关性，确定主观肩部价值以及绝对和调整后的 Constant 评分。将肱骨扭转侧方差异的程度分为以下几类：0°-15°：轻度；>15°-30°：中度；>30°：重度。还评估了性别、手优势、骨折类型和移位等因素，以研究这些变量与 ∆SHT 之间的任何关联。
共分析了 65 例非手术治疗的 PHF（n=47）和 HSF（n=18）患者。平均随访时间为 13.2 个月（范围 2.1-72.6）。大多数（80%（52））结果为轻度，15.4%（10）为中度，4.6%（3）为重度扭转侧方差异。只有轻度或中度扭转差异的患者没有感觉到任何主观的侧方差异。虽然 RORM 与功能结果有相当大的相关性，但这些测量结果与 SHT 和 ∆SHT 之间的相关性非常低。性别、骨折移位和骨折类型与 SHT 和 ∆SHT 无关。然而，当优势侧受累时，观察到的扭转侧方差异明显更大（p=0.026）。
非手术早期功能治疗肱骨近端和肱骨干骨折主要导致轻度肱骨扭转侧方差异。患者可能感觉不到轻度和中度的扭转侧方差异。
