Bandaru Hrushikesh, Shanthappa Arun H
Department of Orthopaedics, Sri Devaraj Urs Medical College, Kolar, IND.
Cureus. 2023 Apr 6;15(4):e37197. doi: 10.7759/cureus.37197. eCollection 2023 Apr.
Background The best surgical procedure for humeral shaft fractures is still plate and screw fixation. Researchers have shown that plate fixation lessens the occurrence of malunion and nonunion. This study aims to describe the functional and radiological outcomes of a humerus shaft fracture treated with a locking compression plate (LCP) using the visual analog scale (VAS) and disabilities of the arm, shoulder, and hand (DASH) scoring systems. Method From December 2020 to July 2022, 25 patients with humerus shaft fractures were enrolled in the prospective observational study at RL Jalappa Hospital, which is affiliated with Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar. We have included closed and open type 1 fractures as per the Gustilo-Anderson classification and excluded humerus shaft fractures associated with neurovascular injury, pathological fractures, and ipsilateral upper limb long bone (radius and ulna) fractures. For a humerus shaft fracture, open reduction and internal fixation (ORIF) + LCP was done on patients who were fit for surgery, had normal test results, and were given the right kind of anesthesia. Every six weeks, every three months, and every six months, patients had regular reviews. A check X-ray was taken each time a patient attended, and we assessed them clinically and radiologically for fracture union, functional outcome, and comorbidities. The patient's DASH and VAS ratings were assessed at the follow-up visit. The Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM SPSS Statistics, Armonk, NY, USA) was used to analyze the data. Result The mean age of the study participants was 33 years, with a standard deviation of 8.9 years. Among the study participants, about 60% of the individuals were males. About 40% of the individuals had injuries due to motorcycle accidents, and 88% of the individuals had direct injuries. Only 12% of the individuals had disease complications. This study recorded a 100% union rate among the study samples. Among the study participants who have histories of hypertension, closed fractures have shown significant improvement according to VAS scores. Among the study participants who were males, those who presented with indirect injury, no history of fracture, right side involvement, and absence of complications showed significant improvement according to the DASH score. Conclusion LCP is reliable for the union of fractures in patients of any age and activity level since we can use it at all levels of the humeral shaft and can achieve 100% union when used with the right principles and osteogenic stimulus. LCPs repair humeral shaft fractures well because they can achieve good functional and radiological results and have few adverse effects.
背景 肱骨干骨折的最佳手术方法仍是钢板螺钉固定。研究人员表明,钢板固定可减少畸形愈合和不愈合的发生。本研究旨在使用视觉模拟量表(VAS)和手臂、肩部和手部功能障碍(DASH)评分系统描述采用锁定加压钢板(LCP)治疗肱骨干骨折的功能和影像学结果。
方法 2020年12月至2022年7月,25例肱骨干骨折患者在隶属于斯里德瓦拉杰·乌尔高等教育与研究学院的RL贾拉帕医院纳入前瞻性观察研究,该医院位于科拉尔县塔马卡。根据 Gustilo-Anderson 分类,我们纳入了闭合性和开放性1型骨折,排除了伴有神经血管损伤、病理性骨折和同侧上肢长骨(桡骨和尺骨)骨折的肱骨干骨折。对于肱骨干骨折,对适合手术、检查结果正常且接受了合适麻醉的患者进行切开复位内固定(ORIF)+LCP。患者每六周、每三个月和每六个月进行定期复查。每次患者就诊时拍摄检查X线片,我们对其进行临床和影像学评估,以了解骨折愈合情况、功能结果和合并症。在随访时评估患者的DASH和VAS评分。使用社会科学统计软件包(SPSS)22.0版(美国纽约州阿蒙克市IBM公司的SPSS Statistics)分析数据。
结果 研究参与者的平均年龄为33岁,标准差为8.9岁。在研究参与者中,约60%为男性。约40%的个体因摩托车事故受伤,88%的个体为直接损伤。只有12%的个体有疾病并发症。本研究记录的研究样本骨折愈合率为100%。在有高血压病史的研究参与者中,闭合性骨折根据VAS评分显示有显著改善。在男性研究参与者中,那些表现为间接损伤、无骨折病史、右侧受累且无并发症的患者根据DASH评分显示有显著改善。
结论 LCP对于任何年龄和活动水平的患者骨折愈合都是可靠的,因为我们可以在肱骨干的所有部位使用它,并且在遵循正确原则和有成骨刺激的情况下可实现100%愈合。LCP能很好地修复肱骨干骨折,因为它们能取得良好的功能和影像学结果且不良反应少。