Dündar Abdulrahim
Department of Orthopedics and Traumatology, Hitit University Erol Olçok Training and Research Hospital, Çorum, TUR.
Cureus. 2023 Jun 8;15(6):e40123. doi: 10.7759/cureus.40123. eCollection 2023 Jun.
Background and objective Treating transcondylar humeral fractures in elderly individuals remains a challenge in trauma surgery, with plate fixation being one potential treatment method. This retrospective study was conducted to assess the effectiveness of plate fixing through a posterior approach in elderly individuals suffering from distal humeral fractures. Methods This retrospective study involved 28 older participants aged ≥65 years with low transcondylar fractures of the humerus (AO/OTA 13A2-3 fractures). We used the 90-90 orthogonal method for treatment. The inclusion criteria were as follows: (1) low transcondylar type of distal humeral fractures (13A2-3 according to the AO/OTA classification system), (2) patients aged ≥65 years, and (3) a follow-up period of at least 12 months. The exclusion criteria were as follows: polytrauma, pathological injuries, chronic elbow osteoarthritis or degenerative arthropathy, and fractures impacting the articular surface of the distal humeral. Clinical outcomes were assessed in terms of the visual analog scale (VAS) score, Mayo Elbow Performance Score (MEPS), and range of motion (ROM) of the elbow joint. Results The mean age of the patients was 72.25 years (range: 65-81 years), of which 14 (50%) were female and 14 (50%) were male. The mean VAS score for pain was 2.7 (range: 0-6). The mean angle of flexion was 130.6 (range: 115-140), and the mean angle of the extension was -27.7 (range: -21 to -34). Regarding MEPS, 23 patients had an excellent score, four patients had a good score, and one patient had a poor score. There were four complications (two major and two minor) in the patients involved in the study. Conclusion Based on our findings, 90-90 plate fixation for low distal humeral fractures is associated with a high union rate and satisfactory clinical outcomes. Although we found complications in four patients, their healing was not affected. Therefore, we concluded that through improved monitoring and care, we could overcome such complications, and they did not affect the healing of the bone.
背景与目的 在创伤外科中，治疗老年患者的肱骨髁上骨折仍然是一项挑战，钢板固定是一种潜在的治疗方法。本回顾性研究旨在评估经后路钢板固定治疗老年肱骨远端骨折的有效性。方法 本回顾性研究纳入了28例年龄≥65岁的肱骨低位髁上骨折（AO/OTA 13A2-3型骨折）老年患者。我们采用90-90正交法进行治疗。纳入标准如下：（1）肱骨远端低位髁上型骨折（根据AO/OTA分类系统为13A2-3型），（2）年龄≥65岁的患者，（3）随访期至少12个月。排除标准如下：多发伤、病理性损伤、慢性肘关节骨关节炎或退行性关节病，以及影响肱骨远端关节面的骨折。根据视觉模拟量表（VAS）评分、梅奥肘关节功能评分（MEPS）和肘关节活动范围（ROM）评估临床结果。结果 患者的平均年龄为72.25岁（范围：65-81岁），其中14例（50%）为女性，14例（50%）为男性。疼痛的平均VAS评分为2.7（范围：0-6）。平均屈曲角度为130.6（范围：115-140），平均伸展角度为-27.7（范围：-21至-34）。关于MEPS，23例患者评分优秀，4例患者评分良好，1例患者评分较差。本研究涉及的患者中有4例并发症（2例严重和2例轻微）。结论 根据我们的研究结果，90-90钢板固定治疗肱骨远端低位骨折的愈合率高且临床结果令人满意。虽然我们在4例患者中发现了并发症，但他们的愈合未受影响。因此，我们得出结论，通过加强监测和护理，我们可以克服此类并发症，且它们不会影响骨折愈合。
