Gupta Tushar, Shamim Sharib, Ahmed Afroz, Gupta Vipin, Mazumdar Gourav, Vaish Akansha
Department of Medicine, Apollo Hospital. New Delhi, India.
Department of Orthopedics, Era Lucknow Medical College and Hospital, Lucknow, India.
J Orthop Case Rep. 2024 Dec;14(12):252-256. doi: 10.13107/jocr.2024.v14.i12.5088.
Conservative or surgical treatment options are available for humeral shaft fractures. To pinpoint individuals who would benefit from early surgical fixation, fracture characteristics were examined. In conservative treatment, the "U" slab prevents displacement, and overriding is corrected by gravity while the patient continues to move about. Rotation is prohibited for 14 days by holding the arm immobile to the chest with the elbow flexed. The preferred course of treatment for fractures of the humeral shaft at all levels is the hanging cast.
This study was conducted at Eras Lucknow Medical College and Hospital. Forty patients with Humerus shaft fractures (HSF) who met the inclusion criteria and presented in casualty or outpatient department participated in the study. This prospective cross-sectional study was of 24 months duration.
Descriptive statistical analysis was performed to calculate the mean with corresponding standard deviations (s.d.). Test of proportion was used to find the standard normal deviate (Z) to compare the difference.
The ratio of male and female (Male: Female) was 3:1. Test of proportion showed that the proportion of males (75.0%) was significantly higher than that of females (25.0%) (Z = 7.07; P < 0.001). Thus, in this study, the males were at higher risk of having fracture shaft of humerus than females. Right-sided fractures (57.5%) were significantly higher than left-sided fractures (42.5%) (Z = 2.12; P = 0.034). About 72.5% of the patients were with disabilities of the arm, shoulder, and hand (DASH) score between 14 and 16 which was significantly higher than other DASH scores (Z = 3.30; P < 0.0001).
Our observation regarding this study is that conservative management of HSF can be opted as the most effective way of treatment, and any complications due to any untoward event during the operative treatment should be limited.
肱骨干骨折有保守治疗或手术治疗两种选择。为了确定哪些患者能从早期手术固定中获益,对骨折特征进行了研究。在保守治疗中,“U”形石膏可防止移位,在患者继续活动时,骨折端的重叠可通过重力自行纠正。通过将手臂弯曲固定于胸前,保持14天不动来防止旋转。肱骨干各水平骨折的首选治疗方法是悬垂石膏。
本研究在勒克瑙时代医学院及医院进行。40例符合纳入标准且在急诊科或门诊部就诊的肱骨干骨折患者参与了本研究。这项前瞻性横断面研究为期24个月。
进行描述性统计分析以计算均值及相应标准差(s.d.)。采用比例检验来计算标准正态偏差(Z)以比较差异。
男性与女性的比例(男:女)为3:1。比例检验显示男性比例(75.0%)显著高于女性比例(25.0%)(Z = 7.07;P < 0.001)。因此,在本研究中,男性发生肱骨干骨折的风险高于女性。右侧骨折(57.5%)显著高于左侧骨折(42.5%)(Z = 2.12;P = 0.034)。约72.5%的患者上肢、肩部和手部功能障碍(DASH)评分在14至16之间,这显著高于其他DASH评分(Z = 3.30;P < 0.0001)。
我们对本研究的观察结果是,肱骨干骨折的保守治疗可作为最有效的治疗方式,且应限制手术治疗期间任何不良事件引起的并发症。