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采用混合式环形固定器治疗创伤后感染性肱骨骨不连的疗效

Outcomes of Post-traumatic Infected Non-union of the Humerus Managed by Hybrid Ring Fixators.

作者信息

Rohilla Rajesh, Das Jyotirmay, Sharma Pankaj Kumar, Lalchandani Tushar, Dhankhar Sarita, Singh Abha, Sharma Jyoti

机构信息

Department of Sports Medicine and Sports Injury Centre, Post-Graduate Institute of Medical Sciences Rohtak, Haryana, 124001 India.

Department of Orthopaedics, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam India.

出版信息

Indian J Orthop. 2025 Apr 11;59(5):602-610. doi: 10.1007/s43465-025-01376-8. eCollection 2025 May.

Abstract

AIMS

The present study evaluated the functional and clinico-radiological outcomes of management of septic non-union of the humeral fractures managed with hybrid ring fixator. Patients and methods: A total of 18 patients with post-traumatic infected non-union of humerus were included. The mean age was 30.8 years and mean duration of presentation after injury was 19.1 weeks. Mean follow-up duration was 28.11 months and mean time of fixator removal was 25.28 weeks. Bone and functional results were evaluated using the modified Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria, and disability of arm, shoulder and hand (DASH) scores. Results: Bone union was achieved primarily in 16 (88.8%) patients. According to modified ASAMI criteria, the bone results were excellent, good, fair, and poor in 9 (50%), 7 (38.9%), 0 and 2 (11.1%) patients, respectively, whilst functional results were excellent, good, fair, and poor in 11 (61.1%), 5 (27.8%), 0 and 2 (11.1%) patients, respectively. The mean DASH score was 15.27 (5.8-50) at the final follow-up. The mean limb length shortening was 2.67 cm (2-5 cm), whereas malunion of more than 15 ℃ angulation was observed in three patients. Conclusions: Hybrid ring fixator is very effective in management of post-traumatic infected non-union of the humerus. Good-to-excellent bone and functional results can be achieved in majority of patients. Elbow stiffness and superficial pin tract infections are common problems encountered by patients.

LEVEL OF EVIDENCE

IV, A Retrospective study.

摘要

目的

本研究评估了采用混合环形固定器治疗肱骨干骨折感染性骨不连的功能及临床影像学结果。

患者与方法

共纳入18例创伤后肱骨干感染性骨不连患者。平均年龄30.8岁,受伤后至就诊的平均时间为19.1周。平均随访时间为28.11个月,固定器拆除的平均时间为25.28周。采用改良的伊里扎洛夫方法研究与应用协会(ASAMI)标准及手臂、肩部和手部功能障碍(DASH)评分评估骨及功能结果。

结果

16例(88.8%)患者实现了一期骨愈合。根据改良ASAMI标准,骨结果优、良、可、差的患者分别有9例(50%)、7例(38.9%)、0例和2例(11.1%),而功能结果优、良、可、差的患者分别有11例(61.1%)、5例(27.8%)、0例和2例(11.1%)。末次随访时平均DASH评分为15.27(5.8 - 50)。肢体平均短缩2.67 cm(2 - 5 cm),3例患者出现大于15°的成角畸形愈合。

结论

混合环形固定器治疗创伤后肱骨干感染性骨不连非常有效。大多数患者可获得良好至优秀的骨及功能结果。肘关节僵硬和浅表针道感染是患者常见的问题。

证据级别

IV,A类回顾性研究。

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