European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2014
Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series.
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Uzer Gökçer, Yıldız Fatih, Elmadağ Mehmet, Bilsel Kerem, Pulatkan Anil
Аннотация
OBJECTIVE: To report the functional and radiological results of unusual comminuted fractures of the proximal humerus, treated with 'closed reduction and external fixation' (CREF) using hybrid-type unilateral external fixators (EFs).
PATIENTS AND METHODS: Between January 2012 and June 2013, eight patients (mean age 62.6; range 48-84 years) with comminuted proximal humeral fractures extending to the humeral head and one-third proximal diaphysis were treated with CREF using hybrid-type EFs. Functional results were evaluated in terms of shoulder ranges of movement, Constant, DASH, and VAS scores, and radiological results were evaluated using antero-posterior and lateral radiograms of the treated humerus.
RESULTS: The mean follow-up was 16.6 (range 12-28) months. The mean fixator time was 84 (range 63-118) days. The mean range of forward flexion, internal rotation, external rotation, and abduction were 145°, 61.2°, 65°, and 115°, respectively. The mean Constant, DASH, and VAS scores were 79.8, 10, and 1.75, respectively. Seven of the eight patients (87.5 %) healed radiologically. Two complications were observed in two patients: non-union and superficial pin site infection.
CONCLUSIONS: In the treatment of unusual, comminuted proximal diaphyseal humeral fractures, CREF using a hybrid-type EF is a minimally invasive, advantageous procedure with acceptable rates of healing, low risk of surgical site infection, and early range of motion.
LEVEL OF EVIDENCE: Level IV, case series.
PATIENTS AND METHODS: Between January 2012 and June 2013, eight patients (mean age 62.6; range 48-84 years) with comminuted proximal humeral fractures extending to the humeral head and one-third proximal diaphysis were treated with CREF using hybrid-type EFs. Functional results were evaluated in terms of shoulder ranges of movement, Constant, DASH, and VAS scores, and radiological results were evaluated using antero-posterior and lateral radiograms of the treated humerus.
RESULTS: The mean follow-up was 16.6 (range 12-28) months. The mean fixator time was 84 (range 63-118) days. The mean range of forward flexion, internal rotation, external rotation, and abduction were 145°, 61.2°, 65°, and 115°, respectively. The mean Constant, DASH, and VAS scores were 79.8, 10, and 1.75, respectively. Seven of the eight patients (87.5 %) healed radiologically. Two complications were observed in two patients: non-union and superficial pin site infection.
CONCLUSIONS: In the treatment of unusual, comminuted proximal diaphyseal humeral fractures, CREF using a hybrid-type EF is a minimally invasive, advantageous procedure with acceptable rates of healing, low risk of surgical site infection, and early range of motion.
LEVEL OF EVIDENCE: Level IV, case series.