[Application of suspensory external fixation technique in treatment of proximal humeral fracture].

Publisher: Hua xi yi ke da xue Fu shu di 1 yi yuan Country of Publication: China NLM ID: 9425194 Publication Model: Print Cited Medium: Print ISSN: 1002-1892 (Print) Linking ISSN: 10021892 NLM ISO Abbreviation: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Subsets: MEDLINE

Publication: Chengdu Shi : Hua xi yi ke da xue Fu shu di 1 yi yuan
Original Publication: Chengdu Shi : Hua xi yi ke da xue Fu shu di 1 yi yuan,

External Fixators* ; Shoulder Fractures*/surgery; Adult ; Aged ; Female ; Fracture Fixation ; Fracture Healing ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective: To investigate the effectiveness of suspensory external fixation technique in treatment of proximal humeral fractures.
Methods: Between August 2013 and October 2018, 14 patients with proximal humeral fractures were treated with suspensory external fixation technique. There were 10 males and 4 females with an average age of 55.9 years (range, 43-76 years). There were 10 cases of falling injury and 4 cases of traffic accident injury. Among them, there were 9 cases of Neer type Ⅲ and 5 cases of Neer type Ⅳ. The time from injury to operation was 3-7 days (mean, 4.6 days). Nine cases were complicated with osteoporosis. The preoperative visual analogue scale (VAS) score was 6.1±1.2. The effectiveness was comprehensively evaluated by hospital stay, fracture healing time, removal time of external fixator, postoperative complications, VAS score, and Neer score of shoulder joint function.
Results: All operations were successfully completed, and the hospital stay was 6-14 days, with an average of 9.4 days. All the incisions healed by first intention, and no infection or other complications occurred. All patients were followed up 16-60 months (mean, 35.4 months). X-ray films examination showed that all fractures healed, the healing time was 4-7 months (mean, 4.9 months). The removal time of external fixator was 5-8 months (mean, 6.3 months). VAS scores were 1.5±0.8 at 1 month after operation and 1.0±0.9 at last follow-up, both of which were significantly improved when compared with preoperative score, the differences were significant between different time points ( P <0.05). Neer score of shoulder joint function was 75-100 (mean, 91.1); 9 cases were excellent, 4 cases were good, and 1 case was fair. The excellent and good rate was 92.9%. During follow-up, there was no adverse events such as acromion impingement, nonunion, or pseudoarthrosis.
Conclusion: For proximal humeral fractures, the suspensory external fixation technique is a simple and reliable treatment method that can significantly improve joint function.

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Keywords: Proximal humeral fracture; shoulder joint; suspensory external fixation technique
Local Abstract: [Publisher, Chinese] 探讨悬张外固定技术治疗肱骨近端骨折的临床疗效。. [Publisher, Chinese] 2013 年 8 月—2018 年 10 月，采用悬张外固定技术治疗 14 例肱骨近端骨折患者。男 10 例，女 4 例；年龄 43～76 岁，平均 55.9 岁。致伤原因：摔伤 10 例，交通事故伤 4 例。其中 Neer Ⅲ型 9 例、Ⅳ型 5 例；受伤至手术时间 3～7 d，平均 4.6 d。合并骨质疏松症 9 例。术前疼痛视觉模拟评分（VAS）为（6.1±1.2）分。记录患者住院时间、骨折愈合时间、外固定物拆除时间、术后并发症发生情况，以 VAS 评分及肩关节 Neer 评分综合评价临床疗效。. [Publisher, Chinese] 患者手术均顺利完成；住院时间 6～14 d，平均 9.4 d。术后切口均Ⅰ期愈合，无感染等早期并发症发生。患者均获随访，随访时间 16～60 个月，平均 35.4 个月。X 线片复查示骨折均愈合，愈合时间 4～7 个月，平均 4.9 个月；术后 5～8 个月拆除外固定物，平均 6.3 个月。术后 1 个月 VAS 评分为（1.5±0.8）分，末次随访时为（1.0±0.9）分，均较术前明显改善，手术前后各时间点间比较差异均有统计学意义（ P <0.05）。术后 1 年肩关节功能 Neer 评分为 75～100 分，平均 91.1 分；获优 9 例、良 4 例、中 1 例，优良率为 92.9%。随访期间均无肩峰撞击、骨不连及假关节形成等不良事件发生。. [Publisher, Chinese] 对于肱骨近端骨折，悬张外固定技术是一种操作简单、固定可靠的治疗方法，可显著改善肩关节功能。.

Date Created: 20210224 Date Completed: 20210225 Latest Revision: 20220420

20231215

PMC8171674

10.7507/1002-1892.202009016

33624464