How Difficult Is It to Surgically Treat AO-C Type Distal Humerus Fractures for Inexperienced Orthopedic Surgeons?

S. Yoo, Suk-Woong Kang, Moo-Ho Song, Young Jun Kim, H. Bae
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Abstract

Financial support: None. Conflict of interests: None. Purpose: Twenty early surgical management cases of distal humerus type-C fractures were analyzed. Materials and Methods: This study analyzed 20 early patients, who received surgical management of distal humerus type-C fractures, and could be followed-ups for more than one year between March of 2013 and May of 2015. The operative time, bone union time, and elbow range of motion were analyzed. The Mayo’s functional score was used to evaluate their postoperative function. The primary and secondary complications of each patient immediately after each of their surgery were also reviewed. Results: All patient groups achieved bone union within an average period of 16.4 weeks. Based on the Mayo functional score, 6, 10, and 4 patients scored excellent, good, and fair, respectively. The average range of motion was a flexion contracture of 14.5 with a follow-up improvement averaging 120.7. Six patients received nine revision operations due to major and minor complications. Two patients received revision fixation from an inadequate fixating power, and another patient received an ulnar nerve transposition. Other complications included olecranon osteotomy site displacement, superficial operational site infection, and pin loosening. Conclusion: Distal humerus fractures of the AO-C type can cause a range of complications and has a very high rate of revision due to its difficult nature of surgical manageability. Therefore, it is imperative for a surgeon to expect various complications beforehand and a careful approach to their postoperative rehabilitation is essential.
没有经验的骨科医生手术治疗AO-C型肱骨远端骨折有多困难?
资金支持:无。利益冲突:无。目的:分析20例肱骨远端c型骨折的早期手术治疗。材料与方法:本研究分析了2013年3月至2015年5月接受手术治疗的20例早期肱骨远端c型骨折患者,随访时间超过1年。分析手术时间、骨愈合时间及肘关节活动度。Mayo功能评分用于评估患者术后功能。每位患者在每次手术后立即发生的原发性和继发性并发症也进行了回顾。结果:所有患者组均在平均16.4周内实现骨愈合。根据Mayo功能评分,分别有6例、10例和4例患者被评为优秀、良好和一般。屈曲挛缩的平均活动范围为14.5,随访改善平均为120.7。6例患者因轻重并发症接受9次翻修手术。2例患者因固定力不足接受矫正固定,另1例患者接受尺神经移位。其他并发症包括鹰嘴截骨部位移位、浅表手术部位感染和针松动。结论:AO-C型肱骨远端骨折可引起一系列并发症,由于其手术难处理的性质,其翻修率很高。因此,外科医生必须事先预料到各种并发症,并对他们的术后康复采取谨慎的方法。
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