Multifocal Humeral Fractures: Clinical Results, Functional Outcomes and Flowchart of Surgical Treatment.

IF 1 Q3 ORTHOPEDICS

Strategies in Trauma and Limb Reconstruction Pub Date : 2022-05-01 DOI:10.5005/jp-journals-10080-1559

Michelangelo Scaglione, Francesco Casella, Edoardo Ipponi, Federico Agretti, Simone Polloni, Michele Giuntoli, Stefano Marchetti

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引用次数: 1

Abstract

Aim and objective: Multifocal fractures of the humerus are rare. The aim of our study is to evaluate the effectiveness of surgical treatment and propose a modification to the Maresca-Pascarella classification. A flowchart for surgical treatment is provided.

Materials and methods: Thirty-one patients with multifocal humeral fractures were treated and evaluated. The Maresca-Pascarella classification was used. All were treated using with either plates and screws, external fixation or intramedullary nailing. Functional outcomes were evaluated using the QuickDASH test, the University of California - Los Angeles (UCLA) shoulder score and the Mayo elbow performance score (MEPS).

Results: There were 12 Type A, 17 Type B, 1 Type C and 1 of combined fractures of the proximal and distal epiphysis. Of the 31 patients, 5 were lost to the follow-up (FU), 1 died of pulmonary embolism (PE) and the remaining 25 had a mean FU of 19.8 (7-35) months. Three patients had radial nerve damage and 1 went to a non-union that required further surgical intervention. The mean QuickDASH score was 15.7, the average UCLA shoulder score was 26.3 and the mean MEPS elbow score resulted to be 83.0.

Conclusion: Although multifocal fractures are severe injuries, patients are able to recover good functionality if treated judiciously.

Clinical significance: We proposed a standardised surgical approach based on the fracture characteristics, site and a modified Maresca-Pascarella classification.

How to cite this article: Scaglione M, Casella F, Ipponi E, et al. Multifocal Humeral Fractures: Clinical Results, Functional Outcomes and Flowchart of Surgical Treatment. Strategies Trauma Limb Reconstr 2022;17(2):81-87.

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肱骨多灶性骨折:临床结果、功能结局和手术治疗流程。

目的和目的:肱骨多灶性骨折是罕见的。我们研究的目的是评估手术治疗的有效性，并提出对Maresca-Pascarella分类的修改。提供了手术治疗的流程图。材料与方法:对31例肱骨多灶性骨折患者进行治疗和评价。采用Maresca-Pascarella分类。所有患者均采用钢板螺钉、外固定或髓内钉治疗。功能结果采用QuickDASH测试、加州大学洛杉矶分校(UCLA)肩关节评分和Mayo肘关节表现评分(MEPS)进行评估。结果:A型骨折12例，B型骨折17例，C型骨折1例，近端和远端骨骺合并骨折1例。31例患者中，5例失访(FU)， 1例死于肺栓塞(PE)，其余25例平均FU为19.8(7-35)个月。3例患者有桡神经损伤，1例出现骨不连，需要进一步手术干预。QuickDASH评分平均为15.7分，UCLA肩部评分平均为26.3分，MEPS肘部评分平均为83.0分。结论:虽然多灶性骨折是一种严重的损伤，但如果治疗得当，患者仍能恢复良好的功能。临床意义:我们根据骨折的特点、部位和改良的Maresca-Pascarella分类提出了标准化的手术入路。文章引用方式:Scaglione M, Casella F, Ipponi E等。肱骨多灶性骨折:临床结果、功能结局和手术治疗流程。创伤肢体重建2022;17(2):81-87。

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来源期刊

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.