The use of transarticular external fixation by arthrodiastasis in complex open proximal humeral fractures at Hospital Militar Central Colombia: A case series

IF 6.3 1区医学 Q1 DERMATOLOGY

Burns & Trauma Pub Date : 2023-08-23 DOI:10.1177/14604086231187158

Carlos Satizabal Azuelo, M. P. Cabrera Méndez, Gustavo Adolfo Rozo López, Saith del Carmen Trouchon Jimenez, Diego Sanchez Cruz

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引用次数: 0

Abstract

To describe the clinical and surgical characteristics of external fixation technique to manage complex open proximal humerus fractures caused by high-energy firearm injuries at the Hospital Militar Central, Colombia. A retrospective case series of patients with open complex proximal humerus fractures (Gustilo & Anderson III A-B or Neer III and IV) caused by long range or fragmentation weapons treated with external fixation. The variables are demographic data, range of motion, consolidation measurements, and functional outcomes according to the Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) functional scale. Seven male patients, with high-energy injuries causing open complex proximal humerus fractures (Gustilo & Anderson III A-B or Neer III or IV) underwent surgical treatment with external fixation and arthrodiastasis. Median age was 21.0 (19–24) years, mean treatment duration was 5.6 (4–7) months, and all patients completed 15 months of follow-up. Mean postoperative active movement measurements were flexion: 80° (40°–120°), abduction 85.7° (40°–130°), external rotation: 24.7° (10°–45°), and internal rotation: 23.6° (10°–45°). Mean postoperative pain according to visual analog scale was 2.7 (1–4) and mean Quick DASH was 36.2 (15.9–58). Two patients presented postoperative complications, one case each of infection and osteitis. Complex open proximal humeral fractures caused by high-energy trauma treated with transarticular external fixation via arthrodiastasis show promising short-term and mid-term results with low complication rates, low levels of postoperative pain, and moderate functional results. This external fixation technique seems to be a valid option for the treatment of polytraumatic patients with humeral injuries. Longer follow ups and larger sample sizes studies must be presented to better characterize the clinical and satisfaction outcomes.

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经关节外固定术治疗复杂开放性肱骨近端骨折在哥伦比亚中部军事医院的应用:一个病例系列

目的:描述哥伦比亚中央军事医院采用外固定技术治疗高能火器伤所致复杂开放性肱骨近端骨折的临床和手术特点。回顾性分析了肱骨近端开放性复杂骨折(Gustilo & Anderson III A- b或Neer III和IV)患者的病例系列，这些骨折是由远距离或碎片化武器引起的，并采用外固定治疗。变量是人口统计数据、活动范围、巩固测量和根据手臂、肩膀和手的快速残疾(Quick DASH)功能量表的功能结果。7例高能损伤导致开放性复杂肱骨近端骨折(Gustilo & Anderson III A-B或Neer III或IV)的男性患者接受了外固定和关节分离手术治疗。中位年龄21.0(19-24)岁，平均治疗时间5.6(4-7)个月，所有患者均完成了15个月的随访。平均术后主动活动测量屈曲80°(40°-120°)，外展85.7°(40°-130°)，外旋24.7°(10°-45°)，内旋23.6°(10°-45°)。术后疼痛视觉模拟评分平均为2.7 (1-4)，Quick DASH平均为36.2(15.9-58)。术后出现并发症2例，感染和骨炎各1例。高能外伤所致复杂开放性肱骨近端骨折经关节分离经关节外固定治疗短期和中期效果良好，并发症发生率低，术后疼痛水平低，功能效果中等。这种外固定技术似乎是治疗肱骨损伤多发创伤患者的有效选择。必须进行更长时间的随访和更大样本量的研究，以更好地描述临床和满意度结果。

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来源期刊

Burns & Trauma 医学-皮肤病学

CiteScore

8.40

自引率

9.40%

发文量

186

审稿时长

6 weeks

期刊介绍： The first open access journal in the field of burns and trauma injury in the Asia-Pacific region, Burns & Trauma publishes the latest developments in basic, clinical and translational research in the field. With a special focus on prevention, clinical treatment and basic research, the journal welcomes submissions in various aspects of biomaterials, tissue engineering, stem cells, critical care, immunobiology, skin transplantation, and the prevention and regeneration of burns and trauma injuries. With an expert Editorial Board and a team of dedicated scientific editors, the journal enjoys a large readership and is supported by Southwest Hospital, which covers authors'' article processing charges.