Guo-Wei Rong | PubMed Health

PubMed2004

[Percutaneous pinning for the treatment of proximal humerus fractures].

OBJECTIVE: The indication, surgical techniques and results had been discussed through clinical analysis of percutaneous pinning for the treatment of proximal humerus fractures. METHODS: Forty-nine patients with 49 shoulders treated with percutaneous pinning had been reviewed with a mean follow-up period of 16.9 months. All were acute fractures, with a mean age of 40.4 years. There were 39 2-part surgical neck fractures, 6 impacted 2-part greater tuberosity fractures and 4 valgus-impaction 4-part fractures. SST (Simple Shoulder Test) questionnaire, ASES (American Shoulder & Elbow Surgeon) score, Constant-Murley score and UCLA score had been adopted for final evaluation at the latest follow-up. RESULTS: The mean ASES score was 91.4, the mean VAS score was 1.7, the mean forward flexion was 146.7 degrees, external rotation 39.6 degrees, internal rotation at T(8)-T(9) level; the mean Constant-Murley score was 88.2; the mean UCLA score was 31.2; the mean number of questions for "yes" in SST questionnaire was 10.1. All fractures healed with a mean period of 8.8 weeks. No patient had been found for any evidence of humeral head necrosis at the latest follow-up The total satisfaction rate for pain relieve was 95.9% (47/49), and for functional recovery was 91.8% (45/49). CONCLUSIONS: Most 2-part surgical neck fractures, impacted 2-part greater tuberosity fractures and 4-part valgus-impaction fractures are good indications for percutaneous pinning. With appropriate and intense rehabilitation, satisfactory results can be expected in percutaneous pinning for the treatment of certain types of proximal humerus fractures.

Adolescent↗

PubMed2004

[Hinged external fixator in elbow trauma management].

OBJECTIVE: To introduce a new way of treatment for elbow stiffness and instability. METHODS: 30 cases of elbow trauma were treated with mobile hinged Orthofix elbow fixator, 26 of them were followed up. There are 15 male patients and 11 female patients. The average age is 32.6 years old. The 26 injured elbows involved 12 cases on left side and 14 cases on right side; Sixteen cases on the dominant side and 10 cases on the non-dominant side. Sixteen cases had elbow stiffness, 5 cases had acute radial head fracture and posterior dislocation of the elbow, 3 of cases had Monteggia's fracture dislocation, and 2 cases had neglected posterior dislocation of the elbow. RESULTS: The average follow up time was 6 months (3 - 12 month). The mean time of fixation with fixator was 8.5 weeks (6 - 11 weeks). The mean ROM of the 16 cases of elbow stiffness was (37.5 +/- 0.8) degrees before operation, and (96.5 +/- 0.6) degrees operation, with a significant difference (P < 0.05). The mean Mayo elbow score was (69.5 +/- 1.7) before operation, compared with (82.8 +/- 1.6) after operation, with a significant difference (< 0.05). For the other 10 cases (5 cases with acute radial head fracture and posterior dislocation of the elbow, 3 cases with Monteggia's fracture dislocation, 2 cases with neglected posterior dislocation of the elbow), the average ROM of the elbow flexion-extension was 95 degrees (65 degrees - 150 degrees ); The average range of flexion was 117 degrees; the average loss of extension was 22 degrees; the average pronation was 76 degrees (20 degrees - 90 degrees ), the average supination was 75 degrees (15 degrees - 90 degrees ). Nine of the cases achieved anatomic reduction and proved by X-ray. The mean Mayo elbow score was 84 (49 - 96). Three cases were rated excellent, 4 good, 2 fair and 1 poor. The rate of excellent and good was 70% (7/10). Nine cases had no pain or mild pain, and did not need analgesic. Eight cases returned to their former work, 5 of the cases had complications. CONCLUSIONS: The mobile hinged elbow external fixator have following advantages: (1) distraction of the articular space and enhance fracture healing; (2) allow early movement of the elbow during healing; (3) provide stable environment for the healing after arthrolysis and reconstruction. Mobile hinged elbow external fixator can achieve successful result in the treatment of elbow stiffness or unstable fracture dislocation of elbow.

Adolescent↗