背景:节段性骨折通常是由高能或间接创伤引起的,在轴向载荷下产生弯曲或扭转力。我们评估了前臂节段骨干骨折患者的手术效果。
方法:我们回顾性分析了2013年3月至2022年3月在釜山国立大学创伤中心接受手术治疗的前臂节段性骨折患者的资料。我们还分析了伴随的伤害,损伤严重程度评分(ISS),损伤机制,开放性骨折的发生,外科技术,和治疗结果。
结果:确定了15例患者,1例前臂双侧段骨干骨折,共16例。9名患者为男性。总体平均年龄为50岁,平均随访时间为16.2个月.6例使用钢板接骨术进行手术的患者在最终随访时实现了骨愈合,而没有长度畸形。仅接受髓内钉治疗的7例患者中有3例因不愈合而接受了再次手术。6例最终随访时骨愈合,其中三个显示长度畸形。三名患者使用IM钉的混合方法进行了手术,plates,迷你电缆。一名接受钢板手术的患者和一名仅接受IM钉手术的患者显示骨不连,无法随访。
结论:钢板接骨术被认为是治疗成人前臂骨干段骨折的金标准。在这项研究中,IM钉与不愈合和长度畸形的高发生率相关。然而,IM钉和钢板-电缆系统的组合可能是节段性骨干前臂骨折的可接受替代方案。实现类似于钢板固定提供的联合率。
BACKGROUND: Segmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm
segmental diaphyseal fractures.
METHODS: We retrospectively analyzed data from patients with forearm
segmental fractures for which they underwent surgery at the Pusan National University Trauma Center from March 2013 to March 2022. We also analyzed accompanying injuries, injury severity score (ISS), injury mechanism, occurrence of open fracture, surgical technique, and treatment results.
RESULTS: Fifteen patients were identified, one with bilateral
segmental diaphyseal forearm bone fracture, for a total of 16 cases. Nine of the patients were male. The overall mean age was 50 years, and the mean follow-up period was 16.2 months. Six cases who underwent surgery using plate osteosynthesis achieved bone union without length deformity at final follow-up. Three of seven patients who underwent intramedullary nailing alone underwent reoperation due to nonunion. Six cases achieved bone union at final follow-up, three of which showed length deformity. Three patients underwent surgery using a hybrid method of IM nailing, plates, and mini cables. One patient who underwent surgery with a plate and one patient who underwent surgery with IM nailing alone showed nonunion and were lost to follow-up.
CONCLUSIONS: Plate osteosynthesis is considered the gold standard for treatment of adult forearm diaphyseal
segmental fractures. In this study, IM nailing was associated with high rates of non-union and length deformity. However, the combination of IM nailing and a plate-cable system may be an acceptable alternative in segmental diaphyseal forearm fracture, achieving a union rate similar to that provided by plate fixation.