Emergency versus delayed definitive management of open distal humeral fractures of Gustilo typesⅠ&Ⅱ
10.3760/cma.j.issn.1671-7600.2018.12.001
- VernacularTitle:一期清创内固定与延迟分期手术治疗GustiloⅠ、Ⅱ型肱骨远端骨折的比较研究
- Author:
Chen CHEN
1
;
Ting LI
;
Xieyuan JIANG
;
Maoqi GONG
;
Yejun ZHA
Author Information
1. 100035,北京积水潭医院创伤骨科
- Keywords:
Elbow;
Humeral fractures;
Fractures,open;
Fracture fixation,internal;
De-bridement
- From:
Chinese Journal of Orthopaedic Trauma
2018;20(12):1013-1019
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical outcomes between emergency and delayed definitive management of open distal humeral fractures of Gustilo types ofⅠ& Ⅱ. Methods A retrospective study was conducted of the 24 patients who had been treated at Department of Orthopaedic Trauma, Beiiing Jishuitan Hospital from January 2013 to June 2017 for open distal humeral fractures of Gustilo types Ⅰ& Ⅱ. Of them, 8 received irrigation, debridement and definitive open reduction and internal fixation in the emergency oper-ation room; the other 16 received only irrigation, debridement and wound suture for the emergency manage-ment and their definitive open reduction and internal fixation was delayed until recovery of their soft tissues. The 2 groups were compared in terms of elbow range of motion, visual analogue scale ( VAS ) , Mayo Elbow Performance Score ( MEPS ) , Quick Disabilities of the Arm, Shoulder and Hand, ( QuickDASH ) , complica-tions and reoperations at the last follow-up. Results All the patients were followed up for more than one year; the average follow-up time was 40.5 months for the emergency treatment group and 30.9 months for the delayed treatment group. There were no significant differences between the 2 groups regarding elbow range of motion, VAS [ 0 ( 0, 1.0 ) versus 0 ( 0, 2.0 ) ] , MEPS [ 95.00 ( 85.00, 100 ) versus 90.00 ( 80.00, 98.75 ) ] , or QuickDASH [ 7.96 ( 2.84, 14.77 ) versus 3.41 ( 0, 13.64 ) ] ( P ＞ 0.05 ). The 2 groups also had similar rates of complications and reoperations. Conclusions Both emergency and staged definitive management can lead to satisfactory clinical outcomes for open distal humeral fractures of Gustilo types ofⅠ&Ⅱ. A proper treatment method should depend on the experience of surgeons concerned and the local and general conditions of the patient.
