LONG-TERM RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH PROXIMAL HUMERUS FRACTURE

Autor: M.V. Gasko, P.Ye. Kovalchuk, I.G. Biryuk, I.L. Kukovska, D.M. Gasko
Rok vydání: 2023
Předmět:
Zdroj: Clinical and experimental pathology. 21
ISSN: 2521-1153
1727-4338
DOI: 10.24061/1727-4338.xxi.4.82.2022.07
Popis: The aim of the study – evaluation of the surgical treatment effectiveness of fractures inthe proximal metaepiphysis of the humerus, the analysis and generalization of the surgerylong-term results of the surgical intervention.Materials and methods. The study has examined and analyzed the results of surgicaltreatment of the proximal humerus fractures in 76 patients who were treated in thetraumatology department of the regional municipal institution «Chernivtsi EmergencyHospital» in the period from 2015-2020. The average age of patients was 52 years old.The results of treatment were evaluated clinically, radiologically and by questionnaire(according to the QuickDASH scale) for 1 year after osteosynthesis. In order toeliminate the influence of individual, age and gender factors, the results of treatmentof the injured limb were compared with the function of a healthy limb of the patient.The QuickDASH scale (brief scale for assessing the inability to use the upper limb)consists of 11 questions that are offered to the patient. The answer to each questionis rated from 0 (best result) to 5 (worst). Using a special formula, the total result iscalculated, which can range from 0 (no violations) to 100 (complete inability to usethe limb). The QuickDASH scale is a brief version of the DASH scale that retains therepresentativeness of the full version.Results. It has been established that the choice of different methods of surgicalinterventions for fractures of the proximal humerus requires consideration of variousfactors, including the patient’s age, type of fracture, the presence of comorbidities,osteoporosis and the patient’s social needs. It has been shown that the long-termconsequences of surgical interventions may also be due to those factors. A methodfor ensuring stable fixation of fragments, which involves holding the spokes throughthree points: acromion-bone fragment- distal metaepiphysis of the humerus, has beenproposed and described.Conclusions. The tactics of surgical treatment of patients with the proximal humerusfractures depends on many factors, including: type of fracture, age of the patient, thepresence of comorbidities, the presence of osteoporosis and social needs of the patient.Closed reposition under the control of EOA (Electron- optical X-ray image amplifier) andfixation with needles allows to improve the results of treatment and reduce the duration ofdisability. Long-term results of treatment of patients with the proximal humerus fractureshave shown that closed reposition and fixation of fractures with needles leads to bettertreatment results compared to bone osteosynthesis.
Databáze: OpenAIRE