Posttraumatic elbow agility and reduction of muscle force after intra-articular distal fractures of the humerus in adults

Autor:	Lars Eden, Hendrik Jansen, Rainer H. Meffert, Sönke Percy Frey, Timo M. Heintel
Rok vydání:	2019
Předmět:	musculoskeletal diseases Adult Male medicine.medical_specialty Humeral Fractures Intra-Articular Fractures Humerus fracture medicine.medical_treatment Elbow Biomedical Engineering Biophysics Health Informatics Bioengineering Isometric exercise Risk Assessment Biomaterials Cohort Studies Fracture Fixation Internal Injury Severity Score Elbow Joint medicine Humans Humerus Muscle Strength Range of Motion Articular Reduction (orthopedic surgery) Aged Retrospective Studies Postoperative Care business.industry Recovery of Function Middle Aged musculoskeletal system medicine.disease Prognosis Surgery medicine.anatomical_structure Heterotopic ossification Female Range of motion business Complication Elbow Injuries Information Systems
Zdroj:	Technology and health care : official journal of the European Society for Engineering and Medicine. 27(4)
ISSN:	1878-7401
Popis:	BACKGROUND Treatment of distal intra-articular humerus fractures is still a technical challenge. Until now, little is known about the regain of strength and elbow agility after surgical treatment of these fractures. Due to small collectives there is only limited data. OBJECTIVE Investigation of regained strength and elbow agility in patients with intra-articular distal humerus fractures. METHODS A total of 28 patients were treated with distal intra-articular humerus fractures followed up for an average period of 62.3 months. The following parameters were examined: Arthrosis, heterotopic ossification, functional outcome (MEPS, DASH score, LES) and isometric strength of the elbow in extension and flexion was tested in 30∘, 60∘ and 90∘ in a custom-made positioning device. RESULTS There was a high complication rate with 32%. At the 60th month post injury, range of motion (ROM) of the elbow was 114∘ with a reduction of 32∘ compared to the contralateral uninjured side (p< 0.001). The highest reduction was seen in extension with an average loss of 16∘ (p< 0.001). Loss of motion correlated with the fracture severity regarding the AO-classification (r= 0.54, p< 0.01). The average regained muscle force was 81.5% in flexion and 92% in extension in comparison to the contralateral healthy side. Patients over 60 years had less range of motion and inferior results in the DASH score compared to younger patients. CONCLUSIONS Functional impairment in terms of reduced ROM and muscle force is a common complication after distal intra-articular humerus fracture. Patients over 60 years have a higher deficit of motion in the injured elbow joint and an inferior clinical outcome. Superiority of modern angle-stable implants could yet not be shown.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ccd34e7afe3fe4cf07c84b2ce7842afe https://pubmed.ncbi.nlm.nih.gov/31033473 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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