Fractures diaphysaires des deux os de l’avant-bras chez l’adulte : une comparaison clinique et biomécanique de quatre ostéosynthèses distinctes - 02/05/16
Adult diaphyseal both-bone forearm fractures: A clinical and biomechanical comparison of four different fixations
Abstract |
Background |
Although there have been a small number of studies reporting single bone fixation of either radius or ulna as well as hybrid fixation, the paucity of data for the hybrid fixation method still remains.
Hypothesis |
Hybrid fixation with plate and IM nailing would achieve good fixation and functional outcome, minimal damage to soft tissues and lower re-fracture risk.
Materials and methods |
Forty cadavers (20 males, 20 females; mean age: 68.06, SD: 1.58 years) were selected in biomechanical study under axial loading, bending loading, and torsional loading. Eighty-seven patients (47 males, 40 females; mean age: 38.03±0.88 years) were enrolled in the clinical study and randomly received different fixation: both-bone plate fixation or both-bone intramedullary nailing, plate fixation of ulna and intramedullary nailing of radius and intramedullary nailing of ulna and plate fixation of radius.
Results |
In the biomechanical study, intramedullary nailing of ulna and plate fixation of radius had similar results with that using both-bone plate method under axial, bending and torsional loading (all P>0.05), suggesting the more stable fixation compared with the other two groups (all P<0.05). In clinical research, both-bone intramedullary nailing was related to shortest operative time, smallest wound size and periosteal stripping area compared with other three groups (P<0.05). Patients receiving intramedullary nailing of ulna and plate fixation of radius showed the lowest incidence of postoperative complications and the best functional recovery outcome comparing with other three groups of patients (both P<0.05).
Conclusion |
The hybrid fixation method of intramedullary nailing of ulna and plate fixation of radius showed good stability in biomechanics, fewer complications and better functional clinical outcomes.
Level of evidence |
Level II, prospective randomised study.
Le texte complet de cet article est disponible en PDF.Keywords : Forearm fractures, Plate, Intramedullary nailing, Biomechanics, Fixation
☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 102 - N° 3
P. 241 - mai 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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