Aims: To compare plate-screw fixation, intramedullary nailing (IMN), and titanium elastic nailing (TEN) as a new fixation method with respect to nonunion, complication rates, and functional outcomes in the repair of adult humeral shaft fractures. Methods: A total of 38 adult patients who were treated due to humeral shaft fracture at our clinic and were followed for minimum six months between January 2012 and January 2015 were retrospectively analyzed. Age, sex, fracture etiology an length of hospitalization were recorded. Fractures were classified according to the Association for Osteosynthesis(AO) classification. Nonunion rates as assessed by X-ray during visits, angulation, shoulder, elbow and hand disability scores were evaluated using the DASH, Mayo Elbow and UCLA Shoulder scoring, and Stewart Hundley criteria. Results: There was no significant epidemiological difference between the groups. The length of hospitalization was lower in the TEN group. There was no significant difference in nonunion rates and functional scores according to the type of treatment. Angulation rate was slightly higher in the TEN group. The effect of angulation on functional score showed no influence on the functional status. The three treatment types mostly achieved excellent and good outcomes. Conclusion: Our study results suggest that TEN seems to be a good alternative treatment in eligible patients with humeral shaft fractures considering complications of other treatments. However, we believe that further, large-scale, randomized-controlled, prospective studies with longer follow-up duration are required to confirm these findings and to establish a definite conclusion. Level of Evidence: Therapeutic Level III.
ÖzetDistal radioulnar eklem (DRUE), el bilek stabilitesinde rol oynayan en önemli yapılardan biridir. DRUE çıkığı atlanırsa, instabilite ile sonuçlanır. Bu da el bileği fonksiyonlarını olumsuz etkiler. Çocuklarda kırık olmadan distal radioulnar eklem çıkığı nadirdir. Cerrahi olarak tedavi edilen ve 12 ay takip edilen nadir görülen pediatrik bir vakayı sunuyoruz. Travma hikayesi olup, ağrılı önkol supinasyon ve pronasyon varlığında bu yaralanmadan şüphe etmek gerekir. Radyografi ile tanı tam doğrulanmalıdır. Kapalı redüksiyon ve perkütan Kirschner teli ile yapılan cerrahi sonrası olumlu klinik ve fonksiyonel sonuç verir. Anahtar kelimeler: Çıkık, distal radioulnar eklem, Kirschner teli, redüksiyon Surgical treatment of isolated acute dislocation of the distal radioulnar joint without fracture: A rare pediatric case report Abstract Distal radioulnar joint (DRUJ) is one of the most important structures that play a role in wrist stability. If the DRUE output is skipped, it results in instability. This affects the wrist functions negatively. It is rare for children to have distal radioulnar joint without fracture. We present a rare pediatric case treated surgically and followed for 12 months. Trauma is a story, painful forearm supination and pronation in the presence of this injury should be suspicious. The diagnosis should be confirmed by radiography. Closed reduction and percutaneous Kirschner wire make positive clinical functional results after surgery.
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