Archive | 2021
Использование аутотрансплантата из диафиза малоберцовой кости при хирургическом лечении пациентов с переломами проксимального отдела плечевой кости на фоне критического остеопороза
Abstract
The frequency of unsatisfactory results of surgical treatment of patients with a fracture of the proximal humerus\xa0remains high and is up to 40 %. This is primarily due to the early instability of the metal structure against the background of osteoporosis and as a consequence of non-fusion of the fracture and the formation\xa0 of a false joint. The aim\xa0of the study was to evaluate the effectiveness and safety of a new surgical method for treating patients with a fracture\xa0of the proximal humerus against the background of critical osteoporosis. After the approval of the local ethics Committee, 2 groups of 10 patients were formed in the clinic: the patients of\xa0 main group were operated by the proposed\xa0method; the group of clinical comparison was operated by the standard method. In all clinical cases, fractures of the\xa0proximal humerus were consolidated on control radiographs. VAS assessment the pain syndrome in the early postoperative period showed that there were no\xa0 statistically significant differences in the shoulder joint area in the groups.\xa0Three months after surgery, when assessing the volume of movement in the shoulder joint (without the participation\xa0of the scapula), there was a statistically significant improvement in the main group: abduction – by 35° and external\xa0\xa0rotation – by 25° (p<0.05). When assessing the range of motion of the operated shoulder joint using the ASES scale, a\xa0 statistically significant improvement was observed in the main group by 11.6 points after 3 months after\xa0 surgery.\xa0According to the assessment of the patient›s functional recovery according to the DASH scale, the indicators in the main\xa0group were statistically significantly better, which indicates a complete recovery of the shoulder joint function. Thus, the\xa0use of the proposed new method, in comparison with other known technologies for surgical treatment of fractures of\xa0the proximal humerus, allows achieving a more rigid and stable fixation of bone fragments in the aftermath of trauma\xa0and the presence of regional osteoporosis.