Konservatif takip edilen ileri yaş proksimal humerus kırıklı hastaların fonksiyonel sonuçlarının değerlendirilmesi

Year 2020, , 1173 - 1176, 01.12.2020

Emre Çalışal

https://doi.org/10.28982/josam.823298

Abstract

Amaç: Literatürde radyolojik veriler ile klinik sonuçlar arasındaki bilgiler sınırlı ve tartışmalıdır. Konservatif tedavi edilen inkomplet proksimal humerus kırığı olan ileri yaş hastalarda radyolojik veriler ile fonksiyonel sonuçlarının kısa-orta dönem sonuçlarını incelemeyi amaçladık.
Yöntem: Çalışmamıza, konservatif olarak tedavi edilen, tek taraflı izole, inkomplet proksimal humerus kırığı tanısı almış 65 yaş üstü 114 hasta dahil edildi. Tüm hastaların demografik özellikleri, radyolojik verileri ve klinik skorları kaydedildi. Kırıklar Neer sınıflamasına göre sınıflandırıldı. Fonksiyonel sonuçların değerlendirmesi Quick-Disabilities of Arm, Shoulder, and Hand (Quick-DASH) ve Visual Analog Scale (VAS) ile yapıldı.
Bulgular: Hastaların VAS skorları ortalama 3,6 (1,4) ve Quick-DASH skorları ise 34,5 (13,7) idi. VAS ve Quick-DASH skorlarındaki fark sırasıyla kırığın parça sayısı arttıkça istatistiksel olarak anlamlıydı (P=0,02, P=0,04). VAS ve Quick-DASH skorları, kadınlarda sırasıyla istatistiksel olarak anlamlı daha yüksekti (P=0,02, P=0,03). Sigara içen grupta VAS ve Quick-DASH skorları sırasıyla istatistiksel olarak anlamlı değildi(P=0,58, P=0,41). VAS ve Quick-DASH skorları, diyabet ve osteoporozlu hasta grubu lehine sırasıyla istatistiksel olarak anlamlıydı (P<0,001, P=0,39).
Sonuç: Tam deplasmanı olmayan 65 yaş üstü humerus proksimal kırıklı hastaların konservatif takip sonrası ağrı ve fonksiyonel sonuçlar çoğu hastada iyidir. Bu nedenle ileri yaş proksimal humerus kırıklı hastalarda konservatif tedavi kırık tipinden bağımsız olarak bir seçenek olabilir.

Keywords

Proksimal Humerus Kırıkları, Konservatif Tedavi, İleri Yaş Hastalar

An evaluation of functional outcome in elderly patients with proximal humeral fractures treated conservatively

Abstract

Aim: The relationship between radiological data and the clinical outcomes in elderly patients with incomplete proximal humeral fractures treated conservatively is limited and controversial in the literature. We aimed to report the short-to-mid-term results of the radiological data and functional outcome in these patients.
Methods: A total of 114 patients over 65 years of age, diagnosed with unilateral isolated incomplete proximal displaced humerus fractures, and treated conservatively, were recruited in the study. Demographic characteristics, radiological data and clinical scores of all patients were recorded. Fractures were classified according to the Neer classification. Functional evaluation of patients was performed via Quick-Disabilities of Arm, Shoulder, and Hand (Quick-DASH) and Visual Analog Scale (VAS).
Results: Mean VAS and Quick-DASH scores of the patients were 3.6 (1.4) and 34.5(13.7), respectively, both of which changed significantly as the number of the parts of fracture increased (P=0.02 and P=0.04, respectively). The VAS and the Quick-DASH scores were significantly higher in females (P=0.02 and P=0.03, respectively), similar among the smokers (P=0.58 and P=0.41, respectively), and significantly higher in diabetic and osteoporotic patients (P<0.001 and P=0.39, respectively).
Conclusion: Functional outcomes after conservative follow-up in patients over 65 years of age with incomplete proximal humerus fractures are good in most patients. Therefore, conservative treatment can be an option regardless of the fracture type in elderly patients with incomplete proximal humeral fractures.

Keywords

Proximal humerus fractures, Conservative Treatment, Elderly Patients

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