دورية أكاديمية
Utilization of axillary brachial plexus block in the postoperative rehabilitation of intra-articular fractures of the distal humerus.
| العنوان: | Utilization of axillary brachial plexus block in the postoperative rehabilitation of intra-articular fractures of the distal humerus. |
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| المؤلفون: | Aksoy SM; Department of Anesthesiology and Reanimation, Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara. drsmaksoy@yahoo.com, Izdeş S, Kömürcü M, Bozkurt M, Başbozkurt M |
| المصدر: | Acta orthopaedica et traumatologica turcica [Acta Orthop Traumatol Turc] 2010; Vol. 44 (2), pp. 111-6. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Turkish Association of Orthopaedics and Traumatology with publishing services by AVES Country of Publication: Turkey NLM ID: 9424806 Publication Model: Print Cited Medium: Internet ISSN: 2589-1294 (Electronic) Linking ISSN: 1017995X NLM ISO Abbreviation: Acta Orthop Traumatol Turc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2020>-: [Ankara, Turkey] : Turkish Association of Orthopaedics and Traumatology with publishing services by AVES Original Publication: İstanbul : Türk Ortopedi ve Travmatoloji Derneği |
| مواضيع طبية MeSH: | Elbow Joint/*diagnostic imaging , Humeral Fractures/*surgery, Adult ; Bone Plates ; Elbow Joint/surgery ; Exercise ; Female ; Fracture Fixation, Internal/methods ; Humans ; Humeral Fractures/classification ; Humeral Fractures/diagnostic imaging ; Humeral Fractures/rehabilitation ; Humerus/diagnostic imaging ; Humerus/surgery ; Male ; Middle Aged ; Osteotomy/methods ; Postoperative Period ; Radiography ; Range of Motion, Articular ; Plastic Surgery Procedures/methods ; Treatment Outcome ; Young Adult |
| مستخلص: | Objectives: An effective rehabilitation program is essential to prevent joint stiffness and regain range of motion after surgical treatment of intra-articular fractures of the distal humerus. We evaluated the effect of a physiotherapy program on functional results, that involved passive resistive stretching exercises performed under axillary brachial plexus block after radiographic observation of bone union of intra-articular fractures of the distal humerus treated with open reduction and internal fixation. Methods: The study included 21 patients (7 females, 14 males; mean age 34+/-5 years; range 21 to 57 years) who underwent open reduction and internal fixation for intra-articular fractures of the distal humerus. All the patients had closed fractures. Six patients had AO type C1, six patients had C2, and nine patients had C3 fractures. Surgical treatment consisted of a posterior incision, olecranon osteotomy, and fixation of the metaphyseal fragments using two reconstruction plates placed medially and laterally. Active range of motion exercises were started on the third postoperative day. To prevent early development of heterotopic ossification, passive range of motion exercises were avoided. Active stretching exercises were initiated three weeks after surgery. Upon radiographic observation of bone union, axillary brachial plexus block was performed. The physiotherapy program involved passive stretching exercises during nerve block, and active weight exercises after recovery from motor block. The catheter remained in the axillary region for three months, during which functional rehabilitation was continued 2-3 times a week on an outpatient basis. Functional results were evaluated according to the criteria of Jupiter et al. after a mean follow-up period of 31 months (range 24 to 46 months). Results: All fractures united within a mean of 11.9 weeks (range 9 to 17 weeks) except for one type C3 fracture. Functional results were excellent in 10 patients (47.6%), good in eight patients (38.1%), moderate in two patients (9.5%), and poor in one patient (4.8%). Two patients with a moderate outcome had associated multiple fractures in the ipsilateral extremity. Distribution of the functional results according to the type of fractures were 4 excellent, 2 good in type C1; 4 excellent, 2 good in C2; and 2 excellent, 4 good, 2 moderate, and 1 poor in C3 fractures. The mean loss of elbow extension was 16 degrees. The mean elbow flexion, pronation, and supination were measured as 131 degrees, 90 degrees, and 75 degrees, respectively. None of the patients had nonunion at the olecranon osteotomy site, superficial or deep infection, or heterotopic ossification. Three patients developed transient ulnar nerve neuropraxia that resolved spontaneously during the follow-up period. There were no complications related to axillary catheterization. Conclusion: Following surgical treatment of intra-articular fractures of the distal humerus, a regular and pain-free physiotherapy program performed under axillary brachial plexus block on an outpatient basis increases patient compliance and enables early return to daily activities. |
| تواريخ الأحداث: | Date Created: 20100803 Date Completed: 20101116 Latest Revision: 20221207 |
| رمز التحديث: | 20221213 |
| DOI: | 10.3944/AOTT.2010.2128 |
| PMID: | 20676012 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2589-1294 |
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| DOI: | 10.3944/AOTT.2010.2128 |