Resultados preliminares da osteossíntese com haste de Ender, por meio da técnica percutânea nas fraturas diafisárias do úmero nos adultos / Preliminary results from osteosynthesis using Ender nails by means of a percutaneous technique, in humeral diaphysis fractures in adults

Demonstrar os resultados clínicos e funcionais do tratamento da fratura diafisária de úmero com uso das hastes de Ender. MÉTODOS: Foram avaliados 18 pacientes submetidos à osteossíntese da fratura diafisária de úmero com uso da haste de Ender. Além das avaliações clínicas e radiográficas, os pacientes com no mínimo um ano de seguimento foram avaliados pelos escores funcionais de Constant, American Shoulder and Elbow Surgeons (Ases), Mayo Clinic, Simple Shoulder Value (SSV) e quanto ao grau de satisfação com o resultado final. A técnica de fixação usada foi por via anterógrada e percutânea. RESULTADOS: Todos os pacientes obtiveram consolidação da fratura, com média de 2,9 meses (variação de dois a quatro). A média do Score de Constant foi de 85,7 (variação de 54-100) e a do ASES de 95,9 (variação de 76-100) e todos obtiveram pontuação máxima pelo escore Mayo Clinic. CONCLUSÃO: A fixação das fraturas diafisárias do úmero com o uso da haste de Ender pela técnica percutânea demonstrou ser um método com resultados preliminares promissores.

To demonstrate the clinical and functional results from treatment of humeral diaphysis fractures using Ender nails. METHODS: Eighteen patients who underwent osteosynthesis of humeral diaphysis fractures using Ender nails were evaluated. In addition to the clinical and radiographic evaluations, patients with a minimum of one year of follow-up were assessed by means of the Constant, American Shoulder and Elbow Surgeons (ASES), Mayo Clinic and Simple Shoulder Value (SSV) functional scores, and in relation to the degree of satisfaction with the final result. The fixation technique used was by means of an anterograde percutaneous route. RESULTS: All the patients achieved fracture consolidation, after a mean of 2.9 months (ranging from 2 to 4 months). The mean Constant score was 85.7 (ranging from 54 to 100) and the mean ASES score was 95.9 (ranging from 76 to 100). All the patients achieved the maximum score on the Mayo Clinic scale. CONCLUSION: Fixation of humeral diaphysis fractures using Ender nails by means of a percutaneous technique was shown to be a method with promising preliminary results.

Effect of minimally invasive percutaneous plates versus interlocking intramedullary nailing in tibial shaft treatment for fractures in adults: A meta-analysis

OBJECTIVE: The aim of this article was to determine the effects of minimally invasive percutaneous plates versus interlocking intramedullary nailing in the treatment of tibial shaft fractures in adults. METHOD: Literature searches of the Cochrane Library, PubMed, EMBASE, the Chinese Biomedical Literature database, the CNKI database, Wanfang Data, and the Weipu Journal database were performed up to August 2013. Only randomized and quasi-randomized controlled clinical trials comparing the use of percutaneous plates and interlocking intramedullary nails for tibial shaft fractures were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. RESULTS: Eleven trials were included. Compared with interlocking intramedullary nailing, minimally invasive percutaneous plates shortened fracture healing time and resulted in lower rates of postoperative delayed union and pain. There was no significant difference between the two methods with regard to the rates of excellent and good Johner-Wruh scoring, the rate of reoperation, and other complications. CONCLUSIONS: Overall, insufficient evidence exists regarding the effects of minimally invasive percutaneous plates versus interlocking intramedullary nailing in the treatment of tibial shaft fractures in adults. Low-quality evidence suggests that minimally invasive percutaneous plates could shorten fracture healing time, decrease the rate of postoperative delayed union, and decrease pain levels compared with interlocking intramedullary nailing. There is no significant difference between the two groups in terms of functional recovery scores, reoperation, and other complications. Further research that includes high-quality randomized controlled, multicenter trials is required to compare the effects of minimally invasive percutaneous plates versus interlocking intramedullary nailing in the treatment of tibial shaft fractures in adults. .