Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment
Abstract Background The purposes of this study were to investigate (1) sonographic humeral torsion (SHT) and side differences (∆SHT), and (2) to determine the relationship between SHT and range of rotational motion (RORM) as well as functional outcome scores of nonoperatively treated proximal humeru...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03671-2 |
| _version_ | 1797864119862296576 |
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| author | Sam Razaeian Jan-Niklas Menzel Dafang Zhang Christian Krettek Nael Hawi |
| author_facet | Sam Razaeian Jan-Niklas Menzel Dafang Zhang Christian Krettek Nael Hawi |
| author_sort | Sam Razaeian |
| collection | DOAJ |
| description | Abstract Background The purposes of this study were to investigate (1) sonographic humeral torsion (SHT) and side differences (∆SHT), and (2) to determine the relationship between SHT and range of rotational motion (RORM) as well as functional outcome scores of nonoperatively treated proximal humerus fractures (PHF) and humeral shaft fractures (HSF). Methods Between October 2020 and July 2021, consecutive patients with radiographically healed nonoperatively treated PHF and HSF were included in this analysis. Subjective perception of torsional side difference, correlation between SHT and RORM, Subjective Shoulder Value as well as absolute and adjusted Constant Score were determined. Degree of humeral torsional side differences were classified as follows: 0°–15°: minor; > 15°–30°: moderate; > 30°: major. Factors including gender, hand dominance, fracture type, and displacement were also assessed in order to investigate any association between these variables and ∆SHT. Results Sixty-five patients with nonoperatively treated PHF (n = 47) and HSF (n = 18) were analyzed. Mean follow-up was 13.2 months (range, 2.1–72.6). The majority (80% (52)) resulted in only minor, 15.4% (10) in moderate, and 4.6% (3) in major torsional side differences. Patients with minor or moderate torsional differences did not perceive any subjective side difference. While RORM correlated fairly to highly with functional outcomes, only very low to low correlation was observed between these measures and SHT and ∆SHT. Gender, fracture displacement, and type of fracture were not related to SHT and ∆SHT. However, significantly greater torsional side differences were observed, when the dominant side was involved (p = 0.026). Conclusion Nonoperative early functional treatment of proximal humerus and humeral shaft fractures results mainly in only minor humeral torsional side differences. Minor and moderate amounts of torsional side differences might not be perceived by patients. |
| first_indexed | 2024-04-09T22:46:25Z |
| format | Article |
| id | doaj.art-e9a31dfd8c6e497a90c060d0ec4a57df |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T22:46:25Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-e9a31dfd8c6e497a90c060d0ec4a57df2023-03-22T11:51:36ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-03-011811710.1186/s13018-023-03671-2Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessmentSam Razaeian0Jan-Niklas Menzel1Dafang Zhang2Christian Krettek3Nael Hawi4Department of Trauma Surgery, Hannover Medical SchoolHannover Medical SchoolDepartment of Orthopaedic Surgery, Brigham and Women’s HospitalHannover Humerus Registry (HHR), Traumastiftung gGmbHOrthopaedic and Surgical Clinic Braunschweig (OCP)Abstract Background The purposes of this study were to investigate (1) sonographic humeral torsion (SHT) and side differences (∆SHT), and (2) to determine the relationship between SHT and range of rotational motion (RORM) as well as functional outcome scores of nonoperatively treated proximal humerus fractures (PHF) and humeral shaft fractures (HSF). Methods Between October 2020 and July 2021, consecutive patients with radiographically healed nonoperatively treated PHF and HSF were included in this analysis. Subjective perception of torsional side difference, correlation between SHT and RORM, Subjective Shoulder Value as well as absolute and adjusted Constant Score were determined. Degree of humeral torsional side differences were classified as follows: 0°–15°: minor; > 15°–30°: moderate; > 30°: major. Factors including gender, hand dominance, fracture type, and displacement were also assessed in order to investigate any association between these variables and ∆SHT. Results Sixty-five patients with nonoperatively treated PHF (n = 47) and HSF (n = 18) were analyzed. Mean follow-up was 13.2 months (range, 2.1–72.6). The majority (80% (52)) resulted in only minor, 15.4% (10) in moderate, and 4.6% (3) in major torsional side differences. Patients with minor or moderate torsional differences did not perceive any subjective side difference. While RORM correlated fairly to highly with functional outcomes, only very low to low correlation was observed between these measures and SHT and ∆SHT. Gender, fracture displacement, and type of fracture were not related to SHT and ∆SHT. However, significantly greater torsional side differences were observed, when the dominant side was involved (p = 0.026). Conclusion Nonoperative early functional treatment of proximal humerus and humeral shaft fractures results mainly in only minor humeral torsional side differences. Minor and moderate amounts of torsional side differences might not be perceived by patients.https://doi.org/10.1186/s13018-023-03671-2Ultrasonographic humeral torsionHumeral head retroversionProximal humerus fractureNonoperative treatmentHumeral shaft fracture |
| spellingShingle | Sam Razaeian Jan-Niklas Menzel Dafang Zhang Christian Krettek Nael Hawi Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment Journal of Orthopaedic Surgery and Research Ultrasonographic humeral torsion Humeral head retroversion Proximal humerus fracture Nonoperative treatment Humeral shaft fracture |
| title | Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment |
| title_full | Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment |
| title_fullStr | Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment |
| title_full_unstemmed | Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment |
| title_short | Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment |
| title_sort | humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures clinical and ultrasonographic assessment |
| topic | Ultrasonographic humeral torsion Humeral head retroversion Proximal humerus fracture Nonoperative treatment Humeral shaft fracture |
| url | https://doi.org/10.1186/s13018-023-03671-2 |
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