在可怕的三角损伤中对冠状体过程骨折的不同治疗方法的比较:一个多中心的随机对照研究
Shengdi Lu1, Yanmao Wang1, Biyu Rui1
1Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
International orthopaedics
|June 20, 2023
概括
这项研究比较了在可怕的三角形损伤中对冠状体过程骨折的三种治疗方法. 所有方法都产生了类似的长期功能结果,外部固定显示了早期疼痛和曲的好处.
科学领域:
- 整形外科手术 整形外科手术
- 创伤外科 手术 创伤外科
- 肘部的重建 肘部的重建
背景情况:
- 严重的三合体损伤 (TTI) 涉及复杂的肘部不稳定性.
- 冠状体过程骨折是TTI的关键组成部分,显著影响肘部功能.
- 在TTI中冠状体过程骨折的最佳手术管理仍在争论中.
研究的目的:
- 为了比较三个不同的手术治疗的功能结果,在患者的冠状体过程骨折的三个不同的手术治疗可怕的三合体损伤.
- 评估内部固定,外部固定和石膏造用于冠状腺过程骨折管理的有效性.
主要方法:
- 在中国的七个1级创伤中心进行了前性随机对照试验.
- 患者被随机分为三个组:ORIF (内部固定),Exfix (外部固定) 和Plaster (长臂造).
- 早期的活跃运动是在手术后开始的,结果在12个月内进行评估.
主要成果:
- 分析了65名患者,在所有组中,肘部运动和前臂旋转的弧度相似.
- 三个治疗组的Mean Mayo Elbow Performance Score (MEPS) 和手臂,肩膀和手的残疾 (DASH) 分数在三个治疗组中是相似的.
- 在12个月的随访期间,没有观察到整体功能恢复的显著差异.
结论:
- 所有三个手术方法 (ORIF,外部固定,石膏造) 在TTI冠状体过程骨折方面都表现出类似的长期功能结果.
- 没有内部固定的外部固定显示了减少早期疼痛和更快地达到最大屈曲的优势.
- 治疗的选择可能会根据患者特定的因素和外科医生的偏好,考虑到可比的长期结果.
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