早期与延迟手术中轴关节骨折:一个系统的审查
Peter H Sanchez1, Ignacio Garcia Fleury2, Emily A Parker1
1University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
The Iowa orthopaedic journal
|June 29, 2023
概括
与延迟手术相比,中轴关节骨折 (MCFs) 的早期手术干预显示出更好的功能结果和更低的并发症率. 建议在个性化的患者治疗计划中进行共享决策.
科学领域:
- 整形外科手术 整形外科手术
- 创伤学 创伤学 创伤学
- 基于证据的医学基于证据的医学.
背景情况:
- 移位的中轴关节骨折 (MCFs) 引发了关于最佳手术时间的争论.
- 早期手术干预与延迟治疗对功能结果和并发症率进行评估.
研究的目的:
- 系统地审查文献,比较早期与延迟的外科手术治疗移位的MCFs.
- 评估功能结果的差异,并发症率,非工会和重新手术率的差异.
主要方法:
- 在多个数据库 (PubMed,CINAHL,Embase,Sport Discus,Cochrane) 进行系统的文献搜索.
- 包括21项研究,包括早期组的1158名患者和延迟组的44名患者.
- 提取和比较早期和延迟固定群体之间的人口和结果数据.
主要成果:
- 早期手术组的手臂,肩膀和手的残疾 (DASH) 评分 (3.6比13.0) 和Constant-Murley (CM) 评分 (94.0比86.0) 显著更好.
- 延迟手术组表现出更高的并发症率 (63.6%对33.8%),非联合率 (11.4%对1.2%) 和重新手术率 (34.1%对15.8%).
- 人口统计学是相似的,尽管早期的组有更多的男性,而延迟的组有更长的时间进行手术.
结论:
- 移位MCF的早期手术管理通常会导致更好的功能结果和更少的并发症.
- 尽管早期手术的结果更好,但延迟组中适度的结果表明共享决策的作用.
- 对MCF的个性化治疗建议应考虑患者特定的因素.
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