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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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整体肘部关节整形术 (TEA) 对于患有类风湿性关节炎或远部腰椎骨折的老年患者来说是一个可行的选择. 最近的文献表明,与其他手术方法相比,相对有利的生存率和功能结果.

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科学领域:

  • 整形外科手术 整形外科手术
  • 类风湿病学 类风湿病学
  • 生物医学工程 生物医学工程

背景情况:

  • 全肘关节整形术 (TEA) 越来越多地用于管理复杂的肘部疾病.
  • 适应症包括类风湿性关节炎 (RA) 和远端骨骨折 (DHFs),特别是在老年人群中.

研究的目的:

  • 审查和综合最近 (2022年) 关于TEA的疗效和结果的文献.
  • 将TEA与其他治疗方法进行比较,例如开放式减缩和内部固定 (ORIF) 和远部部副关节整形 (DHH).
  • 评估在TEA后对周围假肢关节感染 (PJI) 的不同手术策略的成功率.

主要方法:

  • 对2022年出版的近期文学作品进行叙述性回顾.
  • 对TEA与ORIF和DHH的比较研究和结果数据的分析.
  • 对各种手术干预的周围假肢关节感染 (PJI) 根除率的审查.

主要成果:

  • 80岁以上的年龄不是TEA的禁忌.
  • 估计的10年生存率:与TEA相关的92%;与TEA无关的84%.
  • 与老年 DHF 的 ORIF 相比,TEA 显示出优异的曲/延伸弧,较低的重复操作,以及较低的肘部硬率.
  • 在65岁以上的人群中,DHH表现出非可重建DHF的运动范围比TEA更好,不良事件发生率相似.
  • PJI的根除率:69-76% (两阶段),71% (切除关节塑造),67% (一阶段),58% (DAIR),40% (肘部关节切除).

结论:

  • TEA是一种安全有效的程序,具有良好的长期存活率,即使在八十岁的年轻人中也是如此.
  • 对于患有大肠炎的老年患者来说,TEA比ORIF具有显著的功能优势.
  • 虽然DHH可能为特定的DHF病例提供更好的ROM,但不良事件发生率与TEA相当.
  • 两阶段的修复和切除关节整形显示了PJI根除的最高成功率.