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放射性头部置换急性复杂肘部不稳定:对两种植入物设计进行长期比较队列研究

Blanca Diez Sánchez¹, Raúl Barco¹, Samuel A Antuña¹

¹Upper Limb Unit, Hospital Universitario La Paz, Madrid, Spain.

Journal of shoulder and elbow surgery

|August 24, 2023

概括

放射性头部置换 (RHR) 使用解剖压贴或松间距设计,为肘部不稳定提供了良好的长期结果. 间隔植入物提供更高的患者满意度,而解剖植入物具有更高的修订率.

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
生物医学工程生物医学工程

背景情况:

辐射头部骨折通常需要更换 (RHR),当重建是不可行的,特别是与相关的肘部或前臂不稳定性.
两种常见的RHR植入物是解剖压贴系统和松的金属间隔器,具有有限的长期比较数据.
这项研究解决了在复杂的急性肘部不稳定性中这两种RHR设计之间缺乏直接比较的问题.

研究的目的:

为了比较长期的临床和放射性结果,解剖压身与松的间隔器辐射头部置换 (RHR).
为了评估患者的满意度,疼痛和功能评分后RHR复杂的急性肘部不稳定性.
评估与每个RHR类型相关的放射性变化,如松动,骨质损失和过度填充.

主要方法:

预期跟踪95名患者 (平均年龄54岁) 接受急性RHR (46个解剖压身,49个松间距).
复杂的肘部不稳定病例的平均随访时间为61个月,包括可怕的三角形和相关骨折.
使用MEPS评估的临床结果,牛津肘部得分,DASH;通过VAS疼痛和满意度;与植入物相关的并发症的X光分析.

主要成果:

两种RHR类型之间的运动范围,疼痛缓解,MEPS,牛津或DASH得分没有显著差异.
患有间隔器RHR的患者报告了显著更高的满意度 (P=.004).
解剖学RHR显示近接骨损失 (19种植入物) 和光线线 (10种植入物) 的比率更高;间隔RHR也具有常见的光线线,但放射性变化并不总是与较差的结果相关.

结论:

解剖学和间隔器辐射头部置换 (RHR) 设计都为复杂的肘部不稳定提供了良好的长期临床结果.
间隔器RHR植入物与更高的患者满意度有关.
解剖压式RHR具有更高的修订率和有关放射变化的变化,需要持续监测.

关键词:

辐射头部置换器辐射头部置换器肘部不稳定肘部不稳定光的线条光的线条辐射头部骨折辐射头部骨折应力屏蔽应力屏蔽

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