骨不成熟的肩膀周围的骨折:一个范围审查
Tim Kraal1, Peter Aa Struijs1, Lisette C Langenberg2,3
1Department of Orthopedic Surgery and Sports Medicine, Amsterdam University Medical Centers, Amsterdam 1105 AZ, Netherlands.
World journal of orthopedics
|September 4, 2023
概括
大多数儿科肩带骨折,包括关节骨和近腰骨骨折,由于骨改造的优异性,可以通过保守的治疗来愈合. 外科手术只适用于特定的病例,如老年儿童的开放性骨折或严重的移位.
科学领域:
- 整形外科手术 整形外科手术
- 儿科整形医生 儿科整形医生
- 运动医学 运动医学
背景情况:
- 儿童的肩带骨折通常是体育伤害造成的,主要影响关节骨和近腰骨.
- 儿童具有显著的骨改造潜力,有利于大多数骨折的非手术治疗.
- 目前的指导方针缺乏在儿科肩带骨折中进行手术的明确指示.
研究的目的:
- 审查关于儿童关节骨和近腰骨骨折的治疗证据.
- 在儿科肩带骨折中划分手术与保守治疗的指示.
- 为了明确何时手术对这些伤害最有益.
主要方法:
- 关于儿科关节骨和近腰骨骨折的现有证据的文献综述.
- 基于骨折类型,位移和患者年龄的治疗结果分析.
- 确定手术管理的严格指示.
主要成果:
- 对于腹膜关节骨骨折,手术仅适用于开放骨折,皮肤缩与缩,神经血管损伤或浮动的肩膀.
- 对大多数关节骨骨折,甚至是移位骨折,保守的治疗是有效的,因为坏结合通常是无症状的.
- 靠近骨骨折的治疗取决于年龄和位移;保守的护理适用于10岁以下的人,而手术的结果改善了13岁及以上的严重位移 (Neer类型III-IV).
结论:
- 保守治疗是儿科关节骨和靠近腰骨骨折的支柱,因为它具有重塑的潜力.
- 儿科关节骨折的手术指示仅限于特定的严重并发症.
- 10-13岁儿童近端骨骨折的治疗需要仔细考虑位移和角度,随着手术指示的变化.
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