避免螺丝过长使用背部地平线视图在手掌板骨质合成远半径骨折:一个潜在的随机试验
Markus Lill1,2, Thomas Schauer3, Philipp Schultes3
1Praxisgemeinschaft Unfallchirurgie, Bruneckerstrasse 2E, 6020, Innsbruck, Austria. markus.lill@unfall.cc.
Archives of orthopaedic and trauma surgery
|September 19, 2023
概括
背部地平线视图在远半径骨折手术中显著减少背部螺丝穿透. 这种技术改善了螺丝长度评估,最大限度地减少了延伸肌破裂等并发症.
科学领域:
- 整形外科手术 整形外科手术
- 放射学 放射学是一门学科.
- 手术并发症 手术并发症
背景情况:
- 距离半径骨折在成年人中很常见,通常用手掌板固定治疗.
- 背面螺丝穿透是已知的并发症,可能导致二次延伸肌破裂.
- 当前的手术内成像可能不准确地评估背部螺丝的长度在碎碎的骨折.
研究的目的:
- 评估背部地平线视图在远半径骨折固定过程中防止背部螺丝穿透的有效性.
- 为了比较螺丝长度评估的准确性,使用标准与背部地平线视图.
主要方法:
- 一项前性随机试验,涉及40名患有远端半径骨折的患者.
- 患者被分为一个标准组 (AP和横向视图) 和一个地平线组 (AP,横向和背部视图).
- 在手术期间使用螺丝变换和术后CT扫描来测量螺丝长度和评估透度.
主要成果:
- 与标准组 (20/18名患者) 相比,地平线组的穿孔螺丝显著减少 (11/22名患者) (p=0.02).
- 虽然地平线组需要更多的手术内螺丝更换 (42个螺丝),但这反映了手术内评估的改进.
- 术后CT证实了地平线组的螺丝透率降低.
结论:
- 背部地平线视图增强了对距离半径骨折的手掌板骨质合成中螺丝长度的评估.
- 建议经常使用背部地平线视图,以尽量减少背部螺丝透.
- 单层钻孔或螺丝缩小仍然是防止突起的必要条件.
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