在骨骨折后识别骨质死结的危险因素
Maxwell C Alley1, Heather A Vallier2, Paul Tornetta1
1Boston Medical Center, Boston, MA; and.
Journal of orthopaedic trauma
|September 22, 2023
概括
血管亡 (AVN) 影响了42%的口腔骨折患者,特别是那些部骨折或开放损伤的患者. 像吸烟和BMI这样的可改变因素显著增加了AVN的风险,强调了谨慎的手术技术.
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
- 放射学 放射学是一门学科.
背景情况:
- 血管亡 (AVN) 是一个严重的并发症,跟随口腔骨折.
- 识别与AVN相关的因素对于患者的治疗结果至关重要.
研究的目的:
- 为了确定患者,损伤和治疗因素,与AVN骨折后的AVN发展有关.
- 专门调查AVN的可修改风险因素.
主要方法:
- 来自21个美国和1个英国创伤中心的798名患有部和/或身体骨折的患者的回顾性图表审查.
- 纳入标准:至少18岁,12个月的随访或更早的AVN诊断.
- 排除标准:非手术治疗,病理性骨折,关节位移,初级关节切除/截肢.
主要成果:
- 42%的患者发生了AVN (336/798).
- 观察到较高的AVN率与部骨折 (47.0%),严重的霍金斯分类,开口骨折,较高的BMI,吸烟和特定的手术方法.
- 多变量分析确定骨折类型,吸烟,开口骨折,手术方法,年龄和BMI作为重要预测因素.
结论:
- 骨折患者有42%的AVN发病率,部骨折和开放伤害是高风险的.
- 与受伤相关的因素是AVN最强的预测因素.
- 强调解剖缩小和在手术期间保持血液供应至关重要,以尽量减少AVN风险.
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