对于移位的关节内骨折的手术与非手术干预
Sharon R Lewis1, Michael W Pritchard1, Joshua L Solomon2
1Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK.
The Cochrane database of systematic reviews
|November 7, 2023
概括
移位骨折的手术治疗可以改善功能和减少疼痛,但会增加并发症的风险. 需要进一步的研究来证实这些发现,并评估新的外科手术技术.
科学领域:
- 整形外科手术 整形外科手术
- 创伤学 创伤学 创伤学
- 基于证据的医学基于证据的医学.
背景情况:
- 骨 (骨) 骨折占所有骨折的高达2%,通常是由于从高处摔倒而产生的,影响年轻人.
- 移位的关节内骨折的最佳管理仍然不确定,有手术和非手术的选择可用.
- 本综述是2013年首次发表的前一期科克兰综述的更新,该综述解决了治疗疗效的临床不确定性.
研究的目的:
- 为了比较手术与保守治疗对移位的关节内骨折的好处和危害.
主要方法:
- 随机对照试验 (RCT) 和准RCT的系统审查和元分析.
- 包括的研究比较了手术干预 (例如,ORIF) 与非手术管理 (例如,造).
- 评估结果包括功能,疼痛,生活质量,恢复活动和并发症.
主要成果:
- 手术管理可以改善功能 (AOFAS得分) 并在受伤后6-24个月减少慢性疼痛.
- 手术治疗也可能提高身体健康相关的生活质量.
- 恢复工作的证据和需要二次亚关节形的证据几乎没有差异;然而,手术风险包括表面感染和需要切除植入物.
结论:
- 由于研究设计的局限性和小样本大小,证据的确定性很低,这影响了对研究结果的信心.
- 手术治疗对功能和疼痛有潜在的益处,但可能会增加意外重复手术的风险.
- 需要高质量的研究,特别是对最少的侵入性技术,以澄清这些骨折的最佳治疗策略.
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