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双肩肌转移的长头对于巨大的和无法修复的旋转手套撕裂:一个系统的审查和元分析
Ren-Wen Wan1, Zhi-Wen Luo1, Yi-Meng Yang1
1Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
World journal of orthopedics
|December 11, 2023
概括
使用双肩肌长头 (LHBT) 转移的上层囊重建是大规模不可修复的旋转手套撕裂 (MIRCTs) 的可靠技术. 这种方法改善了运动范围,并减少了与其他治疗方法相比的滞后率.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 运动医学 运动医学
背景情况:
- 大规模和无法修复的旋转带撕裂 (MIRCTs) 在整形外科手术中构成了重大挑战.
- 使用长头双肩肌 (LHBT) 转移的上层囊重建 (SCR) 已成为MIRCTs的潜在治疗方法.
- 然而,关于这种技术的生物力学和临床结果的全面数据有限.
研究的目的:
- 系统地审查生物力学结果,并对MIRCT中LHBT转化临床结果进行元分析.
- 与传统的SCR和其他手术方法相比,评估LHBT转移的有效性和安全性.
- 提供基于证据的见解,了解LHBT转移在治疗复杂旋转手腕病理方面的有用性.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆进行了系统的电子数据库搜索.
- 对关节力学和稳定性相关的关键发现进行了生物力学研究的评估.
- 五项涉及253名患者的临床研究被纳入了元分析,以评估临床结果.
主要成果:
- 生物力学研究表明,在不限制运动范围 (ROM) 的情况下,改善了下接触压力和防止了部上部迁移.
- 分析显示,在LHBT转移后,ROM (向前曲,外侧旋转) 和骨角距离 (AHD) 显著改善.
- 与其他MIRCT手术方法相比,LHBT转换组显示了显著降低的回复率.
结论:
- 使用LHBT转换的SCR是MIRCTs的可靠,经济的技术,提供了改善的生物力学和临床结果.
- 该技术提供了可比的功能分数,增强的ROM,改进的AHD和较低的回归率,而不是传统的SCR和其他成熟的方法.
- 需要进一步进行高质量的随机对照试验,以验证SCR与LHBT转移的长期结果.
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