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双边部在COVID-19后的异型骨化和长期固定:一个案例报告
Olaf N van de Langerijt1,2, Olivier Q Groot1,2, Michiel M A Janssen1
1Department of Orthopaedic Surgery, Curaçao Medical Center, Willemstad, Curaçao.
JBJS case connector
|March 14, 2024
概括
手术干预有效地恢复了COVID-19固定后严重异型骨化 (HO) 的患者的部移动性. 这一案例凸显了手术切除作为一种可行的治疗方法,用于因后不动 HO 引起的显著功能障碍.
科学领域:
- 整形外科 整形外科 整形外科
- 创伤外科 手术 创伤外科
- 类风湿病学 类风湿病学
背景情况:
- 不同类型骨化 (HO) 是长时间固定后的潜在并发症.
- 随着COVID-19大流行,固定病例增加,引发了有关HO的担忧.
- 严重的HO可导致功能性关节,显著影响患者的移动性.
研究的目的:
- 报告COVID-19固定后严重关节异型骨化手术干预的第一个病例.
- 评估手术HO切除在恢复关节移动性的有效性.
- 强调手术前计划对于神经血管结构附近的HO切除的重要性.
主要方法:
- 一名43岁的男性患者患有COVID-19后固定性部疼痛,被诊断为布鲁克尔类IV双侧部HO.
- 进行了双边部HO的外科切除.
- 患者的部移动性在1年的随访期被评估.
主要成果:
- 在手术前的评估显示,两个部的功能性关节骨折 (45°曲,-20°内部旋转).
- 在1年后的术后随访显示,部移动性显著改善 (曲90°,内旋30°).
- 手术干预成功地逆转了严重HO引起的功能性关节损伤.
结论:
- 异型骨化手术切除是COVID-19引起的固定后严重的关节限制的有效治疗方法.
- 这一案例代表了手术干预对这种特定并发症的首次记录成功.
- 术前3D规划对于安全有效的HO切除至关重要,特别是在涉及神经血管结构时.
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