[半径头部置换:在与肘部脱位相关的半径头部断裂后,肘部和前臂不稳定性的管理]
1I. chirurgická klinika hrudní, břišní a úrazové chirurgie Všeobecné fakultní nemocnice a 1. lékařské fakulty Univerzity Karlovy, Praha.
概括
与切除相比,辐射头部置换提供了更好的肘部稳定性和功能性结局,与脱的骨折相比. 这种手术方法使得假肢治疗患者的优秀结果比例更高.
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
背景情况:
- 辐射头部骨折经常发生在肘部脱,需要有效的手术治疗.
- 将放射性头部切除与置换的结果进行比较对于管理这些复杂的损伤至关重要.
研究的目的:
- 建立一个指标算法,用于手术治疗带有肘部脱的辐射头部骨折.
- 为了比较半径头部切除和多片段骨折的替换之间的中期功能结果.
主要方法:
- 一组34名患有梅森-约翰斯顿型IV骨折的患者接受了辐射头切除 (EXT组,n=20) 或用ExploR®模块化辐射头系统 (END组,n=14) 替换.
- 手术结果,包括疼痛,运动范围,肘部稳定性和并发症,在平均2.4年的随访中进行了评估.
- 放射图评估了异型骨化,半径近距离化和假肢松动;重新手术的频率也被跟踪.
主要成果:
- 放射性头部置换组 (END) 与切除组 (EXT) 相比,表现出更高的优秀功能结果百分比 (69%与50%的MEPS>90).
- END组表现出改善的肘部和前臂稳定性,没有报告的不稳定性或神经复杂性,与EXT组不同,该组有反复发作的脱位和不稳定性.
- 虽然两组都出现了异型骨化 (每组4名患者),但END组在35%的病例中在假肢茎周围具有辐射发光区域,而不需要修改.
结论:
- 辐射头部置换增强了肘部和前臂的稳定性,用于管理与肘部脱位相关的多片段辐射头部骨折.
- 与放射性头部切除相比,植入放射性头部假体导致更大比例的患者获得了优异的功能结果.
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