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分析手术和非手术治疗的骨突破:一个回顾性的多中心研究

Yu Takahashi¹, Yasuhiko Takegami¹, Katsuhiro Tokutake²

¹Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

JB & JS open access

|July 11, 2024

概括

骨突裂骨折具有挑战性,通常影响到老年女性. 与增强相结合的管式无螺丝可显著减少与仅用于阿基里斯肌损伤的螺丝相比的并发症.

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
足部和脚的手术手术.

背景情况:

在阿基里斯肌插入处的骨突破 (CAvFs) 带来了复杂的治疗挑战.
这些骨折虽然很少见,但与重复手术的高率有关.
最佳的治疗策略,包括非手术和手术选择,需要进一步定义.

研究的目的:

进行CAvF的描述性评估,包括非手术管理.
评估CAvF的外科手术程序,重点关注并发症和重新手术率.
为了比较不同外科手术技术和植入物对CAvFs的疗效.

主要方法:

多中心回顾性研究涉及70名在2012年至2022年期间接受治疗的CAvF患者.
从9家医院收集数据,包括患者人口统计,骨折特征和治疗细节.
对骨碎片大小的量化和对不同外科手术方法的术后并发症和重新手术率的比较.

主要成果:

该研究分析了70个CAvF:20个非手术治疗和50个手术治疗.
术后并发症发生在30%的手术治疗患者中 (感染14%,缩26%,减少损失18%),整体重复手术率为22%.
单靠管式无螺丝 (CCS) 固定就有35%的重新操作率,而CCS与增强将其降至10%,即使对于小碎片.

结论:

CAvF在老年女性中更为普遍,并且患术后并发症的发生率较高.
增强的CCS固定在缓解CAvF的术后并发症方面优于单独的CCS固定.
这种方法证明有效,无论骨碎片的大小如何.

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Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...