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冠状骨折中部肘部方法:对腰椎神经的风险
Olawale A Sogbein1,2, Shav Rupasinghe1, Yibo Li3
1Roth McFarlane Hand and Upper Limb Centre, London, ON, Canada.
JSES international
|February 3, 2025
概括
在冠状腺骨折手术期间的部神经转移可能会改善神经病变的恢复,尽管转移和现场释放之间的发病率相似. 冠状腺固定的中间方法在并发症率上没有差异.
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
- 神经科学是一个神经科学.
背景情况:
- 冠状骨折往往需要开放的减少内部固定 (ORIF) 来保持肘部的稳定性.
- 中间外科手术方法,包括 flexor pronator 分裂, flexor carpi ulnaris (FCU) 分裂,以及泰勒和夏姆 (T&S),是访问冠状腺的常见方法.
- 在这些手术 (释放与转移) 期间对部神经的管理仍然存在争议.
研究的目的:
- 为了比较冠状腺骨折的ORIF后的手术后部神经并发症.
- 根据手术方法和神经管理 (释放与转移) 来评估部神经并发症的差异.
主要方法:
- 通过中介方法 (2004-2022) 用ORIF治疗的91名冠状骨折患者的回顾性评估.
- 纳入标准:18岁以上的冠状腺骨折患者,有或没有相关的损伤.
- 收集的数据:人口统计数据,骨折类型,相关伤害,手术方法,腰椎神经管理和手术后腰椎神经神经病变.
主要成果:
- 术后部神经病变发生在33%的患者中,在in situ释放 (30%) 和转移 (34%) 之间没有显著差异.
- 部神经转移显示神经病症解脱率明显高 (70%),相比之下,局部释放 (22%).
- 在FCU,T&S和柔性前肢分裂方法之间没有观察到神经病变发生率或解决的显著差异.
结论:
- 虽然手术后部神经并发症的发生率很高,但神经转移和局部释放的发生率相似.
- 部神经的转移与术后神经病变的更好的解决率有关.
- 所有评估的中间外科手术方法都显示了可比的部神经功能障碍率.
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