现代外部环固定或内部固定后的功能性结果,用于严重的开放的小腿轴骨折
Justin Solarczyk1, Natasha M Simske2, Austin R Thompson3
1Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California.
The Journal of bone and joint surgery. American volume
|February 20, 2025
概括
内部固定 (IF) 和外部固定 (EF) 在严重的骨骨折的身体功能上没有显著差异. 这两种方法都导致了整体损伤,EF最初需要更多的行走辅助器.
科学领域:
- 整形外科手术 整形外科手术
- 创伤护理的护理人员.
- 康复医学是康复的医学.
背景情况:
- 开放的骨轴骨折在实现最佳功能结果方面存在复杂的挑战.
- 对比固定方法对于指导严重骨折的治疗决策至关重要.
研究的目的:
- 为了比较外部环固定 (EF) 和内部固定 (IF) 之间的功能结果,用于开放的骨轴骨折.
- 调查患者报告的功能,行走和辅助设备使用的差异.
主要方法:
- 一个多中心随机临床试验 (FIXIT研究) 涉及254名 (18-64岁) 患有严重骨折 (IIIA/IIIB型) 的患者.
- 患者被随机分配到内部固定 (IF,n=132) 或外部固定 (EF,n=122).
- 使用SMFA,VR-12PCS和行走状态,在6周和3,6和12个月评估的功能结果.
主要成果:
- 在任何时间点,IF和EF组之间短期肌肉骨功能评估 (SMFA) 评分没有显著差异.
- 略高的退伍军人兰德12项健康调查 (VR-12) 物理组件分数 (PCS) 对于IF在3个月,但12个月没有差异.
- 外部固定 (EF) 与在6个月后使用门诊辅助设备的风险更高有关 (p < 0.0001).
结论:
- 内部固定 (IF) 和外部固定 (EF) 在严重的骨骨折中产生类似的物理功能结果.
- 在两组治疗中都观察到高水平的整体功能障碍.
- 外部固定 (EF) 显示在康复早期 (6个月) 增加了对行走辅助器的依赖.
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