切除硬件后的关节骨折:有没有危险因素? 一个回顾性队列研究
Franziska Kessler1,2, Yannik Kalbas1,3, Jan Hambrecht1,3
1Harald-Tscherne Laboratory for Orthopaedic and Trauma Research, University Hospital Zurich, University of Zurich, Ramistr. 100, 8091, Zurich, Switzerland.
概括
在关节骨骨折固定后去除硬件可能会导致折裂. 在手术期间增加工作长度 (空螺杆孔) 可能会降低关节骨轴骨折硬件移除后折断的风险.
科学领域:
- 整形外科手术 整形外科手术
- 创伤外科手术是什么
- 生物机械工程 生物机械工程
背景情况:
- 在关节骨骨折固定后去除硬件是一种常见的程序.
- 硬件移除后的折断是已知的并发症,特别是在关节骨骨折中.
研究的目的:
- 为了确定关节骨骨折硬件切除后折射的手术治疗相关的风险因素.
- 为了研究影响折断发生的因素,在切除板骨质合成后.
主要方法:
- 从2017年至2022年进行关节硬件切除的患者的回顾性评估.
- 最近邻匹配 (5:1比) 进行折射 (R) 和无折射 (NR) 组的比较.
- 对人口统计学,骨折特征和手术细节的分析,以及关节骨轴骨折的子组分析.
主要成果:
- 分析了60名患者 (10个R,50个NR).
- 在无折射组 (1.94 ± 0.85) 观察到明显更大的工作长度 (更多的空螺杆孔) 与轴骨折的折射组 (1.20 ± 0.92) 相比,在不折射组 (1.94 ± 0.85) 观察到更大的工作长度 (p=0.042).
- 后勤回归表明空螺杆孔和折射风险之间存在反向相关性 (OR 0.369,p=0.035).
结论:
- 在关节轴骨折固定过程中工作时间的增加可能作为一个保护因素,防止拆除硬件后的折射.
- 手术技术,特别是螺丝放置策略,可以影响折断风险.
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