对近腰骨骨折和相关的血管损伤进行系统审查
Jenna Shepherd1, Athanasios Saratzis2,3, Coral Pepper4
1Department of Orthopaedic Surgery, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK.
JVS-vascular insights
|April 11, 2025
概括
靠近腰部骨折与血管损伤在老年人中在跌倒后很常见. 由于严重的相关发病率和各种表现,早期识别和管理至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 血管外科 血管外科
- 创伤护理 创伤护理
背景情况:
- 靠近骨骨折很普遍,神经血管损伤发生在0.09%至5%的病例中.
- 相关的血管损伤可能导致显著的发病率,需要谨慎管理.
研究的目的:
- 系统地审查有关近端骨骨折与相关血管损伤的表现和管理的文献.
- 在这些复杂的病例中为临床决策提供基于证据的指导.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 包含40篇文章,详细介绍55例成年近腰骨骨折与血管损伤的病例.
- 使用乔安娜·布里格斯研究所的批判性评估工具进行质量评估.
主要成果:
- 跌倒等低能耗机制是最常见的原因 (58%).
- 缺血症状包括肢体冷 (53%) 和缺席/减少脉 (85%);神经损伤 (55%) 和脱位 (32.7%) 是常见的.
- 骨科管理通常涉及开放的减少内部固定 (60%),动脉损伤主要通过插入移植 (38%) 修复.
结论:
- 这些伤害最常发生在低能量创伤后的老年人身上.
- 一个高的怀疑指数是必要的,因为表现可能是不典型的,相关的并发症是频繁的.
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