阴道塔尔西与延伸侧向方法对骨折 - 一个多中心研究
Thomas M Seaver1, Zachary Zeller, Paul Tornetta
1From the Department of Orthopedic Surgery, Boston University Medical Center, Boston, MA (Dr. Zeller and Dr. Tornetta); the Lahey Medical Center, Department of Orthopedic Surgery, Burlington, MA (Dr. Marcantonio and Mr. Ment); Department of Orthopedic Surgery, the Florida Orthopaedic Institute, Tampa, FL (Dr. Mir and Dr. McCaskey); Department of Orthopedic Surgery, the University of Alabama at Birmingham, Birmingham, AL (Dr. Messner and Dr. Spitler); Department of Orthopedic Surgery, the Washington University in St. Louis, St Louis, MO (Dr. Hofer and Dr. Miller); the Hennepin County Medical Center, Minneapolis, MN (Mr. Westberg and Dr. Downes), Department of Orthopedic Surgery; Department of Orthopedic Surgery, the Metro Health Medical Center, Cleveland, OH (Dr. Joseph); Department of Orthopedic Surgery, the University of North Carolina, Chapel Hill, NC (Dr. Suh and Dr. Ostrum); Department of Orthopedic Surgery, the University of Nottingham, Nottingham, UK (Dr. Ollivere and Dr. Ikram); Department of Orthopedic Surgery, the Indiana University, Indianapolis, IN (Dr. Mullis and Dr. Figueras); Department of Orthopedic Surgery, the Oregon Health Science University, Portland, OR (Dr. Friess and Ms. Sodders); Department of Orthopedic Surgery, the Stanford University, Palo Alto, CA (Dr. Van Rysselberghe and Dr. Gardner); Department of Orthopedic Surgery, the Stony Brook University, Stony Brook, NY (Dr. Pawlak and Dr. Kottmeier); Department of Orthopedic Surgery, the University of California San Francisco, San Francisco, CA (Dr. Morshed); Department of Orthopedic Surgery, the Harborview Medical Center, Seattle, WA (Dr. Goodnough, Dr. Bunzel, and Dr. Firoozabadi); Department of Orthopedic Surgery, the University of Minnesota, Minneapolis, MN (Dr. Yoon and Mr. Pottinger); Department of Orthopedic Surgery, the Case Western Reserve University, Cleveland, OH (Dr. Vallier); Department of Orthopedic Surgery, the Hughston Clinic, Nashville, TN (Dr. Hofer); Department of Orthopedic Surgery, the SUNY Downstate Health Sciences University, Brooklyn, NY (Dr. Malik); Department of Orthopedic Surgery, the Orillia Soldiers' Memorial Hospital, Orillia, Canada (Dr. Lim); Department of Orthopedic Surgery, the University of Arizona, Phoenix, AZ (Dr. Johnson and Mr. Chaliki); and the Sanford Medical Center, Department of Orthopedic Surgery, Fargo, ND (Dr. Seaver).
与延伸横向 (EL) 方法相比,椎 (ST) 手术治疗骨折的手术方法显示较低的深部感染率. 这一发现有助于选择最佳的外科手术技术,以获得更好的患者结果.
科学领域:
- 整形外科手术 整形外科手术
- 创伤外科 手术 创伤外科
- 手术结果研究研究.
背景情况:
- 关节内骨折会带来复杂的治疗挑战.
- 讨论了手术管理选择,包括延伸侧面 (EL) 和鼻 (ST) 方法.
- 深度感染是手术修复后的一个严重并发症.
研究的目的:
- 为了比较扩展侧面 (EL) 和鼻 (ST) 方法之间的深部手术部位感染的发病率,用于关节内骨折.
- 在手术治疗的骨骨折中识别深层感染的独立风险因素.
主要方法:
- 来自15个机构的782名OTA 82B/C骨折患者的回顾性审查.
- 深度感染被定义为需要手术脱bridement或骨髓炎治疗.
- 单变量和多变量分析以确定风险因素.
主要成果:
- 444个骨折用EL治疗,338个用ST治疗.
- 深度感染率:EL为6.8%,而ST为3.0% (P=0.017).
- 独立的风险因素包括手术方法 (P=0.03) 和患者年龄 (P<0.001). EL有更多的伤口并发症;ST有更多的症状植入物.
结论:
- 与延伸横向 (EL) 方法相比,鼻喉 (ST) 方法与明显较低的深层感染率有关.
- ST方法也显示了较少的伤口并发症.
- 对于管理关节内骨折,包括高风险个体中,ST方法可能是可取的.
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