在手术治疗的骨骨折中,移植是否重要? 一个回顾性分析
Baris Ozkul1, Hanifi Ucpunar2, Kutalmis Albayrak1
1Department of Orthopaedic Surgery and Traumatology, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Türkiye.
概括
骨移植并没有改善移位性关节内骨骨折 (DIACFs) 的结果. 开放式减少和内部固定 (ORIF) 的手术治疗显示,在桑德斯II,III和IV型骨折中,有或没有骨移植的结果类似.
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
- 放射学 放射学是指放射学
背景情况:
- 移位的关节内骨折 (DIACFs) 带来了治疗挑战.
- 在手术修复DIACF的骨移植的必要性是有争议的.
- 最少侵入性技术正在获得引力,可能减少对移植的需求.
研究的目的:
- 评估骨移植利用对手术治疗的桑德斯II型,III型和IV型DIACFs放射性和功能性结局的影响.
- 为了比较移植和非移植组之间的结果,进行开放式减少和内部固定 (ORIF).
主要方法:
- 对115名DIACF患者 (2016-2022) 的回顾性队列研究.
- 骨折根据桑德斯标准进行分类,并分为移植和非移植组.
- 评估了放射性参数 (Böhler/Gissane角,脚高度) 和美国整形足与脚学会 (AOFAS) 的后脚得分.
主要成果:
- 移植和非移植组在放射性参数上均显示出显著的术后改善,没有显著的组间差异.
- 功能性结局 (AOFAS得分) 和表面伤口感染率在两组之间是可比的.
- 在任何时间点,在移植和非移植的DIACF之间没有观察到放射性或功能性结果的统计学上显著差异.
结论:
- 骨头移植对于用ORIF治疗的桑德斯II,III和IV型DIACFs没有优越的放射性或功能性益处.
- 这些发现支持在DIACF中选择性地进行骨移植,特别是在没有显著削减或骨损失的情况下.
- 结果与生物友好和对骨骨折进行最少入侵的手术技术的趋势保持一致.
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