根据关节碎片的严重程度,关节内远端腰椎开放缩小和内部固定的结果
Carl Cirino1, Hannah S Rhee1, Jimmy J Chan1
1Leni & Peter W. May Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY, USA.
Journal of shoulder and elbow surgery
|February 5, 2026
概括
偏骨骨折 (DHFs) 中严重的关节缩小导致更多的并发症和重复手术,尽管现代板块可靠地固定. 患者的结局,如肘部运动和功能得分在高和低碎片化组之间是相似的.
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
- 生物机械工程 生物机械工程
背景情况:
- 现代预定形状的锁定板可增强远部骨骨折 (DHF) 治疗,以解剖适应和安全固定.
- 严重的关节缩小在DHFs构成手术失败的风险,即使在最佳的减少和固定.
研究的目的:
- 为了评估严重的关节缩小对远端骨骨折的结果和并发症的影响,用开放式减少内部固定 (ORIF) 治疗.
主要方法:
- 对51名接受DHFORIF (2015-2020) 的患者进行了回顾性审查.
- 骨折按AO/OTA,解剖位置和关节碎片分类 (高:>=5个碎片;低:<5个碎片).
- 评估结果:肘部运动范围,qDASH,MEPS;并发症分为大/小.
主要成果:
- 与低碎片化相比,高碎片化DHF的重大并发症 (87.5%与16.3%) 和整体并发症 (87.5%与30.2%) 的发生率显着更高.
- 功能性结果 (MEPS,qDASH) 和运动范围在各组之间没有显著差异.
- 所有高碎裂骨折都实现了令人满意的减少,但更高的比例需要修复手术.
结论:
- 预定形状的锁定板可为关节内DHF提供可靠的固定.
- 严重的关节缩小是重大并发症和重复手术的重要风险因素,无论固定质量如何.
- 转换为全肘关节整形仍然很少发生.
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