外部链固定与内部关节稳定肘部不稳定:功能结果和手术并发症的系统审查和元分析
Areeb Ahmad1,2, Kassem Ghayyad1, Alaina Mitchell3
1Rothman Orthopaedics Florida at AdventHealth, Orlando, FL, USA.
JSES reviews, reports, and techniques
|February 9, 2026
概括
悬挂式外部固定器 (HEF) 对创伤性肘部不稳定性而言,与内部关节稳定器 (IJS) 相比,具有临床意义的功能优势. 用HEF治疗的患者报告了明显改善的上肢功能,根据手臂,肩膀和手的残疾分数进行测量.
科学领域:
- 整形外科手术 整形外科手术
- 创伤管理 创伤管理
- 生物机械工程 生物机械工程
背景情况:
- 创伤肘部不稳定性管理涉及链式外部固定器 (HEF) 或内部关节稳定器 (IJS).
- 之前的研究表明,HEF和IJS都存在与设备相关的并发症.
- 对运动范围 (ROM),患者报告的结果和手术并发症的全面比较分析是有限的.
研究的目的:
- 系统地审查和分析复杂肘部不稳定性HEF与IJS的结果.
- 为了比较术后的ROM,患者报告的结果测量 (PROM) 和手术并发症.
- 为了指导创伤肘部不稳定的临床治疗决策.
主要方法:
- 系统审查和元分析遵循系统审查和元分析 (PRISMA) 准则的首选报告项目.
- 搜索了谷歌学者和PubMed (2000年1月至2025年2月) 的I-IV级研究.
- 包括报告手术后ROM,PROM或治疗HEF或IJS的患者手术并发症的研究.
主要成果:
- 38项研究 (500名HEF患者,263名IJS患者) 符合纳入标准.
- 手臂,肩膀和手的残疾 (DASH) 评分与HEF (9.8) 与IJS (23) (P <.001) 相比显著更好.
- 在术后ROM,梅奥肘性能指数,疼痛视觉模拟尺度,异型骨化或神经损伤率方面,没有发现HEF和IJS之间的显著差异.
结论:
- 悬挂式外部固定器 (HEF) 在肘部不稳定性方面表现出比内部关节稳定器 (IJS) 有临床意义的功能优势.
- 与HEF的优异DASH分数可能归因于不那么侵入性的硬件移除.
- 需要进一步的前性研究来完善每个技术的指示.
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