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在距离骨骨折后,关节整形术或关节融合的风险:系统性审查和元分析

Tommaso Greco^1,2,3, Chiara Comisi^1,2, Antonio Mascio^1,2

¹Department of Orthopedics and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy.

Journal of functional morphology and kinesiology

|February 20, 2026

概括

在远距离骨骨折 (DTFs) 后,转换为全关节整形术 (TAA) 或关节融合 (AF) 的风险很低,即使是创伤后关节炎 (PTOA). 手术复杂性,而不是管理失败,可能是治疗骨折中更高的转化率的解释.

科学领域:

整形外科整形外科整形外科
创伤学创伤学创伤学
重建性手术是一种重建性手术.

背景情况:

距离骨骨折 (DTFs) 是创伤后关节炎 (PTOA) 的重要原因.
关于DTF后转换为全脚关节整形术 (TAA) 或脚融合 (AF) 的长期风险存在不确定性.
关于与DTF相关的PTOA结果的现有文献是异质的和不完整的.

研究的目的:

系统地审查和评估与DTF相关的PTOA后的TAA和AF的发生率.
确定转换为TAA或AF的潜在预测因素.
探索初始治疗策略对转换率的影响.

主要方法:

在遵守PRISMA指南的基础上进行系统审查.
用于研究设计和文献搜索的PICO框架.
随机效应的元分析与逻辑转换应用到研究水平的比例.

主要成果:

包括190,383个骨折在内的8项研究符合纳入标准.
整体转化率为TAA或AF为16.4% (31,269名患者).
聚合转换发生率为5.6% (TAA:0.25%,AF:0.76%),具有很高的异质性.

结论:

在DTF之后转换为TAA或AF的风险相对较低,尽管PTOA的流行率很高.
在手术治疗的骨折中,更高的转化率可能表明最初的骨折复杂性,而不是治疗失败.
需要进一步的研究来澄清预测因素并优化与DTF相关的PTOA的管理.

关键词:

距离骨骨折距离骨骨折在创伤后的骨关节炎.柱骨折柱骨折柱骨折部天花板骨折骨折在部整体脚关节整形手术整体关节置换整体关节置换

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Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...