BONE RECONSTRUCTION IN THE TREATMENT OF TIBIAL HEMIMELIA: AN ALTERNATIVE TO AMPUTATION?

IF 0.5 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2024-05-06 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243201e268462

Yesmin Naji Sola, Luna Jeannie Alves Mangueira, Pedro Miranda Portugal, Robson Xavier Ferro, Nayme Naji Sola, Gustavo Teixeira Leão

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Abstract

Objective: To evaluate the advantages and disadvantages of bone reconstruction and lengthening compared to amputation in the treatment of tibial hemimelia for patients and their families.

Methods: Systematic review of articles published in English and Portuguese between 1982 and 2022 in the MEDLINE, PubMed, Cochrane and SciELO databases. The variables of interest were: year of publication, sample characteristics, classification of tibial hemimelia according to Jones, treatment outcome and follow-up time.

Results: A total of eleven articles were included in the scope of this review. The studies involved 131 patients, 53.4% male and 46.6% female. The age of the patients who underwent a surgical procedure ranged from 1 year and 10 months to 15 years. The most common type was Jones' I (40.9%). The most recurrent complications in the reconstruction treatment were: infection of the external fixator path, flexion contracture (mainly of the knee), reduction in the range of motion of the knee and ankle.

Conclusion: We did not find enough relevant studies in the literature to prove the superiority of reconstruction. Amputation remains the gold standard treatment for tibial hemimelia to this day. Level of Evidence III, systematic review of level III studies.

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骨重建治疗胫骨半脱位：截肢的替代方案？

目的评估在治疗胫骨半脱位时，骨重建和骨延长术与截肢术相比对患者及其家属的利弊：系统回顾 1982 年至 2022 年期间在 MEDLINE、PubMed、Cochrane 和 SciELO 数据库中发表的英语和葡萄牙语文章。研究变量包括：发表年份、样本特征、琼斯对胫骨半脱位的分类、治疗结果和随访时间：本综述共纳入了 11 篇文章。这些研究共涉及131名患者，其中53.4%为男性，46.6%为女性。接受手术治疗的患者年龄从1岁10个月到15岁不等。最常见的类型是琼斯I型（40.9%）。重建治疗中最常见的并发症是：外固定器路径感染、屈曲挛缩（主要是膝关节）、膝关节和踝关节活动范围缩小：我们在文献中没有找到足够的相关研究来证明重建的优越性。截肢至今仍是治疗胫骨半脱位的金标准。证据等级 III，对 III 级研究的系统性回顾。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.

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