Timing of Surgery for Elbow Fractures (OTA 13 A-C and 21 A-C) and Patient Outcomes.

IF 1.6 3区 医学 Q3 ORTHOPEDICS
Jacob A Linker, Christopher J Pettit, Abhishek Ganta, Sanjit R Konda, Kenneth A Egol
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引用次数: 0

Abstract

Objectives: To determine if there is a correlation between time to surgery (TTS) and outcomes after repair of elbow fractures.

Methods:

Design: Retrospective comparative study.

Setting: A single, urban hospital system.

Patient selection criteria: Patients from March 2011 to September 2022 who sustained an isolated fracture about the elbow joint (AO/OTA 13-A, B, and C and 21-A, B, and C), underwent surgical repair, and had at least 6 months of postoperative follow-up identified from an Institutional Review Board-approved database.

Outcome measures and comparisons: TTS, in days, was recorded. Radiographic and clinical follow-up was obtained at all visits, and a Mayo Elbow Performance Index was calculated based on the latest follow-up. Complications recorded include elbow contracture, infection, early hardware failure, reoperation, and fracture nonunion. Multivariable regression and Spearman correlation analysis were used to determine any significant outcome differences based on TTS.

Results: Three hundred fifty-one patients included with a mean age of 54.8 (range: 18-86) years with 217 females (61.8%) and 134 males (38.2%). Eighty-two patients (23.4%) developed at least 1 complication, whereas 269 patients (76.6%) did not. As a continuous variable, TTS was not correlated with arc of motion at any follow-up visit nor with the latest recorded Mayo Elbow Performance Index score ( P > 0.05). Mean TTS for patients who did and did not experience a complication was 6 (range: 0-24) and 10 (range: 0-38) days, respectively, and this was not significantly different ( P = 0.217). Complication rate and any of the individual complications were not associated with TTS after a multivariable analysis controlling for age, sex, injury mechanism, open fracture, Charlson Comorbidity Index, and AO/OTA classification ( P > 0.05 for all).

Conclusions: Timing of surgery after OTA 13 A-C and 21 A-C elbow fractures was not associated with differences in postoperative complications or range of elbow motion.

Level of evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

肘关节骨折的手术时机(OTA 13 A-C和21 A-C)和患者预后。
目的:确定肘部骨折修复后手术时间(TTS)与预后之间是否存在相关性。方法:设计:回顾性比较研究。环境:单一的城市医院系统。患者选择标准:2011年3月至2022年9月期间,肘关节发生孤立性骨折(AO/OTA 13-A, B, C和21-A, B, C),接受手术修复,术后随访至少6个月,从机构审查委员会批准的数据库中确定。结果测量和比较:记录手术时间(以天为单位)。所有访问均获得影像学和临床随访,并根据最新随访计算Mayo肘部表现指数(MEPI)。并发症记录:肘关节挛缩、感染、早期硬体失效、再手术和骨折不愈合。使用多变量回归和Spearman相关分析来确定基于手术时间的任何显著结局差异。结果:351例患者,平均年龄54.8岁(范围:18 - 86岁),其中女性217例(61.8%),男性134例(38.2%)。82例(23.4%)患者出现至少一种并发症,269例(76.6%)患者未出现并发症。作为一个连续变量,TTS与任何随访时的运动弧度和最新记录的MEPI评分均无相关性(p > 0.05)。发生并发症和未发生并发症的患者的平均TTS分别为6(范围:0-24)和10(范围:0-38)天,两者无显著差异(p = 0.217)。在控制年龄、性别、损伤机制、开放性骨折、Charlson合病指数和AO/OTA分类的多变量分析后,并发症发生率和任何个体并发症与TTS无关(p < 0.05)。结论:OTA 13 A-C和21 A-C肘关节骨折后的手术时机与术后并发症或肘关节活动范围的差异无关。证据等级:三级。
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来源期刊
Journal of Orthopaedic Trauma
Journal of Orthopaedic Trauma 医学-运动科学
CiteScore
3.90
自引率
8.70%
发文量
396
审稿时长
3-8 weeks
期刊介绍: Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.
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