Operative Orthopadie Und Traumatologie最新文献

{"title":"[Surgical treatment of secondary patella baja following total knee arthroplasty].","authors":"Mara Hold, Henning Windhagen, Lars-Rene Tuecking","doi":"10.1007/s00064-026-00937-w","DOIUrl":"10.1007/s00064-026-00937-w","url":null,"abstract":"<p><strong>Surgical objective: </strong>Improvement of knee joint function through proximalisation of the patella, increase in range of motion (ROM) and reduction of anterior knee pain.</p><p><strong>Indications: </strong>Secondary patella baja following implantation of total knee arthroplasty with shortening of the patellar tendon or scarring of periarticular soft tissues (e.g. Hoffa's fat pad). Particularly in cases of functional impairment of the extensor mechanism and failure of conservative measures.</p><p><strong>Contraindications: </strong>Infection (preoperative joint aspiration recommended), lack of compliance, inability to undergo postoperative rehabilitation, and pseudo-patella baja due to joint line proximalisation.</p><p><strong>Surgical technique: </strong>Release/arthrolysis: release of infrapatellar, anterolateral and femoral adhesions; tendon lengthening using Z‑plasty, if necessary. Tuberosity osteotomy: oblique osteotomy of the tibial tuberosity with distal shift of the fragment and screw fixation.</p><p><strong>Postoperative management: </strong>Early functional physical therapy and continuous passive motion device for the knee. Full weight-bearing possible immediately after surgery. After tuberosity osteotomy, partial weight-bearing (approximately 15 kg for 6 weeks) with gradual increase in weight-bearing after radiological consolidation.</p><p><strong>Results: </strong>The literature on isolated release is limited, with isolated case reports showing functional improvements. For tuberosity osteotomy, there are case series reporting improvements in clinical scores (e.g. Kujala, Knee Society Score) and patella height indices. Nevertheless, postoperative limitations remain possible.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"212-222"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imageless robotic-assisted total knee revision arthroplasty.","authors":"Hendrik Pott, Ricarda Stauss, Max Ettinger, Peter Savov","doi":"10.1007/s00064-026-00941-0","DOIUrl":"10.1007/s00064-026-00941-0","url":null,"abstract":"<p><strong>Objective of the surgery: </strong>Single-stage knee revision arthroplasty under special consideration of bony defects and soft tissue laxity over the full arc of motion.</p><p><strong>Indications: </strong>Aseptic loosening, ligamentous instability, or outlier in implant position requiring single-stage knee revision arthroplasty.</p><p><strong>Contraindications: </strong>Cases with severe bone loss or ligamentous instability requiring a hinged prosthesis. Loss of knee extensor function.</p><p><strong>Surgical technique: </strong>After establishment of a standardized median parapatellar approach and setup of the imageless robotic system, the implant is mapped while still in situ. The bone-implant interface is highlighted in the 3D reconstruction of the implant by the application of special points during mapping. Soft tissue balance is registered and the component position of the revision implant is determined in the virtual implant planning stage. The implant is then removed and the surgical plan is executed with the robotic bur. If necessary, augments can be used to account for excessive bone loss and reconstruct the native joint line.</p><p><strong>Postoperative management: </strong>Full weight-bearing as tolerated, free range of motion.</p><p><strong>Results: </strong>In the literature, robotic-assisted knee revision arthroplasty has mainly been described in the form of case reports and smaller case series; the authors report generally favorable results.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"201-211"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Patellar fractures : Overview of surgical treatment concepts].","authors":"Karl Kilian Stoffel, Christoph Sommer, Tamara Horn Lang, Martin H Hessmann","doi":"10.1007/s00064-026-00939-8","DOIUrl":"10.1007/s00064-026-00939-8","url":null,"abstract":"<p><strong>Objective: </strong>The goal is to anatomically reconstruct the patellar joint surface in order to restore the function of the extensor apparatus. This forms the basis for a stable knee function and physiological gait. Furthermore, it prevents retropatellar arthritis. Early functional mobilization can prevent joint stiffness, muscle atrophy and subsequent complications.</p><p><strong>Indications: </strong>Open or closed patellar fractures with > 2 mm joint incongruity or displacement, impaired extensor mechanism or absent active extension, even if not displaced.</p><p><strong>Contraindications: </strong>Stable, nondisplaced fractures, minimal displacement with an intact extensor mechanism, limited surgical eligibility, here conservative therapy is preferred.</p><p><strong>Surgical technique: </strong>The choice of procedure depends on the fracture type: for simple vertical fractures, screw osteosynthesis; for transverse fractures (1) tension band wiring with Kirschner wires or (2) cannulated screws, alternatively (3) conventional angle stable plate fixation (preferred); for complex, multifragmentary fractures, locking plate fixation. Additional procedures, such as suture augmentation or cerclage wiring can be used as needed.</p><p><strong>Postoperative management: </strong>Full weight-bearing in an extension splint is permitted, with gradual passive mobilization: up to 30° in weeks 1-2, 60° in weeks 3-4, and 90° in weeks 5-6. Subsequent transition to unlimited flexion and active mobilization. Sport-specific training is possible after 3-6 months.</p><p><strong>Results: </strong>Tension band wiring has traditionally been used for patellar fractures but shows high complication rates, especially in complex, multifragmentary fractures. Recent studies show that locking plate osteosynthesis is more stable and has fewer complications.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"223-240"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Minimally invasive arthrodesis of the talonavicular joint].","authors":"D Shukla, J Beschauner, M Felsberg, C Rump, D Arbab, A Zeh, K-St Delank, N Gutteck, F Werneburg","doi":"10.1007/s00064-026-00944-x","DOIUrl":"https://doi.org/10.1007/s00064-026-00944-x","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of minimally invasive talonavicular arthrodesis is to achieve realignment and biomechanical stabilization of the hindfoot through targeted fusion of the talonavicular joint.</p><p><strong>Indications: </strong>This procedure is indicated in cases of idiopathic or posttraumatic talonavicular joint arthritis, with or without associated malalignment. It may also serve as part of a multilevel hindfoot reconstruction.</p><p><strong>Contraindications: </strong>Contraindications include general medical inoperability and local infection at the surgical site. Relative contraindications may include severe peripheral vascular insufficiency or systemic conditions impairing wound or bone healing.</p><p><strong>Surgical technique: </strong>Talonavicular fusion is performed via a minimally invasive, percutaneous approach using cannulated compression screws.</p><p><strong>Postoperative management: </strong>Postoperative care consisted of 6 weeks of mobilization in a below-knee walker with foot contact but without active loading. After radiological assessment at 6 weeks, a gradual transition to full weight-bearing in a stable shoe with a rigid sole was initiated. Physical therapy supported the restoration of mobility and gait function. Thromboprophylaxis was maintained until full mobilization.</p><p><strong>Results: </strong>In this retrospective analysis, 31 patients (32 feet) met the inclusion criteria and were evaluated. Of these, 18 underwent isolated talonavicular arthrodesis, 6 received an additional calcaneal osteotomy, and 8 underwent combined talonavicular and subtalar arthrodesis. The mean clinical follow-up was 131 days (± 89.9). Marked functional improvement was observed across the cohort. The mean American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score increased from 54.5 ± 17.4 preoperatively to 90.3 ± 9.6 at final follow-up, a change that was statistically significant (p < 0.0001) and associated with a very large effect size (Cohen's d = 2.71). Stratified analysis revealed that patients with lower baseline scores demonstrated greater relative improvement, while those with higher initial scores still achieved excellent absolute outcomes. Radiographic assessment demonstrated a marked postoperative correction of the tarsometatarsal angle, with the mean dorsoplantar angle improving from -4.6° (± 11.8) to -0.03° (± 1.5; p = 0.072), and the lateral angle from -3.8° (± 11.8) to -0.4° (± 2.4; p = 0.113). Although both changes narrowly missed statistical significance, they reflect a consistent and clinically relevant restoration of medial column alignment. Importantly, no postoperative complications-such as pseudarthrosis, wound healing disturbances, implant-related symptoms, or neurovascular impairment-were observed during the follow-up period, underscoring the procedural safety and reproducibility of the technique.</p><p><strong>Level of evidence: </strong>IV (Retrospective case series).</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The small distractor-a useful tool for the trauma surgeon.","authors":"Christian Michelitsch, Philipp F Stillhard, Veit Schoenborn, Yves P Acklin, Christoph Sommer","doi":"10.1007/s00064-026-00943-y","DOIUrl":"https://doi.org/10.1007/s00064-026-00943-y","url":null,"abstract":"<p><strong>Background: </strong>Modern trauma surgery requires advanced strategies to manage complex fracture patterns effectively, ensuring optimal anatomical alignment and functional outcomes while minimizing soft tissue damage. Among the tools available, the small distractor has proven invaluable in achieving precise fracture reduction across various anatomical regions.</p><p><strong>Technique: </strong>By utilizing principles such as ligamentotaxis or temporary overdistraction of joints, the small distractor allows for effective approximation of fracture fragments with minimal manipulation for better visualization of articular surfaces, thus preserving vascular integrity and surrounding soft tissues. Its ability to maintain specific force vectors enables correction of axial and torsional malalignments, while providing provisional stabilization before definitive fixation.</p><p><strong>Advantages: </strong>The advantages of the small distractor include quick and versatile placement, reduced soft tissue damage, shorter operation times, decreased radiation exposure, fewer wound healing complications, and faster recovery for patients. Despite requiring specialized instruments and carrying some risks, such as malalignment from unrecognized forces, the benefits far outweigh these drawbacks.</p><p><strong>Results: </strong>The small distractor is routinely used in our clinic and has become indispensable for its versatility and effectiveness in improving surgical outcomes. Its ability to enhance fracture reduction and alignment highlights its role as a critical tool in modern trauma surgery. With consistent success across diverse cases, it represents a significant advancement in achieving optimal patient care.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Talonavicular arthrodesis].","authors":"Dariusch Arbab, Bertil Bouillon, Sebastian Schilde, Natalia Gutteck, Philipp Lichte, Eugen Ulrich","doi":"10.1007/s00064-024-00875-5","DOIUrl":"10.1007/s00064-024-00875-5","url":null,"abstract":"<p><strong>Objective: </strong>Realignment of the hindfoot by talonavicular arthrodesis.</p><p><strong>Indications: </strong>Idiopathic and posttraumatic arthritis of the talonavicular joint with or without malalignment. Optional in flatfoot reconstruction.</p><p><strong>Contraindications: </strong>General medical contraindications to surgical interventions.</p><p><strong>Infection: </strong></p><p><strong>Surgical technique: </strong>Medial, dorsomedial, or dorsal skin incision. Exposure of the talonavicular joint and cartilage removal. Decortication. Reposition of the joint if malaligned. Optional transplantation of corticocancellous bone. Temporary stabilization with Kirschner wires and stabilization with screws, optional with cramps or plates.</p><p><strong>Postoperative management: </strong>Six weeks nonweightbearing in a long walker boot. Afterwards 2 weeks of progressively weight bearing in a long walker boot. Then full weightbearing in walking shoes with stiff soles. Physiotherapy.</p><p><strong>Results: </strong>A total of 18 feet in 18 patients with isolated talonavicular arthritis were treated with isolated talonavicular fusion and corticocancellous bone thorough a midline incision. For postoperative management, patients had nonweightbearing for 6 weeks in a long walker boot. Mean follow-up was 14.5 months (range 8-35 months). Mean age was 63.2 years (range 54-72 years). Preoperative Manchester-Oxford Foot Questionnaire (MOXFQ) score was 65.3 (± 5.2); postoperative MOXFQ score was 28.5 (± 7.0). One revision surgery performed due to pseudarthrosis.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"91-103"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical technique of low-profile dual plating for midshaft clavicle fractures.","authors":"Bryan J M van de Wall, Nadine Diwersi, Lukas Scheuble, Yannic Lecoultre, Björn Christian Link, Reto Babst, Frank J P Beeres","doi":"10.1007/s00064-025-00903-y","DOIUrl":"10.1007/s00064-025-00903-y","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this surgical technique is fracture healing with anatomical alignment and less implant irritation due to smaller, low-profile plates. Equal to superior stability is provided compared to single superior- or anterior-based plates.</p><p><strong>Indications: </strong>The same general indications for surgical stabilization of clavicle fractures apply for low-profile double plating and include fracture displacement of one or more shaft width, shortening of more than 1 cm in length, and patients with high physical activity levels. Double plating is especially suitable for fractures in the midportion of the clavicle.</p><p><strong>Contraindications: </strong>Fractures in the far lateral portion of the clavicle due to physiological thinning of the clavicle potentially causing problems with screw purchase of screws fitted in the anterior plate.</p><p><strong>Surgical technique: </strong>A 2.0 mm low-profile mini plate is used on the superior and a 2.4 or 2.7 mm on the anterior surface of the clavicle. The plates are fixated with a minimum of two cortical or locking screws on each side of the fracture in each plate. A lag screw can be used if absolute stability can be obtained in simple fractures.</p><p><strong>Postoperative management: </strong>A standard functional postoperative regime can be followed after plate fixation with free mobilization up to 90° without weight bearing for 6 weeks. Afterwards free range of motion and weight bearing are allowed.</p><p><strong>Results: </strong>A biomechanical study, meta-analysis, and retrospective analysis have shown that low profile double plating offers equal to superior stability, lower rates of implant irritation and subsequent removal compared to conventional single plating with equal healing potential.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"131-136"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined direct anterior approach and navigation-assisted percutaneous anterograde posterior column fixation for acetabular periprosthetic fractures.","authors":"Gautier Beckers, Dominic Simon, Maximilian Lerchenberger, Wolfgang Böcker, Jörg Arnholdt, Boris M Holzapfel","doi":"10.1007/s00064-025-00900-1","DOIUrl":"10.1007/s00064-025-00900-1","url":null,"abstract":"<p><strong>Objective: </strong>Management of acetabular periprosthetic fractures using a combined direct anterior approach (DAA) with or without proximal intrapelvic Levine extension and navigation-assisted percutaneous anterograde posterior column screw fixation.</p><p><strong>Indications: </strong>Acute and subacute non-displaced or minimally displaced periprosthetic posterior column fracture, pathological fracture, or osteolysis of the posterior column.</p><p><strong>Contraindications: </strong>Highly displaced posterior column, and/or comminuted fractures, narrow osseous corridor, large abdominal pannus, and inguinal skin infection.</p><p><strong>Surgical technique: </strong>A classic DAA approach with or without proximal extension is performed, as for acetabular revisions. The hip is then dislocated, and both the femoral head and insert are extracted. The stability of the acetabular component is assessed. If it is found to be loose, the acetabular component is removed, and the fracture line is evaluated. Following this step, if criteria for anterograde percutaneous screw fixation are met, a minimally invasive stab incision over the iliac crest is performed. After calibration of the navigation system and 3D computed tomography (CT) data acquisition, the fascia is sharply opened, and blunt dissection of the iliac muscle is performed using a Cobb elevator under hip flexion to protect the femoral nerve and iliac muscle. After defining the trajectory in three planes using the navigation system, pre-drilling is performed with a 2.8-mm K-wire. Subsequently, a 7.5-mm fully threaded screw is inserted, and intraoperative CT is repeated to verify the correct screw position. The procedure is then completed by replacing the acetabular component via the DAA if it was loose. Additional screw fixation through the acetabular implant is advised.</p><p><strong>Results: </strong>Based on our preliminary experience, this technique offers a safe alternative with favorable outcomes compared to combined anterior and posterior approaches. It diminishes soft tissue trauma and procedural complexity while retaining the advantages of the anterior approach. The utilization of navigation allows for precise screw positioning and enhances surgical accuracy. Consequently, this surgical technique enables the increasing number of DAA surgeons to address rare complications using their preferred approach.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"104-118"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial.","authors":"Michael Blauth","doi":"10.1007/s00064-026-00936-x","DOIUrl":"https://doi.org/10.1007/s00064-026-00936-x","url":null,"abstract":"","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":"38 2","pages":"89-90"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Radial tunnel syndrome/supinator lodge syndrome-neurolysis facilitating the anterolateral approach].","authors":"Florian Flock, F Unglaub, L P Müller, T Leschinger, Christian K Spies","doi":"10.1007/s00064-025-00906-9","DOIUrl":"10.1007/s00064-025-00906-9","url":null,"abstract":"<p><strong>Objective: </strong>Treatment of pain and hypaesthesia caused by radial tunnel syndrome and functional deficits caused by supinator lodge syndrome. The objective for chronic nerve compression is containment to prevent further damage.</p><p><strong>Indications: </strong>Radial tunnel syndrome, supinator lodge syndrome, tumour compressing the nerve, unsuccessful conservative therapy for at least 6 weeks and up to 4-6 months.</p><p><strong>Contraindications: </strong>Infection or skin disease at the surgical area, severe scarring from previous surgery, systemic diseases that prevent anaesthesia, and nerve entrapment outside the radial tunnel and supinator tunnel.</p><p><strong>Surgical technique: </strong>Decompression of the radial nerve both by addressing the entrapments within the radial tunnel and incising the supinator tunnel facilitating the anterolateral approach via the internerval plane between the brachioradialis and brachialis muscles.</p><p><strong>Postoperative management: </strong>Compressive dressing around the complete arm for 3 weeks.</p><p><strong>Results: </strong>Radial tunnel syndrome (RTS) and supinator lodge syndrome are nerve compression syndromes of the radial nerve. Proximal compression may cause mixed symptoms with pain, sensory, and motor deficits, while distal compression may cause either sensory or motor deficits. If symptoms persist for 4-6 months, surgical decompression is recommended, whereby the anterolateral approach is preferred due to better healing results and extensibility. The success rate after surgical decompression averages between 67 and 92%.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"119-130"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}