贝内特骨折固定后的最佳固定方式:尸体研究

IF 1.1 4区 医学 Q3 ORTHOPEDICS
Orthopedics Pub Date : 2024-05-01 Epub Date: 2023-12-28 DOI:10.3928/01477447-20231220-03
Anthony J Mitchell, Robert H Ablove, Erik Bradley
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引用次数: 0

摘要

目的:治疗高水平运动员需要在尽早恢复比赛和安全恢复比赛之间取得平衡。在手术治疗本内特骨折后,建议采用各种类型的保护性固定。本研究的目的是调查手部固定是否能提供与前臂固定相同的保护:在 8 个新鲜冷冻的尸体前臂上制作了贝内特骨折的尸体模型。使用单个无头加压螺钉进行骨合成。将三对匹配的标本制成手部或前臂长度的拇指棘突石膏模型,另外两个标本未制成石膏模型作为对照。试样安装在定制的测试仪器上。重量以 6.8 千克为单位递增,直至固定失败和骨折移位。每次试验后都要进行透视检查。我们使用 Kruskal-Wallis 非参数检验对各组进行比较。我们考虑了PR结果:对照组样本在 6.8 千克时发生固定失败。手部和前臂长度模型的固定失败平均为 18.1±5.1 kg。我们没有发现对照组标本和 2 个固定类别的失效载荷中位值(公斤)之间存在统计学意义上的显著差异(P=.114)。手部固定组的所有标本都有额外的腕部损伤,而前臂长度固定组没有发现额外的损伤:我们的研究结果表明,与传统的前臂固定相比,手部固定对手术治疗的贝内特骨折提供了同等的固定失败保护,但可能会增加运动员腕部受伤的风险。[骨科。202x;4x(x):xx-xx]。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimal Immobilization After Fixation of Bennett's Fracture: A Cadaveric Study.

Objective: Treating high-level athletes involves a balance between early and safe return to play. Various types of protective immobilization have been recommended after operatively treated Bennett's fracture. The purpose of this study was to investigate if hand-based immobilization offers protection equivalent to forearm-based immobilization.

Materials and methods: A cadaveric model of Bennett's fracture was created in 8 fresh-frozen, cadaveric forearms. Osteosynthesis was performed using a single headless compression screw. Three matched pairs were casted in either hand-based or forearm length, thumb spica casts, while 2 specimens remained un-casted as controls. Specimens were mounted on a custom testing apparatus. Weights were added in 6.8-kg increments until fixation failed and the fracture displaced. Fluoroscopy was performed after each trial. We used the Kruskal-Wallis non-parametric test to compare the groups. We considered P<.05 statistically significant.

Results: Failure of fixation occurred at 6.8 kg in the control specimens. Fixation failed in hand-based and forearm length casts at a mean of 18.1±5.1 kg. We did not find a statistically significant difference between median values of load at failure in kilograms across control specimens and 2 immobilization categories (P=.114). All specimens in the hand-based group sustained additional wrist injuries, while no additional injuries were noted in the forearm length group.

Conclusion: Our study results showed that hand-based immobilization provides equivalent protection against fixation failure for operatively treated Bennett's fractures but may predispose athletes to increased risk of wrist injury compared with traditional, forearm-based casting. [Orthopedics. 2024;47(3):157-160.].

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来源期刊
Orthopedics
Orthopedics 医学-整形外科
CiteScore
2.20
自引率
0.00%
发文量
160
审稿时长
3 months
期刊介绍: For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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