多发性创伤股骨骨折的低感染率和非愈合率：一项回顾性研究。

IF 0.5 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243202e278586

Matheus Trindade Bruxelas de Freitas, Gabriel Benevides Valiate Martins, Matheus Augusto Maciel Santiago, Isaac Rocha Silva, Marcos de Camargo Leonhardt, Jorge Dos Santos Silva, Kodi Edson Kojima

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引用次数: 0

摘要

目的评估使用外固定和髓内钉（DCO）分期治疗股骨干骨折的并发症和风险：分析对象为37名患者，共40处骨折，大部分为男性（87.5%），平均年龄32.9岁。数据包括ASA评分、AO/OTA和Gustilo分类、格拉斯哥昏迷评分、损伤严重程度评分、外固定和转换时间、重症监护室持续时间、钉子类型和铰接状态。追踪的并发症包括死亡率、深部感染和不愈合：主要骨折类型为AO/OTA A型（45%），40%为开放性骨折（Gustilo A型，93.8%）。平均ISS为21；GCS为12.7。重症监护室的中位住院时间为3天；平均转院时间为10.2天。50%的病例使用了逆行钉，67.5%的病例进行了扩孔。并发症包括5%的深部感染和2.5%的不愈合：结论：采用 DCO 策略可降低感染率和不愈合率，同时降低 GCS 和延长重症监护室的住院时间。证据等级 III；回顾性队列研究。

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LOW INFECTION AND NON-UNION RATES IN POLYTRAUMA FEMORAL FRACTURES: A RETROSPECTIVE STUDY.

Objective: Assess complications and risks in staged femoral shaft fracture treatment using external fixation and intramedullary nailing (DCO).

Methods: Analysis involved 37 patients with 40 fractures, mostly male (87.5%), average age 32.9 years. Data included ASA score, AO/OTA and Gustilo classifications, Glasgow Coma Score, Injury Severity Score, times to external fixation and conversion, ICU duration, nail type, and reaming status. Complications tracked were mortality, deep infection, and non-union.

Results: Predominant fracture type was AO/OTA A (45%), with 40% open (Gustilo A, 93.8%). Average ISS was 21; GCS was 12.7. Median ICU stay was 3 days; average time to conversion was 10.2 days. Retrograde nails were used in 50% of cases, with reaming in 67.5%. Complications included deep infections in 5% and non-union in 2.5%.

Conclusion: DCO strategy resulted in low infection and non-union rates, associated with lower GCS and longer ICU stays. Level of Evidence III; Retrospective Cohort Study.

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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.