原发性膀胱萎缩修复术中不进行截骨术的干骺端逼近术的长期矫形和放射学效果。

IF 1.5 3区 医学 Q2 PEDIATRICS
Martin Promm, Raphael Hofbauer, Roland Brandl, Christopher Gossler, Susanne Brandstetter, Michael Kertai, Aybike Hofmann, Marco J Schnabel, Wolfgang H Rösch
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引用次数: 0

摘要

前言:以前的假设认为,原发性外翻修复术(PER)中的不截骨逼近技术只能用于新生儿,而且预期效果较差。最近的研究表明,这种技术不仅可以成功用于即刻修复,而且还能产生良好的长期效果。因此,我们评估并比较了耻骨联合逼近术(无需截骨)在即刻和延迟 PER 中的矫形和放射学长期效果:方法:从 2018 年 3 月至 2020 年 12 月,我们招募了患有 PER 并在不截骨的情况下进行耻骨联合近端切除术的患者。患者结果:共纳入 29 例患者,其中 11 例为即刻性 PER,18 例为延迟性 PER。两组患者在髋关节疼痛(p = 0.419)、活动障碍(p = 0.543)、运动障碍(p = 0.543)、髋关节撞击(p = 1.000)、腿长差异(p = 0.505)和核磁共振成像测量的耻骨横膈宽度(p = 0.401)方面无明显差异。CEA右侧(中位数30度,p = 0.976)、CEA左侧(中位数31.5度,p = 0.420)、ACA右侧(中位数19度,p = 0.382)和ACA左侧(中位数17度,p = 0.880)也无明显差异:结论:对膀胱外翻患者进行立即和延迟膀胱闭合术、干骺端逼近术而不进行截骨术后,其临床矫形或放射学长期疗效无明显差异。建立核心结果集对于获得可靠和可比较的结果至关重要,可进一步推进和证实我们的初步见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Orthopaedic and Radiological Outcomes of Symphysis Approximation without Osteotomy in Primary Bladder Exstrophy Repair.

Introduction:  Previous assumptions suggested that the technique of approximation without osteotomy in primary exstrophy repair (PER) could only be applied in newborns and anticipated poorer outcomes. Recent studies indicated that this technique can be successfully executed not only in immediate PER but also yields favorable long-term results. Therefore, we evaluated and compared the orthopaedic and radiological long-term outcomes after pubic symphysis approximation without osteotomy in immediate and delayed PER.

Methods:  From March 2018 to December 2020, individuals with PER and approximation of the symphysis without osteotomy were recruited. Patients <12 years and with a history of orthopaedic surgery of the bony pelvis were excluded. Orthopaedic examinations and magnetic resonance imaging (MRI) of the bony pelvis including the hip joints were performed and pubic diastasis, the acetabulum angle (ACA), and the center-edge angle (CEA) were evaluated.

Results:  Twenty-nine patients were included, 11 of them had an immediate and 18 had a delayed PER. Between the two groups, no significant differences could be observed concerning hip pain (p = 0.419), mobility impairment (p = 0.543), sports impairment (p = 0.543), hip impingement (p = 1.000), leg length discrepancy (p = 0.505), and width of the pubic diastasis as measured by MRI (p = 0.401). There were also no significant differences with regard to CEA right (median 30 degrees, p = 0.976), CEA left (median 31.5 degrees, p = 0.420), ACA right (median 19 degrees, p = 0.382), and ACA left (median 17 degrees, p = 0.880).

Conclusion:  There were no significant differences in clinical orthopaedic or radiological long-term outcomes between bladder exstrophy patients after immediate and delayed bladder closure with symphysis approximation without osteotomy. Establishing core outcome sets is essential to get robust and comparable results, further advancing and substantiating our initial insights.

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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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