调整方法：脊髓灰质炎后综合征患者股骨骨折的处理

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-03-17 DOI:10.1016/j.jcot.2025.102979

Venkatesan Senthil Kannan, Singanallur Palanivelayutham Sivakumar, Jayaramaraju Dheenadhayalan, Shanmuganathan Rajasekaran

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引用次数: 0

摘要

脊髓灰质炎后综合征（PPS）可以显著改变下肢解剖结构和功能。股骨是脊髓灰质炎后患者最常见的骨折部位。本研究旨在探讨PPS合并股骨骨折患者的手术挑战、采用的固定技术和功能结局。方法对38例PPS合并股骨骨折患者进行回顾性分析。我们评估了潜在的损伤机制、解剖变异（如外翻颈畸形、大转子发育不全、椎管狭窄、固定膝关节屈曲），并采用了固定技术。评估愈合时间和功能恢复情况。结果跌倒是骨折最常见的原因。值得注意的是，观察到各种解剖变异，可能影响治疗策略。髓内钉是首选的固定方法；然而，由于解剖学上的限制，一些病例需要其他髓外固定技术。骨折愈合的平均时间为24周，所有患者均恢复了骨折前的功能状态。结论PPS患者股骨骨折的治疗需要仔细考虑独特的解剖学挑战和患者的具体因素。多学科的方法强调术前计划，术中固定技术的适应性，以及全面的术后康复是获得最佳结果和减少并发症的关键。

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Tailoring the approach: Management of femur fractures in post-polio syndrome patients

Background

Post-polio syndrome (PPS) can significantly alter lower limb anatomy and function. Femur is the most commonly fractured bone in post-polio patients. This study aimed to investigate the surgical challenges, fixation techniques employed, and functional outcomes in PPS patients with femoral fractures.

Methods

A retrospective analysis was conducted on 38 PPS patients diagnosed with femoral fractures. We assessed the underlying injury mechanism, anatomical variations (e.g., valgus neck deformity, hypoplastic greater trochanter, narrow canal, fixed knee flexion), and employed fixation techniques. Union time and functional recovery were evaluated.

Results

Trivial falls were the most frequent cause of fracture. Notably, various anatomical variations were observed, potentially influencing treatment strategies. Intramedullary nailing was the preferred fixation method; however, some cases necessitated alternative extramedullary fixation techniques due to anatomical constraints. The average time for fracture union was 24 weeks, with all patients regaining their pre-fracture functional status.

Conclusion

Femoral fracture management in PPS patients requires meticulous consideration of unique anatomical challenges and patient-specific factors. A multidisciplinary approach emphasizing preoperative planning, intraoperative adaptability in fixation techniques, and comprehensive postoperative rehabilitation is crucial for optimal outcomes and minimizing complications.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.