胫骨平台损伤:机械植入钢板和MIPO进入孟加拉国三级医院

Q4 Medicine
Md. Abdur Rashid, S. Ahmed, Reza Nasim Ahmed
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引用次数: 0

摘要

引言:胫骨近端损伤是具有挑战性的治疗,因为关节面受累,经常充血,和不稳定的软组织状况,特别是在高能创伤后。该治疗旨在恢复支撑典型凹陷的胫骨平台软骨的关节表面的统一,使用强力装置稳定骨折,防止进一步损伤,使其早日康复。我们描述了我们的治疗方法,在需要时使用闭合或打开复位和内固定、多轴钢板、自动骨光泽度或其他由自体血小板凝胶增强的骨传导材料。手术取决于软组织的时机,通常直接或在熟练的外科医生的指导下尽可能使用组织保留技术进行。材料和方法:前瞻性分析2019年1月至2021年6月在孟加拉国拉杰沙希伊斯兰银行医学院医院和多中心三级医院治疗的所有胫骨近端骨折病例(n=58)。通过评估医院图表、办公室记录、术前和术后x线片收集患者资料。骨折分为OTA/AO型。在78%的术后12个月组中,Rasmussen评分对功能结果的评估发现了积极的突出结果。结果:共发现58例胫骨近端(关节内)骨折。手术时的平均年龄为43岁(19 - 79岁),而女性和39名男性的平均年龄为19岁。最常见的伤害机制与交通事故(RTA)有关,占75%的病例。A型AO/OTA骨折09例(18.4%),B型AO/OTA骨折31例(53.5%),C型AO/OTA骨折18例(31.1%)。大多数(90%)病例(44例)采用多轴解剖角度稳定锁定钢板切开复位内固定治疗。结论:采用锁定钢板内固定,遵循MIPO原则(微创经皮骨融合术),可提供可接受的骨折复位,中期临床效果良好。今日医学2022 Vol.34(2): 93-98
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tibial Plateau Injury: Mechanical Implantation with Plates and MIPO Approach Tertiary Level Hospital in Bangladesh
Introduction: Proximal tibial injuries are challenging to treat because of articular surface involvement, frequent congestion, and precariat soft tissue conditions, particularly after high-energy traumas. The treatment is intended to restore the unity of the joint surfaces that supports the typically depressed tibial plateau cartilage, use a strong device to stabilize the fracture and prevent further damage, to enable early recovery. We describe our treatment approach, using closed or open decrease and internal fixation, polyaxy plates, automatic bone-gloss, or other osteoconductive material enhanced by autologous platelet gel, where required. Surgery depends on the timing of the soft tissue and is typically done directly or under the guidance of a skilled surgeon using tissue-sparing techniques as much as feasible. Materials and Methods: A prospective analysis of all (n=58) proximal tibial fractures at the Islamic Bank Medical College Hospital and multicentral tertiary level hospital, Rajshahi, Bangladesh, from January 2019 to June 2021. Patient data were collected by evaluating hospital diagrams, office records, preoperative and after operative radiograph. Fractures were classified in the classification of OTA/AO. In 78 % of the 12-month post-surgery group, the Rasmussen score's evaluation of functional outcomes found positive to outstanding results. Results: Total Number of patient n=58 tibial proximal (intra-articular) fractures have been identified. The mean age was 43 years (range 19–79) at surgery, whereas women and 39 men were 19. The most frequent injury mechanism was linked to traffic accidents (RTA), representing 75% of cases. 09 (18.4%) AO/OTA types A, 31 (53.5%) AO/OTA type B and 18, (31.1%) AO/OTA type C fractures have been identified. Most (90 %) cases (44) were treated with open reduction and internal fixation, using polyaxially anatomical angular stability locking Plates. Conclusions: Internal fixing using locking plates, following the MIPO principles (Minimally Invasive Percutaneous Osteosynthesis), offers an acceptable reduction of fractures with excellent outcomes for the medium-term clinical results. Medicine Today 2022 Vol.34(2): 93-98
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Medicine Today
Medicine Today Medicine-Medicine (all)
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