目的通过这次Meta分析比较桡骨头置换与切开复位内固定在治疗肘关节恐怖三联征(TTIE)桡骨头骨折时疗效的差异。方法计算机检索自2013年3月至2022年3月在Pubmed、Web of Science、Embase、Cochrane Central Register of Controlled Trial...目的通过这次Meta分析比较桡骨头置换与切开复位内固定在治疗肘关节恐怖三联征(TTIE)桡骨头骨折时疗效的差异。方法计算机检索自2013年3月至2022年3月在Pubmed、Web of Science、Embase、Cochrane Central Register of Controlled Trials(Central)、Cinahl、Medline、Cochrane Library、CBM、CNKI等数据库公开发表的切开复位内固定(ORIF)和假体置换(RHA)治疗TTIE中桡骨头骨折的文献,依据检索策略,共检索到相关文献1141篇,并最终纳入12篇文献。根据Cochrane系统分析法,由两名评价员从纳入的研究中独立提取数据,并使用RevMan 5.4进行分析,并评估研究质量。结果通过Meta分析发现,手术治疗肘关节恐怖三联征时,RHA组术后前臂伸展活动度[95%CI(-5.53,-1.50),P<0.001]和术后并发症发生率[95%CI(0.20,0.79),P=0.008]上优于ORIF治疗的患者,差异有统计学意义。Mayo肘关节功能(MEPS)评分、上肢功能障碍评定量表(DASH)评分和旋转活动度方面二者比较差异无统计学意义。结论RHA组较ORIF组术后具有更优异的前臂伸展活动度和更少的术后并发症发生,因此在治疗肘关节恐怖三联征时,RHA优于ORIF。展开更多
Purpose: Failure after radial head arthroplasty is uncommon, but clinically significant. Treatment for failure may involve implant removal. We describe fourteen patients who underwent implant removal after failed radi...Purpose: Failure after radial head arthroplasty is uncommon, but clinically significant. Treatment for failure may involve implant removal. We describe fourteen patients who underwent implant removal after failed radial head arthroplasty. Methods: A retrospective review was performed to determine the cause of failure and clinical data were prospectively collected. Results: At mean follow up of 38 months the mean VAS for pain score was 3.0 and the mean DASH score was 40.5. The mean MEPS was 69. All patients demonstrated improved elbow range of motion. Mean elbow flexion at final follow up was 124°to an average extension deficit of 25°. Fifty percent of patients exhibited clinical symptoms of cubital tunnel syndrome. Three patients required additional surgery after implant removal. Conclusions: Implant removal for failed radial head arthroplasty improves range of motion and demonstrates acceptable outcomes at intermediate-term follow up. However, 50% of patients developed cubital tunnel syndrome and 21% required revision surgery.展开更多
文摘目的通过这次Meta分析比较桡骨头置换与切开复位内固定在治疗肘关节恐怖三联征(TTIE)桡骨头骨折时疗效的差异。方法计算机检索自2013年3月至2022年3月在Pubmed、Web of Science、Embase、Cochrane Central Register of Controlled Trials(Central)、Cinahl、Medline、Cochrane Library、CBM、CNKI等数据库公开发表的切开复位内固定(ORIF)和假体置换(RHA)治疗TTIE中桡骨头骨折的文献,依据检索策略,共检索到相关文献1141篇,并最终纳入12篇文献。根据Cochrane系统分析法,由两名评价员从纳入的研究中独立提取数据,并使用RevMan 5.4进行分析,并评估研究质量。结果通过Meta分析发现,手术治疗肘关节恐怖三联征时,RHA组术后前臂伸展活动度[95%CI(-5.53,-1.50),P<0.001]和术后并发症发生率[95%CI(0.20,0.79),P=0.008]上优于ORIF治疗的患者,差异有统计学意义。Mayo肘关节功能(MEPS)评分、上肢功能障碍评定量表(DASH)评分和旋转活动度方面二者比较差异无统计学意义。结论RHA组较ORIF组术后具有更优异的前臂伸展活动度和更少的术后并发症发生,因此在治疗肘关节恐怖三联征时,RHA优于ORIF。
文摘Purpose: Failure after radial head arthroplasty is uncommon, but clinically significant. Treatment for failure may involve implant removal. We describe fourteen patients who underwent implant removal after failed radial head arthroplasty. Methods: A retrospective review was performed to determine the cause of failure and clinical data were prospectively collected. Results: At mean follow up of 38 months the mean VAS for pain score was 3.0 and the mean DASH score was 40.5. The mean MEPS was 69. All patients demonstrated improved elbow range of motion. Mean elbow flexion at final follow up was 124°to an average extension deficit of 25°. Fifty percent of patients exhibited clinical symptoms of cubital tunnel syndrome. Three patients required additional surgery after implant removal. Conclusions: Implant removal for failed radial head arthroplasty improves range of motion and demonstrates acceptable outcomes at intermediate-term follow up. However, 50% of patients developed cubital tunnel syndrome and 21% required revision surgery.
