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经内固定治疗的马长骨骨折和关节固定术中的骨科感染:192例(1990 - 2006年)

Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006).

作者信息

Ahern Benjamin J, Richardson Dean W, Boston Raymond C, Schaer Thomas P

机构信息

Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348, USA.

出版信息

Vet Surg. 2010 Jul;39(5):588-93. doi: 10.1111/j.1532-950X.2010.00705.x. Epub 2010 Apr 29.

Abstract

OBJECTIVE

To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors.

STUDY DESIGN

Case series.

ANIMALS

Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation.

METHODS

Medical records (1990-2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome.

RESULTS

Of 192 horses (171 [89%] closed, 21 [11%] open fractures), 157 (82%) were discharged from the hospital. Infection occurred in 53 (28% horses), of which 31 (59%) were discharged. Repairs without POI were 7.25 times more likely to be discharged from the hospital. Closed fractures were 4.23 times more likely to remain uninfected and 4.59 times more likely to be discharged from the hospital compared with open fractures. Closed reduction and internal fixation was associated with a 2.5-fold reduction in rate of POI and a 5.9 times greater chance for discharge from the hospital compared with open reduction and internal fixation. Females had a strong trend for increased POI when compared with colts and stallion but not geldings.

CONCLUSIONS

Overall rate of POI was 28%. Fracture classification, method of repair, gender, and surgical duration were significant risk factors.

摘要

目的

确定马长骨骨折内固定修复及关节固定术后感染(POI)率,并识别相关危险因素。

研究设计

病例系列研究。

动物

接受第三掌骨和跖骨、桡骨、尺骨、肱骨、胫骨和股骨骨折修复或关节内固定的马(n = 192)。

方法

回顾1990年至2006年的病历,记录动物特征、解剖位置、骨折分类及修复方法、技术和手术时长、分离出的细菌种类、术后护理、POI发病情况及结果。

结果

192匹马中(171匹[89%]为闭合性骨折,21匹[11%]为开放性骨折),157匹(82%)出院。53匹(28%)马发生感染,其中31匹(59%)出院。未发生POI的修复病例出院可能性高7.25倍。与开放性骨折相比,闭合性骨折未感染可能性高4.23倍,出院可能性高4.59倍。与切开复位内固定相比,闭合复位内固定POI率降低2.5倍,出院可能性高5.9倍。与公马和种马相比,母马POI有增加的强烈趋势,但与去势公马相比无差异。

结论

POI总体发生率为28%。骨折分类、修复方法、性别和手术时长是显著危险因素。

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