预测指关节损伤的严重并发症和高治疗成本：一项系统的文献综述。

Predicting serious complications and high cost of treatment of tooth-knuckle injuries: a systematic literature review.

作者信息

Smith H R, Hartman H, Loveridge J, Gunnarsson R

机构信息

Townsville Clinical School, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Department of Orthopaedic Surgery, Cairns Hospital, Cairns, QLD, Australia.

出版信息

Eur J Trauma Emerg Surg. 2016 Dec;42(6):701-710. doi: 10.1007/s00068-016-0701-6. Epub 2016 Jun 30.

DOI:10.1007/s00068-016-0701-6

PMID:27363840

Abstract

PURPOSE

The tooth-knuckle injury (TKI) is a serious and potentially costly injury seen in orthopaedic practice. The aim was to conduct a systematic literature review on the factors associated with serious complications and high treatment costs in tooth-knuckle injuries.

METHODS

MEDLINE, Scopus and CINAHL were used as the literature sources.

INCLUSION CRITERIA

Original research papers that reported on factors predicting serious complications and high treatment costs in TKIs were included. There were no restrictions placed on study size, language, study design or date of publication.

EXCLUSION CRITERIA

Case studies, case series and review articles were not included.

RESULTS

After duplicates were removed, 403 unique studies remained; after titles and abstracts were screened, 48 titles remained and were retrieved in full text. Of these, 14 titles met the inclusion criteria and were included in the data synthesis. Tenosynovitis, septic arthritis, osteomyelitis and residual stiffness were common serious complications occurring in up to 36.3, 70.0, 47.6 and 65.3 % of cases, respectively. Amputation was also common in up to 18.0 % of injuries. Treatment costs were measured by length of hospital stay and the number of debridements required. On average, patients required 3.8-8 days of admission and 1.3-2.7 debridements each.

CONCLUSION

Increased time delay from injury to treatment, deeply penetrating injuries, proximal interphalangeal joint (PIPJ) injuries and, possibly, E. corrodens infections were associated with serious complications in TKIs. Delayed treatment, inadequate treatment, PIPJ injuries and deeply penetrating injuries predicted higher treatment costs.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42016029949 ( http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016029949 ).

摘要

目的

指节损伤（TKI）是骨科临床中一种严重且可能代价高昂的损伤。本研究旨在对与指节损伤严重并发症及高治疗费用相关的因素进行系统的文献综述。

方法

以MEDLINE、Scopus和CINAHL作为文献来源。

纳入标准

纳入报道指节损伤中预测严重并发症及高治疗费用因素的原创性研究论文。对研究规模、语言、研究设计或发表日期均无限制。

排除标准

不纳入病例研究、病例系列和综述文章。

结果

去除重复文献后，剩余403项独立研究；经标题和摘要筛选后，剩余48篇标题文献并获取全文。其中，14篇标题文献符合纳入标准并纳入数据合成。腱鞘炎、化脓性关节炎、骨髓炎和残留僵硬是常见的严重并发症，分别在高达36.3%、70.0%、47.6%和65.3%的病例中出现。截肢在高达18.0%的损伤中也较为常见。治疗费用通过住院时间和所需清创次数来衡量。平均而言，患者每次住院需要3.8 - 8天，平均需要1.3 - 2.7次清创。