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单骨前臂重建的并发症与结局

Complications and Outcomes of One-Bone Forearm Reconstruction.

作者信息

Kim So Yeon, Chim Harvey, Bishop Allen T, Shin Alexander Y

机构信息

University of São Paulo, Brazil.

University of Miami, FL, USA.

出版信息

Hand (N Y). 2017 Mar;12(2):140-144. doi: 10.1177/1558944716643305. Epub 2016 Jul 7.

Abstract

The objective of this study was to review the outcomes of patients who underwent one-bone forearm (OBF) reconstruction. A retrospective review of patients who underwent OBF surgery between 1994 and 2014 was undertaken. Patient demographics, etiology, associated injuries, number of surgeries prior to OBF surgery, surgical details, and postoperative information were collected. A telephone interview was conducted at final follow-up, including a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, a 10-point scoring system used by Peterson et al, and a series of questions concerning pain and patient satisfaction. There were 6 males and 2 females with a mean age of 44 years (range, 20-66 years). All patients had traumatic etiology, with 6 having open wounds and 2 having closed wounds. All patients had union with a mean follow-up of 83.6 months (range, 16-218 months). The mean pain score was 3 (range, 0-8), of which 3 were painless (score 0). The mean QuickDASH score was 39 (range, 7-75), and 4 patients had good or excellent results according to the 10-point score system used by Peterson et al. All patients were satisfied with the result. Five of 8 had complications related to soft tissues that were residual from their prior injuries and surgeries. One patient had post healing fracture requiring revision fixation and 1 had a postoperative infection requiring parenteral antibiotics. OBF surgery is an effective salvage procedure for complicated forearm instability, particularly after trauma. While union rates are high, complications are typically related to pain and soft tissue secondary to the previous injury and reconstructive procedures.

摘要

本研究的目的是回顾接受单骨前臂(OBF)重建患者的治疗结果。对1994年至2014年间接受OBF手术的患者进行了回顾性研究。收集了患者的人口统计学资料、病因、相关损伤、OBF手术前的手术次数、手术细节及术后信息。在末次随访时进行了电话访谈,包括上肢、肩部和手部快速残疾问卷(QuickDASH)、彼得森等人使用的10分评分系统以及一系列关于疼痛和患者满意度的问题。共有6例男性和2例女性,平均年龄44岁(范围20 - 66岁)。所有患者病因均为创伤,其中6例有开放性伤口,2例有闭合性伤口。所有患者均实现骨愈合,平均随访83.6个月(范围16 - 218个月)。平均疼痛评分为3分(范围0 - 8分),其中3例无痛(评分为0分)。平均QuickDASH评分为39分(范围7 - 75分),根据彼得森等人使用的10分评分系统,4例患者结果为良好或优秀。所有患者对结果均满意。8例中有5例出现与先前损伤和手术残留的软组织相关的并发症。1例患者愈合后骨折需要翻修固定,1例患者术后感染需要胃肠外使用抗生素。OBF手术是治疗复杂前臂不稳定的有效挽救性手术,尤其是创伤后。虽然骨愈合率高,但并发症通常与先前损伤和重建手术继发的疼痛和软组织问题有关。

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