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球囊胫骨成形术治疗胫骨平台骨折。

Balloon tibioplasty for tibial plateau fractures.

机构信息

Department of Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, SY10 7AG, UK; Wales Deanery, Ty Dysgu, Cefn Coed, Nantgarw, CF15 7QQ, UK.

Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy; School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England.

出版信息

Surgeon. 2021 Oct;19(5):297-309. doi: 10.1016/j.surge.2020.08.009. Epub 2020 Sep 18.

Abstract

BACKGROUND

Tibial plateau fractures are complex intra-articular injuries. The aim of treatment is to restore joint congruity and alignment. Balloon tibioplasty is a novel, minimally invasive technique to reduce the fracture and restore the continuity of the articular surface. A systematic review was performed according to the PRISMA guidelines in order to assess the outcomes from this procedure.

SOURCES OF DATA

The online databases of Pubmed, Google scholar, the Cochrane Library, EMBASE and CINAHL were searched. Articles of interest were retrieved and evaluated, including case series, randomised controlled trials and cadaver studies.

AREAS OF AGREEMENT

Eight studies (one randomised controlled trial, four case series and three cadaver studies) were included in the final review. The studies demonstrated adequate fracture reduction with favourable clinical and imaging outcomes from balloon tibioplasty. Very few complications were described.

AREAS OF CONTROVERSY

There is a small volume of literature currently available on balloon tibioplasty with an overall low level of evidence. The overall number of reported cases is also small.

GROWING POINTS

Further research is necessary, with adequately powered randomised controlled trials. Further areas of research include type of bone substitute and the use of arthroscopically assisted surgery.

摘要

背景

胫骨平台骨折是一种复杂的关节内损伤。治疗的目的是恢复关节的一致性和对线。球囊胫骨成形术是一种新颖的微创技术,可用于减少骨折并恢复关节表面的连续性。根据 PRISMA 指南进行了系统评价,以评估该手术的结果。

资料来源

在线检索了 Pubmed、Google Scholar、Cochrane 图书馆、EMBASE 和 CINAHL 数据库。检索并评估了感兴趣的文章,包括病例系列、随机对照试验和尸体研究。

达成共识的领域

最终综述纳入了 8 项研究(1 项随机对照试验、4 项病例系列研究和 3 项尸体研究)。这些研究表明,球囊胫骨成形术可充分减少骨折,并获得良好的临床和影像学结果。仅描述了极少数并发症。

存在争议的领域

目前关于球囊胫骨成形术的文献数量较少,总体证据水平较低。报告的病例总数也较少。

有待研究的领域

需要进一步的研究,包括进行充分有力的随机对照试验。进一步的研究领域包括骨替代物的类型和关节镜辅助手术的应用。

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