Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK.
Academic Medical Unit, The University of Sheffield, Sheffield, UK.
J Hand Surg Eur Vol. 2021 Sep;46(7):768-773. doi: 10.1177/1753193420981871. Epub 2021 Jan 17.
We present 210 patients with hand osteomyelitis in 246 rays over 12 years, including detailed analysis of 29 patients in this cohort with digital artery calcification evident on plain X-ray. Overall 71 patients had diabetes mellitus and/or end-stage renal failure, including 28 of 29 patients with calcification. In the calcification group, 17 patients had ipsilateral arteriovenous fistulae, five had steal syndrome and 15 had digital ulceration or skin necrosis. Compared with 181 controls, patients with calcification had more affected bones, polymicrobial infections, surgical procedures, phalanges and digits amputated and had higher mortality at 1 year (12 of 29) and 5 years (20 of 29), as a result of comorbidities. Absence of calcification in 43 patients with diabetes and/or end-stage renal failure was associated with better outcomes on all the above parameters. Early amputation to maximize disease-free survival may be appropriate for patients with hand osteomyelitis and arterial calcification. IV.
我们报告了 12 年间 246 根手指中有 210 例手部骨髓炎患者，包括对这组 29 例手部动脉钙化的详细分析。29 例有钙化的患者中，71 例患有糖尿病和/或终末期肾病，其中 28 例有钙化。在钙化组中，17 例患者有同侧动静脉瘘，5 例有窃血症，15 例有指溃疡或皮肤坏死。与 181 例对照相比，钙化患者的受累骨骼更多，感染更复杂，手术更多，掌指骨和指骨被截除，1 年（29 例中有 12 例）和 5 年（29 例中有 20 例）的死亡率更高，这是由合并症引起的。在 43 例患有糖尿病和/或终末期肾病的患者中，如果没有钙化，则所有上述参数的预后更好。对于手部骨髓炎和动脉钙化的患者，早期截肢以最大限度地提高无疾病生存可能是合适的。四。
