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老年 COVID-19 大流行期间的尺骨鹰嘴骨折:非手术治疗是否合理?对现有证据的回顾。

Olecranon fractures in the elderly during the COVID-19 pandemic: Is non-operative treatment reasonable? Review of the current evidence.

机构信息

Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.

出版信息

Musculoskelet Surg. 2021 Aug;105(2):125-130. doi: 10.1007/s12306-021-00699-7. Epub 2021 Jan 29.

Abstract

The current COVID-19 global pandemic presents a major challenge and unprecedented pressures on health systems. The national guidelines in the UK advise non-operative treatment of fractures whenever possible to reduce the risk of surgical intervention to both patient and healthcare staff. The elderly population over 70 years are highlighted as a high-risk group in this pandemic as well as being often high risk for surgery in general due to co-morbidities. This article reviews the current literature regarding treatment of displaced olecranon fractures in the elderly. Literature search of the available databases. One randomised controlled trial has been published, comparing operative versus non-operative treatments of olecranon fractures in this age group. The study was terminated prematurely due to the high complication rate in the operative group. No difference in functional scores was recorded. Other published retrospective case series report good functional outcome scores and high satisfaction rates in the majority of patients in whom olecranon fractures were treated non-operatively. Non-operative treatment of olecranon fractures in elderly patients seems to be safe and an acceptable management option in these unprecedented times.

摘要

当前的 COVID-19 全球大流行对卫生系统构成了重大挑战和前所未有的压力。英国的国家指南建议尽可能对骨折进行非手术治疗,以降低手术干预对患者和医护人员的风险。70 岁以上的老年人群在此次大流行中是高风险群体,并且由于合并症,通常手术风险也很高。本文综述了关于老年移位性尺骨鹰嘴骨折治疗的现有文献。对现有数据库进行文献检索。已经发表了一项随机对照试验,比较了手术与非手术治疗该年龄段尺骨鹰嘴骨折的效果。由于手术组的并发症发生率高,该研究提前终止。未记录到功能评分的差异。其他已发表的回顾性病例系列报告显示,对于大多数接受非手术治疗的尺骨鹰嘴骨折患者,其功能评分良好,满意度高。在当前这种前所未有的情况下,对老年患者的尺骨鹰嘴骨折进行非手术治疗似乎是安全且可接受的治疗选择。

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本文引用的文献

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[Epidemiology and control of COVID-19].[新型冠状病毒肺炎的流行病学与防控]
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Results of non-operative treatment of olecranon fracture in over 75-year-olds.75 岁以上老年人尺骨鹰嘴骨折的非手术治疗结果。
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Tension band suture fixation for olecranon fractures.鹰嘴骨折的张力带缝线固定术
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The treatment of olecranon fractures in adults.成人尺骨鹰嘴骨折的治疗
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