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双侧桡骨远端骨折患者的人口统计学特征及治疗结果

The demographics and outcomes in patients with bilateral distal radius fractures.

作者信息

Gonzalez Matthew, Rahman Ayesha, Leucht Philipp, Tejwani Nirmal

出版信息

Acta Orthop Belg. 2021 Jun;87(2):219-225.

Abstract

Although distal radius fractures are quite common, bilateral distal radius fractures seldomly occur. Due to this, treatment is primarily based on surgeon experience with unilateral fractures, however bi- lateral fractures add a level of complexity : loss of functional independence. The purpose of this study was to examine a cohort of patients with bilateral distal radius fractures to identify differences in demographics, mechanism of injury, and outcomes to further our understanding of these rare injuries. 23 patients were identified retrospectively over a 5-year period that met inclusion criteria. The medical records were reviewed with multiple demographic and clinical parameters recorded and analyzed. Males were more likely to sustain high-energy mechanisms (80% vs. 53%). Patients <50 years old were more likely to sustain high-energy mechanisms (90% vs. 46%) and were more likely to be treated operatively (80% vs. 62%). The most commonly associated injury was a head injury (30%). All patients treated non-operatively reported minimal/no pain upon final follow-up where 57% of patients treated operatively noted regular pain. 75% of patients with medical comorbidities had minimal/no pain upon final follow- up. Conclusions : Patients with bilateral fractures were more likely to be younger males who suffered from higher energy mechanisms. Age was a critical factor in determining treatment strategy. Rates of associated head injuries were elevated, which is an important factor for the clinician to keep in mind when treating this population. As we further our understanding of this unique population, we can improve our treatment approaches and subsequently attain better outcomes.

摘要

尽管桡骨远端骨折很常见,但双侧桡骨远端骨折很少发生。因此,治疗主要基于外科医生处理单侧骨折的经验,然而双侧骨折增加了一定程度的复杂性:功能独立性丧失。本研究的目的是检查一组双侧桡骨远端骨折患者,以确定人口统计学、损伤机制和预后方面的差异,从而进一步加深我们对这些罕见损伤的理解。在5年期间回顾性确定了23例符合纳入标准的患者。对病历进行了审查,并记录和分析了多个人口统计学和临床参数。男性更有可能遭受高能量损伤机制(80%对53%)。年龄小于50岁的患者更有可能遭受高能量损伤机制(90%对46%),并且更有可能接受手术治疗(80%对62%)。最常见的合并损伤是头部损伤(30%)。所有接受非手术治疗的患者在最后随访时报告疼痛轻微/无疼痛,而接受手术治疗的患者中有57%注意到有经常性疼痛。75%有内科合并症的患者在最后随访时疼痛轻微/无疼痛。结论:双侧骨折患者更有可能是年轻男性,遭受更高能量的损伤机制。年龄是决定治疗策略的关键因素。合并头部损伤的发生率升高,这是临床医生在治疗该人群时需要牢记的一个重要因素。随着我们对这一独特人群的理解不断深入,我们可以改进我们的治疗方法,从而获得更好的预后。

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