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骶骨跳跃骨折:一种成功复位与固定的新颖且可重复的方法。

Jumper's fracture of the sacrum: a novel and reproducible way for successful reduction and fixation.

作者信息

Linhart Christoph, Befrui Nima, Etzel Lucas, Böcker Wolfgang, Kammerlander Christian, Ehrnthaller Christian

机构信息

Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany.

Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Munich, Germany.

出版信息

Eur Spine J. 2022 Jan;31(1):18-27. doi: 10.1007/s00586-021-07010-z. Epub 2021 Oct 5.

Abstract

PURPOSE

Surgical treatment of jumper's fractures is a highly demanding situation for the surgeon due to its rareness and frequent association with severe concomitant injuries. There is no current consensus regarding a standard treatment approach, thus reducing quality of care. Our objectives were to describe, apply and assess a novel surgical technic.

METHODS

The presented research is an observational retrospective study of patients who underwent the described novel surgical intervention in a level 1 trauma center. We conducted analyses of the patient cohort using patient-related outcome measures at least 1 year after surgery, as well as investigating pain, quality of life and the clinical effectiveness of the procedure.

RESULTS

A total of 24 patients (17 male and 7 female) with an average age 47 ± 16.3 years were included. ISS scores ranged from 9 to 66 with a mean ISS of 40 ± 15. Clinical scores exist of 15 out of 24 patients (62.5%). The mean VAS score was 53.7 ± 12.9. The mean EQ-5D index was 0.68 ± 0.22. Significant negative correlation existed between the ISS value and the EQ-5D index (r =  - 0.704; p < 0.005) and EQ-5D VAS (r =  - 0.809; p < 0.001). Anatomical reduction was achieved in all patients (n = 24). Radiological follow-up was performed in 58%.

CONCLUSION

We present one of the largest studies with operatively treated jumper's fractures of the sacrum. The technique is capable of reproducibly restoring the physiological anatomy of the patient and allows pain-adapted mobilization.

摘要

目的

由于跳跃者骨折较为罕见且常伴有严重的合并伤,因此其外科治疗对外科医生来说是一项极具挑战性的任务。目前对于标准治疗方法尚无共识,从而降低了医疗质量。我们的目标是描述、应用并评估一种新型手术技术。

方法

本研究为一项观察性回顾性研究,研究对象为在一级创伤中心接受所述新型手术干预的患者。我们在术后至少1年使用与患者相关的结局指标对患者队列进行分析,并调查疼痛、生活质量及该手术的临床效果。

结果

共纳入24例患者(17例男性,7例女性),平均年龄47±16.3岁。损伤严重度评分(ISS)范围为9至66,平均ISS为40±15。24例患者中有15例(62.5%)存在临床评分。视觉模拟评分(VAS)平均为53.7±12.9。欧洲五维度健康量表(EQ-5D)指数平均为0.68±0.22。ISS值与EQ-5D指数(r = -0.704;p < 0.005)及EQ-5D视觉模拟评分(VAS)(r = -0.809;p < 0.001)之间存在显著负相关。所有患者(n = 24)均实现了解剖复位。58%的患者进行了影像学随访。

结论

我们展示了一项关于手术治疗骶骨跳跃者骨折的大型研究之一。该技术能够可重复地恢复患者的生理解剖结构,并允许进行适应疼痛的活动。

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