ABOS 第二期候选人的肱骨远端骨折的治疗趋势。

Treatment trends in distal humerus fractures between ABOS part II candidates.

机构信息

William Beaumont Army Medical Center, Department of Orthopaedic Surgery, El Paso, Texas, USA; Texas Tech University Health Science Center, Department of Orthopaedic Surgery, El Paso, Texas, USA.

出版信息

Injury. 2022 Mar;53(3):1044-1048. doi: 10.1016/j.injury.2021.09.058. Epub 2021 Oct 1.

DOI:10.1016/j.injury.2021.09.058

PMID:34654550

Abstract

PURPOSE

The purpose of this study was to determine how fellowship training influences the treatment of distal humerus fractures with either total elbow arthroplasty (TEA) or open reduction internal fixation (ORIF).

METHODS

The American Board of Orthopaedic Surgery (ABOS) Part II Examination Database was queried for all orthopaedic surgeons who sat for the Part II examination between the years 2003-2019. Inclusion criteria were ORIF or TEA cases, selected by individual CPT codes for each procedure, and patients of at least age 65 years who sustained acute distal humerus fractures. Analysis was performed for each type of fellowship training completed, total number of procedures performed, the type of procedure performed, patient demographics, and any complications.

RESULTS

There were 149 TEAs and 1306 ORIFs performed for distal humerus fractures between the exam years of 2003-2019. The proportion of TEA to ORIF increased from 7.6% to 11.0%. Partitioned by fellowship training, Hand and Upper Extremity surgeons performed 69 (17.4%) TEAs and 328 (82.6%) ORIFs, Shoulder and Elbow surgeons performed 34 (29.6%) TEAs and 81 (70.4%) ORIFs, Sports Medicine surgeons performed 14 (5.1%) TEAs and 263 (94.6%) ORIFs, and Trauma surgeons performed 16 (4.2%) TEAs and 366 (95.8%) ORIFs. Hand and Upper Extremity surgeons treated the most distal humerus fractures (397, 27.3%), followed by Trauma surgeons (382, 26.3%).

CONCLUSION

Our data suggests that fellowship training does influence the surgical decision-making process for treating distal humerus fractures in elderly populations. Hand and Upper Extremity surgeons performed the greatest number of TEA for acute distal humerus fractures, followed by Shoulder and Elbow surgeons. Conversely, trauma surgeons performed the lowest proportion of TEA to ORIF.

LEVEL OF EVIDENCE

III.

摘要

目的

本研究旨在确定 fellowship 培训如何影响采用全肘关节置换术（TEA）或切开复位内固定术（ORIF）治疗肱骨远端骨折的治疗方法。

方法

在美国骨科医师协会（ABOS）第 II 部分考试数据库中，查询了 2003 年至 2019 年参加第 II 部分考试的所有骨科医师。纳入标准为 ORIF 或 TEA 病例，通过每个手术的单独 CPT 代码选择，并对至少 65 岁的急性肱骨远端骨折患者进行分析。对完成的每种 fellowship 培训类型、进行的手术总数、进行的手术类型、患者人口统计学资料以及任何并发症进行分析。

结果

在 2003 年至 2019 年的考试年度期间，共进行了 149 例 TEA 和 1306 例 ORIF 治疗肱骨远端骨折。TEA 与 ORIF 的比例从 7.6%增加到 11.0%。按 fellowship 培训分类，手和上肢外科医生进行了 69 例（17.4%）TEA 和 328 例（82.6%）ORIF，肩部和肘部外科医生进行了 34 例（29.6%）TEA 和 81 例（70.4%）ORIF，运动医学外科医生进行了 14 例（5.1%）TEA 和 263 例（94.6%）ORIF，创伤外科医生进行了 16 例（4.2%）TEA 和 366 例（95.8%）ORIF。手和上肢外科医生治疗的肱骨远端骨折最多（397 例，27.3%），其次是创伤外科医生（382 例，26.3%）。