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美国并指松解时机相关因素分析。

Factors Associated with Timing of Syndactyly Release in the United States.

机构信息

Department of Orthopaedic Surgery, Meir Medical Center, Kfar Saba, Israel.

Department of Orthopaedics and Sports Medicine, The Christ Hospital, Cincinnati, OH, USA.

出版信息

J Hand Surg Asian Pac Vol. 2022 Apr;27(2):294-299. doi: 10.1142/S2424835522500229. Epub 2022 Mar 31.

Abstract

Syndactyly is one of the commonly encountered congenital hand anomalies. However, there are no strict guidelines regarding the timing of surgical release. The aim of this study was to investigate the age and factors associated with syndactyly release in the United States. A retrospective analysis of the California and Florida State Ambulatory Surgery and Services Databases for patients aged 18 years or younger who underwent syndactyly release surgery between 2005 and 2011 was performed. Demographic data that included the age at release, gender, race and primary payor (insurance) was collected. A sub-analysis was performed to compare the demographic characteristics between those patients undergoing syndactyly release before 5 years of age ('Early Release') and at (of after) 5 years ('Late Release'). A total of 2,280 children (68% male, 43% Caucasian) were identified. The mean age of syndactyly release was 3.6 years, and 72.9% of patients underwent release before the age of 5 years. A significantly larger proportion of females ( = 0.002), and Hispanics and African Americans ( = 0.024), underwent late release compared to early release. Additionally, a significantly higher percentage of patients undergoing late release utilised private insurance ( = 0.005). However, the actual differences in gender, race and primary payor were small. The majority of syndactyly releases were performed before school age, which is the primary goal in the management of syndactyly. While gender and racial disparities in the surgical treatment of syndactyly may exist, the differences in the present study were relatively small. Level III (Therapeutic).

摘要

并指畸形是一种常见的先天性手部畸形。然而,对于手术松解的时机并没有严格的指导方针。本研究旨在探讨美国并指畸形松解的年龄和相关因素。

对 2005 年至 2011 年间在加利福尼亚州和佛罗里达州门诊手术和服务数据库中接受并指畸形松解手术的 18 岁或以下患者进行了回顾性分析。收集了包括松解时年龄、性别、种族和主要付款人(保险)在内的人口统计学数据。进行了一项亚分析,以比较 5 岁前(“早期松解”)和(或)5 岁后(“晚期松解”)接受并指松解的患者的人口统计学特征。

共确定了 2280 名儿童(68%为男性,43%为白种人)。并指松解的平均年龄为 3.6 岁,72.9%的患者在 5 岁之前接受松解。与早期松解相比,女性(=0.002)、西班牙裔和非裔美国人(=0.024)接受晚期松解的比例明显更高。此外,接受晚期松解的患者中,使用私人保险的比例明显更高(=0.005)。然而,性别、种族和主要付款人之间的实际差异很小。大多数并指松解在学龄期前进行,这是并指畸形管理的主要目标。虽然并指畸形手术治疗中可能存在性别和种族差异,但本研究中的差异相对较小。

III 级(治疗)。

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