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使用电动髓内钉延长肱骨:结局与并发症的系统评价

Humerus Lengthening with a Motorized Intramedullary Nail: A Systematic Review of Outcomes and Complications.

作者信息

Lorange Justin-Pierre, Alamiri Nawaf, Marwan Yousef, Alshammari Abdullah, Hamdy Reggie Charles, Bernstein Mitchell

机构信息

Department of Pediatric Orthopedic Surgery, Limb Deformity Unit, Shriners Hospital for Children, Montreal, Quebec, Canada; Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada.

出版信息

Strategies Trauma Limb Reconstr. 2022 Sep-Dec;17(3):165-171. doi: 10.5005/jp-journals-10080-1568.

Abstract

AIM

In the past decade, internal limb lengthening nails have gained popularity. In this study, we aim to systematically review the literature on humerus limb lengthening with a motorized intramedullary nail (MIN). We intend to assess the outcome and complications of this technique.

MATERIALS AND METHODS

A systematic review was performed in the following databases: PubMed, Embase, Web of Science, and the . The inclusion criteria included limb lengthening of the humerus using an intramedullary nail, clinical studies, all levels of evidence, and no restriction to the date of publication.

RESULTS

Our search yielded 239 journal articles. A total of nine articles remained relevant based on the inclusion and exclusion criteria. The total number of patients was 20, with 22 segments lengthened. The mean age of the patients was 20.8-year-old [standard deviation (SD), 12.0; range, 13-51]. The mean gained length was 5.7 cm (SD, 0.9; range, 5-7.5) with a mean distraction protocol of 0.82 mm/day (SD, 0.2; range, 0.6-1). The average duration of lengthening was 71.6 days (SD, 12.8; range, 50-93), and the mean duration of consolidation was 192.3 days (SD, 40.5; range, 120-228). Reported complications included a range of motion (ROM) limitation, hardware failure, and hypertrophic bone regeneration.

CONCLUSION

Humeral lengthening with an MIN provides favourable outcomes with low complication rates. Future high-level studies should focus on comparing long-term outcomes of humeral lengthening utilising internal and external fixation techniques.

CLINICAL SIGNIFICANCE

Humeral lengthening using MIN can be used safely. Each surgical approach and type of nail have different risks and benefits. These should be carefully discussed when planning the surgery.

HOW TO CITE THIS ARTICLE

Lorange JP, Alamiri N, Marwan Y, . Humerus Lengthening with a Motorized Intramedullary Nail: A Systematic Review of Outcomes and Complications. Strategies Trauma Limb Reconstr 2022;17(3):165-171.

摘要

目的

在过去十年中,髓内延长钉越来越受欢迎。在本研究中,我们旨在系统回顾关于使用电动髓内钉(MIN)进行肱骨延长的文献。我们打算评估该技术的疗效和并发症。

材料与方法

在以下数据库中进行系统回顾:PubMed、Embase、Web of Science以及……纳入标准包括使用髓内钉进行肱骨延长、临床研究、所有证据级别,且对发表日期无限制。

结果

我们的检索共得到239篇期刊文章。根据纳入和排除标准,共有9篇文章符合要求。患者总数为20例,共延长了22个节段。患者的平均年龄为20.8岁[标准差(SD),12.0;范围,13 - 51岁]。平均延长长度为5.7厘米(SD,0.9;范围,5 - 7.5),平均牵张方案为0.82毫米/天(SD,0.2;范围,0.6 - 1)。平均延长持续时间为71.6天(SD,12.8;范围,50 - 93),平均愈合持续时间为192.3天(SD,40.5;范围,120 - 228)。报告的并发症包括活动度(ROM)受限、内固定失败和肥大性骨再生。

结论

使用MIN进行肱骨延长可获得良好疗效,并发症发生率低。未来的高水平研究应侧重于比较使用内固定和外固定技术进行肱骨延长的长期疗效。

临床意义

使用MIN进行肱骨延长可安全实施。每种手术入路和钉的类型都有不同的风险和益处。在制定手术计划时应仔细讨论这些问题。

如何引用本文

洛兰奇JP,阿拉米里N,马尔万Y,……使用电动髓内钉进行肱骨延长:疗效和并发症的系统评价。《创伤肢体重建策略》2022年;17(3):165 - 171。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60af/9886034/16c353125a27/stlr-17-165-g001.jpg

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