2022 年我们处于什么位置？40 年来 11000 例开放性胫骨骨折的总结。

Where Are We in 2022? A Summary of 11,000 Open Tibia Fractures Over 4 Decades.

机构信息

Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch at Galveston, TX.

Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, TX; and.

出版信息

J Orthop Trauma. 2023 Aug 1;37(8):e326-e334. doi: 10.1097/BOT.0000000000002602.

DOI:10.1097/BOT.0000000000002602

PMID:36952593

Abstract

OBJECTIVES

To determine the infection and nonunion rates for open tibia fracture treatment over the past 4 decades since the introduction of the Gustilo-Anderson (GA) open fracture classification.

DATA SOURCES

PubMed, Scopus, CINAHL, and Cochrane databases were reviewed using the PRISMA checklist for articles between 1977 and September 2018.

STUDY SELECTION

One hundred sixty-one articles meeting the following inclusion criteria: English language, published between 1977 and 2018, reported infection rates, reported nonunion rates, and fractures classified by the GA open fracture criteria were selected.

DATA EXTRACTION

All articles were thoroughly evaluated to extract infection and nonunion data for open tibia fractures.

DATA SYNTHESIS

Due to variability in the data reviewed, statistical evaluation could not be reliably done.

RESULTS

11,326 open tibia fractures were reported with 17% type I, 25.2% type II, 25.3% type IIIA, and 32.5% type IIIB/C. The average infection rate over 4 decades was 18.3%, with 24.3% superficial, 11.2% deep, and 14.7% pin tract. The infection rate by decade was 14% for 1977-1986, 16.2% for 1987-1996, 20.5% for 1997%-2006%, and 18.1% from 2007 to 2017. The overall nonunion rate was 14.1%. The nonunion rate was 13% for 1977-1986, 17% for 1987-1996, 12.8% for 1997%-2006%, and 12.3% for 2007-2017.

CONCLUSIONS

This in-depth summary has demonstrated that the percentage rate for infections and nonunion has remained similar over the past 40 years.

LEVEL OF EVIDENCE

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

摘要

目的

自 Gustilo-Anderson（GA）开放性骨折分类引入以来的过去 40 年中，确定开放性胫骨骨折治疗的感染率和不愈合率。

数据来源

使用 PRISMA 清单，在 1977 年至 2018 年 9 月期间，在 PubMed、Scopus、CINAHL 和 Cochrane 数据库中对文章进行了综述。

研究选择

选择了符合以下纳入标准的 161 篇文章：英语语言，发表于 1977 年至 2018 年之间，报告感染率，报告不愈合率，以及根据 GA 开放性骨折标准分类的骨折。

数据提取

对所有文章进行了彻底评估，以提取开放性胫骨骨折的感染和不愈合数据。

数据综合

由于所审查数据的变异性，无法进行可靠的统计评估。

结果

报告了 11326 例开放性胫骨骨折，其中 17%为 I 型，25.2%为 II 型，25.3%为 IIIA 型，32.5%为 IIIB/C 型。40 年来，平均感染率为 18.3%，其中 24.3%为浅表感染，11.2%为深部感染，14.7%为钉道感染。按十年计算，1977-1986 年为 14%，1987-1996 年为 16.2%，1997%-2006 年为 20.5%，2007 年至 2017 年为 18.1%。总的不愈合率为 14.1%。1977-1986 年为 13%，1987-1996 年为 17%，1997%-2006 年为 12.8%，2007-2017 年为 12.3%。