两种前臂骨折切开复位内固定术后的手术时间和结果。

Time to surgery and outcomes following open reduction and internal fixation of both-bone forearm fractures.

机构信息

College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA.

Hand and Upper Extremity Service, Hospital for Special Surgery, New York, NY, 10021, USA.

出版信息

Eur J Orthop Surg Traumatol. 2024 Jan;34(1):135-142. doi: 10.1007/s00590-023-03560-8. Epub 2023 Jun 27.

DOI:10.1007/s00590-023-03560-8

PMID:37368153

Abstract

PURPOSE

To determine the effect of time to surgery on outcomes following open reduction and internal fixation (ORIF) of both-bone forearm fractures (BBFFs).

METHODS

Ninety-nine patients who underwent ORIF of BBFFs in a single academic medical center over a 16-year time period were retrospectively reviewed. Demographic and clinical data including age, sex, current smoking status, time from injury to surgery (t), presence of open injury, polytrauma status, and complications were obtained. Radiographs of the affected extremity were reviewed for fracture morphology, reduction quality, and time to union (or presence of nonunion). In addition to descriptive statistics, Chi-square and Wilcoxon-Mann-Whitney tests were used to compare categorical and interval, respectively, with a significance level of 0.05.

RESULTS

A t > 48 h was associated with increased rate of delayed unions (t < 48 h: 25% vs t > 48 h: 59%, p = 0.03), but not complications (t < 48 h: 44% vs t > 48 h: 47%, p = 0.79). Open BBFFs were not associated with increased rates of delayed unions (closed: 16% vs open: 19%, p = 0.77) or complications (closed: 42% vs open: 53%, p = 0.29). A trend toward increased time to union with t > 48 h was also seen, but did not reach significance (t < 48 h: 13.5 weeks vs t > 48 h: 15.7 weeks, p = 0.11).

CONCLUSION

A t > 48 h is associated with an increased rate of delayed union, but not complications, after ORIF of BBFFs.

LEVEL OF EVIDENCE

Therapeutic Level III (Retrospective Cohort).

摘要

目的

确定手术时间对双骨折前臂骨折（BBFF）切开复位内固定（ORIF）后结果的影响。

方法

回顾性分析了 16 年间在一家学术医学中心接受 BBFF 切开复位内固定术的 99 例患者。获得了包括年龄、性别、当前吸烟状况、受伤至手术时间（t）、开放性损伤、多发伤状态以及并发症等人口统计学和临床数据。评估了受累肢体的 X 线片，以评估骨折形态、复位质量以及愈合时间（或有无骨不连）。除了描述性统计外，还分别使用卡方检验和 Wilcoxon-Mann-Whitney 检验比较了分类和间隔变量，置信水平为 0.05。

结果

t＞48 h 与延迟愈合发生率增加相关（t＜48 h：25% vs t＞48 h：59%，p＝0.03），但与并发症无关（t＜48 h：44% vs t＞48 h：47%，p＝0.79）。开放性 BBFF 与延迟愈合发生率增加无关（闭合性：16% vs 开放性：19%，p＝0.77）或并发症无关（闭合性：42% vs 开放性：53%，p＝0.29）。虽然 t＞48 h 时愈合时间也有延长的趋势，但未达到统计学意义（t＜48 h：13.5 周 vs t＞48 h：15.7 周，p＝0.11）。