膝关节周围骨折第一代锁定钢板和微创技术的疗效。

Outcomes of the First Generation Locking Plate and Minimally Invasive Techniques Used for Fractures About the Knee.

机构信息

NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York, USA.

Jamaica Hospital Medical Center, New York, New York, USA.

出版信息

Iowa Orthop J. 2023;43(1):169-175.

PMID:37383856

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10296454/

Abstract

BACKGROUND

Locking plate technology was developed approximately 25-years-ago and has been successfully used since. Newer designs and material properties have been used to modify the original design, but these changes have yet to be correlated to improved patient outcomes. The purpose of this study was to evaluate the outcomes of first-generation locking plate (FGLP) and screw systems at our institution over an 18 year period.

METHODS

Between 2001 to 2018, 76 patients with 82 proximal tibia and distal femur fractures (both acute fracture and nonunions) who were treated with a first-generation titanium, uniaxial locking plate with unicortical screws (FGLP), also known as a LISS plate (Synthes Paoli Pa), were identified and compared to 198 patients with 203 similar fracture patterns treated with 2nd and 3rd generation locking plates, or Later Generation Locking Plates (LGLP). Inclusion criteria was a minimum of 1-year follow-up. At latest follow-up, outcomes were assessed using radiographic analysis, Short Musculoskeletal Functional Assessment (SMFA), VAS pain scores, and knee ROM. All descriptive statistics were calculated using IBM SPSS (Armonk, NY).

RESULTS

A total of 76 patients with 82 fractures had a mean 4-year follow-up available for analysis. There were 76 patients with 82 fractures fixed with a First-generation locking plate. The mean age at time of injury for all patients was 59.2 and 61.0% were female. Mean time to union for fractures about the knee fixed with FGLP was by 5.3 months for acute fractures and 6.1 months for nonunions. At final follow-up, the mean standardized SMFA for all patients was 19.9, mean knee range of motion was 1.6°-111.9°, and mean VAS pain score was 2.7. When compared to a group of similar patients with similar fractures and nonunions treated with LGLPs there were no differences in outcomes assessed.

CONCLUSION

Longer-term outcomes of first-generation locking plates (FGLP) demonstrate that this construct provides for a high rate of union and low incidence of complications, as well as good clinical and functional results. .

摘要

背景

锁定钢板技术大约在 25 年前发展起来，并在此后成功应用。新的设计和材料特性已被用于改进原始设计，但这些变化尚未与改善患者结局相关联。本研究的目的是评估我们机构在 18 年内第一代锁定钢板（FGLP）和螺钉系统的结果。

方法

在 2001 年至 2018 年间，我们确定了 76 例 82 例胫骨近端和股骨远端骨折（急性骨折和骨不连）患者，这些患者使用第一代钛制、单轴锁定钢板和单皮质螺钉（FGLP）治疗，也称为 LISS 板（Synthes Paoli Pa），并与 198 例 203 例具有相似骨折模式的患者进行了比较，这些患者接受了第二代和第三代锁定板或第三代锁定板（LGLP）治疗。纳入标准为至少 1 年的随访。在最新的随访中，使用影像学分析、短肌肉骨骼功能评估（SMFA）、VAS 疼痛评分和膝关节 ROM 来评估结果。所有描述性统计数据均使用 IBM SPSS（Armonk，NY）计算。

结果

共有 76 例 82 例骨折患者获得 4 年平均随访分析。共有 76 例 82 例骨折患者采用第一代锁定钢板固定。所有患者受伤时的平均年龄为 59.2 岁，61.0%为女性。FGLP 固定膝关节周围骨折的平均愈合时间为急性骨折 5.3 个月，骨不连 6.1 个月。在最终随访时，所有患者的平均标准化 SMFA 为 19.9，平均膝关节活动度为 1.6°-111.9°，平均 VAS 疼痛评分为 2.7。与一组接受类似 LGLP 治疗的类似骨折和骨不连患者相比，评估结果无差异。