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使用传感器支持的鞋垫评估老年骨盆后环脆性骨折的新治疗策略:一项概念验证研究。

Evaluation of a New Treatment Strategy for Geriatric Fragility Fractures of the Posterior Pelvic Ring Using Sensor-Supported Insoles: A Proof-of-Concept Study.

作者信息

Lebert Luca, Keppler Alexander Martin, Bruder Jan, Faust Leon, Becker Christopher Alexander, Böcker Wolfgang, Neuerburg Carl, Cavalcanti Kußmaul Adrian

机构信息

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.

出版信息

J Clin Med. 2023 Aug 10;12(16):5199. doi: 10.3390/jcm12165199.

DOI:10.3390/jcm12165199
PMID:37629241
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10455983/
Abstract

The incidence of fragility fractures of the pelvis (FFPs) is currently rising. Surgical treatment, which is performed using sacroiliac screws, is complicated by compromised bone quality, oftentimes resulting in implant failure. The iFuse implant system aims to improve attachment and durability with promising results for sacroiliac dysfunction, though data for its feasibility on FFPs are rare. Consequently, this study aims to evaluate the feasibility of the iFuse for FFPs. A total of 10 patients with FFPs were treated with the iFuse in this study. Pre- and postoperatively, both mobility using an established insole force sensor for an inpatient gait analysis and general well-being and pain using questionnaires were evaluated. When comparing pre- and postoperative findings, this study demonstrated a significant increase in the average (8.14%) and maximum (9.4%) loading ( < 0.001), a reduction in pain, as measured by the visual analog scale (VAS), from 4.60 to 2.80 at rest ( = 0.011) and from 7.00 to 4.40 during movement ( = 0.008), an increase in the Barthel Index by 20 points ( < 0.001) and an increase in the Parker Mobility Score by 2.00 points ( = 0.011). All this contributes to the possibility of early postoperative mobilization and improved general well-being, ultimately preventing the late consequences of postoperative immobilization and maintaining patients autonomy and contentment.

摘要

骨盆脆性骨折(FFPs)的发病率目前正在上升。使用骶髂螺钉进行的手术治疗因骨质受损而变得复杂,常常导致植入物失败。iFuse植入系统旨在改善附着性和耐用性,对骶髂关节功能障碍有良好效果,不过其在FFPs方面可行性的数据很少。因此,本研究旨在评估iFuse用于FFPs的可行性。本研究共对10例FFPs患者使用iFuse进行了治疗。在术前和术后,使用既定的鞋垫力传感器对住院患者步态分析的活动能力以及使用问卷对总体健康状况和疼痛进行了评估。在比较术前和术后的结果时,本研究表明平均负荷(8.14%)和最大负荷(9.4%)显著增加(<0.001),通过视觉模拟量表(VAS)测量的疼痛在静息时从4.60降至2.80(=0.011),在活动时从7.00降至4.40(=0.008),Barthel指数增加20分(<0.001),Parker活动评分增加2.00分(=0.011)。所有这些都有助于术后早期活动以及改善总体健康状况,最终预防术后固定的后期后果并维持患者的自主性和满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/10455983/7c0a748c3240/jcm-12-05199-g008.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/10455983/70f0fe834330/jcm-12-05199-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf9d/10455983/7c0a748c3240/jcm-12-05199-g008.jpg
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Epidemiology and secular trends of pelvic fractures in Belgium: A retrospective, population-based, nationwide observational study.
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Bone. 2021 Dec;153:116141. doi: 10.1016/j.bone.2021.116141. Epub 2021 Aug 5.
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