老年不可修复性桡骨远端骨折的半关节置换术：一项综述
Hemiarthroplasty for irreparable distal radius fractures in the elderly: A comprehensive review.
作者信息
Cannella Adriano, Caruso Ludovico, Sassara Giulia Maria, Taccardo Giuseppe, Passiatore Marco, Marescalchi Marina, De Vitis Rocco
机构信息
Department of Orthopaedics, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy.
Department of Bone and Joint Surgery, ASST - Spedali Civili, Brescia 25123, Italy.
出版信息
World J Orthop. 2024 Jun 18;15(6):578-584. doi: 10.5312/wjo.v15.i6.578.
BACKGROUND
Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures (DRFs). However, further investigation with long-term follow-up is required to validate these initial findings.
AIM
To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment option.
METHODS
A comprehensive review of the literature was conducted using electronic databases, including PubMed, Medline, and Scopus. The search terms employed were "distal radius fracture" , "hemiarthroplasty" , "wrist arthroplasty" , and related terminology. The search was restricted to articles published in English from 1980 until June 2023. Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty, providing clinical or radiographic outcomes, and published in peer-reviewed journals.
RESULTS
A total of 2508 articles from PubMed and 883 from Scopus were identified initially. Following screening and removal of duplicates, 13 articles met the inclusion criteria. These articles, predominantly clinical retrospective studies, provided insights into hemiarthroplasty outcomes, including functional improvements and complications. Hemiarthroplasty was a treatment option for complex DRF, particularly those cases with severe comminution, intraarticular involvement, or severe osteoporosis. Functional outcomes demonstrated improvements in pain relief, wrist mobility, and grip strength, with variability across studies. Complications included implant loosening, infection, nerve injury, and stiffness, with varying incidence rates influenced by surgical techniques and implant choice. Long-term outcomes were inadequately documented, warranting further research.
CONCLUSION
Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly. Long-term outcomes and complications require further study.
背景
目前，保持功能独立的老年患者可作为原发性腕关节半关节置换术治疗急性不可修复的桡骨远端骨折（DRF）的候选对象。然而，需要进行长期随访的进一步研究来验证这些初步结果。
目的
回顾有关使用现有植入物进行桡骨远端半关节置换术结果的文献，以评估其作为一种治疗选择的可行性。
方法
使用电子数据库（包括PubMed、Medline和Scopus）对文献进行全面回顾。所采用的检索词为“桡骨远端骨折”、“半关节置换术”、“腕关节置换术”及相关术语。检索范围限于1980年至2023年6月发表的英文文章。纳入标准包括用半关节置换术治疗DRF的病例或病例系列，提供临床或影像学结果，并发表在同行评审期刊上。
结果
最初从PubMed中识别出2508篇文章，从Scopus中识别出883篇文章。经过筛选和去除重复项后，13篇文章符合纳入标准。这些文章主要是临床回顾性研究，提供了有关半关节置换术结果的见解，包括功能改善和并发症。半关节置换术是复杂DRF的一种治疗选择，特别是那些伴有严重粉碎、关节内受累或严重骨质疏松的病例。功能结果显示在疼痛缓解、腕关节活动度和握力方面有所改善，但各研究结果存在差异。并发症包括植入物松动、感染、神经损伤和僵硬，其发生率因手术技术和植入物选择而异。长期结果记录不足，需要进一步研究。
结论
半关节置换术是治疗老年患者不可修复DRF的一种有前景的方法。长期结果和并发症需要进一步研究。
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