指骨骨折：切开复位内固定与闭合复位经皮穿针固定的回顾性比较
Phalangeal fractures: A retrospective comparison of open reduction and internal fixation vs. closed reduction and percutaneous pinning.
作者信息
Veeramani Anamika, Meulendijks Mara Z, Szapary Hannah, Moura Steven P, Gomez-Eslava Barbara, Hoftiezer Yannick A J, Chen Neal C, Eberlin Kyle R
机构信息
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 15 Parkman Street, Boston, MA, 02114, USA.
Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
出版信息
J Hand Microsurg. 2024 Jul 2;16(4):100124. doi: 10.1016/j.jham.2024.100124. eCollection 2024 Oct.
UNLABELLED
The treatment of phalangeal fractures is guided by fracture characteristics, patient factors and surgeon judgment. This study retrospectively compares characteristics of phalangeal fractures treated with closed reduction percutaneous pinning (CRPP) with those of fractures treated with open reduction internal fixation (ORIF) to identify risk factors associated with reoperation. A total of 901 phalangeal fractures were included and treated operatively by either CRPP (748 fractures, 83 %) or ORIF (153 fractures, 17 %). Demographics, surgical management, and complication data were collected. Statistical analyses were performed to stratify risk associations and identify potential predictors of reoperation. With multivariate analysis and bootstrapped LASSO regression, fractures addressed by means of ORIF (vs. CRPP), work-related fractures, and open fractures were found to be independently associated with reoperation. These findings can be used to guide patient selection, surgical planning and timing of fracture repair.
LEVEL OF EVIDENCE
Level III, Therapeutic.
未标注
指骨骨折的治疗取决于骨折特征、患者因素和外科医生的判断。本研究回顾性比较了采用闭合复位经皮穿针固定（CRPP）治疗的指骨骨折与采用切开复位内固定（ORIF）治疗的骨折的特征，以确定与再次手术相关的危险因素。共纳入901例指骨骨折，并通过CRPP（748例骨折，83%）或ORIF（153例骨折，17%）进行手术治疗。收集了人口统计学、手术管理和并发症数据。进行统计分析以分层风险关联并确定再次手术的潜在预测因素。通过多变量分析和自展LASSO回归发现，采用ORIF（与CRPP相比）、与工作相关的骨折和开放性骨折治疗的骨折与再次手术独立相关。这些发现可用于指导患者选择、手术规划和骨折修复时机。
证据级别
三级，治疗性。
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