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小儿腕部骨折:各国治疗方法的差异。循证总结

Pediatric wrist fractures: variations in management across countries. An evidence-based summary of evidence.

作者信息

Labianca Luca, Calderaro Cosma, Maffulli Nicola

机构信息

Department of Orthopaedic and Traumatology, S. Andrea Hospital, Faculty of Medicine and Psychology "Sapienza" University of Rome, Via di Grottarossa, 1035 00189 Rome, Italy.

Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, Bancroft Rd, London E1 4DG, United Kingdom.

出版信息

Br Med Bull. 2024 Dec 12;152(1):28-34. doi: 10.1093/bmb/ldae014.

Abstract

INTRODUCTION

Fractures of the distal radius are common in pediatric population, with considerable variation in the management of pediatric wrist fractures across different countries. It is crucial to consider the different approaches to conservative management and surgical intervention. The decision on the appropriate treatment method often depends on the type and severity of the fracture, as well as the available healthcare resources and expertise in each country. This article tries to identify these variations, so the various healthcare systems can work toward implementing best practices in the management of pediatric wrist fractures on a global scale.

SOURCE OF DATA

Published peer-reviewed articles identified in electronic databases, including PubMed Scopus and Google Scholar.

AREAS OF AGREEMENT

The management of pediatric wrist fractures can differ significantly among countries given the high variability in healthcare resources and cultural practices.

AREAS OF CONTROVERSY

The management of pediatric wrist fractures can be challenging in certain countries, especially in developing regions with limited resources.

GROWING POINTS

Challenges such as long therapeutic delays, lack of appropriate anesthesia, and the absence of fluoroscopy can complicate the treatment process. Randomized controlled clinical trials (RCTs) are vital in providing high-quality evidence to guide clinical decision-making, especially in the field of pediatric wrist fractures.

AREAS TIMELY FOR DEVELOPING RESEARCH

Efforts to support and prioritize the conduct and dissemination of RCTs in pediatric wrist fracture management can ultimately lead to more consistent, effective, and evidence-based care for children with wrist fractures worldwide.

摘要

引言

桡骨远端骨折在儿童群体中很常见,不同国家在儿童腕部骨折的治疗上存在很大差异。考虑保守治疗和手术干预的不同方法至关重要。选择合适治疗方法的决定通常取决于骨折的类型和严重程度,以及每个国家现有的医疗资源和专业知识。本文试图找出这些差异,以便各个医疗系统能够在全球范围内努力实施儿童腕部骨折管理的最佳实践。

数据来源

在电子数据库中检索到的已发表的经同行评审的文章,包括PubMed、Scopus和谷歌学术。

共识领域

鉴于医疗资源和文化习俗的高度差异,各国在儿童腕部骨折的治疗上可能存在显著差异。

争议领域

在某些国家,尤其是资源有限的发展中地区,儿童腕部骨折的治疗可能具有挑战性。

发展要点

治疗延迟过长、缺乏合适的麻醉以及没有透视等挑战可能使治疗过程复杂化。随机对照临床试验(RCT)对于提供高质量证据以指导临床决策至关重要,尤其是在儿童腕部骨折领域。

适合开展研究的领域

支持并优先开展和传播儿童腕部骨折管理方面的随机对照试验,最终可为全球腕部骨折儿童提供更一致、有效且基于证据的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4ee/12143971/28440998b109/ldae014fx1.jpg

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