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镍钛诺连续加压植入物在骨科创伤中的应用。

The Use of Nitinol Continuous Compression Implants in Orthopaedic Trauma.

作者信息

Mistry Dylan, Rahman Usama, Khatri Chetan, Carlos William, Stephens Alastair, Riemer Bryan, Ward Jayne

机构信息

University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Rd, Coventry, CV2 2DX UK.

出版信息

Indian J Orthop. 2024 Sep 14;58(12):1861-1870. doi: 10.1007/s43465-024-01253-w. eCollection 2024 Dec.

Abstract

BACKGROUND

Continuous compression implants (CCIs) can provide continuous compression across a fracture site. They are mainly used in foot/ankle surgery, with very limited descriptions in the literature of their potential for trauma. The aim of this study was to describe the use and associated outcomes of CCIs in modern day trauma practice.

METHODS

This was a single-centred case series with a retrospective analysis of a prospectively maintained database of any patients who were treated with a CCI across 4 years. The primary outcome was to determine the mode of the CCIs and secondary outcomes were unplanned returns to theatre.

RESULTS

60 patients were eligible with a mean age of 44.2 and 122 CCIs were used. 51 patients were treated for acute fractures, 9 were treated for non-unions, and 27 patients had open injuries. 42 of the 122 CCIs were used as definitive fixation (midfoot dislocations, an iliac wing fixation and isolated medial malleolus fixation), and the rest as adjuncts for fixation; of this remainder, 39 were used in reduction mode, 38 for fixation of key fragments, and 3 for compression. Ten patients returned to theatre, two for metalwork failure, two for infection and 6 for non-unions-three were acute fractures and three originally non-unions.

CONCLUSION

This paper demonstrates a novel technique for the use of CCIs in UK trauma practice as either definitive fixations or in three different modes as adjuncts to fixation. They do not replace tradition implants but do have equivalent rates of complications. They may be a useful tool in the arsenal for trauma surgeons.

摘要

背景

持续加压植入物(CCIs)可在骨折部位提供持续加压。它们主要用于足/踝关节手术,在创伤方面的潜在应用在文献中的描述非常有限。本研究的目的是描述CCIs在现代创伤治疗中的应用及相关结果。

方法

这是一项单中心病例系列研究,对一个前瞻性维护的数据库进行回顾性分析,该数据库包含4年内接受CCIs治疗的所有患者。主要结局是确定CCIs的使用方式,次要结局是计划外重返手术室情况。

结果

60例患者符合条件,平均年龄44.2岁,共使用了122枚CCIs。其中51例患者治疗急性骨折,9例治疗骨不连,27例患者有开放性损伤。122枚CCIs中,42枚用作确定性固定(中足脱位、髂骨翼固定和孤立内踝固定),其余用作固定辅助;在其余的CCIs中,39枚用于复位模式,38枚用于关键骨折块固定,3枚用于加压。10例患者重返手术室,2例因内固定失败,2例因感染,6例因骨不连——3例为急性骨折,3例原为骨不连。

结论

本文展示了在英国创伤治疗中使用CCIs的一种新技术,既可用作确定性固定,也可在三种不同模式下用作固定辅助。它们不能替代传统植入物,但并发症发生率相当。它们可能是创伤外科医生武器库中的一种有用工具。

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本文引用的文献

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The history of orthopaedic use of nitinol compression staples.镍钛诺加压吻合钉在矫形外科的应用历史。
Injury. 2023 Nov;54(11):111036. doi: 10.1016/j.injury.2023.111036. Epub 2023 Sep 12.
2
Microbiology of fracture related infections.骨折相关感染的微生物学
J Orthop Surg (Hong Kong). 2022 Sep-Dec;30(3):10225536221118512. doi: 10.1177/10225536221118512.
5
Risk Factors Associated With Infection in Open Fractures of the Upper and Lower Extremities.上下肢开放性骨折感染的相关危险因素。
J Am Acad Orthop Surg Glob Res Rev. 2020 Dec 8;4(12):e20.00188. doi: 10.5435/JAAOSGlobal-D-20-00188.
7
3D digital image correlation evaluation of arthrodesis implants.
Clin Biomech (Bristol). 2020 Jan;71:29-36. doi: 10.1016/j.clinbiomech.2019.10.011. Epub 2019 Oct 25.

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