Journal of Orthopaedic Science最新文献_第8页

Comparison of the radiological and functional results of a plaster splint and dynamic stabilization splint for Boxer's fractures: A prospective randomized controlled study 比较石膏夹板和动态稳定夹板治疗拳击手骨折的放射学和功能效果：前瞻性随机对照研究

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.08.004

Purpose

This study compared the clinical and radiological results of fifth metacarpal neck fractures treated with a short-arm plaster splint (SAPS) versus a dynamic metacarpal stabilization splint (DMSS).

Materials and methods

The 119 patients were referred to our institute between 2018 and 2019 and treated with SAPS or DMSS after appropriate initial closed reduction. Follow-up examinations were conducted at days 10 and 20, and at 1, 2, and 3 months after treatment. Alignment of the fracture, range of motion (ROM), and complications were evaluated during each visit. Grip strength was evaluated using a dynamometer. Self-care, usual daily activities, pain/discomfort, and anxiety/depression were evaluated using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) and a VAS.

Results

Of the 119 patients, 103 completed all follow up examinations. In total, 51 patients were treated with SAPS and 52 with DMSS. Skin lesions were detected in five patients in the DMSS group, but none in the SAPS group (p = 0.008). The grip strength of patients in the DMSS group was statistically better at the 1-, 2-month and 3-month follow-up visits (p < 0.001). ROM of the interphalangeal and metacarpophalangeal joints were statistically better in the DMSS group at the 1-month visit (p < 0.001) but similar at the 3-month visit (p = 0.27). Wrist ROM was statistically higher in the DMSS group at the 3-month visit (p < 0.05). Self-care, usual daily activities, pain/discomfort, and anxiety/depression were statistically better in the DMSS group at all follow-up visits (p < 0.05), as determined by the EQ-5D-5L.

Conclusion

Dynamic stabilization of a stable boxer's fracture with DMSS is as effective as static stabilization with SAPS for maintaining the reduction and ensuring union. However, DMSS provides better early ROM, comfort, and muscle strength, as well as an earlier return to usual daily activities despite the occasional skin lesions happened.

目的本研究比较了采用短臂石膏夹板（SAPS）和动态掌骨稳定夹板（DMSS）治疗第五掌骨颈骨折的临床和放射学结果。材料和方法 2018年至2019年期间，119例患者转诊至我院，在适当的初次闭合复位后采用SAPS或DMSS治疗。在治疗后第10天、第20天、第1个月、第2个月和第3个月进行随访检查。每次就诊都会对骨折对位、活动范围（ROM）和并发症进行评估。使用测力计评估握力。此外，还使用EQ-5D-5L（EuroQol 5-Dimension 5-Level）和VAS对自我护理、日常活动、疼痛/不适以及焦虑/抑郁进行了评估。共有 51 名患者接受了 SAPS 治疗，52 名患者接受了 DMSS 治疗。DMSS 组有 5 名患者发现皮肤损伤，而 SAPS 组无皮肤损伤（P = 0.008）。在 1 个月、2 个月和 3 个月的随访中，DMSS 组患者的握力在统计学上更好（p < 0.001）。在1个月的随访中，DMSS组患者的指间关节和掌指关节的活动度在统计学上更佳（p <0.001），但在3个月的随访中情况相似（p = 0.27）。DMSS组的腕关节活动度在3个月访视时显著高于DMSS组（p <0.05）。根据EQ-5D-5L的测定，DMSS组在所有随访中的自理能力、日常活动、疼痛/不适以及焦虑/抑郁方面均优于DMSS组（p <0.05）。然而，DMSS能提供更好的早期活动度、舒适度和肌力，并能更早地恢复正常的日常活动，尽管偶尔会发生皮肤损伤。

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引用次数: 0

Reply to letter to the editor by Li et al. 回复 Li 等人致编辑的信

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2024.06.001

引用次数: 0

A novel diagnostic examination for dropped head syndrome (DHS) (Prone position cervical extension test; DHS test) 一种新的垂头综合征（DHS）诊断检查（俯卧位颈椎伸展试验；DHS试验）。

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.09.003

Background

Dropped head syndrome (DHS) is followed by severe cervical extension muscle weakness that results in chin-on chest deformity. However, maintaining a neutral cervical position can be temporarily possible, and the diagnosis of DHS might sometimes be difficult. The purpose of the present study is to examine a novel clinical test (DHS test) as the diagnostic utility for objective evaluation that focuses on cervical extension condition in the prone position.

Methods

One hundred subjects were diagnosed with isolated neck extensor myopathy (INEM)-DHS at our hospital (17 men and 83 women, mean age 75.0 ± 8.5 years), and 62 subjects were enrolled as age-matched controls. The DHS test consisted of three examinations; the first was “Ceiling gazing test” in standing position, the second was horizontal gazing in “Sphinx prone position test”, and the third was horizontal gazing in “Hands and knees prone position test”. We investigated the sensitivity and specificity of the DHS test for DHS.

Results

The patients showing positive in the INEM-DHS group were 63/100 in Ceiling gaze test, 73/100 in the Sphinx prone position test, and 91/100 in the Hands and knees prone position test. In the control group, 0/62 patients presented positive in the Ceiling gaze test, 4/62 in the Sphinx prone position test, and 0/62 in the Hands and knees prone position test. Sensitivity and specificity of the DHS test were 63.0%/100%, 73.0%/93.5%, and 91.0%/100% in the Ceiling gaze test, Sphinx position prone position test, and Hands and knees prone position test, respectively.

Conclusion

The prone position cervical extension test (DHS test) would be useful as a novel objective diagnostic tool for INEM-DHS.

背景：垂头综合征（DHS）之后是严重的颈部伸展肌无力，导致下巴对胸部畸形。然而，保持中立的宫颈位置可能是暂时的，并且DHS的诊断有时可能很困难。本研究的目的是检验一种新的临床试验（DHS试验），作为客观评估的诊断工具，该试验侧重于俯卧位的颈部伸展状况。方法：在我院诊断为孤立性颈伸肌肌病（INEM）-DHS的100例受试者（17名男性和83名女性，平均年龄75.0±8.5岁），62名受试者作为年龄匹配的对照。DHS测试包括三项考试；第一项是站姿的“天花板凝视测试”，第二项是“狮身人面像俯卧位测试”的水平凝视，第三项是“手脚俯卧位”的水平注视。我们研究了DHS测试对DHS的敏感性和特异性。结果：INEM-DHS组的阳性患者在天花板凝视测试中为63/100，在狮身人面像俯卧位测试中为73/100，在手脚俯卧位试验中为91/100。在对照组中，0/62名患者在天花板凝视测试中呈阳性，4/62名患者在狮身人面像俯卧位测试中呈阴性，0/62例患者在手和膝盖俯卧位试验中呈阳性。DHS测试的敏感性和特异性在天花板凝视测试、狮身人面像俯卧位测试和手脚俯卧位试验中分别为63.0%/100%、73.0%/93.5%和91.0%/100%。结论：俯卧位颈椎伸展试验（DHS试验）是一种新的客观诊断INEM-DHS的工具。

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引用次数: 0

Initial patient demographics affecting return to original work after traumatic hand injury in a rural area in Japan: A retrospective single-center study 日本农村地区手部创伤后影响恢复原工作的初始患者人口统计：一项回顾性单中心研究。

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.09.002

Background

Time off work after traumatic hand injury not only affects individuals but also has socioeconomic repercussions, becoming a serious problem from the viewpoint of labor shortages. In depopulated rural areas, the impact of labor shortages due to time off work is more serious than in urban areas; however, few studies have examined return to original work in rural areas. The purpose of this study was to investigate the patient demographics at the time of hand injury that affect return to original work in a rural area of Japan.

Methods

We retrospectively examined 246 patients with traumatic hand and/or forearm injuries who were working at the time of injury, and who underwent surgical operations and postoperative rehabilitation in a level II hospital in a rural agricultural area. We examined patients' initial demographic data, including gender, age, occupation (white or blue collar), employment status (self-employed, full-time, or part-time workers), complications other than hand injury, workers’ compensation, dominant hand injury, and injury severity as determined using the modified Hand Injury Severity Score. Multivariate logistic regression analysis examined the association between initial patient demographics and return to original work within 150 days after injury.

Results

In total, 186 patients (76 %) were able to return to original work within 150 days. A multivariate logistic regression analysis showed that three explanatory variables (i.e., severity of injury, complications other than hand injury, and female gender) significantly compromised return to original work.

Conclusions

In the treatment of traumatic hand injury, intensive support should be provided for return to original work for patients who are expected to have difficulty returning to work quickly. In addition, labor shortages can be mitigated by sharing information with the workplace about patients’ prospects of return to original work.

背景：从劳动力短缺的角度来看，手外伤后的休假不仅影响个人，而且会产生社会经济影响，成为一个严重的问题。在人口减少的农村地区，由于休假造成的劳动力短缺的影响比城市地区更严重；然而，很少有研究考察农村地区的重返原始工作。本研究的目的是调查日本农村地区手部受伤时影响恢复原工作的患者人口统计数据。方法：我们回顾性检查了246名受伤时正在工作的手部和/或前臂创伤患者，在一个农村农业地区的二级医院接受了外科手术和术后康复。我们检查了患者的初始人口统计数据，包括性别、年龄、职业（白领或蓝领）、就业状况（自营职业者、全职或兼职工人）、手部损伤以外的并发症、工人补偿、主要手部损伤和使用修改的手部损伤严重程度评分确定的损伤严重程度。多变量逻辑回归分析检查了初始患者人口统计数据与受伤后150天内恢复原始工作之间的相关性。结果：总共186名患者（76%）能够在150天内恢复正常工作。多变量逻辑回归分析显示，三个解释变量（即损伤的严重程度、手部损伤以外的并发症和女性）显著影响了重返原工作。结论：在外伤性手部损伤的治疗中，对于预计难以快速返回工作岗位的患者，应为其返回原工作岗位提供强化支持。此外，可以通过与工作场所分享有关患者重返原工作前景的信息来缓解劳动力短缺。

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引用次数: 0

Microbiome of infected fracture nonunion: Does it affect outcomes? 感染性骨折不愈合的微生物组：是否影响疗效？

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.08.018

Background

Infected fracture nonunions often require prolonged treatment and recovery courses. It is unclear whether the bacterial microbiome influences the time to healing as well as the eradication of infection. The goals of this study are (1) to assess the bacterial microbiome affecting infected nonunions and (2) to evaluate the effects of bacterial speciation on associated outcomes.

Methods

Between 2006 and 2022, data from 551 adult patients from a single academic institution who presented with a fracture nonunion were analyzed retrospectively for infection. All patients underwent revision surgery with three sets of cultures obtained intra-operatively. Patients with significant intra-operative cultures were grouped into gram-positive and gram-negative culture cohorts. These patients were managed with a standardized protocol involving surgical debridement, nonunion site fixation, and culture-directed antibiotic treatment. Primary outcome was time to fracture union. Secondary outcomes included number of re-operations and eventual amputation or reconstructive surgery.

Results

56 nonunion patients (10 %) were diagnosed with an infected nonunion (44 g-positive, 12 g-negative). Of these, 3 g-positive patients received an amputation or arthroplasty procedure prior to fracture union, and seven were lost to follow-up. There were no significant differences in age, gender, or nonunion site between cohorts. Most nonunions occurred in the lower extremity. The most common bacteria were staph species (54.3 %). 36 g-positive and 10 g-negative patients achieved fracture union. Time to union was on average 158.4 days longer in the gram-negative cohort—but did not reach statistical significance (446.8 days gram-positive, 662.3 days gram-negative, p = 0.69). There was no difference in re-operation rates (1.9 % gram-positive, 2.2 % gram-negative, p = 0.84).

Conclusions

Patients with infected nonunions had wide-ranging bacterial contamination that were treated successfully using a standardized protocol. However, patients with any gram-negative culture trended toward a delay in time to union.

背景：感染性骨折不愈合通常需要延长治疗和恢复时间。目前尚不清楚细菌微生物组是否会影响愈合时间以及感染的根除。这项研究的目标是（1）评估影响感染非尼翁的细菌微生物组，以及（2）评估细菌物种形成对相关结果的影响。方法：回顾性分析2006年至2022年间，来自一家学术机构的551名出现骨折不愈合的成年患者的感染数据。所有患者均接受了翻修手术，术中获得了三组培养物。术中培养显著的患者被分为革兰氏阳性和革兰氏阴性培养组。这些患者采用标准化方案进行治疗，包括手术清创、骨不连部位固定和培养导向的抗生素治疗。主要结果是骨折愈合时间。次要结果包括多次再次手术和最终的截肢或重建手术。结果：56例骨不连患者（10%）被诊断为感染性骨不连（44g阳性，12g阴性）。其中，3例g阳性患者在骨折愈合前接受了截肢或关节成形术，7例失访。队列之间在年龄、性别或骨不连部位方面没有显著差异。大多数骨不连发生在下肢。最常见的细菌是葡萄球菌（54.3%）。36例g阳性和10例g阴性患者实现了骨折愈合。在革兰氏阴性队列中，愈合时间平均延长158.4天，但没有达到统计学意义（446.8天革兰氏阳性，662.3天革兰氏阴性，p=0.69）。再次手术率没有差异（1.9%革兰氏阳性，2.2%革兰氏阴性，p=0.84）成功地使用了标准化协议。然而，任何革兰氏阴性培养的患者都倾向于延迟愈合时间。

{"title":"Microbiome of infected fracture nonunion: Does it affect outcomes?","authors":"","doi":"10.1016/j.jos.2023.08.018","DOIUrl":"10.1016/j.jos.2023.08.018","url":null,"abstract":"<div><h3>Background</h3><p>Infected fracture nonunions<span> often require prolonged treatment and recovery courses. It is unclear whether the bacterial microbiome<span> influences the time to healing as well as the eradication of infection. The goals of this study are (1) to assess the bacterial microbiome affecting infected nonunions and (2) to evaluate the effects of bacterial speciation on associated outcomes.</span></span></p></div><div><h3>Methods</h3><p><span>Between 2006 and 2022, data from 551 adult patients from a single academic institution who presented with a fracture nonunion were analyzed retrospectively for infection. All patients underwent revision surgery with three sets of cultures obtained intra-operatively. Patients with significant intra-operative cultures were grouped into gram-positive and gram-negative culture cohorts. These patients were managed with a standardized protocol involving surgical debridement, nonunion site fixation, and culture-directed </span>antibiotic<span> treatment. Primary outcome was time to fracture union<span>. Secondary outcomes included number of re-operations and eventual amputation or reconstructive surgery.</span></span></p></div><div><h3>Results</h3><p><span>56 nonunion patients (10 %) were diagnosed with an infected nonunion (44 g-positive, 12 g-negative). Of these, 3 g-positive patients received an amputation or arthroplasty procedure prior to </span>fracture union, and seven were lost to follow-up. There were no significant differences in age, gender, or nonunion site between cohorts. Most nonunions occurred in the lower extremity. The most common bacteria were staph species (54.3 %). 36 g-positive and 10 g-negative patients achieved fracture union. Time to union was on average 158.4 days longer in the gram-negative cohort—but did not reach statistical significance (446.8 days gram-positive, 662.3 days gram-negative, p = 0.69). There was no difference in re-operation rates (1.9 % gram-positive, 2.2 % gram-negative, p = 0.84).</p></div><div><h3>Conclusions</h3><p>Patients with infected nonunions had wide-ranging bacterial contamination that were treated successfully using a standardized protocol. However, patients with any gram-negative culture trended toward a delay in time to union.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1270-1273"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Observational study of ropivacaine and compound betamethasone mixture for analgesia after triangular fibrocartilage complex repair under wrist arthroscopy: A single-center randomized double-blind controlled trial 罗哌卡因和复方倍他米松混合物用于腕关节镜下三角纤维软骨复合体修复术后镇痛的观察研究：一项单中心随机双盲对照试验。

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.08.017

Background

The purpose of this study was to investigate the clinical effect of an intra-articular and local infiltration injection of a compound analgesic mixture of ropivacaine and compound betamethasone on the repair of the triangular fibrocartilage complex under wrist arthroscopy.

Methods

This prospective, double-blind, randomized study involved 20 patients with Atzei type 2 or 3 injuries of the triangular fibrocartilage complex who underwent repair under wrist arthroscopy. Patients were divided into two groups (n = 10) according to the systematic random sampling method. The test group was injected with a “cocktail” mixture for pain relief. The control group was injected with normal saline. The visual analog scale (VAS) pain score, pinch force, wrist joint mobility, wrist joint function score (PRWE score), occurrence of adverse reactions and dosage of analgesic drugs were evaluated before and after the operation in the two groups.

Results

The resting pain of the patients in the test group was less severe than that of the control group at 12 h, 24 h and 48 h after the operation (P < 0.05), and the pinch force of the patients in the test group was significantly greater than that of the control group at 1 d, 2 d and 3 d after the operation (P < 0.01). The amount of postoperative analgesics used in the test group was significantly lower than that in the control group (P < 0.01), and the patient satisfaction rate in the test group was higher than that in the control group (P < 0.05). There were no postoperative adverse effects in either group.

Conclusion

An intra-articular and local infiltration injection of a “cocktail” analgesic mixture in the repair of triangular fibrocartilage complex under wrist arthroscopy can provide good pain control in the early postoperative period and reduce the amount of postoperative analgesic drugs administered, thus improving clinical safety.

Level of evidence

Level II; Randomized Controlled Trial; Treatment Study.

背景：本研究的目的是在腕关节镜下，研究关节内和局部浸润注射罗哌卡因和复方倍他米松的复合镇痛混合物对三角纤维软骨复合体修复的临床效果。方法：这项前瞻性、双盲、随机研究涉及20名Atzei 2型或3型三角纤维软骨复合体损伤患者，他们在腕关节镜下接受了修复。根据系统随机抽样方法将患者分为两组（n=10）。试验组注射了一种“鸡尾酒”混合物来缓解疼痛。对照组注射生理盐水。观察两组患者术前、术后视觉模拟量表（VAS）疼痛评分、握力、腕关节活动度、腕关节功能评分（PRWE）、不良反应发生率及镇痛药物用量。结果：试验组12 h静息痛较对照组减轻，术后24小时和48小时（P结论：关节内和局部浸润注射“鸡尾酒”腕关节镜下应用复合镇痛剂修复三角纤维软骨复合体可以在术后早期提供良好的疼痛控制，减少术后镇痛药物的用量，从而提高临床安全性。证据级别：二级；随机对照试验；治疗研究。

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引用次数: 0

Error of intraoperative measurement of stem anteversion is decreased by measuring in neutral hip position during total hip arthroplasty 在全髋关节置换术中保持髋关节中立位进行测量，可减少术中测量髋干内翻的误差

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.08.008

Background

Intraoperative stem anteversion, which is the angle between the lower leg axis and the trial-stem axis with hip flexion and adduction, is generally evaluated by the surgeon's visual estimation during total hip arthroplasty (THA). However, the conventional approach can be influenced by knee osteoarthritis or uncertain surgeon's observation point. Therefore, we developed a new method for measuring the stem anteversion angle in the neutral hip position using an original rod attached to the trial-stem perpendicular to the long axis and parallel to the stem neck. This study aimed to assess the accuracy of our method in comparison with the conventional method of measuring intraoperative stem anteversion angle.

Methods

We measured the intraoperative stem anteversion angle in consecutive 106 hips of 106 patients who underwent cementless primary THA with a tapered wedge stem. Absolute error in the stem anteversion angle was expressed as the difference between intraoperative (common vs. neutral hip positions) and postoperative computed tomography measurements, i.e., true stem anteversion. Additionally, we investigated the factors affecting these errors.

Results

The absolute error of measurement was significantly smaller in the neutral hip position than in the common position (3.0° ± 2.5° vs. 8.0° ± 3.9°; p < 0.0001). The factor associated with the error was advanced knee osteoarthritis in the common position, whereas it was not statistically significant in the neutral hip position.

Conclusions

This study suggests that the error in the intraoperative measurement of stem anteversion is decreased by measuring in the neutral hip position during THA.

背景在全髋关节置换术（THA）中，通常由外科医生目测评估术中髋关节柄内翻，即髋关节屈曲和内收时小腿轴线与试行髋关节柄轴线之间的角度。然而，传统方法可能会受到膝关节骨关节炎或外科医生观察点不确定的影响。因此，我们开发了一种新方法，在髋关节中立位时使用一根原始杆测量茎干内翻角，该杆与试验茎干的长轴垂直，与茎干颈平行。本研究旨在评估我们的方法与测量术中柄内翻角的传统方法相比的准确性。方法我们测量了连续106例使用锥形楔形柄进行无骨水泥初级THA的患者的术中柄内翻角。柄内翻角度的绝对误差表示为术中（普通髋关节位置与中立髋关节位置）和术后计算机断层扫描测量值之间的差异，即真正的柄内翻。此外，我们还研究了影响这些误差的因素。结果髋关节中立位测量的绝对误差明显小于普通位（3.0° ± 2.5° vs. 8.0° ± 3.9°；p < 0.0001）。在普通体位中，与误差相关的因素是晚期膝关节骨性关节炎，而在中立髋位中，该因素无统计学意义。

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引用次数: 0

Clinical characteristics of and risk factors for poor outcomes in children with bacterial culture-negative septic arthritis of the hip 细菌培养阴性髋关节化脓性关节炎患儿的临床特征和不良后果的风险因素

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.08.009

Background

Septic arthritis of the hip is a serious infection in children. However, blood and joint fluid cultures are often negative, which makes the diagnosis and treatment challenging. We analyzed the clinical features of children with septic arthritis of the hip with negative bacterial cultures and identified the risk factors for poor outcomes.

Methods

The clinical data of children with septic arthritis of the hip with negative bacterial cultures who were treated at our hospital from January 2010 to December 2020 were retrospectively analyzed. The clinical characteristics and outcomes of the culture-negative cohort were compared with those of children with positive bacterial cultures treated during the same period. Culture-negative patients were divided into a group with good outcomes and a group with poor outcomes. The differences between the two groups were compared.

Results

Thirty-nine children with culture-negative septic arthritis of the hip were compared with 37 children with culture-positive sepsis. Compared with the culture-positive group, the culture-negative group had a significantly younger mean age and a significantly lower mean serum C-reactive protein concentration. Logistic regression analysis of culture-negative patients with good versus poor outcomes revealed that the independent risk factors for poor outcomes were an increased serum C-reactive protein concentration and prolonged time from onset to surgery. The cut-off values for predicting a poor outcome in the culture-negative group were a time from onset to surgery of greater than 21 days and a C-reactive protein concentration of greater than 23 mg/L.

Conclusions

Culture-negative septic arthritis of the hip has similar clinical features to culture-positive septic arthritis of the hip and can result in sequelae of varying severity. Therefore, active anti-infective and hip drainage therapy should be performed when children present with clinical symptoms, inflammatory marker concentrations, and imaging findings that are clinically diagnostic for septic arthritis of the hip.

Level of evidence

Level II, retrospective study.

背景髋关节化脓性关节炎是儿童的一种严重感染。然而，血液和关节液培养往往呈阴性，这给诊断和治疗带来了挑战。我们分析了细菌培养阴性的髋关节化脓性关节炎患儿的临床特征，并确定了不良预后的风险因素。方法回顾性分析了 2010 年 1 月至 2020 年 12 月期间在我院接受治疗的细菌培养阴性的髋关节化脓性关节炎患儿的临床数据。将细菌培养阴性患儿的临床特征和疗效与同期细菌培养阳性患儿的临床特征和疗效进行比较。培养阴性患者被分为疗效好的一组和疗效差的一组。结果39名髋关节化脓性关节炎细菌培养阴性患儿与37名败血症细菌培养阳性患儿进行了比较。与培养阳性组相比，培养阴性组的平均年龄明显更小，平均血清 C 反应蛋白浓度明显更低。通过对培养阴性患者良好与不良预后的逻辑回归分析发现，不良预后的独立风险因素是血清C反应蛋白浓度升高和从发病到手术时间延长。在培养阴性组中，预测不良预后的临界值是发病到手术时间超过 21 天和 C 反应蛋白浓度超过 23 mg/L。因此，当儿童出现临床症状、炎症标记物浓度和影像学检查结果，临床诊断为髋关节化脓性关节炎时，应积极进行抗感染和髋关节引流治疗。

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引用次数: 0

Comment on Yokoya et al. : Factors affecting stress shielding and osteolysis after reverse shoulder arthroplasty: A multicenter study in a Japanese population 评论 Yokoya 等人：影响反向肩关节置换术后应力屏蔽和骨溶解的因素：一项针对日本人群的多中心研究。

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2024.04.013

引用次数: 0

Readability and quality of online patient resources regarding knee osteoarthritis and lumbar spinal stenosis in Japan 日本有关膝关节骨关节炎和腰椎管狭窄症的在线患者资源的可读性和质量

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science

Pub Date : 2024-09-01 DOI: 10.1016/j.jos.2023.08.003

Background

This study aimed to quantify the readability and quality of online patient resources on knee osteoarthritis and lumbar spinal stenosis in Japan.

Methods

Three search engines (Google, Yahoo, and Bing) were searched for the terms knee osteoarthritis and lumbar spinal stenosis. The first 30 websites of each search were screened. Duplicate websites and those unrelated to the searched diseases were excluded. The remaining 125 websites (62 on knee osteoarthritis, 63 on lumbar spinal stenosis) were analyzed. The text readability was assessed using two web-based programs (Obi-3 and Readability Research Lab) and lexical density. Website quality was evaluated using the DISCERN score, Clear Communication Index, and Journal of American Medical Association benchmark criteria.

Results

Readability scores were high, indicating that the texts were difficult to understand. Only 24 (19%) and six (5%) websites were classified as average difficulty readability according to Obi-3 and Readability Research Lab, respectively. The overall quality of information was low, with only four (3%) being rated as having sufficient quality based on the Clear Communication Index and Journal of American Medical Association benchmark criteria. None of the websites satisfied the DISCERN quality criteria.

Conclusions

Patient information on Japanese websites regarding knee osteoarthritis and lumbar spinal stenosis were difficult to understand. Moreover, the quality of the websites was insufficient. Orthopaedic surgeons should contribute to the creation of high-quality easy-to-read websites to facilitate patient-physician communication.

背景本研究旨在量化日本有关膝关节骨关节炎和腰椎管狭窄症的在线患者资源的可读性和质量。方法在三个搜索引擎（谷歌、雅虎和必应）上搜索膝关节骨关节炎和腰椎管狭窄症这两个词。对每次搜索的前 30 个网站进行筛选。排除了重复网站和与搜索疾病无关的网站。对剩余的 125 个网站（62 个关于膝关节骨关节炎，63 个关于腰椎管狭窄症）进行了分析。使用两个基于网络的程序（Obi-3 和可读性研究实验室）和词汇密度评估了文本的可读性。使用 DISCERN 分数、清晰交流指数和《美国医学会杂志》基准标准对网站质量进行了评估。根据 Obi-3 和可读性研究实验室的标准，只有 24 个网站（19%）和 6 个网站（5%）被评为可读性一般。信息的整体质量较低，根据清晰交流指数和《美国医学会杂志》基准标准，只有 4 个网站（3%）被评为质量足够高。结论日本网站上有关膝关节骨关节炎和腰椎管狭窄症的患者信息难以理解。此外，网站的质量也不够高。矫形外科医生应为创建高质量、易于阅读的网站做出贡献，以促进患者与医生之间的交流。

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引用次数: 0