Chinese Journal of Traumatology最新文献

Stigmasterol ameliorates neurological deficits and neuroinflammation in rats with traumatic brain injury by suppressing STAT3/NF-κB/LCN-2. 豆甾醇通过抑制STAT3/NF-κB/LCN-2改善创伤性脑损伤大鼠的神经功能缺损和神经炎症。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2026-01-02 DOI: 10.1016/j.cjtee.2025.05.003

Jing-Yuan Zhou, Li-Ming Tan, Zhen-Yu Nie, Bin Liu, Bing Wang

<p><strong>Purpose: </strong>TBI triggers intricate inflammatory processes that lead to secondary damage. Stig, a compound known for its cholesterol-lowering effects, demonstrates significant therapeutic potential, encompassing anti-cancer, antioxidant, and anti-atherosclerotic properties. It possesses an ability to penetrate the blood-brain barrier and accumulate in the brain, where it exerts potent anti-inflammatory, anti-apoptotic, and anti-oxidative stress properties, specifically in conditions impacting the central nervous system.</p><p><strong>Methods: </strong>This study is a basic research combining in vitro and in vivo experiments. The experimental subjects include BV2 microglia (a murine-derived microglial cell line) and HT22 neurons (a murine-derived hippocampal neuronal cell line), with 3 samples of Sprague-Dawley rats in each group. In vitro experiments involved stimulating BV2 mouse microglial cells with LPS and HT22 mouse neuronal cells with H<sub>2</sub>O<sub>2</sub>, followed by treatment with varying concentrations of Stig to assess its impact on pro-inflammatory cytokines, oxidative stress mediators, and LCN-2. In vivo, a TBI rat model was developed, and rats were arbitrarily split into Sham, TBI, TBI + normal saline, and TBI + Stig cohorts. Neurological function was evaluated using the modified neurological severity score for acute phase assessment, while cognitive abilities and spatial learning were assessed via the Morris water maze test. HE staining and Nissl staining were employed to observe neuronal death, and the wet-dry method was utilized to quantify brain water content. Levels of LCN-2, microglial polarization markers, and apoptotic markers were quantified by Western blot and immunofluorescence. Data were examined utilizing GraphPad Prism 9.0 and SPSS 26.0 software. Continuous variables were expressed as mean ± SD. Normality of the data was evaluated utilizing the Shapiro-Wilk test. For normally distributed continuous variables between 2 cohorts, an independent samples t-test was employed. When comparing more than 2 cohorts, a one-way ANOVA was performed. Non-normally distributed data were denoted by the median (Q<sub>1</sub>, Q<sub>3</sub>). The Mann-Whitney U test was applied to compare variables not following a normal distribution. The Spearman correlation test was utilized to assess links between variables. Statistical significance was set as p < 0.05.</p><p><strong>Results: </strong>In vivo treatment with Stig ameliorated neurological dysfunction, brain edema, and neuronal apoptosis in TBI rats while enhancing both memory and learning performance. Stig reduced microglial activation and inflammatory responses in TBI by inhibiting the STAT3/NF-κB pathway and downregulating LCN-2 expression. Additionally, Stig markedly attenuated inflammation in LPS-stimulated microglial cells and reduced neuronal apoptosis and oxidative stress in H₂O₂-treated HT22 cells. Moreover, it effectively suppressed the activation of the STA

目的：脑外伤触发复杂的炎症过程，导致继发性损伤。Stig是一种以其降胆固醇作用而闻名的化合物，具有显著的治疗潜力，包括抗癌、抗氧化和抗动脉粥样硬化的特性。它具有穿透血脑屏障并在大脑中积累的能力，在那里它具有有效的抗炎，抗细胞凋亡和抗氧化应激特性，特别是在影响中枢神经系统的条件下。方法：本研究为体外实验与体内实验相结合的基础研究。实验对象为BV2小胶质细胞（鼠源性小胶质细胞系）和HT22神经元（鼠源性海马神经元细胞系），每组3只Sprague-Dawley大鼠。体外实验包括用LPS刺激BV2小鼠小胶质细胞和用H2O2刺激HT22小鼠神经元细胞，然后用不同浓度的Stig处理，以评估其对促炎细胞因子、氧化应激介质和LCN-2的影响。在体内，建立TBI大鼠模型，将大鼠随机分为Sham、TBI、TBI +生理盐水和TBI + Stig组。神经功能评估采用改良神经严重程度评分法进行急性期评估，认知能力和空间学习通过Morris水迷宫测试进行评估。采用HE染色、尼氏染色观察神经元死亡情况，采用干湿法定量脑含水量。Western blot和免疫荧光法检测LCN-2、小胶质细胞极化标记物和凋亡标记物的表达。采用GraphPad Prism 9.0和SPSS 26.0软件进行数据分析。连续变量用mean±SD表示。使用Shapiro-Wilk检验评估数据的正态性。对于2个队列间正态分布的连续变量，采用独立样本t检验。当比较超过2个队列时，进行单因素方差分析。非正态分布数据用中位数表示（Q1, Q3）。Mann-Whitney U检验用于比较不服从正态分布的变量。Spearman相关检验用于评估变量之间的联系。p < 0.05为差异有统计学意义。结果：Stig在体内可改善脑外伤大鼠的神经功能障碍、脑水肿和神经元凋亡，同时提高记忆和学习能力。Stig通过抑制STAT3/NF-κB通路和下调LCN-2表达，降低TBI小胶质细胞激活和炎症反应。此外，Stig显著减轻lps刺激的小胶质细胞的炎症，减少h2o2处理的HT22细胞的神经元凋亡和氧化应激。有效抑制LPS或H₂O₂诱导的STAT3/NF-κB/LCN-2信号级联的激活。结论：Stig通过抑制STAT3/NF-κB/LCN-2信号级联减轻神经炎症和神经元细胞死亡，在大鼠TBI模型中具有神经保护作用。

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引用次数: 0

A delayed presentation of an intracranial haemorrhage as the result of a full-thickness electrical brain injury: Illustrative case. 全层脑电损伤导致颅内出血的延迟表现：说明性病例。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-12-31 DOI: 10.1016/j.cjtee.2025.03.004

Jesse George Kwete Bulabula, Moses Asante-Bremang, Anthony A Figaji, Nqobile S Thango, Patricia Sn Kambinga, Johannes Mn Enslin

Electrical brain injuries are rare and often under-reported, with most documented cases involving secondary mechanical trauma. Isolated electrical injuries to the brain remain poorly characterised. We report a case of 2-year-old girl who sustained an isolated full-thickness electrical brain injury without associated mechanical trauma. Clinical findings, neuroimaging, and surgical management were reviewed to highlight the progression and complications observed. This report aims to describe the delayed sequelae, pathophysiology, and management challenges of a full-thickness electrical brain injury in a child, and illustrates the complex and delayed pathophysiology of electrical brain injuries, in which venous thromboembolic mechanisms may contribute to secondary deterioration. Aggressive debridement of ischemic tissue during surgical intervention may improve wound healing and overall outcomes.

脑电损伤是罕见的，并且经常被低估，大多数有记录的病例涉及继发性机械损伤。孤立的脑电损伤的特征仍然很差。我们报告一个2岁的女孩谁持续一个孤立的全层电脑损伤没有相关的机械创伤。我们回顾了临床表现、神经影像学和手术治疗，以强调观察到的进展和并发症。本报告旨在描述儿童全层脑电损伤的迟发性后遗症、病理生理和治疗挑战，并说明脑电损伤的复杂和迟发性病理生理，其中静脉血栓栓塞机制可能导致继发性恶化。在手术过程中对缺血组织进行积极的清创可以改善伤口愈合和整体预后。

引用次数: 0

Resuscitative endovascular balloon occlusion of the aorta in trauma patients: Past, present, and future. 创伤患者主动脉血管内球囊闭塞的复苏：过去，现在和未来。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-12-24 DOI: 10.1016/j.cjtee.2025.10.003

Yong Fu, Wei Huang, Xin-Jie Luo, Yong Luo, Lei Li, Wenjie Liu, Demetrios Demetriades

Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a critical intervention for managing severe hemorrhagic shock in trauma patients. By temporarily occluding the aorta, REBOA aims to stabilize hemodynamics and prevent cardiovascular collapse until definitive hemorrhage control can be achieved. However, the clinical efficacy and optimal use of REBOA remain subjects of ongoing debate. This narrative review synthesizes the latest evidence on clinical outcomes, complications, and patient selection to provide a comprehensive assessment of REBOA's role in trauma resuscitation.

Methods: This review is based on a selective analysis of the current literature, including clinical studies, randomized controlled trials, and meta-analyses, to evaluate the benefits and risks associated with REBOA in trauma settings.

Results: While REBOA technology has advanced significantly and its use has expanded across trauma centers, evidence-based guidelines for its application remain limited. The optimal indications and target populations for REBOA have yet to be clearly defined. Recent studies, including the only randomized controlled trial on REBOA to date, suggest that its use in hemodynamically unstable patients does not confer a mortality benefit and may even increase mortality compared to standard care alone. Furthermore, REBOA is associated with substantial risks, including ischemia-reperfusion injury, acute kidney injury, arterial injury, arterial embolism, limb ischemia, and even amputations. These complications highlight the need for careful patient selection and procedural refinement.

Conclusion: Current evidence does not support the routine use of REBOA in trauma patients with hemorrhagic shock. Further research is essential to identify specific subpopulations that may benefit from this intervention and to optimize its application to maximize survival while minimizing complications. Until more robust data are available, REBOA should be employed judiciously, with careful consideration of its risks and benefits in individual cases.

目的：复苏血管内球囊阻塞主动脉（REBOA）已成为处理创伤患者严重失血性休克的关键干预措施。通过暂时阻塞主动脉，REBOA旨在稳定血流动力学，防止心血管衰竭，直到最终出血控制可以实现。然而，REBOA的临床疗效和最佳使用仍然是持续争论的主题。这篇叙述性综述综合了临床结果、并发症和患者选择的最新证据，以提供REBOA在创伤复苏中的作用的综合评估。方法：本综述基于对现有文献的选择性分析，包括临床研究、随机对照试验和荟萃分析，以评估创伤情况下REBOA的获益和风险。结果：虽然REBOA技术取得了显著的进步，并且在创伤中心的应用范围也得到了扩展，但其应用的循证指南仍然有限。REBOA的最佳适应症和目标人群尚未明确界定。最近的研究，包括迄今为止唯一一项关于REBOA的随机对照试验，表明在血液动力学不稳定的患者中使用REBOA并不会降低死亡率，甚至可能比单独使用标准治疗增加死亡率。此外，REBOA存在大量风险，包括缺血再灌注损伤、急性肾损伤、动脉损伤、动脉栓塞、肢体缺血甚至截肢。这些并发症强调了仔细选择患者和完善手术程序的必要性。结论：目前的证据不支持REBOA在创伤失血性休克患者中的常规应用。进一步的研究是必要的，以确定可能从这种干预中受益的特定亚群，并优化其应用，以最大限度地提高生存率，同时减少并发症。在获得更可靠的数据之前，应谨慎使用REBOA，并在个别情况下仔细考虑其风险和益处。

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引用次数: 0

Comparative study on the efficacy of structural support fixation vs. conventional fixation for depressed tibial plateau fractures. 结构支撑固定与常规固定治疗胫骨平台凹陷骨折疗效的比较研究。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-12-15 DOI: 10.1016/j.cjtee.2025.10.002

Zhijiang Li, Xiaomeng Ren, Jiantao Li, Xiaoqi Kang, Ning Ma, Zhidong Zhao, Jianheng Liu, Yanpeng Zhao, Wei Zhang

Purpose: To compare the clinical outcomes of structural support fixation vs. conventional fixation for depressed tibial plateau fractures (TPFs).

Methods: A retrospective analysis was conducted on patients who underwent surgical treatment for depressed TPFs at our hospital between November 2019 and September 2023. Forty-six patients with TPFs who had surgical indications were included. Based on the surgical procedures, patients were categorized into the structural support group receiving locking plate + cage fixation, and the conventional group receiving locking plate + granular bone grafting. The following parameters were evaluated and compared, including operative time, blood loss, time to full weight-bearing, fracture healing time, loss of tibial plateau height, quality of fracture reduction and alignment, hospital for special surgery knee score, and Western Ontario and McMaster Universities Osteoarthritis Index score. Intergroup differences were analyzed using independent-sample t-tests or the rank-sum test.

Results: A total of 46 eligible patients completed the follow-up (20 in the structural support group, 26 in the conventional group). No significant differences were observed between the 2 groups in the mean age, sex, body mass index, injury mechanism, or time from injury to surgery (p = 0.276, 0.860, 0.615, 0.160, 0.065, respectively). The mean operative time was 120.7 min in the structural support group and 164.2 min in the conventional group, with the mean blood loss of 120.0 mL and 168.5 mL, respectively. Neither operative time nor blood loss showed significant differences (p = 0.067 and p = 0.309). The mean follow-up duration was 20.2 months (structural support group) and 20.4 months (conventional group), with no significant difference (p = 0.987). At the final follow-up, the structural support group exhibited significantly less secondary step-off compared to the conventional group (0.3 mm vs. 0.7 mm, p < 0.001). While hospital for special surgery functional scores showed no significant difference (94.1 vs. 88.1, p = 0.066), the structural support group had significantly better Western Ontario and McMaster Universities Osteoarthritis Index scores (1.4 vs. 6.3, p = 0.001), with superior outcomes in pain, stiffness, and functional difficulty subscales (p = 0.009, 0.004, 0.003, respectively). No adverse events (e.g., infection, nonunion, or refracture) were found in both groups.

Conclusion: Compared to conventional fixation, locking plate combined with cage effectively reduces secondary step-off in depressed TPFs and significantly improves pain relief and knee function.

目的：比较结构支撑固定与常规固定治疗胫骨平台凹陷骨折的临床效果。方法：回顾性分析2019年11月至2023年9月在我院接受手术治疗的抑郁症患者。纳入46例有手术指征的tpf患者。根据手术方式将患者分为结构支持组，采用锁定钢板+骨笼固定，常规组采用锁定钢板+颗粒骨移植。评估和比较以下参数，包括手术时间、出血量、完全负重时间、骨折愈合时间、胫骨平台高度损失、骨折复位和对齐质量、特殊外科医院膝关节评分、西安大略和麦克马斯特大学骨关节炎指数评分。组间差异分析采用独立样本t检验或秩和检验。结果：46例符合条件的患者完成随访（结构支持组20例，常规组26例）。两组患者的平均年龄、性别、体重指数、损伤机制、损伤至手术时间差异无统计学意义（p分别为0.276、0.860、0.615、0.160、0.065）。结构支持组和常规组平均手术时间分别为120.7 min和164.2 min，平均出血量分别为120.0 mL和168.5 mL。手术时间和出血量差异无统计学意义（p = 0.067和p = 0.309）。平均随访时间分别为20.2个月（结构支持组）和20.4个月（常规组），差异无统计学意义（p = 0.987）。在最后的随访中，与常规组相比，结构支持组的继发性步距明显减少（0.3 mm vs. 0.7 mm, p < 0.001）。虽然医院特殊外科功能评分无显著差异（94.1比88.1,p = 0.066），但结构支持组在西安大略大学和麦克马斯特大学骨关节炎指数评分上明显更好（1.4比6.3,p = 0.001），在疼痛、僵硬和功能困难亚量表上的结果更优（p = 0.009、0.004、0.003分别）。两组均未发现不良事件（如感染、骨不连或再骨折）。结论：与传统固定相比，锁定钢板联合骨笼可有效减少TPFs抑郁的继发性断步，显著改善疼痛缓解和膝关节功能。

{"title":"Comparative study on the efficacy of structural support fixation vs. conventional fixation for depressed tibial plateau fractures.","authors":"Zhijiang Li, Xiaomeng Ren, Jiantao Li, Xiaoqi Kang, Ning Ma, Zhidong Zhao, Jianheng Liu, Yanpeng Zhao, Wei Zhang","doi":"10.1016/j.cjtee.2025.10.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.10.002","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical outcomes of structural support fixation vs. conventional fixation for depressed tibial plateau fractures (TPFs).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent surgical treatment for depressed TPFs at our hospital between November 2019 and September 2023. Forty-six patients with TPFs who had surgical indications were included. Based on the surgical procedures, patients were categorized into the structural support group receiving locking plate + cage fixation, and the conventional group receiving locking plate + granular bone grafting. The following parameters were evaluated and compared, including operative time, blood loss, time to full weight-bearing, fracture healing time, loss of tibial plateau height, quality of fracture reduction and alignment, hospital for special surgery knee score, and Western Ontario and McMaster Universities Osteoarthritis Index score. Intergroup differences were analyzed using independent-sample t-tests or the rank-sum test.</p><p><strong>Results: </strong>A total of 46 eligible patients completed the follow-up (20 in the structural support group, 26 in the conventional group). No significant differences were observed between the 2 groups in the mean age, sex, body mass index, injury mechanism, or time from injury to surgery (p = 0.276, 0.860, 0.615, 0.160, 0.065, respectively). The mean operative time was 120.7 min in the structural support group and 164.2 min in the conventional group, with the mean blood loss of 120.0 mL and 168.5 mL, respectively. Neither operative time nor blood loss showed significant differences (p = 0.067 and p = 0.309). The mean follow-up duration was 20.2 months (structural support group) and 20.4 months (conventional group), with no significant difference (p = 0.987). At the final follow-up, the structural support group exhibited significantly less secondary step-off compared to the conventional group (0.3 mm vs. 0.7 mm, p < 0.001). While hospital for special surgery functional scores showed no significant difference (94.1 vs. 88.1, p = 0.066), the structural support group had significantly better Western Ontario and McMaster Universities Osteoarthritis Index scores (1.4 vs. 6.3, p = 0.001), with superior outcomes in pain, stiffness, and functional difficulty subscales (p = 0.009, 0.004, 0.003, respectively). No adverse events (e.g., infection, nonunion, or refracture) were found in both groups.</p><p><strong>Conclusion: </strong>Compared to conventional fixation, locking plate combined with cage effectively reduces secondary step-off in depressed TPFs and significantly improves pain relief and knee function.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890148","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

Analysis of outcomes from a Level 1 trauma care hospital before and after movement to an integrated trauma care center. 一级创伤护理医院转到综合创伤护理中心前后的结果分析

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-12-01 DOI: 10.1016/j.cjtee.2025.04.005

Haarini Sundar, Carlton Rowlands, Vijayan Purushothaman, Vignesh Kumar, Srujan Lam Sharma, Shona Rachel Mathuram, Sukria Nayak, Joses Dany James

Purpose: Quality improvement in trauma care often focuses on clinical protocols and systems, with limited emphasis on trauma-specific infrastructure. This study evaluated the impact of trauma-specific infrastructural improvements on patient outcomes in a newly established quaternary care trauma center.

Methods: Data from a prospectively maintained trauma registry were retrospectively analyzed. Patients treated over 8 months at the old center (OC) were compared to those treated during an equivalent period at the new center (NC), which included trauma-specific infrastructure such as a dedicated trauma bay, CT scanner, operating rooms, intensive care unit, and ward. Outcome indicators included time to CT, emergency department (ED) disposition time, hospital stay, 24-h survival, and overall mortality. Regression analyses adjusted for clinical confounders were performed.

Results: A total of 3542 patients (OC: 1627, NC: 1915) were analyzed. The median time to CT (incident rate ratios (IRR): 0.615, 95% confidence intervals (CI): 0.494-0.767) and ED disposition time (IRR: 0.766, 95% CI: 0.641-0.914) were significantly shorter in NC, particularly for priority 1 patients. However, hospital stay was longer in the new center (IRR 1.395, 95% CI: 1.224-1.590). There was no significant difference in 24-h survival (odds ratio: 0.330, 95% CI: 0.092-1.180) or overall mortality (odds ratio: 0.328, 95% CI: 0.084-1.275.

Conclusion: Trauma-specific infrastructure improves key operational metrics like time to CT and ED disposition without significant survival benefits. These findings suggest that infrastructure, while beneficial, should complement robust clinical systems and protocols for improved trauma care quality.

目的：创伤护理质量的提高通常集中在临床方案和系统上，而对创伤特异性基础设施的重视有限。本研究评估了创伤特异性基础设施改善对新建立的创伤四级护理中心患者预后的影响。方法：回顾性分析前瞻性维护的创伤登记处的数据。在老中心（OC）治疗8个月以上的患者与在新中心（NC）治疗8个月以上的患者进行比较，新中心包括创伤专用基础设施，如专用创伤室、CT扫描仪、手术室、重症监护病房和病房。结果指标包括到CT的时间、急诊处理时间、住院时间、24小时生存率和总死亡率。对临床混杂因素进行校正后的回归分析。结果：共分析3542例患者（OC: 1627例，NC: 1915例）。NC患者到CT的中位时间（发生率比（IRR）： 0.615, 95%可信区间（CI）： 0.494-0.767）和ED处置时间（IRR: 0.766, 95% CI: 0.641-0.914）显著缩短，尤其是优先级1的患者。然而，新中心的住院时间更长（IRR 1.395, 95% CI: 1.224-1.590）。24小时生存率（优势比：0.330,95% CI: 0.092-1.180）和总死亡率（优势比：0.328,95% CI: 0.084-1.275）无显著差异。结论：创伤特异性基础设施改善了关键的操作指标，如CT时间和ED处置，但没有显着的生存效益。这些发现表明，基础设施虽然有益，但应补充健全的临床系统和方案，以提高创伤护理质量。

{"title":"Analysis of outcomes from a Level 1 trauma care hospital before and after movement to an integrated trauma care center.","authors":"Haarini Sundar, Carlton Rowlands, Vijayan Purushothaman, Vignesh Kumar, Srujan Lam Sharma, Shona Rachel Mathuram, Sukria Nayak, Joses Dany James","doi":"10.1016/j.cjtee.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.04.005","url":null,"abstract":"<p><strong>Purpose: </strong>Quality improvement in trauma care often focuses on clinical protocols and systems, with limited emphasis on trauma-specific infrastructure. This study evaluated the impact of trauma-specific infrastructural improvements on patient outcomes in a newly established quaternary care trauma center.</p><p><strong>Methods: </strong>Data from a prospectively maintained trauma registry were retrospectively analyzed. Patients treated over 8 months at the old center (OC) were compared to those treated during an equivalent period at the new center (NC), which included trauma-specific infrastructure such as a dedicated trauma bay, CT scanner, operating rooms, intensive care unit, and ward. Outcome indicators included time to CT, emergency department (ED) disposition time, hospital stay, 24-h survival, and overall mortality. Regression analyses adjusted for clinical confounders were performed.</p><p><strong>Results: </strong>A total of 3542 patients (OC: 1627, NC: 1915) were analyzed. The median time to CT (incident rate ratios (IRR): 0.615, 95% confidence intervals (CI): 0.494-0.767) and ED disposition time (IRR: 0.766, 95% CI: 0.641-0.914) were significantly shorter in NC, particularly for priority 1 patients. However, hospital stay was longer in the new center (IRR 1.395, 95% CI: 1.224-1.590). There was no significant difference in 24-h survival (odds ratio: 0.330, 95% CI: 0.092-1.180) or overall mortality (odds ratio: 0.328, 95% CI: 0.084-1.275.</p><p><strong>Conclusion: </strong>Trauma-specific infrastructure improves key operational metrics like time to CT and ED disposition without significant survival benefits. These findings suggest that infrastructure, while beneficial, should complement robust clinical systems and protocols for improved trauma care quality.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783587","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

Clinical experience in the management of penetrating stab wounds to the neck: A retrospective analysis of 5 cases. 颈部穿透性刺伤5例临床分析。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-11-05 DOI: 10.1016/j.cjtee.2025.02.012

Ming-Chao Ding, Shuang Qu, Jing-Fu Wang, Jin Shi, Jia-Wu Liang, Xin-Yu Wang, Guo-Liang Zhang, Jin-Long Zhao, Lei Tian, Ge Ma

Purpose: Penetrating neck trauma can frequently be life-threatening, including those that appear minor. Consequently, thorough examination and quick operative treatment have been the standard measure. In addition, modern precision medicine has shifted the procedure towards more selective non-operative management, whereas advanced imaging like computed tomography angiography plays a key role. The diagnostic and therapeutic protocol remains to be adapted and optimized. The purpose of this study was to present our experience, outcomes, and management strategy, and contribute to establishing an evidence-based algorithm for stab wounds to the neck area.

Methods: This was a retrospective, observational cohort study conducted at 3 hospitals involving 5 patients with stab wounds to the neck. Preoperative interventions included airway and circulation restoration. Ancillary investigations, including imaging and electronic laryngoscopy, were used to assess potential vascular, nerve, and cervical vertebra injury. Surgeries included exploration, debridement, and closure under general anesthesia, with blood transfusion when necessary. Patients were followed up for recovery status and provided postoperative management.

Results: Among the 5 patients aged 21-64 years, 4 were males and 1 was female. All wounds were located on the lateral aspect of the neck. Four patients had pharyngocutaneous fistulas with hematemesis/hemoptysis, and 3 of them experienced hemorrhagic shock. One patient had nerve damage, and 1 patient had an airway compressed. All patients received surgeries that were successful. Patients were followed up for more than 6 months, and examinations revealed good wound healing, partial recovery of facial nerve function, and no other residual functional impairments in any of the 5 patients.

Conclusion: Adequate preoperative preparation and assessment, timely and effective exploratory surgery, efficient multidisciplinary cooperation, and comprehensive postoperative management can maximize the chances of life-saving and functional recovery for penetrating stab wounds in the neck area.

目的：穿透性颈部创伤通常会危及生命，包括那些看似轻微的创伤。因此，彻底检查和快速手术治疗已成为标准措施。此外，现代精密医学已将治疗过程转向更具选择性的非手术治疗，而计算机断层血管造影等先进成像技术起着关键作用。诊断和治疗方案仍有待调整和优化。本研究的目的是介绍我们的经验、结果和管理策略，并为建立颈部刺伤的循证算法做出贡献。方法：回顾性、观察性队列研究在3家医院进行，涉及5例颈部刺伤患者。术前干预包括气道和循环恢复。辅助检查，包括影像学和电子喉镜检查，用于评估潜在的血管、神经和颈椎损伤。手术包括探查、清创和全身麻醉下的缝合，必要时输血。随访患者的恢复情况及术后处理。结果：5例患者年龄21 ~ 64岁，男性4例，女性1例。所有伤口都在颈部外侧。4例患者出现咽瘘伴呕血/咯血，3例出现失血性休克。1例有神经损伤，1例有气道受压。所有患者都接受了成功的手术。随访6个月以上，5例患者伤口愈合良好，面神经功能部分恢复，无其他功能障碍残留。结论：充分的术前准备和评估，及时有效的探查手术，高效的多学科合作，以及全面的术后管理，可以最大限度地提高颈部穿透性刺伤患者的生命和功能恢复机会。

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引用次数: 0

Research on the correlation between rib fracture characteristics and the risk of intrathoracic and intra-abdominal injuries 肋骨骨折特征与胸、腹内损伤风险的相关性研究。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-11-01 DOI: 10.1016/j.cjtee.2025.04.002

Hang Cao , Qiang Chen , Yan Ding , Llion Roberts

Purpose

Intrathoracic and intra-abdominal injuries in patients with rib fractures are often overlooked, leading to delayed and ineffective treatment. However, the relationship between rib fractures and organ damage has been rarely studied. The purpose of this study was to analyze the risk factors associated with intrathoracic and intra-abdominal injuries in patients with rib fractures.

Methods

This retrospective observational study included 1269 patients diagnosed with rib fractures from September 2020 to April 2023. Patient data were collected, including gender, age, body mass index, systolic blood pressure, heart rate, type of rib fracture, number of fractured ribs, location of the rib fracture, and the presence of thoracic and abdominal organ injuries. Patients without imaging examinations, the patient with rib fractures from iatrogenic causes or mental illnesses or rheumatic immune diseases was excluded. The primary outcomes were intra-thoracic and intra-abdominal injuries. Multivariate logistic regression analysis was conducted to identify the risk factors for these injuries in patients with rib fractures.

Results

The rib fracture characteristics in the occurrence group included bilateral fractures, higher number of fractures (≥3), and fractures located anteriorly, posteriorly, and laterally, as well as greater fracture displacement, compared to the non-occurrence group. The results of the multivariate logistic regression analysis indicated that age (p=0.016, odds ratio (OR)=0.95, 95% confidence interval (CI: 0.92−0.98), the number of rib fractures (≥3, p=0.001, OR=1.46, 95% CI: 1.13−1.89), rib type (bilateral rib fractures, p=0.043, OR=2.63, 95% CI: 2.16−3.12), and rib fracture location (lateral rib fractures, p=0.041, OR=2.85, 95% CI: 1.31−4.97; posterior rib fractures, p=0.022, OR=3.25, 95% CI: 1.46−6.92) were independent risk factors for thoracic and abdominal organ injuries in patients with traumatic rib fractures.

Conclusions

Patients with rib fractures resulting from blunt trauma, particularly those with lateral or posterior rib fractures, fractures involving more than 3 ribs, and bilateral rib fractures, are at an increased risk for significant intrathoracic and intra-abdominal injuries. These findings warrant attention and the implementation of appropriate preventive measures during treatment.

目的：肋骨骨折患者的胸内、腹内损伤常被忽视，导致治疗延误和无效。然而，肋骨骨折与器官损伤之间的关系很少被研究。本研究的目的是分析肋骨骨折患者胸内和腹内损伤的相关危险因素。方法：本回顾性观察研究纳入了2020年9月至2023年4月诊断为肋骨骨折的1269例患者。收集患者资料，包括性别、年龄、体重指数、收缩压、心率、肋骨骨折类型、肋骨骨折数量、肋骨骨折位置、有无胸腹器官损伤。没有影像学检查的患者、医源性骨折、精神疾病或风湿性免疫疾病的患者被排除在外。主要结局为胸内和腹内损伤。进行多因素logistic回归分析，以确定肋骨骨折患者这些损伤的危险因素。结果：与未发生组相比，发生组肋骨骨折特征为双侧骨折，骨折数≥3例，骨折位于前、后、外侧，骨折移位较大。多因素logistic回归分析结果显示，年龄（p=0.016，优势比(OR)=0.95, 95% CI= 0.92-0.98）、肋骨骨折数量（≥3例，p=0.001， OR=1.46, 95% CI=1.13-1.89）、肋骨类型（双侧肋骨骨折，p=0.043， OR=2.63, 95% CI=2.16-3.12）、肋骨骨折位置(侧肋骨折，p=0.041， OR=2.85, 95% CI=1.31-4.97；后肋骨骨折（p=0.022， OR=3.25, 95% CI=1.46 ~ 6.92）是外伤性肋骨骨折患者胸腹器官损伤的独立危险因素。结论：钝性创伤导致肋骨骨折的患者，特别是伴有侧肋或后肋骨折、超过3根肋骨骨折和双侧肋骨骨折的患者，发生显著胸内和腹内损伤的风险增加。这些发现值得注意，并在治疗期间采取适当的预防措施。

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引用次数: 0

Peri-implant femoral fractures in elderly: Morbidity, mortality, treatment options and good practices 老年人股骨假体周围骨折：发病率、死亡率、治疗选择和良好做法。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-11-01 DOI: 10.1016/j.cjtee.2024.07.012

Luca Bianco Prevot , Vittorio Bolcato , Stefania Fozzato , Riccardo Accetta , Michela Basile , Livio Pietro Tronconi , Giuseppe Basile

Purpose

Femur fractures are among the most common fractures treated surgically, representing a significant challenge for the orthopedic surgeon. Peri-implant femoral fractures (PIFFs) represent a rare complication of the surgical treatment. It is necessary to pay attention during osteosynthesis, evaluating not only the fracture site but the entire femoral skeletal structure, the characteristics of the fracture, the health comorbidities, and the risk of malunion and pseudarthrosis. There are few studies on the incidence, treatment, and outcomes of PIFFs near osteosynthesis. This study aimed to investigate PIFF after osteosynthesis of femoral fractures and evaluate the mortality after surgery and the morbidity associated with these types of fractures.

Methods

A retrospective cohort study was carried out at the IRCCS Galeazzi Orthopedic Institute, Milan, Italy, between January, 2017 and December, 2022. Inclusion criteria were the presence of a femur fracture around an intramedullary nail to treat a previous fracture, follow-up ≥ 12 months, and patients aged ≥ 65 years. Exclusion criterion was intraoperative periprosthetic fractures. The data were expressed as frequency and percentage. Continuous variables were expressed as mean ± standard deviation or median and range.

Results

Overall, 25 patients were enrolled (88.0% female) and the mean age was 84.5 years (range of 70 – 92 years). There were 20 patients having type B PIFF and 5 having type C. In 22 patients, multiple comorbidities were found with an average Charlson comorbidity score of 5.5 and the mean time to peri-implant fracture was 38 months. After surgery, 1 patient (4.0%) presented renal failure, 1 (4.0%) needed removal surgery for their loosening, and 2 (8.0%) presented surgical site infection. Nine patients (36.0%) died within 1 year with a mortality rate of 20.0% at 30 days, 8.0% at 3 months, and 8.0% at 12 months.

Conclusions

PIFFs in elderly patients are associated with high short-term mortality and morbidity, so careful planning for primary fracture surgery and patient awareness to ensure prolonged compliance and a healthy lifestyle are essential for prevention.

目的：股骨骨折是外科治疗中最常见的骨折之一，对骨科医生来说是一个重大的挑战。股骨假体周围骨折（PIFFs）是手术治疗中一种罕见的并发症。在植骨过程中要注意，不仅要评估骨折部位，还要评估整个股骨骨骼结构、骨折特征、健康合并症、畸形愈合和假关节的风险。关于骨融合术附近piff的发生率、治疗和结局的研究很少。本研究旨在探讨股骨骨折植骨后的PIFF，并评估其术后死亡率和与此类骨折相关的发病率。方法：回顾性队列研究于2017年1月至2022年12月在意大利米兰的IRCCS Galeazzi骨科研究所进行。纳入标准为既往骨折治疗时髓内钉周围存在股骨骨折，随访≥12个月，患者年龄≥65岁。排除标准为术中假体周围骨折。数据以频率和百分比表示。连续变量以均数±标准差或中位数和极差表示。结果：共纳入25例患者（88.0%为女性），平均年龄为84.5岁（70 - 92岁）。20例患者为B型PIFF， 5例为c型。22例患者存在多种合并症，Charlson合并症平均评分为5.5，平均种植体周围骨折时间为38个月。术后1例（4.0%）出现肾功能衰竭，1例（4.0%）因肾脏松动需要切除，2例（8.0%）出现手术部位感染。1年内死亡9例（36.0%），死亡率为20。30天0%，3个月8.0%，12个月8.0%。结论：老年患者的PIFFs与较高的短期死亡率和发病率相关，因此精心规划原发性骨折手术，患者意识确保长期依从性和健康的生活方式对预防至关重要。

{"title":"Peri-implant femoral fractures in elderly: Morbidity, mortality, treatment options and good practices","authors":"Luca Bianco Prevot , Vittorio Bolcato , Stefania Fozzato , Riccardo Accetta , Michela Basile , Livio Pietro Tronconi , Giuseppe Basile","doi":"10.1016/j.cjtee.2024.07.012","DOIUrl":"10.1016/j.cjtee.2024.07.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Femur fractures are among the most common fractures treated surgically, representing a significant challenge for the orthopedic surgeon. Peri-implant femoral fractures (PIFFs) represent a rare complication of the surgical treatment. It is necessary to pay attention during osteosynthesis, evaluating not only the fracture site but the entire femoral skeletal structure, the characteristics of the fracture, the health comorbidities, and the risk of malunion and pseudarthrosis. There are few studies on the incidence, treatment, and outcomes of PIFFs near osteosynthesis. This study aimed to investigate PIFF after osteosynthesis of femoral fractures and evaluate the mortality after surgery and the morbidity associated with these types of fractures.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was carried out at the IRCCS Galeazzi Orthopedic Institute, Milan, Italy, between January, 2017 and December, 2022. Inclusion criteria were the presence of a femur fracture around an intramedullary nail to treat a previous fracture, follow-up ≥ 12 months, and patients aged ≥ 65 years. Exclusion criterion was intraoperative periprosthetic fractures. The data were expressed as frequency and percentage. Continuous variables were expressed as mean ± standard deviation or median and range.</div></div><div><h3>Results</h3><div>Overall, 25 patients were enrolled (88.0% female) and the mean age was 84.5 years (range of 70 – 92 years). There were 20 patients having type B PIFF and 5 having type C. In 22 patients, multiple comorbidities were found with an average Charlson comorbidity score of 5.5 and the mean time to peri-implant fracture was 38 months. After surgery, 1 patient (4.0%) presented renal failure, 1 (4.0%) needed removal surgery for their loosening, and 2 (8.0%) presented surgical site infection. Nine patients (36.0%) died within 1 year with a mortality rate of 20.0% at 30 days, 8.0% at 3 months, and 8.0% at 12 months.</div></div><div><h3>Conclusions</h3><div>PIFFs in elderly patients are associated with high short-term mortality and morbidity, so careful planning for primary fracture surgery and patient awareness to ensure prolonged compliance and a healthy lifestyle are essential for prevention.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 6","pages":"Pages 497-502"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873362","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

Dental trauma related to orotracheal intubation: Prospective study of 43 cases 43例口气管插管所致牙外伤的前瞻性研究。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-11-01 DOI: 10.1016/j.cjtee.2024.08.007

Yosra Mabrouk , Mohamed Hbib Grissa , Souha ben Youssef

Purpose

Orotracheal intubation is one of the most frequently used techniques in emergency procedures and especially in anesthesia and resuscitation. Teeth may be “victims” of the orotracheal intubation. Several factors may predispose to these accidents. The aim of this study is to determine the incidence of oral trauma that occurs during scheduled and urgent oral tracheal intubation, and identify the risk factors, the types and locations of these dental injuries.

Methods

It is a cross-sectional study that lasted 6 months from June to November 2022. This study was carried out in several departments. An examination of the dental and periodontal status of patients who will undergo surgery under general anesthesia was performed before the operation according to the surgical program. Yet, in emergency settings, this examination was not possible. Patients with anterior edentation and patients refusing participation in the study were excluded. After the surgery, included patients were examined to detect eventual dental trauma such as fracture, luxation, and contusion. Collected data were entered and analyzed using SPSS version 18 software. The Wilcoxon Mann-Whitney U test was used to compare quantitative variables. The Chi-square test was used to compare qualitative variables with a statistical significance level of 5% (p < 0.05).

Results

There were 43 patients included in the study, and dental trauma was noted in 11 patients (25.6%). Their mean age was (59.8 ± 15.4) years. The statistical analysis shows that there is a significant relationship between age (over 40 years old) and trauma (p = 0.004). Among the traumatized group, orotracheal intubation was undergone for 8 cases according to the surgical program whereas it was performed, for 3 cases, in emergency settings. The difference between the 2 types of intervention is statistically significant (p = 0.045). The odds ratio was 0.086 (95% CI: 0.008 – 0.942). A Mallampati score of 1 was rated for 6 injured (54.5%). The difference between the difficulty of the intubation evaluated by the Mallampati score and the occurrence of trauma was statistically insignificant (p = 0.278). The dental partial dislocation was the most frequent trauma (6 cases, 54.5%). The maxillary teeth were the most affected (n = 13, 72.2%).

Conclusion

According to the present study, the incidence of orotracheal intubation dental traumas is relatively high. The age of the patient is one of the factors predisposing to these traumas. In scheduled surgery, orotracheal intubation is quietly performed during general anesthesia, and the risk of incidence of dental trauma is reduced than in emergency settings.

目的：气管插管是急诊手术中最常用的技术之一，特别是在麻醉和复苏中。牙齿可能是气管插管的“受害者”。有几个因素可能导致这些事故的发生。本研究的目的是确定在定期和紧急口腔气管插管中发生的口腔创伤的发生率，并确定这些口腔损伤的危险因素、类型和位置。方法：采用横断面研究方法，于2022年6月至11月进行为期6个月的研究。这项研究是在几个部门进行的。术前应根据手术方案对全麻手术患者的牙齿和牙周状况进行检查。然而，在紧急情况下，这种检查是不可能的。排除有前牙缺的患者和拒绝参加研究的患者。手术后，对纳入的患者进行检查，以发现最终的牙齿创伤，如骨折、脱臼和挫伤。使用SPSS 18版软件对收集到的数据进行录入和分析。采用Wilcoxon Mann-Whitney U检验比较定量变量。采用卡方检验比较定性变量，差异有统计学意义，差异为5% (p)。结果：纳入研究的43例患者中，有11例患者有牙外伤，占25.6%。平均年龄（59.8±15.4）岁。统计分析显示，年龄（40岁以上）与创伤有显著相关（p = 0.004）。在创伤组中，有8例根据手术方案进行了口气管插管，而有3例是在紧急情况下进行的。两种干预方式差异有统计学意义（p = 0.045）。优势比为0.086 （95% CI: 0.008 - 0.942）。6例受伤患者（54.5%）Mallampati评分为1分。Mallampati评分评价插管困难程度与创伤发生率的差异无统计学意义（p = 0.278）。牙部分脱位是最常见的外伤（6例，54.5%）。上颌牙受影响最大（n = 13, 72.2%）。结论：根据目前的研究，口腔气管插管牙外伤的发生率较高。患者的年龄是诱发这些创伤的因素之一。在预定的手术中，在全身麻醉下进行口气管插管，并且发生牙齿创伤的风险比急诊情况下要低。

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引用次数: 0

Virtual cutting-based morphological differences in osteoarthritic and healthy knees: Implications for total knee arthroplasty prosthesis design 骨关节炎和健康膝关节基于虚拟切割的形态差异：全膝关节置换术假体设计的意义。

IF 1.9 4区医学 Q2 ORTHOPEDICS

Chinese Journal of Traumatology

Pub Date : 2025-11-01 DOI: 10.1016/j.cjtee.2025.08.003

Bin Yu , Yu Zhang , Dongdong Cao , Jinchang Han , Weiyong Wu , Chao Zhang , Aifeng Liu

<div><h3>Purpose</h3><div>End-stage knee osteoarthritis (OA) patients are the primary candidates for total knee arthroplasty (TKA). However, most morphological refinements of TKA prosthesis are based on anatomical data from the knees of healthy individuals. This study aimed to determine whether differences exist in key bony morphological characteristics of the distal femur and proximal tibia between osteoarthritic knees and healthy knees.</div></div><div><h3>Methods</h3><div>This was a retrospective cross-sectional observational study with a case-control design. Patients who were aged ≥ 50 years, had no history of trauma, fracture, or surgery in the studied knee, and had no obvious knee flexion contracture were included in this study by CT scans. Patients who met the American College of Rheumatology clinical criteria for knee OA were included in the study group. Kellgren-Lawrence grade III or IV knees were studied (for bilateral cases, the more severely affected knee was chosen). Patients who presented with unilateral knee pain or trauma were included in the control group, with CT scans from the opposite (asymptomatic) knee used for analyzing. The studied knee had a Kellgren-Lawrence grade of 0 or I and showed no abnormalities upon physical examination. Archived knee CT scans from 160 patients were divided into 2 groups: the study group (80 moderate-to-severe OA knees) and the control group (80 healthy knees). After 3-dimensional reconstruction and virtual cutting using a CT workstation, 13 morphological parameters of the distal femur and proximal tibia were compared between the 2 groups using independent-samples <em>t</em>-tests.</div></div><div><h3>Results</h3><div>No significant group differences in the femoral anteroposterior dimension (<em>p</em> = 0.797), height of the lateral femoral condyle (<em>p</em> = 0.268), posterior condylar angle (<em>p</em> = 0.240), tibial anteroposterior dimension (<em>p</em> = 0.536), or tibial lateral anteroposterior dimension (<em>p</em> = 0.702) were observed. However, the femoral mediolateral dimension (<em>p</em> = 0.002), distal femoral aspect ratio (femoral mediolateral dimension/femoral anteroposterior dimension) (<em>p</em> < 0.001), height of the femoral trochlear groove (<em>p</em> < 0.001), height of the medial femoral condyle (<em>p</em> < 0.001), tibial mediolateral dimension (<em>p</em> = 0.001), proximal tibial aspect ratio (tibial mediolateral dimension/tibial anteroposterior dimension) (<em>p</em> = 0.004), tibial medial anteroposterior dimension (<em>p</em> = 0.005), and tibial asymmetry ratio (tibial medial anteroposterior dimension/tibial lateral anteroposterior dimension) (<em>p</em> = 0.006) were all significantly greater in the study group.</div></div><div><h3>Conclusion</h3><div>Knees with moderate-to-severe OA are significantly wider than healthy knees, and OA is a risk factor for increased tibial platform asymmetry. When refining the morphological parameters of TKA prostheses

目的：终末期膝关节骨性关节炎（OA）患者是全膝关节置换术（TKA）的主要候选者。然而，大多数TKA假体的形态学改进是基于健康个体膝关节的解剖学数据。本研究旨在确定骨关节炎膝关节与健康膝关节在股骨远端和胫骨近端关键骨形态特征上是否存在差异。方法：采用病例对照设计的回顾性横断面观察性研究。年龄≥50岁，所研究膝关节无外伤、骨折或手术史，且CT扫描无明显膝关节屈曲挛缩的患者纳入本研究。符合美国风湿病学会膝关节OA临床标准的患者被纳入研究组。研究了Kellgren-Lawrence III级或IV级膝关节（对于双侧病例，选择影响更严重的膝关节）。出现单侧膝关节疼痛或创伤的患者被纳入对照组，使用对侧（无症状）膝关节的CT扫描进行分析。所研究的膝关节kelgren - lawrence分级为0或I，体格检查未见异常。将160例患者存档的膝关节CT扫描分为两组：研究组（80例中重度OA膝关节）和对照组（80例健康膝关节）。在CT工作站进行三维重建和虚拟切割后，采用独立样本t检验比较两组股骨远端和胫骨近端13个形态学参数。结果：两组患者股骨前位尺寸（p = 0.797）、股骨外侧髁高度（p = 0.268）、后髁角（p = 0.240）、胫骨前位尺寸（p = 0.536）、胫骨外侧前位尺寸（p = 0.702）差异均无统计学意义。然而，股骨内外侧尺寸（p = 0.002）、股骨远端长径比（股内外侧尺寸/股前后方尺寸）（p < 0.001）、股滑车沟高度（p < 0.001）、股内侧髁高度（p < 0.001）、胫骨内外侧尺寸（p = 0.001）、胫骨近端长径比（胫骨内外侧尺寸/胫骨前后方尺寸）（p = 0.004）、胫骨内侧前后方尺寸（p = 0.005）、研究组胫骨不对称比（胫骨内侧前位尺寸/胫骨外侧前位尺寸）（p = 0.006）均显著大于研究组。结论：中重度骨关节炎患者的膝关节明显比健康患者的膝关节宽，骨关节炎是胫骨平台不对称增加的危险因素。在完善TKA假体的形态参数时，应考虑OA膝关节的特定骨形态特征，以减少股骨或胫骨假体下垂的潜在风险，并促进胫骨假体配合和旋转对齐之间的最佳平衡。

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引用次数: 0