接受肘关节镜手术的儿科患者恢复运动率为 86%，再次手术率为 12%，并发症发生率为 3.7

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-08-01 DOI:10.1016/j.asmr.2024.100952

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引用次数: 0

摘要

目的通过分析一个大型儿科患者系列的适应症和并发症，评估肘关节镜手术在本院儿科人群中的适用性和安全性。方法我们回顾性地识别了2006年至2017年期间接受肘关节镜手术的所有18岁或以下患者，手术均由一名受过研究培训的外科医生完成。排除标准为随访时间少于 8 周和开放手术（非完全关节镜手术）。研究人员对病历进行了审查，以了解基线特征、肘关节镜手术适应症、活动范围、并发症和再手术。关节镜手术的适应症分为治疗骨软骨炎（60%）、骨或软组织病理清创（35%）、挛缩松解（3%）和关节镜诊断（3%）。并发症发生率为 3.7%，其中包括 4 例轻微并发症（3 例表皮伤口问题和 1 例一过性尺骨神经病变）和 3 例严重并发症（1 例因僵硬而在麻醉状态下进行的操作、1 例深部感染和 1 例[计划外]因指数手术后 1 年内持续锁定而再次手术）。23名患者（12%）因新出现、持续或复发的肘部问题而需要进行后续手术。结论儿童肘关节镜手术由经验丰富的外科医生采用标准化技术进行，适用于多种肘关节疾病，并发症发生率可接受，与之前发表的儿童和成人肘关节镜手术文献中的发生率相似；但是，相当一部分患者在随后几年需要进行后续手术。

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Pediatric Patients Who Underwent Elbow Arthroscopy Had an 86% Return-to-Sport Rate, a 12% Reoperation Rate, and a 3.7% Complication Rate

Purpose

To assess the applicability and safety of elbow arthroscopy in the pediatric population at our institution by analyzing the indications and complications in a large pediatric patient series.

Methods

We retrospectively identified all patients who underwent elbow arthroscopy at age 18 years or younger from 2006 to 2017 performed by a single fellowship-trained surgeon. The exclusion criteria were follow-up shorter than 8 weeks and open surgical procedures (not fully arthroscopic). Medical records were reviewed for baseline characteristics, indications for elbow arthroscopy, range of motion, complications, and reoperations.

Results

In total, 191 patients (64 boys and 127 girls) were included, with a median age of 15.5 years (interquartile range, 14.0-16.7 years). Indications for arthroscopic surgery were grouped into treatment of osteochondritis dissecans (60%), debridement for bony or soft-tissue pathology (35%), contracture release (3%), and diagnostic arthroscopy (3%). The complication rate was 3.7%, including 4 minor complications (3 superficial wound problems and 1 case of transient ulnar neuropathy) and 3 major complications (1 case of manipulation under anesthesia for stiffness, 1 deep infection, and 1 [unplanned] reoperation for persistent locking within 1 year of the index procedure). Subsequent surgery was required in 23 patients (12%) because of newly developed, persisting or recurring elbow problems. Of the patients, 86% were able to return to sports.

Conclusions

Pediatric elbow arthroscopy performed by an experienced surgeon using a standardized technique for a wide variety of elbow conditions has an acceptable complication rate that is similar to rates in the previously published literature on elbow arthroscopy in the pediatric and adult populations; however, a significant proportion of patients needed subsequent surgery in the following years.