{"title":"肢体延长手术中的同意：预测材料风险的真实发生率。","authors":"Sonia Makvana, A Robertson, S Britten, P Calder","doi":"10.5005/jp-journals-10080-1616","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>The consent process involves supported decision-making between the surgeon and the patient. Both potential benefits and material risks of the procedure require explanation, with adequate time for reflection. The complexity of limb reconstruction surgery includes the potential for multiple types of complications. In an attempt to delineate the material risks in lower limb lengthening, a literature review was undertaken to ascertain the published rates of complications.</p><p><strong>Materials and methods: </strong>A review of articles from 2003 to 2023 via PubMed and Google Scholar, including keywords 'lengthening', 'tibia', 'lengthening nail' and 'external fixator' was undertaken. Studies with a minimum of 20 patients, undergoing lengthening of the femur, tibia, or both by an external fixator and/or an intramedullary lengthening nail were included for analysis. Complications were reported according to Paley's problems, obstacles, and complications.</p><p><strong>Results: </strong>Twenty-two papers met the inclusion criteria. The commonest complications listed following lengthening using an external fixator were pin site infections (52% in the femur and 18.8% in the tibia), delayed consolidation (8.3%), bone re-fracture (13%), and joint stiffness (18.8%). Following femoral lengthening using the intramedullary lengthening nails reported complication rates were lower, including implant issues (8%) and delayed consolidation (6%).</p><p><strong>Conclusion: </strong>Patients require a full understanding of both benefits and potential harms when undergoing any surgical intervention. Our study has identified the published rates of complications following lower limb lengthening. These figures can be used to guide the consultation and enable surgeons to audit their own surgical results against the published literature.</p><p><strong>How to cite this article: </strong>Makvana S, Robertson A, Britten S, <i>et al.</i> Consent in Limb Lengthening Surgery: Predicting the True Incidence of Material Risk. Strategies Trauma Limb Reconstr 2024;19(2):61-66.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443609/pdf/","citationCount":"0","resultStr":"{\"title\":\"Consent in Limb Lengthening Surgery: Predicting the True Incidence of Material Risk.\",\"authors\":\"Sonia Makvana, A Robertson, S Britten, P Calder\",\"doi\":\"10.5005/jp-journals-10080-1616\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>The consent process involves supported decision-making between the surgeon and the patient. Both potential benefits and material risks of the procedure require explanation, with adequate time for reflection. The complexity of limb reconstruction surgery includes the potential for multiple types of complications. In an attempt to delineate the material risks in lower limb lengthening, a literature review was undertaken to ascertain the published rates of complications.</p><p><strong>Materials and methods: </strong>A review of articles from 2003 to 2023 via PubMed and Google Scholar, including keywords 'lengthening', 'tibia', 'lengthening nail' and 'external fixator' was undertaken. Studies with a minimum of 20 patients, undergoing lengthening of the femur, tibia, or both by an external fixator and/or an intramedullary lengthening nail were included for analysis. Complications were reported according to Paley's problems, obstacles, and complications.</p><p><strong>Results: </strong>Twenty-two papers met the inclusion criteria. The commonest complications listed following lengthening using an external fixator were pin site infections (52% in the femur and 18.8% in the tibia), delayed consolidation (8.3%), bone re-fracture (13%), and joint stiffness (18.8%). Following femoral lengthening using the intramedullary lengthening nails reported complication rates were lower, including implant issues (8%) and delayed consolidation (6%).</p><p><strong>Conclusion: </strong>Patients require a full understanding of both benefits and potential harms when undergoing any surgical intervention. Our study has identified the published rates of complications following lower limb lengthening. These figures can be used to guide the consultation and enable surgeons to audit their own surgical results against the published literature.</p><p><strong>How to cite this article: </strong>Makvana S, Robertson A, Britten S, <i>et al.</i> Consent in Limb Lengthening Surgery: Predicting the True Incidence of Material Risk. 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引用次数: 0
摘要
目的：同意过程涉及外科医生和患者之间的辅助决策。需要对手术的潜在益处和重大风险进行解释，并留出足够的思考时间。肢体重建手术的复杂性包括可能出现多种并发症。为了明确下肢延长术的物质风险，我们对文献进行了回顾，以确定已公布的并发症发生率：通过PubMed和Google Scholar对2003年至2023年的文章进行了综述，关键词包括 "延长"、"胫骨"、"延长钉 "和 "外固定器"。至少有20名患者接受过股骨、胫骨或两者的外固定器和/或髓内加长钉加长手术的研究被纳入分析范围。并发症根据 Paley 的问题、障碍和并发症进行报告：22篇论文符合纳入标准。使用外固定器进行股骨延长术后最常见的并发症是钉部位感染（股骨感染率为52%，胫骨感染率为18.8%）、延迟巩固（8.3%）、骨再骨折（13%）和关节僵硬（18.8%）。使用髓内加长钉进行股骨加长后，报告的并发症发生率较低，包括植入问题（8%）和延迟巩固（6%）：结论：患者在接受任何手术干预时，都需要充分了解手术的益处和潜在危害。我们的研究确定了已公布的下肢延长术后并发症发生率。这些数据可用于指导会诊，并使外科医生能够对照已发表的文献审核自己的手术结果：Makvana S, Robertson A, Britten S, et al：预测材料风险的真实发生率。Strategies Trauma Limb Reconstr 2024;19(2):61-66.
Consent in Limb Lengthening Surgery: Predicting the True Incidence of Material Risk.
Aim: The consent process involves supported decision-making between the surgeon and the patient. Both potential benefits and material risks of the procedure require explanation, with adequate time for reflection. The complexity of limb reconstruction surgery includes the potential for multiple types of complications. In an attempt to delineate the material risks in lower limb lengthening, a literature review was undertaken to ascertain the published rates of complications.
Materials and methods: A review of articles from 2003 to 2023 via PubMed and Google Scholar, including keywords 'lengthening', 'tibia', 'lengthening nail' and 'external fixator' was undertaken. Studies with a minimum of 20 patients, undergoing lengthening of the femur, tibia, or both by an external fixator and/or an intramedullary lengthening nail were included for analysis. Complications were reported according to Paley's problems, obstacles, and complications.
Results: Twenty-two papers met the inclusion criteria. The commonest complications listed following lengthening using an external fixator were pin site infections (52% in the femur and 18.8% in the tibia), delayed consolidation (8.3%), bone re-fracture (13%), and joint stiffness (18.8%). Following femoral lengthening using the intramedullary lengthening nails reported complication rates were lower, including implant issues (8%) and delayed consolidation (6%).
Conclusion: Patients require a full understanding of both benefits and potential harms when undergoing any surgical intervention. Our study has identified the published rates of complications following lower limb lengthening. These figures can be used to guide the consultation and enable surgeons to audit their own surgical results against the published literature.
How to cite this article: Makvana S, Robertson A, Britten S, et al. Consent in Limb Lengthening Surgery: Predicting the True Incidence of Material Risk. Strategies Trauma Limb Reconstr 2024;19(2):61-66.
期刊介绍：
Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.
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