髁上骨折后跛行畸形的临床发现与并发症的关系

Kunihiro Oka, Ryoya Shiode, Toru Iwahashi, Arisa Kazui, Natsuki Yamamoto, Tasuku Miyake, Tsuyoshi Murase, Satoshi Miyamura, Hiroyuki Tanaka
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引用次数: 0

摘要

简介拇趾外翻畸形主要是一种外观问题,会引起一些早期和晚期并发症。然而,目前还没有关于拇趾外翻畸形并发症发生频率、与畸形程度的关系以及从最初受伤到发生的时间的研究报告:方法:共对83名肘关节畸形患者进行了研究。测量患侧和正常侧肱骨-肘-腕角度(∆HEW-A)、倾斜角度(∆TA)和内旋角度(∆IRA)的差异,以确定屈伸和内旋畸形。此外,还调查了从最初受伤到评估日期的时间段。进行了多变量逻辑回归分析,以确定与并发症事件独立相关的解释变量(期间、∆HEW-A、∆TA 和 ∆IRA)。此外,还进行了接收者工作特征曲线分析,以预测发生事件的风险:结果:∆HEW-A 与外观投诉(几率比 [OR],1.171;95% 置信区间 [95%CI],1.056 至 1.336)和不稳定(OR,1.111;95% CI,1.028 至 1.200)的风险独立相关。∆ΔTA与肘关节活动受限(OR,1.176;95% CI,1.077 至 1.285)和运动残疾(OR,0.892;95% CI,0.836 至 0.952)的风险独立相关。初次受伤后的时间与疼痛(OR,1.063;95% CI,1.019 至 1.108)、尺神经病变(OR,1.065;95% CI,1.011 至 1.125)和骨关节炎(OR,1.188;95% CI,1.098 至 1.286)的风险独立相关。接受者工作特征曲线分析显示,∆HEW-A的最佳临界点为20°和27°,以预测外观投诉和不稳定性;∆TA的最佳临界点为25°,以预测肘关节活动受限;预测疼痛、尺神经病变和骨性关节炎的最佳临界点分别为8.8年、8.0年和16.0年:讨论:肘关节屈曲畸形的治疗应根据残余畸形>20°的屈曲度和25°的伸展度来决定,因为随着时间的推移,残余畸形可能会产生并发症。
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Association of Clinical Findings With Complications in the Cubitus Varus Deformity After Supracondylar Fracture.

Introduction: Cubitus varus deformity is primarily a cosmetic complaint that causes some early and late complications. However, no studies have reported the cubitus varus deformity regarding the frequency of complications, relationship to the degree of deformity, and period from the occurrence of the initial injury.

Methods: Overall, 83 patients with cubitus varus deformity were examined. The differences in the humerus-elbow-wrist angle (∆HEW-A), tilting angle (∆TA), and internal rotation angle (∆IRA) between the affected and normal sides were measured to determine varus and extension and internal rotation deformity. The period from the occurrence of the initial injury to the evaluation date was also investigated. Multivariate logistic regression analysis was conducted to identify the explanatory variables (period, ∆HEW-A, ∆TA, and ∆IRA) independently associated with complication events. Receiver-operating characteristic curve analysis was also conducted to predict the risk of events.

Results: ∆HEW-A was independently associated with the risk of cosmetic complaint (odds ratio [OR], 1.171; 95% confidence interval [95% CI], 1.056 to 1.336) and instability (OR, 1.111; 95% CI, 1.028 to 1.200). ∆TA was independently associated with the risk of limited elbow motion (OR, 1.176; 95% CI, 1.077 to 1.285) and sports disability (OR, 0.892; 95% CI, 0.836 to 0.952). The period from the occurrence of the initial injury was independently associated with risk of pain (OR, 1.063; 95% CI, 1.019 to 1.108), ulnar nerve neuropathy (OR, 1.065; 95% CI, 1.011 to 1.125), and osteoarthritis (OR, 1.188; 95% CI, 1.098 to 1.286). The receiver-operating characteristic curve analysis revealed the optimal cutoffs of 20° and 27° for ∆HEW-A to predict cosmetic complaint and instability; of 25° for ∆TA to predict limited elbow motion; and of 8.8, 8.0, and 16.0 years for the period to predict pain, ulnar nerve neuropathy, and osteoarthritis, respectively.

Discussion: The treatment of cubitus varus deformity should be determined because a residual deformity >20° of varus and 25° of extension could develop risk of complications over time.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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